Molecular Characterization, Virulence Determinants, and Antimicrobial Resistance Profile of Methicillin-Resistant Staphylococcus aureus in the North of Iran; a High Prevalence of ST239-SCCmec III/t037 Clone.

OBJECTIVES: Emergence and prevalence of methicillin-resistant Staphylococcus aureus (MRSA) have become a major universal health concern, limiting therapeutic options. METHODS: A total number of 37 MRSA isolates, including 19 clinical isolates from hospitalized patients and 18 colonizing isolates from health care workers were identified from 3 hospitals, in Gorgan, North of Iran. Antimicrobial susceptibility test was performed using the disk diffusion method and E-test. The presence of virulence and antibiotic resistance determinants were evaluated by PCR. The genotypical characterization was further analyzed using multi-locus sequence, spa, staphylococcal cassette chromosome, mec (SCCmec), and agr typing. RESULTS: The frequency of MRSA among S. aureus isolates was 38.14% (37/97). The most frequent S. aureus resistant isolates were found to be obstinate against penicillin (98%) and gentamicin (82.5%). Additionally, the lowest resistance rates were found against daptomycin (0%), vancomycin (2.7%), and quinupristin-dalfopristin (5.4%). All MRSA isolates were susceptible to daptomycin with minimum inhibitory concentration (MIC)50/MIC90 of 0.25/0.5 µg/mL. One isolate belonging to sequence type 239 (ST239)-SCCmecIII/t037 clone (MIC ≥16 µg/mL) was resistant to vancomycin. All but 1 isolate that shares ST22-SCCmec IV/t790 strain were positive for both tsst and pvl genes. The most predominant MRSA isolates (27%) were associated with ST239-SCCmec III/t037, and ST239-SCCmec III/t924 (16.2%) clones, subsequently. In our study, circulating MRSA strains were genetically diverse with a high prevalence of ST239-SCCmec III/t037 clone. CONCLUSION: These findings emphasize the need for future and continuous surveillance studies on MRSA to prevent the dissemination of existing multidrug resistance MRSA clones in an effective manner.

Mycobacterium tuberculosis typing using Allele-specific oligonucleotide multiplex PCR (ASO-PCR) method.

Mycobacterium tuberculosis (M. tuberculosis) genotyping provides valuable information related to the origin and the evolution of the isolates. This study aimed to evaluate the applicability of single-nucleotide polymorphisms (SNPs) technique for lineages identification of M. tuberculosis and compare it with mycobacterial interspersed repetitive units-variable number of tandem repeats (MIRU-VNTR) method. The lineages of 162 clinically isolates were evaluated using six pair primers by Multiplex-PCR based on SNPs. Among 162 isolates, 70 (43.2%) isolates were lineage 4, following that 62 (38.3%) and 22 (13.6%) isolates were lineage 3 and 2, respectively. The method could not type 8 (4.9%) isolates. Moreover, we could identify 71 out of 79 unknown isolates resulted from the MIRU-VNTR method. The results showed that the SNP typing method has the potential to determine the lineages of M. tuberculosis as a rapid laboratory screening test.

Dissociative Experiences In Iranian Depressed Patients.

In the present study, 229 major depressive disorder (MDD) patients (57.6% female; 42.4% male) were selected by convenience sampling and examined for rate of dissociative experiences. Research tools were Dissociative Experiences Scale (DES) and demographic questionnaire. Group difference examinations were performed for gender, settlement region (place of residence), and chief complaints using standard t-test, analysis of variance, and Chi-square tests as appropriate. Ordinal regression was implemented for model building. The average age of the sample was 36.78 ± 10.73. Of which, 150 (65.5%) lived in the urban and 79 (34.5%) in the rural areas. The chief complaint of the 146 patients (63.8%) was psychiatric symptoms specific to MDD, and the remaining 83 patients (36.2%) had physical symptoms. The average DES score was 10.59 ± 13.59; and a significant mean DES score differences (P < 0.01) between patients' referred to physician for physical versus psychological complaints (physical: 23.61 ± 14.39; psychological: 3.19 ± 4.5) and geographic settlements (rural: 19.58 ± 15.13; urban: 5.86 ± 9.86) were observed. This study highlights the presence of subtype within MDD patients with significant dissociative tendencies. Given the relationship between trauma history and dissociation, this subgroup could be considered as probable cases with childhood history of abuse, lending to use dissociation as a defense mechanism. Given the evidence for promising results of trauma-focused psychotherapy in treating such patients, paying proper attention to childhood history of depression especially with somatization may minimize pain and suffering of these individuals overtime.

Spatial Distribution and Birth Prevalence of Congenital Heart Disease in Iran: A Systematic Review and Hierarchical Bayesian Meta-analysis.

BACKGROUND: This study aimed to comprehensively analyze the overall congenital heart disease (CHD) prevalence in live births and children in Iran, along with evaluating the spatial distribution of CHD birth prevalence across various geographical regions within the country. METHODS: A Bayesian hierarchical meta-analysis (PROSPERO 2022: CRD42022331281) was performed to determine the pooled prevalence. A systematic search was conducted using Web of Science, ScienceDirect, PubMed, Iranian Research Institute for Information Science and Technology (IranDoc), Scientific Information Database (SID), and Magiran until October 4, 2023. Cross-sectional and cohort studies in both English and Persian languages, focusing on the age range of 0-10 years, were considered for the study population. The study quality was evaluated using the Agency for Healthcare Research and Quality (AHRQ) Risk of Bias tool. Heterogeneity was assessed by I2 and τ2 statistics, and publication bias by Egger's and Begg's tests. RESULTS: The meta-analysis included 62 studies, revealing an overall CHD prevalence of 2.5 per 1000 births. Over time, CHD birth prevalence in Iran has consistently increased. Spatial distribution analysis, including spatial autocorrelation and local spatial autocorrelation, indicated no spatial clustering (P=.46) or aggregation (P=.65) among Iran's provinces. Geographic disparities were significant (P=.000), with the northern and eastern regions showing the highest and lowest CHD prevalence, respectively. CONCLUSION: The overall CHD prevalence in Iran is lower than global rates, but it continues to rise. Furthermore, there are variations in birth prevalence among different regions of Iran. Environmental, genetic, socioeconomic, and diagnostic accessibility differences are possibly involved in regional variation. The limitations like heterogeneity among studies, the potential inaccuracy of reports due to limited use of accurate diagnostic methods in some studies, and the absence of population-based models to investigate prevalence, underscore the urgent need for standardized diagnostic approaches, and the utilization of population-wide birth defect registries to accurately assess CHD prevalence in Iran.

The study of HMOX1 DNA methylation and gene expression and the diagnostic potential of miR-153-3p in preeclampsia.

Background: The objective was to elucidate the potential epigenetic regulatory mechanism in HMOX1 expression in preeclampsia. Materials & methods: HMOX1 promoter DNA methylation was evaluated in the placental tissue and blood of preeclamptic and normotensive pregnant women. HMOX1 and miR-153-3p gene expression were assessed in placental tissue and peripheral blood mononuclear cells (PBMCs). Related microarray datasets in the Gene Expression Omnibus database were also analyzed. Results: In placental tissue, despite HMOX1 expression downregulation, there was no significant change in HMOX1 methylation. In PBMCs, there was no significant alteration in HMOX1 expression, while hypomethylation was observed in blood. The miR-153-3p expression increased in the placental tissue and in the PBMCs of preeclampsia. Conclusion: DNA methylation does not affect HMOX1 expression, while miR-153-3p might be a biomarker for preeclampsia.

Large optical spectral range dispersion engineered silicon-based photonic crystal waveguide modulator.

We present a dispersion engineered slow light silicon-based photonic crystal waveguide PIN modulator. Low-dispersion slow light transmission over 18 nm bandwidth under the silica light line with a group index of 26.5 is experimentally confirmed. We investigate the variations of the modulator figure of merit, V(π) × L, as a function of the optical carrier wavelength over the bandwidth of the fundamental photonic crystal waveguide defect mode. A large signal operation with a record low maximum V(π )× L of 0.0464 V · mm over the low-dispersion optical spectral range is demonstrated. We also report the device operation at 2 GHz.

Modelling of micropollutant fate in hybrid growth systems: model concepts, Peterson matrix, and application to a lab-scale pilot plant.

Modelling the fate of micropollutants in different wastewater treatment processes is of present concern. Moreover, during the last few years, there has been an increasing interest in the development of hybrid reactors which contain both suspended biomass and biofilm. Here, a new model developed which tries to determine the fate of micropollutants in hybrid reactors such as moving bed biofilm reactor (MBBR) and called the ASM-biofilm-MPs model considered the main mechanisms leading to the micropollutant removal (sorption/desorption, biodegradation, cometabolism) in hybrid reactors. This dynamic model describes the fate of micropollutants in a hybrid reactor using first-order kinetics for biotransformation and sorption/desorption equations. Also, it considered the reactions for carbon oxidation, nitrification, and denitrification in attached and suspended biomass under aerobic conditions. The mathematical model consists of three connected models for the simulation of micropollutants, suspended biomass, and biofilm. Biochemical conversions are evaluated according to the Activated Sludge Model No. 1 (ASM1) for both attached and suspended biomass. The model is applied for a laboratory MBBR, which fed with synthetic wastewater containing 4-nonylphenol (4-NP) as micropollutant, and accurately describes the experimental concentrations of COD, attached and suspended biomass, nitrogen, and 4-NP micropollutant obtained during 180 days working at different loadings. The differences between simulations and experiments in all operational periods for sCOD, NH4-N, NO3-N, and attached and suspended biomass concentrations were less than 15%, 10%, 10%, 5% and 5%, respectively. Finally, the contribution of adsorption and biodegradation mechanisms in the fate of 4-NP was calculated, when 4-NP concentration is set to 1 µg/L (biodegradation = 86.5%, sorption = 5%) and 50 µg/L (biodegradation = 55.9%, sorption = 34.7%).

Pregnancy, Preeclampsia, and COVID-19: Susceptibility and Mechanisms: A Review Study.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters cells through angiotensin converting enzyme 2 (ACE2), which expression of its gene increases during pregnancy that is resulted in an enhanced level of the ACE2 enzyme. It might enhance the risk of SARS-CoV-2 infection and its complications in the pregnant women. Although, pregnancy hypertensive disorders and severe infection with SARS-CoV-2 are correlated with high comorbidity, these two entities should be discriminated from each other. Also, there is a concern about the risk of preeclampsia and consequently severe coronavirus disease 2019 (COVID-19) development in the pregnant women. So, to answer these questions, in the present review the literature was surveyed. It seems there is higher severity of COVID-19 among pregnant women than non-pregnant women and more adverse pregnancy outcomes among pregnant women infected with SARS-CoV-2. In addition, an association between COVID-19 with preeclampsia and the role of preeclampsia and gestational hypertension as risk factors for SARS-CoV-2 infection and its complications is suggested. However, infection of the placenta and the SARS-CoV-2 vertical transmission is rare. Various mechanisms could explain the role of COVID-19 in the risk of preeclampsia and association between preeclampsia and COVID-19. Suggested mechanisms are included decreased ACE2 activity and imbalance between Ang II and Ang-(1-7) in preeclampsia, association of both of severe forms of COVID-19 and pregnancy hypertensive disorders with comorbidity, and interaction between immune system, inflammatory cytokines and the renin angiotensin aldosterone system and its contribution to the hypertension pathogenesis. It is concluded that preeclampsia and gestational hypertension might be risk factors for SARS-CoV-2 infection and its complications.

Occurrence and risk factors of nontuberculous mycobacteria in tuberculosis-suspected patients in the north of Iran.

BACKGROUND AND OBJECTIVES: Some Nontuberculous Mycobacteria (NTM) can occasionally infect the human population and cause infections having symptoms similar to tuberculosis (TB). This study tried to provide updated data about the frequency and diversity of NTM species. MATERIALS AND METHODS: Suspicious samples of Mycobacterium tuberculosis (MTB) with both positive results in Ziehl-Neelsen (ZN) staining and Löwenstein-Jensen medium culturing were evaluated during January 2016 and December 2018 in Gorgan, Iran. After determination of MTB isolates by the growth rate, pigmentation status, the niacin test, and the insertion sequence 6110 (IS6110) PCR assay, other unknown isolates (presumably NTM) were detected by the 16S rDNA sequencing method and drawing the phylogenetic tree. Based on the patients' demographic information, their risk factors were also assessed. RESULTS: Among 226 culture-positive samples, obtained from 2994 individuals with suspected symptoms of TB, the analyses found 12 (5.3%) NTM and three Mycobacterium caprae isolates. Mycobacterium simiae (6/12) was the most prevalent NTM species. The average nucleotide similarity value was 98.2% ± 3.7. In comparison to patients with MTB (211 confirmed cases), other mycobacterium infections were more common in patients over 65 years old (Odd ratio (95% convenience interval): 2.96 (0.69 - 12.59), P = 0.14). CONCLUSION: Although the NTM species has a small portion in TB suspected patients, their prevalence has increased, mainly in elderly patients. Moreover, M. simiae was the most prevalent NTM species in our region. Therefore, identification of common species in each region is recommended and clinicians should pay more attention to them in each region.

Selecting the best stabilization/solidification method for the treatment of oil-contaminated soils using simple and applied best-worst multi-criteria decision-making method.

Oil-contaminated soils resulted from drilling activities can cause significant damages to the environment, especially for living organisms. Treatment and management of these soils are the necessity for environmental protection. The present study investigates the field study of seven oil-contaminated soils treated by different stabilization/solidification (S/S) methods, and the selection of the best treated site and treatment method. In this study, first, the ratios of consumed binders to the contaminated soils (w/w) and the treatment times for each unit of treated soils were evaluated. The ratios of consumed binders to the contaminated soils were between 6 and 10% and the treatment times for each unit of treated soils were between 4.1 and 18.5 min/m3. Physicochemical characteristics of treated soils were also determined. Although S/S methods didn't change the water content of treated soils, they increased the porosity of soils. Unexpectedly, the cement-based S/S methods didn't increase the pH of the treated soils. The highest and the lowest leaching of petroleum hydrocarbons was belonging to S/S using diatomaceous earth (DE) and the combination of Portland cement, sodium silicate and DE (CS-DE), respectively. The best acid neutralization capacity was obtained for soils treated using the combination of Portland cement and sodium silicate (CS). Based on the best-worst multi-criteria decision-making method (BWM-MCDM), the soils treated using CS-DE was select as the best. The BWM-MCDM can be used as an effective tool for the selection of the best alternative in all areas of environmental decontamination.

Influence of microwave-microencapsulated citric acid on some sensory properties of chewing gum.

Over the past few decades, microwave processing and its high potential capabilities have attracted food scientists. Application of microwave for microencapsulation is an innovative and new method in which the shell, due to having different dielectric constant, can fuse and cover core. In this research, the citric acid powder at various size ranges was microencapsulated by casein and inulin, using a domestic microwave oven. Then, for sensory evaluation purposes, they along with uncoated citric acid and commercial microcapsules were incorporated in chewing gum formulation. The qualitative and quantitative evaluations revealed the potential capability of this technique at micronized scales. Moreover, findings on some sensory characteristics showed practical and efficient applicability of inulin-coated microcapsules in chewing gum where its sensory scores were competitive and even much better than commercial ones. In addition, these observations elucidate a new approach for producing functional, nutritional and dietetic chewing gums.

Prevalence of Gram-Negative Bacilli Isolated from the Equipment and Surfaces in Hospital Wards of Golestan Province, North of Iran.

Nosocomial infections are one of the most common causes of death in hospitals. This study aimed to determine the prevalence of gram-negative bacilli isolated from the equipment in hospital wards of the Golestan province, in the year 2015. In this cross-sectional study in 2015, 1980 samples from medical and nonmedical equipment and surfaces were collected from the wards of 13 teaching hospitals, in the Golestan province. Samples were inoculated into eosin methylene blue agar and blood agar culture media and isolated colonies were identified by standard biochemical tests. The obtained results were then analyzed using SPSS 22 software and χ2 test. Among 1980 isolated samples, 601 samples (30.35%) were infected with gram-negative bacilli while Enterobacter aerogenes (37.27%) was responsible for most of the contaminations. The highest rate of infection was observed in the intensive care unit (33.1%), and the highest level of contamination in the medical equipment was associated with laryngoscope and its blade (10.48%), as well as ECG sensor and its monitoring connector (6.65%). Meanwhile, phone (6.32%) and patients' beds and linen (5.15%) had the highest level of contamination in the nonmedical equipment. Considering the high rates of gram-negative bacilli contamination in the hospital wards of the Golestan province, thorough hand washing as the main action for disinfection and sterilizing the equipment, as well as performing periodic cultivation alongside the use of standard guidelines for prevention and control of nosocomial infections, are recommended to reduce the level of contamination.