The challenges of urban family physician program over the past decade in Iran: a scoping review and qualitative study with policy-makers.

Introduction: Despite all the advantages of urban family physician program (UFPP), there is still a gap between UFPP and what is actually achieved by the community after its implementation in Iran. In response, this study attempted to review published studies related to the barriers to the implementation of the UFPP in Iran as well as potential solutions to improve it. Further, a qualitative study was conducted to learn the perspectives of experts at the national level and in the Fars province in order to better understand the program's challenges. Methods: This study was conducted in two phases. First, a scoping review was done, aiming to identify the common barriers and potential solutions to implementing UFPP in Iran. Second, a qualitative study using semi-structured interviews was conducted to investigate the views of decision- and policy-makers regarding barriers to and solutions for implementing the UFPP in the Fars province over the last decade. The findings were classified using the five control knobs framework (organization, financing, payment, regulation, and behavior). Results: The most common barriers to UFPP were: 1) organization (ununited stewardship function of the Ministry of Health, weak management and planning, inadequate training of human resources, and a weak referral system); 2) financing (fragmented insurance funds, insufficient financial resources, and instability of financial resources); 3) payment (inappropriate payment mechanisms and delay in payments); 4) regulation (cumbersome laws and unclear laws); and 5) behavior (cultural problems and conflict of interests). On the other hand, several solutions were identified to improve the implementation of UFPP, including: enhancing the role of government; improving the referral system; providing comprehensive training for UFPP providers; considering sustainable financial resources; moving towards mixed-payment mechanisms; employing appropriate legal and regulatory frameworks; enhancing community awareness; and elevating incentive mechanisms. Conclusion: Our research found that, despite the UFPP having been in place for a decade in Iran, there are still significant challenges in all five components. Therefore, the promotion of this program requires solving the existing implementation challenges in order to achieve the predetermined goals. The ideas in this study can be used to improve the current program in Fars Province and bring it to other cities in Iran.

Progranulin (PGRN) as a regulator of inflammation and a critical factor in the immunopathogenesis of cardiovascular diseases.

Immune dysregulation has been identified as a critical cause of the most common types of cardiovascular diseases (CVDs). Notably, the innate and adaptive immune responses under physiological conditions are typically regulated with high sensitivity to avoid the exacerbation of inflammation, but any dysregulation can probably be associated with CVDs. In this respect, progranulin (PGRN) serves as one of the main components of the regulation of inflammatory processes, which significantly contributes to the immunopathogenesis of such disorders. PGRN has been introduced among the secreted growth factors as one related to wound healing, inflammation, and human embryonic development, as well as a wide variety of autoimmune diseases. The relationship between the serum PGRN and TNF-α ratio with the spontaneous bacterial peritonitis constitute one of the independent predictors of these conditions. The full-length PGRN can thus effectively reduce the calcification of valve interstitial cells, and the granulin precursor (GRN), among the degradation products of PGRN, can be beneficial. Moreover, it was observed that, PGRN protects the heart against ischemia-reperfusion injury. Above all, PGRN also provides protection in the initial phase following myocardial ischemia-reperfusion injury. The protective impact of PGRN on this may be associated with the early activation of the PI3K/Akt signaling pathway. PGRN also acts as a protective factor in hyperhomocysteinemia, probably by down-regulating the wingless-related integration site Wnt/ß-catenin signaling pathway. Many studies have further demonstrated that SARS-CoV-2 (COVID-19) has dramatically increased the risks of CVDs due to inflammation, so PGRN has drawn much more attention among scholars. Lysosomes play a pivotal role in the inflammation process, and PGRN is one of the key regulators in their functioning, which contributes to the immunomodulatory mechanism in the pathogenesis of CVDs. Therefore, investigation of PGRN actions can help find new prospects in the treatment of CVDs. This review aims to summarize the role of PGRN in the immunopathogenesis of CVD, with an emphasis on its treatment.

Isolation, Screening and Identification of Native and New Bacillus subtilis with Strong Antifungal Compound against Fusarium oxysporum.

The genus Fusarium causes a wide range of infections in human, animals and herbs. The purpose of this research was to investigate and identify the native strains of Bacillus subtilis playing an inhibitory role against Fusarium oxysporum by producing surfactin. B. subtilis was isolated from the soil of various parks in Tehran-Iran, and identified by biochemical tests. Growth inhibition zone, minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of B. subtilis were determined. After purification of surfactin, quantitative and qualitative analysis of surfactin conducted using high performance liquid chromatography (HPLC) . Finally, two selected native strains with the highest production rate of surfactin identified using PCR for 16S rRNA and phylogenetic tree was drawn. Sixty strains of B. subtilis were isolated from soil, after identification through phenotypical and biochemical tests, the antagonistic activity of 27 different strains against F. oxysporum by Agar well diffusion assay determined and the highest inhibition zone was 13.66 mm. Six strains showing the best inhibitory effect, were isolated and their metabolite were purified by methanol. MIC and MFC values of different strains were in the range of 0.5-1.6 and 1.6-2.6 mg/mL. Using HPLC, the purified surfactin content in B. subtilis was about 56.7 - 131.9 µg/mL. Based on the curves of the chromatogram, the preferred strains with the highest production of surfactin, by molecular identification, displayed high similarity to B. subtilis. We got a maximum amount of yellow and transparent surfactin from native strains. Furthermore, the selected bacteria can be good candidates for biological control of fungal pathogens.

The Molecular Diversity of 1H-Indole-3-Carbaldehyde Derivatives and Their Role in Multicomponent Reactions.

1H-Indole-3-carbaldehyde and related members of the indole family are ideal precursors for the synthesis of active molecules. 1H-Indole-3-carbaldehyde and its derivatives are essential and efficient chemical precursors for generating biologically active structures. Multicomponent reactions (MCRs) offer access to complex molecules. This review highlights the recent applications of 1H-indole-3-carbaldehyde in such inherently sustainable multicomponent reactions from the period, 2014 to 2021 and provides an overview of the field that awaits further exploitation in the assembly of pharmaceutically interesting scaffolds.

The synthesis and efficiency investigation of a boronic acid-modified magnetic chitosan quantum dot nanocomposite in the detection of Cu2+ ions.

We prepared the magnetic chitosan carbon quantum dot nanoparticles (Fe3O4@CQD NPs) via the hydrothermal treatment of chitosan biopolymer and then its magnetization with Fe3O4 nanoparticles. (4-Acetylphenyl)boronic acid compound was utilized for the modification of surface of Fe3O4@CQD nanoparticles via the covalent imine bond formation between NH2 groups of chitosan quantum dot with carbonyl functional of acetyl-substituted arylboronic acid. The synthesized Fe3O4@CQD@AP-B(OH)2 was characterized by FE-SEM, EDS, XRD, VSM and ICP-OES analysis and its fluorescence property was studied. This magnetic multifunctional nanoplatform sensor has shown high potential sensitivity for Cu2+ ions (in the range of 1.0-30.0 µM with limit of detection 0.3 µM) through interaction of cupric ions with the boronic-acid moiety.

Genetic variants and risk of thyroid cancer among Iranian patients.

The definition of an exclusive panel of genetic markers is of high importance to initially detect among this review population. Therefore, we gave a summary of each main genetic marker among Iranian patients with thyroid cancer for the first time which were classified based on their cellular function. Due to the results, a significant relationship was found between SNP in codons 194, 280, and 399 (XRCC1), Allele 3434Thr (XRCC7), GC or CC genotype 31, G/C (Survivin), 399G>A (XRCC1), Tru9I (vitamin D receptor), G-D haplotype (MDM2), TT genotype, -656 G/T (IL-18), TAGTT haplotype (IL-18), G allele in +49 A>G (CTLA-4), +7146 G/A (PD-1.3), +7785 C/T (PD-1.5), rs1143770 (let7a-2), rs4938723 (pri-mir-34b/c) genes, and thyroid cancers. Moreover, SNP in 677C-->T (MTHFR), GG genotype Asp1312Gly (thyroglobulin), 2259C>T (Rad52), R188H, (XRCC2), T241M (XRCC3) had higher risks of thyroid cancer and lower risks were observed in -16 Ins-Pro (p53), rs3742330 (DICER1). At last, the protective effects were explored in 127 CC genotype (IL-18), rs6877842 (DROSHA). Conduct further studies on the types of DNA repair gene polymorphisms with a larger number in the thyroid cancer using modern methods such as SNP array so that these genes could be used as a biomarker in prediction, diagnosis, and treatment of thyroid cancer. This review presents for the first time a summary of important genetic markers in Iranian patients with thyroid cancer.

Differentiation of dental pulp stem cells into neuron-like cells.

Background and objectives: With regard to their ease of harvest and common developmental origin, dental pulp stem cells (DPSCs) may act as a favorable source of stem cells in generation of nerves. Moreover; cellular migration and differentiation as well as survival, self-renewal, and proliferation of neuroprogenitor species require the presence of the central nervous system (CNS) mitogens including EGF and bFGF. Accordingly, the possibility of the induction of neuronal differentiation of DPSCs by EGF and bFGF was evaluated in the present study.Materials and methods: DPSCs were treated with 20 ng/ml EGF, 20 ng/ml bFGF, and 10 µg/ml heparin. In order to further induce the neuroprogenitor differentiation, DPSC-derived spheres were also incubated in serum-free media for three days. The resulting spheres were then cultured in high-glucose Dulbecco's Modified Eagle Medium (DMEM) with 10% FBS. The morphology of the cells and the expression of the differentiation markers were correspondingly analyzed by quantitative polymerase chain reaction (qPCR), western blotting, and immunofluorescence (IF).Results: The EGF/bFGF-treated DPSCs showed significant increase in the expression of the neuroprogenitor markers of Nestin and SRY (sex determining region Y)-box 2 (SOX2), 72 h after treatment. The up-regulation of Nestin and SOX2 induced by growth factors was confirmed using western blotting and IF. The cultures also yielded some neuron-like cells with a significant rise in Nestin, microtubule-associated protein 2 (MAP2), and Neurogenin 1 (Ngn1) transcript levels; compared with cells maintained in the control media (p < 0.05).Conclusion: DPSCs seemed to potentially differentiate into neuron-like cells under the herein-mentioned treatment conditions.