Students' perception of e-learning during the Covid-19 pandemic: a survey study of Iranian nutrition science students.

BACKGROUND: COVID-19 pandemic caused university closures, which created learning challenges for students worldwide. Switching to online educational systems had significant impact on students' performances. The current study aims to investigate the perception of university students from the Nutrition Science department regarding e-learning in Iran. METHODS: The design of the study is cross-sectional. Data were collected through online surveys from Iranian students from the Nutrition Sciences Department. Stratified random sampling was used to randomly select 955 participants. A self-administered validated questionnaire was used for data collection. Descriptive statistics, Analysis of Variance (ANOVA) and Chi-Square tests were used for analysis of the data. RESULTS: Results revealed that 67.2% of students didn't have any former experience of e-learning. About 38.3% had moderate levels of Information Technology (IT) skills. Our results revealed that based on students' responses, being able to stay at home was one of the most common benefits of e-learning (39.1%). However, the most common challenge that students faced was related to technical problems (39.6%). When compared to e-learning, most students preferred face-to face type of learning. Students believed that this method no only increased their knowledge but also their skills and social competence as compared to e-learning. Only 28% of students rated e-learning as enjoyable. Furthermore, acceptance of online based education was statistically associated with students' degree level. CONCLUSION: In conclusion, students reported both advantages and disadvantages of e-learning but still reported that face-to-face learning is considered the most effective form of learning.

Dietary Total Antioxidant Capacity and Risk of Polycystic Ovary Syndrome: A Case-Control Study.

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, ß-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.

Association of Dietary Glycemic Index, Glycemic Load, Insulin Index, and Insulin Load with Bacterial Vaginosis in Iranian Women: A Case-Control Study.

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.

The association between fertility diet score and polycystic ovary syndrome: A Case-Control study.

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.

Associations between systemic inflammation and intestinal permeability with Onodera's prognostic nutritional index in critically ill patients.

BACKGROUND: Malnutrition is a serious condition in critically ill patients. The aim of this study is to evaluate the relationships between the Onodera's prognostic nutritional index (OPNI) and intestinal permeability and between OPNI and systemic inflammation in critically ill patients. METHODS: This was a cross-sectional study conducted in the general intensive care unit (ICU) of a university-affiliated hospital. A total of 162 patients admitted between May 2018 and December 2019, was included in the study. The OPNI was calculated at admission and categorized as ≤40 or >40. We assessed plasma endotoxin and zonulin concentrations as markers of intestinal permeability as well as serum interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) as markers of systemic inflammation upon admission under stringent conditions. The relationships between these markers and OPNI were assessed after adjusting for potential confounders through estimation of a binary logistic regression model. RESULTS: Median (interquartile range) hs-CRP, IL-6 zonulin, and endotoxin were significantly greater in the low OPNI subgroup than in the high OPNI subgroup (all P<0.05). Multivariate analyses showed significant association between serum IL-6 (odds ratio [OR], 0.88; 95% confidence interval [CI], 0.64-0.96), serum hs-CRP (OR, 0.77; 95% CI, 0.53-0.92), plasma endotoxin (OR, 0.81; 95% CI, 0.72-0.93), and plasma zonulin (OR, 0.83; 95% CI, 0.75-0.98) levels with OPNI in the overall population. CONCLUSIONS: Our results provide evidence that higher plasma endotoxin, zonulin, IL-6, and hs-CRP levels are associated with progressively lower OPNI in mixed ICU populations, particularly in surgical ICU patients.

Association of vitamin D deficiency with COVID-19 severity and mortality in Iranian people: a prospective observational study.

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.

Trial of ready-to-use supplemental food and corn-soy blend in pregnant Malawian women with moderate malnutrition: a randomized controlled clinical trial.

Background: Malnutrition during pregnancy in sub-Saharan Africa is associated with poor birth outcomes. Objective: This study compared maternal and offspring anthropometry for moderately malnourished pregnant women receiving ready-to-use supplemental food (RUSF), a fortified corn-soy blend (CSB+) with a daily multiple micronutrient antenatal supplement [United Nations International Multiple Micronutrient Preparation (UNIMMAP)], or standard of care comprising CSB+ and iron and folic acid (IFA). Design: A single-blind randomized controlled clinical trial was conducted in southern Malawi among 1828 pregnant women with moderate malnutrition, defined as a midupper arm circumference (MUAC) ≥20.6 and ≤23.0 cm. Women received 1 of 3 dietary treatment regimens that provided ∼900 kcal/d and 33-36 g protein/d. Maternal and infant anthropometry were followed until the child was 3 mo old. Results: Newborns had a mean length-for-age z score of -1.3 ± 1.2 and 22% were stunted at birth. Mothers receiving RUSF had the highest weight gain during supplementation (3.4 ± 2.6, 3.0 ± 2.2, and 3.2 ± 2.4 kg for the RUSF, CSB+ with UNIMMAP, and CSB+ with IFA groups, respectively; P = 0.03). Newborn birth weights and lengths were similar across intervention groups, but the incidence of newborns with a birth weight <2.4 kg (weight-for-age z score <-2) was higher in the CSB+ with UNIMMAP group than the other groups (17%, 18%, and 24% for the CSB+ with IFA, RUSF, and CSB+ with UNIMMAP groups, respectively; P = 0.02). At birth, HIV-exposed newborns had a similar length and weight as newborns without HIV exposure, but their head circumference was smaller (34.0 ± 1.5 and 34.3 ± 1.6 cm, respectively; P = 0.02). At 3 mo of age, HIV-exposed infants had smaller weights, lengths, and head and arm circumferences than infants without HIV exposure. Conclusions: RUSF improved maternal weight gain compared with CSB+ with UNIMMAP. The large amount of food given and the modest effect on linear growth in newborns suggests that stunting in utero is unlikely to be reduced by supplemental food alone. This trial was registered at clinicaltrials.gov as NCT02120599.