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Abstract Background Asherman syndrome (AS), or intrauterine adhesions, is a main cause of infertility in reproductive age women after endometrial injury. Mesenchymal stem cells (MSCs) and their extracellular vesicles (EVs) are promising candidates for therapies that repair damaged endometria. However, concerns about their efficacy are attributed to heterogeneity of the cell populations and EVs. A homogenous population of MSCs and effective EV subpopulation are needed to develop potentially promising therapeutic options in regenerative medicine. Methods AS model was induced by mechanical injury in adult rat uteri. Then, the animals were treated immediately with homogeneous population of human bone marrow-derived clonal MSCs (cMSCs), heterogenous parental MSCs (hMSCs), or cMSCs-derived EV subpopulations (EV20K and EV110K). The animals were sacrificed two weeks post-treatment and uterine horns were collected. The sections were taken, and hematoxylin–eosin was used to examine the repair of endometrial structure. Fibrosis was measured by Masson’s trichrome staining and α-SMA and cell proliferation by Ki67 immunostaining. The function of the uteri was explored by the result of mating trial test. Expression changes of TNFα, IL-10, VEGF, and LIF were assayed by ELISA. Results Histological analysis indicated fewer glands, thinner endometria, increased fibrotic areas, and decreased proliferation of epithelial and stroma of the uteri in the treated compared with intact and sham-operated animals. However, these parameters improved after transplantation of both types of cMSCs and hMSCs and/or both cryopreserved EVs subpopulations. The cMSCs demonstrated more successful implantation of the embryos in comparison with hMSCs. The tracing of the transplanted cMSCs and EVs showed that they migrated and localized in the uteri. Protein expression analysis results demonstrated downregulation of proinflammatory factor TNFα and upregulation of anti-inflammatory cytokine IL-10, and endometrial receptivity cytokines VEGF and LIF in cMSC- and EV20K-treated animals. Conclusion Transplantation of MSCs and EVs contributed to endometrial repair and restoration of reproductive function, likely by inhibition of excessive fibrosis and inflammation, enhancement of endometrial cell proliferation, and regulation of molecular markers related to endometrial receptivity. Compared to classical hMSCs, cMSCs were more efficient than hMSCs in restoration of reproductive function. Moreover, EV20K is more cost-effective and feasible for prevention of AS in comparison with conventional EVs (EV110K).

Background: n-Butanol is a four-carbon alcohol used widely in foods, cosmetics industries, biology and chemistry research laboratories, and other fields. Long time-effects of inhalation or consumption of small amounts of Butanol on human health are still unknown. On the other hand, numerous reports about the development of n-Butanol toxicity are available. The main objective of the study was to investigate the effects of inhaled and oral administration of n-Butanol as a long-term in vivo investigation.Materials and Methods: Small white laboratory, male mice (20-30 g) were used in 11 groups (n=4) including experimental 1 to 6, 1 to 4 control "A” and positive control groups. Experimental groups 1-3, for 10, 20, and 40 days; 5 hours a day were inside a box with ventilation facilities exposed to air saturated with n-Butanol vapor. Experimental groups 4 to 6, received water containing n-Butanol 0.2%, 1% and 5% for 10 days. Control groups B, 1 to 3 was placed for 10, 20, and 40 days inside a similar box exposed to normal air, respectively. Control group B 4 received water without any particular substance for 10 days. The positive control group received 30µl subcutaneous vinblastine. Bone marrow cells were extracted 24 hours after treatments and stained by May-Grünwald-Giemsa staining and the number of micronucleus was counted. Vinblastine, as a positive control, increased an average of micronucleus numbers significantly compared to control group (PResults: n-Butanol inhalation caused no significant difference in 1-3 experimental groups in the average numbers of micronucleus compared to control group, even in the 40 days treatment group, average numbers of micronucleus was decreased comparing to control group (P had no effect on the average micronucleus numbers compared to the control group, while oral administration of 5% n-Butanol caused even decrease in average numbers of micronucleus compared to control group (PConclusion: n-Butanol inhalation may not cause chromosome damages in rat bone marrow cells that probably is due to its very fast metabolism and decomposition in the body. Therefore, the amount of n-Butanol in the systemic circulation and tissues is very low and, probably, the damaging potential is decreased.

Summary: The goal of this study was to attempt to determine the rate of contamination of health-care workers’ (HCWs) hands and environmental surfaces in intensive care units (ICU) by the main bacteria associated with hospital acquired infections (HAIs) in Tehran, Iran. A total of 605 and 762 swab samples were obtained from six ICU environments and HCWs’ hands. Identification of the bacterial isolates was performed according to standard biochemical methods, and their antimicrobial susceptibility was determined based on the guidelines recommended by clinical and laboratory standards institute (CLSI). The homology of the resistance patterns was assessed by the NTSYSsp software. The most frequent bacteria on the HCWs’ hands and in the environmental samples were Acinetobacter baumannii (1.4% and 16.5%, respectively), Staphylococcus aureus (5.9% and 8.1%, respectively), S. epidermidis (20.9% and 18.7%, respectively), and Enterococcus spp. (1% and 1.3%, respectively). Patients’ oxygen masks, ventilators, and bed linens were the most contaminated sites. Nurses’ aides and housekeepers were the most contaminated staff. Imipenem resistant A. baumannii (94% and 54.5%), methicillin-resistant S. aureus (MRSAs, 59.6% and 67.3%), and vancomycin resistant Enterococci (VREs, 0% and 25%) were detected on the hands of ICU staff and the environmental samples, respectively. Different isolates of S. aureus and Enterococcus spp. showed significant homology in these samples. These results showed contamination of the ICU environments and HCWs with important bacterial pathogens that are the main risk factors for HAIs in the studied hospitals. Keywords: Hospital acquired infections, Health care workers, Hospital environment, Bacterial contamination, Intensive care units, Drug resistance

Summary: Device-associated health care-acquired infections (DA-HAIs) pose a threat to patient safety, particularly in the intensive care unit (ICU). However, few data regarding DA-HAI rates and their associated bacterial resistance in ICUs from Iran are available. A DA-HAI surveillance study was conducted in six adult and pediatric ICUs in academic teaching hospitals in Tehran using CDC/NHSN definitions. We collected prospective data regarding device use, DA-HAI rates, and lengths of stay from 2584 patients, 16,796 bed-days from one adult ICU, and bacterial profiles and bacterial resistance from six ICUs. Among the DA-HAIs, there were 5.84 central line-associated bloodstream infections (CLABs) per 1000 central line-days, 7.88 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator-days and 8.99 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. The device utilization ratios were 0.44 for central lines, 0.42 for mechanical ventilators and 1.0 for urinary catheters. The device utilization ratios of mechanical ventilators and urinary catheters were higher than those reported in the ICUs of the INICC and the CDC's NHSN reports, but central line use was lower. The DA-HAI rates in this study were higher than the CDC's NHSN report. However, compared with the INICC report, the VAP rate in our study was lower, while the CLAB rate was similar and the CAUTI rate was higher. Nearly 83% of the samples showed a mixed-type infection. The most frequent pathogens were Acinetobacter baumannii, Staphylococcus aureus and Pseudomonas aeruginosa, followed by Klebsiella pneumoniae and Enterococcus spp. In the S. aureus isolates, 100% were resistant to oxacillin. Overall resistances of A. baumannii and K. pneumonia to imipenem were 70.5% and 76.7%, respectively. A multiple drug resistance phenotype was detected in 68.15% of the isolates. The DA-HAI rates in Iran were shown to be higher than the CDC-NHSN rates and similar to the INICC rates. Resistance to oxacillin and imipenem was higher as well. Comparing device use, DA-HAI rates, and bacterial resistance for the primary isolated bacteria indicated a direct association between urinary catheter use and the rates of CAUTI. Keywords: Hospital infection, Iran, INICC, International Nosocomial Infection Consortium, Device-associated infection, Bacterial resistance

The adverse consequences of major accident events have led to development of accident analysis techniques to investigate thoroughly the accidents. However, each technique has its own advantages and shortcomings,which make it very difficult to find a single technique being capable of analyzing all types of accidents. Therefore, the comparison of accident analysis techniques would help finding out their capabilities in different circumstances to choose the most one. In this research, the techniques CBA and AABF were compared with Tripod β in order to determine the superior technique for analysis of major accidents in manufacturing industries. At first step, the comparison criteria were developed using Delphi Method. Afterwards, the relative importance of each criterion was qualitatively determined and the qualitative values were then converted to the quantitative values applying Fuzzy triangular numbers. Finally, the TOPSIS was used to prioritize the techniques in terms of the preset criteria. The results of the study showed that Tripod β is superior to the CBA and AABF. It is highly recommended to compare all available accident analysis techniques based on proper criteria in order to select the best one whereas improper choice of accident analysis techniques may lead to misguided results.