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Bloodstream infections (BSIs) cause >500,000 infections and >80,000 deaths per year in North America. The length of time between the onset of symptoms and administration of appropriate antimicrobials is directly linked to mortality rates. It currently takes 2-5 days to identify BSI pathogens and measure their susceptibility to antimicrobials – a timeline that directly contributes to preventable deaths. To address this, we developed a rapid metabolic preference assay (MPA) that uses the pattern of metabolic fluxes observed in ex-vivo microbial cultures to identify common pathogens and determine their antimicrobial susceptibility profiles. In a head-to-head race with a leading platform (VITEK 2) used in diagnostic laboratories, MPA decreased testing timelines from 40 hours to under 20. If put into practice, this assay could reduce septic shock mortality and reduce the use of broad spectrum antibiotics.One Sentence SummaryMetabolomics enables rapid diagnosis of BSIs.

Background: For most people, the first step in treatment is to take out the tumor (surgery), so precise and fast diagnosis of any sign of high-risk cells in surgical cavity margins is significant. The frozen pathology method is the conventional standard of intraoperative diagnosis, but the low number of slides prepared from non-fixed tissues prevents us to achieve a perfect diagnosis. Although many improvements in intraoperative margin detection were achieved, still no clinically approved intra-operative technique has been reported for the detection of surgical margins with pathologically approved classification in breast cancer.Methods: From November 2018 to April 2020, 227 patients were registered and 213 with different types of breast tumors (IDC: n=151 (70.9%), ILC: n=6 (2.8%), DCIS: n=38 (17.8%), Atypia: n=8 (3.8%), Benign tumors: n=10 (%4.7)) were randomly assigned for CDP clinical trials. Men made up 2 (1%) of the patients; 211 (99%) were women. Functionalized carbon nanotubes grown on the electrode needles lively and selectively determine the H2O2 released from cancer/atypical cells, through reverse Warburg effect and hypoxia assisted glycolysis pathways, in a quantitative electrochemical manner. The study is registered at Iran National Committee for Ethics in Biomedical Research (IR.TUMS.VCR.REC.1397.355).Result: A real-time electrotechnical system, named cancer diagnostic probe (CDP) (Patent Pub. No.: US 2018/0299401A1), has been developed and clinically approved for breast cancer surgery (National Certificate ID:14006918495) to find the presence of pre-neoplastic/neoplastic cells in-vivo. Here, Functionalized carbon nanotubes grown on the electrode needles lively and selectively determine the H2O2 released from cancer or atypical cells, through reverse Warburg effect and hypoxia assisted glycolysis pathways, in quantitative electrochemical manner. A matched clinical diagnostic categorization between the pathological results and response peaks of CDP was proposed based on pathological classifications of WHO. Conclusion: The clinical ability of CDP was verified on more than 1300 human in-vivo breast samples with sensitivity and specificity of 93%, and 97%, respectively. After passing many trials and standard examinations, the system received production and clinical use certifications as a surgeon assistant system for usage in the operating room.

Cutaneous leishmanasis (CL) may present with unusual clinical variants such as acute paronychial, annular, palmoplantar, zosteriform, erysipeloid, and sporotrichoid. The zosteriform variant has rarely been reported. Unusual lesions may be morphologically attributed to an altered host response or owing to an atypical strain of parasites in these lesions. We report a patient with CL in a multidermatomal pattern on the back and buttock of a man in Khozestan province in the south of Iran. To our knowledge, this is the first reported case of multidermatomal zosteriform CL. It was resistant to conventional treatment but responded well to a combination of meglumine antimoniate, allopurinol, and cryotherapy.

Background and aims: ‏ Evaluation of the contractor’s HSE is a key issue for the employer that influences the selection of a contractor. An appropriate method of assessment can play a significant role in the selection of qualified contractors. This paper presents a new method for ranking of contractor’s HSE at pre-contract stage of a project. Methods: To develop this new evaluation method, the c ontracts were categorized in 3 groups of advanced, medium and preliminary. In order to pre-assess the contractors’ status prior to their participation in bids, an HSE data questionnaire was developed in the frame of 40 questions. Then 29 indices were developed for primary HSE assessment based on International Association of Oil and Gas Producers (OGP). Because the role of each index is different in each category of contracts thus, seven elements of HSE model were weighted on the basis of contract category. Contractors scoring system was developed in each category of contract based on the obtained weights. Finally the contractors were categorized in four groups of A, B, C and D based on their scores obtained from their HSE evaluation. Results: The results revealed that each term of HSE have different weight in each contract category. In advanced (group 1) and medium (group 2) contracts, the leadership plus commitment (coefficient of 4.9 and 4.3 respectively) and in preliminary contracts the execution and monitoring (coefficient 3.3) have the highest weights. The Strategy and goals have the minimum weight in all 3 types of contracts (e.g. 4.4 in advanced, 3.6 in medium and 2.4 in preliminary contracts). The minimum score required for an A group contractor to get an advanced contract is 537 while the maximum score of a D group contractor to obtain a preliminary contract is 123. Conclusion: The new developed method is able to rank the HSE of contractors prior to sign the contract.

Background and aims: Planning to increase production and tends to increase the efficiency of human resources in productive organizations without estimating the economic costs imposed on the organization, cause the actual value of safety is ignored in workplaces. Among the financial cost of the productive organizations, the subject of safety promotion through decreasing the probable hazards will cause to impose the amount of extra costs to employers that are often faced them with the reluctance and therefore they will try to decrease these mentioned costs. The object of this study is to determine the numerical value of safety from the perspective of the refinery staff through computing the amount of money which the staff tend to receive to tolerate unsafe conditions in the workplace. This amount will be equivalent to the importance of preventing accidents and promoting the safety condition in the workplace from the perspective of the labor force. Methods: In this study, by applying Contingent Valuation Method (CVM) and determining the amount of willingness to accept (WTA) of employees in exchange for the waiver of improving safety in the workplace, the economic value of safety in Esfahan Oil Refining Company was estimated from the employeechr('39')s perspective. For this purpose, a questionnaire was provided and by creating a hypothetical market scenario for safety as a non-traded goods, data relating to the safety value were asked from the number of 140 operational employees and analyzed by applying 2-steps questionnaire including the pre-test and final test during 2014. Results: Based on the results of this study, the mean of willingness to accept (WTA) a month for each employee at the refinery was estimated at 2 million and five hundred thousand rials. The total economic value estimated for the safety of the refinery personnel for 1,300 people employed in operational units, estimated 39 billion rails. Considering the total annual cost of refinery safety that is 6,700,000,000 rials, it was clear from the employeechr('39')s perspective, the economic value of safety is 5.8 times greater than the cost of refinery existing safety programs conditions in the workplace. Conclusion: According to this point of view, the need to review the annual budget required to implement safety measures described and from an economic point focusing on the search for optimal conditions for market efficiency and cost effectiveness of the safety measures is important.