ApoA1/HDL-C ratio as a predictor for coronary artery disease in patients with type 2 diabetes: a matched case-control study.

INTRODUCTION: This study investigated the possible relationship between the Apo lipoprotein A1 /high-density lipoprotein cholesterol (ApoA1/HDL-C) ratio and coronary artery disease (CAD) in patients with type 2 diabetes (T2D). METHODS: This was a matched case-control study of 482 patients with T2D in two groups of CAD and (n = 241) non-CAD (n = 241). The patients were classified into four quartiles according to the ApoA1/HDL-C ratio, and multivariate logistic regression analysis was performed to assess the relationship between ApoA1/HDL-C and CAD. ROC analysis was also conducted. RESULTS: This study showed that the ApoA1/HDL-C ratio has an independent association with CAD in individuals with T2D. The CAD group exhibited a significantly higher ApoA1/HDL-C ratio than those without CAD (p-value = 0.004). Moreover, the risk of CAD increased significantly across the ApoA1/HDL-C ratio quartiles, with the highest odds in the fourth quartile. The second quartile showed an odds ratio (OR) of 2.03 (p-value = 0.048) compared to the first. Moving to the third quartile, the OR increased to 2.23 (p-value = 0.023). The highest OR was noted in the fourth, reaching 3.41 (p-value = 0.001). Employing a cut-off value of 2.66 and an area under the curve (AUC) of 0.885, the ApoA1/HDL-C ratio predicts CAD among patients with T2D with a sensitivity of 75% and a specificity of 91% (p-value < 0.001). CONCLUSION: The current study revealed an independent association between ApoA1/HDL-C ratio and CAD in patients with T2D. This ratio can be a promising tool for predicting CAD during the follow-up of patients with T2D, aiding in identifying those at higher risk for CAD.

Correlates of normal and decreased HDL cholesterol levels in type 2 diabetes: a cohort-based cross-sectional study.

BACKGROUND: The literature describes an inverse association between the values of triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C). This survey was designed to exhibit the features of people with type 2 diabetes (T2D) who display this inverse association and identify potential contributing factors to having normal HDL-C values. METHODS: A total of 6127 persons with T2D were assigned to the present survey. Demographic features and clinical status data were compared between subjects with a substantial inverse association of TG and HDL-C and those without. Logistic regressions were performed to ascertain the role of different factors related to normal HDL-C. Moreover, the restricted cubic spline (RCS) functions were conducted to scrutinize the underlying relationships between the studied variables and low HDL-C levels. RESULTS: Patients with high TG (150 ≤ TG < 400) compared to patients with normal TG (TG < 150) were less likely to have normal HDL-C. Younger age, narrow hip, lower levels of blood pressure, two-hour postprandial glucose (2hPP), fasting blood sugar (FBS), hemoglobinA1C (HbA1C), low-density lipoprotein cholesterol (LDL-C), total cholesterol, and non-HDL-C, higher atherogenic index of plasma (AIP), and TG/HDL-C ratio correlate with an inverse connection between the values of HDL-C and TG (all P < 0.05). Age greater than 65 years (odds ratio (OR) 1.260, 95% confidence intervals (CI) 1.124-1.413) had a positive association, whereas female sex (OR 0.467, CI 0.416-0.523) , 25 kg/m2 < body mass index (BMI) (OR 0.786, CI 0.691-0.894), and higher serum creatinine levels (OR 0.481, CI 0.372-0.621) had an inverse association with having normal HDL-C. CONCLUSIONS: Patients with an inverse connection between TG and HDL-C values had considerably different anthropometric features, lipid profiles, and glucose indices compared to those without this relationship. Furthermore, patients who aged less than 65 years, had female gender, BMI more than 25 kg/m2, and higher serum creatinine levels were less likely to exhibit normal HDL-C levels.

High prevalence of comorbidities in older adult patients with type 2 diabetes: a cross-sectional survey.

BACKGROUND: Diabetes is a global health problem, and its incidence and complications increase with the duration of the disease and over time. This increase in complications in older patients can lead to disability and a lower quality of life. This study aimed to investigate the rate of diabetes control and complications in older adults. METHOD: This was a cross-section of an ongoing cohort of patients with type 2 diabetes mellitus (T2DM) aged 65 years and older. The clinical and laboratory characteristics of older adult patients with T2DM in good and intermediate health conditions were collected between 2010 and 2022. RESULTS: A total of 2,770 older adult patients with T2DM were enrolled, including 1,530(55.3%) female and 1,240 (44.7%) male participants. Metabolic syndrome, hypertension, and coronary artery disease were the most common comorbidities, affecting 1,889 (71.4%), 1,495 (54.4%), and 786 (29.2%) patients, respectively. Albuminuria was present in 626 (22.6%) patients, while retinopathy was detected in 408 (14.7%) patients, including 6% with proliferative retinopathy. Most patients were treated with oral antidiabetic agents (88.9%), with metformin being the most prescribed medication (85.6%). Statins were prescribed to 71.8% of the patients. The most prescribed antihypertensive medications were angiotensin receptor blockers and angiotensin-converting enzyme inhibitors, prescribed to 54% and 15% of patients, respectively. The hemoglobin A1c (HbA1c) goal (HbA1c < 7.5%) was achieved in 1,350 (56.4%) patients, and the low-density lipoprotein cholesterol (LDL-C) goal (LDL < 100) was achieved in 1,165 (45.6%) patients. Blood pressure control (BP < 140/90) was achieved in 1,755 (65.4%) patients. All three goals were achieved in 278 (10.3%) patients. There were no significant differences in clinical laboratory results and the patients' characteristics based on gender. CONCLUSION: The rate of progression of complications in older adult patients is higher than the effectiveness of the treatment, indicating the need for increased social support for this age group.

Assessing urban family physician program challenges in Iran: the insurance organizations' perspective(2021).

BACKGROUND: The Family Physician Programme is a key health reform in Iran that faces significant challenges in urban areas, particularly in Mazandaran and Fars provinces The study aims to critically evaluate the challenges encountered in the Urban Family Physician Program, with a particular focus on the perspectives of insurance organizations. METHODS: A qualitative approach was adopted, involving semi-structured interviews with 22 experts and managers from basic health insurance funds. Snowball sampling facilitated participant selection, and interviews proceeded until saturation. Data analysis utilized content analysis and Atlas-T software, adhering to COREQ criteria. RESULTS: Implementation problems of the urban family physician program were categorized into ten Categories and 22 Subcategories, including financing, stewardship, human resources, structure, culture, information system, payment, monitoring and control, the function of insurance organizations, and implementation. CONCLUSION: The urban family physician program's implementation challenges, as viewed by health insurance organizations, underscore the necessity for strategic decision-making in financing, payment models, electronic system integration, structural adjustments, comprehensive monitoring, evaluation, cultural considerations, and appropriate devolution to insurance entities.

Effects and safety of resveratrol supplementation in older adults: A comprehensive systematic review.

Resveratrol (RSV) has garnered significant attention in recent years due to its potential benefits against chronic diseases. However, its effects and safety in older adults have not been comprehensively studied. This study aimed to determine the effects and safety of RSV supplementation in older adults. MEDLINE/PubMed, Scopus, and Web of Science databases were comprehensively searched for eligible studies. Studies were enrolled if they were randomized clinical trials and had incorporated RSV supplementation for older adults. Two independent authors conducted the literature search, and eligibility was determined according to the PICOS framework. Study details, intervention specifics, and relevant outcomes were collected during the data collection. The Cochrane RoB-2 tool was used to evaluate the risk of bias. This review included 10 studies. The combination of RSV and exercise improved exercise adaptation and muscle function in healthy older adults and physical performance and mobility measures in individuals with functional limitations. RSV showed potential neuroprotective effects in patients with Alzheimer's disease. In overweight individuals, RSV demonstrated a positive impact on cognitive function, but it increased some biomarkers of cardiovascular disease risk at high doses. In older adults with diabetes and those with peripheral artery disease (PAD), RSV was not more effective than placebo. No study reported significant adverse events following RSV treatment. RSV can improve various health parameters in age-related health conditions. However, the optimal dosage, long-term effects, and potential interactions with medications still need to be investigated through well-designed RCTs.

Myrtenol Ameliorates Recognition Memories' Impairment and Anxiety-Like Behaviors Induced by Asthma by Mitigating Hippocampal Inflammation and Oxidative Stress in Rats.

INTRODUCTION: Asthma is related to neurochemical alterations which affect brain functions and lead to anxiety and cognitive dysfunctions. Myrtenol has sparked considerable interest due to its pharmacological effects, especially for the remediation of chronic disorders. Thus, the present research was designed to evaluate the impacts of myrtenol on anxiety-like behaviors, cognitive declines, inflammation, and oxidative stress in the hippocampus of asthmatic rats. METHODS: Rats were allocated to five groups: control, asthma, asthma/vehicle, asthma/myrtenol, and asthma/budesonide. Asthma was elicited in the rats by ovalbumin, and the animals were then exposed to myrtenol inhalation. Anxiety-like behavior and memory were assessed by elevated plus maze (EPM) and novel object and location recognition tests. Interleukins (interleukin-6, -17, and -10), tumor necrosis factor α (TNF-α), and oxidative stress biomarkers such as malondialdehyde (MDA), superoxide dismutase (SOD), Glutathione peroxidase (GPX), and total antioxidant capacity (TAC) in the hippocampus were assessed by the ELISA method. RESULTS: The levels of IL-6, IL-17, TNF-α, and MDA decreased, but GPX, SOD, and TAC levels increased in the hippocampus of asthmatic animals due to myrtenol inhalation. CONCLUSION: Myrtenol diminished asthma-induced anxiety-like behaviors and cognitive deficits in asthmatic rats; these effects might have been typically mediated by a reduction in inflammation and oxidative stress.

Endurance Exercise Training Attenuates the Waterpipe Smoke Inhaling-Induced Learning and Memory Impairment in Rats: Role of Neurotrophic Factors and Apoptotic System.

INTRODUCTION: The increasing prevalence of waterpipe tobacco smoking (WTS) and its detrimental effects on memory function have been reported. This study was conducted to investigate the effect of moderate-intensity endurance exercise on the detrimental effects of WTS on learning and spatial memory in rats. AIMS AND METHODS: Animals were divided into the Control group (CTL), the exercise group (Ex) which trained for 8 weeks, the WTS group (Wp) exposed to smoke inhalation (30 minutes per day, 5 days each week, and for 8 weeks), and the group that did exercise training and received waterpipe smoke together (Ex + Wp). Thereafter, learning and spatial memory were assessed by the Morris water maze test and hippocampal molecular measurements were done. RESULTS: Waterpipe smoke significantly impaired learning and spatial memory, decreased expression of neurotrophic factors IGF-1 and BDNF (p < .01 and p < .05 vs. CTL group, respectively), increased BAX to BCL-2 ratio (p < .001 vs. CTL group) in hippocampal tissue, and increased the percent of damaged neurons in the hippocampal CA1 area (p < .05 vs. CTL group). Combination of exercise training with WTS prevented learning and spatial memory disturbances and recovered expression of neurotrophic factors IGF-1 (p < .05 vs. Wp group), decreased BAX to BCL-2 ratio (p < .001 vs. Wp group), and reduced percentage of damaged neurons (p < .05 vs. Wp group). CONCLUSIONS: Findings suggest that moderate-intensity endurance exercise training can ameliorate learning and memory impairment caused by waterpipe smoke in rats. This effect partly results from increasing the expression of neurotrophic factors BDNF and IGF-1 and correcting pro/anti-apoptotic proteins balance in the hippocampal tissue. IMPLICATIONS: The popularity of WTS especially among youth is increasing. We assessed the effect of hookah smoke with/without exercise on learning and memory. Hookah smoke leads to CA1-neural injury and impairs learning and memory in rats. A combination of exercise training with hookah smoke attenuates these complications. This positive effect of exercise is partially mediated by the balancing of brain-derived neurotrophic factor (BDNF) and Insulin-like growth factor-1 (IGF-1) and also the BAX to BCL-2 ratio, a significant predictor of cell susceptibility to apoptosis. Extrapolation of these positive findings to humans needs complementary studies.

Bilateral inferior petrosal sinus sampling: validity, diagnostic accuracy in lateralization of pituitary microadenoma, and treatment in eleven patients with Cushing's syndrome - a single-center retrospective cohort study.

BACKGROUND: This single-center retrospective cohort study aimed to describe the findings and validity of Bilateral inferior petrosal sinus sampling (BIPSS) in the differential diagnosis of patients with ACTH-dependent Cushing's syndrome (CS). METHODS: Eleven patients underwent BIPSS due to equivocal biochemical tests and imaging results. Blood samples were taken from the right inferior petrosal sinus (IPS), left IPS, and a peripheral vein before and after stimulation with desmopressin (DDAVP). ACTH and prolactin levels were measured. The diagnosis was based on the ACTH ratio between the IPS and the peripheral vein. Also, lateralization of pituitary adenoma in patients with Cushing's disease (CD) was predicted. No significant complications were observed with BIPSS. RESULTS: Based on the pathology report, eight patients had CD, and three had ectopic ACTH syndrome (EAS). Unstimulated BIPSS resulted in a sensitivity of 87.5%, specificity of 100%, PPV of 100%, NPV of 75%, and accuracy of 91%. Stimulated BIPSS resulted in a sensitivity of 100%, specificity of 100%, PPV of 100%, NPV of 100%, and accuracy of 100%. However, pituitary magnetic resonance imaging (MRI) had a lower diagnostic accuracy (sensitivity:62.5%, specificity:33%, PPV:71%, NPV:25%, accuracy:54%). BIPSS accurately demonstrated pituitary adenoma lateralization in 75% of patients with CD. CONCLUSIONS: This study suggests that BIPSS may be a reliable and low-complication technique in evaluating patients with ACTH-dependent CS who had inconclusive imaging and biochemical test results. The diagnostic accuracy is improved by DDAVP stimulation. Pituitary adenoma lateralization can be predicted with the aid of BIPSS.

The relationship between women's breastfeeding empowerment and conformity to feminine norms.

BACKGROUND: Women empowerment is effective in successful breastfeeding. Hence,identifying the relationship between psychosocial factors, such as acceptance of feminine norms, and empowerment can be beneficial in designing interventions.. Therefore, this study aimed to determine the relationship between breastfeeding empowerment and conformity to feminine norms. METHODS: This cross-sectional study was conducted on 288 primiparous mothers in the postpartum period using validated questionnaires of conformity to gender norms and breastfeeding empowerment in the following domains: "sufficient knowledge and skills for breastfeeding," "a sense of breastfeeding competence," "conscious belief in the value of breastfeeding," "overcoming breastfeeding problems," "negotiation and obtaining family support" and "self-efficacy in breastfeeding" which were completed through the self-report method. Data were analyzed using the multivariate linear regression test. RESULTS: The mean score of 'conformity to feminine norms' and 'breastfeeding empowerment' were 142.39 and 144.14, respectively. The score of breastfeeding empowerment was positively related to conformity to feminine norms (p = 0.003). Among the dimensions of breastfeeding empowerment, 'mothers' adequate knowledge and skills for breastfeeding' (p = 0.001), 'belief in the value of breastfeeding' (p = 0.008), and 'negotiation and obtaining family support' (p = 0.01) were positively related to conformity to feminine norms. CONCLUSIONS: The results indicate a positive relationship between the level of conformity to feminine norms and breastfeeding empowerment. Accordingly, it is recommended that supporting breastfeeding as a valuable role of women be considered in programs designed to improve breastfeeding empowerment.

Lipid accumulation product (LAP) index for the diagnosis of nonalcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis.

BACKGROUND: Lipid accumulation product (LAP) is an index calculated by waist circumference (WC) and triglyceride (TG), which reflects lipid toxicity. This study aims to investigate the association between the LAP index and nonalcoholic fatty liver disease (NAFLD) in a systematic review and meta-analysis. METHODS AND RESULTS: PubMed, Scopus, and Web of Science online databases were searched for eligible studies that investigated the association of the LAP index and NAFLD. Sixteen observational studies with 96,101 participants, including four cohort studies, one case‒control study and 11 cross-sectional studies with baseline data, were entered into this analysis. Fourteen studies reported a significant association between the LAP index and NAFLD, and two reported that this relation was not significant; two different meta-analyses (1- mean difference (MD) and 2- bivariate diagnostic test accuracy [DTA]) were conducted using Stata version 14. The LAP index was compared in subjects with and without NAFLD, and the difference was significant with 34.90 units (CI 95: 30.59-39.31, P < 0.001) of the LAP index. The DTA meta-analysis was conducted and showed that the LAP index pooled sensitivity and specificity for screening of NAFLD were 94% (CI95: 72%-99%, I2 = 99%, P < 0.001) and 85% (CI95: 62%-96%, I2 = 99%, P < 0.001), respectively. CONCLUSION: The LAP Index is an inexpensive, sensitive, and specific method to evaluate NAFLD and may be valuable for NAFLD screening.

Correlation between different levels and patterns of dyslipidemia and glomerular filtration rate in patients with type 2 diabetes: A cross-sectional survey of a regional cohort.

BACKGROUND: Due to the high cardiovascular risk in patients with diabetic nephropathy, more attention should be paid to lipid levels and dyslipidemia in these patients. The current study investigated the association between single and mixed dyslipidemia patterns, estimated glomerular filtration rate (eGFR), and different chronic kidney disease (CKD) stages. METHODS: This cross-sectional study evaluated 4059 patients with type 2 diabetes (T2D). TG, TC, LDL-C, and HDL-C were measured. Non-HDL-C and AIP were calculated. We estimated eGFR using the CKD-EPI equation. RESULTS: With the progression of the kidney failure stage, mean levels of TG, LDL-C, non-HDL-C, and AIP decreased. HDL-C levels decreased with the advance of the CKD stage in men but did not change significantly in women. The prevalence of single dyslipidemia, including high LDL-C and high non-HDL-C, decreased with the advancing CKD stage. The prevalence of mixed dyslipidemia patterns, including high AIP and high LDL-C, high AIP and high non-HDL-C, showed a significant downward tendency. TG and AIP levels were negatively, and HDL-C levels were positively correlated with eGFR after adjusting for the risk factors. Also, CKD stage 3 was positively related to the risk of high TG and low HDL-C. CONCLUSION: This study shows that blood lipids decreased with the progression of renal failure in patients with T2D. However, after adjustment, TG and AIP levels had negative, and HDL-C levels had a positive correlation with eGFR, which could be consistent with the hypothesis that eGFR decreases with increasing TG or AIP levels or decreasing HDL-C levels.

Effects of myo-inositol plus folic acid on ovarian morphology and oocyte quality in PCOS mouse model.

Although the role of myo-inositol (MYO) in promoting the oocyte quality of PCOS patients has been documented in human studies; the cellular effects of this supplement on oocytes have not been directly examined due to ethical limitations. In the first phase of this study, MYO dosimetry was carried out simultaneously with the PCOS model development. An effective dose was obtained following the assessment of fasting insulin and testosterone levels using ELISA and ovarian morphology appraisal by histopathology. In the second phase, following the continuous administration of the effective dose of MYO and dehydroepiandrosterone (DHEA), cellular evaluation was performed. The quality of oocytes from superovulation was analyzed by examining maturity and normal morphology percentage using a stereomicroscope, intracellular reactive oxygen species (ROS) and glutathione (GSH) levels using fluorometry, and ATP count evaluation using ELISA. The results revealed that, among the four different MYO concentrations, the 0.36 mg/g dose compared with the DHEA group reduced testosterone levels and large atretic antral follicles (LAtAnF) diameter. This dose also increased the corpus luteum count and the granulosa:theca (G/T)layer thickness ratio in antral follicles. Furthermore, this dose increased mature oocytes and normal morphology percentage, ATP count, and GSH levels; however, it decreased ROS levels in mature oocytes. Our findings provide the grounds for further cellular and molecular studies on the PCOS mouse model, suggesting that the improvement in mitochondrial function and its antioxidant properties is probably one of the mechanisms by which MYO increases oocyte quality.

Effects of extender filtration and egg yolk concentration on canine semen cryopreservation.

The semen cooling and freezing extenders commonly contain the chicken egg yolk (EY) as the main sperm cryoprotectant. Besides its advantages, the EY has large lipoprotein granules that cause several physical and biological interferences. The previous studies have proposed several methods to resolve the problems with the EY-based semen extenders, including mechanical agitation, EY fractionation, replacing the EY with purified EY LDL, and ultrasonication. In the current research, we aimed to evaluate the syringe filtration (220 nm) of an EY-based canine semen freezing extender as a simple and cheap method to remove the EY granules. We also studied the possibility of re-aggregation of EY granules after cooling, freeze/thawing, and lyophilization/rehydration of the filtered extenders. Additionally, we compared the effects of the filtration on lipid profile, turbidity, EY particle size distribution, and osmolality of the EY-based extenders. Next, we examined the effects of filtered extenders containing different levels of EY (5%, 10%, 15%, 20%, and 25%) versus the control extender (20% EY, unfiltered) on post-thaw sperm quality traits. We collected the semen samples from seven clinically healthy mixed-breed adult dogs and pooled them for sperm freezing procedures. Samplings were repeated at least five times, independently. Our results indicated that the syringe filtration could remove the large EY particles and reduce the extender turbidity without affecting the lipid profile of the whole extender solution. The filtered extender supplemented with 25% (v/v) EY led to the best post-thaw canine spermatozoa quality markers. The frozen-thawed spermatozoa evaluations included motility parameters (computer-assisted semen analysis system), membrane and acrosome integrity (hypo-osmotic swelling test, chlortetracycline binding assay), DNA fragmentation (sperm chromatin dispersion assay), membrane lipid peroxidation (MDA levels), apoptosis (Annexin V/propidium iodide assay), and fertility-associated sperm mRNA transcript abundance (protamine 2 and 3). In conclusion, the syringe filtration of the EY-based semen extenders was a simple and cheap method that could effectively remove large EY lipoprotein granules and possibly prevent EY-origin bacterial contamination of the final extender solution. The EY at 25% (v/v) concentration in the filtered extenders resulted in the highest canine spermatozoa cryo-tolerance.

Ciprofloxacin antibiotic removal from aqueous solutions by ZnO nanoparticles coated on ACA: modeling and optimization.

Antibiotics are one of the most widely used drug groups. The presence of antibiotics in urban water sources and sewage creates many environmental and medical risks for humans and other living organisms. In this study, the potential of zinc oxide (ZnO) coated on almond shell activated carbon (ACA-ZnO) in removing ciprofloxacin (CIP) from aqueous solutions was investigated. Almond shell was used to make activated carbon. Zinc oxide nanoparticles were prepared by the sol-gel method, and finally, ZnO nanoparticles were bonded to activated carbon. The effect of independent parameters pH, contact time, adsorbent dose, and initial CIP concentration on CIP removal efficiency using ACA-ZnO was investigated by response surface methodology. Optimal removal was obtained at pH = 5.4, CIP initial concentration = 7.4 mg/L, adsorbent dose = 0.82 g/L, and reaction time = 67.3 min. This study followed a quadratic model (R2 = 0.958). The best model of adsorption isotherm fits with the Freundlich model (R2 = 0.9972) and the maximum capacity was 251.42 mg/g adsorption kinetics, and pseudo-second-order kinetic model (R2 = 0.959). The results of this study showed that ACA-ZnO as an adsorbent is very efficient, without environmental side effect and cost-benefit.

The Role of the IL-33/ST2 Immune Pathway in Autoimmunity: New Insights and Perspectives.

Interleukin (IL)-33, a member of IL-1 cytokine family, is produced by various immune cells and acts as an alarm to alert the immune system after epithelial or endothelial cell damage during cell necrosis, infection, stress, and trauma. The biological functions of IL-33 largely depend on its ligation to the corresponding receptor, suppression of tumorigenicity 2 (ST2). The pathogenic roles of this cytokine have been implicated in several disorders, including allergic disease, cardiovascular disease, autoimmune disease, infectious disease, and cancers. However, alerted levels of IL-33 may result in either disease amelioration or progression. Genetic variations of IL33 gene may confer protective or susceptibility risk in the onset of autoimmune diseases. The purpose of this review is to discuss the involvement of IL-33 and ST2 in the pathogenesis of a variety of autoimmune disorders, such as autoimmune rheumatic, neurodegenerative, and endocrine diseases.

Assessment of burden of disease induced by exposure to heavy metals through drinking water at national and subnational levels in Iran, 2019.

The burden of disease attributable to exposure to heavy metals via drinking water in Iran (2019) was assessed at the national and regional levels. The non-carcinogenic risk, carcinogenic risk, and attributable burden of disease of heavy metals in drinking water were estimated in terms of hazard quotient (HQ), incremental lifetime cancer risk (ILCR), and disability-adjusted life year (DALY), respectively. The average drinking water concentrations of arsenic (As), cadmium (Cd), chromium (Cr), lead (Pb), mercury (Hg), and nickel (Ni) in Iran were determined to be 2.3, 0.4, 12.1, 2.5, 0.7, and 19.7 µg/L, respectively, which were much lower than the standard values. The total average HQs of heavy metals in drinking water in the entire country, rural, and urban communities were 0.48, 0.65 and 0.45, respectively. At the national level, the average ILCRs of heavy metal in the entire country were in the following order: 1.06 × 10-4 for As, 5.89 × 10-5 for Cd, 2.05 × 10-5 for Cr, and 3.76 × 10-7 for Pb. The cancer cases, deaths, death rate (per 100,000 people), DALYs, and DALY rate (per 100,000 people) attributed to exposure to heavy metals in drinking water at the national level were estimated to be 213 (95% uncertainty interval: 180 to 254), 87 (73-104), 0.11 (0.09-0.13), 4642 (3793-5489), and 5.81 (4.75-6.87), respectively. The contributions of exposure to As, Cd, Cr, and Pb in the attributable burden of disease were 14.7%, 65.7%, 19.3%, and 0.2%, respectively. The regional distribution of the total attributable DALY rate for all heavy metals was as follows: Region 5> Region 4> Region 1> Region 3> Region 2. The investigation and improvement of relatively high exceedance of As levels in drinking water from the standard value, especially in Regions 5 and 3 as well as biomonitoring of heavy metals throughout the country were recommended.

Circular RNAs as prognostic and diagnostic biomarkers in renal cell carcinoma.

BACKGROUND: Circular RNAs (circRNAs) play pivotal roles in proliferation, apoptosis, migration, and invasion of renal cell carcinoma (RCC) cells. This study is aimed to systematically summarize the current evidence regarding the clinical implications of circRNAs in RCC patients. METHODS: A systematic search in PubMed, Embase, and Web of Science was performed until January 1, 2022. The correlation between the expression of circRNAs and clinicopathological, prognostic, and diagnostic features of RCC was evaluated using the meta-analysis. RESULTS: Ultimately, 41 studies with 3485 RCC patients were included in this study: 26 studies for clinicopathological features, 31 studies for prognosis, and eight studies for diagnosis. Altered expression of circRNAs was significantly associated with clinicopathological characteristics of RCC, including tumor size, tumor stage, lymph node metastasis, distant metastasis, and TNM stage. The tumor promoter circRNAs were associated with reduced overall survival (OS) (Hazard Ratio (HR) = 1.98, 95% confidence interval [CI] 1.68-2.34) and disease/progression/recurrence-free survival (DFS/PFS/RFS) (HR = 2.34, 95% CI 1.85-2.97). Contrarily, the tumor suppressor circRNAs were linked with better OS (HR = 0.49, 95% CI 0.40-0.60) and DFS/PFS/RFS (HR = 0.40, 95% CI 0.28-0.59). The pooled sensitivity and specificity of circRNAs for RCC diagnosis in tissue samples were both 0.84. These results in fluid samples (serum and urine) were 0.78 and 0.69, respectively. CONCLUSION: CircRNAs can serve as promising diagnostic and prognostic biomarkers for RCC.

Physicochemical properties of saponin containing Acanthophyllum laxiusculum extract: example application in foam stability and qualitative parameters for malt beverage industry.

Aqueous Extract of Acanthophyllum laxiusculum root (AE) exhibited remarkable foaming profile, emulsification properties and antifungal activity due to the presence of high concentration of total saponins. Total phenolic compounds, another main component, accounted for the AE antioxidant activity. Spray drying of AE, as a thermal process, did not affect the foaming indices of A. laxiusculum Spray-dried Extract (SE) and is a recommended alternate for convenient application in food industry. Addition of SE to the malt extract at accepted levels of total saponin daily intake (below 50 mg/kg) showed positive attribution of malt and carbonation on the foaming quality of SE. Meanwhile, antioxidant activity of commercial malt beverage was enhanced by addition of phenolic compounds containing SE. The 20-60% antifungal inhibitory ratio of the SE developed here is within the applied range of total saponin that supports its application to inhibit the growth of Saccharomyces cerevisiae after malt beverage production. The bitter taste of SE was not sensed in malt beverage at 30 mg/kg total saponin content and suggested A. laxiusculum root extract as a natural additive in malt industry.

Validation of the Persian version of Skindex-16 among older patients with skin diseases.

BACKGROUND: Skin conditions often considerably impact the older patients' psycho-social health and quality of life (QoL). The present study was aimed to examine the validity and reliability of the Persian version of Skindex-16 among older people with skin diseases. METHODS: In this validation study, 260 older patients suffering from a range of skin conditions were recruited from a dermatology clinic in Rasht, Iran. Data were collected using a checklist for demographic and clinical characteristics and the Skindex-16 questionnaire. In this study, validity (face, content, and construct) and reliability (Cronbach's alpha) of the Skindex-16 were assessed and reported. RESULTS: The mean age of participants was 64.51 ± 5.04 years. The results of confirmatory factor analysis showed that the model had acceptable fitness into the expected three-factor structure [χ 2 /df = 249.363, P < 0.001; GFI = 0.961; TLI =0.952; RMSEA = 0.078 (90% CI = 0.06, 0.09) and SRMR = 0.06]. The reliability analysis results confirmed that the values of Cronbach's alpha coefficient for Skindex-16 were in the acceptable range (0.923). CONCLUSIONS: Our evaluation of the Skindex-16 indicates that it is reliable and a valid instrument that can be used for measuring QoL for Iranian dermatologic patients.

Impact of different intensities of forced exercise on deficits of spatial and aversive memory, anxiety-like behavior, and hippocampal BDNF during morphine abstinence period in male rats.

Forced exercise can alleviate cognitive-behavioral deficits in an experimental model of addiction. However, the effects of different intensities of forced exercise in improving behavioral, cognitive and biochemical deficits during morphine abstinence period are not well investigated. Thus, the current work examined the effects of different loads of forced exercise on cognition functions, anxiety behavior and BDNF changes in the hippocampus, and prefrontal cortex (PFC), and also serum levels of BDNF and corticosterone during the abstinent period in male rats. Animals received morphine injections (10 mg/kg, twice a day) for 10 consecutive days. Then, the animals were exposed to a 4-week forced exercise training program under low, moderate or high intensities (30 min per session on 5 days a week), which accompanied by behavioral and biochemical tests. In Experiment 1, anxiety-like behaviors using elevated plus maze (EPM), and light/dark box (L/D box) were examined. In Experiment 2, cognitive functions using T-maze alteration and passive avoidance tasks were tested, which accompanied by BDNF measurements in the hippocampus and PFC. In Experiment 3, serum levels of BDNF and corticosterone following the termination of forced exercise regimen were measured. Morphine-abstinent animals exhibited anxiogenic -like behaviors in the EPM, but not L/D box. They also exhibited impaired T-maze alternation performance and passive avoidance memory, and a decline in hippocampal BDNF, but not PFC. Forced exercise at a moderate intensity alleviated anxiety, cognitive and BDNF defects in morphine-abstinent animals. The high load exercise enhanced serum levels of corticosterone in both saline and morphine groups. Thus, regular moderate forced exercise may be beneficial in preserving cognitive and mood functions in male addicts during the abstinent period and drug rehabilitation.