In silico identification and in vitro evaluation of MRPS30-DT lncRNA and MRPS30 gene expression in breast cancer.

BACKGROUND: It has been reported that long non-coding RNAs (lncRNAs) can play important roles in a variety of biological processes and cancer regulatory networks, including breast cancer. AIMS: This study aimed to identify a novel upregulated lncRNA in breast cancer and its associated gene using bioinformatics analysis, and then evaluate their potential roles in breast cancer. METHODS AND RESULTS: Extensive in silico studies were performed using various bioinformatics databases and tools to identify a potential upregulated breast cancer-associated lncRNA and its co-expressed gene, and to predict their potential roles, functions, and interactions. The expression level of MRPS30-DT lncRNA and MRPS30 was assessed in both BC tissues and cell lines using qRT-PCR technology. MRPS30-DT lncRNA and MRPS30 were selected as target genes using bioinformatics analysis. We found that MRPS30-DT and MRPS30 were significantly overexpressed in BC tissues compared with normal tissues. Also, MRPS30 showed upregulation in all three BC cell lines compared with HDF. On the other hand, MRPS30-DT significantly increased in MDA-MB-231 compared with HDF. While the expression of MRPS30-DT was significantly dropped in the resistance cell line MCF/MX compared to HDF and MCF7. Moreover, bioinformatics analysis suggested that MRPS30-DT and MRPS30 may play a potential role in BC through their involvement in some cancer signaling pathways and processes, as well as through their interaction with TFs, genes, miRNAs, and proteins related to carcinogenesis. CONCLUSIONS: Overall, our findings showed the dysregulation of MRPS30-DT lncRNA and MRPS30 may provide clues for exploring new therapeutic targets or molecular biomarkers in BC.

Deregulation of miR-1245b-5p and miR-92a-3p and their potential target gene, GATA3, in epithelial-mesenchymal transition pathway in breast cancer.

BACKGROUND: MicroRNAs (miRNAs) are small molecules that have prominent roles in tumor development and metastasis and can be used for diagnostic and therapeutic purposes. This study evaluated the expression of miR-92a-3p and miR-1245b-5p and their potential target gene, GATA3 in patients with breast cancer (BC). MATERIALS AND METHODS: In the search for BC-related microRNAs, miR-124b-5p and miR-92a-3p were selected using Medline through PubMed, miR2disease, miRcancer and miRTarBase. Moreover, target gene GATA3 and their possible interaction in the regulating epithelial-mesenchymal transition (EMT) and invasion was evaluated using in silico tools including miRTarBase, TargetScan, STRING-db, and Cytoscape. The expression level of miR-92a-3p, miR1245b-5p, and GATA3 were assessed on extracted RNAs of tumor and nontumor tissues from 36 patients with BC using qPCR. Additionally, clinical-pathologic characteristics, such as tumor grade, tumor stage, lymph node were taken into consideration and the diagnostic power of these miRNAs and GATA3 was evaluated using the ROC curve analysis. RESULTS: In silico evaluation of miR-92a-3p and miR-1245b-5p supports their potential association with EMT and invasion signaling pathways in BC pathogenesis. Comparing tumor tissues to nontumor tissues, we found a significant downregulation of miR-1245b-5p and miR-92a-3p and upregulation of GATA3. Patients with BC who had decreased miR-92a-3p expression also had higher rates of advanced stage/grade and ER expression, whereas decreased miR-1245b-5p expression was only linked to ER expression and was not associated with lymph node metastasis. The AUC of miR-1245b-5p, miR-92a-3p, and GATA3 using ROC curve was determined 0.6449 (p = .0239), 0.5980 (p = .1526), and 0.7415 (p < .0001), respectively, which showed a significant diagnostic accuracy of miR-1245b-5p and GATA3 between the BC patients and healthy individuals. CONCLUSION: MiR-1245b-5p, miR-92a-3p, and GATA3 gene contribute to BC pathogenesis and they may be having potential regulatory roles in signaling pathways involved in invasion and EMT pathways in BC pathogenesis, as a result of these findings. More research is needed to determine the regulatory mechanisms that they control.

Experiences of Mothers Receiving Donated Embryos.

Background: The efficacy of Assisted Reproductive Techniques (ARTs) or technologies used to treat infertile couples has been approved. One such technique is embryo donation. However, there is insufficient knowledge of the experiences of mothers receiving donated embryos. Thus, the present study was conducted with the aim to determine the experiences of mothers receiving donated embryos. Materials and Methods: This qualitative conventional content analysis study was conducted in 2018 for 8 months (from February to September). The research setting was Royan Institute. Mothers receiving donated embryos were selected from among those who were pregnant or were at the postpartum stage using the purposive sampling method. A total of 15 interviews were performed with 13 participants. The qualitative data were collected using deep unstructured interviews and analyzed using the Graneheim and Lundman (2004) method in (version 10; VERBI GmbH, Berlin, Germany) software. Results: Data analysis resulted in 412 open codes that were then categorized into 7 main categories and their subcategories. The main categories were as follows: sociocultural constraint, feeling of insecurity in personal and family identity, protection of personal and family identity, confounded support, pressure and hardship, and achieving relative tranquility. Conclusions: The results of this study showed that the mothers who underwent embryo donation experienced feelings of insecurity regarding both individual and family identities, were confronted with sociocultural difficulties, and faced various pressures. It is suggested that future care plans be focused on the identity crisis of these families and the children resulting from these methods, and that future plans balance the socioeconomic pressures resulting from the use of these methods.

Awareness of Polycystic Ovary Syndrome among Schoolgirls and Their Mothers: A Cross-Sectional Study.

BACKGROUND: One of the most common endocrine disorders of reproductive age women is polycystic ovary syndrome (PCOS). Women with PCOS are at risk for infertility, endometrial cancer, metabolic disorders, and cardiovascular disease. Awareness of the signs and symptoms of PCOS can be effective in diagnosing early stage PCOS and promoting quality of life (QoL). This study assesses the awareness of PCOS in schoolgirls and their mothers. MATERIALS AND METHODS: This cross-sectional study was carried out on 1580 high school girls and 480 of their mothers in Tehran (capital of Iran) in 2017 and 2018. We used the stratified sampling method and divided Tehran into five geographic regions: north, south, east, west, and central. Schools were randomly selected from each of these regions. Students and their mothers separately answered a self-administered questionnaire that pertained to their knowledge of PCOS. Statistical analyses were carried out with SPSS, version 22 (Inc. Chicago, IL, USA) and R version 3.2.1. RESULTS: Students had an average age of 16.97 ± 0.84 years and their mothers' average age was 45.19 ± 5.03 years. The average body mass index (BMI) of the students was 22.01 ± 5.54 kg/m2. The results of this study showed that only 48 students (3.2%) and 148 mothers (27%) had acceptable knowledge about PCOS. The knowledge of students about PCOS was positively related to their mothers' knowledge about PCOS (P<0.001). CONCLUSION: The level of PCOS awareness in Iranian women is insufficient and this may affect their QoL. Therefore, the health authorities should implement educational programs to challenge women's incorrect beliefs about PCOS and increase their awareness of this disease.

Evaluation of the Relative Frequency of Epstein-Barr Virus Infection in Patients with Recurrent Breast Cancer Compared with Patients with Nonrecurrent Breast Cancer.

Background: The roles of Epstein-Barr virus (EBV) in breast cancer and breast lymphoma by transfecting EBV DNA have been indicated in different studies, but few investigations have been conducted on its roles in recurrence of breast cancer. Here, we aimed to evaluate the roles of EBV in recurrent breast cancer tissue. Materials and Methods: This is a cross-sectional retrospective study that was performed in 2020-2021 in Isfahan on patients with breast cancer. The study population consisted of 30 tissue samples from recurrent breast cancer and 30 samples from nonrecurrent breast cancer. We collected demographic data of patients including age using a checklist. Other collected data were type of cancer, stages of cancer, tumor size in greatest dimension, lymph node involvements, and presence of metastasis. Furthermore, we evaluated all of the pathology samples from both groups for the presence of DNA of EBV and compared the data of both groups. Results: The DNA of EBV was positive in 8 patients of the relapsed group (26.6%) and 7 patients in the nonrelapsed patients (23.3%). There was no significant difference between two groups regarding positive DNA of EBV (P = 0.39). There were no significant differences between two groups of positive DNA of EBV with and without recurrent breast cancer regarding type of cancer (P = 0.63), stage of cancer (P = 0.19), tumor size in greatest dimension (P = 0.31), mean lymph node involvement (P = 0.27), number of lymph node involvement (P = 0.43), and metastasis (P = 0.69). Conclusion: EBV might have no significant role in recurrence of breast cancer.

Investigating the role of defense mechanisms on marital adjustment in infertile couples based on the cause of infertility: A cross-sectional study.

Background: Infertility affects individual's and couples' adjustment. The defense mechanism and marital adjustment are mental processes that play a key role in infertile couples' life. Objective: This study aims to investigate the role of defense mechanisms on marital adjustment in infertile couples based on the cause of infertility. Materials and Methods: This cross-sectional study was conducted on 400 infertile couples at Royan Institute (A referral center for infertility, Tehran, Iran). Infertile couples were divided into 4 groups based on the cause of infertility (female, male, both, and unknown). Demographic questionnaire, revised dyadic adjustment scale, and defense styles questionnaire were used for data collection. Results: Results showed that the mean score of marital adjustment of men based on the cause of infertility (female, male, and both) was significantly higher in comparison with their wives (p = 0.04, p ≤ 0.001, p ≤ 0.001, respectively). However, no difference was observed between the mean score of women, men, and couples (women and husbands) in defense mechanisms. But marital adjustment has a significant positive correlation with mature defense mechanisms and a negative correlation with immature ones (p < 0.05). Conclusion: The mean score of marital adjustment is higher in men than in their wives in all groups. So, counseling infertile couples in the field of marital adjustment and training in the use of mature defense mechanisms is recommended especially in women.

Colocolic Intussusception Because of Lipoma in a 44-year-Old Adult.

Lipoma is an uncommon mesenchymal tumor of the colon. They are typically symptom free, the large lipomas within the colon are rare, and can cause obstruction, bleeding, or intussusception. Intussusception is comparatively common in pediatrics and in adults, it could be a rare entity. Pathologic lesions are usually found with a major percentage of malignancy. This is a retrospective evaluation of an adult with an intestinal intussusception who underwent oncosurgical treatment. He was diagnosed with surgically proven intussusception. Using ultrasound and colonoscopy as diagnostic studies, colocolic intussusception was discovered. The patient underwent oncosurgical exploration. Intestinal resection with abrupt anastomosis was the procedure of choice for the patient. The etiology was benign lipoma. Adult intussusception should be evaluated in any patient with subacute abdominal discomfort with bearing in mind the high rate of malignancy and a lower rate of benign tumors. intestinal resection without reducing is highly recommended for colonic intussusceptions.

Awareness and attitude toward oocyte cryopreservation for non-medical reasons: a study on women candidates for social egg freezing.

PURPOSE: The present study was to investigate awareness and attitudes toward female fertility and aging, desire for a child and motherhood, and oocyte freezing for non-medical reasons among women candidates for Social Egg Freezing (SEF). MATERIALS AND METHODS: This was a cross-sectional study on all 216 women who sought oocyte cryopreservation for nonmedical reasons at Royan Institute. A 24-item self-administered questionnaire measured knowledge and attitudes to SEF. Responses were as yes/no or a 4-point Likert scale. RESULTS: Only 40% of participants accurately indicated that having a sexual partner does not help to preserve their fertility. A quarter of women correctly recalled chance of pregnancy with unprotected intercourse during a period of a year, for women 20 to 40 years old. Only one-third of respondents accurately identified the age-related fertility decline at 35-39 years. Only 6.9% correctly mentioned the low chance of pregnancy after egg freezing at 35 years old. Almost a third of women knew that the age range of 31-35 years is the right age to freeze an egg with the highest chance of pregnancy. Aging and health of offspring were most influential in women's decisions on SEF. CONCLUSION: In conclusion, there was significant gaps in knowledge about age-related fertility decline, and egg cryopreservation conditions and its complications. It is crucial to impart to these women a better knowledge about fertility and a realistic picture about SEF, especially on the number of high-quality retrieved mature oocytes and live birth rates depend on women's age.

Evaluation of Relative Abundance of Lymphedema after Reverse Axillary Mapping in Patients with Breast Cancer.

Background: The axillary reverse mapping (ARM) technique identifies and preserves arm nodes during sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). Here, we aimed to investigate the prevalence of lymphedema following ARM. Materials and Methods: This is a clinical trial that was performed in 2019-2020 in Isfahan on patients with breast cancer in the early stages. Demographic and initial information of all cases including age and body mass index (BMI) was collected. Patients were then underwent SLNB ± ALND associated with ARM and were followed up for lymphedema every 6 months to a year. The occurrence of lymphedema was assessed. Results: By evaluating data of 102 patients, we found that 10 patients (9.8%) had lymphedema and patients with lymphedema had significantly higher age (P = 0.004), higher BMI (P = 0.001), larger tumor size (P = 0.018), and longer surgery duration (P < 0.001). The frequency of menopausal women was higher in patients with lymphedema compared to other cases (P = 0.001). Conclusion: The prevalence of lymphedema was high among patients undergoing ARM that was associated with factors including higher age, higher BMI, prolonged surgery duration, larger tumor size, and menopause. We believe that further comparative studies should be conducted on this issue.

Factors Associated with In Vitro Fertilization Live Birth Outcome: A Comparison of Different Classification Methods.

BACKGROUND: In vitro fertilization (IVF) is a useful assisted reproductive technology to achieve pregnancy in infertile couples. However, it is very important to optimize the success rate after IVF by controlling for its influencing factors. This study aims to classify successful deliveries after IVF according to couples' characteristics and available data on oocytes, sperm, and embryos using several classification methods. MATERIALS AND METHODS: This historical cohort study was conducted in a referral infertility centre located in Tehran, Iran. The patients' demographic and clinical variables for 6071 cycles during March 21, 2011 to March 20, 2014 were collected. We used six different machine learning approaches including support vector machine (SVM), extreme gradient boosting (XGBoost), logistic regression (LR), random forest (RF), naïve Bayes (NB), and linear discriminant analysis (LDA) to predict successful delivery. The results of the performed methods were compared using accuracy tools. RESULTS: The rate of successful delivery was 81.2% among 4930 cycles. The total accuracy of the results exposed RF had the best performance among the six approaches (ACC=0.81). Regarding the importance of variables, total number of embryos, number of injected oocytes, cause of infertility, female age, and polycystic ovary syndrome (PCOS) were the most important factors predicting successful delivery. CONCLUSION: A successful delivery following IVF in infertile individuals is considerably affected by the number of embryos, number of injected oocytes, cause of infertility, female age, and PCOS.

Sexual Self-Concept in Fertile and Infertile Women: A Comparative Study.

BACKGROUND: Sexual self-concept has a considerable impact on mental and sexual health. However, the relationship between sexual self-concept and infertility is unknown. This study aimed to compare sexual self-concept between fertile and infertile women. MATERIALS AND METHODS: This cross-sectional study was conducted on a sample of 250 fertile and 250 infertile women who had referred to 9 health centers affiliated to Medical universities in Tehran and Royan infertility treatment clinics in Tehran, Iran in 2017. Sexual self-concept was measured using the Multidimensional Sexual Self-Concept Questionnaire (MSSCQ) consisting of 20 subscales. Analysis of covariance (ANCOVA) was performed to compare sexual self-concept between the two groups. RESULTS: The mean age of fertile and infertile women was 34 ± 5.62 and 29.74 ± 5.29 years, respectively. The highest score in both groups was for the sexual self-schemata subscale (mean score for fertile=3.21 ± 0.68 and for infertile= 3.42 ± 0.62). The lowest score was for sexual-depression subscale (mean score for fertile=0.59 ± 0.81 and for infertile=0.61 ± 0.76). After adjustment for the age of each subject, the husband's age, duration of marriage, and women's education, we analyzed the sexual-satisfaction, the power-other sexual control, and the fear-of-sex subscales, which were found to be significantly lower in infertile women (P<0.05). No other significant differences between the fertile and infertile groups were observed. CONCLUSION: We observed significant differences between fertile and infertile women in terms of sexual-satisfaction, the power-other sexual control, and the fear-of-sex, but not in other sexual self-concept subscales. These findings suggest that there is need to improve sexual self-concept among both fertile and infertile women. Indeed implementation of educational and counseling programs by reproductive health specialists might play an important role in enhancing sexual self-concept among these populations.

The Birth Satisfaction Scale-Revised Indicator (BSS-RI): a validation study in Iranian mothers.

OBJECTIVE: Birth Satisfaction Scale-Revised Indicator (BSS-RI) is a short selfreport instrument designed to measure satisfaction of the childbearing women's experiences of labour and its outcomes. The aim of this study was to examine the reliability and validity of the Persian version of BSS-RI in Iranian mothers. METHODS: This cross-sectional study was conducted on 396 mothers in Tehran, Iran, between July and September 2017. The mothers were administered the BSS-RI, and a demographic questionnaire. Internal consistency of the BSS-RI was examined with Cronbach's alpha, construct validity was evaluated via exploratory factor analysis (EFA), and divergent validity was examined by correlating the BSS-RI with gestational age. RESULTS: The EFA results demonstrated a two-factor structure corresponding to the Stress of Childbearing and Quality of Care domains of the structure proposed by provider. The Cronbach's alpha for Stress of Childbearing and Quality of Care subscales and total BSS-RI were 0.665, 0.847, and 0.563, respectively. The mean of BSS-RI total score was 6.16 (SD = 2.60), and the Stress of Childbearing and Quality of Care subscales were 2.71 (SD = 2.39), and 3.45 (SD = 1.11), respectively. The BSS-RI showed no significant correlation with the gestational age, confirming divergent validity. CONCLUSION: Like the original English version, the Persian version of the BSS-RI is a reliable and valid instrument for measuring birth satisfaction in Iranian mothers. It can also be used as short and easy to administer tool for assessment of birth satisfaction in large sample survey research.

Risk of gestational diabetes mellitus following assisted reproductive technology: systematic review and meta-analysis of 59 cohort studies.

OBJECTIVE: The use of assisted reproductive technology (ART) has been associated with an increased risk of gestational diabetes mellitus (GDM) in previous studies, but its risk has not been consistent. Therefore, we aimed to estimate the risk of GDM in women who conceived with ART via a systematic review and meta-analysis of cohort studies. METHODS: ISI Web of Knowledge, Medline/PubMed, Scopus, and Embase databases were searched to identify studies that evaluated the risk of GDM through May 2017 using the relevant keywords. Two reviewers independently performed the screening, data extraction, and quality assessment. Meta-analysis was performed with a random effects model. RESULTS: The search yielded 957 records relating to GDM and use of ART, from which 59 eligible cohorts were selected for meta-analysis (n = 96,785). There was evidence of substantial heterogeneity among these studies (χ(58)2 = 3072.34, p < .001; I2=98.1%). The pooled estimate of GDM risk using the random effects model was 9.00% (95% CI: 7.90-10.20). Visual inspection of the funnel plot indicated the presence of low publication bias, but Egger's test did not reveal publication bias. CONCLUSIONS: The findings revealed that the risk of GDM was very high among women who conceived with ART treatment. GDM screening, management, and improved care are vital in ART pregnancy.

Evaluation of Sexual Function Among Infertile Women and Their Sexual Self-Concept.

BACKGROUND: The present study was designed to assess the association between sexual self-concept and sexual function in infertile women. METHODS: A study with a convenience sample of women attending a referral infertility center (Royan Institute) was conducted in Tehran, Iran, in 2017. The Multidimensional Sexual Self-Concept Questionnaire (MSSCQ) and the Female Sexual Function Index (FSFI) were used to collect data. Chi-Square, t-test, Mann-Whitney U test and logistic regression were applied to analyze the data. The significance level was set at p<0.05. RESULTS: The mean age of participants was 29.7±5.2 years. Overall, 152 women (60.8%) reported that they were experiencing sexual dysfunction. Comparing women with and without sexual dysfunction, there were significant differences between two groups on most measures such as sexual anxiety, sexual motivation, sexual satisfaction, and sexual depression (p<0.05). However, the results obtained from logistic regression indicated that women's and husband's age (OR for women's age=1.26, 95% CI=1.10-1.44, p<0.001; OR for husband's age=0.86, 95% CI=0.77-0.97, p=0.014), cause of infertility (OR for female factor=9.17, 95% CI=2.26-37.2, p=0.002; OR for male factor=3.90, 95% CI=1.26-12.1, p=0.018; OR for male and female factor=3.57, 95% CI=1.12-11.4, p=0.032), sexual motivation (OR=0.35, 95% CI=0.16-0.75, p= 0.007) and sexual satisfaction (OR=0.23, 95% CI=0.09-0.56, p=0.001) were significantly associated with sexual dysfunction. CONCLUSION: The findings suggest that sexual motivation and sexual satisfaction are important dimensions of sexual self-concept in infertile women. Indeed, it is essential to inform policy makers and stakeholders to provide more sexual health support for this population in the process of treatment.

The Four-item Patient Health Questionnaire for Anxiety and Depression: A Validation Study in Infertile Patients.

BACKGROUND: The most common mental disorders in infertile patients are depression and anxiety. The four-item Patient Health Questionnaire-4 (PHQ-4) is a widely used tool that consists of the PHQ-2 depression and Generalized Anxiety Disorder-2 (GAD-2) scales. Given that PHQ-4 has not been validated in infertile patients, this study aimed to examine its reliability and validity in this population. MATERIALS AND METHODS: Participants in this cross-sectional study consisted of 539 infertile patients from a referral fertility centre in Tehran, Iran. The PHQ-4, Hospital Anxiety and Depression Scale (HADS), World Health Organisation- Five Well-Being Index (WHO-5), Penn State Worry Questionnaire (PSWQ) and demographic/infertility questionnaires were administered to all participants. Factor structure and internal consistency of PHQ-4 were evaluated via confirmatory factor analysis (CFA) and Cronbach's alpha, respectively. The convergent validity of this scale was examined by its relationship with HADS, WHO-5 and PSWQ. RESULTS: CFA results provided support for a two-factor model of PHQ-4. Internal consistency of the PHQ-4 and its subscales both were elevated with Cronbach's alpha coefficients of 0.767 (PHQ-4), 0.780 (PHQ-2) and 0.814 (GAD-2). Inter-item correlations were between 0.386 and 0.639, and corrected item-total correlations were between 0.576 and 0.687. PHQ-4, PHQ-2 and GAD-2 showed positive correlations with measures of HADS-anxiety, HADS-depression, and PSWQ and negative correlations with WHO-5, which confirmed convergent validity. Among demographic/fertility variables, we observed that gender, infertility duration, and failure in previous treatment were correlated with PHQ-4 and its subscales scores. CONCLUSION: The PHQ-4 is a reliable and valid ultra-brief screening instrument for measuring both anxiety and depressive symptoms in infertile patients.

Developing "Code of Ethics for Medical Professionals, Medical Council of Islamic Republic of Iran".

BACKGROUND: The medical profession has always been an inspiration for human societies throughout its diverse history. This position and historical authority in the field of ethics has had a different and higher status, in such a way that many of the norms of general ethics and professional ethics, especially principles, such as trust, confidentiality and respect for human dignity, have been developed by medical professionals. Developing guidelines of general and professional ethics is one of the inherent duties of the Medical Council of the Islamic Republic of Iran (IRIMC) as a professional organization. In this regard, the Supreme Council of IRIMC has approved the "Code of Ethics for Medical Professionals" and, in accordance with its legal authority, has annexed it to the disciplinary regulations of IRIMC. METHODS: A draft document, the result of extensive literature review, was discussed in 27 expert panel meetings and after receiving and endorsing the stakeholders' point of view, was approved by the IRIMC Supreme Council. RESULTS: The first edition of "Code of Ethics for Medical Professionals, Medical Council of Islamic Republic of Iran" was developed on July 6, 2017 by the Supreme Council of IRIMC. The guideline was set to take effect one year after its enactment. The first edition was revised and completed and final edition was adopted on August 9, 2018 by IRIMC in 13 chapters and 140 articles (original full text is available in the Supplementary file 1). CONCLUSION: According to the approved decision by the Supreme Council of IRIMC on May 10, 2018, the final edition takes effect as of October 7, 2018.

Ethics of research on stem cells and regenerative medicine: ethical guidelines in the Islamic Republic of Iran.

BACKGROUND: Regenerative medicine plays a major role in biomedicine, and given the ever-expanding boundaries of this knowledge, numerous ethical considerations have been raised. MAIN TEXT: Rapid advancement of regenerative medicine science and technology in Iran, emerged the Iranian National Committee for Ethics in Biomedical Research to develop a comprehensive national ethical guideline. Therefore, the present ethical guideline which comprises eleven chapters was developed in 2019 and approved in early 2020. The titles of these chapters were selected based on the ethical considerations of various aspects of the field of regenerative medicine: (1) ethical principles of research on stem cells and regenerative medicine; (2) ethical considerations for research on stem cells (embryonic stem cells, epiblast stem cells, tissue-specific stem cells, stem cells derived from transdifferentiation, induced pluripotent stem cells [iPSCs], germline pluripotent stem cells, germline stem cells, and somatic cell nuclear transfer [SCNT] stem cells); (3) ethical considerations for research on somatic cells in regenerative medicine (adult somatic cells, fetal tissue somatic cells, and somatic cells derived from pregnancy products [other than fetus]); (4) ethical considerations for research on gametes in regenerative medicine; (5) ethical considerations for research related to genetic manipulation (human and animal) in regenerative medicine; (6) ethical considerations for research on tissue engineering in regenerative medicine; (7) ethical considerations for pre-clinical studies in regenerative medicine; (8) ethical considerations for clinical trials in regenerative medicine; (9) ethical considerations for stem cells and regenerative medicine bio-banks; (10) ethical considerations for privacy and confidentiality; and (11) ethical considerations for obtaining informed consent. CONCLUSION: This article discusses the process of developing the present ethical guidelines and its practical points. We hope that it can play an important worldwide role in advancing ethics of research on stem cells and regenerative medicine.

The heel amelanotic melanoma, a rare subtype of skin cancer misdiagnosed as foot ulcer: A case report.

Amelanotic melanoma (AM) of the heel is a very rare subtype of malignant melanoma in which the tumour cells, unlike other types of melanoma, are characterised by little or no melanin pigmentation. AM resembles many benign dermatological complications that often lead to late diagnosis of lesions, poor prognosis, and occasionally misdiagnosis at an early stage of the disease. We report a case of a 73-year-old man with a heel ulcer who was admitted to Al-Zahra Hospital (Isfahan, Iran). Chronic osteomyelitis was considered the primary diagnosis, and several courses of antibiotics were prescribed for the patient. The ulcer failed to improve after 9 months' of therapy, and because of an increase in the size of the ulcer and the growth of two tumours in the right heel, a biopsy of the lesion was conducted. The pathology report confirmed invasive AM. The present report emphasises the necessity to biopsy all skin lesions, even with low clinical significance, to avoid wrong subsequent treatments, prevent a delay in diagnosis, reduce misdiagnosis, and improve the survival rate of patients.