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Adherence to the Eat-Lancet diet and its association with depression and anxiety among Iranian adults: a cross-sectional multicentric study
No full textBackground Previous studies have shown a connection between diet and mental health. However, there is limited evidence on how emerging diets, particularly the EAT-Lancet reference diet (ELD), relate to depression and anxiety. This study aims to investigate the potential impact of ELD adherence on these mental health conditions.Methods and materials This cross-sectional study recruited 1,970 Iranian adults using a stratified multistage random cluster sampling method, part of a community-based investigation conducted in five cities from February 2018 to July 2019. Participants' regular dietary intake was assessed using a validated food frequency questionnaire. The ELD was formulated based on the consumption of the 14 dietary components outlined in the ELD. Anxiety and depression were evaluated using a validated Iranian version of the Hospital Anxiety and depression Scale.Results In the fully adjusted model, there was no significant association between ELD adherence and depressive symptoms (aORT3 vs. T1 = 0.89; 95 CI: 0.66, 1.19; p trend = 0.42) and anxiety (aOR T3 vs. T1 = 0.93; 95 CI: 0.70, 1.23; p trend = 0.62) in the whole population. In stratified analysis by sex, a significant inverse association was found only between ELD and depression among men (aOR T3 vs. T1 = 0.66; 95 CI: 0.40, 1.07; p trend = 0.047) but not women (aOR = 0.71, 95 CI: 0.44, 1.15; p trend = 0.103). No significant association was observed between ELD and anxiety either in men or women.Conclusion Despite a null association between ELD and depressive symptoms and anxiety in the whole population, higher adherence to ELD was associated with a lower risk of depressive symptoms in males
Hybrid Nano-Micro Scaffolds for Cartilage Tissue Engineering: Integrating PCL-DWJM-MWCNTs on Chemically Modified Silk Fibroin
No full textNano-micro scaffolds fabricated based on electrospinning and textile methods. The solution containing polycaprolactone (PCL), decellularized Wharton's jelly matrix (DWJM) and functionalized multi-walled carbon nanotubes (MWCNTs) were electrospun on the silk fibroin treated with 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide/N-hydroxysuccinimide (NHS/EDC). Hybrid scaffolds (with/without MWCNTs) were compared with each other in terms of physical, chemical, mechanical, bioactivity, and biological properties. Cross-sectional view showed that the nanofibers are well seated on the NHS/EDC-treated microfibers (T-fibroin). The increase of free functional groups decreased the contact angle to 70.51 degrees +/- 5.22 degrees and improved the tensile strength to 33.84 +/- 3.6 MPa. The presence of NHS/EDC leads to the formation of crosslinks in the fibroin polymer network, resulting in enhanced tensile strength of T-Fibroin compared to untreated fibroin (U-Fibroin). The crosslinks within the fibroin structure and the presence of MWCNTs enhanced the crystallinity of the scaffold structure while reducing its degradation rate (1.73). The presence of carboxyl groups in the structure of MWCNTs, DWJM and T-Fibroin improved bioactivity and enhanced the chondrocytes' viability on the scaffold. The findings suggest using DWJM and surface chemical modification of fibroin knitted fabric is a promising approach in advancing nano-micro scaffolds. PCL-DWJM-MWCNTs/Fibroin Silk scaffold can served as a basic study for articular cartilage regeneration
The Effects of Bitter Melon (Mormordica charantia) on Weight Loss and Body Composition: A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials
No full textResults from the clinical research about Momordica charantia (MC) benefits on weight loss have been contradictory. This study, which included the most available randomized placebo-controlled trials (RCTs), was the first to investigate the impact of MC supplementation on body weight and composition. The effects of the given MC on weight, body mass index (BMI), waist circumference (WC), and percentage of body fat (PBF) were examined in RCTs up to February 2023 (without limitation on release date). Online databases (PubMed/Medline, Google Scholar, Scopus, and Web of Science) were searched for these studies. The inclusion and exclusion criteria were followed in the screening and evaluation of the literature. The Cochrane tool was used to assess bias risk. There were a total of ten RCTs, including 448 participants. The meta-analysis revealed that MC supplementation had no effect on weight (weighted mean difference (WMD): 0.04 kg; 95 confidence interval (CI: -0.16 to 0.25; p = 0.66), BMI (WMD: -0.18 kg/m(2); 95% CI: -0.43 to 0.25; p = 0.16), WC (WMD: -0.94 cm; 95% CI: -3.04 to 1.16; p = 0.37), and BFP (WMD: -0.99; 95% CI: -2.33 to 0.35; p = 0.14). According to the subgroup analysis, MC could lower the BMI at a dosage of <= 2000 mg/d when compared to a placebo group (p<0.001). The dose-response analysis represented a significant nonlinear connection between the MC dosage and weight reduction (Pnon-linearity = 0.011); the effect on weight loss was observed the most at doses of 2000 and 4500 mg. Moreover, MC consumption decreased the BMI by the sixth week and then increased the BMI up to the 17th week (P-nonlinearity = 0.03). Our results indicate that MC consumption can reduce the BMI in some dosages and duration of supplementation
The effects of ursodeoxycholic acid on cardiometabolic risk factors: a systematic review and meta-analysis of randomized controlled trials
No full textBackground Chronic diseases such as obesity, hypertension, and metabolic syndrome are major health concerns worldwide. Ursodeoxycholic acid (UDCA) is a bile acid that is naturally produced in the liver and has been used for the treatment of various liver disorders. In this systematic review and meta-analysis, we investigated how UDCA might affect inflammation, blood pressure, and obesity. Methods Five major databases were searched from inception to August 2024. The investigated outcomes included body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha). A random effect was carried out to estimate pooled weighted mean difference (WMD) with 95 confidence intervals (CI). The registration code is CRD42023428064. Results Of the 7912 articles in the initial search, 12 were included in the systematic review and meta-analysis. UDCA consumption significantly decreased BMI (WMD: -0.29 kg/m(2), 95 CI: -0.58, -0.01, P = 0.044), and DBP (WMD: -2.16 mmHg, 95 CI: -3.66, -0.66, P = 0.005). It also increased SBP (WMD: 5.50 mmHg, 95 CI: 3.65, 7.35, P < 0.001); however, it was not associated with weight loss (WMD: -0.3 kg, 95 CI: -1.3, 0.71, P = 0.561). Our systematic review showed that UDCA consumption has no effect on IL-6 and TNF-alpha. Conclusion This systematic review and meta-analysis suggest that UDCA supplementation may improve BMI and DBP, whereas it may increase SBP and have no effect on weight or inflammation. Further long-term and well-designed RCTs are needed to further assess and confirm these results
Application of novel strategies in chronic wound management with focusing on pressure ulcers: new perspective
No full textInvading blood cells, extracellular tissue, and soluble mediators all play important roles in the wound-healing process. There is a substantial global burden of disease and mortality attributable to skin defects that do not heal. About 1 to 2 of the population in industrialized nations suffers from chronic wounds that don't heal, despite healthcare breakthroughs; this condition is very costly, costing about 25 billion each year in the US alone. Amputation, infection (affecting as many as 25 of chronic wounds), sepsis, and dermal replacements are all consequences of conventional therapeutic approaches like growth factor therapy and diabetic foot ulcers account for 85 of lower limb amputations. Despite these obstacles, scientists are constantly looking for new ways to speed healing and close wounds. The unique immunomodulatory capabilities and multipotency of mesenchymal stem cells (MSCs) have made them a potential therapeutic choice in tissue engineering and regenerative medicine. Animal models of wound healing have shown that MSCs can speed up the process by as much as 40 through enhancing angiogenesis, modulating inflammation, and promoting fibroblast migration. Clinical trials provide more evidence of their effectiveness; for instance, one RCT found that, after 12 weeks, patients treated with MSCs had a 72 smaller wound size than those in the control group. This review offers a thorough examination of MSCs by combining the latest research with preclinical evidence. Highlighting their potential to transform treatment paradigms, it delves into their biological properties, how they work during regeneration and healing, and therapeutic usefulness in controlling chronic wounds
Examining the therapeutic potential and side effects of calcium channel blockers in mortality and morbidity of patients with stroke: A systematic review of pre-clinical and clinical studies
No full textBackground: Blood pressure control is one of the basic steps in preventing stroke and cerebrovascular events. Calcium channel blockers are the first-line drugs in hypertension control. On the other hand, the stroke recovery phase depends on activating calcium channels and N-methyl-D-aspartate (NMDA) receptors. Considering these issues, one of the interdisciplinary challenges of neurology and cardiology is the use of these drugs in hypertensive patients with cerebrovascular accident (CVA) risk and their uses after these events. Objectives: This study's primary goal is to evaluate the effects of calcium channel blockers on reducing the risk, mortality, morbidity, and long-term outcomes of cerebrovascular events. Material and Methods: We conducted this systematic literature review by searching PubMed, Scopus, and Google Scholar databases. Our inclusion criteria were randomized clinical trials, cohort studies, case-cross-over studies, case reports, and in-vitro and animal studies in which they evaluated the effects of calcium channel blockers on the CVA risk and mortality, morbidity, and long-term outcomes of stroke. Our exclusion criteria were review studies with no adequate data and non-English articles. Articles that met our criteria were included in the initial search. After the title and abstract screening, 56 human and animal studies were selected to be discussed in this article. Results: Among 56 selected studies, 33 were human studies, 23 were animal experiments, and one study was carried out both on animals and humans. A total of 1,860,234 patients were enrolled in 24 human studies. A total of 717,131 patients in 22 studies received CCBs. Two studies did not report the number of patients who underwent treatment with CCBs. Among 24 studies, 11 reported favorable outcomes following CCB administration, and two studies reported neuroprotective effects for CCBs without any adverse outcome in stroke patients. Five studies demonstrated that CCBs were associated with adverse outcomes. One study showed favorable and unfavorable outcomes compared to other antihypertensive agents. Stroke was reported in two studies following CCB overdose. Three studies have reported that CCBs had no significant effect on stroke risk, mortality, or long term outcomes. In animal studies, a total of 813 animals were enrolled in 19 studies. Two studies were in vitro using mammalian cells and enzymes, and one study was ex-vivo. Among 24 studies, 18 (75) reported beneficial outcomes following treatment with CCBs, three (12.5 ) revealed both favorable and unfavorable results, two (8.3 ) demonstrated adverse outcomes, and one (4.2 ) showed no effect. Conclusion: Based on the evidence from human and animal studies, authors conclude that CCBs are associated with a lower risk of stroke, lower mortality risk, and improved long-term neurological and other clinical outcomes
Long non-coding RNAs in bipolar disorder
No full textBipolar disorder is characterized by alternating episodes of mania or hypomania and depression, encompassing various forms such as cyclothymia, bipolar I disorder, and bipolar II disorder. Manic periods present with increased energy and decreased sleep, whereas depressive episodes involve poor energy and extended sleep duration. Despite the availability of treatments, approximately 30 of patients with bipolar disorder are drug resistant and require alternative strategies. Recent research highlights the role of long noncoding RNAs (lncRNAs) as potential biomarkers for bipolar disorder, aiding in distinguishing it from other mood disorders and improving diagnostic accuracy. LncRNAs such as GAS5 and FOXD3-AS1 are downregulated in bipolar disorder patients, suggesting their utility as diagnostic tools. LncRNAs regulate gene expression through interactions with DNA, RNA, and proteins, influencing various biological processes. Studies have identified several lncRNAs linked to bipolar disorder, including lincRNA-p21, lincRNA-ROR, and lincRNA-PINT. These findings underscore the potential of lncRNAs as biomarkers and therapeutic targets, facilitating more personalized treatment strategies. This review explores the diagnostic and therapeutic potential of lncRNAs in bipolar disorder, aiming to enhance the current understanding and management of this condition
Advanced glycation end products and risk of mortality in patients with cirrhosis: a prospective cohort study
No full textThe role of diet in reducing the burden of liver disease and mortality attributed to cirrhosis is very imperative. The present study scrutinized the relationship between dietary advanced glycation end products (AGEs) and mortality in patients with cirrhosis. This research was a prospective cohort study on 166 ambulatory cirrhotic patients who had been diagnosed with cirrhosis for a maximum of six months. Follow-up of patients continued for 5 years until May 2024. To determine the incidence of mortality in the quartiles of dietary AGEs, cox regression models were used with the adjustment of potential confounding variables. Although the first model of the analysis by adjusting the results for age and sex failed to show a significant increase in the risk of mortality in patients (HRQ4 vs. Q1 = 2.64; 95 CI = 0.9-7.5, P trend = 0.075), after adjusting the results for further confounders in the second (HRQ4 vs. Q1 = 3.56; 95 CI = 1.1-11.6, P trend = 0.040) and third (HRQ4 vs. Q1 = 3.3; 95 CI = 1.79-13.7, P trend = 0.048) models, the P trend for the risk of mortality during the quartiles of AGEs became significant. In addition, along with increasing trend of dietary AGEs, the number of deaths increased significantly (P = 0.024). Higher mortality risk was generally attributed to higher dietary AGEs in patients with cirrhosis
The association between the dietary inflammatory index and multiple myeloma: a case-control study
No full textThe dietary inflammatory index (DII) is a common grading system for diet inflammatory potential. Recent investigations link DII to hematopoietic malignancies. However, the relationship between DII and Multiple myeloma (MM) is unknown. DII and MM were examined in a present case-control study of Iranian adults. This case-controlstudy was conducted on adults aged 20 to 75 years, selecting 149 cases with newly diagnosed multiple myeloma and 359 healthy individuals. Dietary assessment was conducted using a validated semi-quantitative food frequency questionnaire (FFQ) including 154 items, and energy-adjusted DII scores were calculated to determine the level of inflammatory properties in each individual's diet using 29 dietary parameters. Conditional logistic regression models were used to investigate the relationship between DII and MM. The case group participating in the study was on average 54 years old and mostly male (52.3). After adjusting for age, sex, and energy intake, we found that individuals with the highest DII scores were significantly less likely to have MM compared to those with the lowest scores (OR: 0.02; 95 CI 0.01, 0.08). Additional adjustment with other confounders confirmed this association (OR: 0.03; 95 CI 0.01, 0.13). This association did not change significantly with further adjustment for BMI (OR: 0.04; 95 CI 0.01, 0.14). In conclusion, our research showed that a pro-inflammatory diet was associated with a significantly higher risk of MM. If our findings are confirmed in other large studies, these data will provide personalized approaches for MM patients, particularly for physicians and registered cancer dietitians
Evaluation of machine learning methods for prediction of heart failure mortality and readmission: meta-analysis
No full textBackgroundHeart failure (HF) impacts nearly 6 million individuals in the U.S., with a projected 46 increase by 2030, is creating significant healthcare burdens. Predictive models, particularly machine learning (ML)-based models, offer promising solutions to identify patients at greater risk of adverse outcomes, such as mortality and hospital readmission. This review aims to assess the effectiveness of ML models in predicting HF-related outcomes, with a focus on their potential to improve patient care and clinical decision-making. We aim to assess how effectively machine learning models predict mortality and readmission in heart failure patients to improve clinical outcomes.MethodThe study followed PRISMA 2020 guidelines and was registered in the PROSPERO database (CRD42023481167). We conducted a systematic search in PubMed, Scopus, and Web of Science databases using specific keywords related to heart failure, machine learning, mortality and readmission. Extracted data focused on study characteristics, machine learning details, and outcomes, with AUC or c-index used as the primary outcomes for pooling analysis. The PROBAST tool was used to assess bias risk, evaluating models based on participants, predictors, outcomes, and statistical analysis. The meta-analysis pooled AUCs for different machine learning models predicting mortality and readmission. Prediction accuracy data was categorized by timeframes, with high heterogeneity determined by an I-2 value above 50, leading to a random-effects model when applicable. Publication bias was assessed using Egger's and Begg's tests, with a p-value below 0.05 considered significantResultA total of 4,505 studies were identified, and after screening, 64 were included in the final analysis, covering 943,941 patients. Of these, 40 studies focused on mortality, 17 on readmission, and 7 on both outcomes. In total, 346 machine learning models were evaluated, with the most common algorithms being random forest, logistic regression, and gradient boosting. The neural network model achieved the highest overall AUC for mortality prediction (0.808), while the support vector machine performed best for readmission prediction (AUC 0.733). The analysis revealed a significant risk of bias, primarily due to reliance on retrospective data and inadequate sample size justification.ConclusionIn conclusion, this review emphasizes the strong potential of ML models in predicting HF readmission and mortality. ML algorithms show promise in improving prognostic accuracy and enabling personalized patient care. However, challenges like model interpretability, generalizability, and clinical integration persist. Overcoming these requires refined ML techniques and a robust regulatory framework to enhance HF outcomes