Lifestyle intervention can effectively treat patients with non-alcoholic fatty liver disease (NAFLD). The present study aimed to investigate the association between lifestyle factors with fatty liver ...index (FLI) in Iranian adults.
This study enrolled 7114 subjects from the Ravansar Non-Communicable Diseases (RaNCD) cohort study in western Iran. To compute the FLI score, anthropometric measures, and a few non-invasive liver status indicators were used. Binary logistic regression models examined the association between FLI score and lifestyle.
Participants with FLI < 60 had a lower daily energy intake compared to those with FLI ≥ 60 (2740.29 vs. 2840.33 kcal/day, P = < 0.001). The risk of NAFLD in males with high socioeconomic status (SES) was 72% higher than in those with low SES (OR: 1.72; 95% CIs 1.42-2.08). An adjusted logistic regression model showed a significantly negative association between high physical activity and fatty liver index in both men and women. (OR: 0.44, p-value < 0.001 and OR: 0.54, p-value < 0.001, respectively). The odds of NAFLD in female participants with depression were 71% higher than in non-depressed participants (OR: 1.71, 95% CI: 1.06-2.64). Dyslipidemia and high visceral fat area (VFA) were also associated with a significant increase in the risk of NAFLD (P < 0.05).
In our study, we found that good SES, high VFA, and dyslipidemia were associated with an increased risk of NAFLD. Conversely, high physical activity reduces the risk of NAFLD. Therefore, lifestyle modification may help improve liver function.
The prevalence of type 2 diabetes mellitus (T2DM) is increasing in middle- and low-income countries, and this disease is a burden on public health systems. Notably, dietary components are crucial ...regulatory factors in T2DM. Plant-based dietary patterns and certain food groups, such as whole grains, legumes, nuts, vegetables, and fruits, are inversely correlated with diabetes incidence. We conducted the present study to determine the association between adherence to a plant-based diet and the risk of diabetes among adults. We conducted a cross-sectional, population-based RaNCD cohort study involving 3401 men and 3699 women. The plant-based diet index (PDI) was developed using a 118-item food frequency questionnaire (FFQ). Logistic regression models were used to evaluate the association between the PDI score and the risk of T2DM. A total of 7100 participants with a mean age of 45.96 ± 7.78 years were analysed. The mean PDI scores in the first, second, and third tertiles (T) were 47.13 ± 3.41, 54.44 ± 1.69, and 61.57 ± 3.24, respectively. A lower PDI was significantly correlated with a greater incidence of T2DM (T1 = 7.50%, T2 = 4.85%, T3 = 4.63%; P value < 0.001). Higher PDI scores were associated with significantly increased intakes of fibre, vegetables, fruits, olives, olive oil, legumes, soy products, tea/coffee, whole grains, nuts, vitamin E, vitamin C, and omega-6 fatty acids (P value < 0.001). After adjusting for confounding variables, the odds of having T2DM were significantly lower (by 30%) at T3 of the PDI than at T1 (OR = 0.70; 95% CI = 0.51, 0.96; P value < 0.001). Our data suggest that adhering to plant-based diets comprising whole grains, fruits, vegetables, nuts, legumes, vegetable oils, and tea/coffee can be recommended today to reduce the risk of T2DM.
•Data obtained from eight clinical trials which conducted on 552 participants.•Administration of artichoke and artichoke products has not effect on SBP and DBP.•However, artichoke supplementation ...significantly reduce SBP and DBP in hypertensive patients.•In addition, artichoke supplementation for 12 weeks led to a significantly decreased DBP.
Clinical trials considering the effects of artichoke supplementation on blood pressure have yielded different and contradictory outcomes. Thus, a systematic review and meta-analysis were performed to assess effects of artichoke administration on blood pressure.
Related studies were detected by searching the Cochrane Library, PubMed, Embase and Scopus databases up to 15 March 2020. Weighted Mean Differences (WMD) were pooled using a random-effects model. Heterogeneity, sensitivity analyses, and publication bias were evaluated using standard methods.
Pooled analysis of eight randomized controlled trials revealed that artichoke supplementation did not have an effect on systolic blood pressure (SBP), (WMD: -0.77 mmHg, 95 % CI: −2.76 to 1.22) or diastolic blood pressure (DBP) (WMD: −0.11 mmHg, 95 % CI: −1.72 to 1.50) when compared to the placebo group. However, subgroup analyses based on health status suggested that artichoke administration among hypertensive patients may significantly reduce SBP (WMD: −3.19 mmHg, 95 % CI: −3.32 to −3.06) and DBP (WMD: −2.33 mmHg, 95 % CI: −2.23 to −2.43), but no such reduction was found in NAFLD patients. Furthermore, our results indicated that artichoke supplementation for 12 weeks led to a significantly decreased DBP (WMD: -2.33 mmHg, 95 % CI: −2.43 to −2.23), but 8 weeks of intervention did not (WMD: 0.80 mmHg, 95 % CI: −1.06 to 2.66).
Artichoke supplementation may potentially lead to SBP and DBP reduction in hypertensive patients. In addition, artichoke supplementation for 12 weeks may significantly improve DBP.
Despite evidence supporting the beneficial effects of the Mediterranean diet (MedDiet) on hepatic steatosis in subjects with non-alcoholic fatty liver disease (NAFLD), the relationship of the MedDiet ...with hepatic fibrosis is as yet unclear. The aim of the present study was to explore this association in Iranian adults with NAFLD.
This cross-sectional study included 3,325 subjects with NAFLD from the Ravansar Noncommunicable Disease (RaNCD) cohort. Dietary intake data were collected by a validated food frequency questionnaire (FFQ). The MedDiet score was computed based on a nine-point scale constructed by Trichopoulou et al. Fatty liver index (FLI) and fibrosis-4 (FIB-4) index were used to predict hepatic steatosis and fibrosis in the population. Multivariate regression models were applied to determine associations.
Subjects in the highest tertile of MedDiet score had a higher platelet and a lower weight, total cholesterol (TC), LDL-c, and FLI than those in the lowest tertile (
-value < 0.05). Adherence to the MedDiet was associated with a 7.48 (95%CI: 5.376 to 9.603;
-value: 0.001) × 10
/μl; -0.417 (95%CI: -0.819 to -0.014;
-value: 0.042) kg, -2.505 (95%CI: -3.835 to -1.175;
-value: 0.001) mg/dl; and -1.93 (95%CI: -2.803 to -1.061;
-value: 0.001) mg/dl change in platelet, weight, TC, and LDL-c for each SD increase in the score, respectively. A significant linear trend was observed in odds of hepatic fibrosis across the tertiles of the MedDiet score (P-trend: 0.008). This linear trend was attenuated but remained significant after the adjustment of the relevant confounders (P-trend: 0.032). Adherence to the MedDiet was independently associated with about 16% lower odds of having hepatic fibrosis in patients with NAFLD for each SD increase in the score.
Adherence to the MedDiet characterized by a high intake of whole grains, fruits, vegetables, legumes, nuts, and fish was associated with a lower risk of having hepatic fibrosis in patients with NAFLD. Further studies are required to elucidate the causal relationship of observed association in individuals of all ages, ethnicities, and etiologies of hepatic steatosis.
Apathy in patients with epilepsy is associated with a wide range of consequences that reduce the patient's ability to perform social functions and participate in self-care and rehabilitation ...programs. Therefore, apathy is one of the important diagnoses of the healthcare team in the process of caring for epileptic patients and its dimensions need to be examined and recognized. Therefore, appropriate instruments with the sociocultural milieu of each community should be provided to health care providers. The aim of the present study was to design and measure epilepsy-related apathy scale (E-RAS) in adults with epilepsy.
This study of sequential exploratory mixed methods design was conducted in Iran from April 2019 to December 2019. In the Item generation stage, two inductive (face-to-face and semi-structured interviews with 17 adult epileptic patients) and deductive (literature review) were used. In item reduction, integration of qualitative and literature reviews and scale evaluation were accomplished. For Scale Evaluation, face, content, construct exploratory factor analysis (EFA) (n = 360) and confirmatory factor analysis (CFA) (n = 200), convergent and divergent Validity and reliability (internal consistency and stability) were investigated.
The results of EFA showed that E-RAS has four factors, namely, motivation; self-regulatory; cognition and emotional-effective. These four latent factors accounted for a total of 48.351% of the total variance in the E-RAS construct. The results of CFA showed that the 4-factor model of E-RAS has the highest fit with the data. The results of convergent and divergent validity showed that the values of composite reliability (CR) and average variance extracted (AVE) for the four factors were greater than 0.7 and 0.5, respectively, and the value of AVE for each factor was greater than CR. The Cronbach's alpha coefficient for the whole scale was obtained 0.815. The results of the test-retest showed that there was a significant agreement between the test and retest scores (P < 0.001).
E-RAS is a multidimensional construct consisting of 24 items, and has acceptable validity and reliability for the study of epilepsy-related apathy in adult epileptic patients.
•Data obtained from 10 clinical trials which conducted on 588 participants.•Administration of artichoke and artichoke products has not effect on weight and BMI.•Supplementation of artichoke has ...effect on waist circumference.•However, artichoke supplementation in hypertensive patients significantly reduces the weight.
Studies on the efficacy of artichoke administration on anthropometric indices gave different outcomes. Hence, a systematic review and dose-response meta-analysis were accomplished to understand the effects of artichoke administration on anthropometric indices.
Related clinical trials were found by searching in PubMed, Embase, the Cochrane Library and Scopus databases up to 29 February 2020. Weighted Mean Differences (WMD) were analyzed using a random-effects model. Heterogeneity, publication bias and sensitivity analysis were assessed for anthropometric indices.
Pooled analysis of 10 randomized controlled trials (RCTs) suggested that the artichoke administration has effect on waist circumference (WMD: -1.11 cm, 95 % CI: -2.08 to - 0.14), as opposed to the other anthropometric indices including weight (WMD: -0.62 kg, 95 % CI: -1.86 to 0.61) or BMI (WMD: -0.12, 95 % CI: -0.43 to 0.20). However, the analysis of the subgroups according to the health status showed that artichoke supplementation in hypertensive patients significantly reduced weight (WMD: -2.34 kg, 95 % CI: -3.11 to -1.57) but not the other indicators (WMD: -0.06 kg, 95 % CI: 0.78 to 0.67).
The artichoke supplementation has effect on the waist circumference, but not on the other anthropometric indices. For establishment of more accurate conclusion more studies with longer administration duration are need to be done.
Adult eating behavior questionnaire (AEBQ) is an age upward extension tool that measures appetite traits in individuals. This instrument was developed by Hunot in 2016. The present study aimed to ...determine the psychometric properties of the Persian version of AEBQ in adults with epilepsy.
The current research is a cross-sectional study conducted in 2019 in Iran. 700 adults with epilepsy completed the 35-item AEBQ. Qualitative face validity, qualitative content and structure validity (exploratory factor analysis EFA, N=400, and confirmatory factor analysis CFA, N=300) appetitive traits were evaluated. Reliability was also measured using Cronbach's alpha, Construct reliability (CR), and Intra-Class Correlation (ICC). The SPSS 26-AMOS24 software was employed to analyze the data with a significance level of 0.05.
The EFA and CFA results comprised eight factors, namely enjoyment of food, emotional over-eating, food responsiveness, hunger, satiety responsiveness, emotional under-eating, food fussiness, and eating slowly. Indices of root mean square error of approximation=0.068, parsimonious normed fit index=0.644, parsimonious comparative fit index=0.671, adjusted goodness of fit index=0.618, goodness of fit index=0.911, and Chi square degree-of-freedom ratio (normalized Chi square CMIN/DF=2.842) confirmed the fitness of the final model. Convergent and divergent validity was acceptable for all the factors. The results revealed that the internal stability>0.8 and CR>0.7 of the eight extracted AEBQ structures are confirmed. The ICC was 0.899 (95% CI: 0.878-0.917; P<0.001). The results also showed that AEBQ has acceptable convergent and divergent validity.
The eight-factor structure of AEBQ can measure eating behavior traits and is of good validity and reliability for assessing the eating behavior of Iranian adults with epilepsy.
Drought is one of the main and repeated features of different climates and also one of the environmental events and an integral part of climate fluctuations. Monitoring systems are very important in ...developing plans to deal with drought and its management, and for this reason, available quantitative indicators are used to express this phenomenon. Since these indices are calculated pointwise, it is necessary to process them spatially. In this regard, mediation methods including geostatistics are used. The analysis and how the meteorological drought changes over time, as well as the ability of kriging, cokriging, image distance weighted (IDW) and radial function (RBF) methods, were evaluated in the spatial analysis of meteorological drought in the entire Karun large watershed. Drought analysis was done using rainfall data from 58 rain gauge stations and 11 synoptic stations with a statistical period of 30 years in the period from 1987 to 2016 using the standardized precipitation index (SPI). Then drought maps were prepared and evaluated. The obtained results showed that the lowest value of the root mean square error (RMSE) related to the cokriging method with a value of (0.32), and the radial function method with a value of (0.34), and this method is considered the best method for the year 2013 is Also, in the year 2008 most stations were involved in very severe drought and year 2000, most stations were involved in severe drought. The results showed that the Cokriging method has higher accuracy than other methods in drought zoning.
In the present research, silica nano hollow sphere (SNHS) and amino functionalized silica nano hollow sphere (SNHS-NH2) adsorbents have been used to remove imidacloprid as a high consumption ...pesticides from aqueous solutions. SNHS and SNHS-NH2 have been synthesized based on our previously reported methods. FT-IR and SEM techniques have been employed to analyze physicochemical characteristics of produced adsorbents. The adsorption of imidacloprid has been evaluated in terms of kinetic and equilibrium on used different synthesized adsorbents. The adsorption tests were performed in various conditions, in addition to assess the effects of pH, temperature and adsorbent dosage. Equilibrium empirical data have been fitted by Langmuir, Sips, Freundlich, Toth, Khan, Tempkin and Redlich-Peterson isotherms. Correlation coefficients demonstrated that equilibrium data were better matched with the Redlich-Peterson (R-P) isotherm. On the other hand, experiments showed that the amount of adsorbate per unit mass of adsorbent is decreased by increasing of the pH, and the maximum value of qe is obtained in acidic pH. In addition, the amount of adsorbate per unit mass of adsorbent is reduced by rising temperature and the equilibrium adsorption is dropped by increasing the amount of silica adsorbent. Kinetic data have been fitted with Elovich, pseudo-first-order and pseudo-second-order models; according to the obtained correlation coefficients. It can be stated that the pseudo-first-order model is more suited to the kinetic data related to pesticide adsorption on silica adsorbent. Kinetics of imidacloprid adsorption has been investigated at the concentrations of 7.2 mg/L and 10 mg/L. The results demonstrated that the equilibrium rate slope become much steeper in the initial times by increasing concentrations of imidacloprid.
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•Amino functionalized silica (NH2-SHNS) as new and efficient adsorbent for removal of imidacloprid have been synthesized.•Synthesized nano adsorbent showed spherical and uniform shape with 70 to 250 nm diameters.•The most important parameters affecting the adsorption capacity such as pH, adsorbent dose and temperature were investigated.•Adsorption equilibrium data obeyed from the Redlich-Peterson isotherm.•The rate of adsorption follows pseudo-first order rate equation.
Disease-related fear is one of the important diagnoses of healthcare providers in caring for people with epilepsy whose conceptual dimensions should be discovered and investigated. To this end, it is ...necessary to provide healthcare providers with appropriate tools to assess fears related to the disease in accordance with the sociocultural milieu of each community.
The purpose of this study was to design and psychometrically evaluate the disease-related fear scale (D-RFS) in adults with epilepsy.
This study was of a sequential exploratory mixed methods design conducted in Iran in 2019. In the item generation phase, inductive (face-to-face, semi-structured interviews with 14 adult patients with epilepsy) and deductive (literature review) were used. In the item reduction, integration of qualitative and literature reviews and scale evaluation were performed. For the scale evaluation, face validity, content validity, construct validity exploratory factor analysis (EFA) (n = 367) and confirmatory factor analysis (CFA) (n = 250), and convergent and divergent validity and reliability (internal consistency and stability) were investigated.
After the qualitative phase and literature review, 40 items were codified. After investigation of the qualitative and quantitative face validity, 7 items were deleted. Two items were deleted due to content validity ratio (CVR) of less than 0.56 and one item due to content validity index (CVI) of less than 0.78. Finally, a 30-item scale was obtained, and its construct validity was assessed. Kaiser–Meyer–Olkin (KMO) index was 0.85, and Bartlett's test of sphericity was 7237.504, P < 0. 001. The results of CFA showed that the bivariate model of the D-RFS (fear of seizure consequences and fear of the disease's long-term consequences) had the most appropriate fitness to the data. Convergent and divergent validity results showed that the values of composite reliability (CR) and average variance extracted (AVE) for the two factors were greater than 0.7 and 0.5, respectively, and the AVE for each factor was greater than CR. Internal consistency of the first and second factors were obtained 0.891 and 0.910, respectively. Cronbach's alpha coefficient for the total scale was obtained 0.921. The results of test–retest reliability showed that there was a significant agreement between the scores of the test and retest (P < .001).
The D-RFS has an acceptable factorial structure, and its internal consistency was confirmed by different approaches. This scale is a valid and reliable tool for assessing disease-related fear in patients with epilepsy. The simplicity of the items and the appropriate time to complete the scale can be considered as its strengths.
•Epilepsy is one of the chronic diseases in adults.•To understand fear-related disease, a dedicated tool is needed.•The latest version of D-RFS has an acceptable validity.•D-RFS has acceptable homogeneity and consistency.•D-RFS can be used by health care providers to screen for fears related epilepsy.
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