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In this paper, we develop copula-based measures and testing procedures for the conditional asymmetry of a random variable given another. The resulting tests are ranked based and thus robust to the outliers. The asymptotic properties of the test statistics are investigated. Simulation studies and real data analysis are conducted to illustrate the performance of the proposed tests. [ABSTRACT FROM AUTHOR]

The assumption of conditional symmetry, which implies that the distribution of one random variable given another random variable has a symmetric form, plays a crucial role in various probability and statistics problems. This study aims to examine copula properties related to the conditional symmetry/asymmetry of two random variables. We investigate the possibility of ordering copulas based on their level of conditional asymmetry, similar to the concordance ordering for dependence. To quantify the degree of conditional asymmetry of a copula, we introduce measures that are monotonic for the proposed ordering. The characteristics of the proposed order and measures are elaborated upon. Several examples are included to demonstrate the results. [ABSTRACT FROM AUTHOR]

Hydrological modeling is a critical and decisive technique for estimating hydrological processes and the availability of water resources. In our research, we used Hydrologic Modeling System (HEC-HMS), a 4.4 version, to achieve the affected goals, and a watershed in the east of Algeria, known as Rhumel Smedou watershed, was chosen as a case study which covers an area of 1,083 km2. A Geographic Information System (GIS) was used to analyze and process the Digital Elevation Model 30-meter resolution data accompanied with Landsat of Land Use Land Cover 10-meter resolution with accuracy to extract and deduce the basic inputs of the simulation model, which are: curve number (%), lag time (mn), impermeability (%), and rainfall (Ia) (mm). The research purpose is to compute runoff depth and volume rate for four extreme events. Two events are chosen for model calibration and two for model validation. The results of the statistical tests [NSE (%) RMSE_PBIAS (%)] proved the success and ability of the model to achieve the research objectives, and their averages were as follows: [82%_0.45_32.55%] for calibration phase, and [77%_ 0.45_30.95%] for validation phase. After calibrating and validating the effectiveness of the model, the volume and flow were predicted for different return periods (2y, 10y, 50y, and 100y).

Land degradation is a growing concern, exacerbated by recent climate change. Water erosion emerges as a crucial tool to address this issue. This study focuses on estimating soil loss from water erosion in the Boussellam valley watershed, a part of the ex-pansive Soummam basin in northeastern Algeria, characterized by a semi-humid to humid climate. Covering an expanse of 4,301 km2 with a perimeter of 420 Km, the basin's assessment incorporates often-overlooked factors such as temperature. Utilizing Geographic In-formation System (GIS) in conjunction with GAVRILOVIC's EPM (Erosion Potential Method) model, erosion projections for the year 2022 have been generated. The findings reveal that the entire Boussellam watershed experiences an average erosion rate of 8.50 tonnes per hectare annually. However, it is evident that the current protective measures implemented by decision-makers are suboptimal. To pinpoint the most vulnerable areas, GIS was employed to map and subsequently categorize them into five levels of erosion intensity: low, moderate, medium, high, and very high. These detailed maps will enable more precise and tailored interventions by decision-makers to effectively safeguard the regions most impacted by erosion.

This study employs adaptive deep learning (utilizing DNN and CNN approaches) to accurately predict soil erosion, a crucial aspect of sustainable soil resource management. The goal is to develop fuzzy logic models for erosion forecasting in a large watershed with limited in-puts, comparing them to predictions from the Revised Universal Soil Loss Equation (RUSLE). Integration of GIS enables analysis of satellite data, providing crucial details like land use, slope, rainfall distribution, and flow direction. This synergistic approach enhances erosion prediction capabilities and yields spatial erosion distributions. Producing precise erosion risk maps within GIS is crucial for prioritizing high-risk areas and implementing effective conservation methods in the Wadi Sahel watershed, Algeria. The assessment in the Oued Sahel-Soummam watershed involved overlaying five RUSLE factor maps using Arc GIS spatial analysis, resulting in an aver-age annual soil loss of 4.22 tons per hectare. The DNN and CNN models were integrated with GIS for detailed calculation of annual average soil loss (tons per hectare per year) and mapping erosion risk areas in Wadi Sahel-Soummam watershed. Using the CNN model, estimated annual soil loss in Sahel-Soummam wadi was about 4.00 tons per hectare per year, while the DNN model estimated around 4.13 tons per hectare per year. This study employed two deep learning models for erosion prediction, with the DNN model featuring six hidden layers performing no-tably better than the compared CNN model.

The current research examines the runoff response in the Bouhamdane watershed in Algeria using the soil and water assessment tool (SWAT). The SWAT model is applied for the Bouhamane watershed, which includes three sub-watersheds and 45 Hydraulic Response Units (HRUs). To assess the ability and effectiveness of the model, one-gauge station in the basin (sabat) was chosen. Monthly discharge flow data are sourced from Algeria's National Water Resources Agency (NWRA). The soil and water assessment tool calibration uncertainty programs (SWAT-CUPs) with the sequential uncertainty fitting (SUFI 2) algorithm were used to calibrate and validate the model. The model was run from 1985 to 2004, with a calibration period between 1985 and 1994 and a validation period between 1995 and 2005. The model's runoff simulation efficiency has been improved by adjusting watershed input parameters. The SWAT model's performance was assessed statistically (coefficient of determination [R2], Nash-Sutcliffe Efficiency Coefficient [NSE], and Percent BIAS [PBIAS]). The monthly calibration R2, NSE, and PBIAS were 0.89, 0.68, and 43, respectively, and the monthly validation R2, NSE, and PBIAS were 0.78, 0.76, and 10.4, respectively. These results support that the SWAT model is an effective tool for simulating the surface runoff of the Bouhamdane watershed.

Background and aims: Brain-derived neurotrophic factor (BDNF) has an important role on nervous system growth and development. Animal studies have shown that exercise affects serum levels of BDNF. The aim of the present study was to investigate the effect of endurance and circuit resistance training on BDNF and serum cortisol in inactive males. Methods: In this clinical trial study, 30 inactive males were randomly divided into 3 groups: endurance training, resistance training, and control groups. The endurance training group performed interval running for 30-45 minutes at the intensity of 60-75% of maximum heart rate during 4 weeks. The resistance training group performed circuit resistance training at the intensity of 60-75% with one repeated maximum, 3 days in a week for 4 weeks. Blood samples were taken before and 48 hours after experimental period to assess serum levels of brain-derived neurotrophic factor and cortisol. Results: Circuit endurance and resistance training increased significantly the serum concentration of BDNF (P<0.001). There was no intergroup difference between training groups (P>0.05). The intergroup difference was only observed between endurance training and control groups (P<0.001). Moreover, both endurance and circuit resistance training had no significant effect on serum cortisol levels (P>0.05). Conclusion: According to the findings of the present study, it can be concluded that endurance and circuit resistance training increase neurotropic factors which may lead to structural and functional adaptation in nervous system. [ABSTRACT FROM AUTHOR]

Tabassom Sedaghat Anbouhi,1,* Elnaz Mokhtari Esfidvajani,2,* Fahimeh Nemati,1 Setareh Haghighat,3 Soyar Sari,2 Farnoosh Attar,4 Arezoo Pakaghideh,5 Mohammad Javad Sohrabi,6 Seyyedeh Elaheh Mousavi,6 Mojtaba Falahati7 1Department of Biotechnology, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; 2Department of Cellular and Molecular Biology, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; 3Department of Microbiology, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; 4Department of Biology, Faculty of Food Industry and Agriculture, Standard Research Institute (SRI), Karaj, Iran; 5Department of Toxicology and Pharmacology, Faculty of Pharmacy, Pharmaceutical Science Branch, Islamic Azad University (IAUPS), Tehran, Iran; 6Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; 7Department of Nanotechnology, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran *These authors contributed equally to this work Background: Nanoparticles (NPs) have been emerging as potential players in modern medicine with clinical applications ranging from therapeutic purposes to antimicrobial agents. However, before applications in medical agents, some in vitro studies should be done to explore their biological responses.Aim: In this study, protein binding, anticancer and antibacterial activates of zero valent iron (ZVFe) were explored. Materials and methods: ZVFe nanoparticles were synthesized and fully characterized by X-ray diffraction, field-emission scanning electron microscope, and dynamic light scattering analyses. Afterward, the interaction of ZVFe NPs with human serum albumin (HSA) was examined using a range of techniques including intrinsic fluorescence, circular dichroism, and UV–visible spectroscopic methods. Molecular docking study was run to determine the kind of interaction between ZVFe NPs and HSA. The anticancer influence of ZVFe NPs on SH-SY5Y was examined by MTT and flow cytometry analysis, whereas human white blood cells were used as the control cell. Also, the antibacterial effect of ZVFe NPs was examined on Pseudomonas aeruginosa (ATCC 27853), Escherichia coli (ATCC 25922), and Staphylococcus aureus (ATCC 25923). Results: X-ray diffraction, transmission electron microscope, and dynamic light scattering analyses verified the synthesis of ZVFe NPs in a nano-sized diameter. Fluorescence spectroscopy analysis showed that ZVFe NPs spontaneously formed a complex with HSA through hydrogen bonds and van der Waals interactions. Also, circular dichroism spectroscopy study revealed that ZVFe NPs did not change the secondary structure of HSA. Moreover, UV–visible data presented that melting temperature (Tm) of HSA in the absence and presence of ZVFe NPs was almost identical. Molecular dynamic study also showed that ZVFe NP came into contact with polar residues on the surface of HSA molecule. Cellular assays showed that ZVFe NPs can induce cell mortality in a dose-dependent manner against SH-SY5Y cells, whereas these NPs did not trigger significant cell mortality against normal white bloods in the concentration range studied (1–100 µg/mL). Antibacterial assays showed a noteworthy inhibition on both bacterial strains. Conclusion: In conclusion, it was revealed that ZVFe NPs did not induce a substantial influence on the structure of protein and cytotoxicity against normal cell, whereas they derived significant anticancer and antibacterial effects. Keywords: zero valent iron, nanoparticle, spectroscopy, docking, anticancer, antibacterial activity

The purpose of this study is to make a hydrologic modelling type of rain–flow on watershed of wadi Cheliff-Ghrib, by means of HEC-HMS model. Afterwards, this model is used to predict hydrologic response of the basin to the climate changes scenarios and land use. The model calibration was made in two phases; the first one is to select events, formalism of transfer function and appropriate NRCS downpour. The second is to deduce optimised parameters set which is used in validation. By using optimised parameters set, we were able to predict impact of quantiles downpours, changes in land use due to urbanisation, deforestation and reforestation on the peak flow and on runoff volume. Towards the end, we reconfirmed that influence of land use decreases for extreme storms.

Background: Since foods are consumed in combinations that also interact with other lifestyle variables such as body mass index(BMI) and physical activity, it is difficult to separate the role of single foods or a lifestyle variable alone in predicting the risk of chronic diseases such as metabolic disorders. Therefore, a suitable way to examine the combined effect of food consumption and its interaction with other lifestyle variables is to derive dietary patterns and lifestyle patterns using appropriate statistical methods. This study aimed to derive two dietary and lifestyle patterns related to hyperinsulinemia and insulin resistance(IR) using reduced rank regression(RRR) analysis., Methods: The current study was conducted on 1063 individuals aged ≥ 25 years old of the Tehran Lipid and Glucose Study who have complete data on fasting blood sugar, plasma insulin, anthropometric variables, and nutritional intakes. Dietary intakes were collected using a food frequency questionnaire. Dietary and lifestyle patterns were identified via RRR analysis, using 34 food groups, BMI, smoking, and physical activity as predictor variables, and fasting serum insulin and HOMA-IR as response biomarkers., Results: RRR derived a dietary pattern with a higher intake of processed meat, doogh, pickles, lemon juices, fish, and a lower intake of starchy vegetables, garlic and onion, dried fruits, nuts, red meat, dairy products, and coffee as predictive variables for IR and hyperinsulinemia. Also, RRR derived a lifestyle pattern based on the above-mentioned dietary pattern and high BMI as response variables. In the final adjusted model of cross-sectional analysis, the odds of hyperinsulinemia(OR:1.23,95%CI:1.08-1.41,P trend =0.002) and IR(OR:1.52,95%CI:1.25-1.86,P trend <0.001) were elevated with increasing each quartile of RRR-derived dietary pattern score. Also, a higher adherence to RRR-derived lifestyle pattern was associated with higher odds of hyperinsulinemia(OR:2.49,95%CI:2.14-2.88,P trend <0.001) and IR(OR:3.20,95%CI:2.50-4.10,P trend <0.001). Moreover, after three years of follow-up, the risk of hyperinsulinemia(OR:1.30,95%CI:1.08-1.56,P trend =0.006) and IR(OR:1.26,95%CI:1.01-1.58,P trend =0.037) incidence were increased per each quartile increase of the RRR-derived lifestyle pattern., Conclusions: Our findings suggested that a dietary pattern and lifestyle with elevated BMI level, higher consumption of processed meat, doogh, pickles, lemon juices, and fish, and lower consumption of starchy vegetables, garlic and onion, dried fruits, nuts, red meat, dairy products, coffee may be associated with a higher risk of hyperinsulinemia and IR. It is suggested that further studies with a larger sample size and more extended follow-up duration, especially in other populations with different lifestyles and food habits be performed to confirm the findings of the current study., Competing Interests: Declarations. Ethics approval and consent to participate: All participants filled out a written informed consent. This study was conducted in conformance with good clinical practice standards and was performed according to the Declaration of Helsinki 1975, as subsequent amendments. Also, this study was approved by the ethics research committee of the Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: This study aimed to assess possible changes in mineral intake correlation between family pairs over time. Mineral intake was measured using a food frequency questionnaire., Methods: FCOR command of the Statistical Analysis for Genetic Epidemiology software was used to determine the correlation coefficients of minerals in relative pairs. Our first analysis was conducted on adults (n = 748) who had four complete dietary and familial data on the third to sixth surveys of the Tehran Lipid and Glucose Study. In addition, we assessed respectively the 3-year, 6-year, and 9-year changes in mineral correlations among populations with n = 1773, n = 1672, and n = 1352 samples with two mineral intake measurements., Results: Most of the mineral correlations among various pairs were found to be in the same direction in both four and two measurement analyses. Among the mother-daughter and brother-sister pairs, there was a decreasing correlation for all minerals over time. In father-daughter, we observed decreasing or regression to the mean of correlations. For father-son and spouse pairs, the correlations between minerals showed a decreasing trend or regression to the mean over time, whereas increased for sodium in the father-son and phosphorus in the spouse pair. For mother-son and brother-brother pairs, iron intake correlation increased and other minerals correlations generally showed a decreasing trend or regression to the mean. Among sister-sister pairs, the correlation of calcium and phosphorus decreased, however, the correlation of chromium, selenium, sodium, and potassium increased., Conclusion: Our study revealed a decreasing trend in correlation or regression towards the mean over time for most minerals in family pairs., Competing Interests: Declarations. Ethics approval and consent to participate: Informed written consent was obtained from participants. All procedures performed in studies involving human participants adhered to the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study’s protocol was approved by the ethics research committee of the Shahid Beheshti University of Medical Sciences, Tehran, Iran. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Prevalence of metabolic disorders has been increased in recent years around the world. The relationship between Mediterranean diet (MD) with metabolic health status and serum adropin levels has been less examined in Iranian adults. We investigated the association between MD compliance with metabolic health status and adropin hormone in Iranian adults., Methods: This observational study was conducted on 527 men and women. Food intakes were evaluated by a validated food frequency questionnaire. Blood pressure and anthropometric parameters were measured. Fasting blood samples were drawn to measure serum adropin concentrations, blood glucose, triglycerides, high-density lipoprotein cholesterol, high sensitive C-reactive protein and insulin. Metabolic unhealthy (MU) status was defined as having ≥ 2 cardio-metabolic risk factors., Results: After adjustments for potential confounders, subjects in highest versus lowest tertile of MD had 52% lower odds of MU status (OR = 0.48, 95%CI: 0.23-0.97). Stratified analysis revealed a significant association in normal-weight participants (OR = 0.12; 95%CI: 0.02-0.64), but not in those with overweight/obesity (OR = 0.66, 95%CI: 0.27-1.57). By excluding each component of MD, the association disappeared, except for three components (vegetables, nuts and grains). MD adherence was not significantly related to serum adropin levels in multivariable-adjusted model (unstandardized B= -0.19, 95%CI: -4.97, 4.59; P = 0.94). Serum adropin hormone levels were also not substantially different among metabolic healthy versus unhealthy subjects (P = 0.66)., Conclusions: This cross-sectional study showed an inverse association between adherence to MD and odds of MU status, especially in subjects with normal-weight. Serum adropin concentrations were not associated with MD adherence or metabolic health status., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethical approval and consent to participate: All participants provided an informed written consent. In order to ensure ethical compliance, the researchers got informed consent from the parents of the minor participants included in the study. The protocol of study was in accordance with the ethical principles established in the 1975 Declaration of Helsinki. The study protocol was approved by the local Ethics Committee of Isfahan University of Medical Sciences. Consent for publication: Not applicable. Competing interests: None of the authors had any personal or financial conflicts of interest., (© 2025. The Author(s).)

Recent studies have suggested that the interaction between diet and an individual's genetic predisposition can determine the likelihood of obesity and various metabolic disorders. The current study aimed to examine the association of dietary branched-chain amino acids(BCAAs) and aromatic amino acids(AAAs) with the expression of the leptin and FTO genes in the visceral and subcutaneous adipose tissues of individuals undergoing surgery. This cross-sectional study was conducted on 136 Iranian adults, both men and women, aged ≥18 years. The samples were selected from patients admitted for abdominal surgeries. The dietary intake of BCAAs and AAAs was determined using a valid and reliable 168-item food frequency questionnaire. Using the quantitative PCR method, leptin and FTO mRNA expression was measured in both visceral and subcutaneous fat tissues. The mean age of the participants was 39.8 ± 12.7 years, and the mean intake of BCAAs and AAAs was 17.7 ± 0.9 and 9.3 ± 0.3% of protein per day, respectively. In overweight-obese patients(body mass index = 25-34.9 kg/m 2 ), the intake of BCAAs(β:-0.75,95%CI:-1.47,-0.03), valine(β:-0.78,95%CI:-1.51,-0.05), and tyrosine(β:-0.81,95%CI:-1.55,-0.06) was inversely associated with FTO gene expression in subcutaneous fat tissue in adjusted model. In morbidly obese patients(body mass index ≥ 35 kg/m 2 ), a higher intake of total BCAAs(β:1.10,95%CI:0.07-2.13), leucine(β:1.07,95%CI:0.03-2.13), and isoleucine(β:1.49,95%CI:0.46-2.52) was associated with an increase of leptin gene expression in subcutaneous fat tissue. Our findings suggest that dietary BCAA may associated with gene expression in adipose tissues, potentially influencing obesity-related metabolic pathways. Further prospective studies are warranted to validate results and elucidate the potential for dietary interventions targeting amino acids intake in obesity management., Competing Interests: Declarations. Ethics approval and consent to participate: The written informed consent form was obtained from volunteer patients before their inclusion in the study, and a blood sample was taken from each participant before surgery. All participant information was kept confidential by the research team. All procedures involving human participants adhered to the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study protocol was assessed and approved by the ethics research committee of the National Institute for Medical Research Development (NIMAD), Tehran, Iran. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Familial dietary intake can be influenced by both genetic and environmental factors; the current study aimed to examine the role of these two factors on dietary intake by investigating the resemblance in energy, nutrient, and food group intake among spouses and siblings in twin and family-based studies., Methods: The online literature databases, including PubMed, Scopus, Web of Science, and Cochrane Library were systematically searched up to September 2024. The pooled correlation coefficient (r) of studies was calculated using Fisher's z and standard error (SE) of z's of all studies and our final results were reported in six groups including non-twin siblings, monozygotic (MZ) twins, dizygotic (DZ) twins, all-twins, all siblings, and spouse., Results: Our findings on 30 observational studies indicate that siblings, especially MZ twins, tend to have similar dietary intake, with high correlations for vegetables (r: 0.59), red meat (r: 0.58), and fruits (r: 0.56). Among DZ twins, the lowest correlations were observed for eggs (r: 0.07), soft drinks (r: 0.14), and daily intake of simple carbohydrates (r: 0.17). DZ twins did not show significant differences in dietary resemblance compared to non-twin siblings. Among spouses, the highest correlations for dietary intake were found for polyunsaturated fats (r: 0.41), saturated fats (r: 0.40), and total fats (r: 0.39), while the lowest correlation was for protein intake (r: 0.24)., Conclusions: While the greatest similarity in dietary intake was observed among MZ twins, no significant difference in dietary intake similarity was noted between DZ twins and non-twin siblings. Furthermore, spouses exhibited a significant degree of similarity in their dietary consumption. Therefore, dietary intake is shaped by a complex interplay of genetic and environmental factors, warranting further investigation to validate these observations., Competing Interests: Declarations. Ethics approval and consent to participate: The study protocol was approved by the Ethics Committee of the Research Institute for Endocrine Sciences at the Shahid Beheshti University of Medical Sciences. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background/aim: Familial resemblance in dietary patterns has been a subject of interest, with both genetic and environmental factors playing crucial roles. This study aims to investigate trends in macronutrient intake correlations over a 9-year period among different familial pairs, including parent-offspring, siblings, and spouses, using data from the Tehran Lipid and Glucose Study (TLGS)., Methods: This longitudinal study, conducted within the framework of the TLGS, analyzed data from 1,814 families over a 9-year period. Dietary intakes were assessed using a validated 168-item food frequency questionnaire. Macronutrient intakes were calculated and adjusted for age. Familial correlations were estimated using intraclass correlation coefficients for various familial pairs (parent-offspring, siblings, and spouses) across four consecutive surveys. Changes in correlations were analyzed over 3-year, 6-year, and 9-year intervals, as well as across all four surveys, to determine overall trends in macronutrient intake correlations., Results: The results revealed diverse trends in intake correlations for carbohydrates, proteins, fats, and specific fatty acids across familial relationships. Parent-offspring dyads exhibited varied patterns, with some nutrients showing regression to the mean. Sister-sister pairs demonstrated strengthening correlations for energy, carbohydrates, fats, and saturated fatty acids over time. Conversely, brother-sister pairs displayed weakening correlations for most macronutrients, particularly energy, proteins, cholesterol, and fiber. Spouse correlations tended towards regression to the mean for energy, carbohydrates, and fats, and fiber., Conclusions: The present study illuminates the dynamic nature of familial dietary correlations over time. The contrasting trends between sister-sister and brother-sister dyads suggest a significant influence of gender on shared dietary patterns. These findings underscore the complex interplay of genetic and environmental factors in shaping family dietary behaviors and highlight the importance of considering both gender and relationship type when examining familial nutritional habits., (© 2024. The Author(s).)

Given the sparse conclusive findings regarding the association of magnesium intake with metabolic health status and limited evidence relating magnesium intake to metabolic biomarkers, our objective was to evaluate the association of metabolic health status, adropin, and brain-derived neurotrophic factor (BDNF) in relation to dietary magnesium intake. In this cross-sectional study, 527 male and female adults were investigated in Isfahan City. The data regarding usual dietary intakes were gathered using a valid and reliable 168-item food frequency questionnaire. Biochemical variables, anthropometric indices, and blood pressure were assessed following standard methods. The criteria suggested by Wildman et al. were used to classify participants as metabolically unhealthy (MU) and metabolically healthy (MH). Moderate magnesium intake was associated with 71% reduced odds of MU (OR T2 vs. T1  = 0.29; 95% CI: 0.12-0.70). In the stratified analysis, the inverse association between moderate intake of magnesium and MU was seen only in overweight/obese subjects but not in normal-weight ones. A significant difference was found in serum levels of adropin between the first and second tertile of dietary magnesium intake among overweight/obese subjects (62.74 ± 4.99 vs. 50.13 ± 2.54, P = 0.03). After adjustment for potential covariates, this association became attenuated (59.06 ± 3.47 vs. 50.02 ± 3.64, P = 0.20). No statistically significant link was obtained between dietary intake of magnesium and circulating BDNF levels. Moderate dietary intake of magnesium may exert beneficial effects on metabolic health and serum levels of adropin, especially in obese/overweight individuals. Further prospective studies will be required to approve our findings., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Backgrounds: Dietary potassium can play an important role in decreasing inflammatory factors as a protective factor for cancers. In this case-control study, we aimed to assess the possible association between dietary potassium intake and the risk of breast cancer (BC) among Iranian adult women., Methods: The present case-control study was conducted at Shohada and Imam Hossain hospitals, in Tehran. The study included 134 newly diagnosed cases of BC and 267 controls. A validated semi-quantitative 168-item food frequency questionnaire was used to compute the potassium intake. Logistic regression, adjusted for potential confounders, was used to estimate odds ratios(ORs) and 95% confidence intervals(CI) of BC according to tertiles of potassium intake., Results: The mean(M) ± standard deviation(SD) of age and body mass index (BMI) were 47.9 ± 10.3 years and 29.4 ± 5.5 kg/m 2 , respectively. Also, the M ± SD of potassium intake for the control and case groups was 1616 ± 293 and 1542 ± 338 (mg/1000 Kcal), respectively. In the multivariable-adjusted model for potential confounders, the higher total potassium intake was associated with decreased odds of BC (OR: 0.35, 95%CI: 0.19-0.62, P for trend < 0.001). Moreover, an inverse relationship was observed between potassium from plant sources (OR: 0.39, 95%CI: 0.22-0.69, P for trend = 0.001) and fruit and vegetable sources (OR: 0.49, 95%CI: 0.28-0.87, P for trend = 0.016) and odds of BC., Conclusions: Our findings suggested that diet rich in potassium may have a predictive role to reduce the odds of BC., (© 2024. The Author(s).)

Background: Binge eating disorder is one of the main eating disorders that is characterized by recurrent binge eating episodes that lead to complications like high blood pressure, diabetes, dyslipidemia, etc. Many psychological and biological factors can lead to binge eating disorder and one of the main physiological reasons is insulin resistance. Cinnamon is an old favorite that has positive effects on insulin sensitivity. So, we examined the effect of cinnamon on binge eating disorder in this study., Methods: This study was conducted on 40 binge eating disorder patients with a BMI between 25 and 39.9 kg/m 2 . They were divided into two groups one of them consumed 6 g of cinnamon per day while the other group consumed 6 g of white wheat as a placebo. Before and after the study we examined weight, height, Body Shape Questionnaire (BSQ), and Binge Eating Scale (BES) scale in all participants and did the statistical analysis., Results: There were no significant differences in baseline characteristics, gender, height, weight, BMI, education, and marriage status between the two groups. There were no significant changes between BSQ, BES, weight, and height after the study either., Conclusion: According to our findings, although the weight of the patients in the cinnamon group decreased significantly, after the end of the study, no significant difference was observed in the weight, BMI, and BAS and BSQ indices between the two groups., Trial Registration: The study protocol was registered in the Iran Registry of Clinical Trials (IRCT) center (IRCT code: IRCT20090822002365N26, Registration date: 2021/11/7)., (© 2024. The Author(s).)

Introduction: The role of routine preoperative esophagogastroduodenoscopy (EGD) in bariatric surgery candidates is controversial. This study compares preoperative EGD outcomes with patient-reported gastroesophageal reflux disease (GERD) symptoms to determine if a case-based EGD is appropriate., Patients and Methods: A prospective cohort study was conducted from April 2022 through September 2023 in Mashhad, Iran. All patients underwent EGD. To assess GERD symptoms, we used the GERD-Health Related Quality of Life questionnaire. Patients were categorized into two groups: the asymptomatic group (GERD-HRQL = 0) and the symptomatic group (GERD-HRQL > 0)., Results: A total of 165 patients were included, out of which 133 (80.6%) were in the symptomatic group and 32 (19.4%) were in the asymptomatic group. Esophagitis was present in 41 (24.8%) patients. There was no significant difference in the frequency of esophagitis (18.8% vs. 26.3%, p-value = 0.37), hiatal hernia (18.8% vs. 18.8%, p-value = 1.00), gastritis (56.3% vs. 63.9%, p-value = 0.42), and H. pylori infection (9.4% vs. 12.0%, p-value = 1.00) between the asymptomatic and symptomatic groups, respectively. None of the demographic factors or comorbidities of asymptomatic patients were associated with esophagitis, except for hiatal hernia (OR = 7.67, 95% CI 3.01-19.53, p-value < 0.001). Receiver operating characteristic (ROC) analysis showed that the GERD-HRQL total scores, as well as the heartburn and regurgitation subscales, were poor predictors of esophagitis (AUC 0.57, 0.51, and 0.56, respectively)., Conclusion: EGD findings were not associated with GERD symptoms in candidates for bariatric surgery., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Type 2 diabetes (T2D) is known as a major public health problem with a noticeable adverse impact on quality of life and health expenditures worldwide. Despite using routine multiple pharmacological and nonpharmacological interventions, including diet therapy and increasing physical activity, controlling this chronic disease remains a challenging issue, and therapeutic goals are often not achieved. Therefore, recently, other therapeutic procedures, such as using herbal products and functional foods as complementary or alternative medicine (CAM), have received great attention as a new approach to managing T2D complications, according to the literature. We reviewed the existing evidence that supports using various fundamental medicinal herbs, including cinnamon, saffron, ginger, jujube, turmeric, and barberry, as CAM adjunctive therapeutic strategies for T2D patients. The current review addressed different aspects of the potential impact of the abovementioned herbal products in improving glycemic indices and lipid profiles, including the effect size reported in the studies, their effective dose, possible side effects, herbs-drug interactions, and their potential action mechanisms., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2024 Hossein Farhadnejad et al.)

Background/aims: The current meta-analysis aimed to examine the heritability and familial resemblance of dietary intakes, including energy and macronutrients in both twin and family-based studies., Methods: The online literature databases, including PubMed, Scopus, and Web of Science were searched comprehensively until 2023 to identify the relevant studies. The heritability index in family studies was h 2 and the heritability indices for twin studies were h 2 , A 2 , and E 2 . Three weighted methods were used to calculate the mean and SE of heritability dietary intakes., Results: Eighteen papers including 8 studies on familial population and 12 for twin population studies were included in the present meta-analysis. The heritability of dietary intakes in twin studies (range of pooled estimated h 2 , A 2, and E 2 was 30-55%, 14-42%, and 52-79%, respectively) was higher than family studies (range of pooled estimated h 2  = 16-39%). In family studies, the highest and lowest heritability for various nutrients was observed for the fat (%Kcal) (h 2 range:36-38%) and carbohydrate in g (h 2 range:16-18%), respectively. In twin studies, based on mean h 2 , the highest and lowest heritability for various nutrients was reported for the fat (%Kcal) (h 2 range:49-55%) and protein intake in g (h 2 range:30-35%), respectively. Also, based on the mean of A 2 , the highest and lowest heritability was observed for carbohydrates (% Kcal) (A 2 range:42-42%), and protein (% Kcal) (A 2 range:14-16%), respectively. Furthermore, in twin studies, the highest and lowest mean of E 2 was shown for saturated fats (E 2 range:74-79%) and energy intake (E 2 range:52-57%), respectively., Conclusion: Our analysis indicated that both environmental factors and genetics have noticeable contributions in determining the heritability of dietary intakes. Also, we observed higher heritability in twins compared to family studies., Competing Interests: Declaration of competing interest The authors report there are no competing interests to declare., (Copyright © 2024 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Objective: The Gastroesophageal Reflux Disease Health-Related Quality of Life (GERD-HRQL) is one of the most widely used questionnaires for assessing typical gastro-oesophageal reflux disease (GORD) symptoms. It is simple, concise, and treatment responsive, yet it has not been validated in the Persian language. This study aimed to translate the GERD-HRQL questionnaire into Persian and assess its validity and reliability., Design: In this cross-sectional validation study, a team of gastroenterologists, general surgeons, and professional translators conducted the forward-backward translation. A gastroenterologist interviewed 10 patients with GORD to insure understandability of the questionnaire. Fifty-four patients with GORD and 60 patients with gastrointestinal complaints other than GORD were enrolled using convenience sampling method. To assess concurrent validity, patients with GORD completed the Persian GERD-HRQL and the WHO Quality of Life Brief Version (WHOQOL-BREF) questionnaires. To assess discriminant validity, GERD-HRQL scores were compared between GORD and non-GORD patients. After 2 weeks, the patients with GORD completed the GERD-HRQL questionnaire again to assess test-retest reliability. The internal consistency was measured using Cronbach's alpha., Results: The mean age of the GORD participants was 36.90±10.44, and the majority were women (78%). All GERD-HRQL domains and total scores exhibited significant negative correlations with WHOQOL-BREF domains (ranging from -0.28 to -0.97). The GERD-HRQL scores were significantly different in GORD and non-GORD patients (p<0.001). Test and retest scores did not show any significant differences (p=0.49). Cronbach's alpha was 0.85., Conclusion: The Persian GERD-HRQL questionnaire is valid and reliable and can effectively assess the GORD symptoms in Persian-speaking individuals., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and Aims: Recent investigations suggest that specific dietary patterns during adolescence may predict cardiometabolic complications later in life. In this study, we aimed to examine the association between Mediterranean diet score (MDS) during adolescence and cardiometabolic outcomes when participants reached adulthood., Methods and Results: This cohort study was conducted on 668 subjects, aged 10-19 years, in framework of the Tehran Lipid and Glucose Study. The MDS was determined based on eight components using a validated food-frequency questionnaire. Anthropometric measurements, fasting blood glucose (FBG), and lipid profile data were measured both at baseline and after a 6.8 ± 2.9-year follow-up. Using multivariable linear regression, we explored the association between MDS and changes in cardiometabolic risk factors. Moreover, multivariable-adjusted cox proportional hazard regression was used to estimate hazard ratios (HR) and 95 % confidence intervals (CIs) for cardiometabolic complications across MDS tertiles. The mean ± SD age of participants (43.5 % men) was 15.8 ± 2.47 years. The mean ± SD of MDS was 4.03 ± 1.56, with a median of 4.00 among all participants. Higher MDS was inversely associated with 6.8-year changes in waist circumference (WC), FBG, total cholesterol (TC), and high-density lipoprotein-cholesterol (P trend <0.05). Based on the HR analysis, after controlling for potential confounders, individuals in the highest tertile of MDS had a significantly lower risk of high-TC(HR = 0.36,95%CI:0.18-0.74,P trend  = 0.004) compared to those in the lowest tertile. However, no significant association was observed between MDS and other cardiometabolic risk factors., Conclusions: Greater adolescent adherence to a Mediterranean-type diet was associated with favorable cardiometabolic factors in adulthood, including improving the levels of WC, FBG, TC, as well as reduced risk of high-TC., Competing Interests: Declaration of competing interest The authors declared that there is no conflict of interest., (Copyright © 2023 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Background/aim: Evidence from recent studies suggested that the quality of dietary macronutrients can play a possible role in predicting the risk of metabolic disorders. In the current study, we aimed to assess the association of carbohydrate quality index (CQI) and protein score with the risk of metabolic syndrome (MetS) in Iranian adults., Methods: This prospective study was conducted within the framework of the Tehran Lipid and Glucose Study on 1738 individuals aged between 40 and 70 years old, who were followed up for a mean of 6.1 years. A food frequency questionnaire was used to determine CQI and protein scores. The multivariable adjusted Cox regression model was used to calculate the hazard ratio (HR) of MetS across quartiles of protein score and CQI, and its components., Results: The mean ± standard deviation (SD) age and body mass index of the study population (42.5% men) were 49.3 ± 7.5 years and 27.0 ± 4.0 kg/m 2 , respectively. Mean ± SD scores of CQI and protein for all participants were 12.6 ± 2.4 and 10.3 ± 3.5, respectively. During the study follow-up, 834(48.0%) new cases of MetS were ascertained. In the multivariable-adjusted model, the risk of MetS was decreased across quartiles of CQI (HR = 0.83;95%CI:0.69-1.00, P trend =0.025) and protein score (HR = 0.75; 95% CI:0.60-0.94, P trend =0.041). Also, Of CQI components, the whole grain/total grains ratio showed a significant inverse association with the risk of MetS (HR = 0.75;95%CI:0.60-0.94, P trend =0.012)., Conclusion: Our findings revealed that a dietary pattern with higher CQI and protein score may be related to a reduced risk of MetS in adults., (© 2024. The Author(s).)

The present study aimed to investigate the association of nutrient patterns (NPs) with metabolic health status and serum levels of brain-derived neurotrophic factor (BDNF) and adropin in Iranian adults. This cross-sectional survey was performed on 527 adults aged 20-60 years in Isfahan, Iran. To evaluate dietary intake, a validated 168-item semi-quantitative food frequency questionnaire (FFQ) was used. Participants were categorized as metabolically healthy (MH) and metabolically unhealthy (MU) according to their glycemic and lipid profile, insulin resistance (IR), and inflammation status. An overnight fasting blood sample was collected from each participant and serum levels of BDNF and adropin were assessed. A total of 42.50% of participants were recognized as MU. Three NPs were recognized by factor analysis that labeled as "high animal protein" (NP1), "high vegetable" (NP2), and "high carbohydrate" (NP3) patterns. Moderate adherence to NP2 was related to a lower risk of MU (OR T2 vs. T1  = 0.38, 95% CI: 0.18-0.76). Moreover, high adherence of NP2 (T3 vs. T1) was inversely associated with hypertriglyceridemia (OR = 0.27, 95% CI: 0.11-0.65; P-trend < 0.001) and high hs-CRP values (OR = 0.29, 95% CI: 0.09-1.00; P-trend = 0.03). No significant association was observed between adherence of NP1 and NP3 with MU in crude and adjusted models. However, negative associations were found between moderate adherence to NP3 and insulin resistance (IR) (OR = 0.23, 95% CI: 0.06-0.91) as well as high adherence to NP1 and hypertension (OR = 0.23, 95% CI: 0.09-0.61; P-trend < 0.001). NPs were not associated with serum BDNF and adropin values., (© 2024. The Author(s).)

Background: Evidence from recent studies suggested that variation in the quantity and quality of macronutrients in the diet may potentially play a role in predicting the risk of breast cancer (BC). In the current study, we aimed to assess the association of different high-protein diet scores and replacing fats and carbohydrate (CHO) with protein in the diet with the BC risk among Iranian women., Methods: The current hospital-based case-control study was conducted on 401 participants, aged ≥ 30 years old, including 134 women in the case group who had been diagnosed with histologically confirmed BC and 267 women in the control group. Dietary intake data was collected using a validated food frequency questionnaire, and high protein diet scores were determined. Logistic regression models were used to determine the odds ratios (OR) and 95% confidence interval (CI) of BC across tertiles of high protein diet scores. Also, we assessed how substituting protein with other macronutrients affected BC odds while adjusting for the various confounding variables., Results: Participants' mean ± SD of age and body mass index were 47.9 ± 10.3 years and 29.4 ± 5.5 kg/m 2 , respectively. The scores of high-protein-low-CHO and fat diet, high-protein and CHO-low-fat diet, and high-protein and fat-low-CHO diet in participants were 16.5 ± 3.8, 16.5 ± 6.7, and 16.4 ± 5.9, respectively. In the multivariable model, individuals in the highest tertile of high-protein-low-CHO and fat diet score (OR:0.71;95%CI:0.56-0.90) and high-protein and CHO-low-fat diet (OR:0.76;95%CI:0.60-0.97) had lower odds of BC compared to those in the lowest tertile (P < 0.05). However, no significant association was found between high-protein and fat-low-CHO diet and BC risk. Our results showed that replacing fat by protein (OR differences :-0.40;95%CI:-0.73,-0.07) and also replacing refined-CHO by plant protein (OR differences :-0.66;95%CI:-1.26,-0.07) in the diet are associated inversely with risk of BC(P < 0.05)., Conclusions: The results of our study suggested that higher adherence to a high-protein-low-CHO and fat diet, characterized by a higher intake of plant proteins and a lower intake of refined grains and saturated fat can play a protective role against the odds of BC., (© 2024. The Author(s).)

Introduction: Metabolic disturbances are of major health concerns in the world. In addition to their high prevalence, these disorders have substantial roles in developing other physical and mental diseases. Diet could have a considerable influence on managing the progression of these conditions and their consequent health-related effects. The aim of the 'Diet in relation to Metabolic, sleep and psychological health Status' Project is to explore the association of nutrition with metabolic, sleep and mental health, considering potential mediators including brain-derived neurotrophic factor (BDNF) and adropin., Methods and Analysis: This cross-sectional study will be conducted on adults (20-65 years) working in schools of Isfahan, Iran. A multistage cluster random sampling method will be used to select participants. Anthropometric, body composition and biochemical values including fasting blood glucose, lipid profile, 25-hydroxy vitamin D, insulin, BDNF, adropin, malondialdehyde, superoxide dismutase, glutathione peroxidase, uric acid, creatinine and C reactive protein will be measured for each participant. National Cholesterol Education Program and Adult Treatment Panel III will be considered to define metabolic syndrome. Diet will be assessed through a validated Food Frequency Questionnaire. Furthermore, sleep status, mental health, quality of life, physical activity and demographic status of individuals will be assessed by validated questionnaires. The collected data will be analysed using appropriate statistical methods., Ethics and Dissemination: The study protocol was approved by the local Ethics Committee of Isfahan University of Medical Sciences. All participants will provide written informed consent. Dissemination will be through conference presentations and publications in peer-reviewed journals., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Recently, the serum levels of branched-chain amino acids (BCAAs) have been considered as an indicator to evaluate health status and predict chronic diseases risk. This systematic review and meta-analysis aimed to assess the relationship between Serum BCAAs and the risk of all-cause mortality. We carried out a comprehensive and systematic search in various important databases, including PubMed, Scopus, and Web of Science databases to find the relevant studies published up to October 2022 with no language, design, or time limitation. We extracted the reported hazard ratio (HR) with 95% confidence interval (CI) and odds ratio (OR) with 95%CI in cohorts and case-control studies, respectively, and computed the log HR or OR and its standard error. Then, we used the random-effects model with inverse variance weighting method for the present meta-analysis, to calculate the pooled effect size. Ten observational studies, including nine cohort studies and one case-control study, were included in the present meta-analysis. The number of participants ranges from 53 to 26,711, with an age range of 18-99 years. During 6 months to 24 years of follow-up, 3599 deaths were ascertained. The pooled results indicated that there was no significant association between serum BCAAs (RR: 1.17; 95% CI 0.85-1.60), isoleucine (RR: 1.41; 95%CI 0.92-2.17), leucine (RR: 1.13; 95% CI 0.94-1.36), and valine (RR: 1.02; 95%CI 0.86-1.22) and all-cause mortality. Also, there was significant heterogeneity between studies for serum BCAAs (I 2  = 74.1% and P-heterogeneity = 0.021), isoleucine (I 2  = 89.4% and P-heterogeneity < 0.001), leucine (I 2  = 87.8% and P-heterogeneity < 0.001), and valine (I 2  = 86.6% and P-heterogeneity < 0.001). Our results suggested that the serum BCAAs and its components, including isoleucine, leucine, and valine, were not associated with the risk of all-cause mortality., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

There is controversial evidence about the relationship between consumption of legumes and nuts with metabolic disturbances. The present study was undertaken to explore the association of legumes and nuts intake with metabolic health status among Iranian adults. This cross-sectional study was conducted on 527 adults (45.7% female, aged 20-65 years) chosen through a multistage cluster random-sampling approach. Dietary intakes of individuals were assessed using a validated food frequency questionnaire. Fasting blood samples were gathered to evaluate biochemical parameters. Metabolic health status of subjects was determined according to the criteria defined by Wildman. Data of covariates were collected using pre-tested procedures. The overall prevalence of metabolic unhealthy (MU) phenotype was 42.5%. After controlling all confounders, participants with highest intake of legumes and nuts had lower odds of MU status, compared with the lowest intake (OR 0.35; 95% CI 0.18-0.71). This association was stronger in normal-weight rather than overweight/obese adults and also in women rather than men. Higher consumption of legumes and nuts was additionally related to decreased odds of hyperglycemia, hypertriglyceridemia, and hypertension. A marginally inverse association was observed between legumes and nuts intake with low brain-derived neurotrophic factor (BDNF) levels, in fully-adjusted model (OR T3 vs. T1  0.50; 95% CI 0.25-1.01). Each tertile increase in legumes and nuts intake was marginally related to higher adropin levels ([Formula: see text] = 4.06; P = 0.07). In conclusion, this study demonstrated that higher intake of legumes and nuts is associated with lower chance of MU both in normal weight and overweight/obese adults. The association may be facilitated through serum BDNF and adropin., (© 2023. Springer Nature Limited.)

Backgrounds: We investigated the relation of plant-based diets (PDs) with hypertension (HTN) and Framingham risk score (FRS) in Iranian adults., Objectives: We hypothesized that healthy PDs might have positive effects on blood pressure (BP) and FRS, whereas less-healthy plant-based foods might have negative effects., Methods: The current cross-sectional study was performed on 527 middle-aged adults (45.7% women), who were selected through a multistage cluster random-sampling method. The assessment of dietary intakes was performed by using a validated food-frequency questionnaire. Twelve-hour fasting blood samples were collected to evaluate total cholesterol and high-density lipoprotein concentrations. BP was measured through the standard method and HTN was defined as BP ≥130/80 mmHg. FRS was used to predict the 10-y risk for development of cardiovascular disease (CVD)., Results: The prevalence of HTN and high FRS among study participants were, respectively, 62% and 15.6%. After adjustment for potential confounders, plant-based diet index (PDI) and healthy plant-based diet index (hPDI) were not significantly associated with HTN [odds ratio (OR): 0.99; 95% confidence interval (CI): 0.55, 1.79 and OR: 0.83; 95% CI: 0.45, 1.53, respectively)]. However, those in the highest tertile of unhealthy plant-based diet index (uPDI) in comparison with those in the bottom tertile had a 100% increased odds of HTN (OR: 2.00; 95% CI: 1.04, 3.88). Greater adherence to PDI, hPDI, and uPDI was not related to high FRS chance, in fully adjusted model (OR: 0.50; 95% CI: 0.15, 1.65; OR: 1.03; 95% CI: 0.26, 4.04; and OR: 2.05; 95% CI: 0.56, 7.52, respectively)., Conclusions: This study demonstrated that less-healthy PDs would enhance the chance of HTN in Iranian adults, although PDIs were not significantly related to the 10-y risk of developing CVD., (© 2023 The Authors.)

Nutrient pattern analysis is an easy way to compare nutrient intakes across different nations due to the universality of nutrients nature. The purpose of this study was to examine the relationship between dietary nutrient patterns (NPs) and circulating 25(OH)D concentrations with sleep duration and sleep quality among Iranian adults. We used a multistage cluster random sampling method to enroll 535 adults in this cross-sectional investigation. A validated food frequency questionnaire was applied to evaluate typical dietary intakes. Fasting blood samples were obtained to determine levels of circulating 25(OH)D. Sleep characteristics were assessed using the Pittsburgh Sleep Quality Index (PSQI). Participants had a mean age of 42.57 years and 51.2% of them had insufficient or deficient levels of serum vitamin D. Three NPs were identified: "high animal protein", "high vegetable" and "high carbohydrate". After adjustments for potential confounders, no significant associations were observed between "high animal protein" pattern and short sleeping or sleep quality. Greater adherence to "high vegetable" NP was associated with lower odds of short sleeping (OR 0.24; 95% CI 0.10, 0.54) and poor sleep quality (OR 0.45; 95% CI 0.20, 1.05). Stratified analysis revealed that these associations were stronger in normal-weight participants. Greater adherence to "high carbohydrate" NP, on the other hand, was connected to higher odds of short sleeping (OR 2.83; 95% CI 1.20, 6.72). Low adherence to "high vegetable" pattern and vitamin D insufficiency/deficiency were jointly associated with increased odds of short sleeping (OR 3.42, 95% CI 1.42, 6.64). High adherence to pattern comprising mainly of vegetable nutrients was associated with a reduced likelihood of being short sleepers and having poor sleep quality in Iranian adults, especially among those with a normal weight. Lower adherence to vegetable NP and insufficient/deficient vitamin D levels were synergistically associated with greater likelihood of being short sleepers. Greater adherence to carbohydrate NP was associated with an increased likelihood of short sleeping., (© 2023. Springer Nature Limited.)

Background: We aimed to investigate the familial resemblance of dietary intakes, including energy and nutrients, and the family-based heritability of dietary intake in different age-sex dyads of the Tehran cardiometabolic genetic study., Methods: This cross-sectional study was conducted on 9,798 participants, aged ≥ 18 years, with complete data in each of the third, fourth, fifth, and sixth surveys of the Tehran Cardiometabolic Genetic study, who were eligible to enter the current study based on inclusion and exclusion criteria. Nutrient intake was determined using a valid and reliable food frequency questionnaire (FFQ). FCOR command of the S.A.G.E. software was used to estimate the intra-class correlation coefficients of all relative pairs to verify the family resemblance of dietary nutrient intakes. Classical likelihood-based is used to assess the family-based heritability of dietary nutrient traits., Results: There were 4338 families with a mean family size of 3.20 ± 2.89, including 1 to 32 members (2567 constituent pedigrees and 1572 singletons) and 3627 sibships. The mean ± SD age of participants was 42.0 ± 15.2 years, and 44.5% were males. The heritability of nutrient intake ranged from 3 to 21%. The resemblance degree of energy intake and most nutrients between spouses or between parents and children is weak to moderate; however, a high resemblance of intake was observed for some food components, especially among spouses, including trans fatty acids (TFAs) (r:0.70), chromium (r:0.44), fiber(r:0.35), pantothenic acid (r:0.31), and vitamin C(r:0.31). Based on our findings, the resemblance of nutrient intake in spouses was greater than in parent-offspring. The similarity in parent-offspring nutrient intake was different, and the correlation in mother-girls nutrient intakes was greater than other parent-child correlations. Also, the lowest resemblance in nutrient intake was observed among siblings., Conclusions: Our findings suggested a weak-to-moderate similarity between the nutrient intakes of parents and offspring. The resemblance degree in nutrient intake varied between different family pairs; the strongest correlation of nutrients was observed between spouses, which includes TFAs, chromium, fiber, pantothenic acid, and vitamin C. The lowest correlation of nutrients was between siblings, such as carbohydrates, thiamine, niacin, and vitamin K. An individual's nutrient intake can somewhat be influenced by genetics, family relationships, and the effects of parents, although the significant influence of environmental factors should not be ignored., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Context: Although some studies have examined the connection between circulating 25-hydroxyvitamin D (25(OH)D) concentrations and preeclampsia (PE) risk, the results were inconsistent., Objective: A dose-response meta-analysis on epidemiologic investigations was conducted to evaluate the relation of 25(OH)D concentration and PE., Data Source: Electronic databases, including Scopus, MEDLINE (PubMed), the Institute for Scientific Information, Embase, and Google Scholar, were comprehensively search until July 2021., Data Extraction: A total of 65 observational studies evaluating the link between circulating 25(OH)D concentrations and PE were included. The body of evidence was assessed by the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach., Data Analysis: Combining 32 effect sizes from 32 prospective studies with 76 394 participants revealed that highest vs lowest circulating 25(OH)D concentrations was significantly related to a 33% reduced risk of PE (relative risk [RR], 0.67; 95%CI, 0.54-0.83). Subgroup analysis by study design revealed that PE risk has significantly decreased in cohort and case-cohort studies (RR, 0.72; 95%CI, 0.61-0.85), and a slight decline was found in nested case-control studies (RR, 0.62; 95%CI, 0.38-1.02). Dose-response analysis in 27 prospective studies with 73 626 participants illustrated that each 10 ng/mL increment in circulating 25(OH)D concentration led to a 14% reduced incidence of PE (RR, 0.86; 95%CI, 0.83-0.90). A U-shaped significant association in nonlinear dose-response analysis was found between 25(OH)D and PE. A significant inverse association was also found between highest vs lowest circulating 25(OH)D concentration and PE in 32 nonprospective studies with 37 477 participants (odd ratio, 0.37; 95%CI, 0.27-0.52). This inverse association was significant in almost all subgroups, based on different covariates., Conclusion: This meta-analysis of observational investigations showed blood 25(OH)D levels were negatively related to PE risk, in a dose-response manner., Systematic Review Registration: PROSPERO registration no. CRD42021267486., (© The Author(s) 2023. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Data on the association between Mediterranean diet, sleep and brain-derived neurotrophic factor (BDNF) were limited in Middle Eastern populations. We examined the association between Mediterranean dietary pattern with sleep quality/quantity, and serum BDNF in Iranian adults. This cross-sectional study was performed among 535 middle-aged adults (54% men), selected by multistage cluster random sampling method. The Pittsburgh sleep quality index and a validated food frequency questionnaire were used to assess sleep quality, sleep quantity, and Mediterranean diet score (MDS). Twelve-hour fasting blood samples were taken to evaluate serum BDNF values. Participants in the highest tertile of MDS, in comparison to those in the lowest tertile, had lower odds of having short sleep (OR = 0.44, 95%CI: 0.21-0.91) and poor sleep quality (OR = 0.48, 95%CI: 0.22-0.96), after adjustment for potential confounders. Among specific domains of sleep quality, lower odds of subjective sleep quality, sleep latency, and daytime dysfunction were associated with increased MDS. Higher adherence to MDS among individuals with overweight or obesity reduced the odds of having short sleep; this relation was not seen among individuals with normal weight. In contrast, the association between sleep quality and the MDS was significant in individuals with normal weight, but not those with overweight or obesity. Participants with higher adherence to MDS had lower odds for low BDNF values; however, this relation was not statistically significant. Overall, Iranian adults with a higher adherence to MDS had considerably lower odds of having short sleep and poor sleep quality. BDNF would not be an intermediate molecule for this connection., (© 2023. Springer Nature Limited.)

Background: C-peptide is considered a peptide with active function in the body, which can affect people's health. However, the results of previous studies on the possible association of C-peptide with the risk of cardiometabolic disorders have not been fully understood. This systematic review and meta-analysis aimed to investigate the association between serum C-peptide level and the risk of cardiovascular disease (CVD) events., Methods: The various important databases, including PubMed, Scopus, and Web of Science, were searched comprehensively to November 2022 to identify the relevant studies. The HR(95% CI) or OR(95% CI) for observational studies were extracted and converted into log HR or log OR and their standard deviation(SD) was computed. A random-effects model with an inverse variance weighting method was conducted, to calculate the pooled effect size., Results: Sixteen observational studies, including one case-control study, eight cohort studies, and seven cross-sectional studies were included in the current meta-analysis. The sample size ranged from 90 to 7030, with an age range from 12 to 85 years. During the follow-up time (ranging from 5 to 17 years), 4852 CVD events occurred. Based on cohort and case-control studies, the pooled results showed no significant association between serum C-peptide with CVD events risk (RR = 1.02;95%CI:0.91-1.15, I 2  = 34.7%; P-heterogeneity = 0.140). For cross-sectional studies, the pooled results indicated a positive association between serum C-peptide and the odds of CVD outcomes (OR = 1.35;95%CI:1.04-1.76, I 2  = 83.6%; P-heterogeneity < 0.001)., Conclusions: The pooled results of the current study suggested that C-peptide level was not related to the risk of CVD events in cohort studies, however, the meta-analysis of cross-sectional studies showed a significant association between C-peptide and an increased risk of CVD events., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Aims and Background: Recently, the serum of C-peptide has been the focus of researchers as a possible predictor of mortality. However, the possible association of serum C-peptide with cardiovascular diseases (CVDs) mortality and all-cause mortality has not been clearly identified. This meta-analysis aimed to assess the relationship between serum C-peptide and the risk of CVDs mortality and all-cause mortality., Methods: A comprehensive and systematic search was performed in various important databases, including the PubMed, Web of Science, and Scopus to find relevant studies up to November 2022. The reported hazard ratio (HR) [95% confidence interval (CI)] for all studies was converted into log HR, and their SD was calculated. Then to compute the pooled HR, the random-effects model with inverse variance weighting method was performed., Results: Twenty-three studies were included in the meta-analysis. Fourteen studies reported HR for all-cause mortality, and nine studies for CVDs-related mortality. The pooled results indicate a significant association between serum C-peptide and the risk of all-cause mortality (HR: 1.22; 95% CI: 1.12-1.32, I 2  = 76.8%; P -value < 0.001). Also, higher serum C-peptide was related to the increased risk of CVDs mortality (HR: 1.38; 95% CI: 1.08-1.77, I 2  = 81.8%; P -value = 0.012)., Conclusions: Our investigation suggested that an increased level of serum C-peptide is associated with a higher risk of both CVDs and all-cause mortality. Further, large-scale studies and sufficient samples are recommended to present a convincing link between C-peptide and the risk of CVDs and all-cause mortality., Systematic Review Registration: identifier, CRD42022364842., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Ahmadirad, Teymoori, Mokhtari, Jahromi, Norouzzadeh, Tavakkoli, Shahrokhtabar, Farhadnejad and Mirmiran.)

The current study aimed to examine the possible association of the dietary index for insulin resistance (DIR) and the lifestyle index for insulin resistance (LIR), determined by dietary components, body mass index, and physical activity, with the risk of cardiometabolic diseases, including insulin resistance (IR), hypertension (HTN), diabetes, and metabolic syndrome (MetS). This prospective cohort study was performed on 2717 individuals aged ≥ 19 years in the framework of the Tehran Lipid-Glucose Study. Data on nutritional intakes were assessed using a validated food frequency questionnaire. Logistic regression models were used to determine the odds ratio and 95% confidence intervals (ORs and 95% CIs) of cardiometabolic diseases across tertiles of DIR and LIR scores. During 3-years of follow-up, the incidence rate of diabetes, IR, HTN, and MetS was 3%, 13%, 13.9%, and 17%, respectively. In the multi-variables model, after controlling all potential confounders, the risk of IR(OR: 1.65, 95% CI 1.01-2.69, P-trend = 0.047), diabetes (OR: 1.95, 95% CI 1.02-3.74, P-trend = 0.058), and HTN(OR: 1.52, 95% CI 1.07-2.15, P-trend = 0.016) was increased across tertiles of DIR score. Also, the risk of IR (OR: 2.85, 95% CI 1.72-4.73, P-trend < 0.001), diabetes(OR: 2.44, 95% CI 1.24-4.78, P-trend = 0.004), HTN(OR: 1.95, 95% CI 1.35-2.81, P-trend < 0.001), and MetS (OR: 2.87, 95% CI 1.96-4.18, P-trend < 0.001) were increased across tertiles of LIR score. Our findings reported that a dietary pattern with a higher DIR score and a lifestyle with a higher LIR score might be related to increased cardiometabolic disorders, including diabetes, HTN, Mets, and IR in Iranian adults., (© 2023. The Author(s).)

Considering contradictory findings of previous investigations and growing prevalence of psychological disorders, we investigated association between dietary total fat and omega-3 fatty acids intake with serum brain-derived neurotrophic factor (BDNF) levels, depression, anxiety and psychological distress in Iranian adults. Using a multistage cluster random sampling method, 533 middle-aged adults were included in this cross-sectional study. A validated semi-quantitative 168-item food frequency questionnaire was used to examine dietary intakes. A 12-h fasting blood sample was drawn to measure serum BDNF. Serum BDNF values in the first decile were considered low level. Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ) were used to assess depression, anxiety and psychological distress. A U-shaped relationship between fat intake and prevalence of anxiety and distress was found. The third quartile of fat intake compared to the first quartile was significantly related to 80% decreased odds of depression (OR = 0.20, 95% CI 0.05-0.80), in fully-adjusted model. Participants in the third quartile of fat intake compared to those in the first quartile had significantly 45% lower odds for distress, in the crude model (OR = 0.55, 95% CI 0.33-0.92); however, this association disappeared after considering confounders. There was no significant association between omega-3 fatty acids intake and odds of depression, anxiety or distress. Prevalence of low-BDNF values was higher in participants with depression, as compared to non-depressed subjects (14.9 vs. 9%; P = 0.06). This cross-sectional study illustrated a U-shaped relationship between fat intake and prevalence of anxiety and distress. Moderate intake of fat was related to lower odds of depression. Prevalence of low-BDNF values was slightly higher in subjects with depression compared to non-depressed individuals., (© 2023. The Author(s).)

Background: A dietary pattern with a high glycemic index (GI) and glycemic load (GL) can be a precursor to sleep disorders that link to many chronic diseases. We aimed to assess the association of dietary GI and GL with the risk of insomnia in Iranian adults., Methods: A total of 111 newly diagnosed insomnia cases and 333 controls aged 18-60 years were included in this case-control study. The participants' dietary intakes were collected using a valid and reliable food frequency questionnaire. The diagnosis of insomnia in subjects was performed by a neurologist using the Insomnia Severity Index (ISI) questionnaire. Multivariable logistic regression models, adjusted for the potential confounders, were used to determine the risk of insomnia according to tertiles of dietary glycemic indices., Results: The mean (SD) age and BMI of the study population (78.6% female) were 31.8 (10.0) years and 24.70 (3.62) kg/m 2 , respectively. The median (IQR) of dietary GI and GL in subjects was 62.7 (57.0-68.6) and 213.5(167.4-268.5), respectively. Based on the multivariable-adjusted model, after controlling for age, sex, physical activity, obesity, smoking, socioeconomic score, general health questionnaire (GHQ) score, and dietary energy intake, the odds of insomnia were increased across tertiles of dietary GL[(OR:2.72,95%CI:1.10-6.70),(P trend  = 0.017)], however, no significant association was observed between high GI diet and insomnia risk [(OR:1.38,95%CI:0.77-2.47),(P trend  = 0.298)]., Conclusions: Our results revealed that greater adherence to dietary pattern with high GL could be increased the odds of insomnia in Iranian adults., (© 2023. The Author(s).)

Background: Osteosarcoma of the scapula is extremely rare. Hence, there is no consensus regarding its optimal management. In this study, we report the demographics, characteristic features, and outcomes of scapulectomy with or without scapular allograft reconstruction in a series of patients with primary scapular osteosarcoma., Materials and Methods: Twelve patients with primary scapular osteosarcoma who were treated by scapulectomy with or without scapular allograft reconstruction (five and seven patients, respectively) were included. The allograft was fixed in place using a dacron tape without a plate or screw. The function of the shoulder was evaluated using the Musculoskeletal Tumor Society (MSTS) score for the upper extremity and Toronto Extremity Salvage Score (TESS)., Results: The study population included seven (58.3%) males and five (41.7%) females with a mean age of 30 ± 8.2 years. The histologic type of the tumor was osteoblastic in the majority of patients ( n  = 8, 66.7%). At an average follow-up of 6.5 ± 2.3 years, only one local recurrence (8.3%) occurred in our patients that coincided with lung metastasis. The mean MSTS score was 78.7 ± 3.8% and 66.2 ± 4% in patients with and without scapular allograft, respectively ( P  = 0.006).‏ The mean TESS was 78.6 ± 5.6 and 68.4 ± 2.4 in patients with and without scapular allograft, respectively ( P  = 0.005).‏ The overall 5-year survival of the patients was 85.7%., Conclusion: ‏ Osteosarcoma of scapula more frequently occurs in the fourth decade of life, mainly presented with a sclerotic radiologic appearance. Patients with scapular allograft impaction after scapulectomy have better functional outcomes compared to those without boney reconstruction., Competing Interests: Conflict of interestThe authors of this article declare no conflict of interest to disclose., (© Indian Orthopaedics Association 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)