TET2, DNMT3A, IDH1, and JAK2 Mutation in Myeloproliferative Neoplasms in southern Iran

BACKGROUND

Five epigenetic regulator mutations are considered in myeloproliferative neoplasms (MPN) that have prognostic and therapeutic values.

OBJECTIVE

We aimed to evaluate these mutations in MPNs among the Iranian population.

METHODS

We selected 5 mutations in 4 epigenetic regulatory genes [TET2, DNMT3A, IDH1 (rs147001633&rs121913499), and JAK2)] and evaluated 130 patients with MPNs including 78 Philadelphia chromosome negative (49 ETs, 20 PVs, and 9 PMFs) and 52 Philadelphia chromosome-positive patients as well as 51 healthy controls.

RESULTS

Eight patients (6.5%) carried the DNMT3A mutation, 35 (27%) were positive for TET2 mutation and 64 (49.3%) had the JAK2V617F mutation. In the healthy controls, 16 (31.4%) cases had the TET2 mutation (15 Heterozygote + 1 Homozygote) and one had heterozygote JAK2 mutation. There was no statistically significant difference between patient groups for any of these mutations, except for JAK2. The JAK2 mutation rate was 18 (90%), 25 (51%), 7 (77.8%), 14 (26.9%) in polycythemia vera, essential thrombocythemia, primary myelofibrosis, and chronic myelocytic leukemia, respectively. Patients aged 60 and older were more likely to carry the TET2 mutation (23% vs. 39% in younger and older than 60 years old individuals, p=0.025). IDH1 was not detected at all and PV had the highest TET2 mutation 7(35%). Two PMF patients had a history of bone marrow transplantation that were negative for IDH1and DNMT3A and one was positive for TET2 mutation.

CONCLUSION

In the normal Iranian population, the heterozygote form of TET2 mutation is significant, especially in the elderly. No association was found between JAK2 and TET2 mutations. Both of them are more prevalent in the age group of 60 years and older. DNMT3A mutation has a low prevalence and occurs in both positive and negative MPNs.

Attitudes of nurses towards clinical information systems: a systematic review and meta-analysis

AIM

This systematic review and meta-analysis evaluates the attitudes of Iranian nurses towards clinical information systems in nursing practice.

BACKGROUND

Nurses are essential in the successful adoption and implementation of clinical information systems.

METHODS

A systematic search was performed in Medline, Embase, Cochrane, CINAHL, Scopus, and Web of Science and Farsi databases, to retrieve relevant studies. The methodological quality of the studies is assessed via the Joanna Briggs Institute's critical appraisal checklist for analytical cross-sectional studies. The random effect model was utilized to analyse the data due to the high heterogeneity in the included studies (n = 17).

RESULTS

Results indicate that clinical information systems impact on at least seven aspects of nursing practice, including documentation, patient safety, quality of treatment, communication, treatment management, nursing tasks and hospital resource management. Results also indicated that one aspect of using clinical information systems in nursing practice is satisfaction with the 'quality and design of clinical information systems', such as ease of use and learning, flexibility and software speed.

CONCLUSION

Clinical information systems can contribute to different aspects of nursing practice. However, their design should improve significantly in order to help nurses perform their professional activities in an efficient and satisfactory manner.

IMPLICATIONS FOR NURSING POLICY

Before the full deployment of clinical information systems, their usability should be tested. In pilot testing, nurses should provide necessary feedback about how well the systems work and improvements needed to meet their professional goals.

Colchicine Overdose in a Suicidal Attempt

Colchicine overdose is uncommon; however, it can cause serious adverse effects and even death. Colchicine inhibits microtubule polymerization, causing mitotic spindle disruption. Ingesting ˃0.5 mg of colchicine per kilogram bodyweight causes severe adverse effects and can even be fatal. Therefore, colchicine toxicity must be accurately monitored and managed.In this case report, we described a 21-year-old woman who attempted suicide by the ingestion of an estimated 30 mg colchicine. She was admitted to the hospital due to severe abdominal and chest pain, vomiting, lethargy, and weakness. The patient was medicated with ondansetron, apotel, antibiotics, platelet transfusions, sodium phosphate, calcium gluconate, calcitriol, desmopressin acetate, Granulocyte-Colony Stimulating Factor (G-CSF), and sodium bicarbonate. Fortunately, through the appropriate medical treatment, the signs and symptoms of colchicine toxicity were relieved and the patient survived despite the high colchicine serum level.

Comparison of Human Mesenchymal Stem Cells Derived from Various Compartments of Human Adipose Tissue and Tunica Adventitia Layer of the Arteries Subsequent to Organ Donation

BACKGROUND

Mesenchymal stem cells are one of the most interesting cell sources used in regenerative medicine.

OBJECTIVE

In the present study, we isolated and characterized the mesenchymal stem cells from various compartments of human adipose tissue and tunica adventitia layer of the arteries.

METHODS

Tissue explant culture was done from various compartments of the human adipose tissue and tunica adventitia layer of the arteries, including adipose tissue far from the vessels, perivascular tissues that are completely attached to the vessels, and tunica adventitia layer of the arteries. After the cell culture, characterization of the cells was determined at 3^rd-5^th passages. Flow cytometry was performed for antigen expression analysis of CD34, CD45, CD44, CD90, CD29, CD73, and CD105. For the evaluation of cell differentiation potential, adipogenic and osteogenic differentiation was conducted under appropriate protocols.

RESULTS

The cells were positive for CD44, CD90, CD29, and CD73 and negative for CD34, CD45, and CD105. Adipogenic and osteogenic differentiation potentials were different among the cells from various compartments. The cells derived from perivascular tissue demonstrated better adipogenic and osteogenic differentiation.

CONCLUSION

It is essential to characterize the cells from different tissues and compartments for different purposes in regenerative medicine.

The Effects of Cold Preservation Solutions Supplemented with UDCA and α-Lipoic Acid on the Viability and Function of Isolated Human Hepatocytes

BACKGROUND

Liver transplantation is the only treatment for end-stage and genetic liver diseases. The main burden of this treatment is the shortage of both living and cadaveric liver donors. An alternative treatment is using liver cell transplantation, which can be obtained from unused livers for transplantation. These hepatocytes should be kept ready in viable and functional situation in a frozen state to be instantly used when they would be needed. In our previous experience, we had isolated hepatocytes from unused livers.

OBJECTIVE

To find a preserving solution for increasing viability and function of the isolated hepatocytes that are stored to be transplanted.

METHODS

9 cadaveric donor livers, which were not used for transplantation due to various causes such as severe steatosis, were selected to isolate hepatocytes. Various cold storage solutions were tried to find the best temperature for more viability and functionality for preservation of hepatocytes. University of Wisconsin (UW) solution and Williams E media were used as control media. 2 anti-apoptotic and anti-oxidative solutions, i.e., α-lipoic acid and ursodeoxycholic acid (UDCA), were used as cold preservatives solutions. The numbers of viable hepatocytes were estimated by trypan blue method; the functionality was assessed by the cells ability to produce urea.

RESULTS

The highest number of viable and functional hepatocytes was obtained from freshly isolated cells. However, after preservation, the number of these viable hepatocytes and their functionality were not significantly different in cold storage solutions comparing to the control media used. Functionality of the isolated hepatocytes stored in UW with and without UCDA solution was similar to freshly isolated hepatocytes.

CONCLUSION

Preservatives with anti-apoptotic and antioxidant activity could not increase the number of viable hepatocytes. Functionality of cold storing hepatocytes could be preserved similar to freshly isolated hepatocytes by UW solution with and without UCDA.

A solution for enhancement of transient performance in nonlinear adaptive control: Optimal adaptive reset based on barrier Lyapunov function

In this paper, an adaptive controller based on barrier Lyapunov function combined with an optimal reset rule is devised in order to improve the transient performance of nonlinear adaptive control. A novel reset rule is designed such that the estimated parameters of the adaptive controller jump to the optimal values in a way that optimizes a cost function representing the transient performance index. It is proved that asymptotic tracking is achieved and the output remains in a desired bound by ensuring boundedness of the barrier Lyapunov function. Besides, the convergence rate is increased by resetting the estimated parameters to optimal values. A regularly referred example is simulated to demonstrate the effectiveness of the proposed method and the results are compared with the existing investigations.

Intrathecal Autologous Bone Marrow-Derived Hematopoietic Stem Cell Therapy in Neurological Diseases

BACKGROUND

Cellular transplantation is a promising treatment strategy for neurological diseases.

OBJECTIVE

To report the results of intrathecal hematopoietic stem cell therapy in different neurological diseases in the past 6 years in a single center.

METHODS

From October 2011 to September 2018, 220 patients with various neurological diseases were transplanted intrathecally by their bone marrow stem cells. To have a longer follow up, we only reported the first 80 patients, transplanted up to July 2015-10 patients had spinal cord injuries and paralysis, 12 had advanced Parkinson's disease, 28 had cerebral palsy, 7 had hypoxic brain damage, 2 had autism, 4 had multiple sclerosis, 5 had progressive cerebellar atrophy, and 12 had other neurological diseases. The patients were admitted to the Bone Marrow Transplant Unit. On the first day, 50-200 (median 100) mL bone marrow was aspirated from the patients' posterior iliac crests, mixed with 120 mL culture media (RPMI), and 12 mL heparin. The samples were then transferred to immunology lab in cold box. Mononuclear cells (MNCs) were separated by a Ficoll-Hypaque gradient, washed, and suspended in ringers. Cell viability was assessed with trypan blue viability test. Transplantation was performed 3-4 hours after bone marrow collection. 5-10 mL of the cerebrospinal fluids were aspirated and about 20 mL MNCs (containing stem cells) in ringers were injected intrathecally (IT). The patients were laid down on their back for 4-5 hours. The median number of MNCs was 4×10⁷ (range 1-450×10⁷). The median viability of the cells was 90% (range 60%-98%). The patients received intravenous ceftriaxone every 12 hours and were discharged from the hospital few days after autologous stem cell therapy.

RESULTS

We noted clinical improvements in 9 of 12 patients with Parkinson's disease, 20 of 28 patients with cerebral palsy, 6 of 7 patients with hypoxic brain damage, 2 of 4 patients with multiple sclerosis, and 4 of 5 patients with cerebellar atrophy. The improvements were noted after 2-4 weeks of cell therapy. There were no improvements in patients with spinal cord injury and complete paralysis and those with autism. There were variable improvements in other patients treated.

CONCLUSION

Most patients with advanced Parkinson's disease, cerebral palsy, hypoxic brain damage, progressive cerebellar atrophy, and kernicterus neuropathy reported clinical effects of this safe intervention resulting in better functioning and an increased quality of life.

Hydralazine induces stress resistance and extends C. elegans lifespan by activating the NRF2/SKN-1 signalling pathway

Nuclear factor (erythroid-derived 2)-like 2 and its Caenorhabditis elegans ortholog, SKN-1, are transcription factors that have a pivotal role in the oxidative stress response, cellular homeostasis, and organismal lifespan. Similar to other defense systems, the NRF2-mediated stress response is compromised in aging and neurodegenerative diseases. Here, we report that the FDA approved drug hydralazine is a bona fide activator of the NRF2/SKN-1 signaling pathway. We demonstrate that hydralazine extends healthy lifespan (~25%) in wild type and tauopathy model C. elegans at least as effectively as other anti-aging compounds, such as curcumin and metformin. We show that hydralazine-mediated lifespan extension is SKN-1 dependent, with a mechanism most likely mimicking calorie restriction. Using both in vitro and in vivo models, we go on to demonstrate that hydralazine has neuroprotective properties against endogenous and exogenous stressors. Our data suggest that hydralazine may be a viable candidate for the treatment of age-related disorders.

A Significant Breakthrough in the Incidence of Childhood Cancers and Evaluation of its Risk Factors in Southern Iran

Background and Objective:

This study investigates epidemiologic and practical information about the incidence and risk factors of childhood cancer in a population of Southern Iranian children.

Materials and Methods:

A total number of 300 cancer patients along with 600 age- and gender-matched healthy control were interviewed by a trained physician regarding their demographic characteristics, and major family-associated risk factors, childhood malignancies.

Results:

The average annual percentage change for cancers in the studied population is calculated as 45%. Our study indicated that possible risk factors which could contribute to the development of childhood cancer are maternal oral contraceptive pill use during pregnancy, exposure to radiation during pregnancy, parental smoking, residence near high voltage electricity lines, exposure to pesticides and fertilizers, patient allergy, contact with domestic animals and father's educational degree. Furthermore, new ecological risk factors such as air pollution due to nonstandard petroleum or toxic inhalant particles, nonhealthy food consumption, and satellite jamming are other predisposing factors.

Conclusion:

Our study reported a higher average annual percentage change of childhood cancers in our area, compared to the existing literature. In conclusion, detection and prevention of the consistent and possible new environmental risk factors such as nonstandard petroleum or satellite jamming from all around the country should be taking into consideration.

An experimental investigation of knowledge acquisition techniques

Purpose

Knowledge is a key driver for the competitive success of organizations, but about 90 percent of organizational knowledge is inside employees’ minds with personal essence; therefore, this paper provides valuable vision for managers by exploring knowledge acquisition (KA) techniques and personality type. The purpose of this paper is to examine KA techniques and explore the impact of personality type on the KA process in the aerospace industry.

Design/methodology/approach

This paper examines KA techniques through an empirical study involving 83 participants to take part in KA sessions. For exploring techniques, a questionnaire was used, and also the Myers-Briggs Type Indicator was used to identify participants’ personality type. The impact of personality type on KA processes was determined by correlation analysis.

Findings

Analyses confirmed some association between the type of personality and KA process. In addition, the findings of exploring questionnaire items showed that participants gave the laddering technique the highest rating.

Originality/value

The paper may be of high value to researchers in the field of KA, especially in aerospace industries, because there is very little experimental investigation of KA, and it also provides valuable information and guidelines that hopefully will help researchers to select appropriate KA techniques.

An investigation of the effect of extroverted and introverted personalities on knowledge acquisition techniques

Purpose

This paper aims to explore the relationship between personality traits (introversion versus extroversion) and knowledge acquisition (KA) techniques.

Design/methodology/approach

The major methodology of the current study is survey. Results are based on 152 usable responses provided by experts in different industries including electronic, communication, information technology, computer and biology. The major analytical technique used is Pearson correlation analysis.

Findings

According to the results, there are significant relationships between personality traits (i.e. introversion versus extroversion) and KA techniques.

Research limitations/implications

This study was conducted on data from 152 Iranian experts which limits the generalizability of the results. This limitation can be addressed by future studies conducting similar studies on cross-country samples. Further, due to the analytical technique adopted in this study, causality implications cannot be drawn from the results.

Originality/value

This study reveals linkages between personality traits (i.e. introversion versus extroversion) and KA techniques. Results shed light on the KA process for both scholars and practitioners involved in KA programs in the organizations.

Pulmonary Mucormycosis in a Patient with Chronic Rejection of Kidney Transplant: A Case Report

Pulmonary mucormycosis is a rare but fatal condition that frequently occurs in immunocompromised patients. Correct diagnosis and rapid start of preferred antifungal treatment need clinical suspicion. Patient's symptoms may be confluent with other conditions such as bacterial and other fungal infections. We present a case of pulmonary mucormycosis in a patient with end stage renal disease successfully treated with a long course of amphotericin B deoxycholate (AmB) and upper lobectomy of the left lung despite of low pulmonary capacity.

Awareness of Religious Leaders' Fatwa and Willingness to Donate Organ

BACKGROUND

It is believed that religious leaders' positive attitude towards organ donation can be an effective factor in Muslims' inclination to donate organs.

OBJECTIVE

To assess the knowledge of freshmen students in Mashhad University of Medical Sciences about religious leaders' fatwa on organ donation and its effect on their willingness to donate organs.

METHODS

This cross-sectional study was conducted in 2013 on 400 freshmen of various medical disciplines, selected using a simple random sampling in Mashhad, Iran. Data were collected by a valid and reliable researcher-made questionnaire. Data were analyzed by multiple logistic regression analysis.

RESULTS

41.5% of the students were aware of religious authorities' views on organ donation and 55.6% were willing to donate organs. Participants' main reasons for lack of willingness to donate organs included the fear of organ donation before the brain death is confirmed (52%), unwillingness to disfigure their body (51%), and belief in the burial of organs (50%). The willingness to organ donation for students who were aware of religious leaders opinion was more than twice more than those who were not (OR: 2.56, 95% CI: 1.75-4.52). Also, female gender, the Shia religion and awareness of the correct definition of brain death were associated factors affecting the desire to donate organs, although their effects were not statistically significant on regression model.

CONCLUSION

A considerable proportion of students were not aware of the religious leaders' fatwa on organ donation. The most important factor for the desire to donate organs was the awareness of religious leaders' fatwa. Therefore, it seems necessary that religious leaders' fatwa be known to all by appropriate methods.

Identification of multivariable nonlinear systems in the presence of colored noises using iterative hierarchical least squares algorithm

This paper presents an efficient method for identification of nonlinear Multi-Input Multi-Output (MIMO) systems in the presence of colored noises. The method studies the multivariable nonlinear Hammerstein and Wiener models, in which, the nonlinear memory-less block is approximated based on arbitrary vector-based basis functions. The linear time-invariant (LTI) block is modeled by an autoregressive moving average with exogenous (ARMAX) model which can effectively describe the moving average noises as well as the autoregressive and the exogenous dynamics. According to the multivariable nature of the system, a pseudo-linear-in-the-parameter model is obtained which includes two different kinds of unknown parameters, a vector and a matrix. Therefore, the standard least squares algorithm cannot be applied directly. To overcome this problem, a Hierarchical Least Squares Iterative (HLSI) algorithm is used to simultaneously estimate the vector and the matrix of unknown parameters as well as the noises. The efficiency of the proposed identification approaches are investigated through three nonlinear MIMO case studies.

The Effect of Melatonin on Maturation, Glutathione Level and Expression of H MGB1 Gene in Brilliant Cresyl Blue (BCB) Stained Immature Oocyte

OBJECTIVE

Nutrients and antioxidants in the medium of immature oocyte have a profound effect on maturation, fertilization and development of resulting embryos. In this study the effects of melatonin as an antioxidant agent on maturation, glutathione level and expression of High mobility group box-1 (HMGB1) gene were evaluated in immature oocytes of mice stained with brilliant cresyl blue (BCB).

MATERIALS AND METHODS

In this experimental study, immature oocytes were harvested from ovaries of Naval Medical Research Institute (NMRI) mice. Oocytes were stained with 26 μM BCB for 90 minutes and transferred to in vitro maturation medium containing varying doses of melatonin (10-12, 10-9, 10-6, 10-3 M) and without melatonin, for 22-24 hours. Maturation was monitored using an inverted microscope. Glutathione was assessed by monochlorobimane (MCB) staining and HMGB1 expression in mature oocyte was analyzed using real-time polymerase chain reaction (PCR).

RESULTS

Melatonin in the concentration of 10-6 M had the most effect on maturation and HMGB1 expression of BCB+ oocytes (p<0.05). Meanwhile melatonin had no effects on glutathione levels. Additionally in immature BCB- oocytes, compared to the control group, melatonin did not affect cytoplasm maturation (p>0.05).

CONCLUSION

In vitro treatment with melatonin increases the maturation and HMGB1 expression in BCB+ immature oocytes and has no significant effect on glutathione levels.

Achillea Millefolium L. Hydro- Alcoholic Extract Protects Pancreatic Cells by Down Regulating IL- 1β and iNOS Gene Expression in Diabetic Rats

Interleukin-1β (IL-1β) has a role in β- cell destruction in autoimmune diabetes by stimulating the expression of inducible nitric oxide synthase (iNOS) that generates the free radical nitric oxide. We aimed to investigate the effect of Achillea millefolium L, as a traditional hypoglycemic agent, on IL-1β and iNOS gene expression of pancreatic tissue in the STZ- induced diabetic rats. Forty adult male Wistar rats were randomly divided into four groups: 1. diabetic control; 2. diabetic rats treated with Achillea millefolium L. extract; 3. normal rats received only extract and 4. negative control (n= 10 each). Diabetes was induced by single i.p. injection of 45 mg/ kg streptozotocin (STZ). Rats in groups 2 and 3 were treated with i.p. injection of Achillea millefolium L. extract (100 mg/ kg/ day) for 14 days. Body weight, serum glucose and insulin levels were assayed at baseline and on days 3, 7, 10 and 14 of the experiment. Finally, the quantity of pancreatic IL-1β and iNOS mRNA was determined by real- time PCR. The mRNA expression level of IL-1β and iNOS genes, was significantly (p<0.001) increased in diabetic rats of group 1. Treatment with Achillea millefolium L. caused a significant (p<0.01) reduction in both IL-1β and iNOS genes expression. Moreover, rats in group 2 had higher insulin level associated with lower glucose level and higher body weight compared to control diabetic group. It seems that beneficial effect of Achillea millefolium L. on STZ- induced diabetes is at least partly due to amelioration of IL-1β and iNOS gene over expression which can have a β-cell protective effect.