The prevalence and concentration of aflatoxins in beers: a global systematic review and meta-analysis and probabilistic health risk assessment.

Mycotoxins have been identified as considerable contaminants in beer. The current investigation's concentration and prevalence of aflatoxins (AFs) in beer were meta-analyzed. The health risk of consumers was estimated through MOEs in the Monte Carlo simulation (MCS) model. The rank order of AFs in beer based on pooled prevalence was AFB1 (26.00%) > AFG1 (14.93%) > AFB2 (7.69%) > AFG2 (7.52%), In addition, the rank order of AFs in beer based on their pooled concentration was AFG1 (0.505 µg/l) > AFB1 (0.469 µg/l) > AFB2 (0.134 µg/l) > AFG2 (0.071 µg/l). The prevalence and concentration of AFs in beer in Malawi were higher than in other countries. The health risk assessment shows consumers in all countries, especially Malawi, Brazil, and Cameroon, are exposed to unacceptably health risks (MOEs <10,000). It is recommended to monitor levels of AFs in beer efficiently and implement control plans in order to decrease health risk of exposed population.

Application of molecularly imprinted polymers as the sorbent for extraction of chemical contaminants from milk.

Milk is one of the most consumed and balanced foods with a high nutritional value which could be contaminated with different chemicals such as antibiotics, melamine, and hormones. Because of the low concentration of these compounds and the complexity of milk samples, there is a need to use sample pre-treatment methods for purification and preconcentration of these compounds before instrumental techniques. Molecular imprinting polymers (MIPs) are synthetic materials with specific recognition sites complementary to the target molecule. MIPs have selectivity for a specific analyte or group of analytes, which could be used to extract and determine contaminants and remove the interfering compounds from complex samples. Compared to other techniques, sample preparation, high selectivity, excellent stability, and low cost are other advantages of using MIPs. The present article gives an overview of the synthesis of MIPs and their application for extracting antibiotics, hormones, and melamine in milk samples.

Custom-Made Ethyl Vinyl Acetate Insoles with Arch Support Could Improve Static Balance in Diabetic Women with Neuropathic Foot.

BACKGROUND: Individuals with diabetic neuropathy may experience plantar ulcers and postural instability. Although use of an insole with arch support has the potential to decrease the incidence of plantar ulcers, the choice of proper design and material density concerning postural stability is challenging. The objective of this pilot study was to conduct a preliminary evaluation of the immediate effects of custom-made ethyl vinyl acetate insoles with arch support and Shore A values of 30 or 50 on static balance in patients with diabetes and neuropathic foot/feet. METHODS: Ten women with diabetes participated in this study. Static balance was analyzed while in double-limb standing with eyes closed and eyes open and while standing on a dominant limb with eyes open wearing shoes only and wearing shoes and insoles with Shore A values of 30 and 50. RESULTS: With insole, the mean values of center of pressure excursions decreased significantly while standing on double limbs with eyes closed. The improvement in static balance was greater while using the insole with greater density; however, the difference was not statistically significant. CONCLUSIONS: An insole with arch support made of ethyl vinyl acetate Shore A of 30 and 50, which could decrease plantar pressure concentration, had no negative effect on the static balance of diabetes. Therefore, further research on the long-term effects of such insoles on the static balance of diabetes is suggested.

The efficacy of cognitive-motor rehabilitation on cognitive functions and behavioral symptoms of attention deficit/hyperactivity disorder (ADHD) children: Specification of near-transfer and far-transfer effects in comparison to medication.

BACKGROUND AND AIM: This study aimed to investigate and compare the efficacy of cognitive-motor rehabilitation (CMR) with methylphenidate on cognitive functions and behavioral symptoms of children with attention deficit/hyperactivity disorder (ADHD) and specified the near-transfer and far-transfer effects. MATERIALS AND METHODS: The research was semiexperimental with posttest and follow-up assessments, in a single-blind design. Forty-eight boys with ADHD, aged 9-12, were selected conveniently regarding the inclusion/exclusion criteria, matched base on severity and Intelligence quotient (IQ) and were randomly assigned to CMR (n = 16), methylphenidate medication (MED, n = 16), and placebo CMR groups (PCMR, n = 16). CMR and PCMR received 20 3-h training sessions, and the MED group received 20 or 30 mg/day methylphenidate. Tower of London (TOL), Swanson, Nolan, and Pelham, Version IV Scale (SNAP-IV), Wechsler's digit span and mathematic subscales, dictation test, and restricted academic situation scale (RASS) were completed at posttest and follow-up. The data were analyzed by repeated measures multivariate analysis of variance. RESULTS: CMR outperformed PCMR on forward digit span, backward digit span, ToL score at both posttest, and follow-up (P < 0.05). CMR scored lower than MED on ADHD-PI and ADHD-C at both posttest and follow-up (P < 0.05). Moreover, CMR outperformed MED on dictation at both assessment phases (P < 0.01) and RASS at the follow-up phase (P < 0.05). CMR outperformed PCMR on mathematics at post-test (P = 0.038) and also, in dictation and RASS, at both post-test (P < 0.001) and follow-up (P < 0.05). CONCLUSION: CMR Improves near-transfer cognitive functions and behavior symptoms of ADHD as much as MED, but only CMR has more generalizable and endurable improvement on complex Efs and academic performance (far-transfer effects).

Development of fortified probiotic dairy desserts with added date extract, whey protein, inulin, folic acid, vitamin D and calcium.

This study aimed to develop fortified dairy desserts containing Lactobacillus casei and evaluate the physicochemical, sensory, and microbiological characteristics of the product during 28 days of storage. Seven dairy desserts were formulated by date extract (8%), whey protein (1.56%), inulin (4%(, folic acid (0.00066%), vitamin D (0.002%) and gluconate calcium (0.66%). The addition of date extract and inulin increased total solids while whey protein incorporation into dairy desserts led to the improvement of protein and phosphorous content. Furthermore, all fortified dairy desserts showed higher antioxidant activity and total phenolic content. Fortification of dairy desserts had no negative effect on the sensory acceptability and syneresis was not observed. In addition, the pH reduction and increased acidity did not adversely affect the count of L. casei, which remained above 8 log CFU g-1 during storage. Consequently, the fortified dairy dessert developed in this research is an innovative food product with good acceptability and high nutritional quality.

A ten-year study of anti-diabetic drugs utilization in Iran.

Objectives: According to the world health organization (WHO), by the year 2030 diabetes will become the world's seventh leading cause of death. This study aimed to design and conduct a descriptive pharmacoepidemiological investigation of anti-diabetic drugs utilization during a ten-year period using the anatomical therapeutic classification/defined daily dose (ATC / DDD) system in Iran. Methods: Based on pharmaceutical wholesalers' sale reports, sale data, including value and volume, were retrieved from the Iranian Annual Pharma Statistics for 2009-2018. The ATC/DDD system was used to standardize the raw sales data. Anti-diabetic drug utilization was reported as DDD per 1000 person in the population per day. Expenditure was calculated as USD per DDD. Results were then analyzed descriptively. Results: During the ten-year study period, total anti-diabetic drug consumption increased by 235.53%. Insulin utilization grew by 148.65%, whereas non-insulin agents' use showed a 132.68% increase. Anti-diabetic drugs' expenditure increased by almost 9-fold, but changes were accompanied with many fluctuations. Although the absolute expenditure of almost all classes of anti-diabetic drugs were increasing, this growth was greater in biguanides, which only includes metformin in Iran. Approximately one-third of anti-diabetic drugs expenditures were related to fast-acting insulins. Imported drugs share in cost was significant, but not in consumption. The overall share of insulin consumption was less than 19%, but their share of total value reached 60% of the anti-diabetic market. Conclusions: The growing trend in both insulin and non-insulin anti-diabetic drugs utilization is a substantial issue for health authorities' policy making for sustainable access to medicine.

The effect of toe-only rocker sole shoes on gait variability of the elderly.

Gait variability could associate with fall risk in older people. Rocker sole shoes are commonly prescribed to reduce plantar pressure and facilitate forward movement. Thus, it may affect gait stability. The purpose of this study was to investigate the effects of toe-only rocker shoes on gait variability in the elderly. Seventeen healthy elderly participants walked on a treadmill under six different conditions including barefoot (BF), normal shoe (NS), and four types of toe-only rocker sole shoes with various degrees of rocker angle (RS10, RS20, RS30, and RS40). Then the step length variability (SLV), the step time variability (STV), the step width variability (SWV), and the stance time variability were measured. Increasing rocker angle in toe-only rocker did not significantly affect gait variability more than the standard shoe. It seems that different rocker angles in toe-only rocker sole shoes do not pose a threat to gait variability compared to the standard shoes in healthy elderly. Findings of the study suggested that the toe-only rocker sole can be used to facilitate forward progression in the elderly. Further investigation is also required to examine the long-term effects of toe-only rocker sole shoes on gait variability in frail elderly.

The effect of rocker sole shoes on ground reaction force in the elderly.

Aging is associated with decreases in gait performance and mobility. Toe-only rocker sole is prescribed as a common shoe modification in restricted foot and ankle joints mobility. Therefore, this study aimed to determine the effect of toe-only rocker sole shoes on the ground reaction force (GRF) in the elderly. Twenty-one older adults walked on a walkway equipped with one force plate under six different conditions including barefoot (BF), normal shoe (NS), and four types of toe-only rocker sole shoes (RS) with various degrees of rocker angle (RS10, RS20, RS30, and RS40). The peaks of the GRFs in three planes were obtained. Different rocker angles could affect GRF parameters. The first peak of GRF (FZ1) significantly increased with both RS30 and RS40 compared to BF, NS, RS10, and RS20. FZ1 significantly decreased with RS30 compared to RS40. The braking force (FX1) was significantly lower with NS compared to RS30 and RS40. FX1 was significantly higher with RS40 compared to the other shoe conditions. The propulsive force (FX2) significantly decreased during walking with BF compared to NS, RS20, RS30, and RS40. A higher FX2 was observed in RS40 than the other shoe conditions except RS30. Also, FX2 was significantly lower with RS10 compared to RS30. Increasing rocker angle may result in an increase in the peak magnitude of FZ1, FX1, FX2 in the elderly without any improvement in walking speed.

Roles of Gut Microbiota in Colorectal Carcinogenesis Providing a Perspective for Early Diagnosis and Treatment.

Colorectal cancer (CRC) is the third most prevalent malignant neoplasm in the world. CRC is influenced by both environmental and genetic factors. Through toxin-mediated DNA damage and the promotion of persistent dysregulated inflammation, the gut microbiota plays a crucial role in the development of CRC. In this review, we discussed the correlation between the bacterial microbiota and CRC carcinogenesis as well as the mechanism by which Streptococcus bovis/gallolyticus, Fusobacterium nucleatum, Bacteroides fragilis, and Escherichia coli can cause CRC.

Nonlinear analysis of dynamic stability in walking with toe-only rocker sole shoes in elderly.

BACKGROUND: Elderly subjects are at the risk of falling. One type of shoe intervention used for this group of the subjects is the shoe with rocker. The aim of this study was to investigate the effects of shoes with various degrees of rockers on dynamic stability of elderly subjects while walking. METHOD: 15 elderly subjects were recruited in this study. A motion analysis system was used to record the motions of body while walking on a treadmill. The local dynamic stability (LDS) was evaluated based on use of Lyapunov exponent of center of mass (COM) movement. The subjects were asked to walk barefoot, with shoe with no rocker and with shoe with various rockers (10, 20, 30 and 40°). RESULTS: The mean values of LDS (λmax-S) in anteroposterior direction were 0.95 ± 0.46, 0.78 ± 0.51 and 0.74 ± 0.54 in bare foot, shoes with no rocker and shoe with 10° rocker, respectively. The mean value of LDS (λmax-S) in vertical direction varied between 1.21 and 1.23. There was no significant difference between LDS of elderly subjects while walking with shoes with various rocker angles. DISCUSSION: Use of shoes with various rocker angles dose not influence on dynamic stability of elderly subjects while walking. Therefore, it is recommended to use this kind of shoe intervention for other trapeutic purposes.

Escherichia coli and Colorectal Cancer: Unfolding the Enigmatic Relationship.

Colorectal cancer (CRC) is one of the deadliest cancers in the world. Specific strains of intestinal Escherichia coli (E. coli) may influence the initiation and development of CRC by exploiting virulence factors and inflammatory pathways. Mucosa-associated E. coli strains are more prevalent in CRC biopsies in comparison to healthy controls. Moreover, these strains can survive and replicate within macrophages and induce a pro-inflammatory response. Chronic exposure to inflammatory mediators can lead to increased cell proliferation and cancer. Production of colobactin toxin by the majority of mucosa-associated E. coli isolated from CRC patients is another notable finding. Colibactin-producing E. coli strains, in particular, induce double-strand DNA breaks, stop the cell cycle, involve in chromosomal rearrangements of mammalian cells and are implicated in carcinogenic effects in animal models. Moreover, some enteropathogenic E. coli (EPEC) strains are able to survive and replicate in colon cells as chronic intracellular pathogens and may promote susceptibility to CRC by downregulation of DNA Mismatch Repair (MMR) proteins. In this review, we discuss current evidence and focus on the mechanisms by which E. coli can influence the development of CRC.

The Effect of an Educational Intervention on Health Literacy and the Adoption of Nutritional Preventive Behaviors Related to Osteoporosis Among Iranian Health Volunteers.

OBJECTIVES: Given the increase in osteoporosis among health volunteers and the effect of health literacy on the adoption of nutritional preventive behaviors, this study aimed to determine the effects of an educational intervention on health literacy and the adoption of nutritional preventive behaviors related to osteoporosis among health volunteers. METHODS: This was a quasi-experimental, interventional study of health volunteers conducted in 2020. In this study, 140 subjects (70 in both intervention and control groups) were selected using the random multi-stage sampling method. An educational intervention was conducted using the Telegram application, and educational messages were sent to the health volunteers in the intervention group across 6 sessions. Data were collected via a demographic questionnaire, the Health Literacy for Iranian Adults survey, and a nutritional performance questionnaire, which were completed before and 3 months after the intervention. The data were collected and analyzed using SPSS version 23. RESULTS: Before the intervention, there were no significant differences in the mean scores for health literacy variables and the adoption of nutritional preventive behaviors between the intervention and control groups (p>0.05). After the intervention, there was a significant change in the mean scores for health literacy and the adoption of preventive behaviors in the intervention group (p<0.05) as opposed to the control group. CONCLUSIONS: Interventions aimed at increasing health literacy are effective for promoting the adoption of preventive and healthy nutritional behaviors related to osteoporosis.

Mucosa-Associated Escherichia coli in Colorectal Cancer Patients and Control Subjects: Variations in the Prevalence and Attributing Features.

Accumulating evidence indicates that specific strains of mucosa-associated Escherichia coli (E. coli) can influence the development of colorectal carcinoma. This study aimed to investigate the prevalence and characterization of mucosa-associated E. coli obtained from the colorectal cancer (CRC) patients and control group. At two referral university-affiliated hospitals in northwest Iran, 100 patients, 50 with CRC and 50 without, were studied over the course of a year. Fresh biopsy specimens were used to identify mucosa-associated E. coli isolates after dithiothreitol mucolysis. To classify the E. coli strains, ten colonies per sample were typed using enterobacterial repetitive intergenic consensus-based PCR (ERIC-PCR). The strains were classified into phylogroups using the quadruplex PCR method. The PCR method was used to examine for the presence of cyclomodulin, bfp, stx1, stx2, and eae-encoding genes. The strains were tested for biofilm formation using the microtiter plate assay. CRC patients had more mucosa-associated E. coli than the control group (p < 0.05). Enteropathogenic Escherichia coli (EPEC) was also found in 23% of CRC strains and 7.1% of control strains (p < 0.05). Phylogroup A was predominant in control group specimens, while E. coli isolates from CRC patients belonged most frequently to phylogroups D and B2. Furthermore, the frequency of cyclomodulin-encoding genes in the CRC patients was significantly higher than the control group. Around 36.9% of E. coli strains from CRC samples were able to form biofilms, compared to 16.6% E. coli strains from the control group (p < 0.05). Noticeably, cyclomodulin-positive strains were more likely to form biofilm in comparison to cyclomodulin-negative strains (p < 0.05). In conclusion, mucosa-associated E. coli especially cyclomodulin-positive isolates from B2 and D phylogroups possessing biofilm-producing capacity colonize the gut mucosa of CRC patients.

The role of Akkermansia muciniphila in obesity, diabetes and atherosclerosis.

Alteration in the composition of the gut microbiota can lead to a number of chronic clinical diseases. Akkermansia muciniphila is an anaerobic bacteria constituting 3-5% of the gut microbial community in healthy adults. This bacterium is responsible for degenerating mucin in the gut; its scarcity leads to diverse clinical disorders. In this review, we focus on the role of A. muciniphila in diabetes, obesity and atherosclerosis, as well as the use of this bacterium as a next-generation probiotic. In regard to obesity and diabetes, human and animal trials have shown that A. muciniphila controls the essential regulatory system of glucose and energy metabolism. However, the underlying mechanisms by which A. muciniphila alleviates the complications of obesity, diabetes and atherosclerosis are unclear. At the same time, its abundance suggests improved metabolic disorders, such as metabolic endotoxemia, adiposity insulin resistance and glucose tolerance. The role of A. muciniphila is implicated in declining aortic lesions and atherosclerosis. Well-characterized virulence factors, antigens and cell wall extracts of A. muciniphila may act as effector molecules in these diseases. These molecules may provide novel mechanisms and strategies by which this bacterium could be used as a probiotic for the treatment of obesity, diabetes and atherosclerosis.

Dysregulation of lncRNA in Helicobacter pylori-Infected Gastric Cancer Cells.

Helicobacter pylori (H. pylori) infection is the most common cause of gastric cancer (GC). This microorganism is genetically diverse; GC is caused by several genetic deregulations in addition to environmental factors and bacterial virulence factors. lncRNAs (long noncoding RNAs) are significant biological macromolecules in GC, have specific functions in diseases, and could be therapeutic targets. Altered lncRNAs can lead to the abnormal expression of adjacent protein-coding genes, which may be important in cancer development. Their mechanisms have not been well understood, so we are going to investigate the risk of GC in a population with both high lncRNA and H. pylori infection.

Effects of Gentamicin-Loaded Chitosan-ZnO Nanocomposite on Quorum-Sensing Regulation of Pseudomonas Aeruginosa.

Cell density-based intercellular signaling mechanism is known as Quorum sensing (QS); it serves a significant role in regulating the pathogenic factors. The objective of the present study was to assess the influence of chitosan-zinc oxide nanocomposite (CH-ZnO nanocomposite), alone and in combination with gentamicin, on the sensitivity to hydrogen peroxide (H2O2), the production of pathogenic factors and QS-regulated genes of Pseudomonas aeruginosa. The efficacy of the minimum inhibitory concentration (MIC) and 1/4 MIC of the CH-ZnO nanocomposite, alone and in combination with gentamicin, on the sensitivity to H2O2, pyocyanin secretion, swarming and twitching motilities was evaluated. In addition, the expression of some QS-regulated genes including rhlI, rhlR, lasI and lasR genes was measured by Real-time quantitative PCR (RT-qPCR) following exposure to the nanocomposite. The results demonstrated that at MIC concentrations, the gentamicin-loaded CH-ZnO nanocomposite significantly inhibited QS-regulated phenotypes such as pyocyanin secretion (82.4%), swarming (76%) and twitching (73.6%) motilities; further it increased the inhibition growth zone (134.5%), as well as, at 1/4 MIC concentration decreased the expression of lasI (72%), lasR (78%), rhlI (76%) and rhlR (82%) genes; as compared to untreated P. aeruginosa PAO1 (P < 0.05). Our results also demonstrated that the CH-ZnO nanocomposite combined with gentamicin could be a potential innovative candidate, which could be broadly applied in the treatment of P. aeruginosa infections.

Novel Strategies to Combat Bacterial Biofilms.

Biofilms are considered as a severe problem in the treatment of bacterial infections; their development causes some noticeable resistance to antibacterial agents. Biofilms are responsible for at least two-thirds of all infections, displaying promoted resistance to classical antibiotic treatments. Therefore, finding new alternative therapeutic approaches is essential for the treatment and inhibition of biofilm-related infections. Therefore, this review aims to describe the potential therapeutic strategies that can inhibit bacterial biofilm development; these include the usage of antiadhesion agents, AMPs, bacteriophages, QSIs, aptamers, NPs and PNAs, which can prevent or eradicate the formation of biofilms. These antibiofilm agents represent a promising therapeutic target in the treatment of biofilm infections and development of a strong capability to interfere with different phases of the biofilm development, including adherence, polysaccharide intercellular adhesion (PIA), quorum sensing molecules and cell-to-cell connection, bacterial aggregation, planktonic bacteria killing and host-immune response modulation. In addition, these components, in combination with antibiotics, can lead to the development of some kind of powerful combined therapy against bacterial biofilm-related infections.

Determination of the correlation between muscle forces obtained from OpenSim and muscle activities obtained from electromyography in the elderly.

Measurement of muscle forces related to aging can help to better identify the gait impairment mechanisms in the elderly. To this end, musculoskeletal modeling has been developed to estimate muscle forces. This study aimed to check the validity of OpenSim modeling (i.e., computed muscle control) approach in elderly subjects. Kinematic and kinetic data and Electromyography (EMG) signals for four different muscles were collected in nine healthy elderly males during walking. Dynamic simulation was done within OpenSim. Correlation analysis was performed to quantitatively compare the maximum estimated muscle forces with maximum measured muscle activities during the first double limb support, single limb support, and the second double limb support phases. The area-time plots of OpenSim and EMG data during gait cycle were obtained for qualitative assessment. In quantitative assessment, a low to moderate correlation was observed for the peak of muscle force and muscle activation of four muscles during sub phases of gait. The muscle forces pattern from OpenSim was found to be relatively similar to the muscle activity pattern from EMG especially for Gastrocnemius Medialis. A low to moderate consistency between OpenSim and EMG in the elderly can be explained by using a single mathematical estimation approach.

Can Oral Tolerance Explain the Inconsistencies Associated with Total Dietary Diversity and Colon Cancer? A Mechanistic Systematic Review.

Among the gastrointestinal tract cancers, the risk of colon cancer is strongly dependent on dietary factors. For the first time in the current review, all the original case-control studies, associated with the correlation between total dietary diversity score and colon cancer risk, were evaluated. In this regard, three databases, including PubMed/MEDLINE, Scopus, and Web of Sciences, were investigated to retrieve the related citations from 1990 until 2019. Among the included citations, three studies were finally included. In these included studies, the dietary diversity score was evaluated with 129-item and 800-item FFQs. Findings reveal that total dietary diversity can increase the risk of colon cancer in men, but not women; while, one study using 57-item FFQ reported the beneficial association of total dietary diversity with colon cancer among men. Significant demand for conducting more research to investigate the real mechanistic effects of dietary diversity on the risk of colon cancer development was demonstrated due to the inconsistent, questionable, and incomplete findings associated with the included studies.