North Of Iran Research Articles

Evaluation and valuation of tajan river basin ecosystem services

Rivers as a blue ecosystem have a lot of ecosystem services that awareness of the value of their services will protect them as much as possible and communities will benefit from their environmental services. In this study, Tajan river basin ecosystem services in the north of Iran was valuated. To valuate, the choice experiment method was used to estimate willingness to pay. Tajan river basin ecosystem services attributes including regulating, supporting, provisioning and cultural services and a price attribute at three levels were determined. Data from 239 resident households of Mazandaran province were used in 2017. The empirical analysis did by the conditional logit model and mixed logit model. Also, multi criteria decision making including techniques Entropy, TOPSIS and SAW used for evaluating the role and importance of the Tajan river basin ecosystem services. The findings indicated that residents were willing to pay for the conservation of Tajan river basin ecosystem services, 13.77 USD per year. It was for regulating, supporting, provisioning and cultural services of Tajan river basin, 2.62, 6.30, 2.50 and 2.35 USD per year to move away from the status quo to the improvement status respectively. Also, findings of weighting and prioritization of Tajan river basin ecosystem services with TOPSIS and SAW methods showed that supporting and provisioning services had the highest weight for the evaluation Tajan river basin ecosystem services. In other words, the residents prefer the services as the most important Tajan river basin ecosystem services. Results showed that willingness to pay can be introduced as a useful tool to investigated people's preference for conservation of river basin ecosystem services under various activities. Therefore, by determining the value of river ecosystem services, community will understand that river services are of great importance, and the application of its value in calculations related to comprehensive management of basin water resources will provide a suitable economic solution to increase user utility the river.

Measuring spatiotemporal change in land use and habitat quality through remote sensing: A case study of the Tajan watershed, north of Iran

Measuring spatiotemporal change in land use and habitat quality through remote sensing: A case study of the Tajan watershed, north of Iran

Assessment of machine learning algorithms and new hybrid multi-criteria analysis for flood hazard and mapping.

Floods in Iran cause a lot of damage in different places every year. The 2019 floods of the Gorgan and Atrak rivers basins in the north of Iran were one of the most destructive events in this country. Therefore, investigating the flood hazard of these areas is very necessary to manage probable future floods. For this purpose, in the present study, the capability of Random Forest (RF) and Support Vector Machine (SVM) algorithms was investigated in combination with Sentinel series and Landsat-8 images to prepare the 2019 flood map. Then, the flood hazard map of these areas was prepared using the new hybrid Fuzzy Best Worse Model-Weighted Multi-Criteria Analysis (FBWM-WMCA) model. According to the results of the FBWM-WMCA model, 38.58%, 50.18%, 11.10%, and 0.14% of the Gorgan river basin and 45.11%, 49.96%, 4.17%, and 0.076% of the Atrak river basin are in high, medium, low, and no hazards, respectively. The highest flood hazard areas in Gorgan and Atrak rivers basins in the north, northwest, west, and east, and south and southwest are mostly at medium flood hazard. Also, the results of RF and SVM algorithms with an overall accuracy of more than 85% for Sentinel-1, Sentinel-2, and Landsat-8 images and 80% for Sentinel-3 images indicate that the flooding is related to the western, southwestern, and northern regions including agricultural, bare lands and built up. According to the obtained results and the efficiency of the FBWM-WMCA model, the Gorgan and Atrak rivers basins need proper planning for flood hazard management.

Identification and genotyping of Echinococcus granulosus from human clinical samples in Guilan province, north of Iran

Cystic echinococcosis (CE) is a significant health problem in both human and veterinary medicine. It is caused by the tapeworm Echinococcus granulosus (E. granulosus). The objective of this study was to investigate molecular diversity of E. granulosus from the paraffin-embedded human (FFPE) tissue samples using sequencing of mitochondrial genes. Thirty-five FFPE tissue samples were collected from different regions of Guilan province, north of Iran. Demographic data were recorded using a questionnaire. Five sections (1 mm) of the tissue were prepared and deparaffined using xylene and ethanol methods. Molecular analysis was performed using the Nad1 and Cox1 genes using PCR and DNA sequencing. Totally, 25 cases (71.43%) were women and 10 cases (28.57%) were men. The most affected age group was 21–30 yr old. The most of cysts were isolated from the liver (n = 19; 54.29%) and others in the lung (n = 16; 45.71%). The Cox1 and Nad1 genes were successfully amplified in 16 (45.71%) and 12 (34.28%) DNA samples from FFPE tissue. Sequencing analysis revealed that all samples were E. granulosus sensu stricto complex (G1 and G3). In this study, E. granulosus sensu stricto complex G1 and G3 were identified in human hydatid cysts and showed the presence of sheep/dog cycle in human infection. This finding confirmed and completed previous studies on the geospatial distribution of E. granulosus sensu stricto complex G1 and G3 in the southern and coastal areas of the Caspian Sea region.

Comorbidities affecting re-admission and survival in COVID-19: Application of joint frailty model.

One of the common concerns of healthcare systems is the potential for re-admission of COVID-19 patients. In addition to adding costs to the healthcare system, re-admissions also endanger patient safety. Recognizing the factors that influence re-admission, can help provide appropriate and optimal health care. The aim of this study was to assess comorbidities that affect re-admission and survival in COVID-19 patients using a joint frailty model. This historical cohort study was done using data of patients with COVID-19 who were re-hospitalized more than twice in a referral hospital in North of Iran. We used the joint frailty model to investigate prognostic factors of survival and recurrence, simultaneously using R version 3.5.1 (library "frailtypack"). P-values less than 0.05 were considered as statistically significant. A total of 112 patients with mean (SD) age of 63.76 (14.58) years old were recruited into the study. Forty-eight (42.9%) patients died in which 53.83% of them were re-admitted for a second time. Using adjusted joint model, the hazard of re-admission increased with cancer (Hazard ratio (HR) = 1.92) and hyperlipidemia (HR = 1.22). Furthermore, the hazard of death increased with hyperlipidemia (HR = 4.05) followed by age (HR = 1.76) and cancer (HR = 1.64). It Also decreased with lung disease (HR = 0.11), hypothyroidism (HR = 0.32), and hypertension (HR = 0.97). Considering the correlation between re-admission and mortality in the joint frailty model, malignancy and hyperlipidemia increased the risk of both re-admission and mortality. Moreover, lung disease probably due to the use of corticosteroids, was a protective factor against both mortality and re-admission.

Placenta accreta outcomes and risk factors in a referral hospital in north of Iran: A case control study.

Placenta accreta syndrome (PAS) may led to heavy blood loss and maternal death. Here we analyzed the main risk factors of PAS+ pregnancies and its complications in a referral hospital in the north of Iran. In a case control study, all pregnant women with PAS referred to our department during 2016 till 2021 were enrolled and divided in two groups case (PAS+) and control (PAS-) based on preoperative imaging, intraoperative findings, and pathological reports. The sociodemographic features and neonatal-maternal outcomes also were recorded. The most frequent reason for cesarean (C/S) was repeated C/S (62.9%, 56/89). A significant difference showed up in the time lag between previous C/S and the present delivery (p < 0.001) which shows that when the time distance is longer, the risk of PAS rises (OR: 1.01 [95% CI: 1.003-1.017]). Also, a positive history of prior abortion and elective type of previous C/S were related to PAS+ pregnancies. Our other finding showed that PAS+ pregnancies will end in lower gestational age and have a longer duration of operation and hospitalization, heavy blood transfusion, and hysterectomy. Also, PAS+ pregnancies were not related to poor neonatal outcomes. It seems that, in addition to repeated C/S as a strong risk factor, previous abortion is a forgotten key which leads to incomplete evacuation or damage the endometrial-myometrial layers.

Epidemiology of Ocular Trauma in Patients Referred to a Tertiary Center in Northern Iran

Background: Ocular trauma is a debilitating condition and one of the most important and leading causes of visual impairments that have high socioeconomic consequences. Objectives: This study aims to investigate the epidemiology of ocular trauma in patients referred to a tertiary center in northern Iran. Materials &amp; Methods: This cross-sectional study was carried out on 476 patients with ocular trauma referred to the eye emergency department of a teaching hospital in Guilan Province, north of Iran, in 2020-21. Personal and trauma-related information was extracted from the patient’s medical records using a checklist. Results: Most patients were in the 31-40 age group (28.8%), with a mean age of 41.5±17.4 years. Most of the injuries occurred at home (57.1%). Few of the patients had used eye safety glasses (5.3%). Most of the patients were living in the city. Closed globe injuries were the common types of traumas (96%), and the prevalence of open globe injuries was at a very low level (4%). Conclusion: Closed globe injuries are the most common types of ocular traumas in northern Iran. Most of the ocular traumas are preventable using eye protection equipment.

Molecular investigation of exoU and exoY virulence genes in Pseudomonas aeruginosa collected from hospitalized patients in North of Iran: A descriptive-analytical study

Objective: To investigate the frequency of exoU and exoY genes in patients with Pseudomonas aeruginosa infection. Methods: In this study, 100 clinical isolates of Pseudomonas aeruginosa were collected from patients hospitalized in educational- therapeutic hospitals and were identified using standard microbiological tests. Then, the antibiotic resistance pattern of the isolates was determined by the disk agar diffusion method. The bacterial DNAs were extracted by the alkaline lysis method. Finally, the presence of exoU and exoY genes was evaluated by the PCR test. Results: In this study, 47%, 72%, 29%, 39%, 40%, and 44% of the isolates were non-susceptible to piperacillin, aztreonam, ceftazidime, imipenem, tobramycin, and ciprofloxacin, respectively. In addition, 95% and 93% of the clinical isolates carried the exoU and exoY genes. Blood and fecal isolates had both virulence genes, while only one wound isolate had neither genes. Meanwhile, all urinary isolates contained the exoY gene and only one isolate lacked the exoU gene. Also, 88 isolates simultaneously had both exoU and exoY genes. Conclusions: High prevalence of exoU and exoY genes in this region indicates a significant role of type III secretion system in pathogenesis of Pseudomonas aeruginosa. The type III secretion system may be a suitable target to reduce the pathogenicity of this bacterium.

THE ARABIA – EURASIA COLLISION ZONE IN IRAN: TECTONOSTRATIGRAPHIC AND STRUCTURAL SYNTHESIS

The Arabia – Eurasia collision zone in the central part of the Alpine – Himalayan orogenic system has had a complex deformation history since the Palaeozoic. In Iran, the collision zone consists of the Alborz‐Talesh, Kopeh Dagh and Zagros foldbelts and the intervening Central Iran area. In this review paper, we summarize the structural architecture and tectonostratigraphic characteristics of these domains and attempt to correlate regional deformation events between them. The results show that six regional‐scale deformation phases can be recognized and correlated in Iran over a time interval extending from the Late Palaeozoic to the Late Cenozoic.Late Palaeozoic rifting in northern Gondwana and subsequent oceanic spreading resulted in the separation of the Central and North Iran blocks from the Arabian Platform. These blocks later converged and collided with the southern margin of Eurasia due to the subduction of the intervening PalaeoTethys lithosphere (“Cimmerian orogeny”: Late Triassic). The convergent setting resulted in the initial development of the Alborz‐Talesh foldbelt in present‐day northern Iran, while extensional basins developed in the forebulge area in Central Iran. Continuing northward subduction of NeoTethyan oceanic lithosphere at the southern Eurasia margin produced Early Cretaceous back‐arc extension and associated volcanism in Central Iran and the Alborz‐Talesh area to the north. A phase of compressional deformation in the Late Cretaceous was related to the collision of a series of microcontinents derived from Northern Gondwana, including the Ercinjan and Bitlis massifs, with the Central Iran block, and is recorded in the Alborz‐Talesh foldbelt and in Central Iran. Further back‐arc extension in the late Paleocene – Eocene was accompanied by pervasive volcanism and volcaniclastic sedimentation throughout northern and Central Iran. The final closure of NeoTethys and convergence between the Arabian and Eurasian Plates evolved through phases of early Oligocene “soft” collision and middle Miocene “hard” collision. This was accompanied by thrusting in the internal parts of the Zagros foldbelt and by folding and subordinate thrusting in the more external parts, with related development of the flexural Mesopotamian Basin in the foreland to the SW.

Para Medicine Students’ Experiences of Virtual Education: A Qualitative Study

Background: The emergence of the Internet and its development led to the expansion of virtual education. The development of virtual education in recent years has had a tremendous impact on the improvement of education and the establishment of educational justice in different parts of the world. Despite its advantages, virtual education is also associated with some challenges. The present study aimed to investigate para medicine students’ experiences of virtual education. Methods: This qualitative study was conducted using conventional content analysis. The participants were 25 students in various fields of para medicine who were selected using purposive sampling. The study took place at universities in the north of Iran. The data were collected using semi-structured in-depth interviews and focus groups from January to April 2022. The collected data were analyzed using Graneheim and Lundman’s qualitative content analysis method. Results: The core category identified in this study was from helplessness to interaction which was divided into three main categories (challenges and desperation, deprivation of mutual interaction and learning, and resilience and adaptation) and fourteen subcategories. Conclusion: The main theme extracted from the interviews with the participants was from helplessness to interaction. When a person has numerous failures, cannot control environmental conditions, and feels the ineffectiveness of their activity and response, they will experience a sense of vulnerability. Thus, the person has to accept the conditions and interact with them. In other words, interaction is a skill that improves the ability to quickly learn new skills and behaviors in response to the conditions. Thus, identifying challenges and realizing the weaknesses, strengths, opportunities, and threats governing the existing virtual education environment can help to turn many threats into opportunities, promote virtual education, and support teachers and students to improve the quality and quantity of the teaching-learning process in the COVID-19 and post-COVID-19 era.

Prevalence of Neural Tube Defects Following Flour Fortification with Folic Acid in North Iran

Background: Neural tube defects are prevalent malformations of the central nervous system in infants, often fatal, and considered global medical-social problems. Due to National Laws fortifying wheat flour in the bread industry, 100% of the population of this province has consumed wheat flour enriched with folic acid since June 2007. Objectives: This study aimed to determine the prevalence of neural tube defects following the fortification of flour with folic acid in the north of Iran. Methods: This descriptive-analytical study examined all neural tube defect cases in Golestan province, northern Iran, from March 2016 to March 2018. Data on the parent's age, ethnicity, mother's education, residency, and types of neural tube defects were recorded for each subject. Results: The prevalence rate of NTDs was 1.04 per 1000 births. The highest frequency was observed in the Turkmen ethnic group, with a prevalence rate of 1.251 per 1000 births. Geographically, most cases were in the West of Golestan province, with a prevalence rate of 1.876 per 1000 births. Additionally, the highest prevalence of NTD in Kalaleh City was reported as 1.67 per 1000 births. Among NTD cases, the highest frequency was related to mothers aged less than 35 years (82.72%). Conclusions: The prevalence of neural tube defects during 2016 - 2018 has increased compared to the previous study conducted in this region from 2006 - 2009. Future studies should investigate the reasons behind this increase.

Investigating the mortality trend of gastrointestinal cancers in Babol, North Iran (2013–2021)

Background and aimThis study aims to examine the mortality rate and trend of gastrointestinal cancers, particularly gastric cancer, as the leading cause of death among cancers in northern Iran over a 9-year period. In light of the changing incidence and mortality rates of cancer in Iran and around the world, the importance of these diseases in people’s lives, and the necessity of updating and monitoring the trend of cancer mortality, we have decided to report on the mortality trend of gastrointestinal cancers, based on crude and age-standardized rates.MethodThis study is a cross-sectional examination of deaths caused by gastrointestinal cancers in Babol city, Iran, between 2013 and 2021. Data was collected from the cause of death registration and classification system of Babol University of Medical Sciences. Population estimation was obtained from the latest census reports. The crude and age-standardized mortality rates and trends of the cancers were calculated.ResultsOverall, there were 1345 deaths from gastrointestinal cancers with an average age of 69.11 ± 14.25 years. The crude and age-standardized rates of these cancers rose from 24.1 to 20.1 per hundred thousand people in 2012 to 29.5 and 25.5 per hundred thousand people, respectively. This trend became more prevalent significantly with the increase of each decade of age for both men (P-value Trend = 0.002) and women (P-value Trend = 0.012). An analysis of gastrointestinal cancers revealed a decreasing trend for cancers of the small intestine, an increasing trend for cancers of the colon, pancreas, and gallbladder, and a stable trend for the remaining cancers over the study period.ConclusionThe age-standardized rate and the number of gastrointestinal cancers is rising, highlighting the importance of preventative measures such as screening, increasing public awareness, and appropriate diagnostic methods.

Role of family communication patterns as predictors of behavioral health among students of public universities in north of Iran.

Communication is one of the oldest and greatest human achievements and the basis of social life. The aim of this study was to evaluate the role of family communication patterns as predictors of behavioral health among students of public universities in the north of Iran. In this cross-sectional study, a total of 461 students from all the public universities of Babol, Iran, were selected in 2019. A stratified sampling random method was used to select the samples. The demographic characteristics, Depression Anxiety Stress Scale, Acceptance and Action Questionnaire, Rosenberg self-esteem questionnaire, and Communication Skills Interpersonal Test were used to collect data. Simple and multi-variate linear regressions as well as Pearson's correlation coefficient were utilized for data analysis. The mean and standard deviation scores of conversation orientation and conformity orientation were 35.61 ± 0.55 and 19.31 ± 0.41, respectively. Family conversation orientation was a significant predictor of behavioral health scales of students (except for acceptance and action), predicting negatively and significantly depression, anxiety, stress, and positively self-esteem and inter-personal communication skills of students. Family conformity orientation was also a significant predictor of behavioral health scales (except for inter-personal communication skills) of students, which predicted positively and significantly depression, anxiety, stress, and negatively acceptance, action, and students' self-esteem. To prevent behavioral health problems, it is necessary to observe conformity orientation and rely on conversation orientation.

Joint modeling of longitudinal and competing risks for assessing blood oxygen saturation and its association with survival outcomes in COVID-19 patients.

The objective of the present study is to evaluate the association between longitudinal and survival outcomes in the presence of competing risk events. To illustrate the application of joint modeling in clinical research, we assessed the blood oxygen saturation (SPO2) and its association with survival outcomes in coronavirus disease (COVID-19). In this prospective cohort study, we followed 300 COVID-19 patients, who were diagnosed with severe COVID-19 in the Rohani Hospital in Babol, the north of Iran from October 22, 2020 to March 5, 2021, where death was the event of interest, surviving was the competing risk event and SPO2 was the longitudinal outcome. Joint modeling analyses were compared to separate analyses for these data. The estimation of the association parameter in the joint modeling verified the association between longitudinal outcome SPO2 with survival outcome of death (Hazard Ratio (HR) = 0.33, P = 0.001) and the competing risk outcome of surviving (HR = 4.18, P < 0.001). Based on the joint modeling, longitudinal outcome (SPO2) decreased in hypertension patients (β = -0.28, P = 0.581) and increased in those with a high level of SPO2 on admission (β = 0.75, P = 0.03). Also, in the survival submodel in the joint model, the risk of death survival outcome increased in patients with diabetes comorbidity (HR = 4.38, P = 0.026). The association between longitudinal measurements of SPO2 and survival outcomes of COVID-19 confirms that SPO2 is an important indicator in this disease. Thus, the application of this joint model can provide useful clinical evidence in the different areas of medical sciences.

The Frequency of Septal Abscess and Underlying Factors in Affected Patients in a Referral Hospital in North of Iran

The Frequency of Septal Abscess and Underlying Factors in Affected Patients in a Referral Hospital in North of Iran

Barriers to financial access of disabled people to health services in rural areas: A case study of Iran.

People with disabilities (PWDs) account for a significant percentage of the world's population, with a higher prevalence in less developed countries. Access to healthcare services is the main component of health systems performance, with lower access for PWDs living in rural areas. The current study aimed to investigate PWD's access to healthcare services in rural areas of Iran and, secondly, factors that contribute to this issue. Following a cross-sectional design, the current descriptive-analytical study is performed in the north of Iran. Using the quota sampling technique, 471 PWDs were recruited. Data were collected using a valid and reliable questionnaire, covering three dimensions of access, by face-to-face interview. Data analysis was administered using central tendency indicators and multiple regression by SPSS version 17. Statistical significance was considered when the P value <0.05. The mean score of PWD's access to healthcare services for dimensions of utilization, availability, and affordability was 8.91 (±6.86), 14.54 (±2.3), and 51.91 (±8.78), indicating very low, low, and moderate levels of access. All three regression models were significant (P < 0.05), and variables of gender, age, marital status, education level, residence status, the income of the household head, receiving financial aid, and house area showed a significant effect (P < 0.05). This study demonstrated the seriousness of paying attention to PWD's financial access to healthcare services, particularly in rural areas of Iran. Hence, policymakers should better focus on this problem, mainly regarding accessibility and utilization and factors that result in inequalities.

Patients’ sense of security from clinical factors in Iran: a cross-sectional study

BackgroundOne of the clinical responsibilities and goals of hospitals is to provide patients with comfort and security. The present study aims to assess patients’ sense of security among patients in Iranian hospitals.MethodsThe present research employed a cross-sectional design. The sample consisted of 830 patients visiting public, private, and social security hospitals in Mazandaran in the North of Iran. The required data were collected using a questionnaire developed by the researcher of this study.This questionnaire consisted of 4 dimensions:nursing, medical, advanced facilities and patient rights. The participants were selected using a proportional stratified random sampling method. Exploratory factor analysis, confirmatory factor analysis, descriptive statistics, and ANOVA were used for data analysis using SPSS version 22.ResultsThe mean scores of patients’ sense of security in social security, private, and public hospitals were 4.16 ± 0.89, 3.78 ± 0.67, and 3.60 ± 0.89, respectively. Medical factors with a mean and standard deviation of 3.92 ± 0.76, advanced facilities and equipment with 3.89 ± 0.89, nursing factors with 3.87 ± 0.73, and patient rights with 3.71 ± 0.90 were the highest to the lowest scores, respectively. The results showed that the type of hospital significantly affected the mean dimensions of security (p < 0.05).ConclusionsThe study revealed variations in the sense of securityacross the sampled hospitals. Particularly, the sense of security attributed to the patient rights factors was lower than other factors. Therefore, to enhance the sense of security for patients, it is recommended to focus on staff training and fostering a culturethat emphasizes obtaining informed consent, demonstrating respect for the patient, and introducing the medical team to the patient before initiating any treatment.

Utilizing supply-demand bundles in Nature-based Recreation offers insights into specific strategies for sustainable tourism management

Balancing supply and demand in Nature-based Recreation (NbR) has the potential to yield co-benefits across multiple Ecosystem Services (ES), helping to make tourism activities more sustainable. However, a comprehensive understanding of supply-demand mismatches in NbR is challenging due to the complex interaction among various social, economic and ecological factors. This paper investigates mismatches in NbR supply and demand to provide insights for informing spatial and regional planning to achieve sustainable tourism. To this end, the paper uses a wide range of indicators such as biophysical attributes, accessibility and social indicators to map and assess NbR supply and demand, followed by the application of spatial statistics to analyse supply-demand mismatches. Cluster analysis was performed based on the supply-demand relationship to identify a typology of NbR ES across the study area in the north of Iran. The paper proposes an innovative application of recreation ES bundles with potential implications for sustainable tourism in a region marked as a hot spot for tourism. The analysis generated a typology of five bundles of NbR ES with differing recreational opportunities. Bundles 1 and 2, characterized by a supply surplus and substantial ecological value, are suitable for NbR activities such as camping, hiking, climbing, and birdwatching. In contrast, bundle 4 and 5 associated with urban centres, experience a supply deficit, making them less suitable for NbR. Bundle 3, characterized by a mixture of natural and productive lands, plays an important role in maintaining a balanced supply-demand state. This region holds potential for diverse forms of tourism, including rural and agricultural recreation such as farm tours and farm life experiences. Based on findings, the paper provides valuable insights for spatial and regional planning by proposing targeted strategies to sustainably manage tourism activities.

Fatigue in taxi drivers and its relationship with traffic accident history and experiences: a cross-sectional study in the north of Iran

BackgroundThe monotonous nature of work, long driving duration, and working overload hours cause frequent fatigue in taxi drivers. A high prevalence of fatigue is associated with traffic accidents. However, the risk factors associated with taxi driver fatigue are unclear. Therefore, the present study aims to determine the rate of fatigue in taxi drivers and its relationship to their traffic accident experience.MethodsIn this descriptive-analytical study, 400 taxi drivers in the city of Rasht were registered in Taxi association selected through random sampling and entered into the study based on inclusion criteria. Data was collected through a researcher-made questionnaire reliable and valid by two medical students. The statistical analysis used ordinal data and a Poisson regression model with SPSS software version 21, with a significance level set at 5%.ResultsThe driver fatigue self-reported was directly and significantly related to alcohol consumption (OR = 3.43, 95% CI 1.01–11.62) and had a significant and inverse relationship with smoking (OR = 0.50, 95% CI 0.32–0.76), being married (OR = 0.08, 95% CI 0.01–0.40) and driving experience there was (OR = 0.96, 95% CI 0.94–0.98). Drivers’ sense of quality of life (QOL) was directly and significantly related to smoking (IRR = 1.43, 95% CI 1.28–1.59), education level under diploma (IRR = 2.41, 95% CI 1.43–4.06) diploma (IRR = 2.06, 95% CI 1.21–3.48) and bachelor (IRR = 2.42, 95% CI 1.36–4.29) and there was a significant and inverse relationship with age (IRR = 0.98, 95%CI 0.98–0.99). There was a significant relationship between the number of traffic accidents in the past year with the level of bachelor’s degree (IRR = 3.10, 95% CI 1.43–6.76) and driving experience (IRR = 1.03, 95% CI 1.02–1.04 and inverse relationship between the number of traffic accidents in the past year and the QOL sense (IRR = 0.96, 95% CI 0.93–0.99) and the working hours (IRR = 0.96, 95% CI 0.94–0.99).ConclusionLegislators and policymakers should pay more attention to fatigue in single and inexperienced taxi drivers. Regarding the QOL, pay attention to drivers with high education and older. To reduce the number of crashes, pay more attention to drivers with a bachelor’s degree and less driving experience and improve the feeling of QOL.

A New Approach to Eliminate Hymenoptera Venom Grading Sensitization Test in the North Iran: Cross-Sectional Study.

Anaphylaxis is an allergic reaction which occurs with or without the stimulation of the immune system. Hymenoptera stings are common causes of anaphylaxis in the world. Skin tests are the first-line diagnostic measure for Hymenoptera anaphylaxis. The present study aimed to evaluate the safety of a single-step approach in sensitization testing for Hymenoptera venom. This cross-sectional study was conducted in 2019 in Golestan province the north of Iran. The sample population consisted of 140,000 individuals covered by 84 rural healthcare centers in the vicinity of Gorgan, Iran. Thirty-three patients agreed to receive the diagnostic test. In this research, in contrast to the 2011 ACAAI guideline, the extracts of venom of three types of Hymenoptera were injected intra-dermally without any dilution at the concentration of 1 μg/ml. The results of the skin test in the patients bitten by honey bee, yellow jacket, and paper wasp were negative in 15.2%, 15.2%, and 21.2% of the cases, respectively. After the test, no allergic reaction was observed, with the exception of a minor skin reaction, which improved within a short time. These preventive measures were taken during the test for the following four hours when the patient was present at the test site and up to 48 hours afterward via follow-up from the healthcare center to the home of the patient. The results of our study showed that the non-diluted single injection of the Hymenoptera sting was accompanied by no side effects.