key: cord-0907184-hnvf634e authors: Bandarian, Fatemeh; Namazi, Nazli; Amini, Mohammad Reza; Pajouhi, Mohammad; Mehrdad, Neda; Larijani, Bagher title: Endocrinology and Metabolism Research Institute from inception to maturity: an overview of 25-year activity date: 2020-10-03 journal: J Diabetes Metab Disord DOI: 10.1007/s40200-020-00645-7 sha: f00e92576e313b92973545c710761cca9d1c4120 doc_id: 907184 cord_uid: hnvf634e Endocrinology and Metabolism Research Institute (EMRI) was founded in 1993. EMRI progressed step by step from inception and reached to its maturation during the past 25 years. EMRI has expanded and progressed in different aspects including human resources and infrastructures (laboratories and new technologies) and has obtained the first rank in the country in endocrinology research. It has also collaborated with regional and international organizations such as World Health Organization (WHO), International Osteoporosis Foundation (IOF), and American Association of Clinical Endocrinologists (AACE). This article provides an overview of EMRI activities during a quarter of a century. Endocrinology and Metabolism Research Institute (EMRI) was founded for the first time 26 years ago in1993 in a small room in Endocrine Ward at third floor of Dr. Shariati Hospital as one of the five research centers founded in the country at that time and entitled as "Endocrinology and Metabolism Research Center" (EMRC). The research center was founded by four top Endocrinologists university staffs in the country. Eight to nine years earlier than establishment of EMRI (1984) (1985) , Endocrine ward of Dr. Shariati Hospital had been launched jointly with gastrointestinal ward with 9 to 11 beds and in the next years they increased to 22 to 24 beds (in 1995) . Therefore, a primary background had been provided for research. Following an increase in the numbers of bed for patients with diabetes, patients with thyroid and hypothalamic disorders were admitted in the ward as well. After a few years, thyroid cancer registry was launched in endocrine department and this department became a referral center for Cushing Disease. Currently, endocrine ward w is working jointly with gastrointestinal ward and admits patients with different endocrine disorders. The purpose of this article is to review the activities of the Endocrinology and Metabolism Research Institute over a quarter of a century. After establishment, EMRC started research with small epidemiological retrospective studies using hospital records with only one research fellow. Most hospital records were incomplete at that time and there was no complete archive in the hospital. At the beginning of EMRI work, it faced with several limitations including space, budget and staff. When EMRI started, only five university staffs subspecialist in endocrinology were in EMRI and in the next years by graduation of more endocrinologists and joining to EMRI, the number of staffs increased. The first EMRI budget was allocated in 1997 by the University (governmental). The EMRI budget before that was provided by the institutes out of university. Two years after establishment (1995), the center received official approval from the Ministry of Health and Medical Education. At the same year the center moved to a new place with 2-3 rooms out of Endocrine ward at the 5th floor of Dr. Shariati Hospital near the hormone and biochemical laboratory. In this new place, the center expanded for the first time and the number of research fellows and staffs increased to six to seven. Seven years later (Oct 2002), by providing a proper space at the same flat, a large new building was built and prepared and EMRI moved to the new building. This building contained a long corridor with multiple rooms that different research units were deployed there and required manpower was employed gradually. To expand research activities with limited budget and for more productivity, EMRI recruited young motivated newly graduated physicians covered by the Human Resources Project (the Ministry of Health and Medical Education) with minimum payment that was supported by the Ministry. By this policy, EMRI in order to advance the goals, used the potential of motivated young graduated human resources appropriately and expanded research activities. Research products of EMRI in the first decade of its activity were limited [1] [2] [3] [4] [5] [6] [7] and most of them published in local journals with Persian language (Fig. 1) . In this decade, most activities were focused on building of infrastructures. Activity of EMRC in different subjects during those years was categorized in separate small research teams. The last two years of first decade (2001 and 2002) was associated with significant achievements that had decisive role in the future of EMRI. These important decisive achievements were as follows: Evaluation of research centers launched by the Ministry of Health and Medical Education was one of the administrative events. At the first year of assessment, EMRI ranked 6th in Razi Festival. By further progress, EMRI obtained first rank in Razi Festival in the next year. Afterward up to now (except one year), EMRI has obtained fist rank in the country consistently. Allocation of an independent budget line to EMRI for the first time by the ministry was another important event in the same years that was the main achievement of EMRI. To facilitate multicenter studies and expand national research in the country, EMRI established "National Diabetes Research Network" (NDRN) [8] (http://emri.tums.ac.ir/ DMNet) and "Iranian Osteoporosis Research Network" [9] (http://emri.tums.ac.ir/OsteoNet) that were endorsed by the ministry of health in the same years (2002). By cooperation Fig. 1 Number of EMRI publications during the past 25-years of NDRN, local diabetes guideline was prepared and released for the country [10] . Currently, more than 20 universities all over the country are member of these networks. At the same time, in the field of research expansion and internationalization, EMRI was approved as a collaborating center of World Health Organization (WHO) for diabetes and osteoporosis. Collaboration with International Osteoporosis Foundation (IOF) was also started. First EMRI journal entitled "Diabetes and Metabolic Disorders" was published for the first time in 2001 in Persian language in the first years and then changed to English in the next years and published by Springer. Notably, the journal has obtained many important achievements among local journals (Fig. 2 ). Simultaneously (2001-2002), diabetes clinic affiliated to EMRI was launched in Dr. Shariati hospital to provide medical services for diabetic patients and to provide a research platform for EMRI as well [11] [12] [13] [14] . The second decade was the beginning of the EMRI jump and was associated with significant advances. At the beginning of second decade of activity, EMRI infrastructure, facilities, and human resources were acceptable and the related process was ongoing. By availability of such potentials in this space, research development was begun and accelerated. During the second decade of EMRI activity, improvement continued. Following moving to new building and expansion of EMRI infrastructures and staffs, organizational chart of EMRI was developed and EMRI activities were categorized into education, research, administrative, and support sections. Administrative and support section EMRI in 2010 promoted to Research Institute and research activities were organized in three main areas in three research centers including "Diabetes Research Center", "Osteoporosis Research Center" and "Endocrinology and Metabolism Research Center". Other related research topics out of the aim and scope of the above mentioned research centers were considered as research groups and units within these research centers such as immunogenetic group [15] , fasting group [16] , nutrition unit [17, 18] and so on. Training Ph.D by Research students was started by EMRI for the first time in the country in 2010 and since then annually few talented interested eligible students are selected and admitted by EMRI for this program. These students have conducted practical research projects that lead to valuable outputs [19] [20] [21] [22] [23] [24] . In Launching Population Sciences Institute was a background for conducting population-based studies. By this background, EMRI collaborated in Bushehr Elderly Health Cohort for the first time in 2012 [25, 26] and after that started and contributed in other population-based cohorts including IMOS [27] , CASPIAN study [28, 29] , STEPS [30, 31] and so on. During the last years of second decade diabetes clinic expanded to a sub-specialty diabetes clinic with multidisciplinary approach and moved to a new independent building. The main activity of EMRI was in research section as its intrinsic duty. During this period, an important policy in the research section was providing facility for theses of under graduate and post graduate students in the field of medicine that resulted in considerable improvement in research productions [12, [32] [33] [34] [35] [36] . Another policy of EMRI in the platform of diabetes clinic was collaboration with medicinal industries and taking research grants to support remarkable projects [11, 37, 38] . At the beginning of second decade, publishing unit was launched in EMRI to provide professional counseling and facility, and to handle and support research product publication. This strategic policy caused a significant growth in research output of EMRI [12, 33, 39] . During this period, staffs in basic sciences were employed by EMRI and following that policy, genetic, cellular, and molecular lab was setup and various molecular techniques including PCR, RT-PCR, epigenetic and methylation tests, etc., were launched. They provided a background for conducting invaluable research projects including genetics, molecular, and cellular studies [19, [40] [41] [42] [43] [44] [45] [46] . By these available facilities in EMRI, taking post doc students was started that helped to expand collaborations with other research institutes [47] . After 2008, using available facilities, EMRI moved to high tech research in the edge of the frontiers of knowledge. In 2008, cell therapy project was conducted on patients with diabetes for the first time in Iran [48] . In this study, fetal liver-derived hematopoietic stem cell allotransplantation was performed in a small number of patients with type 1 or 2 diabetes. In the mentioned study, after one year of transplantation, none of the patients became insulin free, transiently, or permanently [48] . Safety of fetal cell transplantation was evaluated three years later that showed no significant complications and confirmed long term safety [49] . Pancreas transplant project was started for the first time in EMRI in 2010 and first pancreas transplantation was performed [50, 51] . Educational activities of EMRI in this decade were in the area of professional and public education. Professional medical education was provided by holding local, national, and international workshops, courses, seminars, and congress in the field of endocrinology with special programs in anniversary dates such as World Osteoporosis Day (on October 20 each year) [52] and World Diabetes Day (on 14 November each year) [53] . Moreover, diabetes guideline [10] , diabetic foot care guideline (approved by International Working Group on the Diabetic Foot/IWGDF) [54] for physicians, and other care providers were prepared and published. Patient education was provided for patients with diabetes by local workshops and face to face education as well as general conferences, especially in World Diabetes Day [53] . In addition, many different booklets and brochures as well as guidelines for diabetic patients were published that are updated every few years. In the third decade of EMRI activity, improvement of infrastructure continued in different areas. Following expanding EMRI activities, six years later than second promotion (2018), three new research centers including Personalized Medicine Research Center, Metabolomics and Genomics Research Center, Cell Therapy and Regenerative Medicine Research Center, and one another research institute (Translational Endocrinology) were added to EMRI with the aim of moving toward high tech molecular and cellular advanced research in the field of endocrinology and multidisciplinary studies and conducting research on the edge of the frontiers of knowledge [55] [56] [57] . These new research centers contributed in knowledge production in the field of metabolomics, personalized medicine, and cell therapy, significantly [56, 58, 59] and these progresses still continue in various aspects. EMRI to extend metabolomics research in recent years has provided infra-structures such as MS/MS for metabolom analysis and has launched Zebrafish Lab as animal model for various diseases and for basic science studies as well. Research output and the numbers of citation increased continuously during a quarter of a century of EMRI activity and reached maximum in 2019 (Fig. 3) . Launching and establishing registry programs for diabetes, thyroid cancer, and pituitary adenoma are examples of EMRI outstanding achievements in the past years that provide a big data for the future analysis of disease progress status and outcome as well. In the third decade, the collaboration of EMR with international organizations such as WHO, International Osteoporosis Foundation (IOF), and American Association of Clinical Endocrinologists (AACE) continued and recently it was approved as WHO collaboration center for non-communicable diseases (NCDs). Collaboration with International Working Group on the Diabetic Foot (IWGDF) was also approved in this decade. In order to extend diabetes education in national and regional level, Iranian Diabetes academy was launched in EMRI in this decade. Face to face and electronic diabetes education programs were provided for health care providers and patients [60] . Different educational modules for different care of diabetes and its complications as well as for diabetic foot care were prepared and released for professionals and patients that is advantageous in these days of Covid-19 pandemics. In this decade, in line of WHO program to control NCDs mortality in the world up to 2025, Iran committed to follow WHO program. In collaboration with the ministry of health, EMRI prepared "National Document for Non-communicable diseases (NCDs)" [61] and "Iranian National Service Framework for Diabetes" and clarified the national targets to reach WHO goals in 2025. In conclusion, research and development is ongoing in EMRI from inception up to present. This path continues with the advancement of research, science, and knowledge and a bright horizon is ahead of EMRI. Data Availability Not applicable. Declarations Not applicable. Ethics approval Not applicable. Number of publications and citation during the past 25-years by EMRI J Diabetes Metab Disord Baradar-Jalili R. Treatment of hyperfunctioning thyroid nodules by percutaneous ethanol injection Comparison of fine-needle-nonaspiration with fine-needleaspiration technique in the cytologic studies of thyroid nodules Diagnostic value of frozen section examination in thyroid nodule-surgery at the shariati hospital Clinicopathological features of thyroid cancer as observed in five referral hospitals in Iran-a review of 1177 cases Metabolic and endocrinologic complications in beta-thalassemia major: a multicenter study in Tehran Cost analysis of different screening strategies for gestational diabetes mellitus Adjunctive estrogen treatment in women with chronic schizophrenia: a double-blind Iranian national diabetes research network project: background, mission, and outcomes Iranian osteoporosis research network: Background, mission and its role in osteoporosis management Developing a clinical diabetes guideline in diabetes research network in Iran Psyllium decreased serum glucose and glycosylated hemoglobin significantly in diabetic outpatients Potential risk factors for diabetic neuropathy: a case control study Effect of vitamin D on insulin resistance and anthropometric parameters in Type 2 diabetes; a randomized double-blind clinical trial Serum uric acid levels and risk of metabolic syndrome in healthy adults VEGF gene polymorphism association with diabetic neuropathy The effect of nutritional education program based on Health Belief Model (HBM) on the knowledge of fasting type 2 diabetic patients Effects of black seed (Nigella sativa) on metabolic parameters in diabetes mellitus: A systematic review The effects of supplementation with conjugated linoleic acid on anthropometric indices and body composition in overweight and obese subjects: A systematic review and meta-analysis Global DNA methylation as a possible biomarker for diabetic retinopathy Epigenetic alterations and exposure to air pollutants: Protocol for a birth cohort study to evaluate the association between adverse birth outcomes and global DNA methylation Aberrant DNA methylation patterns in diabetic nephropathy GMP-grade human fetal liver-derived mesenchymal stem cells for clinical transplantation Meta-analysis of promoter methylation in eight tumor-suppressor genes and its association with the risk of thyroid cancer Liquid biopsy as a minimally invasive source of thyroid cancer genetic and epigenetic alterations Bushehr Elderly Health (BEH) Programme, phase I (cardiovascular system) Bushehr Elderly Health (BEH) programme: study protocol and design of musculoskeletal system and cognitive function (stage II) Prevalence of hypertension in an Iranian population Association between body mass index and perceived weight status with self-rated health and life satisfaction in Iranian children and adolescents: the CASPIAN-III study Association of fruit and vegetable intake with meal skipping in children and adolescents: the CASPIAN-V study Insulin pen use and diabetes treatment goals: A study from Iran STEPS 2016 survey Is salt intake reduction a universal intervention for both normotensive and hypertensive people: a case from Iran STEPS survey Burden of diabetes and it's complications in Iran in year 2000 Coronary heart disease and associated risk factors in Qazvin: a population-based study Insulinoma in Iran: a 20-year review Primary thyroid malignancies in Tehran Comparison of different screening tests for detecting diabetic foot neuropathy The efficacy of Silybum marianum (L.) Gaertn. (silymarin) in the treatment of type II diabetes: a randomized, double-blind, placebo-controlled, clinical trial The clinical investigation of Citrullus colocynthis (L.) schrad fruit in treatment of Type II diabetic patients: a randomized, double blind, placebo-controlled clinical trial Insulin production by human stem cells Curcumin inhibits in vitro MCP-1 release from mouse pancreatic islets Gender-specific differences in the association of adiponectin gene polymorphisms with body mass index Adenosine deaminase gene polymorphism is associated with obesity in Iranian population Severe acanthosis nigricans in a 17 year-old female with partial lipodystrophic syndrome Associations between HLA-C alleles and papillary thyroid carcinoma Expression level of circulating cell free miR-155 gene in serum of patients with diabetic nephropathy Expression level of circulating miR-93 in serum of patients with diabetic nephropathy Clinical microbiology study of diabetic foot ulcer in Iran; pathogens and antibacterial susceptibility The effect of fetal liver-derived cell suspension allotransplantation on patients with diabetes: first year of follow-up Evaluation of fetal cell transplantation safety in treatment of diabetes: a three-year followup Establishing a cGMP pancreatic islet processing facility: the first experience in Iran In vitro modulation of TCF7L2 gene expression in human pancreatic cells World osteoporosis day: celebrating two decades of progress in preventing osteoporotic fractures in Iran World diabetes day: celebrating two decades of Progress in combating diabetes and its complications in Iran A multidisciplinary team approach in Iranian diabetic foot research group Personalized treatment options for thyroid cancer: current perspectives The pathway from gene therapy to genome editing: A nightmare or dream Precision medicine in non communicable diseases Co-transplantation of human fetal mesenchymal and hematopoietic stem cells in type 1 diabetic mice model Amino acid profiling in the gestational diabetes mellitus Conceptual map of diabetes education: necessity of establishing Iran diabetes academy National action plan for noncommunicable diseases prevention and control in Iran; a response to emerging epidemic Publisher's note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations