Functional analysis and clinical classification of 462 germline BRCA2 missense variants affecting the DNA binding domain.

Variants of uncertain significance (VUSs) in BRCA2 are a common result of hereditary cancer genetic testing. While more than 4,000 unique VUSs, comprised of missense or intronic variants, have been identified in BRCA2, the few missense variants now classified clinically as pathogenic or likely pathogenic are predominantly located in the region encoding the C-terminal DNA binding domain (DBD). We report on functional evaluation of the influence of 462 BRCA2 missense variants affecting the DBD on DNA repair activity of BRCA2 using a homology-directed DNA double-strand break repair assay. Of these, 137 were functionally abnormal, 313 were functionally normal, and 12 demonstrated intermediate function. Comparisons with other functional studies of BRCA2 missense variants yielded strong correlations. Sequence-based in silico prediction models had high sensitivity, but limited specificity, relative to the homology-directed repair assay. Combining the functional results with clinical and genetic data in an American College of Medical Genetics (ACMG)/Association for Molecular Pathology (AMP)-like variant classification framework from a clinical testing laboratory, after excluding known splicing variants and functionally intermediate variants, classified 431 of 442 (97.5%) missense variants (129 as pathogenic/likely pathogenic and 302 as benign/likely benign). Functionally abnormal variants classified as pathogenic by ACMG/AMP rules were associated with a slightly lower risk of breast cancer (odds ratio [OR] 5.15, 95% confidence interval [CI] 3.43-7.83) than BRCA2 DBD protein truncating variants (OR 8.56, 95% CI 6.03-12.36). Overall, functional studies of BRCA2 variants using validated assays substantially improved the variant classification yield from ACMG/AMP models and are expected to improve clinical management of many individuals found to harbor germline BRCA2 missense VUS.

The effects of L-carnitine supplementation on inflammation, oxidative stress, and clinical outcomes in critically Ill patients with sepsis: a randomized, double-blind, controlled trial.

BACKGROUND: Sepsis, a life-threatening organ dysfunction caused by a host's dysregulated response to infection with an inflammatory process, becomes a real challenge for the healthcare systems. L-carnitine (LC) has antioxidant and anti-inflammatory properties as in previous studies. Thus, we aimed to determine the effects of LC on inflammation, oxidative stress, and clinical parameters in critically ill septic patients. METHODS: A randomized double-blinded controlled trial was conducted. A total of 60 patients were randomized to receive LC (3 g/day, n = 30) or placebo (n = 30) for 7 days. Inflammatory and oxidative stress parameters (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), superoxide dismutase (SOD), malondialdehyde (MDA), total antioxidant capacity (TAC), 28-day mortality rate, and some monitoring variables were evaluated. RESULTS: There was no statistically significant difference between study arms in baseline characteristics and disease severity scores. CRP (p < 0.001) and ESR (p: 0.004) significantly reduced, and SOD (p < 0.001) and TAC (p < 0.001) significantly improved in the LC group after 7 days. Between-group analysis revealed a significant reduction in CRP (p: 0.001) and serum chloride (p: 0.032), an increase in serum albumin (p: 0.036) and platelet (p: 0.004) significantly, and an increase in SOD marginally (p: 0.073). The 28-day mortality rate was also lower in the LC group compared with placebo (7 persons vs. 15 persons) significantly (odds ratio: 0.233, p: 0.010). CONCLUSIONS: L-carnitine ameliorated inflammation, enhanced antioxidant defense, reduced mortality, and improved some clinical outcomes in critically ill patients with sepsis. TRIAL REGISTRATION: IRCT20201129049534N1; May 2021.

Comparison of different corneal imaging modalities using artificial intelligence for diagnosis of keratoconus: a systematic review and meta-analysis.

PURPOSE: This review was designed to compare different corneal imaging modalities using artificial intelligence (AI) for the diagnosis of keratoconus (KCN), subclinical KCN (SKCN), and forme fruste KCN (FFKCN). METHODS: A comprehensive systematic search was conducted in scientific databases, including Web of Science, PubMed, Scopus, and Google Scholar based on the PRISMA statement. Two independent reviewers assessed all potential publications on AI and KCN up to March 2022. The Critical Appraisal Skills Program (CASP) 11-item checklist was used to evaluate the validity of the studies. Eligible articles were categorized into three groups (KCN, SKCN, and FFKCN) and included in the meta-analysis. The pooled estimate of accuracy (PEA) was calculated for all selected articles. RESULTS: The initial search yielded 575 relevant publications, of which 36 met the CASP quality criteria and were included in the analysis. Qualitative assessment showed that Scheimpflug and Placido combined with biomechanical and wavefront evaluations improved KCN detection (PEA, 99.2, and 99.0, respectively). The Scheimpflug system (92.25 PEA, 95% CI, 94.76-97.51) and a combination of Scheimpflug and Placido (96.44 PEA, 95% CI, 93.13-98.19) had the highest diagnostic accuracy for the detection of SKCN and FFKCN, respectively. The meta-analysis outcomes showed no significant difference between the CASP score and accuracy of the publications (all P > 0.05). CONCLUSIONS: Simultaneous Scheimpflug and Placido corneal imaging methods provide high diagnostic accuracy for early detection of keratoconus. The use of AI models improves the discrimination of keratoconic eyes from normal corneas.

Downregulation of miR-211 expression in the blood plasma of infertile men compared to the fertile controls.

OBJECTIVES: Infertility is inability to conceive after 12 months of regular unprotected sex. MiRNA expression changes can serve as potential biomarkers for infertility in males due to impaired spermatogenesis. This research was conducted to measure the expression level of miR-211 in plasma samples as a factor identifying infertility in comparison with the control group. METHODS: In this study, blood plasma were taken from the infertile men (n = 103) nonobstructive azoospermia (NOA) or severe oligozoospermia (SO) and the control group (n = 121). The expression of circulating miR-211 in plasma was assessed by qRT-PCR. A relative quantification strategy was adopted using the 2-ΔΔCT method to calculate the target miR-211 expression level in both study groups. RESULTS: Plasma miR-211 levels were significantly lower in infertile men compared to the control group (0.544 ± 0.028 and 1.203 ± 0.035, respectively, p < 0.001). Pearson's correlation analysis showed that miR-211 expression level has a positive and significant correlation with sperm parameters, including sperm concentration, sperm total motility, progressive motility, and normal morphology (p < 0.001). CONCLUSIONS: Decreased expression of miR-211 in blood plasma seems to be associated with male infertility. This experiment showed that miR-211 can be considered as a biomarker for evaluation, diagnosis, and confirmation of the results of semen analysis in male infertility.

The role of endothelial growth factor and tear levels in diabetic retinopathy in type 2 diabetes.

PURPOSE: To evaluate the tear level of VEGF and the quantity of tear film in type 2 diabetic patients. METHODS: Thirty patients with diabetic retinopathy (DR group) and 30 patients with no DR (NDR group), and 30 healthy subjects with age and gender matching were enrolled in this prospective comparative study. The tear samples were collected using the Schirmer strips, and the amount of moisture absorbed by the strips was used to determine the quantitative level of the tear film. The concentration of VEGF in the tear samples was measured using the enzyme-linked immunosorbent assay method. The variables were compared with an independent t-test and covariance analysis. RESULTS: Mean tear level of VEGF was significantly higher in DR group (235.42 pg/ml) compared to NDR (75.11 pg/ml) and control (58.77 pg/ml) groups (P ≤ 0.001). There was no significant difference in the mean of VEGF between NDR and control patients (P = 1.00). Mean quantitative tear film levels were 7.15%, 9.72%, and 15.11% in DR, NDR, and healthy subjects, respectively (P < 0.05). The pairwise analysis showed significant differences in the level of VEGF between DR and both NDR (P = 0.001) and normal (P = 0.017) groups. However, there was no significant difference observed between NDR and normal eyes (P = 0.743). CONCLUSION: The VEGF level in tear was higher in diabetic patients with DR, independent of tear volume. The tear VEGF measurement can be used as a valuable predictor to prevent DR in diabetic patients.

Latent class of depressive symptoms of and its determinants: A cross-sectional study among Iranian University students.

Background: According to the report of the World Health Organization, mental disorders are one of the 10 most important causes of disability in the world. This study was conducted with the aim of determining the number and frequency of latent classes of depression and its determinants in Isfahan university of medical students. Materials and Methods: A total of 1408 medical students from Isfahan University of Medical Sciences, Iran, were enrolled in the study in 2017. The symptoms and severity of depression were assessed using the standard Hospital Anxiety and Depression scale questionnaire. Latent class analysis was applied to seven symptoms of depression, all of which had four levels. Latent class subgroups were compared using the Chi-square test and analysis of variance test. The regression model was used to check the relationship between identified classes and related factors. Analyzes were done using SPSS-21 and Mplus7 software. Results: In this study, three latent classes were identified, that is, the group of healthy people, the group of borderline people, and the group of people suspected of depression. The prevalence of identified latent classes among medical students is 0.52, 0.32, and 0.16%, respectively. The regression results showed that compared to the healthy group, the factors affecting depression in the borderline and suspicious group were increasing age, female gender, interest in the field of study, physical activity, history of depression, and history of anxiety. Conclusion: The three classes that were identified based on the students' answers to the depression symptoms questions differed only based on severity. The history of depression and anxiety were the strongest predictors of latent classes of depression.

Clinicopathological significance and prognostic role of LAG3 + tumor-infiltrating lymphocytes in colorectal cancer; relationship with sidedness.

BACKGROUND: It is well-documented that the interplay between tumor-infiltrating lymphocytes (TILs) and tumor cells is a major determining factor in cancer progression. CD45RO seems to be a reliable indicator for predicting prognosis and disease outcome, along with CD3 and CD8 markers. LAG-3 is another important marker that overexpresses on TILs in a variety of cancers and is associated with disease prognosis; however, its prognostic impact is controversial. Hence, in the present study, we aimed to investigate the presence of CD45RO + , LAG3 + , CD3 + , and CD8 + lymphocytes in CRC tumor tissues and their association with clinicopathological parameters of the disease as well as patients' survival, according to primary tumor locations. METHODS: Expression of CD45RO, LAG3, CD3, and CD8 was immunohistochemically assessed in tissue sections of 136 patients with CRC. The percentages of TILs expressing these markers were then separately determined in both invasive margin (IM) and center of tumor (CT). Their associations with clinicopathological factors and patients' survival were analyzed in the entire cohort and the subgroups of patients with right- and left- rectum tumors. RESULTS: Based on our observation, CD45RO + and CD3 + cells were the most frequent infiltrated lymphocytes in both CT and IM regions of colon tumor tissue. Whilst, LAG3 + lymphocytes were the least frequent subset in both areas. Statistical analysis indicated that the frequency of CD45RO + TILs was positively associated with advanced TNM stages (III/IV), in the entire cohort and right-sided tumors (P < 0.05). LAG3 + TILs in IM were also increased in tumor tissues with higher T-stages in the entire cohort (P = 0.027). In univariate analysis, high score of CD45RO + TILs in IM was associated with better overall survival in the entire cohort. High score of CD8 + and CD45RO + lymphocytes in IM were also associated with improved survival in patients with right-sided tumors. CONCLUSIONS: Our findings generally suggest that the clinicopathological and prognostic significance of immune system-related markers such as CD45RO and LAG3 depends on the primary tumor sides. Our results collectively demonstrated that infiltration of CD45RO + lymphocytes in IM could be an independent prognostic factor in a site-dependent manner.

Association of omega-6 polyunsaturated fatty acids with blood pressure: A systematic review and meta-analysis of observational studies.

OBJECTIVES: This systematic review and meta-analysis aimed at summarizing earlier findings on the association of n-6 PUFAs levels in diets or blood with blood pressure. METHODS: PubMed/Medline, Scopus, and Web of Science were searched for observational studies. Publications with data on the risk of hypertension, or the correlation between n-6 PUFAs or mean values of serum n-6 PUFAs levels in normotensive and hypertensive were included. RESULTS: Twenty-two studies (16 cross-sectional studies, 5 cohorts and one case-control) were eligible. Combining 14 extracted effect sizes showed that higher circulatory/dietary n-6 PUFAs tended to be associated with 10% lower risk of HTN (95% CI: 0.81, 1.00), whereas combining 23 effect sizes illustrated no difference in circulatory/dietary n-6 PUFAs mean levels between normotensive and hypertensive subjects. According to subgroup analysis based on fatty acid types, total n-6 PUFAs (OR = 0.82, 95% CI: 0.70, 0.97) and linoleic acid (OR = 0.56, 95% CI: 0.39, 0.82) were inversely related to the risk of HTN. Circulatory/dietary n-6 PUFAs were correlated neither with systolic nor with diastolic blood pressure. CONCLUSIONS: Higher circulatory/dietary n-6 PUFAs tend to be associated with lower odds of HTN. Particularly, total n-6 PUFAs and linoleic acid were associated with lower risk of HTN.

Associations between empirically derived dietary patterns and oxidative stress and inflammation in adults with primary hypothyroidism: a case-control study.

BACKGROUND: Primary hypothyroidism is a common endocrine disorder caused by impaired production of thyroid hormones. Recent studies have shown that dietary habits, oxidative stress, and inflammation may play roles in thyroid hypofunction. Thus, the present article aimed to determine the relationship between major dietary patterns and oxidative stress and inflammation in primary hypothyroid patients and healthy people in Iranian adults. METHODS: This matched case-control study was conducted on 200 participants (100 cases and 100 controls). The presence of primary hypothyroidism was determined by endocrinologists based on American Thyroid Association (ATA) criteria. Dietary intake was assessed using a validated 168-item, semi-quantitative food frequency questionnaire (FFQ). The principal component analysis (PCA) method was used to derive major dietary patterns. Statistical analysis was performed using logistic regression analysis, and the findings were reported using odds ratios (ORs) with 95% CIs. RESULTS: We identified 2 major dietary patterns (i.e., healthy and Western dietary patterns). After adjusting for confounding variables, participants in the highest tertile of the healthy eating pattern had lower odds of primary hypothyroidism. Also, there was a significant relationship between total antioxidant capacity (TAC) levels and thyroid hypofunction; however, no significant correlation was seen between the Western dietary pattern and malondialdehyde (MDA) and C-reactive protein (CRP) with hypothyroidism. CONCLUSIONS: There were statistically direct associations between healthy dietary patterns (loaded with vegetables, nuts and seeds, fruits, dried fruits, olives, garlic, black pepper, starchy vegetables, low-fat dairy, and legumes) and increased TAC levels with a decreased risk of thyroid hypofunction. However, Western dietary patterns and MDA and CRP levels did not associate with an underactive thyroid.

The effect of a low renal acid load diet on blood pressure, lipid profile, and blood glucose indices in patients with type 2 diabetes: a randomized clinical trial.

BACKGROUND: Observational studies have reported that dietary renal acid load has an important role in insulin resistance and metabolic factors. The aim of the present study was to assess the effect of a low renal acid load diet (LRALD) on blood pressure, lipid profile, and blood glucose indices in patients with type 2 diabetes. METHODS: In this parallel randomized clinical trial, 80 patients with type 2 diabetes were randomly assigned to the LRALD (n = 40) or control (n = 40) groups, for 12 weeks. Both groups received a balanced diet and a list of nutritional recommendations based on healthy eating behaviors. In the LRALD group, food items with low renal acid load were prescribed. Primary outcomes including: fasting blood glucose (FBG), hemoglobin A1c (HbA1c), fasting serum insulin, quantitative insulin sensitivity check index (QUICKI), homeostatic model assessment for insulin resistance (HOMA) and secondary outcomes including: weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL). were measured at baseline and end of the study. The present trial was registered at IRCT.ir (IRCT20130903014551N5). RESULTS: Seventy subjects completed the study (n = 35 in control group and n = 36 in LRALD). Weight (P < 0.001), body mass index (P < 0.001), FBG (P < 0.001), HbA1c (P < 0.001), SBP (P = 0.004), and TG (P = 0.049) were reduced and HDL (P = 0.002) was increased in both groups, compared with baseline. After adjusting for baseline values, DBP (P = 0.047) was reduced in the LRALD group compared with control group. Results had no changes after using intention to treat analysis. CONCLUSION: A LRALD may decrease DBP in type 2 diabetic patients. However, it elicited no significant effect on lipid profile compared with a healthy diet. TRIAL REGISTRATION: This randomized clinical trial was registered at IRCT.ir (IRCT20130903014551N5).

Association of AXIN1 rs12921862 C/A and rs1805105 G/A and CTSB rs12898 G/A polymorphisms with papillary thyroid carcinoma: A case-control study.

BACKGROUND: Papillary thyroid cancer (PTC) is the most common type of thyroid cancer which its precise etiology remains unknown. However, environmental and genetic factors contribute to the etiology of PTC. Axis inhibition protein 1 (Axin1) is a scaffold protein that exerts its role as a tumor suppressor. In addition, Cathepsin B (Ctsb) is a cysteine protease with higher expression in several types of tumors. Therefore, the aim of this study was to investigate the possible association of AXIN1 rs12921862 C/A and rs1805105 G/A and CTSB rs12898 G/A polymorphisms with PTC susceptibility. MATERIALS & METHODS: In total, 156 PTC patients and 158 sex-, age-, and BMI-matched control subjects were enrolled in the study. AXIN1 rs12921862 C/A and rs1805105 G/A and CTSB rs12898 G/A polymorphisms were genotyped using the PCR-RFLP method. RESULTS: There was a relationship between AXIN1 rs12921862 C/A polymorphism and an increased risk of PTC in all genetic models except the overdominant model. The AXIN1 rs1805105 G/A polymorphism was associated with an increased PTC risk only in codominant and overdominant models. The frequency of AXIN1 Ars12921862 Ars1805105 haplotype was higher in the PTC group and also this haplotype was associated with an increased risk of PTC. Moreover, the AXIN1 rs12921862 C/A polymorphism was not associated with PTC clinical and pathological findings, but AXIN1 rs1805105 G/A polymorphism was associated with almost three folds of larger tumor size (≥1 cm). There was no association between CTSB rs12898 G/A polymorphism and PTC and its findings. CONCLUSION: The AXIN1 rs12921862 C/A and rs1805105 G/A polymorphisms were associated with PTC. AXIN1 rs1805105 G/A polymorphism was associated with higher tumor size.

The possible impact of DNA-binding chromodomain-helicase 5 polymorphisms on male infertility: A case-control study.

BACKGROUND: Chromodomain-helicase 5 (CHD5) is a conventional tumor-suppressing gene in many tumors. The CHD5 gene, as a key factor in the chromatin density process during sperm maturation, can affect the risk of infertility. This study aimed to determine whether CHD5 variants contribute to the risk of male infertility. METHODS: Gene variants were identified using tetra primer-ARMS-PCR method on nonobstructive azoospermia and severe oligozoospermia in a case-control study. SPSS software 20 (SPSS Inc. Chicago, IL, USA) was used for data recording and statistical analysis. RESULTS: In the codominant pattern, the rs12067480 TT variant versus CC significantly increased the risk of disease, and also, in the recessive pattern, TT variant versus CC + CT and T allele versus C. The rs2273032 variant was associated with the risk of infertility in codominant pattern AA versus GG and recessive pattern AA versus GG + GA and allele. We discovered that the rs12067480 T and rs2273032 A alleles increase the risk of male infertility. Also, the interaction of the CT/GA, CT/AA, TT/GA genotypes and rs12067480T/rs2273032A and rs12067480T/rs2273032G haplotypes significantly increased the risk of infertility. CONCLUSIONS: Our results suggest that the CHD5 gene polymorphisms contribute to the risk of male infertility. Our findings can be valuable in improving the diagnosis and treatment of infertility.

The role of antral histopathology in diagnosing paediatric celiac disease.

The aim of this study was to evaluate the diagnostic potential of gastric antrum histology in children suspected of having celiac disease (CD). The present retrospective study was performed on 224 patients who were suspected of having CD and had several duodenal and one gastric antrum biopsies. They were divided into 2 groups based on the definite diagnosis of CD. The statistical analysis was performed using SPSS version 22 software. Receiver operating characteristic (ROC) curves were drown and the area under the curves (AUCs) was calculated. Article authorized by the Editor-in-Chief. Based on MARSH criteria, out of 224 patients, 124 were diagnosed as definite CD and 100 patients comprised the non-celiac group. The AUC for the mean of all pathological tests was estimated to be 0.90 (p < 0.001). The pooled AUC for the combination of 3 pathologic findings with the highest AUCs (cell, crypt, and gland size) was estimated to be 0.89 (p < 0.001). We observed that the histological changes we found in the gastric antrum were identical to those found in the duodenum of paediatric CD patients. Because providing a biopsy from the gastric antrum is easier than getting multiple biopsies from the duodenum, we suggest using the criteria mentioned in this study in other studies with larger sample sizes.

Human health risk assessment of Triclosan in water: spatial analysis of a drinking water system.

Triclosan (TCS) has been increased in the water during the COVID-19 pandemic because it cannot remove by conventional water treatment. In addition, it can accumulate in the human body over time through long-term exposure. Therefore, the occurrence of TCS in the water treatment plant (WTP) and tap water, and its human health risk assessment through tap water ingestion, dermal absorption, and inhalation routes in Isfahan, Iran, were investigated. Moreover, spatial regression methods were used for the prediction of water quality parameters, TCS concentration, and total hazard quotient (HQ). The average TCS concentration in the influent and effluent of WTP and tap water was 1.6, 1.4, and 0.4 µg/L, respectively. Conventional WTP has low efficiency in the removal of TCS (12.6%) from water. The average values of total HQ for males were 7.79×10-5, 4.97×10-4, and 4.97×10-5 and for females were 3.31×10-5, 2.11×10-4, and 2.11×10-5 based on RfDEPA, RfDMDH, and RfDRodricks, respectively that were in the low-risk levels (HQ<1). Furthermore, TCS concentration in tap water and the ingestion rate of drinking water had the highest effect on the risk of TCS exposure from tap water. The non-carcinogenic health risk of TCS in water was low. The results of this study may be useful for promoting WTP processes to remove emerging pollutants.

Vector analysis of astigmatism correction after PRK, FS-LASIK, and SMILE for myopic astigmatism.

PURPOSE: To compare astigmatic correction among photorefractive keratectomy (PRK), femtosecond laser-assisted in situ keratomileusis (FS-LASIK), and small-incision lenticule extraction (SMILE). METHODS: This prospective study enrolled 157 eyes that underwent three procedures (59 PRK, 47 FS-LASIK, and 51 SMILE) for the treatment of myopia with low to high astigmatism (- 0.25 to - 4.50 D). Ocular residual astigmatism (ORA) was calculated by vector analysis using refractive (RA) and corneal astigmatism. Vector analysis results were compared in different procedures in the two RA groups (low ≤ 1.00 D and high > 1.00 D) at 3 and 12 months postoperatively. RESULTS: There were no significant between-group differences in postoperative safety and efficacy outcomes (all P > 0.05). No significant differences were found in postoperative cylinders between all surgical groups (all p > 0.05), except for 3 months postoperative ORA in FS-LASIK (P = 0.004). At 12 months, 77%, 59.2%, and 50% of eyes attain emmetropia in the FS-LASIK, SMILE, and PRK groups, respectively. Vector analysis showed comparable values for surgical induced astigmatism, target induced astigmatism, mean error, and angle of error between groups at 12 months. Significant differences were observed only in the correction index and difference vector parameters in the astigmatic > 1.00 D group at 3 months (P < 0.001), and FS-LASIK was preferable. CONCLUSIONS: One-year outcomes revealed that PRK, FS-LASIK, and SMILE were all equally effective in correcting myopic astigmatism. However, FS-LASIK demonstrated more favorable astigmatism correction in eyes with astigmatism > 1.00D in early postoperatively.

Best indices of dual Scheimpflug/Placido tomographer for keratoconus detection.

PURPOSE: To evaluate the accuracy of different corneal parameters in detecting keratoconus using a dual Scheimpflug/Placido system (Sirius, CSO, Italy). METHODS: Sixty-eight eyes of 68 keratoconus patients and 77 eyes of 77 normal subjects were prospectively assessed in a diagnostic test study. The mean differences of the corneal parameters were compared using the independent t-test. The accuracy of curvature, elevation, pachymetry, and aberrometry indices, aqueous depth, and corneal volume in 10 mm was evaluated using the area under the curve (AUC), and the DeLong method was used for the comparison of AUCs. Multiple tests in a parallel manner and multiple logistic regression analysis were applied to determine the best predictor indices. RESULTS: All indices except aqueous depth and corneal volume were significantly different between the two groups (P < 0.001). Back keratoconus vertex (KVb) and front Baiocchi-Calossi-Versaci index (BCVf) had the highest sensitivity (for both 98.53%) followed by front symmetry index (SIf) (96.12%) and thinnest point of the cornea (88.24%) in elevation, aberrometry, curvature, and pachymetry parameters, respectively. The highest diagnostic ability was observed in KVb (AUC 0.993) and BCVf index (AUC 0.992) (DeLong > 0.05). Multiple test analysis showed a combination of indices with the highest accuracy that was similar to the performance of each one individually, and keratoconus was diagnosed correctly in 98.5% of the cases (R2 = 93%). CONCLUSION: The parameters extracted from Sirius can differentiate keratoconus from normal corneas with high accuracy without the need for complex computational algorithms. Elevation-based and combined aberrometry indices had the highest diagnostic power.

Epidemiology of emotional and psychological problems in Iranian children: Protocol of a cross-sectional study in Isfahan.

Background: The present study aimed at providing comprehensive epidemiological data about the prevalence of psychological and emotional problems in a representative sample of Iranian children and evaluates the major and common determinants of parents and family environment of these problems. Materials and Methods: The epidemiology of emotional and psychological problems in Iranian children is a cross-sectional study was conducted on 786 families and their 800 children during 2019-2021 in Isfahan, Iran. Personality traits, psychological health, marital satisfaction, individual's perceptions of his/her family and quality of life of parents were evaluated using Iranian-validated questionnaires. Various aspects of emotional, general, psychological, and sleep health as well as physical activity levels and nutritional habits of children also have been assessed using Iranian validated instruments. Data on sociodemographic characteristics representing parents and family status also have been collected. Results: The mean age of parents and children was 39.5 ± 5.5 and 10.20 ± 1.90 (years), respectively. The mean duration of marriage was 16.1 ± 5.1 years and majority of parents his or her wife were at bachelor degree while parents with other degrees of education were sufficiently available in our study. The participated children were nearly equally distributed in terms of gender. A large portion (81.9%) of questionnaires about children was filled by mothers. Majority of children (62.2%) were first birth order. Conclusion: The current study provides comprehensive data about various psychological, emotional, and educational problems of Iranian children and new insights about family environment and parental interrelationship as key risk factors for the aforementioned problems in which may have implications for both clinical and preventive psychological health to improve individual educational and treatment efficacy and problem-solving in problematic children.

Impact of molar incisor hypomineralization on oral health-related quality of life in 8-10 years old children: A systematic review and meta-analysis.

OBJECTIVES: This study aimed to evaluate the impact of molar incisor hypomineralization (MIH) and its different severities on various aspects of oral health-related quality of life (OHRQoL) in children between 8 and 10 years of age. DATA SOURCES: The search terms were chosen according to the Medical Subject Headings (MeSH) and non-MeSH. Potentially eligible studies involved the OHRQoL evaluation in 8-10 years old children with MIH. An electronic search of published studies was carried out in August 2022 on Scopus, Web of Science, and PubMed databases. Of 130 papers retrieved initially, 21 were eligible to be included in the systematic review, of which 8 were excluded. The OHRQoL questionnaires used in the studies included Caregivers Perceptions Questionnaire (CPQ) 8-10, Child Oral Health Impact Profile questionnaire, and Child Oral Impacts on Daily Performances questionnaire. Nine studies using CPQ8-10 contributed to the meta-analysis. RESULTS: According to meta-analysis, the results revealed that in MIH children a significant increase was observed in the total score of CPQ 810 with the pooled mean of 15.89 (95% confidence interval [CI]:8.95-22.84; P-value = .001) and in oral symptoms, functional limitation and emotional well-being domains with the pooled means of 6.25 (95% CI:4.01-8.50; P-value = .001), 3.88 (95% CI:1.93-5.83; P-value = 0.001), and 3.24 (95% CI:0.96-5.52; P-value = .01), respectively. While the increase in social well-being with the pooled mean of 1.65 (95% CI: -0.47 to 3.76; P-value = .13) was not significant. Subgroup analysis based on MIH severity showed no significant difference in OHRQoL means for all variables. CONCLUSION: Suffering from MIH, negatively affected the total score and all domains of the CPQ 8-10 questionnaire, except for social well-being. Furthermore, different severities of MIH had no significant impact on OHRQoL in children.

Effects of inulin-type fructans with different degrees of polymerization on inflammation, oxidative stress and endothelial dysfunction in women with polycystic ovary syndrome: A randomized, double-blind, placebo-controlled trial.

OBJECTIVE: Polycystic ovary syndrome (PCOS) is associated with several cardiovascular risk factors. Prebiotics were proposed to beneficially affect risk factors associated with metabolic disorders. The aim of this study was to investigate and compare the effects of inulin-type fructans (ITFs), as well-studied prebiotics, with different degrees of polymerization, on markers of inflammation, oxidative stress and endothelial dysfunction in PCOS patients. DESIGN: A randomized, double-blind, placebo-controlled trial. PATIENTS: Seventy-five PCOS women were randomly assigned to receive 10 g/day of either high-performance inulin (HPI) or oligofructose-enriched inulin (OEI) or placebo for 12 weeks. MEASUREMENTS: Biochemical indices and blood pressure levelswere assessed before and after the intervention. RESULTS: In the intent-to-treat analysis, high-sensitive C-reactive protein (hs-CRP) decreased in HPI and OEI groups, over the 12 weeks, and the changes were significant in the HPI group, compared to placebo (changes from baseline in the HPI group: -0.11 vs. placebo group: 0.004 mg/L [conversion factor to SI units (nmol/L): 9/5238]; p = .007). Serum levels of nitric oxide (NO) increased, and endothelin-1 and total oxidant status decreased in HPI and OEI groups, at the end of the trial; however, these changes were not significantly compared to placebo (p = .07, .36 and .22, respectively). No differences in systolic and diastolic blood pressure were found. Per-protocol analysis (n = 68) yielded consistent results for all endpoints, with the exception that the significant effect of ITFs on serum hs-CRP levels in the unadjusted ITT analysis became nonsignificant in the per-protocol analysis (p = .06). CONCLUSION: A 12-week supplementation with long-chain ITFs had favourable effects on inflammatory status among PCOS patients.

Is there a relationship between dietary sodium and potassium intake and clinical findings of a migraine headache?

Few studies have assessed the association between sodium (Na) and potassium (K) and migraine headaches. In this study, we aimed to examine the relationship between 24-hour urine Na and K intakes and clinical findings of migraine in an Iranian sample. In this cross-sectional study, 262 participants, aged 20-50 years, were included with a body mass index (BMI) of 18·5-30 kg/m2 and a diagnosis of migraine. One 24-hour urine sample was collected from each subject to estimate the Na and K intakes. The clinical features of migraine, including frequency, duration, severity, Migraine Headache Index Score (MHIS), and Headache Impact Test (HIT) score, were assessed. Besides, a multiple linear regression analysis was performed, and beta estimates and the corresponding 95% confidence intervals (CIs) were reported. Overall, 224 women and 38 men, with a mean age of 36·10 years and BMI of 25·55 kg/m2 comprised our study population. After controlling for potential confounders, the 24-hour urine Na was positively associated with a longer headache duration (ß = 0·29; 95% CI: 0·06, 0·53) in the group with the highest urine Na levels as compared to the group with the lowest levels. After adjustments for potential confounders, an increase of 13·05 in the MHIS was observed when the 24-hour urine Na level increased from the first to the third tertile (ß = 13·05; 95% CI: 1·70, 24·41). Our findings suggested that a higher 24-hour urine Na level was positively associated with a longer duration of migraine headaches and a higher MHIS.