Mohammad Amin Karimi

This systematic review and meta-analysis aimed to evaluate the effects of bariatric surgery on serum anti-Müllerian hormone (AMH) levels in women, highlighting potential implications for ovarian reserve and fertility management. A systematic literature search was conducted in PubMed, Web of Science, Scopus, and Embase databases up to February 2025. The included studies were observational in design (cohort, case-control, cross-sectional) and provided quantitative pre- and post-operative AMH data. Quality assessment was performed using the Newcastle-Ottawa Scale, and data were analyzed using a random-effects meta-analysis. A total of 14 studies were included in the systematic review, with 591 participants contributing to the quantitative meta-analysis. The pooled results indicated that bariatric surgery did not significantly alter AMH levels overall (WMD = 0.05 ng/mL; 95% CI: -0.66, 0.75; p = 0.897), with substantial heterogeneity among effect estimates (I² = 93.9%, p < 0.001). Subgroup analyses suggested significant AMH reductions in studies with baseline AMH > 3 ng/mL, upper age limit ≤ 35 years, longer follow-up, retrospective design, smaller sample size, and South Asian populations, while a significant increase was observed in the fertile subgroup. Bariatric surgery was not associated with a significant overall change in serum AMH levels. Findings suggest variable AMH responses across clinical and methodological contexts; however, given substantial heterogeneity and limited reproductive outcome data, these changes should be interpreted as dynamic endocrine biomarker responses rather than direct evidence of altered ovarian reserve or fertility potential. Not applicable.

Background: Non‐alcoholic fatty liver disease (NAFLD) has emerged as a significant public health issue due to its close association with metabolic abnormalities. Concurrently, celiac disease (CD), an autoimmune disorder triggered by gluten, has been increasingly investigated in connection with various chronic conditions. Given the potential link between these two conditions, this systematic review and meta‐analysis aimed to determine the prevalence of CD in individuals diagnosed with NAFLD. Methods: A comprehensive literature search was performed in multiple databases including PubMed, Scopus, Embase, and Web of Science. Studies were considered eligible if they reported clear data regarding CD prevalence among NAFLD populations. Results: Pooled data analysis revealed an overall CD prevalence of 3.8% (95% CI: 0.02–0.07) among NAFLD patients, with significant heterogeneity observed ( I ² = 97.36%, p < 0.01). Further subgroup analyses demonstrated variations in CD prevalence related to disease characteristics; notably, the prevalence was higher among patients specifically evaluated for CD using serological and histological methods. Exploratory stratified analyses indicated that CD was more prevalent in patients with NAFLD who had lower body mass index (BMI), higher levels of aspartate aminotransferase (AST), lower hemoglobin (HB) concentrations, and reduced platelet (PLT) counts. Conclusion: The findings from this meta‐analysis suggest a higher‐than‐expected prevalence of CD among patients with NAFLD, though the substantial heterogeneity across studies limits the precision of this estimate. These findings indicate that clinicians may consider selective screening for CD, particularly in patients presenting with specific clinical features. However, given the exploratory nature of the subgroup analyses and the variability in diagnostic approaches across included studies, larger prospective studies with standardized diagnostic criteria are needed to confirm these observations and better elucidate the relationship between these two conditions.

Background and Aims: Coffee and caffeine consumption have been widely investigated for their potential effects on cancer risk, driven by their bioactive compounds and antioxidant properties. However, findings on the association between them and breast cancer risk remain inconsistent across studies. This study aimed to conduct a systematic review and meta‐analysis to examine the association between coffee, decaffeinated coffee, and caffeine intake and the risk of breast cancer. Methods: A literature search was conducted in databases from inception through 1st February 2026 to identify relevant cohort studies. Meta‐analyzes were performed using the RRs with 95% confidence intervals (95% CI) as effect measures. Results: Thirty‐one cohort studies were included. Regular coffee consumption was associated with a modest reduction in breast cancer risk among women (pooled HR: 0.95; 95% CI: 0.91–0.99; p = 0.035), particularly in postmenopausal populations. In contrast, no significant associations were observed for caffeine intake (HR: 0.99; 95% CI: 0.94–1.04; p = 0.824) or decaffeinated coffee consumption (HR: 1.00; 95% CI: 0.94–1.07; p = 0.793). Subgroup analyzes by menopausal status, cohort duration, and hormone receptor subtype yielded consistent null results across both caffeine‐ and decaffeinated‐coffee categories. Conclusion: This meta‐analysis indicates that while caffeine and decaffeinated coffee intake are not significantly associated with breast cancer risk, regular coffee consumption may offer a modest inverse association, especially among postmenopausal women. The findings highlight the potential influence of bioactive compounds in coffee beyond caffeine on breast cancer development. Further large‐scale prospective studies are needed to substantiate these results and elucidate underlying biological pathways.

This systematic review and meta‐analysis was conducted to investigate the effects of Chlorella supplementation on cardiometabolic health indicators in individuals with overweight or obesity. A systematic search of PubMed, Scopus, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials was conducted up to November 2024. Eighteen studies published between 2012 and 2024 were included, involving a total of 717 participants. The duration of the trials ranged from 1 to 12 weeks, with daily Chlorella doses varying from 135 to 15,000 mg/day. Chlorella supplementation significantly reduced body fat percentage (WMD = −0.72%, 95% CI: −1.11 to −0.34), body mass index (WMD = −0.35 kg/m ² , 95% CI: −0.55 to −0.14), weight (WMD = −1.41 kg; 95% CI: −2.19 to −0.64), Waist‐Hip Ratio (WMD = −0.01, 95% CI: −0.02 to −0.01), Homeostatic Model Assessment for Insulin Resistance (WMD = −0.16 units, 95% CI: −0.29 to −0.04), insulin levels (WMD = −1.00 μU/mL, 95% CI: −1.34 to −0.66), low‐density lipoprotein cholesterol (WMD = −5.73 mg/dL, 95% CI: −8.77 to −2.70), total cholesterol (WMD = −6.62 mg/dL, 95% CI: −10.18 to −3.05), triglycerides (WMD = −3.24 mg/dL, 95% CI: −6.25 to −0.23), alanine aminotransferase (WMD = −5.22 IU/L, 95% CI: −8.78 to −1.65), aspartate aminotransferase (WMD = −3.45 IU/L, 95% CI: −5.00 to −1.90), and leptin (WMD = −0.66 ng/mL, 95% CI: −1.24 to −0.08). Additionally, there were significant increases in catalase activity (WMD = 19.15 IU/g Hb, 95% CI: 0.44 to 37.85), and superoxide dismutase levels (WMD = 20.53 U/L, 95% CI: 15.03 to 26.02). Chlorella supplementation may benefit anthropometric and cardiometabolic outcomes in adults with overweight or obesity. However, the overall certainty of evidence was low to very low according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework, limiting confidence in these findings. Moreover, most included trials were conducted in Iran, which may restrict generalizability. Further high‐quality, well‐powered randomized trials in diverse populations are needed to confirm these effects.

Purpose: Our review aims to assess the role of DCE-MRI in radiogenomics, with a focus on ML-based predictive models. Methods: A comprehensive search was conducted in the PubMed, Scopus, Web of Science, Embase, and ProQuest databases via key terms related to “DCE-MRI”, “Machine learning”, “Deep learning”, “Glioblastoma”, and “Radiogenomics”. The extracted data include dataset descriptions, tumor classifications, MRI sequences, predicted genes, ML approaches, performance metrics, results, external validation status, and interpretability methods. Results: Out of the 432 identified articles, five studies involving 621 GBM patients met the inclusion criteria. Studies have employed DCE-MRI alongside other sequences, including T1-weighted, T2-weighted, and FLAIR. The predicted genetic markers included IDH1 mutation, EGFR mutation, MGMT methylation, and key cell cycle regulatory molecules such as RTK, p53, and RB1. Forty percent of the studies utilized DL approaches, with only one study performing external validation. Performance metrics, such as the area under the receiver operating characteristic curve, were reported across studies. Conclusion: Our findings underscore the promising role of DCE-MRI in GBM radiogenomics, particularly when combined with ML approaches. However, the lack of external validation limits the broader applicability of these models. Future research should focus on larger, multicenter studies with thorough validation methods to enhance the clinical relevance and advance precision medicine in GBM management.

Rheumatoid arthritis (RA) is a chronic autoimmune disorder marked by persistent synovial inflammation, joint destruction, and systemic complications. Recent research has revealed the complex involvement of autophagy, a cellular degradation and recycling process, in the pathogenesis and progression of RA. This review provides a comprehensive analysis of autophagy’s multifaceted roles across immune regulation, synovial hyperplasia, osteoclastogenesis, and antigen presentation. Particular attention is given to the dualistic nature of autophagy, which may exert both protective and pathogenic effects depending on the cellular context and disease stage. We explore key molecular pathways regulating autophagy, including the mTOR, AMPK, and ULK1 axes, and detail how these are modulated by cytokines and signaling molecules characteristic of the RA inflammatory milieu. Epigenetic and genetic factors, including polymorphisms in ATG and BECN1 genes, microRNA regulation, and histone modifications, are also examined for their impact on autophagic flux and immune dysregulation. The diagnostic potential of autophagy-related biomarkers is discussed through transcriptomic and bioinformatics studies that stratify RA subtypes and correlate autophagic activity with disease severity. Additionally, we review therapeutic strategies targeting autophagy, encompassing conventional DMARDs, biologics, small molecules, nanoparticles, and phytochemicals. While modulating autophagy shows clinical promise, challenges remain regarding safety, specificity, and long-term efficacy. The integration of high-throughput omics technologies with artificial intelligence presents new opportunities to refine diagnostic precision and develop personalized therapeutic interventions. This review underscores the necessity of further translational research to define context-specific roles of autophagy in RA and to harness its potential in advancing precision medicine.

Background: Alcohol use disorder (AUD) affects nearly half a billion people globally and is associated with significant physical and psychiatric comorbidities. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), approved for diabetes and obesity, have shown promise in modulating reward-related brain pathways, suggesting potential benefits in the management of AUD. Methods: This systematic review and meta-analysis, registered in PROSPERO and conducted per PRISMA guidelines, assessed the effects of GLP-1RA use on AUD and alcohol-related outcomes in adults with obesity or type 2 diabetes mellitus. Five databases (PubMed, Embase, Web of Science, Scopus, and Cochrane Library) were searched up to September 30, 2025. Random-effects models were applied, and sensitivity analyses examined result stability. No subgroup or meta-regression analyses were performed owing to the small number of eligible studies. Results: Five observational cohort studies (three on AUD diagnosis, two on alcohol-related hospitalization) were included, with sample sizes ranging from 4,321 to > 53,000 participants. GLP-1RA use was associated with a 28% lower risk of AUD diagnosis (HR = 0.72, 95% CI 0.59–0.89; I² = 65%). For alcohol-related hospitalization, a non-significant reduction was observed (HR = 0.76, 95% CI 0.57–1.01; I² = 77%). Leave-one-out sensitivity analyses confirmed the direction and magnitude of the AUD finding but highlighted the limited evidence base for hospitalization. Conclusion: GLP-1RA use was associated with a reduced risk of AUD diagnosis, with a possible but non-significant reduction in alcohol-related hospitalization. Effects may be mediated through modulation of mesolimbic reward pathways and the gut–brain axis. Further large-scale trials are warranted to confirm these findings. Graphical

Background and Aims: Gastrointestinal neuroendocrine neoplasms (g‐NENs) represent a heterogeneous group of tumors with variable prognoses. Inflammation‐based markers, such as the neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR), have emerged as potential prognostic indicators in various malignancies. This study aimed to evaluate the prognostic significance of NLR and PLR in g‐NENs and their associations with histopathological features and survival outcomes. Methods: A retrospective, cross‐sectional study was conducted on 80 patients with histologically confirmed g‐NENs from April 2017 to March 2019. Baseline NLR and PLR were calculated, and their relationships with tumor grade, Ki‐67 proliferation index, metastatic status, and survival outcomes were analyzed. Cox regression and logistic regression models were used to determine independent prognostic factors. Results: The hazard of death was approximately one‐third in the low NLR group after adjusting for metastasis and tumor grade (HR = 0.33, 95% CI: 0.14–0.80, p < 0.05). Elevated PLR was associated with poor outcomes; however, the difference between the high and low PLR groups was not statistically significant. Higher tumor grades and elevated Ki‐67 indices correlated with worse survival and increased metastatic potential ( p < 0.001). No significant associations were observed for CRP or ESR levels with survival. Conclusion: Our findings suggest that NLR may serve as an independent and accessible prognostic marker in g‐NENs, potentially offering a cost‐effective tool to support clinical decision‐making. The combined assessment of inflammatory biomarkers and histopathological parameters could improve prognostic accuracy and help guide personalized management strategies in patients with g‐NENs. Nevertheless, these observations should be interpreted with caution due to the retrospective, single‐center design and limited sample size. Future large‐scale, prospective studies are warranted to confirm and expand upon these results.

Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for obesity and type 2 diabetes mellitus (T2DM). While their metabolic benefits are well-established, their impact on postoperative outcomes following total joint arthroplasty (TJA) remains controversial. This study aimed to systematically evaluate the association between GLP-1 RA use and postoperative outcomes in patients undergoing total hip (THA), knee (TKA), or shoulder arthroplasty (TSA). Methods: We conducted a PRISMA-compliant systematic review and meta-analysis across PubMed, Embase, Web of Science, and Scopus through April 24, 2025. Eligible retrospective cohort studies compared adults undergoing TJA with and without preoperative GLP-1 RA exposure. Primary outcomes were 90-day readmission and all-cause revision. Pooled odds ratios (ORs) and standardized mean differences (SMDs) were calculated under random-effects models. Subgroup analysis based on the type of arthroplasty was conducted where applicable. Results: Fourteen studies (total sample size of 365,154; including 62,117 (17.01%) GLP-1 consumers, and 303,037 (82.98%) control cases) met the inclusion criteria (All studies included primary TJA cases). GLP-1 RA use was associated with lower 90-day readmission (OR = 0.86, 95% CI: 0.74-0.99, p = 0.033) and reduced sepsis incidence (OR = 0.63, 95% CI: 0.46–0.88, p = 0.006). No significant differences were observed for all-cause revision, thromboembolic events, and other medical and surgical complications. Length of stay was marginally shorter in GLP-1 users (SMD = −0.09, p = 0.048). Subgroup analyses showed the strongest sepsis reduction in TSA. Conclusion: GLP-1 RA use before TJA is associated with reduced readmission and sepsis risk without increasing surgical or thromboembolic complications. These findings support the potential perioperative benefits of GLP-1 RAs, warranting prospective trials to confirm causality and define optimal perioperative strategies for high-risk arthroplasty patients.