Applications of Innovation Technologies for Personalized Cancer Medicine: Stem Cells and Gene-Editing Tools.

Personalized medicine is a new approach toward safer and even cheaper treatments with minimal side effects and toxicity. Planning a therapy based on individual properties causes an effective result in a patient's treatment, especially in a complex disease such as cancer. The benefits of personalized medicine include not only early diagnosis with high accuracy but also a more appropriate and effective therapeutic approach based on the unique clinical, genetic, and epigenetic features and biomarker profiles of a specific patient's disease. In order to achieve personalized cancer therapy, understanding cancer biology plays an important role. One of the crucial applications of personalized medicine that has gained consideration more recently due to its capability in developing disease therapy is related to the field of stem cells. We review various applications of pluripotent, somatic, and cancer stem cells in personalized medicine, including targeted cancer therapy, cancer modeling, diagnostics, and drug screening. CRISPR-Cas gene-editing technology is then discussed as a state-of-the-art biotechnological advance with substantial impacts on medical and therapeutic applications. As part of this section, the role of CRISPR-Cas genome editing in recent cancer studies is reviewed as a further example of personalized medicine application.

Comparing Sequential Organ Failure Assessment Score, Acute Physiology and Chronic Health Evaluation II, Modified Acute Physiology and Chronic Health Evaluation II, Simplified Acute Physiology Score II and Poisoning Severity Score for Outcome Prediction of Pesticide Poisoned Patients Admitted to the Intensive Care Unit.

Objective: This study aimed to assess the severity of poisoning, various scoring systems, including Sequential Organ Failure Assessment (SOFA) score, acute physiology and chronic health evaluation II (APACHE II), Simplified Acute Physiology Score (SAPS II), Modified APACHE II, and poisoning severity score (PSS) were used. In this study, we compared the predictive value of these scoring systems on the outcome of pesticide-poisoned patients. Methods: This is a cross-sectional study of pesticide-poisoned patients (140 patients) who were admitted to the intensive care unit (ICU) of Khorshid Hospital, Isfahan, Iran, between January 2015 and 2019. The area under the receiver operating characteristic (AUC) curve and the predictive value of scoring systems were compared. Findings: Poisoning was higher in the male population (72.8%). The causes of poisoning were paraquat, (38.6%), aluminum phosphide, (32.1%), and organophosphate, (29.3%). The mean age of the patients was 33.9 years. Most patients (79.3%) attempted suicide. The mortality rate was 46.43%. The mean of "SOFA score," "APACHE II," "SAPS II," "Modified APACHE II," and "PSS" was 5.9; 15.7; 30.02; 15.8; and 1.9, respectively. There was a significant difference in the mean of all scoring systems for outcome prediction. Among all scoring systems, the SAPS II score with the cutoff point (16.5) had the best criteria for outcome prediction (AUC (0.831 ± 0.037), sensitivity (83.1%, 95% confidence interval [CI]: [71.7-91.2]), specificity (75.7%, 95% CI: [64.3-84.9]), positive predictive values (75.0%, 95% CI: [66.4-82.0]), negative predictive values (83.6%, 95% CI: [74.5-89.9]). Conclusion: The SAPS II scoring system may be a suitable indicator for outcome predictions in pesticide-poisoned patients in the ICU.

Co-delivery of curcumin and Bcl-2 siRNA to enhance therapeutic effect against breast cancer cells using PEI-functionalized PLGA nanoparticles.

PURPOSE: Breast cancer is the second major cause of death worldwide among women. Co-delivery of anticancer drugs and nucleic acids targeting the apoptosis pathway could be a promising new approach. METHODS: In the present study, we synthesized a novel nanostructure for the co-delivery of curcumin and siRNA to breast cancer cells. Curcumin-loaded polylactic-co-glycolic acid (PLGA) was synthesized using an O/W emulsion-solvent diffusion method. It was coated with polyethylenimine (PEI) and subsequently complexed with Bcl-2 siRNA. Also, nanoparticles were characterized such as zeta potential, size distribution and drug encapsulation. Finally, the cytotoxicity of NP and Bcl-2 expression was evaluated. RESULTS: The curcumin-loaded PLGA nanoparticles were 70 nm in size, and increased to 84 nm after incorporation of PEI plus Bcl-2 siRNA. The encapsulation ratio of the drug in our nanoparticle was 78%. Cellular internalization of PLGA-CUR-PEI/Bcl-2 siRNA NPs was confirmed by fluorescence microscopy with the broadcasting of the fluorescence in the cytoplasm and into the nucleus. The results of the cell viability assay revealed that curcumin-loaded PLGA coated with PEI and Bcl-2 siRNA exhibited the highest cytotoxicity against the T47D cell line, while the siRNA decreased the Bcl-2 expression by 90.7%. CONCLUSION: The co-delivery of curcumin plus Bcl-2 siRNA with the PLGA-PEI nanosystem could be a synergistic drug carrier against breast cancer cells.

Saponin and fluorine-modified polycation as a versatile gene delivery system.

Despite the development of many novel carriers for the delivery of various types of genetic material, the lack of a delivery system with high efficiency and low cytotoxicity is a major bottleneck. Herein, low molecular weight polyethylenimine (PEI1.8k) was functionalized with saponin residues using phenylboronic acid (PBA) as an ATP-responsive cross-linker, and a fluorinated side chain to construct PEI-PBA-SAP-F polycation as a highly efficient delivery vector. This vehicle could transfect small plasmid DNA (∼3 kb) with outstanding efficiency into various cells, including HEK 293T, NIH3T3, A549, PC12, MCF7 and HT-29, as well as robust transfection of a large plasmid (∼9 kb) into HEK 293T cells. The carrier indicated good transfection efficacy even at high concentration of serum and low doses of plasmid. The use of green fluorescent protein (GFP) knock-out analysis demonstrated transfection of different types of CRISPR/Cas9 complexes (Cas9/sgRNA ribonucleoproteins RNP, plasmid encoding Cas9 plus sgRNA targeting GFP, Cas9 expression plasmid plusin vitro-prepared sgRNA). In summary, we report an effective PEI-PBA-SAP-F gene carrier with the appropriate lipophilic/cationic balance for biomedical applications.

Histidine-enhanced gene delivery systems: The state of the art.

Gene therapy has emerged as a promising tool for treating different intractable diseases, particularly cancer or even viral diseases such as COVID-19 (coronavirus disease 2019). In this context, various non-viral gene carriers are being explored to transfer DNA or RNA sequences into target cells. Here, we review the applications of the naturally occurring amino acid histidine in the delivery of nucleic acids into cells. The biocompatibility of histidine-enhanced gene delivery systems has encouraged their wider use in gene therapy. Histidine-based gene carriers can involve the modification of peptides, dendrimers, lipids or nanocomposites. Several linear polymers, such as polyethylenimine, poly-l-lysine (synthetic) or dextran and chitosan (natural), have been conjugated with histidine residues to form complexes with nucleic acids for intracellular delivery. The challenges, opportunities and future research trends of histidine-based gene deliveries are investigated.

Smart Strategies for Precise Delivery of CRISPR/Cas9 in Genome Editing.

The emergence of CRISPR/Cas technology has enabled scientists to precisely edit genomic DNA sequences. This approach can be used to modulate gene expression for the treatment of genetic disorders and incurable diseases such as cancer. This potent genome-editing tool is based on a single guide RNA (sgRNA) strand that recognizes the targeted DNA, plus a Cas nuclease protein for binding and processing the target. CRISPR/Cas has great potential for editing many genes in different types of cells and organisms both in vitro and in vivo. Despite these remarkable advances, the risk of off-target effects has hindered the translation of CRISPR/Cas technology into clinical applications. To overcome this hurdle, researchers have devised gene regulatory systems that can be controlled in a spatiotemporal manner, by designing special sgRNA, Cas, and CRISPR/Cas delivery vehicles that are responsive to different stimuli, such as temperature, light, magnetic fields, ultrasound (US), pH, redox, and enzymatic activity. These systems can even respond to dual or multiple stimuli simultaneously, thereby providing superior spatial and temporal control over CRISPR/Cas gene editing. Herein, we summarize the latest advances on smart sgRNA, Cas, and CRISPR/Cas nanocarriers, categorized according to their stimulus type (physical, chemical, or biological).

Could artificial intelligence revolutionize the development of nanovectors for gene therapy and mRNA vaccines?

Gene therapy enables the introduction of nucleic acids like DNA and RNA into host cells, and is expected to revolutionize the treatment of a wide range of diseases. This growth has been further accelerated by the discovery of CRISPR/Cas technology, which allows accurate genomic editing in a broad range of cells and organisms in vitro and in vivo. Despite many advances in gene delivery and the development of various viral and non-viral gene delivery vectors, the lack of highly efficient non-viral systems with low cellular toxicity remains a challenge. The application of cutting-edge technologies such as artificial intelligence (AI) has great potential to find new paradigms to solve this issue. Herein, we review AI and its major subfields including machine learning (ML), neural networks (NNs), expert systems, deep learning (DL), computer vision and robotics. We discuss the potential of AI-based models and algorithms in the design of targeted gene delivery vehicles capable of crossing extracellular and intracellular barriers by viral mimicry strategies. We finally discuss the role of AI in improving the function of CRISPR/Cas systems, developing novel nanobots, and mRNA vaccine carriers.

Smart arginine-equipped polycationic nanoparticles for p/CRISPR delivery into cells.

An efficient and safe delivery system for the transfection of CRISPR plasmid (p/CRISPR) into target cells can open new avenues for the treatment of various diseases. Herein, we design a novel nonvehicle by integrating an arginine-disulfide linker with low-molecular-weight PEI (PEI1.8k) for the delivery of p/CRISPR. These PEI1.8k-Arg nanoparticles facilitate the plasmid release and improve both membrane permeability and nuclear localization, thereby exhibiting higher transfection efficiency compared to native PEI1.8kin the delivery of nanocomplexes composed of PEI1.8k-Arg and p/CRISPR into conventional cells (HEK 293T). This nanovehicle is also able to transfect p/CRISPR in a wide variety of cells, including hard-to-transfect primary cells (HUVECs), cancer cells (HeLa), and neuronal cells (PC-12) with nearly 5-10 times higher efficiency compared to the polymeric gold standard transfection agent. Furthermore, the PEI1.8k-Arg nanoparticles can edit the GFP gene in the HEK 293T-GFP reporter cell line by delivering all possible forms of CRISPR/Cas9 system (e.g. plasmid encoding Cas9 and sgRNA targeting GFP, and Cas9/sgRNA ribonucleoproteins (RNPs) as well as Cas9 expression plasmid andin vitro-prepared sgRNA) into HEK 293T-GFP cells. The successful delivery of p/CRISPR into local brain tissue is also another remarkable capability of these nanoparticles. In view of all the exceptional benefits of this safe nanocarrier, it is expected to break new ground in the field of gene editing, particularly for therapeutic purposes.

Anti-inflammatory ethosomal nanoformulation in combination with iontophoresis in chronic wound healing: An ex vivo study.

Prescription of anti-inflammatory drugs may be considered as a promising strategy in chronic wound healing where the inflammatory disturbance has delayed the healing process. It seems that hydrocortisone 17-butyrate (HB17) would be promising in the form of a nano-formulation to enhance drug delivery efficacy. In the present study, transdermal delivery of nano-HB17 in combination with iontophoresis was investigated ex vivo. Ethosomal-HB17 was synthesised using lecithin, ethanol and cholesterol with a different ratio by hot method. The negative ethosomal-HB17 particle size was around 244 ± 4.3 nm with high stability of up to 30 days. Additionally, evaluated entrapment efficiency of HB17 in ethosomes by high performance liquid chromatography was 40.6 ± 2.21%. Moreover, the permeation speed and amount of H17B in complete-thickness rat skin in the presence and absence of iontophoresis showed that the penetration of free H17B and ethosomal-H17B formulations were zero and 7.98 µg/cm2 in 120 min, respectively. Whereas in the case of applying iontophoresis, permeation amount obtained was zero and 19.69 µg/cm2 in 30 min in free H17B and ethosomal-H17B formulations, respectively. It has been concluded that transdermal delivery of ethosomal-H17B is an effective strategy to enhance drug delivery and it will be improved when it is combined with iontophoresis.

Highly Photoluminescent Nitrogen- and Zinc-Doped Carbon Dots for Efficient Delivery of CRISPR/Cas9 and mRNA.

Safe and efficient delivery of CRISPR/Cas9 systems is still a challenge. Here we report the development of fluorescent nitrogen- and zinc-doped carbon dots (N-Zn-doped CDs) using one-step microwave-aided pyrolysis based on citric acid, branched PEI25k, and different zinc salts. These versatile nanovectors with a quantum yield of around 60% could not only transfect large CRISPR plasmids (∼9 kb) with higher efficiency (80%) compared to PEI25k and lipofectamine 2000 (Lipo 2K), but they also delivered mRNA into HEK 293T cells with the efficiency 20 times greater than and equal to that of PEI25k and Lipo 2K, respectively. Unlike PEI25k, N-Zn-doped CDs exhibited good transfection efficiency even at low plasmid doses and in the presence of 10% fetal bovine serum (FBS). Moreover, these nanovectors demonstrated excellent efficiency in GFP gene disruption by transferring plasmid encoding Cas9 and sgRNA targeting GFP as well as Cas9/sgRNA ribonucleoproteins into HEK 293T-GFP cells. Hence, N-Zn-doped CDs with remarkable photoluminescence properties and high transfection efficiency in the delivery of both CRISPR complexes and mRNA provide a promising platform for developing safe, efficient, and traceable delivery systems for biological research.

Synthesis and characterization of vitamin D3-functionalized carbon dots for CRISPR/Cas9 delivery.

Aim: To develop a novel nanovector for the delivery of genetic fragments and CRISPR/Cas9 systems in particular. Materials & methods: Vitamin D3-functionalized carbon dots (D/CDs) fabricated using one-step microwave-aided methods were characterized by different microscopic and spectroscopic techniques. The 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl tetrazolium bromide assay and flow cytometry were employed to determine the cell viability and transfection efficiency. Results: D/CDs transfected CRISPR plasmid in various cell lines with high efficiency while maintaining their remarkable efficacy at high serum concentration and low plasmid doses. They also showed great potential for the green fluorescent protein disruption by delivering two different types of CRISPR/Cas9 systems. Conclusion: Given their high efficiency and safety, D/CDs provide a versatile gene-delivery vector for clinical applications.

Nanotechnology against COVID-19: Immunization, diagnostic and therapeutic studies.

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in early 2020 soon led to the global pandemic of Coronavirus Disease 2019 (COVID-19). Since then, the clinical and scientific communities have been closely collaborating to develop effective strategies for controlling the ongoing pandemic. The game-changing fields of recent years, nanotechnology and nanomedicine have the potential to not only design new approaches, but also to improve existing methods for the fight against COVID-19. Nanomaterials can be used in the development of highly efficient, reusable personal protective equipment, and antiviral nano-coatings in public settings could prevent the spread of SARS-CoV-2. Smart nanocarriers have accelerated the design of several therapeutic, prophylactic, or immune-mediated approaches against COVID-19. Some nanovaccines have even entered Phase IΙ/IIΙ clinical trials. Several rapid and cost-effective COVID-19 diagnostic techniques have also been devised based on nanobiosensors, lab-on-a-chip systems, or nanopore technology. Here, we provide an overview of the emerging role of nanotechnology in the prevention, diagnosis, and treatment of COVID-19.

Polyethylenimine-Functionalized Carbon Dots for Delivery of CRISPR/Cas9 Complexes.

Carbon dots (CDs) have become the focus of many studies due to their outstanding optical properties and good biocompatibility. We investigated their potential application to produce a smart and highly efficient yet nontoxic nanovector for gene delivery. This was achieved by conjugating PEI1.8k-functionalized CDs (synthesized by one-step microwave-assisted pyrolysis) with arginine-disulfide linkers to produce CD-PEI1.8k-Arg nanoparticles. This nanovector could deliver p-CRISPR (9.3 kb) into different types of cell lines with higher efficiency compared to native PEI1.8k or PEI25k. CD-PEI1.8k-Arg also maintained its outstanding transfection efficiency at a high serum concentration and low p-CRISPR dose, compared to PEI25k, which was ineffective under those conditions. Additionally, CD-PEI1.8k-Arg could knock out the GFP gene with great efficiency by delivering the required components of CRISPR/Cas9, including a plasmid encoding Cas9, sgRNA targeting GFP, and Cas9/sgRNA ribonucleoproteins (RNPs) into the HEK 293T-GFP cells. Moreover, the nanoparticles showed potential for the local delivery of p-CRISPR into brain tissue. The remarkable properties of CD-PEI1.8k-Arg could enable the development of a safe, highly efficient gene-delivery nanovector for the treatment of various diseases in the near future.

Dietary total antioxidant capacity and severity of stenosis in patients with coronary artery disease.

Aim: Coronary artery disease (CAD) is a major cause of mortality worldwide. Many studies suggest that dietary antioxidant can offer significant protection against stroke, heart failure, and coronary heart disease. However, there is no study that assessed the association between dietary TAC and severity of stenosis in patients with CVD. The aim of this study was to investigate the association of dietary TAC and severity of stenosis in patients with coronary artery disease. Methods: Dietary and medical History of 160 patients with CAD were assessed. The extent of Stenosis was determined using the Gensini score. Dietary history was investigated by food frequency questionnaire (FFQ), and Dietary TAC was calculated by multiplying the average frequency of intake of each food by oxygen radical absorbance capacity (ORAC) content. Results: Across the Gensini score quartiles the dietary TAC, dietary hydrophilic TAC, dietary lipophilic TAC, and dietary phenolic TAC values were significantly increased in the highest quartile compared with the lowest quartile (dietary TAC (mmolTE/100 g):17.5 ± 1.82 vs. 11.2 ± 1.90; dietary hydrophilic TAC (mmolTE/100 g): 16.56 ± 1.29 vs. 10.74 ± 1.81; dietary lipophilic TAC (mmolTE/100 g): 0.55 ± 0.12 vs. 0.23 ± 0.09; dietary phenolic TAC (mmolTE/100 g):1.84 ± 0.31 vs. 0.98 ± 0.21; (P < 0.001 for all)). However, a non-significant association between the plasma TAC and Gensini quartiles was observed (P = 0.789). Multivariate regression analysis showed that dietary TAC (Beta = -0.53; P < 0.001) was statistically significant independent predictors that associated with the Gensini score values. Conclusions: There was a significant association between dietary TAC and severity of stenosis in patients with coronary artery disease.

The Relationship Between Antioxidants and Inflammation in Children With Attention Deficit Hyperactivity Disorder.

INTRODUCTION: Recent studies have identified Attention Deficit Hyperactivity Disorder (ADHD) as an inflammatory condition associated with immunological and oxidative responses. Therefore, it is necessary to examine these processes in these patients. The present study aimed at investigating the relationship between the dietary intake of antioxidants, Superoxide Dismutase (SOD) activity, and the serum levels of inflammatory factors in ADHD students. METHODS: This retrospective case-control study was conducted on 64 ADHD children aged 6 - 13 years. The demographic questionnaire, Food Frequency Questionnaire, and Baecke Physical Activity Questionnaire were used for data collection. SOD activity and the serum level of inflammatory factors (homocysteine, interleukin-6, and C-reactive Protein (CRP)) were measured in all patients. According to the CRP values, 32 patients were included in the case group (CRP≥1 mg/L) and 32 patients in the control group (0≤CRP<1 mg/L). RESULTS: There was no significant difference between the two groups in age, sex, weight, height, and body mass index. In the case group, the mean SOD activity (P=0.034), the physical activity (P=0.04), zinc intake (P=0.02), and homocysteine levels were higher than the control group (P=0.001). Of all studied variables, the best predictors were homocysteine (OR: 1.34, 95% CI: 1.082-1.670, P=0.029) and physical activity (OR: 0.85, 95% CI: 0.761-0.952, P=0.022) respectively, whereas other variables were not significant predictors. CONCLUSION: The present study showed that the level of inflammatory factors in the case group was significantly higher than the control group. Homocysteine and physical activity can predict the inflammation status induced by CRP.

Effect of cinnamon on migraine attacks and inflammatory markers: A randomized double-blind placebo-controlled trial.

Migraine is the most common type of primary headaches. Increased levels of interleukin-6 (IL-6), calcitonin-gene-related peptide (CGRP) and nitric oxide (NO) lead to inflammation and neurogenic pain. Cinnamon has anti-inflammatory and neuroprotective properties. Thus, the aim of this study was to assess the effect of cinnamon on migraine attacks and inflammatory status. Fifty patients with migraine were randomized to receive either cinnamon powder (three capsules/day each containing 600 mg of cinnamon) or three placebo capsules/day each containing 100 mg of corn starch (control group) for 2 months. Serum levels of IL-6, CGRP and NO were measured at baseline and at the end of the study. The frequency, severity and duration of pain attacks were also recorded using questionnaire. Serum concentrations of IL-6 and NO were significantly reduced in the cinnamon group compared with the control group (p < .05). However, serum levels of CGRP remained unchanged in both groups. The frequency, severity and duration of migraine attacks were significantly decreased in the cinnamon group compared with the control group. Cinnamon supplementation reduced inflammation as well as frequency, severity and duration of headache in patients with migraine. Cinnamon could be regarded as a safe supplement to relieve pain and other complications of migraine.

Assessment of educational intervention in enhancing parenting self-efficacy in parents of primary school students.

BACKGROUND AND AIMS: Parenting self-efficacy, which is one of the main determinants of effective and positive parental behavior, has been commonly defined as the parents' opinions and beliefs to develop their ability to affect their children in a way that raises their confidence development and adjustment. This study was performed to examine the effect of educational intervention on parenting self-efficacy in parents of primary school students. MATERIALS AND METHODS: This quasi-experimental study was conducted on 104 parents of primary school students in Khomeini Shahr city, Isfahan province of Iran, in 2017. In this study, 104 parents (52 couples) of primary school students were selected and randomly assigned to experimental and control groups. Then, an educational intervention was implemented in the experimental group during 6 sessions of 2 h while the control group received only the usual family school education program. The parenting self-efficacy was measured before the intervention and 2 months afterward. The data were analyzed by independent t-test, paired t-test. RESULTS: There was no statistically significant difference between the demographic variables of parents in both groups. Both the experimental and control groups were similar in terms of age, number of children, education, and employment as well as parenting self-efficacy. Two months after the intervention, the mean of total parenting self-efficacy, as well as play and entertainment with the child, discipline and boundaries, self-acceptance, learning and knowledge in the experimental group, were significantly higher than the control group, but the mean scores of other areas were not significantly different between the two groups (P > 0.05). CONCLUSION: Educational interventions that engage parents in group task and facilitate expression of experiences, are feasible in the primary school meetings and have a helpful effect on parenting self-efficacy.

Photoluminescent functionalized carbon dots for CRISPR delivery: synthesis, optimization and cellular investigation.

Gene therapy using clustered regularly interspaced short palindromic repeat plasmids (pCRISPR) reduces mistakes in gene editing and prevents engendering integrational mutagenesis that has been seen in available genome engineering technologies. Developing an ideal and traceable nanocarrier, which can accurately and efficiently transfer this complex into the cytosol and which facilitates the journey towards the nucleus, is a fascinating area of research. Polyethylenimine (PEI) functionalized carbon dots (CD-PEI) were fabricated by one-step microwave assisted pyrolysis with an average size around 3 nm. This CD-PEI showed good potential for intracellular delivery of genetic materials (∼70%). Also, this CD-PEI with passive surface modification with low molecular PEI (2 kDa) has a very high quantum yield, as high as 40% with low cytotoxicity. The expression rate of the pCRISPR was around 15% in the HEK-293 cell which is comparable with the pristine PEI. Furthermore, the CD-PEI demonstrated good properties, such as high quantum yield, biocompatibility and tunable emission wavelengths, suggesting the potential application of photoluminescent functionalized CDs as a suitable, traceable nanocarrier for CRISPR delivery.

The survey of quality of life, perceived stress, and its relationship with marital satisfaction in married women working at health centers.

INTRODUCTION: Employed women experience a wide range of stresses that will potentially impact on their quality of life, mental status, and marital satisfaction. The aim of this study was to determine the relationship between the above components in employed women. METHODS: The statistical population of this cross-sectional descriptive-analytical study was 124 married employed women of Khorramabad Health Center. The WHO Standard Questionnaire (SF-36), Perceived Stress Questionnaire (COHEN questionnaire), Marital Satisfaction Questionnaire (ENRICH questionnaire 47), and Demographic Information Questionnaire were used to collect data. Information was analyzed by SPSS software. RESULTS: Most of the participants in the research had a good (45/2%) and very good (34/7%) quality of life. Most of them reported high (57/1%) and very high (15/3%) levels of marital satisfaction. Furthermore, the majority of women participating in the study had a low level (64/5%) of perceived stress. There was a significant inverse correlation between perceived stress and marital satisfaction (r = -0/446, P < 0.001) and quality of life (r = -0/612, P < 0.05). There was a direct correlation between marital satisfaction and quality of life (r = -0/449, P < 0.05). Linear regression analysis showed that the importance of quality of life and perceived stress scores, respectively, were significant predictors of marital satisfaction score. There was no statistically significant correlation between the total score of quality of life and marital satisfaction with demographic variables; only a weak relationship was found between perceived stress and family monthly income (r = -0/184, P = 0/04). CONCLUSION: The findings of this study indicate that quality of life and perceived stress can be significant predictors of marital satisfaction in married employed women.

A study of picture archiving and communication system adoption in one hospital: Applying the unified theory of acceptance and use of technology model.

CONTEXT: The advent of picture archiving and communication system (PACS) as medical image information system represent a major change of work pattern for radiologists and physicians and has proved to be a substantial challenge to the organization. AIMS: The study aimed to investigate the factors affecting the use of PACS through the unified theory of acceptance and use of technology model. SETTINGS AND DESIGN: It was an applied and analytical study. SUBJECTS AND METHODS: Ninety questionnaires were distributed in Kashani hospital of Esfahan which implemented web-based PACS, and 45 usable questionnaires were returned. The questionnaire consists of scales for performance expectancy (PE), effort expectancy, facility condition, social influences, and behavioral intention (BI) and was developed by the author comparing the similar studies in which validity was confirmed by a committee of experts and the reliability was calculated using a Cronbach's α (α = 0.946). STATISTICAL ANALYSIS USED: Data were analyzed using SPSS version 20. The statistical tests for data analysis were Pearson's correlation and multiple regression analysis. RESULTS: The findings suggested a direct correlation between BI and factors of PE (P < 0.001, r = 0.788), effort expectancy (P < 0.001, r = 0.564), social influences (P = 0.001, r = 0.472), and facility condition (P < 0.001, r = 0.477). CONCLUSIONS: According to the findings, only the PE is sufficient for predict and evaluation of user behavior toward PACS. The results could be useful in terms of designing new systems and understanding users' need.