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Breast cancer poses a significant global health challenge, with Iran experiencing particularly high incidence and mortality rates. Understanding the adaptation process of Iranian breast cancer survivors’ post-treatment is crucial. This study explores the health perceptions, barriers, and coping mechanisms of Iranian survivors by integrating Stress-Coping Theory (SCT) and the Health Belief Model (HBM). Semi-structured interviews were conducted with 17 survivors, and a grounded theory approach guided the deductive content analysis of the data. The findings reveal key themes, including perceived susceptibility, benefits, barriers to care, cues to action, self-efficacy, and appraisal of action. Perceived susceptibility highlights diagnostic challenges stemming from practitioner errors and symptom misconceptions. Perceived benefits underscore the importance of early detection and support from healthcare providers and families. Barriers include cultural and financial obstacles, while cues to action reflect the influence of media, family, and personal experiences on healthcare-seeking behavior. The study also examines coping strategies, such as problem-focused and emotion-focused approaches, along with family support and external stressors. To address these barriers and enhance support systems, the study suggests specific strategies for healthcare providers, including targeted training to improve diagnostic accuracy and patient communication. Culturally sensitive awareness campaigns can correct symptom misconceptions, while financial counseling can mitigate economic barriers. Establishing community-based support groups and involving family members in care plans can enhance emotional and psychological support. These strategies aim to overcome the identified barriers and improve support systems for Iranian breast cancer survivors, ultimately fostering better recovery outcomes.

Background Despite extensive global research on mothers’ intentions regarding human milk banking (HMB), its acceptability remains underexplored in non-Western contexts, particularly in Muslim-majority countries. This study investigates barriers to HMB acceptability among nursing mothers in Iran through the lens of Social Cognitive Theory (SCT), emphasizing how cultural, religious, and contextual factors intersect with maternal decision-making. Methods A qualitative study was conducted in Tehran, Iran, between August and October 2024. Semi-structured interviews were held with twelve nursing mothers of premature infants unable to breastfeed. Data were analyzed thematically using Braun and Clarke’s six-step approach, guided by SCT to capture the interplay between personal, behavioral, and environmental influences on mothers’ decision-making regarding HMB. Rigorous strategies, including iterative coding and peer debriefing, were employed to ensure trustworthiness of the analysis. Results Three overarching themes emerged. Personal factors included emotional states, risk perceptions, self-efficacy, outcome expectations, and religious beliefs and ethics. Behavioral factors comprised trust-based decision-making and past behavioral patterns, which shaped willingness to engage with HMB. Environmental factors involved institutional accessibility, social support systems, authoritative influence, and cultural norms. Findings revealed that mothers experienced emotional conflict, mistrust in milk safety, and religious concerns about milk kinship and halal practices. Institutional and logistical barriers, coupled with lack of family and community support, further reduced HMB acceptability. Nevertheless, participants emphasized that religious endorsements, transparent regulations, health professional guidance, and improved service accessibility could enhance trust and participation. Conclusions This study highlights how reciprocal interactions among personal beliefs, behavioral patterns, and environmental contexts shape the acceptability of HMB among Iranian mothers. To improve uptake, culturally sensitive interventions are essential particularly those involving religious authorities, healthcare professionals, and awareness campaigns to address misconceptions and build trust. Strengthening institutional accessibility and transparency can further promote HMB as a viable feeding option. Future research should also examine the roles of socioeconomic status, healthcare access, and generational differences to broaden the evidence base for culturally adapted HMB policies in Muslim-majority contexts.

Background and aims Chronic heart failure (HF) is often linked to increased oxidative stress and metabolic issues like high uric acid, which can worsen outcomes. Astaxanthin (ASX), a strong antioxidant, may help reduce these harmful effects. This study aimed to investigate the effects of ASX supplementation on oxidative stress markers as the primary outcome and clinical symptoms in patients with HF. Methods In this randomized, double-blind, placebo-controlled clinical trial, 80 patients with HF were enrolled and randomly assigned to receive either ASX (20 mg/day) or a placebo (20 mg/day of maltodextrin) for 8 weeks. Biomarkers including total antioxidant capacity (TAC), malondialdehyde (MDA), superoxide dismutase (SOD), serum UA, and clinical symptoms (dyspnea, fatigue, appetite) were assessed pre-and post-intervention. Results After eight weeks, compared to the placebo group, participants receiving ASX supplementation showed a significant increase in TAC (0.12 vs. -0.04 mmol/L, P  = 0.002) and SOD levels (156.92 vs. 36.14 U/mL, P  < 0.001). In contrast, the ASX group demonstrated significantly greater reductions in MDA (-2.19 vs. -0.68 nmol/L, P  < 0.001) and serum UA levels (-1.82 vs. -0.63 mg/dl, P  = 0.003) compared to placebo. Furthermore, among ASX treated patients, improvements in dyspnea and fatigue were statistically significant ( P  < 0.001), while the increase in appetite was only marginally significant ( P  = 0.071). Conclusion These findings suggest that ASX supplementation may be effective in improving oxidative stress biomarkers and clinical status in patients with HF. Trial registration Iranian Registry of Clinical Trials IRCT20200429047235N3. Registered on 26 March 2024, prior to the enrollment of the first participant. http://irct.behdasht.gov.ir/trial/75913 .

Background Heart failure is a chronic and progressive disease where the heart muscle is unable to pump enough blood and oxygen to meet the body’s needs. Oxidative stress and inflammation are key elements in the development and progression of heart failure. Astaxanthin, a carotenoid, has strong anti-inflammatory and antioxidant effects that may protect the cardiovascular system. A study will evaluate the effect of astaxanthin supplementation on inflammatory status, oxidative stress, lipid profile, uric acid levels, endothelial function, quality of life, and disease symptoms in people with heart failure. Methods The current study is a double-blind controlled randomized clinical trial for 8 weeks, in which people with heart failure were randomly assigned to two groups: intervention (one capsule containing 20 mg of astaxanthin per day, n  = 40) and placebo (one capsule containing 20 mg of maltodextrin per day, n  = 40) will be divided. At the beginning and end of the intervention, uric acid, lipid profile, oxidative stress indices, inflammatory markers, blood pressure, nitric oxide, and anthropometric factors will be measured, and questionnaires measuring quality of life, fatigue intensity, shortness of breath, and appetite will be completed. SPSS version 22 software will be used for statistical analysis. Discussion There is a growing global interest in natural and functional food products. This RCT contributes to the expanding body of research on the potential benefits of astaxanthin in heart failure patients, including its antioxidant, lipid-lowering, and anti-inflammatory effects. Trial registration Iranian Registry of Clinical Trials IRCT20200429047235N3. Registered on 26 March 2024.

Intrahepatic neutrophil infiltration has been implicated in severe alcoholic hepatitis (SAH) pathogenesis; however, the mechanism underlying neutrophil-induced injury in SAH remains obscure. This translational study aims to describe the patterns of intrahepatic neutrophil infiltration and its involvement in SAH pathogenesis. Immunohistochemistry analyses of explanted livers identified two SAH phenotypes despite a similar clinical presentation, one with high intrahepatic neutrophils (Neuhi), but low levels of CD8+ T cells, and vice versa. RNA-Seq analyses demonstrated that neutrophil cytosolic factor 1 (NCF1), a key factor in controlling neutrophilic ROS production, was upregulated and correlated with hepatic inflammation and disease progression. To study specifically the mechanisms related to Neuhi in AH patients and liver injury, we used the mouse model of chronic-plus-binge ethanol feeding and found that myeloid-specific deletion of the Ncf1 gene abolished ethanol-induced hepatic inflammation and steatosis. RNA-Seq analysis and the data from experimental models revealed that neutrophilic NCF1-dependent ROS promoted alcoholic hepatitis (AH) by inhibiting AMP-activated protein kinase (a key regulator of lipid metabolism) and microRNA-223 (a key antiinflammatory and antifibrotic microRNA). In conclusion, two distinct histopathological phenotypes based on liver immune phenotyping are observed in SAH patients, suggesting a separate mechanism driving liver injury and/or failure in these patients.

This study aims to examine the effect of CEO compensation, duality of managing director, and quality of internal organizational controls on audit fee. Audit fee is the written fee in the related financial statements; CEO compensation is extracted from the decisions in the public meeting session. Duality of managing director is simultaneous attribution of chief or vice presidency of CEO to one person obtained from CEO reports. To measure internal controls´ quality, reference of the auditor in his report to the significant internal control weaknesses was the basis. Using systematic random sampling, 91 firms listed in Tehran Stock Exchange from 2013-2015 were selected. For hypothesis test, panel regression model and Hausman test were used to select from combined models, fixed and random effects. Results showed a positive and significant correlation between natural logarithm of CEO compensation and audit fee. There was no significant correlation between duality of managing director, weakness of internal controls, and audit fee.

The pathogenesis of antibodies in severe alcoholic hepatitis (SAH) remains unknown. We analyzed immunoglobulins (Ig) in explanted livers from SAH patients (n=45) undergoing liver transplantation and tissues from corresponding healthy donors (HD, n=10) and found massive deposition of IgG and IgA isotype antibodies associated with complement fragment C3d and C4d staining in ballooned hepatocytes in SAH livers. Ig extracted from SAH livers, but not patient serum exhibited hepatocyte killing efficacy. Employing human and Escherichia coli K12 proteome arrays, we profiled the antibodies extracted from explanted SAH, livers with other diseases, and HD livers. Compared with their counterparts extracted from livers with other diseases and HD, antibodies of IgG and IgA isotypes were highly accumulated in SAH and recognized a unique set of human proteins and E. coli antigens. Further, both Ig- and E. coli -captured Ig from SAH livers recognized common autoantigens enriched in several cellular components including cytosol and cytoplasm (IgG and IgA), nucleus, mitochondrion, and focal adhesion (IgG). Except IgM from primary biliary cholangitis livers, no common autoantigen was recognized by Ig- and E. coli -captured Ig from livers with other diseases. These findings demonstrate the presence of cross-reacting anti-bacterial IgG and IgA autoantibodies in SAH livers.

There is growing evidence of left ventricular decompensation following the closure of the patent ductus arteriosus, which most often happens early in the post-surgical time and improves on its own a few months after. Here, we aim to present nine cases whose left ventricular ejection fraction deteriorated early or late after the procedure. There were nine patients diagnosed with patent ductus arteriosus by echocardiography. The patients presented with a murmur, easy fatigability, exercise intolerance, and poor weight gain. The age varied from 5 months to 41 years old. Patients developed left ventricular ejection fraction deterioration, starting from the day after the operation to 3 years after the closure. Pre-closure left ventricular ejection fraction ranged from 60% to 75% and post-closure from 33% to 59%. The range for shortening fraction (SF) was from 30% to 42% and 16% to 31%, respectively. The patent ductus arteriosus was moderate to large in all patients. One patient was finally diagnosed with dilated cardiomyopathy. Patients with patent ductus arteriosus show left ventricular ejection fraction deterioration up to years after closure, whether percutaneous or operative. Large patent ductus arteriosus is associated with more complications and reduced post-surgery cardiac function due to the amount of the shunt before closure.

Background: Adenosine deaminase (ADA) is involved in recurrent spontaneous abortion (RSA) while normal pregnancy is defined by suppressed cell-mediated immunity. Objectives: This study aimed to determine the connection between single nucleotide polymorphism (SNP) G22A and protection against RSA. Methods: In this analytical case-control study, the allele frequency of ADA G22A gene polymorphism was determined in 113 participants including 50 women with RSA and 63 healthy pregnant women using RFLP-PCR to determine if there is a statistically significant difference in the frequency of ADA genotypes between the patient group and the control group. Results: The frequency of ADA2/ADA2 (AA) genotype was significantly different between RSA patients and controls (P = 0.004) while no significant differences were identified in the genotype frequency of ADA1/ADA1 (GG) (OR = 0.678; P = 0.228) and ADA1/ADA2 (GA) (OR = 0.976; P = 0.943). SNP G22A in the ADA gene was associated with the protection against RSA. The frequency of ADA alleles in RSA patients was compared between the age groups, and the results indicated that the ADA2 (A) allele was associated with protection against RSA in patients aged 35 years or younger (P < 0.0001). Conclusions: The findings showed that women carrying the ADA*2 allele are protected against RSA.

Endothelial nitric oxide synthase, encoded by , produces an atheroprotective metabolite. The and 4a/4b variants of this gene associated with increased risk for coronary artery diseases (CAD) have been evaluated in different populations worldwide, and inconsistent results have been obtained. We investigated the association between these three polymorphisms and presence of CAD in Iranian individuals. Overall, 234 people including angiography-positive patients from Amir-Almomenin Hospital (Heart Center), Kordkoy City, Golestan Province, northern Iran in 2016, angiography-negative subjects and healthy individuals from north of Iran were genotyped for the and variations by PCR-RFLP, and 4a/4b VNTR only by PCR. The genotype distribution and allelic frequencies for the three variants tested were not dramatically different between CAD and control subjects and also between CAD patients and people with pains and symptoms very similar to CAD but no stenosis ( >0.05). Moreover, the odds ratio for CAD related to the G894T (OR=1.09, 95% CI=(0.60-2.00), T-786C (OR=1.04, 95% CI=(0.57-1.89) and 4a/4b (OR=1.75, 95% CI=(0.92-3.32) variants did not show statistical significance. Similarly, the odds ratio for stenosis confirmed by angiography related to the 894T (OR=1.03, 95% CI= (0.61-1.74), -786C (OR=0.90, 95% CI=(0.54-1.50) and 4b (OR=1.64, 95% CI=(0.92 -2.93) alleles were not significant. , and 4a/4b variants were not associated with risk for CAD and occurrence of angiography-assessed stenosis in Northern Iranian population ( >0.05). These alleles might be population-specific and not to be associated with their corresponding gene pool. However, further analysis is required to clarify other CAD-correlated markers in our community.