IL-18 and CD14 variants in chronic HBV predisposition: a case-control study with in silico analyses focused on transcription and splicing.

Hepatitis B virus (HBV), a vaccine-avoidable infection, is a health concern worldwide, leading to liver disorders such as acute self-constraint and chronic hepatitis, liver failure, hepatic cirrhosis, and even hepatocellular carcinoma if untreated. 'Immunogeneticprofiling', genetic variations of the pro- and anti-inflammatory cytokines responsible for regulating the immune responses, cause person-to-person differences and impact the clinical manifestation of the disease. The current experimental-bioinformatics research was conducted to examine whether promoteric IL-18-rs187238 C > G and -rs1946518 T > G and intronic CD14-rs2569190 A > G variations are associated with chronic HBV. A total of 400 individuals (200 in each case and control group) participated in the study and were genotyped using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. The data was also assessed bioinformatics-wise for conservation, genomic transcription and splicing, and protein interactions. Findings proposed that unlike the IL-18-rs1946518 T > G and CD14-rs2569190 A > G, the IL-18-rs187238 C > G is a protector against chronic HBV (odds ratio [OR] = 0.62, 95% confidence intervals [CI]: 0.46-0.83, and p = 0.002). The TG/CC/AA, TG/CC/AG, TT/CC/AG, and GG/CC/AA combined genotypes significantly increased chronic HBV risk (p < 0.05), while the IL-18 G/T and G/G haplotypes lessened it (p < 0.05). Moreover, IL-18-rs1946518 T > G is in the protected genomic regions across mammalian species. In contrast to the IL-18-rs1946518 T > G, IL-18-rs187238 C > G is likely to create novel binding sites for transcription factors, and the CD14-rs2569190 A > G presumably changed the ribonucleic acid splicing pattern. More research on larger populations and other ethnicities is required to authenticate these results.

The national health program for vitamin D supplementation in a developing country.

BACKGROUND: Previous studies have reported a high frequency of vitamin D deficiency (VDD) among different age groups in Iran. AIMS: In this study, the current coverage, status of vitamin D supplement taking, and program efficacy have been evaluated by the Office of Nutrition Department Society in Iran since 2014. METHODS: This study was conducted in collaboration with the International UNESCO center for Health-Related Basic Sciences and Human Nutrition and the Office of Nutrition Department Society. Sixty three medical universities were included in the current study to calculate the availability, accessibility and acceptability coverages. Furthermore, 3 medical universities including Mashhad (MUMS), Qom (QUMS) and Zahedan (ZAUMS) University of Medical Sciences were selected based on the results of the National Integrated Micronutrient Survey 2012 (NIMS-II study), in order to assess the status of vitamin D supplement intake in all age ranges. RESULTS: Quantitative analysis showed that availability coverage was 74.96% and 77.56% and accessibility was 80.70% and 83.26% in elderly and middle-aged subjects, respectively in 2018. The acceptability was approximately 43.7% and 43.9% among elderly and middle-aged participants, respectively. The availability and acceptability coverage was 80.99% and 85.0% among students in high schools. The mean vitamin D supplement uptake frequency was 27.0% (n = 387); 20.7% and 29.2% in rural and urban area, respectively (P = 0.001). The results showed that there was no significant difference in serum vitamin D levels between urban (20.41 ± 6.43 ng/ml) and rural areas, (P = 0.887). There was no significant difference in the serum vitamin D concentrations between men and women (P = 0.461). CONCLUSIONS: The frequency of taking vitamin D supplements was 27.0% in Iran in 2018. The frequency of taking of vitamin D supplements among vitamin D deficient group (serum vitamin D levels <19.99 ng/ml) was 43.6%. Lack of knowledge was the most important reason for not taking vitamin D supplement. Moreover, the serum vitamin D levels have increased in subjects aged 18-30 years old after the implementation of the vitamin D supplementary program.

Economic evaluation of a national vitamin D supplementation program among Iranian adolescents for the prevention of adulthood type 2 diabetes mellitus.

BACKGROUND: This study aimed to evaluate the cost-effectiveness of vitamin D supplementation in preventing type 2 diabetes mellitus (T2DM) among Iranian adolescents. METHODS: This analytical observational study was conducted, using the decision tree model constructed in TreeAge Pro to assess the cost per quality-adjusted life-year (QALY) of monthly intake vitamin D supplements to prevent T2DM compared to no intervention from the viewpoint of Iran's Ministry of Health and through an one-year horizon. In the national program of vitamin D supplementation, 1,185,211 Iranian high-school students received 50,000 IU vitamin D supplements monthly for nine months. The costs-related data were modified to 2018. The average cost and effectiveness were compared based on the Incremental Cost-Effectiveness Ratio (ICER). RESULTS: Our analytical analysis estimated the 4071.25 (USD / QALY) cost per AQALY gained of the monthly intake of 50,000 IU vitamin D for nine months among adolescents over a one-year horizon. Based on the ICER threshold of 1032-2666, vitamin D supplementation was cost-effective for adolescents to prevent adulthood T2DM. It means that vitamin D supplementation costs were substantially less than the costs of T2DM treatments than the no intervention. CONCLUSIONS: Based on the findings, the national vitamin D supplementation program for Iranian adolescents could be a cost-effective strategy to reduce the risk of diabetes in adulthood. From an economic perspective, vitamin D supplementation, especially in adolescents with vitamin D deficiency, would be administrated.

The Effects of Vitamin D Supplementation on Lipid and Inflammatory Profile of Healthy Adolescent Boys: A Randomized Controlled Trial.

BACKGROUND: Deficiency of vitamin D, an anti-inflammatory micronutrient with some favorable effects on lipid profiles, has been found to be highly prevalent in adolescents. We aimed to investigate the effect of a school-based vitamin D supplementation regimen on the correction of vitamin D deficiency as well as lipid and inflammatory profiles of healthy adolescent boys. METHODS: In this randomized single-blind placebo-controlled trial, seventy-one healthy adolescent boys (age 17 years old) were recruited from one high school in Tehran, Iran, and randomly assigned to two groups. The supplement group received vitamin D pearls at a dose of 50,000 IU monthly for 6 months, this dose is indeed defined by the Ministry of Health in Iran for a potential national school-based vitamin D supplementation program. The other group was given placebo pearls for the same duration. Before and after the treatment, the serum levels of 25-hydroxy vitamin D (25(OH) D), parathyroid hormone (PTH), retinol, lead (Pb), the lipid profile and the inflammatory biomarkers were measured and compared. RESULTS: Between-groups statistical analysis showed that a dose (50,000 IU/month) vitamin D significantly increased the serum levels of 25-hydroxyvitamin D (25 (OH) D) (p < 0.001) and decreased serum levels of PTH (p = 0.003). No significant change was observed in serum levels of retinol and Pb. Between-group analysis revealed that the serum levels of TG (P = 0.001) decreased while an increase in serum levels of HDL (p = 0.021) was observed (p < 0.05). Both the within- and between-group analysis showed that serum tumor necrosis factor receptor 2 (TNFR2) concentration declined while serum interleukin-10 (IL-10) increased in response to vitamin D supplementation (p < 0.05). CONCLUSION: A supplementation regimen of (50,000 IU/month) vitamin D in a context with high rates of vitamin deficiency has shown positive impacts on the serum vitamin D, lipid profile and inflammatory biomarkers in healthy adolescent boys.

An Improved Method for Fabrication of Ag-GO Nanocomposite with Controlled Anti-Cancer and Anti-bacterial Behavior; A Comparative Study.

In this study, two green procedures for Silver-Graphene Oxide (Ag-GO) nanocomposite synthesis were investigated. As a common method, AgNO3 was first loaded on the GO surface and then was reduced and stabilized by walnut green husk extract, producing Ag-GO-І. As an innovative approach, GO was first exposed to the extract and then the AgNO3 was added as the second step, producing Ag-GO-П. Physicochemical properties, antibacterial and cytotoxicity activity of both nanocomposites were subsequently studied comparing with free silver nanoparticles (AgNPs) and pure GO. Based on the results, exposure of GO to the extract, as a reducing agent, at the first/last step of the synthesis process resulted in the fundamental differences in the final products. So that, high amounts of agglomerated silver nanoparticles were formed between the GO sheets, when using the common method, whereas in Ag-GO-П, small AgNPs were formed on the GO sheets without aggregation, entirely covering the sheets. Antibacterial and cytotoxic behavior of these nanomaterials could be compared as AgNPs > Ag-GO-П > Ag-GO-І. It is assumed that these differences are due to control of unwanted nucleation in the synthesis process that Ag nanoparticles are smaller with less agglomeration when the GO surfaces are pre-treated with reducing agent.

Implementation evaluation of an iron supplementation programme in high-school students: the crosswise model.

OBJECTIVE: To evaluate the implementation of the national health promotion programme (through nutritional education and Fe supplementation) among female high-school students in Iran and to assess the application of the crosswise model (CM) for evaluating the programme's implementation. DESIGN: Two cross-sectional surveys in female high-school students, one using the direct questioning (DQ) method and the other using the CM, were conducted. Two survey questionnaires used to collect the data contained questions about three aspects of the programme: delivering the Fe supplements, consuming them and holding nutritional training sessions. SETTING: Female high schools, West Azerbaijan Province, Iran. PARTICIPANTS: A sample of 2180 students, of whom 1740 were surveyed by the CM and 440 were interviewed by DQ. RESULTS: The CM resulted in estimates that were consistently lower than the estimates of the DQ. The proportion of students in the DQ and CM who reported receiving the pills weekly and on a regular basis was 73·2 and 22·5 %, respectively. About 43 and 31 % of students in the DQ and CM surveys reported consuming all pills delivered to them. In the DQ method, only 12 % of students who reported the number of pills consumed had taken the complete dose (sixteen pills). CONCLUSIONS: Implementation of the Fe supplementation programme in female high schools was poor and insufficient, so that it seems unsuccessful in reducing Fe-deficiency anaemia in adolescent girls. The CM might be considered for evaluating the health programme's implementation at high schools.

PEGAylated graphene oxide/superparamagnetic nanocomposite as a high-efficiency loading nanocarrier for controlled delivery of methotrexate.

Polymer-coated nanocarriers play an important role in targeted drug delivery. The use of polymers such as polyethylene glycol increases stability, biocompatibility, and blood circulation time of the drug, and may consequently improve the success of drug delivery. In the present work, a simple approach has been reported for synthesizing polyethylene glycol bis amin (PEGA) functionalized graphene oxide/iron oxide nanocomposite as a remarkable unit for loading drugs. The biomedical applications of the synthesized nanocomposite were investigated by immobilizing methotrexate (MTX), as an anticancer drug. The structural and morphological characteristics and the successful synthesis of the nanocomposite were evaluated by different charachterization techniques. The cytotoxicity assay of the nanocarrier showed higher toxicity against HeLa and MCF-7 cell lines, compared to free MTX. The drug release experiments in acidic and physiological conditions suggested the first order kinetics model for the release of MTX from the nanocomposite. Furthermore, the agglutination, complement activation, and coagulation time experiments demonstrated the blood compatibility of the synthesized nanocarrier.

An Explanation for Variation in Age at Menopause in Developing Countries Based on the Second National Integrated Micronutrient Survey in Iran.

BACKGROUND: It is reported that women in developing countries reach menopause earlier compared to developed countries. This seems to be due to underestimation of age at menopause as pre-menopause women who will reach menopause at older ages are commonly excluded in cross-sectional settings. In this study, we propose an estimation method which can deal with this bias. We also assessed major determinants of menopause. METHODS: The second national integrated micronutrient survey in Iran completed in 2015 is a population-based study with a nationally representative sample of 4,898 Iranian women aged 50 to 60 years. We used data on menopause status and menopausal age (asked retrospectively) to estimate the median survival time. We also used Logistic regression to model menopausal status on the current age and to estimate the median age, at which 50% of women will experience menopause. Demographic, lifestyle, and anthropometric determinants were also examined. RESULTS: The estimated age at menopause was 51.2 (51.0-51.3) years in the logistic model and 50.5 (48.1, 53.7) years in survival analysis. In both models, the age at menopause was significantly lower among rural and underweight women. In addition, survival analysis showed that smokers and women with smaller family size had significantly lower age at menopause. CONCLUSION: While many studies stress a gap in age at menopause between developed and developing countries, this study with a reliable estimation method showed that such a gap might originate from an underestimation of age at menopause in developing countries rather than a real difference.

A School-Based Intervention to Reduce Excess Weight in Overweight and Obese Primary School Students.

BACKGROUND: This study evaluated the effect of an intervention for reducing excess weight gain in primary school-age children in Tehran. METHODS: A cluster-randomized controlled trial was conducted in 12 primary schools in Tehran. Three hundred thirty-four pupils, 167 in the intervention and 167 in the comparison group, determined to be overweight or obese based on World Health Organization standards, were recruited for the study. The intervention included nutrition education and increased physical activity (PA) for the pupils, lifestyle modification for parents, and a change in food items sold at the schools' canteens. The entire intervention lasted approximately 18 weeks. Measures were taken before and immediately after the intervention. RESULTS: The intervention significantly reduced body mass index Z-score and hip circumference (p = .003 and p < .001, respectively). Waist circumference increased in both groups, but the increase was higher in the comparison group (p = .001). No significant difference was seen in time spent on TV viewing between groups (p = .08). Vigorous PA increased in the intervention group (p < .001), while the comparison group showed an increase in moderate activity only (p < .001). Energy intake increased significantly in the intervention group (p < .001). Neither triceps skinfold thickness nor time spent on the computer changed in the intervention group (p = .51 and p = .1, respectively), while they increased in the comparison group (p < .001 and p = .004, respectively). CONCLUSION: The study provides a successful model for the implementation of similar interventions throughout the country.

Intraoperative monitoring of intestinal viability: Evaluation of a new combined sensor.

A dual wavelength photoplethysmography (PPG) and laser Doppler flowmetry (LDF) sensor was developed to investigate the suitability of these techniques for monitoring bowel viability intraoperatively. Clinical measurements were obtained from thirty patients undergoing bowel surgery. Three measurements were performed at different stages of the operation. The amplitude of infrared PPG decreased from the baseline measurement to the pre-anastomosis measurement by 36% and LDF flux decreased by 21% for the same measurements. An increase of 33% in amplitude for infrared PPG was observed from the pre-anastomotic to post-anastomosis measurement; the equivalent increase was not seen for LDF flux. The results revealed that the sensor could potentially indicate changes in perfusion and blood flow at critical phases of surgery, thereby assisting in the early detection of inadequate blood supply in bowel tissue. The results also suggest that laser Doppler is more sensitive to movement artefact compared to PPG.

Flour fortification with iron: a mid-term evaluation.

OBJECTIVES: Iron-deficiency anaemia is a major nutritional problem in Iran. A programme of flour fortification with iron was launched in 2001. A mid-term evaluation was conducted in 2004 to determine the effectiveness and coverage of this programme. METHODS: To determine the effectiveness of the program, a field trial was conducted in which blood hemoglobin and ferritin levels were measured in a sample population from Bushehr (intervention) and Fars (control) provinces. The target population was women aged 15-49 years. The coverage of the programme was determined using a cross-sectional study that measured iron content in samples of flour and bread from Bushehr province. RESULTS: Five hundred and sixty-seven and 296 women were studied in the intervention and control provinces, respectively. Women in the intervention province had a lower prevalence of low ferritin levels compared with women in the control province (P=0.04). Women from the two provinces did not differ in terms of haemoglobin levels and iron-deficiency anaemia. The coverage of fortified flour and bread was 100% and 99.7%, respectively. CONCLUSIONS: This mid-term evaluation found that the iron fortification programme in Iran has only had a beneficial effect on the prevalence of low ferritin levels. The final evaluation is likely to provide more useful information regarding the effect of this programme on a number of anaemia indicators.