Effect of goji berry incorporation on the texture, physicochemical, and sensory properties of wheat bread.

The regular intake of Lycium barbarum (goji berry) is supposed to play an important role in the promotion of human health. Regarding, its incorporation into staple foods, including bread, seems to be effective. However, it requires the evaluation of dough behavior and final product quality. This study investigated the effect of goji berry incorporation at levels of 10, 15, 20, 25, and 30% ww-1 on the textural, physicochemical, and sensory properties of wheat bread. Results indicated a significant enhancement of water absorption and gelatinization temperature in composite flour via the inclusion of goji berry powder (p < 0.05). Using goji berry powder up to 20% ww-1 has shown to obtain the structure able to restore gases through the baking process and provide enhancement in a specific volume at about 10%. Alongside, the hardness of composite bread decreased, and the optimal hardness was observed at formulations containing 20% w/w goji berry powder with a value equal to 1199.95 ± 0.05 g, which is supposed to be induced by the higher specific volume and lower moisture content of bread samples. Moreover, color and sensory perception have been found to be significantly changed by goji berry substitution. Goji berry substitution up to 20% ww-1 is found to be preferred by the consumer, and a drop in overall acceptability was observed at its higher inclusion. The technological characteristic changes induced by goji berry incorporation are induced by its gluten dilution impact. However, the gel-like structure formed by the high fiber content of goji berries compensates for this adverse impact up to 20% w/w substitution level.

Association between lipid profiles and cigarette smoke among adults in the Persian cohort (Shahedieh) study.

OBJECTIVES: Exposure to cigarette smoke introduces a large amount of nicotine into the bloodstream through the lungs. So, smoking can be a risk factor for many diseases. The present study was conducted to investigate the effect of active and passive cigarette smoke on the blood lipid profile and dyslipidemia. METHODS: This cross-sectional study was performed on 5052 individuals who participated in the recruitment phase of the Shahedieh cohort study. A logistic regression model was used to investigate the relationship between smoking exposure status and lipid profiles. RESULTS: The prevalence of abnormal low-density lipoprotein-cholesterol (LDL-C), abnormal HDL-C, abnormal total cholesterol (TC), abnormal triglyceride (TG), and dyslipidemia were 254 (5.00%), 562 (11.10%), 470 (9.30%), 1008 (20.00%), and 1527 (30.20%), respectively. Adjusting for confounders, it was observed that current smokers had higher odds of having abnormal HDL-C [OR (95% CI), 2.90 (2.28-3.69)], abnormal TG [OR (95% CI), 1.71 (1.38-2.13)] and dyslipidemia [OR (95% CI), 1.86 (1.53-2.25)]. Ex-smokers also had greater odds of abnormal HDL-C [OR (95% CI), 1.51 (1.06-2.16)] compared to non-smokers who were not exposed to cigarette smoke. CONCLUSIONS: The findings indicated that current smokers had higher TG and lower HDL. So, necessary measures should be taken to reduce smoking. The findings also showed that the prevalence of abnormal TG and HDL in ex-smokers was lower than in current smokers. Therefore, the existence of incentive policies to quit smoking seems necessary.

Agreement between ten-years cardiovascular disease risk assessment tools: An application to Iranian population in Shahedieh Cohort Study.

Background and aim: Cardiovascular risk-prediction models are efficient primary prevention tools to detect high-risk individuals. The study aims to use three tools to estimate the 10-year risk of developing cardiovascular disease (CVD) and investigate their agreement in an Iranian adult population. Methods: The current cross-sectional study was carried out on 8569 adults between 35 and 70 who participated in the first phase of the Shahedieh cohort study in Yazd, Iran, and were free of CVDs (cardiac ischemia or myocardial infarction or stroke). World Health Organization/International Society of Hypertension (WHO/ISH) chart, Laboratory-Based (LB) and Non-Laboratory-Based (NLB) Framingham Risk Score (FRS) were used to predict the 10-year risk of developing CVD. The agreement across tools was determined by Kappa. Results: WHO/ISH chart indicated the highest prevalence of low CVD risk for males (96.10%) and females (96.50%), while NLB Framingham had the highest prevalence of high CVD risk for males (19.40%) and females (5.30%). In total, there was substantial agreement between both FRS models (Kappa = o.70), while there was a slight agreement between WHO/ISH and both FRS tools. For under 60 years males and females, substantial agreements were observed between FRS methods (kappa = 0.73 and kappa = 0.68). For males and females over 60 years, this agreement was moderate and substantial, respectively (kappa = 0.54 and kappa = 0.64). WHO/ISH and LB Framingham model had substantial agreement for over 60 years females (kappa = 0.61). Conclusions: Framingham models classified more participants in the high-risk category than WHO/ISH. Due to the lethality of CVDs, categorizing individuals based on FRS can ensure that most of the real high-risk people are detected. Remarkable agreement between FRS methods in all sex-age groups suggested using the NLB Framingham model as a primary screening tool, especially in a shortage of resources condition.

Comparing the effectiveness of metformin with lifestyle modification for the primary prevention of type II diabetes: a systematic review and meta-analysis.

BACKGROUND: Concerning ascending trend in the prevalence of chronic type II diabetes, prevention and the development of an effective approach after the recognition of at-risk individuals is crucial. This study aims to investigate comparing the influence of lifestyle modification and metformin interventions in the prevention of type II diabetes developments. METHOD: The search was conducted using PubMed, Google Scholar, Scopus and Web of Science databases. The inclusion criteria include randomized controlled trials (RCT) which studied both lifestyle modification and metformin interventions in the population above 18 years old without a history of any type of diabetes. After excluding studies with intervention time of fewer than 6 months, a systematic review and meta-analysis were performed to evaluate relative risk (RR) with a confidence interval (CI) of 95% of type II diabetes development. RESULTS: Data from 5 studies were included in the meta-analysis. The population also consists of individuals with a mean age of 50 years old with BMI and FBS of 35.5 and 104.7 mg/dl respectively. Participants range of prevention years was between 2-3 years with a mean of 2.8 years. Lifestyle modification decreases the probability of the incidence of type II diabetes by 25.3% (RR: 0.747, 95% CI, 0.6-0.92) compared to the metformin intervention (p-value = 0.007). Our results indicate that long-term lifestyle modifications can prevent diabetes type II and decrease diabetes mellitus incidence down to one-quarter in comparison to metformin. CONCLUSION: Lifestyle modification can be more efficacious than metformin in diminishing the incidence of type II diabetes. Therefore, lifestyle modification can be a therapeutic strategy for controlling type II diabetes incidence, especially in high-risk individuals.

COVID-19 vaccine in pregnant women and pregnancy outcomes: A historical cohort in center of Iran.

BACKGROUND: Starting vaccination in pregnant women; numerous theories have been proposed that the vaccine might affect the mother or the fetus. OBJECTIVE: The goal of this research was to see whether there was a link between the Sinopharm vaccination and certain pregnancy outcomes in COVID-19-vaccinated women. STUDY DESIGN: This is a retrospective cohort study. METHOD: This study was conducted on pregnant women who delivered from 1 August 2021 to 1 January 2022 in Yazd city. We have followed the STROBE Guidelines when preparing the manuscript. In this period time, all pregnant women were 5787 people in which 5666 were in the second and third trimester. Among these women, 1222 women were randomly selected. RESULTS: Among 1222 pregnant women, 558 (45.6%) women had received one dose vaccine, 162 (13.3%) people had received two doses, and 502 (41.1%) women had not been vaccinated. On crude analysis, there was no significant difference between vaccinated and non-vaccinated groups. After adjusting for maternal age, maternal body mass index, parity, stillbirth history, abortion history, and gestational diabetes in multivariate analysis, no differences were found between the groups in pregnancy as well. CONCLUSION: Vaccinations during pregnancy seem to have no negative effects on the mother or the baby. This finding may aid pregnant women in deciding whether or not to take the vaccination.

Catalytic electrodes' characterization study serving polluted water treatment: environmental healthcare and ecological risk assessment.

Pesticide residues in the environment have irreparable effects on human health and other organisms. Hence, it is necessary to treat and degrade them from polluted water. In the current work, the electrochemical removal of the fenitrothion (FT), trifluralin (TF), and chlorothalonil (CT) pesticides were performed by catalytic electrode. The characteristics of SnO2-Sb2O3, PbO2, and Bi-PbO2 electrodes were described by FE-SEM and XRD. Dynamic electrochemical techniques including cyclic voltammetry, electrochemical impedance spectroscopy, accelerated life, and linear polarization were employed to investigate the electrochemical performance of fabricated electrodes. Moreover, evaluate the risk of toxic metals release from the catalytic electrode during treatment process was investigated. The maximum degradation efficiency of 99.8, 100, and 100% for FT, TF, and CT was found under the optimal condition of FT, TF, and CT concentration 15.0 mg L-1, pH 7.0, current density 7.0 mA cm-2, and electrolysis time of 120 min. The Bi-PbO2, PbO2, and SnO2-Sb2O3 electrodes revealed the oxygen evolution potential of 2.089, 1.983, 1.914 V, and the service lifetime of 82, 144, and 323 h, respectively. The results showed that after 5.0 h of electrolysis, none of the heavy metals such as Bi, Pb, Sb, Sn, and Ti were detected in the treated solution.

Effect of Cornus mas L. fruit extract on blood pressure, anthropometric and body composition indices in patients with non-alcoholic fatty liver disease: A double-blind randomized controlled trial.

BACKGROUND & AIMS: Obesity is linked to the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Patients with NAFLD are at increased risk for hypertension. Some investigations have hypothesized that Cornus mas L. fruit can improve obesity and hypertension. We investigated the effect of C. mas L. fruit extract on blood pressure, anthropometric and body composition indices in patients with NAFLD. METHODS: This 12-week double-blind randomized controlled trial was conducted on fifty patients with NAFLD. Patients received 20 cc/d C. mas L. fruit extract or placebo. We measured diastolic blood pressure (DBP), systolic blood pressure (SBP), weight, waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), body fat mass (BFM), body fat percent (BFP) and fat free mass (FFM) before and after intervention. RESULTS: Treatment group compared to control group showed a significant reduction in DBP (-8.62 ± 11.86 mmHg vs. 0.53 ± 8.53 mmHg; Pcrude = 0.003; Padjucted = 0.03) and SBP (-8.63 ± 14.37 mmHg vs. 0.0 ± 12.67 mmHg; Pcrude = 0.02; Padjucted = 0.02). We found no difference between groups in weight, WC, HC, WHR, BFM, BFP and FFM (P > 0.05). After adjusting for confounding factors, a significant reduction was observed in treatment group compared to control group in BFM (-0.2 ± 3.9 kg vs. 0.7 ± 2.4 kg; P = 0.01) and BFP (-0.2 ± 4.9% vs. 0.8 ± 2.8%; P = 0.02). CONCLUSIONS: C. mas L. fruit extract statistically reduced blood pressure and body fat. However, it had no effect on other anthropometric and body composition indices. Studies with larger sample sizes and higher dosages of extract are needed. TRIAL REGISTRATION: Registered on 30/9/2018 at Iranian Registry of Clinical Trials IRCT20180419039359N1 (https://www.irct.ir/trial/30707).

Models and components in disaster risk communication: A systematic literature review.

BACKGROUND AND AIM: Risk communication is considered a major factor in disaster risk management by the concerned policymakers and researchers. However, the incoherence of variables affecting risk communication in various studies makes it difficult to plan for disaster risk communication. This study aims to identify and classify the influential components in disaster risk communication. MATERIALS AND METHODS: This systematic review was conducted in 2020. Databases included PubMed, Scopus, and Web of Science. In searching for articles, there was no limit on the date of publication and the language of the article. The research addressed both natural and man-made disasters. The Preferred reporting items for systematic review and meta-analysis protocols (PRISMA) checklist was followed throughout the research, and the quality of the papers was assessed using the mixed methods evaluation tool (MMAT). RESULTS: In searching the articles, 3956 documents were obtained, of which 1025 duplicated articles were excluded. The titles and abstracts of the remaining documents (2931) were examined, of which 2822 were deleted, and the full text of 109 documents was studied for further assessment. Finally, after applying the inclusion and exclusion criteria and reviewing the full texts, 32 documents were considered to extract the data and for quality assessment. On studying the full text of the obtained documents, 115 components were found, which were classified into five groups (message, message sender, message receiver, message environment, message process) and 13 subgroups. In addition, the obtained components were classified as those proposed by the authors of the article and those obtained from disaster risk communication models. CONCLUSION: Identifying the effective components in the disaster risk communication gives a more comprehensive view of risk communication to the disaster managers and executives and provides the decision-makers with an important platform to be able to use the components of risk communication and increase the impact of messages and ultimately increase people's preparedness for disasters in planning operations for the risk communication.

Efficacy of the Novel Formulation of Topical Liothyronine and Liothyronine-Insulin in Mild to Moderate Diabetic Foot Ulcer: A Randomized, Triple-blind Clinical Trial.

BACKGROUND: Diabetic foot ulcer (DFU) is one of the challenging complications of chronic diabetes. OBJECTIVE: The study aimed to investigate whether liothyronine (T3) and liothyronine-insulin (T3/Ins) topical preparations could significantly reduce the healing time of DFU. METHODS: A prospective, randomized, placebo-controlled, patient-blinded clinical trial was conducted on patients with mild to moderate DFU, over a lesion area of no greater than 100 cm2. The patients were randomized to receive T3, T3/Ins, or honey cream 10% as the routine of care twice a day. Patients were examined for tissue healing weekly for 4 weeks, or until the total lesion clearance was observed, whichever was earlier. RESULTS: Of 147 patients with DFUs, 78 patients (26 per group) completed the study and were included in the final evaluation. At the time of study termination, all participants in each of the T3 or T3/Ins groups were free of symptoms based on the REEDA score, while about 40% of participants in the control group were detected with each of grades 1, 2, or 3. A significant difference was observed on days 7, 14, and 21 of consumption of topical preparations (P-value < 0.001). The mean time to complete wound closure in the routine care group was about 60.6 days, while it was 15.9 and 16.4 days in T3 and T3/Ins groups, respectively. Within the T3 and T3/Ins groups, significant earlier wound closure was detected at day 28 (P-value < 0.001). CONCLUSION: T3 or T3/Ins topical preparations are effective for wound healing and acceleration of wound closure in mild to moderate DFUs.

Concentration of mineral and heavy metals in raw mare (horse) milk consumed in Yazd, Iran: A risk assessment study.

BACKGROUND: In recent years, the mare's milk has been introduced as a rich source of nutrients with hypoallergic characteristics which is widely used for Iranian infants. OBJECTIVES: The present study aimed to investigate the heavy metal concentration of mare's milk and its consumption risk assessment. METHODS: About 88 mare's milk was collected from Yazd, the centre of Iran, during the summer of 2020. The raw mare's milk was digested and analysed for mineral and heavy metal content (As, Ca, Cd, Co, Cu, Fe, Mg, Mn, Ni, P, Pb and Zn) by ICP-OES. To estimate the health hazard for consumers the Estimated Daily Intake (EDI), Hazard Quotient (HQ) and Hazard Index (HI) of heavy metals were determined. RESULTS: The Ca ranged from 260.52 to 201.43 mg/L, which was the highest mineral in mare's milk followed by P and Mg. By increasing the age, P and Ca content was increased. The obtained ranges of Cu, Co, Fe, Mn and Zn were 72.12-75.11, 1.12-9.3, 180.69-230.21, 31.24-47.13 and 1060-1200 µg/L, respectively. The Cd and Arsenic content of mares' 8-11 years of age had higher concentrations. The highest Pb content was reported in mares 4-7 years old (10 µg/L). Although, Pb, Cd and As content of the mare's milk was evaluated lower than the permissible limit. Also, the HQ value was As > Cd > Pb > Zn > Ni > Cu for infants, toddlers and adults. The HI of mare's milk was 0.16, 0.15 and 0.022 for infants, toddlers and adults, respectively. CONCLUSIONS: Mare's milk could be an effective nutrition source for infants and children suffering from milk protein allergies.

Prevalence of diabetes and its correlates among Iranian adults: Results of the first phase of Shahedieh cohort study.

Background and Aims: The diabetes is one of the most common noncommunicable diseases, the prevalence of which is increasing worldwide. This study aimed to determine the prevalence, and correlates the factors of diabetes in the setting of Shahedieh cohort study in Yazd, Iran. Method: The present study is a cross-sectional study conducted on the data of the initial stage of Shahdieh Yazd cohort. This study examined the data of 9747 participants aged from 30 to 73 years. The data included demographic, clinical, and blood test variables. Multivariable logistic regression was used to calculate the adjusted odds ratio (OR), and the risk factors of diabetes were studied. Meanwhile, population attributable risks for diabetes were estimated, and reported. Results: The prevalence of diabetes was 17.9% (CI95%: 17.1-18.9); 20.5% in women, and 15.4% in men. Based on the results of multivariable logistic regression showed female sex (OR = 1.4, CI95%: 1.24-1.58), waist-hip ratio (OR = 1.4, CI95%: 1.24-1.58), high blood pressure (OR = 2.1, CI95%: 1.84-2.4), cardiovascular diseases (CVD) (OR = 1.52, CI95%: 1.28-1.82), stroke (OR = 1.91, CI95%: 1.24-2.94), age (OR = 1.81, CI95%: 1.67-1.96), hypercholesterolemia (OR = 1.79, CI95% triglyceride: 1.59-2.02), and low-density lipoprotein (LDL) (OR = 1.45, CI95%: 1.4-1.51), as risk factors for diabetes. Among the modifiable risk factors, high blood pressure(52.38%), waist-to-hip ratio (48.19%), the history of stroke (47.64%), hypercholesterolemia (44.13%), history of CVD (34.21%), and LDL ≥ 130 (31.03%) had the greatest population-attributable, respectively. Conclusion: The results showed that some of the main determinants of diabetes are the modifiable risk factors. Therefore, implementing early detection, and screening programs for people at risk and preventive measures, such as lifestyle modification programs, and control of risk factors can prevent this disease.

A comprehensive health-promoting neighborhood intervention to improve health care seeking behavior among reproductive age Iranian women.

BACKGROUND: Women's health care seeking delays remains an unresolved major public health problem in developing and underdeveloped countries. This study aimed to evaluate a health-promoting neighborhood intervention to improve health care seeking behavior (HCSB) among reproductive age Iranian women using Health Promotion Model (HPM). METHOD: This randomized controlled trial was conducted on 160 women of reproductive age in two groups: experimental and control. Data were collected by self-administered questionnaire based on HPM constructs and a medical symptom checklist. A health-promoting neighborhood intervention was performed in seven sessions for the experimental group. HCSB and HPM constructs were measured before and 3 months after intervention in the two groups. p < 0.05 was considered significant level. RESULTS: The average mean age of participants was 30.45 ± 7.80 years. After intervention, the mean score of self-efficacy, interpersonal influences, commitment to plan and HCSB was increased significantly in women in the experimental group, while negative constructs such as perceived barriers, negative activity-related affect, and immediate competing demands and preferences significantly decreased (p < 0.05). In addition, the mean score of referring for symptoms such as excessive sweating, persistent fatigue or weakness, headache, bleeding or spotting between periods, vaginal itching and irritation, unusual vaginal discharge, flashing, chest pain, rapid heartbeats, aching muscles or joints, urinary problems and some mental disorder was increased significantly in experimental group compared to control group (p < 0.05). CONCLUSIONS: The results of study show that an intervention based on the HPM have a positive impact on HCSB and its associated factors and can help improve women's health behaviors and health outcomes.

Burden of road traffic injuries in Iran: a national and subnational perspective, 1990-2019.

OBJECTIVES: Reliable and valid information on burden of road traffic injuries (RTIs) is essential for short-term and long-term planning. We designed the present study to describe the levels and trends of burden of RTIs in Iran from 1990 to 2019. METHODS: This is an observational epidemiological study. We used the Global Burden of Disease (GBD) 2019 estimates to report RTIs incidence, prevalence, mortality and disability-adjusted life-years (DALYs) by sex, age group and road user category in Iran and each of the 31 provinces from 1990 to 2019. RESULTS: Age-standardised incidence, prevalence, death and DALY rates of RTIs decreased by 31.7% (95% uncertainty interval (UI): 29.4 to 33.9), 34.9% (33.8 to 36.0), 57.7% (48.1 to 62.3) and 60.1% (51.7 to 65.2), respectively between 1990 and 2019. The 2019 age-standardised DALY rates varied from smallest value in Tehran 303.8 (216.9 to 667.2) per 100 000 to largest value in Sistan-Baluchistan 2286.8 (1978.1 to 2627.9) per 100 000. The burden of RTIs was mainly related to injuries sustained by drivers or passengers of motorised vehicles with three or more wheels and pedestrians' injuries, mostly affected males aged 15-29 years and individuals aged ≥70 years. CONCLUSION: The reducing trend in the burden of RTIs in Iran possibly reflects the effectiveness of the intervention programmes. However, with regard to the Sustainable Development Goals the burden is still at an alarming level. Further reductions are necessary for specific road user groups such as adolescent and adult male drivers or passengers of motorised vehicles, also pedestrians aged ≥70 years.

Simultaneous electrochemical degradation of pesticides from the aqueous environment using Ti/SnO2-Sb2O3/PbO2/Bi electrode; process modeling and mechanism insight.

In this work, modified Bi-PbO2 electrode was fabricated and employed for simultaneous degradation of fenitrothion (FT), trifluralin (TF), and chlorothalonil (CT) from synthetic and pesticide wastewater through the anodic oxidation process. A novel high-performance liquid chromatography method was developed and optimized to identify the pesticides simultaneously. Quadratic models were developed to investigate the effects of main operating parameters and predict the degradation efficiencies of the treatment processes. The R2 of the degradation efficiencies were obtained of 0.9847, 0.9910, and 0.9821 for FT, TF, and CT, respectively, which indicates the degree of conformity between the experimental and the actual values of degradation efficiencies, and the adjusted R2 values for the degradation efficiency of FT, TF, and CT in proposed models were 0.9826, 0.9898, and 0.9796, and the values of the predicted R2 were 0.9792, 0.9875, and 0.9755, respectively. The maximum degradation efficiencies of 99.7, 100, and 100% obtained for FT, TF, and CT, respectively, under the optimal operating condition of FT, TF, and CT concentration of 10.0, 6.0, and 8.0 mg L-1, respectively, pH 6.0, the current density 6.0 mA cm-2, and electrolysis time of 60 min. Chemical oxygen demand removal and energy consumption were 64.7% and 5.1 kWh m-3. Eventually, the generated intermediates and other produced species of pesticides through the treatment process was evaluated using a gas chromatography-mass spectrometry method, and their degradation pathways were proposed.

Risk Factors of Osteoporosis in Females: A Hospital-Based Case-Control Study, Yazd, Iran.

Background: The aim of this study was to evaluate the predictors of osteoporosis in women in Yazd, Iran. Methods: This hospital-based case-control study was performed on 270 women 35-65 yr old (135 case and 135 control) from Mar 2016 to Mar 2017. Case and control were matched in terms of age ± 2 (year) as a group matching. Osteoporosis is defined as a T-score of bone mineral density (BMD) below -2.5 SD. Data were analyzed using SPSS 20 software. Statistical tests included chi-square, student t test and Mann Whitney test .Multiple logistic regression (MLR) which forward method was used for modeling. Results: Odds ratio (OR) of osteoprosis were menarche age>12 yr (OR=3.37, CI:2.29-15.89), history of hysterectomy (OR=13, CI:3.81-44.82), rheumatoid arthritis (RA) (OR=6.58, CI:2.29-18.91) calcium supplements (OR=0.14, CI:0.04-0.41), menopause age <40 (OR=11.84, CI:1.54-90), second smoking (OR=3.38, CI:1.16-9.81) and increase of weight (OR=0.86, CI:0.80-0.94). Conclusion: Predictors of osteoporosis was menarche age >12 yr (3 times), history of hysterectomy (13 times), RA (6.5 times), menopause age <40 (12 times), second smoking (more than 3 times), calcium supplements and weight (protective).

Technological characteristics of sodium reduced wheat bread: Effects of fermentation type and partial replacement of salt with potassium chloride.

Rheological, physicochemical, textural, and sensory characteristics of wheat bread prepared by potassium chloride (KCl) substitution of sodium chloride (NaCl) at different ratio (0:100, 10:90, 20:80, 30:70, 40:60, 50:50) in the presence of two different fermentation types (Saccharomyces cerevisiae yeast starter (YSF) and mixed fermentation based on sourdough (MFSD)) were investigated. Considering the results obtained at this study, the technological characteristics change through KCl substitution ratio which depends on the type of fermentation. In other words, the enhanced activity of microflora in MFSD-fermented samples and decreased activity of yeast in YSF-fermented ones have been found by increasing the ratio of KCl incorporation level. Despite the increased activity of starter microflora in MFSD-fermented samples through increasing the KCl incorporation level, the lowest specific volume (p < .05) is found in SD50 (containing 50%w/w KCl in the presence of MFSD) with a quantity equal to 1.71 ± 0.47 cm3/g confirming its inability to restore gases. No significant difference has been found in KCl substitution levels up to 20%w/w in YSF-fermented samples (Y20) with control (p ≥ .05). The lowest crumb lightness (L*) (65.27 ± 0.12), highest cohesiveness (1.31 ± 0.07 mm), and springiness (0.76 ± 0.01) is also found in Y20. Considering sensory characteristics perception, no significant difference has been found in textural characteristics perception of Y10 and Y20 containing KCl at 10%w/w and 20% w/w, respectively, in the presence of YSF with control sample (Y). The overall acceptability is also found to be more influenced by texture perception(r = 0.827, p < .00).

Prevalence of chronic kidney diseases and its determinants among Iranian adults: results of the first phase of Shahedieh cohort study.

BACKGROUND: Chronic kidney disease (CKD) is one of the major global causes of mortality, described as the most neglected chronic disease. This study aimed to determine the prevalence and determinants of CKD in the setting of the Shahedieh cohort study in Yazd, Iran. METHODS: This cross-sectional study was conducted on adults in the baseline phase of the Shahedieh cohort study in Yazd, Iran. In this study, 9781 participants aged 30-73-year-old were investigated. The data used in this study included demographic and clinical variables and blood samples. Adjusted odds ratios were employed using multivariate logistic regression; meanwhile, population attributable risks for CKD were calculated and reported. RESULTS: CKD prevalence was 27.5% (95%CI: 26.57-28.34) in all participants, 24% in male, and 30.3% in female. The results of multivariate logistic regression analysis identified age (OR = 1.89, 95%CI:1.082-1.96), women (OR = 1.62, 95%CI: 1.45-1.79), BMI ≥ 30 (OR = 1.40,95%CI: 1.20-1.62), diabetes (OR = 1.38, 95%CI: 1.22-1.57), hypertriglyceridemia(OR = 1.20, 95%CI: 1.01-1.43), history of cardiovascular disease (OR = 1.20, 95%CI: 1.01-1.43), hypertension (OR = 1.18, 95%CI: 1.04-1.33), smoking (OR = 1.17, 95% CI: 1.02-1.33), LDL ≥ 130 (OR = 1.15, 95%CI: 1.01-1.31), history of kidney stone (OR = 1.14, 95%CI: 1.01-1.32) and hypercholesterolemia (OR = 1.14, 95%CI: 1.01-1.32) as risk factors for CKD. Among individual factors, obesity (11.25%), Hypertriglyceridemia (9.21%), LDL ≥ 130 (7.12%) had the greatest Population-Attributable Fraction, followed by Hypercholesterolemia (5.2%), diabetes (5.05%), smoking (3.73%) and high blood pressure (2.82%). CONCLUSION: The results showed that the main determinants of CKD are potentially modifiable risk factors. Therefore, implementing early detection and screening programs in people at risk as well as preventive measures such as lifestyle modification programs and risk factors controlling can prevent the disease.

Effects of the liaison nurse management on the infectious stroke complications: a randomized controlled trial.

BACKGROUND: Two of the most serious complications after stroke are pneumonia, and urinary tract infection. Liaison nurse, from hospital admission to discharge and then at home helps patients with complicated caring issues stroke. This study investigates the effect of liaison nurse management on the incidence of pneumonia and urinary tract infection in patients with stroke after discharge from the hospital. METHODS: This randomized controlled trial was conducted on 80 patients in a hospital in Iran. The intervention group was assessed and developed a caring program by the liaison nurse and the control group received routine care. Two weeks and two months after discharge, the patients were evaluated for the incidence of pneumonia and urinary tract infection. Collected data were analyzed using the Chi-square test. P < 0.05 was considered statistically significant. RESULTS: The two groups were homogenous in terms of mean age; gender frequently distribution and having urinary catheter. The incidence of pneumonia in intervention and control groups (11.6% vs. 19.2%, P = 0.35) had no statistically significant differences, but there was a significant difference in the incidence of urinary tract infection (0% vs. 24.6%, P < 0.001). CONCLUSIONS: With liaison nurse performance, there was a significant difference in the incidence of urinary tract infection, in two months after discharge from hospital, but the incidence of pneumonia had no statistically significant differences in two groups. Nurse's evaluation each patient individually according to needs, developing and monitoring the home-based care program, beyond overall education to these patients, could reduce some of complications of a stroke. TRIAL REGISTRATION: This study is retrospectively registered by Iranian Registry of Clinical Trials with decree code: IRCT20170605034330N3 on April 4, 2018.

The challenges of strategic management of the wastage produced due to earthquake in Kermanshah and Varzaghan-Ahar: A qualitative study.

BACKGROUND: Strategic management of the wastage produced due to earthquakes has faced many challenges over the recent decade. Thus, the present study seeks to identify and explain the challenges in earthquake wastage strategic management. MATERIALS AND METHODS: The present qualitative study has been steered through a content analysis approach and conducted using semi-structured interviews and a purposive selection of 17 professors, experts, and managers experienced in the field of waste management in Kermanshah and Varzaghan-Ahar earthquakes over 2020-2021. Besides, the interviews were initially categorized using MAXQDA18 software. RESULTS: Analysis of the experiences and perception regarding the changes in strategic management of wastage produced due to Kermanshah and Varzaghan-Ahar earthquakes revealed 418 codes, 97 subcategories, 33 categories, and 8 main categories including management and leadership, organizational culture, planning, organizational learning, employee management, rules and regulations, resource management, and procedure management. CONCLUSION: Strategic waste management has not been implemented in a coherent, integrated, and well-planned manner in the cases of the Kermanshah and Varzaghan-Ahar earthquakes. The challenges of strategic waste management turned out to be due to various reasons which will result in many issues in achieving the goals and selecting the suitable method for resource and procedure management should they not be managed well. Hence, policymakers, managers, and executors in the field of crisis management and waste management in disasters -specifically earthquakes- must take the necessary measures to remove these barriers.

The effect of L-carnitine supplementation on insulin resistance, sex hormone-binding globulin and lipid profile in overweight/obese women with polycystic ovary syndrome: a randomized clinical trial.

PURPOSE: Polycystic ovary syndrome (PCOS) is a common endocrine disorder among reproductive-age women. Insulin resistance and dyslipidemia are linked to PCOS. L-Carnitine supplementation as a management strategy for women with PCOS has been proposed. The effect of L-carnitine supplementation on insulin resistance, sex hormone-binding globulin (SHBG) and lipid profile in overweight/obese women with PCOS was investigated. METHODS: This randomized, double-blind, controlled clinical trial, was conducted on 62overweight/obese women with PCOS. Participants were randomly assigned into two groups to receive 1000 mg/day L-carnitine or placebo (1000 mg starch) for 12 weeks. RESULTS: L-Carnitine supplementation compared to the placebo showed a significant improvement in insulin [- 0.7 (- 7.3 to 4.0) vs. 0.7 (- 3.0 to 5.2); P = 0.001], homeostatic model assessment for insulin resistance [- 0.4 (- 1.7 to 1.1) vs. 0.0 (- 0.7 to 1.3); P = 0.002], quantitative insulin sensitivity check index (+ 0.01 ± 0.02 vs. - 0.01 ± 0.01; P = 0.02) and a non-significant change toward improvement in SHBG (+ 11.5 ± 40.2 vs. - 3.2 ± 40.2; P = 0.2). However, there was no significant differences between the two groups in serum levels of fasting plasma glucose, total cholesterol, triglyceride, low density lipoprotein-cholesterol and high density lipoprotein cholesterol (P > 0.05). CONCLUSION: 12-week L-carnitine supplementation in overweight or obese women with PCOS ameliorate insulin resistance, but has no effect on SHBG and lipid profile. Studies with higher dosages and duration of L-carnitine intake are required. The trial was registered on 30 December 2019 at Iranian Registry of Clinical Trials IRCT20191016045131N1. TRIAL REGISTRATION: Registered on 30th December 2019 at Iranian Registry of Clinical Trials (IRCT20191016045131N1).