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Background: Promoting the immunity of pregnant women during the Covid-19 pandemic through vaccination against SARS-CoV-2 infection is one of the main challenges. It is important to manage the information related to receiving the vaccine and its possible complications for surveillance of its safety and to deal with the challenges. Based on this, it is necessary to design a national information management system for the COVID-19 vaccination. Objectives: To promote the safety of pregnant women by providing a national model of an information management system for pregnant women's COVID-19 vaccination in Iran. Methods: The present research was of applied descriptive type. Based on the review of articles and information sources and a comparative study of the information management and surveillance system for the vaccination of pregnant women in developed countries, and according to the country's organizational structure, the national model of the information management system for pregnant women's COVID-19 vaccination was designed for Iran. Then the validation of the model was examined in two steps using the Delphi technique. Finally, after analyzing the data, the final model was presented. Results: The findings were categorized into two main groups, including the structural components (responsible organization and databases, surveillance center, participating organizations, and data sources) and informational process (data set, data collection, quality control, data exchanges, data processing, reporting) that reached 100% consensus of experts. Conclusions: For developing IMS for the COVID-19 vaccination of pregnant women, it is necessary to specify the responsible organization and the participating centers, create surveillance centers and databases, and define the information management system process.

In recent studies, the void of evaluation and in-depth understanding of unknown clinically relevant potential molecular biomarkers involved in colorectal cancer (CRC) from the inflammatory stage of ulcerative colitis (UC) to CRC metastasis, which can be suitable therapeutic targets, is deeply felt. The regulation and interaction among different cancer-promoting molecules, including messenger RNAs (mRNAs) and micro RNAs (miRNAs) in CRC and its progression, were the aim we pursued in this study. Using microarray data, we investigated the differential expression for five datasets, including mRNA and microRNA samples related to UC, tumor/normal. Then, using robust data analysis, separate lists of differentially expressed genes (DEGs) and differentially expressed miRNAs (DEmiRNAs) were identified, which were used for robust rank aggregation (RRA) and co-expression network analysis. Then, comprehensive computational systems biology analyses, including gene ontology and Kyoto encyclopedia of genes and genomic pathway enrichment analyses, mRNA-miRNA regulatory network, and survival analysis, were employed to achieve the aim of this study. Finally, we used clinical samples to validate this potential and new target. According to this systems biology approach, a total of 98 DEGs and 8 DEmiRNAs with common differential expression were identified. By combining the distinct results of RRA and network, several potential therapeutic targets, and predictive and prognostic biomarkers for UC and CRC were identified. These targets include six common hub genes, CXCL1, CXCL8, MMP7, SLCA16A9, PLAU, and TIMP1, which are upregulated. Among these, the important and new biomarker SLC16A9 is negatively regulated by hsa-mir-194-5p, and hsa-miR-378a-5p take. The findings of the present study provide new insight into the pathogenesis of CRC in UC. Our study suggests future evaluation of the functional role of SLC16A9 and hsa-mir-194-5p and hsa-miR-378a-5p in CRC development.

Background. The incidence of coronary artery disease (CAD), the leading cause of mortality in most developed and developing countries, is increasing. The adoption of hospital registries can improve care delivery and facilitate the management of CAD through better planning, as well as help with outcome assessment through more effective data management. Objectives. The present study is aimed at designing a hospital-based CAD registry for managing CAD data. Methods. This developmental study was conducted in three phases. Initially, sources related to CAD registries were reviewed, the results of which were published in two studies. In the next phase, the prerequisites and requisites of the software were determined through a qualitative study. In this phase, the registry dataset was determined by using a questionnaire. Finally, the developed conceptual model of the software was validated. The software was then developed based on the validated conceptual model. Results. The registry data elements were classified into 13 main categories, including identification data, medical history, and risk factors. The dataset included 171 data elements, including data related to surgical and nonsurgical procedures. The conceptual model was approved by field experts, and the software was developed accordingly. Conclusion. The steps followed in the present study for developing the CAD registry can be used as an appropriate approach for designing similar hospital-based registries. Considering the pivotal role of the registry in the management of CAD, the routine and systemic use of the registry is suggested in all healthcare centers.

Background: Time management is effective in controlling stress especially for medical residents. Time management in the surgical field and residential education is very important as they are directly involved in treating patients. Proper time management will help decrease work-related stress and increase efficacy, although there is no time management in medical courses. There are few studies in Iran in this field. So, we designed this study to assess the effects of time management on improvement of educational and therapeutic services in surgical residents of Imam Hospital. Methods: This before–after study was done in Imam hospital between February-March 2015. In this before-after study, 18 surgical residents of Imam Hospital (residents of 1-4 years), were enrolled. Their activities were evaluated in 11 scopes. To evaluate the effects of this self-evaluation, 5 scopes were assessed by the staff. The time during two weeks spent on each item was claimed as a percentage of 336 hours in two weeks. The self-assessment results and their effects on their scores were considered. Data regarding age, sex, and marital status were also gathered. Data were analyzed using SPSS software. Results: Eighteen residents were enrolled in this study. Ten residents were male (55.6%) and eight were female. Six (33.3%) were married. The mean age was 30±3.7 years. Resting time and emergency room time were significantly higher in the first-year residents while studying time was higher in the fourth-year residents. Second-year residents spend more time in training classes than others. The mean score at the beginning and the end of the study was highest in the forth-year residents and lowest in the first-year residents. All scores at the end of the study were significantly higher than the beginning except clinical judgment. The increase of the mean overall score was significantly higher in the fourth-year group and lowest in the first-year group. Conclusion: Time management could improve the educational performance of surgical residents.

Background and Aim: Implementation of a program to support physicians’ working long in deprived areas is one of the most important programs of the Health System Transformation Plan in response to the challenge of the shortage of expert staff, particularly physicians. Numerous factors affect the persistence of physicians in different regions, especially in deprived ones. This study aims to explain the experiences of physicians in relation to the challenges of working long in deprived areas. Materials and Methods: The present research is a qualitative study that was conducted in 2020 in Tehran, Iran. To achieve information saturation, 16 physicians and specialists were chosen using purposive sampling method. Then, for data collection, semi-structured interviews were used. Moreover, data analysis was performed using Graneheim and Lundman contractual content analysis method, and data management was done with MAXQDA software version 12. Furthermore, Lincoln and Guba reliability criteria were applied to achieve data accuracy and reliability. Results: Three female and 13 male physicians with a mean work experience of 45.4±7.8 years and an average work experience in deprived areas of 8±6.3 years participated in the study. Six participants were native to the region and the rest were non-native. Twelve participants in the study were the faculty members of the university. When the data were analyzed, 286 initial codes were extracted. The information was divided into four main categories and eleven subcategories. Welfare, motivation, justice and security were the main categories of this study. Conclusion: Providing individual and social welfare for physicians, and fair treatment in financial payments and educational justice along with establishing security provide the necessary motivation for physicians to stay in a deprived area. Besides by combining several solutions at the same time, the presence of doctors in deprived areas can be guaranteed.

Introduction and goal to background Due to the importance of segmentation of MRI images in identifying brain tumors, various methods including deep learning have been introduced for automatic brain tumor segmentation. On the other hand, using a combination of methods can improve their performance. Among them is the use of wavelet transform as an auxiliary element in deep networks. The analysis of the requirements of such combinations has been addressed in this study. Method In this developmental study, different wavelet functions were used to compress brain MRI images and finally as an auxiliary element in improving the performance of the convolutional neural network in brain tumor segmentation. Results Based on the results of the tests performed, the Daubechies1 function was most effective in enhancing network performance in segmenting MRI images and was able to balance the performance and computational overload. Conclusion Choosing the wavelet function to optimize the performance of a convolutional neural network should be based on the requirements of the problem, also taking into account some considerations such as computational load, processing time, and performance of the wavelet function in optimizing CNN output in the intended task.

BACKGROUND Despite the increasing development of different smartphone apps in the health care domain, most of these apps lack proper evaluation. In fact, with the rapid development of smartphones and wireless communication infrastructure, many health care systems around the world are using these apps to provide health services for people without sufficient scientific efforts to design, develop, and evaluate them. OBJECTIVE The objective of this study was to evaluate the usability of CanSelfMan, a self-management app that provides access to reliable information to improve communication between health care providers and children with cancer and their parents/caregivers, facilitating remote monitoring and promoting medication adherence. METHODS We performed debugging and compatibility tests in a simulated environment to identify possible errors. Then, at the end of the 3-week period of using the app, children with cancer and their parents/caregivers filled out the User Experience Questionnaire (UEQ) to evaluate the usability of the CanSelfMan app and their level of user satisfaction. RESULTS During the 3 weeks of CanSelfMan use, 270 cases of symptom evaluation and 194 questions were recorded in the system by children and their parents/caregivers and answered by oncologists. After the end of the 3 weeks, 44 users completed the standard UEQ user experience questionnaire. According to the children’s evaluations, attractiveness (mean 1.956, SD 0.547) and efficiency (mean 1.934, SD 0.499) achieved the best mean results compared with novelty (mean 1.711, SD 0.481). Parents/caregivers rated efficiency at a mean of 1.880 (SD 0.316) and attractiveness at a mean of 1.853 (SD 0.331). The lowest mean score was reported for novelty (mean 1.670, SD 0.225). CONCLUSIONS In this study, we describe the evaluation process of a self-management system to support children with cancer and their families. Based on the feedback and scores obtained from the usability evaluation, it seems that the children and their parents find CanSelfMan to be an interesting and practical idea to provide reliable and updated information on cancer and help them manage the complications of this disease.

Since the emergence of the COVID-19 pandemic, medical education has been a concerning issue, especially in surgical fields. Due to the postponement of many elective surgeries and even alternations in the pattern of emergent surgeries, concerns have been raised about whether residents of surgical disciplines are experienced enough after graduation or not. We aimed to describe the impact of the COVID-19 pandemic on surgical residency training in different fields.We conducted a cross-sectional study with a 20-item questionnaire on residents of surgical disciplines from three different educational hospitals of Tehran University of Medical Sciences, Iran in 2020. In addition, we reviewed the current literature regarding the impact of COVID-19 pandemic on surgical education worldwide.Our survey, with a response rate of 56.8% demonstrated significant reduction in the time spent in elective surgeries, surgical clinics and even in emergent surgeries for residents. Besides, it has reported that significant time has been spent in COVID 19 wards which resulted in decreased satisfaction of educational activities.The impacts of COVID 19 pandemic on surgical education are significant and inevitable. Thus, we must integrate novel educational methods in surgical curriculum to optimize training and minimize the adverse effects of the pandemic on surgical education.

There is increasing evidence showing that microbial dysbiosis impacts the health and cancer risk of the host. An association between adherent–invasive Escherichia coli (AIEC) and colorectal cancer (CRC) has been revealed. Cyclomodulins (CMs) have been receiving increasing attention for carcinogenic changes. In this study, the incidence and features of intracellular AIEC and cyclomodulin-encoding genes were investigated and the phylogenetic grouping and genetic relatedness were evaluated. E. coli strains were isolated from the colorectal biopsies. Adhesion and invasion assays and intramacrophage cell survival test were performed to separate the AIEC isolates. Virulence genotyping for the genes htrA, dsbA, chuA, and lpfA and the cyclomodulin toxins was also conducted. In addition, phylogenetic grouping of the isolates was determined. Subsequently, repetitive element sequence-based PCR (rep-PCR) fingerprinting was performed. A total of 24 AIEC pathovars were isolated from 150 patients. The prevalence rates of htr, dsbA, and lpfA were 70.83% and that of chuA was 91.66%. The frequencies of the cyclomodulin toxins were as follows: cnf1, 29.2%; cnf2, 25%; colibactin, 29.2%; and cdt, 4.2%; cif was not found. Among the AIEC isolates, 4.2%, 4.2%, 54.2%, 29.2%, and 8.3% with phylotypes A or C, B1, B2, D, and E were identified, respectively. Left-sided colon carcinoma and adenocarcinoma T≥1 stage (CRC2) were colonized by B2 phylogroup AIEC-producing CMs more often than the samples from the other groups. Close genetic relatedness was observed in AIEC isolates with rep-PCR.

Background. Long noncoding RNAs (lncRNAs) perform as competing endogenous RNAs (ceRNAs) to sponge microRNAs (miRNAs) lead to the advancement of cancer. In this work, we attempted to identify possible long noncoding RNA biomarkers as well as a new regulatory axis in colorectal cancer. This investigation was carried out in consideration of the critical oncogenic function played by miR-616-3p in many malignancies, as well as its regulatory involvement in several signaling pathways.Material and Methods: Differentially expressed lncRNAs (DELs) were identified from Gene Expression Omnibus (GEO) database. Targeted mRNAs were recognized by the Targetscan database. ciBioPortal database and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis also were applied to identify mRNAs. CeRNA networks constructed via Cytoscape 3.7.1. QRT-PCR was utilized to verify these RNA molecules' expression levels in 30 CRC tissues compared to 30 adjacent tissue samples. Results: Three lncRNAs and three mRNAs were discovered to have the greatest interaction with miR-616-3p. QRT-PCR revealed overexpression of (Linc01282, lnc-MYADM-1:1, ZNF347, XIAP) and downregulation of (Lnc-atp12a-1:1, SIK1 and miR-616-3p). In CRC, bioinformatic research revealed many unique ceRNA networks centered on miR-616-3p that were previously unknown.Conclusion: This work reveals novel, previously unreported lncRNAs as prognostic biomarkers for CRC, as well as potential mRNAs as new therapeutic targets and predictive biomarkers for CRC. Furthermore, our analysis identified novel ceRNA networks that need be investigated further in CRC.

With regard to the importance of health Information Governance (IG) programs in improving the quality and reducing the cost of healthcare services and the lack of a coherent health IG program in Iran’s health system, this study aimed to develop a model for national health information governance program in Iran. The present research was an applied, cross-sectional descriptive study that was done in three steps, including literature review, development of a model for national health IG program in Iran, and model validation. In the third step, we used a questioner to validate the model through the Delphi method. Data analysis was done by descriptive statistics. The model for the national IG program in Iran was developed in 3 main sections consisting of 13 components, 12 principles, natural and judicial authorities of the health IG program, and their job description. Findings from the validation of the initial model showed that most experts (93%) confirmed the components and sub-components, principles, and natural and legal bodies supervising the national health IG program and their job description in the proposed model. Considering the structure of the Iranian health system, it was recommended to establish a health IG council in the Ministry of Health and Medical Education in order to develop guidelines and give advice to health care providers. Based on the proposed model, directors and staff of different departments of health care centers, especially those involved in health IG, are also responsible for the better implementation of the national health IG program.

The emergence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in 2020, which has a substantial structural similarity to severe acute respiratory syndrome coronavirus (SARS-CoV) that caused the outbreak in 2003, is currently a threat to global health. Lung involvement is the principal clinical feature in infected patients but extra-pulmonary clinical presentations are also common. The reasons for the extensive involvement of other organs are not yet clear. Angiotensin-converting enzyme 2 (ACE2), the key peptide of renin–angiotensin system (RAS), has recently identified as a major receptor for the both SARS-CoV and SARS-CoV-2 that might be a main target of coronavirus infection. ACE2 is mainly expressed in the pulmonary pneumocytes, the small intestine enterocytes as well as the proximal tubule epithelial cells of the kidneys. In addition to the respiratory tract infection symptoms, the noticeable prevalence of gastrointestinal symptoms as well as kidney impairment in hospitalized infected patients highlights other routes of infection/transmission. In present review, we discussed the role of RAS with emphasis on ACE2 in the pathogenesis of SARS-CoV and SARS-CoV-2, particularly in gastrointestinal and kidney manifestations of the diseases.

BACKGROUND The unique features of smartphones have extended their use in different fields, especially in the health care domain. These features offer new opportunities to support patients with chronic conditions by providing them with information, education, and self-management skills. We developed a digital self-management system to support children with cancer and their caregivers in Iran (low- and middle-income country). OBJECTIVE This study is aimed at the development and preliminary evaluation of a cancer self-management system (CanSelfMan) tailored to the needs of children with cancer and their parents or caregivers. METHODS This study was conducted in collaboration with a multidisciplinary team between January and February 2020 at MAHAK’s Pediatric Cancer Treatment and Research Center. We developed a self-management system in six stages: requirement analysis, conformity assessment, preparation of educational content, app prototyping, preliminary evaluation, and developing the final version. RESULTS A total of 35 people (n=24, 69% parents and n=11, 31% children) volunteered to participate in the study. However, only 63% (15/24) of parents and 73% (8/11) of children were eligible to participate. By adopting a user-centered design approach, we developed a mobile app, CanSelfMan, that includes five main modules (knowledge base, self-management tips, self-assessment report, ask a question, and reminders) that provide access to reliable information about acute lymphocytic leukemia and the self-management skills required for side effect measurement and reporting. A web-based dashboard was also developed for oncologists and included a dashboard to monitor users’ symptoms and answer their questions. CONCLUSIONS The CanSelfMan app can support these groups by providing access to reliable information about cancer, facilitating communication between children or parents and health care providers, and helping promote medication adherence through a reminder function. The active participation of the target group can help identify their needs. Therefore, through the involvement of stakeholders such as patients, caregivers, and oncologists in the design process, we improved usability and ensured that the final product was useful. This app is now ready to proceed with feasibility studies.

A large number of people worldwide are affected by chronic metal exposure, which is known to be associated with different type of malignancies. The mechanisms of metal carcinogenicity are complex in nature, and excessive reactive oxygen species (ROS) generation induced by chronic metal exposure, among the other factors, has been proposed as one of the major mechanisms involved in that process. In tumor cells, ROS buildup may lead to cell death through intrinsic and extrinsic signaling pathways. Furthermore, ROS-mediated redox signaling has a crucial role in angiogenesis, which is recognized as an essential step in tumor progression. There are several redox-modulating pathways and among them, the nuclear factor erythroid2-related factor2 (Nrf2), as a sensor of oxidative or electrophilic stress, has introduced as a master regulator of cellular response against environmental stresses. Activation of Nrf2 signaling induces expression of wide variety of antioxidant and detoxification enzymes genes. Thus, this transcription factor has recently received much attention as a target for cancer chemoprevention. But meanwhile, constitutive Nrf2 activation in cancerous cells may promote cancer progression and resistance to chemotherapy. The current review describes the major underlying mechanisms involved in carcinogenesis of trace metals: copper, silver, and cadmium, with a special focus on the Nrf2 signaling pathway as a crossroad between oxidative stress and angiogenesis.

INTRODUCTION: The personal health record (PHR) makes it possible for patients to access, manage, track, and share their health information. By engaging patients in chronic disease care, they will be active members in decision-making and healthcare management. OBJECTIVES: This study aimed to identify the functions and outcomes of PHR for patients with four major groups of chronic diseases (cardiovascular diseases, cancers, diabetes, and chronic respiratory diseases). METHOD: A systematic review was conducted on studies published in PubMed, Scopus, Web of Science, and Embase. Searching and screening were performed using the keyword of “Personal Health Record” without time limitation, and ended in August 2018. RESULTS: In total, 3742 studies were retrieved, 35 of which met the inclusion criteria. Out of these 35, 18 studies were conducted in the United States, 24 studies were related to patients with diabetes, and 32 studies focused on tethered PHRs. Moreover, in 25 studies, the function of viewing and reading medical records and personal health information was provided for three groups of chronic patients. Results showed that the use of PHRs helps the management and control of chronic diseases (10 studies). CONCLUSION: It is recommended that integrated PHRs with comprehensive functions and features were designed in order to support patient independence and empowerment in self-management, decrease the number of referrals to health centers, and reduce the costs imposed on families and society.

Background: Increased number of intestinal intraepithelial lymphocytes (IELs) is a key histological finding in the diagnosis of celiac disease (CD); however, the number of IELs in celiac patients and healthy subjects may vary from one region to another. Additionally, there are some seronegative celiac patients with a borderline histology. Objective: To determine the number of the CD3+ and CD8+ IELs T-cells in the celiac patients and healthy subjects (controls) in Isfahan. Methods: The duodenal biopsies were obtained from the celiac patients (n=15) and the controls (n=19). The total number of IELs/100 epithelial cells (ECs) were counted using the hematoxylin-eosin (H&E) staining method, and that of CD3+ and CD8+ IELs/100 ECs were counted using the immunohistochemistry (IHC) staining method. Results: This study defined the upper normal limit for each variable as mean + 2SD. Accordingly, the upper normal limits of the total IELs, CD3+ IELs, and CD8+ IELs/100 ECs were calculated as 37 (95% confidence intervals, CI: 33–41), 22 (95% CI: 19–25) and 12 (95% CI: 10–14), respectively. In 3 clinically CD diagnoses, the total IELs counts/100 ECs were below the upper normal limit, and the histopathological and serologic assays were negative. Nevertheless, the CD8+ IELs T-cells counts/100 ECs showed borderline values. Interestingly, these patients responded to a gluten-free diet (GFD). Conclusions: The study findings suggest that in the clinically diagnosed celiac disease, IELs count/100 ECs below the upper normal limit as well as negative histopathological and serologic assays and the cell density counts of the CD8+ IELs T-cells/100 ECs could be a useful parameter for CD diagnosis and make a decision to put them on a GFD.

BACKGROUND Acute lymphocytic leukemia (ALL) is the most prevalent form of pediatric cancer with numerous side effects during the treatment period. Children and their families require knowledge and information about the disease in order to control and manage these side effects. The use of mHealth provides a good opportunity for this group to receive information and education without having to visit specialists and healthcare centers, thus improving their quality of life through self-management OBJECTIVE This study aimed to develop the CanSelfMan app to empower and support children with ALL and their parents. METHODS This study was conducted in collaboration with a multidisciplinary team in six stages: 1) requirement analysis, 2) conformity assessment, 3) determining the educational content, 4) app prototyping, 5) preliminary evaluation, and 6) producing the final version. RESULTS The app comprised five main modules (ALL knowledge base, self-management skills, self-assessment report, ask a question, and reminder) that provide access to reliable information about ALL and the self-management skills required for side-effect measurement, reporting, and control. The app also improves communication between this group and the healthcare providers to help promote medication adherence through a reminder function. A web-based version of the app was also developed for Oncologists and included a dashboard for monitoring the users’ symptoms and answering their questions. CONCLUSIONS The use of mHealth can facilitate access to accurate information about cancer and its management by patients and their families. Therefore, in this study, we developed a smartphone app to address the self-management needs of children with ALL and their parents/caregivers. CanSelfMan can support these groups by providing access to reliable information, symptoms management skills, and facilitate communication between child/parents and oncologists.

The risk of transition to colorectal cancer (CRC) in advanced colorectal adenomas (ACAs) is about 2.5 times higher than the non-advanced ones. This systematic review and meta-analysis was performed to determine the effect of calcium and dairy products on the incidence of CAs and ACAs. Six databases were systematically searched and 37 relevant clinical trials and observational studies involving over 10,964 cases were selected for inclusion. The results showed that calcium consumption reduced the risk of CAs incidence by 8% (RR: 0.92; 95% CI: 0.89-0.96), and calcium intake as a food and dairy product reduced it about 21% (RR: 0.79; 95% CI: 0.72-0.86), and 12% (RR: 0.88; 95% CI: 0.78-0.98), respectively. However, calcium supplementation did not show a significant effect on CAs incidence (RR: 0.97; 95% CI: 0.89-1.05). Results also revealed that total calcium intake markedly reduced the risk of ACAs (RR: 0.79; 95% CI: 0.73-0.85) and the risk of recurrence of adenomas about 12% (RR: 0.88; 95% CI: 0.84-0.93). Our results suggest that natural sources of calcium such as dairy products and foods may have more effective role than supplementary calcium in terms of reducing the risk of incidence and recurrence of colorectal adenomas and advanced adenomas.

Purpose Lynch syndrome is the most common hereditary cancer syndromes due to a germline mutation in one of the mismatch-repair (MMR) genes. It results in early-onset colorectal cancer (CRC) and other Lynch-associated cancers in an autosomal dominant pattern. In this article, a new pathogenic variant in a Persian family with familial CRCs and positive Amsterdam II criteria has been described. Methods IHC-MMRs was done on tissue sections from tumor and its adjacent healthy tissue of the proband. Microsatellite instability (MSI) testing was also performed on DNA extracted from tumor and healthy tissue using Promega kit. Next Generation Sequencing (NGS) was finally done on genomic DNA of the proband using a 12-gene-panel including MMR genes. Variant filtering and prioritization were done using bioinformatics tools. Co-segregation analysis was used to evaluate the explored pathogenic variant. Results The proband was a 38-year woman at-diagnosis affected with CRC located in the sigmoid colon. The family history of cancer was observed in three successive generations. IHC was absent for MSH2 and MSH6, and MSI-High was reported from MSI testing. NGS analysis explored a new stop gained codon mutation on the first exon of MSH2 gene as a substitution of A to G MSH2: c.364A > T which was pathogenic according to the variant interpretation guidelines of American College of Medical Genetics and Genomics. Conclusion Revealing of a more obvious molecular feature of Lynch-syndrome among Iranian populations could lead to identification of at-risk people for early care and prevention of cancer.

Background: The use of mobile-based software for the self-management of patients with asthma improves the quality of life, reduces healthcare costs, provides effective health care interventions in asthma, and supports the patients in self-management. The current study was performed to identify the features of mobile-based self-management software for patients with asthma (MSSPA). Materials and Methods: The present review study was performed in 2018. Four databases including PubMed, Scopus, Emerald, and Google Scholar were screened by the combination of selected keywords. Data were collected using a data extraction form. Data were analyzed using the content analysis method. Results were abstracted and reported based on the study objectives. Results: Of the 297 articles retrieved during the first round of search, 24 were selected; 15 of which were the original articles (62.5%). As the most important applications of MSSPA, it could be used as a tool to support patients in self-management, provide them with educational information, and self-observation. Also, 75% of the studies (n=18) emphasized the effectiveness of MSSPA. Identification of the required field of the software was the most important requirement in using MSSPA. Nevertheless, some of the studies reported the low quality and compatibility of some designed apps compared with those of the available information systems. Conclusion: Identification of MSSPA features and considering them in new versions can promote the quality of MSSPA. However, according to the results of the study, in addition to identifying the software features, more attention should be paid to the users’ needs in software design.

Understanding the close interaction between the specialties of cardiology and oncology is necessary for early detection of cardiovascular disease (CVD) events in cancer patients. For the risk assessment of CVD in Breast and Colorectal Cancers (CIBC) study, in the current study we aimed to validate a questionnaire for the assessment of clinical history in patients with breast cancer and colorectal cancer (CRC).We determined the content validity of the questionnaire using the 2 indexes of content validity ratio (CVR) and content validity index (CVI) to examine the specificity, simplicity, clarity, and transparency of the items. Content validity assessment was performed through a panel of experts including 2 oncologists, 5 cardiologists, 2 general practitioners, and 1 epidemiologist. The reliability of the questionnaire was estimated using Cronbach's alpha coefficient in 50 patients. Intraclass correlation coefficient (ICC) was used to examine the reproducibility of the questionnaire during 1 week.The CRC and breast cancer questionnaire were designed with 16 and 32 questions, respectively. To obtain acceptable CVR, 5 and 11 questions were removed from the CRC and breast cancer questionnaires, respectively. Cronbach's alpha was 0.70 in the breast cancer questionnaire and 0.94 in the CRC questionnaire. All questions had a CVI of higher than 80%. The ICC in the breast cancer questionnaire ranged between 0.71 and 0.96 and in CRC questionnaire ranged between 0.78 and 0.98.The validity and reliability of our newly developed questionnaire was desirable. The reliability of the breast cancer questions was acceptable and that of the CRC questions was excellent. Thus, thus questionnaire can be used in this group of patients regardless of whether the goal is cardiac care or not.