The Effectiveness of Laboratory Parameters in Predicting the in-Hospital Mortality of Iranian Patients with Coronavirus Disease 2019 (COVID-19).

Background: The novel coronavirus 2019-nCoV (now SARS-CoV-2) has spread globally and affected healthcare systems worldwide. Due to lack of long-term immunization and effective specific treatments for the COVID-19 disease, there is a need of identifying the patients who are at the risk of a fatal outcome, according to the available epidemiological data and laboratory parameters. Objective: Thus, we aimed to evaluate the prognostic value of epidemiological data and laboratory para-meters for in-hospital case fatality in patients with COVID-19. Materials and Methods: A retrospective cohort of patients with COVID-19 admitted to the Shahid Mostafa Khomeini Hospital of Ilam University of Medical Sciences from February 29 until March 29, 2020 was performed. Epidemiologic data and laboratory results were collected. Univariate and multivariate logistic regression models were performed to evaluate the prognostic value of the laboratory parameters for in-hospital death. Results: A total of 256 Iranian COVID-19 patients were included in the evaluation; 38 of them died, resulting in a in-hospital case-fatality rate of 14.8%. The univariate analysis showed that advanced age [OR=1.04, 95% CI: 1.02, 1.06, P=0.001], smoking [OR=4.041, 95% CI: 1.546-10.563, P=0.004], white blood cells [OR=0.941, 95% CI: 0.904-0.980, P =0.003] and hematocrit [OR=1.060, 95% CI: 1.009-1.113, P=0.020] were positively associated with the risk of a fatal outcome. Multivariate logistic regression analysis revealed that COVID-19 patients with an elevated white blood cell count and elevated hemoglobin level had 1% and 9% greater risk of an in-hospital death for each elevated unit [OR=1.07; 95 %CI: 1.024-1.088, P =0.002 and OR=1.379; 95% CI 0.064-1.788, P =0.015, respectively]. Conclusions: An increase in white blood cell count and an increase in hemoglobin level might be indepen-dent risk factors for in-hospital death in Iranian patients with COVID-19. Further studies are necessary in order to conferm the prognostic value of the variables discussed.

Antisense mqsR-PNA as a putative target to the eradication of Pseudomonas aeruginosa persisters.

Chemotherapy is frequently unsuccessful in fully eradicating bacterial biofilm infections. Persisters are a main cause for the failure of antibiotic therapies and are assumed to significantly impact the increased multidrug tolerance and unsuccessful elimination of chronic biofilm infections. Pseudomonas aeruginosa infections are frequently linked to high rates of drug-tolerant persisters, triggering a major challenge to human health. It is crucial to classify persisters to develop novel useful therapeutic strategies to fight infectious diseases. In this study, the mqsR gene was selected as a novel antimicrobial target, and silencing was with antisense peptide nucleic acid (PNA) assay to eradicate the P. aeruginosa persisters. First, they were analysed by experimental procedures. Functionality was assessed by stress conditions. We found that the expression of mqsR (as the toxin) compared with mqsA (as antitoxin) was increased under stress conditions. We demonstrated that when mqsR was targeted and treated with different concentrations of mqsR-PNA after 24 hours; the formation of P. aeruginosa persisters was eradicated. Antisense mqsR-PNA in concentrations of 35 µM or more could eradicate persister cell formation in P. aeruginosa. It was suggested that other toxin-antitoxin loci in P. aeruginosa are examined by antisense PNA to detect their functionality. However, considering the importance of persisters in human infections, ex vivo, in vivo, preclinical and clinical settings should be highlighted.

Sub-minimum inhibitory concentrations of biocides induced biofilm formation in Pseudomonas aeruginosa.

It is clear that biofilm formation causes many serious health-care problems. Interestingly, sub minimum inhibitory concentrations (sub-MICs) of some biocides can induce biofilm formation in bacteria. We investigated whether sub-MICs of Savlon, chlorhexidine and deconex®, as biocidal products, can induce biofilm formation in clinical isolates of Pseudomonas aeruginosa. To determine MICs and biofilm formation, we performed microtitre plate assays. All three biocides induced biofilm formation at sub-MICs; Savlon was the most successful antiseptic agent to induce biofilm formation among P. aeruginosa isolates. Deconex had the best inhibition effect on planktonic cultures of P. aeruginosa isolates. We concluded that sub-MICs of Savlon and deconex could significantly induce biofilm formation.

Increase in RNASEL gene expression by miR-29-3p inhibitors in HEK293T cells.

BACKGROUND: RNase L is known as a terminal component of antiviral and Interferon (IFN) pathways in mammalian cells. On the other hand, the human miR-29 family of microRNAs (miRs) has three mature members, miR-29a, miR-29b, and miR-29c. miR-29 is encoded by two gene clusters and the family members have multifunctional roles in various biological processes. OBJECTIVES: To determine the potential role of miR-29 in the regulation of RNASEL gene expression by designing inhibitors against its targeting miRNA, miR-29a-3p and evaluate the RNase L expression. MATERIAL AND METHODS: After selecting miR-29a-3p as a main regulating miRNA for RNASEL in silico, two inhibitors were designed against it and synthesized. Synthesized strands were made double-stranded DNA oligos, treated with T4 polynucleotide kinase (PNK), cloned into the pCDH-CMV-MCS-EF1-cGFP-T2A-Puro vector and transformed into DH5α. Colony PCR and sequencing was done for affirmation. Then the miR-29a-3p inhibitors were transfected into HEK-293T cell line and RNASEL gene expression was analyzed. RESULTS: The miR-29a-3p inhibitors decreased miR-29a-3p expression in vitro. In addition, miR-29a-3p expression reduction resulted in an increase of RNASEL gene expression. CONCLUSIONS: miR-29a-3p inhibitors could increase in RNASEL gene expression which potentially affects the antiviral/IFN pathway. The inhibitors could be considered as drug candidates in different diseases especially viral infections.

Asymptomatic carriers of Neisseria meningitidis and Moraxella catarrhalis in healthy children.

There is a close correlation between asymptomatic oropharyngeal colonization by bacterial pathogens and paediatric respiratory diseases. Evaluation of the frequency of asymptomatic carriers of Neisseria meningitidis and Moraxella catarrhalis in healthy children was the main aim of the current study. In this cross-sectional study, 123 oropharyngeal swabs were collected from children between 2 and 6 years old in kindergartens of Ilam, Iran. Moraxella catarrhalis and N. meningitidis were identified using phenotypic and genotypic assays. In addition, the occurrence of the virulence factors (ctrA and uspA1) and iron uptake (tbpA) genes was evaluated by PCR. Results showed that 21 M. catarrhalis isolates and 17 N. meningitidis isolates were identified by conventional microbiological and biochemical methods, but the RT-PCR assay detected that 18 and 8 isolates were positive for M. catarrhalis and N. meningitidis, respectively. The tbpA gene was positive in all N. meningitidis and M. catarrhalis isolates. Seven isolates were positive for the ctrA gene in N. meningitidis and seven isolates were positive for the uspA1 gene in M. catarrhalis. These pathogenic bacteria often occurred as asymptomatic carriage of N. meningitidis in children from large families with low economic status, which reflects the importance of the environment and socio-economic level of families in the distribution of these potentially pathogenic bacteria in the oropharynx of children. Monitoring for the carriage of potential pathogenic bacteria in the nasopharynx of healthy children is important as this can predispose to infectious diseases; common exposure to human respiratory bacterial pathogens is a further risk factor.

Rapid and direct molecular detection of Streptococcus pneumoniae and Haemophilus influenzae isolated in oropharynx and nasal cavity of children.

There is a direct correlation between asymptomatic oropharyngeal colonization by pathogenic bacteria and the prevalence of paediatric respiratory infections. Streptococcus pneumoniae and Haemophilus influenzae are common cause of serious bacterial infections such as meningitis in children. This study aimed to monitor healthy children to detect asymptomatic carriers of S. pneumoniae and H. influenzae. In the present cross-sectional study, real-time PCR assay was developed and evaluated in comparison with culture for direct detection of S. pneumoniae and H. influenzae in 123 oropharynx and nasal cavity specimens from healthy children in Ilam, Iran. In addition, virulence factor (ply and hpd) and iron uptake (tbpA and piuA) genes were evaluated by PCR. Our results demonstrated that among all isolates only 14 S. pneumoniae and eight H. influenzae were identified by phenotypic methods, whereas 37 and 21 S. pneumoniae and H. influenzae were identified, respectively, by real-time PCR assay. All S. pneumoniae and H. influenzae isolates possessed tbpA and piuA genes. Also, 81% (30/37) of S. pneumoniae isolates were positive for ply gene, which encoded pneumolysin, as well as 90% (19/21) of H. influenzae isolates were positive for hpd gene. Simultaneous colonization of S. pneumoniae and H. influenzae could indicate the importance of monitoring of healthy children to identification of carriers.

Electric Field Exposure Assessments and a Novel Control Method for Buildings Installed Nearby High-Voltage Lines.

This essay presents a review of new methods for electric field value assessment in high-voltage areas. For buildings that are placed near high-voltage transmission line corridor, two main scenarios are modeled using finite element method. A new approach to reduce electric field value is also simulated and the results are discussed in detail. The results are compared to related standards values. In some cases the improvement rate exceeds 65%.

A review of natural polysaccharides for drug delivery applications: Special focus on cellulose, starch and glycogen.

Natural polysaccharides are renewable with a high degree of biocompatibility, biodegradability, and ability to mimic the natural extracellular matrix (ECM) microenvironment. Comprehensive investigations of polysaccharides are essential for our fundamental understanding of exploiting its potential as bio-composite, nano-conjugate and in pharmaceutical sectors. Polysaccharides are considered to be superior to other polymers, for its ease in tailoring, bio-compatibility, bio-activity, homogeneity and bio-adhesive properties. The main focus of this review is to spotlight the new advancements and challenges concerned with surface modification, binding domains, biological interaction with the conjugate including stability, polydispersity, and biodegradability. In this review, we have limited our survey to three essential polysaccharides including cellulose, starch, and glycogen that are sourced from plants, microbes, and animals respectively are reviewed. We also present the polysaccharides which have been extensively modified with the various types of conjugates for combating last-ditch pharmaceutical challenges.

Online Estimation of Elbow Joint Angle Using Upper Arm Acceleration: A Movement Partitioning Approach.

Estimating the elbow angle using shoulder data is very important and valuable in Functional Electrical Stimulation (FES) systems which can be useful in assisting C5/C6 SCI patients. Much research has been conducted based on the elbow-shoulder synergies. The aim of this study was the online estimation of elbow flexion/extension angle from the upper arm acceleration signals during ADLs. For this, a three-level hierarchical structure was proposed based on a new approach, i.e. 'the movement phases'. These levels include Clustering, Recognition using HMMs and Angle estimation using neural networks. ADLs were partitioned to the movement phases in order to obtain a structured and efficient method. It was an online structure that was very useful in the FES control systems. Different initial locations for the objects were considered in recording the data to increase the richness of the database and to improve the neural networks generalization. The cross correlation coefficient (K) and Normalized Root Mean Squared Error (NRMSE) between the estimated and actual angles, were obtained at 90.25% and 13.64%, respectively. A post-processing method was proposed to modify the discontinuity intervals of the estimated angles. Using the post-processing, K and NRMSE were obtained at 91.19% and 12.83%, respectively.

Design, simulation and modelling of auxiliary exoskeleton to improve human gait cycle.

Exoskeleton is a walking assistance device that improves human gait cycle through providing auxiliary force and transferring physical load to the stronger muscles. This device takes the natural state of organ and follows its natural movement. Exoskeleton functions as an auxiliary device to help those with disabilities in hip and knee such as devotees, elderly farmers and agricultural machinery operators who suffer from knee complications. In this research, an exoskeleton designed with two screw jacks at knee and hip joints. To simulate extension and flexion movements of the leg joints, bearings were used at the end of hip and knee joints. The generated torque and motion angles of these joints obtained as well as the displacement curves of screw jacks in the gait cycle. Then, the human gait cycle was simulated in stance and swing phases and the obtained torque curves were compared. The results indicated that they followed the natural circle of the generated torque in joints with a little difference from each other. The maximum displacement obtained 4 and 6 cm in hip and knee joints jack respectively. The maximum torques in hip and knee joints were generated in foot contact phase. Also the minimum torques in hip and knee joints were generated in toe off and heel off phases respectively.

Solar degradation of Direct Blue 71 using surface modified iron doped ZnO hybrid nanomaterials.

This paper reports photodegradation of Direct Blue 71 under irradiation by sunlight. We synthesized Fe:ZnO nanomaterials under mild hydrothermal conditions (P = autogenous, T = 100 °C, t = 18 h). The precursors were Fe(2)O(3) as dopant, n-butylamine as surface modifier, NaOH as mineralizer and reagent grade ZnO. The systematic experiments on the photodegradation of Direct Blue 71 were carried out by changing different effective parameters. The variables in this study were type of nanomaterials synthesized (4 types), nanomaterial dosage (0.4-1.0 g/L), contact time (30-120 min), pH (3-11), and dye concentration (20-100 ppm). The photodegradation efficiency was determined using a UV-Vis spectrophotometer. Determination of total organic carbon (TOC) amount was used to find out mineralization efficiency. Our experimental results revealed that the nanomaterials synthesized had higher efficiency compared with the reagent grade ZnO. The best efficiency was achieved at the following conditions: 1.0 g/L nanomaterials loading, 120 min contact time, pH 5, and photodegradation efficiency from more than 75 up to 99% depending upon the dye concentration.

Pre-Hospital Emergency Medical Services in Developing Countries: A Case Study about EMS Response Time in Yazd, Iran.

BACKGROUND: Prehospital emergency medical services, a subsystem of Emergency Medical Services (EMS),provides early care to critically ill and injured patients in the field. Time is an important factor in pre-hospital care and the length of time it takes to reach care, has a significant impact on patient outcome. This study aims to calculate the response time in EMS stations of Yazd, Iran. METHODS: During 2008-2009, 11961 run report forms from all 7 EMS stations in Yazd that had been submitted to central station were surveyed. By using Excell statistical software and descriptive statistics (percent, cumulative distribution and standard deviation), we calculated fractile response times for Yazd EMS. RESULTS: 81.15 percent of response times were within 8 minutes as a referenced standard for EMS. CONCLUSION: The majority of call services in Yazd EMS have been responded in a suitable time interval comparing with reference standards and country's approved EMS response time goal, but there are still rooms for improvement.

Multi-trace elements level in drinking water and the prevalence of multi-chronic arsenical poisoning in residents in the west area of Iran.

First, we determined the levels of 8 trace elements (As, Se, Hg, Cd, Ag, Mn, Cr and Pb) in 530 village drinking water sources by graphite furnace or flame atomic absorption spectroscopy method, in Kurdistan Province in the west of Iran. The results showed that the level of As, Cd and Se in 28 village drinking water sources exceeded WHO or National Standard limits. The levels of concentration of arsenic in drinking water ranged from 42 to 1500microg/L. Then in a cross-sectional survey, 587 people from 211 households were chosen for clinical examinations of multi-chronic arsenical poisoning including pigment disorders, keratosis of palms and soles, Mee's line in fingers and nails and the gangrene as a systemic manifestation. Of 587 participants, 180 (30.7%) participants were affected by representing the type of chronic arsenical poisoning. The prevalence of Mee's line, keratosis, and pigment disorders were 86.1%, 77.2% and 67.8% respectively. Therefore, the prevalence of Mee's line between inhabitants was higher than the other disorders. The results show a strong linear relationship between arsenic exposure and occurrence of multi-chronic arsenical poisoning (R(2)=0.76). The association between age for more than 40 years and gender for more than 60 years with chronic arsenical poisoning is significant (p<0.05). Also, there is a relationship between subjects who were affected with disorders and duration of living in the village. Except for gangrene disorder, the odds ratio of prevalence of other disorders with arsenic exposure level in drinking water show a highly significant relationship between arsenic content and the risk of chronic disorders (p<0.01). These results confirm the need to further study trace elements in drinking waters, food products and other samples in this area and the relationship to other chronic diseases arising out of arsenicosis.

The prevalence of coronary artery disease in an urban population in Isfahan, Iran.

OBJECTIVE: Cardiovascular diseases, especially coronary artery disease (CAD), are responsible for the highest mortality rate in Iran. This study was conducted to determine the prevalence of CAD in an urban sample in Isfahan by the Minnesota code of a 12-lead resting electrocardiogram (ECG), the Rose questionnaire on chest pain and a self-reported previous medical history. METHODS AND RESULTS: Among the target sample of 6,470 men and women aged 35-79 years who were randomly selected from 80 random clusters in Isfahan, 5,773 subjects (about 90%) have participated. The WHO (Rose) questionnaires (Q) on chest pain were completed for all participants and 12-lead ECGs were taken. The overall prevalence of CAD based on the Rose Q and/or ECG was 19.4% (95% CI 18.4% to 20.4%) which was significantly higher among women 21.9% (95% CI 20.5% to 23.3%) than men 16.0% (95% CI 14.5% to 17.5%) (p < 0.05). The prevalence of CAD increased with age in both sexes. The prevalence of definite and possible angina based on the questionnaire was higher among women compared to men (p < 0.05), also a greater prevalence of ECG-based possible ischaemia was observed among woman than men (12.3% vs. 7.5%) (p < 0.05). However, definite and possible MI and definite ischaemia based on ECG abnormalities were higher among men than women (p < 0.05). The total prevalence of symptomatic CAD was 9.3% and about 22% of those with symptoms of CAD on Q have some evidence on ECG. The findings also showed that CAD is more common among people with less education, lower income and the unemployed (p < 0.05). CONCLUSION: These findings indicate that there is a high prevalence of CAD among the Iranian population which need more programmes of health promotion and lifestyle changes and further studies to assess the used epidemiological methods for estimating CAD prevalence, especially among women.