Evaluation of the cytotoxic activities of the essential oil from Pistacia atlantica Desf. oleoresin on human gastric cancer cell lines

Numerous herbal products have been the subject of research regarding their potential role in cancer prevention or adjuvant therapy. Pistacia atlantica and its main phytochemicals have garnered significant attention for their potential anti-cancer effects. The study aimed to assess the growth inhibitory effects of P. atlantica essential oil (PAEO) on MKN-45 and AGS cells. This study quantified the volatile compounds in PAEO using Gas Chromatography-Mass Spectrometry (GC-MS). Subsequently, MKN-45 and AGS cells were treated with varying concentrations of PAEO (5%, 2.5%, 1.25%, 0.625%, 0.3125%, 0.156%, 0.0781%, 0.0391%, 0.0195%) for 24 h. Cell viability was evaluated through the MTT assay. The impact of PAEO on gene expression was investigated by quantifying the mRNA levels of Bax and Bcl2 in the various experimental groups using quantitative Real-Time PCR (qRT-PCR) analysis. Additionally, flow cytometry was utilized to evaluate apoptosis in the treated cells. The analysis of PAEO revealed that α-pinene was the predominant monoterpene, constituting 87.9% of the oil composition. The cytotoxic effects of PAEO were evaluated, and it was found that the oil significantly reduced the viability of MKN-45 and AGS cells. The IC50 for MKN-45 cells was determined to be 1.94 × 10-3% after 24 h of treatment, while for AGS cells the IC50 was 2.8 × 10-3% after 24 h. Additionally, the research revealed that PAEO triggered a notable rise in apoptotic cells in both AGS and MKN-45 cell lines. Moreover, at the molecular level, the findings indicated an increase in Bax expression and a decrease in Bcl2 mRNA expression, providing further evidence of the induction of apoptosis in both MKN-45 and AGS cell lines following PAEO treatment. The findings of this study offer evidence supporting the cytotoxic effects of PAEO on gastric cancer cell lines by promoting apoptosis. The findings suggest that PAEO may offer potential as a therapeutic candidate in managing and treating gastric cancer.

tRNA-derived fragments: Key determinants of cancer metastasis with emerging therapeutic and diagnostic potentials

Metastasis is a significant clinical challenge responsible for cancer mortality and non-response to treatment. However, the molecular mechanisms driving metastasis remain unclear, limiting the development of efficient diagnostic and therapeutic approaches. Recent breakthroughs in cancer biology have discovered a group of small non-coding RNAs called tRNA-derived fragments (tRFs), which play a critical role in the metastatic behavior of various tumors. tRFs are produced from cleavage modifications of tRNAs and have different functional classes based on the pattern of these modifications. They perform post-transcriptional regulation through microRNA-like functions, displacing RNA-binding proteins, and play a role in translational regulation by inducing ribosome synthesis, translation initiation, and epigenetic regulation. Tumor cells manipulate tRFs to develop and survive the tumor mass, primarily by inducing metastasis. Multiple studies have demonstrated the potential of tRFs as therapeutic, diagnostic, and prognostic targets for tumor metastasis. This review discusses the production and function of tRFs in cells, their aberrant molecular contributions to the metastatic environment, and their potential as promising targets for anti-metastasis treatment strategies.

Exosomal microRNAs in regulation of tumor cells resistance to apoptosis

Exosomes are a type of extracellular vesicle that contains bioactive molecules that can be secreted by most cells. Nevertheless, the content of these cells differs depending on the cell from which they originate. The exosome plays a crucial role in modulating intercellular communication by conveying molecular messages to neighboring or distant cells. Cancer-derived exosomes can transfer several types of molecules into the tumor microenvironment, including high levels of microRNA (miRNA). These miRNAs significantly affect cell proliferation, angiogenesis, apoptosis resistance, metastasis, and immune evasion. Increasing evidence indicates that exosomal miRNAs (exomiRs) are crucial to regulating cancer resistance to apoptosis. In cancer cells, exomiRs orchestrate communication channels between them and their surrounding microenvironment, modulating gene expression and controlling apoptosis signaling pathways. This review presents an outline of present-day knowledge of the mechanisms that affect target cells and drive cancer resistance to apoptosis. Also, our study looks at the regulatory role of exomiRs in mediating intercellular communication between tumor cells and surrounding microenvironmental cells, specifically stromal and immune cells, to evade therapy-induced apoptosis.

Hijacking and rewiring of host CircRNA/miRNA/mRNA competitive endogenous RNA (ceRNA) regulatory networks by oncoviruses during development of viral cancers

A significant portion of human cancers are caused by oncoviruses (12%-25%). Oncoviruses employ various strategies to promote their replication and induce tumourigenesis in host cells, one of which involves modifying the gene expression patterns of the host cells, leading to the rewiring of genes and resulting in significant changes in cellular processes and signalling pathways. In recent studies, a specific mode of gene regulation known as circular RNA (circRNA)-mediated competing endogenous RNA (ceRNA) networks has emerged as a key player in this context. CircRNAs, a class of non-coding RNA molecules, can interact with other RNA molecules, such as mRNAs and microRNAs (miRNAs), through a process known as ceRNA crosstalk. This interaction occurs when circRNAs, acting as sponges, sequester miRNAs, thereby preventing them from binding to their target mRNAs and modulating their expression. By rewiring the host cell genome, oncoviruses have the ability to manipulate the expression and activity of circRNAs, thereby influencing the ceRNA networks that can profoundly impact cellular processes such as cell proliferation, differentiation, apoptosis, and immune responses. This review focuses on a comprehensive evaluation of the latest findings on the involvement of virus-induced reprogramming of host circRNA-mediated ceRNA networks in the development and pathophysiology of human viral cancers, including cervical cancer, gastric cancer, nasopharyngeal carcinoma, Kaposi's sarcoma, hepatocellular carcinoma, and diffuse large B cell lymphoma. Understanding these mechanisms can improve our knowledge of how oncoviruses contribute to human tumourigenesis and identify potential targets for developing optimised therapies and diagnostic tools for viral cancers.

ZIF-8 Nanoparticle: A Valuable Tool for Improving Gene Delivery in Sperm-Mediated Gene Transfer

Metal-organic frameworks (MOFs) are porous materials with unique characteristics that make them well-suited for drug delivery and gene therapy applications. Among the MOFs, zeolitic imidazolate framework-8 (ZIF-8) has emerged as a promising candidate for delivering exogenous DNA into cells. However, the potential of ZIF-8 as a vector for sperm-mediated gene transfer (SMGT) has not yet been thoroughly explored.This investigation aimed to explore the potential of ZIF-8 as a vector for enhancing genetic transfer and transgenesis rates by delivering exogenous DNA into sperm cells. To test this hypothesis, we employed ZIF-8 to deliver a plasmid expressing green fluorescent protein (GFP) into mouse sperm cells and evaluated the efficiency of DNA uptake. Our findings demonstrate that ZIF-8 can efficiently load and deliver exogenous DNA into mouse sperm cells, increasing GFP expression in vitro. These results suggest that ZIF-8 is a valuable tool for enhancing genetic transfer in SMGT, with important implications for developing genetically modified animals for research and commercial purposes. Additionally, our study highlights the potential of ZIF-8 as a novel class of vectors for gene delivery in reproductive biology.Overall, our study provides a foundation for further research into using ZIF-8 and other MOFs as gene delivery systems in reproductive biology and underscores the potential of these materials as promising vectors for gene therapy and drug delivery.

Methyl β-Cyclodextrin-sperm-mediated gene editing (MBCD-SMGE): a simple and efficient method for targeted mutant mouse production

BACKGROUND

Generating targeted mutant mice is a crucial technology in biomedical research. This study focuses on optimizing the CRISPR/Cas9 system uptake into sperm cells using the methyl β-cyclodextrin-sperm-mediated gene transfer (MBCD-SMGT) technique to generate targeted mutant blastocysts and mice efficiently. Additionally, the present study elucidates the roles of cholesterol and reactive oxygen species (ROS) in the exogenous DNA uptake by sperm.

RESULTS

In this study, B6D2F1 mouse sperm were incubated in the c-TYH medium with different concentrations of MBCD (0, 0.75, 1, and 2 mM) in the presence of 20 ng/µl pCAG-eCas9-GFP-U6-gRNA (pgRNA-Cas9) for 30 min. Functional parameters, extracellular ROS, and the copy numbers of internalized plasmid per sperm cell were evaluated. Subsequently, in vitro fertilization (IVF) was performed and fertilization rate, early embryonic development, and transfection rate were assessed. Finally, our study investigated the potential of the MBCD-SMGT technique in combination with the CRISPR-Cas9 system, referred to as MBCD-SMGE (MBCD-sperm-mediated gene editing), for generating targeted mutant blastocysts and mice. Results indicated that cholesterol removal from the sperm membrane using MBCD resulted in a premature acrosomal reaction, an increase in extracellular ROS levels, and a dose-dependent influence on the copy numbers of the internalized plasmids per sperm cell. Moreover, the MBCD-SMGT technique led to a larger population of transfected motile sperm and a higher production rate of GFP-positive blastocysts. Additionally, the current study validated the targeted indel in blastocyst and mouse derived from MBCD-SMGE technique.

CONCLUSION

Overall, this study highlights the significant potential of the MBCD-SMGE technique for generating targeted mutant mice. It holds enormous promise for modeling human diseases and improving desirable traits in animals.

Designing a Multi-epitope Vaccine against the SARS-CoV-2 Variant based on an Immunoinformatics Approach

BACKGROUND

SARS-CoV-2 is a life-threatening virus in the world. Scientific evidence indicates that this pathogen will emerge again in the future. Although the current vaccines have a pivotal role in the control of this pathogen, the emergence of new variants has a negative impact on their effectiveness.

OBJECTIVES

Therefore, it is urgent to consider the protective and safe vaccine against all subcoronavirus species and variants based on the conserved region of the virus. Multi-epitope peptide vaccine (MEV), comprised of immune-dominant epitopes, is designed by immunoinformatic tools and it is a promising strategy against infectious diseases.

METHODS

Spike glycoprotein and nucleocapsid proteins from all coronavirus species and variants were aligned and the conserved region was selected. Antigenicity, toxicity, and allergenicity of epitopes were checked by a proper server. To robust the immunity of the multi-epitope vaccine, cholera toxin b (CTB) and three HTL epitopes of tetanus toxin fragment C (TTFrC) were linked at the N-terminal and C-terminal of the construct, respectively. Selected epitopes with MHC molecules and the designed vaccines with Toll-like receptors (TLR-2 and TLR-4) were docked and analyzed. The immunological and physicochemical properties of the designed vaccine were evaluated. The immune responses to the designed vaccine were simulated. Furthermore, molecular dynamic simulations were performed to study the stability and interaction of the MEV-TLRs complexes during simulation time by NAMD (Nanoscale molecular dynamic) software. Finally, the codon of the designed vaccine was optimized according to Saccharomyces boulardii.

RESULTS

The conserved regions of spike glycoprotein and nucleocapsid protein were gathered. Then, safe and antigenic epitopes were selected. The population coverage of the designed vaccine was 74.83%. The instability index indicated that the designed multi-epitope was stable (38.61). The binding affinity of the designed vaccine to TLR2 and TLR4 was -11.4 and -11.1, respectively. The designed vaccine could induce humoral and cellular immunity.

CONCLUSION

In silico analysis showed that the designed vaccine is a protective multi-epitope vaccine against SARS-CoV-2 variants.

Use of Massive Online Open Courses (MOOCs) model in virtual education development in first macro-region universities of medical sciences in countrywide territorial planning

BACKGROUND

Massive online open cources (MOOCs) are a new chapter in the topic of teaching-learning in higher education, which have been able to acquire a significant and valuable position in higher education and prestigious universities worldwide in line with the advancement of technology. The present study was conducted pursuing the goal to investigating the effect of use of MOOCs in the development of virtual education in universities of medical sciences in the first macro-region of countrywide territorial planning.

MATERIALS AND METHODS

This research is based on a mixed method and practical in terms of purpose, and it was carried out in 2021 and 2022 in first macro-region of countrywide regional planning Medical Sciences Universities. The data of the qualitative section were converted into a questionnaire using the method of qualitative content analysis in a purposeful and semi-structured interview with 24 experts in the field of virtual education who had sufficient experience in the field of MOOC courses. The statistical population of the quantitative section is 1938 faculty members of the first macro-region of countrywide regional planning, of which 324 were selected by stratified random sampling. Its validity was calculated by Lawshe and Waltz-Bausell method by R software, and the reliability was calculated using Cronbach's alpha method with SPSS-21.

RESULTS

Universities are facing challenges in structural, managerial, cultural, social, technological, and evaluation dimensions, and the current situation of using MOOCs in them is not appropriate.

CONCLUSION

Besides, the analysis of the optimal situation of using MOOCs in these universities indicates that technological, structural, managerial, evaluation, educational, and personal dimensions are the most important in the effect of using MOOCs on the development of virtual education.

The psychological toll of the COVID-19 pandemic on dental care providers in Iran: A multicenter cross-sectional study

Background/Purpose

The COVID-19 pandemic affects social and psychological resources. Healthcare workers, especially dental personnel, are more at risk for mental issues due to anxiety, pressure, and frustration. This study assessed mental health outcomes during the COVID-19 epidemic among Iranian dental care providers, focusing on insomnia, anxiety, depression, and posttraumatic stress disorder (PTSD).

Methods

In this multicenter cross-sectional survey, the Insomnia Severity Index, the Hospital Anxiety and Depression Scale, and the Global Psychotrauma Screening were masured. Six hundred thirty-eight dental care providers (dental specialists, general dentists, dental hygienists, dental assistants, and dental students) from different parts of Iran (Tehran, Shiraz, Tabriz, and Mashhad) were investigated by the stratified sampling method. The univariate analysis was incorporated as independent in binary logistic regression models to analyze the data. In this study, the significance level was set at 0.05.

Results

Among all the participants, 42.8% were dental students or residents, 21.9% were general or specialist dentists, 18.7% were dental assistants, and 16.6% were nonclinicians. The prevalence of insomnia, anxiety, and depression was 31.3%, 40.8%, and 54.9%, respectively. The frequency of participants in the low, moderate, and high levels of PTSD resulting from LCA 56.6%, 33.7%, and 9.7%, respectively.

Conclusions

This study found a significant frequency of mental health issues among Iranian dentists. Females, participants whose relatives have COVID-19, and those with a higher workload were more likely to develop mental health symptoms. As mental problems among dental professionals might affect the quality of patient care, diagnostic, supportive, and therapeutic interventions should be taken.

Intrauterine administration of autologous peripheral blood mononuclear cells regulates the endometrium estrogen and progesterone receptor expression: An RCT

Background

Repeated implantation failure (RIF) affects 15% of women of reproductive age. There is a high endometrial expression of both estrogen receptors and progesterone receptors (PRs) during the window of implantation in women with RIF.

Objective

To evaluate the effects of intrauterine administration of human peripheral blood mononuclear cells (PBMC) on estrogen receptor α (ERα) and PRs expression in the endometrium of women with RIF during the implantation window.

Materials and Methods

This randomized clinical trial study was conducted on 22 women with RIF history from January 2018 to August 2019 in Erfan hospital, Tehran, Iran. Participantswere divided into 2 groups (PBMC-treated group [n = 11] and control group [n = 11]). Endometrial tissue samples were collected at the implantation window time, during the mid-secretory phase (luteinizing hormone surge +7 days) of each menstrual cycle. The quantitative real-time polymerase chain reaction technique was used to measure the mRNA levels of ERα and PRs isoforms (PR-A and PR-B) in endometrial tissues. Furthermore, the protein expression of ERα and PRs was investigated using immunohistochemical staining.

Results

PBMC treatment significantly decreased the mRNA expression of endometrial ERα and PRs isoforms at the time of the implantation window (p < 0.001). Moreover, the endometrial ERα and PRs protein localization were significantly lower in PBMC-treated women compared with controls (p = 0.01, and p < 0.001 respectively).

Conclusion

The intrauterine administration of PBMC decreased the endometrial ERα and PRs expression during the window of implantation in women with RIF. This local response to PBMC therapy could promote endometrial receptivity and embryo implantation.

Deep Learning-based Non-rigid Image Registration for High-dose Rate Brachytherapy in Inter-fraction Cervical Cancer

In this study, an inter-fraction organ deformation simulation framework for the locally advanced cervical cancer (LACC), which considers the anatomical flexibility, rigidity, and motion within an image deformation, was proposed. Data included 57 CT scans (7202 2D slices) of patients with LACC randomly divided into the train (n = 42) and test (n = 15) datasets. In addition to CT images and the corresponding RT structure (bladder, cervix, and rectum), the bone was segmented, and the coaches were eliminated. The correlated stochastic field was simulated using the same size as the target image (used for deformation) to produce the general random deformation. The deformation field was optimized to have a maximum amplitude in the rectum region, a moderate amplitude in the bladder region, and an amplitude as minimum as possible within bony structures. The DIRNet is a convolutional neural network that consists of convolutional regressors, spatial transformation, as well as resampling blocks. It was implemented by different parameters. Mean Dice indices of 0.89 ± 0.02, 0.96 ± 0.01, and 0.93 ± 0.02 were obtained for the cervix, bladder, and rectum (defined as at-risk organs), respectively. Furthermore, a mean average symmetric surface distance of 1.61 ± 0.46 mm for the cervix, 1.17 ± 0.15 mm for the bladder, and 1.06 ± 0.42 mm for the rectum were achieved. In addition, a mean Jaccard of 0.86 ± 0.04 for the cervix, 0.93 ± 0.01 for the bladder, and 0.88 ± 0.04 for the rectum were observed on the test dataset (15 subjects). Deep learning-based non-rigid image registration is, therefore, proposed for the high-dose-rate brachytherapy in inter-fraction cervical cancer since it outperformed conventional algorithms.

Locked nucleic acid (LNA): A modern approach to cancer diagnosis and treatment

Cancer is responsible for about one in six deaths in the world. Conventional cancer treatments like chemotherapy, radiotherapy, and surgery are associated with drug poisoning and poor prognosis. Thanks to advances in RNA delivery and target selection, new cancer medicines are now conceivable to improve the quality of life and extend the lives of cancer patients. Antisense oligonucleotides (ASOs) and siRNAs are the most important tools in RNA therapies. Locked Nucleic Acids (LNAs) are one of the newest RNA analogs, exhibiting more affinity to binding, sequence specificity, thermal stability, and nuclease resistance due to their unique properties. Assays using LNA are also used in molecular diagnostic methods and provide accurate and rapid mutation detection that improves specificity and sensitivity. This study aims to review the special properties of LNA oligonucleotides that make them safe and effective antisense drugs for cancer treatment by controlling gene expression. Following that, we go over all of the molecular detection methods and cancer treatment antisense tactics that are possible with LNA technology.

An investigation into the hammer toe effects on the lower extremity mechanics and plantar fascia tension: A case for a vicious cycle and progressive damage

Hammer toes are one of the common deformities of the forefoot that can lead to compensatory changes during walking in individuals with this condition. Predicting the adverse effects of tissue damage on the performance of other limbs is very important in the prevention of progressive damage. Finite element (FE) and musculoskeletal modeling can be helpful by allowing such effects to be studied in a way where the internal stresses in the tissue could be investigated. Hence, this study aims to investigate the effects of the hammer toe deformity on the lower extremity, especially on the plantar fascia functions. To compare the joint reactions of the hammer toe foot (HTF) and healthy foot (HF), two musculoskeletal models (MSM) of the feet of a healthy individual and that of a participant with hammer toe foot were developed based on gait analysis. A previously validated 3D finite element model which was constructed using Magnetic Resonance Imaging (MRI) of the diabetic participant with the hammer toe deformity was processed at five different events during the stance phase of gait. It was found that the hammer toe deformity makes dorsiflexion of the toes and the windlass mechanism less effective during walking. Specifically, the FE analysis results showed that plantar fascia (PF) in HTF compared to HF played a less dominant role in load bearing with both medial and lateral parts of PF loaded. Also, the results indicated that the stored elastic energy in PF was less in HTF than the HF, which can indicate a higher metabolic cost during walking. Internal stress distribution shows that the majority of ground reaction forces are transmitted through the lateral metatarsals in hammer toe foot, and the probability of fifth metatarsal fracture and also progressive deformity was subsequently increased. The MSM results showed that the joint reaction forces and moments in the hammer toe foot have deviated from normal, where the metatarsophalangeal joint reactions in the hammer toe were less than the values in the healthy foot. This can indicate a vicious cycle of foot deformity, leading to changes in body weight force transmission line, and deviation of joint reactions and plantar fascia function from normal. These in turn lead to increased internal stress concentration, which in turn lead to further foot deformities. This vicious cycle cause progressive damage and can lead to an increase in the risk of ulceration in the diabetic foot.

Identifying Key Lysosome-Related Genes Associated with Drug-Resistant Breast Cancer Using Computational and Systems Biology Approach

Background

Drug resistance in breast cancer is an unsolved problem in treating patients. It has been recently discussed that lysosomes contribute to the invasion and angiogenesis of cancer cells. There is evidence that lysosomes can also cause multi-drug resistance. We analyzed this emerging concept in breast cancer through computational and systems biology approaches.

Objectives

We aimed to identify the key lysosome-related genes associated with drug-resistant breast cancer.

Methods

All genes contributing to the structure and function of lysosomes were inquired through the Human Lysosome Gene Database. The prioritized top 51 genes from the provided lists of Endeavour, ToppGene, and GPSy as prioritization tools were selected. All lysosomal genes and 12 breast cancer-related genes aligned to identify the most similar genes to breast cancer-related genes. Different centralities were applied to score each human protein to calculate the most central lysosomal genes in the human protein-protein interaction (PPI) network. Common genes were extracted from the results of the mentioned methods as a selected gene set. For Gene Ontology enrichment, the selected gene set was analyzed by WebGestalt, DAVID, and KOBAS. The PPI network was constructed via the STRING database. The PPI network was analyzed utilizing Cytoscape for topology network interaction and CytoHubba to extract hub genes.

Results

Based on biological studies, literature reviews, and comparing all mentioned analyzing methods, six genes were introduced as essential in breast cancer. This computational approach to all lysosome-related genes suggested that candidate genes include PRF1, TLR9, CLTC, GJA1, AP3B1, and RPTOR. The analyses of these six genes suggest that they may have a crucial role in breast cancer development, which has rarely been evaluated. These genes have a potential therapeutic implication for new drug discovery for chemo-resistant breast cancer.

Conclusions

The present work focused on all the functional and structural lysosome-related genes associated with breast cancer. It revealed the top six lysosome hub genes that might serve as therapeutic targets in drug-resistant breast cancer. Since these genes play a pivotal role in the structure and function of lysosomes, targeting them can effectively overcome drug resistance.

Effects of human chorionic gonadotropin-producing peripheral blood mononuclear cells on the endometrial receptivity and implantation sites of the mouse uterus

Objective: This research investigated the effects of human chorionic gonadotropin (HCG)-producing peripheral blood mononuclear cells (PBMCs) on the implantation rate and embryo attachment in mice. Methods: In this experimental study, a DNA fragment of the HCG gene was cloned into an expression vector, which was transfected into PBMCs. The concentration of the produced HCG was measured using enzyme-linked immunosorbent assay. Embryo attachment was investigated on the co-cultured endometrial cells and PBMCs in vitro. As an in vivo experiment, intrauterine administration of PBMCs was done in plaque-positive female mice. Studied mice were distributed into five groups: control, embryo implantation dysfunction (EID), EID with produced HCG, EID with PBMCs, and EID with HCG-producing PBMCs. Uterine horns were excised to characterize the number of implantation sites and pregnancy rate on day 7.5 post-coitum. During an implantation window, the mRNA expression of genes was evaluated using real-time polymerase chain reaction. Results: DNA fragments were cloned between the BamHI and EcoRI sites in the vector. About 465 pg/mL of HCG was produced in the transfected PBMCs. The attachment rate, pregnancy rate, and the number of implantation sites were substantially higher in the HCG-producing PBMCs group than in the other groups. Significantly elevated expression of the target genes was observed in the EID with HCG-producing PBMCs group. Conclusion: Alterations in gene expression following the intrauterine injection of HCG-producing PBMCs, could be considered a possible cause of increased embryo attachment rate, pregnancy rate, and the number of implantation sites.

Production of CFTR Mutant Gene Model by Homologous Recombination System

OBJECTIVE

The most common mutation in cystic fibrosis (CF), (ΔF508-CFTR), results in impaired protein maturation, folding and transportation to the surface of the cell. As a consequence of impaired protein maturation and/or transport from the extracellular matrix to the cell, different systems are influenced, including gastrointestinal system and glandular system, reproductive system and respiratory systems. CF models are essential tools to provide further knowledge of CF pathophysiology. With this aim, we designed a transgenic CF model based on the homologous recombination (HR) system.

MATERIALS AND METHODS

In this experimental study, a specifically designed construct containing the CFTR gene with F508del was cloned into a PTZ57R cloning vector and then the construct was transformed into the male pronucleus by microinjection after in vitro fertilization (IVF). Then the rates of blastocyst formation and embryonic development at 72 hours after IVF, were evaluated using the inverted microscope and the insertion of the construct was approved by polymerase chain reaction (PCR) method.

RESULTS

The CFTR gene was successfully cloned into the PTZ57R cloning vector and overall, from 22 injected cells, 5 blastocysts were observed after pronuclear injection of the CFTR gene construct. PCR verification of the blastocyst with CFTR-specific primers represented complete recombination of CFTR into the mouse genome.

CONCLUSION

For the first time we designed a unique genome construction that can be detected using a simple PCR method. The pronuclear injection was performed for the transformation of the genome construct into the male pronuclei using microinjection and the development of zygote to the blastocyst stage has been observed following transgenesis.

The quality of reporting in cardiac MRI artificial intelligence segmentation studies - a systematic review

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): This work was supported by an NIHR AI Award, AI_AWARD01706. This research was also funded in part, by the Wellcome Trust [Grant number 205188/Z/16/Z ].

Background

There has been a rapid increase in the number of Artificial Intelligence (AI) studies of cardiac MRI (CMR) segmentation. AI has huge potential to improve image analysis assessments. However, advancement and clinical translation in this field depend on researchers presenting their work in a transparent and reproducible manner.

Purpose

This systematic review aimed to evaluate the quality of reporting in AI studies involving CMR segmentation.

Methods

MEDLINE and EMBASE databases were searched for AI CMR segmentation studies on 18/11/2021. The flow of study inclusion is shown in Figure 1. Any AI method to segment any cardiac structure on CMR was eligible for inclusion. Each study was assessed for compliance with the Checklist for Artificial Intelligence in Medical Imaging (CLAIM).

Results

70 studies were included in the qualitative analysis. Studies were published between 2015 to 2021, with the majority (71%) published in 2020 and 2021. Most studies were performed in Europe (33%), China (27%) and the USA (26%). Short-axis sections were segmented in 70% of studies and most commonly included both ventricles (51%) or the left ventricle alone (30%). 20 different architecture implementations were represented. Figure 2 summarises the most relevant CLAIM domains to AI segmentation. The training sample eligibility criteria, demographics and clinical characteristics were not reported in 47% and 81% of studies, respectively. Ground truth annotations, source of the annotations and annotation tool were absent in 31%, 36% and 51% of studies respectively. Preprocessing steps and software libraries and packages used in training were not included in 27% and 24%. Details on the training approach including the number of models trained and method of selecting the final model were missing in 20% and 17% of the studies. Methods of validation or testing on external data, inter- and intra- rater variability and failure analysis were unreported in 57%, 63% and 74%, respectively.

Conclusion

This systematic review highlights important gaps in the AI literature of CMR studies. We identified key items missing in the dataset description, model development, validation and testing that limit the transparency, reproducibility and hence validity of published AI studies. This review may support closer adherence to established frameworks for reporting standards.

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

BACKGROUND

Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications.

METHODS

We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC).

FINDINGS

In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]).

INTERPRETATION

In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required.

FUNDING

British Journal of Surgery Society.

An investigation of the ankle contact forces in a foot with hammer toe deformity. A comparison of patient-specific approaches using finite element modeling and musculoskeletal simulation

The internal forces and stresses in the tissue are important as they are linked to the risk of mechanical trauma and injuries. Despite their value, the internal stresses and forces cannot be directly measured in-vivo. A previously validated 3D finite element model (FEM) was constructed using Magnetic Resonance Imaging (MRI) of a person with diabetes and hammer toe deformity. The foot model simulated at five different instances during the stance phase of gait. The internal stress distribution on the talus that was obtained using the FEM simulation, was used to calculate the joint reaction force at the ankle joint. In addition, the musculoskeletal model (MSM) of the participant with hammer toe foot was developed based on the gait analysis and was used to determine the muscle forces and joint reactions. The result showed that the vertical reaction forces obtained from the FEM and MSM follow a similar trend through the stance phase of gait cycle and are significantly correlated ( R=0.99). The joint reaction forces obtained through the two methods do not differ for the first 25% of the gait cycle, while the maximum difference was ∼0.7 Body weight that was observed at 50% of the stance phase. Clinical Relevance: Finite element modeling and musculoskeletal simulation can shed light on the internal forces at the ankle in pathological conditions such as hammer toe. The similarities and differences observed in the joint reaction forces calculated from the two methods can have implications in assessing the effect of clinical interventions.

P-180 Alterations of methylation level of H19/IGF2 DMR differentially methylated region(DMR) in human blastocysts following re-vitrification

Study question

Does re-vitrification affect on methylation level of H19/IGF2 DMR differentially methylated region(DMR) in human in vitro-produced blastocysts?

Summary answer

The results of this study showed that re-vitrification had no significant effect on the methylation level of H19 / IGF2 DMR region in human blastocysts.

What is known already

Nowadays, re-vitrification seems to be a successful and useful method to prevent the discarding of extra embryos. Several reports have indicated that the embryo manipulations during ART may result in epigenetic errors. This has been attributed to the concurrency of the ART manipulations and epigenetic events after fertilization. The effect of embryo re-vitrification on epigenetic changes has not been studied so far. The aim of this study is to evaluate the effect of embryo re-vitrification on methylation level of H19/IGF2 differentially methylated region (DMR) in donated human blastocysts.

Study design, size, duration

The effect of re-vitrification on methylation level of H19/IGF2 DMR was evaluated in 9 ICSI-derived human embryos individually and the expressions of H19 and IGF2 were assessed in 15 embryos individually. Embryos were donated from fertile couples referring for family balancing program. Donated embryos were cultured to blastocyst stage and high quality blastocyst (AA-AB) assigned to three groups: fresh, vitrified and re-vitrification. Scoring of blastocysts were according to Gardner et al. (2012) grading system.

Participants/materials, setting, methods

Collected blastocysts were vitrified on Cryotech carriers, with the method described by Kuwayama. After warming of blastocysts and 4-5 hours culturing of them, expression of H19 and IGF2 genes in blastocysts evaluated with Real time PCR and methylation levels of H19/IGF2 DMR in blastocysts were analyzed by Bisulfite Sequencing PCR (BSP) technique. 10 clones were sequenced per replicate. Methylation status of lymphocyte was used as control to verify the credibility of our analysis system.

Main results and the role of chance

The results showed that the overall percentage of methylated CpGs of H19/IGF2 DMR in the control, vitrification, re-vitrification groups and lymphocyte were 42.71, 40.90, 39.23% and 49.30 %. respectively. There was no significant difference in methylation level of H19/IGF2 DMR between the groups. H19 and IGF2 expression did not show a significant difference in vitrified group compared to the control and in re-vitrified group compared to vitrified.

Limitations, reasons for caution

- Small number of samples examined due to difficult access to human blastocysts donated by fertile couples.

- Evaluation of high-quality embryos donated by healthy fertile couples while embryos of infertile couples may respond differently.

Wider implications of the findings

According to the obtained results, embryo re-vitrification did not have a significant change on the methylation level of H19/IGF2 DMR and expression of H19 and IGF2 genes. However, that further studies on the effect of re-vitrification on epigenetic errors in low-quality embryos and the embryos of infertile couples are needed.

Trial registration number

not applicable

Multilocus Genotyping of ‘Candidatus Phytoplasma Solani’ Associated with Grapevine Bois Noir in Iran

Simple Summary

Understanding the epidemiological cycle of Bois noir (BN) associated with ‘Candidatus Phytoplasma solani’ is vital to managing the disease effectively. The genotyping of ‘Ca. P. solani’ strains, according to tuf, vmp1, and stamp genes, contributes to a better knowledge of the geographical distribution of BN. In this study, we provide information on the molecular variants of ‘Ca. P. solani’ in Iranian vineyards. We observed six known vmp1 variants and discovered two new ones, V24 and V27. This information is useful for future investigations to more accurately understand the epidemiological cycle(s) of BN in Iranian vineyards, contributing to the management of the disease.

Abstract

Grapevine Bois noir (BN) is associated with ‘Candidatus Phytoplasma solani’. It has been recorded in vineyards throughout Europe as well as in different countries in Asia, where it now constitutes a threat to Iranian viticulture. BN is strictly dependent on ‘Ca. P. solani’ strains, wild host plants, and insect vectors. The molecular typing of ‘Ca. P. solani’, based on the nonribosomal gene tuf and the two hypervariable markers vmp1 and stamp, is valuable for the reconstruction and clarification of the pathways of BN spread. In this study, an RFLP analysis was performed on the vmp1 gene, and a single-nucleotide polymorphism analysis confirmed new vmp types in ‘Ca. P. solani’. A stamp gene phylogenetic analysis allowed us to distinguish between the new genotype infections in the grapevines and the ‘weeds’ Convolvulus arvensis and Erigeron bonariensis in Iranian vineyards, highlighting the close genetic relatedness of the strains of ‘Ca. P. solani’ found in Iran and Azerbaijan. The most common genotype in the grapevines was tuf b/V24/stamp III, which was associated with C. arvensis. This information contributes toward the identification of further routes of introduction of ‘Ca. P. solani’ in Iran to sustain the control measures for the management of BN.

The efficacy and safety of furazolidone-bismuth quadruple therapy for Helicobacter pylori eradication with or without probiotic supplementation

Aim

In this clinical trial we use furazolidone-bismuth quadruple therapy with or without probiotics for H.pylori eradication.

Background

Increasing rates of eradication failure in H.pylori infection mainly due to antibiotic resistance has led to search for alternative regimens such as using novel antibiotics and/or using probiotic supplementation as conjunctive to the standard eradication regimens.

Methods

This double blind clinical trial was performed in gastrointestinal clinic of Loghman Hakim University Hospital, Tehran, Iran. Patients with a positive pathology test for H.pylori were enrolled to the study and received a 14 day course of furazolidone 100 mg q.i.d, bismuth 240 mg b.i.d, amoxicillin 1000 mg b.i.d, pantoprazole 40 mg b.i.d plus either probiotic (Familact) b.i.d or placebo b.i.d. Adverse effects and adherence to therapy were evaluated at the end of the treatment course. Eradication was established by H.pylori fecal antigen test.

Results

A total of 200 patients entered the study and were randomly assigned to two groups of placebo and probiotic. There was no significant difference regarding age or gender between placebo and probiotic groups. Adherence to therapy was higher than 90% in total and not significantly different between placebo and probiotic groups. Total eradication rate was 80.5% (n=161). Eradication rate was 84% in probiotic group vs 77% in placebo group (P=0.2). Total rate of adverse effects was 30% in probiotic group vs 62% in placebo group. The most common adverse effects were abdominal pain (15% in probiotic group vs 28% in placebo group, P=0.03) followed by diarrhea (5% in probiotic group vs 12% in placebo group, P=0.1).

Conclusion

According to our results, adding probiotic to furazolidone-bismuth quadruple therapy did no increase the eradication rate significantly. However, adverse effects particularly abdominal pain was lower in the probiotic group when compared with placebo.

Effect of metformin on the eradication of H.Pylori infection in 25 -75 years old patients referring Loghman Hakim Hospital

Background

Various ways of treating H.pylori infection are reported, such as triple-therapy and quadruple therapy for two weeks. Some side effects have been seen during these treatments, besides Helicobacter pylori becoming resistant to these antibiotics easily. According to some studies, there is a relationship between metformin and reduction in Helicobacter pylori infection. Thus, in this study, we determine the effects of metformin on Helicobacter pylori infection.

Methods

We performed this assessment in a randomized, case-controlled way in the diagnosis of Helicobacter pylori infected outpatients and inpatients. In both groups (case group and control group), patients took two tablets for a two-week period. In the case group, the patients were given two metformin tablets (each containing 500mg of metformin (extended release) and in the control group, they were given two placebo tablets (each containing 500mg of white flour). We took h.pylori Ag stool test and rapid urease test to confirm the presence of Helicobacter pylori infection.

Results

In this study, at first all the patients had positive h.pylori Ag stool test or positive rapid urease test. At the end of this study, the results of h.pylori Ag stool*- test presented that Helicobacter pylori infection was negative in 82.7% of the case group patients and 76% of control group patients which illustrates suppression of Helicobacter pylori infection. However, comparing to the control group (P=0.36), this difference was not statistically remarkable.

Conclusion

According to these findings, it is stated that having metformin along with prescribed antibiotics can help decrease Helicobacter pylori infection.

Impulsivity, inhibition, and internet addiction in medical students of North of Iran

BACKGROUND

Internet addiction, a serious psychological disorder, has rapidly increased among students and caused substantial interpersonal impairments. On the other hand, some evidence has indicated that impulsivity is associated with addictive behaviors.

OBJECTIVES

There are a few studies concerning the relationship between internet addiction and impulsivity in Iranian students. Therefore, this study aimed to evaluate the relationship between impulsivity and internet addiction in the medical students of Golestan University of Medical Sciences, Golestan, Iran, within 2020-2021.

METHODS

In a cross-sectional study, 260 medical students at Golestan University of Medical Sciences in 2021 completed demographic, Barratt Impulsiveness Scale, and Young questionnaires and participated in a Go/No-Go computer test. Based on Young test scores, the students were divided into three groups of normal users, at-risk users, and users requiring treatment and compared regarding impulsivity and inhibition ability. Data was analyzed using SPSS v 23.

RESULTS

The mean age of the participants was 24.16 years. The results showed a significant correlation between impulsivity and internet addiction (p = 0.001), which was established in all contextual indicators. A significant correlation was also shown between impulsivity and internet addiction (r = 0.602 and p = 0.001), both in male and female student. However, restraint index was correlated with internet addiction only in females (r = 0.187 and p = 0.033).

CONCLUSION

Based on these findings, impulsivity increases alongside the rising of the internet addiction severity and does not influence by gender.

Repurposing new drug candidates and identifying crucial molecules underlying PCOS Pathogenesis Based On Bioinformatics Analysis

BACKGROUNDS

Polycystic ovary syndrome affects 7% of women of reproductive ages. Poor-quality oocytes, along with lower cleavage and implantation rates, reduce fertilization.

OBJECTIVE

This study aimed to determine crucial molecular mechanisms behind PCOS pathogenesis and repurpose new drug candidates interacting with them. To predict a more in-depth insight, we applied a novel bioinformatics approach to analyze interactions between the drug-related and PCOS proteins in PCOS patients.

METHODS

The newest proteomics data was retrieved from 16 proteomics datasets and was used to construct the PCOS PPI network using Cytoscape. The topological network analysis determined hubs and bottlenecks. The MCODE Plugin was used to identify highly connected regions, and the associations between PCOS clusters and drug-related proteins were evaluated using the Chi-squared/Fisher's exact test. The crucial PPI hub-bottlenecks and the shared molecules (between the PCOS clusters and drug-related proteins) were then investigated for their drug-protein interactions with previously US FDA-approved drugs to predict new drug candidates.

RESULTS

The PI3K/AKT pathway was significantly related to one PCOS subnetwork and most drugs (metformin, letrozole, pioglitazone, and spironolactone); moreover, VEGF, EGF, TGFB1, AGT, AMBP, and RBP4 were identified as the shared proteins between the PCOS subnetwork and the drugs. The shared top biochemical pathways between another PCOS subnetwork and rosiglitazone included metabolic pathways, carbon metabolism, and citrate cycle, while the shared proteins included HSPB1, HSPD1, ACO2, TALDO1, VDAC1, and MDH2. We proposed some new candidate medicines for further PCOS treatment investigations, such as copper and zinc compounds, reteplase, alteplase, gliclazide, Etc.

CONCLUSION

Some of the crucial molecules suggested by our model have already been experimentally reported as critical molecules in PCOS pathogenesis. Moreover, some repurposed medications have already shown beneficial effects on infertility treatment. These previous experimental reports confirm our suggestion for investigating our other repurposed drugs (in vitro and in vivo).

Lithium and preventing chemotherapy-induced peripheral neuropathy in breast cancer patients: a placebo-controlled randomized clinical trial

BACKGROUND

Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of some chemotherapy regimens. Lithium has been suggested for CIPN in some animal studies. We aimed to study lithium's preventive effect on CIPN in breast cancer patients treated with taxanes and platinum-based medications.

METHOD

A double-blind placebo-controlled randomized clinical trial (RCT) was implemented on 36 breast cancer patients in two equal-size groups by block randomization. Participants in both groups consumed daily tablets, either placebo or lithium (300 mg), for 5 days in each course of chemotherapy. The tablets were prescribed 1 day before the start of chemotherapy. The electromyography (EMG) and nerve-conduction-velocity (NCV) tests were achieved before the first chemotherapy, 3 and 9 months after the treatment. The changes and signs or symptoms of CIPN, such as numbness, tingling, freezing, sensitivity to touch, muscle weakness, fibrillation, and knee and elbow reflex disorders, were recorded by examination. The trend of outcome changes was compared between two groups during the 9 months of study.

RESULTS

In both groups, neurologic signs and symptoms were exacerbated during the first 3 months and improved up to the ninth month of study. Results showed significant changes of all EMG-NCV variables during the 9 months of research in each group (P < 0.001), but the interaction of time and group effect was not significant in none of those indices. All symptoms changed significantly over the study time (P < 0.001) without significant statistical difference between the two groups (P=0.352). No side effect was found during the study.

CONCLUSION

The study showed that 300 mg lithium prescription once daily for 5 days might not effectively prevent CIPN in breast cancer patients. Evaluation of lithium effect on CIPN on different cancers in future studies is suggested.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials IRCT20160813029327N10 .  Registration date: May 16, 2018.

Low defect and high electrical conductivity of graphene through plasma graphene healing treatment monitored with in situ optical emission spectroscopy

Fundamental studies on graphene (Gr) and its real device applications have been affected by unavoidable defects and impurities which are usually present in synthesized Gr. Therefore, post treatment methods on Gr have been an important subject of research followed by the community. Here, we demonstrate a post-treatment of cm-sized CVD-grown graphene in a Radio Frequency-generated low-pressure plasma of methane and hydrogen to remove oxygen functional groups and heal the structural defects. The optimum plasma treatment parameters, such as pressure, plasma power, and the ratio of the gases, are optimized using in-situ optical emission spectroscopy. This way we present an optimal healing condition monitored with in situ OES. A twofold increase in the conductivity of plasma-treated Gr samples was obtained. Plasma treatment conditions give insights into the possible underlying mechanisms, and the method presents an effective way to obtain improved Gr quality.

Alterations of miR-16, miR-let-7a and their target genes expression in human blastocysts following vitrification and re-vitrification

Embryo cryopreservation is a widely used technique in infertility management and today is an essential part of assisted reproductive technology (ART). In some cases, re-vitrification can be applied to good quality supernumerary warmed embryos that have not been transferred in the present cycle. However, there is no study about re-vitrification impact on microRNA and gene expression in human embryos. The purpose of this study is to evaluate miR-16, miR-let7a and target genes expression in in vitro produced human blastocysts following re-vitrification.Day3 embryos obtained from ICSI cycles of fertile couples referring for family balancing program were biopsied and cultured individually. On the fourth day (post-ICSI) male ones (choices of their parents) were transferred and the females (good quality embryos) were donated for research. Donated embryos were cultured to blastocyst stage and assigned to three groups: fresh, vitrified and re-vitrification. Embryos were vitrified on Cryotech carriers. Then blastocysts of three groups were individually assessed for expression of miR-16, miR-let7a and target genes.The results showed that re-vitrification of human blastocysts did not affect the ability to re-expand in culture. In addition, significant decrease was observed in miR-16 and miR-let7a expression in re-vitrified group compared to fresh (p < 0.05). A significant upregulation of the target genes ITGβ3 and BCL-2 in re-vitrified and vitrified embryos was observed compared to the fresh group (p < 0.05). The expression of BAX as a pro-apoptotic gene showed a significant decrease in re-vitrification group comparing with the fresh one (P < 0.05).The results of this research indicated that re-vitrification of embryos changes the expression of miR-16, miR-let-7a and their target genes. These alterations include increased expression of BCl-2 and ITGβ3 genes which play important roles in embryo survival and implantation, respectively. Clinical proof of these effects requires further research.

Neuroscience-Informed Psychoeducation for Recovery: A Program to Promote Metacognition in People With Substance Use Disorders

Introduction:

A brief neuroscience-informed psychoeducation program (Neuroscience-Informed Psychoeducation for Recovery [NIPER]) was developed to promote awareness (metacognition) in the main cognitive domains affected by drug and alcohol use to increase willingness to invest time and effort in the brain and cognition recovery process. The primary aim of this pilot study was to determine the feasibility and acceptability of the NIPER program and its potential effectiveness in increasing metacognition, psychological wellbeing, and willingness for the brain and cognition recovery programs among patients with Substance Use Disorders (SUDs).

Methods:

A total of 56 patients with SUDs were recruited from four outpatient treatment centers in Tehran City, Iran. They participated in four 90-min weekly sessions delivered adjunct to their routine treatment. The program’s effectiveness was measured in terms of metacognition and psychological wellbeing at baseline and the end of the program. The rate of adherence and participation and willingness to continue with brain and cognition recovery programs were measured as feasibility outcomes.

Results:

A total of 51 participants completed the study. Compared to the baseline assessments, patients reported more problems in dimensions of attention, memory, inhibitory control, decision making, motor/speech, interoception, insight, and a higher level of psychological wellbeing (t=4.66; P<0.001). In terms of feasibility outcomes, the adherence and participation rates were found above 85%. Most participants expressed their high willingness to continue the brain and cognition recovery programs (86.2%) and would introduce NIPER to their peers (98%).

Conclusion:

Considering the pilot results in terms of feasibility and preliminary effectiveness of NIPER in the clinical context of addiction treatment, we think that NIPER is a potentially beneficial intervention to be offered to people with SUD. It would increase their awareness and engage them in the brain and cognition recovery process. However, the clinical efficacy of the intervention should be tested in future randomized clinical trials.

MicroRNA-21 is involved in oocyte maturation, blastocyst formation, and pre-implantation embryo development

Follicular fluid is one source of microRNAs (miRNAs). These miRNAs originate from oocytes and their neighboring cells. The changes in the miRNAs profile in the follicular fluid could alter folliculogenesis and oocyte maturation, and lead to infertility. Polycystic ovary syndrome (PCOS) patients have increased miR-21 levels in their sera, granulosa cells, and follicular fluid, and this mi-RNA plays a role in the pathophysiology and follicular dysfunction of PCOS patients. In the current study, we intend to examine whether expression levels of miR-21 influence oocyte maturation and embryo development. We examined miR-21 over-expression and down-regulation of miR-21 by miR-off 21 during in vitro maturation (IVM) to assess its influence on oocyte maturation and embryo development in mice. Over-expression of miR-21 in cumulus cells decreased expansion, meiotic progression, Glutathione-S-transferase GSH levels, and decreased expressions of Bmpr2 and Ptx3 genes. Subsequently, we noted that in vitro fertilization, and the cleavage rate and blastocyst formation significantly increased in cumulus oocyte complexes (COCs) that over-expressed miR-21. Inhibition of miR-21 by miR-off 21 led to increased cumulus expansion and GSH levels, along with decreased cleavage rate and blastocyst formation by alterations in Cdk2ap1 and Oct4 gene expressions. However, oocyte progression from the germinal vesicle (GV) to the metaphase II (MII) stage was not significant. miR-21 altered the gene expression levels in cumulus cells and influenced cytoplasmic oocyte maturation, cumulus expansion, and subsequent embryonic development in mice.

Adaptive two-stage inverse sampling design to estimate density, abundance, and occupancy of rare and clustered populations

Sampling rare and clustered populations is challenging because of the effort required to find rare units. Heuristically, a practitioner would prefer to discontinue sampling in areas where rare units of interest are apparently extremely sparse or absent. We take advantage of the characteristics of inverse sampling to adaptively inform practitioners when it is efficient to move on to sample new areas. We introduce Adaptive Two-stage Inverse Sampling (ATIS), which is designed to leave a selected area after observation of an a priori number of only non-rare units and to continue sampling in the area when rare units are observed. ATIS is efficient in many cases and yields more rare units than conventional sampling for a rare and clustered population. We derive unbiased estimators of population total and variance. We also introduce an easy-to-compute estimator, which is nearly as efficient as the unbiased estimator. A simulation study on a rare plant population of buttercups (Ranunculus) shows that ATIS even with the easy-to-compute estimator is more efficient than its conventional sampling counterparts and is more efficient than Two-stage Adaptive Cluster Sampling (TACS) for small and moderate final sample sizes. Additional simulations reveal that ATIS is efficient for binary data (e.g., presence or absence) whereas TACS is inefficient for binary data. The overall results indicate that ATIS is consistently efficient compared to conventional sampling and to adaptive cluster sampling in some important cases.

Factors influencing engagement and utilisation of opium tincture-assisted treatment for opioid use disorder: A qualitative study in Tehran, Iran

INTRODUCTION

In response to a high burden of opioid use disorder (OUD), Iran established a network of opioid agonist treatment (OAT) centres beginning in 2002. To increase treatment diversity, particularly for patients who use opium as their drug of choice, opium tincture (OT)-assisted treatment was introduced to the network. This study aimed to explore factors influencing OT-assisted treatment selection for OUD in Tehran, Iran.

METHODS

We conducted 54 in-depth interviews with patients with OUD (n = 33), family members of patients (n = 9) and drug treatment providers (n = 12). Participants were recruited from 12 drug treatment centres across Tehran, between September and November 2019. All interviews were audio-recorded, transcribed and coded in OpenCode 4.02 software and analysed using thematic analysis.

RESULTS

Study participants more commonly reported individual-level factors as facilitators (e.g. to reduce harms associated with illicit opioid use, achieve recovery through a gradual dose reduction regimen combined with Congress 60 recovery program) and structural level factors (e.g. low adoption by OAT system and lack of familiarity of treatment providers) as barriers for utilisation of OT-assisted treatment regimens. OT was perceived to produce lower levels of physiological dependence than methadone, but the requirement for twice supervised dosing was restrictive. Low familial and community acceptance were also seen as barriers to access.

DISCUSSION AND CONCLUSIONS

This research identified a range of perceived benefits for OT-assisted treatment ranging from harm reduction to an intermediate step to achieve recovery. However, several structural-, individual-, familial- and community-level barriers impede its availability and acceptability.

Isolation and Purification of Low Molecular Weight Proteins from Culture Filtrate of Mycobacterium Tuberculosis Strain C

In the last couple of years, a number of new and rapid tests for the diagnosis of Tuberculosis (TB) have been developed based on the low molecular weight antigens from Mycobacterium tuberculosis (Mtb) culture supernatant. This study aimed to isolate and purify low molecular weight antigens secreted by Mtb strain C for diagnostic purpose. The secretory proteins from culture filtrate of Mtb were extracted using ammonium sulphate precipitations and sephadex-G50 gel chromatography. The obtained antigen fractions were analyzed for their protein concentrations and approximate molecular weight using Lowry method and SDS-PAGE (12.5%), respectively. DOT-ELISA and Western blot assay was performed to confirm the presence of purified low molecular weight proteins isolated from Mtb using sera from pulmonary tuberculosis patients (polyclonal antibodies). During chromatography, low molecular weight proteins were separated, that was approximately 0.7 mg/ml of the total proteins (1.662 mg/ml). The purified protein fractions in molecular weight range of 14 kDa-41kDa appeared during SDS-PAGE analysis. The chromatographic band fraction in the weight range of 30-41 kDa was identified in the TB patients&amp;rsquo; sera using Western blotting. The low molecular weight proteins in the culture filtrate of Mtb strain C were purified using ammonium sulphate and chromatography. These fractions were confirmed using Western blotting. The obtained results might support the hypothesis that the Mtb culture filtrate antigens could be used as a rapid and sensitive assay for the detection of patients with pulmonary TB.

Associations between changes in loading pattern, deformity, and internal stresses at the foot with hammer toe during walking; a finite element approach

Over the past decade, Finite Element (FE) modelling has been used as a method to understand the internal stresses within the diabetic foot. Foot deformities such as hammer toe have been associated with increased risk of foot ulcers in diabetic patients. Hence the aim of this study is to investigate the influence of hammer toe deformity on internal stresses during walking. A 3D finite element model of the human foot was constructed based on capturing Magnetic Resonance Imaging (MRI) of a diabetic neuropathic volunteer exhibiting hammer toe. 3D gait measurements and a multi-body musculoskeletal model for the same participant were used to define muscle forces. FE simulations were run at five different instances during the stance phase of gait. Peak plantar pressure and pressure distribution results calculated from the model showed a good agreement with the experimental measurement having less than 11% errors. Maximum von Mises internal stresses in the forefoot hard tissue were observed at the 3^rd and 5^th metatarsals and 4^th proximal phalanx. Moreover, presence of hammer toe deformity was found to shift the location of maximum internal stresses on the soft tissue to the forefoot by changing the location of centre of pressure with internal stress 1.64 times greater than plantar pressure. Hammer toe deformity also showed to reduce the involvement of the first phalanx in internal/external load-bearing during walking. The findings of this study support the association between changes in loading pattern, deformity, and internal stresses in the soft tissue that lead to foot ulceration.

Opium tincture-assisted treatment for opioid use disorder: A systematic review

BACKGROUND

Some countries have used opioid agonist medications other than methadone and buprenorphine as a strategy to increase treatment diversity. In Iran and other countries where opium use is common and culturally tolerated, opium tincture (OT) has gained growing popularity and been approved to treat opioid use disorder (OUD). Given the increasing interest in this intervention, we conducted a systematic review of the literature to evaluate the safety and efficacy of OT-assisted treatment for OUD.

METHODS

We systematically searched international (MEDLINE, Embase, CINAHL, PsychInfo, Google Scholar, and clinicaltrials.gov) and Iranian (Scientific Information Database (SID), Iranmedex, IranDoc, digital library of Iran's Drug Control Headquarters and the Iranian Registry for Clinical Trials) databases on November 04, 2020 without any language or publication date limitations. Two reviewers screened the titles, abstracts, and full-text of the retrieved records to find clinical trials or observational studies that assessed the safety and efficacy of OT-assisted treatment for OUD.

RESULTS

We screened 1301 records and included 21 unique studies on assisted withdrawal (n = 5), maintenance (n = 9), and gradual dose reduction (n = 7) treatment regimens. Most studies included men and people with opium use disorder. We found only six randomized controlled trials (RCT). Our results showed that OT-assisted treatment is associated with comparable outcomes with methadone treatment in both assisted withdrawal and maintenance treatment regimens. We also found promising results for using gradual dose reduction regimen of OT-assisted treatment from observational studies. The overall quality of scientific evidence was low due to the limited number RCT and high risk of bias in the included studies.

CONCLUSIONS

The body of evidence supporting the safety and efficacy of OT-assisted treatment in assisted withdrawal, maintenance, and gradual dose reduction regimens is limited but somewhat promising, in particular among people with opium use disorder. Our review calls for higher-quality studies to investigate the comparative efficacy of these treatment methods with standard pharmacotherapies for OUD.

Opium dependence and the potential impact of changes in treatment coverage level: A dynamic modeling study

Background : The most common drug, illegally used in Iran is opium. The treatment of people with substance use disorder is one of the most important strategies in reducing its burden. The aim of this study was to investigate the effect of different increasing and decreasing opium treatment coverage on the patterns of abstinence, transition to heroin dependence and mortality, over 30 years. Methods: This study was a dynamic compartmental modeling conducted in three stages: 1) presenting a conceptual model of opium dependence treatment in Iran, 2) estimating model's parameters value, and 3) modeling of opium dependence treatment and examining the outcomes for different treatment coverage scenarios. The input parameters of the model were extracted from the literature, and secondary data analysis, which were finalized in expert panels. Results: The number of opium dependence will increase from 1180550 to 1522063 [28.93% (95% CI: 28.6 to 29.2)] over 30 years. With a 25% decrease in coverage compared to the status quo, the number of deaths will increase by 459 cases [3.28% (95% CI: 0.91 to 5.7)] in the first year, and this trend will continue to be 2989 cases [15.63% (95% CI: 13.4 to 17.9)] in the 30th year. A 25% increase in treatment coverage causes a cumulative decrease of heroin dependence by 14451 cases [10.1% (95% CI: 9.5 to 10.8)] in the first decade. Conclusion: The modeling showed that the treatment coverage level reduction has a greater impact than the coverage level increase in the country and any amount of reduction in the coverage level, even to a small extent, may have a large negative impact in the long run.

Automated detection of pneumonia cases using deep transfer learning with paediatric chest X-ray images

OBJECTIVE

Pneumonia is a lung infection and causes the inflammation of the small air sacs (Alveoli) in one or both lungs. Proper and faster diagnosis of pneumonia at an early stage is imperative for optimal patient care. Currently, chest X-ray is considered as the best imaging modality for diagnosing pneumonia. However, the interpretation of chest X-ray images is challenging. To this end, we aimed to use an automated convolutional neural network-based transfer-learning approach to detect pneumonia in paediatric chest radiographs.

METHODS

Herein, an automated convolutional neural network-based transfer-learning approach using four different pre-trained models (i.e. VGG19, DenseNet121, Xception, and ResNet50) was applied to detect pneumonia in children (1-5 years) chest X-ray images. The performance of different proposed models for testing data set was evaluated using five performances metrics, including accuracy, sensitivity/recall, Precision, area under curve, and F1 score.

RESULTS

All proposed models provide accuracy greater than 83.0% for binary classification. The pre-trained DenseNet121 model provides the highest classification performance of automated pneumonia classification with 86.8% accuracy, followed by Xception model with an accuracy of 86.0%. The sensitivity of the proposed models was greater than 91.0%. The Xception and DenseNet121 models achieve the highest classification performance with F1-score greater than 89.0%. The plotted area under curve of receiver operating characteristics of VGG19, Xception, ResNet50, and DenseNet121 models are 0.78, 0.81, 0.81, and 0.86, respectively.

CONCLUSION

Our data showed that the proposed models achieve a high accuracy for binary classification. Transfer learning was used to accelerate training of the proposed models and resolve the problem associated with insufficient data. We hope that these proposed models can help radiologists for a quick diagnosis of pneumonia at radiology departments. Moreover, our proposed models may be useful to detect other chest-related diseases such as novel Coronavirus 2019.

ADVANCES IN KNOWLEDGE

Herein, we used transfer learning as a machine learning approach to accelerate training of the proposed models and resolve the problem associated with insufficient data. Our proposed models achieved accuracy greater than 83.0% for binary classification.

Meiosis Resumption of Immature Human Oocytes following Treatment with Calcium Ionophore In Vitro

Objective:

In vitro maturation (IVM) of human oocytes is used to induce meiosis progression in immature retrieved oocytes. Calcium (Ca2+) has a central role in oocyte physiology. Passage through meiosis phase to another phase is controlled by increasing intracellular Ca2+. Therefore, the current research was conducted to evaluate the role of calcium ionophore (CI) on human oocyte IVM.

Materials and Methods:

In this clinical trial study, immature human oocytes were obtained from 216 intracytoplasmic sperm injection (ICSI) cycles. After ovarian stimulation, germinal vesicle (GV) stage oocytes were collected and categorized into two groups: with and without 10 µM CI treatment. Next, oocyte nuclear maturation was assessed after 24–28 hours of culture. Real-time reverse transcription polymerase chain reaction (RT-PCR) was used to assess the transcript profile of several oocyte maturation-related genes (MAPK3, CCNB1, CDK1, and cyclin D1 [CCND1]) and apoptotic-related genes (BCL-2, BAX, and Caspase-3). Oocyte glutathione (GSH) and reactive oxygen species (ROS) levels were assessed using Cell Tracker Blue and 2’,7’-dichlorodihydrofluorescein diacetate (H2DCFDA) fluorescent dye staining. Oocyte spindle configuration and chromosome alignment were analysed by immunocytochemistry.

Results:

The metaphase II (MII) oocyte rate was higher in CI‐treated oocytes (73.53%) compared to the control (67.43%) group, but this difference was not statistically significant (P=0.13). The mRNA expression profile of oocyte maturation-related genes (MAPK3, CCNB1, CDK1, and CCND1) (P<0.05) and the anti-apoptotic BCL-2 gene was remarkably up-regulated after treatment with CI (P=0.001). The pro-apoptotic BAX and Caspase-3 relative expression levels did not change significantly. The CI‐treated oocyte cytoplasm had significantly higher GSH and lower ROS (P<0.05). There was no statistically significant difference in meiotic spindle assembly and chromosome alignment between CI treatment and the control group oocytes.

Conclusion:

The finding of the current study supports the role of CI in meiosis resumption of human oocytes. (Registration Number: IRCT20140707018381N4)

Role of intrauterine administration of transfected peripheral blood mononuclear cells by GM-CSF on embryo implantation and pregnancy rate in mice

One of the effective treatments in women with recurrent implantation failure (RIF) is the use of immune cells to facilitate embryo implantation. Previous studies have shown that intrauterine transmission of peripheral blood mononuclear cells (PBMC) increased the embryo implantation rate. In this study using B6D2F1 (C57BL/6 × DBA2) mice, a fragment of the granulocyte macrophage colony-stimulating factor (Gm-csf) gene was cloned into an enhanced green fluorescent protein vector (pEGFP-N1) and then transfected into PBMC. The protein level of GM-CSF was evaluated in the transfected PBMC and untransfected PBMC by ELISA. Attachment of mouse embryos and the mRNA expression levels of leukemia inhibitory factor (Lif), vascular endothelial growth factor (Vegf), matrix metalloproteinase 9 (Mmp9), Gmcsf-receptor (Gmcsf-r) and interleukin 6 (Il6) in vitro were assessed by real-time PCR in endometrial cells. To determine the pregnancy rate and number of implantation sites in vivo, the mouse uterine horns were analyzed on Day 7.5 post coitum. A greater amount of GM-CSF was produced in PBMC transfected with recombinant vector (552 pg/mL) compared with the untransfected PBMC (57 pg/mL) and PBMC transfected with empty vector (34 pg/mL) (P < 0.05). The data showed that the embryo attachment rate and mRNA expression levels (Vegf [1.7-fold], Mmp9 [1.4-fold], Lif [1.5-fold], Gm-csf r [1.6-fold] and Il6 [1.2-fold]) in the in vitro study (P < 0.01), pregnancy rate (P < 0.01) and number of implantation sites (P < 0.01) in the in vivo investigation (P < 0.05) were increased in PBMC transfected with recombinant vector compared with the PBMC group. The study demonstrated that, in mice, endometrium immunotherapy with transfected PBMC that contained recombinant GM-CSF before embryo implantation was effective in improving embryo implantation and endometrial receptivity.

Comparison of osteogenic differentiation potential of induced pluripotent stem cells and buccal fat pad stem cells on 3D-printed HA/β-TCP collagen-coated scaffolds

Production of a 3D bone construct with high-yield differentiated cells using an appropriate cell source provides a reliable strategy for different purposes such as therapeutic screening of the drugs. Although adult stem cells can be a good source, their application is limited due to invasive procedure of their isolation and low yield of differentiation. Patient-specific human-induced pluripotent stem cells (hiPSCs) can be an alternative due to their long-term self-renewal capacity and pluripotency after several passages, resolving the requirement of a large number of progenitor cells. In this study, a new biphasic 3D-printed collagen-coated HA/β-TCP scaffold was fabricated to provide a 3D environment for the cells. The fabricated scaffolds were characterized by the 3D laser scanning digital microscopy, X-ray diffraction, Fourier transform infrared spectroscopy, and mechanical test. Then, the osteogenesis potential of the hiPSC-seeded scaffolds was investigated compared to the buccal fat pad stem cell (BFPSC)-seeded scaffolds through in vitro and in vivo studies. In vitro results demonstrated up-regulated expressions of osteogenesis-related genes of RUNX2, ALP, BMP2, and COL1 compared to the BFPSC-seeded scaffolds. In vivo results on calvarial defects in the rats confirmed a higher bone formation in the hiPSC-seeded scaffolds compared to the BFPSC-seeded groups. The immunofluorescence assay also showed higher expression levels of collagen I and osteocalcin proteins in the hiPSC-seeded scaffolds. It can be concluded that using the hiPSC-seeded scaffolds can lead to a high yield of osteogenesis, and the hiPSCs can be used as a superior stem cell source compared to BFPSCs for bone-like construct bioengineering.

Delivery of miR-381-3p Mimic by Mesenchymal Stem Cell-Derived Exosomes Inhibits Triple Negative Breast Cancer Aggressiveness; an In Vitro Study

Recent investigations have emphasized the role of aberrant expression of microRNAs (miRNAs) in progression of almost all types of cancers. Exosomes, membrane-enclosed natural nanovesicles, transport cellular contents, including proteins, mRNAs, and miRNAs, between cells. Unique features of exosomes make them an appropriate carrier for drug delivery. miRNA-381 is one of the downregulated miRNAs in several cancers including triple-negative breast cancer (TNBC) and restoration of its expression in TNBC cells can restrict their migratory ability through targeting several signaling pathways. In current study, we exploited the exosomes isolated from adipose-derived mesenchymal stem cells (ADMSC-exosomes) to deliver miR-381 mimic to MDA-MB-231 cells to elucidate their effects on TNBC cells. The effects of miR-381 loaded ADMSC-exosomes on proliferation, apoptosis, migration, and invasion of MDA-MB-231 cells were analyzed. Our results indicated that ADMSC-exosomes were successfully isolated and internalized by MDA-MB-231 cells. miR-381 mimic was efficiently delivered to MDA-MB-231 cells by ADMSC-exosomes. miR-381 loaded ADMSC-exosomes significantly downregulated the expression of epithelial to mesenchymal transition (EMT) related genes and proteins. Notably, miR-381 loaded ADMSC-exosomes inhibited proliferation, migration, and invasion capacity of MDA-MB-231 and promoted their apoptosis in vitro. Taken together, we showed that ADMSC-exosomes could be used as efficient nanocarriers for RNA-based therapies. Graphical abstract.

The Cost of Heart Transplant in Iran: A Multicenter Analysis

BACKGROUND

Heart transplantation is an established treatment for end-stage heart failure patients, but its cost-effectiveness is under question.

OBJECTIVE

This study aimed to assess the cost of heart transplantation in Iran as a developing country in Asia to contribute to future planning in the region.

METHODS

This study was conducted in two phases. First, in a retrospective multicenter study, hospital data of heart transplant and hospitalization of three active heart transplant centers in Tehran, Iran, were reviewed from April 2013 to May 2015. Then pre-transplantation, transplantation, and one-year posttransplant costs were calculated according to the ABC (activity-based costing) method in 2016.

RESULTS

Data were obtained for 120 patients, among which 95 (79.17%) were males with a mean (SD) age of 35.31±13.41 years. Mean (SD) hospital and ICU length of stay were 17.85±14.91 and 9.74±8.94 days, respectively. A significant correlation existed between the mean of hospital and ICU length of stay (P<0.001, r: 0.754). The mean heart transplant and hospitalization cost was 3445.47±1243.29 USD from 2013 to 2015. Using the activity-based costing method, the cost of pre-transplantation, transplantation, and one-year -post-transplantation were extracted 6.5%, 73.5%, and 20%, respectively, with a total cost of 26232 USD.

CONCLUSION

Compared to other countries, the cost of heart transplantation in Iran is very low. Numerous reasons lead to this difference. Firstly, a heart transplantation surgery is performed in university-based hospitals and is supported by the government. On the other hand, a significant difference exists between personnel costs in Iran compared to other countries.

Artificial intelligence in automatic classification of invasive ductal carcinoma breast cancer in digital pathology images

Background: Breast cancer is one of the most causes of death in women. Early diagnosis and detection of Invasive Ductal Carcinoma (IDC) is an important key for the treatment of IDC. Computer-aided approaches have great potential to improve diagnosis accuracy. In this paper, we proposed a deep learning-based method for the automatic classification of IDC in whole slide images (WSI) of breast cancer. Furthermore, different types of deep neural networks training such as training from scratch and transfer learning to classify IDC were evaluated. Methods: In total, 277524 image patches with 50×50-pixel size form original images were used for model training. In the first method, we train a simple convolutional neural network (named it baseline model) on these images. In the second approach, we used the pre-trained VGG-16 CNN model via feature extraction and fine-tuning for the classification of breast pathology images. Results: Our baseline model achieved a better result for the automatic classification of IDC in terms of F-measure and accuracy (83%, 85%) in comparison with original paper on this data set and achieved a comparable result with a new study that introduced accepted-rejected pooling layer. Also, transfer learning via feature extraction yielded better results (81%, 81%) in comparison with handcrafted features. Furthermore, transfer learning via feature extraction yielded better classification results in comparison with the baseline model. Conclusion: The experimental results demonstrate that using deep learning approaches yielded better results in comparison with handcrafted features. Also, using transfer learning in histopathology image analysis yielded significant results in comparison with training from scratch in much less time.

The Expression of miR-31 and its Target Gene FOXP3 in Recurrent Implantation Failure Patients

Objectives: Endometrial receptivity is a complex event that occurs during the midluteal phase of the menstrual cycle known as the "window of implantation". During this period, the endometrium develops characteristics that allow the adhesion and invasion of the embryo to the uterine epithelium. Accordingly, the expressions of miR-31 and its target gene were evaluated to study the effect of miR-31 on FOPX3 gene expression in recurrent implantation failure (RIF) patients and normal fertile women. More precisely, the aim of this study was to understand the expression of miR-31 as one of the important regulators of the FOXP3 gene in the endometrium of RIF patients versus receptive endometria from fertile patients. Materials and Methods: This case-control study was conducted on 20 endometrial tissue samples of normal fertile women and RIF patients in order to evaluate miR-31 and its target gene expression. Results: According to the results of this study, a significant difference existed between RIF patients and normal fertile women (control group). The expression of the FOXP3 gene was more significant in the control group. miR-31 was also significantly expressed, which was due to the endometrial immunological disorder leading to the decreased expression of its target gene (FOXP3). Conclusions: In general, implant abnormalities and recurrent abortions were observed in RIF patients due to the decreased expression of the FOXP3 gene resulting from the inhibitory effects of miR-31.