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Abstract Introduction The outbreak of cardiovascular disease (CVD) augments with age. Gut dysbiosis can worsen or initiate systemic disorders such as metabolic diseases and CVDs. Therefore, this research aimed to assess the effect of kefir fortified with Lactobacillus helveticus R0052 and Bifidobacterium longum R017 on CVD risk factors in the elderly population. The subjects of this study were selected from the Motahari Clinic in Shiraz, Iran. Method This study was a double-blind, randomized, and controlled clinical trial that was conducted on 67 elderly people who were randomly divided into two groups: the fortified kefir group (n = 32), which received one bottle of fortified kefir (240 cc), and the placebo group (n = 35), which received one bottle of regular kefir for eight weeks. To analyze the data, SPSS software was applied. Results After eight weeks, significant differences were seen in atherogenic and Castell’s risk index I between the fortified and regular groups (p = 0.048 and p = 0.048, respectively). No significant differences were found in Castelli’s risk index II, high-density lipoprotein cholesterol (HDL-C), total cholesterol, triglycerides (TG), non-HDL-C, TG-cholesterol index, and fasting blood sugar by comparing the two groups. Conclusion Our investigation demonstrated that fortified kefir with probiotics did not significantly affect lipid profiles. Still, it could significantly affect some indices, including Castelli’s risk index I and atherogenic index. More studies are required to confirm the findings and mechanisms of probiotics’ effect on CVD risk factors. Trial number The present registered at the Iranian Registry of Clinical Trials (IRCT20130227012628N3) at 2023-02-21.

The city of Tabriz, which has the fastest urban growth in the northwest of the country, is one of the largest cities in Iran in terms of population, economic activity, industry and transportation options. Public transportation and industry combustion and lack of proper filtration of these industries, such as thermal power plants, has led to increased air pollution in the city. For this purpose, the present study tries to use input variables (distance from industrial centers, humidity, temperature, population density, distance from commercial centers, distance from bus stations, distance from educational centers, vegetation changes, distance from free Roads, building density, wind direction, carbon dioxide and carbon monoxide) to assess air pollution using artificial neural networks in the metropolis of Tabriz. In the present study, the independent variables affecting the distribution of pollution probability in two models of multilayer perceptron neural network (MLP) and linear regression were tried to be defined by defining measures in urban management and influencing and planning the mentioned variables.‌Improve pollution control.The results show that the major pollutants are mostly suspended particles (PM10), gas (CO2), (SO2) and (NOx).The dispersion of airborne particles is mostly‌due to vehicle traffic, industrial activities, fuel combustion of diesel engines and construction and the need to generate more electricity.-The activities of thermal power plants, Tabriz refinery and domestic and commercial heating systems are also among the factors producing SO2 and the highest CO2 production is related to the fuel of gasoline-burning vehicles.‌The intensity of the increase in the amount of this pollutant in all selected stations in the autumn and winter seasons is much higher, so that in these seasons the pollutants reach more than twice the allowable level.The share of Tabriz air pollutants can be divided into three general categories, the most important of which is the thermal power plant and transportation.

Overweight and obesity are associated with an increased risk of cardiovascular disease, hypertension and type 2 diabetes. The purpose of this study was to determine the effect of two continuous aerobic training and high-intensity interval training on body weight, body mass index, waist to hip ratio, and body fat percentage in overweight and obese military people. In this quasi-experimental study, 30 overweight or obese military personnel stationed in a military center were divided into two equal groups of 15 subjects within continuous aerobic training group and high-intensity interval training group. The training protocol consisted of six weeks of continuous aerobic training and high intensity interval training performed every week for three sessions and each session for 60 minutes with equal intensity. The research variables included body weight, body mass index, waist to hip ratio and body fat percentage, which were measured in the same and standard conditions in two stages of pre-test and post-test. After 6 weeks of intervention, high-intensity interval training group showed a significant reduction in body mass index, waist-hip ratio and body fat percentage compared to the continuous aerobic training group(P

Abstract Background A large number of studies have investigated the association of the Mediterranean and DASH diets with psychological health as well as sleep related outcomes. However, only a few number of studies have examined the association of their newly proposed hybrid, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) dietary pattern, with sleep quality and sleep related outcomes. Methods This cross-sectional study was conducted on 400 male health professions (mean age 38.67 years). Dietary information was collected using a validated 168-item semi-quantitative food frequency questionnaire. The MIND score was computed based on major dietary components emphasized or minimized in this pattern. The higher the MIND score of a subject, the greater his adherence to the MIND pattern. Mental health was evaluated using the 21-item depression, anxiety, and stress scale (DASS-21). Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Sleep-related outcomes (day-time sleepiness and insomnia) were also evaluated using standard questionnaires Results No significant associations were found between adherence to the MIND diet score and odds of stress, anxiety and depression either in the crude or multivariable-adjusted models (P > 0.05). Nevertheless, participants with the greatest adherence to the MIND diet had lower odds of poor sleep quality (OR for T3 vs. T1: 0.56 (95% CI: 0.34, 0.92), P-trend = 0.023). The results remained significant after full adjustment for confounding variables (P-trend = 0.042). Participants in the highest tertile of MIND diet had a 42% lower odds of daytime sleepiness in the crude and multivariable-adjusted model (P-trend

Background: Due to long-term use of computers and not maintaining the correct position and angle of the body while working with it, various skeletal and muscular problems and pain in the neck area occurs. This study aims to use a biofeedbck system to alert the computer users of an inappropriate angle of their necks, and as a result help them to establish a correct neck position. Method: The user's neck angle is measured using a three dimensional accelerometer and the signal is processed, digitalized, and sent to the computer. User friendly software is designed to process the received data and warn the users when their neck angle is inappropriate. Results: The results show that the application of the biofeedback system reduces the users' total time with inappropriate neck angle to

This paper proposes an efficient path planning technique for the autonomous collision-free navigation of wheeled mobile robots with simple hardware based on an adaptive neuro-fuzzy inference system (ANFIS). The distance between the robot and obstacles is measured using three ultrasonic sensors that are installed on the left, front, and right of the robot. These distances from the sensors form the inputs to the ANFIS-utility function block that calculates an obstacle avoidance steering angle for the robot. The obstacle avoidance behavior of the robot is modeled under six scenarios of facing an obstacle. The instantaneous position of the robot and the target are available from Global Positioning System (GPS) modules. A simulation mobile robot in V-REP has been integrated into the ANFIS controller coded in MATLAB. The simulation results show that the proposed ANFIS-utility function-based path planning technique surpasses some of the related algorithms in terms of finding near-optimal paths.

Oxidative stress and inflammation are the key players in neuroinflammation, in which microglia dysfunction plays a central role. Previous studies suggest that argan oil attenuates oxidative stress, inflammation, and peroxisome dysfunction in mouse brains. In this study, we explored the effects of two major argan oil (AO) phytosterols, Schottenol (Schot) and Spinasterol (Spina), on oxidative stress, inflammation, and peroxisomal dysfunction in two murine microglial BV-2 cell lines, wild-ype (Wt) and Acyl-CoA oxidase 1 (Acox1)-deficient cells challenged with LPS treatment. Herein, we used an MTT test to reveal no cytotoxicity for both phytosterols with concentrations up to 5 µM. In the LPS-activated microglial cells, cotreatment with each of these phytosterols caused a significant decrease in intracellular ROS production and the NO level released in the culture medium. Additionally, Schot and Spina were able to attenuate the LPS-dependent strong induction of Il-1β and Tnf-α mRNA levels, as well as the iNos gene and protein expression in both Wt and Acox1−/− microglial cells. On the other hand, LPS treatment impacted both the peroxisomal antioxidant capacity and the fatty acid oxidation pathway. However, both Schot and Spina treatments enhanced ACOX1 activity in the Wt BV-2 cells and normalized the catalase activity in both Wt and Acox1−/− microglial cells. These data suggest that Schot and Spina can protect cells from oxidative stress and inflammation and their harmful consequences for peroxisomal functions and the homeostasis of microglial cells. Collectively, our work provides a compelling argument for the protective mechanisms of two major argan oil phytosterols against LPS-induced brain neuroinflammation.

Software development paradigms help a software developer to select appropriate strategies to develop software projects. They include various methods, procedures, and tools to describe and define the software development life cycle (SDLC). The waterfall and iterative models are two useful development paradigms, which have been used by various software developers in the last decades. This paper proposes a new software development methodology, called waterative model, which applies an integration of the waterfall and iterative development paradigms. In this model, the iterative model is embedded into the waterfall model to use the advantages of both models as an integrated one. It, in the most cases, is appropriate for large software products that need a long-term period of time for the development process. Experimental results demonstrate that the customer satisfaction score could be high by using the proposed model in various software projects.

Background and Objective: A basic intervention to reduce prevalence of the disease is educating healthy lifestyle particularly for those who are at risk. Present study aimed to assess the effectiveness of two methods of in-situ training and text messaging on blood pressure and lifestyle in a number of military forces susceptible to hypertension. Methods: Using a quasi-experimental study, 100 individuals from military forces were randomly assigned to either in-situ training or text messaging groups. Initial assessment on systolic and diastolic blood pressure as well as lifestyle, body mass index, and physical activity were conducted. Then both groups experienced an educational intervention either by in-situ training or text messaging. Three months after the intervention all variables were assessed again and the data were analyzed by student t-test and Chi-square statistical tests. Results: Systolic blood pressures in average revealed a significant reduction in both groups after intervention compared to baseline. Variables such as weight, body mass index, and physical activity improved in both groups after intervention. Although, the lifestyle total score changed considerably in both groups, in the text-messaging group there was no notable change in domains including health responsibility, spiritual growth, and interpersonal relationships. Conclusion: Text messaging to somewhat may be effective as well as in-situ training to change some health related behaviors and consequently be resulted in blood pressure control.

Background: Dietary quality indices are practical as an instrument to investigate the extent of adhering to a special diet to prevent cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM). Considering the lack of any systematic review with regards to this issue, our aim was to examine observational studies to test the relationship between dietary quality indices and CVD risk factors in T2DM. Methods: Systematic search was performed in Web of knowledge, PubMed, Cochrane, Science direct, Google Scholar and Scopus databases from January 1990 to July 2020. The studies exploring the relationship between dietary quality indices (diet quality score (DQS), dietary diversity score (DDS), healthy diet indicator (HDI), healthy eating index (HEI), diet quality index (DQI), Mediterranean diet score (MDS)) and lipid profile, anthropometric indices, glucose profile as well as blood pressure were eligible to be included in this review. Overall, mean changes, odd ratio (RR), correlation coefficients, and beta coefficient of outcomes were extracted, with the quality assessment of studies performed applying The Newcastle-Ottawa scale. Results: From among 1627 papers, 10 articles were included: Eight cross-sectional and two prospective (cohort) studies. The association between HEI as well as MDS and CVD risk factors was more evident in the included studies. Fasting blood sugar, hemoglobin A1c, body mass index, and waist circumference revealed the greatest inverse significant relationship with dietary quality indices in adults with T2DM. Conclusion: Overall, the findings of this study suggest that the level of CVD risk factors in T2DM decreases significantly with increase in the score of dietary quality indices. Further studies in future are required to confirm these findings.

Aging is characterized by a progressive increase in oxidative stress, which favors lipid peroxidation and the formation of cholesterol oxide derivatives, including 7β-hydroxycholesterol (7β-OHC). This oxysterol, which is known to trigger oxidative stress, inflammation, and cell death, could contribute to the aging process and age-related diseases, such as sarcopenia. Identifying molecules or mixtures of molecules preventing the toxicity of 7β-OHC is therefore an important issue. This study consists of determining the chemical composition of Tunisian Pistacia lentiscus L. seed oil (PLSO) used in the Tunisian diet and evaluating its ability to counteract the cytotoxic effects induced by 7β-OHC in murine C2C12 myoblasts. The effects of 7β-OHC (50 µM; 24 h), associated or not with PLSO, were studied on cell viability, oxidative stress, and on mitochondrial and peroxisomal damages induction. α-Tocopherol (400 µM) was used as the positive control for cytoprotection. Our data show that PLSO is rich in bioactive compounds; it contains polyunsaturated fatty acids, and several nutrients with antioxidant properties: phytosterols, α-tocopherol, carotenoids, flavonoids, and phenolic compounds. When associated with PLSO (100 µg/mL), the 7β-OHC-induced cytotoxic effects were strongly attenuated. The cytoprotection was in the range of those observed with α-tocopherol. This cytoprotective effect was characterized by prevention of cell death and organelle dysfunction (restoration of cell adhesion, cell viability, and plasma membrane integrity; prevention of mitochondrial and peroxisomal damage) and attenuation of oxidative stress (reduction in reactive oxygen species overproduction in whole cells and at the mitochondrial level; decrease in lipid and protein oxidation products formation; and normalization of antioxidant enzyme activities: glutathione peroxidase (GPx) and superoxide dismutase (SOD)). These results provide evidence that PLSO has similar antioxidant properties than α-tocopherol used at high concentration and contains a mixture of molecules capable to attenuate 7β-OHC-induced cytotoxic effects in C2C12 myoblasts. These data reinforce the interest in edible oils associated with the Mediterranean diet, such as PLSO, in the prevention of age-related diseases, such as sarcopenia.

Mobile robots are endeavoring toward full autonomy. To that end, wheeled mobile robots have to function under non-holonomic constraints and uncertainty derived by feedback sensors and/or internal dynamics. Speed control is one of the main and challenging objectives in the endeavor for efficient autonomous collision-free navigation. This paper proposes an intelligent technique for speed control of a wheeled mobile robot using a combination of fuzzy logic and supervised machine learning (SML). The technique is appropriate for flexible leader-follower formation control on straight paths where a follower robot maintains a safely varying distance from a leader robot. A fuzzy controller specifies the ultimate distance of the follower to the leader using the measurements obtained from two ultrasonic sensors. An SML algorithm estimates a proper speed for the follower based on the ultimate distance. Simulations demonstrated that the proposed technique appropriately adjusts the follower robot’s speed to maintain a flexible formation with the leader robot.

The Mediterranean diet is associated with health benefits due to bioactive compounds such as polyphenols. The biological activities of three polyphenols (quercetin (QCT), resveratrol (RSV), apigenin (API)) were evaluated in mouse neuronal N2a cells in the presence of 7-ketocholesterol (7KC), a major cholesterol oxidation product increased in patients with age-related diseases, including neurodegenerative disorders. In N2a cells, 7KC (50 µM; 48 h) induces cytotoxic effects characterized by an induction of cell death. When associated with RSV, QCT and API (3.125; 6.25 µM), 7KC-induced toxicity was reduced. The ability of QCT, RSV and API to prevent 7KC-induced oxidative stress was characterized by a decrease in reactive oxygen species (ROS) production in whole cells and at the mitochondrial level; by an attenuation of the increase in the level and activity of catalase; by attenuating the decrease in the expression, level and activity of glutathione peroxidase 1 (GPx1); by normalizing the expression, level and activity of superoxide dismutases 1 and 2 (SOD1, SOD2); and by reducing the decrease in the expression of nuclear erythroid 2-like factor 2 (Nrf2) which regulates antioxidant genes. QCT, RSV and API also prevented mitochondrial dysfunction in 7KC-treated cells by counteracting the loss of mitochondrial membrane potential (ΨΔm) and attenuating the decreased gene expression and/or protein level of AMP-activated protein kinase α (AMPKα), sirtuin 1 (SIRT1) and peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) implicated in mitochondrial biogenesis. At the peroxisomal level, QCT, RSV and API prevented the impact of 7KC by counteracting the decrease in ATP binding cassette subfamily D member (ABCD)3 (a peroxisomal mass marker) at the protein and mRNA levels, as well as the decreased expresssion of genes associated with peroxisomal biogenesis (Pex13, Pex14) and peroxisomal β-oxidation (Abcd1, Acox1, Mfp2, Thiolase A). The 7KC-induced decrease in ABCD1 and multifunctional enzyme type 2 (MFP2), two proteins involved in peroxisomal β-oxidation, was also attenuated by RSV, QCT and API. 7KC-induced cell death, which has characteristics of apoptosis (cells with fragmented and/or condensed nuclei; cleaved caspase-3; Poly(ADP-ribose) polymerase (PARP) fragmentation) and autophagy (cells with monodansyl cadaverine positive vacuoles; activation of microtubule associated protein 1 light chain 3–I (LC3-I) to LC3-II, was also strongly attenuated by RSV, QCT and API. Thus, in N2a cells, 7KC induces a mode of cell death by oxiapoptophagy, including criteria of OXIdative stress, APOPTOsis and autoPHAGY, associated with mitochondrial and peroxisomal dysfunction, which is counteracted by RSV, QCT, and API reinforcing the interest for these polyphenols in prevention of diseases associated with increased 7KC levels.

The brain, which is a cholesterol-rich organ, can be subject to oxidative stress in a variety of pathophysiological conditions, age-related diseases and some rare pathologies. This can lead to the formation of 7-ketocholesterol (7KC), a toxic derivative of cholesterol mainly produced by auto-oxidation. So, preventing the neuronal toxicity of 7KC is an important issue to avoid brain damage. As there are numerous data in favor of the prevention of neurodegeneration by the Mediterranean diet, this study aimed to evaluate the potential of a series of polyphenols (resveratrol, RSV; quercetin, QCT; and apigenin, API) as well as ω3 and ω9 unsaturated fatty acids (α-linolenic acid, ALA; eicosapentaenoic acid, EPA; docosahexaenoic acid, DHA, and oleic acid, OA) widely present in this diet, to prevent 7KC (50 µM)-induced dysfunction of N2a neuronal cells. When polyphenols and fatty acids were used at non-toxic concentrations (polyphenols: ≤6.25 µM; fatty acids: ≤25 µM) as defined by the fluorescein diacetate assay, they greatly reduce 7KC-induced toxicity. The cytoprotective effects observed with polyphenols and fatty acids were comparable to those of α-tocopherol (400 µM) used as a reference. These polyphenols and fatty acids attenuate the overproduction of reactive oxygen species and the 7KC-induced drop in mitochondrial transmembrane potential (ΔΨm) measured by flow cytometry after dihydroethidium and DiOC6(3) staining, respectively. Moreover, the studied polyphenols and fatty acids reduced plasma membrane permeability considered as a criterion for cell death measured by flow cytometry after propidium iodide staining. Our data show that polyphenols (RSV, QCT and API) as well as ω3 and ω9 unsaturated fatty acids (ALA, EPA, DHA and OA) are potent cytoprotective agents against 7KC-induced neurotoxicity in N2a cells. Their cytoprotective effects could partly explain the benefits of the Mediterranean diet on human health, particularly in the prevention of neurodegenerative diseases.

Background: This study aimed to determine whether motivational interviewing (MI) could change dietary habit and body mass index (BMI) in obese/overweight women. Methods: A cluster-randomized controlled study was performed in four health centers in Qazvin, central Iran. In total, 327 obese/overweight women were selected by a multi-stage sampling method and randomly assigned into control and experimental groups. Food frequency (using questionnaire; FFQ), BMI, and metabolic markers including blood pressure, total serum cholesterol and fasting blood glucose levels were measured in all participants. Data were collected twice (before and one year after the MI interventions). Data were analyzed using student t-test, and Stepwise Linear Regression. Results: There was a significant increase in daily consumption of dietary fiber, whole grain products, fruits and vegetables in the MI group (P

Nano packaging is currently one of the most important topics in food packaging technologies. The aim of the application of this technology in food packaging is increasing shelf life of foods by preventing internal and external corruption and microbial contaminations. Use of silver nanoparticles in food packaging has recently attracted much attention. The aim of this study was to investigate the effect of nano-silver packaging in increasing the shelf life packages of nuts in an In vitro model. In this experimental study, the effects of different nano-silver concentrations (0, 1, 2 and 3 percent) on biological and chemical properties of 432 samples of nuts including walnuts, hazelnuts, almonds and pistachios were evaluated during 0, 3, 6, 9, 12, 15, 18, 21 and 24 months. In most samples, different concentrations of nano-silver (1, 2 and 3 %) significantly reduced total microbial count, mold and coliform counts compared to control group and the 3% nano-silver concentration was more effective than other concentrations (P

Background and Objectives: There is convincing evidence that subjects concomitantly affected by type 2 diabetes (T2D) and metabolic syndrome (MeS) are at greater risk for cardiovascular disease (CVD). Many metabolic derangements in T2D might be attributed to poor vitamin D status. The purpose of this study was to investigate the associations among vitamin D status, MeS and glycemic status in subjects with T2D. Materials and Methods: A total of 101 known cases of T2D (39 males, 62 females) were enrolled in a cross-sectional study by convenient sampling. Serum 25(OH)D3, glycemic markers and lipid profile were assessed. Results: Mean concentration of serum 25(OH)D3 was 42.2±33.8 nmol/L. Prevalence of undesirable vitamin D status (25(OH)D < 50nmol/L) was significantly higher among the subjects with MeS as compared to those without MeS (p=0.020). The subjects with sufficient vitamin D status had 50% lower risk for MeS compared to those who had vitamin D deficiency, and this association remained significant even after additional adjustment for body mass index (BMI), percent of fat mass or waist circumference. Conclusions: Our data showed that firstly higher vitamin D status is inversely associated with fasting glycemia, and secondly serum 25(OH)D3 predicts MeS risk in the subjects with T2D. Demonstrating the association of hypovitaminosis D with disorders of glucose metabolism and higher risk for development of further complications, notably CVD, may lead to a new target for preventive efforts at the population level. Keywords: Vitamin D, Type 2 diabetes, Metabolic syndrome, Cardiovascular disease

A Wireless Sensor Network (WSN) is a collection of low-cost, low-power and large-scale wireless sensor nodes. Routing protocols are an important topic in WSN. Every sensor node should use a proper mechanism to transmit the generated packets to its destination, usually a base station. In previous works, routing protocols use the global information of the network that causes the redundant packets to be increased. Moreover, it leads to an increase in the network traffic, to a decrease in the delivery ratio of data packets, and to a reduction in network life. In this paper, we propose a new inferential routing protocol called SFRRP (Static Three-Dimensional Fuzzy Routing based on the Receiving Probability). The proposed protocol solves the above mentioned problems considerably. The data packets are transmitted by hop-to-hop delivery to the base station. It uses a fuzzy procedure to transmit the sensed data or the buffered data packets to one of the neighbors called selected node. In the proposed fuzzy system, the distance and number of neighbors are input variables, while the receiving probability is the output variable. SFRRP just uses the local neighborhood information to forward the packets and is not needed by any redundant packet for route discovery. The proposed protocol has some advantages such as a high delivery ratio, less delay time, high network life, and less network traffic. The performance of the proposed protocol surpasses the performance of the Flooding routing protocol in terms of delivery ratio, delay time and network lifetime.

Introduction & Objective: High prevalence of vitamin D insufficiency in Iran calls for a reliable assessment of vitamin D status for diagnostic, research as well as public health purposes. Circulating level of 25(OH)D has been generally accepted as a reliable indicator of vitamin D status. HPLC-based analyses are considered as standard methods for 25(OH)D assays. The aim of this study was to set up a precise, reliable and rather simple HPLC-based method to determine serum levels of 25(OH)D using ultra violet detector. Materials & Methods: Serum proteins were precipitated using ethanol and then methanol: iso-propanol (90:10, v/v). 25(OH)D was then extracted using hexane, which was then evaporated under nitrogen flow. The sediment reconstituted in methanol was further filtered. Finally, 20μL of the filtrate was injected to the column, teknochroma tracer excel 150×4, 3 μm. Chromatography was run with the mobile phase of methanol:water (85:15, v/v) containing 0.01% BHT at the column temperature 40°C. The vitamers 25(OH)D3 and 25(OH)D2 were detected at 265nm. For further evaluation of the method, 90 human serum samples were analyzed for 25(OH)D using HPLC, competitive protein binding assay (CPBA) and radioimmunoassay (RIA). The degree of agreement between those three methods was evaluated using coefficient of correlation and Bland-Altman analysis. Results: Retention times of 25(OH)D3 and 25(OH)D2 were 9.5 and 10.7 min, respectively. Standard curves of both vitamers showed linearity up to 375 nmol/L (D3) and 187.5 nmol/L (D2). Recovery percents for 25(OH)D3 and 25(OH)D2 were found 101±5% and 100.8±5.4%, respectively. Intra- and inter-assay variations for 25(OH)D3 were 8.1% and 12.6%, respectively. The results of RIA and CPBA were significantly higher than those of HPLC (p=0.02). RIA, compared to CPBA, showed more agreement with HPLC. Conclusion: The new HPLC method for serum 25(OH)D determination is reliable and rather fast with the advantage of detecting both 25(OH)D2 and 25(OH)D3.

The development of cataract is associated with some lipid changes in human lens fibers, especially with increased accumulation and redistribution of cholesterol inside these cells. Some direct and indirect lines of evidence, also suggest an involvement of cholesterol oxide derivatives (also named oxysterols) in the development of cataract. Oxysterol formation can result either from nonenzymatic or enzymatic processes, and some oxysterols can induce a wide range of cytotoxic effects (overproduction of reactive oxygen species (ROS); phospholipidosis) which might contribute to the initiation and progression of cataract. Thus, the conception of molecules capable of regulating cholesterol homeostasia and oxysterol levels in human lens fibers can have some interests and constitute an alternative to surgery at least at early stages of the disease.

Background: This study compared the rate of thromboembolic events during carotid angioplasty and stenting (CAS) with and without embolic protection devices (EPDs). We reviewed literature to find studies comparing embolic event rates during CAS with and without EPDs and conducted a meta-analysis to determine the safer approach. Methods: The Embase, PubMed, and Web of Science databases were thoroughly searched following PRISMA guidelines. Each estimation was executed using random-effects models. The I2 index was used to assess the heterogeneity among the studies. Egger and Begg’s tests were applied to evaluate publication bias. Stata version 14.2 was used for statistical analysis. Results: For 25% of patients, an EPD was used during CAS, and for 75% it was not. Of the patients undergoing CAS, the prevalences of hypertension, diabetes mellitus, coronary artery disease, and cigarette smoking were 81%, 37%, 39% and 43%, respectively. In total, of the patients included 52% were symptomatic and 48% were asymptomatic. The mortality rate reduced from 2% in the no-EPD subgroup to 1% in the EPD subgroup. The occurrence of all other complications was also reportedly higher in patients who did not receive an EPD, including major stroke and myocardial infarction, except for minor events, which were reported to be almost the same in both subgroups. Conclusions: We found that the use of an EPD can help reduce the occurrence of thromboembolic complications of CAS, including myocardial infarction, major stroke, and death. Altogether, our results suggest that the benefits of using an EPD during CAS outweigh its risks.