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ABSTRACT Aims/Introduction The aim was to examine the joint effect of metabolic syndrome (MetS) and insulin resistance (IR) with ideal cardiovascular health (iCVH) status on incident cardiovascular diseases (CVDs). Materials and Methods The study included 6,240 Iranian adults ≥30 years, free of prior cardiovascular disease. Ideal cardiovascular health was determined based on American Heart Association's Life Simple 7. Metabolic syndrome was defined according to the Joint Interim Statement Criteria, and insulin resistance was defined as HOMA‐IR ≥1.85 in women and ≥2.17 in men. Multivariable Cox proportional hazard ratios (HRs) were applied to examine the impact of metabolic syndrome, and insulin resistance at various levels of iCVH status. Results During the median follow‐up of 14.0 years, 909 cases of cardiovascular disease occurred. Metabolic syndrome and insulin resistance were significantly associated with incident cardiovascular disease events. In the poor and intermediate status, metabolic syndrome increased cardiovascular disease events with HRs of 1.83 and 1.57, respectively; the corresponding values for insulin resistance in the mentioned categories were 1.91 and 1.25, respectively (P values

Abstract Background and aims Childhood and adolescence overweight/obesity is an important predictor of obesity and increased long-term cardiometabolic abnormalities in adulthood. In this study, we aimed to investigate the association of body mass index (BMI) and waist circumference (WC) trajectories among children and adolescents with adulthood carotid intima-media thickness (cIMT) as a determinant of subclinical atherosclerosis. Methods In this prospective cohort study, 1265 participants aged 3 to 18 were followed up for 18 years. By using Latent Class Growth Analysis, three groups of BMI and WC trajectory were defined; low stable, moderate-increasing, and high-increasing. Linear and logistic regression analysis were used to investigate the association of each lifetime BMI and WC trajectory group with cIMT. Results Although the high-increasing BMI trajectory group was significantly associated with higher cIMT (ß=0.0464, P

In this report, we synthesized some pyrimidine derivatives by multi-component reaction of urea, benzaldehydes, and 1,3-indandione in the presence of ZIF-8/ZnFe2O4/GO-OSO3H nanocomposite under reflux conditions. Initially, graphene oxide was prepared from graphite, and then it was sulfonated using ClOSO3H. Next, GO-OSO3H nanosheets were used to support ZIF-8/ZnFe2O4 nanostructure. The construction of the synthesized structure was established using different spectral techniques such as X-ray crystallography (XRD), scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX/Mapping), Fourier transform infrared (FTIR), thermal gravimetric analysis (TGA), vibrating sample magnetometer (VSM), and Brunauer-Emmett-Teller (BET). The present method provides various benefits including the efficiency of outcomes, easy separation of the catalyst, and excellent yield of the products within short reaction times. Moreover, the antibacterial activities of pyrimidine derivatives were investigated via the agar-well diffusion method on gram-negative (Escherichia coli) and gram-positive (Staphylococcus aureus) bacteria and the obtained results illustrated reasonable effects.

Abstract Objective: To evaluate sex- and age-stratified body composition (BC) parameters in subjects with wide age range of 20–79 years. Design: Cross-sectional. Setting: Participants of Tehran Lipid and Glucose Study (TLGS). Participants: Two thousand nine hundred seventy participants met our inclusion criteria. They were divided into five age groups, and BC parameters were analysed based on sex and age using a bioelectrical impedance analyser (BIA). Result: The mean age of the participants was 42·1 ± 12·5 years, and 54 % of them were males. The mean BMI was 26·7 ± 3·7 kg/m2. Obesity indices were significantly higher in females (P < 0·001); however, skeletal muscle mass (SMM) and fat-free mass (FFM) were significantly higher in males (P < 0·001). Both SMM and FFM decreased significantly after the age of 50 years. Obesity indices significantly increased from the age group of 20–29 to 30–39 years in males and the age groups of 30–39 to 40–49 years and 40–49 to 50–59 years in females. The fat mass ratio (fat mass/SMM) showed two peaks in both sexes (after the ages of 30 and 50 years in males and 40 and 50 years in females). A strong correlation was found between BMI and percentage of body fat (r = 0·823 in females v. r = 0·768 in males). Conclusion: This is the first community-based study in the MENA region identifying sex- and age-stratified BC values using BIA. Our findings can be used as a reference for comparison in appropriate settings.

Abstract Background Waist circumference (WC), a representative of abdominal visceral fat, is strongly associated with cardiovascular disease (CVD) and its outcomes. We aimed to define body mass index (BMI)-specific WC thresholds as predictors of CVD and all-cause mortality. Methods In this prospective cohort study in the context of the Tehran Lipid and Glucose Study (TLGS), a total of 3344 men and 4068 women were followed up for 18 years. Based on BMI, the participants were categorized into three groups: BMI 30. In each BMI category, sex-specific WC thresholds were estimated by the maximum value of Youden’s index to predict based on incident CVD events and all-cause mortality prediction. Results Overall 667 and 463 CVD events (the incidence rate of 3.1 to 4.5 in men and 1.1 to 2.6 in women per 1,000 person-years within BMI categories) and 438 and 302 mortalities (the incidence rate of 2.1 to 2.7 in men and 1.2 to 1.4 in women per 1,000 person-years within BMI categories) were recorded in men and women, respectively. WC thresholds in the BMI categories of 30 kg/m2 with regard to CVD events were 82, 95, and 103 cm in men and 82, 89, and 100 cm in women, and regarding all-cause mortality, the respective values were 88, 95, and 103 cm in men and 83, 90, and 99 cm among women. Conclusion BMI-specific WC thresholds observed here can help to better identify individuals at high risk of developing CVDs.

Abstract Aims We investigated whether thyroid function could be associated with obesity phenotypes amongst euthyroid individuals. Materials and methods A cross-sectional analysis was conducted among healthy, euthyroid subjects. The study participants were chosen from the Tehran Thyroid Study (TTS). We analyzed 2988 euthyroid adults and classified them into four obesity phenotype groups: metabolically healthy normal weight (MHNW), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obese (MUO). The statistical differences between thyroid hormones between various obesity phenotypes according to age and sex was compared using analysis of covariance (ANCOVA). Results It was found that MHNW participants had higher levels of FT4 when compared with metabolically healthy or unhealthy obese subjects (P 0.05). Conclusion “Metabolically abnormality” was independently related to low normal FT4 levels in overweight/obese euthyroid individuals. There is a need for further research to understand how low FT4 levels are linked to metabolically unhealthy states in euthyroid individuals.

Abstract Background Calcium could impact on vascular functions and structures and cause atherosclerosis. Thus, we aimed to examine the association of long-term calcium and dairy products intake in adolescence with cIMT and MetS in early adulthood. Methods We considered 217 adolescents aged 12–18 years in the frame work of the Tehran Lipid and Glucose Study (2006–2009) and follow-up them to early adulthood (2015–2017). The valid food frequency questionnaire was used to assess dietary intake. Ultrasound examination was used to measure common carotid artery. The joint interim statement and cook et al. criteria were used for adults and adolescents to consider MetS, respectively. Results Adolescents’ average calcium intake from dairy and non-dairy sources were 395 mg/d and 1088 mg/d, respectively while adults had 212 mg/d and 1191 mg/d. In addition, the mean of cIMT in adults was 0.54 mm. There was no relationship of non-dairy (β: − 0.03; P = 0.804), and total calcium (β: − 0.001; P = 0.591) intake with cIMT and TG. None of the dairy products had link with cIMT, MetS and its components, except cream with cIMT after full adjustment of potential confounders (β: 0.245; P = 0.009). Also, we found that the intake of non-dairy products could increase DBP after controlling for potential confounders (β: 0.365; P = 0.012). Adolescence with higher quartiles of total calcium intake had no odds ratio of MetS in early adulthood (β: 2.05, P = 0.371). Conclusions Adolescence calcium and dairy products intake, with the exception of cream did not increase early adulthood cIMT and MetS and its components.

Abstract Background Obesity is a global health priority, particularly in developing countries. The preventive effect of bariatric surgery against obesity-related diseases in the developing countries of the Middle East and North Africa region, where type 2 diabetes mellitus (T2DM), hypertension (HTN), and dyslipidemia prevail, has not been examined. Method Severely obese participants who underwent bariatric surgery were compared with their counterparts who underwent no intervention. These patients had been followed up in two prospective cohort studies for three years. We here determined the incidence of new-onset T2DM, HTN, and dyslipidemia and reported absolute and relative risks for the incidence of these comorbidities in the two groups. Results In this study, 612 participants in the bariatric surgery group were compared with 593 participants in the control group. During the follow-up period, T2DM developed in eight (2.9%) people in the surgery group and 66 (15.0%) people in the control group (P

Abstract Background Assessment of both behavior and factors of health as ideal cardiovascular health (iCVH) in adolescence could contribute to cardiovascular disease prevention in adulthood. Aims To explore the changes in the prevalence of iCVH and its components during a decade among Tehranian adolescents. Methods The 12–19 years old adolescents were selected from the Tehran Lipid and Glucose Study(TLGS). The iCVH score was calculated in the study period 1 (2007–2008; n = 267) and 2 (2015–2017; n = 336). To calculate iCVH, body mass index(BMI), systolic and diastolic blood pressure (BP), total cholesterol, fasting plasma glucose (FPG), physical activity, smoking status, and dietary intakes were measured by standard protocols. The changes in iCVH components between the two study periods were reported by prevalence (95% confidence interval). A logistic regression model was conducted to test the effects of study periods, sex, and age groups on the iCVH(≥ 6 scores). Results Overall, there was a reduction in the prevalence of ideal FPG (97.4 vs. 91.1%) and ideal BP(91.8 vs. 82.7%). Girls had a decrease in the prevalence of ideal BP(91.2 vs. 79.4%) as well as an increase in non-smoking status(77.6 vs. 89.7%). However, the prevalence of ideal FPG (96.5 vs. 88.5%) and ideal BP(92.2 vs 85.0%) decreased in boys. Study period 2, compared to period 1 was associated with lower odds of having iCVH. Furthermore, boys were 1.57 folds more likely to have ideal CVH factors than girls. Conclusion There was a decrease in the prevalence of ideal CVD metrics, including FPG and BP, after one decade. Generally, adolescent boys had higher odds of having ideal CVH compared to girls.

Abstract Ideal cardiovascular health (CVH) is associated with a lower risk of developing cardiovascular diseases. This study aims to investigate the association of CVH metrics with carotid intima-media thickness (cIMT) as a marker of subclinical atherosclerosis in young adults. A cross-sectional study was performed on 1295 adults, average age of 29.7 ± 4.0 years, selected from the participants of the Tehran Lipid and Glucose Study. The participants were divided into three groups based on the overall CVH score: ideal, intermediate, and poor CVH. Multivariate-adjusted linear regression was used to determine the association of the CVH score with cIMT. Multivariate-adjusted odds ratios (ORs) were calculated for high cIMT (≥ 95% percentile). Also, the independent effects of each ideal CVH metric on cIMT were analyzed. The prevalence of ideal CVH was 6.4% in men and 12.4% in women, and mean cIMT was obtained 0.53 ± 0.09 mm in men and 0.57 ± 0.08 mm in women. A 1-point increase of the CVH score in men and women was associated with a cIMT decrease of 0.009 and 0.011 mm (men: Beta [SE] = − 0.009 [0.003]; women: − 0.011 [0.007], p

Abstract Background This study aimed to investigate the effects of legumes in dietary approaches to stop hypertension (DASH) on blood pressure and urinary sodium and potassium in participants with type 2 diabetes. We further investigated whether changes in individual dietary food groups in the DASH diet contribute to blood pressure. Methods Participants were randomized to the traditional DASH diet (n = 150) or the legume-based DASH diet (n = 150). Blood pressure and urinary sodium and potassium were measured at baseline and after 16-week interventions. An intention-to-treat approach with multiple imputations of missing data was applied. The restricted cubic spline (RCS) was applied to assess the linearity and explore the shape of the relationship between the changes in food groups and systolic blood pressure (SBP) in the two intervention groups. Results A reduction in SBP and urinary sodium was observed at week 16 in both dietary interventions, and this reduction was more significant in the legume-based DASH diet, than in the DASH diet. In the legume-based DASH diet, SBP decreased with the legume intake of more than 95.8 g/day (P nonlinear

PurposeThe association between metabolic phenotypes and thyroid function has not yet been established; therefore, this study examined whether different metabolic phenotypes are associated with the development of hypothyroidism.MethodsStudy participants were selected from the Tehran Thyroid Study (TTS). A total of 3338 euthyroid adults were included and categorized into four obesity phenotype groups: metabolically healthy normal weight (MHNW), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obese (MUO). The participants were assessed at baseline and during three follow-up studies at three-year intervals. Multiple logistic regression analysis was used to examine the relationship between metabolic phenotypes and the development of hypothyroidism.ResultsIn the total population, the chi-square test was only significant (P=0.008) in 3rd year with a higher prevalence of hypothyroidism in the MUNW phenotype, followed by MHO, MUO, and MHNW. Moreover, in the 3rd and 9th years of follow-up, hypothyroidism was more prevalent in MUO only in male subjects (P=0.002 and 0.035, respectively). In the unadjusted model, the MHO phenotype increased the odds of hypothyroidism compared with the MHNW phenotype (OR=1.51; 95% CI=1.04, 2.18; P-value=0.031). After adjusting for confounding factors, the odds of hypothyroidism were higher in the MUNW (OR=1.86; 95% CI=1.17, 2.96; P-value=0.008), MHO (OR=1.71; 95% CI=1.09, 2.67; P-value=0.018), and MUO (OR=1.64; 95% CI=1.03, 2.62; P-value=0.036) phenotypes than in the MHNW group. The MUNW phenotype increased the risk of hypothyroidism compared to MHNW, only in males. However, in females, the MHO phenotype increased the risk of hypothyroidism compared to MHNW.ConclusionBoth obesity and metabolic abnormalities are associated with hyperthyroidism. Healthy metabolic and weight maintenance were associated with a lower risk of hypothyroidism in males and females.

BackgroundThere is debate regarding which anthropometric indices is the most appropriate predictor of cardiovascular disease (CVD) among adolescents. The purpose of this study was to investigate the association of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) in adolescents with high carotid intima-media thickness (cIMT) in early adulthood, as the surrogate marker of CVD in a cohort study.MethodsA total of 875 Iranian adolescents (female = 421) aged 10–17 years old were entered the study. The cIMT was measured in early adulthood (20–38 years old) after 18.2 (median) years of follow-up and defined as > 90th percentile for sex and age groups. The gender specific association between a 1-SD increase in each anthropometric measures with high cIMT was examined using multivariate logistic regression analysis adjusted for age, smoking, family history of CVD, systolic blood pressure, total cholesterol, and fasting blood sugar. In the multivariable analysis, the interaction between sex and age groups with anthropometric measures were significant (all p-values < 0.05).ResultsAmong males, all anthropometric measures including BMI, WC, WHR, and WHtR were associated with high cIMT; the corresponding odds ratios were 1.43 (1.05–1.94), 1.63 (1.22–2.19), 1.33 (1.03–1.71), and 1.41 (1.07–1.87), respectively. However, after considering the related adulthood anthropometric measurements, the association remained significant for WC 1.48 (1.04–2.10) and WHR [1.28 (0.99–1.66), P = 0.06]. Moreover, among early adolescent boys aged 10–14 years, all of the anthropometric measures were significantly associated with high cIMT in the multivariate analysis that included the related adulthood anthropometric measures. The area under the curve (AUC) for the anthropometric measurements among males ranged from 0.576 for WHtR up to 0.632 for WC, without any superiority between them. Among females, only in linear regression analysis, a significant association were found between the higher value of WC and WHtR with cIMT measurement in adulthood; however, the risk reached to null after considering adult anthropometric measures.ConclusionGeneral and central obesity measures were significantly associated with high cIMT only among Iranian male adolescents, the relationship that were more prominent among pre-pubertal males.

Abstract Objective To examine the association of age, period, and birth cohort with body mass index (BMI) and waist circumference (WC) changes among the participants of the Tehran Lipid and Glucose Study from 1999 to 2015. Methods This prospective cohort study included 4895 participants aged ≥20 years (41.3% men), who were divided into twelve gender stratified groups, having a ten-year age difference between them. Analyses were conducted to explicitly assess the association of age vs. period on BMI and WC changes. In addition, we evaluated BMI and WC changes among different birth cohorts. Results Upon 15 years of follow-up, the mean BMI of men and women increased from 26.0 ± 3.9 to 27.5 ± 4.3 kg/m2 and from 27.5 ± 4.8 to 29.9 ± 5.4 kg/m2 (P trend

In this research, support vector machine (SVM) as a supervised classification method has been used to explore the relationship between the geochemical anomaly and the surface alterations quantitatively in the Tanurcheh mineralization area. The Tanurcheh area has been located in the Khorasan Razavi province, Iran. This area has been considered as a high potential region for Cu and Au mineralization. The different mineralization processes of Au and Cu have unclearly been intertwined in this area and have created extreme surface alterations.Determination of the major origin of mineralization that has created strong alterations in this area is an important issue that can be addressed using a new proposed scenario. The relationship between the geochemical distribution map and the alteration zone was mathematically calculated using the proposed approach and then the geochemical anomaly map was predicted based on the alteration zones as an innovative achievement.In this paper, the Au and Cu geochemical data were divided into three classes, namely background, regional anomaly and local anomaly using the probability plot method. Two threshold values for Cu (70 and 300 PPM) and Au (0.13 and 0.4 PPM) were obtained by the probability plot method. Then the SVM was utilized to classify the geochemical samples using the ASTER images based on these obtained thresholds. The ASTER 14-band images were used as features in this classification. Using this novel scenario, the relationships between the Au and Cu mineralization processes with the intensity of alterations were determined and therefore the origin of these alteration zones was clarified. The SVM classification indices of correct classification rate (CCR) and confusion matrix demonstrate the main origin of alterations is related to the Cu mineralization process in this area. The CCR indices obtained based on the Au and Cu thresholds are 0.66 and 0.85 respectively. It demonstrates the intensity of alterations has more been affected by the Cu mineralization process and there is a relatively good relationship between the alteration zone and the Cu geochemical distribution map. Finally, the geochemical anomaly and background maps were properly predicted using the SVM and the ASTER bands. This paper shows the new application of SVM as a powerful tool for the interpretation of geochemical anomaly and the intensity of alteration.

Abstract Background Individuals with transition from metabolically healthy overweight/obese (MHO) to metabolically unhealthy overweight/obese (MUO) phenotype are significantly predisposed to greater risks of cardiovascular events compared to those with a persistent MHO phenotype. The aim of this study was to evaluate the predictive performance of wrist circumference for this transition in adults over a 15.5-year follow-up. Methods We included 309 males and 821 females with the age of ≥18 years old, body mass index ≥25 kg/m2, and metabolically healthy status according to the criteria of the Joint Interim Statement. The incidence of MUO phenotype was evaluated for each gender, across tertiles wrist circumference, using Cox-proportional hazard models. Results The overall rate of transition from MHO to MUO phenotype was 87.1% in males and 77.5% in females. The hazard ratios (HRs) with 95% CI across second and third tertiles of wrist circumference were 0.89 (0.64-1.24) and 1.31 (0.99-1.73) in men (P for trend =0.027); and 1.34 (1.09-1.66) and 1.61 (1.30-2.00) in women (P for trend

Abstract Background The prevalence of obesity among children and adolescences have been increased, which can consequently increase the prevalence of metabolic and cardiovascular diseases later in life. The objective of this study is to compare the ability of different childhood body mass index cut-offs in prediction of carotid intima media thickness (CIMT) as an indicator of subclinical atherosclerosis. Methods Participants were categorized into normal weight, overweight and obesity group, based on world health organization (WHO), center for disease control and prevention (CDC), international obesity task force (IOTF) and local IOTF cut-offs. After 18 years of follow up CIMT was measured. Akaike’s information criterion and relative efficiency were measured in order to compare regression models on the role of obesity on CIMT. Results In this prospective cohort study, 1295 subjects aged 3 to 18 years old were enrolled. The overall prevalence of overweight was 15.4, 11.5, 16.3 and 14.1 along with obesity prevalence of 6.6, 8.5, 7.7 and 5.0% based on WHO, CDC, local IOTF and international IOTF criteria, respectively. CIMT was higher in obese compare to normal groups across all classification criteria. After regression analysis, international IOTF was the best to predict adulthood CIMT, followed by local IOTF and WHO. CDC had the least discriminatory ability. Conclusion Due to the results of this study, IOTF could be a better tool in national and international surveillances of children in order to define overweight and obesity, which can help us to intervene more effectively in reducing the burden of cardiovascular diseases.

BackgroundThe rs2282679 polymorphism in the vitamin D binding protein (DBP) gene may influence the response to vitamin D supplementation. Therefore, we examine the effect of 1-year vitamin D supplementation on vitamin D deficiency (VDD) with the interaction of rs2282679 polymorphism in overweight and obese children and adolescents.Materials and methodsThe participants (n = 300) were part of a randomized controlled trial who received a daily supplement of either 1,000 or 2,000 IU or four supplements of 1,000 IU weekly (equal to 600 IU daily) of vitamin D3 for 12 months. Genotyping was performed using amplification refractory mutation system polymerase chain reaction (ARMS-PCR).ResultsThe mean of 25(OH)D values at baseline for participants with the TT, TG, and GG genotypes were 15.4, 14.4, and 10.8 ng/mL, respectively, and were not different between the three genotype groups (P = 0.062). A significant reduction in VDD was observed after vitamin D supplementation with dosages of 1,000 or 2,000 IU compared to 600 IU. No significant association of genotypes with risk of VDD was observed in each intervention group after vitamin D supplementation, except, that individuals with TG genotype showed a higher risk of VDD compared to those with TT genotype in the 2,000 IU group after 6 months of supplementation [odds ratio (95% CI): 6.94; 1.30–37.02]. We observed no interaction between time duration, three genotypes, and dosages with serum 25(OH)D, calcium, phosphorus, alkaline phosphatase, and parathyroid hormone levels.ConclusionResponse to vitamin D supplementation by three doses of 600, 1,000, and 2,000 IU could not be affected by rs2282679 polymorphism during 12 months in overweight and obese children and adolescents.

Background & Objective: In recent studies visfatin has been introduced as a multifaceted protein that plays a role in pathogenesis of many disorders and disease such as obesity and type 2 diabetes. The aim of this study was to evaluate the association of visfatin with fasting blood glucose, insulin resistance and body mass index in patients with type 2 diabetes / impaired fasting glucose (T2DM, IFG) compared to non-diabetic subjects. Material & Methods: This case control study was performed on 160 volunteers. 80 participants were categorized in type 2 diabetic group holding FBG ≥100 (mg/dl) and 80 participants were categorized in non-diabetic (healthy) group holding FBG 70-100 (mg/dl). Serum visfatin levels were measured using enzyme-linked immune sorbent assay (ELISA) and HOMA-IR equation was used for insulin sensitivity check. Results: The result was presented as mean+ standard deviation and p

BackgroundVisceral obesity is a significant predictor of cardiovascular disease (CVD). Diet may associate with CVD risk through its effects on visceral adiposity. This study aimed to find dietary patterns (DPs) related to indicators of visceral adiposity and to determine whether the DPs were associated with CVD risk.MethodsThis prospective study included 2,496 participants of the Tehran Lipid and Glucose Study (TLGS) without CVD, who were followed from the third study examination (2005–2008; baseline) to March 2018. DPs at baseline were determined using reduced rank regression (RRR) and partial least squares regression (PLS). The response variables were age and BMI-adjusted waist circumference (WC) and age-adjusted visceral adiposity index (VAI).ResultsTwo and three DPs were retained with RRR and PLS, respectively. The first patterns of each method were mainly characterized by adjusted-WC (RRR: 10.8%, PLS: 8.6%); none of them were associated with CVD risk. The second pattern of RRR and the third pattern of PLS were mainly explained by adjusted-VAI (RRR: 3.3, PLS: 2.1%). After adjusting for CVD risk factors, the hazard ratios [95% confidence intervals (CI)] for CVD in the second and third tertiles of the RRR-pattern 2 were 1.76 (1.15, 2.69) and 1.55 (1.00, 2.43) vs. the first tertile (p-trend: 0.058). This pattern had high positive loadings for non-leafy vegetables, pickled vegetables, fried vegetables, and bread and high negative loadings for eggs, cakes, butter, jam-honey, red meat, poultry, fish, juice, non-fermented dairy, and fruits. Per one SD increase in PLS-pattern 3 score, the risk of CVD was 19% higher (95%CI = 3–38%). This positive association was also observed across tertiles of the pattern (p-trend: 0.032). This pattern was characterized by high intakes of leafy vegetables, non-leafy vegetables, organ meat, soft drinks, olive oil, pickled vegetables, fried vegetables, and bread and low intakes of biscuits, cakes, butter, eggs, and non-fermented dairy.ConclusionFor each of the RRR and PLS approaches, a visceral-related DP that was positively linked to CVD was identified. These two patterns had a modest correlation. The pattern generated by PLS explained more variations in food groups and offered stronger evidence of association with CVD than the RRR-derived pattern.

Abstract Men have been historically considered to be higher-risk patients for bariatric surgery compared to women, the perception of which is suggested to be a barrier to bariatric surgery in men. The purpose of this study is to conduct a matched-pair analysis to evaluate sex disparities in laparoscopic bariatric surgery outcomes. Data on patients who underwent laparoscopic bariatric surgery from March 2013 to 2017 was collected prospectively. Then, 707 men and 707 women pair-matched for age, preoperative body mass index (BMI) and the procedure type (i.e., sleeve gastrectomy, Roux-en-Y, or one-anastomosis gastric bypass) were compared in terms of weight loss, remission of obesity-related comorbidities, and postoperative complications classified according to the Clavien–Dindo classification. There was no difference between the two sexes regarding the operation time, bleeding during surgery and length of postoperative hospital stay. We observed similar total weight loss, BMI loss, and percentage of excess BMI loss at 12, 24, and 36 months postoperatively between men and women, with no difference in remission of diabetes mellitus, hypertension and dyslipidemia at 12 months. The rate of in-hospital, 30-day and late complications according to Clavien–Dindo classification grades was similar between men and women. Our matched-pair cohort analysis demonstrated that bariatric surgery results in comparable short- and mid-term efficacy in men and women, and is associated with similar rate and severity of postoperative complications between sexes. These findings suggest bariatric surgeons not to consider sex for patient selection in bariatric surgery.

In this article, by categorizing the methods of referring Mullā Ṣadrā, evidence of the similarity of his statements with the works of others has been shown, which has led to the accusation of piracy (plagiarism). An attempt has been made in this research to explain the causes of this event in his works. For this purpose, with the analytical-historical method, seventeen different explanations about the reason for adapting Mullā Ṣadrā from the expressions of others have been proposed and evaluated and it has been shown that some of these explanations are not acceptable. Acceptable explanations were then divided into two categories of specific and general explanations. Specific explanations include: trying to write a comprehensive book, transmitting Sunni theories to Shiite books, and using other people’s contents to consecrate, guarantee, and adapt popular phrases. General explanations are also: the prevalence of unsourced quotations in philosophical texts, the instrumental view of theoretical wisdom, the need to maintain the didactic aspect in the expression of topics, the confirmation of one’s own opinions by quoting others, and the avoidance of phrase reprocessing. Accordingly, not all expressions in Mullā Ṣadrā’s works are necessarily his own, and researchers must be more careful in their attribution.

Abstract Background Based on data regarding nutrition transition in the Middle East and North Africa, this study aim to investigate the general structure and secular trend of dietary patterns reported from the Tehran Lipid and Glucose Study (TLGS) and adherence to these dietary patterns among Iranian population from 2006 till 2017. Methods We investigated on four examination waves of TLGS, including wave 1 (2006–2008), wave 2 (2009–2011), wave 3 (2012–2014), and wave 4 (2015–2017), using a validated and reliable food frequency questionnaire. Generalized Estimating Equations was used to assess secular trends in anthropometric, biochemical, and dietary variables across the study period. To identify general structure and secular trend of dietary patterns during each waves, principle component analysis (PCA) and K-mean cluster analysis were used, respectively. Results After adjusting for potential confounders including age, sex, body mass index, and total energy intake, the carbohydrate and protein intake gradually increased and the total fat intake decreased during study period (P-value

Abstract Background Bariatric surgery is an effective treatment for obesity and its associated comorbidities. This is the first comprehensive report of a prospective cohort study, comparing sleeve gastrectomy (SG) with gastric bypass (GB) regarding their effectiveness and safety. Methods The prospectively collected data of patients, who presented to a specialized bariatric center and underwent a primary bariatric procedure, were compared in terms of weight loss, remission of obesity-associated comorbidities, complication rate, and quality of life improvement at 6-, 12-, and 24-month follow-ups. Results Of 3287 patients (78.6% female) analyzed, 67% (n = 2202) and 33% (n = 1085) underwent SG and GB, respectively. Effective outcomes were reported in both groups regarding the body composition indices. Type 2 diabetes mellitus (T2DM) remission rate at the end of follow-up was 53.3% and 63.8% in the SG and GB groups, respectively. Following the propensity score-adjusted analysis, the T2DM remission rate was not significantly different between the groups. Conversely, the remission rate of hypertension in the 24-month follow-up (39.1% vs. 54.7%) and the remission rate of dyslipidemia in all follow-ups were lower in the SG group, compared to the GB group. Moreover, both procedures caused substantial improvements in various domains of quality of life. The surgery duration, early complication rate, and nutritional deficiencies were lower in the SG group, compared to the GB group. Conclusion Both surgical procedures were effective in the control of obesity and remission of its comorbidities. However, since SG was associated with a lower rate of complications, it seems that SG should be considered as a suitable procedure for obese patients, especially those with a healthier metabolic profile.

Background &Objective: Resistin an adipocytokines secreted by adipocytes, is associated with insulin resistance and increases in obesity, cardiovascular disease and other inflammatory diseases. The aim of this study was to investigate the relationship between resistin levels, metabolic variables, and insulin resistance in patients with prediabetes / diabetes in an Iranian population. Material& Methods: This study was conducted on 75 patients with fasting plasma glucose (FPG)≥ 100 mg/dl in prediabet­ic/ diabetic group and 75 participants with FPG less than 100 mg/dl as control group. Plasma levels of resistin and insulin were measured by ELISA kit and other variables were determined by standard methods. Statistical analysis was performed using SPSS software, version 19. Results: Resistin levels, body mass index, triglyceride, cholesterol, FPG and insulin resistance were significantly higher in patients with pre-diabetes / diabetes compared with controls (P-value

Abstract Background To investigate the association between markers of insulin metabolism and carotid intima-media thickness(cIMT) among overweight and obese children and adolescents. Methods A total of 378 children and adolescents aged from 6 to 13 years, with WHO body mass index Z-Scores ≥2 were enrolled in this study. We measured fasting serum insulin and glucose, conducted a homeostatic model assessment of insulin resistance(HOMA-IR), and calculated the quantitative insulin sensitivity check index(QUICKI). Carotid intima-media thickness was measured in the common carotid artery with high-resolution ultrasonography. Results The study participants consisted of 198 boys and 180 girls with a mean(±SD) age of 9.3 ± 1.7 years, 18.3% being pre-pubertal. In boys, after controlling for confounders, a one-SD increase in fasting insulin and HOMA-IR were associated with 0.351 mm(P

Considering that the data available on the cardiovascular (CV) risk of metabolically healthy obesity phenotype, and the effect of transition to an unhealthy status are inconsistent, the aim of this study was to investigate the possible role of transition to unhealthy status among metabolically healthy overweight/obese (MHO) subjects on CVD incidence over a median follow-up of 15.9 years. In this large population-based cohort, 6758 participants (41.6% men) aged ≥ 20 years, were enrolled. Participants were divided into 4 groups based on their obesity phenotypes and follow-up results, including persistent metabolically healthy normal weight (MHNW), persistent MHO, transitional MHO and metabolically unhealthy overweight/obese (MUO). Metabolic health was defined as not having metabolic syndrome based on the Joint Interim Statement (JIS) criteria. Multivariable adjusted hazard ratios (HRs) were calculated for cardiovascular events. During follow-up, rate of CVD Incidence per 1000 person-years were 12 and 7 in males and females, respectively. Multivariable adjusted HRs (CI 95%) of CVD incidence among males and females were 1.37 (.78-2.41) and .85 (.34-2.15) in persistent MHO group, 1.55 (1.02-2.37) and .93 (.41-2.12) in transitional MHO group and 2.64 (1.89-3.70) and 2.65 (1.24-5.68) in MUO group. Our findings showed that CVD risk did not increase in the persistent MHO phenotype over a 15.9-year follow-up in both sexes. However, transition from MHO to MUO status during follow-up increased the CVD risk just in male individuals. Further studies are needed to provide conclusive evidence in favor of benign nature of transitional MHO phenotype in females.

Abstract: Coronary artery disease (CAD) is a multifactorial problem. Although hyperlipidemia (HLP), diabetes (DM), and hypertension (HTN) are known as the familial and cardiac risk factors, CABG is rare in the several members of a family. We reported the six members of a family who presented with MI and/or advanced angina pectoris during the 6 years. CABG(Coronary artery bypass graft) considered for all patients due to involvement in main coronary arteries and clinical presentation. The ejection fraction (EF) was varied between 25% to 70%. Beating heart cardiopulmonary bypass (beating heart CPB) and off-pump were chosen as surgical method. The mean duration of surgery was about 4 hours. The only post-operative complication was deep wound infected in a young man who was smoker and drug abuser. According to family relationship of patients and the high effect of genetic penetration, we presume the gene influence to incidence CAD and potential to undergoing CABG, in members of a special family.

Introduction: Diabetes is a chronic disease which usually begins with impaired glucose tolerance. This step is known as pre-diabetes. People with pre-diabetes are at greater risk for diabetes. Typically for the variable selection, stepwise approach is used which does not take into account model uncertainties. In this study, Bayesian Model Averaging (BMA) method was used to sort out the above shortcoming. Materials and Methods: The study population was 734 pre-diabetic women with 20 years and older participated in Tehran Lipid and Glucose Study (TLGS). In this study, the stepwise and BMA variable selection methods were employed in logistic regression. Then area under curve (AUC) for both methods was computed and compared with Delong test. All analyses was done using R version 3.1.3. Results: BMA selected the fasting plasma glucose, 2 hours’ blood glucose, and family history of diabetes, body mass index and aspirin use at baseline as risk factors for diabetic. In addition to these factors, stepwise method selected diastolic blood pressure, history of past 3 months’ hospitalization, thyroid drug use and education. Although the number of variables selected by BMA (5 variables) was less than that of stepwise (9 variables), AUC for the two methods was not significant. Conclusion: It seems that the BMA provide better model for screening of diabetes because with selecting fewer variables, prediction ability of the model is preserved

Background and Aim: Pseudomonas aeruginosa is a gram-negative pathogen that causes a variety of serious infections predominantly in immunocompromised patients. To promote severe illness, P. aeruginosa uses a type III secretion system to inject toxic effector proteins into the cytoplasm of eukaryotic cells. Four effector proteins have been described in P. aeruginosa: ExoU, ExoS, ExoT, and ExoY. The aim of the study was to determine the prevalence of the type III secretion system toxins-encoding genes among P. aeruginosa isolates collected from different clinical specimens such as urine, wound, blood and respiratory secretions from patients. Materials and Methods: 55 Pseudomonas aeruginosa isolates were identified from hospitalized patients in Tehran during 2015 – 2016, using conventional microbiological tests. The susceptibility of isolates to antibiotics were assessed using disk diffusion test. After DNA extraction, Multiplex PCR was performed on the P. aeruginosa isolates to detect the secretion toxins-encoding genes. Results: High resistance rates were seen for cefipime (89%), ceftazidime (85.45%), aztreonam (83.63%), tobramycin (78.18%) and gentamicin (60%). The prevalence of the genes among all isolates was as follows; exoT (76.32%), exoS (30.90%), exoY (14.54%) and exoU (67.27%). exoU was more prevalent among MDR than in non-MDR strains (81.3% versus16.6%). exoU+ isolates were more likely to be fluoroquinolone-resistant than exoS+ isolates (32% versus 17%). Conclusions: Type III secretion system toxins-encoding genes found in isolated P.aeruginosa, in which exoT, exoU and exoS gene detected in most isolates while exoY gene was detected in minaroty of the isolates.

In this paper, the effect of the structural properties and morphology of iron oxide product, have been studied in co-precipitation and hydrothermal methods. Also, the effect of adding CCl4 impurities and final annealing of the materials is taken into account. The more homogeneous particle size in hydrothermal method has been explained by the effect of adding CCl4 as impurities to prevent the continuation of nucleation. It has also been observed that in co-precipitation sample additive has a key role for providing the bar shape particles by mediating of the anisotropic connection of nuclei. The difference in the crystal structure of the anneal samples has been related to the oxygen content.

This study evaluated the effect of Pseudomonas strains and arbuscular mycorrhiza fungi (AMF) in enhancing strawberry yield and phenolic and antioxidant capacity on a phosphorus (P) deficient calcareous soil. The experiments were conducted in three replicates with six treatments (four Pseudomonas strains, AMF and control) and three rates of P-fertilizer (0, 75, 150 kg P ha–1). Application of higher phosphate rates decreased total antioxidant capacity, total phenolic and flavonols content, whereas AMF and Pseudomonas strains increased quality and P concentration of fruit. The use of AMF and Pseudomonas strains resulted in better quality when used along with 75 kg P ha–1. These results demonstrated that the rhizospheric microorganisms improved the quality of fruit, especially when they applied in combination with lower rates of chemical fertilizers. Therefore, application of these microorganisms in sustainable agriculture is recommended.

The level of serum 25-hydroxyvitamin D (25(OH)D) at which intact parathyroid hormone (iPTH) is maximally suppressed (suppression point) and below which PTH begins to rise (inflection point) has been used to define optimum 25(OH)D concentration. We aimed to study the association of circulating iPTH with 25(OH)D concentrations and to determine a 25(OH)D threshold associated with a significant iPTH suppression. This cross-sectional study was conducted on 198 boys and 180 girls, aged 6-13 years with BMI ≥ 1SD (WHO criteria) recruited from primary schools. Adjusted iPTH for BMI z-score, pubertal status, and dietary calcium was used. Nonlinear regression was used to model the relationship between 25(OH)D and iPTH and identify a suppression point for 25(OH)D at which iPTH reached a plateau. Piecewise regression analysis with a single knot for all possible values of 25(OH)D were fitted. Furthermore, 95% confidence intervals (95%CI) for those point had been calculated. The mean age (SD) of girls and boys was 9.1 (1.6) and 9.4 (1.7) years, respectively. Median 25(OH)D and iPTH were 13.8 ng/mL and 33.9 pg/mL in boys and 9.9 ng/mL and 47.8 ng/mL in girls, respectively. The equation in girls was: log-iPTH = 3.598+0.868 exp[(-0.190×25(OH)D. The point for near maximal suppression of iPTH by 25(OH)D for girls occurred at a 25(OH)D concentration of 20 ng/mL (95% CI: 7.1 to 32.2). No point of maximal suppression was found for boys. We also found a 25(OH)D threshold of 10 ng/mL (95% CI: 4.6 to 22.5) for girls (f: 9.8) by linear piecewise regression modeling of adjusted iPTH. No significant inflection point for boys was observed. In overweight/obese girls, when the concentration of 25(OH)D was higher than 20 ng/mL, an iPTH mean plateau level is reached, and when its concentrations approach 10 ng/mL, the slope of iPTH concentration has been accelerated.

Abstract The current investigation was aimed toward standardization of learning environment perceptions survey (PES-HS). Method: Four-hundred students (204 female and 196 male) were selected through multi-stage stratified sampling method. Students completed the Farsi version of PES-HS. The exploratory factor analysis and confirmatory factor analysis and internal consistency were used to compute the PES-HS factorial validity and reliability, respectively.The results of principle component analysis (PC) and voarimax rotation replicated the five-factor structure of the PES-HS. Based on item content, factors were named Engagement, Membership, Authenticity, Ownership and Support. Based on linear Structural Relations (LISREL) software, Goodness-of-fit indices of confirmatory factor analysis confirmed the 5 extracted factors. The multidimensional Scales of PES-HS were shown to be an acceptable measurement model in this sample.Cronbach''s alpha coefficients for the five factors of the PES-HS were learning environment perceptions for Iranian students. Keywords: Standardization, Learning environment perceptions survey, Validity, Reliability.ranged from 0.74 to 0.89.Conclusion: PES-HS is a

This semi- experimental study was conducted to investigate the effect of virtual instruction in students with hearing loss‏.‏Using a pretest-posttest control group design, 24 fifth grade elementary students were selected by multistage random sampling and then assigned in to two equal size experimental and control groups. The virtual instruction for science was administered to the experimental group in 3 weeks (60 minutes, three times per week). During this period the control group received routine program. before and after the experiment, the two groups were assessed by an achievement test in three parallel forms‏.‏ANOVA showed that virtual instruction could increase both learning and recalling in the experimental group.Virtual instruction can increase the amount of science learning and recalling can be applied as an effective teaching method for students with hearing impairment in educational settings.

A new Pt(II) complex, [Pt(DIP)(LL)](NO3)2 (in which DIP is 4,7-diphenyl-1,10-phenanthroline and LL is the aliphatic dinitrogen ligand, N,N-dimethyl-trimethylenediamine), was synthesized and characterized using different physico-chemical methods. The interaction of this complex with calf thymus DNA (CT-DNA) was investigated by absorption, emission, circular dichroism (CD), and viscosity measurements. The complex binds to CT-DNA in an intercalative mode. The calculated binding constant, Kb, was 6.6×104 M−1. The enthalpy and entropy changes of the reaction between the complex and CT-DNA showed that the van der Waals interactions and hydrogen bonds are the main forces in the interaction with CT-DNA. In addition, CD study showed that phenanthroline ligand insert between the base pair stack of double helical structure of DNA. It is remarkable that this complex has the ability to cleave the supercoiled plasmid.

The World Health Organization, has declared the recent multiregional outbreak of monkeypox, a global public health emergency. Monkeypox is a zoonotic viral infection endemic to the west and central Africa. It belongs to the Poxviridae family, the Chordopoxvirinae subfamily, and the Orthopoxvirus genus. The Poxviridae family generally consists of complex, large, enveloped, and linear double-stranded DNA viruses. The initial clinical symptoms of monkeypox are often fever, severe headache, lymphadenopathy, myalgia, and fatigue. The skin lesions typically erupt within 1–3 days of the onset of fever. The rash tends to be more localized on the face and extremities than on the trunk. Monkeypox is often a self-limiting infection, and symptoms last from 2 to 4 weeks. It is isolated from various species, but the exact natural host is uncertain. Monkeypox is transmitted by close contact with infected humans or animals. Currently, no specific medication is available for monkeypox, and the existing therapeutics are the anti-viral agents approved for smallpox infection, including tecovirimat, cidofovir, and brincidofovir. Additionally, the U.S. Food and Drug Administration has approved Vaccinia Immune Globulin Intravenous for treating vaccination complications. It is diagnosed by PCR. There are currently two vaccines licensed by the U.S. Food and Drug Administration. According to the WHO guidance, the first-generation smallpox vaccines held in national reserves of some countries are not recommended as they do not meet the current safety and manufacturing standards. The interim guidance indicates that new and safer (second- and third generation) vaccines for smallpox, may be beneficial for monkeypox prevention, including JYNNEOS, which has been approved for the prevention of monkeypox. Human monkeypox was first reported in 1970. Since then, it has caused several outbreaks, mainly in central and west Africa. The first monkeypox outbreak outside of Africa occurred in the United States in 2003, linked to contact with infected pet prairie dogs. More recently (2018-2021), monkeypox cases have been reported in travelers from Nigeria to the United Kingdom, Israel, Singapore, and the US. Since May 2022, multiple monkeypox cases have been confirmed in several non-endemic countries, raising the concern of an emerging global pandemic. This review is an updated overview of our current state of knowledge regarding monkeypox virology, pathophysiology, clinical characteristics, epidemiology, vaccines, diagnosis, and treatment options.

Purpose: Patients with HIV may be more likely to become severely ill from COVID-19. The present meta-analysis aims to determine the impact of HIV/AIDS infection on the clinical outcomes of COVID-19. Methods: A comprehensive literature search was performed to identify relevant cohort studies to evaluate the association of HIV/AIDS infection with clinical outcomes of COVID-19. International databases, including PubMed (Medline), Web of Sciences, Scopus, and Embase, were searched from the emergence of the COVID-19 pandemic until January 2022. We utilized the risk ratio (RR) with its 95% confidence interval (95% CI) to quantify the effect of cohort studies. Results: Twelve cohort studies were included in this meta-analysis, which examined a total number of 17,786,384 patients. Among them, 40,386 were identified to be HIV positive, and 17,745,998 were HIV negative. The pooled analyses showed HIV positive patients who were co-infected with SARS-CoV-2 were 58% more likely to develop a fever (RR=1.58; 95% CI: 1.42, 1.75), 24% more likely to have dyspnea (RR=1.24; 95% CI: 1.08, 1.41), 45% more likely to be admitted to ICU (RR=1.45; 95% CI: 1.26, 1.67), and 37% more likely to die from to COVID-19 (RR=1.37; 95% CI: 1.30, 1.45) than HIV negative patients. Conclusion: HIV/AIDS coinfection with COVID 19 increased the risk of fever, dyspnea, ICU admission, and mortality.