Investigating the Effect of Satureja khuzestanica Essential oil on MDR1 Gene Expression in Leishmania major

BACKGROUND

Cutaneous leishmaniasis is among the neglected diseases in the world. Pentavalent antimonial compounds are considered the first-line treatment for this disease. However, using alternative natural products has received great attention due to the side effects of chemical drugs and drug resistance of the Leishmania parasite. The present study aims to investigate the effect of Satureja khuzestanica essential oil (SKEO) on MDR1 gene expression.

METHODS

In this study, standard strains of Leishmania major promastigotes were exposed to 5, 10, 15, and 20 µg/ml of SKEO. MDR1 gene expression of parasites exposed to essential oil was evaluated using real-time PCR. GAPDH was employed as the housekeeping gene for internal control.

RESULTS

Despite the increase, no statistically significant difference was observed in the relative expression of the MDR1 gene between the control group and the groups containing 5, 10, and 20 µg/ml of SKEO (P > 0.05). The relative expression of the MDR1 gene significantly increased in the group containing 15 μg/ml of essential oil compared to the control one (P < 0.05).

CONCLUSION

This study showed that the use of essential oil of Satureja khuzestanica plant can have an increasing effect on the expression of MDR1 gene of Leishmania promastigotes, which is the best case if Satureja khuzestanica essential oil reduces the expression of MDR1 gene. So it seems that the use of essential oil of Satoria plant is effective in controlling Leishmania parasite, but its concentrations induce drug resistance. As a result, concentrations of essential oil should be used that have a controlling effect on the growth and proliferation of Leishmania parasite and also have the least effect on the induction of MDR1 gene expression.

Ovarian Torsion and Oophorectomy in Childhood: A Case Report

BACKGROUND

Ovarian torsion in infants can be asymptomatic or may present with abdominal mass and malnutrition. It is an uncommon and non-specific condition in children. We report a girl who underwent detorsion and ovariopexy for suspected ovarian torsion after a previous oophorectomy. The role of progesterone therapy is determined in reducing the size of adnexal mass.

CASE PRESENTATION

The patient was diagnosed with right ovarian torsion and underwent an oophorectomy at one year of age. About 18 months later, she was diagnosed with left ovarian torsion and underwent detorsion with lateral pelvic fixation. Despite the pelvic fixation of the ovary, a continuous increase in the volume of the ovarian tissue was evident during successive ultrasounds. Progesterone therapy was started at five years of age in order to prevent retorsion and preserve the ovarian tissue. In successive follow-ups during the therapy, ovarian volume decreased, and its size (27*18 mm) was restored.

CONCLUSION

The presented case reminds doctors of the possibility of ovarian torsion in young girls with pelvic pain. More research is needed on the use of hormonal drugs, such as progesterone, in similar cases.

Colorectal cancer-secreted exosomal circ_001422 plays a role in regulating KDR expression and activating mTOR signaling in endothelial cells by targeting miR-195-5p

BACKGROUND

As non-coding RNAs, exosomal circular RNAs (circRNAs) regulate colorectal cancer (CRC) progression, although the functional mechanisms by which such molecules affect the tumor microenvironment are still elusive. Herein, we aimed to explore the potential clinical significance of a signature of five serum-derived circRNAs in CRC and investigated the mechanisms underlying endothelial cell angiogenesis mediated by CRC-secreted exosomal circ_001422.

METHODS

The expression of a signature of five serum-derived circRNAs (circ_0004771, circ_0101802, circ_0082333, circ_0072309, and circ_001422) were measured by RT-qPCR, and their associations with tumor staging and lymph node metastasis were further evaluated in CRC patients. In silico analysis was used to show the relationship between circ_001422, miR-195-5p, and KDR, validated by dual-luciferase reporter and Western blotting assays. CRC cell-derived exosomes were isolated and characterized by scanning electron microscopy and Western blotting. Endothelial cell uptake of PKH26-labeled exosomes was demonstrated using a spectral confocal microscope. In vitro genetic strategies were used to exogenously alter the expression level of circ_001422 and miR-195-5p expression. Cell proliferation assay, transwell migration assay, and capillary tube formation assay were conducted to explore the role of CRC-secreted exosomal circ_001422 in endothelial cell function in vitro.

RESULTS

The expression levels of serum-derived circ_0004771, circ_0101802, circ_0082333, and circ_001422 were significantly higher in CRC and were positively correlated with the lymph node metastasis status. However, circ_0072309 showed a significant down-regulation in CRC than in healthy individuals. Furthermore, a higher expression level of circ_001422 in both cellular and exosomal fractions was found in HCT-116 CRC cells. We found that HCT-116 exosomes considerably enhanced proliferation and migration of endothelial cells through shuttling of circ_001422. We also observed that exosomes derived from HCT-116 cell, but not non-aggressive Caco-2 CRC cells, increased in vitro tubulogenesis of endothelial cells. Importantly, knockdown of circ_001422 impaired the capability of endothelial cells to form the capillary-like tube structures. CRC-secreted circ_001422 acted as an endogenous miR-195-5p sponge to inhibit miR-195-5p activity, which led to increased KDR expression and mTOR signaling activation in endothelial cells. Importantly, ectopic expression of miR-195-5p mimicked the effect of circ_001422 silencing on KDR/mTOR signaling in endothelial cells.

CONCLUSION

This study attributed a biomarker role for circ_001422 in CRC diagnosis and proposed a novel mechanism whereby circ_001422 up-regulates KDR through sponging miR-195-5p. These interactions may give rise to the activation of mTOR signaling and may be a possible clarification for the pro-angiogenesis effects of CRC-secreted exosomal circ_001422 on endothelial cells.

Relationship between health practices with attitudes towards pregnancy and motherhood and pregnancy symptoms in Iranian pregnant women: a cross-sectional study

OBJECTIVES

Pregnancy is a vulnerable period for women's health, and health practices play an essential role in this period. This study aimed to determine the relationship between health practices with attitudes toward pregnancy and motherhood and pregnancy symptoms.

DESIGN

It was a cross-sectional study using cluster sampling conducted on 351 pregnant women in 2021-2022. Data were collected using questionnaires of socio-demographic characteristics, health practices in pregnancy (Health Practices Questionnaire-II), attitude towards motherhood and pregnancy (Prenatal Attitudes Towards motherhood and Pregnancy) and pregnancy symptoms (Pregnancy Symptoms Inventory). The general linear model (GLM), with the adjustment of socio-demographic characteristics, was used to determine the relationship of the health practices with attitudes towards motherhood and pregnancy and pregnancy symptoms.

SETTING

Health centres in Tabriz city, Iran.

PARTICIPANTS

Women were eligible if living in the Tabriz city, Iran, were pregnant and had a personal health record at the health centre.

RESULTS

The mean (SD) of the total health practices score was 117.9 (20.5) out of 34-170. The mean (SD) of the attitudes towards motherhood and pregnancy was 33.4 (4.5) out of 11-44. The mean (SD) of the pregnancy symptoms was 28.0 (12.1) out of 0-123. According to the Pearson correlation test, there was a significant direct correlation between health practices with attitudes towards motherhood and pregnancy (r=0.39; p<0.001) and a significant inverse correlation with pregnancy symptoms (r=-0.29; p<0.001). Based on the GLM with an increase in the score of health practices, the mean score of the attitude towards motherhood and pregnancy increased (B=0.07; 95% CI: 0.05 to 0.1), and the mean score of pregnancy symptoms decreased (B=-0.1; 95% CI: -0.2 to -0.05).

CONCLUSION

Considering the relationship between health practices with the attitude towards motherhood and pregnancy symptoms, healthcare providers better use educational and counselling strategies to promote health practices in pregnant women.

The effect of fenugreek on the severity of dysmenorrhea: a systematic review and meta-analysis

INTRODUCTION

Dysmenorrhea is the most common periodic pain, which affects more than 50% of women with regular menstruation. Fenugreek is one of the medicinal plants with analgesic properties. This study aimed to determine the effect of fenugreek application in the severity of dysmenorrhea and its side effects in women with dysmenorrhea. PICO: population: women with dysmenorrhea; intervention: fenugreek; comparison: control groups; and outcome: reduction in the severity of dysmenorrhea and its side effects Methodology: English database (PubMed, Cochrane Library, Scopus, and Web of Science) and Persian database [SID (Scientific Information Database) and Magiran] were used for research until February 11, 2023, using the keywords "Dysmenorrhea [Mesh]," "Foenum [Mesh]," "fenugreek [Mesh]," and "Trigonella [Mesh]." The reference list of the selected articles was also checked. The quality assessment was conducted through the Cochrane Handbook for Systematic Reviews of Interventions version 5.2.0. The RevMan 5.3 software was used to analyze and report the data of the entered studies. Meta-analysis results were reported with the standardized mean difference (95% confidence interval). A subgroup analysis was performed based on the type of control groups. The quality of evidence was assessed using the GRADE approach.

RESULTS

After removing duplicates and ineligible cases, four articles were included in the systematic review out of the 1526 records obtained. The results showed that the pain intensity caused by primary dysmenorrhea decreased with fenugreek compared to placebo (pooled result SMD: -2.21; 95% CI: -3.26 to -1.17; Z: 4.17; P <0.001). There was no significant difference between fenugreek with mefenamic acid (SMD: 0.05; 95% CI: -0.57 to 0.67; Z: 0.17; P = 0.86) and fenugreek with Chandrasura churna (SMD: 0.06; 95% CI: -0.56 to 0.68; Z: 0.19; P = 0.85). Bias, in terms of incomplete outcome data and selective reporting, was low risk in all studies, and the available evidence was low quality according to the GRADE approach.

CONCLUSION

The results showed that the effect of fenugreek on pain intensity in dysmenorrhea is highly uncertain. The true effect is likely to be substantially different from the estimate of effect. Regarding the importance of the health and quality of life of women of reproductive age and the low quality of evidence of the studies, clinical trials with stronger methodology are suggested in this field.

Sexual and reproductive health-related questions and concerns of newly married couples: A qualitative content analysis

Background and Aims

Approximately half of Iranian marring couples have poor sexual knowledge and attitudes. This article delves into the main concerns and queries regarding sexual and reproductive health among Iranian newly married couples.

Methods

We conducted a content analysis of the sexual and reproductive health questions and concerns that were anonymously submitted by newly married couples to the researcher via social media in 2021-2022.

Results

A total of 141 questions and concerns that were related to sexual and reproductive health were considered for content analysis. Findings illustrated two main categories: (1) the need to create a reproductive life plan, and (2) the need for sexual knowledge and counseling. The first category consisted of three subcategories: "Poor contraceptive knowledge," "Need for support in case of a missed period or unplanned pregnancy," and "Need for preconception care." The second category included three subcategories: "Concern regarding virginity," "Sexual problems on the honeymoon," and "Sexual problems in newlyweds."

Conclusion

Iranian newly married couples need long-term specialized services addressing their reproductive life planning and sexual knowledge needs. Integrating reproductive life planning and comprehensive sex education into the primary care services for newly married couples can help to reduce delayed childbearing, unintended pregnancy, unsafe and illegal abortion, and subsequent infertility.

Psychometric evaluation of the postpartum specific anxiety scale - research short-form among iranian women (PSAS-IR-RSF)

BACKGROUND

The increasing prevalence of postpartum anxiety as a common psychological problem affects a large part of women's lives. Despite the existence of tools in this field, but due to the lack of specificity in reflecting postpartum anxiety, it is necessary to have a specific tool to screen it. Since the psychometric evaluation of the Postpartum Specific Anxiety Scale-Research Short-Form (PSAS-RSF) among Iranian women has not been assessed in Iran until now, so we decided to conduct this study with the aim of psychometric evaluation of the PSAS-IR-RSF.

METHODS

We included 180 women (six weeks to six months postpartum) in the study by random sampling during the period from December 2021 to June 2022. We examined the validity of the PSAS-IR-RSF tool in terms of face, content and construct (through exploratory and confirmatory factor analyses). We used internal consistency and test-retest reliability to determine the reliability of the scale.

RESULTS

In the present study, content validity index (CVI) and content validity ratio (CVR) of the PSAS-IR-RSF tool were equal to 0.91 and 0.97, respectively. We extracted a four-factor structure through the process of exploratory factor analysis. The values of fitting indices confirmed the validity of the model. Cronbach's alpha coefficient was equal to 0.72 and intra-class correlation coefficient (with 95% confidence interval) was 0.97 (0.98 to 0.93).

CONCLUSIONS

The Persian version of the PSAS-IR-RSF is a valid and reliable tool for the specific evaluation of postpartum anxiety among Iranian women.

Validation of the Iranian version of the Postpartum Specific Anxiety Scale 12-item research short-form for use during global crises (PSAS-IR-RSF-C)

BACKGROUND

Due to its high pervasiveness and adversarial consequences, postpartum anxiety has been one of the most worrying public health concerns in the last decade. According to previous research, the occurrence of mental disorders among women in the postpartum period upsurges significantly in the course of universal disasters. The Postpartum Specific Anxiety Scale - Research Short Form - for use in global Crises [PSAS-IR-RSF-C] has not been used in Iran for postpartum women during a health system shock. Consequently, this study was conducted to determine the validity and reliability of the Persian version (PSAS-IR-RSF-C) during the COVID-19 pandemic.

METHODS

This cross-sectional study was performed with 180 women who were between six weeks and six months after delivery, by random sampling method from December 2021 to June 2022. The validity of the PSAS-RSF-C in terms of face, content, was analyzed, and the construct validity was assessed using exploratory and confirmatory factor analyses. Internal consistency and test-retest reliability of the questionnaire were measured using (Cronbach's alpha, McDonald's ω) and intraclass correlation coefficient (ICC), respectively.

RESULTS

The content validity index and content validity ratio of the Persian version of the PSAS-IR-RSF-C were 0.96 and 0.98, respectively. A three-factor structure was extracted during the exploratory factor analysis process, and model validity was confirmed by the values of fit indices. Cronbach's alpha coefficient, McDonald's ω and intra-cluster correlation coefficient (95% confidence interval) were 0.74, 0.92 (0.78 to 0.93) and 0.97 (0.93 to 0.98), respectively.

CONCLUSIONS

For the specific assessment of postpartum anxiety among Iranian women during crises, the Persian version of the PSAS-IR-RSF-C is a valid and reliable tool.

The effect of cognitive-behavioral counseling with or without Citrus aurantium essential oil on sleep quality in pregnant women: a randomized controlled trial

Sleep disorder is very common during pregnancy. Non-pharmacological treatments are a priority to improve the sleep pattern. This study aimed to determine the effect of cognitive-behavioral counseling with or without Citrus aurantium essential oil on sleep quality (primary outcome) and anxiety and quality of life (secondary outcomes). This randomized controlled trial was performed on 75 pregnant women in Tabriz, Iran. Participants were randomly assigned to the intervention and control groups. The first intervention group received 8 sessions of cognitive-behavioral counseling and aromatherapy with Citrus aurantium essential oil 15-20 min before bedtime. The second intervention group received cognitive-behavioral counseling and aromatherapy with placebo and the control group received only routine prenatal care. Pittsburgh Sleep Quality Index, Pregnancy-Specific Quality of life Questionnaire, and Pregnancy-Specific Anxiety Scale were completed before and after intervention. After the intervention based on ANCOVA test and by adjusting the baseline score, the mean score of anxiety in the intervention group 1 (AMD: - 4.54; 95% CI - 6.79 to - 2.28) and intervention group 2 (AMD: - 3.30; 95% CI - 5.60 to - 0.97) was significantly lower than the control group. Also, the mean score of quality of life in intervention group 1 (AMD: 2.55; 95% CI 0.45-4.65) and intervention group 2 (AMD: 2.72; 95% CI 0.60-4.83) was significantly higher than the control group, but there was no statistically significant difference between the study groups in terms of sleep quality (P > 0.05). Also, there was no statistically significant difference between the two intervention groups after the intervention in terms of anxiety (P = 0.379) and quality of life (P = 0.996). Cognitive-behavioral counseling reduced anxiety and improved quality of life. However, further trials are required to reach a definitive conclusion. Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N63. Date of registration: 4/10/2020. URL: https://en.irct.ir/user/trial/54986/view; Date of first registration: 18/10/2020.

The relationship between urinary incontinence with sexual function and quality of life in postmenopausal women

BACKGROUND

Urinary incontinence has a significant impact on the psychosocial well-being of postmenopausal women. This study aimed to determine the relationship between urinary incontinence with sexual function and quality of life.

METHOD

It was a cross-sectional study using cluster sampling on 433 postmenopausal women in Tabriz-Iran, 2021-2022. Data were collected using questionnaires of socio-demographic and obstetrics characteristics, female sexual function index (FSFI), Menopause-Specific Quality of Life (MENQOL), and Urinary Incontinence Diagnosis (UIDQ). Independent sample t-test and general linear model (GLM) were used to compare the quality of life and sexual function score between the two groups of women with and without stress, urgency, and mixed urinary incontinence.

RESULTS

Independent sample t-test showed a significant difference in the quality of life and sexual function between women with and without stress, urgency, and mixed urinary incontinence (p < 0.05). Based on the GLM with adjusting the socio-demographic and obstetrics characteristics, women without stress incontinence reported a lower mean score of MENQOL (B = - 23.38; 95% CI = -30.1 to -16.6; p < 0.001) and a higher mean score of sexual function (B = 4.5; 95% CI = 2.1-7.0; p < 0.001) compared to women with stress incontinence; a lower MENQOL score and a higher sexual function score indicate better condition. However, there was no significant relationship between urgency and mixed incontinence with quality of life and sexual function (p > 0.05).

CONCLUSION

As urinary incontinence remarkably affects sexual function and quality of life of postmenopausal women, health care providers should consider better solutions for this issue in their work program.

Predictors of Quality of Life In Women with Premature Ovarian Insufficiency

Background::

Women with premature ovarian insufficiency (POI) have more difficulty concerning their physical and psychological health, indicating a need to provide adequate psychosocial and clinical support for these women to minimize the repercussion of this diagnosis on their activities and quality of life.

Objective::

To determine the predictors of quality of life in women with premature ovarian insufficiency (POI).

Methods::

This cross-sectional study was performed on 130 women with POI in Tabriz in 2021 by convenience sampling. Data were collected using the socio-demographic characteristics questionnaire, Spielberger state-trait anxiety inventory (STAI), Beck depression scale (BDI), female sexual function index (FSFI), and the World Health Organization quality of life questionnaire (WHOQOL). The adjusted general linear model was used to estimate the impact and determine the relationship between independent variables (socio-demographic characteristics, anxiety, depression, and sexual function) and dependent variables (quality of life and its domains).

Results::

The mean total score of quality of life was 46.3 (SD: 18.3) out of 0 to 100. The lowest mean score belonged to the social relations domain [35.6 (17.0)], and the highest mean score belonged to the physical health domain [40.0 (16.0)]. Sexual function was one of the predictors of overall quality of life score, and all its domains except environmental health. Depression was one of the predictors of psychological health. Education was also a predictor of psychological and environmental health.

Conclusion::

Sexual function and mental health are directly related to the quality of life of women with POI.

Prevalence and severity of urinary incontinence and associated factors in Iranian postmenopausal women: a cross-sectional study

BACKGROUND

Urinary incontinence (UI) is one of the most common symptoms during menopause, leading to a decreased quality of life and limited social activities. This study aimed to determine the prevalence and severity of urinary incontinence and associated risk factors in postmenopausal women.

METHODS

It was a cross-sectional study using cluster sampling on 433 postmenopausal women in Tabriz-Iran, 2021-2022. Data were collected using questionnaires of socio-demographic characteristics, Questionnaire for Urinary Incontinence Diagnosis (QUID), and International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UISF). Multivariate logistic regression was used to determine factors related to urinary incontinence.

RESULTS

The overall prevalence of urinary incontinence was 39.5%; 20.6% stress urinary incontinence (SUI), 10.4% urgency urinary incontinence (UUI), and 8.5% mixed urinary incontinence (MUI). Multivariate logistic regression analysis showed that the prevalence of SUI (aOR 0.38; 95% CI 0.18-0.77) and UUI (aOR 0.38; 95% CI 0.15-0.94) was significantly lower in women with three childbirths than the ones with fewer childbirths. Also, the odds of UUI increased significantly in women at the 50-55 age range (aOR 3.88; 95% CI 1.16-12.93) than those less than 50 years.

CONCLUSION

Due to the high prevalence of urinary incontinence in postmenopausal women, caregivers should screen for early diagnosis and appropriate treatment of urinary incontinence to prevent its destructive impact on the quality of life.

Retinoic acid-inducible gene 1 (RIG-1) and IFN-β promoter stimulator-1 (IPS-1) significantly down-regulated in the severe coronavirus disease 2019 (COVID-19)

INTRODUCTION

Retinoic acid-inducible gene 1 (RIG-1) and melanoma differentiation-associated protein 5 (MDA5) are the well-known cytoplasmic sensors that recognize microbial DNA or RNA and active down-stream molecules, including IFN-β promoter stimulator-1 (IPS-1) and receptor interacting protein 1 (RIP1). The roles played by the networked molecules on the infection with SARS-CoV-2 needs more investigations.

MATERIAL AND METHOD

In this project MDA5, RIG-1, IPS-1 and RIP1 mRNA levels were evaluated in 45 hospitalized patients suffering from coronavirus disease of 2019 (COVID-19) and 45 healthy subjects using Real Time-qPCR technique.

RESULT

The results showed significant decreased RIG-1 and IPS-1 in the SARS-CoV-2 infected patients when compared to healthy cases. MDA5 and RIP1 did not change when compared two groups. Male patients had similar expression of MDA5, RIG-1, IPS-1 and RIP1 when compared to female patients.

CONCLUSION

Based on the results, it seems that RIG-1 and its signaling molecule, IPS-1, play key roles in the peripheral blood immune cells against SARS-CoV-2 and, their down-regulation may be induced by the virus to escape from immune responses.

The effect of mindfulness training on stress and sleep quality of postmenopausal women: A systematic review and meta-analysis

INTRODUCTION

Mindfulness is an effective method for empowering women to cope with menopausal changes. This study aimed to determine the effect of mindfulness training on stress and sleep quality in postmenopausal women.

MATERIALS AND METHODS

English (PubMed, Cochrane Library, Google Scholar, Scopus, Web of Science, and CINHAL) and Persian (SID, Magiran) databases were searched until 25 June 2022, using the free and MeSH keywords included Mindfulness and Menopause. The quality of the published papers was evaluated using Cochrane Handbook for Systematic Reviews of Interventions version 5.2.0. The meta-analysis was conducted in RevMan 5.3 and the results were reported with mean difference (95% confidence interval). The quality of evidence was assessed using the GRADE approach.

RESULTS

A total of 1206 records were obtained. After removing duplicate and non-eligible records, finally five articles were included in the systematic review and meta-analysis. The results indicated that sleep quality score (SMD = -1.44; 95% CI = -2.44 to -0.46; p = 0.004) and perceived stress score (MD = -4.21; 95% CI = -6.41 to -2.00; p = 0.0002) were significantly reduced in the mindfulness training group compared to control group.

CONCLUSION

Mindfulness training is associated with improving sleep quality and perceived stress (with a low quality of evidence) in postmenopausal women. Mental health and quality of life in postmenopausal women impressively affect the community health. Given the low quality of evidence of the studies in this field, randomized controlled trials with better methodologies are suggested.

The effect of cognitive-behavioral therapy on stress and anxiety of women with premature ovarian insufficiency: A randomized controlled trial

TRIAL REGISTRATION

Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N64. Date of registration: 14/02/2021. URL: https://en.irct.ir/user/trial/52024/view; date of first registration: 17/02/2021.

Severity of oEsophageal Anastomotic Leak in patients after oesophagectomy: the SEAL score

Background

Anastomotic leak (AL) is a common but severe complication after oesophagectomy. It is unknown how to determine the severity of AL objectively at diagnosis. Determining leak severity may guide treatment decisions and improve future research. This study aimed to identify leak-related prognostic factors for mortality, and to develop a Severity of oEsophageal Anastomotic Leak (SEAL) score.

Methods

This international, retrospective cohort study in 71 centres worldwide included patients with AL after oesophagectomy between 2011 and 2019. The primary endpoint was 90-day mortality. Leak-related prognostic factors were identified after adjusting for confounders and were included in multivariable logistic regression to develop the SEAL score. Four classes of leak severity (mild, moderate, severe, and critical) were defined based on the risk of 90-day mortality, and the score was validated internally.

Results

Some 1509 patients with AL were included and the 90-day mortality rate was 11.7 per cent. Twelve leak-related prognostic factors were included in the SEAL score. The score showed good calibration and discrimination (c-index 0.77, 95 per cent c.i. 0.73 to 0.81). Higher classes of leak severity graded by the SEAL score were associated with a significant increase in duration of ICU stay, healing time, Comprehensive Complication Index score, and Esophagectomy Complications Consensus Group classification.

Conclusion

The SEAL score grades leak severity into four classes by combining 12 leak-related predictors and can be used to the assess severity of AL after oesophagectomy.

Quality of reporting of literature search strategies in systematic reviews published on the role of telehealth during COVID-19

A comprehensive and reproducible search strategy for systematic reviews especially about COVID-19 plays a pivotal role in conducting a reliable and unbiased review. The primary aim of this study was to investigate the quality of the search strategy reporting in systematic reviews conducted on the role of telehealth during COVID-19. The secondary aim of study was to explore some affecting factor in the quality of search strategy. The study evaluated the quality of the search strategy reporting with PRISMA-S checklist. The search was performed in MEDLINE, Embase, CINAHL, and other related databases. Systematic reviews were included. There was no language restriction. The correlation of the PRISMA-S scores with journal impact factor, CiteScore, and librarians’ role were evaluated using Spearman’s rank correlation coefficient. A total of 85 articles were included in the review. The overall mean score of PRISMA-S checklist was 6.12 ± 1.46. PubMed was the most popular database for search. More than half of the studies did not provide a full search strategy. There was a significant positive correlation between PRISMA-S score and the journal impact factor (Spearman’s rho = 0.217; P = 0.46) and CiteScore (Spearman’s rho = 0.235; P = 0.03). The quality of literature search was poor in the included studies. Using the PRISMA-S as a search reporting guideline can be a helpful tool for authors. A professional librarian can be beneficial in improving the quality of the search. It is recommended to use a new pattern in COVID-19-related searches, such as preprint sources.

Isolation of bacteriophages from wastewaters on clinical Streptococcus species

Aim: Excessive use of antimicrobials has resulted in broad antimicrobial resistances in bacteria as well as problems in their infection treatments, which lead to increased case mortalities and medical costs. One of the alternative treatments includes use of bacteriophages. Therefore, the major aim of the current study was to isolate bacteriophages from sewages on bacteria from biological samples to potentially use in infections. Materials & methods: Urban wastewater samples were used to isolate bacteriophages on streptococcal isolates. Bacteriophages were characterized using phenotypic and genotypic methods. Results: Five bacteriophages were isolated on Streptococcus agalactiae, mostly belonging to Caudovirales order. Conclusion: As emergence of antimicrobial-resistant bacteria has created medical problems, identification of novel bacteriophages for use in infection treatments seems an appropriate solution.

Identification of a six-microRNA signature as a potential diagnostic biomarker in breast cancer tissues

BACKGROUND

Breast cancer (BC) is by far the most common malignancy among women. Epigenetic modulators, microRNAs in particular, may set stages for BC development and its progression. Herein, we aimed to assess the diagnostic potentiality of a signature of six miRNAs (i.e., hsa-miR-25-3p, -29a-5p, -105-3p, -181b1-5p, -335-5p, and -339-5p) in BC and adjacent non-tumor tissues.

METHODS

A pair of 50 tumor and adjacent non-tumor samples were taken from BC patients. The expression of each candidate miRNA was measured using quantitative reverse transcription PCR. To investigate the possible roles of each miRNA and their impressions on BC prognosis, in silico tools were used. Receiver operating characteristic (ROC) curves were performed to determine the diagnostic accuracy of each miRNA and the possible association of their expression with clinicopathological characteristics was analyzed.

RESULTS

Our findings showed the upregulation of hsa-miR-25-3p, -29a-5p, -105-3p, and -181b1-5p, and the downregulation of hsa-miR-335-5p and -339-5p in BC tumor compared to corresponding adjacent tissues. Except for hsa-miR-339-5p, the up-/down-regulation of the candidate miRNAs was associated with TNM stages. Except for hsa-miR-105-3p, each candidate miRNA was correlated with HER-2 status. ROC curve analysis showed that the signature of six-miRNA is a potential biomarker distinguishing between tumor and non-tumor breast tissue samples.

CONCLUSION

We showed that the dysregulation of a novel signature of six-miRNA can be used as a potential biomarker for BC diagnosis.

Frequency of Beta-Lactamase Antibiotic Resistance Genes in Escherichia Coli and Klebsiella pneumoniae

Background

This cross-sectional study was performed on isolates of Klebsiella pneumoniae, and E.coli from clinical specimens of patients admitted to Sayyad Shirazi Hospital by census sampling method in 2019. Antibiogram testing was performed using the disk diffusion method as defined by the Clinical and Laboratory Standards Organization for performing this test. Finally, the abundance of genes was evaluated by PCR using specific primers. Frequency, percentage, mean±SD were used to describe the data. Chi-square and Fisher's exact tests were used to compare the presence and absence of the studied genes alone and in the presence of each other.

Result

This study was performed on 130 positive samples, isolated from 32 (24.6%) males and 98 (65.4%) females with a mean age of 43.78 ± 21.72. From the total number of 130 isolates, 84 (64.6%) consisted of E.coli, and 46 (35.4%) were Klebsiella. Most of the cultures were urine and vaginal (61.5%). The highest antibiotic resistance in isolates was cephalexin and cefazolin (67.9% in E.coli & 63% in Klebsiella). Colistin was identified as the most effective antibiotic (100%) in both. AMPC extendedspectrum β-lactamase genes were present in 40 (30.8%) isolates. The highest frequency about the gene pattern of AMPC positive β-lactamase bacteria was correlated to DHA, FOX, and CIT genes, while none of the samples contained the MOX β-lactamase gene. E.coli and Klebsiella beta-lactamase-producing AMPC isolates were also significantly correlated with antibiotic resistance to the cephalosporin class (P <0.05).

Conclusion

This study indicated a high percentage of resistance to third and fourth generation cephalosporins. Hence, careful antibiogram tests and prevention of antibiotic overuse in infections caused by AMPC-producing organisms and screening of clinical samples for the resistance mentioned above genes and providing effective strategies to help diagnose and apply appropriate treatments and change antibiotic usage strategies can partially prevent the transmission of this resistance.

A study on the correlation of serum magnesium with intima-media thickness of carotid in hemodialysis patients

Introduction: Atherosclerosis progression in the patients suffering from end-stage renal disease (ESRD) is more than normal population. Magnesium levels are also associated with an increase in atherosclerosis in the common carotid artery. Intima-media carotid calcification is either directly or indirectly related to cardiovascular disease and a higher rate of death among patients with chronic renal failure. Objectives: The purpose of the present study was to evaluate the protective role of serum magnesium levels in vascular calcification and the improvement of the carotid intima-media thickness (CIMT). Patients and Methods: In this cross-sectional research, the participants were selected from all patients with ESRD in Five Azar Medical Center of Gorgan, Iran. Blood samples collected from research units were tested for serum magnesium level in three times. Patients were referred to a radiologist to measure CIMT. Data collected in all patients were evaluated based on Spearman’s correlation test. Results: The correlation between serum magnesium level and CIMT was not statistically significant (P = 0.66 r= 0.04), however a positive correlation between CIMT and the dialysis adequacy (KT/V) was detected (r = 0.306, P = 0.006). Conclusion: This study demonstrated no correlation between the serum magnesium level and the CIMT in hemodialysis patients.

Optimization of Patient Flow in Urgent Care Centers Using a Digital Tool for Recording Patient Symptoms and History: Simulation Study

Background

Crowding can negatively affect patient and staff experience, and consequently the performance of health care facilities. Crowding can potentially be eased through streamlining and the reduction of duplication in patient history-taking through the use of a digital symptom-taking app.

Objective

We simulated the introduction of a digital symptom-taking app on patient flow. We hypothesized that waiting times and crowding in an urgent care center (UCC) could be reduced, and that this would be more efficient than simply adding more staff.

Methods

A discrete-event approach was used to simulate patient flow in a UCC during a 4-hour time frame. The baseline scenario was a small UCC with 2 triage nurses, 2 doctors, 1 treatment/examination nurse, and 1 discharge administrator in service. We simulated 33 scenarios with different staff numbers or different potential time savings through the app. We explored average queue length, waiting time, idle time, and staff utilization for each scenario.

Results

Discrete-event simulation showed that even a few minutes saved through patient app-based self-history recording during triage could result in significantly increased efficiency. A modest estimated time saving per patient of 2.5 minutes decreased the average patient wait time for triage by 26.17%, whereas a time saving of 5 minutes led to a 54.88% reduction in patient wait times. Alternatively, adding an additional triage nurse was less efficient, as the additional staff were only required at the busiest times.

Conclusions

Small time savings in the history-taking process have potential to result in substantial reductions in total patient waiting time for triage nurses, with likely effects of reduced patient anxiety, staff anxiety, and improved patient care. Patient self-history recording could be carried out at home or in the waiting room via a check-in kiosk or a portable tablet computer. This formative simulation study has potential to impact service provision and approaches to digitalization at scale.

Let-7d and miR-185 Impede Epithelial-Mesenchymal Transition by Downregulating Rab25 in Breast Cancer

Objective:

MicroRNAs (miRNAs) expression has deregulated in several cancer types including breast cancer (BC). The present study aims at investigating the role, mechanism, clinical value of let-7d and miR-185 in BC, and the possible correlation these miRNAs with Rab25.

Materials and Methods:

Tumor samples as well adjacent normal tissues (ANT) were acquired from fresh surgical specimens from 110 patients and the expression levels of let-7d, miR-185, Rab25, and snail were evaluated using real-time PCR. The immunohistochemical (IHC) process and western blot were done to detect the level of Rab25 and Snail protein expression in BC samples.

Results:

By comparing miRNAs expression profiles in clinical tissues of 110 patients using real-time PCR, let-7d, and miR-185 expression were dramatically downregulated in BC tissues (P < 0.05). Tumor size, stage, and lymph node metastasis were significantly related to miRNAs expression. Based on qRT-PCR and bioinformatics database analyses, we also recognized Rab25 as a possible target of miR-185 and let-7d. Rab25 expression was enhanced in BC cells and associated inversely with the expression level of mentioned miRNAs. qRT-PCR, immunohistochemistry, and western blot studies verified that Rab25 upregulation increased the levels of the snail, that key transcription factor of epithelial-mesenchymal transition (EMT).

Conclusion:

These findings demonstrated that let-7d and miR-185 inhibited EMT by targeting Rab25 expression in BC. Therefore, targeting the let-7d and miR-185/Rab25 interaction may offer new therapeutic opportunities for treating BC patients.

How accurate are digital symptom assessment apps for suggesting conditions and urgency advice? A clinical vignettes comparison to GPs

OBJECTIVES

To compare breadth of condition coverage, accuracy of suggested conditions and appropriateness of urgency advice of eight popular symptom assessment apps.

DESIGN

Vignettes study.

SETTING

200 primary care vignettes.

INTERVENTION/COMPARATOR

For eight apps and seven general practitioners (GPs): breadth of coverage and condition-suggestion and urgency advice accuracy measured against the vignettes' gold-standard.

PRIMARY OUTCOME MEASURES

(1) Proportion of conditions 'covered' by an app, that is, not excluded because the user was too young/old or pregnant, or not modelled; (2) proportion of vignettes with the correct primary diagnosis among the top 3 conditions suggested; (3) proportion of 'safe' urgency advice (ie, at gold standard level, more conservative, or no more than one level less conservative).

RESULTS

Condition-suggestion coverage was highly variable, with some apps not offering a suggestion for many users: in alphabetical order, Ada: 99.0%; Babylon: 51.5%; Buoy: 88.5%; K Health: 74.5%; Mediktor: 80.5%; Symptomate: 61.5%; Your.MD: 64.5%; WebMD: 93.0%. Top-3 suggestion accuracy was GPs (average): 82.1%±5.2%; Ada: 70.5%; Babylon: 32.0%; Buoy: 43.0%; K Health: 36.0%; Mediktor: 36.0%; Symptomate: 27.5%; WebMD: 35.5%; Your.MD: 23.5%. Some apps excluded certain user demographics or conditions and their performance was generally greater with the exclusion of corresponding vignettes. For safe urgency advice, tested GPs had an average of 97.0%±2.5%. For the vignettes with advice provided, only three apps had safety performance within 1 SD of the GPs-Ada: 97.0%; Babylon: 95.1%; Symptomate: 97.8%. One app had a safety performance within 2 SDs of GPs-Your.MD: 92.6%. Three apps had a safety performance outside 2 SDs of GPs-Buoy: 80.0% (p<0.001); K Health: 81.3% (p<0.001); Mediktor: 87.3% (p=1.3×10^-3).

CONCLUSIONS

The utility of digital symptom assessment apps relies on coverage, accuracy and safety. While no digital tool outperformed GPs, some came close, and the nature of iterative improvements to software offers scalable improvements to care.

The Relationship Between Renal Arterial Resistive Index (RRI) and Renal Outcomes in Patients with Resistant Hypertension

INTRODUCTION

There is a mutual relationship between hypertension and renal failure, so that hypertension can be considered as a common finding in patients with end-stage renal disorders. Patients with persistent hypertension despite multiple medications are at high risk for adverse cardiovascular and kidney events. Some studies suggest that there is a correlation between RI and renal function in kidney diseases. Therefore, we conducted a study to investigate the relationship between renal arterial resistive index (RRI) and renal outcomes in patients with resistant hypertension.

METHODS

This 2-years cross-sectional study was performed on patients with resistant hypertension. All patients undergo GFR, serum Cr and urine Alb tests. Then Doppler ultrasound was performed by a radiologist to measure RRI and was evaluated for the relationship between RRI and renal function.

RESULTS

Among 133 patients with resistant hypertension, 57.5% were male and the rest were female. Average age of participants and average RI were 48.26 ± 16.90 and 0.63 ± 0.80, respectively. There was no significant relationship between RI and gender (P > .05). Relationship between RI index with age, GFR, serum creatinine level, and albuminuria was significant in all cases (P < .05). Patients were divided into two groups with RI ≥ 0.7 and RI less than 0.7. Results showed a significant increase in serum creatinine and urinary albumin excretion in group with RI ≥ 0.7 (P < .05), while age, protein exertion level, and GFR in the two groups were not statistically significant (P > .05), despite the difference in the mean. Results of analysis of difference in the mean RI in 3 groups (macro-, micro-, normo- albuminuria) showed no significant difference between them (P > .05).

CONCLUSION

These data demonstrate the clinical importance of renal Doppler that may be an effective way to evaluate the prognosis of renal involvement in resistant hypertension.

Upregulation of the long noncoding RNAs DSCAM-AS1 and MANCR is a potential diagnostic marker for breast carcinoma

Breast cancer (BC) is one of the most common malignancies among women in the world. There is a global attempt to diagnose BC as early as possible. Long noncoding RNAs (lncRNAs) are emerging as novel targets and biomarkers for BC diagnosis and prognosis. Aberrant expression of lncRNAs is associated with BC development, making them a potential tumor marker for BC. To investigate this possibility, we determined the expression levels of Down syndrome cell adhesion molecule-antisense RNA-1 (DSCAM-AS1) and mitotically-associated long non-coding RNA (MANCR) lncRNAs in BC tissues. This case-control study included 50 paired tumor and adjacent nontumor tissues from female BC patients. The total RNA was isolated and the expression levels of MANCR and DSCAM-AS1 lncRNAs were assessed using quantitative real-time reverse transcription-PCR. Potential correlations between lncRNA levels and clinicopathological characteristics were also analyzed. DSCAM-AS1 and MANCR lncRNAs were significantly upregulated in BC tumor tissues compared with the adjacent nontumor tissues. We also found the significant upregulation of DSCAM-AS1 in advanced tumor-node-metastasis stage (TNM III) of BC tumor tissues. Furthermore, the expression of DSCAM-AS1 and MANCR in HER-2 positive patients was significantly higher than HER-2 negative affected individuals. Receiver operating characteristic curve analysis showed a satisfactory diagnostic efficacy (P value < 0.0001), which means that DSCAM-AS1 and MANCR lncRNAs can potentially serve as a biomarker. The present study might provide further approval for the clinical diagnostic significance of DSCAM-AS1 and MANCR lncRNAs that their high expressions were associated with aggressive clinical parameters of BC.

Advances of exosome isolation techniques in lung cancer

Lung cancer (LC) is among the leading causes of death all over the world and it is often diagnosed at advanced or metastatic stages. Exosomes, derived from circulating vesicles that are released from the multivesicular body, can be utilized for diagnosis and also the prognosis of LC at early stages. Exosomal proteins, RNAs, and DNAs can help to better discern the prognostic and diagnostic features of LC. To our knowledge, there are various reviews on LC and the contribution of exosomes, but none of them are about the exome techniques and also their efficiency in LC. To fill this gap, in this review, we summarize the recent investigations regarding isolation and also the characterization of exosomes of LC cells. Furthermore, we discuss the noncoding RNAs as biomarkers and their applications in the diagnosis and prognosis of LC. Finally, we compare the efficacy of exosome isolation methods to better fi + 6 + guring out feasible techniques.

FORESEE: a tool for the systematic comparison of translational drug response modeling pipelines

Summary

Translational models that utilize omics data generated in in vitro studies to predict the drug efficacy of anti-cancer compounds in patients are highly distinct, which complicates the benchmarking process for new computational approaches. In reaction to this, we introduce the uniFied translatiOnal dRug rESponsE prEdiction platform FORESEE, an open-source R-package. FORESEE not only provides a uniform data format for public cell line and patient datasets, but also establishes a standardized environment for drug response prediction pipelines, incorporating various state-of-the-art pre-processing methods, model training algorithms and validation techniques. The modular implementation of individual elements of the pipeline facilitates a straightforward development of combinatorial models, which can be used to re-evaluate and improve already existing pipelines as well as to develop new ones.

Availability and implementation

FORESEE is licensed under GNU General Public License v3.0 and available at https://github.com/JRC-COMBINE/FORESEE and https://doi.org/10.17605/OSF.IO/RF6QK, and provides vignettes for documentation and application both online and in the Supplementary Files 2 and 3.

Supplementary information

Supplementary data are available at Bioinformatics online.

Effects of journal therapy counseling with anxious pregnant women on their infants' sleep quality: a randomized controlled clinical trial

BACKGROUND

Sleep is especially important for infants, since it stimulates the development of neural connections in their brains. Psychological stress such as anxiety could affect sleep quality. This study investigated the effects of journal therapy counseling sessions on the infants' sleep quality based on mothers' perception (primary outcome), maternal anxiety, infants' anthropometric and developmental parameters, and the frequency of exclusive breastfeeding (secondary outcomes).

METHODS

A total of 70 healthy women with gestational age of 28-31 weeks participated in this randomized controlled trial. The participants were randomly allocated into intervention and control groups using randomized block design. Three in-person journal therapy sessions and three telephone counseling sessions (2 between in-person sessions and 1 one month postpartum) were provided to those in the intervention group, while the control group only received routine care. The Infant Sleep Questionnaire (ISQ), Exclusive Breastfeeding Checklist, and Infant Anthropometric Parameters Checklist were completed at two and four months postpartum. The Beck Anxiety Inventory (BAI) was completed during pregnancy, at the end of the intervention, and at two and four months postpartum, and the Ages and Stages Questionnaire (ASQ) was completed at 4 months postpartum. Data were analyzed using chi-square, independent t-test, ANCOVA and repeated measure ANOVA.

RESULTS

There was no significant difference between the two groups in demographic characteristics and baseline anxiety scores. The mean sleep quality score in infants two months of age (MD: -4.2; 95%CI: - 1.1 to - 7.2; P = 0.007) and four months of age (MD: -5.5; 95%CI: - 8.4 to - 2.7; P < 0.001) was significantly lower in the intervention group than that of those in the control group. Based on the repeated measure ANOVA results, the mean postpartum anxiety score of mothers in the intervention group was significantly lower than that of those in the control group (AMD: -7.7; 95%CI: - 5.5 to - 10.1; P < 0.001). There was no significant difference between the two groups regarding other outcomes including the frequency of exclusive breastfeeding, and anthropometric and developmental parameters (P > 0.05).

CONCLUSION

Journal therapy can decrease mothers' anxiety and improve the infants' sleep quality based on their perception. However, further studies are required before drawing any definitive conclusion.

TRIAL REGISTRATION NUMBER

Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N45. Date of registration: August 11, 2018. URL: https://en.irct.ir/trial/33211.

Fault Detection of continuous time linear switched systems using combination of Bond Graph method and switching observer

In this paper, a new Fault Detection (FD) scheme based on combination of switching observer and Bond Graph (BG) method for linear continuous time switched systems with Average Dwell Time (ADT) approach is proposed. The proposed scheme is a BG-based two-stage FD system in which the compact state space representation and Global Analytical Redundancy Relations (GARRs) are derived based on the BG model. In the first stage, a switched observer is designed considering disturbance attenuation level, fault sensitivity and rapid fault detection criteria by solving a weighted Linear Matrix Inequality (LMI) optimization problem. Next, a new form of GARRs which is based on output estimation error of the observer and is called Error-based Global Analytical Redundancy Relations (EGARRs) is developed to combine the observer and BG method. The output estimation errors from the observer, which are adequately sensitive to faults and simultaneously the effects of disturbances are attenuated therein, are given to the EGARRs to generate the residuals of the FD system. The proposed method may be used for fault detection of switched linear systems with ADT based on the BG model of the system. Finally, two case studies including a two-tank system and a buck converter-driven DC motor are considered to show the efficiency and real-time implementation of the proposed method.

Expression Analysis of PVT1, CCDC26, and CCAT1 Long Noncoding RNAs in Acute Myeloid Leukemia Patients

BACKGROUND

Recent evidence indicates that the PVT1, CCDC26, and CCAT1 long noncoding RNAs (lncRNAs) are involved in the leukemogenic process. This study quantified the expression levels of the PVT1, CCDC26, and CCAT1 lncRNAs in patients with acute myeloid leukemia (AML) and also correlated their expression levels with the clinicopathological features of the patients.

MATERIALS AND METHODS

The expression levels of the PVT1, CCDC26, and CCAT1 lncRNAs were analyzed using quantitative reverse transcription-polymerase chain reaction of bone marrow specimens obtained from 86 AML patients, 48 AML-M3 patients, and 40 normal controls.

RESULTS

No differences were found between the combined AML patient populations and the healthy controls with respect to the expression levels of PVT1, CCDC26, and CCAT1 (p = 0.35, p = 0.09, and p = 0.77, respectively). However, compared with the controls, the AML-M3 patients had higher PVT1 expression (p = 0.017). Furthermore, high-risk AML-M3 patients manifested higher expression levels of PVT1 than low- and intermediate-risk groups. In addition, distinctive CCDC26 and CCAT1 expression levels were observed among patients with different French-American-British subtypes (p = 0.001 for CCDC26 and p = 0.013 for CCAT1). Compared with the healthy controls, AML-M4 and M5 had higher CCAT1 expression (p = 0.04) and AML-M2 and AML-M4/M5 patients had higher CCDC26 expression (p < 0.001 and p = 0.02, respectively). In addition, different patterns of CCDC26 expression were found among the different cytogenetic risk subtypes (p = 0.005). Finally, patients with intermediate cytogenetic risk showed higher CCDC26 expression levels.

CONCLUSION

The differential expression of the PVT1, CCDC26, and CCAT1 lncRNAs in different AML subtypes suggests that the deregulation of these transcripts may function in the multistep leukemogenic process and that they may serve as new therapeutic targets for this malignancy.

Low Expression of Long Noncoding RNA IRAIN Is Associated with Poor Prognosis in Non-M3 Acute Myeloid Leukemia Patients

AIMS

Deregulation of the long noncoding RNA IRAIN has been identified in several cancers. However, the expression pattern of IRAIN and its clinical implication in acute myeloid leukemia (AML) are unknown. The purpose of this study was to investigate the expression status of IRAIN and its clinical significance in non-M3 AML patients.

METHODS

Quantitative reverse transcription-polymerase chain reaction was performed to examine IRAIN transcript levels in 64 de novo non-M3 AML patients and 51 healthy controls. The association of IRAIN expression with clinicopathological factors was statistically analyzed.

RESULTS

Compared with the controls, IRAIN was significantly downregulated in non-M3 AML patients (p < 0.001). The median of IRAIN expression divided the non-M3 AML patients into IRAIN low-expressing (IRAIN^low) and IRAIN high-expressing (IRAIN^high) groups. The IRAIN^low group tended to have higher white blood cell count and blast counts and had markedly shorter overall survival (OS) and relapse-free survival (RFS) (p = 0.044 and 0.009, respectively). In addition, patients with refractory response to chemotherapies and those with subsequent relapse had lower initial IRAIN expression. Multivariate analysis further identified IRAIN transcript levels as an independent prognostic factor for both RFS and OS.

CONCLUSIONS

Our finding suggests that IRAIN transcript levels may be a useful biomarker for the prognosis of non-M3 AML patients.

Up-regulation of miR-21 decreases chemotherapeutic effect of dendrosomal curcumin in breast cancer cells

OBJECTIVES

Despite the good results of anticancer activities by curcumin, there are some hurdles that limit the use of curcumin as an anticancer agent. Many methods were examined to overcome this defect like the use of the dendrosomal curcumin (DNC). There is increasing evidence that miRNAs play important roles in biological processes. In this study, we focus on the roles of microRNA-21 in the anti-cancer effects of DNC in breast cancer.

MATERIALS AND METHODS

Also, we have used different methods such as MTT, apoptosis, cell cycle analysis, transwell migration assay and RT-PCR to find out more.

RESULTS

We observed that miR-21 decreased apoptotic cells in both cells (from 6.35% to 0.34 % and from 7.72% to 1.32% orderly) and DNC increased it. As well as, our findings indicated that cell migration capacity was increased by miR-21 over expression and was decreased by DNC. The combination of miR-21 vector transfection and DNC treatment showed lower percentage of apoptotic cells or a higher level of penetration through the membrane compared with DNC treatment alone. Furthermore, DNC induced a marked increase in the number of cells in sub G1/G1 phase and a decrease in G2/M phase of the cell cycle in both; but, we observed reverse results compared it, after transfection with miR-21 vector.

CONCLUSION

We observed that miR-21 suppress many aspects of anti-cancer effects of DNC in breast cancer cells, it seems that co-treatment with DNC and mir-21 down-regulation may provide a clinically useful tool for drug-resistance breast cancer cells.

Interleukin-1 receptor antagonist mediates toll-like receptor 3-induced inhibition of trophoblast adhesion to endometrial cells in vitro

STUDY QUESTION

Is interleukin-1 receptor antagonist (IL-1RA) involved in the toll-like receptor 3 (TLR 3)-induced inhibition of trophoblast cells' adhesion to endometrial cells in vitro?

SUMMARY ANSWER

IL-1RA mediates the TLR 3-induced inhibition of trophoblast cells' adhesion to endometrial cells in vitro.

WHAT IS KNOWN ALREADY

It is well documented that endometrial TLR 3 activation leads to impairment of trophoblast binding to endometrial cells in vitro. IL-1RA is known as an anti-implantation factor, as its injection significantly reduced implantation rates in mice by an effect on endometrial receptivity.

STUDY DESIGN, SIZE, DURATION

Poly I:C was used as a TLR3 specific ligand and endometrial cells were either treated or not with Poly I:C (treated versus control) in vitro. IL-1RA was applied to block IL-1 signal transduction. IL-1RA was knocked down by Accell Human IL1RN siRNA. Flagellin was used to stimulate TLR 5. SP600125 (JNK) was applied to inhibit the mitogen-activated protein kinases (MAPK) pathway. BAY11 -7082 was used to inhibit the nuclear factor-κB (NF-κB) pathway. The experiments were performed in three replicates on three separate days.

PARTICIPANTS/MATERIALS, SETTING, METHODS

An in vitro assay was developed using RL95-2 (an endometrial cell line) and JAr (a trophoblast cell line) cells. Initially, the production of IL-1RA in RL95-2 cells in response to TLR 3 activation was measured. To determine whether the TLR 3-induced inhibition of trophoblast binding was mediated through IL-1RA: (i) we evaluated the effect of IL-1RA on the attachment of trophoblast cells to endometrial cells; (ii) we knocked down TLR3-induced IL-1RA gene expression by IL-1RA Small interfering RNA (siRNA) and evaluated trophoblast attachment to endometrial cells. Finally, to clarify through which pathway TLR 3-induced inhibition of trophoblast binding occurs: (i) activation of NF-κB and MAPK was detected by transfecting the cells with secreted placental alkaline phosphatase reporter plasmids bearing promoter sequences for each transcription factor; (ii) the inhibitors for NF-κB and MAPK were used to block signaling; (iii) it was then investigated whether addition of these inhibitors could restore the TLR 3-induced impairment of trophoblast attachment to the endometrial cells.

MAIN RESULTS AND THE ROLE OF CHANCE

Our results showed that addition of polyinosinic:polycytidylic acid (Poly I:C) to RL95-2 cells significantly increased the production of IL-1RA (P < 0.05). Addition of human recombinant IL-1RA to RL95-2 cells remarkably decreased the adhesion rate of trophoblast cells to endometrial cells (P < 0.05). In addition, suppression of TLR3-induced IL-1RA gene expression in RL95-2 cells significantly restored trophoblast cells attachment to endometrial cells in the presence of Poly I:C (P < 0.05). Only TLR3 and not TLR5 induced MAPK activation (P < 0.05). TLR3 ligation did not affect NF-κB activation. Of NF-kB and MAPK inhibitors, only MAPK's inhibitor could achieve restoration of spheroid adhesion to endometrial cells (P < 0.05).

LIMITATIONS, REASONS FOR CAUTION

This study has been only done in vitro. Future in vivo studies will confirm our data.

WIDER IMPLICATIONS OF THE FINDINGS

The findings of this study have a potential clinical application in introducing IL-1RA as one of the diagnostic infertility markers in the endometrium, which can affect the process of embryo adhesion at the time of implantation. Moreover, based on the novel data obtained in the current study, blocking and regulating the MAPK pathway by its inhibitors can be used as a new strategy to prevent and treat virus-induced infertility cases in ART techniques.

STUDY FUNDING/COMPETING INTEREST

This study was partially funded by a Marie Curie IIF-253948 grant to I.C. and was partially funded by the author's institutions. The authors have no conflict of interest to declare.

Dendrosomal curcumin nanoformulation modulate apoptosis-related genes and protein expression in hepatocarcinoma cell lines

The side-effects observed in conventional therapies have made them unpromising in curing Hepatocellular carcinoma; therefore, developing novel treatments can be an overwhelming significance. One of such novel agents is curcumin which can induce apoptosis in various cancerous cells, however, its poor solubility is restricted its application. To overcome this issue, this paper employed dendrosomal curcumin (DNC) was employed to in prevent hepatocarcinoma in both RNA and protein levels. Hepatocarcinoma cells, p53 wild-type HepG2 and p53 mutant Huh7, were treated with DNC and investigated for toxicity study using MTT assay. Cell cycle distribution and apoptosis were analyzed using Flow-cytometry and Annexin-V-FLUOS/PI staining. Real-time PCR and Western blot were employed to analyze p53, BAX, Bcl-2, p21 and Noxa in DNC-treated cells. DNC inhibited the growth in the form of time-dependent manner, while the carrier alone was not toxic to the cell. Flow-cytometry data showed the constant concentration of 20μM DNC during the time significantly increases cell population in SubG1 phase. Annexin-V-PI test showed curcumin-induced apoptosis was enhanced in Huh7 as well as HepG2, compared to untreated cells. Followed by treatment, mRNA expression of p21, BAX, and Noxa increased, while the expression of Bcl-2 decreased, and unlike HepG2, Huh7 showed down-regulation of p53. In summary, DNC-treated hepatocellular carcinoma cells undergo apoptosis by changing the expression of genes involved in the apoptosis and proliferation processes. These findings suggest that DNC, as a plant-originated therapeutic agent, could be applied in cancer treatment.

Combined Population Dynamics and Entropy Modelling Supports Patient Stratification in Chronic Myeloid Leukemia

Modelling the parameters of multistep carcinogenesis is key for a better understanding of cancer progression, biomarker identification and the design of individualized therapies. Using chronic myeloid leukemia (CML) as a paradigm for hierarchical disease evolution we show that combined population dynamic modelling and CML patient biopsy genomic analysis enables patient stratification at unprecedented resolution. Linking CD34⁺ similarity as a disease progression marker to patient-derived gene expression entropy separated established CML progression stages and uncovered additional heterogeneity within disease stages. Importantly, our patient data informed model enables quantitative approximation of individual patients’ disease history within chronic phase (CP) and significantly separates “early” from “late” CP. Our findings provide a novel rationale for personalized and genome-informed disease progression risk assessment that is independent and complementary to conventional measures of CML disease burden and prognosis.

The Association Between Primary Open Angle Glaucoma and Clustered Components of Metabolic Syndrome

Purpose :

There is conflicting evidence whether components of metabolic syndrome (MetS) increase or decrease the risk of primary open-angle glaucoma (POAG). The aim of the present study was to determine the association between metabolic syndrome and primary open-angle glaucoma.

Methods :

A total of 200 participants comprising 100 controls and 100 patients with POAG documented by clinical tests and examined by an experienced ophthalmologist using standard ophthalmologic equipment were included in the study. MetS was defined and based on ATP III criteria and POAG was defined by the criteria of the International Society of Geographic and Epidemiological Ophthalmology (ISGEO). The data were entered into the SPSS software and analyzed.

Results :

The prevalence of MetS in the glaucoma group was 53% in comparison to 38% in the control group (p=0.037). MetS was associated with an increased odds ratio for an IOP higher than 21 mmHg (OR: 1.72; 95% CI 1.03-2.79; p=0.034). The mean IOP was 24.91±4.29 mmHg in the patients without MetS, and 27.23±4.81 mmHg in those with MetS (p=0.027). The mean values of CCT were 603.64±63.16 µm in MetS patients and 579.27±72.87 µm in controls (p=0.018).

Conclusion :

Data showed an increased prevalence of components of metabolic syndrome in patients with glaucoma. The mechanisms underlying these associations need to be established in future studies. Our results support the recommendation that patients with metabolic syndrome undergo regular ophthalmological exams to monitor for the onset or progression of glaucoma.

Activation of Toll-like receptor 3 reduces actin polymerization and adhesion molecule expression in endometrial cells, a potential mechanism for viral-induced implantation failure

STUDY QUESTION

Does activation of endometrial Toll-like receptor 3 (TLR 3) affect cell receptivity to trophoblast adhesion?

SUMMARY ANSWER

TLR 3 activation in vitro reduces the attachment of trophoblast cells to endometrial cells by altering the cell cytoskeleton and reducing the expression of adhesion molecules in human endometrial cells.

WHAT IS KNOWN ALREADY

It is well documented that the presence of an infection at the time of implantation can lead to implantation failure. The female reproductive tract recognizes invading micro-organisms through the innate pathogen recognition receptors such as the TLRs.

STUDY DESIGN, SIZE, DURATION

Poly I:C was used as a TLR 3-specific ligand and endometrial cells were either treated or not with Poly I:C (treated versus control) in vitro. The experiments were performed in three replicates on three separate days.

PARTICIPANTS/MATERIALS, SETTING, METHODS

An in vitro assay was developed using RL95-2 (a human endometrial cell line) and JAr (a human trophoblast cell line) cells. Initially, the percentage of attached JAr spheroids to RL95-2 was measured in response to TLR 3 activation. Next, actin polymerization in RL95-2 cells was assessed in response to TLR 2/6, 3 and 5 activation. Phalloidin was used to assess the mean fluorescence intensity of F-actin by flow cytometry or confocal microscopy. Secondly, the influence of TLR 2/6, 3 and 5 activation on the expression of cluster of differentiation 98 (CD98) and β3 integrin was determined. To further understand through which pathways the TLR 3-induced alterations occur, inhibitors were applied for Toll/interleukin-1 receptor domain-containing adaptor inducing interferon-beta (TRIF), myeloid differentiation primary response 88 (MYD88), mitogen-activated protein kinases (MAPK) and nuclear factor pathways.

MAIN RESULTS AND THE ROLE OF CHANCE

We observed that stimulation of TLR 3 in endometrial cells with different concentrations of Poly I:C led to a reduction in the percentage of trophoblasts attached to the endometrial cells in a dose-dependent manner (P < 0.05). This decrease was consistent in the Poly I:C treated group regardless of the co-incubation time (P < 0.05). In addition, our results demonstrated that actin polymerization and CD98 expression significantly decreased only in response to TLR 3 activation (P < 0.05). Activation of endometrial cells with TLR 2/6, 3 and 5 significantly reduced β3 integrin expression (P < 0.05). These alterations were shown to work via MYD88-MAPK pathways (P < 0.05).

LIMITATIONS, REASONS FOR CAUTION

This study has been performed in vitro. Future in vivo studies will be required in order to confirm our data.

WIDER IMPLICATIONS OF THE FINDINGS

This is a novel discovery which extends our current knowledge concerning diagnosis and treatment of viral-induced infertility cases.

STUDY FUNDING/COMPETING INTERESTS

This research was supported by the COST Action FA1201 (GEMINI) by granting a Short Term Scientific Mission and the Instituto de Salud Carlos III by granting Grant PI11/01645. The authors have no conflict of interest to declare.