Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 4 2023 07 04 195 203 EN Andréia Alcântar Department of Animal Bioscience, Federal Rural University of Pernambuco, Pernambuco, Brazil Ivan Barros Department of Computer Engineering, Institute of Education and Research, São Paulo, Brazil Luiz Prazeres Department of Medicine, Federal University of Alagoas, Alagoas, Brazil Ivan Barros Department of Mathematics, Federal University of Pernambuco, Pernambuco, Brazil Maria Diniz https://orcid.org/0000-0001-5893-455X Paulo Souza Souza Department of Animal Bioscience, Federal Rural University of Pernambuco, Pernambuco, Brazil 2020 11 09 2023 01 15 Knowledge of other Coronaviruses has contributed to the development of a vaccine for the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2). As soon as the genetic sequence of SARS-CoV-2 was released, intense global activity around different vaccine platform technologies started. Among these platforms, the viral vectored chimpanzee adenovirus Oxford1 (ChAdOx1)-previously studied for various indications, including for the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) vaccine, and currently is adapted for the ChAdOx1 nCoV-19 (novel Coronavirus-19). Therefore, this systematic review aimed to investigate the potential of the ChAdOx1 platform for the development of a vaccine for SARS-CoV and MERS-CoV, the Lethal Human-Coronaviruses (Lh-CoVs). For this purpose, a highly sensitive literary search was conducted through electronic databases that reached 1,445 related articles, of which, eight articles were elected according to previous eligibility criteria. The gathering of the articles demonstrated that the previous approaches, referring to the ChAdox1 platform, have contributed to the development of vaccines against Lh-CoVs and, that thus far, ChAdOx1 (nCoV-19 and MERS) vaccines are safe and immunogenic. However, it is important to emphasize that further studies are needed to ensure the effectiveness of vaccines in humans. https://acta.tums.ac.ir/index.php/acta/article/view/8931 https://acta.tums.ac.ir/index.php/acta/article/download/8931/5769

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 4 2023 07 04 204 210 Wasiu Olooto Department of Chemical Pathology and Immunology, Olabisi Onabanjo University, Ago-Iwoye, Ogun, Nigeria Hammed Adenusi Department of Chemical Pathology and Immunology, Olabisi Onabanjo University, Ago-Iwoye, Ogun, Nigeria Joseph Soola Department of Physiology, Olabisi Onabanjo University, Ago-Iwoye, Ogun, Nigeria Monisola Ayodele Department of Chemical Pathology and Immunology, Olabisi Onabanjo University, Ago-Iwoye, Ogun, Nigeria Frank Agidigbi School of Medical Laboratory Technology, Baptist Medical Center, Saki, Nigeria 2021 03 26 2023 01 21 Accurate diagnosis of the cause of infertility assists in the choice of treatment modalities and amelioration of the associated psychosocial problems. The research was carried out using 75 infertile males and 75 males with proven fertility as controls. The anthropometrics (weight, height) were measured and body mass index (BMI) computed. Venous blood was collected from each participant, allowed to clot, and centrifuged to obtain the serum which was analysed for testosterone, follicle stimulating hormone (FSH) and luteinizing hormone (LH) concentrations. Semen was collected by masturbation and analysed for sperm quality, seminal fructose concentration, and histone deacetylase (HDAC) activities. A non-significant difference (P>0.05) in weight, height, and BMI; a significant increase (P<0.05) in ejaculated volume, serum LH, FSH, seminal fructose concentrations and HDAC activities; and a decrease in sperm count, sperm motility, serum testosterone concentration was observed among subgroups of infertile men. A direct and significant correlation exists between seminal HDAC activities and fructose concentration. Also, an inverse non-significant correlation exists between HDAC activities and spermatozoa motility. Base on the result obtained from this study, it can be concluded that measuring seminal fructose and HDAC activities in addition to routine biochemical and biophysical parameters will assist in diagnostic work up in subgroups of male infertility. https://acta.tums.ac.ir/index.php/acta/article/view/9261 https://acta.tums.ac.ir/index.php/acta/article/download/9261/5770

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 4 2023 07 04 211 215 Hengameh Mojdeganlou Department of Pathology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran Ata Abbasi Department of Pathology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran .AND Hematology, Immune Cell Therapy and Stem Cells Transplantation Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran Rahim Asghari Hematology, Immune Cell Therapy and Stem Cells Transplantation Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran 2021 03 03 2023 01 22 Multiple myeloma (MM) is a hematologic malignancy with a variable clinical course. We investigated the prognostic role of routine laboratory factors including CBC indices and serum vitamin D levels to predict MM recurrence after receiving an autologous stem cell transplant (ASCT). 29 patients were enrolled. Before ASCT, demographic data and CBC, serum Cr, and Vit D levels were obtained. Patients underwent bone marrow aspiration (BMA) and biopsy (BMB) before ASCT and pretransplant plasma cell counts were also evaluated. Patients were followed for 6 months and BMA and biopsy were done in the 3rd and 6th month of the follow-up to detect recurrence. Overall, 9 patients were reported to have recurrence. The patient's WBC count mean was 13.3±11.6. WBC count was lower in patients with overall recurrence (P=0.005). Patients were divided into 2 groups according to WBC count (<5.5 109/L and ≥5.5 109/L) and we found that WBC count <5.5 109/L was associated with increased risk of recurrence by 15.2 times (Odds ratio: 15.2, 95%CI: 1.4-168, P=0.005). We also evaluated Wbc to Hb ratio (Wbc/Hb) and found that Wbc/Hb <1 had a significant statistical relationship with overall recurrence (P=0.026) as patients with WBC/Hb <1 were in 9.8 times increased risk of recurrence (Odds ratio:9.8, 95% CI: 2-93.5, P=0.026). pretransplant WBC <5.5 109/L and WBC/Hb <1 were associated with 9.8 and 15.2 times increased risk of myeloma recurrence and could be useful predictive factors for a patient's short-term recurrence. https://acta.tums.ac.ir/index.php/acta/article/view/9209 https://acta.tums.ac.ir/index.php/acta/article/download/9209/5772

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 4 2023 07 04 216 222 EN Tina Daneshrad Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran Ezzatollah Fathi Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran Raheleh Farahzadi Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran 2021 02 21 2023 01 21 Many studies have shown that bone marrow (BM) stem/progenitor cells have the highest probability of cardiomyocyte differentiation. Regarding the major role of C-kit+ BM stem cells in cell therapy of patients with heart disease and getting cells with higher differentiation potential, this study aimed to investigate the capacity and effect of L-carnitine (LC) on cardiomyogenic differentiation of C-kit+ BM cells through MAPK/ERK signaling pathway. For this purpose, C-kit+ was enriched from the BM mononuclear cell population using a magnetic activating cell sorting technique. The purity of the separated C-kit+ cells was then evaluated by flow cytometry. In the next step, C-Kit+ cells were treated in a cardiomyogenic differentiation culture medium for 21 days once in the presence and once in the absence of 0.2 µM LC (the experimental and control groups). To evaluate the cardiomyogenic differentiation potential of C-kit+ cells, the Desmin cell marker was determined by immunocytochemistry. The expressions of both GATA4 and ERK proteins were measured using western blotting and flow cytometry, respectively. The results show that 95.7 percent of the cells separated by the MACS technique expressed a C-kit+ cell marker. Additionally, it was found that 0.2 mM LC significantly increased the expression of GATA4 protein in the cardiomyogenic differentiated cells. The expression of ERK protein also suggested a significant increase of about 1.60 times in the experimental group in comparison with the control group (*P˂0.05). In brief, it was found that treating C-kit+ BM cells with LC increases cardiomyogenic differentiation by increasing the expression of GATA4. Notably, this effect can take place through MARK/ERK signaling pathway. The results of this research can be valuable in suggesting a treatment solution for cardiovascular diseases. https://acta.tums.ac.ir/index.php/acta/article/view/9184 https://acta.tums.ac.ir/index.php/acta/article/download/9184/5773

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 4 2023 07 04 223 228 Mohammad Hassan Kheirandish Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran Mohammad Tollabi Department of Medical Biotechnology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Fatemeh Davami Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran Behnaz Rahmani Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran Negin Sadat Hashemi Aval Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran Javad Behroozi Department of Genetics and Advanced Medical Technology, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran Hossein Zarei Jaliani Department of Medical Biotechnology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 2022 12 27 2023 05 07 L-asparaginase is recognized as a first-line anticancer drug for acute lymphoblastic leukemia (ALL); however, low-substrate specificity and exhibiting glutaminase activity cause various off-target toxicities on normal cells. In the following study, we functionalized wild-type asparaginase with the TMTP1 targeting peptide which specifically targets a variety of hematological and metastatic cancer cells. The peptide sequence was genetically added to the N-terminal end of the asparaginase using the restriction endonuclease-free cloning method. Wild-type and engineered asparaginases were expressed in E. coli and purified by Nickel affinity chromatography column. The in vitro activity of both types of enzymes was evaluated by Nessler’s method. The sequencing results showed that the TMTP1 sequence was added in the correct frame to the asparaginase. Wild-type and TMTP1-fused asparaginases were produced in a soluble state with the specific activity of 172 U/mg and 153 U/mg, respectively. The evidence from this study suggests that TMTP1-fused asparaginase could preserve its solubility and activity compared to the wild-type species and can be proposed for future research in anticancer therapies. https://acta.tums.ac.ir/index.php/acta/article/view/10492 https://acta.tums.ac.ir/index.php/acta/article/download/10492/5774

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 4 2023 07 04 229 237 Mohammadreza Salamat Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Amirhossein salamat Research and Development Division, Osteoporosis Diagnosis Center, Isfahan, Iran Mohammad Sattari Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Mehdi Asgari Department of Nursing, School of Nursing, Larestan University of Medical Sciences, Larestan, Iran 2021 05 04 2023 01 27 Osteoporosis is one of the primary causes of disability and mortality in the elderly. If osteoporosis's significant features can be identified, the risk of developing this disease will be reduced. In recent years, data mining approaches have become a suitable tool for medical researchers. This study applied data mining methods to identify osteoporosis’s significant features. This study applied data from women having osteoporosis or osteopenia in the period 2011-2019 in the Osteoporosis Diagnosis Center, Isfahan, Iran. Data mining methods such as linear regression, naïve bayes, decision tree, support vector machine, random forest, and neural network were implemented on the dataset. This study consisted of 8258 patients’ information, of which 1482 had osteoporosis. The results showed that the support vector machine, decision tree, neural network are the best method based on accuracy, precision, and AUC measures. Six candidate features were age, weight, back pain, low activity, menopause date, and previous fracture. Support vector machine, decision tree, and neural network are the best candidate techniques for predicting osteoporosis. Thin older people are more at risk of osteoporosis than other people. Yet, people with middleweight and middle age are at lower risk of osteoporosis. https://acta.tums.ac.ir/index.php/acta/article/view/9377 https://acta.tums.ac.ir/index.php/acta/article/download/9377/5775

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 4 2023 07 04 238 246 Mahafarin Maralani Department of Medical Oncology, MOCA, University Hospital Antwerp (UZA), Antwerp, Belgium Tufan Cankaya Department of Medical Genetics, Dokuz Eylul University, Izmir, Turkey Esra Ataman Department of Medical Genetics, Dokuz Eylul University, Izmir, Turkey Yavuz Tokgoz Division of Pediatric Gastroenterology and Nutrition, Adnan Menderes University, Aydın, Turkey Erkan Kaytankas Department of Medical Genetics, Dokuz Eylul Un.php/acta/article/download/11013/5835

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 9 2024 03 16 531 539 Asghar Hajipour Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Alireza Montaseri Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Mojgan Rahimi Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Amirhossein Orandi Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Laila Rahmah School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Shahram Samadi Anesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Sleep Breathing Disorders Research Center (SBDRC), Tehran University of Medical Sciences, Tehran, Iran 2024 03 16 This retrospective cohort study aimed to assess the frequency of emergency cesarean sections with epidural analgesia and its implications on Apgar scores and Neonatal Intensive Care Unit (NICU) admissions among patients at Tehran University of Medical Sciences Hospitals from 2017 to 2018. Data from 7170 patients were extracted from the hospital information system (HIS) through a consensus method. Descriptive statistics, cross-tabulation, and logistic regression analyses were conducted using Stata v17 software. Out of 9387 patients, 62.7% underwent cesarean sections, and 37.1% had normal vaginal deliveries. Epidural analgesia was administered to 127 patients, with 98.4% achieving successful normal vaginal delivery. Nulliparous women constituted 64.29% of those receiving epidural analgesia. Apgar scores at five and ten minutes were comparable between epidural and non-epidural groups. Emergency cesarean rates with epidural analgesia were low (1.6%). Findings align with previous research indicating no significant impact of epidural analgesia on Apgar scores. Nulliparous women predominated in the epidural group, consistent with pain pattern disparities. The study supports recent research showing epidural analgesia does not increase emergency cesarean rates, even in high-risk pregnancies. This study suggests that epidural analgesia does not significantly impact Apgar scores, NICU admissions, or emergency cesarean rates. While the comprehensive dataset enhances reliability, retrospective design limitations are acknowledged. Prospective studies exploring factors contributing to neonatal mortality and overall labor duration are recommended for more robust evidence. https://acta.tums.ac.ir/index.php/acta/article/view/11014 https://acta.tums.ac.ir/index.php/acta/article/download/11014/5836

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 9 2024 03 16 539 546 Saeideh Sadat Mousavi Department of Curriculum Studies and Instruction, Ferdowsi University of Mashhad, Mashhad, Iran. AND Sleep Breathing Disorders Research Center (SBDRC), Tehran University of Medical Sciences, Tehran, Iran Morteza Karami Department of Curriculum Studies and Instruction, Ferdowsi University of Mashhad, Mashhad, Iran Seyed Mohammad Mireskandari Anesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran Shahram Samadi Anesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Sleep Breathing Disorders Research Center (SBDRC), Tehran University of Medical Sciences, Tehran, Iran 2024 03 16 2024 03 16 The use of educational technology is considered a necessity due to the increasing changes in medical education. This study aimed to design a novel blended virtual reality and clinical learning environment (CLE) and to investigate its effectiveness in the learning transfer of anesthesiology residents during spinal anesthesia procedures. In this experimental study, 25 residents (academic year 2020/2021) were randomly divided into blended (n=11) and clinical (n=14) groups. Spinal anesthesia training for the blended group was performed in the virtual training laboratory (week 1) and the operating room (from week 2 to week 4), while for the CLE group, it was only performed in the operating room. Training, based on task-centered learning, was provided for both groups, and then, a 360-degree assessment of learning transfer was conducted by professors, patients, co-workers, and self-assessments using a standard questionnaire. Data were analyzed using non-parametric tests. There was a significant difference in the learning transfer of residents between the blended and CLE groups (U=39, P=0.03<0.05). There was also a significant difference in the subcategories of learning transfer according to the professors and co-workers; however, there was no significant difference according to the patients and self-assessments. The blended VR/CLE learning environment was more effective than CLE in improving residents’ learning transfer. Besides, an increase in scores indicated an improvement in professional competence. https://acta.tums.ac.ir/index.php/acta/article/view/11015 https://acta.tums.ac.ir/index.php/acta/article/download/11015/5837

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 9 2024 03 16 547 554 Fariba Mansouri Department of Respiratory, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran Majid Akrami Department of Anesthesiology, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran Neda Faraji Department of Internal Medicine, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran Masoomeh Nataj Majd Department of Anesthesiology, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran 2024 03 16 2024 03 16 Early commencement of enteral nutrition (EEN) in critically ill patients requiring mechanical ventilation may improve outcomes. But there is a lack of enough data regarding EEN effects on COPD exacerbation patients’ outcomes. This retrospective study involved 129 COPD exacerbation patients who received invasive mechanical ventilation in ICU. The clinical outcomes were compared based on the timing of enteral nutrition (<48h vs >48h) during 60 days of ICU stay. We surveyed and analyzed mortality, pleural effusion, ventilator-associated pneumonia, weaning failure, cardiac arrhythmias, GI bleeding, electrolyte imbalances, renal dysfunction and length of ICU stay. All analyses were performed using SPSS software version 22.0. 129 COPD-exacerbated patients (EEN group n=66; DEN group n=63) who met the inclusion criteria were enrolled in the study. EEN group had a lower death rate (39% vs 44.4%) than the DEN group, but no significant difference was found in the overall mortality during the 60-day follow-up (P 0.561). The EEN group also had lower ICU stay and pleural effusion rate than the DEN group (P:0.006 and 0.020 respectively). No significant differences were found in other outcomes. Early enteral nutrition might be associated with shorter ICU stay and lower odd ratio of acquisition of pleural effusion in COPD patients requiring invasive mechanical ventilation. EEN could not decrease mortality rate compared with DEN in the current study. https://acta.tums.ac.ir/index.php/acta/article/view/11016 https://acta.tums.ac.ir/index.php/acta/article/down