Abnormal multisensory temporal discrimination in Parkinson's disease.

Cognitive deficits are prevalent in Parkinson's disease (PD), ranging from mild deficits in perception and executive function to severe dementia. Multisensory integration (MSI), the ability to pool information from different sensory modalities to form a combined, coherent perception of the environment, is known to be impaired in PD. This study investigated the disruption of audiovisual MSI in PD patients by evaluating temporal discrimination ability between auditory and visual stimuli with different stimulus onset asynchronies (SOAs). The experiment was conducted with Fifteen PD patients and fifteen age-matched healthy controls where participants were requested to report whether the audiovisual stimuli pairs were temporal simultaneous. The temporal binding window (TBW), the time during which sensory modalities are perceived as synchronous, was adapted as the comparison index between PD patients and healthy individuals. Our results showed that PD patients had a significantly wider TBW than healthy controls, indicating abnormal audiovisual temporal discrimination. Furthermore, PD patients had more difficulty in discriminating temporal asynchrony in visual-first, but not in auditory-first stimuli, compared to healthy controls. In contrast, no significant difference was observed for auditory-first stimuli. PD patients also had shorter reaction times than healthy controls regardless of stimulus priority. Together, our findings point to abnormal audiovisual temporal discrimination, a major component of MSI irregularity, in PD patients. These results have important implications for future models of MSI experiments and models that aim to uncover the underlying mechanism of MSI in patients afflicted with PD.

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.

A Systematic Review and Meta-analysis of Rituximab-Associated Infections Among Children and Adolescents With Glomerular Disease: Focus on the Risk of Infections.

OBJECTIVE: This systematic review and meta-analysis aimed to explore rituximab (RTX) associated infectious complications in children with glomerular disease. METHODS: We performed an electronic search of PubMed, International Scientific Information (ISI), Scopus, and EMBASE between January 2010 and July 2021. Infection rates and total drug-related adverse events were the outcomes. Statistical heterogeneity was evaluated by using the I2 statistic. When there was statistical evidence of heterogeneity (I2 > 50%, p > 0.1), a random-effect model was adopted. Data analysis was performed with Stata17.0 software. RESULTS: A total of 7 studies with 668 patients (136 with lupus nephritis [LN] and 532 with nephrotic syndrome were included in the meta-analysis. The pooled risk ratio showed that the administration of RTX was significantly associated with lower risk of infectious complications in patients with LN and nephrotic syndrome (0.72 [95% CI 0.58, 0.85]) when compared with population data of patients without glomerular disease (p = 0.2). There was no significant difference between the LN and nephrotic syndrome groups in terms of total serious adverse events or the occurrence of infections. There was significant heterogeneity among the reported studies (Q = 42.39, p < 0.001, I2 = 81%). CONCLUSION: Administration of RTX in children with glomerular disease is associated with a lower rate of infections when compared with population data of patients without LN or nephrotic syndrome. Additional high-quality randomized controlled trials with long-term follow-up are needed to identify the long-term potential complications. Trial registration PROPERO ID: CRD42021274869 (https://www.crd.york.ac/prospero/display_record.php?).

Neural oscillatory characteristics of feedback-associated activity in globus pallidus interna.

Neural oscillatory activities in basal ganglia have prominent roles in cognitive processes. However, the characteristics of oscillatory activities during cognitive tasks have not been extensively explored in human Globus Pallidus internus (GPi). This study aimed to compare oscillatory characteristics of GPi between dystonia and Parkinson's Disease (PD). A dystonia and a PD patient performed the Intra-Extra-Dimension shift (IED) task during both on and off-medication states. During the IED task, patients had to correctly choose between two visual stimuli containing shapes or lines based on a hidden rule via trial and error. Immediate auditory and visual feedback was provided upon the choice to inform participants if they chose correctly. Bilateral GPi Local Field Potentials (LFP) activity was recorded via externalized DBS leads. Transient high gamma activity (~ 100-150 Hz) was observed immediately after feedback in the dystonia patient. Moreover, these bursts were phase synchronous between left and right GPi with an antiphase clustering of phase differences. In contrast, no synchronous high gamma activity was detected in the PD patient with or without dopamine administration. The off-med PD patient also displayed enhanced low frequency clusters, which were ameliorated by medication. The current study provides a rare report of antiphase homotopic synchrony in human GPi, potentially related to incorporating and processing feedback information. The absence of these activities in off and on-med PD patient indicates the potential presence of impaired medication independent feedback processing circuits. Together, these findings suggest a potential role for GPi's synchronized activity in shaping feedback processing mechanisms required in cognitive tasks.

Hybrid feature engineering of medical data via variational autoencoders with triplet loss: a COVID-19 prognosis study.

Medical machine learning frameworks have received much attention in recent years. The recent COVID-19 pandemic was also accompanied by a surge in proposed machine learning algorithms for tasks such as diagnosis and mortality prognosis. Machine learning frameworks can be helpful medical assistants by extracting data patterns that are otherwise hard to detect by humans. Efficient feature engineering and dimensionality reduction are major challenges in most medical machine learning frameworks. Autoencoders are novel unsupervised tools that can perform data-driven dimensionality reduction with minimum prior assumptions. This study, in a novel approach, investigated the predictive power of latent representations obtained from a hybrid autoencoder (HAE) framework combining variational autoencoder (VAE) characteristics with mean squared error (MSE) and triplet loss for forecasting COVID-19 patients with high mortality risk in a retrospective framework. Electronic laboratory and clinical data of 1474 patients were used in the study. Logistic regression with elastic net regularization (EN) and random forest (RF) models were used as final classifiers. Moreover, we also investigated the contribution of utilized features towards latent representations via mutual information analysis. HAE Latent representations model achieved decent performance with an area under ROC curve of 0.921 (±0.027) and 0.910 (±0.036) with EN and RF predictors, respectively, over the hold-out data in comparison with the raw (AUC EN: 0.913 (±0.022); RF: 0.903 (±0.020)) models. The study aims to provide an interpretable feature engineering framework for the medical environment with the potential to integrate imaging data for efficient feature engineering in rapid triage and other clinical predictive models.

Effects of whole grain intake on glucagon-like peptide 1 and glucose-dependent insulinotropic peptide: a systematic review and meta-analysis.

CONTEXT: Whole grain intake may control help glycemia and reduce food intake by affecting the secretion of glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP). OBJECTIVE: This systematic review and meta-analysis aimed to assess the postprandial and long-term effects of whole grains on GLP-1 and GIP levels. DATA SOURCES: PubMed, Web of Science, and Scopus online databases were searched systematically to identify relevant randomized clinical trials (RCTs) published up to April 2021. STUDY SELECTION: RCTs that evaluated the effects of whole grains, compared with refined grains, on the postprandial area under the curve (AUC) value, the postprandial serum concentration of incretins from 0 to 180 minutes, or the fasting level of incretins after at least 14 days of intervention were included. RESULTS: Nineteen studies were included in the meta-analysis. The results showed that acute intake of whole grains could not significantly change the AUC value of GLP-1 or GIP. However, the AUC value of GIP was reduced more significantly in (1) unhealthy participants (standard mean difference [SMD] -1.08; 95%CI, -2.07 to -0.10; I2 = 75.9%) compared with healthy participants, and (2) those with a baseline fasting blood glucose of ≥99 mg/dL (SMD -0.71; 95%CI, -1.30 to -0.11; I2 = 74.4%) compared with those with a baseline value of < 99 mg/dL. On the other hand, the results of time-response evaluation during 0 to 180 minutes after the intake of test meals showed that serum concentrations of GIP decreased significantly from 0 to 30 minutes (coefficient = -44.72; P = 0.005), but increased from 60 to 180 minutes (coefficient = 27.03; P = 0.005). However, long-term studies found no significant effects of whole grains on fasting concentrations of GLP-1 or GIP. CONCLUSION: Whole grain intake did not affect postprandial levels of GLP-1 but enhanced postprandial levels of GIP from 60 to 180 minutes. Further high-quality trials are required to assess the long-term effects of whole grain intake on serum levels of incretins. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42021256695.

Comparison of nutritional supplements for glycemic control in type 2 diabetes: A systematic review and network meta-analysis of randomized trials.

AIMS: Direct and indirect evidence were combined in this systematic-review and network meta-analysis (NMA) to assess and compare the effect of nutritional supplements on glycemic control, and rank the supplements accordingly. METHODS: PubMed, Scopus, and Web of Science were searched up to April 2021. We included randomized controlled trials that investigated the effect of vitamins D, C, and E, magnesium, zinc, calcium, selenium, and omega-3 on at least one glycemic marker, including glycated hemoglobin (HbA1c), fasting blood sugar (FBS), homeostasis model assessment-estimated insulin resistance (HOMA-IR), HOMA-B, and insulin, in adults with type 2 diabetes. To estimate effectiveness of supplements, a random-effects NMA in the Bayesian framework was applied. To assess risk of bias, Cochrane Collaboration Tool was used. RESULTS: Analysis of 178 studies indicated that zinc, vitamin D, omega-3, vitamin C, and vitamin E were effective in reducing HbA1c with low certainty. For reduction of FBS, zinc, vitamin D, and vitamin C, and for HOMA-IR, vitamin D were effective with low certainty. None of the supplements were effective in the reduction of insulin and HOMA-B with low certainty. After excluding poor-quality studies, only vitamin D was significantly effective in reducing all of the markers. Consistently, when the analysis was restricted to studies with a duration of ≥12-weeks, vitamin D reduced HbA1c, FBS, and HOMA-IR. CONCLUSIONS: Vitamin D supplementation was more effective compared to other supplements in improving HbA1c, FBS, and HOMA-IR, albeit with low certainty of evidence. This result was confirmed by low-risk of bias studies. REGISTRATION: CRD42021240691.

Patients' satisfaction with healthcare services providers and its determinants in the urban family physician program in Iran: A cross-sectional study.

Introduction: The quality of healthcare services can be determined by patient satisfaction as it affects the performance, sustainability, and durability of health services. This study aims to determine patients' satisfaction with healthcare service providers and its determinants in the urban family physician program in Fars and Mazandaran provinces, Iran. Methods: A cross-sectional study was conducted on the populations covered by the urban family physician program in Fars and Mazandaran provinces in 2016. In total, 864 households were selected in each province using random cluster sampling. Socio-demographic variables and underlying factors were gathered. Patient satisfaction levels were evaluated using a validated questionnaire. Results: Of the 1,480 participants with a mean age of 46.9 ± 14.2 years, 53.3% lived in Fars province and 74.2% were female. Furthermore, 67.9% of the patients were satisfied with their healthcare service providers. A higher satisfaction level was observed among the patients who resided in Fars province, lived in cities with <100,000 residents, walked <10 minutes to the family physician's office, had a family physician they previously knew, accepted the family physician, had a positive attitude towards the importance of having a family physician and a referral system, and had adequate knowledge of the family physician program. Conclusion: The results indicated that two-thirds of the patients were satisfied with healthcare service providers. Several socio-demographic variables were associated with the patients' satisfaction levels. Improving the family physician program by providing adequate medical equipment and monitoring physicians' performance could increase patient satisfaction and improve the sustainability of the program.

Effects of vitamin D-fortified oil intake versus vitamin D supplementation on vitamin D status and bone turnover factors: A double blind randomized clinical trial.

PURPOSE: The aim of this study was to compare the effect of vitamin D fortified oil consumption and vitamin D supplementation on serum 25-hydroxy vitamin D and bone turnover factors. METHODS: This study was a double-blind, parallel, randomized controlled clinical trial conducted over 12 weeks on 93 healthy participants aged 18-30 years. Participants were randomly allocated to 1 of the 3 groups: (a) supplement (a tablet of 1000 IU vitamin D supplement + 25 g canola oil daily, n = 31); (b) fortified oil (a placebo tablet + 25 g canola oil fortified with 1000 IU vitamin D daily, n = 30) and (c) control (a placebo tablet + 25 g canola oil, n = 32). Before and after the intervention 25-hydroxy vitamin D (25(OH)D1), parathyroid hormone (PTH2), bone alkaline phosphatase (BAP3) and collagen type 1 cross-linked C-telopeptide I (CTX4) were assessed. RESULTS: Serum 25(OH)D increased more in the vitamin D supplement group compared to the controls (P = 0.001). In addition, subgroup analysis revealed that just in the vitamin D sufficient subgroup, serum 25(OH)D increased more in both vitamin D supplement group and vitamin D fortified oil group, compared to the controls (P = 0.001 for both). The mean differences of PTH, BAP, and CTX were not significantly different among the study groups. CONCLUSION: Consumption of 1000 IU vitamin D per day for 12 weeks as a supplement or fortified oil could enhance the serum vitamin D in main population. However, the protective effect of vitamin D supplementation and oil fortification was seen just in vitamin D sufficient subgroup, not vitamin D deficient one. Besides, this dose of vitamin did not have a noticeable effect on bone turnover markers in this period. Registered under Iranian Registry of Clinical Trials (IRCT.ir) with ID number of: IRCT20180708040401N1.

Investigation of fused remote N-heterocyclic silylenes (frNHSis), at DFT.

We compared and contrasted the ΔΕs-t, band gap (ΔΕHOMO-LUMO), aromaticity, charge distribution, and reactivity of singlet (s) and triplet (t) benzopyridine-4-ylidene as the fused remote N-heterocyclic carbene (frNHC) and frNHSis with different fused aromatic rings, at (U)B3LYP/AUG-cc-pVTZ and (U)M06-2X/AUG-cc-pVTZ levels of theory. In this investigation, we found (1) all s and t divalent states appear as minimum structures, for having no negative force constant. Nonetheless, only singlets present more thermodynamic stability than their triplet analogous; (2) the trend of ΔΕs-t in kcal/mol is ortho-pyrrole (52.94) > ortho-furan (51.84) > ortho-thiophene (50.38) > para-furan (49.36) > para-pyrrole (49.00) > para-phosphole (48.67) ≥ para-thiophene (48.64) > benzene (44.33) > ortho-phosphole frNHSi (27.50), while ΔΕs-t of frNHC is 15.65 kcal/mol; (3) apart from phosphole frNHSis, the order of ΔΕs-t in a "ortho position or zigzag array" about 1.8-4.0 kcal/mol is more than that of in a "para position or chair array"; (4) the highest ΔΕHOMO-LUMO is demonstrated by ortho-pyrrole frNHSi (95.65 kcal/mol) while the lowest ΔΕHOMO-LUMO is verified by the reference frNHC (63.44 kcal/mol); (5) in contradiction of frNHC, all singlet frNHSis reveal higher band gap and lower global reactivity than their triplet congeners; (6) charge distribution along with MEP maps indicate differentially electronic cloud in middle of rings frNHSis vs. frNHC; (7) we anticipate higher nucleophilicity and lower electrophilicity of triplet frNHSis than singlet congeners, will make them worthy of synthetic surveys.

Molecular mechanisms underlying curcumin-mediated microRNA regulation in carcinogenesis; Focused on gastrointestinal cancers.

Curcumin is a bioactive ingredient found in the Rhizomes of Curcuma longa. Curcumin is well known for its chemopreventive and anti-cancer properties. Recent findings have demonstrated several pharmacological and biological impacts of curcumin, related to the control and the management of gastrointestinal cancers. Mechanistically, curcumin exerts its biological impacts via antioxidant and anti-inflammatory effects through the interaction with various transcription factors and signaling molecules. Moreover, epigenetic modulators such as microRNAs (miRNAs) have been revealed as novel targets of curcumin. Curcumin was discovered to regulate the expression of numerous pathogenic miRNAs in gastric, colorectal, esophageal and liver cancers. The present systematic review was performed to identify miRNAs that are modulated by curcumin in gastrointestinal cancers.

A comparative review of immunoassays for COVID-19 detection.

Introduction: The gold standard for diagnosis of coronavirus disease 2019 (COVID-19) is detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR), which is expensive, time-consuming and may result in false-negative results. Serological tests can be employed for RT-PCR negative patients, contact tracing, determining the probability of protection against re-infection, and seroepidemiological studies.Areas covered: The main methodologies of serology-based tests for the detection of SARS-CoV-2 including enzyme-linked immunosorbent assays (ELISAs), chemiluminescent immunoassays (CLIAs) and lateral flow immunoassays (LFIAs) were reviewed and their diagnostic performances were compared. Herein, a literature review on the databases of PubMed, Scopus and Google Scholar between January 1, 2020 and June 30, 2020 based on the main serological methods for COVID-19 detection with the focus on comparative experiments was performed. The review was updated on December 31, 2020.Expert opinion: Serology testing could be considered as a part of diagnostic panel two-week post symptom onset. Higher sensitivity for serology-based tests could be achieved by determining combined IgG/IgM titers. Furthermore, higher sensitive serological test detecting neutralization antibody could be developed by targeting spike (S) antigen. It was also demonstrated that the sensitivity of ELISA/CLIA-based methods are higher than LFIA devices.

Effect of Dietary Fiber on Serum Leptin Level: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Dietary fibers may induce satiety through affecting gastro-intestinal and peripheral appetite regulating hormones. Thus, we aimed to investigate the effect of dietary fiber consumption on serum leptin level compared to control diet, in short- and long- term trials, through a systematic review and meta-analysis. METHODS: We searched PubMed, web of science, Scopus, ProQuest, EMBASE, and Cochrane Library to find randomized controlled clinical trials that evaluated effect of any type of dietary fiber on serum leptin level compared to control diet, until April 2019. Both short-term (1-4 days) and long-term (longer than 2 weeks) studies were selected. Mean differences (MD) of changes in serum leptin level and 95% confidence intervals were extracted from eligible studies, and random effects model was used to analyze data. RESULTS: Thirteen studies included the systematic review and 11 entered in the meta-analysis. No significant change was seen in serum leptin level in short-term (MD=0.02, 95% CI; -0.15, 0.20, Tau2=0.0) and long-term studies (MD=-0.10, 95% CI; -0.28, 0.08, Tau2=0.0), followed by fiber consumption. However, this effect was statistically significant in obese participants (MD=-0.36, 95% CI; -0.71, -0.02, Tau2=0.0) in long-term studies. Moreover, we found no significant results in subgroups of baseline serum leptin level, intervention duration, fiber dose, and fiber type. CONCLUSIONS: This meta-analysis found that taking dietary fiber for long term could lower serum leptin level, just in obese persons. However, further clinical trials are needed in this field to clarify this issue.

Moderate Consumption of Red Meat, Compared to Soy or Non-Soy Legume, Has No Adverse Effect on Cardio-Metabolic Factors in Patients with Type 2 Diabetes.

BACKGROUND: Recently, it has been proposed that red meat consumption could enhance risk of diabetes and worsen lipid profile and glycemic status, in comparison with soy or non-soy legume, but the results of clinical trials are controversial. OBJECTIVES: This study aimed to compare the effect of red meat, soy bean, and non-soy legume consumption on cardio-metabolic factors in patients with type 2 diabetes. METHODS: This was a randomized controlled clinical trial which included 75 patients with diabetes, aged 40-65 years. Participants were randomly allocated to receive two servings of red meat (control group), soy bean, or non-soy legume, 3 days a week for 8 weeks. All groups also received a balanced-macronutrients weight maintenance diet. Body composition and cardio-metabolic factors including fasting blood glucose (FBG), fasting insulin, glycated hemoglobin (HbA1c), serum lipids, and blood pressure were measured at baseline and endpoint of the study. Quantitative insulin sensitivity check index (QUICKI) score and Framingham risk score (FRS) were also computed. RESULTS: We found no significant differences in changes of FBG, fasting insulin, HbA1c, QUICKI score, serum lipids, FRS, and systolic and diastolic blood pressure among the 3 groups. Within group analysis showed that FRS reduced significantly in all groups (P<0.05). In addition, systolic (P=0.01) and diastolic (P=0.03) blood pressure reduced within red meat group. CONCLUSIONS: Compared to soy bean or non-soy legume, moderate consumption of red meat had no adverse effect on cardio-metabolic factors including FBG, fasting insulin, HbA1C, QUICKI score, total cholesterol, low-density lipoprotein , high-density lipoprotein , and blood pressure in adults with type 2 diabetes.

Prevalence, Associated Factors and Consequences of Unwanted Pregnancy in Iran.

BACKGROUND: Unwanted pregnancy is a type of unplanned pregnancy that can endanger health of mother and child. This study aimed to determine the prevalence of unwanted pregnancy and its associated factors and consequences in Iran. METHODS: This cross-sectional study was conducted in regions with low, moderate and high risk of maternal death. Two provinces were randomly selected in each region and 24 public health centers in each province during 2007-2012. Thereafter, 15-20 mothers, received at least one session of pregnancy care, were selected from each healthcare center. Data were gathered from both health records and interview with the mothers. RESULTS: Of 2714 participants, 86.4% and 13.6% had respectively wanted and unwanted pregnancies. The underlying factors of unwanted pregnancy were determined as low distance with previous and next pregnancy, economic problems and have enough children. Moreover, there were significant relationships between unwanted pregnancy and place of residence, mother's age and education, father's education, pre-pregnancy care and number of previous pregnancies and children. There were also significant association between unwanted pregnancy and pregnancy care, anemia, exposure to risk factors and disease, intake of folic acid and iron, domestic violence, bitter memories and men's participation. CONCLUSION: Although the prevalence of unwanted pregnancy has had a significant decrease in Iran, these mothers still require a higher level of educational, counseling and supportive services due to their low access to pregnancy care services and high exposure to associated risk factors.

Sex Difference in Trigeminal Neuropathic Pain Response to Exercise: Role of Oxidative Stress.

Aim: Orofacial chronic neuropathic pain commonly occurs following trigeminal nerve injuries. We investigated whether swimming exercise can reduce trigeminal neuropathic pain through improving antioxidant capacity. Materials and Methods: Twenty-eight Wistar rats of either sex and 180-220 grams were divided into 4 groups as sham, neuropathy, neuropathy + single bout exercise, and neuropathy + 2 weeks of exercise. Trigeminal neuropathy was carried out through chronic constriction injury (CCI) of infraorbital nerve. Protocols of exercise were included a single bout session (45 minutes) and a 2-week (45 minutes/day/6 days a week) swimming exercise. Mechanical allodynia was detected using Von Frey filaments. The activity of the serum antioxidant enzymes glutathione peroxidase and superoxides dismutase was assayed using ELISA kits. Results: We found that CCI significantly reduced facial pain threshold in both sexes (P < 0.05). Both swimming exercise protocols significantly reduced mechanical allodynia in female rats compared to the sham group; however, only 2 weeks of exercise were significantly effective in male rats. The activity of antioxidant enzyme glutathione peroxidase significantly (P < 0.05) decreased following CCI in female rats against that in the sham group and 2-week exercise significantly (P < 0.05) increased it toward the control level. The levels of glutathione peroxidase in male rats and superoxidase dismutase in both sexes were not significantly different compared to their sham groups. Conclusion: Swimming exercise alleviates trigeminal neuropathic pain in both sexes. Oxidative stress as a possible mechanism was involved in the effect of exercise on female rat trigeminal neuropathy.

The Frequency of Anemia and Underlying Factors among Iranian Pregnant Women from Provinces with Different Maternal Mortality Rate.

BACKGROUND: Anemia is a common nutritional disorder that is more prevalent in pregnant women than other population groups. This study aimed to assess the frequency of anemia and its association with health care determinants among Iranian pregnant women from provinces with different Maternal Mortality Rate (MMR). METHODS: This cross-sectional survey was carried out on 2737 pregnant women referred to public health centers in Iran, 2015. The participants were randomly selected by multistage sampling from six provinces with low, moderate or high MMR. The level of hemoglobin lower than 11 g/dl were defined as anemia in first and third trimester of pregnancy. RESULTS: The rate of anemia in first and third trimester were respectively 8.2 and 26.7%. The most determinants of anemia among women in both first and third trimester of pregnancy were geographical classes with high MMR, no care before pregnancy, and type of house. Moreover, lower number of previous pregnancies (OR, 0.48; 95% CI, 0.27 to 0.85) and adequate care during pregnancy (OR, 0.66; 95% CI, 0.47 to 0.92) were protected women from anemia and high number of children (OR, 2.07; 95% CI, 1.13 to 3.80) enhanced risk of anemia in first trimester of pregnancy. Moreover, higher body mass index had lower odds of anemia in third trimester. CONCLUSION: The rate of anemia is differed in various parts of Iran, and this disorder gets worse in third trimester of pregnancy than first. Strengthening health care programs may be a useful strategies to prevent and control anemia.

Association of Vitamin D Status and Metabolic Syndrome Components in Iranian Children.

BACKGROUND: Recently, it has been found that Vitamin D can affect cardiometabolic risk factors. However, these findings have not been confirmed in younger population. We aimed to assess the associations of serum 25-hydroxyvitamin D (25(OH)D) and metabolic syndrome (MetS) components in Iranian children. METHODS: This cross-sectional study was conducted on 240 children aged 6-9 years old. Anthropometric indices (weight, height, waist circumference, and body fat), biochemical parameters (low-density lipoprotein, high-density lipoprotein, triglyceride [TG], fasting blood sugar, and serum 25(OH)D), systolic blood pressure (SBP) and diastolic blood pressure (DBP) blood pressure, and dietary intake and physical activity were measured. Multivariate linear regression analysis was used to assess the association of MetS components and serum 25(OH)D. RESULTS: Mean age of children was 7.8 ± 1.06 year. Mean serum 25(OH)D concentration was 14.6 ± 10.64 ng/ml, and the prevalence of Vitamin D deficiency (serum 25(OH)D lower than 10 ng/ml) was 41.66%. Dietary intake of Vitamin D was 1.91 ± 1.8 mcg/day. Serum 25(OH)D was inversely associated with TG (ß = -0.16; CI: -0.27, -0.04) after adjusting by age, gender, body mass index, physical activity, and some dietary components. Serum 25(OH)D was negatively associated with SBP (ß = -0.02; CI: (-0.05, -0.004), and DBP (ß = -0.02; CI: -0.05, -0.003); however, it was not significant anymore after adjustment for sodium, potassium, and fiber. CONCLUSIONS: Vitamin D deficiency is alarming among Iranian children. Among the components of MetS, lower serum Vitamin D concentration was only associated with TG that could contribute in onset and progression of cardiometabolic disorders later in life.

Comparison of blood lipid-lowering effects of olive oil and other plant oils: A systematic review and meta-analysis of 27 randomized placebo-controlled clinical trials.

Objective: We aim to report a systematic review and meta-analysis of randomized controlled trials (RCTs) on effects of olive oil consumption compared with other plant oils on blood lipids. Methods: PubMed, web of science, Scopus, ProQuest, and Embase were systematically searched until September 2017, with no age, language and design restrictions. Weighed mean difference (WMD) and 95% confidence interval (CI) were expressed as effect size. Sensitivity analyses and pre specified subgroup was conducted to evaluate potential heterogeneity. Meta-regression analyses were performed to investigate association between blood lipid-lowering effects of olive oil and duration of treatment. Results: Twenty-seven trials, comprising 1089 participants met the eligibility criteria. Results of this study showed that compared to other plant oils, high-density lipoprotein level increased significantly more for OO (1.37 mg/dl: 95% CI: 0.4, 2.36). Also OO consumption reduced total cholesterol (TC) (6.27 mg/dl, 95% CI: 2.8, 10.6), Low-density lipoprotein (LDL-c) (4.2 mg/dl, 95% CI: 1.4, 7.01), and triglyceride (TG) (4.31 mg/dl, 95% CI: 0.5, 8.12) significantly less than other plant oils. There were no significant effects on Apo lipoprotein A1 and Apo lipoprotein B. Conclusion: This meta-analysis suggested that OO consumption decreased serum TC, LDL-c, and TG less but increased HDL-c more than other plant oils.

Effects of Canola Oil Consumption on Lipid Profile: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials.

Hyperlipidemia is a well- known risk factor of cardiovascular disease. A healthy diet containing vegetable oils such as canola oil (CO) may help to reduce serum lipids. This study aimed to quantify the effects of CO on lipid parameters using a systematic review and meta-analysis of randomized controlled trials. PubMed, Web of Science, Scopus, ProQuest, and Embase were systematically searched until December 2017, with no time and design restrictions. Also, a manual search was performed to find extra relevant articles. Lipid parameters including total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), triglycerides (TG), apolipoprotein A1 (Apo A1), and apolipoprotein B (Apo B) were entered the meta-analysis. Weighed mean difference (WMD) and 95% confidence interval (CI) were stated as the effect size. Sensitivity analyses and prespecified subgroup were conducted to evaluate potential heterogeneity. Twenty-seven trials, comprising 1359 participants, met the eligibility criteria. Results of this study showed that CO consumption significantly reduced TC (-7.24 mg/dl, 95% CI, -12.1 to -2.7), and LDL (-6.4 mg/dl, 95% CI, -10.8 to -2), although it had no effects on HDL, TG, Apo B, and Apo A1. Effects of CO on TC and LDL significantly decreased after CO consumption in subgroups of >50 years of age participants and >30 intervention duration subgroup. Moreover, CO decreased LDL and TC compared to sunflower oil and saturated fat. This meta-analysis suggested that CO consumption improves serum TC and LDL, which could postpone heart disease progression. Key Teaching Points CO consumption could decrease serum TC and LDL, although it had no effects on other blood lipids. There was an overall significant effect of canola oil on TC and LDL compared to sunflower oil and saturated fats. CO could have beneficial effects on serum TC and LDL just when consumed longer than 30 days. CO consumption improved lipid profiles in participants older than 50 years.