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Pseudomonas aeruginosa is a multidrug-resistant bacterium capable of forming biofilms. This study aimed to assess resistance of clinical isolates from Libyan hospitals to antipseudomonal antibiotics, the prevalence of selected extended-spectrum β-lactamases and carbapenemase genes among these isolates, and the microorganisms’ capacity for alginate and biofilm production. Forty-five isolates were collected from four hospitals in Benghazi and Derna, Libya. Antimicrobial susceptibility was determined using agar disc diffusion. The presence of resistance genes (blaCTXM, blaTEM, blaSHV-1, blaGES-1, blaKPC, and blaNDM) was screened using PCR. Biofilm formation was quantified via the crystal violet assay, while alginate production was measured spectrophotometrically. Resistance to antipseudomonal antibiotics ranged from 48.9% to 75.6%. The most prevalent resistance gene was blaNDM (26.7%), followed by blaGES-1 (17.8%). Moreover, all isolates demonstrated varying degrees of biofilm-forming ability and alginate production. No statistically significant correlation was found between biofilm formation and alginate production. The dissemination of resistant genes in P. aeruginosa, particularly carbapenemases, is of great concern. This issue is compounded by the bacteria’s biofilm-forming capability. Urgent intervention and continuous surveillance are imperative to prevent further deterioration and the catastrophic spread of resistance among these formidable bacteria.

Pseudomonas aeruginosa is a multidrug-resistant bacterium capable of forming biofilms. This study aimed to assess resistance of clinical isolates from Libyan hospitals to antipseudomonal antibiotics, the prevalence of selected extended-spectrum β-lactamases and carbapenemase genes among these isolates, and the microorganisms' capacity for alginate and biofilm production. Forty-five isolates were collected from four hospitals in Benghazi and Derna, Libya. Antimicrobial susceptibility was determined using agar disc diffusion. The presence of resistance genes (blaCTXM, blaTEM, blaSHV-1, blaGES-1, blaKPC, and blaNDM) was screened using PCR. Biofilm formation was quantified via the crystal violet assay, while alginate production was measured spectrophotometrically. Resistance to antipseudomonal antibiotics ranged from 48.9% to 75.6%. The most prevalent resistance gene was blaNDM (26.7%), followed by blaGES-1 (17.8%). Moreover, all isolates demonstrated varying degrees of biofilm-forming ability and alginate production. No statistically significant correlation was found between biofilm formation and alginate production. The dissemination of resistant genes in P. aeruginosa, particularly carbapenemases, is of great concern. This issue is compounded by the bacteria's biofilm-forming capability. Urgent intervention and continuous surveillance are imperative to prevent further deterioration and the catastrophic spread of resistance among these formidable bacteria. [ABSTRACT FROM AUTHOR]

The present study sought to investigate the role of assistive technology (AT) in English vocabulary learning by students with visual impairment (VI) in an English as a foreign language (EFL) context. It also endeavored to elicit their attitudes towards AT through a semi-structured interview. To this end, 22 students with VI were divided into an experimental and a control group. Before the experiment, their initial vocabulary knowledge was measured through a pretest. Over five sessions, the experimental group was assigned to learn the target vocabulary items via a screen reader, i.e., non-visual desktop access (NVDA). In the absence of NVDA, the control group was exposed to the same vocabulary items by implicit instruction. Then, both groups received a posttest. The results of an independent samples t-test run on the data obtained from the post-test demonstrated that the experimental group built significantly larger vocabulary items than the control group. Responses given to a semi-structured interview revealed that learners prompted by AT acknowledged that the assistance afforded by NVDA, as a supplementary tool, facilitated learning the target vocabulary items. Based on the findings of the present study the incorporation of AT into the instructional materials of students with VI is recommended.

Abstract Glycosaminoglycans are often deprioritized as targets for synthetic immunotherapy due to the complexity of glyco-epitopes and limited options for obtaining specific subtype binding. Solid tumors express proteoglycans that are modified with oncofetal chondroitin sulfate (CS), a modification normally restricted to the placenta. Here, we report the design and functionality of transient chimeric antigen receptor (CAR) T cells with selectivity to oncofetal CS. Following expression in T cells, the CAR could be “armed” with recombinant VAR2CSA lectins (rVAR2) to target tumor cells expressing oncofetal CS. While unarmed CAR T cells remained inactive in the presence of target cells, VAR2-armed CAR T cells displayed robust activation and the ability to eliminate diverse tumor cell types in vitro. Cytotoxicity of the CAR T cells was proportional to the concentration of rVAR2 available to the CAR, offering a potential molecular handle to finetune CAR T cell activity. In vivo, armed CAR T cells rapidly targeted bladder tumors and increased the survival of tumor-bearing mice. Thus, our work indicates that cancer-restricted glycosaminoglycans may be exploited as potential targets for CAR T cell therapy.

Abstract Antimicrobial peptides, such as nisin, are proposed as promising agents for cancer treatment. While glycation has been recognized as an effective method for enhancing various physicochemical properties of nisin, its anticancer effects remain unexplored. Therefore, we aimed to assess the anticancer potential of glycated nisin against MDA-MB-231 cells. The MDA-MB cells were treated with increasing concentrations of nisin and glycated nisin for 24, 48, and 72 h. The IC50 values for nisin were higher than those for glycated nisin. Glycated nisin at concentrations of 20 and 40 µg/mL decreased cell viability more than nisin at the same concentrations. The rate of apoptosis in the group treated with 20 µg/mL of nisin was lower compared to other treatment groups, and no significant difference in apoptosis rates was observed at different time points (p > 0.05). However, in the glycated nisin groups with concentrations of 10, 20, and 40 µg/mL, the level of apoptosis was very high after 24 h (73–81% of cells undergoing apoptosis). Overall, our study suggests that glycated nisin exhibits stronger cytotoxic effects on MDA-MB-231 cells, primarily involving the induction of apoptosis. This indicates its potential utilization as an alternative approach to address the issue of drug resistance in cancer cells.

Abstract Background This study aimed to compare the effect of two methods of maintenance intravenous fluid therapy on hyponatremia in hospitalized infants with sepsis. Methods In a double-blinded randomized clinical trial, 60 term infants with sepsis were enrolled. Blood samples were taken to determine sodium, potassium, Creatinine, and BUN levels before the initiation of treatment. Urine samples were taken to assess specific gravity and urinary output. Infants in the intervention group received half saline in 10% dextrose and infants in the control group were assigned to receive the conventional solution as maintenance. The above indicators were re-evaluated 24 and 48 h after the initiation of treatment. Two groups were compared concerning the incidence of hyponatremia, and other criteria such as urinary output and urinary specific gravity, blood urea nitrogen (BUN), and creatinine levels. Results Hyponatremia was more common in the control group. Sodium levels were significantly higher in half saline recipients 24 h (137.83 ± 2.86 vs. 134.37 ± 1.91 mmol/L), and 48 h (138.10 ± 2.41 vs. 133.66 ± 1.98 mmol/L) after treatment (P

Background: No systematic review/meta-analysis has been conducted on the microbiological profile associated with the occurrence of periodontitis in patients with HIV. The aim of this study was to evaluate the prevalence of identified bacteria in HIV-infected patients with periodontal disease. Methods: Three English electronic databases (MEDLINE (via PubMed), SCOPUS, and Web of Science) were searched systematically from the beginning to February 13, 2021. The frequency of each identified bacteria in HIV-infected patients with periodontal disease was extracted. All meta-analysis methods were performed using STATA software. Results: Twenty-two articles met inclusion criteria and were enrolled into the systematic review. This review analyzed a total of 965 HIV-infected patients with periodontitis. The prevalence of periodontitis was higher in HIV-infected male patients (83% (CI 95%: 76 - 88%)) compared to females (28% (CI 95%: 17 - 39%)). In our study, the pooled prevalence of necrotizing ulcerative periodontitis and necrotizing ulcerative gingivitis in patients with HIV infection was 67% (CI 95%: 52 - 82%) and 60% (CI 95%: 45 - 74%), while a lower prevalence of linear gingivitis erythema was reported (11% (CI 95%: 5 - 18%)). More than 140 bacterial species were identified from HIV-infected patients with periodontal disease. High prevalence of Tannerella forsythia (51% (CI 95%: 5 - 96%)), Fusobacterium nucleatum (50% (CI 95%: 21 - 78%)), Prevotella intermedia (50% (CI 95%: 32 - 68%)), Peptostreptococcus micros (44% (CI 95%: 25 - 65%)), Campylobacter rectus (35% (CI 95%: 25 - 45%)), and Fusobacterium spp. (35% (CI 95%: 3 - 78%)) in HIV-infected patients with periodontal disease was found. Conclusions: Our study demonstrated that the prevalence of the red and orange complex of bacteria in HIV patients with periodontal disease is relatively high. [ABSTRACT FROM AUTHOR]

Background: Assessing the learning environment provides an overview of the current educational status and aids in identifying areas of concern. This study aimed to understand the students’ perceptions of the educational environment at the Paramedical Faculty of Ilam University of Medical Sciences in 2021.Methods: This cross-sectional research was conducted at Ilam University of Medical Sciences, where 300 paramedical students were recruited by census. The Dundee Ready Education Environment Measure (DREEM) was used as the data collection tool. An independent t-test and one-way analysis of variance were used to investigate the relationships between demographic variables and each dimension of the questionnaire. Data analysis was performed using SPSS-26 software.Results: The sample studied included 166 female and 134 male students with an average age of 24.68±7.837 years. The mean and SD of the perception of the educational environment were 112.34 (24.63). There was a significant relationship between marital status, education level, age, and academic semester with students’ understanding of the educational environment (P≤0.05). Twenty percent of the items in the questionnaire indicated a “problematic” situation, while the rest were in a “need of attention” status.Conclusion: The results of this study showed that paramedical students have a positive perception of the educational environment. The lowest mean and SD of the dimensions of the questionnaire were observed in students’ understanding of learning and social self-perception. The other dimensions were in a more satisfactory condition.

The present study aimed to evaluate the acute phase proteins (serum amyloid A, alpha-1 acid glycoprotein, and C-reactive protein) profile in canine and feline fetal fluids during the second half of gestation. Seventeen pregnant domestic short-hair queens and 19 pregnant mixed-breed bitches were enrolled. Animals were divided into three groups according to their gestational age (30–39, 40–49, and 50–60 days). After ovariohysterectomy and sample collection, the concentration of the mentioned APPs was measured by the ELISA method. There was an increasing trend in the concentration of APPs in canine fetal fluids alongside increasing pregnancy age, but these changes were not statistically significant. Canine amniotic SAA concentration was significantly higher than allantoic. The highest concentration of SAA and CRP in the feline fetal fluids was observed at days 40–49, and the maximum concentration of AGP was observed at days 50–60. For the first time, the current study investigated the APPs profile in canine and feline fetal fluids during pregnancy. The maximum concentration of APPs was observed at the end of canine pregnancy and at days 40–49 of feline pregnancy.

Introduction: Team-observed structured clinical examination (TOSCE) is a powerful approach to formative assessment resources, regarded as an essential element of students’ performance in a team format. Considering the importance of teamwork in rehabilitation, this study implements an intervention focused on enhancing teamwork skills within diverse groups of rehabilitation students, employing TOSCE as a tool for assessment and improvement. Materials and Methods: A total of 49 fourth-year undergraduate students specializing in audiology, physical therapy, and speech therapy constituted three groups in our study. Students in each major were randomly divided into four groups. The students were asked to complete the teamwork (19-item scale of Lencioni) and satisfaction (researcher-made scale) questionnaires after TOSCE. A knowledge assessment questionnaire was also conducted at pre- and post-TOSCE time points. Results: There was no significant difference between the average score of the teamwork (F=1.508, P>0.05) and satisfaction (F=3.508, P>0.05) levels across different majors. All participants had high scores on both teamwork and satisfaction scales. By comparing the pre-test and post-test knowledge assessment, in all groups, there was a statistically significant difference between the pre-and post-test results (P

Background & Objective: The learning environment plays a vital role in shaping a student's academic success and overall satisfaction. In this study, we aimed to evaluate the impact of the educational climate in the Operating Room (OR) on the moral distress experienced by operating room technology students. Material & Methods: In 2022, we conducted a descriptive-analytical study on 58 undergraduate operating room technology students from North Khorasan University of Medical Sciences. We utilized purposeful sampling in the form of a census from qualified academic departments. To collect information, we used three questionnaires: one for demographic information, one for IMOTEC, and one for moral distress. We analyzed the data using independent t-tests, one-way analysis of variance, and Pearson's correlation coefficient, as well as multiple linear regression analysis at a 95% confidence level using SPSS 26 software. Results: The mean score for the OR educational climate was 71.14 ± 12.01. The rate of moral distress was measured in severity and frequency dimensions, with scores of 1.87 ± 1.08 and 1.79 ± 0.94, respectively. We found a significant inverse relationship between the mean of the educational environment and the severity (p < 0.001) and frequency (p < 0.05) of moral distress. Conclusion: Given that the educational climate is one of the key factors affecting moral distress, it appears that enhancing the educational climate in the OR environment can play a significant role in reducing the moral distress experienced by students.

Abstract Introduction Pedestrians are considered the most vulnerable and complex road users as human behavior constitutes one of the fundamental reasons for traffic-related incidents involving pedestrians. However, the role of health literacy as a predictor of Pedestrian safety behavior remains underexplored. Therefore, the current study was designed to examine the level of health literacy and its association with the safety behavior of adult pedestrians in the city of Tabriz. Methods This cross-sectional analytical study was conducted among individuals aged 18 to 65 years in the metropolitan area of Tabriz from January to April 2023. Data were collected using the HELIA standard questionnaire (Health Literacy Instrument for adults), comprising 33 items across 5 domains (access, reading, understanding, appraisal, decision-making and behavior), as well as the Pedestrian Behavior Questionnaire (PBQ) consisting of 29 items. Data were analyzed using descriptive and analytical statistics (independent t-tests, ANOVA, and Pearson correlation coefficient) via SPSS-22 software. Results Based on the results, 94% (376 individuals) had excellent health literacy levels, and their safety behavior scores were at a good level. Health literacy and safety behavior were higher among the age group of 31 to 45 years, women, married individuals, those who read books, and individuals with higher education. However, safety behavior showed no significant association with education level (P > 0.05). There was a significant and positive relationship between health literacy and all its domains and pedestrian safety behavior (r = 0.369, P

Knowledge transfer between university and industry is an important driver in innovation and economic growth. The purpose of this study was to design a model for improving productivity in wood industry focusing on the commercialization of university knowledge and ideas. This research was developmental-applicative, a mixed method (qualitative-quantitative) study with a combined exploratory-sequential design. The target community of the research was experts who were aware of the research topic. In order to conduct in-depth interviews and collect qualitative data, from the targeted snowball technique to the theoretical saturation stage, 17 people were selected as a sample and in order to complete the researcher-made questionnaires in the quantitative section, a sample of five people was suggested. The validity of the qualitative data of the research was confirmed through continuous observation and review by a colleague and the reliability of these data was estimated to be 89% using the two-coder index method. The validity of the quantitative data was found to be 80% by using the Lawshe content validity ratio and their reliability was 86% using the Cronbach’s alpha coefficient. Conducting the thematic analysis method based on the model of Braun and Clark (2006), the effective indicators of improving productivity with a commercialization approach toward university knowledge and ideas were identified and then modeling was done using structural-interpretive analysis (ISM). Based on the results of the research, 114 primary concepts were identified including 20 sub-themes and 13 main themes. These indicators were at six levels of the structural-interpretive model consisting of the index of strategic plans at the sixth level, the structure and support management at the fifth level, the development of interaction at the fourth level, the improvement of the educational system, the development of infrastructure and the personal characteristics at the third level, the indicators of modeling, industrialization, motivation, human resources, and attracting the private sector at the second level, and the marketing index was at the first level. Therefore, managers and policy makers need to understand the nature and relationships among the identified indicators in wood industry and apply the necessary measures in this field in order to improve productivity in industries with a commercializing approach toward university knowledge and ideas.

Considering the increasing usage of Artificial Intelligence (AI) and Machine Learning (ML) in various specializations of medicine, it seems necessary to instruct our medical students on how to utilize them. This paper provides a view on incorporating ML educational content into the medical curriculum.

Abstract Background Change is a very complex and multifaceted phenomenon that is intertwined with the understanding of nursing practice, so, resistance to change in nursing can be considered as an important challenge. Knowing the reasons for this resistance can help in solving it in nursing. Therefore, the present study was conducted with the aim of investigating the reasons for resistance to change in nursing as an integrated review. Methods This integrative review was conducted using the Whittemore & Knafl method in 5 stages, including problem identification, searching the literature, evaluating primary sources, analyzing data, and presenting the results. Databases like SID, Irandoc, Magiran, Google Scholar, Web of Science, PubMed, CINAHL, and Scopus were searched using the keywords; “Resistance”, “Change”, “Nursing”, “Resistance to Change” and their Persian equivalents in the time range of 2000 to January 2023. After applying inclusion criteria and assessing the articles using Bowling’s Quality Assessment Tool, finally, 15 papers were included from 2964. Results After reviewing and critically appraisal of the qualified articles, the findings were placed in three main categories including; (1) individual factors, (2) interpersonal factors, and (3) organizational factors and six subcategories. Conclusion Undoubtedly, change is an integral component in nursing care, and resistance to it is the result of a set of individual, interpersonal and organizational factors that change managers should pay special attention to in order to make changes due to the reasons of this resistance, and the development process of developing changes in the clinical field is easily possible.

Abstract Background Anchorage control is one of the most important determinants of orthodontic treatments. Mini‐screws are used to achieve the desired anchorage. Despite all their advantages, there is a possibility that treatment will not be successful due to conditions related to their interaction with the periodontal tissue. Objective To evaluate the status of the periodontal tissue at the sites adjacent to the orthodontic mini‐implants. Methods A total of 34 teeth (17 case and 17 control) in 17 orthodontic patients requiring a mini‐screw in the buccal area to proceed with their treatment were included in the study. Oral health instruction was provided to the patients prior to the intervention. In addition, scaling and root planing of the root surface were done using manual instruments and ultrasonic instruments if needed. For tooth anchorage, a mini‐screw with Elastic Chain or Coil Spring was used. The following periodontal indices were examined in the mini‐screw receiving tooth and the contralateral tooth: plaque index, pocket probing depth, attached gingiva level (AG), and gingival index. Measurements were made before the placement of the mini‐screws and 1, 2, and 3 months following that. Results The results revealed a significant difference only in the amount of AG between the tooth with mini‐screw and the control tooth (p = 0.028); for other periodontal indices, there were no significant differences between the two groups. Conclusion This study showed that periodontal indices in adjacent teeth of the mini‐screws do not change significantly compared to other teeth and mini‐screws can be used as a suitable anchorage without posing a threat to the periodontal health. Using mini‐screws is a safe intervention for orthodontic treatments.

Background: Information literacy enables learners to master information content and expand their exploration and control to learn more. Information literacy is an essential element in the development of independent and effective learning in higher education. The purpose of the study was to evaluate the organization and use of electronic information and its relationship with some demographic characteristics of students.Method: In this descriptive-analytical study, the studied population included all medical students from the third to the seventh year of medicine at Jundishapur University of Medical Sciences in Ahvaz in the academic year of 2020-2021. The sample size consisted of 302 people, of which 28 people were dropped. Data was collected by using information literacy questionnaire including 30 items and five skills. The validity and reliability of the questionnaire has been checked. The random sampling method was simple. To analyze the data, descriptive and analytical statistics were used using SPSS software at a significance level of p

Abstract Background Methylmalonic acidemia (MMA) is a rare metabolic disorder resulting from functional defects in methylmalonyl-CoA mutase. Mutations in the MMAB gene are responsible for the cblB type of vitamin B12-responsive MMA. Results This study used Whole-exome sequencing (WES), Sanger sequencing, linkage analysis, and in-silico evaluation of the variants’ effect on protein structure and function to confirm their pathogenicity in a 2-day-old neonate presenting an early-onset metabolic crisis and death. WES revealed a homozygous missense variant on chromosome 12, the NM_052845.4 (MMAB):c.557G > A, p.Arg186Gln, in exon 7, a highly conserved and hot spot region for pathogenic variants. After being confirmed by Sanger sequencing, the wild-type and mutant proteins’ structure and function were modeled and examined using in-silico bioinformatics tools and compared to the variant NM_052845.4 (MMAB):c.556C > T, p.Arg186Trp, a known pathogenic variant at the same position. Comprehensive bioinformatics analysis showed a significant reduction in the stability of variants and changes in protein–protein and ligand–protein interactions. Interestingly, the variant c.557G > A, p.Arg186Gln depicted more variations in the secondary structure and less binding to the ATP and B12 ligands compared to the c.556C > T, p.Arg186Trp, the known pathogenic variant. Conclusion This study succeeded in expanding the variant spectra of the MMAB, forasmuch as the variant c.557G > A, p.Arg186Gln is suggested as a pathogenic variant and the cause of severe MMA and neonatal death. These results benefit the prenatal diagnosis of MMA in the subsequent pregnancies and carrier screening of the family members. Furthermore, as an auxiliary technique, homology modeling and protein structure and function evaluations could provide geneticists with a more accurate interpretation of variants’ pathogenicity. Graphical Abstract

Permanent Magnet Synchronous Motors (PMSMs) with high energy efficiency, reliable performance, and a relatively simple structure are widely utilised in various applications. In this paper, a suboptimal controller is proposed for PMSMs without sensors based on the state-dependent Riccati equation (SDRE) technique combined with customised impulsive observers (IOs). Here, the SDRE technique facilitates a pseudo-linearised display of the motor with state-dependent coefficients (SDCs) while preserving all its nonlinear features. Considering the risk of non-available/non-measurable states in the motor due to sensor and instrumentation costs, the SDRE is combined with IOs to estimate the PMSM speed and position states. Customised IOs are proven to be capable of obtaining quality, continuous estimates of the motor states despite the discrete format of the output signals. The simulation results in this work illustrate an accurate state estimation and control mechanism for the speed of the PMSM in the presence of load torque disturbances and reference speed changes. It is clearly shown that the SDRE-IO design is superior compared to the most popular existing regulators in the literature for sensorless speed control.

Background. Adenosine deaminase deficiency 2 (DADA2) is an autoinflammatory disorder, caused by the CECR1 gene mutation. The major clinical manifestations include recurrent vasculitis, neurological disorders such as stroke, hematologic abnormalities, and immunodeficiency. As reported in previous studies, DADA2 may be manifested by ischemic or hemorrhagic strokes. This disorder also includes various hematological manifestations (pure red cell aplasia, pancytopenia, hemolytic anemia, and pancytopenia with bone marrow involvement). Case Presentation. In this case report, we present the clinical and immunological findings of two unrelated patients with DADA2. The first patient was a 7-year-old female who experienced recurrent neurological symptoms such as vertigo, tinnitus, hearing loss, and right-sided hemiparesis. Her brain magnetic resonance imaging (MRI) revealed a left-sided stroke, and she responded well to antitumor necrosis factor alpha agents and plasmapheresis. The second patient was a 6-year-old female who had recurrent fever and bicytopenia, aphthous lesions, cervical lymphadenopathy, and elevated liver enzymes. We also discussed the strategies used to manage the clinical manifestations in these two DADA2 patients. Conclusion. In this case report, we discussed two cases with DADA2 deficiency and their respective manifestations. The first case showed neurological symptoms while the second case had hematological symptoms. Although there is no established treatment for DADA2 due to its rarity, steroids are commonly used to treat this disorder. Antitumor necrosis factor is also effective in controlling the symptoms, especially the neurological ones. In cases where there is no appropriate response to these treatments, hematopoietic stem cell transplantation can be beneficial.

Abstract Background Infections in neonates are mainly caused by sepsis and are the most important complications of low birth weight. In the treatment of these infections, it is common to use broad-spectrum antibiotics such as cholestin. Cholestin can cause changes in the latency of brainstem-evoked response waves. The current cohort study tried to investigate the probability of changes caused by cholestin in LBW neonates and benefiting from two common tests to identify the hearing system in neonates after treatment by cholestin and compared them with a control group. Methods The study was an exposure-based cohort, during which hearing damage caused by receiving cholestin was evaluated in 104 low birth weight neonates, in two groups (52 exposure and 52 no-exposure to cholestin). OAE and ABR tests were performed at the age of 3 months to identify complications in two groups and their results were compared. Results The absolute latency of waves I, III, and V in the brainstem evoked response test with an intensity of 80 dB Hl showed a significant difference in the exposure group with the control group. The interpeak latency of the waves as well as the effect of the drug on the gender of the infants did not show significant differences with the control group. Conclusion Cholestin did not affect the axonal or synaptic transmission time of the auditory nerve to the brainstem. It is possible that the simultaneous presence of risk factors, such as the use of cholestin, low birth weight, noises in the intensive care unit, and other unknown factors, can be effective in the change of the absolute latency of waves.

Abstract Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and fibromyalgia (FM) are two chronic complex diseases with overlapping symptoms affecting multiple systems and organs over time. Due to the absence of validated biomarkers and similarity in symptoms, both disorders are misdiagnosed, and the comorbidity of the two is often unrecognized. Our study aimed to investigate the expression profiles of 11 circulating miRNAs previously associated with ME/CFS pathogenesis in FM patients and individuals with a comorbid diagnosis of FM associated with ME/CFS (ME/CFS + FM), and matched sedentary healthy controls. Whether these 11 circulating miRNAs expression can differentiate between the two disorders was also examined. Our results highlight differential circulating miRNAs expression signatures between ME/CFS, FM and ME/CFS + FM, which also correlate to symptom severity between ME/CFS and ME/CFS + FM groups. We provided a prediction model, by using a machine-learning approach based on 11 circulating miRNAs levels, which can be used to discriminate between patients suffering from ME/CFS, FM and ME/CFS + FM. These 11 miRNAs are proposed as potential biomarkers for discriminating ME/CFS from FM. The results of this study demonstrate that ME/CFS and FM are two distinct illnesses, and we highlight the comorbidity between the two conditions. Proper diagnosis of patients suffering from ME/CFS, FM or ME/CFS + FM is crucial to elucidate the pathophysiology of both diseases, determine preventive measures, and establish more effective treatments.

Background: Hospital Safety and Health Management System (HSH-MS) and Hospital Safety Climate (HSC) are the significant elements to develop safe work practices. The current study aimed to examine the dimensions of HSH-MS and HSC and the association with the prevalence of Needlestick and Sharp Injury (NSI) and NSI recidivism. Materials and Methods: A cross-sectional study was conducted among 1070 nurses in Iranian hospitals (89% response rate). Results: More than 54% (n = 579) had sustained at least 1 NSI in the previous year. The NSI recidivism rate was 8.6% and recidivists were more likely to be younger, female, married, with higher Body Mass Index (BMI), and on night shift. Two aspects of HSH-MS including management leadership and employee participation were associated with the incidence of NSIs Odds Ratio (OR): 1.91 and 95% Confidence Interval (CI): 0.69–1.21; OR: 1.29 and 95% CI: 0.92–1.82) and NSI recidivism rate (OR: 1.98 and 95% CI: 0.55–1.74; OR: 1.12 and 95% CI: 0.83–1.49). Furthermore, three dimensions of HSC comprising management support (OR: 1.02 and 95% CI: 0.93–1.11 for NSIs; OR: 1.21 and 95% CI: 0.77–1.22 for NSI recidivism), absence of job hindrances (OR: 1.06 and 95% CI: 0.98–1.16 for NSIs; OR: 1.11 and 95% CI: 0.96–1.30 for NSI recidivism) and cleanliness/orderliness (OR: 1.07 and 95% CI: 0.98–1.08 for NSIs; OR: 0.84 and 95% CI: 0.87–0.97 for NSI recidivism) were correlated with reduced NSIs risk. Conclusions: This study suggests that HSH-MSs and employees' safety climate are significant factors, which are correlated with not only the prevalence of recurrent NSIs but also the single NSI in hospitals.

Abstract Background The aim of current study was to construct, express, purify and immunogenicity evaluate of a novel recombinant fusion protein including Pyruvate dehydrogenase beta subunit (PDHB) and high antigenic region of lipoprotein P80 of Mycoplasma agalactiae. Using bioinformatics tools, antigenicity and physiochemical properties of fused protein were assessed. Material and methods The recombinant fusion protein of GST-PDHB-P80 were expressed in pGEX4T-1 and purified then verified by Western blot assay. The purified protein was successfully used for immunization of mice. 30 female BALB/c mice were divided into three groups (10 mice per each group) injected with GST-PDHB-P80, inactivated bacteria vaccine and PBS as negative control, separately. Results Western blot analysis confirmed the interaction between the immunized mice serum and the blotted recombinant protein GST-PDHB-P80, demonstrating the immunogenicity of this protein. Moreover, the sera of vaccinated mice with inactivated bacteria vaccine, containing whole cell proteins, detected the recombinant protein GST-PDHB-P80 confirming the antigenicity of PDHB-P80. Negative control displayed no reactivity with GST-PDHB-P80. Conclusion We proposed a novel designed chimeric protein of Mycoplasma agalactiae as a potential marker for serodiagnostic assays but still further field research is required.

Background. Mothers with autistic children suffer a lot of psychological and physical pressures that can affect their quality of life, emotional states, and judgment about medical services. This study aimed to evaluate the quality of life, anxiety, and satisfaction with rehabilitation services for mothers of children with autism spectrum disorders and of non-autistic children in Ahvaz-Iran. Methods. In this cross-sectional descriptive-analytical study, 128 mothers with autistic children and 30 mothers with non-autistic children needing rehabilitation interventions were selected from Ahvaz rehabilitation centers. All participants were asked to complete Quality of Life (WHOQOL-BREIF) questionnaire, 14-item Perceived Stress Scale as well as Satisfaction Questionnaire. Data analysis was performed using a multivariate three-way ANOVA test. Results. It was found that mothers of autistic children had a significantly lower quality of life score than those without autistic children (P

One of the most important and significant issues in the present study is how to apply economic models in identifying and establishing liability rules. The function of models in analyzing the legal phenomena, including liability rules, is to understand the decision-making logic when encountering interdisciplinary issues so that decisions made by decision-making entities can be optimized in the liability system. The application of the liability rules to achieve the optimization goal by economics makes the nature of the issue raised in these models interdisciplinary. For example, the criterion for the efficiency of liability rules is to create optimal economic incentives to apply care and activity. In fact, the problem facing the presented economic model regarding the rules of liability is to establish the liability rules in cases of unilateral incidents in such a way that the decision variables such as care and activity level, optimality, and the goal contained in the objective function are realized. While emphasizing the role of modeling in identifying and establishing liability rules, the present study strives to first determine the unilateral incident cases and present the criterion for determining these cases and second to conduct analysis of the strict rules of liability and negligence in the cases of unilateral incidents based on the modeling approach. This issue has not been addressed in the research conducted so far. Accordingly, this study presents an example of the application of the modeling method, which indeed a problem with an interdisciplinary nature is presented.

Purpose Chicken eggshell as a byproduct of the egg product industry makes serious problems to the environment. The aim of this study was to evaluate the effect of eggshell as a potential option in supplementing of the organic matter and improvement of soil conditions in the pot culture and the area. Method Two pot experiments were carried out to estimate the effects of CD and CDES vermicomposts provided from cow dung and cow dung + eggshell’s powder, respectively, on symbiotic relationships of Serendipita indica with wheat and soil enzyme activities tested under sterilized and non-sterilized soil conditions, respectively. Two in vitro experiments were also conducted to test the effects of eggshell extract and humic and fulvic acids extracted from CD vermicompost on S. indica growth.Results CDES vermicompost improved soil enzyme activities of urease, phosphatase and invertase. Root colonization of wheat with multiple species of mycorrhiza and facultative symbiont S. indica was improved by CDES. S. indica growth was induced by eggshell extract. Humic and fulvic acids increased in S. indica mycelia mats dry yield. Results revealed when cow dung was amended with eggshell powder provided a better condition for earthworm growth and enhancing the colonization percentage of wheat root with indigenous mycorrhizal fungi. CDES vermicompost caused the increase in soil basal respiration and soil enzymatic activities.Conclusion Eggshell powder growth promoting effect can be attributed to the biologically active compound that exists in eggshell extract.

Abstract Background Mendelian susceptibility to mycobacterial disease (MSMD) is an uncommon disorder with increased susceptibility to less virulent mycobacteria including bacillus Calmette-Guérin (BCG). Fibrosing mediastinitis (FM) is also a rare condition defined by excessive fibrotic reactions in the mediastinum. So far, some infectious organisms and autoimmune diseases have been introduced as possible etiologies of FM. However, no study has ever discussed the possible association of BCG infection and FM. Case presentation In this study, we report a 3-year-old female presenting with persistent fever, weakness, and bloody diarrhea in addition to mediastinal lymphadenopathy, hepatosplenomegaly, and pleural and pericardial effusion. Further examinations established a diagnosis of MSMD based on her clinical condition, immunologic data, positive tests for mycobacterial species, positive family history, and genetic study (IL12RB1 gene, c.G1193C, p.W398S). A year and a half later, she was referred with submandibular lymphadenitis and underwent immunologic work-up which revealed high inflammatory indices, a slight reduction in numbers of CD3 + and CD4 + cells as well as elevated CD16/56 + cell count and hyperimmunoglobulinemia. Purified protein derivative (PPD), QuantiFERON, and gastric washing test were all negative. Her chest computed tomography (CT) scan revealed suspicious para-aortic soft tissue and her echocardiography was indicative of strictures in superior vena cava and pulmonary veins. She further underwent chest CT angiography which confirmed FM development. Meanwhile, she has been treated with anti-mycobacterial agents and subcutaneous IFN-γ. Conclusion In summary, we described a novel case of MSMD in a child presenting with granulomatous FM possibly following BCG infection. This is the first report introducing aberrant BCG infection as the underlying cause of FM. This result could assist physicians in identifying early-onset FM in suspicious cases with MSMD. However, more studies are required to support this matter.

Perfluorocarbon (PFC) are biocompatible compounds, chemically and biologically inert, and lacks toxicity as oxygen carriers. PFCs nanoemulsions and nanoparticles (NPs) are highly used in diagnostic imaging and enable novel imaging technology in clinical imaging modalities to notice and image pathological and physiological alterations. Therapeutics with PFCs such as the innovative approach to preventing thrombus formation, PFC nanodroplets utilized in ultrasonic medication delivery in arthritis, or PFC-based NPs such as Perfluortributylamine (PFTBA), Pentafluorophenyl (PFP), Perfluorohexan (PFH), Perfluorooctyl bromide (PFOB), and others, recently become renowned for oxygenating tumors and enhancing the effects of anticancer treatments as oxygen carriers for tumor hypoxia. In this review, we will discuss the recent advancements that have been made in PFC’s applications in theranostic (therapeutics and diagnostics) as well as assess the benefits and drawbacks of these applications.

BACKGROUND: Mobile learning has played an important role during the COVID-19 pandemic and medical schools now consider it as an effective educational method in current and future crises. In this qualitative study, an attempt was made to demonstrate the principles of designing a mobile learning strategy in medical education from the perspective of experts. MATERIALS AND METHODS: The study was conducted by the qualitative content analysis method. The data were collected from July 2022 to Feb 2023. Twelve participants were included in this study from Iran’s medical universities, consisting of two members of the Higher Council of Virtual Education, three educational directors, three clinical faculty members, two faculty members specializing in e-learning and medical education, an educational vice, and a dean. Data were collected using semi-structured interviews and analyzed by Granheim and Lundman’s (2004) method. RESULTS: Out of twelve participants in the study, eight (66%) were males and four (44%) females. Data were classified into eight categories and one theme. Based on the participants’ experiences, the main theme, that is, “the principles of medical education design in mobile learning,” included pedagogical component, interactive design, effective and comprehensive analysis, achieving objectives with the mobile learning platform, generating micro- and interactive e-content, teaching-learning interactive methods, course implementation and interactive evaluation at both micro- and macro-levels. CONCLUSION: Data analysis revealed that in addition to the eight principles in the medical education design in mobile learning, the participants prioritized the two principles of pedagogical component and interactive design over other principles in educational design. Using a successful mobile learning strategy in situations of restrictions limiting physical presence may improve the quality of medical education.

Introduction: Obesity is defined as an increase in body fat composition. Aim: The purpose of our study was to evaluate metabolic risk factors and diseases in different patterns of abdominal fat distribution. Materials and methods: This is a cross-sectional study. Among patients aged 15 to 65 years who have had no significant weight loss in the past year and were referred to the Radiology Department to perform an abdominal CT-scan, the visceral and subcutaneous fat area (VFA and SFA) with Hounsfield units -30 to -190 (±2 SD) was calculated at the umbilical level. Based on the VFA and SFA, patients were stratified into four groups, group 1: V(+)S(+); group 2: V(+)S(-); group 3: V(−)S(+); group 4: V(−)S(−). The following parameters were assessed in the groups: anthropometric parameters including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist to hip ratio (WH); laboratory parameters, including fasting blood glucose (FBG), lipids profile (TG, LDH, LDL, and total cholesterol), creatinine, and liver enzymes (AST, ALT). Additionally, sensitivity, specificity, positive predictive value (PPV), and negative predictive value of study variables were assessed in predicting group 1. Results: The study included 180 individuals (mean age 50±14 years, range 15-65 years). Group 1 was the most, and group 2 was the least prevalent pattern of abdominal fat distribution. Most females (75%) had high percentage of subcutaneous fat tissue. There was a significant association between the abdominal fat distribution pattern and BMI, WC, WHtR, TG, LDL, HDL, total cholesterol, FBG, diabetes, and metabolic syndrome (p

Background: Given the international recognition concerning the importance of digital literacy, and the increasing understanding of its importance in active learning, virtual education has recently attracted a great deal of attention. This method has provided an opportunity for teaching innovation in times of COVID-19. In this study, we aimed to compare the effects of virtual interactive education on improving nurses’ knowledge and performance in neonatal skin care.Methods: This quasi-experimental pre-post study was performed on 100 nurses working in the neonatal intensive care units. The participants were divided into three groups, namely the in-person workshop (n=34), virtual interactive education (n=33), and control (n=33). The instruments included Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN) standardized questionnaire. The t test, exact fisher, and repeated measures ANCOVA were conducted to analyze the data using SPSS V. 16 software.Results: The results revealed a significant difference between the pre and post test scores of workshop and multimedia groups in terms of the mean score of knowledge compared to the control group (P

Fault slip rate is the amount of displacement of one wall relative to another fault wall over a period of time. The duration of this shift can be measured using the luminescence dating method. To determine the age by luminescence dating method, two dose parameters equivalent to normal dose and annual dose are needed. By dividing the dose equivalent to the natural dose by the annual dose rate, the age value is determined per structural unit. To determine the dose equivalent to the normal dose, a protocol for measuring luminescence signals (data) and a program for analyzing the data are required. Data analysis was performed using R software. Because the usual international program to do this is analytics software. Data were also analyzed with analyst software. The results of these two softwares and their effect in determining the slip rate of Rafsanjan fault were compared. The amount of displacement measured on the Rafsanjan fault is 48 ± 4 meters. The age was estimated to be 97-118thousand years using R software and 101-129 thousand years by analyst software. Slip rates were obtained by R software and analysts, 0.41 to 0.53 and 0.36 to 0.48 mm / year, respectively. Slip rates were obtained by R software and analysts, 0.41 to 0.53 and 0.36 to 0.48 mm / year, respectively.

Introduction: Mobile learning is one of the innovative teaching techniques that help medical students gain knowledge and skills. One of the factors that expanded the use of this strategy was the COVID-19 pandemic. However, the educational pedagogy of such technology has been neglected. This article aimed to critically review available mobile learning models in medical education to suggest a comprehensive model in the field of mobile learning.Methods: We conducted this critical review based on the five steps of the Carnwell and Daly method. For a comprehensive systematic search from 2000 to April 2021, the following keywords were used: Personal Digital Assistant, m learning, Mobile learning, Ubiquitous learning, U learning, medical students, and medical education. 3176 studies in PubMed, Scopus, ERIC, Magiran, and Web of Science were identified. In total, 8 articles entered the study.Results: Eight models of mobile learning in medical education were identified. The key features of each model were extracted and integrated into the new model for the successful design and implementation of mobile learning. This model includes three main elements of mobile learning: 1-stakeholders, 2-interaction, and 3-technology, which are influenced by external factors including Mobiquette, legitimacy, and awareness.Conclusion: The results of this study are an important contribution to the knowledge collection in mobile learning inmedical education. We introduced a comprehensive model of mobile learning including specific characteristics of strategies in the context of medical education.

Objective(s): Early, specific, and sensitive detection methods of COVID-19 are essential for force stopping its worldwide infection. Although CT images of the lung and/or viral RNA extraction followed by real-time reverse-transcriptase-polymerase chain reaction (rRT-PCR) are widely used; they have some limitations. Here, we developed a highly sensitive magnetic bead-based viral RNA extraction assay followed by rRT-PCR. Materials and Methods: Case group included oropharyngeal/nasopharyngeal and blood samples from 30 patients diagnosed positive by PCR test for COVID-19 and control group included 30 same samples from COVID-19 negative PCR test individuals. RNA was extracted, using viral RNA extraction kit as well as using our hand-made capture bead-based technique. A one-step cDNA synthesis and Real Time PCR was conducted. A two-step comparison of the different viral RNA extraction methods for oropharyngeal/nasopharyngeal and blood samples was performed. Student t-test was applied with a P

Background: Support for evolutionary care of twin or multiple birth infants whose populations are rapidly growing is of considerable interest. Co-bedding has been considered as one of the evolutionary care strategies being implemented in many neonatal intensive care units (NICUs) throughout the world. This study is designed to investigate the effect of co-bedding among premature twin or multiple birth infants on their growth and physiological stability in a NICU with the largest number of births in Iran. Methods: It is a randomized clinical trial performed on 80 pairs of premature twin infants hospitalized in the NICU of Shahid AkbarAbadi Hospital in Tehran, Iran. Patients were randomly allocated into the two groups; co-bedded and routine care. Data were collected through a demographic questionnaire and a co-bedding checklist and compared between the two groups. Results: Data analysis showed that the weight gain and mean of NICU hospitalization days in the co-bedded group were significantly different from those of the standard care infants (P

Abstract Background PRAETORIAN is the first randomized controlled trial that demonstrated the noninferiority of subcutaneous ICD (S‐ICD) in comparison with transvenous ICD (TV‐ICD). We retrospectively reviewed electronic records of patients with ICD implanted over the past 6 years, with the primary objective to compare our real‐world single tertiary center experience with the randomized data from the PRAETORIAN study. Methods Seventy S‐ICD patients were compared with 197 TV‐ICD patients, from July 2014 to June 2020 retrospectively, over a median period of 1304 days (296–2451 days). Primary composite endpoints included inappropriate shocks and device‐related malfunctions. Results Patients with S‐ICD implantation were younger than those who received TV‐ICD (mean, 49.7 years vs 63.9 years, p

Abstract Background Combining photosensitizer and light irradiation, named antimicrobial photodynamic therapy (aPDT) is an adjuvant therapy for eliminating microbial biofilms. This ex vivo study evaluates the effect of anti-biofilm activity of aPDT based on emodin-chitosan nanoparticles (Emo-CS-NPs) plus blue laser light against Streptococcus mutans biofilm on the enamel surface. Materials After determination of the fractional inhibitory concentration index of Emo and CS by checkerboard array assay, Emo-CS-NPs were synthesized and characterized. Following treatment of pre-formed S. mutans biofilms on the enamel slabs, cellular uptake of Emo-CS-NPs and intracellular reactive oxygen species (ROS) production were determined. The anti-biofilm and anti-metabolic activities of aPDT were investigated. Eventually, lactic acid production capacity, concentrations of S. mutans extracellular DNA (eDNA) levels, and expression of the gene involved in the biofilm formation (gtfB) were evaluated. Results The maximum uptake of Emo-CS-NPs occurs in an incubation time of 5 min. When irradiated, Emo-CS-NPs were photoactivated, generating ROS, and led to a decrease in the cell viability and metabolic activity of S. mutans significantly (P