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The potential preventive effect of probiotics, prebiotics, and synbiotics on cardiovascular risk factors through modulation of gut microbiota: A review
No full textCardiovascular diseases (CVDs) are a significant contributor to global morbidity and death, underscoring the importance of their prevention and treatment. The association between the development and progression of CVD and several risk factors has been extensively studied. Among these risk factors, the gut microbiota has garnered considerable attention of the scientific community during the last two decades. In particular, dysbiosis is directly associated with many risk factors of CVD in the host, such as diabetes. Prior research has demonstrated a robust correlation between dysbiosis and the development of CVD. Probiotics, prebiotics, and synbiotics are considered important regulators of microbiota imbalances as they increase the colonization of beneficial bacteria and thereby alter the gut microbiota. Although these beneficial effects of biotics are now widely recognized, new evidence has demonstrated that target therapy of the microbiota affects many other organs, including the heart, through a process commonly referred to as the gut–heart axis. In this review, we will discuss the potential benefits of probiotics, prebiotics, and synbiotics for the beneficial effects on cardiovascular disease by modulating gut microbiota
Effect of sequential cleavage and blastocyst embryo transfer compared to single cleavage stage embryo transfer on assisted reproductive technology outcome: An RCT
No full textBackground: Assisted reproductive technology (ART), offers hope for many infertile couples by increasing the chance of successful pregnancy. The success of in vitro fertilization depends on various factors, in which embryo transfer (ET) is one of the critical steps influencing in vitro fertilization success rates. Extended embryo culture and blastocyst-stage ET have been considered in ART due to their potential benefits including improved implantation rates. Objective: This study aimed to compare the outcomes of sequential ET vs single cleavage-stage ET in women undergoing a fresh ET cycle with a limited number of embryos. Materials and Methods: This randomized clinical trial was conducted on 140 women undergoing infertility treatments and candidates for fresh ET at the Research and Clinical Center for Infertility, Yazd, Iran from August 2023 to January 2024. Women with a number of embryos from 2–5 (≥ 2 and ≤ 5 available embryos) were randomly divided into 2 groups: One group underwent sequential ET (one cleavage-stage ET followed by one blastocyst ET) and the other group underwent single-step 2 cleavage-stage ET. The primary outcome was clinical pregnancy, and the secondary outcome included chemical pregnancy and early abortion rates. Results: Our findings showed significantly higher rates of clinical (33.5% vs 13.6%, p = 0.003) and chemical (41.3% vs 18.2%, p = 0.004) pregnancies in the sequential ET group compared to the single-step cleavage ET group. The early abortion rate was higher in single-step cleavage ET (13% vs 44.4%, p = 0.053). Conclusion: Sequential fresh ET is a useful choice in women who have a limited number of embryos and can improve ART outcomes
Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
No full textBackground: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions. Funding: Bill & Melinda Gates Foundation
Investigating the Relationship Between Exposure to Cadmium and Lung Cancer Risk: A Systematic Review and Meta-analysis
No full textIntroduction: Lung cancer is the second most common cancer in the world. Smoking occupational and environmental exposures are the most important causes of lung cancer. Cadmium is known as a human carcinogen due to its ability to increase lung cancer risk. This study estimates the general results of all studies on the relationship between cadmium and lung cancer. Material and Methods: In the present study, studies that evaluated the relationship between cadmium and lung cancer until May 2022 were searched and retrieved. From the funnel plot to determine the existence of diffusion skew, from the statistical tests Chi-squared test (x2) and I2 to determine heterogeneity, from the meta-regression method to identify the root of heterogeneity, and from the sensitivity analysis approach to identify the effect of each study on the result, it was generally used. This study performed all analyses with Stata statistical software version 15. Results: In this study, it was observed that the chance of developing lung cancer compared to the base group, in the people exposed to a higher dose than the base level of cadmium is equal to 1.31 (95 CI: 1.06-1.62; p-value = 0.024), which is statistically significant. Based on Egger’s test (p-value = 0.178) and Begg’s (p-value = 0.276), no diffusion bias was observed in this study. Conclusion: ccording to the final results of this review research, exposure to cadmium leads to a 31 increase in lung cancer risk, which is statistically significant. Therefore, cadmium is a risk factor for lung cancer
The Relationship Between Egg Consumption and Risk of Type 2 Diabetes in the Shahrekord Cohort Study
No full textBackground and aims: Diabetes is a common non-communicable and metabolic disease, and its prevalence is predicted to double by 2045. It is also a significant risk factor for cardiovascular complications and mortality. The study investigated the association between egg consumption and the prevalence of type 2 diabetes (T2D) in a cohort of Iranian adults. Methods: This study compared 261 cases of T2D with 261 controls matched for age and features and assessed their dietary intake using a food frequency questionnaire. The inclusion criterion involved the absence of concurrent chronic diseases apart from T2D. Results: Based on the results, the participants’ average age was 53.32 years, with a slightly higher proportion of females in both groups. Logistic regression analysis revealed that increased consumption of eggs is associated with a diminished risk of developing T2D (P = 0.01). Conclusion: The study suggests that egg consumption may have beneficial effects on glucose metabolism and insulin sensitivity, and regional and genetic differences may influence the relationship between egg consumption and T2D. It calls for further longitudinal and interventional studies to confirm the findings
Development and validation of the questionnaire of OSCE's educational effects
No full textIntroduction: One of the most common assessment tools for examining the competencies of health professionals is the Objective Structured Clinical Examination (OSCE). Methods: In this study, an Educational Effects of OSCE Questionnaire (EEOQ) was developed and validated in seven steps: (1) Reviewing the literature, (2) Holding focus groups, (3) Synthesizing the results of literature review and focus groups, (4) Developing items, (5) Evaluating content validity, (6) Conducting cognitive interviews, and (7) Implementing a pilot test. Results: The analysis of the literature review and focus groups revealed that the educational effects of OSCE are influenced by factors related to the test, the examiner, the peers, and the student. Initially, 22 items were developed, but one item was excluded based on the results of the I-CVR and I-CVI indices. In the Exploratory Factor Analysis, the KMO index was computed to be 0.85, and the significance of Bartlett's test of sphericity was confirmed (p < 0.001). The Total Variance Explained table showed that the educational effects of OSCE were grouped into four factors: content, structure, reflection and review, and feedback along with OSCE. Conclusions: This study found good evidence of validity and reliability for a questionnaire measuring the educational effects of OSCEs. It was discovered that OSCE can have different effects on student learning processes
Sensitivity analysis of human error in the steel industry: exploring the effects of psychosocial and mental health risk factors and burnout using Bayesian networks
No full textIntroduction: Human error and the high rates of fatalities and other occupational accidents in the steel industry are of significant global relevance. The aim of this study was to investigate the effect of psychosocial, mental health, and burnout risk factors on human error probabilities in an industrial environment using Bayesian networks. Methods: This cross-sectional study was conducted in 2023. The participants were 252 employees of a steel company. Error probabilities related to the tasks of participants were estimated using the Human Error Assessment and Reduction Technique (HEART). Other data was collected using a survey that consisted of demographic information, the Maslach Burnout Inventory, Depression Anxiety Stress Scales, and a short version of the Copenhagen Psychosocial Questionnaire. A theoretical model was drawn in GeNIe academic software (version 2.3). Results: The results showed that all the studied variables were able to significantly affect the distribution of human error probabilities. Considering a distribution of 100% for the high state of these variables, the results showed that the greatest increases in error probability were related to two burnout dimensions: emotional exhaustion (29%) and depersonalization (28%). All the variables, with a probability of 100%, increased the probability of high human error probabilities by 46%. Conclusion: The most important variables in terms of their effect on human error probabilities were burnout dimensions, and these variables also had a mediation effect on the psychosocial and mental health variables. Therefore, preventive measures to control human error should first focus on managing the risks of burnout in workers. This, in turn, can also reduce the effect of psychosocial risk factors and mental health problems on human error in the workplace
Gelatin-based nanoparticles and antibiotics: a new therapeutic approach for osteomyelitis?
No full textThe result of infection of bone with microorganisms is osteomyelitis and septic arthritis. Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for most of its cases (more than 50%). Since MRSA is resistant to many treatments, it is accompanied by high costs and numerous complications, necessitating more effective new treatments. Recently, development of gelatin nanoparticles have attracted the attention of scientists of biomedicine to itself, and have been utilized as a delivery vehicle for antibiotics because of their biocompatibility, biodegradability, and cost-effectiveness. Promising results have been reported with gelatin modification and combinations with chemical agents. Although these findings have been suggested that gelatin has the potential to be a suitable option for continuous release of antibiotics in osteomyelitis and septic arthritis treatment, they still have not become routine in clinical practices. The most deliver antibiotic using gelatin-derived composites is vancomycin which is showed the good efficacy. To date, a number of pre-clinical studies evaluated the utility of gelatin-based composites in the management of osteomyelitis. Gelatin-based composites were found to have satisfactory performance in the control of infection, as well as the promotion of bone defect repair in chronic osteomyelitis models. This review summarized the available evidence which provides a new insight into gelatin-derived composites with controlled release of antibiotics
Resveratrol: Targeting Cancer Stem Cells and ncRNAs to Overcome Cancer Drug Resistance
No full textA major challenge in treating cancer is the development of drug resistance, which can result in treatment failure and tumor recurrence. Targeting cancer stem cells (CSCs) and non-coding RNAs (ncRNAs) with a polyphenolic substance called resveratrol has the ability to combat this problem by lowering cancer resistance to drugs and opening up new therapeutic options. Resveratrol alters the expression of genes related to self-renewal, modulating important signaling pathways involved in cancer initiation and CSC control. Additionally, resveratrol affects non-coding RNAs (ncRNAs), including Micro-RNAs (miRNAs) and long non-coding RNAs (lncRNAs which are essential for stemness, drug resistance, and other cancer-related activities. Numerous studies have shown that resveratrol has the potential to be an effective anticancer drug when used in combination therapy, but issues with absorption and pharmacokinetics still need to be resolved before it can be used in clinical applications. Reducing chemotherapy resistance by better understanding the intricate mechanisms by which resvera-trol affects cancer cells and CSCs, as well as its impact on ncRNA expression, could eventually contribute to more effective cancer treatments. To completely understand these pathways and optimize the utilization of resveratrol in combination treatments, additional study is necessary
The Effect of Mesenchymal Stem Cells on the Wound Infection
No full textWound infection often requires a long period of care and an onerous treatment process. Also, the rich environment makes the wound an ideal niche for microbial growth. Stable structures, like biofilm, and drug-resistant strains cause a delay in the healing process, which has become one of the important challenges in wound treatment. Many studies have focused on alternative methods to deal the wound infections. One of the novel and highly potential ways is mesenchymal stromal cells (MSCs). MSCs are mesoderm-derived pluripotent adult stem cells with the capacity for self-renewal, multidirectional differentiation, and immunological control. Also, MSCs have anti-inflammatory and antiapoptotic effects. MScs, as pluripotent stromal cells, differentiate into many mature cells. Also, MSCs produce antimicrobial compounds, such as antimicrobial peptides (AMP), as well as secrete immune modulators, which are two basic features considered in wound healing. Despite the advantages, preserving the structure and activity of MSCs is considered one of the most important points in the treatment. MSCs’ antimicrobial effects on microorganisms involved in wound infection have been confirmed in various studies. In this review, we aimed to discuss the antimicrobial and therapeutic applications of MSCs in the infected wound healing processe