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Background: Regenerative medicine is an emerging multidisciplinary branch of science that addresses the replacement, engineering, and re-engineering of cells, tissues or organs in order to establish or restore their normal functions. According to the basic concepts of regenerative medicine, marine regenerative medicine (MRM), inspired by marine organisms, can be defined as following the regenerative medicine strategies to develop regenerative medicine products for clinical applications. Materials and Methods: The common framework of the proposed convergence roadmap of the Albright Strategy Group, which consists of four steps, was used to develop the roadmap for the development of MRM in I.R. Iran. The first step is definition and scope of MRM; the second step shows the direction to MRM based on its structure and fundamental elements; the third step discloses the most competitive technologies in MRM; and the fourth step presents an investment summary and action plan for MRM in the I.R. Iran. Results: Five strategies may be considered for the development of MRM in I.R. Iran. 1. The establishment of a center of excellence for research in MRM in the south of Iran; 2. Networking and establishment of a common platform for MRM with the regenerative medicine community; 3. Establishing connections with industries and the world of business; 4. Educating and training the next generation of human resources to provide a critical national mass of workforce for MRM; 5. The development of biological models, tools and techniques of MRM. Conclusion: Since research on marine stem cells, whole body regeneration (WBR) of marine organisms, application of advanced biomaterials, and the principles of regenerative pharmacology are fundamental pillars for MRM, these structural elements should be considered in the roadmap draft of MRM in I.R. Iran.

Background: Razi is one of the greatest physicians in the history of medicine, and his book, Al-Hawi, is one of the most reliable medical resources. The structure of Al-Hawi is such that in each section, Razi expresses the opinion of his predecessors and contemporary physicians after mentioning the name of each physician and also expresses his first-hand experiences after the phrase “My View”. To date, ten original papers have explored the surgical points raised in Razi’s works; however, none of these studies have extensively reviewed the entire scientific approach of Razi to surgical sciences in Al-Hawi. Materials and Methods: The source of the present library research was the original text of Al-Hawi compiled by Ehsan Moqaddas and its Persian translation by Mohammad Ibrahim Zaker. In this study, Razi’s views, which are discussed in the "My View" sections, were collected, and his ideas about the principles and knowledge of surgery were investigated. Results: A total of 48 topics in surgical sciences were found in Al-Hawi, most of which (23 out of 48) were in the therapeutic domain, and ophthalmic surgery was the most frequently-discussed topic (in 12 out of 48). In 26 (54%) of the cases, Razi addressed the topic independently, without discussing any opinions from his predecessors or contemporary physicians. Conclusion: Not only did Razi have a comprehensive understanding of the position, precautions, necessary subtleties and contraindications of surgical measures, but also in various examples, he presented original ideas on diagnosis and treatment with regard to topics in surgery.

Abstract Metabolic syndrome (MetS), comprising obesity, insulin resistance, hypertension, and dyslipidemia, increases the risk of type II diabetes mellitus and cardiovascular disease. This study aimed to identify the prevalence and determinants of specific clusters of the MetS components and tobacco consumption among older adults in Iran. The current study was conducted in the second stage of the Bushehr Elderly Health (BEH) program in southern Iran—a population-based cohort including 2424 subjects aged ≥ 60 years. Latent class analysis (LCA) was used to identify MetS and tobacco consumption patterns. Multinomial logistic regression was conducted to investigate factors associated with each MetS class, including sociodemographic and behavioral variables. Out of 2424 individuals, the overall percentage of people with one or more components of MetS or current tobacco use was 57.8% and 20.8%, respectively. The mean (SD) age of all participants was 69.3(6.4) years. LCA ascertained the presence of four latent classes: class 1 (“low risk”; with a prevalence of 35.3%), class 2 (“MetS with medication-controlled diabetes”; 11.1%), class 3 (“high risk of MetS and associated medication use”; 27.1%), and class 4 (“central obesity and treated hypertension”; 26.4%). Compared to participants with a body mass index (BMI)

Abstract Background & objective Osteoporosis is a growing public health concern, particularly among the aging population. This study aimed to evaluate the association between osteoporosis and quality of life (QoL) in a sample of older adults. Methods This cross-sectional study utilized data from all the participants of Bushehr Elderly Health program (BEHP), phase 2. QoL was assessed using the 12-Item Short Form Survey (SF-12 Questionnaire), and participants were classified as having osteoporosis or not based on the WHO diagnostic criteria. The physical (PCS) and mental (MCS) component summaries of QoL were estimated. The association between osteoporosis and QoL was evaluated separately for men and women, considering various health and lifestyle factors using linear regression analysis. Results The study included 2,399 participants (average age 71.27 ± 7.36 years). 1,246 were women and 1,153 were men. Osteoporosis was present in 59% of women and 23% of men. Participants with osteoporosis had significantly lower PCS scores compared to those without osteoporosis (women: 38.1 vs. 40.2, p

Abstract Cardiometabolic risk factors increase the chance of developing cardiovascular disease (CVD) and type 2 diabetes. Most CVD risk factors are influenced by total and regional obesity. A higher risk of developing CVD may be linked to vitamin D deficiency, which is more prevalent in the older population. With the goal of evaluating the association between vitamin D and cardiometabolic risk factors and total and regional obesity in older adults, this research included 25 (OH) vitamin D3 concentrations and biochemical markers associated with cardiometabolic diseases, as well as total and regional adiposity, which was measured by DXA. A total of 1991 older participants in the PoCOsteo study were included. Overall, 38.5% of participants had vitamin D deficiency. After adjusting for confounders, the results of multiple linear and logistic regression suggested an inverse association between vitamin D and body mass index (P = 0.04), waist circumference (P = 0.001), total fat (P = 0.02), android fat (P = 0.001), visceral fat (P

Abstract Background Falls are a common cause of fractures in older adults. This study aimed to investigate the factors associated with spontaneous falls among people aged ≥ 60 years in southern Iran. Methods The baseline data of 2,426 samples from the second stage of the first phase of a prospective cohort, the Bushehr Elderly Health (BEH) program, were included in the analysis. A history of spontaneous falls in the year before recruitment was measured by self-report using a standardized questionnaire. Demographic characteristics, as well as a history of osteoarthritis, rheumatoid arthritis, low back pain, Alzheimer’s disease, epilepsy, depression, and cancer, were measured using standardized questionnaires. A tandem gait (heel-to-toe) exam, as well as laboratory tests, were performed under standard conditions. A multiple logistic regression model was used in the analysis and fitted backwardly using the Hosmer and Lemeshow approach. Results The mean (standard deviation) age of the participants was 69.34 (6.4) years, and 51.9% of the participants were women. A total of 260 (10.7%, 95% CI (9.5–12.0)%) participants reported a spontaneous fall in the year before recruitment. Adjusted for potential confounders, epilepsy (OR = 4.31), cancer (OR = 2.73), depression (OR = 1.81), low back pain (OR = 1.79), and osteoarthritis (OR = 1.49) increased the risk of falls in older adults, while the ability to stand ≥ 10 s in the tandem gait exam (OR = 0.49), being male (OR = 0.60), engaging in physical activity (OR = 0.69), and having high serum triglyceride levels (OR = 0.72) reduced the risk of falls. Conclusion The presence of underlying diseases, combined with other risk factors, is significantly associated with an increased risk of falls among older adults. Given the relatively high prevalence of falls in this population, it is crucial to pay special attention to identifying and addressing these risk factors.

Background The aim of this study was to investigate the association of osteosarcopenia with frailty and poor health conditions among older Iranian adults. Methods This cross-sectional study analyzed data from the Bushehr Elderly Health Program. Osteosarcopenia was defined as the presence of osteopenia/osteoporosis and sarcopenia, while the Fried criteria were used to assess frailty. We assessed the history of falls and health-related quality of life (HRQoL), including physical and mental component summaries (PCS and MCS, respectively), history of fractures, activities of daily living (ADL), and instrumental activities of daily living (IADL), as indicators of poor health conditions. Results This study included a total of 2,371 older adults. The prevalence rates of osteosarcopenia-only, frailty-only, and osteosarcopenia with frailty were 17.4%, 3%, and 4.8%, respectively. The prevalence of a history of falls, poor ADL, and poor IADL was significantly higher in the frailty-only and osteosarcopenia with frailty groups. Osteosarcopenia with frailty was significantly associated with a history of falls (adjusted odds ratio [adjOR]=1.94; 95% confidence interval [CI], 1.20–3.15), poor ADL (adjOR=2.85; 95% CI, 1.81–4.50), and poor IADL (adjOR=5.09; 95% CI, 2.85–9.11). However, the frailty-only group also showed an association with falls and poor ADL and IADL. Only osteosarcopenia was associated with an increased OR for fracture. Frailty had the greatest effect on the MCS and PCS scores, whereas osteosarcopenia with frailty had a moderate impact. Conclusion Osteosarcopenia with frailty significantly increased the odds of falls, poor ADL, poor IADL, and lower HRQoL compared with the robust group. Combined osteosarcopenia and frailty were not associated with poor health. These findings indicate the importance of diagnosing osteosarcopenia and frailty as separate entities to provide appropriate interventions and treatment.

Abstract This study investigated the association between serum concentrations of Polychlorinated Biphenyls (PCBs) and the risk of type 2 diabetes within the general population. A ten-year follow-up historical cohort study was conducted during 2009–2019 as part of the Bushehr MONICA cohort study in Iran. Of 893 non-diabetes participants at base line, 181 individuals were included in the study. The concentration of nine PCB congeners was measured in individuals’ serum samples at baseline, and the risk of type 2 diabetes was determined based on fasting blood sugar at the end of follow-up. Multiple logistic regression models were used to assess the study outcomes after adjusting for covariates. This study included 59 diabetes individuals (32.6%; mean [SD] age: 58.64 [8.05]) and 122 non-diabetes individuals (67.4%; mean [SD] age: 52.75 [8.68]). Multivariable analysis revealed that a one-tertile increase (increasing from 33rd centile to 67th centile) in Σ non-dioxin-like-PCBs (OR 2.749, 95% CI 1.066–7.089), Σ dioxin-like-PCBs (OR 4.842, 95% CI 1.911–12.269), and Σ PCBs (OR 2.887, 95% CI 1.120–7.441) significantly associated with an increased risk of type 2 diabetes. The strongest association was obtained for dioxin-like PCBs. The results highlight a significant correlation between PCB exposure and an increased risk of type 2 diabetes. The evidence suggests that additional epidemiological studies are necessary to clarify the link between PCBs and diabetes.

Abstract As the population ages, the global burden of cardiometabolic disorders will increase. This study aimed to investigate the prevalence of cardiometabolic disorders (diabetes, hypertension, and hyperlipidemia) in elderly and to evaluate the effects of various variables including age, sex, education, marital status, smoking, income, physical activity, dementia and depressed mood on untreated cardiometabolic disorders. This was a cross sectional study conducted in Bushehr Elderly Health Program. A total 2381 participants were included. Medical data were collected by trained interviewers. The mean age of the study participants was 69.34 years. Proportions of diabetes, hypertension, hyperlipidemia and hypercholesterolemia were 43.25%, 75.71%, 64.74% and 35.31% respectively. Untreated diabetes prevalence was higher for males (OR = 1.60, 95%CI = 1.20–2.15), older adults (OR = 1.02, 95%CI = 1.00–1.05), and pre-frail status (OR = 0.69, 95%CI = 0.52–0.92). Males (OR = 2.16, 95%CI = 1.64–2.84) and current smokers (OR = 1.42, 95%CI = 1.05–1.93), in contrast to married participants (OR = 0.25, 95%CI = 0.08–0.78), people with higher education levels (OR = 0.51, 95%CI = 0.29–0.89) and dementia (OR = 0.78, 95%CI = 0.61–1.00) were more likely to have untreated HTN. Untreated dyslipidemia is more common in smokers (OR = 1.78, 95%CI = 1.19–2.66) and males (OR = 1.66, 95%CI = 1.21–2.27), while untreated hypercholesteremia is more common in males (OR = 3.20, 95%CI = 1.53–6.69) and is reported lower in people with dementia (OR = 0.53, 95%CI = 0.28–1.01).

Abstract Background and objectives Multimorbidity, defined as the presence of two or more long-term health conditions in an individual, is one of the most significant challenges facing health systems worldwide. This study aimed to identify determinants of classes of multimorbidity among older adults in Iran. Research Design and methods In a cross-sectional sample of older adults (aged ≥ 60 years) from the second stage of the Bushehr Elderly Health (BEH) program in southern Iran, latent class analysis (LCA) was used to identify patterns of multimorbidity. Multinomial logistic regression was conducted to investigate factors associated with each multimorbidity class, including age, gender, education, household income, physical activity, smoking status, and polypharmacy. Results In 2,426 study participants (mean age 69 years, 52% female), the overall prevalence of multimorbidity was 80.2%. Among those with multimorbidity, 3 latent classes were identified. These comprised: class 1, individuals with a low burden of multisystem disease (56.9%); class 2, individuals with predominantly cardiovascular-metabolic disorders (25.8%) and class 3, individuals with predominantly cognitive and metabolic disorders (17.1%). Compared with men, women were more likely to belong to class 2 (odds ratio [OR] 1.96, 95% confidence interval [CI] 1.52–2.54) and class 3 (OR 4.52, 95% CI 3.22–6.35). Polypharmacy was associated with membership class 2 (OR 3.52, 95% CI: 2.65–4.68) and class 3 (OR 1.84, 95% CI 1.28–2.63). Smoking was associated with membership in class 3 (OR 1.44, 95% CI 1.01–2.08). Individuals with higher education levels (59%) and higher levels of physical activity (39%) were less likely to belong to class 3 (OR 0.41; 95% CI: 0.28–0.62) and to class 2 (OR 0.61; 95% CI: 0.38–0.97), respectively. Those at older age were less likely to belong to class 2 (OR 0.95). Discussion and implications A large proportion of older adults in Iran have multimorbidity. Female sex, polypharmacy, sedentary lifestyle, and poor education levels were associated with cardiovascular-metabolic multimorbidity and cognitive and metabolic multimorbidity. A greater understanding of the determinants of multimorbidity may lead to strategies to prevent its development.

Abstract Background and objective Considering the importance of diabetes and its increased prevalence with aging, this study aimed to evaluate the association between diabetes status and quality of life (QOL) and the determining factors in individuals over 60. Methods Two thousand three hundred seventy-five individuals including 819 (34.5%) with diabetes, aged 69.4 ± 6.4, from Bushehr Elderly Health Program (BEHP) were enrolled. We categorized the participants as non-diabetic, controlled diabetic, and poorly controlled diabetic. The QOL was assessed using the SF-12 questionnaire. The physical (PCS) and mental (MCS) component summaries of QOL were estimated. We compared the SF-12 domains and components between the categories using ANOVA. Further, the association of diabetes status with PCS and MCS was assessed after adjustment for possible confounders including age, sex, depression, cognitive impairment, physical activity, and other relevant factors using linear regression analysis. Results Individuals with diabetes had lower PCS (40.9 ± 8.8 vs. 42.7 ± 8.6, p-value

Marine invertebrate stem cells (MISCs) represent a distinct category of pluripotent and totipotent cells with remarkable abilities for self-renewal and differentiation into multiple germ layers, akin to their vertebrate counterparts. These unique cells persist throughout an organism’s adult life and have been observed in various adult marine invertebrate phyla. MISCs play crucial roles in numerous biological processes, including developmental biology phenomena specific to marine invertebrates, such as senescence, delayed senescence, whole-body regeneration, and asexual reproduction. Furthermore, they serve as valuable models for studying stem cell biology. Despite their significance, information about MISCs remains scarce and scattered in the scientific literature. In this review, we have carefully collected and summarized valuable information about MISC detection by perusing the articles that study and detect MISCs in various marine invertebrate organisms. The review begins by defining MISCs and highlighting their unique features compared to vertebrates. It then discusses the common markers for MISC detection and in vitro techniques employed in invertebrate and vertebrates investigation. This comprehensive review provides researchers and scientists with a cohesive and succinct overview of MISC characteristics, detection methods, and associated biological phenomena in marine invertebrate organisms. We aim to offer a valuable resource to researchers and scientists interested in marine invertebrate stem cells, fostering a better understanding of their broader implications in biology. With ongoing advancements in scientific techniques and the continued exploration of marine invertebrate species, we anticipate that further discoveries will expand our knowledge of MISCs and their broader implications in biology.

Abstract Background Metabolic syndrome (MetS) known as a risk factor for cardiovascular diseases (CVDs) has developed into a major source of health issue, especially for the elderly. In the present study, we investigated the association between continuous MetS (cMetS) score and its components with electrocardiographic (ECG) abnormalities in the community-dwelling older adults. Methods This cross-sectional study is derived from the second phase of BEH cohort study which is conducted on individuals aged over 60 years old. Standard 12-lead ECGs were recorded and coded by qualified physicians and continuous values of metabolic syndrome risk scores (cMetS) were measured. Data regarding socio-demographic, medical history, and lifestyle variables were collected by trained interviewers. The multinomial regression analysis was used to investigate the relationship between cMetS and its components with ECG abnormalities in the included participants. Results 2426 individuals (mean age ± standard deviation: 69.30 ± 6.33 years) were included in the final analysis. Overall, 22.5% of the participants showed ECG abnormalities. Among these, 8.0% (n = 139) of participants had minor and 14.6% (n = 354) had major ECG abnormalities. In the final models, cMetS (OR = 1.04), mean arterial pressure (MAP((OR = 1.01), and higher fasting blood glucose (FBG) (OR = 1.01) increased the risk of ECG abnormalities (p

Objectives: This cross-sectional study, conducted as part of the Bushehr Elderly Health program stage II in Bushehr, Iran, aimed to evaluate health-related quality of life (HR-QoL) in individuals aged ≥ 60 with osteosarcopenia, a condition characterized by the co-occurrence of osteopenia/osteoporosis and sarcopenia. Given the increasing elderly population worldwide, understanding the HR-QoL of this demographic is crucial, with osteosarcopenia being a significant factor. Methods: The study enrolled 2369 participants aged ≥ 60 and collected demographic and anthropometric data. Various questionnaires, including the Short Form 12, Patient Health Questionnaire-9, Activities of Daily Living, and Instrumental Activities of Daily Living, were administered. Comparisons were made between individuals with and without osteosarcopenia. Regression models were employed to identify variables associated with HR-QoL in those with osteosarcopenia. Results: Key findings revealed that 22.5% of participants had osteosarcopenia. Significantly different HR-QoL measures were observed between the 2 groups, especially in physical functioning and physical component summary scores. Male gender, advanced age, and chronic illnesses were linked to lower physical and mental HR-QoL scores among those with osteosarcopenia. In female participants, a history of fractures and physical disability were associated with reduced quality of life. Conclusions: This study underscores the negative impact of osteosarcopenia on HR-QoL, particularly in male participants, with a focus on physical aspects. It also highlights age and chronic disease as contributing factors to diminished HR-QoL in individuals with osteosarcopenia. These findings emphasize the importance of addressing osteosarcopenia in the elderly population to improve their overall well-being.

Abstract Background and objective Dysmobility Syndrome (DS) is characterized as an accumulation of clinical risk factors for functional disability, such as osteoporosis, sarcopenia, and obesity. Neurological disorders that affect the motor and sensory systems can also contribute to the condition, resulting in gait and muscle strength disturbances, as well as a history of falls and fractures. The study aimed to determine the association between fat distribution in different body areas and the odds of older adults developing DS, as there is still uncertainty about the accumulation of fat in which area is most closely linked to the condition. Methods This cross-sectional study was conducted according to the data from the second phase of the Bushehr Elderly Health Cohort (BEH). Dysmobility Syndrome was defined based on the co-occurrence of at least three outcomes of its criteria. Body composition was measured using dual-energy X-ray absorptiometry (DXA) and anthropometric studies. For evaluating the relationship, multivariate logistic regression and adjusted univariate linear regression were used. Results Of 2,359 who were recruited in the study, 1,277 participants (54.13%) had DS. According to the final logistic regression model in the limb region, FM and FM to FFM ratios were significantly associated with DS [OR (95%CI) = 1.04 (1.02 to 1.05), and 3.42 (1.95 to 5.99), respectively]. Also, In the trunk region, the FM and FM to FFM ratio were significantly related to the odds of DS, although this relationship was weaker than in the limbs region [OR (95%CI) = 1.02 (1.00 to 1.03), and 2.45 (1.36 to 4.39), respectively]. Conclusion Our findings indicate that a higher regional and whole-body amount of fat mass rather than fat-free mass is closely linked to an increased risk of DS, particularly in the elderly population. Notably, higher fat mass in the limbs (especially in the legs) is associated with greater odds of DS, while a higher android-to-gynoid fat mass ratio is associated with lower DS risk. Screening fat mass distribution in older individuals can be a valuable strategy for promptly diagnosing DS, implementing interventions to prevent disabilities, and improving their quality of life.

Abstract Background A significant proportion of the global burden of disability and premature mortality has caused by hypertension. It seems that the relationship between obesity and hypertension is not only associated with excessive body fat mass (FM) but also with body adipose distribution patterns. The present study investigated the association between regional fat distribution using dual-energy X-ray absorptiometry and hypertension in older adults. Methods This cross-sectional study was performed using the data from Bushehr Elderly Health Program (BEH) on a total of 2419 participants aged 60 and over. Hypertension was defined as SBP of at least 140 mmHg and/or DBP of at least 90 mmHg. SBP between 120 and 139 mmHg and/or a DBP between 80 and 89 mmHg were considered prehypertension. Participants underwent body composition measurement by dual-energy x-ray absorptiometry to analyze FM, fat-free mass (FFM) in trunk and extremities composition. Results The results showed that 460 (19.02%) of participants had prehypertension, and 1,818 (75.15% ) had hypertension. The odds of having prehypertension (OR: 1.06, 95%CI: 1.01–1.12) and hypertension (OR: 1.08, 95%CI: 1.03–1.13) increased with a rise in total body FM percentage. Moreover, people with a higher FM to FFM ratio had increased odds of being prehypertensive (OR: 9.93, 95%CI: 1.28–76.99) and hypertensive (OR: 16.15, 95%CI: 2.47-105.52). Having a higher android to gynoid FM ratio was related to increased odds of being prehypertensive and hypertensive. Conclusions This study showed that a higher body FM, particularly in the android region, is associated with higher odds of having hypertension in older adults.

Objective: The current study assessed hepatoprotective effects of Sargassum boveanum (S. boveanum) in cholestatic rats. To induce cholestasis, bile duct ligation (BDL) was utilized.Materials and Methods: Five groups of Sprague-Dawley rats including Sham and four BDL groups were assigned to receive vehicle (BDL-V) or ethanolic extract of S. boveanum at 100 (BDL-SE 100), 200 (BDL-SE 200) and 500 (BDL-SE 500) mg/kg/day for seven days.Results: BDL group receiving the vehicle (BDL-V) had substantially increased blood levels of alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, total, and indirect bilirubin in comparison to the sham group. S. boveanum significantly decreased these variables compared to the BDL-V group. Hepatic malondialdehyde and tumor necrosis factor-α (TNF-α) level, and nuclear factor kappa light chain enhancer of activated B cells (NF-κB) and TNF-α gene expression were higher in BDL-V rats compared to the sham group but these were reduced markedly in BDL groups receiving S. boveanum in comparison to the BDL-V group. BDL-V group had a significantly lower hepatic glutathione value, glutathione peroxidase (GPx) and superoxide dismutase (SOD) activity and gene expression of SOD, GPx, Nrf2, HO-1 in comparison to the sham group. S. boveanum prevented the decrease of these variables. The histopathological assay showed marked bile ducts proliferation, portal inflammation, and hepatocellular damage in the BDL-V group and S. boveanum administration remarkably reduced hepatic injury. Gas chromatography-mass spectroscopy (GC-MS) analysis revealed that S. boveanum ethanolic extract contained 39 active compounds.Conclusion: S. boveanum treatment significantly ameliorated cholestatic hepatic injury via anti-oxidative and anti-inflammatory effects.

Background: Planetary health is a concept that denotes the human health is connected with Earth’s natu-ral systems and they are not separable from each other. Planetary health indicates for the importance of Earth’s natural systems in terms of averted cases of disease and the potential harm that arises from human-caused perturbations of these systems. Materials and Methods: In order to evaluate the perspective of medical students of Bushehr University of Medical Sciences about planetary health in relation to medical profession, the method of focus group discussion (FGD) was used. Four sessions of FGDs with participation of 21 medical student were de-signed. The level of their knowledge on climate change and its relationship with human health (the first goal), the scope of physicians’ duty in connection with planetary health, and how to introduce this duty to medical students (the second goal) were the keystones of the FDG sessions. Results: The medical students were thoroughly aware of climate change and its impacts on environment via the media and their personal experiments. They also had a high level of knowledge about the close relation of human-caused perturbations with human health. The majority of participants believed that the attention to bioenvironmental challenges should be among the ethical and organizational duty of the future physicians. The use of attractive and multimedia approaches in association with field work were emphasized to improve the level of medical students’ knowledge about topics of planetary health. Conclusion: It is possible to integrate planetary health educations into the medical curricula by avoid-ance of traditional methods and turning to innovative and creative approaches in the format of interdisci-plinary and field works. Hence, the future physicians will attain a sufficient level of knowledge in order to combat with human-caused climate perturbations.

Abstract Introduction Depression and increased blood pressure are significant burdens in elderly care. This study was conducted to discover the association between hypertension (HTN) and depression based on data obtained from the Bushehr Elderly Health (BEH) program in a large population of Iranian elderly in Bushehr, southern Iran. Methods This study was carried out based on data obtained from the Bushehr Elderly Health (BEH) program in a large population of Iranian elderly in Bushehr, a southern city in Iran. 2419 old adults were included in the study through multi-stage random sampling. Depression was assessed using Patient Health Questionnaire-9 (PHQ-9), and blood pressure was measured using a standard mercury sphygmomanometer. Statistical analysis was conducted via chai-square, analysis of variance (ANOVA), and univariate and multivariate linear regression tests. Results The mean age of participants was 69.95 ± 6.95 years. The prevalence of depression was 23.8%. Diastolic blood pressure (DBP) decreased with increasing PHQ score (B=-0.001; 95%CI: -0.00 to -0.00, P-value = 0.011). In the final model adjusted for confounding variables, no significant association was found between depression score and DBP (B=-0.00; 95%CI: -0.00 to 0.00, P = 0.13). Conversely, in the final model, which included the confounding variable, SBP was significantly associated with depression. It was deduced that a variable acted as a negative confounder in this association; in a way that with increased depression score, SBP significantly decreased (B=-0.00; 95% CI: -0.00 to -0.00, P = 0.04). Conclusion Depression and its related medications could be significantly associated with controlled SBP. Health practitioners in primary health care centers must monitor the elderly inflicted with HTN for early symptoms of depression to help maintain blood pressure levels using medicinal and non-medicinal interventions.

Abstract Purpose Osteoporosis is a systemic disease characterized by decreased bone strength and an increased risk of fracture in old age. Age and pathologic renal failure are independent risk factors for osteoporosis. However, it is not determined whether age-related decreased renal function, in the context of senescence, can be considered as an independent risk factor for osteoporosis. Therefore, this study was conducted to evaluate the effect of senescence-induced renal failure on bone quality and trabecular bone score. Methods This study used a cross-sectional design and was carried out based on data collected during the Bushehr Elderly Health (BEH) program, Phase II. A total of 2,125 elderly participants aged over 60 years old entered the study after meeting the inclusion criteria and providing informed consent. They underwent examinations for weight, height, abdominal and hip circumference, as well as blood pressure measurement. All participants also underwent DXA to assess bone mass density (BMD). Trabecular bone score (TBS) was calculated using the DXA apparatus software output. Univariate and adjusted multivariate linear regression analyses were used to evaluate the associations. Results In the univariate linear regression analysis, there was a direct correlation between age-related renal failure and TBS (β = 0.038, p

Abstract The term “geriatric giants” refers to the chronic disabilities of senescence leading to adverse health outcomes. This study aimed to investigate the prevalence and predictors of geriatric giants in Southern Iran. The participants were selected from Bushehr city using a multistage cluster random sampling method. Demographic data were collected through interviews. Frailty, incontinence, immobility, depression, cognitive impairment, and malnutrition were measured by questionnaires and instruments. Finally, data from 2392 participants were analyzed. The prevalence of fecal incontinence was less than 1% among all participants and similar in men and women. In contrast, compared with men, women had higher prevalence of urinary incontinence (36.44% vs. 17.65%), depression (39.05% vs. 12.89%), anorexia and malnutrition (2.35% vs. 0.82%), immobility (8.00% vs. 2.5%), frailty (16.84 vs. 7.34), and pre-frailty (54.19 vs. 38.63%). The prevalence of dependence and cognitive impairment was also higher in women and considerably increased with the age of participants. In total, 12.07% of subjects were frail, and 46.76% were pre-frail. The prevalence of frailty exponentially increased in older age, ranging from 4.18% among those aged 60–64 years to 57.35% in those aged ≥ 80 years. Considering 95% confidence interval (CI), multivariate logistic regression revealed that low physical activity [odds ratio (OR) 31.73 (18.44–54.60)], cancer (OR 3.28 (1.27–8.44)), depression [OR 2.42 (1.97–2.98)], age [OR 1.11 (1.08–1.14)], waist circumference [OR 1.03 (1.01–1.06)], BMI [OR 1.07 (1.01–1.14)], MNA score [OR 0.85 (0.79–0.92)], polypharmacy [OR 2.26 (1.30–3.95)] and male gender [OR 0.63 (0.42–0.93)] were independently associated with frailty. White blood cell count (WBC), smoking, marital status, and number of comorbidities were not independently associated with frailty. Low physical activity was the strongest predictor of frailty, which may need more attention in geriatric care. Frailty, its predictors, and other components of geriatric giants were considerably more common among women and older ages.

Neural EGFL like 1 (NELL-1), is a secreted glycoprotein and stimulates osteogenic cell differentiation and bone mineralization. This study aimed to explore the relationship between NELL-1 and Trabecular Bone Score (TBS) as a novel tool for the evaluation of osteoporosis in an elderly population-based cohort study in Iran. A single-locus analysis was performed on TBS using data from 2,071 participants in the Bushehr Elderly Health (BEH) Program. The study investigated 376 independent single nucleotide polymorphisms (SNPs) within the NELL-1 on chromosome 11p15.1. The association between SNPs and the mean TBS L1 to L4 was analyzed through an additive model. Significant variants in the additive model (PFDR

Background: Ethnopharmacology is a very diverse approach to drug discovery that involves the observation, description, and experimental study of native drugs and their biological activities based on botany, chemistry, biochemistry, pharmacology, and other disciplines such as anthropology, archeology, history, and linguistics that helps discovering of natural products with biological activity. The aim of this study was to identify medicinal plants that have a traditional use in the north and west of Dashtestan county, Bushehr in the north of Persian Gulf. Materials and Methods: The medical uses of medicinal plants were gathered from 25 local informants by face-to-face interviews. The relative frequency of citation (FRC) and cultural importance (CI) indices were calculated. Results: A total of 117 medicinal plants related to 63 families were identified in the north and west of Dashtestan region. Zataria multiflora, Cuminum cyminum, Aloe vera, Achillea eriophora DC, Matricario chamomilla, Echium amoenum, Trachyspermum copticum, Foeniculum vulgare, Plantago psyllium, Fumaria parviflora and Nigella sativa had the highest cultural importance index. The highest medical uses were for gastrointestinal discomforts, infectious diseases, respiratory diseases, pediatric problems, kidney and urinary tract diseases, OB & Gyn problems, psychiatric and neurological diseases, dermatologic and the metabolic disorders, respectively. The native people used some of these medicinal plants for some diseases which these usages were unique for this region. For example, they used Achillea eriophora DC for ulcers, abscesses, and carbuncles, Matricario chamomilla for fever and abdominal discomfort, Echium amoenum for promotion of labor pain, Plantago psyllium for purulent infections, Fumaria parviflora for neonatal jaundice and Nigella sativa for musculoskeletal pains. Conclusion: There is a vast variety of medicinal plants in the north and west of Dashtestan region. Although most of the therapeutic applications of these plants in this area are the same as Iran’s traditional medicine, the people in this region use some of these plants for some diseases which these usages are unique for this region. Thus, investigation about these plants should be initiated to discover novel drugs for clinical applications.

The outbreak of COVID-19 has been revealed some pathogenic mechanisms which are indicating the role of virus in the pathogenesis of diseases such as diabetes mellitus, autoimmune and cardiovascular diseases. COVID-19 results in deterioration of glycemic control in diabetic patients and even in some cases developed new onset diabetes mellitus which are indicating the possible interfering role of SARS-CoV-2 in different metabolic pathways. Furthermore, during COVID-19 exacerbation of inactivated or de novo autoimmune diseases have been reported which indicate the causative role of virus in the stimulation of immune system and aggravation of autoimmune diseases through different mechanisms. In this report, a 31 year old male case of systemic lupus erythematosus (SLE) has been introduced who developed flu like illness, generalized edema and renal failure following the administration of third dose of Sinopharm BIBP COVID-19 (Sinopharm Beijing institute of Biological Products, China). During hospital course, proper therapeutic response was not achieved despite biopsy proven class IV lupus nephritis and standard therapy with methyl prednisolone and cyclophosphamide. He discharged with administration of routine hemodialysis thrice weekly. According to the course of disease, findings of biopsy and serologic tests, there were some challenging scenarios that are discussed in this report.

Background: Microplastics, as emerging and persistent pollutants, are ubiquitous in different environmental compartments and could be considered an ecological threat to wildlife and humans. Materials and Methods: In the present review article, the existing studies on the presence of microplastics in water, sediments, and aquatic organisms of the Persian Gulf were reviewed with regard to different sampling techniques, samples preparation, and identification methods. Results: The results indicated that the contributions of various countries to microplastics pollution of the Persian Gulf were different. The findings from the Iranian side of the Persian Gulf (especially for coastal sediments) showed higher pollution than its Arabian side. Blue and black fibers were the most predominant types of microplastics in the Persian Gulf. Based on the results, low density microplastics were more dominant in the water column, while high-density plastics were mostly found in sediments. The predominant types of microplastics in marine organisms were related to their habitats. Conclusion: Microplastics contamination is a severe threat to the Persian Gulf’s environment. However, the lack of harmonized procedure for microplastics sampling, preparation, analysis, and report makes the comparison of different studies challenging. For instance, four studies reported the level of microplastics in seawater of the Persian Gulf with three different units. Hence, we suggest all studies use the same methodologies in the Persian Gulf to increase the comparability of the results.

Abstract Background Sarcopenia is a progressive age-related skeletal muscle disorder associated with harmful impacts on health. The present study aimed to investigate the relation between sarcopenia, platelet (PLT), white blood cell (WBC), and PLT to WBC ratio (PWR) due to the importance of early sarcopenia diagnosis. Methods This cross-sectional study was conducted based on the second stage of the Bushehr Elderly Health (BEH) Program. Sarcopenia was defined based on the revised edition of the European Working Group on Sarcopenia in Older People (EWGSOP2) in accordance with the Iranian cut-off point. Univariate and adjusted multivariate logistic regression and linear regression were used to evaluate the associations. Results The prevalence of sarcopenia among participants was 35.73%. PLT count and PWR were statistically higher in severe sarcopenic participants, while no differences were seen in WBC. In crude analysis, sarcopenia was not associated with quartiles of PLT, WBC, and PWR, while after adjusting for age, marital status, and sex, the association was seen in the fourth quartile of PLT and PWR [OR (95%CI) = 1.40 (1.08 to 1.81), p-value = 0.009 for PLT; OR (95%CI) =1.55 (1.20 to 2.00), p-value =0.001 for PWR]. This association remained significant in the fully adjusted model [OR (95%CI) =1.82 (1.20 to 2.78), p-value =0.005 for PLT; OR (95%CI) =1.57 (1.03 to 2.40), p-value =0.035 for PWR]. Among sarcopenia parameters, PLT count was more likely to be associated with handgrip strength and muscle mass. After stratifying the participants by gender, sarcopenia parameters were no longer statistically significant in men. Conclusion This study showed that PLT and PWR were associated with sarcopenia after considering confounding factors, while this association was not seen in WBC. Moreover, results showed that gender had an important impact on sarcopenia parameters.

Background: The rapid and increasing growth of technology in the artificial intelligence era and its impact on fundamentals changes in the development of science including biomedicine and health presents a need for the future studies in medical sciences. This project is striving to provide a desirable model based on authentic forecasting models in order to clarify the probable and uncertain futures of medicine and health in Iran, with their complexities. Methods: The Jay Ogilvy’s eight steps scenario planning and strategic forecasting was engaged in a five phases model including the identification approach (phase 1) for detection of paradigms in medicine; the extrapolation approach (phase 2) for detection of megatrends and key technologies in medicine and healthcare; the convergence approach (phase 3) for discovering of critical uncertainties and achieving to the logic of scenario; the creative approach (phase 4) for composition of the scenario and technology roadmap; the policy making approach (phase 5) for planning of strategies and tactics. Results: In the first phase, it was revealed that the realm of medicine is under a huge disruption and the current medicine is going to systems medicine with precision medicine in its scope. In the second phase, it was clarified that the convergence of knowledge, technology and society (CKTS) is a megatrend that drives medical sciences to “deep medicine”. In the third phase, it was unfolded that CKTS and “deep medicine” including deep phenotyping of the patient using multiple omics technologies are cardinal key points that not realization of their goals in Iran would lead to a deep and critical gap in advanced and updated medicine and healthcare between Iran and the developed countries. In the fourth phase, four possible scenarios for the future of medicine and healthcare in Iran were described in which the ideal scenario would be flourishing of deep medicine along CKTS. In the fifth phase, three strategies were developed in order to realize the ideal scenario including 1/ the establishment of knowledge regions, mediated by universities; 2/ moving toward digital health and artificial intelligence; 3/ driving forces for precision medicine Conclusion: The establishment of infrastructures and preparedness for realizing precision medicine and moving toward digital health and artificial intelligence are crucial strategies to achieve the ideal future of medicine in Iran. These important issues should be considered as national priorities by policy makers and programmers in the realm of medical sciences.

Enki/Ea, the God of wisdom and deep had a prominent role in incantations and healing rituals. He was the creature of apkallus (the seven sages). These seven sages were distributing the wisdom and power of Enki/Ea among people. Oannes (Adapa) was one of the apkallus who was a hybrid of gish-man with the Enki/Ea ‘s power in healing and wisdom. Hence, the Mesopotamian priests who imitated Oannes and resorted to him, dressed in the bodies of fish hanging from their back, complete with caudal and dorsal fines, presented over the patients’ beds for healing rituals. Sometimes, induction of emesis, enema, and fumigation were also used by them. The presence of the fish-man hybrid of Oannes (Adapa), as one of the seven sages in the carving of Kourosh’s palace in Pasargad indicates a powerful influence of the Mesopotamian medicine on Achaemenid Empire.

Background: Epithelial ovarian cancer (EOC) is the most common type of ovarian cancer. About 90% of ovary tumors are epithelial. The current treatment for EOC involves surgical debulking of the tumors followed by a combination of chemotherapy. While most patients achieve complete remission, many EOCs will recur and develop chemoresistance. The cancer cells can adapt to several stress stimuli, becoming resistant. Therefore, new ways to fight resistant cells during the disease are being studied. Recently, exosomes, which reflect cell behavior in normal and pathological conditions such as epithelial ovarian cancer, are of academic interest as new biomarkers for diagnosis and therapy. Consequently, the current study aimed to investigate the research output of exosomes in EOC.Method: A bibliometric method was used for analyzing publications on exosome and epithelial ovarian cancer from the beginning to 15 October 2022 by searching keywords in Scopus, PubMed and Google scholar. Annual scientific publications, authors, citations, journals, co-authorships, and keywords co-occurrence were analyzed and plotted using Microsoft Office Excel and VOS viewer. 39 original journal articles and 3 reviews have been published since 2015 up to 15 October 2022.Results: The findings showed that China is the top country in research output, international collaborations, organization, author, and sponsorship. The top journals were the Journal of Ovarian Research, Oncotarget, and Tumor Biology, all in the United States. The top institution was Shanghai Jiao Tong University in China. The top author was Xipeng Wang. Co-occurrence analysis showed that academics’ interest is toward:1) 1) Exosomes as prognostic biomarkers of EOC as well as their role in the proliferation and migration of cells. 2) The role of exosomes in metastasis through different mechanisms; 3) The role of exosomes in epithelial-mesenchymal transition of ovarian cancer cells; 4) The diagnostic role of EVs in EOC; and 5) Conferring chemoresistance in EOC through the exosomal transfer of miRNAs.Conclusion: Research on the exosome and EOC has an increasing trend, and China is much more involved than other countries in research, financial support, and international cooperation. These findings could aid researcher in understanding novel ideas and subjects interested by sponsors in this field.

Abstract Background Osteosarcopenia, defined as sarcopenia plus osteopenia/osteoporosis, may increase the risk of fractures and affects morbidity and mortality in the older population. Falling is also common in the elderly and increases the risk of fractures and mortality. We examined the association of cardio-metabolic risk factors with a history of falling in osteosarcopenic men. Methods We used the baseline data of the Bushehr Elderly Health (BEH) program. Osteosarcopenia was defined as having both sarcopenia (reduced skeletal muscle mass plus low physical performance and/or low muscle strength) and osteopenia/osteoporosis (T-score ≤ − 1.0). Falling was defined as a self-reported history of an unintentional down on the ground during the previous year before the study. We used logistic regression analysis to estimate the adjusted odds ratio (AOR) with a 95% Confidence Interval (CI) to quantify the associations. Results All elderly men diagnosed with osteosarcopenia (n = 341), with a mean age of 73.3(±7.4) years, were included. Almost 50(14.7%) participants reported falling. Age showed a positive association with falling (AOR: 1.09, 95%CI: 1.04–1.14). An increase of 10 mmHg in systolic blood pressure(SBP), reduces the odds of falling by 26%(AOR:0.74, 95%CI:0.62–0.89), while a positive association was detected for fasting plasma glucose (FPG), as 10 mg/dl increase in the FPG, raises the chance of falling by 14%(AOR = 1.14, 95%CI:1.06,1.23). Hypertriglyceridemia was inversely associated with falling (AOR = 0.33, 95% CI: 0.12, 0.89). Conclusions Falling is a major public health problem in rapidly aging countries, especially in individuals with a higher risk of fragility fractures. Older age-raised fasting plasma glucose and low SBP are associated with falling in osteosarcopenic patients. Considering the higher risk of fracture in osteosarcopenic men, comprehensive strategies are needed to prevent fall-related injuries in this high-risk population.

Abstract Background Osteosarcopenia is referred to as co-incidence of osteoporosis/osteopenia and sarcopenia which is defined as a geriatric syndrome with a significant prevalence that increases morbidity and mortality. There are some relevant factors that can show an increased risk of incidence of osteosarcopenia. Aim We aimed to consider the association of bone turnover markers such as Osteocalcin (OC), C-terminal cross-linked telopeptide (CTX), Tartrate Resistant acid Phosphatase (TRAP), Bone Alkaline Phosphatase (BALP) and also other factors like vitamin D, calcium, phosphorous, and ALP with osteosarcopenia in elderly. Methods We carried out a cross-sectional study on a random sample including 400 elder participants of Bushehr Elderly Health (BEH) study, in Iran. Osteopenia/ osteoporosis was defined as a T-score ≤ -1.0 standard deviation below the mean values of a young healthy adult. We defined sarcopenia as low muscle strength (handgrip strength

Abstract Background Accumulating evidence indicates that vitamin D deficiency has been increased globally over the last two decades. However, the majority of these studies are concerned with cities and there is scant information regarding the prevalence of vitamin D in rural areas. The main aim of this study was to investigate the prevalence of vitamin D deficiency and its associated risk factors among the rural population in Bushehr province which shares the longest border with the Persian Gulf. Methods The rural inhabitants of more than 25 years old from three mountainous, plain, and seashore areas of Bushehr province were selected through a stratified multi-cluster random sampling method. After obtaining the participants’ demographic and anthropometric data and their past medical history, serum 25-hydroxyvitamin D [25(OH)D] was measured using ELISA. Results A total of 1806 (means ±SD, 46± 14years old) rural subjects (35 % males and 65 % females) participated in this study. The prevalence of vitamin D deficiency, insufficiency, and sufficiency were 28 %, 50 %, and 22 %, respectively. The deficiency of vitamin D in women was higher than in men (OR=1.27, 95 % CI: 1.05 to 1.54, P=0.04). There was a positive significant correlation between age and serum vitamin D levels. Men with vitamin D deficiency had higher BMI (P=0.008); this association was not observed among women (P=0.7). There was no significant difference between the food item’s consumption frequencies, and vitamin D status (P>0.05). The mountainous, and plain areas had the highest and lowest vitamin D levels, respectively. Conclusions Although, Bushehr province is located in a sunny part of Iran, the prevalence of vitamin D deficiency was high among its rural population. The shift of their lifestyle patterns and rapid industrialization in these rural areas may be responsible. Therefore, the enrichment of dietary sources with vitamin D and the use of vitamin D supplements are recommended to tackle the high prevalence of vitamin D deficiency in the rural population of the northern part of the Persian Gulf.

A surprisingly large number of sea snail species are venomous. Cone snail venoms are produced in a lengthy tubular duct from a complex venom gland and form a cocktail of many toxins, particularly conotoxins which have high potency and specificity for their target specific receptors. They inhibit various channels, neuromuscular receptors or hormones of the victim, and interfere in the transmitted signals of the prey, or dissuade predators. Cone snails have an amazing ability to quickly convert between two different types of defense-evoked and predation-evoked venoms in response to defensive or predatory stimuli. Various conotoxins and conopeptides such as α-conotoxins, σ-conotoxins, ω-conotoxins, μ-conotoxins, ψ-conotoxins, τ-conotoxins, δ-conotoxins, κ-conotoxins and conkunitzins, conantokins, contryphans, Ac1 conotoxins, conoinsulins, granulin-like conotoxins from conoides; augerpeptides derived from the venom peptide family Terebridae; turripeptides from the venom peptide family Turridae; crassipeptides venom peptides from Crassispirids; clathurellipeptides from venomous micro-conoides Clathurellidae, and other toxins such as RFamide peptides and endogenous neuropeptide-like peptides such as conopressins, as well as contulakins have been found in cone snail venoms, which have demonstrated remarkable biological and pharmacological functions. Given the approval of some conotoxins, such as the analgesic medication ziconitide (Prialt®) in clinical trials as well as their biomedical potential, current research has focused on these toxins. The use of integrated venomics approaches has dramatically accelerated the detection of conotoxin sequences. It is anticipated that a better understanding and identification of conotoxins and other toxins derived from other sea snails will lead to their use for the treatment of diseases to which humans have succumbed.

Background:: Sponges produce a wide range of toxins and secondary metabolites. The deadly poisons of some of them contain the strongest toxins known in nature and complex mixtures of bioactive compounds with different chemical structures. One of the aims of this systematic review study is to study the toxinology of sea sponges as well as toxins and bioactive compounds and their functional mechanisms. Materials and Methods: To find studies on the toxicology of sea sponges and their bioactive compounds, in April 2021, the keywords of "toxinology, toxin, secondary metabolite, alkaloid, peptide, terpene, aromatic, steroid and lactone" along with the word "sponge" or "Porifra" were searched through the Google Scholar and Pubmed databases, from 2017 to 2021. After initial reviews based on the purpose of the study, 184 out of 211 articles were selected. The search for “Porifra” and the abovementioned compounds did not yield any results. Since the limited number of studies on sponge toxins were found in the initial search, the keywords "sponge and toxin" were re-searched between 1980 and 2021 in the Pubmed database, Scifinder (database of chemical compounds) and the Marin Lit Database (marine natural compounds research), and after omitting the duplicate articles, a total of 27 other related articles were selected and reviewed along with other selected articles. Results: Some toxins and main compounds isolated from different sea sponges, including different chemical groups such as okadaic acid; terpene derivatives such as agelasine, oxofasciospongia, dysivillosins, and hipposponlachnins; peptides such as polytheonamides, soritesidines, and scleritodermins; many different alkaloid compounds include guanidine alkaloids such as monanchocidins, mycalins, crambescidins, unguiculins, netamines, zarzissine, hachijodines; Acridine alkaloids such as amphimedines; bromine and bromotyrosine alkaloids such as aplysinins; benzonaphthryidine derivatives such as aaptamines; imidazole derivatives such as nonamidines; indole derivatives such as fascaplysins, dragmacidins and topsentins; piperidine alkaloids such as saraines, madangamines, haliclonacyclamines, and arenosclerins; pyrimidine alkaloids such as lanesoic acid, hyrtinadine, and variolins; pyridine alkaloids such as amphimedosides and pyrinadines; pyrrole and pyrroloiminoquinoline alkaloids such as makaluvamine, discorhabdins, tsitsikammamines and batzellines; pyrrole compounds such as hymenialdisines as well as quinoline alkaloids such as araguspongines, renieramycins, renierol and lihouidine; steroid compounds such as plakinamines; lactones such as thorectandrols, palauolol, koshikamides, petrosaspongias, latrunculins and other compounds with unique structure and biological effects. Conclusion: There is a great variety of toxins and bioactive molecules in different species of sea sponges that offer a wide range of amazing pharmacological and biological activities.

Background: Ethnopharmacology, as a multidisciplinary approach for novel drug discovery, provides valuable data about medicinal plants in different cultures.The aim of this ethnopharmacological study was to identify medicinal plants in the Giskan mountain area. Materials and Methods: The medical uses of medicinal plants were gathered from 20 local nformants by face-to-face interviews. The relative frequency of citation (FRC) and cultural importance (CI) indices were calculated. Results: A total of 126 medicinal plants belonging to 58 families were identified. Zataria multiflora, Achillea eriophora DC, Matricario chamomilla, Glycyrrhiza glabra, Pistacia Atlantica, Plantago psyllium, Teucirum polium, Scrophularia striata, Cichorium intybus, Foeniculum vulgare had the highest CI and FRC indices. The highest medical uses were for respiratory diseases, gastrointestinal discomforts, obstetrics and gynecology, general conditions (temprament and weakness), infectious diseases and metabolic disorders. Conclusion: There is a vast variety of medicinal plants in the Giskan mountain area. Although most of the therapeutic applications of these plants in this area are the same as Iran’s traditional medicine, the people in the Giskan mountain area use some of these plants for some diseases which are unique for this region. Thus, investigation about these plants should be initiated to discover novel drugs for clinical applications.

Abstract Background Bone mineral density (BMD) and trabecular bone score (TBS) are moderately correlated. TBS is sometimes used as an adjuvant to BMD in the fracture risk assessment. Some individuals with normal BMD or osteopenia, have more degraded TBS. We aimed to identify factors associated with TBS worse than BMD in the non-osteoporotic elderly population. Methods The study subjects were selected from 2384 women and men aged ≥60 years participating in the second stage of the Bushehr Elderly Health program, a population-based prospective cohort study in Iran. The BMDs of different sites and the lumbar spine texture were measured using dual-energy X-ray absorptiometry and the TBS algorithm, respectively. Subjects were categorized based on their BMD and TBS status. Logistic regression was performed to identify the factors associated with “TBS worse than BMD” in non-osteoporotic individuals. Results Of 1335 participants included in the study, 112 of 457 women, and 54 of 878 men had worse TBS than BMD. In multivariable analysis, TBS worse than BMD in women was statistically significantly associated with years since menopause (OR: 1.04 (1.00–1.07)) and waist circumference (OR: 1.09 (1.05–1.14)). However, in men, the condition was statistically significantly associated with waist circumference (OR: 1.10 (1.03–1.17)), current smoking (OR: 2.54 (1.10–5.84)), and HDL-C (OR: 1.03 (1.00–1.06)). Conclusion The results of the study show that higher waist circumference is associated with more degraded TBS than BMD in both men and women. Years passed since menopause and current smoking, respectively in women and men, were associated with more degraded TBS. Considering TBS values in older individuals with higher waist circumference, or a history of smoking despite normal BMDs might help more accurate assessment of bone health. However, further studies are required to confirm the benefit.

Oncogenic osteomalacia secondary to glomus tumor is extremely rare. Localization of causative tumors is critical as surgical resection can lead to a complete biochemical and clinical cure. We present a case of oncogenic osteomalacia treated with resection of glomus tumor. A 39-year-old woman with a history of chronic sinusitis presented with chronic body ache and muscle weakness. Biochemical evaluation revealed elevated alkaline phosphatase hypophosphatemia, increased urinary phosphate excretion, low calcitriol, and FGF23 was unsuppressed suggestive of oncogenic osteomalacia. Diagnostic studies showed increase uptake in multiple bones. Localization with MRI of paranasal sinuses revealed a sinonasal mass with concurrent uptake in the same area on the octreotide scan. Surgical resection of the sinonasal mass was consistent with the glomus tumor. The patient improved both clinically and biochemically postoperatively. Along with the case of oncogenic osteomalacia secondary to a glomus tumor, we have also discussed in detail the recent development in the diagnosis and management of oncogenic osteomalacia.

This study set out to evaluate the wound healing properties of brittle star extracts in vitro and in vivo. Due to the great arm regeneration potential of the brittle star, Ophiocoma cynthiae, the present study aimed to evaluate the wound healing effect of hydroalcoholic extracts of brittle star undergoing arm regeneration in wound healing models. The brittle star samples were collected from Nayband Bay, Bushehr, Iran. After wound induction in the arm of brittle stars, hydroalcoholic extracts relating to different times of arm regeneration were prepared. The GC-MS analysis, in vitro MTT cell viability and cell migration, Western blot, and computational analysis tests were performed. Based on the in vitro findings, two BSEs were chosen for in vivo testing. Macroscopic, histopathological and biochemical evaluations were performed after treatments. The results showed positive proliferative effects of BSEs. Specifically, forty-two compounds were detected in all groups of BSEs using GC-MS analysis, and their biological activities were assessed. The MTT assay showed that the 14 d BSE had a higher proliferative effect on HFF cells than 7 d BSE. The cell migration assay showed that the wound area in 7 d and 14 d BSEs was significantly lower than in the control group. Western blot analysis demonstrated an increase in the expression of proliferation-related proteins. Upon the computational analysis, a strong affinity of some compounds with proteins was observed. The in vivo analysis showed that the evaluation of wound changes and the percentage of wound healing in cell migration assay in the 7 d BSE group was better than in the other groups. Histopathological scores of the 7 d BSE and 14 d BSE groups were significantly higher than in the other groups. In conclusion, the hydroalcoholic extract of O. cynthiae undergoing arm regeneration after 7 and 14 days promoted the wound healing process in the cell and rat skin wound healing model due to their proliferative and migratory biological activity.

Abstract Background and objectives The present study aimed to investigate the relation between anemia and hemoglobin (Hgb) concentration, physical performance, and cognitive function in a large sample of Iranian elderly population. Methods Data were collected from Bushehr elderly health (BEH) program. A total of 3000 persons aged ≥60 years were selected through multistage random sampling. Hemoglobin values lower than 12 and 13 g/dL were considered as anemia for women and men, respectively. The cognitive function was measured using the Mini-cog test and Category fluency test (CFT), and the physical function was measured using handgrip strength (muscle strength), Relative handgrip strength (RHGS), and 4.57-m usual gait speed. Univariate and adjusted multivariate logistic regression and linear regression with Stata MP (version 15) were run, and a p-value of 0.05). Conclusion There was a cross-sectional and significant association between anemia and functional variables (e.g., Relative and mean handgrip) in Iranian elderly population, whereas Semantic memory, Late recall, and walking were more affected by gender.

Abstract Stem cells have been introduced as new promising therapeutic agents in treatment of degenerative diseases because of having high differentiation potential while maintaining the ability to self-replicate and retaining features of their source cells. Among different type of cell therapies, mesenchymal stromal/stem cell (MSC) therapy is being increasingly developed as a new way to treat structural defects that need to be repaired and regenerated. Non-obstructive azoospermia (NOA) is a reproductive disease in men that causes infertility in 10% of infertile men. Based on in vitro studies, MSCs from different tissue sources have been differentiated into germ cells or gamete progenitor cells by simple methods in both male and female. On the other hand, the therapeutic effects of MSCs have been evaluated for the treatment of NOA animal models created by chemical or surgical compounds. The results of these studies confirmed successful allotransplantation or xenotransplantation of MSCs in the seminiferous tubules. As well, it has been reported that exosomes secreted by MSCs are able to induce the process of spermatogenesis in the testes of infertile animal models. Despite numerous advances in the treatment of reproductive diseases in men and women with the help of MSCs or their exosomes, no clinical trial has been terminated on the treatment of NOA. This systematic review attempts to investigate the possibility of MSC therapy for NOA in men.

Abstract Background Iran’s population is aging. Disability is a major public health problem for older adults, not only in Iran but all over the world. The purpose of this study was to investigate the relationship between cardio-metabolic and socio-demographic risk factors and disability in people 60 years and older in Iran. Methods The baseline (cross-sectional) data of 2426 samples from the Bushehr Elderly Health (BEH) program was included in the analysis. The participants were selected through multi-stage random sampling in Bushehr, southern Iran. Socio-demographic characteristics, as well as the history of diabetes and other chronic diseases, and smoking were measured using standardized questionnaires. Anthropometric measurements and laboratory tests were performed under standard conditions. Dependency was determined by the questionnaires of basic activities of daily living (BADL) and instrumental activities of daily living (IADL) using Barthel and Lawton scales respectively. Multiple logistic regression was used in the analysis. Results Mean (Standard Deviation) of the participants’ age was 69.3 (6.4) years (range: 60 and 96 years), and 48.1% of the participants were men. After adjusting for potential confounders, being older, being female (OR (95%CI): 2.3 (1.9–2.9)), having a lower education level, a history of diabetes mellitus (OR: 1.4 (1.2–1.7)) and past smoking (OR: 1.3 (1.0–1.6)), and no physical activity (OR: 1.5 (1.2–1.9)) were significantly associated with dependency in IADL. Also, being older and female (OR: 2.4 (1.9–3.0)), having a lower education level, no physical activity (OR: 2.2 (1.6–2.9)) and daily intake of calories (OR: 0.99 (0.99–0.99)) were associated with dependency in BADL. Conclusion Dependency in older adults can be prevented by increasing community literacy, improving physical activity, preventing and controlling diabetes mellitus, avoiding smoking, and reducing daily calorie intake.

Introduction: Sarcopenia can be measured by a variety of indicators, and in many cases these indicators are quite positively correlated. With the aim of improving statistical model results, the objective of this study was to use multivariate methods to identify genetic variants affecting sarcopenia indices simultaneously. Methods: GWAS analysis was performed based on data collected from 2426 Iranians aged 60 and over who were enrolled in the Bushehr Elderly Health program (BEH). DNA samples were collected from all subjects during this phase to measure prevalence of musculoskeletal disorders and risk factors. To analyze BEH DNA samples, we used a combination of Multiphen test, which is a linear combination of phenotypes most associated with genotypes, and GATES, a gene-based association test that can handle millions of SNP results efficiently and that can assess gene-level statistical significance. Result: The upper and lower 50 kb of the IL10 gene are extracted from chromosome 1 at the position (206940947, 206945839). The next step was done to calculate P-values for SNPs in this gene of SMI and handgrip using Multiphen (joint model). In the Gates method, these P-values are used to calculate the overall P-value (0.046). Given the fact that this value is less than 5%, it is clear that this gene has been effective in preventing sarcopenia in the Iranian elderly population. The tutorial describes how Multiphen and Gates can be used to analyze sarcopenia, a multifactorial disease. In this study, the gene Il10 (P-value = 0.046) was analyzed as a risk gene for sarcopenia. Conclusion: GWAS (Genome-wide association study) is a primary method for identifying genetic variants that influence the phenotype of a disease. Multi-phenotype analysis, which evaluates multiple phenotypes associated with the disease, can, however, identify additional genetic associations associated with the disease. An alternative to univariate GWAS, Multiphen tests the most related linear combinations of multifactorial diseases using a multi-phenotypic approach rather than univariate GWAS. The overall P-value of the selected gene is determined by using Gates, a gene-based analysis.

Background: Sea hares of the Aplysia genus are among the mollusks of interest for various researchers to study their phylogeny, bioactive compounds and the nervous system. These mollusks are herbivorous and produce chemical compounds (ink) to defend themselves. The present study provided molecular identification of the Persian Gulf (Bushehr city) sea hare using 16s rRNA gene sequence. Materials and Methods: Sampling was done in coastal waters of Bushehr (Bushehr Province, Iran). Total DNA was extracted using CTAB method and target DNA was amplified by 16sar-L and 16sbr-H universal primers. For phylogenetic analysis, both Maximum Likelihood and Bayesian methods (by RAxML and Mr. Bayes programs, respectively) were used. For ML algorithm, 1000 bootstrap replicates were generated. In Bayesian approach, the program was implemented for 20 million generations and one tree for every 1000 generations was sampled. Results: Based on the obtained tree from ML method, Persian Gulf sea hare and Aplysia dactylomela were placed in a clade with 87% bootstrap and high posterior probability (PP=1). The obtained phylogenetic tree from Bayesian approach showed similar topology. The Persian Gulf sea hare with 95.8% bootstrap and PP=1 was again supported in the sister group of A. dactylomela. Conclusion: The results from the molecular analysis of 16s rRNA gene sequence indicate probable existence of a new species of sea hare in the Persian Gulf region. In order to determine the exact position of the present species, the phylogenetic analysis of COI gene sequence and morphological characteristics are essentials.

Background: Ethnopharmacology, as a multidisciplinary approach for novel drug discovery, provides valuable data about medicinal plants in different cultures. The aim of this ethnopharmacological study was to identify medicinal plants in the south of Dashtestan area in the north of the Persian Gulf. Materials and Methods: The medical uses of medicinal plants were gathered from 20 local nformants by face-to-face interviews. The relative frequency of citation (FRC) and cultural importance (CI) indices were calculated. Results: A total of 97 medicinal plants belonging to 51 families were identified. Zataria multiflora, Achillea eriophora DC, Matricario chamomilla, Nigella sativa, Foeniculum vulgare, Echium amoenum, Boswellia sp., Trachyspermum copticum, Astragulus fasciculifolius, and Zingiber officinale had the highest CI and FRC indices. The highest medical uses were for gastrointestinal discomforts, metabolic disorders, obstetrics and gynecology, and respiratory diseases. Conclusion: There is a vast variety of medicinal plants in the south of Dashtestan area. Although most of the therapeutic applications of these plants in this area are the same as Iran’s traditional medicine, the people in the south of Dashtestan area use some of these plants for some diseases which are unique for this region. Thus, investigation about these plants should be initiated to discover novel drugs for clinical applications.

Although the widespread distribution of venomous marine worms around the world, the structural and toxinologcal studies of their toxins are still limited.This study was aimed to evaluate the toxicity of poisonous marine worms. Touching the cilium of Chloeia flava and Sipuncula marine worms cause painful inflammation of the skin. Many species of nemertines prey their victims by a flexible proboscis and dense mucus on the surface of the skin. They have recently been classified into three groups of the Palaeonmertea, Pilidiophora, and Hoplonemertea. Their toxins comprise the three main groups of peptides, pyridine alkaloids, and tetradotoxin and their derivatives. The nicotinoide amphiporine compound, anabaseine and its derivatives, Nemertelline, and anabasine are as alkaloid toxins. They are selectively stimulated the nicotinic receptors, in particular the type of α-7 receptors. Nemerteans are produced a variety of peptide toxins.The hemolytic activity is the most prominent activity of the cerebratulus toxins A-I to A-IV. Cytotoxin A-III, by forming tetrameric forms in the membranes of many different cells, and creating large pores, makes them very permeable. The toxin inhibits the protein kinase C and the selective cationic sodium and calcium channels of the voltage-gate in the nervous and cardiovascular systems at low lytic concentrations. From four main proteins "Cerebratulus toxins- B-II to B-IV", the toxin B-II performed to be the most toxic compound.The assessment of the Lineus extract showed that they are actually more toxic than Cerebratulus extracts. The neurotoxins α- and β-nemertides, respectively, belong to the family of three and six kilodaltons. The nemertide α-1 is highly potent toxin against the VGSC. Dose-dependent injections have caused permanent paralysis to death. Many toxin genes have been predicted or discovered in the genomes and transcriptoms of nemerteans. The most prominent of the toxin genes were the Plancitoxin-1 sequence, Stichodactyla toxin peptide (Shk toxin), Se-Cephalotoxin, β pore-forming toxin aerolysin, and several neurotoxin-related sequences, such as delta-actitoxin-Amc1a, Perivitellin-2, Mu-theraphotoxin Hhn2a 4 and turripeptide Gsg9.2, different α-, β-nemertides (B-neurotoxins analogs), and Parborlysin. Most likely, the Parborlysins belong to the same family of cytotoxins AI-AIV. Study on these marine organism toxins can provide useful probes for examining receptors, ion channels, and even innate immunity mechanisms against infectious viruses, parasites, and other microbes.

Background: Ethnopharmacology is a very diverse approach to drug discovery that involves the observation, description, and experimental study of native drugs and their biological activities based on botany, chemistry, biochemistry, pharmacology, and other disciplines such as anthropology, archeology, history, and linguistics that helps discovering of natural products with biological activity. The aim of this study was to identify medicinal plants that have a traditional use in the Tangestan region of Bushehr in the north of Persian Gulf. Materials and Methods: The medical uses of medicinal plants were gathered from 20 local informants by face to face interviews. The relative frequency of citation (FRC) and cultural importance (CI) indices were calculated. Results: A total of 109 medicinal plants belonging to 55 families were identified. Zataria multiflora, Descuraninia Sophia, Matricarria charmomilla, Achillea eriophora DC, Salvia mirzayanii, Plantago psyllium, Haplophyllum tuberculatum, Teucrium polium, Prunus amygdalus had the highest CI and FRC indices. The highest medical uses were for gastrointestinal problems, infectious diseases, gynecology and obstetrics, metabolic diseases, and skin problems. Conclusion: There is a wide variety of medicinal plants in the Tangestan region of Bushehr province which are used for various diseases that are consistent with the traditional medicine uses that are common in Iran and had been reported in the international medical literature. However, in this region, a number of plants are used to treat diseases that are specific to this region and research on these medicinal plants can be the beginning of a way to discover new drugs in the therapeutic field.

The quintuple helix innovation model has been introduced by E.G. Carayannis and F.J. Campbell. The natural environments of society and the economy are major drivers of this innovation model. The third generation university (the convergence of government, industry and university), the fourth generation universities (the convergence of government, industry, university and civil society) and the fifth generation university (the convergence of government, industry, university, civil society and bio-environment) perform within Triple Helix, Quadruple Helix and Quintuple Helix models, respectively. According to the viewpoints of Carayannis and Campbell, the cardinal characteristics of the fifth generation university could be conceptualized as a knowledge-based innovation system which is sensitive to natural environment of society, produces knowledge within the mode 3 knowledge production framework, supports co-evolution and co-existence of different knowledge paradigms, shapes co-opetitive ecosystem for knowledge management and promotes knowledge democracy.

Background: Very recently, Eric Topol, a physician-scientist, introduced his “deep medicine” theory in 2019. This theory has been originated from the last two decades advancements of systems medicine and digital medicine, science and technology convergence in biological fields and formation of the precision medicine. The transcendent medicine theory that has been derived from Sadr ad-Din Shirazi’s transcendent theosophy looks to medicine with a holistic view. Materials and Methods: In extension of the theory of Transcendent medicine, we discussed paradigm shift in medicine with deep medicine theory and its three components were challenged via the viewpoints of transcendent medicine. Results: The body theosophy which has been derived from the transcendent medicine theory is the counterpart of “deep phenotyping” component of deep medicine. The speculative reason of Ibn-Sins’s science of soul which has been projected in transcendent medicine theory could be compare with “deep learning” component of deep medicine theory. With extraction of Ibn-Arabi’s concept of perfect man and its integration with transcendent medicine, the advanced model this theory could present “deep empathy”, the third component of deep medicine. Conclusion: The transcendent medicine theory expresses all three components of deep medicine in a unique form. Hence, this theory could be used as a tool in the paradigm shift of modern medicine.