the prevalence of non-communicable diseases is increasing worldwide. Multimorbidity and long-term medical conditions is common among these patients. this study aimed to investigate the patterns of non-communicable disease multimorbidity and their risk factors at the individual and aggregated level. Data was inquired from the nationwide survey performed in 2011, according to the WHO stepwise approach on NCD risk factors. A latent class analysis on multimorbidity components (11 chronic diseases) was performed and the association of some individual and aggregated risk factors (urbanization) with the latent subclasses was accessed using multilevel multinomial logistic regression. Latent class analysis revealed four distinct subclasses of multimorbidity among the iranian population (10069 participants). Musculoskeletal diseases and asthma classes were seen in both genders. In males, the odds of membership in the diabetes class was 41% less by increasing physical activity; but with increased BMI, the odds of membership in the diabetes class was 1.90 times higher. Tobacco smoking increased the odds of membership in the musculoskeletal diseases class, 1.37 and 2.30 times for males and females, respectively. Increased BMI and low education increased the chances of females' membership in all subclasses of multimorbidity. At the province level, with increase in urbanization, the odds of membership in the diabetes class was 1.28 times higher among males (P = 0.027). Increased age, higher BMI, tobacco smoking and low education are the most important risk factors associated with ncD multimorbidity among iranians. interventions and policies should be implemented to control these risk factors.The World Health Organization (WHO) global status report on non-communicable diseases (NCDs) in 2014 reported that NCDs are globally the leading cause of death 1 . In 2016, NCDs killed 287000 people in Iran and the number of NCD related deaths and disability-adjusted life years (DALYs) have increased during the past decades. In just 2016, 6.5 million years of life loss (YLLs), and 8.2 million years of disability (YLDs) were attributed to NCDs in Iran 2 . According to 2017 reports, in the past 20 years, NCD mortality has risen by 14.5%, in Iran; and an adult Iranian's probability of dying prematurely (between 30 and 70 years) from one of the four main NCDs was 17% 3 .A systematic review in WHO Eastern Mediterranean countries in 2013 showed that the high mortality of NCDs is partially related to their multimorbidity 4 . More than half of the adults with NCDs have multimorbidity or multiple concurrent morbid conditions, and not one single chronic disease 5 .The prevalence of multimorbidity is increasing worldwide 6 . NCD multimorbidity affects more young people in low-and middle-income countries. The mean prevalence of multimorbidity was 7.8% in 28 developing open Scientific RepoRtS | (2020) 10:3034 | https://doi.org/10.1038/s41598-020-59668-y www.nature.com/scientificreports www.nature.com/scientificreports/ countries in 2015 7 . NCD multimor...

Lung cancer is the most rapidly increasing malignancy worldwide with an estimated 2.1 million cancer cases in the latest, 2018 World Health Organization (WHO) report. The objective of this study was to investigate the association of air pollution and lung cancer, in Tehran, Iran. Residential area information of the latest registered lung cancer cases that were diagnosed between 2014 and 2016 (N = 1,850) were inquired from the population-based cancer registry of Tehran. Long-term average exposure to PM10, SO2, NO, NO2, NOX, benzene, toluene, ethylbenzene, m-xylene, p-xylene, o-xylene (BTEX), and BTEX in 22 districts of Tehran were estimated using land use regression models. Latent profile analysis (LPA) was used to generate multi-pollutant exposure profiles. Negative binomial regression analysis was used to examine the association between air pollutants and lung cancer incidence. The districts with higher concentrations for all pollutants were mostly in downtown and around the railway station. Districts with a higher concentration for NOx (IRR = 1.05, for each 10 unit increase in air pollutant), benzene (IRR = 3.86), toluene (IRR = 1.50), ethylbenzene (IRR = 5.16), p-xylene (IRR = 9.41), o-xylene (IRR = 7.93), m-xylene (IRR = 2.63) and TBTEX (IRR = 1.21) were significantly associated with higher lung cancer incidence. Districts with a higher multiple air-pollution profile were also associated with more lung cancer incidence (IRR = 1.01). Our study shows a positive association between air pollution and lung cancer incidence. This association was stronger for, respectively, p-xylene, o-xylene, ethylbenzene, benzene, m-xylene and toluene.

Background:School bullying, the most common type of school violence, comprises a spectrum of aggressive behaviors that involve both perpetrators and victims.Objectives:The current study aimed to investigate the extent and nature of school bullying among middle school students in the North of Iran.Patients and Methods:A cross-sectional study was conducted on a sample of 834 Iranian middle school students. Participants completed a self-report anonymous questionnaire measuring bullying and victimization (Iranian-Olweus bullying questionnaire). Descriptive statistics and the Pearson's chi-squared test and multinomial logistic regressions with area, gender and grade variables were applied.Results:Prevalence rates of bullying behaviors based on the cut-off point at 2 or 3 times a month were 5.4% for only bully, 22.1% for only victim and 11% for both bully-victim. The prevalence of each form of victimization were 24.7% verbal, 15% relational, 10.3% physical and for each form of bullies 11% verbal, 5.3% relational, 6.4% physical. Boys were more involved in all forms of bullying behaviors. The students from rural areas were more involved in bullying .The most common places of victimization were the playground or athletic fields. The majority of victims were bullied by their classmates.Conclusions:Different forms of bullying have a distinct nature and the epidemiological pattern indicates that bullying exists in the Iranian schools. Thus, the effective bullying prevention and appropriate intervention programs are recommended.

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