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Highlights • The mean age of 119,883 healthcare workers identified in this study was 38.37 years (95% CI, 36.72 – 40.03) and males comprised 21.4% (95% CI, 12.4 – 34.2) of the population. • The most prevalent symptoms were fever 27.5% (95% CI, 17.6-40.3) and cough 26.1% (95% CI, 18.1-36) • The prevalence of hospitalization of healthcare workers infected with COVID-19 was 15.1% (95% CI, 5.6-35) and mortality of (95% CI, 0.5-3.9). • Comparisons of healthcare workers with and without infection showed an increased relative risk for COVID-19 related to PPE, workplace setting, profession, exposure, contacts, and testing-related factors., Background The COVID-19 pandemic has focused attention on the challenges and risks faced by frontline healthcare workers (HCW). Our aim is to describe the clinical outcomes and risk factors for SARS- CoV-2 infection in HCW. Methods Three databases were surveyed identifying 328 articles. Of these, 225 articles did not meet inclusion criteria; 97 full-text article were reviewed. Finally, after further revision, 30 articles were included in the systematic review and 28 used for meta-analysis. Results A total of 28 studies were identified involving 119,883 patients. The mean age of the patients was 38.37 years (95% CI, 36.72 – 40.03) and males comprised 21.4% (95% CI, 12.4 – 34.2) of the population of health workers. The prevalence of HCW who tested positive for COVID-19 is 51.7% (95% CI, 34.7-68.2). The total prevalence of co-morbidities in 7 studies was 18.4% (95% CI, 15.5 – 21.7). The most prevalent symptoms were fever 27.5% (95% CI, 17.6-40.3), cough 26.1% (95% CI, 18.1-36).The prevalence of hospitalization of HCW was 15.1% (95% CI, 5.6-35) in 13 studies and the prevalence of death was 1.5% (95% CI, 0.5-3.9) in 12 studies. Comparisons of HCW with and without infection showed an increased relative risk for COVID-19 related to PPE, workplace setting, profession, exposure, contacts, and testing. Conclusion A significant number of HCW have been reported to be infected with COVID-19 during the first 6 months of the pandemic, with a prevalence of hospitalization of 15.1% and mortality of 1.5%. Further data is needed to track the continued risks in HCW as the pandemic evolves and health systems adapt.

Objective: The aim of this study was to determine the effect of 12 weeks resistance training on G6Pase expression in liver cells, as well as glucose and insulin levels in type 2 diabetic rats. Materials and Methods: In this experimental study, 16 wistar rats were selected as the research sample. After injection of nicotinamide and streptozocin to induce diabetes, the rats were randomly divided into two groups of resistance training and control. The resistance group participated in a course of resistance training for up to 12 week in five sessions per week, with intensity of 75% and a time of 30 to 45 minutes. Finally, 48 hours after the last exercise session, G6Pase expression in liver cells, as well as glucose and insulin levels were measured in both groups. Results: Comparison of resistance and control training groups showed a decrease in glucose levels (P-value= 0.001) and increased insulin levels (P-value= 0.001). Exercise also reduced the expression of G6Pase in liver cells in the resistance training group (P-value= 0.001). Conclusion: Based on the results of the study, it is recommended that diabetics use resistance training under the supervision of a specialist to reduce the negative effects of diabetes.

Objective: This study aimed to investigate the effects of moderate to high-intensity aerobic exercise on HbA1c (Glycated hemoglobin), FBS (fasting blood sugar) and cognitive function in mild cognitive impairment prediabetes patients. Materials and Methods: Seventeen elderly mild cognitive impairment (age 55-70) men and women were selected and were randomly divided into 2 groups as aerobic (n=10) and control (n=10). Six subjects were excluded during the study. Finally, 14 subjects were continued the exercise program. Assessments were done at baseline and 12 weeks after intervention. The 12-weeks aerobic exercise program consisted of 90 min sessions in length 3 days per week under the supervision of the exercise specialist. Cognitive function, HbA1c, and FBS were evaluated. The differences in all variables (one way ANOVA), correlation (Pearson single correlation) and relative changes between baseline and 12 weeks (paired T-tests) were investigated. Results: HbA1c, FBS decreased significantly in the aerobic group whereas cognitive function increased significantly after 12 weeks aerobic ( P -value< 0.05 for all). Also, the change of cognitive function was significantly associated with a change of FBS (r= -0.84) after a 12-week aerobic exercise ( P -value: 0.011). Differences between groups in HbA1c, FBS and cognitive function (Mini-Mental State Examination) were not significant. Conclusion: Aerobic exercise may improve HbA1c, FBS and subsequently cognitive function in prediabetes elderly subjects. Therefore, a decrease in glycemic indicators could lead to improve cognitive function.

Objective: The study aimed to determine the effect of eight weeks high intensity interval (HIIT) and sub-maximal continuous trainings on plasma betatrophin level in diabetic rats treated with metformin. Materials and Methods: In this experimental study, 42 diabeticwistar rats were divided into six groups (n=7): diabetic control (C), diabetic control + metformin consumption(C+M), diabetic HIIT, diabetic HIIT + metformin (HIIT+M), diabetic sub-maximal continuous training (SMCT), and diabetic sub-maximal continuous training + metformin (SMCT+M). Metformin was given 150 mg/kg/day by gavage every day, 48 hours after the end of the last training session, the rats were sacrificed. Then blood glucose and glycated hemoglobin (HbA1c) levels were measured. One-way ANOVA test was used for statistical analysis of data. Results: The level of plasma betatrophin was significantly different in the HIIT ( P -value= 0.01) and C+M ( P -value= 0.001) groups compared to C group. Blood glucose was significantly decreased in all training groups with or without betatrophin compared with the diabetic control group ( P -value= 0.001). However, there were no significant changes between glucose levels in HIIT, HIIT+M, SMCT, and SMCT+M groups but SMCT showed most reduction in blood glucose. Conclusion: Treatment with metformin did not change blood glucose but two types of exercise training with high and moderate intensity reduced blood glucose thus exercise can be a good alternative modality rather than taking medicine.

Background: Transplant success largely depends on the number of hematopoietic stem cells. The release of catecholamines following exercise can, as a treatment in addition to medication, affect the mobilization of stem cells from the bone marrow into the peripheral blood. The aim of the present study is to compare two types of aerobic exercise on stem cell mobilization before autologous transplantation. Materials and Methods: In a quasi-experimental applied study, 60 patients in the age range of 22-69 years referred to Taleghani Hospital were randomly selected and assigned into 3 groups of 20 members (continuous aerobic, discontinuous aerobic and control group). Aerobic exercise program was performed for 7 consecutive days of mobilization period including walking on a treadmill (according to the patient's ability) continuously and discontinuously for 30 minutes in the morning and afternoon. Blood samples were taken the morning before and after mobilization and the CD34 and MNC levels were counted as absolute. Chi-square test, paired t-test, analysis of covariance (ANCOA) and multiple comparison test were used for statistical analysis. All analyses were considered significant at p ≤ 0. Results: Moderate-intensity continuous and discontinuous aerobic activity increases the number of CD34 and MNC cells. A comparison between continuous and discontinuous aerobic activity showed an increase in the amount of these cells. The continuous aerobic activity group was found to have a statistically significant increase compared to the discontinuous group (P≤0.05). Conclusion: Moderate intensity continuous and discontinuous aerobic exercise significantly increased hematopoietic stem cells. However, this increase was greater as a result of continuous aerobic exercise than discontinuous exercise. Regarding the potential role of these cells in transplantation, they could possibly help the transplant process.

Background: It has been assumed that during and after BFR exercises, many blood factors are activated and angiogenesis response is stimulated in the arteries. Objectives: Therefore, the current study aimed to determine the effect of two eccentric resistance training methods with and without blood flow restriction on serum IL6 and MMP9 levels in active young men. Methods: In this quasi-experimental study, 16 healthy men with a mean age of 27.8 ± 2.85 (years), the weight of 79.4 ± 12.4 (kg), and a body mass index of 25.5 ± 3.7 (kg/m2) were randomly assigned to either low-intensity eccentric group with BFR or the high-intensity eccentric without BFR. The high-intensity (70% - 80% maximum voluntary contraction MVC) eccentric exercise without BFR included 3 - 5 cycles of eccentric contraction of the quadriceps muscles, up to exhaustion, whereas low-intensity eccentric exercise executed similar exercise modality at intensity of 20% - 30% MVC with blood flow restriction up to exhaustion. Blood samples were taken from antecubital both before and after the exercise to measure serum IL6 and MMP9 values using the ELISA method. Data were analyzed using paired t-test and analysis of variance with repeated measure test in SPSS version 22. A P value of < 0.05 was defined as statistically significant. Results: High-intensity resistance per se and low-intensity resistance exercise with BFR similarly resulted in a non-significant reduction of IL-6 and elevated levels of MMP-9 serum levels in active young men. Conclusions: Overall, the results indicated that a low-intensity resistance exercise session with restricted blood flow and a high-intensity resistance exercise without blood flow restriction equally did not affect IL6 and MMP9 serum of active young men. Further studies are needed to clarify the exact exercise modality that sufficiently stimulates angiogenesis.

Objective: The use of non-enzymatic antioxidants in food supplements and proper exercise can have a positive effect on decreasing oxidative stress by free radical hunting. The purpose of this study was to investigate the effect of aerobic training and Lcarnitine supplementation on some of the oxidative stress factors in the liver of diabetic rats. Materials and Methods: In this experimental study, 45 male wistar rats (200-300 gr) were randomly divided into six groups: 1) sham group, 2) healthy control group 3) diabetic control group, 4) diabetic group receiving L-carnitine, 5) diabetic group of aerobic training, 6) diabetic group of aerobic training and receiving Lcarnitine. The aerobic exercise protocol included six weeks, five sessions per week on the treadmill. After intervention, malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GPX) levels were determined in liver tissue. Results: Six weeks of aerobic exercise had a significant effect on MDA factor in hepatic tissue in diabetic rats (P-value: 0.024). However, supplementation (P-value: 0.868) and combined intervention of aerobic exercise and supplementation of L-carnitine (P-value: 0.465) did not have the significant effect on MDA factor. Also, 6 weeks of aerobic training, supplementation of L-carnitine, and combined intervention had no significant effect on SOD and GPX factors of hepatic tissue in diabetic rats (P-value> 0.05). Conclusion: L-carnitine supplementation with regular exercise can have beneficial effects on hepatic antioxidant defense system in rats with type 2 diabetes.

Introduction: Visfatin is predominantly secreted from visceral adipose tissue and mimics the effect of insulin by binding to insulin receptors. The purpose of the present research is to examine the effect of glucose intake on plasma visfatin concentration following an aerobic exercise session. Methods: In a quasi-experimental study, 16 male non-athlete students (21.91±2.31 yrs., 77.53±8.93 kg, 1.768±0.07 cm, 24.31±2.07 kg/m2) were randomly divided into water and glucose groups. Blood samples were collected at five stages: before exercise, immediately after exercise, and 30, 60, and 90 minutes after exercise. The subjects were instructed to perform a 45-minute aerobic exercise (a 10-min warm-up, followed by a 1- mile running at maximum speed with 3-minute rests between bouts). Immediately after the second blood sampling, sugary liquids (1.5g glucose for each kg body weight) and water (similar volume) were administered. The data was analyzed using repeated measures ANOVA and LSD test at P Results: Plasma visfatin levels increased immediately after exercise, but the increase was not significant. At the following times (30, 60, and 90 minutes after exercise), plasma visfatin levels decreased in both groups, but the decrease was not significant. Significant difference was observed in the visfatin levels of the glucose group at 60 and 90 minutes after exercise compared to immediately after exercise. The plasma glucose level of the glucose group was significantly lower than the water group. Significant increase in plasma insulin was observed by glucose intake at 30 and 60 minutes after exercise. Although at 90 minutes after exercise the plasma insulin level of the glucose group was higher than that of the water group, but the difference was not significant. Conclusion: According to the findings, changes made in visfatin levels following acute exercise and glucose intake is not significant. So, probably visfatin has no role in improving the acute exercise-induced metabolic status and glucose intake in healthy subjects.

Background: It is suggested that quercetin has anti-inflammatory properties and can improve endurance performance, but study results are contradictory especially in human models. Therefore, the purpose of the present study was to evaluate the effect of quercetin supplementation on TNF-α, lactate and immune cell responses after one session of exhausting swimming. Methods: 20 trained (at least 3 years’ history of swimming training) female adolescent swimmers with average age of 15.1 ± 0.21 yrs and BMI, 21.05 ± 2.3 kg/m2 were divided in two groups including placebo (n = 10) and quercetin (n = 10) groups. Participants in the quercetin group consumed 1000 mg of quercetin supplement daily for two weeks. After two weeks, all participants took part in one exercise session as swimming with 80 - 85 percent of maximum heart rate until exhaustion. Blood samples were collected at three times (baseline, pre and immediately after exercise) and TNF-α was measured by ELISA method. data were analyzed by SPSS-24 software using repeated-measures ANOVA and paired sample t-test. P 0.05). Moreover, the quercetin supplement caused change in immune cell response in which the difference in leukocytes and monocytes were significant (P < 0.05) compared to placebo group. Conclusions: It seems that quercetin can exert anti-inflammatory function after exhausting swimming. Therefore, quercetin can be consumed by athletes to attenuate exercise-induced inflammation.

Summary Objective There is limited research on voice problems of athletes, especially Kabaddi athletes who use their voice during Kabaddi exercises and may damage their vocal folds and impair their voice quality. The present study aimed to compare maximum oxygen uptake (VO2max) and rating perceived exertion (RPE) in Woman's Kabaddi athletes without breathy voice (BV) to severe BV. Materials and Methods Seventy woman's Kabaddi athletes (mean age of 20.5 ± 2.7 years, height of 163 ± 3.6 cm, weight of 61.4 ± 5.4 kg) at the club and national team level (without BV to severe BV) were compared in this study. Data were collected by imaging the larynx by a stroboscopic device (there is gap and asymmetry between vocal folds, presence of mass on vocal folds, muscle tension dysphonia, hoarseness, and harshness), evaluating the voice parameters by Vocal Assessment software (mean F0 (Hz), F0SD (Hz), jitter (%), shimmer (%), Normal Noise Energy (NNE) (dB)), and calculating VO2max by Bruce treadmill test. RPE was calculated by a 15-point (6–20) Borg test. Results The results showed that 39 (55.17%) subjects had moderate and high BV symptoms and 31 (44.28%) had no symptoms of BV and low BV. The mean fundamental frequency in the group with moderate and severe BV was equal to 2.59 Hz opposite the mean fundamental frequency in the group without BV and low BV was equal to 0.65 Hz, and in contrast, the jitter (0.47%) opposite (0.19%) and the shimmer was equal to (6.64%) opposite (0.67%) and the NNE was equal to (−3.08 dB) In front of (−11.95 dB). There was no significant difference between VO2max in two groups of Woman's Kabaddi athletes as well as RPE in two groups of Woman's Kabaddi athletes at significant level of P ≤ 0.05. Conclusions Severe BV is affected by voice abuse. Voice abuse during Kabaddi is negatively affecting the quality of voice. After Kabaddi sport, athletes are complained from obstruction, hoarseness, and harshness due to disturbances in vocal folds and throat dryness. According to the data obtained from this study, abuse has a negative effect on vocal folds, which is followed by BV in various degrees in Kabaddi athletes.

Background: Breast cancer is the most common cancer diagnosed in women throughout the world and the leading cause of cancer-related deaths in women Objectives: The current study aimed to investigate the effect of eight weeks of training on IL-6, TNF-α and hCRP in postmenopausal breast cancer survivors. Patients and Methods: Twenty-seven postmenopausal breast cancer survivors with mean age of 44.1 ± 4.6, mean height of 158 ± 5.9 cm and mean Body Mass Index (BMI) of 30.2 ± 3.2 kg/m2, were randomly divided to three groups; continuous, interval and the control groups. Inflammatory markers, anthropometric variables and VO2 peak were measured before and after the eight weeks. Statistical analysis of the data was carried out using the Kruskal-Wallis and Wilcoxon test at a significance level of P 0.05). The human C-Reactive Protein (hCRP) levels showed a significant reduction in the continuous group (P = 0.015), and the reductions in Tumor Necrosis Factor alpha (TNF-α) and Interleukin6 (IL-6) were also greater in this group than in the other two groups. No significant differences were observed between the two exercise groups in their inflammatory markers. Conclusions: Exercise can improve anthropometric variables, body composition and VO2 peak and reduce some inflammatory markers in breast cancer survivors.

This study examined the independent and combined effects of exercise training, weight loss and changes in dietary quality on the serum lipid profile in sedentary, healthy and overweight young women. 83 women 18-25 years with body mass index>25 were randomly assigned to four groups, control (C), diet (D), exercise (E) and exercise and diet (ED). Height, weight, per cent body fat (BF%), TC, HDL-C, TG and LDL-C were measured before and after an 8-week intervention period. Subjects in the two exercise groups walked five times a week, 45 min per session, at 60%-80% of maximum heart rate (MHR). Duration and intensity of exercise were gradually increased over a 3-week period from 25 to 30 min/sessions at 60%-65% of MHR during week 1 to 45 min at 70% to 80% MHR from weeks 4 through 8. Subjects in the two nonwalking groups (C and D) reported to the exercise facility 5 days per week for 45 min of stretching and mild range of motion calisthenics. The intent was to keep heart rate below 100 beats per minute. One-way ANOVA was the statistical test (α=0.05). Relative to control group, the ED and D groups displayed a 4.2% and 4.1% reduction in body mass, 9% and 7% reduction in BF%, 29% and 26% reduction in TG. LDL-C fell by 12% in ED group. For each kg of weight loss there was a decrease of 0.05, 0.02 and 0.015 mg/dl in TC, LDL-C and TG respectively. No change of body mass occurred in E group. Exercise alone was insufficient to stimulate change in any lipid or lipoprotein measures. These results demonstrated that weight loss mostly was due to diet, because the exercise was the same in groups E and ED. The lipid profile improved and body mass decreased.

The aims of the present study were: (1) to determine the anthropometric profile, body composition and somatotype of female basketball (B) and handball (H) players, (2) to compare the mean scores among sports and (3) to detect possible differences in relation to competition level. A total of 28 female athletes, all members of the Iranian national teams, participated in the present study. Anthropometric measures required for the calculation of body composition indexes and somatotype components were obtained according to the established literature. Although B and H group had homogeneity in somatotype characteristics (p

The purpose of this study was to examine the correlation of lifestyle, body composition and lipoprotein-lipid profiles in obese females. A total of 26 healthy females (age=23.01±3.56 years, height=160.05±5.70 cm, weight=74.50±5.90 kg, body fat=38.40±4.31%, body mass index (BMI)=28.95±2.01) were randomly selected from 86 healthy obese female (BMI > 25). The subjects were randomly assigned to a control group (CG, n=13) and training group (TG, n=13). Body weight, percent body fat, fat weight, BMI, total cholesterol, triglyceride, high density lipoprotein cholesterol and low density lipoprotein cholesterol and correlation between them were measured. TG exercised with selected exercise with 70–80% maximum heart rate and diet in 10 weeks period of training. A total of energy expenditure through exercise and diet was about 3200 kcal per week. In TG, significant improvement (p