The Development of an Empirical Model for Estimation of the Sensitivity to Heat Stress in the Outdoor Workers at Risk

Background: Workers who work in hot environments may be at risk for heat stress. Exposure to heat can result in occupational illnesses, including heat stroke, heat cramps, and heat exhaustion. The risk of exposure to heat depends on individual, environmental, and occupational risk factors. Individual risk factors may decrease the individual’s tolerance to heat stress. Sensitivity as an intrinsic factor may predispose a person to heat stress. Aim: This study was aimed to determine the criteria for sensitivity parameter, specify their weights using the fuzzy Delphi-analytical hierarchy, and finally providing a model to estimate sensitivity. The significant of the study is presenting a model to estimate the sensitivity to heat stress. Materials and Methods: The expert’s opinions were used to extract the criteria in Delphi method. After determining the weight of each criterion, Fuzzy analytic hierarchy Process (FAHP), by mathematical principles matrix and triangular fuzzy numbers, was applied for the prioritization of criteria. Results: According to experts’ viewpoints and considering some exclusion, 10 of 36 criteria were selected. Among 10 selected criteria, age had the highest percentage of responses (90% (27/30)) and its relative weight was 0.063. After age, the highest percentages of response were assigned to the factors of preexisting disease (66.6% (20/30)), body mass index (56.6% (17/30)), work experience (53.3% (16/30)), and clothing (40% (16/30)), respectively. Other effective criteria on sensitivity were metabolic rate, daily water consumption, smoking habits, drugs that interfere with the thermoregulatory processes, and exposure to other harmful agents. Conclusions: Eventually, based on the criteria, a model for estimation of the workers’ sensitivity to heat stress was presented for the first time, by which the sensitivity is estimated in percent.Keywords: Heat stress, Sensitivity, Personal factors, Fuzzy AH

EPISPOT: An epigenome-driven approach for detecting and interpreting hotspots in molecular QTL studies.

We present EPISPOT, a fully joint framework which exploits large panels of epigenetic annotations as variant-level information to enhance molecular quantitative trait locus (QTL) mapping. Thanks to a purpose-built Bayesian inferential algorithm, EPISPOT accommodates functional information for both cis and trans actions, including QTL hotspot effects. It effectively couples simultaneous QTL analysis of thousands of genetic variants and molecular traits with hypothesis-free selection of biologically interpretable annotations which directly contribute to the QTL effects. This unified, epigenome-aided learning boosts statistical power and sheds light on the regulatory basis of the uncovered hits; EPISPOT therefore marks an essential step toward improving the challenging detection and functional interpretation of trans-acting genetic variants and hotspots. We illustrate the advantages of EPISPOT in simulations emulating real-data conditions and in a monocyte expression QTL study, which confirms known hotspots and finds other signals, as well as plausible mechanisms of action. In particular, by highlighting the role of monocyte DNase-I sensitivity sites from >150 epigenetic annotations, we clarify the mediation effects and cell-type specificity of major hotspots close to the lysozyme gene. Our approach forgoes the daunting and underpowered task of one-annotation-at-a-time enrichment analyses for prioritizing cis and trans QTL hits and is tailored to any transcriptomic, proteomic, or metabolomic QTL problem. By enabling principled epigenome-driven QTL mapping transcriptome-wide, EPISPOT helps progress toward a better functional understanding of genetic regulation

An Orthopedic-, Surgical-, and Epidemiological-Based Investigation of Leprosy, in the Tamil Nadu State of India

No other research paper has ever been written about leprosy in this manner. The orthopedic and surgical implications, as well as the functional debility caused by the disease, have not been previously explained by past research as they have in such a comprehensive manner in this paper. The results of this study have regional and global implications as they pertain to disease pathology, risk factor recognition/disease prevention, and treatment. This paper is a unique, in that it also serves as a combination of a review of the current medical literature, as well as an epidemiological survey of the disease in a region of the world which has never been researched in the past. Clinical data points to the possibility of a new strain of the disease. This information is of significance because it effects prevention and improved treatment of the disease, which leads to devastating sequela. This was a cross-sectional study involving subjects diagnosed with leprosy in the Chengalpet region of the Kancheepuram District, of the Tamil Nadu state of India. The study was performed at the Tamil Nadu Medical College Teaching Hospital and Research Center. This study included various physical examinations, observation and survey of lesions, questionnaires in regard the debilitating orthopedic and medical effects of the disease, as well as treatment options

Assessment of noise induced psychological stresses on printery workers

The purpose of this study was to assess the relationship between psychological stresses and noise stresses on printery workers in Tehran, Iran. Hence, 267 workers were randomly selected. The Leq and Lmax were measured and the psychological stresses such as depression, anxiety, aggression and job satisfaction were also studied by the relevant questionnaires. The data were statistically analyzed by Pearson correlation test. The results demonstrated that there was no significant statistical relationship between noise and psychological stresses. In addition, by using Spearman regression method, the influence of variables such as age, gender and job history on psychological stresses caused by Leq and Lmax was studied and the results only revealed that the aggression caused by Leq increased in young personnel (P=0.02) as well as, anxiety caused by Lmax increased accompanied by increasing the job history and age of the workers (P=0.002 and P=0.007). Therefore, more variables must be taken into consideration to judge about noise induced psychological stresses in workplaces. © IRSEN, CEERS, IAU

Modeling signal-to-noise ratio of otoacoustic emissions in workers exposed to different industrial noise levels

Introduction: Noise is considered as the most common cause of harmful physical effects in the workplace. A sound that is generated from within the inner ear is known as an otoacoustic emission (OAE). Distortion-product otoacoustic emissions (DPOAEs) assess evoked emission and hearing capacity. The aim of this study was to assess the signal-to-noise ratio in different frequencies and at different times of the shift work in workers exposed to various levels of noise. It was also aimed to provide a statistical model for signal-to-noise ratio (SNR) of OAEs in different frequencies based on the two variables of sound pressure level (SPL) and exposure time. Materials and Methods: This case-control study was conducted on 45 workers during autumn 2014. The workers were divided into three groups based on the level of noise exposure. The SNR was measured in frequencies of 1000, 2000, 3000, 4000, and 6000 Hz in both ears, and in three different time intervals during the shift work. According to the inclusion criterion, SNR of 6 dB or greater was included in the study. The analysis was performed using repeated measurements of analysis of variance, spearman correlation coefficient, and paired samples t-test. Results: The results showed that there was no statistically significant difference between the three exposed groups in terms of the mean values of SNR (P > 0.05). Only in signal pressure levels of 88 dBA with an interval time of 10:30-11:00 AM, there was a statistically significant difference between the right and left ears with the mean SNR values of 3000 frequency (P = 0.038). The SPL had a significant effect on the SNR in both the right and left ears (P = 0.023, P = 0.041). The effect of the duration of measurement on the SNR was statistically significant in both the right and left ears (P = 0.027, P < 0.001). Conclusion: The findings of this study demonstrated that after noise exposure during the shift, SNR of OAEs reduced from the beginning to the end of the shift

Inflammatory B cells correlate with failure to checkpoint blockade in melanoma patients.

The understanding of the role of B cells in patients with solid tumors remains insufficient. We found that circulating B cells produced TNFα and/or IL-6, associated with unresponsiveness and poor overall survival of melanoma patients treated with anti-CTLA4 antibody. Transcriptome analysis of B cells from melanoma metastases showed enriched expression of inflammatory response genes. Publicly available single B cell data from the tumor microenvironment revealed a negative correlation between TNFα expression and response to immune checkpoint blockade. These findings suggest that B cells contribute to tumor growth via the production of inflammatory cytokines. Possibly, these B cells are different from tertiary lymphoid structure-associated B cells, which have been described to correlate with favorable clinical outcome of cancer patients. Further studies are required to identify and characterize B cell subsets and their functions promoting or counteracting tumor growth, with the aim to identify biomarkers and novel treatment targets

Clinical features of pregnant women in Iran who died due to COVID-19

Background: To evaluate the clinical presentation of pregnant women in Iran who died due to COVID-19. Methods: Data were evaluated of pregnant women who died following a laboratory diagnosis of COVID-19. The data were obtained from electronic medical records. Additionally, a questionnaire was completed for each patient, including demographic, clinical, laboratorial, imaging, and treatment data. In case of missing information, a member of the research team contacted the first-degree relatives via phone. Results: Of 32 pregnant women who tested positive for COVID-19, 15 were enrolled into the study (mean age 30.0 ± 5.0 years). The mean time from first symptoms to death was 12 ± 7.0 days. Pre-existing comorbidities were seen in six patients. The main presentations at admission were fatigue and coughing, but most of the women had a fever below 38 °C. Increased white blood cell count and neutrophils were noticeable. A significant drop of saturation of O2 with ground glass and consolidation seen in both lungs were prominent. The most common complications were acute respiratory distress syndrome followed by respiratory failure. Conclusion: Computed tomography findings, O2 pressure, and regular blood assessment may be considered suitable indicators for the surveillance of patients. © 2020 International Federation of Gynecology and Obstetric

Comparative assessment of tear function tests, tear osmolarity, and conjunctival impression cytology between patients with pterygium and healthy eyes

Purpose: To compare histologic abnormalities of tear film and tear osmolarity between normal eyes and eyes with pterygium. Methods: This was a prospective, hospital-based, case-control study involving 95 patients (65 men, 30 women) with unilateral pterygium. The tear meniscus height (TMH), Schirmer's test-1 (SCH-1) score, Rose Bengal staining (RBS) score, tear film breakup time (TBUT), tear osmolarity (TO), and conjunctival impression cytology (CIC) were assessed in both eyes. The Chi-square and Student's t-tests were used to compare the results between the two groups. P values <0.05 were considered statistically significant. Results: The mean patient age was 50.9 years, with the largest age group being the 45-55 year-old bracket across both genders. Most patients (82.1) had nasal pterygium, and 80 were involved in outside activities. The mean assessment values in the case and control groups were as follows: TMH, 0.21 vs. 0.24 mm; SCH-1, 13.2 vs. 17.8 mm; RBS, 4.38 vs. 2.51 points; TBUT, 8.7 vs. 13.2 seconds; TO, 306 vs. 299 mOsm/L (P < 0.001 in all cases). The proportions of abnormal assessment values in the case and control groups were as follows: TMH, 82.1 vs. 3.16; SCH-1, 20 vs. 2.1; RBS, 30.53 vs. 4.22; TBUT, 61.05 vs. 6.3; TO, 10.52 vs. 1.05; CIC, 33.7 vs. 7.37 (P < 0.05 for all comparisons). Conclusion: This study showed that the quantity and quality of tear film, as well as the number of goblet cells, decreased, but the tear osmolarity increased in eyes with pterygium. Furthermore, the TMH, RBS results, TBUT, and CIC have more precise state of the patient's tear condition with the disease of the pterygium. Safarzadeh Masoud 1 Department of Optometry, Faculty of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran Heidari Sahel 2 Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran Azizzadeh Parvin 3 Bahman Ophthalmology Research Center, Bahman Hospital, Tehran Sheibani Kourosh 4 Basir Eye Safety Research Center, Basir Eye Clinic, Tehran Nassiri Nader 5 Ophthalmic Research Center, Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran Heidari Laleh 6 Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran Aghataheri Sattar 7 Department of Optometry, Faculty of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran Moukoury Nyolo E, Epee E, Nsangou JFI, Noa Noa Tina B. Pterygiun in a tropical region: Analysis of 344 cases in Cameroon. Bull Soc Belge Ophtalmol 2009;311:11-15. Shiroma H, Higa A, Sawaguchi S, Iwase A, Tomidokoro A, Amano S. 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Collecting tear osmolarity measurements in the diagnosis of dry eye. Exp Rev Ophthalmol 2009;4:451-453. Ozsutcu M, Arslan B, Erdur SK, Gulkilik G, Kocabora SM, Muftuoglu O. Tear osmolarity and tear film parameters in patients with unilateral pterygium. Cornea 2014;33:1174-1178. Singh R, Joseph A, Umapathy T, Tint NL, Dua HS. Impression cytology of the ocular surface. Br J Ophthalmol 2005;89:1655-1659. Viso E, Gude F, Rodríguez-Ares MT. Prevalence of pinguecula and pterygium in a general population in Spain. Eye (Lond) 2011;25:350-357. Antony AT, Mini PA, Dalia S. Pterygium and Dry Eye- A Clinical Correlation. J Med Scie Clin Res 2017;5:23654-23659. Rahman A, Yahya K, Fasih U, Huda W, Shaikh A. Comparison of Schirmer's test and tear film breakup time test to detect tear film abnormalities in patients with Pterygium. J Pak Med Assoc 2012;6:1214-1216. Lee AJ, Lee J, Saw SM, Gazzard G, Koh D, Widjaja D, Tan DT. Prevalence and risk factors associated with dry eye symptoms: A population based study in Indonesia. Br J Ophthalmol 2002;86:1347-1351. Fotouhi A, Hashemi H, Khabazkhoob M, Mohammad K. Prevalence and risk factors of pterygium and pinguecula: The Tehran Eye Study. Eye (Lond) 2009;23:1125-1129. Dolezalova V. Is the occurrence of a temporal pterygium really so rare? Ophthalmologica 1977;174:88-91. Asokan R, Venkatasubbu RS, Velumuri L, Lingam V, George R. Prevalence and associated factors for pterygium and pinguecula in a South Indian population. Ophthalmic Physiol Opt 2012;32:39-44. Jang SY, Lee SY, Yoon JS. Meibomian gland dysfunction in longstanding prosthetic eye wearers. Br J Ophthalmol 2013;97:398-402. Das P, Gokani A, Bagchi K, Bhaduri G, Chaudhuri S, Law S. Limbal epithelial stem-microenvironmental alteration leads to pterygium development. Mol Cell Biochem 2015;402:123-139. Onkar A, Pandey DJ, Bist HK, Sen S. Tear and pterygium: A clinico-pathological study of conjunctiva for tear film anomaly in pterygium. J Eye Cataract Surg 2017;3:24. Bekibele CO, Baiyeroju AM, Ajaiyeoba A, Akang EE, Ajayi BG. Case control study of dry eye and related ocular surface abnormalities in Ibadan, Nigeria. Int Ophthalmol 2010;30:7-13. Rajiv, Mithal S, Sood AK. Pterygium and dry eye-A clinical correlation. Indian J Ophthalmol 1991;39:15-16. Oh HJ, Park YG, Yoon KC. Changes of ocular surface and tear film in patients with pinguecula and pterygium. J Korean Ophthalmol Soc 2006;47:717-724. Moreno JC, Garcia VG, Garcia L. Evaluation of tear film in patients with Pterygium. Eur J Ophthalmol 2011;00 (00). Roka N, Shrestha SP. Assessment of tear secretion and tear film instability in cases with pterygium and normal subjects. Nepal J Ophthalmol 2013;5:16-23. El-Sersy TH. Role of pterygium in ocular dryness. J Egypt Ophthalmol Soc 2014;107:205-208. Lemp MA, Baudouin C, Baum J. 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Indian J Pathol Microbiol 2010;53:692-695. Shreya T, Poorvi G. Role of impression cytology in detecting gobletcell damage in various ocular surface disorder. Austin J Clin Ophthalmol 2016;3:1065. © 2019 Journal of Ophthalmic and Vision Research | Published by Wolters Kluwer - Medknow

Exposure to heat stress in the workplace: A systematic review

Background and aims: Working in hot environments is one of the common physical risks factor in the workplace, which can also cause heat-related illnesses and various health effects on workers, and also increasing the risk of injuries and occupational accidents. The purpose of this paper is review conducted studies about heat stress in different countries, investigation the indices of heat stress, the characteristics of the exposure in hot environments, high-risk occupations, and sutvey the status and importance of these studies. Methods: In this review study used Web of Science, Scopus, Pubmed, ScienceDirect, Iran Medex, Magiran, Google Scholar and SID databases. The keywordsincluded Heat stress, Heat strain, Heat exposure, Heat waves, Workplace, Knowledge and attitude of workers about heat stress, the period of 2000 to 2015 was investigated, and finally 103 original articles were identifed. Results: 90 of all study being cross-sectional studies, 41 being related to outdoor workplaces, and 42 being related to indoor environment. 19 studies were about perceptions and behavioural responses of exposure to heat stress.A range of heat indices were used with 60 (71) studies using Wet Bulb Globe Temperature Index (WBGT). Most of studied focused on manufacturing workers and farmers. Most of studies indicated that workers were suffering from heat stress and strain. Conclusion: The results of reviewed studies showed that stress in workplace is worrying due to the nature of the working processes both indoor and outdoor, and of climate change. Therefore it is necessary to considering preventive and control programs to reduce the heat stress by the management and staff's participation to eliminate or reduce its lethal effects. © 2018 JTehran University of Medical Sciences and Health Services. All rights reserved