Effect of biological sewage sludge and its derived biochar on accumulation of potentially toxic elements by corn (Zea mays L.).

The land application of sewage sludge can cause different environmental problems due to the high content of potentially toxic elements (PTEs). The objective of this study was to compare the effect of urban biological sewage sludge (i.e. the waste of activated sludge process) and its derived biochar as the soil amendments on the bioavailability of PTEs and their bioaccumulation by corn (Zea mays L.) under two months of greenhouse conditions. The soil was treated by adding biochar samples at 0 (control), 1, 3, 5% w/w. The diethylenetriamine pentaacetic acid (DTPA)-extractable concentrations of PTEs including Zn, Pb, Cd, Cr, Ni, Fe, and Cu in soil and their accumulation by plant shoot and root were measured. Conversion of the biological sewage sludge into the biochar led to decrease the PTEs bioavailability and consequently decreased their contents in plant tissues. The DTPA extractable metal concentrations of produced biochar in comparison to the biological sewage sludge reduced 75% (Cd), 65% (Cr), 79% (Ni and Pb), 76% (Zn), 91% (Cu) and 88% (Fe). Therefore, the content of Ni, Fe, Zn and Cd in corn shoot was decreased 61, 32, 18 and 17% respectively in application of 5% biochar than of raw sewage sludge. Furthermore, the application of 5% biochar enhanced the physiological parameters of the plants including shoot dry weight (twice) and wet weight (2.25 times), stem diameter (1.70 times), chlorophyll content (1.03 times) in comparison to using 5% raw sewage sludge. The results of the study highlight that application of the biochar derived from urban biological sewage sludge in soil could decrease the risk of PTEs to the plant.

Phototrophic Nitrogen Fixation, a Neglected Biogeochemical Process in Mine Tailings?

Biological nitrogen fixation (BNF) has important ecological significance in mine tailing by contributing to the initial accumulation of nitrogen. In addition to chemolithotrophic and heterotrophic BNF, light may also fuel BNF in oligotrophic mine tailings. However, knowledge regarding the occurrence and ecological significance of this biogeochemical process in mine tailings remains ambiguous. The current study observed phototrophic BNF in enrichment cultures established from three primary successional stages (i.e., original tailings, biological crusts, and pioneer plants) of tailings. Notably, phototrophic BNF in tailings may be more active at vegetation stages (i.e., biological crusts and pioneering plants) than in bare tailings. DNA-stable isotope probing identified Roseomonas species as potential aerobic anoxygenic phototrophs responsible for phototrophic BNF. Furthermore, metagenomic binning as well as genome mining revealed that Roseomonas spp. contained essential genes involved in nitrogen fixation, anoxygenic photosynthesis, and carbon fixation, suggesting their genetic potential to mediate phototrophic BNF. A causal inference framework equipped with the structural causal model suggested that the enrichment of putative phototrophic diazotrophic Roseomonas may contribute to an elevated total nitrogen content during primary succession in these mine tailings. Collectively, our findings suggest that phototrophic diazotrophs may play important roles in nutrient accumulation and hold the potential to facilitate ecological succession in tailings.

Potential of Pinus eldarica Medw. tree bark for biomonitoring polycyclic aromatic hydrocarbons in ambient air.

Urban trees' biomonitoring of pollutants such as polycyclic aromatic hydrocarbons (PAHs) yields pertinent and useful data for air pollution management. The aim of this study was to biomonitor PAHs in pine (Pinus eldarica Medw.) trees in the city of Isfahan and identify their sources. In total, 34 samples of outer bark of the trees were collected and their contents of 16 EPA PAHs were analyzed. With a median value of 136.3 ng/g, the total PAH contents in tree barks varied from 53.4 to 705.2 ng/g. The average values of the diagnostic ratios for Ant/(Ant + Phe), Flu/(Flu + Py), BaA/(BaA + Chr) and IP/(IP + BP) were 0.19, 0.49, 0.45 and 0.49, respectively, revealing the PAHs majority source of pyrogenic. Meanwhile, principal component analysis showed two major types of PAHs sources including pyrogenic (fossil fuel combustion and industrial activities) and petrogenic (uncombusted) sources. The average ratio An/(An + Phe) and Flu/(Flu + Py) in bark samples was close to their relevant ratios in ambient air which demonstrated the potential use of this approach for biomonitoring of PAHs.

Family engagement in the care of infectious patients in intensive care units: A hybrid concept analysis.

AIM: This study aims to define and investigate characteristics, antecedents, and consequences of the concept of family engagement in caring for patients with infectious diseases hospitalised in intensive care units. DESIGN: This is a three-phase hybrid model study (theoretical, fieldwork, and analytical phase). METHODS: The York University Guidelines were used in the theoretical phase, and ultimately, 16 pieces of literature related to the subject under study from 2011 to 2021 were reviewed. The content analysis was used for fieldwork phases; eight participants were interviewed. Then, the theoretical and fieldwork findings were compared, integrated, and analysed. RESULTS: This concept has characteristics such as; awareness, belief, perception, and willingness of the nurse to engage the family; a sense of responsibility, willingness, and sacrifice of the family; the physical or virtual presence of the family; triangular interaction between the nurse, patient, and family; perception and identifying the goals; education and information transfer; team collaboration; delegation of responsibility to the family; decision making; and protection of the family. Antecedents include the availability of infrastructure; patient, family, and nurse conditions; and the quality implementation of engagement. The consequences include positive consequences related to the patient, family, nursing, and society, as well as some negative consequences. This study provided a comprehensive perception of family engagement in the care of patients with infectious diseases in intensive care units and defined it more clearly, showing its characteristics, antecedents, and consequences. PATIENT OR PUBLIC CONTRIBUTION: Eight participants were interviewed, including five nurses, two family caregivers, and one patient.

Development and psychometric properties evaluation of nurses' innovative behaviours inventory in Iran: protocol for a sequential exploratory mixed-method study.

INTRODUCTION: Nurses' innovative behaviours play a crucial role in addressing the challenges including adapting to emerging technologies, resource limitations and social realities such as population ageing that are intricately tied to today's healthcare landscape. Innovative behaviours improve healthcare quality, patient safety and satisfaction. Organisational factors and individual attributes influence nurses' inclination to innovate. With the rise of artificial intelligence and novel technology, healthcare institutions are actively engaged in the pursuit of identifying nurses who demonstrate innovative qualities. Developing a comprehensive protocol to elucidate the various dimensions of nurses' innovative behaviours and constructing a valid measuring instrument, rooted in this protocol represents a significant step in operationalising this concept. METHODS AND ANALYSIS: The study encompasses two phases: a qualitative study combined with a literature review, followed by the design and psychometric evaluation of the instrument. To ensure diversity, a maximum variation purposive sampling method will be used during the qualitative phase to select clinical nurses. In-depth semistructured interviews will be conducted and analysed using conventional content analysis. Additionally, a comprehensive literature review will supplement any missing features not captured in the qualitative phase, ensuring their inclusion in the primary tool. The subsequent quantitative phase will focus on evaluating the questionnaire's psychometric properties, including face, content and construct validity through exploratory factor analyses (including at least 300 samples) and confirmatory factor analyses (including at least 200 samples). Internal consistency (Cronbach's alpha), reliability (test-retest), responsiveness, interpretability and scoring will also be assessed. ETHICS AND DISSEMINATION: This study originates from a doctoral dissertation in nursing. Permission and ethical approval from Semnan University of Medical Sciences has been obtained with reference code IR.SEMUMS.1401.226. The study's findings will ultimately be submitted as a research paper to a peer-reviewed journal.

Microbial-mediated oxidative dissolution of orpiment and realgar in circumneutral aquatic environments.

Arsenic (As) is a toxic metalloid that causes severe environmental contamination worldwide. Upon exposure to aqueous phases, the As-bearing minerals, such as orpiment (As2S3) and realgar (As4S4), undergo oxidative dissolution, in which biotic and abiotic activities both contributed significant roles. Consequently, the dissolved As and S are rapidly discharged through water transportation to broader regions and contaminate surrounding areas, especially in aquatic environments. Despite both orpiment and realgar are frequently encountered in carbonate-hosted neutral environments, the microbial-mediated oxidative dissolution of these minerals, however, have been primarily investigated under acidic conditions. Therefore, the current study aimed to elucidate microbial-mediated oxidative dissolution under neutral aquatic conditions. The current study demonstrated that the dissolution of orpiment and realgar is synergistically regulated by abiotic (i.e., specific surface area (SSA) of the mineral) and biotic (i.e., microbial oxidation) factors. The initial dissolution of As(III) and S2- from minerals is abiotically impacted by SSA, while the microbial oxidation of As(III) and S2- accelerated the overall dissolution rates of orpiment and realgar. In As-contaminated environments, members of Thiobacillus and Rhizobium were identified as the major populations that mediated oxidative dissolution of orpiment and realgar by DNA-stable isotope probing. This study provides novel insights regarding the microbial-mediated oxidative dissolution process of orpiment and realgar under neutral conditions.

Exploring the geospatial epidemiology of breast cancer in Iran: identifying significant risk factors and spatial patterns for evidence-based prevention strategies.

BACKGROUND: Breast Cancer (BC) is a formidable global health challenge, and Iran is no exception, with BC accounting for a significant proportion of women's malignancies. To gain deeper insights into the epidemiological characteristics of BC in Iran, this study employs advanced geospatial techniques and feature selection methods to identify significant risk factors and spatial patterns associated with BC incidence. METHODS: Using rigorous statistical methods, geospatial data from Iran, including cancer-related, sociodemographic, healthcare infrastructure, environmental, and air quality data at the provincial level, were meticulously analyzed. Age-standardized incidence rates (ASR) are calculated, and different regression models are used to identify significant variables associated with BC incidence. Spatial analysis techniques, including global and local Moran's index, geographically weighted regression, and Emerging hotspot analysis, were utilized to examine geospatial patterns, identify clustering and hotspots, and assess spatiotemporal distribution of BC incidence. RESULTS: The findings reveal that BC predominantly affects women (98.03%), with higher incidence rates among those aged 50 to 79. Isfahan (ASR = 26.1) and Yazd (ASR = 25.7) exhibit the highest rates. Significant predictors of BC incidence, such as marriage, tertiary education attainment rate, physician-to-population ratio, and PM2.5 air pollution, are identified through regression models. CONCLUSION: The study's results provide valuable information for the development of evidence-based prevention strategies to reduce the burden of BC in Iran. The findings underscore the importance of early detection, health education campaigns, and targeted interventions in high-risk clusters and adjacent regions. The geospatial insights generated by this study have implications for policy-makers, researchers, and public health practitioners, facilitating the formulation of effective BC prevention strategies tailored to the unique epidemiological patterns in Iran.

Biochemical Markers of Early Renal Dysfunction in Patients with ß-thalassemia Major: A Systematic Review and Meta-analysis.

BACKGROUND: Early diagnosis of renal dysfunction in ß-thalassemia major (ß- TM) may help take specific measures to delay irreversible damage and renal failure. Therefore, the present meta-analysis aimed to compare biochemical markers of premature renal dysfunction between ß-TM and healthy subjects and identify renal issues' prevalence in patients with ß-TM. METHODS: We searched PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, Scopus, Web of Science, ScienceDirect, ProQuest, Google Scholar, and State Inpatient Databases (SIDs) without any language constraints for all relevant articles published up to April 2019. RESULTS: Out of 1458 articles published up to April 2019, 24 case-control and 22 crosssectional studies were investigated. The investigated levels of serum phosphorus, uric acid (UA), cystatin C, and ferritin were significantly different between ß-TM patients and controls. The albumin/creatinine ratio (ACR), N-acetyl-ß-D-glucosaminidase/creatinine (NAG/Cr) ratio, urinary and serum ß2 microglobulin (ß2MG), and serum ferritin levels were significantly higher in ß-TM patients than in healthy individuals. However, glomerular filtration rate, creatinine clearance, and pretransfusion hemoglobin indicated a significantly lower rate. The general prevalence of renal glomerular and/or tubular defects in patients with ß-TM was 50.22%. CONCLUSION: Urinary NAG, ß2MG, ACR, and Scys-C may be early markers of renal dysfunction in patients with ß-thalassemia major. An observation of elevated levels of these markers despite normal levels of other markers of renal dysfunction may indicate primary, subclinical injury to the renal tubules and glomeruli.

Cultural competence in critical care nurses and its relationships with empathy, job conflict, and work engagement: a cross-sectional descriptive study.

BACKGROUND: Cultural competence is more important than ever for nurses today; therefore, it may be helpful to learn more about it and examine how it relates to empathy, job conflict, and work engagement. The purpose of this study was to determine (a) the level of cultural competence, empathy, job conflict, and work engagement; (b) the relationship between cultural competence, demographic information, and main variables; (c) the predictors of cultural competence among critical care nurses. METHODS: A multicenter, descriptive cross-sectional study was conducted in Iran from August to October 2022. Through convenience sampling, 153 critical care nurses from three hospitals participated. The research tool consisted of five parts: Demographic information questionnaire, Cultural Competence Questionnaire, Jefferson Scale Empathy, Dobrin Job Conflict, and Utrecht Work Engagement, which were collected by paper self-report. Descriptive statistics, the correlation between variables, and linear regression were used to analyze the data. RESULTS: Among critical care nurses (response rate 79.27%), the mean (SD) scores for cultural competence, empathy, job conflict, and work engagement were 74.05 (7.96), 83.44 (29.17), 11.00 (2.38), and 43.69 (16.33), respectively. There was a significant correlation between cultural competence and age (r = 0.46, p = 0.001), marital status (r = 0.27, p = 0.004), academic degree (r = 0.44, p = 0.001), work experiences (r = 0.43, p = 0.001), empathy (r = 0.50, p = 0.001), and job conflict (r=-0.16, p = 0.049). Academic degree (ß = 0.36, p < 0.001) and empathy (ß = 0.26, p < 0.001) were significant explanatory variables that predict cultural competence. CONCLUSION: In Iranian critical care nurses, cultural competence and job conflict were moderate, empathy was good, and work engagement was poor. There was a significant relationship between cultural competence, age, marital status, academic degree, work experiences, empathy, and job conflict. Academic degree and empathy predict cultural competence.

Breast Cancer Survivors' Experiences of Acceptance Following Recurrence: A Qualitative Content Analysis.

BACKGROUND: Breast cancer recurrence is a traumatic event for patients, and its treatment depends on the patient's ability to accept the circumstances. OBJECTIVE: The aim of this study was to explore how patients experience breast cancer recurrence and go through a process of negotiating acceptance. METHODS: This study explored the experiences of 16 patients with breast cancer recurrence regarding the acceptance of recurrence in a hospital in Tehran, Iran. Purposive sampling with maximum diversity was used. Data were collected through semistructured telephone interviews from November 2020 to November 2021 and analyzed using the qualitative content analysis. RESULTS: Four themes emerged that described the process of accepting cancer recurrence: (1) response to recurrence (emotional reactions and loss of trust); (2) psychological preparedness (confirmation of medical diagnosis and acceptance of fate); (3) mobilizing supports (using spiritual capacities, utilizing supportive resources, and seeking relationships to promote knowledge); and (4) return to the path of treatment (rebuilding trust and continuation of treatment). CONCLUSIONS: The acceptance of breast cancer recurrence is a process that begins with emotional reactions and ends with returning to the treatment path. The patient's psychological preparation, support systems, behavior of healthcare providers, and rebuilding trust are the determining factors in acceptance of recurrence. IMPLICATIONS FOR PRACTICE: Nurses can compensate for the failures created in the primary treatment of breast cancer by spending time with patients and paying attention to their concerns, providing effective education, strengthening communication between patients with similar conditions and using the spiritual capacities of patients, and mobilizing the support of family and relatives.

The effect of a family-based participatory care program on anxiety in patients with acute coronary syndrome in coronary care units: A randomised controlled clinical trial.

BACKGROUND: Admission to the coronary care units (CCUs) and the patient's reduced interaction with family are regarded as important sources of anxiety. Family participation in care programs is pivotal to patient outcomes. OBJECTIVES: The present study was conducted to determine the effect of a care program based on family participation on anxiety in patients with acute coronary syndrome. METHODS: This randomised controlled trial was conducted on 90 patients in CCUs and their families. The patients were randomly assigned to one of the following three groups: routine care, control, and intervention. Routine care measures were provided to the routine care group, increased participation of the family was ensured in the control group, and a family-based participatory care program was implemented in the intervention group with the interaction of the nurse, patient, and family based on five principles, including presence, determination of needs, communication, participation in decision-making, and cooperation in care. The patients' anxiety was measured in the three groups on day 1 and 3 days after the admission to the CCU using the Spielberger State-Trait Anxiety Inventory. RESULTS: The patients' mean state anxiety score before the intervention was 44.4 ± 12.7, 46.6 ± 12.4, and 45.5 ± 12.1 in the routine care, control, and intervention groups, respectively, with no significant differences between them (P = 0.81). After adjusting for anxiety before the intervention and study hospital, the mean (before-after) changes in anxiety score in the three groups showed that anxiety was significantly lower in the intervention group than in the other groups (P < 0.05). CONCLUSION: Increased family presence alone has no effect on the patients' anxiety, but the family's participation and interaction with the care team can affect anxiety levels in cardiac patients in CCUs and improve the care processes. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, Trial No. IRCT201105146481N1.

MicroRNAs and their Implications in CD4+ T-cells, Oligodendrocytes and Dendritic Cells in Multiple Sclerosis Pathogenesis.

MicroRNAs (miRNAs) have been established as key players in various biological processes regulating differentiation, proliferation, inflammation, and autoimmune disorders. Emerging evidence suggests the critical role of miRNAs in the pathogenesis of multiple sclerosis (MS). Here, we provide a comprehensive overview of miRNAs, which are differentially expressed in MS patients or experimental autoimmune encephalomyelitis (EAE) mice and contribute to MS pathogenesis through regulating diverse pathways, including CD4+ T cells proliferation, differentiation, and activation in three subtypes of CD4+ T cells, including Th1, Th17 and regulatory T cells (Tregs). Moreover, the regulation of oligodendrocyte precursor cells (OPC) differentiation as a crucial player in MS pathogenesis is also described. Our literature research showed that miR-223 could affect different pathways involved in MS pathogenesis, such as promoting Th1 differentiation, activating the M2 phenotype of myeloid cells, and clearing myelin debris. MiR-223 was also identified as a potential biomarker, distinguishing relapsing-remitting multiple sclerosis (RRMS) from progressive multiple sclerosis (PMS), and thus, it may serve as an attractive target for further investigations. Our overview provides novel potential therapeutic targets for the treatment and new insights into miRNAs' role in MS pathogenesis.

Chemolithotrophic Biological Nitrogen Fixation Fueled by Antimonite Oxidation May Be Widespread in Sb-Contaminated Habitats.

Nitrogen (N) deficiency in mining-contaminated habitats usually hinders plant growth and thus hampers tailing revegetation. Biological N fixation (BNF) is an essential biogeochemical process that contributes to the initial accumulation of N in oligotrophic mining-contaminated regions. Previous studies reported that chemolithotrophic rather than heterotrophic diazotrophs frequently dominated in the mining-contaminated regions. Chemolithotrophic diazotrophs may utilize elements abundant in such habitats (e.g., sulfur (S), arsenic (As), and antimony (Sb)) as electron donors to fix N2. BNF fueled by the oxidation of S and As has been detected in previous studies. However, BNF fueled by Sb(III) oxidation (Sb-dependent BNF) has never been reported. The current study observed the presence of Sb-dependent BNF in slurries inoculated from Sb-contaminated habitats across the South China Sb belt, suggesting that Sb-dependent BNF may be widespread in this region. DNA-stable isotope probing identified bacteria associated with Rhodocyclaceae and Rhizobiaceae as putative microorganisms responsible for Sb-dependent BNF. Furthermore, metagenomic-binning demonstrated that Rhodocyclaceae and Rhizobiaceae contained essential genes involved in Sb(III) oxidation, N2 fixation, and carbon fixation, suggesting their genetic potential for Sb-dependent BNF. In addition, meta-analysis indicated that these bacteria are widespread among Sb-contaminated habitats with different niche preferences: Rhodocyclaceae was enriched in river sediments and tailings, while Rhizobiaceae was enriched only in soils. This study may broaden our fundamental understanding of N fixation in Sb-mining regions.

Reduction of CO2 emission through a photocatalytic process using powder and coated zeolite-supported TiO2 under concentrated sunlight irradiation.

The efficiency of a novel synthetic zeolite (Ze) prepared from stone cutting sludge and a natural zeolite (clinoptilolite, Cp) as the support of TiO2 photocatalyst was examined for the CO2 removal under solar irradiation using a designed parabolic trough collector (PTC). The used samples were characterized using XRF, BET, SEM/EDS, and XPS analyses. The enhanced sunlight irradiation obtained by PTC increased the performance of CO2 photocatalytic removal. The maximum CO2 adsorption by TiO2-Ze and TiO2-Cp composites was 21.1% and 28.4% which increased to 61.8% and 78.9% under sunlight irradiation, respectively. The efficiency of zeolite-TiO2 composites for CO2 removal was approximately two times higher than zeolites and TiO2 alone. The performance of TiO2-Ze-coated composite with lower use of photocatalyst for CO2 adsorption and photocatalytic removal was better than that of powder one. Regeneration of TiO2-Ze using NaOH solution improved its removal efficiency. The adsorption behavior of CO2 on TiO2-Ze composite was well described by the Langmuir isotherm and the pseudo-first-order kinetic model. This work promises CO2 reduction using natural and synthetic zeolite as an efficient photocatalyst support under solar irradiation.

Quality of Life in Heart Patients Receiving Telerehabilitation: An Overview with Meta-Analyses.

Background: This overview is conducted to evaluate the effect of telerehabilitation on Health-Related Quality of Life (HRQOL) in patients with cardiovascular diseases (CVDs). Methods: A comprehensive search was performed through the [MeSH] keywords (heart diseases, coronary disease, coronary artery disease, myocardial infarction, coronary artery bypass, heart failure, cardiac rehabilitation and telemedicine) until January 20, 2021 in databases of Science Direct, Medline/PubMed, Web of Science, Scopus, ProQuest, Google Scholar and Cochrane library. Finally, 20 reviews were entered into the analysis. Results: The results of meta-analyses showed that receiving telerehabilitation program by telemedicine method has a positive effect on the physical dimension and changing the mental status of patients following this intervention depends on age so that the use of these technologies in heart patients with younger ages promotes mental status. On the other hand, increasing the duration of the intervention 18 months or more affects the physical dimension and 12 months or more affects promoting overall HRQOL. Among the various types of Telemedicine methods, telephone support has a greater effect on promoting the physical dimension. Conclusion: The ability to use virtual technology is less at older ages, so age conditions of patients should be considered in choosing this type of intervention. The living place of the people and the level of access to advanced care, seem to play an important role in changing outcomes and choosing this type of intervention because the main purpose of telerehabilitation is to provide treatment care in areas with low access levels.

Effect of Citrus aurantium Aroma on the Happiness of Pre-Hospital Emergency Staff: A Randomized Controlled Trial.

Happiness is a positive internal experience and an indicator of mental health. Having happy and efficient employees is one of the ideals of healthcare organizations, given its impact on the quality of healthcare services. Emergency healthcare staff members face various unpleasant and stressful events. It has been suggested that fragrant herbs such as Citrus aurantium can have cheerfulness effects on individuals. Therefore, this study was conducted to investigate the effect of Citrus aurantium aroma on the happiness of pre-hospital emergency staff. A randomized placebo controlled clinical trial was carried out on 167 prehospital emergency medical staff who were randomly assigned into two groups of aromatherapy and placebo. The participants received Citrus aurantium aromatherapy and placebo for five work shifts and for two consecutive weeks. Aromatherapy was performed using 10% Citrus aurantium scent applied via a pendant containing 1.5 cc of Citrus aurantium scent. The distance from the nose to the container was about 20 cm with the neck straight and the head in a balanced position. Data regarding staff happiness were collected using the Oxford Happiness Questionnaire, which were analyzed using descriptive and inferential statistics. The mean level of happiness did not differ between the intervention and control groups (p = 0.99). Work experience had a statistically significant inverse association with happiness (coefficient = -0.76, 95% CI: -1.49, -0.03). The findings of this randomized controlled trial indicate that Citrus aurantium aroma has no effect on the happiness of prehospital emergency medical services workers. There is a need to study the effect of a combination of complementary and alternative methods on the creation of positive psychological feelings among pre-hospital emergency staff.

Current status of acute ischemic stroke management in Iran: Findings from a single-center study.

OBJECTIVES: This study investigated the current status of acute ischemic stroke (AIS) management in an Iranian emergency department (ED). METHODS: A descriptive study using a retrospective chart review was conducted on medical records of 270 patients with AIS who presented to the ED of a tertiary university hospital in the northeast of Iran from March 22 to September 22, 2019. The steps of this review process included instrument identification, medical records retrieval, data extraction, and data verification. RESULTS: Of patients with AIS, 88.9% (n = 240) did not receive stroke code activation. For the 11.1% of patients (n = 30) who received activation, 7% of codes (n = 19) were canceled by the acute stroke team and IV recombinant tissue plasminogen activator (r-tPA) was only administered for 4.1% of patients (n = 11). ED arrival outside 4.5 h from symptom onset was the main barrier to IV r-tPA administration for 83.8% of potentially eligible patients with AIS (n = 217). The median door-to-needle time was 70 min (interquartile range: 47-90 min). CONCLUSIONS: There was a better clinical performance in terms of critical time goals in potentially eligible patients with AIS if managed with stroke team activation compared to no stroke team activation.

Characterization of diazotrophic root endophytes in Chinese silvergrass (Miscanthus sinensis).

BACKGROUND: Phytoremediation is a potentially cost-effective way to remediate highly contaminated mine tailing sites. However, nutrient limitations, especially the deficiency of nitrogen (N), can hinder the growth of plants and impair the phytoremediation of mine tailings. Nevertheless, pioneer plants can successfully colonize mine tailings and exhibit potential for tailing phytoremediation. Diazotrophs, especially diazotrophic endophytes, can promote the growth of their host plants. This was tested in a mine-tailing habitat by a combination of field sampling, DNA-stable isotope probing (SIP) analysis, and pot experiments. RESULTS: Bacteria belonging to the genera Herbaspirillum, Rhizobium, Devosia, Pseudomonas, Microbacterium, and Delftia are crucial endophytes for Chinese silvergrass (Miscanthus sinensis) grown in the tailing, the model pioneer plant selected in this study. Further, DNA-SIP using 15N2 identified Pseudomonas, Rhizobium, and Exiguobacterium as putative diazotrophic endophytes of M. sinensis. Metagenomic-binning suggested that these bacteria contained essential genes for nitrogen fixation and plant growth promotion. Finally, two diazotrophic endophytes Rhizobium sp. G-14 and Pseudomonas sp. Y-5 were isolated from M. sinensis. Inoculation of another pioneer plant in mine tailings, Bidens pilosa, with diazotrophic endophytes resulted in successful plant colonization, significantly increased nitrogen fixation activity, and promotion of plant growth. CONCLUSIONS: This study indicated that diazotrophic endophytes have the potential to promote the growth of pioneer plant B. pilosa in mine tailings. Video Abstract.

Vanadate reducing bacteria and archaea may use different mechanisms to reduce vanadate in vanadium contaminated riverine ecosystems as revealed by the combination of DNA-SIP and metagenomic-binning.

Vanadium (V) is a transitional metal that poses health risks to exposed humans. Microorganisms play an important role in remediating V contamination by reducing more toxic and mobile vanadate (V(V)) to less toxic and mobile V(IV). In this study, DNA-stable isotope probing (SIP) coupled with metagenomic-binning was used to identify microorganisms responsible for V(V) reduction and determine potential metabolic mechanisms in cultures inoculated with a V-contaminated river sediment. Anaeromyxobacter and Geobacter spp. were identified as putative V(V)-reducing bacteria, while Methanosarcina spp. were identified as putative V(V)-reducing archaea. The bacteria may use the two nitrate reductases NarG and NapA for respiratory V(V) reduction, as has been demonstrated previously for other species. It is proposed that Methanosarcina spp. may reduce V(V) via anaerobic methane oxidation pathways (AOM-V) rather than via respiratory V(V) reduction performed by their bacterial counterparts, as indicated by the presence of genes associated with anaerobic methane oxidation coupled with metal reduction in the metagenome assembled genome (MAG) of Methanosarcina. Briefly, methane may be oxidized through the "reverse methanogenesis" pathway to produce electrons, which may be further captured by V(V) to promote V(V) reduction. More specially, V(V) reduction by members of Methanosarcina may be driven by electron transport (CoMS-SCoB heterodisulfide reductase (HdrDE), F420H2 dehydrogenases (Fpo), and multi-heme c-type cytochrome (MHC)). The identification of putative V(V)-reducing bacteria and archaea and the prediction of their different pathways for V(V) reduction expand current knowledge regarding the potential fate of V(V) in contaminated sites.