The association between vitamin D status and sleep duration in school-aged children; the CASPIAN-V study.

Background: Considering the high prevalence of both vitamin D deficiency (VDD) and sleep impairment in children and adolescents, this study was conducted to determine the association between VDD and sleep duration in the Iranian pediatric population. Methods: This multicentric national study was conducted in 2019 on 2564 frozen sera obtained from 7 to 18- year students who were studied in the fifth survey of a national school-based surveillance program conducted in 30 provinces of Iran. Sleep duration was assessed using a questionnaire based on the World Health Organization-Global School-based Student Health Survey protocol. Short sleep duration was defined as sleep duration less than 8 h/day VDD Vitamin D < 20 ng/dL, and vitamin D insufficiency as 20-30 ng/dL.An adjusted logistic regression model was applied to evaluate the associations of vitamin D status with sleep duration. Results: The Mean (SD) of students' age was 12.1(3.0) years; overall 10.6%of participants had VDD and 23% of participants had short sleep duration. in the adjusted logistic model, students with a low level of vitamin D (insufficient and deficient) had a higher odds of short sleep duration in comparison to those with normal vitamin D level (OR: 1.29, 95%CI: 1.02-1.62). Conclusion: The current study showed that low Vitamin D levels (insufficient and deficient)were significantly associated with short sleep duration in school-aged children. Further studies are recommended to determine the efficacy of vitamin D replacement in improving sleep duration and quality.

The Open, Randomized, Positive Control Clinical Trial of Guluronic Acid (G2013) on SARS-CoV-2 Patients.

INTRODUCTION: Recently, the coronavirus disease 2019 (COVID-19) infection, with a vast spectrum of clinical and paraclinical symptoms has been a major health concern worldwide. Therapeutical management of COVID-19 includes antiviral and anti-inflammatory drugs. NSAIDs, as the second-line therapy, are often prescribed to relieve the symptoms of COVID-19. The α-L-guluronic acid (G2013) is a non-steroidal patented (PCT/EP2017/067920) agent with immunomodulatory properties. This study investigated the effect of G2013 on the outcome of COVID-19 in moderate to severe patients. METHODS: The disease's symptoms were followed up during hospitalization and for 4 weeks postdischarge in G2013 and control groups. Paraclinical indices were tested at the time of admission and discharge. Statistical analysis was performed on clinical and paraclinical parameters and ICU admission and death rate. RESULTS: The primary and secondary outcomes indicated the efficiency of G2013 on COVID-19 patients' management. There were significant differences in the duration of improvement of fever, coughing, fatigue/malaise. Also, a comparison of paraclinical indices at the time of admission and discharge showed significant change in prothrombin, D-dimer, and platelet. As the main findings of this study, G2013 significantly decreased the percentage of ICU admission (control:17 patients, G2013:1 patient) and death (control: 7 cases, G2013:0). CONCLUSION: These results conclude that G2013 has sufficient potential to be considered for moderate to severe COVID-19 patients, can significantly reduce the clinical and physical complications of this disease, has a positive effect on modulating the coagulopathy process, and aids in saving lives.

Junk food consumption and psychological distress in children and adolescents: a systematic review and meta-analysis.

Background: Available evidence indicates that junk foods, defined as unhealthy foods with high-calorie and low-nutrient value, negatively affect mental and metabolic health of children. This study aimed to conduct a meta-analysis to clarify the association between junk food consumption and psychological distress in children and adolescents.Methods: A systematic literature search of relevant documents published in PubMed, Web of Science, and SCOPUS was conducted up to 2022. All observation studies which assessed association of junk foods and psychological distress in children and adolescents were included. Random-effect model was used to pool odds ratio (OR) and 95% confidence interval (CI) from individual studies. Subgroup meta-analysis was performed based on junk foods categories (sweet drinks, sweet snacks and snacks).Results: Data of 17 included articles on junk foods consumption in relation to depression, stress, anxiety, sleep dissatisfaction and happiness in children and adolescents were included in this systematic review. According to random effect model, the pooled OR in the highest vs. the lowest category of junk foods was 1.62 (95% CI: 1.35-1.95) for depression, 1.34 (95% CI: 1.16-1.54) for stress, 1.24 (95% CI: 1.03-1.50) for anxiety, 1.17 (95% CI: 1.05-1.30) for sleep dissatisfaction and 0.83 (95% CI: 0.75-0.92) for happiness. In subgroup meta-analysis, there were significant associations between different types of junk foods and psychological distress (P < 0.05).Conclusion: This meta-analysis showed that junk foods consumption was associated with increased odds of psychological distress in children and adolescents. These findings support the current recommendation of decreasing junk foods intake.

Association of dietary phytochemical index with cardiometabolic risk factors.

Objective(s): Cardio-metabolic risk factors are becoming a global health concern. To address this problem, one of the proposed ways is to focus on phytochemical-rich foods consumption. Therefore, we aimed to summarize the results of observational studies (cohorts, case-control, and cross-sectional) that investigated the association between dietary phytochemical index (PI) as a new index for evaluating phytochemical-rich food intake and various risk factors of cardio-metabolic disorders. Methods: We conducted a comprehensive systematic review through PubMed, Scopus, and Web of Science databases. The literature search was performed up to August 2021 with no publication year restriction on observational studies investigating the association between PI and cardiometabolic risk factors on adults and children. A random-effect meta-analysis was used. Results: Overall, 16 articles (cross-sectional, case-control, cohort) were eligible for this systematic review and 8 studies with 99771 participants were included in the meta-analysis. Random effect meta-analysis showed that adherence to higher dietary PI decrease the odds of abdominal obesity (OR: 0.73, 95% CI: 0.58, 0.88, I2: 84.90), generalized obesity (OR: 0.84, 95% CI: 0.69, 0.98, I2: 68.10), hypertriglyceridemia (OR: 0.81, 95% CI: 0.73, 0.89, I2: 0.00), hypertension (OR: 0.86, 95% CI: 0.73, 0.99, I2: 7.02), and MetS (OR: 0.79, 95% CI: 0.69, 0.88, I2: 84.90). However, results considering the associations between dietary PI with glycemic indices, and low high-density lipoprotein cholesterol (HDL-C) were not significant (p<0.05). Conclusion: Evidence showed adverse associations between dietary PI and some cardio-metabolic risk factors such as obesity, hypertriglyceridemia, hypertension and metabolic syndrome.

Association of cardiometabolic risk factors with insulin resistance in overweight and obese children.

INTRODUCTION: Regarding the increased prevalence of obesity among children and adolescents, and the impact of obesity on insulin resistance (IR) and other metabolic disorders, this study was performed to determine the association of cardiometabolic risk factors (CMRFs) with IR in overweight and obese children. METHOD: In this cross-sectional study 150 overweight and obese children (BMI ≥ 85th and BMI ≥ 95th age-sex specific percentile) and adolescents were selected via convenient sampling method from Endocrinology clinic in Karaj; Iran in 2020. Anthropometric indices, lipid profile, fasting blood glucose (FBG), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) were evaluated. IR was defined as HOMA-IR ≥ 2.6. Multivariable linear and logistic regression model was used to assess the association of CMRFs with insulin level and IR respectively. RESULTS: The mean age of children was 10.37 (± 2.6) years. Fifty-four percent of the participants were girls. IR was increased through increasing age (P < 0.001). In the multivariate logistic regression model, by increasing each unit increment in waist circumference (OR: 1.03, 95% CI: 1.01-1.06), wrist circumference (OR: 1.47, 95% CI: 1.06-2.02) total cholesterol (OR: 1.01, 95% CI: 1.003-1.03) and FBG (OR: 1.11, 95% CI: 1.05-1.18) the odds of IR increased significantly. Moreover, in the adjusted linear regression model, HOMA-IR was associated significantly with waist to height ratio (ß: 2.45), and FBG (ß: 0.02). CONCLUSION: There was a significant association between some CMRFS with IR in overweight and obese children.

Seafarers' mental health status and life satisfaction: Structural equation model.

Background: A variety of factors influence seafarers' health. Such factors might affect their satisfaction with life. Aims: To examine the relationships between seafarers' mental health status and satisfaction with life by using a structural equation method. Methods: In this survey, 470 seafarers were selected via convenience sampling method from two shipping companies. Validated questionnaires including Satisfaction with Life Scale (SWLS), generalized anxiety disorder-7 (GAD-7), Post-traumatic Stress Disorder-8 (PTSD-8), Patient Health Questionnaire-9 (PHQ-9), General Health Questionnaire-12 (GHQ-12), Perceived Health status and Depression-Anxiety-Stress scale-21 (DASS-21) were used to assess different aspects of well-being and life satisfaction. The stratified path analysis method was applied to analyze the data. Results: 439 seafarers (200 officers and 237 non-officers) with a mean age of 34.5 (SD: 8.05) participated in the current study. The GHQ score directly affected satisfaction with life in both officers (ß = 0.35) and non-officers (ß = 0.40). Also, perceived health status directly and indirectly affected satisfaction with life among officers (ß = 0.19) and non-officers (ß = 0.06). While officers working days per month indirectly impacted satisfaction with life through the general anxiety disorder, perceived health status, depression, anxiety, stress and current mental health. In non-officers, generalized anxiety disorder had the most potent indirect effects on satisfaction with life through perceived health status and current mental health. Conclusion: Perceived health status, directly and indirectly, affected seafarers' satisfaction with life. Measures should be taken in order to improve seafarers' perceived health status and its effects on satisfaction with life.

Association of periodontitis with lipid profile: an updated systematic review and meta-analysis.

Purpose: The aim of this updated version of the systematic review and meta-analysis was to assess the association of PD with lipid profile. Methods: A comprehensive literature search was done in electronic databases including PubMed, Web of Science, and Scopus until August 2021. Cross-sectional, case-control, and cohort studies investigating the relationship between PD and lipid profile were included. Screening, data extraction, and quality assessment were performed independently by two investigators. A random-effect model was used to pool the effect size. Odds ratio (OR) was used as effect size for the association of PD with Hyperlipidemia, and SMD was used for the association of PD with the mean level of lipid profile. Results: Overall, 34 documents met the inclusion criteria for this systematic review, and 31 were included for the meta-analysis. Sixteen studies were cross-sectional, 16 case-control, and two cohorts. Results of the random effect model showed that PD increased the odds of dyslipidemia by 15% (OR: 1.15, 95% CI: 1.04, 1.26). The Association of PD with low HDL, high LDL, hypertriglyceridemia, and hypercholesteremia was not statistically significant (P > 0.05). The mean level of HDL in patients with PD was significantly lower than in subjects without PD (SMD: -0.69, 95% CI: -1.11, -0.26). Moreover, the mean level of LDL, TC, TG in patients with PD was significantly higher than in subjects without PD (P < 0.05). Conclusions: This meta-analysis suggests that periodontitis is associated with an increased odds of dyslipidemia. Therefore, treating periodontitis may improve dyslipidemia, particularly HDL and triglyceride levels.

Immune checkpoint blockade in melanoma: Advantages, shortcomings and emerging roles of the nanoparticles.

The early stages of melanoma could be treated promisingly by surgical resection; however, the challenge is in advanced cases in which targeted therapy could be an option. The expression of immune checkpoints such as CTLA-4, PD-1, PD-L1, TIM-3, LAG-3, and VISTA is at adequate levels in the melanoma tumor microenvironment (TME) implying the promising outcomes of applying immune checkpoint blockades (ICBs). Since the first Food and Drug Administration (FDA) approved ICB, ipilimumab, in melanoma patients, the treatment of melanoma patients with ICBs resulted in improved survival rate and anti-tumor responses, making ICB one of the promising therapeutic approaches. However, due to high biodistribution, these drugs could non-specifically target healthy cells and empower the immune reactions out of control, which results in the incidence of immune-related adverse events. Although there are development management approaches, a new emerging platform is recently available with aid of drug delivery strategies, particularly nanoparticles (NPs). Here, we investigated the recent trials of ICBs in the context of melanoma cases while showing the challenges of this approach. Also, the application of NPs in order to locally deliver ICBs in melanoma tumor models is discussed.

Association of single child family with subjective health complaints in children and adolescents.

The number of single-child families has been increasing across developing countries during the last decades. We aimed to examine the association between being a single child (SC) and subjective health complaints (SHCs) in Iranian children and adolescents. This study was conducted as a part of the fifth survey of a national surveillance program entitled Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable disease (CASPIAN-V). This national survey included a total of 14,400 students 7-18 years and their parents from rural and urban areas in 30 provinces of Iran. Data on demographic characteristics, lifestyle variables, and SHCs were measured using the questionnaire of the World Health Organization on Global School-based Health Survey (WHO-GSHS). Multivariate logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) for the association of being an SC with SHCs. Data on 14,151 participants were available for this study, of whom 7.7% (1092) were SCs. The most frequent SHCs were irritability (37.1%, 95%CI: 36.3-37.9%), feeling nervous 32.5%, 95% CI: (31.7-33.3%), and headache 24.3%, 95%CI: (23.6-25.0% ). In the multivariate model, being an SC significantly increased the odds of dizziness [adjusted OR (95% CI): 1.37(1.08-1.72)] and backache complaint [1.22(1.01-1.47)]. The association of being an SC with other SHCs (feeling low, irritability, feeling nervous, difficulty in getting to sleep, headache, stomachache) was not statistically significant (p value > 0.05). Our results suggest that being an SC may be associated with higher odds of dizziness and backache complaints.

Association of zinc serum level with metabolic syndrome in iranian children and adolescents: The CASPIAN-V study.

Introduction: Metabolic syndrome comprises a set of metabolic risk factors associated with cardiovascular disease and type 2 diabetes. Zinc plays an essential role in numerous enzyme functions that may be associated with metabolic dysfunctions. The relationship between serum zinc levels and metabolic syndrome in adolescents has not been specifically studied. Therefore, this study was performed to determine the relationship between serum zinc levels and metabolic syndrome in Iranian children and adolescents. Materials and methods: This cross-sectional study was performed using data collected in the CASPIAN-V study. In this project, data were collected using interviews, examinations, biochemical assessments, anthropometric studies, and the nutritional status of participants. The variables considered in this study included serum zinc levels, triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), fasting blood sugar, height, weight, abdominal circumference, and systolic and diastolic blood pressure. Results: A total of 1371 participants were included in this study, with a mean age of 12.24 ± 3.23 years. In total, 12.40% (n = 170) of the study population had metabolic syndrome, of which 55.7% were boys and 44.3% were girls. Mean zinc levels (µg/dL) in patients with and without metabolic syndrome were 107.03 and 110.6, respectively (p-value = 0.211) and 111.8 for boys and 109.10 for girls (p-value = 0.677). Conclusion: This cross-sectional study showed no association between serum zinc levels and metabolic syndrome in children. Further similar studies and cohort studies with large sample sizes are needed to reveal the exact relationship between serum zinc levels and metabolic syndrome.

A meta-analysis of dietary inflammatory index and bone health status.

Background: The inflammatory potential of diets is associated with several diseases and can affect bone health. We aimed to systematically review and pool the current evidence on the association of DII with bone health in observational studies. Methods: We searched PubMed and NLM Gateway (for Medline), Web of Science, Scopus and EMBASE up to December 16, 2020 for studies that examined the relationship between DII score and bone mineral density (BMD) or fracture. All observational studies were included in this meta-analysis. Heterogeneity between studies was evaluated using Cochran Q-statistic and I2 statistics. Random effect meta-analysis method was used to pool the effect size. Stratified meta-analysis according to the type of study (cohort/ non-cohort) was performed to assess the relationship of DII with BMD and fracture. Results: In total, 13 articles were included in the present systematic review, including five cohorts, five cross-sectional, and three case-control studies. The total sample size of these studies was 211,938 individuals aged 5 to 85 years. According to random-effect meta-analysis, DII was associated with increased odds of fracture in non-cohort studies (pooled OR=1.42, 95%CI: 1.17, 1.67), but this association was not statistically significant in cohort studies (pooled OR=1.03, 95%CI: 0.97, 1.09). Moreover, only in non-cohort studies, the mean of BMD in subjects in the highest DII category was significantly lower than those in the lowest DII category (SMD: -9.59, 95%CI: -10.84,-8.33). Conclusions: Our findings showed that high score of DII can have devastating effects on bone health. Further longitudinal studies are necessary to confirm these findings among more diverse populations.

Effect of vitamin D supplementation on cardiac-metabolic risk factors in elderly: a systematic review and meta-analysis of clinical trials.

BACKGROUND: There has been a longstanding interest in the potential effect of vitamin D in preventing cardiac-metabolic diseases. However, there are divergent results regarding the impact of vitamin D supplementation (VDS) on managing cardiac-metabolic outcomes in the elderly population. MATERIAL AND METHOD: We systematically searched electronic databases; Web of Science, PubMed, Scopus, EMBASE, Cochrane, and ProQuest. We included all trials that evaluated the effect of VDS on cardiac-metabolic risk factors in the elderly population, which were published until 30 September 2021. The effects of VDS on cardiac-metabolic outcomes were assessed using standardized mean difference (SMD). A random-effect model was used to pool the SMD and 95% confidence interval (CI). RESULT: The literature search identified 4409 studies, of which 12 trials met inclusion criteria. Results of random effect meta-analysis indicated a significant reduction in total cholesterol (TC) (SMD: - 0.14 mg/dl; 95% CI: - 0.25, - 0.02) and triglyceride (TG) (SMD: - 0.45 mg/dl; 95% CI: - 0.86, - 0.04) with VDS compared to the placebo. The subgroup analyses revealed that the reduction of TG in patients with diabetes and vitamin D deficiency was significant. Furthermore, short-term intervention (≤ 6 months) induced a significantly lower level of TG and insulin in comparison to longer duration (> 6 months). CONCLUSION: The study suggests that VDS could improve insulin concentration and dyslipidemia in the elderly population. The systematic review was registered in Alborz university of medical sciences with 2060-01-03-1397 number and the Ethics council IR.ABZUMS.REC.1397.207 number.

Dietary diversity score and cardio-metabolic risk factors: an updated systematic review and meta-analysis.

CONTEXT: Dietary diversity score (DDS) has been known as a useful and convenient indicator of overall diet quality. Previous studies have reported the association between DDS and health problems such as diabetes, metabolic syndrome and cardiovascular disease. OBJECTIVES: This systematic review and meta-analysis aimed to assess the association between dietary diversity score (DDS) and cardio-metabolic risk factors such as obesity and overweight, lipid profile, blood pressure, metabolic syndrome (MetS) and diabetes. DATA SOURCES: We systematically searched PubMed and NLM Gateway, Scopus and Institute of Scientific Information (ISI) by up to October 2019. DATA EXTRACTION: All observational studies which assessed the association of DDS with cardio-metabolic risk factors including anthropometric measures, blood pressure, lipid profile, glycemic indices and MetS without limitation in time of publication and language were included and critically reviewed by two independent experts. Random-effects meta-analysis was used to estimate the effect sizes. DATA ANALYSIS: Among 843 documents retrieved from literature search, 23 studies met the inclusion criteria for systematic review, and 18 studies were eligible for meta-analysis. Random-effects meta-analysis showed that the association of DDS with obesity, abdominal obesity, overweight, body mass index, MetS, diabetes, blood pressure, and lipid profile (TC, LDL, HDL) was not statistically significant. On the other hand, the association of DDS and TG was statistically significant (SMD: - 0.23, 95% CI - 0.45, - 0.01). CONCLUSIONS: Our findings revealed that there was no significant association between DDS and cardio-metabolic risk factors. Reassessment of the overall DDS tool as a criterion of diet quality and production of new and valid DDS standard tools is highly desirable. More high-quality studies are also needed to confirm the findings of this study. STUDY REGISTRATION: This study is registered as PROSPERO CRD42020157127. LEVEL OF EVIDENCE: Level I, systematic reviews and meta-analyses.

Association of hyperglycaemia and periodontitis: an updated systematic review and meta-analysis.

PURPOSE: The aim of this updated systematic review and meta-analysis was the association between hyperglycemia and periodontitis. METHODS: We searched PubMed/MEDLINE, Web of Science, and Scopus until March 2021. The key search words were based on "periodontitis" and "hyperglycemia." We included cohort, case-control, and cross-sectional studies, restricted to publications in English. The quality assessment of included studies and data extraction were done by two independent reviewers. Meta-analysis was performed for cross-sectional studies using the random-effects model. RESULTS: The literature search yielded 340 studies, and finally, 19 and 11 studies were included in systematic review and meta-analysis, respectively. The total sample size of the eligible studies in the meta-analysis was 38,896 participants, of whom 33% were male with a mean age of 51.20 ± 14.0 years. According to a random-effect meta-analysis in cross-sectional studies, the pooled odds ratio (OR) for the association between hyperglycemia and periodontal indices was statistically significant (OR: 1.50, 95%CI: 1.11, 1.90). There was evidence of publication bias (coefficient: - 3.53, p-value = 0.014) which, after imputing missing studies, the pooled OR of the association between hyperglycemia and periodontitis change to 1.55 (95%CI: 1.20, 1.90). CONCLUSION: Results of the present study show that hyperglycemia was positively associated with periodontitis. However, more cohort and prospective longitudinal studies should be conducted to find the exact association. Overall, it seems the management of hyperglycemia could be considered as a preventive strategy for periodontitis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-021-00861-9.

Erratum: Author Correction: Association of a body shape index and hip index with cardiometabolic risk factors in children and adolescents: the CASPIAN-V study.

[This corrects the article DOI: 10.1007/s40200-021-00743-0.].

Long-term Trends in Hypertension Prevalence, Awareness, Treatment, and Control Rate in the Middle East and North Africa: a Systematic Review and Meta-analysis of 178 Population-Based Studies.

PURPOSE OF REVIEW: This study investigated and pooled the long-term trends in prevalence, awareness, treatment, and control of hypertension (HTN) in the Middle East and North Africa (MENA) region. In this systematic review and meta-analysis, we searched MEDLINE/PubMed, Web of Science, Google Scholar, EMBASE, and Scopus between database inception and November 2020. All cross-sectional studies that investigated the prevalence of pre-HTN, HTN, awareness, treatment, and control in the MENA counties were included. The selection study, data extraction, and quality assessment were conducted by two investigators independently. Heterogeneity between studies was assessed using Cochran's Q test and I-squared, and due to sever heterogeneity between studies, the random effect model was used to pool the estimates. Sensitivity analysis was performed to estimate the long-term trends in prevalence, awareness, treatment, and control rates of HTN according to definition of HTN as systolic blood pressure of 140 mm Hg or more, or diastolic blood pressure of 90 mm Hg or more, or being on pharmacological treatment for HTN. RECENT FINDINGS: Overall, 178 studies met the inclusion criteria. Studies comprised 2,262,797 participants with a mean age of 45.72 ± 8.84 years. According to random effect model, the pooled prevalence of pre-HTN and HTN was 33% (95% CI 28, 39) and 26% (25, 27), respectively. Over the past three decades, prevalence of hypertension increased significantly in the region. The pooled awareness, treatment, and control rates were 50% (48, 53), 41% (38, 44), and 19% (17, 21), receptively. The pooled awareness, treatment, and control rates of HTN were lower significantly in men than women. According to definition of HTN as blood pressures above 140/90 mm Hg, over the past three decades, although the awareness and treatment rates did not change significantly, the control rates improved significantly in the region. The findings showed that HTN is a significant public health problem in the MENA region. Although there are low levels of pooled awareness, treatment, and control rates, the control rates improved over the past three decades in the region.

Matrix metalloproteinases are involved in the development of neurological complications in patients with Coronavirus disease 2019.

BACKGROUND: Evidence show that Matrix metalloproteinases (MMPs) have been associated with neurological complications in the viral infections. Here in the current investigation, we intended to reveal if MMPs are potentially involved in the development of neurological symptoms in the patients with Coronavirus disease 2019 (COVID-19). METHODS: The levels of MMPs, inflammatory cytokines, chemokines, and adhesion molecules were evaluated in the serum and cerebrospinal fluid (CSF) samples from 10 COVID-19 patients with neurological syndrome (NS) and 10 COVID-19 patients lacking NS. Monocytes from the CSF samples were treated with TNF-α and the secreted levels of MMPs were determined. RESULTS: The frequency of monocytes were increased in the CSF samples of COVID-19 patients with NS compared to patients without NS. Levels of inflammatory cytokines IL-1ß, IL-6, and TNF-α, chemokines CCL2, CCL3, CCL4, CCL7, CCL12, CXCL8, and CX3CL1, MMPs MMP-2, MMP-3, MMP-9, and MMP-12, and adhesion molecules ICAM-1, VCAM-1, and E-selectin were significantly increased in the CSF samples of COVID-19 patients with NS compared with patients without NS. Treatment of CSF-derived monocytes obtained from COVID-19 patients with NS caused increased production of MMP-2, MMP-3, MMP-9, and MMP-12. CONCLUSIONS: Higher levels of inflammatory cytokines might promote the expression of adhesion molecules on blood-CSF barrier (BCSFB), resulting in facilitation of monocyte recruitment. Increased levels of CSF chemokines might also help to the trafficking of monocytes to CSF. Inflammatory cytokines might enhance production of MMPs from monocytes, leading to disruption of BCSFB (and therefore further infiltration of inflammatory cells to CSF) in COVID-19 patients with NS.

Decomposition of socioeconomic inequality in growth disorders to its determinants in pediatric population: the CASPIAN IV study.

PURPOSE: The current study aims to evaluate socioeconomic inequality in growth disorders and its determinants in Iranian children and adolescents. METHODS: In this nationwide cross-sectional survey, 14,880 students aged 6-18 years were selected through multistage cluster sampling method from urban and rural areas of 30 provinces of Iran in 2011. Socioeconomic status (SES) was calculated using principle component analysis. Socioeconomic inequality in growth disorders (including; underweight, excess weight, overweight, general obesity, abdominal obesity, and short stature) was assessed using concentration index (C) and slope index of inequality (SII). The Oaxaca Blinder decomposition method was used to determine determinants of this inequality. RESULTS: Totally, 13,486 students participated in this study (participation rate: 90.6%), comprising 50.8% boys and 75.6% urban inhabitants. Their mean age was 12.47 ± 3.36 years with no significant gender difference. The prevalence of excess weight, overweight, and general and abdominal obesity increased linearly as SES increased, and the prevalence of underweight and short stature decreased linearly as SES increased. The C index for underweight and short stature was negative, which suggests that inequality was in favor of high SES groups, and regarding overweight, excess weight, general and abdominal obesity, the index was positive, indicating that inequality was in favor of in low SES groups. CONCLUSION: Our findings show a considerable inequality in prevalence of growth disorders in Iranian children and adolescents. These findings provide practical information for health policies and programs.

Validity of continuous metabolic syndrome score for predicting metabolic syndrome; a systematic review and meta-analysis.

BACKGROUND: Nowadays, use of continuous metabolic syndrome (cMetS) score has been suggested to improve recognition of metabolic syndrome (MetS). The aim of this study was to evaluate the validity of cMetS scores for predicting MetS. METHODS: We searched the electronic databases included MEDLINE/PubMed, Embase, ISI Web of Science, and Scopus from 1 January 1980 to 30 September 2020. Observational studies on participants with different cMetS scores were included in this meta-analysis. The sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR) and diagnostic odds ratio (DOR) with 95% CI were calculated. RESULTS: Ten studies involving a total of 25,073 participants were included. All studies had cross-sectional design. The pooled sensitivity and specificity of cMetS scores for predicting MetS were 0.90 (95% CI: 0.83 to 0.95) and 0.86 (95% CI: 0.83 to 0.89), respectively. Moreover, cMetS scores had the pooled LR+ of 6.5 (95% CI: 5.0 to 8.6), and a pooled (LR-) of 0.11 (95% CI: 0.063 to 0.21). The pooled DOR of cMetS scores to predict MetS were 57 (95% CI: 26 to 127). CONCLUSIONS: The high sensitivity and specificity of cMetS scores indicates that it has a high accuracy to predict the risk of MetS. Furthermore, the cMetS scores has a good ability to rule out healthy people. STUDY REGISTRATION: This study was registered as PROSPERO CRD42020157273.