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Advanced melanoma is considered the most aggressive and deadly form of skin cancer whose incidence has been rising over the past three decades. In the absence of treatment, the median overall survival for advanced-stage metastatic disease is less than 6 months. Although most melanomas detected at an early stage can be cured with surgery, a subset of these eventually metastasize. Therefore, a critical need exists to identify unique molecular features that would be predictive of long-term outcome and response to specific therapies. Recent promising therapeutic regimens have included the use of immune checkpoint inhibitors, such as anti-PD1 antibodies. However, the ability to identify responders and non-responders to this therapy remains elusive. To address this challenge at the molecular level, previously our laboratory identified the emergence of a stem cell phenotype associated with advanced melanoma and other aggressive forms of cancer. Underlying this phenotype is the aberrant re-expression of the embryonic morphogen Nodal. Particularly noteworthy, we have observed Nodal to remain in advanced tumors of non-responders to standard-of-care therapies (i.e., BRAFi). This pilot study is the first proof-of-principle attempt to predict treatment response survival outcome in a small cohort of melanoma patients receiving anti-PD1 immune checkpoint inhibitor therapy - based on their Nodal expression profile. Using advanced multiplex immunohistochemistry-based digital pathology, the major finding of this preliminary study indicates that higher Nodal expression is often associated with poorer overall survival after anti-PD1 therapy, reaching nearly statistical relevance.

Abstract Background Effective self-care practices are crucial for maintaining health and well-being, as inadequate self-care can lead to increased health risks and decreased overall quality of life. To address these issues, one promising approach involves leveraging progressive web app (PWA) platforms to educate and empower individuals with necessary self-care services. This study aims to design, implement, and evaluate a national self-care PWA platform, aiming to enhance accessibility and effectiveness in promoting health and self-care practices. The platform designed to improve self-care processes can be utilized by mothers, children, adolescents, youth, adults, and patients with emotional and mental disorders. Methods This study was conducted in three phases. In the first phase, during 35 meetings with 19 health care providers including physicians and another group of professionals, the most common illnesses and conditions that require self-care were identified. Platform capabilities were then assessed based on stakeholder opinions. Subsequently, during 15 meetings 19 health care providers identified a comprehensive list of conditions benefiting from dedicated decision aids to enhance individuals’ self-care processes. In the second phase, a progressive web app platform was designed based on these common illnesses and conditions and capabilities and subsequently evaluated. To usability evaluation the platform, 26 evaluators utilized the system for two weeks. The QUIS 5.5 questionnaire was employed for evaluation, and the results were analyzed using SPSS 23. In the final phase, the system was implemented at the Smart University of Medical Sciences (SMUMS), affiliated with the Ministry of Health and Medical Education in Iran. Results Based on the most common illnesses and conditions (n = 87) and identified capabilities, the national self-care platform was designed with eight sections catering to ‘Maternal and child health services,’ ‘Mothers,’ ‘Infants,’ ‘Teenagers,’ ‘Adults,’ ‘Elderly,’ ‘Health of All Age Groups,’ ‘Patients with Mental and Emotional Health Disorders,’ and ‘General Information’ for user education. Furthermore, the platform features 54 decision aids (DA), teleconsultation services, and a self-care magazine (Access link: https://khodmoragheb.ir/ ). These features were integrated to provide comprehensive support and resources for self-care. A mean exceeding 7 was attained across all evaluated dimensions, indicating that evaluators generally agreed the platform performed well. Conclusion The designed national self-care platform offers a promising solution for managing healthcare challenges. This innovative approach addresses the specific needs of individuals and extends its reach to Persian-speaking patients worldwide, fostering a global impact. By embracing self-care practices on an international scale, this platform contributes to a more inclusive and accessible healthcare landscape for individuals in Iran, Afghanistan, Tajikistan, and beyond.

Background: Patient education (PE) is a fundamental patient right and an essential tool for improving health outcomes and enhancing patient satisfaction. However, barriers to effective PE exist, and understanding these obstacles is crucial for addressing them.Objectives: This study aimed to conduct a systematic review of the barriers to PE in Iran.Methods: A systematic review was conducted to analyze published articles on the barriers to PE in Iran, available in both English and Persian. The search was performed across multiple databases, including PubMed, Science Direct, and ProQuest, and academic search engine of Google Scholar, and Iranian databases such as MagIran, SID, IranDoc, and IranMedex, covering the period from January 1, 2000, to January 1, 2022. Specific keywords such as "barrier", "education", "learning", "client", "Iran" and "patient" were employed, resulting in a total of 185 articles related to the topic. Ultimately, 47 studies were included in the review.Results: The review encompassed 47 studies, comprising 32 descriptive, 9 qualitative, 3 intervention, and 3 review studies. The findings identified five categories of barriers: environmental barriers, nurse-related barriers, patient-related barriers, managerial barriers, and educational barriers removal.Conclusion: Educating patients presents challenges due to various barriers. To address these obstacles, it is imperative for managers to support nurses by providing necessary resources, adequate funding, dedicated nursing personnel, suitable infrastructure, and training in innovative teaching techniques.

Abstract Background The shadow curriculum is an emerging concept in curriculum studies that has not yet garnered significant attention in medical education. It includes programs and activities outside formal education to improve students’ academic performance in the formal educational system. Objective In this study, we designed and developed an online course based on the shadow curriculum and evaluated its effect on students’ learning and academic performance. Methods This study represents a form of developmental research, with the study population comprising medical and dental students from universities of medical sciences in Iran. The course was conducted at the Smart University of Medical Sciences, following the ADDIE instructional design approach in three phases. The initial two phases involved designing and implementing the program according to the students’ needs and requirements. In the third phase, we evaluated the program using the Kirkpatrick model. In the first level evaluation, the reaction of 70 students in the course was investigated. To assess the impact of the course, pre and post-tests were administered to 30 students. Finally, the effect of the course on students’ success in the comprehensive exams for basic medical sciences, dentistry, and pre-internship was analyzed by examining the passing and failing statuses of 83 and 57 students who participated in the September 2023 and February 2024 exams. Results The results indicated that the students responded positively to the program. The analysis of pre-test and post-test scores showed a significant improvement in the students’ academic performance across all the subjects presented in the course, including basic medical sciences, dentistry, and pre-internship (p

Abstract Higher education plays a critical role in driving an innovative economy by equipping students with knowledge and skills demanded by the workforce. While researchers and practitioners have developed data systems to track detailed occupational skills, such as those established by the U.S. Department of Labor (DOL), much less effort has been made to document which of these skills are being developed in higher education at a similar granularity. Here, we fill this gap by presenting Course-Skill Atlas – a longitudinal dataset of skills inferred from over three million course syllabi taught at nearly three thousand U.S. higher education institutions. To construct Course-Skill Atlas, we apply natural language processing to quantify the alignment between course syllabi and detailed workplace activities (DWAs) used by the DOL to describe occupations. We then aggregate these alignment scores to create skill profiles for institutions and academic majors. Our dataset offers a large-scale representation of college education’s role in preparing students for the labor market. Overall, Course-Skill Atlas can enable new research on the source of skills in the context of workforce development and provide actionable insights for shaping the future of higher education to meet evolving labor demands, especially in the face of new technologies.

Tyrosinase is an essential enzyme in melanin production, which plays an important role in the browning of plants and vegetables and skin diseases in humans. Therefore, the design and synthesis of tyrosinase inhibitors are important in the food industry and in treating melanin-related skin diseases. In this study, the tyrosinase inhibitory activity and the antioxidant capacity of a series of 3-hydroxypyridin-4-one derivatives that have been synthesized in the Department of Medicinal Chemistry at the Faculty of Pharmacy, Shiraz University of Medical Sciences, were assessed. The antioxidant activities were evaluated using the 1,1-diphenyl-2-picrylhydrazine (DPPH) radical scavenging method. The biological results indicated that these derivatives exhibit mild anti-tyrosinase and antioxidant properties. Docking studies were also conducted, and the results showed that the compounds have suitable binding free energy and interactions with the active site of the tyrosinase enzyme, which were not consistent with the biological results. Finally, the investigation of the pharmacokinetic characteristics and drug-likeness of the derivatives showed that they have the potential for oral bioavailability.

ackground & Objective: Evaluating the academic performance and competencies of medical students is essential in the medical field. Written tests play a big part in this situation. This study's primary goal was to comprehend medical students' experiences with their exams. Materials & Methods: The study was carried out from 2020 to 2022 at the Fasa University of Medical Sciences in the Iranian province of Fars, using a qualitative research methodology using a phenomenological approach. In-depth one-on-one interviews with the investigators were conducted with twenty-three medical students from a variety of professions, including health, medicine, nursing, operating room technology, anesthesiology technology, and medical emergencies. The interpretive phenomenological approach was used to analyze the data, including observations made during written exams and in-depth interviews. Results: The results of the study revealed four general themes that reflected the views of the medical students about their exam experiences. The themes that emerged were emotional fluctuations, stressful difficulty, coping strategies, and blessings in disguise. Conclusion: Despite the participants' initial uncertainty, the study participants saw the exams as a blessing in disguise. They saw exams as essential learning resources and a means of gaining access to stable job chances. However, because of the psychological strain and scoring direction, the exam also presented a hard challenge. Furthermore, students experienced a range of positive and negative emotional changes as a result of the test. In order to manage their test anxiety, the students used both positive and negative strategies for coping. These results have substantial implications for policies that might be implemented in the field of education.

Abstract Zic family member ZIC4 is a transcription factor that has been shown to be silenced in several cancers. However, understanding the regulation and function of ZIC4 in pediatric choroid plexus tumors (CPTs) remained limited. This study employed data mining and bioinformatics analysis to investigate the DNA methylation status of ZIC4 in CPTs and its correlation with patient survival. Our results unveiled ZIC4 methylation as a segregating factor, dividing CPT cohorts into two clusters, with hyper-methylation linked to adverse prognosis. Hyper-methylation of ZIC4 was confirmed in a choroid plexus carcinoma-derived cell line (CCHE-45) by bisulfite sequencing. Furthermore, our study demonstrated that demethylating agent and a histone methyltransferase inhibitor could reverse ZIC4 silencing. RNA sequencing and proteomic analysis showed that ZIC4 over-expression influenced genes and proteins involved in immune response, antigen processing and presentation, endoplasmic reticulum stress, and metabolism. Functionally, re-expressing ZIC4 negatively impacted cell proliferation and migration. Ultimately, these findings underscore ZIC4 hyper-methylation as a prognostic marker in CPTs and shed light on potential mechanisms underlying its tumor suppressor role in CPC. This insight paves the way for novel therapeutic targets in treating aggressive CPTs.

Background: The COVID-19 pandemic caused an unprecedented mid-semester transition to virtual learning. Instructors and students had to adapt to new ways of delivering and receiving course material. Objective: The present investigation examined whether course format and sense of belongingness were associated with learning satisfaction during the COVID-19 pandemic, as well as racial/ethnic or gender identity differences in academic experiences during this time. The current study also explored student perceptions of instructor support, changes in workload, and changes in learning. Method: Undergraduate students (N = 157) responded to quantitative and qualitative items regarding their academic experiences during the first semester of the pandemic in an online survey. Results: Blended courses were associated with poorer outcomes than solely synchronous and asynchronous courses. There were no racial differences in academic experiences; however, women had more positive academic experiences than men. Greater academic and campus belongingness predicted better academic experiences. Students perceived clear, frequent instructor communication as vital to their success. Conclusion: Students' experiences with virtual learning varied depending on instructor and student factors.

This article examines the potential contribution of social enterprise to the "wicked" problem of creativity and literacy in a performative schooling environment, drawing on an ethnographic study of Ciento, a social enterprise organization that works with under-resourced young people, families, and communities in Melbourne, Australia. In light of the growing body of research on the ways in which schools navigate creativity and performativity, this article contributes new knowledge on non-school organizations that is largely missing from this conversation, as well as new insights on the operations of education-focused social enterprises in Australia. It considers the social, political, and historical factors that have shaped this unique space of educational "wickedity" and the ways in which organizational rationales and practices, as well as the experiences and views of staff and participants, indicate a complex, promising, and innovative approach to educational problem-solving.

Research suggests that English for Specific Purposes (ESP) students in English-as-a-Foreign-Language (EFL) contexts have difficulties understanding the passages in technical English textbooks of various fields of study including computer software engineering. Few experimental studies to date have investigated the effect of an online hybrid reading intervention on the reading comprehension performance of these students. To fill this gap, the present experimental study sought to assist these students with comprehending the passages of an ESP textbook entitled ''Technical English for Computer Software Engineers'', developed for computer software engineering students of a non-profit university in Babol, Iran. In doing so, an 8-session online hybrid reading intervention featuring cognitive and metacognitive strategies was administered to an experimental group (n = 30) of ESP students, while the control group (n = 30) followed the conventional approach to teaching the reading skill. To track the participants' reading comprehension, International English Language Testing System (IELTS) reading tests were used before and after the intervention. Results showed that the treatment led to a statistically significant difference between the two groups in terms of the reading comprehension and strategy use. In addition, the teachers' and students' perceptions with regard to the whole textbook were reported. Findings bear pedagogical significance for all the stakeholders.