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In this study, we aimed to examine the relationship between energy-adjusted dietary inflammatory index (E-DII) and a comprehensive profile of malnutrition in Iranian haemodialysis (HD) patients. In this cross-sectional study, 291 participants on HD for at least 6 months before enrollment were included. The current dietary intakes of participants were assessed using a 4-d diet diary-assisted recall, including 2 non-dialysis days and 2 dialysis days to calculate E-DII. To determine the malnutrition status of HD patients, BMI, subjective global assessment (SGA), dialysis malnutrition score (DMS) and malnutrition inflammation score (MIS) were used. Overall, 291 HD patients comprised our study population. After controlling for potential confounders, E-DII was associated with a higher risk of malnutrition, as evidenced by SGA (OR = 2·23; 95 % CI: 1·11, 4·49), DMS (OR = 2·31; 95 % CI: 1·16, 4·60) and MIS (OR = 2·50; 95 % CI: 1·28, 4·88). No significant association was detected between E-DII and BMI either before (OR = 1·78; 95 % CI: 0·83, 3·81) or after adjustment for possible confounders (OR = 1·43; 95 % CI: 0·58, 3·54). This study showed that E-DII was significantly associated with reliable malnutrition markers including SGA, DMS and MIS in HD patients. However, further longitudinal studies are warranted to infer a cause-and-effect relationship between DII and malnutrition. [ABSTRACT FROM AUTHOR]

The star-shaped ordering between probability distributions is a common way to express aging properties. A well-known criterion was proposed by Saunders and Moran [(1978). On the quantiles of the gamma and F distributions. Journal of Applied Probability 15(2): 426–432], to order families of distributions depending on one real parameter. However, the lifetime of complex systems usually depends on several parameters, especially when considering heterogeneous components. We extend the Saunders and Moran criterion characterizing the star-shaped order when the multidimensional parameter moves along a given direction. A few applications to the lifetime of complex models, namely parallel and series models assuming different individual components behavior, are discussed. [ABSTRACT FROM AUTHOR]

The relationship between the Dietary Approaches to Stop Hypertension (DASH) diet and clinical, quality of life and mental health outcomes in migraine is unknown. To address this knowledge gap, we conducted a parallel-group, randomised controlled trial to evaluate the effect of the DASH diet on these health outcomes in women with migraine. Of 102 eligible women (20–50 years), fifty one randomised to the DASH and fifty one to the usual dietary advice (control) groups completed a 12-week intervention. The DASH diet was designed using a 7-d menu cycle to provide 15–20 % of total daily energy requirements from proteins, 25–30 % from fats and 55–60 % from carbohydrates. Dietary records and serum vitamin C levels were used to assess women's compliance with the DASH diet. The clinical symptoms of migraine (i.e., frequency, duration and severity) and quality of life and mental health (i.e., depression, anxiety and stress) outcomes were assessed in groups pre-and post-intervention. We observed greater decreases in the frequency (–3·00 v. −1·40, P = 0·025) and severity (–1·76 v. −0·59, P < 0·001) of migraine in the DASH v. control group post-intervention. Similarly, the DASH group exhibited a tendency towards greater decreases in migraine duration (–0·58 v. −0·33 d, P = 0·053) and had lower scores of depression (–4·50 v. −2·73, P = 0·019) and stress (–5·84 v. −2·98, P = 0·011) v. controls. However, the quality of life and anxiety outcomes remained comparable in groups post-intervention. Together, evidence supports the benefits of the DASH diet on improving migraine health outcomes in reproductive-aged women. Further research is needed to confirm our findings. [ABSTRACT FROM AUTHOR]

Objective: The outbreak of coronavirus disease 2019 (COVID-19) has exerted unprecedented pressure on healthcare systems throughout the world. This study was designed to develop a national health emergency management program based on risk assessment for COVID-19. Methods: Mixed-methods research was used. Based on recommendations of the national epidemiology committee, 2 risk scenarios were used as basic scenarios for risk assessment. Two rounds of Focus Group Discussions (FGDs) were conducted between January and May 2020 with 30 representatives of the health system. The data were collected, analyzed, and integrated by the research team. Results: In the risk matrix, "contamination of environment and individuals" and "burnout of medical staff" occupied the red zone (intolerable risk). "Defects in screening and admissions," "process disruption in medical care and rehabilitation," "increased mental disorders," "social dissatisfaction," "the decline in healthcare services," and "loss of medical staff" were identified as the orange zone (significant risk) of the matrix. Conclusions: The avoidance of environmental and individual contamination and healthcare worker burnout are the priorities in Iran. Attention to intersectoral cooperation, the involvement of non-governmental organizations and private center capacities, integration of information health systems, and developing evidence-based protocols are other measures that can improve the health system's capacity in the response COVID-19. [ABSTRACT FROM AUTHOR]

As defined by the World Health Organization, the Eastern Mediterranean Region (EMR), given its special geopolitical situation and internal/external conflicts, faces an increase in illegal activities such as drug production and trafficking, highlighting the need for a comprehensive understanding of the substance use situation. On the basis of a review of published papers between 2015 and 2021 we briefly review substance use in the EMR with special focus on the emerging drugs pertinent to this region, namely tramadol, captagon and khat. [ABSTRACT FROM AUTHOR]

Few studies have assessed the association between sodium (Na) and potassium (K) and migraine headaches. In this study, we aimed to examine the relationship between 24-hour urine Na and K intakes and clinical findings of migraine in an Iranian sample. In this cross-sectional study, 262 participants, aged 20–50 years, were included with a body mass index (BMI) of 18·5–30 kg/m2 and a diagnosis of migraine. One 24-hour urine sample was collected from each subject to estimate the Na and K intakes. The clinical features of migraine, including frequency, duration, severity, Migraine Headache Index Score (MHIS), and Headache Impact Test (HIT) score, were assessed. Besides, a multiple linear regression analysis was performed, and beta estimates and the corresponding 95% confidence intervals (CIs) were reported. Overall, 224 women and 38 men, with a mean age of 36·10 years and BMI of 25·55 kg/m2 comprised our study population. After controlling for potential confounders, the 24-hour urine Na was positively associated with a longer headache duration (β = 0·29; 95% CI: 0·06, 0·53) in the group with the highest urine Na levels as compared to the group with the lowest levels. After adjustments for potential confounders, an increase of 13·05 in the MHIS was observed when the 24-hour urine Na level increased from the first to the third tertile (β = 13·05; 95% CI: 1·70, 24·41). Our findings suggested that a higher 24-hour urine Na level was positively associated with a longer duration of migraine headaches and a higher MHIS. [ABSTRACT FROM AUTHOR]

Shahab Ahmed's What Is Islam? The Importance of Being Islamic (2016) challenges Islamic Studies scholars, (art) historians, and anthropologists to reconsider theoretical frameworks underpinning historical and ethnographic research. This article addresses Ahmed's concerns that studies of Islam often conceptually privilege orthodoxy, by including drinking and intoxication as worthy of close attention in examining the history and the anthropology of Islam. The case of Wine Shop the Philosopher, run by a former Afghan refugee in The Hague and Amsterdam, is presented after establishing the comparative and interdisciplinary relevance of alcohol consumption in studies of Islam and Muslims. Ahmed's conceptual framework is used and assessed in comparison with the wine shops' contemporary pluralist reality by exploring the idealized boundaries of Persianate culture and Islam in dialogues between Persian-speaking interlocutors. It is argued that alcoholic drinks lend themselves to competing gastro-nationalisms and prompt ethnolinguistic tensions between and within groups with Turkish, Moroccan, Iranian, and Afghan backgrounds in the Netherlands. The focus on diverse, coexisting and clashing drink regimes, in conclusion, allows us to deconstruct dichotomies between sober Muslims and European drinkers, African and Asian believers and European unbelievers, and refugees and citizens. [ABSTRACT FROM AUTHOR]