Palladium supported magnetic Fucus Vesiculosus extract as a natural and novel catalyst for the synthesis of N-alkyl-2-(4-methyl-1-oxoisoquinolin-2(1H)-yl)-2-phenylacetamide derivatives.

In this paper, a novel catalyst is introduced based on the immobilization of palladium onto magnetic Fucus Vesiculosus extract (Pd@mFuVe catalyst). For the synthesis of Pd@mFuVe catalyst, Fucus Vesiculosus extract is obtained from the plant source, followed by the synthesis of superparamagnetic iron oxide nanoparticles (SPION) onto the extract. The catalyst is characterized by several methods, including scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), FT-IR spectroscopy, vibrating sample magnetometer (VSM), powder X-ray diffraction analysis (XRD), and inductively coupled plasma (ICP). The activity of Pd@mFuVe catalyst is studied in the synthesis of N-alkyl-2-(4-methyl-1-oxoisoquinolin-2(1H)-yl)-2-phenylacetamides. The products were synthesized in three steps, the synthesis of 2-iodobenzoic acid from 2-aminobenzoic acid, which participated in a multicomponent reaction with allylamine, aldehydes, and isocyanides, followed by a cyclization reaction, catalyzed by Pd@mFuVe catalyst. The product yields are high and the catalyst showed good reusability after 5 sequential runs. The most significant, Pd@mFuVe catalyst is fabricated from a plant extract source as a green support for the catalyst.

Coffee consumption and caffeine intake in relation to risk of fractures: a systematic review and dose-response meta-analysis of observational studies.

BACKGROUND: Conflicting reports are available about the association of coffee or caffeine intake and risk of fracture. We performed the current updated systematic review and dose-response meta-analysis of coffee consumption and caffeine intake and risk of fracture to quantify this association. MATERIALS AND METHODS: PubMed/Medline, ISI Web of Science, and Scopus, Cochrane database were searched up to July 2021. Random-effects model or fixed-effects model was used to pool the study-specific effect sizes (ESs) and 95% confidence intervals (CIs). Dose-response relationship was examined using linear and non-linear dose-response analyses. The certainty of evidence was assessed using NutriGrade tool. RESULTS: Out of 22 eligible studies included in the meta-analysis, 15 had cohort and 7 had case-control design. We found no significant association between coffee consumption and risk of fracture, either based on pooling cohort (RR: 0.99; 95% CI: 0.88, 1.12; I2 = 71.4%, Pheterogeneity < 0.01) or case-control studies (OR: 1.13; 95% CI: 0.87, 1.46; I2 = 49.0%, Pheterogeneity=0.08). In the subgroup analysis of cohort studies, we observed that higher coffee intake was inversely associated with risk of fracture in men (RR: 0.85; 95% CI: 0.76 to 0.94). In addition, a positive association was seen between coffee consumption and risk of fracture in studies with less than 12 years of follow-up (RR: 1.14; 95% CI: 1.02 to 1.27). With regard to caffeine intake, a statistically significant positive association was seen with risk of fracture (RR: 1.15; 95% CI, 1.08 to 1.23; I2=26.6%, n = 8). In the dose-response analysis, we found that each additional 100 mg caffeine intake was marginally associated with 2% greater risk of fracture (RR: 1.02; 95% CI: 1 to 1.05; I2= 70.3%, n = 6). CONCLUSION: High coffee consumption was protectively associated with risk of fracture in men, while caffeine intake was positive associated with risk.

Therapeutic effects of dietary antioxidative supplements on the management of type 2 diabetes and its complications; umbrella review of observational/trials meta-analysis studies.

Background: Controversial data on the effects of vitamins (V) and nutrients on the management of type 2 diabetes mellitus (T2DM) is available. Thus, it is aimed to clarify the role of vitamins and nutrients through an umbrella review regarding the available observational/ trials meta-analyses. Methods: All meta-analyses of observational and clinical trials conducted on the impact of vitamins and nutrients in T2DM published until 5th June 2021 in PubMed or Web of Sciences were included in this review. Also, the meta-analysis on children, pregnant women, type 1 DM, or in vivo/in vitro studies was excluded. Search results were reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) flowchart. Results: The overall of 93 papers (99 studies) consisting of 75 trials and 24 observational studies were included. Most studies were conducted on the effect of VD and alpha-lipoic acid (ALA) in both genders. Consumption of VD or its analogous; 20 IU/d to 450,000 IU/once for 3 weeks to 7 years showed to have a positive effect on the parameters of glucose hemostasis. Moreover, an inverse association was observed between VD level and T2DM risk. Daily consumption of 1200 mg VC for at least 12 weeks improved lipid profile and glucose hemostasis parameters. Furthermore, VB and medications for diabetic polyneuropathy (DPN) increased nerve conduction velocity. Vitamins K and E were showen to not have significant impact on T2DM. ALA had a beneficial effect on DPN symptoms after 2-4 weeks of intake of at least 300 mg/d. T2DM risk was reduced by doubling ALA intake. The effective daily doses of chromium, zinc and coenzyme Q10 on lipid profile and glucose hemostasis parameters were > 200 mg, < 25 mg, and < 200 mg, respectively. Conclusion: This umbrella review suggests that dietary vitamins and nutrients can result in protective impacts the complications associated with T2DM. However, due to discrepancies between the results of the trials and observational studies is essential to conduct long-term high-qualified studies to prove the beneficial therapeutic effects of the vitamins and nutrients on T2DM and its complications.

The association of opioid consumption and osteoporosis in old men: Bushehr Elderly Health (BEH) program.

In a population of 1156 men aged ≥ 60 years, opioid drug use was reported by 4.1% (n = 47) of participants. Among opioids, opium was the most prevalent consuming drug (83%). Adjusting for potential confounders, opioid consumption showed a positive association with osteoporosis. PURPOSE: Limited evidence suggest a relationship between opioid consumption and osteoporosis. This study aims to investigate the possible association of osteoporosis and drug use among older adult men of Bushehr, Iran. METHODS: In this study, 1156 men aged ≥ 60 years of Bushehr Elderly Health (BEH) were included. Bone density and trabecular bone score (TBS) were measured using dual-energy X-ray absorptiometry. Total osteoporosis was noted based on osteoporosis at either site of the lumbar spine, femoral neck, and total hip densitometry. Drug use was defined as a self-reported current use of opioid drugs, either regular (daily) use or irregular consumption. Multivariable modified Poisson regression analysis was used for investigating the association of opioids and osteoporosis, reporting the adjusted prevalence ratio (APR) with 95% confidence interval (CI). The association between drug use and TBS was evaluated using a linear regression model. RESULTS: Opioid drug use was reported by 4.1% (n = 47) of participants. Among drug users, opium was the most prevalent consuming drug (83%). In all, 38.3% of drug users and 22.4% of non-users had osteoporosis (p-value = 0.011). Multivariable analysis showed that adjusting by age, education, smoking, alcohol consumption, body mass index, diabetes, and physical activity, a positive and significant association was detected between opioid drug use and the likelihood of osteoporosis (APR: 1.46, 95%CI: 1.02-2.10). Considering the potential confounders, the results also showed a negative association between drug consumption and TBS (ß: - 0.027, 95%CI: - 0.053, - 0.001). CONCLUSION: Opioid drug use has a positive association with osteoporosis in elderly men, independent of other conventional risk factors. Elderly drug users might be at a higher risk for osteoporotic fractures, given the effect of substance use on cognition. So, osteoporosis among drug users would be of importance, especially in countries where opium consumption is prevalent.

Effect of vitamins C and E on cancer survival; a systematic review.

PURPOSE: Association between vitamins C (VC)/ E (VE) and cancer survival is inconsistent. This systematic review is aimed to summarize trials for effects of VC/VE on cancer survival. METHODS: Relevant English trials were retrieved from PubMed, Cochrane Library, Embase, Web of Science, Scopus databases, and Clinicaltrials.gov through 21/June/2022. Inclusion criteria were all trials which assessed sole/combinations intake of VC/VE on survival rate, mortality, or remission of any cancer. Exclusion criteria were observational and animal studies. RESULTS: We reached 30 trials conducted on 38,936 patients with various cancers. Due to severe methodological heterogeneity, meta-analysis was impossible. High dose VC + chemotherapy or radiation was safe with an overall survival (OS) 182 days - 21.5 months. Sole oral or intravenous high dose VC was safe with non-significant change in OS (2.9-8.2 months). VE plus chemotherapy was safe, resulted in stabling diseases for 5 years in 70- 86.7% of patients and OS 109 months. It was found 60% and 16% non-significant reductions in adjusted hazard ratio (HR) deaths or recurrence by 200 mg/d tocotrienol + tamoxifen in breast cancer, respectively. Sole intake of 200-3200 mg/d tocotrienol before resectable pancreatic cancer was safe and significantly increased cancer cells' apoptosis. Combination VC and VE was non-significantly reduced 7% in rate of neoplastic gastric polyp. CONCLUSION: Although our study is supported improvement of survival and progression rates of cancers by VC/VE, more high quality trials with large sample sizes are required to confirm. PROSPERO REGISTRATION NUMBER: CRD42020152795.

Association of amino acid metabolites with osteoporosis, a metabolomic approach: Bushehr elderly health program.

INTRODUCTION AND OBJECTIVES: Amino acids are the most frequently reported metabolites associated with low bone mineral density (BMD) in metabolomics studies. We aimed to evaluate the association between amino acid metabolic profile and bone indices in the elderly population. METHODS: 400 individuals were randomly selected from 2384 elderly men and women over 60 years participating in the second stage of the Bushehr elderly health (BEH) program, a population-based prospective cohort study that is being conducted in Bushehr, a southern province of Iran. Frozen plasma samples were used to measure 29 amino acid and derivatives metabolites using the UPLC-MS/MS-based targeted metabolomics platform. We conducted Elastic net regression analysis to detect the metabolites associated with BMD of different sites and lumbar spine trabecular bone score, and also to examine the ability of the measured metabolites to differentiate osteoporosis. RESULTS: We adjusted the analysis for possible confounders (age, BMI, diabetes, smoking, physical activity, vitamin D level, and sex). Valine, leucine, isoleucine, and alanine in women and tryptophan in men were the most important amino acids inversely associated with osteoporosis (OR range from 0.77 to 0.89). Sarcosine, followed by tyrosine, asparagine, alpha aminobutyric acid, and ADMA in women and glutamine in men and when both women and men were considered together were the most discriminating amino acids detected in individuals with osteoporosis (OR range from 1.15 to 1.31). CONCLUSION: We found several amino acid metabolites associated with possible bone status in elderly individuals. Further studies are required to evaluate the utility of these metabolites as clinical biomarkers for osteoporosis prediction and their effect on bone health as dietary supplements.

Scientometric assessment of scientific documents published in 2020 on herbal medicines used for COVID-19.

Objective: Many studies have suggested herbal medicines as alternatives or adjuvants to modern drugs for COVID-19. Their scientometric analyses can provide a scientific overview of this topic. Materials and methods: Web of Science (WOS) and Scopus were searched for articles on the use of herbal medicines in COVID-19 published until 26 October 2020. Collected data were analyzed for document type, subject area, top journal, citation number, and authors' collaboration network using VOSviewer 1.6.15, ScientoPy 2.0.3, Gephi 0.9.2, and SPSS 15 statistical tools. Results: After screening the 3185 retrieved records, 378 and 849 records, respectively from WOS and Scopus, remained for quantity analysis. Original and review articles were the two main types of papers in both databases. Top subject areas were drug and medicine, respectively in the WOS and Scopus databases. The top three productive countries in the field were China, the US, and India. The most cited article was a practice guideline in both databases. "Journal of Biomolecular Structure Dynamics" in WOS and "Chinese Traditional and Herbal Drugs" in Scopus were the top journals. Top keywords included "COVID-19″ and "Traditional Chinese Medicine". US authors had the highest collaboration with other authors. Conclusions: The current study provides a snapshot of the quantity and characteristics of published scholarly documents in recent months in the intersection of herbal medicines and COVID-19. Our findings help scientists to find the existing gaps, identify the active authors and scientific institutes to collaborate with and use their experience to produce new knowledge in the future.

Effect of vitamin E supplementation on cardiometabolic risk factors, inflammatory and oxidative markers and hormonal functions in PCOS (polycystic ovary syndrome): a systematic review and meta-analysis.

Polycystic ovary syndrome (PCOS) is a common endocrinopathy among reproductive-age women. Various therapeutical approaches are currently used to manage or control symptoms associated with PCOS. This systematic review intended to assess the effects of Vit E supplementation on cardiometabolic risk factors, inflammatory and oxidative markers, and hormonal functions in PCOS women based on the clinical trial's results. The databases including PubMed, Scopus, Cochrane, Web of Science, and Embase were used to find all relevant studies. The authors reviewed all relevant clinical trials via systematic evaluation of abstracts and titles. Searches were conducted on August 1, 2020. After the initial search and reading of the article's title and abstract, 353 articles were reviewed; finally, 12 articles met the inclusion criteria. Vitamin E supplementation improves lipid profile, decreases insulin and HOMA-IR levels. Furthermore, while Vitamin E supplementation decreases LH and testosterone concentrations, it increases FSH and progestrone concentrations. The following meta-analysis showed that vitamin E supplementation made statistically significant improvements in triglyceride (TG) and low-density lipoproteins (LDL) levels, meanwhile, pooled mean difference for waist circumference (WC) and HOMA-IR were also statistically significant. Supplementary regimens containing vitamin E can positively affect metabolic and hormonal parameters in women with PCOS.

Molecular Docking as a Therapeutic Approach for Targeting Cancer Stem Cell Metabolic Processes.

Cancer stem cells (CSCs) are subpopulation of cells which have been demonstrated in a variety of cancer models and involved in cancer initiation, progression, and development. Indeed, CSCs which seem to form a small percentage of tumor cells, display resembling characteristics to natural stem cells such as self-renewal, survival, differentiation, proliferation, and quiescence. Moreover, they have some characteristics that eventually can demonstrate the heterogeneity of cancer cells and tumor progression. On the other hand, another aspect of CSCs that has been recognized as a central concern facing cancer patients is resistance to mainstays of cancer treatment such as chemotherapy and radiation. Owing to these details and the stated stemness capabilities, these immature progenitors of cancerous cells can constantly persist after different therapies and cause tumor regrowth or metastasis. Further, in both normal development and malignancy, cellular metabolism and stemness are intricately linked and CSCs dominant metabolic phenotype changes across tumor entities, patients, and tumor subclones. Hence, CSCs can be determined as one of the factors that correlate to the failure of common therapeutic approaches in cancer treatment. In this context, researchers are searching out new alternative or complementary therapies such as targeted methods to fight against cancer. Molecular docking is one of the computational modeling methods that has a new promise in cancer cell targeting through drug designing and discovering programs. In a simple definition, molecular docking methods are used to determine the metabolic interaction between two molecules and find the best orientation of a ligand to its molecular target with minimal free energy in the formation of a stable complex. As a comprehensive approach, this computational drug design method can be thought more cost-effective and time-saving compare to other conventional methods in cancer treatment. In addition, increasing productivity and quality in pharmaceutical research can be another advantage of this molecular modeling method. Therefore, in recent years, it can be concluded that molecular docking can be considered as one of the novel strategies at the forefront of the cancer battle via targeting cancer stem cell metabolic processes.

Design and synthesis of novel nitrothiazolacetamide conjugated to different thioquinazolinone derivatives as anti-urease agents.

The present article describes the design, synthesis, in vitro urease inhibition, and in silico molecular docking studies of a novel series of nitrothiazolacetamide conjugated to different thioquinazolinones. Fourteen nitrothiazolacetamide bearing thioquinazolinones derivatives (8a-n) were synthesized through the reaction of isatoic anhydride with different amine, followed by reaction with carbon disulfide and KOH in ethanol. The intermediates were then converted into final products by treating them with 2-chloro-N-(5-nitrothiazol-2-yl)acetamide in DMF. All derivatives were then characterized through different spectroscopic techniques (1H, 13C-NMR, MS, and FTIR). In vitro screening of these molecules against urease demonstrated the potent urease inhibitory potential of derivatives with IC50 values ranging between 2.22 ± 0.09 and 8.43 ± 0.61 µM when compared with the standard thiourea (IC50 = 22.50 ± 0.44 µM). Compound 8h as the most potent derivative exhibited an uncompetitive inhibition pattern against urease in the kinetic study. The high anti-ureolytic activity of 8h was confirmed against two urease-positive microorganisms. According to molecular docking study, 8h exhibited several hydrophobic interactions with Lys10, Leu11, Met44, Ala47, Ala85, Phe87, and Pro88 residues plus two hydrogen bound interactions with Thr86. According to the in silico assessment, the ADME-Toxicity and drug-likeness profile of synthesized compounds were in the acceptable range.

Nutrition and Diet Therapy in Diabetes Mellitus: A Roadmap based on available evidence.

BACKGROUND: Nutrition is considered as a primary approach for diabetes management. It needs a comprehensive assessment of evidence to identify nutritional dimensions that should be explored in the future. We aimed to provide a roadmap on diabetes and nutrition and clarify research gaps in this field. METHODS: In the present review, we searched Scopus and PubMed electronic databases to collect eligible publications with English and Farsi languages from 2015 to December 2019 in the field of nutrition and diabetes. Relevant papers were classified into six subgroups including biochemistry/ animal studies, clinical nutrition, food industry, genetic, public health, and dietary supplements. Based on evidence-based pyramid, publications were categorized as well. Publications trend from 2015 to 2019 and frequency of publications in each category were provided. RESULTS: Finally, we reached 438 eligible papers. Most studies (40.86%) were clinical trials and in most human studies (n = 224) patients with type 2 diabetes were considered. Probiotic/prebiotic/ symbiotic, vitamin D, and omega-3/fish oil were the most frequent studied dietary supplements. Low portions of studies were dedicated to diabetic children (n = 3), type 1 diabetes (n = 6), diabetes complications (n = 23) and GDM (n = 25). CONCLUSION: An increasing trend in nutrition publications in the field of diabetes was observed. Publications were mostly dedicated to clinical trials with a focus on dietary supplements. Low portion of studies have been dedicated to children with diabetes, diabetes complications, and GDM. More attention to high quality basic research, product-based projects, and interdisciplinary studies in the field of nutrition and diabetes are needed.

Targeting dyslipidemia with antioxidative vitamins C, D, and E; a systematic review of meta-analysis studies: Dyslipidemia and antioxidative vitamins.

BACKGROUND: There is controversial evidence for the beneficial effects of antioxidative vitamins (vits) on dyslipidemia. In this regard, we aimed to systematically review all meta-analyses of trials on this topic. METHODS: We comprehensively searched PubMed, Web of Science, Scopus, and Cochrane Library databases until January 2021 to explore the published English meta-analyses of trials conducted to assess the effects of single or combined vits C, D and E consumption on lipid profile. The meta-analyses of observational, in vivo/in vitro, or case-report studies were excluded. Search results were reported based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) flowchart. RESULTS: Overall, 25 meta-analyses including 32,177 individuals with different underlying disorders met our inclusion criteria. Numerous studies had assessed supplementation with Vit-D or its combination with other agents on lipid profile. Consumption of 400 IU/day (d) to 50,000 IU/week (w) Vit-D for at least eight weeks improved the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) in type 2 diabetes mellitus or polycystic ovary syndrome (PCOS) patients. This treatment reduced the levels of TC and TG in patients with chronic kidney disease. A significant increase in high-density lipoprotein cholesterol (HDL-C) levels was only observed in coronary artery disease patients. Sole intake of 500-2000 mg/d Vit-C for at least 3 weeks improved LDL-C and TG values in hypercholesterolemic patients. Nevertheless, sole intake of Vit-E had controversial effects on lipid profile. The combination of 400-1800 IU/d omega-3 free fatty acid (FFA) and 400 IU/d Vit-E significantly reduced the levels of LDL-C and TG in overweight individuals, without any significant effect on other components. A significant improvement of TG values was observed after consumption of 1000-2000 mg/d omega-3 FFA plus 400 IU/d Vit-E along with 50,000 IU/each 2w Vit-D for at least 6 weeks in diabetic patients. CONCLUSION: The beneficial effects of antioxidative vitamins (C, D, E) or their combination with other agents on lipid profile varied based on their dosage, intake duration, and the health status of the individuals. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-021-00919-8.

Probiotics as a New Regulator for Bone Health: A Systematic Review and Meta-Analysis.

Despite the proposed role of the gut microbiota-bone axis, findings on the association between probiotic consumption and bone health are conflicting. This systematic review aimed to assess the effect of probiotic consumption on bone health parameters. A systematic literature search of relevant reports published in PubMed/Medline, Web of Science, SCOPUS, EMBASE, and Google scholar before December 2020 was conducted. All clinical trials or experimental studies, which examined the relationship between probiotic consumption and bone health parameters, were included. No limitation was applied during the search. After screening articles based on inclusion criteria, 44 studies remained. In clinical trials, probiotic consumption affects bone health parameters such as serum calcium levels (3.82; 95% CI: 1.05, 6.59 mmol/l), urinary calcium levels (4.85; 95% CI: 1.16, 8.53 mmol/l), and parathyroid hormone (PTH) levels (-5.53; 95% CI: -9.83, -0.86 ng/l). In most studies, Lactobacillus species such as L. helveticus, L. reuteri, and L. casei were consumed and women aged 50 years or older were assessed. Spinal and total hip bone mineral density (BMD) was not affected significantly by probiotic consumption. In 37 animal experiments, probiotic or symbiotic feeding mostly had effects on bone health parameters. Some strains of Bifidobacterium and Lactobacillus including L. reuteri, L. casei, L. paracasei, L. bulgaricus, and L. acidophilus have indicated beneficial effects on bone health parameters. In conclusion, this systematic review and meta-analysis indicate that probiotic supplementation might improve bone health. Further studies are needed to decide on the best probiotic species and appropriate dosages.

Factors associated with TBS worse than BMD in non-osteoporotic elderly population: Bushehr elderly health program.

BACKGROUND: Bone mineral density (BMD) and trabecular bone score (TBS) are moderately correlated. TBS is sometimes used as an adjuvant to BMD in the fracture risk assessment. Some individuals with normal BMD or osteopenia, have more degraded TBS. We aimed to identify factors associated with TBS worse than BMD in the non-osteoporotic elderly population. METHODS: The study subjects were selected from 2384 women and men aged ≥60 years participating in the second stage of the Bushehr Elderly Health program, a population-based prospective cohort study in Iran. The BMDs of different sites and the lumbar spine texture were measured using dual-energy X-ray absorptiometry and the TBS algorithm, respectively. Subjects were categorized based on their BMD and TBS status. Logistic regression was performed to identify the factors associated with "TBS worse than BMD" in non-osteoporotic individuals. RESULTS: Of 1335 participants included in the study, 112 of 457 women, and 54 of 878 men had worse TBS than BMD. In multivariable analysis, TBS worse than BMD in women was statistically significantly associated with years since menopause (OR: 1.04 (1.00-1.07)) and waist circumference (OR: 1.09 (1.05-1.14)). However, in men, the condition was statistically significantly associated with waist circumference (OR: 1.10 (1.03-1.17)), current smoking (OR: 2.54 (1.10-5.84)), and HDL-C (OR: 1.03 (1.00-1.06)). CONCLUSION: The results of the study show that higher waist circumference is associated with more degraded TBS than BMD in both men and women. Years passed since menopause and current smoking, respectively in women and men, were associated with more degraded TBS. Considering TBS values in older individuals with higher waist circumference, or a history of smoking despite normal BMDs might help more accurate assessment of bone health. However, further studies are required to confirm the benefit.

Targeting dyslipidemia by herbal medicines: A systematic review of meta-analyses.

ETHNOPHARMACOLOGICAL RELEVANCE: The worldwide increasing prevalence of dyslipidemia has become a global health concern. Various herbal remedies have been claimed to be effective for the treatment of dyslipidemia in traditional and folkloric medicine of different regions clinical trials have been conducted to investigate their efficacy. The aim of the current systematic review is to critically assess the meta-analyses of controlled trials (CT) evaluated herb medicines for dyslipidemia. MATERIALS AND METHODS: Relevant studies from Web of Science, PubMed, Scopus, and Cochrane Library databases based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist until January 2021 have been searched. All meta-analyses which pooled studies on the effect of herbal medicines on lipid profile including total cholesterol (TC), triglyceride (TG), and low- or high-density lipoprotein cholesterol (LDL-C, HDL-C) were also included. Meta-analyses of in vitro, animal or observational studies were excluded. RESULTS: The overall of 141 meta-analyses were revealed. Vegetable oils, phytosterols, tea, soy protein, nuts, and curcumin have been studied frequently among the herbal medicines. Among 13 meta-analyses on vegetable oils, the greater reduce of TC (18.95 mg/dl), LDL-C (16.24 mg/dl) and TG (13.69 mg/dl) were exhibited from sunflower oil. Furthermore, rice bran oil (6.65 mg/dl) increased HDL-C significantly. Phytosterols in 12 meta-analyses demonstrated significant improvements in reducing TC, LDL-C and TG as 16.4, 23.7, and 8.85 mg/dl, respectively, and rise in HDL-C as 10.6 mg/dl. The highest reduction in serum level of TC, LDL-C and TG was reported while intake Green tea; 27.57, 24.75, and 31.87 mg/dl, accordingly within 9 meta-analyses. Average improvement of lipid profiles by 6 meta-analyses on plant proteins were 23.2, 21.7, 15.06, and 1.55 mg/dl for TC, LDL-C, TG, and HDL-C, respectively. Among 11 meta-analyses on nuts, almond showed better and significant alleviations in TC (10.69 mg/dl), walnut in LDL-C (9.23 mg/dl), pistachio in TG (22.14 mg/dl), and peanut in HDL-C (2.72 mg/dl). Overall, Curcumin, Curcuminoid, and Turmeric have resulted in the reduction of TC (25.13 mg/dl), LDL-C (39.83 mg/dl), TG (33.65 mg/dl), and an increase in the HDL-C (4.31 mg/dl). CONCLUSION: The current systematic review shed light on the use of herbal medicines for the management of dyslipidemia. However, more well-conducted CTs are required to determine effective doses of herbal medicines.

The effects of vitamin D supplementation on inflammatory biomarkers in patients with abnormal glucose homeostasis: A systematic review and meta-analysis of randomized controlled trials.

FINDINGS: on the level of inflammatory cytokines following vitamin D supplementation among individuals with abnormal glucose homeostasis (AGH) are controversial. Therefore, the present study was conducted on AGH patients to assess the impact of vitamin D on inflammatory cytokines such as CRP, TNF-α and IL-6. A systematic search up to September 2020 was performed through PubMed and Scopus databases. All clinical studies which evaluated the effect of oral vitamin D supplementation on inflammation in patients with AGH were included. The random-effects model was applied to obtain pooled results. For dose-response analysis, we used a fractional polynomial model. Overall, 38 studies, with 46 effect sizes, were included in this study. Combining effect sizes, we found that vitamin D considerably decrease serum concentrations of CRP (weight mean difference (WMD): - 0.67 mg/l; 95%CI: - 0.92, - 0.43; P < 0.001), IL-6 (WMD: -1.93 pg/mL; 95%CI: -2.80, -1.07; P < 0.001) and TNF-α (WMD: -0.81 pg/mL; 95%CI: -1.59, -0.03; P = 0.04). In the dose-response analysis, we failed to find any correlation between dosage of supplements and inflammatory biomarkers concentrations. Summarizing earlier studies, we demonstrated that circulating concentrations of inflammatory cytokines such as CRP, TNF-α, and IL-6 might be decreased following vitamin D supplementation among individuals with AGH.

Total, Dietary, and Supplemental Magnesium Intakes and Risk of All-Cause, Cardiovascular, and Cancer Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies.

A meta-analysis of prospective studies was conducted to examine the association of total, supplemental, and dietary magnesium intakes with risk of all-cause, cancer, and cardiovascular disease (CVD) mortality and identify the dose-response relations involved in these association. We performed a systematic search of PubMed, Scopus, Google Scholar, and ISI Web of Knowledge up to April 2020. Prospective cohort studies that reported risk estimates for the association between total, supplemental, and dietary magnesium intakes and risk of mortality were included. Random effects models were used. Nineteen publication with a total of 1,168,756 participants were included in the current meta-analysis. In total, 52,378 deaths from all causes, 23,478 from CVD, and 11,408 from cancer were identified during the follow-up period of 3.5 to 32 years. Dietary magnesium intake was associated with a lower risk of all-cause [pooled effect size (ES): 0.87; 95% CI: 0.79, 0.97; P = 0.009; I2 = 70.7%; P < 0.001] and cancer mortality (pooled ES: 0.80; 95% CI: 0.67, 0.97; P = 0.023; I2 = 55.7%; P = 0.027), but not with CVD mortality (pooled ES: 0.93; 95% CI: 0.82, 1.07; P = 0.313; I2 = 72.3%; P < 0.001). For supplemental and total magnesium intakes, we did not find any significant associations with risks of all-cause, CVD, and cancer mortality. However, linear dose-response meta-analysis indicated that each additional intake of 100 mg/d of dietary magnesium was associated with a 6% and 5% reduced risk of all-cause and cancer mortality, respectively. In conclusion, higher intake of dietary magnesium was associated with a reduced risk of all-cause and cancer mortality, but not CVD mortality. Supplemental and total magnesium intakes were not associated with the risk of all-cause, CVD, and cancer mortality. These findings indicate that consumption of magnesium from dietary sources may be beneficial in reducing all-cause and cancer mortality and thus have practical importance for public health.

Probiotics as a Complementary Therapy for Management of Obesity: A Systematic Review.

BACKGROUND: Considering the observed role of probiotics in modulating gut microbiome, probiotics are discussed to be one potential complementary therapy for obesity management in recent years. The aim of the present study was to systematically review the meta-analyses of controlled trials and investigate the effects of probiotics on obesity. METHODS: A comprehensive search was conducted on PubMed, Web of Science, and Cochrane Library web databases up to May 2020. Inclusion criteria were meta-analyses of controlled trials which evaluated the impact of probiotics on obesity in English language. Meta-analyses done on pregnant women, children, animal studies, or the effect of prebiotics on anthropometric indices were excluded. RESULTS: Within 325 recorded studies, 20 studies met the inclusion criteria consisting of 16676 overweight/obese adults with different underlying disorders such as nonalcoholic fatty liver disease (NAFLD), or polycystic ovary syndrome (PCOS). The length of intervention varied from 2 to 26 weeks. Results of meta-analyses have shown a moderate effect of probiotics on body weight in overweight/obese adults: from -0.526 kg/m2 (95% CI: -0.810, -0.247) to -0.25 kg/m2 (95% CI: -0.33, -0.17). Body mass index (BMI) was changed from -1.46 kg/m2 (95% CI: -2.44, -0.48) to -1.08 kg/m2 (95% CI: -2.05, -0.11) in NAFLD. Probiotics could reduce BMI from -0.36 kg/m2 (95% CI: -0.74, 0.02) to -0.29 kg/m2 (95% CI: -0.54, -0.03) in patients with PCOS. CONCLUSION: It seems that the probiotic products could have beneficial effects as an adjunct therapy for care and management of obesity when used in high dose. However, due to heterogeneity of included studies, it is required to confirm our results by more meta-analyses of clinical trials.

Transcendent Philosophy of Medicine: A Deductive Synthesis According to the Transcendental Wisdom (Mulla Sadra School of Thought).

Medicine is dependent to definition of human being in all existential dimensions, and this study attempts to synthesize a philosophy of medicine based on transcendental wisdom that was instituted by Mulla Sadra (979-1045 AH /1571-1635 AD). Using implication eliciting methodology, in the paradigm of consensual qualitative research, ten main principles of transcendental wisdom were selected and described after being approved by experts (n = 13). Then, after more than 4 years of prolonged engagement using these principles, the transcendent philosophy of medicine was deductively synthesized. Afterward, to reach consensus, the results were reviewed in four panel discussions with experts (n=20). According to the transcendental wisdom, human being has four main dimensions including corpus, psyche, nous and soul and each contain two core aspects. These dimensions and aspects construct a real unity complex called human being (Nafs), that is the survival agent and cause of all aware and unaware biological, cognitive and behavioral capabilities in all dimensions of human existence. A holistic model of health was presented, and coherent strategies according to the ten transcendental wisdom principles were recommended in all corporeal and incorporeal aspects of human health, including environmental, biological, mental, identity-related, logical, intellectual, spiritual, ethical and social health.

Is there any association between fruit consumption and the risk of gestational diabetes mellitus? A systematic review and meta-analysis.

AIM: Although a considerable number of studies have illustrated the positive effects of fresh fruits on metabolic status, the impacts of fruits on the risk of gestational diabetes mellitus (GDM) are inconsistent. In consideration of this issue, we aimed to systematically summarize the findings of cohort studies with respect to the link between fresh fruits and the risk of GDM. METHOD: We selected cohort studies with English language indexed in PubMed/Medline, Scopus, Web of Science, and Embase from 2000 to 31 January 2018. To examine the link between fresh fruits and the risk of GDM development, relative risk (RR) and 95 % confidence intervals (CIs) for the highest versus the lowest consumption of fruits were pooled using a random effect model and the DerSimonian and Laird method. RESULTS: Out of 2522 publications, finally 5 cohort studies were obtained. No significant association between fruit consumption and GDM incidence was found (Pooled RR: 0.95; 95 % CI: 0.84, 1.08; I2: 90.3 %, p = 0001). In women who consumed higher amount of fruits before pregnancy, the risk of GDM was 5% lower than in those who consumed lower amount of fruits (0.95; 95 %CI: 0.91, 0.99, I2: 0%, p = 0.85). No link was obtained between fruit consumption during the pregnancy and GDM onset (1.18, 95 % CI: 0.48, 2.91; I2:94.6 %, p = 0.0001). CONCLUSION: In women who consumed greater fruits before pregnancy, the risk for GDM was 5 % lower than those consumed lower amounts of fruits, while there was no link between fruit consumption throughout the pregnancy and GDM onset. However, due to limited studies and considerable heterogeneity, the findings must be interpreted with great caution.