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B-cell acute lymphoblastic leukemia (B-ALL), a prevalent malignancy predominantly affecting children, poses challenges such as drug resistance and cytotoxicity despite available treatment methods. The persistence of these challenges underscores the necessity for innovative therapeutic approaches to enhance efficacy. Natural compounds derived from plants, recognized for their potential to inhibit cancer cell growth, have drawn attention. Trifolium pratense extract, known for its significant anticancer properties in previous studies, was the focus of this investigation. This experimental study aimed to explore the impact of T. pratense extract on apoptosis and autophagy in NALM-6 cells. The cells were exposed to varying concentrations of the extract at specific time intervals, with viability and metabolic activity assessed using Trypan blue exclusion and MTT assays. Flow cytometry was employed to evaluate apoptosis using Annexin V/PI staining and ROS production using DCFH-DA staining. Real-time PCR was used to quantify gene expression related to apoptosis, autophagy, and oxidative stress, with data analysis performed using GraphPad PRISM software. Trifolium pratense extract demonstrated the capacity to induce apoptosis, autophagy, and significantly increase ROS production in NALM-6 cells. These effects were facilitated by the upregulation of corresponding genes. The MTT assay revealed an IC50 of 231 μg/mL at 48 h, and Flow cytometry analysis showed a 51.8% increase in apoptosis in this cell line. Overall, this study emphasizes the effectiveness of T. pratense extract in inducing autophagy and apoptosis pathways in NALM-6 cells derived from B-cell acute lymphoblastic leukemia, suggesting its potential as a candidate for further investigation as a supplement in ALL treatment., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Trace elements (TEs) play a crucial role in metabolism through their biochemical and catalytic effects, and alterations in their levels have been observed in various malignancies. Given that chemotherapy is a common treatment for cancer, it is important to understand how it may affect the levels of TEs in the body. By investigating changes in TEs levels before and after chemotherapy, this study aims to provide insights into the potential impact of chemotherapy on TEs levels in cancer patients. In the present study, analyses were performed on the serum level of some elements including Zn, Cu, Cd, and Se in 69 patients with leukemia, lymphoma, prostate and breast cancers before and after three courses of chemotherapy. The serum TEs were measured by atomic absorption spectroscopy. The serum Zn levels in patients with leukemia, lymphoma, and breast cancer significantly decreased after chemotherapy (P < 0.05). Significant reductions were also observed in the post-chemotherapy serum level of Cd in patients with prostate (P = 0.020) and breast cancer (P = 0.013). Moreover, the Se serum level significantly decreased after chemotherapy compared to before it in the breast cancer patients (P < 0.001). In contrast, the serum level of Cu was higher before than after chemotherapy in all the patients, but no significant difference was found (P > 0.05). The results show that chemotherapy can alter the level of TEs. The assessment of TEs in cancer patients may provide information about the side effects of chemotherapy as well as the use of appropriate strategies to better manage the clinical conditions of patients., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: Trace elements (TEs) have electrochemical and catalytic effects and play a crucial role in metabolism. A change in the concentrations of specific TEs may be associated with the incidence of various diseases such as solid tumors and hematological malignancies. By comparing the concentrations of TEs in the cases and controls, this study aims to provide insights into the possible impacts of TEs concentration on the incidence of leukemia and lymphoma., Materials and Methods: In the current study, the serum concentrations of Zn, Cu, Cd, Fe, and Se were analyzed for 20 patients with leukemia and lymphoma and 20 healthy individuals. Those concentrations were measured by atomic absorption spectroscopy., Results: The serum Zn concentration in the cases was significantly lower than that in the controls (P < 0.05). The serum concentrations of Cu, Cd and Fe were also lower in the cases than in the controls. However, no significant difference was found (P > 0.05). Also, the serum concentration of Se was higher in the patients than in the controls, but no significant difference was found (P > 0.05)., Conclusion: The results indicate that a low serum concentration of Zn may be associated with the incidence of leukemia and lymphoma. The assessment of TEs in hematological malignancies may be of a prognostic value and provide knowledge about the side effects of alterations in the concentration of those elements. It may also lead to the use of suitable strategies to better manage the clinical conditions of patients., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: Radiotherapy is one of the primary treatments for cancer, but it can cause damage to normal tissues and lead to side effects. The use of radiosensitizers can enhance the sensitivity of cancer cells to radiation, thereby reducing the amount of radiation required and minimizing damage to healthy tissues. Bismuth selenide nanoparticles (Bi2Se3 NPs) have been shown to have potential as radiosensitizers., Materials and Methods: In this study, we investigated the potential of Bi2Se3 NPs as a radiosensitizer in colon cancer cells (HCT-116) in vitro. The cells were treated with various concentrations of Bi2Se3 NPs and then exposed to ionizing radiation. The viability of the cells was assessed using the MTT assay, and the survival rate was evaluated., Results: Our results showed that Bi2Se3 NPs significantly enhanced the sensitivity of colon cancer cells to ionizing radiation in a dose-dependent manner. The combination of Bi2Se3 NPs and radiation resulted in a significant decrease in cell viability and survival rate compared to radiation alone., Conclusion: Bi2Se3 NPs have the potential to be used as a radiosensitizer in the treatment of colon cancer. The findings of this study suggest that combining Bi2Se3 NPs with radiation may enhance the effectiveness of radiotherapy and reduce the mortality rate associated with colon cancer. Further studies are needed to investigate the safety and efficacy of this approach in vivo., Competing Interests: The researchers state that they have no conflict of interest., (© 2024 The Authors. Published by Elsevier B.V.)

Background: Healthcare organizations are among high-risk organizations due to the nature of their work as well as structural, physical and technological complexities. Accordingly, it is important to use risk management and control programs in all departments of these organizations., Objective: The present study was conducted for the first time to evaluate the risk management status of the operating room and laboratory departments of Hamadan hospitals in 2022., Methods: In this descriptive-observational cross-sectional study, laboratory and operating room departments were selected as the research environment. To conduct this research, a valid and reliable questionnaire was used to collect data, and the data were analyzed using SPSS 22 statistical software., Results: The findings of the present study showed that the overall mean score of risk management status for the laboratory and operating room departments was 2.66 ± 0.15 and 2.89 ± 0.13, respectively. Furthermore, there was no statistically significant difference in the mean scores of the research components based on work experience, education level, and gender., Conclusion: It is suggested that the laboratory and operating room departments should focus more on adopting policies and solutions to improve the position of risk management, training and budget allocation for risk management.

Objective: Rare bleeding disorders (RBDs) are the diseases in which patients experience a deficiency of coagulation factors. In the management of these disorders, surveillance is a significant challenge. This study aimed to assess the survival of patients with RBDs in a five-year follow-up., Materials and Methods: This descriptive cross-sectional study was conducted on 146 patients with RBDs who had referred to Be'sat Hospital of Hamadan, Iran from July 2017 to August 2022. A computerized record search was performed to identify the patients. The surveillance time for a five-year follow-up was assessed with the Kaplan-Meier curve. A log-rank test also served to compare the survival rates according to the type of factor., Results: Out of 146 patients, 117 (80.2%) were males and 29 (19.8%) were females. They were in the range of 2-59 years of age with a mean of 23.11 ± 14.6. The most common disorder was FVIII deficiency (65.8%), and the rarest one was FXIII deficiency (4.8%). The rate of survival for any reason was 54.42 ± 1.3 months. The survival in combined FV and FVIII deficiencies was found to be longer than in the other deficiencies (55.9 ± 5.7), but there was no significant difference (P ≥ 0.05). In contrast, the survival in FXIII deficiency was observed to be lower than the other cases (44 ± 9.6); however, no significant difference was found in this regard (P ≥ 0.05)., Conclusion: The results of this study show that patients with RBDs have different rates of survival, which suggests that identifying high-risk patients may be helpful for the improvement of their survival time through timely therapeutic interventions., Competing Interests: The authors have no interests to declare., (© 2023 The Authors.)

Background: Trauma is one of the most critical public health issues worldwide, leading to death and disability and influencing all age groups. Therefore, there is great interest in models for predicting mortality in trauma patients admitted to the ICU. The main objective of the present study is to develop and evaluate SMOTE-based machine-learning tools for predicting hospital mortality in trauma patients with imbalanced data., Methods: This retrospective cohort study was conducted on 126 trauma patients admitted to an intensive care unit at Besat hospital in Hamadan Province, western Iran, from March 2020 to March 2021. Data were extracted from the medical information records of patients. According to the imbalanced property of the data, SMOTE techniques, namely SMOTE, Borderline-SMOTE1, Borderline-SMOTE2, SMOTE-NC, and SVM-SMOTE, were used for primary preprocessing. Then, the Decision Tree (DT), Random Forest (RF), Naive Bayes (NB), Artificial Neural Network (ANN), Support Vector Machine (SVM), and Extreme Gradient Boosting (XGBoost) methods were used to predict patients' hospital mortality with traumatic injuries. The performance of the methods used was evaluated by sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), accuracy, Area Under the Curve (AUC), Geometric Mean (G-means), F1 score, and P-value of McNemar's test., Results: Of the 126 patients admitted to an ICU, 117 (92.9%) survived and 9 (7.1%) died. The mean follow-up time from the date of trauma to the date of outcome was 3.98 ± 4.65 days. The performance of ML algorithms is not good with imbalanced data, whereas the performance of SMOTE-based ML algorithms is significantly improved. The mean area under the ROC curve (AUC) of all SMOTE-based models was more than 91%. F1-score and G-means before balancing the dataset were below 70% for all ML models except ANN. In contrast, F1-score and G-means for the balanced datasets reached more than 90% for all SMOTE-based models. Among all SMOTE-based ML methods, RF and ANN based on SMOTE and XGBoost based on SMOTE-NC achieved the highest value for all evaluation criteria., Conclusions: This study has shown that SMOTE-based ML algorithms better predict outcomes in traumatic injuries than ML algorithms. They have the potential to assist ICU physicians in making clinical decisions., (© 2023. The Author(s).)

Background: Ionizing radiation (IR) is widely used in the treatment of cancer in radiotherapy. One of the main concerns of patients with gastrointestinal cancers undergoing radiotherapy is the harmful side effects of IR on normal tissues. The liver, kidney, and duodenum are usually exposed to high doses of radiation in the treatment of some cancers in abdominal region radiotherapy. We aimed to assess the radioprotective effects of Malva sylvestris L. against IR damages to the abdominal region., Materials and Methods: This current study was conducted on 45 rats divided randomly into nine groups of five: A) negative control group, B) sham group, C) irradiation group, D) mallow treatment-1(200gr/kg), E) mallow treatment-2(400gr/kg), F) mallow treatment-3(600gr/kg), G) mallow treatment-4(200gr/kg) plus irradiation, H) mallow treatment-5(400gr/kg) plus irradiation, I) mallow treatment-6(600gr/kg) plus irradiation. Irradiation was performed with a 6Gy x-ray. Histopathological evaluations were performed 10 days after irradiation., Results: The histopathological examination results confirmed that preventive therapy with the effective dose of mallow reduced the liver, kidney, and intestine damage induced by radiation. The dose of 400 mg/kg was more effective than other selected dose in improving the damage caused by irradiation in the studied tissues., Conclusion: This study concludes that Malva sylvestris L. contributed to significant improvements in radiation-induced histological parameters of the liver and kidney and, to a lesser extent, in the intestine. These results collectively indicate that mallow is an effective radioprotective agent., Competing Interests: The authors declare that there are no conflicts of interest., (© 2023 The Authors.)

Background: Acute myeloid leukemia (AML) is a common malignancy in adults. A vast variety of environmental and lifestyle factors play a role in AML incidence. This study aimed to assess the factors related to AML., Study Design: A case-control study., Methods: This case-control study was performed on 137 AML cases during 2018-2021 at Beheshti Hospital in Hamadan, Iran, and 137 gender/age-matched controls. A questionnaire including 12 items was used to obtain information about lifestyle and environmental factors. A univariate and multiple variate logistic regression was used to estimate the odds ratios (OR), and a 95% confidence interval (CI) was used to investigate the relationship between the studied variables and the incidence of AML., Results: Based on findings, 62 (45.3%) out of the 137 leukemic cases were male and 75 (4.7%) were females. A statistically significant increased risk for AML was found with regard to prior usage of cytotoxic agents (OR: 8.00, 95% CI 1.01, 63.9, P=0.050), family history of malignancies (OR: 3.62, 95% CI: 1.65, 7.92, P=0.001), exposure to electrical power (OR: 3.22, 95% CI: 1.52, 6.81, P=0.002), and history of mental diseases (OR: 8.50, 95% CI: 3.64, 19.80, P=0.001). It was found that the AML incidence had no association with age, gender, radiation therapy, cigarette smoking, prior chemotherapy, congenital disorders, exposure to chemical agents, history of infectious mononucleosis, exercise, and blood transfusion (P&gt;0.05)., Conclusion: The current results suggested that cytotoxic agents, family history of malignancy, mental disorders, and exposure to electrical power could play a role in AML incidence.

Background and Aims: As a curative procedure, hematopoietic stemcell transplantation (HSCT) is an approved treatment for many malignant orbenign hematologic and non-hematologic diseases. There are different outcomes of HSCT, as well as several parameters influencing these outcomes., Methods: We had searched scientific sources like Web ofScience and PubMed with a combination of keywords such as HSCT, engraftment,survival, outcomes, etc. Totally, 80 articles were included., Results: Here we have reviewed the effective factors onmain outcomes of HSCT including engraftment, survival, graft versus hostdisease, and Mobilization. Also, the prediction of hematological reconstitutionand some novel suggestions leading to better outcomes are reviewed., Conclusion: The study will be applicable for improvedmanagement of autologous and allogeneic HSCT process to increase the procedureefficiency., Competing Interests: The authors declare no conflict of interest., (© 2021 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

Bone marrow (BM) niche is a specific microenvironment for hematopoietic stem cells (HSCs) as well as non-hematopoietic cells. Evidence shows that chemo/radiotherapy can lead to the disruption of different properties of HSCs such as proliferation, differentiation, localization, self-renewa, and steady-state of cell populations. Investigations have shown that the deregulation of balance within the marrow cavity due to chemo/radiotherapy could lead to bone loss, abnormal hematopoiesis, and enhanced differentiation potential of mesenchymal stem cells towards the adipogenic lineage. Therefore, understanding the underlying mechanisms of chemo/radiotherapy induced BM niche changes may lead to the application of appropriate therapeutic agents to prevent BM niche defects. Highlights Chemo/radiotherapy disrupts the steady-state of bone marrow niche cells and result in deregulation of normal balance of stromal cell populations. Chemo/radiotherapy agents play a significant role in reducing of bone formation as well as fat accumulation in the bone marrow niche. Targeting molecular pathways may lead to recovery of bone marrow niches after chemo/radiotherapy.

Background: Rare bleeding disorders include inherited coagulation disorders except for von Willebrand disease and hemophilia A and B. These disorders affect both men and women worldwide and mainly have an autosomal recessive pattern of inheritance. Given the paucity of cases of rare bleeding disorders, there are limited data regarding some topics among bleeding disorders., Methods: This retrospective study from 2005-2019 collected demographic data and the causes of death among cases with rare bleeding disorders from 2 provinces of Iran., Results: Overall, 5 deaths were reported, including 3 cases with factor V deficiency, a case with factor XIII deficiency, and a case with combined factor V and factor VIII deficiencies. The main causes of death were bleeding in the central nervous system (2 cases; 1 with factor V deficiency and 1 with combined factor XIII deficiency). Post-partum hemorrhage was the cause of death in a woman with factor V deficiency while anaphylaxis shock was the cause of death in the case with combined factor V and factor VIII deficiencies. A woman with factor V deficiency died from an internal bleeding episode., Conclusion: Gathering data on the causes of death in rare bleeding disorders through worldwide registries can be helpful for the management of this rare group of bleeding disorders.

This study aimed to compare the hematologic variables and pro-inflammatory biomarkers in urban adults living in Tabriz, Iran, facing various levels of outdoor volatile organic compounds (VOCs). Of all 219 people (212 male and 7 female), 71 were from the low traffic area and 148 were from high traffic and industrial areas. To validate the exposure levels, 93 air samples were taken to determine the target VOCs (benzene, toluene, xylenes, and styrene collectively called BTXS) concentrations in the studied areas. ANOVA and Tukey's tests were used for statistical analysis. Based on the results, significant differences were observed between the mean concentrations of BTXS with the following order of abundance: industrial > high traffic > low traffic. The Considerable decrease was observed in red blood cells (RBCs), hemoglobin, hematocrit, and eosinophils of 0.324 ( × 10 6 /μL), 0.57 g/dL, 1.87%, and 0.17 ( × 10 3 /μL), respectively in industrial area participants as compared to the low traffic area. However, a significant increase was observed in white blood cell count (WBC), neutrophils number, neutrophils percent, TNF-α and INF-γ of 0.88 ( × 10 3 /μL), 0.80 ( × 10 3 /μL), 3.53%, 34.2 ng/mL, and 40.06 ng/mL, respectively in the same groups. The comparison of low and high traffic areas showed significant differences in RBC (p = 0.034), tumor necrosis factor alpha (TNF-α) (p < 0.001), and interferon gamma (INF-γ) (p < 0.001). On the contrary, no significant difference was observed in TNF-α and INF-γ among the high traffic and industrial areas. In conclusion, the results showed that the samples from high traffic and industrial areas were regularly exposed to higher values of BTXS due to traffic and industrial pollutants as compared to the samples residing in low traffic regions. Based on the results living in both high traffic and industrial regions can increase adverse effects on hematologic parameters and pro-inflammatory cytokines., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Acute lymphoblastic leukemia (ALL) is the most common malignancy in children. Different environmental factors might be effective in the occurrence of this malignancy during childhood. The aim of this study was to find environmental risk factors in childhood ALL in Hamadan, Iran. Methods: This case-control study was done in 2015-2018 on 125 children younger than 15 years of age suffering from ALL. Patients were matched with 130 controls with respect to age, gender, and residence location. The identification of risk factors for ALL was sought based on the comparison of studied variables between case and control individuals. Results: A statistically significant increased risk for ALL was found with regard to type of delivery (OR: 0.43, 95% CI: 0.20 - 0.92, p˂0.02), childcare (OR: 4.58, 95% CI: 0.95 - 22.20, p˂0.04), birth weight (OR: 1.44, 95% CI: 1.53 - 2.21, p˂0.006), father’s education level (OR: 2.67, 95% CI: 1.10 - 6.45, p˂0.02), and father’s job (OR: 0.2 95% CI: 0.08 - 0.51, p˂0.001). Also observed were increased odds for ALL regarding male gender, mother’s high education level, mother’s freelance job, and medium or high family income. No association with ALL incidence was observed for age, gender, breastfeeding, mother’s age at pregnancy, malignancy in first- or second-degree relatives, or mother’s use of hair dye during pregnancy (p> 0.05). Conclusion: This study showed that father’s education level, father’s job, delivery type, birth weight, and childcare can play a role in the incidence of childhood ALL.

Solid tumors are a heterogeneous group of malignancies that result from out-of-control proliferation of cells. Thrombocytopenia is a common complication among patients with solid tumors that predispose them to bleeding disorders. The aim of this review article is to investigate the underlying mechanisms of the risk and incidence of thrombocytopenia in solid tumors. It can be argued that thrombocytopenia is a poor prognostic factor in solid tumors that can result from several factors such as polymorphism and mutation in some transcription factors and cytokines involved in megakaryocytic maturation or from the adverse effects of treatment. Therefore, an understanding of the exact mechanism of thrombocytopenia pathogenesis in each stage of solid tumors can help in developing therapeutic strategies to decrease bleeding complications in these malignancies., Competing Interests: Conflict of interest: The authors declare no conflict of interest.

Multiple Sclerosis (MS) is an autoimmune inflammatory demyelinating disease of the central nervous system. The aim of this study was to investigate the neuroprotective effects of transplanted human umbilical cord blood mesenchymal stromal cells (UCB-MSC) derived neural progenitor cell (MDNPC) in EAE, an experimental model of MS. To initiate neuronal differentiation of UCB-MSCs, the pre-induction medium was removed and replaced with induction media containing retinoic acid, b FGF, h EGF, NGF, IBMX and ascorbic acid for one week. The expression of neural genes was examined in comparison to control group by real-time PCR assay. Then, experimental autoimmune encephalitis (EAE) was induced using myelin oligodendrocyte glycoprotein (MOG, 35-55 peptides) in 24 C57BL/6 mice. After induction, the mice were divided in four groups (n=6) as follows: healthy, PBS, UCB-MSCs and MDNPC, respectively. At the end of the study, disease status in all the groups was analyzed using hematoxylin-eosin (H&E) staining of brain sections. We found that UCB-MSCs exhibit neuronal differentiation potential in vitro and transplanted MDNPC lowered clinical score and reduced CNS leukocyte infiltration compared to untreated mice. Our results showed that MDNPC from UCB may be a proper candidate for regenerative therapy in MS and other neurodegenerative diseases.

Objectives: Umbilical cord blood-derived mesenchymal stromal cells (UCB-MSCs) are ideally suited for use in various cell-based therapies. We investigated a novel induction protocol (NIP) to improve the neuronal differentiation of human UCB-MSCs under appropriate conditions., Materials and Methods: This experimental study was performed in Iranian Blood Transfusion Organization (IBTO), Tehran, Iran. UCB-MSCs were cultured in DMEM medium supplemented with 10% FBS in a humidified incubator in equilibration with 5% CO2 at 37°C. For neuronal differentiation of UCB-MSCs, DMEM was removed and replaced with pre-induction medium containing RA, bFGF, EGF, and basal medium for two days. Then, NGF, IBMX, AsA, and Neurobasal medium were used for six days for this purpose. Real-time PCR was performed to analyze the neuronal differentiation of UCB-MSCs for the first time in Iran., Results: We found that the maximum and minimum levels of gene expression were related to GFAP and nestin, respectively. In addition, our study showed that compared to other neuronal inducers, RA might play the main role in neuronal differentiation and fate of MSCs compared to other neuronal inducers., Conclusion: Our data showed that the combination of chemical (RA, IBMX, AsA) and growth factors (NGF, EGF, bFGF) in NIP may improve the efficiency of neuronal differentiation of UCB-MSCs and may provide a new method for easy and quick application of UCB-MSCs in regenerative medicine in the future. However, the functionality of neuron-like cells must be carefully assessed in animal experiments prior to use in clinical applications.