Developing a community-responsive research model in the healthcare system: a mixed-method study.

BACKGROUND: Responsiveness to the population's non-clinical needs encompasses various dimensions, including responsive research and an educational outreach plan at the community level. This study aims to develop a community-responsive research model in the healthcare system to ensure the connection between community-identified health priorities and research funds, as well as capacity-building efforts. METHODS: A mixed-methods research study was conducted in three main phases, including a comprehensive literature review, a qualitative analysis of an expert panel's points of view, and the developing of a model using the Equation Modeling (SEM) technique. R software version 3.2.4 was used to conduct statistical analysis, considering a significance level of 0.05. RESULTS: Based on the literature review, 41 responsiveness components were identified from sixteen relevant studies conducted between 2000 and 2022. Ten sub-themes in four major themes, including planning, implementation, monitoring and evaluation, and action, were identified through qualitative content analysis. Standardized coefficients revealed that components such as dissemination of results to all stakeholders, research prioritization aligned with community needs, commitment to implement research findings, and collaborative learning had statistically significant effects on the community-responsive research model. CONCLUSION: It is essential to identify community health priorities by following a community-focused, priority-setting process based on the principles of community engagement to develop a community-responsive research model. Afterward, dissemination of research findings to all stakeholders, commitment to apply the obtained results in the real world, and promotion of shared learning among research partners have been proven to facilitate collaborative investigation and mutual understanding between the community and academic partners.

Evaluation of human papillomavirus type 16 viral load and genome physical status in Iranian women with cervical disease.

BACKGROUND: This study examined the viral load and physical status of the human papillomavirus 16 (HPV-16) genome in non-cancerous, precancerous and cancerous cervical lesions. METHODS: Quantitative real-time PCR was performed to determine HPV-16 E2 and E6 viral load in 132 cervical specimens. E2/E6 viral load ratio was used to determine the physical status of HPV-16 genome. RESULTS: E2 gene viral load was a significant (P < 0.001) predicting biomarker in differentiating non-cancerous from precancerous and cancerous samples. E6 gene viral load was significantly different between the groups (P < 0.001). The specificity and sensitivity of E2 and E6 in distinguishing SCC samples were 100% and 95% respectively. CONCLUSION: HPV-16 viral load measured through E2 and E6 genes is a reliable indicator of lesion type.

Developing a responsive model to societal needs in medical education.

BACKGROUND: Responsiveness is relevant in the context of treatment and the provision of medical services. However, if we delve deeper into the subject, we must establish and develop responsiveness within the medical sciences education system. This study aims to identify the dimensions that significantly impact responsiveness in the medical education system based on a comprehensive review and expert opinions in healthcare. METHODS: The present research is descriptive-analytical in terms of its objective and follows a mixed-method approach. This study was conducted in three stages. Initially, we utilized relevant keywords related to education in databases, such as Web of Science, Scopus, ScienceDirect, OVID, CINHAL, EBSCO, Google Scholar, Iranmedex, SID, and Irandoc. Subsequently, in the expert panel session stage, the factors influencing responsiveness were identified in the comprehensive review stage, and with this thematic background, they were conceptualized. Finally, the Confirmatory Factor Analysis (CFA) technique was employed to coherently examine the relationships between variables and present the final model. RESULTS: We obtained 32 articles from the comprehensive review of studies. Four components in planning, implementation, monitoring and evaluation, and intersectoral cooperation were identified based on expert panel opinions. Based on the standardized coefficients, the components of research-based educational planning, community-oriented education evaluation indicators, and utilization of modern educational methods are statistically significant. CONCLUSION: The establishment and development of responsiveness in the medical sciences education system involve training specialized and responsive human resources through innovative educational methods that have sufficient familiarity with the multidimensional concepts of health and how to achieve them. This approach allows for practical and responsible steps toward training competent and committed physicians in line with the needs of society. On the other hand, responsiveness in the medical sciences education system can be improved by enhancing research-based educational planning and developing community-oriented evaluation indicators that can assess the number of revised educational programs based on societal needs. Therefore, understanding the critical elements in revising medical education programs, which play the most significant role in addressing societal needs and responding to changing disease patterns and new health priorities, is both a necessity and an important priority.

The effect of circadian on the productivity of nurses with the mediating role of quality of work life.

BACKGROUND: Circadian rhythms, as an integral part of daily life, govern the scheduling, management, and coordination of living organisms. Given the irregular nature of shift patterns in nurses' work schedules, investigating their implications is paramount to increasing Quality of Work Life (QWL) and productivity. The study aimed to investigate the impact of circadian rhythm on the efficiency of nurses working in hospitals in Qazvin, Iran, with QWL serving as a mediating variable. METHODS: This study employed a descriptive-analytical research design, utilizing cross-sectional data collected in 2022-2023 based on the implementation of Structural Equation Modeling (SEM). The number of participants was 378 nurses. The data were obtained by administering a questionnaire and various tools, organized into four sections: demographic information, the Circadian Questionnaire, the Quality of Work Life Questionnaire, and the Nurses' Efficiency Questionnaire. The collected data were subsequently analyzed using SEM techniques within the R software. RESULTS: The findings demonstrated statistically significant variations in mean scores about gender and efficiency (p = 0.008), marital status and efficiency (p = 0.000), and employment type and efficiency (p = 0.002) among the study participants. There was a significant association between shift patterns and QWL (p = 0.004). Expressly, the confirmed results indicated a direct impact of circadian on QWL (with a path coefficient of 0.013), as well as an indirect impact on efficiency mediated by the variable QWL (with a path coefficient of 0.037) (p < 0.05). CONCLUSION: Due to the critical role of nurses in the healthcare system, implementing strategies that promote their efficiency is paramount. Therefore, managers can create an environment that enhances nurses' productivity by improving methods that positively impact their QWL.

Can HDL cholesterol be replaced by paraoxonase 1 activity in the prediction of severe coronary artery disease in patients with type 2 diabetes?

BACKGROUND AND AIMS: Novel biomarkers are required to improve cardiovascular disease prediction in patients with type 2 diabetes (T2D) as a high-risk population. This study was conducted to examine whether coronary artery disease (CAD) risk assessment can be improved by substituting high-density lipoprotein (HDL)-bound paraoxonase 1 (PON1) activity for HDL cholesterol (HDL-C) concentration in patients with T2D. METHODS AND RESULTS: In this study, we studied 139 patients with T2D (mean age 64.12 ± 8.17 years) who underwent coronary angiographic examination. The initial rate of substrate hydrolysis was spectrophotometrically assayed in kinetic mode for measuring PON1 activity. Receiver operating characteristic (ROC) graphs are created by plotting true positivity versus false positivity. In patients with HbA1c ≥ 7%, PON1 (AUC = 0.7, p = 0.029) and nonHDL-C/PON1 (AUC = 0.75, p = 0.013) were significantly more capable of differentiating patients with CAD from those without CAD compared to HDL-C and nonHDL-C/HDL-C. Also, the predictive power of PON1 (AUC = 0.64, p = 0.029) and nonHDL-C/PON1 (AUC = 0.71, p = 0.004) were significantly higher in comparison with HDL-C and nonHDL-C/HDL-C for CAD characterization in patients aged ≥50 years. Moreover, PON1 and nonHDL-C/PON1 are associated with the incidence of CAD with an AUC of 0.7 (p = 0.026) and AUC of 0.64 (p = 0.087), respectively, among subjects with low HDL-C. CONCLUSION: PON1 and the ratio of nonHDL-C/PON1 significantly improve the prediction of severe CAD in T2D patients and in patients with HbA1c ≥ 7%, age ≥50 years, or low HDL-C. PON1 activity and lipid ratios using this enzyme may be valuable as substitutes of HDL-C for increasing clinical efficacies in cardiovascular risk assessment.

The causal effect of family physician program on the prevalence, screening, awareness, treatment, and control of hypertension and diabetes mellitus in an Eastern Mediterranean Region: a causal difference-in-differences analysis.

BACKGROUND: Hypertension (HTN) and diabetes mellitus (DM) as part of non-communicable diseases are among the most common causes of death worldwide, especially in the WHO's Eastern Mediterranean Region (EMR). The family physician program (FPP) proposed by WHO is a health strategy to provide primary health care and improve the community's awareness of non-communicable diseases. Since there was no clear focus on the causal effect of FPP on the prevalence, screening, and awareness of HTN and DM, the primary objective of this study is to determine the causal effect of FPP on these factors in Iran, which is an EMR country. METHODS: We conducted a repeated cross-sectional design based on two independent surveys of 42,776 adult participants in 2011 and 2016, of which 2301 individuals were selected from two regions where the family physician program was implemented (FPP) and where it wasn't (non-FPP). We used an Inverse Probability Weighting difference-in-differences and Targeted Maximum Likelihood Estimation analysis to estimate the average treatment effects on treated (ATT) using R version 4.1.1. RESULTS: The FPP implementation increased the screening (ATT = 36%, 95% CI: (27%, 45%), P-value < 0.001) and the control of hypertension (ATT = 26%, 95% CI: (1%, 52%), P-value = 0.03) based on 2017 ACC/AHA guidelines that these results were in keeping with JNC7. There was no causal effect in other indexes, such as prevalence, awareness, and treatment. The DM screening (ATT = 20%, 95% CI: (6%, 34%), P-value = 0.004) and awareness (ATT = 14%, 95% CI: (1%, 27%), P-value = 0.042) were significantly increased among FPP administered region. However, the treatment of HTN decreased (ATT = -32%, 95% CI: (-59%, -5%), P-value = 0.012). CONCLUSION: This study has identified some limitations related to the FPP in managing HTN and DM, and presented solutions to solve them in two general categories. Thus, we recommend that the FPP be revised before the generalization of the program to other parts of Iran.

An estimation of global Aeromonas infection prevalence in children with diarrhoea: a systematic review and meta-analysis.

OBJECTIVES: Diarrhoea is the most commonly related disease caused by Aeromonas. To improve knowledge on prevalence, this systematic review and meta-analysis was performed to evaluate the global prevalence of Aeromonas in children with diarrhoea worldwide. METHODS: We systematically searched PubMed, Google scholar, Wiley Online Library, ScienceDirect, and Web of sciences to identify all cross-sectional published papers between 2000 and 10 July 2022. After initial scrutinizing, 31 papers reporting the prevalence of Aeromonas in children with diarrhoea were found to be adequate for meta-analysis. The statistical study was accompanied by using random effects models. RESULTS: A total of 5660 identified papers, 31 cross-sectional studies encompassing 38,663 participants were included in the meta-analysis. The pooled prevalence of Aeromonas in children with diarrhoea worldwide was 4.2% (95% CI 3.1-5.6%). In the subgroup analysis, the highest prevalence was seen among children in Upper middle-income countries with pooled prevalence of 5.1% (95% CI 2.8-9.2%). The prevalence of Aeromonas in children with diarrhoea was higher in countries with populations of over 100 million people (9.4%; 95% CI 5.6-15.3%), and water and sanitation quality score of less than 25% (8.8%; 95% CI 5.2-14.4%). Additionally, Cumulative Forest Plot showed a decreasing trend in the prevalence of Aeromonas infection in children with diarrhoea over time (P = 0.0001). CONCLUSION: The results of this study showed a better comprehension of Aeromonas prevalence in children with diarrhoea on a global scale. As well as our findings showed that much work is still required to decline the burden of bacterial diarrhoea in countries with high populations, low-level income, and unsanitary water.

COMPARATIVE EFFICACY OF 1% CURCUMIN NANOMICELLE GEL AND 2% CURCUMIN GEL FOR TREATMENT OF RECURRENT APHTHOUS STOMATITIS: A DOUBLE-BLIND RANDOMIZED CLINICAL TRIAL.

OBJECTIVE: Recurrent aphthous stomatitis (RAS) is a highly prevalent painful inflammatory condition. Curcumin is currently used as a medicinal herb with optimal anti-inflammatory properties for many inflammatory conditions. However, due to its low water solubility and consequently low bioavailability, its nanoparticulate formulation has been considered for use. This study aimed to compare the efficacy of topical application of 1% curcumin nanomicelle gel and 2% curcumin gel for treatment of RAS. METHODS: This double-blind randomized clinical trial evaluated 48 RAS patients. The patients randomly received 1% curcumin nanomicelle gel or 2% curcumin gel, and were asked to apply it 3 times/day for 1 week. The severity of pain was measured using a visual analog scale (VAS), and the size of lesions (in millimeters) was measured by a periodontal probe before (baseline), and at 4, and 7 days after treatment. Data were analyzed by repeated measures ANOVA. RESULTS: No significant difference was noted in the pain score (P = .160) or size of lesions (P = .432) between the 2 groups at baseline. At 7 days, the pain score and size of lesions significantly decreased in both groups (P < .05). The reduction in pain score and lesion size was significantly greater in the curcumin nanomicelle gel group at both 4 and 7 days (P < .05). Also, the efficacy index (EI) was higher in curcumin nanomicelle gel group. CONCLUSIONS: The 1% curcumin nanomicelle gel can be effectively used to enhance the healing of RAS.

Improved risk assessment of coronary artery disease by substituting paraoxonase 1 activity for HDL-C: Novel cardiometabolic biomarkers based on HDL functionality.

BACKGROUND AND AIMS: Developing laboratory assays to evaluate HDL functions and improve cardiovascular disease (CVD) risk assessment has recently emerged as a challenge. The present study was conducted to help predict the risk of coronary artery disease (CAD) by investigating new cardiometabolic risk factors based on substituting paraoxonase 1 (PON1) as a critical enzyme in the functionality of HDL for that of HDL-C. METHODS AND RESULTS: The present study recruited 274 subjects undergoing diagnostic coronary angiography, 92 without significant CAD (non-CAD), and 182 with a severe CAD. The diagnostic accuracy of the new biomarkers in non-CAD versus multi-vessel disease was obtained in descending order of AUC as 0.72 (P < 0.001) for log (TG/PON1), 0.70 (P < 0.001) for nonHDL-C/PON1, and 0.67 (P < 0.001) for LDL-C/PON1. After performing a multivariate adjustment for age, gender, BMI, statin therapy, and diabetes mellitus, the increased odds of CAD remained significant for the new cardiometabolic ratios as independent variables [adjusted OR = 1.47 (1.15-1.88), p = 0.002 for LDL-C/PON1; adjusted OR = 2.15 (1.41-3.5), p = 0.009 for nonHDL-C/PON1; adjusted OR = 5.03 (2.14-13.02), p = 0.004 for log (TG/PON1)]. CAD was diagnosed with an optimal discriminating cutoff of 1.84 for LDL-C/PON1, 2.8 for nonHDL-C/PON1, and 0.48 for log (TG/PON1). CONCLUSIONS: To improve CAD's risk assessment, the PON1 activity was proposed as an alternative to HDL-C in the commonly used atherogenic lipid ratios. Substituting the PON1 activity for the HDL-C concentration can provide an index of the HDL activity. The present study sought to exploit the lipoprotein-related risk factors of CAD from a more effective perspective.

Comprehensive Survey of Plagiarism in Iran.

BACKGROUND AND OBJECTIVE: We conducted this study to assess the prevalence of plagiarism and to shed light on some dark aspects of this issue. The main objectives included to find out the etiology, prevalence, and detection of various forms plagiarism. METHODS: In this Cross-sectional study we used a questionnaire, face-to-face interview, analyzing the present notifications and codes, websites, and literature review. The current study was conducted throughout Iran from 2017-2018. Those associated with scientific journalism, academic staffs, and authors were interviewed or asked to fill out a prepared questionnaire. RESULTS: Nine hundred seventy nine questionnaires were circulated. Out of this 706 (72.1%) were completed and returned. Those with a master degree were most cooperative in filling out the questionnaires (36.4%); followed by Assistant Professors (29.6%). About 74.1% of respondents, had not participated in any educational workshops on plagiarism (P<0.001) while 10.8% had not heard anything about plagiarism (P<0.001). As regards correct reply as for definition and detecting plagiarism; 91.1%, 40.8%, 48.4% and 57.9% could reply correctly (P<0.001). Forty-one-point one percent of the participants believed that reprimand would be the best punishment. The percentage of plagiarism as per people associated in journal administration, was 22.9%; based on experts' opinions, it was 30.0%; and based on analysis of some journals published in Iran, it was 25.5%. CONCLUSION: We found a noticeable prevalence of plagiarism in Iran. Many factors are involved in this misconduct; most important being the need for academic staff and students to publish e more papers regardless of their quality to meet some of the academic requirements. Considering the high rank of Iran in terms of scientific growth worldwide, it is expected from the regulatory authorities to monitor all aspects of scientific misconducts in medical journalism.

Assisted reproductive technology and the risk of preeclampsia: an updated systematic review and meta-analysis.

BACKGROUND: The objective of this systematic review and meta-analyses was to assess the risk of preeclampsia among women who conceived with assisted reproductive technology (ART). METHODS: We searched the ISI Web of Knowledge, Medline/PubMed, Scopus, and Embase (from inception to May 2017) for English language articles using a list of key words. In addition, reference lists from identified studies and relevant review articles were also searched. Data extraction was performed by two authors, and the study quality was assessed using the Newcastle-Ottawa Scale. Random-effects model meta-analysis was applied to pool the relative risks (RR) across studies. RESULTS: A total of 48 studies (5 case-control studies and 43 cohort studies) were included in this meta-analysis. The Cochran Q test and I2 statistics revealed substantial heterogeneity (Q = 26,313.92, d.f. = 47, p < 0.001 and I2 = 99.8%). Meta-analysis showed a significant increase in preeclampsia in women who conceived by ART compared with those who conceived spontaneously (RR = 1.71, 95% CI = 1.11-2.62, p = 0.015). CONCLUSIONS: The findings of this systematic review indicate that the use of ART treatment is associated with a 1.71-fold increase in preeclampsia.

The myo-inositol effect on the oocyte quality and fertilization rate among women with polycystic ovary syndrome undergoing assisted reproductive technology cycles: a randomized clinical trial.

PURPOSE: The aim of the present study was to evaluate the effect of myo-Inositol administration on oocyte quality, fertilization rate and embryo quality in patients with PCOS during assisted reproductive technology (ART) cycles. METHODS: Fifty infertile PCOS patients were randomly designated in two groups. In the study group, patients received daily doses of 4 g myo-Inositol combined with 400 mg folic acid and in the control group patients received only 400 mg folic acid from 1 month before starting the antagonist cycle until the day of ovum pick up. Oocyte and embryo qualities were assessed according to European Society of Human Reproduction and Embryology (ESHRE) guidelines. The gene expression of PGK1, RGS2 and CDC42 as a factor of oocyte quality in granulosa cells was analyzed using real-time RT-PCR. Levels of total antioxidant capacity (TAC) and reactive oxygen species (ROS) were evaluated by chemiluminescence assay in follicular fluid. RESULTS: The percentage of metaphase II oocyte, fertilization rate and embryo quality significantly improved in the study group (p < 0.05), but the number of retrieved oocytes and follicle count were not statistically different between groups. Furthermore, the gene expression of PGK1, RGS2 and CDC42 was significantly higher in the study group (p < 0.05) but no differences were found between two groups in terms of TAC and ROS levels. CONCLUSIONS: The present study findings suggest that myo-Inositol alters the gene expression in granulosa cells and improves oocyte and embryo quality among PCOS patients undergoing ART.

Measurement of peripheral dose to the pelvic region and the associated risk for cancer development after breast intraoperative electron radiation therapy.

This study aimed to measure the received dose to the pelvic region of patients during breast intraoperative electron radiation therapy (IOERT). Furthermore, we compared the findings with those of external beam radiation therapy. Finally, secondary ovarian and uterus cancer risks following breast IOERT were estimated. In the current study, the received dose to the pelvic surface of 18 female patients during breast IOERT boosts were measured by thermoluminescent dosimeter (TLD-100) chips. All patients were treated with 12 Gy given in a single fraction. To estimate the dose to the ovary and uterus of the patients, conversion coefficients for depth from the surface dose were obtained in a Rando phantom. Given the received dose to the pelvic region of the patients, secondary ovarian and uterus cancer risks following breast IOERT were estimated. The received doses to the ovary and uterus surface of the patients were 0.260 ± 0.155 mGy to 31.460 ± 6.020 mGy and 0.485 ± 0.122 mGy to 22.387 ± 15.476 mGy, respectively. Corresponding intra-pelvic (ovary and uterus) regional doses were 0.012 ± 0.007 mGy to 1.479 ± 0.283 mGy and 0.027 ± 0.001 mGy to 1.164 ± 0.805 mGy, respectively. Findings demonstrated that the ratio of the received dose by the pelvic surface to the regional dose during breast IOERT was much less than external beam radiation therapy. The mean of the secondary cancer risks for the ovary in 8 and 10 MeV electron beam energies were 135.722 ± 117.331 × 10-6 and 69.958 ± 28.072 × 10-6, and for the uterus were 17.342 ± 10.583 × 10-6 and 2.971 ± 3.604 × 10-6, respectively. According to our findings, the use of breast IOERT in pregnant patients can be considered as a safe radiotherapeutic technique, because the received dose to the fetus was lower than 50 mGy. Furthermore, IOERT can efficiently reduce the unnecessary dose to the pelvic region and lowers the risk of secondary ovarian and uterus cancer following breast irradiation.

Paraoxonase-2 variants potentially influence insulin resistance, beta-cell function, and their interrelationships with alanine aminotransferase in type 2 diabetes.

BACKGROUND: The aim of this study was to determine whether insulin resistance, beta-cell function, and their associations with alanine aminotransferase (ALT) are affected by the functional variants of paraoxonase-2 (PON2) as an intracellular antioxidant in patients with type 2 diabetes (T2D). MATERIALS AND METHODS: Quantitative insulin sensitivity check index (QUICKI) and homeostasis model assessment for beta-cell function (HOMA-BCF) were assessed in T2D patients. Insulin levels were determined using ELISA. The variants PON2-A148G and PON2-S311C were genotyped using polymerase chain reaction-based restriction fragment length polymorphism. RESULTS: According to the PON2-G148A variant, ALT was found to be significantly correlated with QUICKI (r = -0.616, P = 0.005) and HOMA-BCF (r = 0.573, P = 0.01) in the GA + GG group; however, the correlations were not statistically significant in the AA genotypes. Based on the genotypes of PON2-S311C, there was a significant correlation between ALT with QUICKI (r = -0.540, P = 0.031) and HOMA-BCF (r = 0.567, P = 0.022) in the SC + CC group. In the multiple adjusted logistic regression analyses, considering the variants PON2-G148A and PON2-C311S as independent variables and QUICKI and HOMA-BCF as the dependent variables, both variants were significantly associated with the QUICKI (P = 0.019 for PON2-G148A and P = 0.041 for PON2-C311S). Furthermore, PON2-C311S remained significantly associated with HOMA-BCF (P = 0.03). CONCLUSION: These data implicate a role for the functional variants of PON2 in insulin resistance and beta-cell function as well as underscore the effective role of these variants in the associations between them and ALT. Our data contribute to our understanding of the important physiologic functions of PON2 in glucose metabolism and its related metabolic diseases.

Allele frequency and genotype distribution of a common variant in the 3´-untranslated region of the SLC22A3 gene in patients with type 2 diabetes: Association with response to metformin.

BACKGROUND: Organic cation transporter 3 (OCT3) is an excellent transporter for metformin, which is used as first-line therapy for type 2 diabetes (T2D). OCT3 genetic variants may influence the clinical response to metformin. This study aimed to determine the genotype and allele frequency of OCT3-564G>A (rs3088442) variant and its role in the glycemic response to metformin in patients with newly diagnosed T2D. MATERIALS AND METHODS: Based on the response to metformin, 150 patients were classified into two groups: Sixty-nine responders (decrease in glycated hemoglobin [HbA1c] values by more than 1% from the baseline) and 81 nonresponders (decrease in HbA1c values <1% from the baseline). HbA1c levels were determined by chromatography. The variant OCT3-564G>A was genotyped using polymerase chain reaction - based restriction fragment length polymorphism. RESULTS: The genotypes frequencies were 51.3% GG, 36% AG, and 12.7% AA. Allele frequency of major allele (G) and minor allele (A) in OCT3-564G>A variant was found to be 0.69 and 0.31, respectively. Fasting glucose, HbA1c, body mass index, and lipid profile in both GG genotypes and GA + AA group decreased significantly after 3 months of metformin therapy compared with baseline (P < 0.05). In both responders and nonresponders, HbA1c and fasting glucose levels were lower in patients with the GA + AA genotype than in those with the GG genotype; however, the differences were not statistically significant (P > 0.05). CONCLUSION: The A allele frequency (which may be a protective allele against coronary heart disease) in the Iranian diabetic patients was lower than Iranian, Caucasian and Japanese healthy populations. Metformin is useful in improving the lipid profile, in addition to its impacts in glycemic control, and these effects are regardless of OCT3-564G>A variant.

Detection of Merkel cell polyomavirus large T-antigen sequences in human central nervous system tumors.

Despite decades of epidemiological investigation, little is known about the etiology of the central nervous system (CNS) tumors, and few well-established risk factors have been recognized. This study tested the presence of Merkel cell polyomavirus (MCPyV), the only member of the Polyomaviridae family convincingly linked to human cancer, in diverse CNS malignancies. In total, 58 CNS tumor biopsies were analyzed for the MCPyV large T-antigen (LT-Ag) gene by quantitative real-time PCR. Merkel cell polyomavirus LT-Ag DNA load was determined as viral copies per cell and viral copies per microliter of purified genomic DNA from CNS tumor samples. The MCPyV LT-Ag sequence was detected in 34 (58.6%) of the 58 tested samples. Viral LT-Ag was quantified in 19.0% of schwannomas, 13.8% of meningiomas, and 5.2% of pituitary adenomas. The difference between MCPyV positivity in different types of CNS malignancies was not statistically significant (P = 0.066). The mean LT-Ag copy number in 34 positive samples was 744.5 ± 737.7 and 0.056 × 10(-3) ± 0.091 × 10(-3) per microliter and per cell, respectively. Among MCPyV-positive CNS tumors, the mean MCPyV copy number was higher in meningiomas (993.8 ± 853.2 copy per microliter and 0.098 × 10(-3) ± 0.108 × 10(-3) copy per cell). Multiple linear regression analysis revealed statistically significant difference in MCPyV copy number between meningioma and other CNS tumor types, when the model was adjusted for age and sex (P = 0.024). This study shows the first evidence of the detection of MCPyV LT-Ag sequence at a low copy number in human CNS tumors.

Prevalence of JC polyomavirus large T antigen sequences among Iranian patients with central nervous system tumors.

The human neurotropic JC virus (JCV) is of significant interest due to its experimental neuro- oncogenic potential. In clinical samples from human central nervous system (CNS) tumors, detection of JCV sequences suggests a possible association with CNS neoplasms, but the results are discrepant worldwide. To assess the prevalence of JCV sequences in Iranian patients with primary and metastatic CNS malignancies, a total of 58 fresh CNS tumors were examined by quantitative real-time PCR targeting the JCV large T antigen (LT-Ag) gene, and JCV DNA load was determined as viral copy number per cell. All patients were immunocompetent, and none of them had received immunosuppressive therapy before surgical operation. JC virus LT-Ag sequences were found in a total of 15 (25.9 %) out of the 58 tested samples. In primary CNS tumors, JCV sequences were identified more frequently in meningiomas (50.0 %) and schwannomas (35.7 %). In metastatic CNS tumors, JCV LT-Ag was identified in one case with brain adenocarcinoma originating from lung cancer. No statistically significant association between JCV positivity and various types of CNS malignancies was observed (P = 0.565). The mean JCV LT-Ag copy number in 15 positive cases was 1.8 × 10(-4) ± 4.5 × 10(-4) copies per cell (range 1.0 × 10(-5)-1.78 × 10(-3) copies per cell). An inverse correlation between white blood cell (WBC) count and JCV copy number was observed, but this correlation was not statistically significant (R = -0.198, P = 0.480). This study provides the first data on the prevalence of JCV in primary and metastatic CNS tumors from Iranian patients.

cyp51A gene silencing using RNA interference in azole-resistant Aspergillus fumigatus.

An increasing number of reports have described the emergence of acquired resistance of Aspergillus fumigatus to azole compounds. The primary mechanism of resistance in clinical isolates is the mutation of the azole drug target enzyme, which is encoded by the cyp51A gene. The aim of this study was to evaluate the impact of silencing the cyp51A gene in azole-resistant A. fumigatus isolates. A 21-nucleotide small-interfering RNA (siRNA) was designed based on the cDNA sequence of the A. fumigatus cyp51A gene. After silencing the cyp51A gene in germinated conidia (15, 20, 25 and 50 nM), azole-resistant A. fumigatus was cultured on broth media and gene expression was analysed by measuring the cyp51A mRNA level using RT-PCR assay. Hyphae were successfully transfected by siRNA and expression of the cyp51A gene was significantly reduced by siRNA at the concentration of 50 nM (P ≤ 0.05). In addition, at this siRNA concentration, the minimum inhibitory concentration of itraconazole for the treated cells was decreased, compared with that for untreated control cells, from 16 to 4 µg/ml.

Accuracy of Dental Calcification Stages in Predicting the Peak Pubertal Stage of Females.

Objective: This study aimed to evaluate the accuracy of dental calcification stages in predicting the peak pubertal stage. Methods: This retrospective study was conducted on panoramic and lateral cephalometric images of 406 female patients aged 9-14 years. The skeletal maturity and calcification stages of the mandibular canines, first premolars, second premolars, and second molars were determined using the Hassel-Farman and Demirjian (DI) methods, respectively. The prediction accuracy of the peak pubertal stage with the studied teeth was assessed using a receiver operating characteristic curve and the area under the curve (AUC). The DI stage of H was designated as the reference level, and Bayesian logistic regression analysis was used to assess the coinciding chance of each DI stage and peak pubertal stage. Results: The AUC range of studied teeth was 0.84-0.92 in predicting peak pubertal stage (all p<0.001). In the canines and first premolars, the coinciding chance of peak pubertal stage and stage H was significantly higher than that in other stages [p<0.05, odds ratio (OR) ≤0.14]. In the second premolars and second molars, the chance of peak pubertal stage coinciding with stages H and G did not significantly differ (p>0.05); however, the chance of stage G coinciding with peak pubertal stage in the second molars was higher than in stage H (OR=4.59). Conclusion: Stage H in all studied teeth and stage G in the second premolars and second molars predict peak pubertal stage with high accuracy. Considering that stage H is the end of tooth calcification stages and the accuracy of predicting stage G of second molar teeth is higher than the above stage, estimating the peak pubertal stage is recommended by the second case.

Associations of perceived and common dyadic coping with self-care in older couples with cardiovascular disease: A dyadic analysis.

BACKGROUND: Dyadic engagement of patients and caregivers in self-care is essential for management of heart disease. However, little is known how dyadic coping at individual and partner levels is associated with self-care in couples living with cardiovascular disease. OBJECTIVE: This study examined whether dyadic coping at self, partner, and common levels was associated with patients' engagement in self-care and spouses' contribution to self-care in older couples living with cardiovascular disease. METHODS: In this cross-sectional study, 288 older patients and spouses were recruited from outpatient heart clinics in Qazvin, north of Iran. Data were collected using the Dyadic Coping Inventory, the Self-care of Coronary Heart Disease Inventory, and the Caregiver's Contribution to Self-care of Coronary Heart Disease. Dyadic data were analyzed using the actor-partner interdependence model. RESULTS: The results showed that patients' engagement in self-care maintenance was associated with partner dyadic coping in patients, self and common dyadic coping in spouses. Patients' engagement in self-care monitoring was only associated with self dyadic coping in spouses. Dyadic analysis also showed that self-care confidence in patients was only associated with by partner dyadic coping in spouses. CONCLUSIONS: This study revealed that self-care was associated with dyadic coping employed by each member of the dyad at self, partner and common levels. Findings of this study suggest that perceived and provided levels of dyadic coping can be employed for maintaining or restoring self-management in older couples living with cardiovascular disease.