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Acute myeloid leukemia (AML) is one of the most prevalent leukemia in adults. Among the various NK receptors, killer immunoglobulin-like receptors (KIRs) carry out indispensable roles in NK cell development and function through engaging with class I human leukocyte antigens (HLA-I) as their ligands. Besides divergent KIR and HLA loci, KIR / HLA-I combinations have a significant effect on NK cell response. In this case–control study, we aimed to verify the association of KIR / HLA-I combinations with susceptibility to AML in the Southwestern Iranian population. KIR and HLA genotyping was performed with PCR-SSP by some novel primers for 181 patients with AML and 181 healthy controls. According to our results, the frequencies of KIR3DS1 ( p  = 0.0001, OR = 2.32, 95% CI 1.51–3.58), KIR2DS4fl ( p  = 0.02, OR = 1.53, 95% CI 1.05–2.21), CxT4 genotypes ( p  = 0.03, OR = 2.0, 95% CI 1.05–3.82), and T4 gene cluster ( p  = 0.01, OR = 1.99, 95% CI 1.17–3.41) were significantly higher in patients than controls, while C1/C2 genotype ( p  = 0.00002, OR = 0.39, 95% CI 0.25–0.61), HLA-A Bw4 ( p  = 0.02, OR = 0.6, 95% CI 0.38–0.94), and HLA-A*11 ( p  = 0.03, OR = 0.57, 95% CI 0.34–0.95) alleles were more frequent in controls. In addition, inhibitory (i)KIR / HLA-I combinations analysis revealed higher frequencies of KIR2DL1( +) / HLA-C2( +), KIR2DL2/3( +) / HLA-C1( +), KIR3DL1( +) / HLA-A Bw4( +), and KIR3DL2( +) / HLA-A*03/11( +) in the control group ( p  = 0.002, OR = 0.49, 95% CI 0.3–0.78; p  = 0.04, OR = 0.62, 95% CI 0.39–0.99; p  = 0.04, OR = 0.63, 95% CI 0.4–0.99; and p  = 0.03, OR = 0.62, 95% CI 0.4–0.95, respectively). Overall, the number of iKIR / HLA-I combinations was more in the control group. Moreover, KIR3DS1( +) / HLA-B Bw4 Ile80 ( +) and the sum of HLA-B Bw4/A Bw4 combined with KIR3DS1 as activating KIR / HLA-I combinations were more frequent among patients than controls ( p  = 0.01, OR = 1.99, 95% CI 1.14–3.49 and p  = 0.005, OR = 1.97, 95% CI 1.22–3.19, respectively). In conclusion, our results postulate that inhibitory combinations play a protective role against AML by developing potent NK cells during education. It is noteworthy that KIR / HLA-I combination studies can be applicable in donor selection for allogeneic NK cell therapy in hematological malignancies.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a known virus that leads to a respiratory disease called coronavirus disease 19 (COVID-19). Natural killer (NK) cells, as members of innate immunity, possess crucial roles in restricting viral infections, including COVID-19. Their functions and development depend on receiving signals through various receptors, of which killer cell immunoglobulin-like receptors (KIRs) belong to the most effective ones. Different studies investigated the association between KIR gene content and susceptibility to COVID-19. Since previous studies have yielded contradictory results, we designed this meta-analysis study to draw comprehensive conclusions about COVID-19 risk and KIR gene association. According to PRISMA guidelines, a systematic search was performed in the electronic databases to find all studies investigating KIR gene contents in COVID-19 patients before March 2023. Any association between KIR genes and COVID-19 risk was determined by calculating pooled odds ratio (OR) and 95% confidence interval (CI). After applying the inclusion and exclusion criteria, 1673 COVID-19 patients and 1526 healthy controls from eight studies were included in this meta-analysis. As the main results, we observed a positive association between the 2DL3 (OR = 1.48, 95% CI = 1.17–1.88, P < 0.001) and susceptibility to COVID-19 and a negative association between the 2DP1 and the risk for COVID-19 (OR = 0.48, 95% CI = 0.23–0.99, P = 0.049). This meta-analysis demonstrated that KIR2DL3, as a member of iKIRs, might be associated with an increased risk of COVID-19 disease.

In this paper, we consider two new stock models in which their differential equations are modeled by Liu process in uncertain environment. Firstly, we study the uncertain Schöbel–Zhu–Hull–White hybrid model and obtain its closed European call option pricing using Liu calculus. Also, we solve this model by Monte Carlo simulation to ensure the performance of Monte Carlo method. Our main purpose is to present a new model, uncertain Heston–CIR hybrid model, in which its uncertain differential equations cannot be solved and so we can calculate the option value via Monte Carlo simulation. Finally, some examples are stated for illustrating these models to obtain successful results and show the efficiency of Monte Carlo method.

Face masks are used to reduce exposure to viruses and other environmental hazards such as air pollution, and integrating wearable electronics into face masks could provide valuable insights into personal and public health. However, relevant wearable devices are typically designed only to monitor biological information such as breathing patterns, and do not provide information about the status of the face mask. Here we report a conformable sensory interface that can be attached to the inside of any user-supplied face mask and used to monitor signals related to infectious diseases, environmental conditions and wear status of the face mask. Multimodal signals from the sensory face mask are wirelessly transmitted to a server through a custom-made mobile app. The system can simultaneously monitor multiple signals, including skin temperature, humidity, verbal activity, breathing pattern and fit status of the face mask. We also develop a machine learning algorithm that can be used to reliably decode the face mask position. A conformable sensory interface that can be attached to the inside of any user-supplied face mask can be used to monitor signals related to infectious diseases, environmental conditions and wear status of the face mask.

BACKGROUND: Professional behavior of physicians is under scrutiny by medical associations, media, and patients; therefore, medical students are expected to be self-directed learners rather than the passive ones. One of the useful strategies for professional development and life-long learning of students is self-regulated learning. Self-regulation concept and lifelong learning commitment are in the heart of medical practice. Therefore, this study aimed to evaluate the validity of Self-Reflection and Insight Scale (SRIS) to inspect the medical students' readiness for self-regulation. MATERIALS AND METHODS: SRIS was translated according to the Sousa and Rojjanasrirat guideline. To examine the reliability and validity evidence of the scale, 136 medical students from Tehran University of Medical Sciences completed the questionnaire. Internal consistency and intraclass correlation were used to examine the reliability evidence, as well as qualitative content validity, and confirmatory factor analysis and exploratory factor analysis (EFA) were used to examine the construct validity of the scale. RESULTS: The content validity of the scale was verified. Cronbach's alpha and the Interclass Correlation Coefficient value for the four-factor model was 0.87 and 0.79, respectively. Goodness-of-fit indices displayed acceptable and poor values (P = 0.0001, χ2 = 373.51, df = 167, Root Mean Square Error Of Approximation = 0.096, standardized root mean square residual = 0.12). EFA was conducted; a well-structured model was achieved through the EFA. The new four-factor model was extracted as the best model by performing EFA. CONCLUSION: SRIS Persian version is saturated with four factors and has desirable content validity and constructs reliability.

Many medical schools around the world have included professionalism training in their formal curriculum. However, these efforts may not be adequate; given the exposure of students to unprofessional behaviors in the clinical settings. In the present study, we aimed to design, implement, and evaluate a longitudinal program to improve professionalism among medical students upon their transition to clinical settings. A total of 75 medical students were enrolled in the study and randomly assigned to two groups. The control group did not receive any training, while for the intervention group; a 10-hour program through 16 weeks was organized based on the Holmes' reflection approach. The effectiveness of the program was evaluated by measuring three outcomes in both groups. Data analysis was performed using paired t-test and Multiple Linear Regression. Scores of judgment of professionalism increased in the intervention group (from 7.56 to 10.17; P< 0.001), while there was no significant improvement in the control group’s scores. Students' attitudes towards professionalism and their professional behaviors did not change significantly. Based on our findings, the Holmes reflection approach helps students improve their cognitive base of professionalism. Long-term follow-up and further qualitative studies will help us better understand the effects of this approach on other desirable outcomes.

To present a multiple-instructor, active-learning strategy in the undergraduate medical curriculum. This educational research is a descriptive one. Shared teaching sessions, were designed for undergraduate medical students in six organ-system based courses. Sessions that involved in-class discussions of integrated clinical cases were designed implemented and moderated by at least 3 faculties (clinicians and basic scientists). The participants in this study include the basic sciences medical students of The Tehran University of Medical Sciences. Students' reactions were assessed using an immediate post-session evaluation form on a 5-point Likert scale. Six two-hour sessions for 2 cohorts of students, 2013 and 2014 medical students during their two first years of study were implemented from April 2014 to March 2015. 17 faculty members participated in the program, 21 cases were designed, and participation average was 60 % at 6 sessions. Students were highly appreciative of this strategy. The majority of students in each course strongly agreed that this learning practice positively contributed to their learning (78%) and provided better understanding and application of the material learned in an integrated classroom course (74%). They believed that the sessions affected their view about medicine (73%), and should be continued in future courses (80%). The percentage demonstrates the average of all courses. The program helped the students learn how to apply basic sciences concepts to clinical medicine. Evaluation of the program indicated that students found the sessions beneficial to their learning.

The quality of the educational environment is a key determinant in postgraduate training programs. In order to evaluate and understand this environment a valid and reliable instrument is required. The PHEEM (Postgraduate Hospital Educational Environment Measure) questionnaire is one of the most widely used tools for evaluating the perception of hospital-based residents. The aim of this study was to examine the psychometric quality of the PHEEM in the context of emergency medicine program. This study evaluated the reliability, construct validity and applicability of the Persian version of the PHEEM questionnaire using a sample of emergency medicine residents from 3 emergency medicine residency programs in Iran. Eighty-nine residents were asked to complete the questionnaire and indicate their agreement with each of the 37 statements using a 5-point Likert scale(strongly disagree: 0 to strongly agree: 4). Cronbach's alpha coefficient was calculated to determine internal consistency. Confirmatory and explanatory factor analyses were performed to assess the construct validity of the original 3 subscales of the questionnaire. The mean score for the total questionnaire was 2.24 (SD: 0.06). The Cronbach's alpha value was found to be 0.86. Factor analysis did not confirm the original three subscales of the PHEEM questionnaire. The Persian version of PHEEM proved a reliable and practical tool for assessing clinical educational environment in emergency medicine departments.

Despite the existence of a large variety of competency frameworks for medical graduates, there is no agreement on a single set of outcomes. Different countries have attempted to define their own set of competencies to respond to their local situations. This article reports the process of developing medical graduates' competency framework as the first step in the curriculum reform in Tehran University of Medical Sciences (TUMS). A participatory approach was applied to develop a competency framework in Tehran University of Medical Sciences (TUMS). Following literature review, nominal group meetings with students and faculty members were held to generate the initial list of expectations, and 9 domains was proposed. Then, domains were reviewed, and one of the domains was removed. The competency framework was sent to Curriculum Reform Committee for consideration and approval, where it was decided to distribute electronic and paper forms among all faculty members and ask them for their comments. Following incorporating some of the modifications, the document was approved by the committee. The TUMS competency framework consists of 8 domains: Clinical skills; Communication skills; Patient management; Health promotion and disease prevention; Personal development; Professionalism, medical ethics and law; Decision making, reasoning and problem-solving; and Health system and the corresponding role of physicians. Development of a competency framework through a participatory approach was the first step towards curriculum reform in TUMS, aligned with local needs and conditions. The lessons learned through the process may be useful for similar projects in the future.

The purpose of this study was to utilize the Context, Input, Process and Product (CIPP) evaluation model as a comprehensive framework to guide initiating, planning, implementing and evaluating a revised undergraduate medical education programme. The eight-year longitudinal evaluation study consisted of four phases compatible with the four components of the CIPP model. In the first phase, we explored the strengths and weaknesses of the traditional programme as well as contextual needs, assets, and resources. For the second phase, we proposed a model for the programme considering contextual features. During the process phase, we provided formative information for revisions and adjustments. Finally, in the fourth phase, we evaluated the outcomes of the new undergraduate medical education programme in the basic sciences phase. Information was collected from different sources such as medical students, faculty members, administrators, and graduates, using various qualitative and quantitative methods including focus groups, questionnaires, and performance measures. The CIPP model has the potential to guide policy makers to systematically collect evaluation data and to manage stakeholders’ reactions at each stage of the reform in order to make informed decisions. However, the model may result in evaluation burden and fail to address some unplanned evaluation questions.