Journal of Advanced Biomedical Sciences

Molecular Mechanisms of Aerobic Exercise in Modulating Cardiac Apoptosis: A Systematic Review in Cardiovascular Patients

Mehran Ghahramani, Saydeh Elham Setooni zadeh fard, Mohammad Ghahramani — Mon, 22 Sep 2025 09:09:50 +0000

This systematic review examines the molecular mechanisms through which aerobicexercise influences cardiac apoptosis in patients with cardiovascular diseases (CVDs),which remain the leading cause of global mortality and are strongly linked to risk factorssuch as hypertension, diabetes, and sedentary lifestyles. Apoptosis, or programmed celldeath, plays a pivotal role in myocardial injury and disease progression in CVDs. Acomprehensive search of PubMed, Scopus, and Web of Science databases was conductedfor studies published between 2000 and 2025, yielding 60 initially relevant records. Afterapplying strict inclusion criteria (original research examining the effects of exercise oncardiac apoptosis) and exclusion criteria (methodological weaknesses, inadequate data, ora non-cardiac focus), eight studies were deemed eligible for detailed analysis. The findingsindicate that aerobic exercise markedly reduces the expression of pro-apoptotic proteins,including caspase-3 (~47% reduction, p<0.01) and Bax (~43% reduction, p<0.01), whilesimultaneously alleviating oxidative stress within cardiac tissue. In addition, regularaerobic training promotes mitochondrial homeostasis, enhances systemic circulation, andstrengthens overall cardiac performance, with particularly pronounced benefits in patientswith metabolic disorders. Nevertheless, the review highlights important limitations,most notably the small number of human clinical trials and the heterogeneity of exerciseprotocols across studies.

Additive Effects of Ezetimibe and Statins in Managing Elevated LDL-C: An Approach to Reducing Cardiovascular Risk

Narges Yaghoobi, Mojtaba Farjam, Babak Pezeshki — Mon, 22 Sep 2025 09:11:32 +0000

Elevated low-density lipoprotein cholesterol (LDL-C) is a key modifiable risk factor for cardiovascular disease. While statins are the cornerstone of LDL-C-lowering therapy, their long-term use may result in dose-dependent adverse effects. Ezetimibe, a Niemann– Pick C1-Like 1 inhibitor, reduces intestinal cholesterol absorption and complements the reduction of hepatic cholesterol synthesis achieved through statin therapy. Evidence from major trials, including IMPROVE-IT, SHARP, RACING, and EWTOPIA 75, demonstrates that combination therapy achieves greater LDL-C reduction and provides modest improvements in clinical outcomes compared with statin monotherapy, while maintaining a favorable safety profile. The early initiation of combination therapy may permit the use of lower statin doses, thereby reducing adverse effects such as insulin resistance and hepatotoxicity. The co-administration of ezetimibe with statins, when implemented alongside guideline-recommended strategies, represents a rational and patient-centered approach for high-risk individuals. This strategy offers enhanced lipid control and improved safety outcomes compared with statin monotherapy.

Investigation of Antibiotic Resistance Profiles of Acinetobacter spp. Isolated from ICU Samples in Mashhad, Iran (October 2018–May 2019)

Tahmineh Ghanei Yazdi, Nazanin Ataee, Parastoo Tajzadeh, Masoud Chaboksavar — Mon, 22 Sep 2025 09:12:34 +0000

Background & Objectives: Acinetobacter spp. are non-fermentative, Gram-negative, opportunistic pathogens characterized by high levels of antibiotic resistance and are frequently associated with nosocomial infections in intensive care units (ICUs). This study aimed to investigate the antibiotic resistance profiles of Acinetobacter spp. isolated from ICU patients using the BD Phoenix system, which determines antimicrobial susceptibility based on the Minimum Inhibitory Concentration (MIC) method.

Materials & Methods: A descriptive, cross-sectional study was conducted from October 2018 to May 2019 involving 60 ICU patients at Mehr-e Hazrat Abbas Hospital in Mashhad, Iran. Clinical specimens—including blood, bronchoalveolar lavage, tracheal secretions, wound swabs, biopsies, pleural fluid, and sternum swabs—were collected under sterile conditions. Acinetobacter species were identified through standard culture techniques and confirmed via PCR (polymerase chain reaction) targeting the blaOXA-51-like gene. Antimicrobial susceptibility testing against 21 antibiotics was performed using the BD Phoenix system in accordance with CLSI guidelines. Data were analyzed using SPSS software employing chi-square tests (p < 0.05).

Results: All 60 isolates were confirmed as Acinetobacter spp. Colistin demonstrated the highest susceptibility rate (90%). The highest resistance rates were observed against aminoglycosides, carbapenems, and quinolones (each 55%), followed by cephalosporins, macrolides, and β-lactamase inhibitors (54%), sulfonamides (43%), and monobactams (40%).

Conclusion: The findings underscore the alarming rise in antibiotic resistance among Acinetobacter spp. and highlight the necessity of implementing targeted antibiotic stewardship programs and localized surveillance systems to optimize treatment outcomes and curb the spread of resistance

Risk Factors of Coronavirus Disease 2019 Reinfection: Findings of a Hospital-Based Case-Control Study from Southwest of Iran

Pezhman Bagheri, Maryam Sadat Mousavi SeyedJalali, Zahra Montaseri — Mon, 22 Sep 2025 09:13:20 +0000

Background & Objectives: Following the global pandemic, Coronavirus Disease 2019 (COVID-19) has remained endemic in many regions of the world; therefore, examining the various factors influencing reinfection can help establish a stronger evidence base for effective prevention and control. Accordingly, this study aimed to identify predictors of COVID-19 reinfection and the associated risk factors.

Materials & Methods: A hospital-based case-control study was conducted with 147 patients in southern Iran. Information on the case group was collected, and a control group was selected. Structured interviews were conducted to obtain relevant data, which were documented in a checklist. The data were then analyzed using chi-square tests and logistic regression.

Results: The study included 74 (50.3%) men, with a mean age of 36.45 years. The control group reported a higher frequency of mask use and daily fruit consumption compared to the case group. In the univariate analysis, mask use, underlying diseases, and fruit consumption were significantly associated with reinfection. However, in the multivariate analysis, only the association with underlying diseases remained statistically significant (p = 0.031, OR = 3.445).

Conclusion: The findings indicate that underlying diseases substantially increase the risk of COVID-19 reinfection and should therefore be prioritized in prevention strategies.

Serum Lactate Dehydrogenase, Creatinine Phosphokinase, and Troponin Levels Among Cardiac Patients with Coronavirus Disease 2019: A Retrospective Study

Javad Poursamimi, Babak Barmaki , Hamid Reza Ghaffari, Yahya Ehsanollahi — Mon, 22 Sep 2025 09:14:08 +0000

Background & Objectives: Coronavirus disease 2019 (COVID-19) can cause myocardial injury and thereby worsen clinical outcomes in patients with preexisting cardiac disease. This study assessed the association between admission serum lactate dehydrogenase (LDH), creatine phosphokinase (CPK), and troponin levels and clinical outcomes among hospitalized cardiac patients with and without PCR-confirmed COVID-19.

Materials & Methods: In this retrospective comparative study, we analyzed 200 consecutive cardiac patients admitted in Zabol, Iran, between March 2019 and March 2020. One-hundred patients had PCR-confirmed COVID-19 and 100 did not. We compared demographic characteristics, admission blood pressure, admission serum LDH, CPK, and troponin levels, baseline left ventricular ejection fraction (EF), and length of hospital stay between groups. Multivariable logistic regression was used to identify independent predictors of in-hospital mortality.

Results: Compared with non-COVID-19 cardiac patients, those with COVID-19 exhibited higher mean systolic blood pressure (166.96 versus 143.08 mmHg; p < 0.001), higher mean diastolic blood pressure (110.55 versus 91.35 mmHg; p < 0.001), and higher mean levels of CPK (363.06 versus 270.99 U/L; p < 0.001) and LDH (570.69 versus 384.43 U/L; p < 0.001). Troponin positivity was more frequent among COVID-19 patients (71% versus 41%; p < 0.001). An EF below 35% occurred more often in the COVID-19 cohort (54% versus 20%; p = 0.048). In multivariable analysis, independent predictors of in-hospital mortality were COVID-19 status (adjusted odds ratio [aOR] 2.42; 95% confidence interval [CI], 1.28–4.56), troponin positivity (aOR 3.15; 95% CI, 1.63–6.08), and EF < 35% (aOR 2.89; 95% CI, 1.41–5.91). After adjustment for covariates, neither admission CPK nor LDH remained statistically significant predictors of mortality.

Conclusion: Troponin positivity and reduced left ventricular ejection fraction are robust independent predictors of mortality among hospitalized cardiac patients, particularly in the context of COVID-19. Although CPK and LDH are frequently elevated in patients with COVID-19, these markers may predominantly reflect nonspecific tissue injury rather than myocardial-specific damage. Early assessment of troponin and EF on admission can facilitate risk stratification and inform clinical management in this high-risk population

The Relationship between the Implicit Self-Esteem, the Behavioral Activation and Inhibition Systems (BAS/BIS), and Narcissistic Traits in Students

Naser Herfedoost, Seyed Mahmoud Tabatabaei — Mon, 22 Sep 2025 09:15:02 +0000

Background & Objectives: Narcissistic personality traits are shaped by multiplecognitive and behavioral processes. This study investigated the extent to which implicitself-esteem and the behavioral activation and inhibition systems (BAS/BIS) predictnarcissistic personality traits in students.

Materials & Methods: This descriptive correlational study included 295 students whowere selected by simple random sampling. Participants completed the Dirty DozenNarcissistic Personality Questionnaire, the Gray-Wilson Personality Questionnaire,and the Implicit Association Test for self-esteem. Relationships among variables wereexamined using correlation and multiple regression analyses to determine the variance innarcissistic traits.

Results: Results revealed significant correlations between narcissistic personality traitsand implicit self-esteem (r = −0.48), the behavioral inhibition system (r = −0.53), and thebehavioral activation system (r = 0.82). Multiple regression analysis indicated that implicitself-esteem and the behavioral systems together accounted for 74% of the variance innarcissistic traits. Although this R² is large, it is atypical in behavioral research andtherefore warrants replication to rule out overfitting.

Conclusion: These findings underscore the roles of implicit self-esteem and reinforcementsensitivity in shaping narcissistic traits and offer guidance for psychologists and counselorsdeveloping culturally informed preventive and therapeutic interventions for students

Bioinformatic Analysis of lncRNA H19 Reveals Its Regulatory Networks and Clinical Relevance in Gastric Cancer

Kianoush Mohammadi, Reza Safaralizadeh, Elham Safarzadeh — Mon, 22 Sep 2025 09:15:48 +0000

Background & Objectives: Gastric cancer (GC) continues to rank among the leading causes of cancer-related mortality worldwide, primarily because of late-stage diagnosis, marked molecular heterogeneity, and the emergence of therapeutic resistance. The long non-coding RNA (lncRNA) H19 has been recognized as an oncogene in multiple malignancies; however, its precise molecular mechanisms and clinical significance in GC remain incompletely understood.

Materials & Methods: We conducted an integrative bioinformatics analysis of 431 TCGA-STAD (stomach adenocarcinoma) samples, integrating somatic mutation, RNA- seq, and clinical datasets. The study examined mutational landscapes, tumor mutational burden (TMB), and distinct mutational signatures. Patients were classified according to H19 expression levels for subsequent differential expression, correlation, pathway enrichment, protein–protein interaction (PPI) network construction, and survival analyses.

Results: The most frequent mutations were identified in TTN (51%), TP53 (46%), MUC16 (31%), ARID1A (27%), and LRP1B (27%). Six distinct mutational signatures were detected, reflecting processes associated with aging, mismatch repair deficiency, POLE-driven hypermutation, and prior chemotherapy exposure. Stratification based on H19 expression revealed 15,179 differentially expressed genes that were significantly enriched in pathways related to extracellular matrix organization, focal adhesion, and cell adhesion. H19 exhibited strong positive correlations with IGF2, TCF15, and miR- 675, suggesting a potential competing endogenous RNA (ceRNA) function, and negative correlations with ATP4A and ATP4B, indicating possible disruption of parietal cell activity. The hub genes identified within the PPI network included GAPDH, COL1A1, TGFB1, and SIRT1.

Conclusion: Collectively, these findings suggest that H19 acts as a pivotal regulator in GC by modulating ceRNA networks, promoting extracellular matrix remodeling, and influencing oncogenic signaling cascades. Although its independent prognostic significance has yet to be fully established, this comprehensive systems-level analysis provides valuable insights and lays the groundwork for future experimental and clinical studies exploring H19 as a potential diagnostic biomarker and therapeutic target

An Exploratory Bioinformatics Investigation of microRNA Signatures in Cisplatin- Resistant Gastric Cancer Cell Lines

Kianoush Mohammadi, Reza Safaralizadeh, Asadollah Asadi — Mon, 22 Sep 2025 09:16:36 +0000

Background & Objective: Gastric cancer (GC) remains one of the most prevalent and lethal malignancies worldwide, with cisplatin serving as a cornerstone in its chemotherapeutic regimen. However, the frequent and often rapid development of cisplatin resistance significantly compromises therapeutic efficacy. MicroRNAs (miRNAs) are key post-transcriptional regulators that modulate critical cellular mechanisms underlying chemoresistance, including apoptosis, DNA repair, drug efflux, and proteostasis. This study aimed to identify candidate miRNAs and molecular pathways associated with cisplatin resistance through an integrated bioinformatics approach.

Materials & Methods: miRNA expression profiles from the GEO dataset GSE86195, comprising cisplatin-sensitive and cisplatin-resistant GC cell lines, were analyzed. Differential expression analysis was conducted using limma, followed by functional enrichment analysis of validated miRNA targets via clusterProfiler. Family-level aggregation, Weighted Gene Co-expression Network Analysis (WGCNA), and Random Forest feature ranking were subsequently applied to identify potential hub and predictive miRNAs.

Results: Although no miRNAs survived false discovery rate (FDR) correction, an exploratory nominal p-value threshold of < 0.05 revealed 957 candidate differentially expressed miRNAs (538 upregulated and 416 downregulated). Enrichment analysis indicated the involvement of pathways related to nucleocytoplasmic transport, RNA splicing, ubiquitin-mediated proteolysis, and platinum drug resistance. A coordinated dysregulation of the miR-346, miR-421, and miR-139-5p families was identified. Machine learning further highlighted hsa-let-7e and hsa-miR-20a-star as top-ranked predictive candidates, although both WGCNA and Random Forest findings should be interpreted cautiously due to the limited sample size (n = 4).

Conclusion: This exploratory bioinformatics analysis identifies candidate miRNAs and signaling pathways that may underlie cisplatin resistance in GC. The findings should be considered hypothesis-generating and warrant validation in larger cohorts (e.g., TCGA) as well as experimental confirmation through functional assays prior to clinical translation.