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2. Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic : a comprehensive demographic analysis for the Global Burden of Disease Study 2021
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Schumacher, A. E., Kyu, H. H., Antony, C. M., Aravkin, A. Y., Azhar, G. S., Bisignano, C., Burkart, K., Cercy, K. M., Chung, E., Coberly, K., Comfort, H., Cousin, E., Culbreth, G. T., Cunningham, M., Weaver, N. D., Degenhardt, L., Deitesfeld, L., Dirac, M. A., Estep, K., Feigin, V. L., Flaxman, A. D., Flor, L. S., Force, L. M., Fuller, J. E., Gakidou, E., Hay, S. I., Ikuta, K. S., Jones, D. P., Kassebaum, N. J., Kassel, M. B., Keller, C., Kinzel, K. E., Krohn, K. J., Lozano, R., May, E. A., McKowen, A. W., McLaughlin, S. A., Mehlman, M. L., Mestrovic, T., Mokdad, A. H., Mosser, J. F., Mougin, V., Naghavi, M., Nesbit, O. D., Novotney, A., Ozten, Y., Pease, S. A., Pigott, D. M., Reiner, R. C., Robinson-Oden, H. E., Shaw, D. H., Slepak, E. L. N., Sorensen, R. J. D., Verghese, N. A., Vollset, S., Vongpradith, A., Vos, T., Wang, D., Watson, S., Weaver, M. R., Wells, K. M., Wilson, S., Wool, E. E., Zheng, P., Lim, S. S., Murray, C. J. L., Boyko, E. J., Chahine, Y., Kalani, R., Krishnamoorthy, V., Khalil, I. A., Minja, N. W., Morrison, S. D., Nafukho, F. M., Olivas-Martinez, A., Orellana, E., Tram, K., Aali, A., Rahnavard, N., Ahmadzade, A., Mohammad-Pour, S., Morovatdar, N., Pourali, G., Zafari, N., Abbafati, C., Cattaruzza, M. S., Abbas, J., Phillips, M. R., Abbasgholizadeh, R., Emamverdi, M., Friedman, J., Abbasi, M. A., Daneshvar, S., Dashti, M., Ghasemzadeh, A., Mirza-Aghazadeh-Attari, M., Doshmangir, L., Ghafourifard, M., Lotfi, M., Hosseini, M., Jadidi-Niaragh, F., Kalankesh, L. R., Karimi, S., Mohammad-Alizadeh-Charandabi, S., Khalafi, M., Mirghafourvand, M., Mirinezhad, S., Heris, R. M., Mousavi, S., Kafil, H. S., Abbasian, M., Momenzadeh, K., Santos, F. C. D., Carr, S., Chi, G., Elgendy, I. Y., Feroze, A. H., Kempen, J. H., Kubeisy, C. M., Li, Z., Rohloff, P., Liu, X., Natto, Z. S., Olanipekun, T. O., Pigeolet, M., Pradhan, P. M. S., Zweck, E., Sharfaei, S., Sheikh, A., Abtahi, D., Salimi, S., Shakeri, A., Tajbakhsh, A., Aghamiri, S., Ahmadzade, M., Hashemi, M. B., Ajami, M., Asgary, S., Ghasemi, M., Hassanian-Moghaddam, H., Kolahi, A., Nikoobar, A., Heidari-Foroozan, M., Montazeri, F., Nejadghaderi, S., Rahmani, S., Ziaeefar, P., Hesami, H., Zahir, M., Jahankhani, K., Rasouli-Saravani, A., Jahanmehr, N., Kashani, H. K., Nasiri, M., Raee, P., Rezaee, M., Safi, S., Shool, S., Tabatabai, S., ElHafeez, S. A., Tantawi, M. E., Elmeligy, O. A. A., Ghazy, R. M., Talaat, I. M., Abdelmasseh, M., Sanabria, J., Abd-Elsalam, S., Abdelwahab, A., Abdollahi, M., Abolhassani, H., Rezaei, N., Saghazadeh, A., Ala, M., Noroozi, N., Bahri, R. A., Khatami, F., Ayyoubzadeh, S., Azadnajafabad, S., Keykhaei, M., Momtazmanesh, S., Mousavi, P., Behnoush, A., Farrokhpour, H., Karimi, H., Khalaji, A., Khanmohammadi, S., Mayeli, M., Mohammadi, S., Eskandarieh, S., Sahraian, M., Fahimi, S., Malekzadeh, R., Mansouri, V., Sepanlou, S. G., Ghassemi, F., Haddadi, M., Kazemian, S., Khadembashiri, M., Khamesipour, F., Khavandegar, A., Khormali, M., Salamati, P., Kompani, F., Larijani, B., Mirdamadi, N., Seyedi, S., Malazy, O. T., Mahmoudi, E., Rashedi, S., Rad, E. M., Mansournia, M., Nasab, E. M., Mohammadshahi, M., Mostafavi, H., SeyedAlinaghi, S., Shafie, M., Shahbandi, A., Vahdani, A. M., Sharifan, A., Shirkoohi, R., Sohrabi, H., Tavangar, S., Heidari-Soureshjani, R., Abdoun, M., Abdullahi, A., Awotidebe, A. W., Borodo, S. B., Gadanya, M. A., Ladan, M., Ali, M. U., Tyrovolas, S., Abdurehman, A. M., Debele, A. T., Getachew, T., Gudeta, M. D., Misgana, T., Sertsu, A., Abebe, M., Ayele, G. M., Afework, A., Lerango, T. L., Tebeje, T. M., Sibhat, M. M., Tesfaye, S. H., Abedi, A., Gholamrezanezhad, A., Salehi, S., Athari, S., Hanifi, N., Abegaz, T. M., Kifle, Z. D., Zuñiga, R. A. A., Abhilash, E. S., Abiodun, O. O., Aboagye, R. G., Amu, H., Ayanore, M. A., Dowou, R. K., Immurana, M., Klu, D., Orish, V. N., Carrero, J. J., Cederroth, C. R., Deuba, K., Laflamme, L., Fereshtehnejad, S., Kauppila, J. H., Abouzid, M., Abreu, L. G., Malta, D. C., Prates, E. J. S., Nascimento, B. R., Abrha, W. A., Weldemariam, A. H., Girmay, A., Abrigo, M. R. M., Rumeileh, S. A., Abu-Rmeileh, N. M., Aburuz, S., Ahmed, L. A., Alam, Z., Elbarazi, I., Grivna, M., Nauman, J., Khan, G., Khan, M. A., Zaki, N., Ahmad, M. M., Abu-Zaid, A., Temsah, R. M. H., Zand, R., Acuna, J. M., Gautam, P., Chowdhury, R., Adair, T., Jiang, H., Babu, A. S., Borschmann, R., Meretoja, A., Wijeratne, T., Addo, I. Y., Okeke, S. R., Dai, Z., Xu, X., Huda, M., Mitchell, P. B., Peden, A. E., Resnikoff, S., Sharma, S., Si, Y., Sitas, F., Ye, P., Adebayo, O. M., Aladelusi, T. O., Salami, A. A., Ilesanmi, O. S., Owolabi, M. O., Adegboye, O. A., Adekanmbi, V., AlBataineh, M. T., Almahmeed, W., Aden, B., Adepoju, A. V., Adetunji, C. O., Adeyeoluwa, T. E., Oyeyemi, I. T., Oyeyemi, O. T., Udoakang, A. J., Adeyomoye, O. I., Anuoluwa, I. A., Bello, O. O., Oluwafemi, Y. D., Ekundayo, T. C., Idowu, O. O., Oluwatunase, G. O., Afolabi, A. A., Ekholuenetale, M., Fagbamigbe, A. F., Olufadewa, I. I., Ibitoye, S. E., Okekunle, A. P., Adha, R., Adikusuma, W., Adibi, A., Chen, M., Hossain, M., Rasali, D. P., Pashaei, A., Adnani, Q. E. S., Postma, M. J., Adra, S., Barqawi, H. J., Dash, N. R., Halwani, R., Maghazachi, A. A., Saber-Ayad, M. M., Sharif-Askari, N. S., Ahmad, F., Saddik, B., Saleh, M. A., Alzoubi, K. H., Omar, H. A., Arumugam, A., Bustanji, Y., Elemam, N. M., Faris, M. E. M., Karim, A., Qaisar, R., Semreen, M. H., Soliman, S. S. M., Altirkawi, K. A., Afraz, A., Ilaghi, M., Nematollahi, M., Afyouni, S., Amindarolzarbi, A., Zandieh, G. G. Z., Columbus, A., Kamireddy, A., Shafaat, O., Kazemi, F., Vervoort, D., Zhang, H., Jamshidi, E., Afzal, S., Agasthi, P., Agodi, A., Barchitta, M., D'Amico, E., Maugeri, A., Veroux, M., Biondi, A., Isola, G., Vacante, M., Falzone, L., Libra, M., Agyemang-Duah, W., Nikpoor, A., Ahinkorah, B. O., Demant, D., Ahmad, A., Mustafa, G., Pathan, A. R., Tabish, M., Ahmad, D., Bagheri, N., Burns, R. A., Cherbuin, N., Ahmad, T., Ahmadi, K., Saxena, S., Beaney, T., Palladino, R., Rawaf, S., Mossialos, E., Rawaf, D. L., Ahmed, A., Siddig, E. E., Ahmed, H., Ahmed, M. B., Shiferaw, D., Ashemo, M. Y., Gerema, U., Getachew, M. E., Bayileyegn, N. S., Mohamed, A. I., Eshetie, T. C., Tiruye, T. Y., Ahmed, S., Ali, H., Bodunrin, A. O., Tumurkhuu, M., Tung, K., Ubah, C. S., Aruleba, R. T., Aji, B., Ajumobi, O., Akalu, G. T., Beyene, H. B., Deribe, K., Ijo, D., Kassaw, N. A., Akara, E., Akinosoglou, K., Akkala, S., Asaad, M., Hassan, A. M., Bleyer, A., Akyirem, S., Bell, M. L., Song, Y., Etaee, F., Goldust, M., Li, W., Pawar, S., Hamad, H. A., Sathian, B., Hasan, S. A., Homsi, A. A., Almidani, O., Göbölös, L., Qadire, M. A., AL-Ahdal, T. M. A., Chen, S., Moazen, B., Alalalmeh, S. O., Hegazi, O. E., Shahwan, M. J., Shamsi, M. A., Zyoud, S. H., Al-Aly, Z., Wang, C., Alam, K., Alam, M., Al-Amer, R. M., Naik, G. R., Alanzi, T. M., Bah, S., Menezes, R. G., Alanezi, F. M., Albashtawy, M., Aldridge, R. W., Chung, S., Hossain, S., Kim, J., Kivimäki, M., Sunkersing, D., Umar, T., Zumla, A., Alemi, S., Al-Eyadhy, A., Temsah, M., Alhabib, K. F., ElGohary, G. M. T., Meo, S. A., Al-Gheethi, A. A. S., Kiross, G. T., Alhalaiqa, F. A. N., Al-Maweri, S. A. A., Alomari, M. A., Mohammed, M., Al-Hanawi, M. K., Binmadi, N., Malik, A. A., Samargandy, S., Ali, A., Khan, I., Sawyer, S. M., Ali, B. A., Ali, R., Ali, S. S., Ali, Z., Samakkhah, S. A., Alicandro, G., Alif, S. M., Maharjan, P., Rai, P., Hasan, M., Thapa, R., Thrift, A. G., Aligol, M., Alimi, R., Aliyi, A. A., Jema, A., Al-Jumaily, A., Hankey, G. J., Kujan, O., Mansour, A., Aljunid, S. M., Al-Sabah, S. K., Al-Marwani, S., Almazan, J. U., Poddighe, D., Al-Mekhlafi, H. M., Ariffin, H., Lim, L., Bandyopadhyay, S., Basnyat, B., Maude, R. J., Bennett, D. A., Browne, A. J., Dolecek, C., Dunachie, S. J., Newton, C. R. J., Rodriguez, J. A. B., Kheirallah, K. A., Alonso, N., Bensenor, I. M., Brunoni, A. R., Castaldelli-Maia, J., Peres, M. F. P., Wang, Y., Alqahtani, J. S., Alqutaibi, A., Altaf, A., Alvi, F. J., Nargus, S., Arooj, M., Latif, M., Shahid, S., Shahid, W., Ashraf, M., Riaz, M. A., Al-Tawfiq, J. A., Alwafi, H., Rehman, F., Al-Worafi, Y. M., Aly, H., Ali, A. H., Amare, A., Gill, T. K., Yadav, L., Noubiap, J., Opio, J., Mengesha, E. W., Ameyaw, E. K., Amhare, A., Lin, S., Amin, T. T., Elhabashy, H. R., Hassan, A., Dehkordi, J. A., Kabir, H., Amiri, S., Amugsi, D. A., Wado, Y. D., Amzat, J., Bello, M. B., Shittu, A., Aruleba, I. T., Ancuceanu, R., Andrei, C., Florin, B. T., Negoi, I., Serban, D., Hostiuc, M., Hostiuc, S., Matei, C. N., Negoi, R. I., Anderlini, D., Begum, T., Kanmiki, E., Maravilla, J. C., Khan, A., Moni, M., Lalloo, R., McGrath, J. J., Veerman, L. J., Andrade, P. P., Busse, R., Mohammed, S., Andrei, T., Herteliu, C., Mirica, A., Otoiu, A., Petcu, I., Dima, A., Stefan, S., Angappan, D., Anil, A., Charan, J., Shamim, M., Singh, S., Varthya, S. B., Baskaran, P., Bhardwaj, P., Bhardwaj, N., Dixit, S. G., Krishna, H., Nayyar, A. K., Choudhary, R., Dixit, A., Misra, S., Mittal, M., Saravanan, A., Singh, M., Ram, P., Anjum, A., Antriyandarti, E., Anwar, S., Anyasodor, A. E., Appiah, S., Boampong, M. S., Aqeel, M., Arabloo, J., Eghdami, S., Panahi, P., Kabir, A., Salahi, S., Behnagh, A. K., Kasraei, H., Khodadoust, E., Latifinaibin, K., Moradi-Lakeh, M., Toroudi, H. P., Sarveazad, A., Zahedi, M., Moradi, M., Arab-Zozani, M., Ghalibaf, A. M., Rajabpour-Sanati, A., Arafat, M., Araújo, A. M., Belo, L., Carvalho, F., Costa, V. M., da Silva, D. D., Silva, J. P., Carvalho, M., Cruz-Martins, N., Freitas, A., Vieira, R. J., Pinheiro, M., Ribeiro, A., Aremu, A., Odetokun, I. A., Aripov, T., Armocida, B., Unim, B., Sabbatucci, M., Artamonov, A. A., Artanti, K. D., Efendi, F., Purnobasuki, H., Wulandari, R. D., Arulappan, J., Chavula, M. P., Edvardsson, D., Orru, H., Fattahi, H., Asika, M. O., Onwujekwe, O. E., Atout, M. M. W., Atreya, A., Attia, S., Aujayeb, A., Avan, A., Hachinski, V., Stranges, S., Bolarinwa, O. A., Ginindza, T. G., Ogunsakin, R. E., Quintanilla, B. A., Rahman, M., Ayuso-Mateos, J. L., Ortiz, A., Soriano, J. B., Catalá-López, F., Aziz, S., Azzam, A. Y., Babashahi, M., Bayati, M., Kouhanjani, M. F., Fazeli, P., Karajizadeh, M., Ghahramani, S., Sarikhani, Y., Shahabi, S., Iravanpour, F., Jafarinia, M., Oliaee, R. T., Ravangard, R., Razeghian-Jahromi, I., Roshanzamir, S., Mansoori, Y., Bakkannavar, S. M., Nayak, V. C., Holla, R., Kamath, A., Rao, M., Ligade, V. S., Rao, C. R., Shetty, R. S., Rao, I., Reshmi, B., Badar, M., Badawi, A., Bhutta, Z. A., Chattu, V., Malhotra, A. K., Mostofinejad, A., Shakil, H., Badiye, A. D., Bansal, H., Kapoor, N., Baghdadi, S., Bagherieh, S., Fatehizadeh, A., Mehrabani-Zeinabad, K., Sadeghi, M., Mirmosayyeb, O., Saber, K., Shafaat, A., Bahadorikhalili, S., Bai, J., Yu, C., Bai, R., Baker, J. L., Bako, A. T., Makram, O. M., Balakrishnan, S., Balogun, S. A., Singh, A., Tian, J., Jatau, A., Baltatu, O. C., Baltatu, O., Campos, L. A., Bam, K., Olaiya, M. T., Bhandari, D., Dalli, L. L., Banach, M., Banik, B., Banik, P. C., Barati, S., Saeedi, M., Bardhan, M., Barker-Collo, S. L., Beyene, K. A., Barone-Adesi, F., Barr, R. D., Kurmi, O. P., Mannan, F., Olagunju, A. T., Barrero, L. H., Basharat, Z., Bashir, A. I. J., Bashiru, H. A., Folayan, M. O., Bassat, Q., Basso, J. D., Silva, S., Rodrigues, M., Basu, S., Batra, K., Batra, R., Sharma, M., Baune, B. T., Bedi, N., Ghailan, K. Y., Khan, M., Halboub, E. S., Shanawaz, M., Sayeed, A., Siraj, M., Behboudi, E., Soleimani, H., Beiranvand, M., Ramirez, D. F. B., Malagón-Rojas, J. N., Belgaumi, U. I., Bello, A. K., Ebenezer, O., Eboreime, E., Umair, M., Beloukas, A., Lunevicius, R., Bendak, S., Benzian, H., Friedman, S. D., Peprah, E. K., Berezvai, Z., Berman, A. E., Bermudez, A. C., Loreche, A., Liu, S., Mohamed, M. F. H., Bettencourt, P. J. G., Bhagat, D. S., Bhagavathula, A. S., Bhala, N., Dehbandi, R., Glasbey, J. C., Bhalla, A., Marasini, B. P., Paudel, U., Poudel, L., Bhardwaj, P. V., Bhargava, A., Kahe, F., Bhaskar, S., Bhat, V., Bhatti, G. K., Kalra, S., Bhatti, J. S., Senapati, S., Bhatti, M. S., Bhatti, R., Das, J. K., Bikbov, B., Bintoro, B., Bisulli, F., Golinelli, D., Guicciardi, S., Lenzi, J., Mazzotti, A., Muccioli, L., Sanmarchi, F., Violante, F. S., Biswas, A., Dhali, A., Biswas, R., Chen, L., Driscoll, T. R., Tang, H. K., Islam, S., Kandel, H., You, Y., Leigh, J., Singh, B. B., Visontay, R., Bitaraf, S., Kaydi, N., Eini, E., Khafaie, M. A., Sadeghian, S., Bjørge, T., Dadras, O., Wojewodzic, M. W., Bodolica, V., Bonny, A., Bora, K., Basara, B. B., Francis, K. L., Kerr, J. A., Carvajal, A. B., Bouaoud, S., Ouyahia, A., Boudalia, S., Lanfranchi, F., Bragazzi, N. L., Braithwaite, D., Ding, D. D., Karanth, S. D., Naghavi, P., Brenner, H., Britton, G., Bulamu, N. B., Bulto, L. N., Foley, K. M., Jemere, D., Kaambwa, B., Mpundu-Kaambwa, C., Buonsenso, D., Villani, L., Nagaraja, S. B., Butt, Z. A., Cai, T., Calina, D., Cámera, L. A., Campos-Nonato, I. R., Denova-Gutiérrez, E., Ortega-Altamirano, D. V., Rios-Blancas, M., Pando-Robles, V., Cao, C., Cardenas, C. A., Cárdenas, R., Carreras, G., Carugno, A., Castañeda-Orjuela, C. A., Castelpietra, G., Catapano, A. L., Damiani, G., Vecchia, C. L., Caye, A., Duncan, B. B., Schmidt, M. I., Hugo, F. N., Cembranel, F., Cenderadewi, M., Emeto, T. I., Obamiro, K. O., Cerin, E., Poudel, G. R., Guo, C., Sarkar, C., Yip, P., Cevik, M., Chacón-Uscamaita, P. R., Chirinos-Caceres, J. L., Chakraborty, C., Chan, J., Chang, C., Douiri, A., Wafa, H. A., Hbid, Y., Mazidi, M., Urso, D., Charalampous, P., Volovici, V., Chatzimavridou-Grigoriadou, V., Johnson, O., Mathioudakis, A. G., Mughal, F., Cheema, H. A., Chen, A., Chen, H., Zhu, Z., Chew, D. S., Tonelli, M., Yang, L., Chitheer, A., Cho, S. J., Ebrahimi, A., Nguyen, D. H., Cho, W. C. S., Chong, B., Ma, S., Ramazanu, S., Tan, K., Venketasubramanian, N., Chopra, H., Mini, G., Tovani-Palone, M. R., Pantazopoulos, I., Pilgrim, T., Stortecky, S., Chu, D., Chukwu, I. S., Cini, K. I., Clark, C. C. T., Conde, J., Conti, S., Cortesi, P. A., Fornari, C., Mantovani, L. G., Ferrara, P., Cowden, R. G., Criqui, M. H., Cullen, P., Jarlais, D. C. D., Gunturu, S., Dadana, S., Dalal, Koustuv, Kurmanova, A., Guha, A., Qattea, I., Darwesh, A. M., Hosseinzadeh, M., Das, S., Dávila-Cervantes, C. A., Davletov, K., Leo, D. D., Delgado-Enciso, I., Delgado-Ortiz, L., Morawska, L., Demessa, B. H., Demetriades, A. K., Eze, U. A., Simpson, C. R., Verras, G., Deng, X., Dervenis, N., Patoulias, D., Desai, H. D., Desai, R., Devanbu, V. G. C., Dey, S., Perianayagam, A., Dhama, K., Ranabhat, C. L., Dhimal, M. L., Dhimal, M., Ghimire, S., Pandey, A., Dhingra, S., Diaz, D., Do, T. C., Pham, H., Do, T. H., Prado, C. B. D., Dodangeh, M., Dokova, K. G., Dorsey, E., Santos, W. M. D., Doshi, R., Dsouza, H. L., Rastogi, P., Shetty, B. K., Jeganathan, J., Joseph, N., Kumar, N., Mithra, P., Thapar, R., Reddy, M. M. R., Unnikrishnan, B., Dube, J., Dumith, S. C., Duraes, A. R., Pereira, M., Rasella, D., Duraisamy, S., Durojaiye, O. C., Oguta, J. O., Dutta, S., Dzianach, P. A., Gething, P. W., Sanna, F., Weiss, D. J., Kiss, J., McPhail, M. A., Rumisha, S. F., Lubinda, J., Saddler, A., Dziedzic, A. M., Tsermpini, E., Echieh, C. P., Ed-Dra, A., Edinur, H. A., Edvardsson, K., Efendi, D., Kusuma, D., Trihandini, I., Latief, K., Eikemo, T., Ekpor, E., Arab, R. A. E., Morsi, D. A. E., Zaki, M. E. S., Elshaer, M., Ramadan, H., Elgar, F. J., Mate, K. K. V., Ortiz-Brizuela, E., Rana, J., Nabhan, A. F., Samy, A. M., Elhadi, M., Elsohaby, I., Saad, A. M. A., Zeydi, A. E., Goudarzian, A., Taheri, A., Bain, L. E., Erkhembayar, R., Espinosa-Montero, J., Fabin, N., Fadaka, A. O., Okonji, O. C., Farinha, C. S. E., Faro, A., Ward, P., Fauk, N. K., Gnedovskaya, E. V., Kravchenko, M. A., Piradov, M. A., Fekadu, G., Huang, J., Zhong, C., Jin, Y., Fetensa, G., Ferrante, D., Ferreira, N., Filip, I., Fischer, F., Steinbeis, F., Flavel, J., Fomenkov, A. A., Foroutan, B., Foschi, M., Sacco, S., Franklin, R. C., Vieira, R., Fukumoto, T., Gaal, P. A., Joo, T., Lám, J., Palicz, T., Pollner, P., Szócska, M., Gaihre, S., Gaipov, A., Galali, Y., Sadee, B. A., Galehdar, N., Baghani, A. N., Zandi, M., Gallus, S., Lugo, A., Gan, Q., Gandhi, A. P., Patil, A., Ganesan, B., Garg, J., Gau, S., Gautam, R. K., Gazzelloni, F., Gebregergis, M. W., Mehari, M., Negash, H., Gebrehiwot, M., Gebremariam, T. B., Yesuf, S. A., Miller, T. R., Ghajar, A., Ghanbarnia, M., Mahjoub, S., Mouodi, S., Gholamian, A., Tahbaz, S. 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- Abstract
Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, ant
- Published
- 2024
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3. Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
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Idowu, Olivas-Martinez, Antonio, Oliveira, Gláucia Maria Moraes, Oliver, Susan, Olorukooba, Abdulhakeem Abayomi, Olufadewa, Isaac Iyinoluwa, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Oluwafemi, Yinka Doris, Oluwatunase, Gideon Olamilekan, Omar, Hany A, Omer, Goran Latif, Ong, Sokking, Onwujekwe, Obinna E, Onyedibe, Kenneth Ikenna, Opio, John Nelson, Ordak, Michal, Orellana, E Roberto, Orisakwe, Orish Ebere, Orish, Verner N, Orru, Hans, Ortega-Altamirano, Doris V, Ortiz, Alberto, Ortiz-Brizuela, Edgar, Ortiz-Prado, Esteban, Osuagwu, Uchechukwu Levi, Otoiu, Adrian, Otstavnov, Nikita, Ouyahia, Amel, Ouyang, Guoqing, Owolabi, Mayowa O, Oyeyemi, Ifeoluwa Temitayo, Oyeyemi, Oyetunde T, Ozten, Yaz, P A, Mahesh Padukudru, Padubidri, Jagadish Rao, Pahlavikhah Varnosfaderani, Mahsa, Pal, Pramod Kumar, Palicz, Tamás, Palladino, Claudia, Palladino, Raffaele, Palma-Alvarez, Raul Felipe, Pana, Adrian, Panahi, Parsa, Pandey, Ashok, Pandi-Perumal, Seithikurippu R, Pando-Robles, 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Constance Dimity, Postma, Maarten J, Poudel, Govinda Raj, Poudel, Lisasha, Pourali, Ghazaleh, Pourtaheri, Naeimeh, Prada, Sergio I, Pradhan, Pranil Man Singh, Prajapati, Vijay Kumar, Prasad, Chandra P, Prasad, Manya, Prashant, Akila, Prates, Elton Junio Sady, Purnobasuki, Hery, Purohit, Bharathi M, Puvvula, Jagadeesh, Qaisar, Rizwan, Qasim, Nameer Hashim, Qattea, Ibrahim, Qian, Gangzhen, Quan, Nguyen Khoi, Radfar, Amir, Radhakrishnan, Venkatraman, Raee, Pourya, Raeisi Shahraki, Hadi, Rafiei Alavi, Seyedeh Niloufar, Rafique, Ibrar, Raggi, Alberto, Rahim, Fakher, Rahman, Md Mosfequr, Rahman, Mosiur, Rahman, Muhammad Aziz, Rahman, Tafhimur, Rahmani, Amir Masoud, Rahmani, Shayan, Rahnavard, Niloufar, Rai, Pramila, Rajaa, Sathish, Rajabpour-Sanati, Ali, Rajput, Prashant, Ram, Prasanna, Ramadan, Hazem, Ramasamy, Shakthi Kumaran, Ramazanu, Sheena, Rana, Juwel, Rana, Kritika, Ranabhat, Chhabi Lal, Rancic, Nemanja, Rani, Smitha, Ranjan, Shubham, Rao, Chythra R, Rao, Indu Ramachandra, Rao, Mithun, Rao, Sowmya J, Rasali, Drona Prakash, Rasella, Davide, Rashedi, Sina, Rashedi, Vahid, Rashid, Ahmed Mustafa, Rasouli-Saravani, Ashkan, Rastogi, Prateek, Rasul, Azad, Ravangard, Ramin, Ravikumar, Nakul, Rawaf, David Laith, Rawaf, Salman, Rawassizadeh, Reza, Razeghian-Jahromi, Iman, Reddy, Murali Mohan Rama Krishna, Redwan, Elrashdy Moustafa Mohamed, Rehman, Faizan Ur, Reiner Jr, Robert C, Remuzzi, Giuseppe, Reshmi, Bhageerathy, Resnikoff, Serge, Reyes, Luis Felipe, Rezaee, Malihe, Rezaei, Negar, Rezaei, Nima, Rezaeian, Mohsen, Riaz, Mavra A, Ribeiro, Ana Isabel, Ribeiro, Daniel Cury, Rickard, Jennifer, Rios-Blancas, Maria Jesus, Robinson-Oden, Hannah Elizabeth, Rodrigues, Mónica, Rodriguez, Jefferson Antonio Buendia, Roever, Leonardo, Rohilla, Ravi, Rohloff, Peter, Romadlon, Debby Syahru, Ronfani, Luca, Roshandel, Gholamreza, Roshanzamir, Sharareh, Rostamian, Morteza, Roy, Bedanta, Roy, Priyanka, Rubagotti, Enrico, Rumisha, Susan Fred, Rwegerera, Godfrey M, Rynkiewicz, Andrzej, S, Manjula, S N, Chandan, S Sunnerhagen, Katharina, Saad, Aly M A, Sabbatucci, Michela, Saber, Korosh, Saber-Ayad, Maha Mohamed, Sacco, Simona, Saddik, Basema, Saddler, Adam, Sadee, Bashdar Abuzed, Sadeghi, Ehsan, Sadeghi, Masoumeh, Sadeghian, Saeid, Saeed, Umar, Saeedi, Maryam, Safi, Sare, Sagar, Rajesh, Saghazadeh, Amene, Saheb Sharif-Askari, Narjes, Sahoo, Soumya Swaroop, Sahraian, Mohammad Ali, Sajedi, Seyed Aidin, Sajid, Mirza Rizwan, Sakshaug, Joseph W, Salahi, Saina, Salahi, Sarvenaz, Salamati, Payman, Salami, Afeez Abolarinwa, Salaroli, Luciane B, Saleh, Mohamed A, Salehi, Sana, Salem, Marwa Rashad, Salem, Mohammed Z Y, Salimi, Sohrab, Samadi Kafil, Hossein, Samadzadeh, Sara, Samara, Kamel A, Samargandy, Saad, Samodra, Yoseph Leonardo, Samuel, Vijaya Paul, Samy, Abdallah M, Sanabria, Juan, Sanadgol, Nima, Sanganyado, Edmond, Sanjeev, Rama Krishna, Sanmarchi, Francesco, Sanna, Francesca, Santri, Ichtiarini Nurullita, Santric-Milicevic, Milena M, Sarasmita, Made Ary, Saravanan, Aswini, Saravi, Babak, Sarikhani, Yaser, Sarkar, Chinmoy, Sarmiento-Suárez, Rodrigo, Sarode, Gargi Sachin, Sarode, Sachin C, Sarveazad, Arash, Sathian, Brijesh, Sathish, Thirunavukkarasu, Sattin, Davide, Saulam, Jennifer, Sawyer, Susan M, Saxena, Sonia, Saya, Ganesh Kumar, Sayadi, Yaser, Sayeed, Abu, Sayeed, Md Abu, Saylan, Mete, Scarmeas, Nikolaos, Schaarschmidt, Benedikt Michael, Schlee, Winfried, Schmidt, Maria Inês, Schuermans, Art, Schwebel, David C, Schwendicke, Falk, Šekerija, Mario, Selvaraj, Siddharthan, Semreen, Mohammad H, Senapati, Sabyasachi, Sengupta, Pallav, Senthilkumaran, Subramanian, Sepanlou, Sadaf G, Serban, Dragos, Sertsu, Addisu, Sethi, Yashendra, SeyedAlinaghi, SeyedAhmad, Seyedi, Seyed Arsalan, Shafaat, Amir, Shafaat, Omid, Shafie, Mahan, Shafiee, Arman, Shah, Nilay S, Shah, Pritik A, Shahabi, Saeed, Shahbandi, Ataollah, Shahid, Izza, Shahid, Samiah, Shahid, Wajeehah, Shahwan, Moyad Jamal, Shaikh, Masood Ali, Shakeri, Alireza, Shakil, Husain, Sham, Sunder, Shamim, Muhammad Aaqib, Shams-Beyranvand, Mehran, Shamshad, Hina, Shamshirgaran, Mohammad Ali, Shamsi, Mohammad Anas, Shanawaz, Mohd, Shankar, Abhishek, Sharfaei, Sadaf, Sharifan, Amin, Shariff, Mariam, Sharifi-Rad, Javad, Sharma, Manoj, Sharma, Rajesh, Sharma, Saurab, Sharma, Vishal, Shastry, Rajesh P, Shavandi, Amin, Shaw, David H, Shayan, Amir Mehdi, Shehabeldine, Amr Mohamed Elsayed, Sheikh, Aziz, Sheikhi, Rahim Ali, Shen, Jiabin, Shenoy, Manjunath Mala, Shetty, B Suresh Kumar, Shetty, Ranjitha S, Shey, Robert Adamu, Shiani, Amir, Shibuya, Kenji, Shiferaw, Desalegn, Shigematsu, Mika, Shin, Jae Il, Shin, Min-Jeong, Shiri, Rahman, Shirkoohi, Reza, Shittu, Aminu, Shiue, Ivy, Shivakumar, K M, Shivarov, Velizar, Shool, Sina, Shrestha, Sunil, Shuja, Kanwar Hamza, Shuval, Kerem, Si, Yafei, Sibhat, Migbar Mekonnen, Siddig, Emmanuel Edwar, Sigfusdottir, Inga Dora, Silva, João Pedro, Silva, Luís Manuel Lopes Rodrigues, Silva, Soraia, Simões, Jorge Piano, Simpson, Colin R, Singal, Anjali, Singh, Abhinav, Singh, Aditya, Singh, Ambrish, Singh, Balbir Bagicha, Singh, Baljinder, Singh, Mahendra, Singh, Mayank, Singh, Narinder Pal, Singh, Paramdeep, Singh, Surjit, Siraj, Md Shahjahan, Sitas, Freddy, Sivakumar, Shravan, Skryabin, Valentin Yurievich, Skryabina, Anna Aleksandrovna, Sleet, David A, Slepak, Erica Leigh N, Sohrabi, Hanye, Soleimani, Hamidreza, Soliman, Sameh S M, Solmi, Marco, Solomon, Yonatan, Song, Yimeng, Sorensen, Reed J D, Soriano, Joan B, Soyiri, Ireneous N, Spartalis, Michael, Sreeramareddy, Chandrashekhar T, Starnes, Joseph R, Starodubov, Vladimir I, Starodubova, Antonina V, Stefan, Simona Cătălina, Stein, Dan J, Steinbeis, Fridolin, Steiropoulos, Paschalis, Stockfelt, Leo, Stokes, Mark A, Stortecky, Stefan, Stranges, Saverio, Stroumpoulis, Konstantinos, Suleman, Muhammad, Suliankatchi Abdulkader, Rizwan, Sultana, Abida, Sun, Jing, Sunkersing, David, Susanty, Sri, Swain, Chandan Kumar, Sykes, Bryan L, Szarpak, Lukasz, Szeto, Mindy D, Szócska, Miklós, Tabaee Damavandi, Payam, Tabatabaei Malazy, Ozra, Tabatabaeizadeh, Seyed-Amir, Tabatabai, Shima, Tabb, Karen M, Tabish, Mohammad, Taborda-Barata, Luis M, Tabuchi, Takahiro, Tadesse, Birkneh Tilahun, Taheri, Amirmasoud, Taheri Abkenar, Yasaman, Taheri Soodejani, Moslem, Taherkhani, Amir, Taiba, Jabeen, Tajbakhsh, Ardeshir, Talaat, Iman M, Talukder, Ashis, Tamuzi, Jacques Lukenze, Tan, Ker-Kan, Tang, Haosu, Tang, Hong K, Tat, Nathan Y, Tat, Vivian Y, Tavakoli Oliaee, Razieh, Tavangar, Seyed Mohammad, Taveira, Nuno, Tebeje, Tsion Mulat, Tefera, Yibekal Manaye, Teimoori, Mojtaba, Temsah, Mohamad-Hani, Temsah, Reem Mohamad Hani, Teramoto, Masayuki, Tesfaye, Solomon Hailemariam, Thangaraju, Pugazhenthan, Thankappan, Kavumpurathu Raman, Thapa, Rajshree, Thapar, Rekha, Thomas, Nihal, Thrift, Amanda G, Thum, Chern Choong Chern, Tian, Jing, Tichopad, Ales, Ticoalu, Jansje Henny Vera, Tiruye, Tenaw Yimer, Tohidast, Seyed Abolfazl, Tonelli, Marcello, Touvier, Mathilde, Tovani-Palone, Marcos Roberto, Tram, Khai Hoan, Tran, Nghia Minh, Trico, Domenico, Trihandini, Indang, Tromans, Samuel Joseph, Truong, Vien T, Truyen, Thien Tan Tri Tai, Tsermpini, Evangelia Eirini, Tumurkhuu, Munkhtuya, Tung, Kang, Tyrovolas, Stefanos, Ubah, Chukwudi S, Udoakang, Aniefiok John, Udoh, Arit, Ulhaq, Inam, Ullah, Saeed, Ullah, Sana, Umair, Muhammad, Umar, Tungki Pratama, Umeokonkwo, Chukwuma David, Umesh, Anushri, Unim, Brigid, Unnikrishnan, Bhaskaran, Upadhyay, Era, Urso, Daniele, Vacante, Marco, Vahdani, Amir Mohammad, Vaithinathan, Asokan Govindaraj, Valadan Tahbaz, Sahel, Valizadeh, Rohollah, Van den Eynde, Jef, Varavikova, Elena, Varga, Orsolya, Varma, Siddhartha Alluri, Vart, Priya, Varthya, Shoban Babu, Vasankari, Tommi Juhani, Veerman, Lennert J, Venketasubramanian, Narayanaswamy, Venugopal, Deneshkumar, Verghese, Nicholas Alexander, Verma, Madhur, Verma, Pratibha, Veroux, Massimiliano, Verras, Georgios-Ioannis, Vervoort, Dominique, Vieira, Rafael José, Villafañe, Jorge Hugo, Villani, Leonardo, Villanueva, Gabriela Ines, Villeneuve, Paul J, Violante, Francesco S, Visontay, Rachel, Vlassov, Vasily, Vo, Bay, Vollset, Stein Emil, Volovat, Simona Ruxandra, Volovici, Victor, Vongpradith, Avina, Vos, Theo, Vujcic, Isidora S, Vukovic, Rade, Wado, Yohannes Dibaba, Wafa, Hatem A, Waheed, Yasir, Wamai, Richard G, Wang, Cong, Wang, Denny, Wang, Fang, Wang, Shu, Wang, Song, Wang, Yanzhong, Wang, Yuan-Pang, Ward, Paul, Watson, Stefanie, Weaver, Marcia R, Weerakoon, Kosala Gayan, Weiss, Daniel J, Weldemariam, Abrha Hailay, Wells, Katherine M, Wen, Yi Feng, Werdecker, Andrea, Westerman, Ronny, Wickramasinghe, Dakshitha Praneeth, Wickramasinghe, Nuwan Darshana, Wijeratne, Tissa, Wilson, Shadrach, Wojewodzic, Marcin W, Wool, Eve E, Woolf, Anthony D, Wu, Dongze, Wulandari, Ratna Dwi, Xiao, Hong, Xu, Bin, Xu, Xiaoyue, Yadav, Lalit, Yaghoubi, Sajad, Yang, Lin, Yano, Yuichiro, Yao, Yao, Ye, Pengpeng, Yesera, Gesila Endashaw, Yesodharan, Renjulal, Yesuf, Subah Abderehim, Yiğit, Arzu, Yiğit, Vahit, Yip, Paul, Yon, Dong Keon, Yonemoto, Naohiro, You, Yuyi, Younis, Mustafa Z, Yu, Chuanhua, Zadey, Siddhesh, Zadnik, Vesna, Zafari, Nima, Zahedi, Mohammad, Zahid, Muhammad Nauman, Zahir, Mazyar, Zakham, Fathiah, Zaki, Nazar, Zakzuk, Josefina, Zamagni, Giulia, Zaman, Burhan Abdullah, Zaman, Sojib Bin, Zamora, Nelson, Zand, Ramin, Zandi, Milad, Zandieh, Ghazal G Z, Zanghì, Aurora, Zare, Iman, Zastrozhin, Mikhail Sergeevich, Zeariya, Mohammed G M, Zeng, Youjie, Zhai, Chunxia, Zhang, Chen, Zhang, Haijun, Zhang, Hongwei, Zhang, Yunquan, Zhang, Zhaofeng, Zhang, Zhenyu, Zhao, Hanqing, Zhao, Yang, Zhao, Yong, Zheng, Peng, Zhong, Chenwen, Zhou, Juexiao, Zhu, Bin, Zhu, Zhaohua, Ziaeefar, Pardis, Zielińska, Magdalena, Zou, Zhiyong, Zumla, Alimuddin, Zweck, Elric, Zyoud, Samer H, Lim, Stephen S, and Murray, Christopher J L
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- 2024
4. Manganese Oxide Nanocomposite for adsorption of Cd(II) Ions from Aqueous Phase: Optimization by Experimental Design
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Rafizadeh, M., Langeroodi, N. Samadani, and Khalafi, M.
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- 2021
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5. Time series analysis of covariance based on linear transfer function models
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Azimmohseni, M., Khalafi, M., and Kordkatuli, M.
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- 2019
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6. UV activated single aligned TiO2 nanofiber embedded silver nanoparticles as room temperature ammonia gas sensor
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Khalafi, M, primary, Nikfarjam, A, additional, Hajghassem, H, additional, and Bidmeshkipour, S, additional
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- 2023
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7. Impact of exercise training plus caloric restriction on cardiometabolic health in menopausal women who are overweight or obese: A meta-analysis
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Khalafi, M., primary and Symonds, M.E., additional
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- 2022
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8. Time series analysis of covariance based on linear transfer function models
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Azimmohseni, M., primary, Khalafi, M., additional, and Kordkatuli, M., additional
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- 2018
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9. SUN-P246: Prevalence of Metabolic Syndrome in Children with Obesity
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Esfarjani, F., primary, Mohammadi, F., additional, Khalafi, M., additional, Roustaee, R., additional, Alikhanian, H., additional, and Kelishadi, R., additional
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- 2017
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10. MON-PP223: Olive Oil in the Diet of Obese Children
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Esfarjani, F., primary, Mohammadi, F., additional, Khalafi, M., additional, and Roustaee, R., additional
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- 2015
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11. Simulation of Real Discrete Time Gaussian Multivariate Stationary Processes with Given Spectral Densities
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Azimmohseni, M., primary, Soltani, A. R., additional, and Khalafi, M., additional
- Published
- 2015
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12. PP188-MON: Assessment of Milk Consumption in Households and some of its Related Factors of Western Azarbayjan Province in Iran
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Esfarjani, F., primary, Mohammadi, F., additional, Khalafi, M., additional, and Rashidi, A., additional
- Published
- 2014
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13. PP243-MON: The Effectiveness of Lifestyle Modification Intervention in Obese Children
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Esfarjani, F., primary, Mohammadi, F., additional, Khalafi, M., additional, and Roustaee, R., additional
- Published
- 2014
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- View/download PDF
14. PP238-MON METABOLIC SYNDROME IN OBES CHILDREN
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Esfarjani, F., primary, Khalafi, M., additional, Mohammadi, F., additional, Zamani-Nour, N., additional, and Kelishadi, R., additional
- Published
- 2013
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15. Design and fabrication of microwindmill for fluidic media based on SU-8 for using flow-meter
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Sabri Alirezaei, I., primary, Ghaderi, M., additional, Khalafi, M., additional, and Latifi, H., additional
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- 2012
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16. Fascial Interposition Technique for Vasectomy: Is It Justified?
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Shakeri, S., primary, Aminsharifi, A.R., additional, and Khalafi, M., additional
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- 2009
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17. Design and fabrication of microwindmill for fluidic media based on SU-8 for using flow-meter
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Sabri Alirezaei, I., Ghaderi, M., Khalafi, M., and Latifi, H.
- Abstract
In this paper, we have introduced a method for design and fabrication of a micro-windmill based on SU-8 photoresist that is rotated by gas flow. This device is used for measuring gas flow by assessment of rotational speed of the microwindmill. The flow-meter sensitivity is influenced by different parameters such as number of blades and dimension of the windmills. Therefore, we have tried to experimentally reduce the dimensions and increase of the number of blades to obtain the higher sensitivity in measuring gas flow. An experimental setup is arranged to measure the rotational frequency of the windmill as a function of gas flow with optical methods.
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- 2012
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18. FAMILY-BASED INTERVENTION FOR CHILDHOOD OBESITY: AN EXPERIENCE AMONG TEHRANIAN CHILDREN
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Esfarjani, F., Khalafi, M., Mohammadi, F., Mansour, A., Roustaee, R., Zamani-Nour, N., and Roya Kelishadi
19. Longer-term effects of intermittent fasting on body composition and cardiometabolic health in adults with overweight and obesity: A systematic review and meta-analysis.
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Khalafi M, Maleki AH, Ehsanifar M, Symonds ME, and Rosenkranz SK
- Abstract
The aim of the present study was to investigate the effects of long-term intermittent fasting (IF) on body composition and cardiometabolic health in adults with overweight and obesity. PubMed, Web of Science, and Scopus were searched from inception to March 2024 to identify original randomized trials that investigated the effects of IF versus either a control diet (CON) and/or continuous caloric restriction (CR). Participants were adults with overweight and obesity and intervention durations were ≥ 6 months. Overall, a total of 24 studies involving 2032 participants were included in the meta-analysis. Compared with CON, IF significantly reduced body weight [WMD: -2.84 kg], BMI [WMD: -1.41 kg.m
2 ], fat mass [WMD: -3.06 kg], fat-free mass [WMD: -0.81 kg], waist circumference [WMD: -3.85 cm], visceral fat [SMD: -0.37], fasting glucose [WMD: -0.14 mmol/l], triglycerides [WMD: -0.12 mmol/l], and diastolic blood pressure [WMD: -2.24 mmHg]. Conversely, IF significantly increased high-density lipoproteins [WMD: 0.04 mmol/l] when compared with CON, but had no effects on insulin, hemoglobin A1c%, total cholesterol, low-density lipoprotein, or systolic blood pressure. Compared with CR, IF significantly reduced fat mass [WMD: -0.70 kg], body fat percentage [WMD: -0.59%], and DBP [WMD: -0.91 mmHg], and increased HDL [WMD: 0.03 mmol/l], with no other significant effects. Subgroup analyses showed that the mode of IF and intervention duration were the primary moderators of IF effects on the markers. In adults with overweight or obesity, IF and CR are comparably effective for reducing body weight and adiposity, as well as for improving cardiometabolic health markers., (© 2024 World Obesity Federation.)- Published
- 2024
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20. The effects of intermittent fasting on body composition and cardiometabolic health in adults with prediabetes or type 2 diabetes: A systematic review and meta-analysis.
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Khalafi M, Habibi Maleki A, Symonds ME, Rosenkranz SK, Rohani H, and Ehsanifar M
- Subjects
- Humans, Adult, Caloric Restriction methods, Blood Glucose metabolism, Cardiovascular Diseases prevention & control, Cardiovascular Diseases etiology, Cardiovascular Diseases epidemiology, Randomized Controlled Trials as Topic, Intermittent Fasting, Diabetes Mellitus, Type 2 diet therapy, Diabetes Mellitus, Type 2 blood, Prediabetic State diet therapy, Prediabetic State blood, Prediabetic State physiopathology, Fasting, Body Composition
- Abstract
Aim: To perform a meta-analysis to investigate the effects of intermittent fasting (IF), as compared with either a control diet (CON) and/or calorie restriction (CR), on body composition and cardiometabolic health in individuals with prediabetes and type 2 diabetes (T2D)., Methods: PubMed, Web of Science, and Scopus were searched from their inception to March 2024 to identify original randomized trials with parallel or crossover designs that studied the effects of IF on body composition and cardiometabolic health. Weighted mean differences (WMDs) or standardized mean differences with 95% confidence intervals (CIs) were calculated using random-effects models., Results: Overall, 14 studies involving 1101 adults with prediabetes or T2D were included in the meta-analysis. IF decreased body weight (WMD -4.56 kg [95% CI -6.23 to -2.83]; p = 0.001), body mass index (BMI; WMD -1.99 kg.m
2 [95% CI -2.74 to -1.23]; p = 0.001), glycated haemoglobin (HbA1c; WMD -0.81% [95% CI -1.24 to -0.38]; p = 0.001), fasting glucose (WMD -0.36 mmol/L [95% CI -0.63 to -0.09]; p = 0.008), total cholesterol (WMD -0.31 mmol/L [95% CI -0.60 to -0.02]; p = 0.03) and triglycerides (WMD -0.14 mmol/L [95% CI -0.27 to -0.01]; p = 0.02), but did not significantly decrease fat mass, insulin, low-densitiy lipoprotein, high-density lipoprotein, or blood pressure as compared with CON. Furthermore, IF decreased body weight (WMD -1.14 kg [95% CI -1.69 to -0.60]; p = 0.001) and BMI (WMD -0.43 kg.m2 [95% CI -0.58 to -0.27]; p = 0.001), but did not significantly affect fat mass, lean body mass, visceral fat, insulin, HbA1c, lipid profiles or blood pressure., Conclusion: Intermittent fasting is effective for weight loss and specific cardiometabolic health markers in individuals with prediabetes or T2D. Additionally, IF is associated with a reduction in body weight and BMI compared to CR, without effects on glycaemic markers, lipid profiles or blood pressure., (© 2024 John Wiley & Sons Ltd.)- Published
- 2024
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21. Female and underrepresented minority representation in radiology.
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Doddi S, Khalafi M, Shimoura E, Shanbhogue KP, and Tirumani SH
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- Humans, Female, United States, Physicians, Women statistics & numerical data, Radiology education, Minority Groups statistics & numerical data, Internship and Residency statistics & numerical data, Education, Medical, Graduate
- Abstract
Rational and Objective: Diversity, equity, inclusion, and representation in various sectors have garnered increasing attention in the past two decades, including healthcare. In this report we investigate representation of females and underrepresented minorities (URM) in the field of radiology and asses for significant growth trends in representation in residency training programs in the United States., Materials and Methods: De-identified trainee demographic information for active radiology trainees from 2016 to 2021 was queried using the Accreditation Council for Graduate Medical Education (ACGME), and new radiology trainees using the National Resident Matching Program (NRMP)'s Main Residency Match Data and Reports databooks., Results: In 2021 females represented 26.7% of DR residency trainees and 22% of IR integrated trainees. In the same year URM trainees represented 11.3% of trainees and 8.7% of IR integrated trainees. From 2017 to 2021, diagnostic radiology had a compound average growth rate (CAGR) 1% (p <0.01) of female representation and 1.12% (p<0.01) of URM representation., Conclusion: This study quantifies female and underrepresented minority representation among radiology trainees for diagnostic radiology and radiology subspecialities, identifying modest uptrends in representation within both demographics., Competing Interests: Declaraion of Competing Interest None., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
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22. Effects of low-carbohydrate diets, with and without caloric restriction, on inflammatory markers in adults: a systematic review and meta-analysis of randomized clinical trials.
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Kazeminasab F, Miraghajani M, Khalafi M, Sakhaei MH, Rosenkranz SK, and Santos HO
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- Adult, Humans, C-Reactive Protein analysis, C-Reactive Protein metabolism, Interleukin-6 blood, Randomized Controlled Trials as Topic, Tumor Necrosis Factor-alpha blood, Weight Loss, Biomarkers blood, Caloric Restriction methods, Diet, Carbohydrate-Restricted methods, Inflammation blood
- Abstract
Low-carbohydrate diets (LCDs) have gained interest due to their favorable effects on health outcomes, such as inflammation. However, further research is needed to ascertain the overall effects of LCDs on inflammatory parameters, but at the same time considering weight loss and calorie intake. Thus, a systematic review and meta-analysis of randomized clinical trials was performed to investigate the effects of LCDs compared with low-fat diets (LFDs), with and without caloric restriction, on inflammatory markers in adults. PubMed, Scopus, and Web of Science were searched through March 2022 to select intervention studies addressing LCDs vs. LFDs, in which the following circulating inflammatory markers were used: C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), and interleukin (IL-6). Analyses were conducted comparing LCDs vs. LFDs through weighted mean differences (WMD) or standardized mean differences (SMD) and 95% confidence intervals (95% CIs) using random effects models. The systematic review and meta-analysis included a total of 51 studies with a total sample of 4,164 adults, with or without other chronic diseases. Intervention durations ranged from 2-144 weeks. LCDs, compared with LFDs, significantly decreased body weight [WMD = -1.35%, p = 0.001], CRP [SMD = -0.1, p = 0.03], and IL-6 [SMD = -0.15, p = 0.09]. However, LCDs did not significantly decrease TNF-α [SMD = -0.02, p = 0.7] compared to LFDs. In conclusion, LCDs have a beneficial effect on markers of inflammation by decreasing CRP and IL-6; this effect has an association with weight loss. However, LCDs were not more effective than LFDs in decreasing TNF-α., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)
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- 2024
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23. The effects of exercise training on inflammatory markers in children and adolescents: A systematic review and meta-analysis.
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Khalafi M, Symonds ME, Faramarzi M, Sharifmoradi K, Maleki AH, and Rosenkranz SK
- Subjects
- Adolescent, Child, Humans, C-Reactive Protein, Cytokines, Exercise, Interleukin-6 metabolism, Tumor Necrosis Factor-alpha metabolism
- Abstract
Introduction and Aim: Exercise training is effective for improving cardiometabolic health in children and adolescents, but less is known about its impact on inflammatory markers. We therefore, undertook a systematic review and meta-analysis to investigate the role of exercise training on pro-inflammatory cytokines including interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP) in children and adolescents., Method: A comprehensive search was conducted in three electronic databases including PubMed, Web of Science, and Scopus, from inception to December 2023 to identify exercise trials with and without control groups, involving participants with mean ages ranging from ≥ 6 to < 18 years, of age with measurements of at least one of the following pro-inflammatory cytokines IL-6, TNF-α, or CRP. Standardized mean differences (SMD) and 95 % confidence interval (ICs) were calculated using random effects models., Results: Thirty-eight studies involving 2043 children and adolescents were included. The results show that exercise training resulted in significant reductions in IL-6 [SMD: -0.44; 95 % CI: -0.68, -0.21; P = 0.001] and CRP [SMD: -0.28; 95 % CI: -0.41, -0.16; P = 0.001], but not TNF-α [SMD: -0.15; 95 % CI: -0.38, -0.07; P = 0.19]. Subgroup analyses showed that IL-6 and CRP were reduced with aerobic training in adolescents, as was CRP with high-intensity interval training., Conclusion: These results provide evidence that exercise training is effective for reducing IL-6 and CRP in adolescents, but not in children, and any benefits may be modulated by the type of exercise performed., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)
- Published
- 2024
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24. A green tea extract confection decreases circulating endotoxin and fasting glucose by improving gut barrier function but without affecting systemic inflammation: A double-blind, placebo-controlled randomized trial in healthy adults and adults with metabolic syndrome.
- Author
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Zeng M, Hodges JK, Pokala A, Khalafi M, Sasaki GY, Pierson J, Cao S, Brock G, Yu Z, Zhu J, Vodovotz Y, and Bruno RS
- Subjects
- Humans, Double-Blind Method, Adult, Male, Female, Endotoxemia drug therapy, Fasting, Middle Aged, Intestinal Mucosa metabolism, Intestinal Mucosa drug effects, Camellia sinensis chemistry, Metabolic Syndrome drug therapy, Endotoxins blood, Plant Extracts pharmacology, Tea chemistry, Catechin pharmacology, Catechin analogs & derivatives, Catechin administration & dosage, Inflammation drug therapy, Inflammation blood, Blood Glucose metabolism, Blood Glucose drug effects, Cross-Over Studies, Permeability, Acute-Phase Proteins, Carrier Proteins, Membrane Glycoproteins
- Abstract
Anti-inflammatory activities of catechin-rich green tea extract (GTE) in obese rodents protect against metabolic endotoxemia by decreasing intestinal permeability and absorption of gut-derived endotoxin. However, translation to human health has not been established. We hypothesized that GTE would reduce endotoxemia by decreasing gut permeability and intestinal and systemic inflammation in persons with metabolic syndrome (MetS) compared with healthy persons. A randomized, double-blind, placebo-controlled, crossover trial in healthy adults (n = 19, 34 ± 2 years) and adults with MetS (n = 21, 40 ± 3 years) examined 4-week administration of a decaffeinated GTE confection (890 mg/d total catechins) on serum endotoxin, intestinal permeability, gut and systemic inflammation, and cardiometabolic parameters. Compared with the placebo, the GTE confection decreased serum endotoxin (P = .023) in both healthy persons and those with MetS, while increasing concentrations of circulating catechins (P < .0001) and γ-valerolactones (P = .0001). Fecal calprotectin (P = .029) and myeloperoxidase (P = .048) concentrations were decreased by GTE regardless of health status. Following the ingestion of gut permeability probes, urinary lactose/mannitol (P = .043) but not sucralose/erythritol (P > .05) was decreased by GTE regardless of health status. No between-treatment differences (P > .05) were observed for plasma aminotransferases, blood pressure, plasma lipids, or body mass nor were plasma tumor necrosis factor-α, interleukin-6, or the ratio of lipopolysaccharide-binding protein/soluble cluster of differentiation-14 affected. However, fasting glucose in both study groups was decreased (P = .029) by the GTE confection compared with within-treatment arm baseline concentrations. These findings demonstrate that catechin-rich GTE is effective to decrease circulating endotoxin and improve glycemic control in healthy adults and those with MetS, likely by reducing gut inflammation and small intestinal permeability but without affecting systemic inflammation., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
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- 2024
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25. Combined versus independent effects of exercise training and intermittent fasting on body composition and cardiometabolic health in adults: a systematic review and meta-analysis.
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Khalafi M, Symonds ME, Maleki AH, Sakhaei MH, Ehsanifar M, and Rosenkranz SK
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- Adult, Humans, Body Composition, Exercise, Cholesterol, HDL, Obesity therapy, Intermittent Fasting, Cardiovascular Diseases prevention & control
- Abstract
Introduction and Aim: Exercise training (Ex) and intermittent fasting (IF) are effective for improving body composition and cardiometabolic health overweight and obese adults, but whether combining Ex and IF induces additive or synergistic effects is less well established. We therefore, performed a systematic review and meta-analysis to compare the combined versus independent effects of Ex and IF on body composition and cardiometabolic health in adults., Method: An electronic search was conducted in three main online databases including PubMed, Web of Science, and Scopus, from inception to March 9, 2023 for studies involving Ex plus IF trials versus standalone Ex and/or IF interventions in adults. Interventions had a duration of ≥ 2 weeks. Standardized (SMD) or weighted mean differences (WMD) and 95% confidence intervals were calculated in order to compare effects on body weight, body mass index (BMI), body fat lean body mass (LBM), visceral fat, and waist circumference. For cardiometabolic health, outcomes included fasting glucose, insulin, total cholesterol (TC), low-density lipoprotein cholesterol (LDL), triglycerides (TG), high-density lipoprotein cholesterol (HDL), systolic (SBP) and diastolic (DBP) blood pressure, and VO
2 max/peak., Results: Ex plus IF decreased body weight [WMD: -3.03 kg (95% CI: -3.44 to -2.61), p = 0.001], BMI [WMD: -1.12 kg.m2 (95% CI: -1.28 to -0.95), p = 0.001], body fat [SMD: -0.72 (95% CI: -1.23 to -0.21), p = 0.005], visceral fat [SMD: -0.34 (95% CI: -0.63 to -0.05), p = 0.01], and waist circumference [WMD: -2.63 cm (95% CI: -4.16 to -1.11), p = 0.001] more than Ex alone. However, changes in body composition and cardiometabolic health markers were not significantly different for Ex plus IF when compared with IF alone, with the exception of VO2 max/peak [SMD: 0.55 (95% CI: 0.14 to 0.97), p = 0.009]., Conclusion: We demonstrate that a combination of Ex and IF produces superior changes in body composition, but not in markers of cardiometabolic health when compared with Ex or IF alone. Ex plus IF could therefore be effective for weight and fat loss but has no additive or synergistic effects for other cardiometabolic health markers., (© 2024. The Author(s).)- Published
- 2024
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26. Interleukin-15 responses to acute and chronic exercise in adults: a systematic review and meta-analysis.
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Khalafi M, Maleki AH, Symonds ME, Sakhaei MH, Rosenkranz SK, Ehsanifar M, Korivi M, and Liu Y
- Subjects
- Adult, Humans, Body Mass Index, Exercise, Health Status, Interleukin-15, Cytokines
- Abstract
Purpose: Interlukin-15 (IL-15) is an inflammatory cytokine that plays a vital role in immunology and obesity-associated metabolic syndrome. We performed this systematic review and meta-analysis to investigate whether exercise promotes circulating IL-15 concentrations in adults., Methods: We searched PubMed, Web of Science, and Scopus from inception to May, 2023 and identified original studies that investigated the effectiveness of acute and/or chronic exercise on serum/plasma IL-15 levels in adults. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated using random effect models. Subgroup analyses were performed based on type of exercise, and training status, health status and body mass indexes (BMI) of participants., Results: Fifteen studies involving 411 participants and 12 studies involving 899 participants were included in the acute and chronic exercise analyses, respectively. Our findings showed that acute exercise increased circulating IL-15 concentrations immediately after exercise compared with baseline [SMD=0.90 (95% CI: 0.47 to 1.32), p=0.001], regardless of exercise type and participants' training status. Similarly, acute exercise was also associated with increased IL-15 concentrations even one-hour after exercise [SMD=0.50 (95% CI: 0.00 to 0.99), p=0.04]. Nevertheless, chronic exercise did not have a significant effect on IL-15 concentrations [SMD=0.40 (95% CI: -0.08 to 0.88), p=0.10]., Conclusion: Our results confirm that acute exercise is effective in increasing the IL-15 concentrations immediately and one-hour after exercise intervention, and thereby playing a potential role in improving metabolism in adults., Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=445634, identifier CRD42023445634., 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. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision, (Copyright © 2024 Khalafi, Maleki, Symonds, Sakhaei, Rosenkranz, Ehsanifar, Korivi and Liu.)
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- 2024
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27. Diagnostic performance of MRI radiomics for classification of Alzheimer's disease, mild cognitive impairment, and normal subjects: a systematic review and meta-analysis.
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Shahidi R, Baradaran M, Asgarzadeh A, Bagherieh S, Tajabadi Z, Farhadi A, Korani SS, Khalafi M, Shobeiri P, Sadeghsalehi H, Shafieioun A, Yazdanifar MA, Singhal A, and Sotoudeh H
- Subjects
- Humans, Magnetic Resonance Imaging methods, Sensitivity and Specificity, Alzheimer Disease diagnosis, Neurodegenerative Diseases, Cognitive Dysfunction diagnosis
- Abstract
Background: Alzheimer's disease (AD) is a debilitating neurodegenerative disease. Early diagnosis of AD and its precursor, mild cognitive impairment (MCI), is crucial for timely intervention and management. Radiomics involves extracting quantitative features from medical images and analyzing them using advanced computational algorithms. These characteristics have the potential to serve as biomarkers for disease classification, treatment response prediction, and patient stratification. Of note, Magnetic resonance imaging (MRI) radiomics showed a promising result for diagnosing and classifying AD, and MCI from normal subjects. Thus, we aimed to systematically evaluate the diagnostic performance of the MRI radiomics for this task., Methods and Materials: A comprehensive search of the current literature was conducted using relevant keywords in PubMed/MEDLINE, Embase, Scopus, and Web of Science databases from inception to August 5, 2023. Original studies discussing the diagnostic performance of MRI radiomics for the classification of AD, MCI, and normal subjects were included. Method quality was evaluated with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) and the Radiomics Quality Score (RQS) tools., Results: We identified 13 studies that met the inclusion criteria, involving a total of 5448 participants. The overall quality of the included studies was moderate to high. The pooled sensitivity and specificity of MRI radiomics for differentiating AD from normal subjects were 0.92 (95% CI [0.85; 0.96]) and 0.91 (95% CI [0.85; 0.95]), respectively. The pooled sensitivity and specificity of MRI radiomics for differentiating MCI from normal subjects were 0.74 (95% CI [0.60; 0.85]) and 0.79 (95% CI [0.70; 0.86]), respectively. Also, the pooled sensitivity and specificity of MRI radiomics for differentiating AD from MCI were 0.73 (95% CI [0.64; 0.80]) and 0.79 (95% CI [0.64; 0.90]), respectively., Conclusion: MRI radiomics has promising diagnostic performance in differentiating AD, MCI, and normal subjects. It can potentially serve as a non-invasive and reliable tool for early diagnosis and classification of AD and MCI., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
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- 2023
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28. Versatile function of AMPK signaling in osteosarcoma: An old player with new emerging carcinogenic functions.
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Hashemi M, Razzazan M, Bagheri M, Asadi S, Jamali B, Khalafi M, Azimi A, Rad S, Behroozaghdam M, Nabavi N, Rashidi M, Dehkhoda F, Taheriazam A, and Entezari M
- Subjects
- Humans, AMP-Activated Protein Kinases metabolism, Carcinogenesis, Carcinogens, Neoplasm Recurrence, Local, Quality of Life, Bone Neoplasms metabolism, Osteosarcoma metabolism
- Abstract
AMP-activated protein kinase (AMPK) signaling has a versatile role in Osteosarcoma (OS), an aggressive bone malignancy with a poor prognosis, particularly in cases that have metastasized or recurred. This review explores the regulatory mechanisms, functional roles, and therapeutic applications of AMPK signaling in OS. It focuses on the molecular activation of AMPK and its interactions with cellular processes like proliferation, apoptosis, and metabolism. The uncertain role of AMPK in cancer is also discussed, highlighting its potential as both a tumor suppressor and a contributor to carcinogenesis. The therapeutic potential of targeting AMPK signaling in OS treatment is examined, including direct and indirect activators like metformin, A-769662, resveratrol, and salicylate. Further research is needed to determine dosing, toxicities, and molecular mechanisms responsible for the anti-osteosarcoma effects of these compounds. This review underscores the complex involvement of AMPK signaling in OS and emphasizes the need for a comprehensive understanding of its molecular mechanisms. By elucidating the role of AMPK in OS, the aim is to pave the way for innovative therapeutic approaches that target this pathway, ultimately improving the prognosis and quality of life for OS patients., Competing Interests: Declaration of Competing Interest There is no conflict of interest., (Copyright © 2023 Elsevier GmbH. All rights reserved.)
- Published
- 2023
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29. The effects of exercise training on circulating adhesion molecules in adults: A systematic review and meta-analysis.
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Khalafi M, Symonds ME, Sakhaei MH, and Ghasemi F
- Subjects
- Humans, Adult, Middle Aged, Vascular Cell Adhesion Molecule-1, Cell Adhesion Molecules, Intercellular Adhesion Molecule-1, Exercise, Cardiovascular Diseases, Metabolic Diseases
- Abstract
Introduction: The current meta-analysis investigated the effects of exercise training on circulating adhesion molecules i.e. soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in adults., Method: PubMed, Web of Science, Scopus and Embase were searched to identify original articles, published in English languages journal from inception up to 31 August 2023 that compared the effects of exercise training with non-exercising control on sICAM-1 and sVCAM-1 in adults. Standardized mean differences (SMDs) and 95% CIs were calculated using random-effect models., Results: Twenty-three studies including 31 intervention arms and involving 1437 subjects were included in the meta-analysis. Exercise training effectively reduced sICAM-1 [SMD: -0.33 (95% CI -0.56 to -0.11), p = 0.004; I2 = 56.38%, p = 0.001; 23 intervention arms]. Subgroup analyses showed that sICAM-1 decreased in adults with age <60 years (p = 0.01) and BMI ≥ 27 kg/m2 (p = 0.002) and those with metabolic disorders (p = 0.004) and cardiovascular diseases (p = 0.005). In addition, aerobic (p = 0.02) and resistance training (p = 0.007) are effective in reducing sICAM-1. However, exercise training did not indicate a superior effect on sVCAM-1 [SMD: -0.12 (95% CI -0.29 to 0.05), p = 0.17; I2 = 36.29%, p = 0.04; 23 intervention arms]., Conclusion: Our results show that exercise training reduces sICAM-1, but not for sVCAM-1, where both aerobic and resistance training is effective in reducing sICAM-1 in adults with metabolic disorders and cardiovascular diseases., Trial Registration: The current meta-analysis was registered at www.crd.york.ac.uk/prospero with ID registration number: CRD42023410474., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Khalafi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2023
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30. The effects of resistance training on myostatin and follistatin in adults: A systematic review and meta-analysis.
- Author
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Khalafi M, Aria B, Symonds ME, and Rosenkranz SK
- Subjects
- Humans, Adult, Aged, Muscle, Skeletal physiology, Follistatin metabolism, Follistatin pharmacology, Exercise physiology, Myostatin, Resistance Training
- Abstract
Introduction and Aim: Myostatin and follistatin are the main hormones for regulating muscle mass, and previous research suggests they are modulated by resistance training. We therefore performed a systematic review and meta-analysis to investigate the impact of resistance training on circulating myostatin and follistatin in adults., Methods: A search was conducted in PubMed and Web of science from inception until October 2022 to identify original studies investigating the effects of resistance training compared with controls that did not exercise. Standardized mean differences and 95% confidence intervals (CIs) were calculated using random effects models., Results: A total 26 randomized studies, including 36 interventions, and involving 768 participants (aged ∼18 - 82 years), were included in the meta-analysis. Resistance training effectively decreased myostatin [-1.31 (95% CI -1.74 - -0.88, p = 0.001, 26 studies] and increased follistatin [2.04 (95% CI: 1.51 - 2.52), p = 0.001, 14 studies]. Subgroup analyses revealed a significant decrease in myostatin and increase in follistatin regardless of age., Conclusion: Resistance training in adults is effective for reducing myostatin and increasing follistatin which may contribute to the beneficial effects of resistance training on muscle mass and metabolic outcomes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)
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- 2023
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31. Radiomics: The New Promise for Differentiating Progression, Recurrence, Pseudoprogression, and Radionecrosis in Glioma and Glioblastoma Multiforme.
- Author
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Alizadeh M, Broomand Lomer N, Azami M, Khalafi M, Shobeiri P, Arab Bafrani M, and Sotoudeh H
- Abstract
Glioma and glioblastoma multiform (GBM) remain among the most debilitating and life-threatening brain tumors. Despite advances in diagnosing approaches, patient follow-up after treatment (surgery and chemoradiation) is still challenging for differentiation between tumor progression/recurrence, pseudoprogression, and radionecrosis. Radiomics emerges as a promising tool in initial diagnosis, grading, and survival prediction in patients with glioma and can help differentiate these post-treatment scenarios. Preliminary published studies are promising about the role of radiomics in post-treatment glioma/GBM. However, this field faces significant challenges, including a lack of evidence-based solid data, scattering publication, heterogeneity of studies, and small sample sizes. The present review explores radiomics's capabilities in following patients with glioma/GBM status post-treatment and to differentiate tumor progression, recurrence, pseudoprogression, and radionecrosis.
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- 2023
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32. Influence of different modes of exercise training on inflammatory markers in older adults with and without chronic diseases: A systematic review and meta-analysis.
- Author
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Khalafi M, Akbari A, Symonds ME, Pourvaghar MJ, Rosenkranz SK, and Tabari E
- Subjects
- Humans, Aged, Tumor Necrosis Factor-alpha metabolism, Biomarkers metabolism, C-Reactive Protein metabolism, Inflammation metabolism, Exercise physiology, Chronic Disease, Interleukin-6 metabolism, Sarcopenia
- Abstract
Introduction: Ageing can be accompanied by increased inflammation, which contributes to the development of sarcopenia. Exercise training could be effective for preventing sarcopenia and mitigate inflammation and thus a viable intervention in ageing. Therefore, we performed a systematic review and meta-analysis to investigate the effects of exercise training on markers of inflammation including interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) in older adults (≥65 years). Exercise-based interventions are most successful in preventing the decline in skeletal muscle mass and in preserving or ameliorating functional capacities with increasing age., Method: PubMed and Web of Science were searched through to December 2021 using "exercise", "inflammatory markers", "elderly", and "randomized controlled trial" to identify randomized trials evaluating the effects of exercise training versus control groups on IL-6, TNF-α, and CRP in older adults with mean ages ≥ 65 yrs. Standardized mean differences (SMD) and 95% confidence intervals (95% CIs) were determined using random effects models., Results: Forty studies involving 49 trials and 1,898 older adults were included in the meta-analysis. Overall, exercise training reduced IL-6 [-0.17 (95% CI -0.32 to -0.02), p = 0.02], TNF-α [-0.30 (95% CI -0.46 to -0.13), p = 0.001], and CRP [-0.45 (95% CI -0.61 to -0.29), p = 0.001]. Subgroup analyses showed that IL-6 was reduced significantly by combined training, TNF-α by aerobic training, and CRP by aerobic, resistance, and combined training. In addition, exercise training reduced IL-6 and TNF-α in older adults with chronic diseases, and CRP in older adults with and without chronic diseases., Conclusion: The current results highlight that exercise training, regardless of exercise type, has small to moderate beneficial effects on markers of inflammation in older adults, particularly in those with chronic diseases., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)
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- 2023
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33. Exercise training, dietary intervention, or combined interventions and their effects on lipid profiles in adults with overweight and obesity: A systematic review and meta-analysis of randomized clinical trials.
- Author
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Khalafi M, Sakhaei MH, Kazeminasab F, Rosenkranz SK, and Symonds ME
- Subjects
- Adult, Humans, Randomized Controlled Trials as Topic, Obesity diagnosis, Obesity therapy, Triglycerides, Exercise, Cholesterol, HDL, Overweight diagnosis, Overweight therapy, Lipids
- Abstract
Aims: We performed a systematic review and meta-analysis to compare the effects of Ex (exercise training) vs. DI (dietary intervention) vs. combined Ex and DI on total cholesterol (TC), low-density lipoprotein cholesterol (LDL), triglycerides (TG), and high-density lipoprotein cholesterol (HDL) in adults with overweight and obesity., Data Synthesis: PubMed, Web of Science, and Scopus were searched to identify original articles published until March 2022, using keywords for the categories "exercise training," "dietary intervention," "overweight and obesity," and "randomized." Studies that included lipid profiles as outcomes and performed in adults with body mass indexes (BMIs) ≥ 25 kg/m
2 were included. A total of 80 studies involving 4804 adult participants were included in the meta-analysis. Ex was not as effective as DI for reducing TC and TG and was less effective for reducing LDL. In addition, Ex increased HDL to a greater extent than DI. Combined interventions decreased TC, TG, and LDL but did not increase HDL more than Ex alone. Combined interventions failed to reduce TC or LDL but decreased TG and increased HDL more than DI alone., Conclusions: Our results suggest that the combination of Ex and DI can be more effective than either Ex or DI alone in improving lipid profiles in adults with overweight and obesity., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts 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.)- Published
- 2023
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34. Effectiveness of supplementation with date seed (Phoenix dactylifera) as a functional food on inflammatory markers, muscle damage, and BDNF following high-intensity interval training: a randomized, double-blind, placebo-controlled trial.
- Author
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Moslemi E, Dehghan P, and Khalafi M
- Subjects
- Male, Humans, Female, Interleukin-10, Brain-Derived Neurotrophic Factor, Functional Food, Interleukin-6, Antioxidants pharmacology, Iran, Powders, Dietary Supplements, Inflammation, Muscles, Phoeniceae, High-Intensity Interval Training methods
- Abstract
Purpose: High-intensity interval training (HIIT) is one of the most effective protocols, even though acute HIIT causes inflammatory and oxidative damage. The aim of this study was to examine the effect of date seeds powder (DSP) during HIIT sessions on inflammation markers, oxidants and antioxidants, brain-derived neurotrophic factor (BDNF), exercise-induced muscle damage, and body composition., Material and Methods: Thirty-six recreational runners (men and women), aged 18-35 years, were randomly assigned to consume 26 g/day of DSP or wheat bran powder during HIIT workouts for a period of 14 days. At baseline, at the end of the intervention, and 24 h after the intervention, blood samples were obtained to determine inflammatory, oxidant/antioxidant, and muscle damage markers, as well as BDNF., Results: DSP supplementation resulted in a significant downward trend in high-sensitivity C-reactive protein (Psupplement × time = 0.036), tumor necrosis factor alpha (Psupplement × time = 0.010), interleukin-6 (Psupplement × time = 0.047), malondialdehyde (Psupplement × time = 0.046), creatine kinase (Psupplement × time = 0.045), and lactate dehydrogenase (Psupplement × time = 0.040) after the intervention, as well as a significant increase in total antioxidant capacity (Psupplement × time ≤ 0.001). However, interleukin-10 (Psupplement × time = 0.523), interleukin-6/interleukin-10 (Psupplement × time = 0.061), BDNF (Psupplement × time = 0.160), and myoglobin (Psupplement × time = 0.095) levels did not change significantly in comparison to the placebo group. Moreover, analysis demonstrated that DSP supplementation over 2 weeks had no significant effect on body composition., Conclusion: During the 2 weeks of the HIIT protocol, the consumption of date seed powder by participants who had engaged in moderate or high physical activity alleviated inflammation and muscle damage., Ethics and Dissemination: This study was approved by the Medical Ethics Committee of TBZMED (No.IR.TBZMED.REC.1399.1011)., Trial Registration: Iranian Registry of Clinical Trials website ( www.IRCt.ir/ , IRCT20150205020965N9)., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)
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- 2023
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35. Machine learning algorithms for diagnosis of hip bone osteoporosis: a systematic review and meta-analysis study.
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Rahim F, Zaki Zadeh A, Javanmardi P, Emmanuel Komolafe T, Khalafi M, Arjomandi A, Ghofrani HA, and Shirbandi K
- Subjects
- Humans, Algorithms, Machine Learning, Pelvic Bones, Osteoporosis diagnostic imaging, Hip Fractures
- Abstract
Background: Osteoporosis is a significant health problem in the skeletal system, associated with bone tissue changes and its strength. Machine Learning (ML), on the other hand, has been accompanied by improvements in recent years and has been in the spotlight. This study is designed to investigate the Diagnostic Test Accuracy (DTA) of ML to detect osteoporosis through the hip dual-energy X-ray absorptiometry (DXA) images., Methods: The ISI Web of Science, PubMed, Scopus, Cochrane Library, IEEE Xplore Digital Library, CINAHL, Science Direct, PROSPERO, and EMBASE were systematically searched until June 2023 for studies that tested the diagnostic precision of ML model-assisted for predicting an osteoporosis diagnosis., Results: The pooled sensitivity of univariate analysis of seven studies was 0.844 (95% CI 0.791 to 0.885, I
2 = 94% for 7 studies). The pooled specificity of univariate analysis was 0.781 (95% CI 0.732 to 0.824, I2 = 98% for 7 studies). The pooled diagnostic odds ratio (DOR) was 18.91 (95% CI 14.22 to 25.14, I2 = 93% for 7 studies). The pooled mean positive likelihood ratio (LR+ ) and the negative likelihood ratio (LR- ) were 3.7 and 0.22, respectively. Also, the summary receiver operating characteristics (sROC) of the bivariate model has an AUC of 0.878., Conclusion: Osteoporosis can be diagnosed by ML with acceptable accuracy, and hip fracture prediction was improved via training in an Architecture Learning Network (ALN)., (© 2023. The Author(s).)- Published
- 2023
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36. The effects of exercise training on postprandial glycemia and insulinemia in adults with overweight or obesity and with cardiometabolic disorders: A systematic review and meta-analysis.
- Author
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Khalafi M, Symonds ME, Ghasemi F, Rosenkranz SK, Rohani H, and Sakhaei MH
- Subjects
- Humans, Adult, Obesity therapy, Exercise, Glucose, Randomized Controlled Trials as Topic, Overweight therapy, Cardiovascular Diseases
- Abstract
Background: We performed a systematic review and meta-analysis to investigate the effects of exercise training on postprandial glycemia (PPG) and insulinemia (PPI) in adults with overweight or obesity and with cardiometabolic disorders., Methods: PubMed, Web of Science, and Scopus databases were searched until May 2022 using the key words "exercise," "postprandial," and "randomized control trial" to identify original studies investigating the effects of exercise training on PPG and/or PPI in adults with a body mass indexes (BMI) ≥ 25 kg.m
2 . Standardized mean differences (SMD) and 95 % confidence intervals (CIs) were calculated using random effects models to calculate effect sizes for outcomes and to generate forest plots. Sub-group analyses and meta-regressions were performed for potential categorical and continuous moderators., Results: Twenty-nine studies involving 41 intervention arms and 1,401 participants were included in the systematic review and meta-analysis. Overall, exercise training significantly decreased PPG [-0.36 (95 % CI -0.50 to -0.22), p = 0.001] and PPI [-0.37 (95 % CI -0.52 to -0.21), p = 0.001]. Subgroup analyses showed that PPG decreased following both aerobic and resistance training; whereas PPI was reduced following aerobic training, independent of age, BMI, and baseline glucose levels. Meta-regression analyses showed that frequency of exercise sessions, intervention durations, and duration of exercise time, did not moderate the effects of exercise training on PPI or PPG (p > 0.05)., Conclusion: In adults with overweight or obesity and with cardiometabolic disorders, exercise training is effective for reducing PPG and PPI, across ages and BMIs, irrespective of baseline glucose levels and exercise training characteristics., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)- Published
- 2023
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37. Impact of Exercise in Hypoxia on Inflammatory Cytokines in Adults: A Systematic Review and Meta-analysis.
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Khalafi M, Sakhaei MH, Symonds ME, Noori Mofrad SR, Liu Y, and Korivi M
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Background: Both acute exercise and environmental hypoxia may elevate inflammatory cytokines, but the inflammatory response in the hypoxic exercise is remaining unknown., Objective: We performed this systematic review and meta-analysis to examine the effect of exercise in hypoxia on inflammatory cytokines, including IL-6, TNF-α and IL-10., Methods: PubMed, Scopus and Web of Science were searched to identify the original articles that compared the effect of exercise in hypoxia with normoxia on IL-6, TNF-α and IL-10 changes, published up to March 2023. Standardized mean differences and 95% confidence intervals (CIs) were calculated using a random effect model to (1) determine the effect of exercise in hypoxia, (2) determine the effect of exercise in normoxia and (3) compare the effect of exercise in hypoxia with normoxia on IL-6, TNF-α and IL-10 responses., Results: Twenty-three studies involving 243 healthy, trained and athlete subjects with a mean age range from 19.8 to 41.0 years were included in our meta-analysis. On comparing exercise in hypoxia with normoxia, no differences were found in the response of IL-6 [0.17 (95% CI - 0.08 to 0.43), p = 0.17] and TNF-α [0.17 (95% CI - 0.10 to 0.46), p = 0.21] between the conditions. Exercise in hypoxia significantly increased IL-10 concentration [0.60 (95% CI 0.17 to 1.03), p = 0.006] compared with normoxia. In addition, exercise during both hypoxia and normoxia increased IL-6 and IL-10, whereas TNF-α was increased only in hypoxic exercise condition., Conclusion: Overall, exercise in both hypoxia and normoxia increased inflammatory cytokines; however, hypoxic exercise may lead to a greater inflammatory response in adults., (© 2023. The Author(s).)
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- 2023
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38. The effects of exercise training on body composition in postmenopausal women: a systematic review and meta-analysis.
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Khalafi M, Habibi Maleki A, Sakhaei MH, Rosenkranz SK, Pourvaghar MJ, Ehsanifar M, Bayat H, Korivi M, and Liu Y
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- Humans, Female, Exercise, Intra-Abdominal Fat, Muscles, Postmenopause, Body Composition
- Abstract
Introduction: We conducted a systematic review and meta-analysis to investigate the effect of exercise training on body composition outcomes in postmenopausal women., Methods: PubMed, Web of Science, CINAHL, and Medline were searched to identify the randomized controlled trials which evaluated effect of exercise training versus control in postmenopausal women. Standardized mean differences (SMD), weighted mean differences (WMD) and 95% confidence intervals (95% CIs) were calculated using random effects model., Results: One hundred and one studies involving 5,697 postmenopausal women were included in the meta-analysis. Results indicated that exercise training effectively increased muscle mass/ volume, muscle and fiber cross-sectional area and fat-free mass, and decreased fat mass, body fat percentage, waist circumference and visceral fat. Furthermore, subgroup analyses results revealed that aerobic and combined training had greater beneficial effects on fat mass outcomes, whereas resistance and combined training had greater beneficial effects on muscle mass outcomes., Discussion: Overall, our results revealed that exercise training is effective for improving body composition in postmenopausal women. To be specific, aerobic training is effective on fat loss, whereas resistance training is effective on muscle gain. However, combination of aerobic and resistance trainings may be considered a viable strategy to improve body composition in postmenopausal women., Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42021283425., 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., (Copyright © 2023 Khalafi, Habibi Maleki, Sakhaei, Rosenkranz, Pourvaghar, Ehsanifar, Bayat, Korivi and Liu.)
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- 2023
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39. Influence of exercise type and duration on cardiorespiratory fitness and muscular strength in post-menopausal women: a systematic review and meta-analysis.
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Khalafi M, Sakhaei MH, Habibi Maleki A, Rosenkranz SK, Pourvaghar MJ, Fang Y, and Korivi M
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Background and Aim: Both cardiorespiratory fitness (CRF) and muscular strength are reported to decrease with age and menopause, which considered to be risk for cardiovascular diseases (CVDs). Previous relevant meta-analyses are inconclusive on the beneficial effects of exercise, particularly in post-menopausal women. In this systematic review and meta-analysis, we investigated the effects of exercise modalities on CRF and muscular strength in post-menopausal women, and identified the effective exercise type and duration., Methods: A comprehensive search was conducted on PubMed, Web of Science, CINAHL, and Medline to identify the randomized controlled trials, which evaluated exercise effect on CRF, lower- and upper-body muscular strength, and/or handgrip strength in post-menopausal women and compared the results with control. Standardized mean differences (SMD), weighted mean differences (WMD), and 95% confidence intervals (95% CIs) were calculated using random effects models., Results: A total of 129 studies comprising 7,141 post-menopausal women with mean age and BMI ranging from ∼53 to 90 years and 22 to 35 kg/m
2 , respectively, were included in the meta-analysis. Overall, exercise training effectively increased CRF (SMD: 1.15; 95% CI: 0.87, 1.42; p = 0.001), lower-body muscular strength (SMD: 1.06; 95% CI: 0.90, 1.22; p = 0.001), upper-body muscular strength (SMD: 1.11; 95% CI: 0.91, 1.31; p = 0.001), and handgrip strength (WMD: 1.78 kg; 95% CI: 1.24, 2.32; p = 0.001) in post-menopausal women. These increments were found to be irrespective of ages and intervention durations. Regarding exercise type, aerobic, resistance, and combined training significantly increased CRF and lower-body muscular strength, while resistance and combined training effectively increased handgrip strength. However, only resistance training increased the upper-body muscular strength in women., Conclusion: Our findings suggest that exercise training is effective in increasing CRF and muscular strength in post-menopausal women, which might be cardioprotective. Both aerobic and resistance training alone or in combination increased CRF and lower-body muscular strength, but only resistance training increased upper-body strength in women., Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=283425, identifier: CRD42021283425., 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 Khalafi, Sakhaei, Habibi Maleki, Rosenkranz, Pourvaghar, Fang and Korivi.)- Published
- 2023
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40. ALK-positive histiocytosis involving the cavernous sinus: A deceptive radiologic mimic of meningioma.
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Alizadeh M, Ravindran A, Chkheidze R, Goyal G, Hosseini M, Shobeiri P, Shafieioun A, Khalafi M, Shahidi R, Sotoudeh H, and Singhal A
- Abstract
Anaplastic lymphoma kinase (ALK)-positive histiocytosis is an uncommon condition, recently considered a separate condition from other histiocytosis by WHO 5th edition. It can involve intracranial structures. This manuscript describes a case of ALK-positive histiocytosis of the cavernous sinus, focusing on the radiologic and pathologic presentation of the entity. Our case had MRI manifestations mimicking meningioma, metastasis, and Langerhans histiocytosis. On CT imaging, benign osseous remodeling of the cavernous sinus was detected, which can be helpful in differentiating it from more common meningioma., (© 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)
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- 2023
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41. Functional Magnetic Resonance Spectroscopy of Lactate in Alzheimer Disease: A Comprehensive Review of Alzheimer Disease Pathology and the Role of Lactate.
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Shirbandi K, Rikhtegar R, Khalafi M, Mirza Aghazadeh Attari M, Rahmani F, Javanmardi P, Iraji S, Babaei Aghdam Z, and Rezaei Rashnoudi AM
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- Humans, Magnetic Resonance Spectroscopy methods, Magnetic Resonance Imaging, Lactic Acid metabolism, Alzheimer Disease
- Abstract
Abstract: Functional 1H magnetic resonance spectroscopy (fMRS) is a derivative of dynamic MRS imaging. This modality links physiologic metabolic responses with available activity and measures absolute or relative concentrations of various metabolites. According to clinical evidence, the mitochondrial glycolysis pathway is disrupted in many nervous system disorders, especially Alzheimer disease, resulting in the activation of anaerobic glycolysis and an increased rate of lactate production. Our study evaluates fMRS with J-editing as a cutting-edge technique to detect lactate in Alzheimer disease. In this modality, functional activation is highlighted by signal subtractions of lipids and macromolecules, which yields a much higher signal-to-noise ratio and enables better detection of trace levels of lactate compared with other modalities. However, until now, clinical evidence is not conclusive regarding the widespread use of this diagnostic method. The complex machinery of cellular and noncellular modulators in lactate metabolism has obscured the potential roles fMRS imaging can have in dementia diagnosis. Recent developments in MRI imaging such as the advent of 7 Tesla machines and new image reconstruction methods, coupled with a renewed interest in the molecular and cellular basis of Alzheimer disease, have reinvigorated the drive to establish new clinical options for the early detection of Alzheimer disease. Based on the latter, lactate has the potential to be investigated as a novel diagnostic and prognostic marker for Alzheimer disease., Competing Interests: The authors declare no conflict of interest, (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2023
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42. Prevalence of positive findings of brain computed tomography scans in pediatric population.
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Jahanshahi A, Sadeghvand S, Khalafi M, Jafarzadeh A, and Zarrintan A
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Objectives: Computed tomography (CT) scans are used more frequently in medical centers, increasing unnecessary requests for it as a first-line evaluation. This study aimed to investigate the rate and prevalence of abnormal findings in a brain CT scan in children at the Children's Hospital of Tabriz, Iran., Materials &methods: This study was a cross-sectional descriptive-analytical study that included all children under 15 years old undergoing a brain CT scan at the Children's Hospital of Tabriz, Iran. All patients who fulfilled the inclusion criteria and were referred to the Children's Hospital of Tabriz during the spring of 2018 entered the study. Age, gender, patient history, and clinical findings were examined. In the next step, the results of each patient's CT scan were evaluated., Results: In this study, 108 patients were studied with a median age of 18.0 months. CT scan results were normal in seventy-four cases (68.5%), hydrocephalus was seen in 15 (13.9%), and benign infantile hydrocephalus was seen in eight (7.4%). The study revealed a statistically significant relationship between patient history and CT scan results (p=0.017). A statistically significant relationship was observed between the clinical findings and CT scan results (p=0.042)., Conclusion: Brain CT scans have more abnormal findings in patients with positive clinical findings. Although a CT scan is a highly sensitive and specificmodality in diagnosing central nervous system (CNS) abnormalities, its value depends on the underlying medical history and physical exam., Competing Interests: The authors declare no conflict of interest.
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- 2023
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43. The effects of camelina sativa oil and high-intensity interval training on liver function and metabolic outcomes in male type 2 diabetic rats.
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Kavyani Z, Dehghan P, Khani M, Khalafi M, and Rosenkranz SK
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Objectives: The purpose of this study was to evaluate the independent and combined effects of camelina sativa oil and high-intensity interval training (HIIT) on liver function, and metabolic outcomes in streptozotocin-induced diabetic rats., Methods: Forty male Wistar rats were randomly assigned to five equal groups (8 per group): Normal control (NC), diabetic control (DC), diabetic + camelina sativa oil (300 mg/kg by oral gavage per day; D + CSO), diabetic + HIIT (running on a treadmill 5 days/week for 8 weeks; D + HIIT), diabetic + camelina sativa oil + HIIT (D + CSO + HIIT)., Results: In all three intervention groups (D + CSO, D + HIIT, and D + CSO + HIIT) compared to the DC, hepatic TNF-α, MDA, and histopathology markers, decreased and hepatic PGC-1α, and PPAR-γ increased (p < 0.05). However, the effect of D + CSO was greater than D + HIIT alone. Hepatic TG decreased significantly in D + HIIT and D + CSO + HIIT compared to other groups ( p < 0.001). Fasting plasma glucose in all three intervention groups (D + CSO, D + HIIT, and D + CSO + HIIT) and HOMA-IR in D + CSO and D + CSO + HIIT were decreased compared to DC ( p < 0.001). Only hepatic TAC and fasting plasma insulin remained unaffected in the three diabetic groups ( p < 0.001). Overall, D + CSO + HIIT had the largest effect on all outcomes., Conclusions: At the doses and treatment duration used in the current study, combination of CSO and HIIT was beneficial for reducing liver function and metabolic outcomes other than CSO and HIIT alone., 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., (Copyright © 2023 Kavyani, Dehghan, Khani, Khalafi and Rosenkranz.)
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- 2023
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44. Exposure to Low Levels of Radiofrequency Electromagnetic Fields Emitted from Cell-phones as a Promising Treatment of Alzheimer's Disease: A Scoping Review Study.
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Shirbandi K, Khalafi M, J Bevelacqua J, Sadeghian N, Adiban S, Bahaeddini Zarandi F, Mortazavi SA, Mortazavi SH, Mortazavi SMJ, and S Welsh J
- Abstract
Background: Alzheimer's disease (AD) is one of the most significant public health concerns and tremendous economic challenges. Studies conducted over the past decades show that exposure to radiofrequency electromagnetic fields (RF-EMFs) may relieve AD symptoms., Objective: To determine if exposure to RF-EMFs emitted by cellphones affect the risk of AD., Material and Methods: In this review, all relevant published articles reporting an association of cell phone use with AD were studied. We systematically searched international datasets to identify relevant studies. Finally, 33 studies were included in the review. Our review discusses the effects of RF-EMFs on the amyloid β (Aβ), oxidative stress, apoptosis, reactive oxygen species (ROS), neuronal death, and astrocyte responses. Moreover, the role of exposure parameters, including the type of exposure, its duration, and specific absorption rate (SAR), are discussed., Results: Progressive factors of AD such as Aβ, myelin basic protein (MBP), nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, and neurofilament light polypeptide (NFL) were decreased. While tau protein showed no change, factors affecting brain activity such as glial fibrillary acidic protein (GFAP), mitogen-activated protein kinases (MAPKs), cerebral blood flow (CBF), brain temperature, and neuronal activity were increased., Conclusion: Exposure to low levels of RF-EMFs can reduce the risk of AD by increasing MAPK and GFAP and decreasing MBP. Considering the role of apoptosis in AD and the effect of RF-EMF on the progression of the process, this review indicates the positive effect of these exposures., Competing Interests: None, (Copyright: © Journal of Biomedical Physics and Engineering.)
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- 2023
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45. The impact of exercise and dietary interventions on circulating leptin and adiponectin in individuals who are overweight and those with obesity: A systematic review and meta-analysis.
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Khalafi M, Hossein Sakhaei M, Kheradmand S, Symonds ME, and Rosenkranz SK
- Subjects
- Humans, Adiponectin, Obesity, Exercise, Leptin, Overweight
- Abstract
The effects of exercise training (Ex), dietary interventions (DIs), and a combination of Ex and DI (Ex + DI) on leptin and adiponectin have been established. However, less is known regarding the comparisons of Ex with DI and of Ex + DI with either Ex or DI alone. The aim of the present meta-analysis is to compare the effects of Ex with those of DI and those of Ex + DI with those of either Ex or DI alone on circulating leptin and adiponectin in individuals who are overweight and those with obesity. PubMed, Web of Science, and MEDLINE were searched to identify original articles, published through June 2022, that compared the effects of Ex with those of DI and/or the effects of Ex + DI with those of Ex and/or DI on leptin and adiponectin in individuals with BMIs (in kg/m
2 ) of ≥25 and aged 7-70 y. Standardized mean differences (SMDs), weighted mean differences, and 95% CIs were calculated using random-effect models for outcomes. Forty-seven studies, comprising 3872 participants who were overweight and those with obesity, were included in the current meta-analysis. DI reduced the concentration of leptin (SMD: -0.30; P = 0.001) and increased the concentration of adiponectin (SMD: 0.23; P = 0.001) compared with Ex, as did Ex + DI (leptin: SMD: -0.34; P = 0.001; adiponectin: SMD: 0.37; P = 0.004) compared with Ex alone. However, Ex + DI did not affect the concentration of adiponectin (SMD: 0.10; P = 0.11) and led to inconsistent and nonsignificant changes in the concentration of leptin (SMD: -0.13; P = 0.06) compared with DI alone. Subgroup analyses showed that age, BMI, duration of intervention, type of supervision, quality of the study, and magnitude of energy restriction are sources of heterogeneity. Our results suggest that Ex alone was not as effective as DI or Ex + DI for decreasing leptin and increasing adiponectin in individuals with overweight and obesity. However, Ex + DI was not more effective than DI alone, suggesting that diet plays a critical role in beneficially altering the concentrations of leptin and adiponectin. This review was registered at PROSPERO as CRD42021283532., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)- Published
- 2023
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46. A comparison of the impact of exercise training with dietary intervention versus dietary intervention alone on insulin resistance and glucose regulation in individual with overweight or obesity: a systemic review and meta-analysis.
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Khalafi M, Azali Alamdari K, Symonds ME, Rohani H, and Sakhaei MH
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- Humans, Overweight, Glucose, Obesity, Body Weight, Insulin, Exercise, Blood Glucose, Insulin Resistance, Diabetes Mellitus, Type 2 prevention & control
- Abstract
Purpose: Obesity is associated with the development of insulin resistance (IR) and type 2 diabetes for which exercise training (Ex) and dietary interventions (DI) are effective interventions that can improve IR. We therefore performed a systematic meta-analysis to compare the effect of Ex + DI compared with DI on IR and glucose homeostasis., Methods: PubMed and Cochrane Library were conducted up to May 2021. Meta-analyses were conducted to compare the effect of Ex + DI compared with DI on fasting glucose and insulin, IR and body weight. Standardized mean differences (SMDs), weighted mean differences (WMD) and 95% confidence intervals (95% CIs) were computed using random or fixed effect models., Results: Fifty studies involving 2864 participants with overweight or obesity were included in the meta-analysis. Ex + DI caused a larger decrease in fasting glucose ( p = 0.001, 62 trials) and IR ( p = 0.01, 29 trials) when compared with DI alone. There was no significant evidence, however, for a greater effect of Ex + DI on fasting insulin (p = 0.07, 48 trials) and body weight ( p = 0.12, 58 trials), compared with DI alone., Conclusion: Our results suggest that a combination of Ex and DI may be more effective than DI alone at improving IR and fasting glucose in individuals with overweight and obesity.
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- 2023
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47. The impact of high-intensity interval training on vascular function in adults: A systematic review and meta-analysis.
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Khalafi M, Sakhaei MH, Kazeminasab F, Symonds ME, and Rosenkranz SK
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Aim: We performed a systematic review and meta-analysis to investigate the effects of high-intensity interval training (HIIT) compared with moderate-intensity continuous training (MICT) or with no exercise (CON) on vascular function in adults who were free of cardiometabolic diseases and those with cardiometabolic diseases., Methods: A search across three electronic databases including Scopus, PubMed, and Web of Science was conducted through February 2022 to identify the randomized trials evaluating HIIT vs. MICT and/or CON on vascular function as measured using brachial artery flow-mediated dilation (FMD) in adults. Separate analyses were conducted for HIIT vs. MICT and/or CON to calculate weighted mean differences (WMD) and 95% confidence intervals (95% CIs) using random or fixed models., Results: A total of 36 studies involving 1,437 participants who were either free of cardiometabolic diseases or had cardiometabolic diseases were included in the meta-analysis. HIIT effectively increased FMD when compared with MICT [1.59% (95% CI 0.87-2.31), p = 0.001] or CON [3.80% (95% CI 2.58-5.01), p = 0.001]. Subgroup analysis showed that HIIT increased FMD in participants with cardiovascular and metabolic diseases, but not in participants who were free of cardiometabolic diseases. In addition, HIIT effectively increased FMD regardless of age and body mass index., Conclusion: We confirm that HIIT is effective for improving vascular function in individuals with metabolic disorders and cardiovascular diseases and has a superior effect compared to MICT, demonstrating time efficiency., Systematic Review Registration: [https://www.crd.york.ac.uk/prospero], identifier [CRD42022320863]., 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., (Copyright © 2022 Khalafi, Sakhaei, Kazeminasab, Symonds and Rosenkranz.)
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- 2022
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48. Impact of concurrent training versus aerobic or resistance training on cardiorespiratory fitness and muscular strength in middle-aged to older adults: A systematic review and meta-analysis.
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Khalafi M, Sakhaei MH, Rosenkranz SK, and Symonds ME
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- Aged, Aged, 80 and over, Exercise Therapy, Humans, Middle Aged, Muscle Strength, Cardiorespiratory Fitness, Resistance Training methods
- Abstract
The effects of aerobic training (AT) on cardiorespiratory fitness (CRF), and resistance training (RT) on muscular strength, are well known in older adults. However, less is known about the potential additive benefits of concurrent training (CT) versus AT or RT alone in this population. We conducted a systematic review and meta-analysis to investigate the effects of CT, versus AT or RT, on CRF and muscular strength in middle-aged to older adults. PubMed and Web of Science were searched through October 2021 to identify randomized trials evaluating CT versus AT and/or RT in middle-aged and older adults (>50 yrs). Studies were included that measured CRF, using maximal or peak oxygen uptake (VO
2max/peak ); and/or lower- and upper-body muscular strength measured using 1-repetition maximum (1RM) to 10RM tests during isoinertial contractions, or peak torque during isometric dynamometry or isokinetic dynamometry at 30 to 60°/s. Standardized mean differences (SMD) and 95% confidence intervals (95% CIs) were determined using random or fixed effects models. Forty-nine studies involving 2,587 middle-aged to older participants with mean ages ranging from 55 to 88 years, were included in the meta-analysis. Results indicated that CT effectively increased VO2max/peak (SMD: 0.77, p = 0.005, 12 intervention arms) when compared to RT. In addition, CT effectively increased lower- (SMD: 0.60, p = 0.001, 43 intervention arms) and upper-body (SMD: 0.57, p = 0.001, 28 intervention arms) muscular strength when compared to AT. However, there were no differences in VO2max/peak (SMD: 0.09, p = 0.09, 33 intervention arms) between CT and AT, or in lower-body (SMD: 0.07, p = 0.48, 21 intervention arms) and upper-body (SMD: -0.07, p = 0.38, 17 intervention arms) muscular strength between CT and RT. Overall, CT was shown to be effective for increasing CRF and muscular strength in middle-aged to older adults and there was no negative effect on the magnitude of changes in these outcomes compared to either AT or RT alone. These results suggested that CT should be considered a viable strategy to improvement of CRF and muscular strength with aging., (Copyright © 2022. Published by Elsevier Inc.)- Published
- 2022
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49. High-intensity interval exercise versus moderate-intensity continuous exercise on postprandial glucose and insulin responses: A systematic review and meta-analysis.
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Khalafi M, Mojtahedi S, Ostovar A, Rosenkranz SK, and Korivi M
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- Adult, Blood Glucose metabolism, Child, Exercise physiology, Glucose, Humans, Postprandial Period physiology, High-Intensity Interval Training, Insulin
- Abstract
We performed a meta-analysis to investigate the effects of high-intensity interval exercise (HIIE) as compared to moderate-intensity exercise (MIE) and a control condition (CON) on postprandial glucose (PPG) and insulin (PPI) responses. PubMed, Web of Science, and Scopus were comprehensively searched to identify relevant studies until October 2021. Separate analyses were conducted for HIIE versus MIE and HIIE versus CON. A total of 30 studies comprising 36 intervention arms and involving 467 participants (350 adults) were included in the meta-analysis. HIIE reduced PPG and PPI when compared with CON. Based on subgroup analyses, reductions in PPG and PPI were significant for both children and adult participants, as well as for healthy participants and participants with metabolic disorders, with larger effects in those with metabolic disorders. There were no significant differences between HIIE and MIE for PPG or PPI. However, when comparing studies matched for total work performed, HIIE was more effective for decreasing PPG as compared with MIE. HIIE is effective for reducing PPG and PPI in both children and adult participants, particularly in those with metabolic disorders. In addition, HIIE has superior effects for reducing PPG as compared with MIE, when equivalent work was performed at both intensity levels., (© 2022 World Obesity Federation.)
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- 2022
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50. The impact of high-intensity interval training on postprandial glucose and insulin: A systematic review and meta-analysis.
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Khalafi M, Ravasi AA, Malandish A, and Rosenkranz SK
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- Blood Glucose, Glucose, Humans, Insulin, Insulin, Regular, Human, High-Intensity Interval Training methods
- Abstract
Aims: We performed a systematic review and meta-analysis to investigate the effects of high-intensity interval training (HIIT) on postprandial glucose (PPG) and insulin (PPI) versus non-exercise control and moderate-intensity continuous training (MICT) in participants with both normal and impaired glucose., Methods: The PubMed, Scopus, and Web of Science electronic databases were searched up to October 2021 for randomized trials evaluating HIIT versus control and/or versus MICT on glucose and insulin AUC using oral glucose tolerance testing. Subgroup analyses based on intervention duration (short-duration < 8 weeks, moderate-duration ≥ 8 weeks), baseline glucose levels (normal glucose and impaired glucose) and type of HIIT (L-HIIT and SIT) were also conducted across included studies., Results: A total of 25 studies involving 870 participants were included in the current meta-analysis. HIIT effectively reduced glucose [-0.37 (95% CI -0.60 to -0.13), p = 0.002] and insulin [-0.36 (95% CI -0.68 to -0.04), p = 0.02] AUC when compared with a CON group. Reductions in glucose AUC were significant for those with impaired glucose at baseline (p = 0.03), but not for those with normal glucose levels (p = 0.11) and following moderate-duration (p = 0.01), but not short-duration interventions (p = 0.18). However, there were no differences in glucose (p = 0.76) or insulin (p = 0.43) AUC between HIIT and MICT intervention arms., Conclusions: Our results demonstrated that both HIIT and MICT are effective for reducing postprandial glycemia and insulinemia, particularly by moderate-duration interventions, and in those with impaired glucose., (Copyright © 2022 Elsevier B.V. All rights reserved.)
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- 2022
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