Perceived Barriers and Needs in Accessing Sexual Health Services for Iranian Couples: A Qualitative Research.

Background: Sexual and Reproductive Health (SRH) and access to related services are the most important issues and are part of reproductive health rights. Therefore, this study was designed and conducted to explain the perceived barriers and needs in accessing sexual health services for Iranian couples. Materials and Methods: We conducted this study on 14 subjects at the Navab Health Center in Isfahan and Behsa Counseling Center in Tehran from November 2015 to December 2016 by common qualitative content analysis approach through semi-structured interviews. Results: The results show that sub-subcategories "Therapist's Individual Traits" and "Specialized Skills of Therapist" formed "Need for Access to a Professional Therapist" subcategory and sub-subcategories "Provide specialized problem-based treatments" and "Rapid and Timely Therapy of Sexual Problems" formed the "Need for Timely and Comprehensive Access" subcategory and these two subcategories formed the main category of "Need to access a specialized, comprehensive and timely sexual health services system." Furthermore, sub-subcategories of "Failure to Prioritize Sexual Matters" and "Lack of sexual awareness" formed the "Individual Challenges of Search for Sexual Health Services" subcategory, and sub-subcategories of "Sexual Problems are a Taboo" and "Lack of awareness of the existence of sex therapists and sexual health service centers" formed "Sociocultural Challenges to Access Sexual Health Services" subcategory. Two subcategories formed the main category of "Obstacles to Access Efficient and Proper Sexual Health Services." Conclusions: The explored couple's experiences demonstrated that the need to receive timely and comprehensive specialized sexual health services because of the obstacles to access is not provided.

Fisetin-loaded grape-derived nanoparticles improve anticancer efficacy in MOLT-4 cells.

PURPOSE: Fisetin (FIS) is a natural flavonoid with anti-proliferative and anti-apoptotic effects on different human cancer cell lines and can be considered a therapeutic agent for ALL treatment. However, FIS has little aqueous solubility and bioavailability, limiting its therapeutic applications. Thus, novel drug delivery systems are needed to improve solubility and bioavailability of FIS. Plant-derived nanoparticles (PDNPs) could be considered a great delivery system for FIS to the target tissues. In this study, we investigated the anti-proliferative and anti-apoptotic effect of free FIS and FIS-loaded Grape-derived Nanoparticles (GDN) FIS-GDN in MOLT-4 cells. MATERIALS/METHODS: In this study, MOLT-4 cells were treated with increasing concentration of FIS and FIS-GDN and viability of cells were assessed by MTT assay. Additionally, cellular apoptosis rate and related genes expression were evaluated using flow cytometry and Real Time-PCR methods, respectively. RESULTS: FIS and FIS-GDN decreased cells viability and increased cells apoptosis dose-dependently, but not time dependently. Treatment of MOLT-4 cells with increasing concentrations of FIS and FIS-GDN considerably increased the expression of caspase 3, 8 and 9 and Bax level, and also decreased the expression of Bcl-2. Results indicated an increased apoptosis after increased concentration of FIS and FIS-GDN at 24, 48 and 72 h. CONCLUSIONS: Our data proposed that FIS and FIS-GDN can induce apoptosis and have antitumor properties in MOLT-4 cells. Furthermore, compared to FIS, FIS-GDN induced more apoptosis in these cells by increasing the solubility and efficiency of FIS. Additionally, GDNs increased FIS effectiveness in proliferation inhibition and apoptosis induction.

Preeclampsia-Derived Exosomes Imbalance the Activity of Th17 and Treg in PBMCs from Healthy Pregnant Women.

The disturbance of maternofetal immune tolerance is identified as one of the important issues in the pathology of preeclampsia (PE). PE exosomes are believed to possess significant roles in immune abnormalities. In this study, to assess the possible effects of PE exosomes in the pathophysiology of preeclampsia patients, exosomes were isolated from the serum of PE patients and incubated with peripheral blood mononuclear cells (PBMCs) of healthy pregnant women. Also, exosomes from healthy pregnant women were utilized as the control. Th17/Treg ratio in PE and healthy pregnant women and the effects of PE exosomes on expression level of Th17 and Treg transcription factors, as well as their related cytokines in PBMCs of healthy pregnant women, were evaluated. A significant decrease in Treg cell number and increase in Th17 cells and Th17/Treg ratio were observed in PE patients. Following PE-exosome intervention, a significant increase in mRNA expression level of RORγt, IL-17, IL-23, IL-1ß, and IL-6, and significant decrease in IL-10 and TGFß were evident. On the other hand, no significant difference in FoxP3 level was detected. Additionally, increased IL-6, IL-17, IL-23, and IL-1ß levels and decreased IL-10 level in the supernatant of cultured PBMCs from healthy pregnant women following PE-exosome intervention were exhibited. However, TGF-ß level did not change significantly. Based on our findings, PE exosomes are able to alter the activity of Th17 and Treg cells as well as their related gene expression and cytokine profiles. These findings support the probable role of PE exosomes in PE pathogenesis.

Nursing and Midwifery Students' Mental Health Status and Intention to Leave During Covid-19 Pandemic.

Introduction: COVID-19 has not only affected the physical health of people but it has also had a major impact on their mental health. Objective: To investigate the nursing, midwifery, and operating room students' mental health and intention to leave during COVID-19 pandemic. Methods: This cross-sectional study was conducted at the nursing and midwifery school of Tabriz, Iran. Over a period of three months (February-May 2021) and through random sampling, 284 students were selected. The research tool consisted of three parts including demographic information, Depression Anxiety Stress scales, and a questionnaire on intention to leave. Results: More than 20% of the students experienced some degrees of depression, anxiety, and stress. Nearly one-third of participants mentioned a high level of intention to leave. Nursing students had a higher level of a turnover tendency than other students (p = .004). Male students and who experienced moderate to high level of depression displayed greater intention to leave (p = .005). Conclusion: Students suffered from some degrees of stress, anxiety, and depression during the COVID-19, and it strengthened the participants' intention to leave. Relevant authorities are recommended to improve mental health of the students by providing psychological counseling sessions, reducing their direct contact with patients, and providing personal protective equipment.

Paediatric pre-B acute lymphoblastic leukaemia-derived exosomes regulate immune function in human T cells.

Exosomes derived from solid tumour cells are involved in immune suppression, angiogenesis and metastasis; however, the role of leukaemia-derived exosomes has less been investigated. Hence, changes in immune response-related genes and human T cells apoptosis co-incubated with exosomes isolated from patients' pre-B cell acute lymphoblastic leukaemia were evaluated in this in vitro study. Vein blood sample was obtained from each newly diagnosed acute lymphoblastic leukaemia (ALL) patient prior any therapy. ALL serum exosomes were isolated by ultrafiltration and characterized using Western blotting and transmission electron microscopy. Exosomes were then co-incubated with T lymphocytes and the gene expressions, as well as functions of human T cells were quantified by qRT-PCR. Apoptosis and caspase-3 and caspase-9 protein expression were also evaluated by flowcytometry and Western blotting analysis, respectively. Exosomes isolated from ALL patients affected T lymphocytes and elevated the apoptosis. Moreover, these exosomes altered the T cells profile into regulatory type by increasing the expression of FOXP3 and Tregs-related cytokines, including TGF-B and IL-10. The expression level of Th17-related transcription factors (RoRγt) and interleukins (IL-17 and IL-23) decreased after this treatment. According to our findings, exosomes derived from ALL patients' sera carry immunosuppressive molecules, indicating the possible effect of exosomes as liquid biomarkers for cancer staging.

Cell cycle involvement in cancer therapy; WEE1 kinase, a potential target as therapeutic strategy.

Mitosis is the process of cell division and is regulated by checkpoints in the cell cycle. G1-S, S, and G2-M are the three main checkpoints that prevent initiation of the next phase of the cell cycle phase until previous phase has completed. DNA damage leads to activation of the G2-M checkpoint, which can trigger a downstream DNA damage response (DDR) pathway to induce cell cycle arrest while the damage is repaired. If the DNA damage cannot be repaired, the replication stress response (RSR) pathway finally leads to cell death by apoptosis, in this case called mitotic catastrophe. Many cancer treatments (chemotherapy and radiotherapy) cause DNA damages based on SSBs (single strand breaks) or DSBs (double strand breaks), which cause cell death through mitotic catastrophe. However, damaged cells can activate WEE1 kinase (as a part of the DDR and RSR pathways), which prevents apoptosis and cell death by inducing cell cycle arrest at G2 phase. Therefore, inhibition of WEE1 kinase could sensitize cancer cells to chemotherapeutic drugs. This review focuses on the role of WEE1 kinase (as a biological macromolecule which has a molecular mass of 96 kDa) in the cell cycle, and its interactions with other regulatory pathways. In addition, we discuss the potential of WEE1 inhibition as a new therapeutic approach in the treatment of various cancers, such as melanoma, breast cancer, pancreatic cancer, cervical cancer, etc.

Properties of Lime-Cement Concrete Containing Various Amounts of Waste Tire Powder under Different Ground Moisture Conditions.

Lime-cement concrete (LCC) is a non-structural concrete in which lime and cement are used as the main binders. However, although LCC has many applications in reducing the settlement of foundations and providing a support layer for shallow foundations, little research has been conducted to evaluate its behaviour in various moisture conditions. Previous researchers have studied the feasibility of using waste tires in conventional concrete to alleviate their negative environmental impacts. However, in field projects, rubber has not been widely used because its application leads to the strength reduction of concrete. In the case of LCC, attaining high strengths is not required and thus application of waste tire particles sounds reasonable. This research evaluated the impact of various rubber powder contents on the fresh, geotechnical and durability properties of LCC at different saturation degrees induced by the capillary action and groundwater level increment, which has not been studied before. The results of more than 320 tests showed that the application of tire powder increases workability and decreases the water absorption of LCC. Moreover, all 60-day cured specimens exposed to 100% saturation degree experienced a strength reduction of less than 10% by using rubber powder contents varying from 0 to 20%. Moreover, increasing the saturation degree from 0 to 100% decreased the average compressive strength by 13.5 and 22% for 60-day cured samples of two different mix designs. The results of this research confirm that LCC containing up to 10% rubber powder could be promisingly used underneath or close to the groundwater table without its strength and geotechnical properties being jeopardized due to rubber employment and/or exposure to ground moisture.

Application of Emerging Plant-Derived Nanoparticles as a Novel Approach for Nano-Drug Delivery Systems.

Nanotechnology has enabled the delivery of small molecular drugs packaged in nanosized vesicles to the target tissues. Plant-Derived Nanoparticles (PDNPs) are vesicles with natural origin and unique properties. These nanoparticles have several advantages over synthetic exosomes and liposomes. They provide bioavailability and biodistribution of therapeutic agents when delivered into different tissues. These nanoparticles can be modified according to the specificity of their functions in target tissues. When PDNPs are internalized, they can induce stem cells proliferation, reduce colitis injury, activate intrinsic and extrinsic apoptosis pathways, and inhibit tumor growth and progression. These properties make them potential drug delivery systems in targeting diseased tissues, such as inflammatory regions and different cancers.

Relationship between coronavirus disease 2019 in pregnancy and maternal and fetal outcomes: Retrospective analytical cohort study.

OBJECTIVE: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has caused many deaths and complications worldwide. However, limited data are available about COVID-19 during pregnancy. This study aimed to assess the epidemiological and clinical features of COVID-19, and the adverse maternal and fetal outcomes. DESIGN: This retrospective analytical cohort study was conducted on all pregnant women with confirmed COVID-19 at Nekouei-Hedayati-Forghani Hospital in Qom, Iran from 15 March 2020 to 15 November 2020. For the same period, 165 pregnant women who did not have COVID-19 were selected at random and included in this study. All epidemiological and clinical features were collected from the medical records of the participants. A logistic regression model was used to determine associations between COVID-19 in pregnancy and maternal and fetal outcomes. FINDINGS: The most common symptoms reported by pregnant women with COVID-19 were shortness of breath (60.9%), dry cough (59%) and fever (42.9%). After adjustment for potential confounding factors, COVID-19 in pregnancy was associated with a significantly higher risk of admission to the intensive care unit (ICU) [odds ratio (OR) 6.16, 95% confidence interval (CI) 1.23-31], caesarean section (OR 0.45, 95 CI 0.25-1.03), preterm birth (OR 3.01, 95% CI 1.4-6.54), fetal distress (OR 5.7, 95% CI 2.13-15.59) and admission to the neonatal intensive care unit (NICU) (OR 3.04, 95% CI 1.21-7.70). KEY CONCLUSIONS: COVID-19 is associated with adverse maternal and fetal outcomes, including ICU admission, caesarean section, fetal distress, preterm birth and NICU admission.

SARS-CoV-2: Unique Challenges of the Virus and Vaccines.

In November 2019, the highly infectious coronavirus SARS-CoV-2 emerged in Wuhan, China, and has since spread to almost all countries worldwide. Since its emergence, the COVID-19 infection has led to significant public health, economic and social problems. The current pandemic has inspired researchers to make every effort to design and develop an effective COVID-19 vaccine to provide sufficient protection against the virus and control the infection. In December 2020, the Pfizer vaccine was the first COVID-19 vaccine given Emergency Use Authorization (EUA), and the second FDA so-approved vaccine was the Moderna mRNA-1273 vaccine, which was introduced a week later. Both Pfizer and Moderna vaccines are mRNA-based vaccines, and are estimated to have an efficacy rate of more than 94%. The aim of this article is to provide a review of the attempts made to develop safe SARS-CoV-2 vaccines, highlighting potential challenges and concerns, such as disease enhancement, virus mutations, and public acceptance of the vaccine.

The severity of COVID-19 among pregnant women and the risk of adverse maternal outcomes.

OBJECTIVE: To evaluate the relationship between the severity of coronavirus disease 2019 (COVID-19) during pregnancy and the risk of adverse maternal outcomes. METHODS: A descriptive-analytical cross-sectional study conducted on 258 pregnant women who were hospitalized due to confirmed COVID-19 from March 2020 to January 2021 at the Forghani Hospital in Qom, Iran. Demographic and obstetric characteristics, laboratory findings, and adverse maternal outcomes were recorded from the patients' medical records. The Fisher exact test, one-way analysis of variance, and regression logistics were used to assess the relationship between variables. RESULTS: Of the total study population, 206 (79.8%) pregnant women had mild to moderate disease, 43 (16.7%) had severe disease, and 9 (3.5%) were in the critical stage of the disease. Eight women (3.1%) died and 33 (12.8%) were admitted to the intensive care unit (ICU). The most important demographic factors associated with the severity of the disease were ethnicity, underlying conditions, maternal age, and parity. The severity of the disease was significantly associated with increased cesarean delivery and admission to the ICU. CONCLUSION: Pregnant women with severe and critical disease had a high rate of cesarean delivery and admission to the ICU. There were eight cases of maternal mortality.

The keys to a good and lasting marriage: Exploration of Iranian couple's experiences.

BACKGROUND AND AIM: Marital satisfaction is a multidimensional phenomenon, which refers to the quality of marital relationship, or the general view of marriage status and reflection of happiness and marital performance. Repetition of certain positive behaviors can make a huge difference in the success of continued married life, and that awareness of such behaviors seems to be critical to recognizing certain warnings. Therefore, this study with qualitative approach conducted to promoting long-term marital satisfaction by exploring couple's experiences. MATERIALS AND METHODS: This study was conducted using descriptive phenomenology method. The participants were 12 person (six couples) with a history of 20-30 years of married life expectancy and a marital satisfaction score of above 65. The data were collected by purposeful sampling and semi-structured interviews, analyzed using Colaizzi method. By categorizing the codes, subcategories, and main categories were extracted. RESULTS: An analysis of the experiences of the participants resulted in emergence of eight subcategories, and three main categories: "Strong Foundation For Living Together," "Mutual Commitment To Protecting Marital Cohesion," and "Striving To Improve Sexual Relations." CONCLUSIONS: A long-term marriage associated with a variety of variables, including a strong foundation for living together, a mutual commitment to protect marital cohesion, and an effort to improve sexuality. And the results showed that the type of relationship will change during the years after marriage in a way that takes on certain meanings and concepts and can be interpreted in physiological, cultural and other specific contexts.

Exosome: From leukemia progression to a novel therapeutic approach in leukemia treatment.

Exosomes, as small vesicles, are released by tumor cells and tumor microenvironment (cells and function as key intercellular mediators and effects on different processes including tumorigenesis, angiogenesis, drug resistance, and evasion from immune system. These functions are due to exosomes' biomolecules which make them as efficient markers in early diagnosis of the disease. Also, exosomes have been recently applied in vaccination. The potential role of exosomes in immune response toward leukemic cells makes them efficient immunotherapeutic agents treating leukemia. Furthermore, variations in exosomes contents make them beneficial to be used in treating different diseases. This review introduces the role of exosomes in the development of hematological malignancies and evaluates their functional role in the treatment of these malignancies.

Berberine: A novel therapeutic strategy for cancer.

Cancer, even currently, is one of the main reasons for mortality and morbidity, worldwide. In recent years, a great deal of effort has been made to find efficient therapeutic strategies for cancer, however, particularly with regards to side effects and the possibility of complete remission. Berberine (BBR) is a nature-driven phytochemical component originated from different plant groups such as Berberis vulgaris, Berberis aquifolium, and Berberis aristata. BBR is a well-known nutraceutical because of its wide range of pharmacological activities including anti-inflammatory, antidiabetic, antibacterial, antiparasitic, antidiarrheal, antihypertensive, hypolipidemic, and fungicide. In addition, it exhibits inhibitory effects on multiple types of cancers. In this review, we have elaborated on the anticancer effects of BBR through the regulation of different molecular pathways such as: inducing apoptosis, autophagy, arresting cell cycle, and inhibiting metastasis and invasion.

The Effect of Acupressure at Spleen 6 Acupuncture Point on the Anxiety Level and Sedative and Analgesics Consumption of Women during Labor: A Randomized, Single-blind Clinical Trial.

BACKGROUND: Labor pain is the most severe pain women would experience, which could lead to loss of emotional control that plays a key role in creating a traumatic delivery experience and psychological disorders. The goal of this study was to evaluate the effect of acupressure on anxiety level and sedative and analgesics consumption in women during labor. MATERIALS AND METHODS: This study was a randomized, single-blind clinical trial performed at Maryam Hospital in Tehran, Iran. One hundred and thirty-one pregnant women in Labor Ward were selected by convenience sampling. Subjects were randomly allocated to three groups, namely experimental group (pressure group), control group 1(touh group) and, control group 2 (routine care group). The study data were gathered using demographic information form, and assessed with Faces Anxiety Scale (FAS). For participants belonging to the experimental group, pressure was applied to the Spleen 6 acupoint for 30 min, and for those with only light touch was applied to the Spleen 6 acupoint for 30 min. The collected data were analyzed using Statistical Package for the Social Sciences 16 and descriptive statistics. RESULTS: There was a significant difference between the three groups in terms of the mean of anxiety after 30 min of starting the intervention and 30 min after termination of the intervention; the anxiety of the experimental group was significantly decreased (p = 0.03). Sedative and analgesics consumption was significantly lower in the experimental group compared to the other groups (p = 0.006). CONCLUSIONS: This study showed that compression of the Spleen 6 acupoint was an effective complementary method to decrease maternal anxiety and analgesic consumption, especially pethidine.