Progress of antibody-drug conjugates (ADCs) targeting c-Met in cancer therapy; insights from clinical and preclinical studies.

The cell-surface receptor tyrosine kinase c-mesenchymal-epithelial transition factor (c-Met) is overexpressed in a wide range of solid tumors, making it an appropriate target antigen for the development of anticancer therapeutics. Various antitumor c-Met-targeting therapies (including monoclonal antibodies [mAbs] and tyrosine kinases) have been developed for the treatment of c-Met-overexpressing tumors, most of which have so far failed to enter the clinic because of their efficacy and complications. Antibody-drug conjugates (ADCs), a new emerging class of cancer therapeutic agents that harness the target specificity of mAbs to deliver highly potent small molecules to the tumor with the minimal damage to normal cells, could be an attractive therapeutic approach to circumvent these limitations in patients with c-Met-overexpressing tumors. Of great note, there are currently nine c-Met-targeting ADCs being examined in different phases of clinical studies as well as eight preclinical studies for treating various solid tumors. The purpose of this study is to present a broad overview of clinical- and preclinical-stage c-Met-targeting ADCs.

A study of the effects of blended learning on university students' critical thinking: A systematic review.

One of the basic, constructive needs of humans, which plays a major part in their development is critical thinking. As education is one of the factors in shaping individuals' critical thinking, the present study addresses the effects of blended learning and its subcategories on university students' critical thinking (and its subcategories). The present article is a review study. Data were collected using valid search engines and databases. The keywords which were used included blended learning, integrated learning, blended training, integrated training, critical thinking, critical thinking disposition, and critical thinking skills, as well as the subcategories of blended learning, that is, the flex model, the self-blended model, the enriched virtual model, and the rotation model and its subcategories (the station rotation model, the lab rotation model, the flipped classroom model, and the individual rotation model). The results of 14 sources, out of the selected 15 sources, showed that blended learning and its subcategories, that is, the flex model, the self-blended model, the enriched virtual model, and the rotation model and its subcategories contribute to university students' critical thinking of disposition and skill. One of the essential skills which must be given more serious attention in learning in the twenty-first century is critical thinking. Having the benefits of both lecturing and e-learning, blended learning is a more effective and practical method for promoting critical thinking in university students.

The effect of Crocus sativus L. (saffron) herbal tea on happiness in postmenopausal women: a randomized controlled trial.

BACKGROUND: Evidence suggests that menopause can be associated with a variety of negative psychological changes such as depression and anxiety, and improving the mental health status of women during menopause is one of the important priorities and challenges of the health system. The aim of this study was to determine the effect of saffron (Crocus sativus L., Iridaceae) herbal tea on happiness in postmenopausal women. METHODS: In this randomized clinical trial which was conducted in 2021, 72 postmenopausal women were enrolled and divided into intervention and control groups. The randomization blocks method was used for random allocation, and the Oxford Happiness Questionnaire was utilized to measure the scores. The intervention included the use of 30 mg of dried stigmas of the saffron plant, which was boiled once (in the morning, in 300 ml of boiling water for 10-15 min) and consumed with white rock candy as one cup of saffron tea daily. To compare the trend of changes and after removing the effect of other variables, generalized estimating equation (GEE) was used. RESULTS: There was no significant difference between the intervention and control groups in any of the quantitative and qualitative characteristics (p > 0.05). The results of paired samples t-test showed that the happiness mean score in the intervention group increased significantly (p < 0.001) from 42.93 ± 8.54 to 61.58 ± 8.24, while in the control group, there was no significant difference between the happiness mean score at the beginning and end of the study (p = 0.861). Also, after applying the treatment program in the intervention group, there was a significant difference between the two groups in terms of the happiness mean scores (p < 0.001). CONCLUSION: Saffron herbal tea had a positive effect on reducing depression and increasing the happiness score; thus, it is recommended that it should be used as a complementary treatment in consultation with the treating physician. TRIAL REGISTRATION: The present study was registered with the code of IRCT20210403050818N1 (Registration date: 09/04/2021) in the Iranian Registry of Clinical Trials. It was also approved by the Ethics Committee of Larestan University of Medical Sciences (Approval ID: IR.LARUMS.REC.1399.017).

Changes in incidence and mortality trend due to COVID-19 in southern Iran, from 2020 to 2021: based on Cochran-Armitage trend test.

Background: In 2020, COVID-19 spread rapidly in Iran and other parts of the world. Some of the epidemiological aspects of this disease remain unknown; therefore, the present study was designed with the aim of determining the trend of incidence and mortality of COVID-19 from February 2020 to July 2021 in southern Iran. Methods: The present study was a cross-sectional analytical study that included all people who had COVID-19 in the period from February 2020 to July 2021 and whose information had been registered in the Infectious Diseases Center of Larestan city and MCMC unit. The study area included the cities of Larestan, Evaz, and Khonj, located in the south of Fars province in southern Iran. Results: Since the emergence of COVID-19 until July 2021, a total of 23,246 new cases of infection were reported in the southern region of Fars province. The average age of patients was 39.90±18.30 years and the range of ages varied from 1 to 103 years. The results of the Cochran-Armitage trend test showed that the trend of the disease in 2020 was completely upward. The first positive case of COVID-19 was recorded on February 27, 2020. The incidence curve in 2021 is sinusoidal, but in general, the results of the Cochran-Armitage trend test showed that the incidence of the disease increased significantly (P-trend < 0.001). Most cases were reported in July, April, and the end of March. Conclusion: In general, the incidence rate of COVID-19 has varied sinusoidally from 2020 to mid-2021. Although the incidence of the disease increased, the number of deaths has fallen. It seems that the increase in the number of diagnostic tests and the implementation of the national COVID-19 immunization program have been effective in changing the trend of the disease.

The effect of micro-learning on learning and self-efficacy of nursing students: an interventional study.

BACKGROUND: In the present age, e-learning has been playing a good role in educational and clinical settings along with face-to-face training. This study aimed to determine the effect of distance class using micro-learning contents on learning outcomes and self-efficacy in the clinical education of nursing students in 2021. METHODS: This research is a quasi-experimental pre-test-post-test study conducted at Shiraz University of Medical Sciences. The study population consisted of 46 nursing students who were recruited by the full census method. Students were randomly divided into two groups of intervention and control. Before and after educational interventions in both groups, students' learning and self-efficacy were evaluated using a questionnaire. Data Analysis was done using descriptive and analytical statistical methods and with SPSS software version 23. RESULTS: The results revealed a statistically significant difference in the mean score of clinical learning level of nursing students between the control and experimental groups after the intervention (p = 0.041). Also, the difference between the mean score of self-efficacy in the intervention group before and after the training was statistically significant (p = 0.001). CONCLUSION: Micro-learning is an effective training method for raising learning outcomes and self-efficacy among nursing students, especially in internship units. This method is recommended since multimedia pays attention to all learning styles of learners and affects the learning outcomes and self-efficacy of learners.

Changing Patterns in Epidemiology of Brucellosis in the South of Iran (2015-2020): Based on Cochrane-Armitage Trend Test.

BACKGROUND: Brucellosis is known in Iran as an endemic disease; however, its incidence is not the same in all provinces and is higher in some areas. OBJECTIVE: The present study was designed to determine the epidemiological status and trend of brucellosis in the period from 2015 to 2020 in the south of Fars province, Southern Iran. METHODS: This is a cross-sectional analytical study. This study included all patients with brucellosis in the period from 2015 to 2020 whose information had been registered in the Infectious Diseases Center of Larestan city. To collect the data, we used a checklist that included information such as age, gender, number of cases by year and month, occupation, and nationality of the patients with brucellosis. The rate of brucellosis incidence during these years was analyzed using the Cochran-Armitage trend test. P-value less than 0.05 was considered significant. RESULTS: The average annual incidence of the disease was 8.94 per 100 000 population. It has decreased from 26.83 (per 100 000 people) in 2015 to 1.83 (per 100 000 people) in 2020. The results of Cochrane-Armitage process test showed that the reduction in the incidence of the disease from 2015 to 2020 was significant (PTrend = 0.001). The trend of the disease by month also showed that the majority of cases occurred between December and February, with the highest incidence of the disease in February (9.93 per 100 000 people) and the lowest in May (1.1 per 100 000 people) (P = 0.001). CONCLUSION: Although the results of the present study indicated a decrease in the incidence of the disease in the southern region of Fars province, due to the fact that the disease is common between humans and livestock, there is the possibility of scattered and irregular epidemics in each period.

Zinc in depression: From development to treatment: A comparative/ dose response meta-analysis of observational studies and randomized controlled trials.

BACKGROUND: A previous meta-analysis suggested that zinc status may be linked to depression status. However, it remains unclear whether zinc status can predict the risk of depression development, or whether the monotherapy of zinc is superior to the combination of zinc supplementation and antidepressant medications in the treatment of depression. Therefore, this meta-analysis aimed to clarify the impact of zinc status and supplementation on depression development and status across all available evidence. METHODS: PubMed, EMBASE, Scopus, and ISI web of science were searched, up to 14 May 2020, for relevant publications. Pooled relative risks (RRs) with 95% confidence intervals (CI) in observational studies, and mean and standard deviation (SD) for the change in depression score in RCTs were calculated using a random-effects model. RESULTS: The meta-analysis of RCTs indicated that zinc supplementation significantly lowered depressive symptom scores of depressed patients [weighted mean difference (WMD = -4.15 point; 95% CI: -6.56, -1.75 point; P < 0.01)], and the improvement in depression status occurred only when zinc supplementation was prescribed as a monotherapy. The cohort studies showed that the highest level of zinc intake was associated with a 28% reduced risk of depression (RR: 0.66; 95% CI: 0.50, 0.82; I2 = 13.90). Dose-response analyses revealed a significant non-linear effect of baseline mood status on depression score. CONCLUSION: Current evidence from observational studies and RCT's supports the potential benefits zinc to reduce the risk of, and alleviate, depression. However, further trials are needed to confirm the beneficial effect of zinc as a monotherapy versus adjunctive therapies.

Effect of Hypnotism on the Severity of Gastrointestinal Symptoms and Quality of Life in Individuals With Irritable Bowel Syndrome.

The current study aimed to determine the effects of hypnotism on the severity of gastrointestinal symptoms and quality of life in individuals with irritable bowel syndrome (IBS). This trial study was conducted on 100 people with IBS in Shiraz, Iran. Hypnotism of participants was performed in 1-hour sessions for the intervention group at Weeks 4 and 6. A demographic characteristic questionnaire, Gastrointestinal Symptom Rating Scale, and IBS Quality of Life Index were used for data collection. The severity of gastrointestinal symptoms of participants in the intervention group significantly improved at 6 and 15 weeks after hypnotherapy. These individuals also had a significantly better quality of life after 15 weeks of hypnotherapy. Hypnotherapy may be beneficial in reducing gastrointestinal symptoms and improving quality of life in individuals with IBS. Combining this method with medicinal treatments could be effective for patients and health systems. [Journal of Psychosocial Nursing and Mental Health Services, 60(5), 55-62.].

The effect of training program based on health belief model on burn prevention knowledge in mothers of children aged to 1-3 years: A randomized controlled.

PURPOSE: One of the effective models in health education is the health belief model that considers a person's behavior as a under the influence of knowledge and attitude. In the present study, we investigated the efficacy of a training program based on the health belief model in burn prevention knowledge in mothers of children aged between 1 and 3 years old. DESIGN AND METHODS: This single blind randomized Control Trial study was conducted on 64 mothers with a child aged between 12 and 36 months who were referred to the Health Centers of Shiraz, Iran, in 2018. Accordingly, using cluster sampling, 4 health centers were selected and then 2 centers were assigned to the intervention group and 2 other centers to the control group by randomization. The intervention group received six sessions of training. However, in order to observe the ethical principles, the educational content was provided to the control group at the end of the present study. Both groups completed health belief model questionnaire before, after the intervention, and by passing 2 months from the intervention. The collected data were compared between the two groups using SPSS software, version 25. RESULTS: We found no differences in the demographics of the two study groups (P > 0.05). Intragroup comparison in the intervention and control groups indicated a significant difference among the three intervals (both P = 0.001). As well, a difference was found between the intervention and the control groups immediately after the intervention and 2 months after the intervention (both P < 0.001). Additionally, in both groups, the relationship between mothers' knowledge score and each dimension of the health belief model was examined, which was a significant. (P = 0.001). CONCLUSION: Health belief model can be considered as an effective method for educating mothers in terms of the prevention of children's burn and the increased the mothers' knowledge. PRACTICE IMPLICATIONS: The health belief model was shown to have a good effect on educating mothers regarding child burn's prevention. So, due to this reason, it is recommended to use this model for burn's prevention training programs.

The effect of vitamin C supplementation on mood status in adults: a systematic review and meta-analysis of randomized controlled clinical trials.

OBJECTIVE: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to clarify the effect of vitamin C supplementation on mood in both depressed and non-depressed populations. METHODS: A systematic search of PubMed, EMBASE, ISI web of science and Scopus databases was conducted, from inception to 1 March 2020. Random-effects meta-analyses were used to estimate the effect size (as Hedge's g) of vitamin C supplementation on depressive symptoms. RESULTS: Finding from 10 trials with 836 participants revealed no significant improvement in mood status in overall analysis (n = 10, Hedge's g = 0.09; 95% confidence interval: -0.15 to 0.33; P = 0.465). However, subgroup analysis showed beneficial effects of vitamin C supplementation in patients who were not prescribed antidepressants (subclinical depressed) (n = 5, Hedge's g: -0.18; 95% CI: -0.35, -0.01, P = 0.041; I2 = 0.00%,). CONCLUSIONS: Although no significant effect on mood status was observed in overall population, this meta-analysis tentatively suggests that vitamin C may produce mood-elevating effects in patients with subclinical depression. Further research is recommended to reach a firm conclusion. PROTOCOL REGISTRATION: The study protocol was registered in the international prospective register of systematic reviews database (http://www.crd.york.ac.uk/PROSPERO, registration no: CRD42018086677).

Protective effects of pharmacological agents against aminoglycoside-induced nephrotoxicity: A systematic review.

Introduction: Aminoglycosides have been long used for antibacterial treatment and are still commonly used in clinical practice. Despite their extensive application and positive effects, drug-related toxicity is considered as the main obstacle for aminoglycosides. Aminoglycosides induce nephrotoxicity through the endocytosis and accumulation of the antibiotics in the epithelial cells of proximal tubule. Most importantly, however, a number of pharmacological agents were demonstrated to have protective activities against nephrotoxicity in experimental animals.Areas covered: In the present systematic review, the authors provide and discuss the mechanisms and epidemiological features of aminoglycoside-induced nephrotoxicity, and focus mainly on recent discoveries and key features of pharmacological interventions. In total, 39 articles were included in this review.Expert opinion: The majority of studies investigated gentamicin-induced nephrotoxicity in animal models. Antioxidants, chemicals, synthetic drugs, hormones, vitamins, and minerals showed potential values to prevent gentamicin-induced nephrotoxicity. Indicators used to evaluate the effectiveness of nephroprotection included antioxidative indexes, inflammatory responses, and apoptotic markers. Among the nephroprotective agents studied, herbs and natural antioxidant agents showed excellent potential to provide a protective strategy against gentamicin-induced nephrotoxicity.

Correction: The effects of melatonin supplementation on blood pressure in patients with metabolic disorders: a systematic review and meta-analysis of randomized controlled trials.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Role-play versus lecture methods in community health volunteers.

BACKGROUND: Considering the key role of health volunteers in promoting community's health, their effective training is of particular importance. Training can be more effective through cooperative and learner-centered methods. Role-play is among the cooperative methods with numerous advantages. Considering the positive impact of training via various methods, we aimed to compare training through role-play and lecture on health volunteers' health knowledge in selected comprehensive health centers of Shiraz, Iran. METHODS: This quasi-experimental study was conducted on all health volunteers in four comprehensive health centers selected via random cluster sampling during the second half of 2017. The participants were divided into intervention and control groups and took part in the pretest based on the book entitled "Promotion of Breastfeeding". Based on the pretest results, health volunteers trained the participants in three educational sessions. The two groups were evaluated again immediately and two months after the intervention. RESULTS: The mean age of the participants was 49.97 ±â€¯8.1 and 46.52 ±â€¯10.74 years in intervention and control groups, respectively. Most participants were married (94.8%) and had diplomas (92.1%).A significant difference was seen between both groups in knowledge scores at the three time points (P < 0.001). A significant difference was found between the two groups regarding knowledge scores immediately and two months after the intervention (P < 0.001), indicating the effectiveness of training through role-play. CONCLUSION: The advantages of role-play, including development of communication skills and active listening, resulted in the learners' enthusiasm and motivation. This method was accompanied with higher educational output as well as longer knowledge persistence. Role-play increased cooperation and group discussions performed after the role-play promoted the transfer emotional experiences.

The effects of melatonin supplementation on blood pressure in patients with metabolic disorders: a systematic review and meta-analysis of randomized controlled trials.

The current systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to evaluate the potential effect of melatonin supplementation on blood pressure in patients with metabolic disorders. The following databases were searched until June 2018: PubMed, MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. Two reviewers independently assessed the eligibility of retrieved studies, extracted data from included trials, and evaluated the risk of bias of included studies. Statistical heterogeneity was tested using Cochran's Q test and I-square (I2) statistic. Data were pooled using random-effect models and standardized mean difference (SMD) was considered as the effect size. Eight RCTs, out of 743 potential citations, were eligible to be included in the current meta-analysis. The pooled findings indicated a significant reduction in systolic (SBP) (SMD = -0.87; 95% CI, -1.36, -0.38; P = 0.001; I2: 84.3) and diastolic blood pressure (DBP) (SMD = -0.85; 95% CI, -1.20, -0.51; P = 0.001; I2: 68.7) following melatonin supplementation in individuals with metabolic disorders. In summary, the current meta-analysis demonstrated that melatonin supplementation significantly decreased SBP and DBP in patients with metabolic disorders. Additional prospective studies are recommended using higher supplementation doses and longer intervention periods to confirm our findings.

Lived Experiences of Iranian Nurses Caring for Brain Death Organ Donor Patients: Caring as "Halo of Ambiguity and Doubt".

BACKGROUND: Brain death is a concept in which its criteria have been expressed as documentations in Harvard Committee of Brain Death. The various perceptions of caregiver nurses for brain death patients may have effect on the chance of converting potential donors into actual organ donors. OBJECTIVE: The present study has been conducted in order to perceive the experiences of nurses in care-giving to the brain death of organ donor patients. METHODS: This qualitative study was carried out by means of Heidegger's hermeneutic phenomenology. Eight nurses who have been working in ICU were interviewed. The semi-structured interviews were recorded bya tape-recorder and the given texts were transcribed and the analyses were done by Van-Mannen methodology and (thematic) analysis. RESULTS: One of the foremost themes extracted from this study included 'Halo of ambiguity and doubt' that comprised of two sub-themes of 'having unreasonable hope' and 'Conservative acceptance of brain death'. The unreasonable hope included lack of trust (uncertainty) in diagnosis and verification of brain death, passing through denial wall, and avoidance from explicit and direct disclosure of brain death in patients' family. In this investigation, the nurses were involved in a type of ambiguity and doubt in care-giving to the potentially brain death of organ donor patients, which were also evident in their interaction with patients' family and for this reason, they did not definitely announce the brain death and so far they hoped for treatment of the given patient. Such confusion and hesitance both caused annoyance of nurses and strengthening the denial of patients' family to be exposed to death. CONCLUSION: The results of this study reveal the fundamental perceived care-giving of brain death in organ donor patients and led to developing some strategies to improve care-giving and achievement in donation of the given organ and necessity for presentation of educational and supportive services for nurses might become more evident than ever.

The students' intentions and satisfaction with the field of study and university.

INTRODUCTION: The present study aimed to find an appropriate method to inform senior high school students to correctly select their academic field of study and their intentions. METHODS: This is a descriptive-analytic and cross-sectional study. A verified questionnaire was given to a total of 2600 students selected by stratified random sampling method (ten different colleges and entrance year from the 1(st) to 4(th) are considered as the strata). The position of the present field of study (major) among the list of the fields in the entrance exam was asked. The students' methods of familiarity with different fields of study in Shiraz University of Medical Sciences (SUMS), the reasons for their selection, the students' motivation and insistence on studying in the same field and university were asked in the questionnaire. Data were analyzed using independent two samples t-test, Analysis of Variance (ANOVA) and Chi-Square test. RESULTS: The most significant references for university field selection were high school teachers, the students' parents and the adjacency of university to one's living place. Also, the results revealed the good reputation of SUMS in the first year and its downward trend during the following years. 59.4% of the 1(st) year students were satisfied with their field of study and SUMS. 31.8% were satisfied with the university but not with their fields of study. 6.4% were dissatisfied with the university but not with their fields of study. 2% of the students were dissatisfied with both their fields of study and university. Dissatisfaction with SUMS and field of study increased little by little so that the results obtained among the students who had entered the university earlier (in the 4(th) year of their study) showed nearly 16.3% dissatisfaction with both the university and the study fields.   CONCLUSION: The methods for introducing the university are recommended to be revised.

Students' readiness for and perception of inter-professional learning: a cross-sectional study.

BACKGROUND: Inter-professional education is a critical pedagogical approach aiming at preparing healthcare students for providing patient care in a collaborative team atmosphere. OBJECTIVES: To investigate the readiness for and perception of inter-professional learning and their relationship among healthcare students. DESIGN: It was a correlational, cross-sectional study. PARTICIPANTS: Two hundred and fifty undergraduate medical, B.Sc. nursing, and B.Sc. science in surgical technology students participated in this study. SETTING AND SAMPLES: The samples were selected from the colleges affiliated to Shiraz University of Medical Sciences using stratified random sampling. METHODS: The Readiness for Inter-Professional Learning Scale (RIPLS) and Interdisciplinary Education Perception Scale (IEPS) were used to measure the readiness for and perception of inter-professional leaning. The data were analyzed using One-way Analysis of Variance (ANOVA) and independent sample T-test. RESULTS: The total mean scores of readiness for and perception of inter-professional learning were 82.40 (SD=23.16) and 74.04 (SD=14.26), respectively. Besides, the medical students' total mean score of readiness was significantly lower than that of the nursing and science in surgical technology students (F=76.73, P<0.0001). The results showed a significant difference between the current years of study regarding RIPLS and IEPS (P<0.0001). Also, a significant difference was demonstrated among the three fields concerning IEPS and its four subscales. Moreover, the total score of RIPLS was associated with that of IEPS (r=0.43, P<0.0001). CONCLUSION: This study indicated that the medical students had the lowest RIPLS. In addition, the nursing students reported the lowest IEPS; therefore, this group's curriculum is suggested to be revised. For evidence based practice, other studies are recommended to improve inter-professional learning.