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In our previous work, we introduced a method that combines two unsupervised algorithms: Density-based spatial clustering of applications with noise (DBSCAN) and Gaussian mixture model (GMM). We applied this method to 12 open clusters based on Gaia Early Data Release 3 (EDR3) data, demonstrating its effectiveness in identifying reliable cluster members within the tidal radius. However, for studying cluster morphology, we need a method capable of detecting members both inside and outside the tidal radius. By incorporating a supervised algorithm into our approach, we successfully identified members beyond the tidal radius. In our current work, we initially applied DBSCAN and GMM to identify reliable members of cluster stars. Subsequently, we trained the random forest algorithm using DBSCAN- and GMM-selected data. Leveraging the random forest, we can identify cluster members outside the tidal radius and observe cluster morphology across a wide field of view. Our method was then applied to 15 open clusters based on Gaia DR3, which exhibit a wide range of metallicity, distances, members, and ages. Additionally, we calculated the tidal radius for each of the 15 clusters using the King profile and detected stars both inside and outside this radius. Finally, we investigated mass segregation and luminosity distribution within the clusters. Overall, our approach significantly improved the estimation of the tidal radius and detection of mass segregation compared to the previous work. We found that in Collinder 463, low-mass stars do not segregate in comparison to high-mass and intermediate-mass stars. Additionally, we detected a peak of luminosity in the clusters, some of which were located far from the centre, beyond the tidal radius. [ABSTRACT FROM AUTHOR]

Migraine, a complex disorder, is characterized by recurrent headache episodes. The production of melatonin in the pineal gland, which is crucial for controlling circadian rhythms and sleep-wake cycles, is altered in various conditions, including neurological disorders such as migraine. Recent studies underscore the significance of serum melatonin levels in patients with chronic and episodic migraine, the focus of this study. This case‒control study, conducted from September 2017 to June 2020 in Tehran, Iran, selected potential participants aged 18-65 years from a headache clinic at Sina Hospital (affiliated with Tehran University of Medical Sciences). Both episodic migraine and chronic migraine were diagnosed following the diagnostic criteria in the International Classification of Headache Disorders' third edition. Melatonin levels were measured according to the instructions of the ELISA kits. There were significant differences in the frequency of headache days and the duration of abortive medication usage between the two groups (P value < 0.001). Besides, analysis revealed significantly lower serum melatonin levels in patients with episodic ((80.45-45.06) 72.83) and chronic migraine ((154.34-63.34) 70.38, P value < 0.001) than in healthy controls (281.25-160.86) 280). Although no considerable differences were found between episodic and chronic migraine patients, the current study demonstrated that serum melatonin levels were substantially greater in healthy controls than in patients with migraine., (© 2024. The Author(s).)

Context: Today, there are many discussions about the best way to maintain weight and prevent weight regain after a period of weight loss., Objectives: The aim of this study was to summarize, based on data from randomized clinical trials (RCTs), the impact of nonsurgical interventions for adults' weight loss maintenance., Data Sources: The Medline (PubMed), Scopus, and Web of Science databases were reviewed during June 2023., Data Extraction: Meta-analyses assessing the impacts of nonsurgical interventions for weight loss maintenance were conducted. Effect sizes of nutritional interventions were recalculated by applying a random-effects model. The Grading of Recommendations, Assessment, Development, and Evaluation framework was implemented to determine evidence certainty., Results: Meta-analysis of data from a total of 56 RCTs (n = 13 270 participants) represented a significant weight reduction after behavior and lifestyle interventions (mean difference [MD], -0.64 kg [95% CI, -1.18 to -0.09]; I2 = 89.5%; P < .001 for heterogeneity). Pharmacological interventions had also a significant effect on weight change during the weight maintenance phase (MD, -2.57 kg [95% CI, -3.12 to -2.02]; I2 = 91.6%; P < .001 for heterogeneity). The weight loss reduction from pharmacological interventions was greater with sibutramine (MD, -2.57; 95% CI: -3.12 to -2.02). Additionally, diet intervention and dietary and physical activity strategies were associated with a negligible trending decrease in weigh regain (respectively: MD, -0.91 kg [95% CI, -2.18 to 0.36], I2 = 55.7%, P = .016 for heterogeneity; and MD, -0.3 kg [95% CI, -4.13 to 3.52], I2 =  94.1%, P < .001)., Conclusion: The findings of this review indicate there is a favorable impact of behavior-based interventions and antiobesity medications on weight maintenance., Systematic Review Registration: PROSPERO registration no CRD42023468056., (© The Author(s) 2024. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Bacterial vaginosis (BV) is a common inflammatory condition affecting the vaginal microbiome. In the present study we aimed to explore the relationship between dietary inflammatory index, plant-based dietary index, and BV., Methods: In this case-control study, 143 individuals with BV and 151 healthy participants aged 15-45 years were included. Bacterial vaginosis diagnosis was based on the Amsel criteria by a gynecologist. Participants' dietary intakes over the past year were assessed using a 168-item food frequency questionnaire. Logistic regression models were employed to analyze the association between dietary inflammatory index, plant-based dietary index, and BV odds., Results: Our study revealed that elevated dietary inflammatory index scores were strongly associated with higher BV odds in the crude model (odds ratio [OR]: 2.88, 95% confidence interval [CI]: 1.57-5.30, P value <0.001), and even after accounting for potential confounding factors (adjusted OR: 3.52, 95% CI: 1.66-7.46, P value = 0.001). While no significant relationship was observed between total plant-based dietary index and healthy plant-based dietary index scores with BV odds, a clear positive association existed between unhealthy plant-based dietary index and the odds of BV (aOR: 2.13, 95% CI: 1.09-4.15, P value = 0.018)., Conclusion: A positive correlation may exist between unhealthy plant-based dietary index and the likelihood of BV. Furthermore, the dietary inflammatory index may remain linked to increased BV odds., (© 2024 International Federation of Gynecology and Obstetrics.)

Introduction: By studying the dietary habits of patients with bacterial vaginosis (BV) and the controls, we aim to find out whether the dietary intakes of phytochemicals could reduce the odds of BV. To the best of our knowledge, no study has ever examined the matter before. Therefore, we decided to conduct this secondary analysis of case-control study to examine the association between dietary phytochemicals and BV., Method: This case-control study was conducted at the gynecological clinic of Imam Hossein Hospital using a convenience sampling method from November 2020 to June 2021. To diagnose BV, all participants underwent examination by a gynecologist, assessing the presence of 3 or 4 criteria from the Amsel criteria. A validated semi-quantitative food frequency questionnaire was used. The phytochemical index was determined using McCarty's method. To assess the association between dietary phytochemical intake and the odds of BV, binary logistic regression was utilized., Results: After adjusting for potential confounders, the association between phytochemical index and BV remained significant (odds ratio (OR) = 0.349, 95% confidence interval (CI): 0.176-0.695, p-value = 0.003). Furthermore, each unit increase in fat intake was associated with higher odds of BV (OR = 1.008, 95% CI: 1.002-1.014, p-value = 0.006), and a positive family history of BV continued to show significantly increased odds of BV (OR = 3.442, 95% CI: 2.068-5.728, p-value < 0.001)., Conclusion: In summary, the findings of this study indicate that increased consumption of dietary phytochemicals is associated with a reduced risk of BV among Iranian women of reproductive age. Additional research, especially longitudinal dietary studies, is required to explore the potential impact of dietary modifications on BV., (© 2024. The Author(s).)

Introduction: Multiple sclerosis (MS) is an immune-mediated condition of the central nervous system (CNS). Intake of fruits and vegetables high in vitamins, minerals, fiber, and active molecules contributes to the body's overall health, immunity, and physiological function. This study sought to review the literature and investigate the relationship between fruits and vegetables consumption and MS odds., Methods: In the current systematic review and meta-analysis, a systematic search of original databases from inception to 21 Dec 2022 was conducted based on the PRISMA 2020 statement. Human observational studies examining the association between fruits or vegetables consumption and MS prevalence were included if they reported and provided effect size with 95% confidence intervals (CIs)., Results: The systematic review and meta-analysis included eight studies. Random effect model showed the protective effect of fruits ( I 2  = 81.0%, P for heterogeneity < 0.001; pooled OR = 0.52, 95%CI = 0.27, 0.97, P -value = 0.042) and vegetables consumption ( I 2  = 73.5%, P for heterogeneity = 0.002; pooled OR = 0.61, 95%CI = 0.38, 1.00, P -value = 0.050) on MS odds. According to a linear dose-response meta-analysis of four case-control studies, an increase of 100 grams of fruits per day reduced the odds of MS by 9% ( I 2  = 0.0%, P for heterogeneity = 0.77; pooled OR = 0.91, 95%CI = 0.83, 0.99, P -value = 0.021)., Conclusion: Consumption of fruits and vegetables may be associated with a potential protective effect against MS. However, further confirmation is required through prospective longitudinal studies and randomized clinical trials.

Meta-analyses have been conducted with conflicting results on this topic. Due to missing several eligible studies in previous meta-analysis by Lam et al., we conducted an extensive systematic review and dose-response meta-analysis of randomized controlled trials in this regard. A comprehensive search was conducted across various databases, including MEDLINE/PubMed, ISI Web of Knowledge, Scopus, and Google Scholar, until November 2023. Based on the analysis of 33 studies comprising 2,047 individuals, it was found that there was a significant increase in body weight for each 1 g/day increase in omega-3 lipids (standardized MD [SMD], 0.52 kg; 95% confidence interval [CI], 0.31, 0.73; I 2 = 95%; Grading of Recommendations Assessment, Development and Evaluation [GRADE] = low). Supplementation of omega-3 fatty acids did not yield a statistically significant impact on body mass index (BMI) (SMD, 0.12 kg/m 2 ; 95% CI, -0.02, 0.27; I 2 = 79%; GRADE = very low), lean body mass (LBM) (SMD, -0.02 kg; 95% CI, -0.43, 0.39; I 2 = 97%; GRADE = very low), fat mass (SMD, 0.45 kg; 95% CI, -0.25, 1.15; I 2 = 96%; GRADE = low), and body fat (SMD, 0.30%; 95% CI, -0.90, 1.51; I 2 = 96%; GRADE = very low). After excluding 2 studies, the findings were significant for BMI. Regarding the results of the dose-response analysis, body weight increased proportionally by increasing the dose of omega-3 supplementation up to 4 g/day. Omega-3 fatty acid supplementation can improve body weight, but not BMI, LBM, fat mass, or body fat in cancer patients; large-scale randomized trials needed for more reliable results., Trial Registration: PROSPERO Identifier: CRD42023395341., Competing Interests: Conflict of Interest: The authors declare that they have no competing interests., (Copyright © 2024. The Korean Society of Clinical Nutrition.)

Vitamin D is a fat-soluble steroid hormone that was initially known only for regulating calcium and phosphorus levels and maintaining bone health. However, it was later discovered that many organs express vitamin D metabolizing enzymes and have a ligand for vitamin D, which regulates the expression of an extensive assortment of genes. As a result, vitamin D is indispensable for the proper function of organs, and its deficiency is believed to be a critical factor in symptoms and disorders such as cardiovascular diseases, autoimmune diseases, and cancers. The significance of vitamin D in reproductive tissues was recognized later, and studies have revealed its crucial role in male and female fertility, as well as proper reproductive function during pregnancy. Vitamin D deficiency has been identified as a risk factor for infertility, gonadal cancers, pregnancy complications, polycystic ovary syndrome, and endometriosis. However, data investigating the association between vitamin D levels and reproductive disorders, including endometriosis, have encountered inconsistencies. Therefore, the present study aims to review existing research on the effect of vitamin D on proper reproductive function, and the role of deficiency in reproductive diseases and specifically focuses on endometriosis., (© 2024. The Author(s).)

Migraine headaches are the most prevalent disabling primary headaches, affecting individuals at an active age. Dietary interventions are considered low-cost and practical approaches to migraine prophylaxis. Hence, the present study aimed to assess the association between adherence to the Healthy Eating Index 2015 (HEI-2015) and migraine headaches. The present case-control study was conducted on 476 newly diagnosed adults with migraine headaches, based on the International Classification of Headache Disorders 3rd edition (ICHDIII criteria(, and 512 healthy controls. Participants' dietary intakes were collected using a validated, 168-item semi-quantitative food frequency questionnaire (FFQ). The association between HEI-2015 and migraine headaches was assessed using logistic regression models. Although the trend was not statistically significant, being in the 4th quantile of the HEI-2015 was associated with about 50% lower odds of migraine headaches in both primary (adjusted for age and gender) (odds ratios (OR): 0.51, 95% confidence intervals (CI): 0.33, 0.78) and fully adjusted models (additionally adjusted for body mass index (BMI) and total calories) (adjusted OR: 0.50, 95%CI: 0.32, 0.77). Intriguingly, the odds of migraine headaches were significantly higher in those in the last quantile of "Total Fruits," which is equal to more than 237 g per 1000 kcal (aOR: 2.96, 95%CI: 1.99, 4.41) and "Whole Fruits," which is equal to more than 233 g per 1000 kcal (aOR: 2.90, 95%CI: 1.94, 4.31). Similarly, higher intakes of "Dairy," which is equal to more than 138 g per 1000 kcal (aOR: 2.66, 95%CI: 1.71, 4.14), and "Total Protein Foods," which is equal to more than 259 g per 1000 kcal (aOR: 2.41, 95%CI: 1.58, 3.70), were associated with higher odds of migraine headaches. The current study revealed an indirect association between HEI-2015 and its components, including "Greens and Beans," "Whole Grains," "Refined Grains," and "Added Sugars" and lower odds of migraine headaches., Competing Interests: D.F., M.N., S.RJ., M.T., Z.Gh., A.H., P.R., Z.T., P.Sh., H.A., A.K., and F.Kh. declare that they have no competing interests., (© 2024 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Purpose: To evaluate the effect of a low-calorie dietary approach to stop hypertension (DASH) compared to a low-calorie diet on weight control, body composition and glycemic measures in post sleeve patients with weight regain., Materials and Methods: Participants were randomly allocated to either the low-calorie DASH diet group (intervention) or the low-calorie diet group (control) for a duration of 16 weeks. Both groups had a prescribed caloric intake of 1000-1200 calories. The DASH diet group made dietary adjustments in accordance with the DASH pattern., Results: At the end of the study, both interventions significantly reduced anthropometric and body composition parameters (P-value < 0.001), with a greater decrease observed in the low-calorie DASH diet group (P-value < 0.001). Insulin levels and homeostatic model assessment for insulin resistance (HOMA-IR) decreased significantly in both groups, but the magnitude of these changes was not statistically different between the two groups. After adjusting for confounders, a significant difference was observed in post-intervention values and changes in weight, body mass index, and fat mass and fat-free mass., Conclusion: In summary, adhering to a calorie-restricted DASH diet for 16 weeks improved weight loss, body mass index, and fat mass reduction in post-bariatric patients who experienced weight regain 2 years after surgery, compared to a calorie-restricted control diet. However, there was no significant difference in the effect on blood glucose, insulin, and HOMA-IR between the two diets., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Although studies have reported an inverse association between fruits, vegetables, and fiber consumption and all-cause and cause-specific mortality, the issue remains incompletely defined in the Middle Eastern population., Aims: The current study aimed to investigate the association between dietary fiber, fruit, and vegetable intake and all-cause and cause-specific mortality., Methods: A total of 48632 participants (mean age = 52years), 57.5% (n = 27974) women and 42.5% (n = 20658) men, were recruited from an ongoing large-scale prospective cohort study (the Golestan Cohort Study (GCS)), in the north of Iran. Using a validated semi-quantitative 116-item food questionnaire, dietary intakes were collected. Hazard ratios (HRs) and 95% confidence intervals (95%CIs) of all-cause and cause-specific mortality were reported., Results: After approximately 14 years of follow-up, 10,774 deaths were recorded. In the fully adjusted model, compared to those in the lowest quintile of intake, those in the second and third quintiles of dietary fiber intake had a 7%-10% reduction in risk of all-cause mortality, and a 15%-17% reduction in the risk of mortality from other causes. Increasing consumption of fruits was also associated with a decreased risk of mortality for all-cause mortality by 9%-11%, and all cancer by 15-20%. Further, those in the third and fourth quintiles of vegetables intake had 11%-12% lower risk for CVD mortality., Discussion: The results from the GCS further support the current recommendations on following a healthy diet containing proper amounts of fiber, vegetables, and fruits, as health-protective dietary items., Conclusions: Higher intake of dietary fiber, fruits, and vegetables has the potential to reduce both overall and cause-specific mortality rates. However, additional cohort studies with larger sample size and long-term follow-up durations are required to establish these findings., (© 2023. The Author(s).)

Background & Aims: Rice Bran Arabinoxylan Compound (RBAC) results from an enzymatic modification of rice bran, which is reported to have immunomodulatory, anti-oxidant, and anti-inflammatory effects by regulating the production of pro-inflammatory cytokines. The current systematic review and meta-analysis aimed to determine the hepatic adverse effects of RBAC by assessing the effect through liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST)., Methods: In the present study, the Medline (PubMed), Web of Sciences, and Scopus databases were searched for relevant publications from the beginning to October 2022. The meta-analysis was based on the Mixed effect model to generate the mean effect sizes in weighted mean differences (WMD) and the 95% confidence intervals (95%CI). The heterogeneity was assessed using the Cochrane Chi-squared test, and the analysis of Galbraith plots was applied., Results: Subgroup meta-analysis on five eligible randomized controlled trials (n = 239) showed a significant decrease in serum AST regarding RBAC supplementation in powder form (WMD (95%CI) = -3.52 (-5.62, -1.42) U/L; P-value = 0.001, I2 (%) = 46.9; P heterogeneity = 0.170), three months and more supplementation duration (WMD (95%CI) = -3.71 (-5.95, -1.48) U/L; P-value = 0.001, I2 (%) = 29.9; P heterogeneity = 0.240) and studies with a good quality (WMD (95%CI) = -3.52 (-5.62, -1.42) U/L; P-value = 0.001, I2 (%) = 46.9; P heterogeneity = 0.170)., Conclusions: In conclusion, RBAC supplementation seems to not have any hepatic adverse effects and its supplementation as powder or for three months and more may decrease serum AST levels. However, we need further studies to confirm the results., Registry Number for Systematic Reviews or Meta-Analyzes: CRD42022361002, registration time: 29/09/2022., Competing Interests: Declaration of competing interest Morvarid Noormohammadi, Zeinab Ghorbani, Hossein Shahinfar, and Farzad Shidfar declare they do not have any conflicts of interest., (Copyright © 2023 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Introduction: In this study, we sought to summarize the associations between overall, plant-, and animal-based low carbohydrate diet (LCD) scores and the risk of all-cause, cardiovascular disease (CVD), and cancer mortality from prospective cohort studies., Methods: We searched PubMed, Scopus, and Web of Science up to January 2022. We included prospective cohort studies that investigated the relationship between LCD-score and risk of overall, CVD, or cancer mortality. Two investigators assessed the studies for eligibility and extracted the data. Summary hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a random-effects model., Results: Ten studies, with 421022 participants, were included in the analysis. In the high-versus-low meta-analysis, overall (HR:1.05,95%CI:0.97, 1.13, I 2 =72.0%) and animal-based LCD-scores (HR: 1.08, 95% CI: 0.97-1.21; I 2 = 88.0%) were not associated with all-cause mortality, but plant-based LCD-score was associated with a risk reduction (HR:0.87, 95%CI:0.78,0.97; I 2 = 88.4%). CVD mortality was not associated with overall, plant-, or animal-based LCD-scores. Overall (HR:1.14, 95%CI:1.05,1.24; I 2 = 37.4%) and animal-based LCD scores (HR:1.16,95%CI:1.02,1.31; I 2 = 73.7%) were associated with a higher risk of cancer mortality, while plant-based LCD-score was not. A U-shaped relationship was revealed between overall LCD-score and all-cause and CVD mortality. The shape of relationship between LCD and cancer mortality was a linear dose-response., Conclusion: In conclusion, diets with a moderate carbohydrate content were associated with the lowest risk of all-cause and CVD mortality. If the sources of macronutrients that replaced carbohydrates were plant-based, the risk of all-cause mortality was reduced linearly with lower carbohydrate content. The risk of cancer mortality increased linearly with the increase in carbohydrate content. Considering the low certainty of evidence, more robust prospective cohort studies are suggested., Competing Interests: Declaration of Competing Interest All the authors (ZGh, AK, NSh, KT, MN) declare no conflicts of interest, (Copyright © 2023 Elsevier B.V. All rights reserved.)

Objectives: According to the World Health Organization, depression is a common mental health illness that is characterised by a persistent feeling of sadness and loss of interest. The present study examined the association of two mental health variables (ie, depression, anxiety) with quality of life (QoL) and the sociodemographic characteristics of Afghan women living in urban areas under the rule of Taliban government in Afghanistan., Design: Cross-sectional study administered between 10 November 2021 to 25 December 2021 among women., Setting: Across major provinces of Afghanistan (Herat, Mazar-e-Sharif, Kabul and Samangan)., Measurements: Data were collected using a pretested structured questionnaire. Data entry was carried out using Microsoft Excel 2016. And then exported to IBM SPSS V.26 for Microsoft Windows. Logistic regression models were used to examine the association of depression, anxiety with QoL and sociodemographic characteristics among women (N=438)., Results: The prevalence of depression symptoms was 80.4%, and the prevalence of mild to extremely severe anxiety was 81.0%. Depression symptoms among Afghan women were associated with being older, having more children, lower education level, other individuals' bad behaviour, bad events experienced in the past month, and feeling physically ill. Multiple regression analysis indicated that low monthly household income (adjusted OR, AOR 2.260; 95% CI 1.179 to 4.331, p=0.014) poor physical domain of QoL (AOR 4.436; 95% CI 1.748 to 11.256, p=0.002) and poor psychological domain of QoL (AOR 23.499; 95% CI 7.737 to 71.369, p<0.001) were significantly associated with depression., Conclusion: The prevalence of depression was high among women living under the government of the Taliban in Afghanistan. Considering the high prevalence of depression, anxiety and their impact on QoL and the overall quality of healthcare services, international health organisations should implement programmes for regular screening of depression and anxiety, and there should be psychological counselling services available for vulnerable women living under the government of the Taliban., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

This study aimed to investigate the association between dietary acid load (DAL) and multiple sclerosis (MS), through the potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores. In a hospital-based case-control study of 109 patients with MS and 130 healthy individuals, a validated 168-item semi-quantitative food frequency questionnaire and a logistic regression model were used to evaluate the association between the DAL and MS. After adjusting for age (years), gender (male/female), body mass index (Kg/m 2 ), and total calories (Kcal), the MS odds were 92% lower for those in the highest tertile of total plant-based protein (OR: 0.08, 95%CI: 0.03, 0.23; p -value < 0.001) and about four times higher for those in the highest tertile of the PRAL (OR: 4.16, 95%CI: 1.94, 8.91; p -value < 0.001) and NEAP scores (OR: 3.57, 95%CI: 1.69, 7.53; p -value < 0.001), compared to those in the lowest tertile. After further adjusting for sodium, saturated fatty acid, and fiber intake, the results remained significant for total plant-based protein intake (OR: 0.07, 95%CI: 0.01, 0.38; p -value = 0.002). In conclusion, a higher NEAP or PRAL score may be associated with increased odds of MS, while a higher intake of plant-based protein instead of animal-based protein may be protective.

Although the available evidence emphasizes the beneficial effects of probiotics in normalizing various cardiometabolic markers, there is still substantial uncertainty in this regard. Thus, we set out to determine the effect sizes of probiotics on blood lipid parameters more coherently. A systematic literature search of the Medline (PubMed) and Scopus databases was conducted from inception to 12 February 2021, applying both MeSH terms and free text terms to find the relevant randomized controlled trials (RCTs). The meta-analysis was conducted based on a random-effect model to calculate the mean effect sizes demonstrated as weighted mean differences (WMDs) and the 95% confidence intervals (95% CIs). To explore the heterogeneity, the Cochrane χ2 test, and analysis of Galbraith plots were performed. Meta-analysis of data from 40 RCTs (n = 2795) indicated a significant decrease in serum/plasma triglyceride [WMD (95% CI) = -12.26 (-17.11 to -7.41) mg/dL; P-value <0.001; I2 (%) = 29.9; P heterogeneity = 0.034], total cholesterol (with high heterogeneity) (WMD (95% CI) = -8.43 (-11.90 to -4.95) mg/dL; P-value <0.001; I2 (%) = 56.8; P heterogeneity < 0.001), LDL-C [WMD (95% CI) = -5.08 (-7.61, -2.56) mg/dL; P-value <0.001; I2 (%) = 42.7; P heterogeneity = 0.002], and HDL-C (with high heterogeneity) (WMD (95% CI) = 1.14 (0.23, 2.05) mg/dL; P-value = 0.014; I2 (%) = 59.8; P heterogeneity < 0.001) following receiving probiotic/synbiotic supplements. Collectively, the current preliminary evidence supports the effectiveness of probiotics/synbiotics in improving dyslipidaemia and various lipid parameters more prominently among subjects with hyperlipidaemia, diabetes, and metabolic syndrome. However, large and well conducted RCTs are required to provide further convincing support for these results., Competing Interests: Conflict of interest:The authors declare that they have no conflict of interest., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Recent studies have demonstrated the effect of probiotics, prebiotics, and synbiotics on adiponectin and leptin levels; however, those findings remain contested. The present study aimed to explore the impact of probiotics/synbiotics on appetite-regulating hormones and the desire to eat., Methods: A systematic review was conducted by searching the Medline (PubMed) and Scopus databases from inception to December 2021, using relevant keywords and MeSH terms, and appropriate randomized controlled trials (RCTs) were extracted. The standardized mean differences (SMD) and 95% confidence intervals (95%CIs) were calculated as part of the meta-analysis using a random-effect model to determine the mean effect sizes. Analysis of Galbraith plots and the Cochrane Chi-squared test were conducted to examine heterogeneity., Results: Meta-analysis of data from a total of 26 RCTs (n = 1536) showed a significant decrease in serum/plasma leptin concentration following probiotic/synbiotic supplementation (SMD: -0.38, 95%CI= -0.638, -0.124); P-value= 0.004; I 2 = 69.4%; P heterogeneity < 0.001). The leptin level decrease from probiotic/synbiotic supplementation was higher in patients with NAFLD than those with overweight/obesity or type 2 diabetes mellitus/ metabolic syndrome/ prediabetes. Probiotic/synbiotic supplementation was associated with a trending increase in adiponectin levels, stronger in patients with type 2 diabetes mellitus, metabolic syndrome, and prediabetes (SMD: 0.25, 95%CI= 0.04, 0.46) µg/mL; P-value= 0.021; I 2 = 16.8%; P heterogeneity= 0.30). Additionally, supplementation with probiotic/synbiotic was linked to a slight increase in desire to eat (SMD: 0.34, 95%CI= 0.03, 0.66) P-value = 0.030; I 2 = 39.4%; P heterogeneity= 0.16)., Conclusion: Our meta-analysis indicates a favorable impact of probiotic/synbiotic supplementation on regulating leptin and adiponectin secretion., Competing Interests: Conflict of interest Authors declare that there is no conflict of interest., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: Migraine is recognized as a disease with unknown etiology and various pathophysiologic pathways which are not fully understood. Due to the relation between dairy intake and various chronic conditions in children and also the paucity of data on the probable role of dairy intake on pediatrics' odds of having migraine, this study was designed., Materials & Methods: The present study was a population-based case-control design that was accomplished in a tertiary headache clinic.290 child (aged from7 to 14 years old) was included in this study. A definite diagnosis of migraine was performed by a neurologist; concerning the 2018 international classification of headache disorder 3 (ICHD3) criteria. Also, demographic and anthropometric characteristics were obtained. In addition, the usual dietary intake of participants was evaluated using a validated semi-quantitative food frequency questionnaire (FFQ)., Results: Those children in the case group significantly had higher age and BMI means (P.value:0.000). In the second regression model, odds of migraine were 48% (OR: 0.52; 95%CI:0.27-1.00) diminished in the second tertile and 53% (OR:0.47;95%CI:0.24-0.92) in the third tertile of low-fat dairy intake (P-trend:0.03). In the fully adjusted model, the achieved migraine ORs were as followings:0.48 (95% CI:0.240.95) in the second tertile and 0.46 (95% CI:0.21-0.96) in the third tertile (P-trend:0.04), respectively. Children with more high-fat dairy intake also consumed higher amounts of energy, pastries, simple sugar, unhealthy snacks, and hydrogenated oil (P<0.05)., Conclusion: This study results proposed that a greater amount of low-fat dairy intake may attenuate the odds of having migraine attacks in pediatrics and adolescents who might be at risk of headache, which can be attributed to the micronutrient and also to the bioactive content of these dietary components., Competing Interests: The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Changing the dietary pattern may be an alternative treatment for bacterial vaginosis, the prevalent vaginal infection in women., Methods: One hundred and forty-three bacterial vaginosis-affected women diagnosed by Amsel criteria and 151 healthy controls aged 18 to 45 entered the current case-control research. To calculate the alternative healthy eating index and dietary acid load score, food consumption was recorded with an accurate and precise food frequency questionnaire. The dietary acid load was measured by potential renal acid load (PRAL) and net endogenous acid production (NEAP) indices. Using logistic regression models, the association between the alternative healthy eating index and dietary acid load score with bacterial vaginosis was investigated., Results: The last tertile of the alternative healthy eating index had a 75% decreased odds of experiencing bacterial vaginosis in the adjusted model (adjusted odds ratio (aOR) = 0.25, 95% confidence interval (CI) = 0.12-0.53, P for trend = 0.001). Besides, vegetables (aOR = 0.34, 95% CI = 0.17-0.69, P for trend = 0.003), nuts and legumes (aOR = 0.44, 95% CI = 0.23-0.87, P for trend = 0.028), and meats (aOR = 0.31, 95% CI = 0.16-0.60, P for trend = 0.001) intake was linked to a decreased bacterial vaginosis odds. However, sugar-sweetened beverages and fruit juice (aOR = 3.47, 95% CI = 1.68-7.17, P for trend < 0.001), trans fatty acids (aOR = 2.29, 95% CI = 1.18-4.43, P for trend = 0.005), and sodium (aOR = 3.44, 95% CI = 1.67-7.06, P for trend = 0.002) intake were directly associated with bacterial vaginosis odds. There was no evidence of a link between dietary acid load and bacterial vaginosis., Conclusion: According to the present study's findings, there is no correlation between dietary acid load and the likelihood of developing bacterial vaginosis. However, following a plant-based dietary pattern based on the healthy eating index may lead to a lower odds of bacterial vaginosis., (© 2022. The Author(s).)

Background: Considering the close link between metabolic syndrome (MetSyn) and cardiovascular diseases, considerable attention has been devoted to the identification of their shared underlying pathological mechanisms in recent decades., Objectives: This study aimed to investigate the association between pro-inflammatory factors and newly-diagnosed MetSyn., Methods: This case-control study recruited obese and nonobese individuals who were newly diagnosed with MetSyn (cases, n = 84) and healthy individuals (controls, n = 83). The medical and sociodemographic data of the participants were collected on enrollment. Serum analysis was performed to ascertain the concentrations of tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), fasting blood sugar (FBS), total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and atherogenic coefficient (AC). Multiple regression analysis was carried out to explore the relationship between inflammatory markers and AC with MetSyn odds. The Pearson correlation test was also performed to investigate the correlations between metabolic and inflammatory parameters., Results: Positive relationships were observed between the serum levels of TNF-α and CRP with the odds of MetSyn following controlling for confounders (adjusted odds ratio [AOR] = 1.32; 95% confidence interval [CI]: 1.01 - 1.72; AOR = 1.29; 95% CI: 1.18 - 1.41; respectively, P ≤ 0.03). Additionally, higher AC was accompanied by increased odds of MetSyn (AOR = 1.98; 95% CI: 1.31 - 2.98; P = 0.001). The Pearson correlation analysis also showed positive correlations between TNF-α levels and serum metabolic abnormalities, including elevated LDL-C, FBS, and AC and lowered HDL-C levels (P ≤ 0.02)., Conclusions: The present results revealed that higher serum concentrations of pro-inflammatory and atherogenic indices, including CRP, TNF-α, and AC, might be associated with elevated odds of newly diagnosed MetSyn regardless of potential confounders, particularly body mass index. The obtained findings might be moderated by the positive correlations observed between serum TNF-α, as the chronic inflammatory state indicator, and impaired lipid and glycemic markers., Competing Interests: Conflict of Interests: The authors declare no conflict of interest associated with this manuscript., (Copyright © 2022, International Journal of Endocrinology and Metabolism.)

Background: Among multiple factors that affect the etiology of polycystic ovary syndrome (PCOS), diet has, an important contribution. Chronic oxidative stress has also been implicated in the development of PCOS. The, present study is an attempt to evaluate dietary total antioxidant capacity (TAC) and its relationship with odds of, PCOS in Iran., Materials and Methods: The study was carried out as a case-control study in hospital outpatient clinics, Tehran,, Iran. Totally, 310 female participants with a history of PCOS and 602 age-matched controls took part in this, study between June 2015 and December 2018. A reproducible and valid 168-item semi-quantitative food frequency, inventory was utilized to determine the entire antioxidants of the usual diet in order to calculate dietary, TAC. The relationship of dietary TAC with odds of PCOS were assessed adjusting for potential confounders, through an estimation of two multivariable conditional regression models. The first tertile was presented as a, reference category., Results: In a fully adjusted model, the highest tertile of dietary TAC was associated with a reduced odds of, PCOS [odds ratio (OR): 0.81, 95% confidence interval (95% CI): 0.59, 0.96, P for trend: 0.038). In addition, PCOS odds decreased in the highest tertile of α-tocopherol intake (OR: 0.73, 95% CI: 0.56, 0.88, P for trend:, 0.023). The adjusted ORs in the highest tertile of vitamin C, β-carotene and magnesium were 0.79 (95% CI: 0.83-0.97), 0.81 (95% CI: 0.67-0.98) and 0.91 (95% CI: 0.55-0.9 8) respectively, with a significant trend., Conclusion: Our results provide evidence that there was a relationship between high TAC diets and lower odds of, PCOS.

Bacterial vaginosis (BV) is a predominant vaginal disturbance that affects about 25% of childbearing-aged women. Dietary consumption may have a crucial role in vaginal flora imbalances. This study was a hospital-based case-control study. In total, 144 incident BV cases and 151 healthy participants were recruited from the gynecology clinic in Tehran, Iran, between November 2020 and June 2021. Participants' typical diets were collected by a food frequency questionnaire. Vaginal flora was characterized based on the Amsel criteria. Factor analysis was used to pinpoint the principal dietary patterns. For logistic regression, the first tertile was assumed as a reference. Five principal dietary patterns emerged and were nominated as "Healthy diet," "Unhealthy diet," "Ovo-vegetarian diet," "Pseudo-Mediterranean diet," and "Western diet." The "Unhealthy diet" pattern were positively associated with BV (adjusted odds ratio (aOR) = 3.35; 95% confidence interval (CI) 1.41, 7.94; p trend : 0.006), while adherence to the "Ovo-vegetarian diet" pattern was associated with a reduced odds of BV (aOR = 0.16; 95% CI 0.07, 0.34; p trend  < 0.001). These results provide evidence that following the "unhealthy diet" pattern may lead to developing BV, and plant-based eating patterns may be associated with reduced BV odds., (© 2022. The Author(s).)

Background: Bacterial vaginosis, BV, is a common inflammatory vaginal dysbiosis. The Mediterranean diet, MD, containing foods rich in antioxidant compounds, is shown to be beneficial for inflammatory conditions. This study aimed to investigate the association between MD adherence and dietary total antioxidant capacity (DTAC) with BV., Methods: This case-control study was conducted on 143 BV-affected and 151 healthy individuals aged between 15 and 45 years. The Amsel criteria were used to detect newly diagnosed patients with BV by a gynecologist. The 168-item food frequency questionnaire (FFQ) was used to record participants' dietary intakes in the last year. The reported data in the FFQ was used to measure adherence to the MD by calculating the Medi-Lite score and to measure the DTAC by calculating ferric-reducing antioxidant power, FRAP, based on the related databases. Logistic regression models were used to determine the association between Medi-Lite and DTAC and BV odds., Results: The highest tertile of Medi-Lite score was associated with a reduced odds of BV in the crude model (Odds Ratio, OR: 0.49, 95% Confidence Interval, 95% CI 0.25, 0.96, P for trend: 0.023). This significant inverse association was not observed in the last model adjusted for age, body mass index (kg/m 2 ), waist circumferences (cm), cigarette smoking, frequency of pregnancy, and physical activity (MET/h/d). In crude and adjusted odels, BV odds decreased in the highest tertile of vegetable (adjusted OR, aOR: 0.32, 95% CI 0.16, 0.63, P for trend: 0.001), fish (aOR: 0.46, 95% CI 0.25, 0.84, P for trend: 0.009), legumes (aOR: 0.26, 95% CI 0.14, 0.50, P for trend < 0.001), and meat (aOR: 0.29, 95% CI 0.15, 0.56, P for trend < 0.001) groups. There was no significant association between DTAC and BV odds., Conclusions: The significant inverse association between the MD adherence and BV odds did not remain after modifying for confounders; besides, DTAC was not associated with BV odds. However, some of the MD components might be associated with a reduced odds of BV., (© 2022. The Author(s).)

Background: Inconsistent findings have been reported for associations between dietary indices and bacterial vaginosis (BV). The aim of this study was to examine the association of dietary glycemic index (DGI), glycemic load (DGL), insulin index (DII), and insulin load (DIL) with BV among Iranian women., Methods: The current case-control study consisted of 144 new cases of BV and 151 controls. The diagnosis of BV was made based on the Amsel criterion in hospital clinics in Tehran, Iran, from November 2020 until June 2021. DGI, DGL, DII, and DIL were calculated from a validated semiquantitative food frequency questionnaire. The association between dietary carbohydrate indices and odds of BV were assessed adjusting for potential confounders through an estimation of two multivariate regression models., Results: The multivariate adjusted odds ratio (OR) comparing the highest tertile of dietary DGI and DGL with the lower tertile was 2.99 (95% confidence interval (CI): 1.47-6.81; P trend = 0.003) and 4.01 (95% CI: 1.22-5.91; P trend = 0.029), respectively. In a fully adjusted model, the top tertile of dietary fiber compared to the bottom was associated with 88% (95% CI: 0.14-0.33) lower odds of BV ( P trend < 0.001). DII and DIL were not significantly associated with odds of BV in both crude and adjusted regression models., Conclusion: The findings support the hypothesis of moderate, direct associations between DGI or DGL and BV. Also, a diet high in fiber decreases odds of BV., Competing Interests: None of the authors had any conflicts of interest to report., (Copyright © 2022 Morvarid Noormohammadi et al.)

Introduction: The Mediterranean Dietary Approaches to the Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet has been shown to have beneficial neuroprotective effects. The purpose of this research was to evaluate the link between the MIND diet adherence and multiple sclerosis (MS), a degenerative neurological illness., Methods: In a hospital-based case-control setting, 77 patients with relapsing-remitting multiple sclerosis (RRMS) and 148 healthy individuals were recruited. A validated 168-item semi-quantitative food frequency questionnaire was used to assess participants' dietary intakes and the MIND diet score. A logistic regression model was used to evaluate the association between MIND diet adherence and MS., Results: There was significant difference between RRMS and control groups in the median (Q1-Q3) of age (years, P value < 0.001), body mass index (BMI) (kg/m 2 , P value < 0.001), and total intake of calories (kcal, P value = 0.032), carbohydrates (g, P value = 0.003), animal-based protein (g, P value = 0.009), and fiber (g, P value = 0.001). Adherence to the MIND diet was associated with a reduced odds of MS [adjusted odds ratio (aOR) = 0.10, 95 percent confidence interval (95% CI) = 0.01-0.88, P for trend = 0.001]. MS odds was significantly lower in the last tertile of green leafy vegetables (aOR = 0.02, 95% CI = 0.00-0.21, P value < 0.001), other vegetables (aOR = 0.17, 95% CI = 0.04-0.73, P value = 0.001), butter and stick margarine (aOR = 0.20, 95% CI = 0.06-0.65, P value = 0.008), and beans (aOR = 0.05, 95% CI = 0.01-0.28, P value < 0.001) consumption. While it was significantly higher in the last tertile of cheese (aOR = 4.45, 95% CI = 1.70-11.6, P value = 0.003), poultry (aOR = 3.95, 95% CI = 1.01-15.5, P value = 0.039), pastries and sweets (aOR = 13.9, 95% CI = 3.04-64.18, P value < 0.001), and fried/fast foods (aOR = 32.8, 95% CI = 5.39-199.3, P value < 0.001)., Conclusion: The MIND diet and its components, including green leafy vegetables, other vegetables, and beans, seem to decrease the odds of MS; besides butter and stick margarine, the MIND diet's unhealthy components seem to have the same protective effects, while pastries and sweets, cheese, poultry, and fried/fast foods have an inverse effect., (© 2022. The Author(s).)

We performed this case-control study with 303 polycystic ovarian syndrome (PCOS) patients and 588 age-matched controls to evaluate the relation between fertility diet score and odds of PCOS. In a fully adjusted model, the top tertile of fertility diet score compared to the bottom was associated with 22% [95%CI 0.71-0.93] lower odds of PCOS ( P trend = 0.012). Ratio of monounsaturated to trans fat and vegetable protein was associated with a lower odd of PCOS. Animal protein intake and glycemic load were associated with a higher odd of PCOS. Based on our results, increasing the quality of the diet according to fertility diet score can reduce the odds of PCOS.

Background: As the coronavirus disease 2019 (COVID-19) pandemic continues to escalate, it is important to identify the prognostic factors related to increased mortality and disease severity. To assess the possible associations of vitamin D level with disease severity and survival, we studied 248 hospitalized COVID-19 patients in a single center in a prospective observational study from October 2020 to May 2021 in Tehran, Iran., Methods: Patients who had a record of their 25-hydroxyvitamin D level measured in the previous year before testing positive with COVID-19 were included. Serum 25-hydroxyvitamin D level was measured upon admission in COVID-19 patients. The associations between clinical outcomes of patients and 25-hydroxyvitamin D level were assessed by adjusting for potential confounders and estimating a multivariate logistic regression model., Results: The median (interquartile range) age of patients was 60 years (44-74 years), and 53% were male. The median serum 25-hydroxyvitamin D level prior to admission decreased with increasing COVID-19 severity (P=0.009). Similar findings were obtained when comparing median serum 25-hydroxyvitamin D on admission between moderate and severe patients (P=0.014). A univariate logistic regression model showed that vitamin D deficiency prior to COVID-19 was associated with a significant increase in the odds of mortality (odds ratio, 2.01; P=0.041). The Multivariate Cox model showed that vitamin D deficiency on admission was associated with a significant increase in risk for mortality (hazard ratio, 2.35; P=0.019)., Conclusions: Based on our results, it is likely that deficient vitamin D status is associated with increased mortality in COVID-19 patients. Thus, evaluating vitamin D level in COVID-19 patients is warranted.

Context: The application of bleomycin is limited due to its side effects including lung toxicity. Silymarin is a flavonoid complex isolated from milk thistle [Silybum marianum L. (Asteraceae)] which has been identified as an antioxidant and anti-inflammatory compound., Objective: This study evaluates the effect of silymarin on oxidative and inflammatory parameters in the lungs of mice exposed to bleomycin., Materials and Methods: BALB/c mice were divided into four groups of control, bleomycin (1.5 U/kg), bleomycin plus silymarin (50 and 100 mg/kg). After bleomycin administration, mice received 10 d intraperitoneal silymarin treatment. On 10th day, blood and lung samples were collected for measurement of oxidative and inflammatory factors., Results: Silymarin led to a decrease in lung lipid peroxidation (0.19 and 0.17 nmol/mg protein) in bleomycin-injected animals. Glutathione-S-transferase (GST) which was inhibited by bleomycin (32.4 nmol/min/mg protein) induced by higher dose of silymarin (41 nmol/min/mg protein). Silymarin caused an elevation in glutathione (GSH): 2.6 and 3.1 µmol/g lung compare with bleomycin-injected animals 1.8 µmol/g lung. Catalase (CAT) was increased due to high dose of silymarin (65.7 µmol/min/ml protein) compare with bleomycin treated-mice. Myeloperoxidase (MPO) which was induced due to bleomycin (p < 0.05) reduced again by high dose of silymarin (0.51 U/min/mg protein). Bleomycin led to an increase in TNF-α and interleukin-6 (IL-6) (7.9 and 11.8 pg/ml). These parameters were reduced by silymarin (p < 0.05)., Conclusions: Silymarin attenuated bleomycin induced-pulmonary toxicity. This protective effect may be due to the ability of silymarin in keeping oxidant-antioxidant balance and regulating of inflammatory mediator release.

Healthcare professionals worldwide have expressed concern over infections by extended-spectrum ß-lactamase (ESBL) and metallo-ß-lactamase (MBL)-producing bacteria. We evaluated the prevalence of ESBL- and MBL-producing Escherichia coli (E. coli) isolated from community-acquired urinary tract infections (UTIs) and their antibiotic-resistance profiles at 3 private laboratories in Tehran, Iran. E. coli isolates were mostly susceptible to meropenem (90.4%) and imipenem (90.0%), followed by amikacin (89.0%) and gentamicin (84.7%). Moreover, we detected that, of the E. coli isolates, 67 (22.3%) were ESBL producers and 21 (7.0%) of E. coli isolates were MBL positive via the imipenem-ethylenediaminetetraacetic acid (EDTA) combined disc test. This report is the first, to our knowledge, on the prevalence of MBL-producing uropathogenic E. coli (UPEC) strains in Iran. The antibiotic resistance of E. coli isolates revealed that 122 (40.7%) were multidrug resistant. The high number of antibiotic-resistant and ß-lactamase-producing UPEC strains necessitates further attention and consideration, particularly MBL-producing strains., (Copyright© by the American Society for Clinical Pathology (ASCP).)