bluuebunny/crossref_metadata_2025 huggingface dataset:
Different Types of Environmental Stressors Could Have Disruptive or Constructive Effects on Vestibular Compensation
Authors: Sardari Sara , Asadi-Shekaari Majid , Khaksari Mohammad , Aghaei Iraj , Delavari Fateme , Vaziri Zohre
Published: December 2021

Background and Aim: Stress could play either helpful or harmful roles in vestibular compensation, the process of recovery after vestibular system lesions. Herein, we examined the effect of two stressor types on vestibular compensation: chronic anxiety disorder induced by early maternal separation (MS), and caloric restriction by an intermittent fasting (IF) diet.
Methods: Male Wistar rats (n=56) received maternal separation (the MS group), intermittent fasting (IF group), unilateral vestibular deafferentation (UVD group), or a mixture of these interventions (UVD+IF, UVD+MS, and UVD+IF+MS). All the groups were compared with control animals. The animals’ balance, motor coordination, anxiety, locomotor activity, and serum cortisol levels were evaluated by rotarod, open field, and enzyme-linked immunosorbent assay methods, respectively. The data were compared with those of the healthy control (HC) group.
Results: The UVD animals did not show a significant change in the time on the rod, except for the IF+UVD group (p=0.04). There was no significant difference between the experimental groups on the open field indices, except for the MS+IF+UVD group which traveled a significantly less total distance (p=0.02). Serum cortisol levels were significantly higher than HCs for all the groups except for the sham saline and IF+UVD group (p<0.05).
Conclusion: IF seems to promote compensation after UVD, while MS may disrupt it. However, IF loses its beneficial outcomes if the animal has received another source of stress, i.e. MS.
Validity and Reliability of the Persian Versions of Primary and Secondary Screening Instrument for Targeting Educational Risk Questionnaires
Authors: Khodaei Fatemeh , Fatahi Arzaneh , Rouhbakhsh Nematollah , Jalaie Shohreh , Koravand Amineh
Published: December 2021

Background and Aim: Hearing loss in children leads to speech and language delays, low academic achievement, literacy delays, and psychosocial difficulties. Screening instrument for targeting educational risk (SIFTER) is one of the questionnaires used for evaluation of students’ performance in schools. The current study aims to develop Persian versions of primary and secondary SIFTER questionnaires and assessing their validity and reliability.
Methods: The main English versions of primary and secondary SIFTER questionnaires were translated into Persian named as P-SIFTER and secondary P-SIFTER. Then, their face validities were determined based on the options of related experts. The final versions were completed by 55 teachers of 150 students (64 primary and 86 secondary school students) divided into two groups of hearing-impaired (HI) and normal-hearing (NH) students. The test- retest reliabilities were assessed in 117 students (64 primary and 53 secondary school students).
Results: The results revealed that these questionnaires had high face validity. The content validity index for P-SIFTER and secondary P-SIFTER were obtained 0.94 and 0.92, respectively. The total score of P-SIFTER was 51.85 and 65.41 in HI and NH students, respectively. For the secondary P-SIFTER, it was 58.75 and 67.48, respectively. The test-retest reliability showed high correlation for NH and HI students between P-SIFTER and secondary P-SIFTER scores. The Cronbach’s alpha value for the overall score of P-SIFTER was 0.96 for both HI and NH students; for secondary P-SIFTER, the values were 0.94 and 0.93, respectively.
Conclusion: The Persian versions of primary and secondary SIFTER questionnaires have acceptable validity and reliability.
Religious Coping and COVID 19 in Aging
Authors: Rezaeipandari Hassan
Published: December 2021

The article's abstract is not available.
The Role of Digital Communication Technologies in Middle-Aged Health and Relationships
Authors: Hashempour-Sadeghian Maryam , Taghi Abbasi Shavazi Mohammad
Published: December 2021

The article's abstract is not available.
Predictors of Delay in Seeking Post-Exposure Prophylaxis in Older Adults with Animal Bite Injuries: A Population-Based Study
Authors: Soleimanpour Hassan , Abbasian Mehdi , Sarbazi Ehsan , Paknezhad Seyed Pouya , Jalilvand Hadi , Masoudi Nazanin , Azizi Hosein , Khalili Zahra
Published: December 2021

Introduction: Animal bites are of the major health threats. Delayed post-exposure prophylaxis (PEP), especially in frail older people, may lead to mortal risks in this age group. The aim of this study was to investigate the pattern of delayed PEP in animal-bites injuries and to identify its contributing factors in older people of Tabriz city, Iran.
Methods: In this cross-sectional study, the census method was used to obtain data from health records of older adults who were referred to Tabriz's Rabies Treatment Center between March 2013 and March 2018. The delay was defined as starting PEP longer than 24 hours after a suspected rabies virus exposure. The relations between delayed PEP and each of the predictors were investigated using the chi-square test in univariate analysis. The decision tree model was applied to predict the delay time of PEP.
Results: A total of 322 older people with a mean age of 67.62 ± 7.18 were studied. In all, 31.7 % of the older persons victims who were bitten by an animal had a delayed PEP. Urban victims (34.1%) compared to rural (16.3 %), stray animal victims (42.0 %) compared to an owned animal-bite victim 24.6 %, all other animal bite-related victims (39.9 %) compared to dog-bite injuries (23.8%) experienced a higher frequency of delayed PEP. The decision tree revealed that animal ownership status, animal status, and animal species were the most important factors for predicting delayed PEP (p < 0.001).
Conclusion: The possibility of delayed PEP in older adults bites victims, increased if the animal was ownerless and escaped. A reasonable approach to tackle this issue might be to conduct larger population studies in the future.
The Effect of Eight Weeks of Continuous and Interval Training with Citrus Aurantium Consumption on Autophagy Markers and MyoD Activation in the Muscle Tissue of Elderly Rats
Authors: Jafari Mina , Hosseinpour Delavar Sedigheh , Safikhani Hassan , Azizi Masoomeh
Published: December 2021

Introduction: Although exercise training and herbs consumption have protective effects on many diseases, the mechanism of action of exercise training with different intensities and citrus aurantium (CA) extract consumption on the autophagy-dependent MyoD activation pathway is not yet known. The aim of this study was to investigate the effect of eight weeks of moderate intensity continuous training (MICT) and high intensity interval training (HIIT) with CA consumption on the expression of LC3-II, Beclin-1 and MyoD as autophagy related markers in the muscle tissue of elderly rats.
Methods: In this experimental study, 42 elderly female rats were randomly assigned to (1) control (C) (2) MICT, (3) HIIT, (4) MICT + CA, (5) HIIT + CA, (6) CA and (7) sham (normal saline) groups. HIIT was performed at 85-110% VO2max intensity and 15-25 m / min speed and MICT at 65% VO2max intensity and 20-25 m / min speed; 300 mg / kg / day CA was received peritoneally. One-way analysis of variance with Tukey's post hoc test was used to analyze the findings. Findings were analyzed using Graph Pad Prism 8.3.0 software (p ≤ 0.05).
Results: MICT and HIIT increased LC3II, Bclin1 and MyoD gene expression (p ≤ 0.05); The effect of HIIT on MyoD increase was greater than MICT (p ≤ 0.05). CA increased the expression of LC3II and Bclin1 (p ≤ 0.05). MICT + CA and HIIT + CA increased the expression of LC3II, Bclin1 and MyoD in the muscle tissue of elderly rats (p ≤ 0.05).
Conclusion: It seems that exercise training and CA consumption with different mechanism of action activate autophagy in the soleus muscle tissue, however the simultaneous use of HIIT, MICT and CA also has favorable effects on the autophagy-dependent MyoD activation pathway.
Effects of Chlorogenic Acid on Epileptic Behavior and mRNA Expressions of Brain Derived Neurotrophic Factor in the Brain of Aged Rats
Authors: Soleimani Hossain , Rezvani Mohammad Ebrahim , Hafizi-Barjin Zainab , Esmaeilidehaj Mansour , Zaremehrjerdi Fatemeh
Published: December 2021

Introduction: The present study was conducted to evaluate the effect of chlorogenic acid (CA) and Diazepam (DZP) on epileptic complication that induced by repetitive intra-peritoneal injections of pentylenetetrazle (PTZ) in aged rats.
Methods: Twenty-four month-old male Wistar rats (age > 12 months, 300-350 g) were divided in 4 experimental groups. Animal in control group (PTZ + Vehicle) received only PTZ. Animal in treated groups (PTZ + DZP, PTZ + CA10 and PTZ + 25) received diazepam 2 mg/kg, CA 10 mg/kg, or CA 25 mg/kg. All drugs injection were performed  30 min prior to each PTZ injection. Epilepsy was induced by injection of subconvulsive dose of PTZ every other day until the rats were completely kindled or epileptic. After each PTZ injection, animal was monitored for 40 min and epileptic behaviors were scored. At the end of the study, rats were sacrificed and the brains removed for evaluation of histological changes and Brain Derived Neurothrophic Factor (BDNF) gene expression.
Results: CA at dose of 25 mg/kg reduced percent of generalized tonic-clonic seizure (GTCS) in aged rats (24%) in compared to control group (50%) (p < 0.05). The latencies to the start of GTCS were decreased in both dose of CA (p < 0.05). Also, the percent of survived neurons in rats treated with CA (154%) were significantly higher relative to that of control animals (100%) (p < 0.05). The mRNA levels of BDNF significantly increased in CA treated rats (p < 0.05).
Conclusion: Hence, these findings revealed that CA have antiepileptic, neuroprotective and trophic effects in aged rats. CA can protect aged brain from deteriorative processes and save neurons during epilepsy in rats.
Impact Analysis of Coronavirus on Elderly Population in Worldwide and Kazakhstan
Authors: Izekenova Assel , Tolegenova Akbota , Izekenova Aigulsum , Rakhmatullina Alina
Published: December 2021

Covid-19 pandemics has affected the lives of all level population but brought an unprecedented threat to the health and daily life of the elderly population. Starting from Huanan Seafood Market in Wuhan, China, the virus spread to the world fleetingly, from 44 cases in January 2019 to 171,615,923 cases all around the world as of June 01, 2021, including Kazakhstan. SARS-CoV-2 positive patients had shown asymptomatic, mild, severe, and critical symptoms which brought to respiratory failure, shock, or multiorgan dysfunction in 5% of cases. The severity of the disease correlated with the older age and existing medical conditions, making the geriatric population more at hazard. A remarkable superiority of cases and deaths of Covid-19 was found within the elderly group, and particularly in those with pre-existing conditions and comorbidities, additionally to the immunosenescence and inflamm-aging. Studies done in the USA, Europe, and Asian countries showed a similar prevalence of the disease among adults and older people, but the mortality was extremely higher than in other age groups. Despite the similar prevalence, Kazakhstani researchers revealed a higher mortality rate (83.3%) than those countries. Therefore, the world, especially developing countries, needs additional advanced policies in vaccination policy, immediate testing, easy access to healthcare and information without ageist biases, income security, and more researches should be done that can address the issues, improve the lives and diminish the mortality of the geriatric population.
Vascular Aging and Diseases: Molecular Mechanisms and Influences
Authors: Saberianpour Shirin
Published: December 2021

Vascular aging plays an important role in the mortality of the elderly, but vascular aging can be dependent on other factors such as diseases. Various diseases such as Alzheimer, diabetes, thalassemia, and other diseases affect the mechanisms of vascular aging. It will harm the recovery process of these patients. There are methods for measuring vascular aging such as instrumental measurements and molecular methods. The best way to measure vascular aging is a combination of methods to determine the mechanism and cause of vascular aging. In this review article, we first summarize the various mechanisms of vascular aging and then discuss the effect of different disease on vascular aging.
Robotic Surgery Advantages and Challenges
Authors: Mirbagheri Alireza , Aghanouri Mehrnaz
Published: December 2021

The interest in using robotic surgery especially for gynecology, gastroenterology, and urology is increasing every day as this technology is expected to be the first line of surgery in many medical fields in the near future. This attentiveness is due to the unique features of this method and its advantages over open surgery and laparoscopy technique. Knowing curiously about robotic surgery, its components, characteristics, advantages, and challenges is crucial to be prepared for such huge evolution and to be engaged in the advancement of this new technology.
Estimating the Entrance Surface Dose in the Eyes, Thyroid, and Parotid Gland Regions in Adult and Pediatric Groups: A Cone-Beam Computed Tomography Technique
Authors: Omidi Reza , Farhadi Birgani Fariba , Asghar Parach Ali , Zamani Hamed , Dalvand Saman , Ezoddini-Ardakani Fatemeh , Namiranian Nasim , Zare Mohammad Hosein
Published: December 2021

Purpose: This study aimed to determine the Entrance Surface Dose (ESD) of sensitive organs in Cone-Beam Computed Tomography (CBCT) imaging of the maxillofacial region in the two age groups of adult and pediatric.
Materials and Methods: In this work, the measurements were performed using Thermo Luminescent Dosimeters (TLD-GR200). The imaging was performed using a PROMAX 3D CBCT scanner for 30 adults and 20 pediatric patients. The ESD value for each patient in the region of eyes, thyroid, and parotid glands was measured by 15 TLDs during CBCT of maxillofacial.
Results: The highest and lowest mean values of ESDs were related to the parotid and thyroid gland regions in adults, 4.77 ± 0.61 mGy and 0.37 ± 0.16 mGy, respectively. In addition, these values were obtained 2.97 ± 0.36 mGy and 0.35 ± 0.12 mGy in pediatric groups as the highest and lowest values in that order. The results showed that the ESD values of the parotid gland regions in maxilla and mandible examinations had a significant difference (P <0.05). In addition, there was a significant difference between the ESD values of the parotid gland regions among the adults and pediatric groups (P <0.05).
Conclusion: According to the results, the ESD values in both age groups were higher in the parotid gland region during maxillofacial CBCT examinations. Therefore, it is recommended to set radiation parameters like mAs as low as possible for reducing the patient dose, especially pediatric patients due to the more sensitive organs.
The Classification of Heartbeats from Two-Channel ECG Signals Using Layered Hidden Markov Model
Authors: Sadoughi Azadeh , Bagher Shamsollahi Mohammad , Fatemizadeh Emad
Published: December 2021

Purpose: Cardiac arrhythmia is one of the most common heart diseases that can have serious consequences. Thus, heartbeat arrhythmias classification is very important to help diagnose and treat. To develop the automatic classification of heartbeats, recent advances in signal processing can be employed. The Hidden Markov Model (HMM) is a powerful statistical tool with the ability to learn different dynamics of the real time-series such as cardiac signals.
Materials and Methods: In this study, a hierarchy of HMMs named Layered HMM (LHMM) was presented to classify heartbeats from the two-channel electrocardiograms. For training in the first layer, the morphology of the heartbeats was used as observations, while observations in the second layer were the inference results of the first layer. The performance of the proposed LHMM was evaluated in classifying three types of heartbeat arrhythmias (Atrial premature beats (A), Escape beats (E), Left bundle branch block beats (L)) using fifteen records of the MIT-BIH arrhythmia database. Furthermore, the obtained results of the proposed model were compared with other HMM generalizations.
Results: The best average accuracy was achieved 97.10±1.63%. The best sensitivity of 96.8±1.24%, 98.85±0.52%, and 95.64±1.41 were obtained for A, E, and L, respectively. Furthermore, the results of the proposed method were better than other HMM generalizations.
Conclusion: Extracting information from time-series dynamics by HMM-based methods has good classification results. The proposed model shows that applying a two-layered HMM can lead to better extraction of information from the observations; therefore, the classification performance of cardiac arrhythmias has been improved using LHMM.
Photodynamic Therapy as A New Technology for Inactivation of Coronavirus Disease (COVID-19)
Authors: Mahmoudi Hassan
Published: December 2021

Purpose: Coronavirus Disease (COVID-19) could be an emerging disease with a severe acute respiratory infection, and its epidemiology and unique medicinal properties are perpetually increasing. Regarding the lack of COVID-19 controls, this needs current technical events to worsen and treat. Antiviral Photodynamic Therapy (aPDT) could also be effective in reducing and inhibiting the coronavirus. aPDT with various photosensitizers is a very favorable procedure to manage viral infections.
Materials and Methods: A total of 37 articles related to the publication of this review manuscript were mentioned. Several scientific databases such as Scopus, PubMed, Web of Science (ISI), and Google Scholar have checked the key phrases of COVID-19, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), photodynamic therapy, and antiviral photodynamic therapy. All 50 main studies were found, and 37 related studies were deemed suitable for this study after review.
Results: Studies have shown that aPDT with different photosensitizers can be used to treat viral lung complications caused by infectious pathogens such as Middle East Respiratory Syndrome (MERS), SARS-CoV-2, and influenza. Recent studies have shown that aPDT-mediated Methylene Blue (MB) can help control and eradicate coronavirus. In general, more research is needed to use antiviral photodynamic therapy to control COVID-19.
Conclusion: Regarding the lack of treatment for COVID-19, MB-mediated aPDT can help reduce the impact of COVID-19. More evidence is needed to support aPDT as a treatment (SARS-CoV-2).
COVID-19 and RAAS inhibitors: is there a final conclusion?
Authors: Talebi-Taher Mahshid , Najafi Mohammad Hosein , Behzad Shima
Published: December 2021

Coronavirus disease 2019 (COVID-19), the first pandemic caused by a human infecting coronavirus, has drawn global attention from the first time it appeared in Wuhan city of China in late December 2019. Detection of the responsible viral pathogen, named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by WHO, and its possible pathogenesis lead to the forming of many hypotheses about the factors that may affect the patients’ outcome.
One of the SARS-CoV-2 infection concerns was the potential role of angiotensin-converting enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) in COVID-19 patients’ morbidity and mortality. Studies demonstrated that because SARS-CoV-2 uses human ACE2 cell receptors as an entry receptor to invade the cells, there might be an association between antihypertensive drugs such as RAAS inhibitors (specifically ACEIs and ARBs) and the COVID-19 disease. Data are scarce and conflicting regarding ACEI or ARB consumption and how it influences disease outcomes, and a single conclusion has not been reached yet.
According to the literature review in our article, the most evidentially supported theory about the use of RAAS inhibitors in COVID-19 is that these medications, including ACEI/ARB, are not associated with the increased risk of infection, disease severity, and patient prognosis. However, further studies are needed to support the hypothesis.
COVID-19-associated acute respiratory distress syndrome versus classical acute respiratory distress syndrome (a narrative review)
Authors: Krynytska Inna , Marushchak Mariya , Birchenko Inna , Dovgalyuk Alina , Tokarskyy Oleksandr
Published: December 2021

Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus, Severe Acute Respiratory Syndrome-Coronavi- rus-2 (SARS-CoV-2), led to the ongoing global public health crisis. Existing clinical data suggest that COVID-19 patients with acute respiratory distress syndrome (ARDS) have worse outcomes and increased risk of intensive care unit (ICU) admission. The rapid increase in the numbers of patients requiring ICU care may imply a sudden and major challenge for affected health care systems. In this narrative review, we aim to summarize current knowledge of pathophysiology, clinical and morphological characteristics of COVID-19-associated ARDS and ARDS caused by other factors (classical ARDS) as defined by Berlin criteria, and therefore to elucidate the differences, which can affect clinical management of COVID-19-as- sociated ARDS. Fully understanding the characteristics of COVID-19-associated ARDS will help identify its early progres- sion and tailor the treatment, leading to improved prognosis in severe cases and reduced mortality. The notable mechanisms of COVID-19-associated ARDS include severe pulmonary infiltration/edema and inflammation, leading to impaired alveolar homeostasis, alteration of pulmonary physiology resulting in pulmonary fibrosis, endothelial inflammation and vascular thrombosis. Despite some distinct differences between COVID-19-associated ARDS and classical ARDS as defined by Ber- lin criteria, general treatment principles, such as lung-protective ventilation and rehabilitation concepts should be applied whenever possible. At the same time, ventilatory settings for COVID-19-associated ARDS require to be adapted in individ- ual cases, depending on respiratory mechanics, recruitability and presentation timing.
Comparative evaluation of cost effective extraction free molecular technique for detection of SARS-CoV-2 with reference to standard VTM based RT-qPCR method
Authors: Dhakad Megh Singh , Gogoi Sanjib , Kumari Ansu , Singh Aashish Kumar , Jais Manoj B. , Prakash Anupam , Pangtey Ghanshyam , Kaur Ravinder
Published: December 2021

Background and Objectives: The entire globe is undergoing an unprecedented challenge of COVID-19. Considering the need of rapid and accurate diagnostic tests for SARS-CoV-2, this study was planned to evaluate the cost effective extraction free RT-PCR technique in comparison to the standard VTM based RT-qPCR method.
Materials and Methods: Paired swabs from nasopharynx and oropharynx were collected for SARS-CoV-2 testing, from 211 adult patients (≥18 years) in VTM and plain sterile tubes (dry swabs). These samples were processed and RT-qPCR was carried out as per standard protocols.
Results: 54.5% of the patients were females and 45.5% were males with sex ratio 1:1.19 (M: F). 38.86% were symptomatic, of which fever (86.59%), cough (79.23%) and breathlessness (46.34%) were the most common symptoms. The positivity by VTM based method and index method was 31.27% and 13.27% respectively. Of the 27 inconclusive results from index method, 37.04% were positive, 48.15% were negative by VTM based method. However, in 40 inconclusive results by VTM based method, 90% were negative and rest remained inconclusive by index method. The sensitivity and specificity of the index method were 39.39% and 85.71% respectively. The overall agreement between VTM based method and index method was 49.59% with estimated Kappa value of 0.19.
Conclusion: VTM based method showed higher sensitivity compared to the index method. The higher positivity by VTM based method, suggests that VTM based method could plausibly be a better detection method of SARS-CoV-2. Still, the index method might add value in a resource limited setups for detection of SARS-CoV-2.
Frequency and antimicrobial resistance pattern of bacterial isolates from patients with COVID-19 in two hospitals of Zanjan
Authors: Moradi Narges , Kazemi Niloufar , Ghaemi Mehdi , Mirzaei Bahman
Published: December 2021

Background and Objectives: The outbreak of COVID-19 has been challenging the global health systems. As one of the major associated concerns, microbial co-infections and antimicrobial resistance play critical roles in the prognosis of the disease. This study aims to evaluate co-infections in COVID-19 patients regarding drug resistance.
Materials and Methods: A total number of 5530 Real Time PCR-confirmed COVID-19 cases, who were admitted to two major educational Hospitals in Zanjan, Iran, from February 2019 to February 2020 were included. Respiratory, blood and urine specimens were collected and cultured on selective media. Subsequently, isolates identification, disc diffusion suscep- tibility tests, and data analysis were carried out.
Results: Bacterial and fungal co-infections were confirmed in 423 patients (8.1%). Co-infections were more prevalent among females (53.2%) than males (46.8%). Coinfected patients had a significantly higher mortality rate compared to those without co-infections (54.8% vs. 12.2%, P<0.001). Acinetobacter baumannii was the most prevalent bacteria isolated from respiratory tract (15.4%) and blood (2.1%). Escherichia coli (12.5%) was the most frequent bacteria in urine. Fungal co-in- fection was confirmed in 174 (3.36%) patients. Gram-negative bacteria were highly sensitive to colistin (97.85%) and wide- ly resistant to cefixime (91.79%) and trimethoprim-sulfamethoxazole (89.64%). Gram-positive bacteria were considerably sensitive to vancomycin (68%) and nitrofurantoin (66%). Tetracycline and ampicillin were the least effective antibiotics for Gram-positive bacteria with respective resistance rates of 90.91% and 83.33%.
Conclusion: Given the high incidence of bacterial co-infections in COVID-19 patients, it is important to develop rapid and efficient diagnostic, therapeutic and disinfection guidelines to control these infections in the hospitals.
Activity of imipenem/relebactam on Klebsiella pneumoniae with different mechanisms of imipenem non-susceptibility
Authors: Mashaly Mervat El-Sayed , Mashaly Ghada El-Saeed
Published: December 2021

Background and Objectives: Imipenem/relebactam (IMP/R) is a newly FDA approved β-lactam/β-lactamase inhibitor combination. Relebactam ability to restore IMP activity could differ according to the cause of imipenem non-susceptibility. Therefore, we investigated the in-vitro activity of IMP/R against Klebsiella pneumoniae with different mechanisms of imi- penem non-susceptibility.
Materials and Methods: Imipenem-nonsusceptible (IMP-NS) K. pneumoniae isolates were collected and characterized for β-lactamase encoding genes by multiplex PCR. For IMP-NS carbapenemase-negative isolates, study of Ompk35 & Ompk36 gene expression was performed by reverse transcription-PCR while efflux pump activity was studied by minimum inhibitory concentration (MIC) reduction assay using efflux pump inhibitor. Susceptibility testing of K. pneumoniae to IMP and IMP/R were achieved by broth microdilution (BMD) method.
Results: During the study period, 140 isolates of IMP-NS K. pneumoniae were collected. BMD method showed that relebac- tam restored IMP susceptibility in 100%, 60% and 49% of isolates that only harbor AmpC, extended spectrum beta lactamase (ESBL) and carbapenemases, respectively. IMP/R was most potent against all bla KPC and 50% of bla _producing isolates. No demonstrable activity of IMP/R against K. pneumoniae harboring metallo-β-lactamases (MBLs). Out of 18 isolates with IMP non-suceptibility due to porins loss with overproduction of ESBL and/or AmpC, 14 (77.7%) isolates were IMP/R sus- ceptible. IMP/R showed no activity against isolates with only efflux pump hyperactivity.
Conclusion: Relebactam could restore IPM activity in KPC or AmpC-producing IMP/NS K. pneumoniae but with no ac- tivity against MBL- producing isolates. Relebactam activity against isolates harbouring-bla OXA-48 or with altered Ompk35 & Ompk36 gene expression and efflux pump hyperactivity need further studies. Therefore, using IMP/R antibiotic in the treat- ment of infections caused by IMP/NS K. pneumoniae should be based on its molecular profile of IMP resistance to optimize the utility of IMP/R.
Different effects of sub-minimum inhibitory concentrations of gentamicin on the expression of genes involved in alginate production and biofilm formation of Pseudomonas aeruginosa
Authors: Davarzani Fateme , Yousefpour Zahra , Saidi Navid , Owlia Parviz
Published: December 2021

Background and Objectives: Antibiotics at sub-minimum inhibitory concentrations (sub-MIC) may alter bacterial viru- lence factors. The objective of this study was to investigate the effect of gentamicin at sub-MIC concentrations on the expres- sion of genes involved in alginate production and biofilm formation of Pseudomonas aeruginosa.
Materials and Methods: The broth microdilution method was used to determine the MIC of gentamicin for three P. aeru- ginosa clinical isolates (P1-P3) and standard strains (PAO1 and 8821M). Alginate production and biofilm formation of the bacteria in the presence and absence of sub-MIC concentrations of gentamicin were measured using microtiter plate and carbazole assay, respectively. The real-time PCR method was used to determine the effect of gentamicin at sub-MIC con- centrations on the expression level of genes involved in biofilm formation (pelA and pslA) and alginate production (algD and algU).
Results: Gentamicin at sub-MIC concentrations significantly reduced alginate production, biofilm formation, and the expres- sion of alginate and biofilm-encoding genes in clinical isolate P1. This inhibitory effect was also observed on the alginate production of 8821M strain and biofilm formation of PAO1strain. In clinical isolates, P2 and P3, alginate production, biofilm formation, and the expression of alginate and biofilm-encoding genes were significantly increased in exposure to sub-MIC concentrations of gentamicin.
Conclusion: This study showed that different phenotypic changes in clinical isolates and standard strains of P. aeruginosa in exposure to sub-MIC concentrations of gentamicin are associated with changes in the expression of virulence genes. Further researches are required to understand the mechanisms involved in regulating the expression of virulence genes after exposure to sub-MIC concentrations of antibiotics.
A comparative characterization of nasal and clinical isolates of Staphylococcus aureus from west of Iran
Authors: Goudarzi Gholamreza , Hasanvand Yaser , Rezaei Faranak , Delfani Somayeh
Published: December 2021

Background and Objectives: Recently, the rise of methicillin-resistant Staphylococcus aureus (MRSA) isolated from hos- pital healthcare workers (HCWs) and various infectious samples has become one of the main concerns in hospital settings. Therefore, epidemiological studies are necessary to monitor antibiotic resistance patterns in each region and to study the pathogenesis of this strain to control infections.
Materials and Methods: In this cross-sectional study, a total of 100 S. aureus isolates, including 50 isolates obtained from the anterior nares of healthcare workers, as well as 50 other isolates cultured from the various clinical specimens from the referral hospitals in Khorramabad (West of Iran) were tested. All isolates were examined to determine antibiotic resistance pattern, and the presence of staphylococcal enterotoxin A (sea), staphylococcal enterotoxin B (seb) and mecA genes.
Results: The mecA gene was found among 36% (18/50) of the clinical S. aureus isolates (CSIs) and 14% (7/50) of nasal S. aureus isolates (NSIs), with statistically significant difference (X2 = 6.53; p = 0.011). The difference between the frequency rate of sea gene among MRSA strains isolated from clinical specimens (46.6%, 7/15) was significant compared to strains isolated from nostrils (14.3%, 1/7) (X2 = 3.85; p = 0.049).
Conclusion: The frequency of mecA, sea, and seb genes among the clinical samples was more than strains isolated from the nostrils of healthcare personnel.
Isolation and immunogenicity of extracted outer membrane vesicles from Pseudomonas aeruginosa under antibiotics treatment conditions
Authors: Hadadi-Fishani Mehdi , Najar-Peerayeh Shahin , Siadat Seyed Davar , Sekhavati Mohammad , Mohabati Mobarez Ashraf
Published: December 2021

Background and Objectives: Different types of antibiotics have been indicated to enhance the secretion of OMVs from Pseudomonas aeruginosa. We aimed to investigate the effect of meropenem and amikacin antibiotics on inducing the secre- tion of OMVs and immunologic features in P. aeruginosa.
Materials and Methods: The OMVs were prepared from P. aeruginosa under hypervesiculation condition (treatment with amikacin and meropenem), and extraction was carried out by the sequential ultracentrifugation. Physicochemical features of extracted OMVs were evaluated by electron microscopy and SDS-PAGE. To quantify antibody synthesis and function after immunization with OMV, we used ELISA, serum bactericidal activity, and opsonophagocytosis. Production of cytokines from splenocytes of immunized mice was measured with ELISA.
Results: Specific-antibody IgG production, particularly IgG1 subclass, increased in mice primed with hypervesiculation-de- rived OMVs compared to normal condition-derived OMVs. Serum bactericidal activity and opsonophagocytosis of secreted antibody was enhanced in mice primed with hypervesiculation-derived OMVs. Investigation of cytokine production showed the upregulation of IL-8, IL-12, IL-17, and TNF-α and downregulation of IL-10.
Conclusion: Based on our findings, OMVs production can be increased by treating P. aeruginosa with amikacin and mero- penem antibiotics. Moreover, hypervesiculation-derived OMV scan possibly activate the humoral and cellular immune re- sponse more than normal OMVs.
Cell death analysis of recombinant mature epsilon toxin on the kidney cell line
Authors: Chehreara Roza , Zare Karizi Shohreh , Mahmoodzadeh Hosseini Hamideh , Mirhosseini Seyed Ali , Shafiei Mohammad , Amani Jafar , Kazemi Rouhollah
Published: December 2021

Background and Objectives: Epsilon toxin is the third hazardous bacterial toxin causing ABS enterotoxaemia in domestic animal. In addition, epsilon toxin is known as a biological warfare agent. The aim of this study was to produce the recombi- nant mature epsilon toxin to evaluate cell death impact on the kidney cell line.
Materials and Methods: For this purpose, the sequence of mature epsilon toxin (46-328 aa) in pET28a was cloned and expressed in Escherichia coli BL21 (DE3) and purified by nickel-nitrilotriacetic acid (Ni-NTA) column and confirmed by western blot analysis using HRP conjugated anti-His antibody. Then, to assess the anti-proliferative effects of different con- centrations of recombinant epsilon toxin, the MTT assay was done on the HEK293 cell line. The annexin V/PI staining was done to investigate the apoptotic and necrotic cell populations after exposure to epsilon toxin.
Results: Induction by 1 mM IPTG for 4 h at 37°C was an optimized condition for expressing mature epsilon toxin in E. coli strain BL21 (DE3). Electrophoresis on SDS-PAGE 12% gel showed the desired band approximately at 38 KDa. Our results showed that recombinant epsilon toxin is mainly expressed as an inclusion body. Furthermore, 100, 150, and 200 µg/mL of mature epsilon toxin are significantly reduced the cell viability (P≤0.05). The considerable increase of necrotic cell percent- age was shown after exposing to 100, 150, and 200 µg/mL of mature epsilon toxin (P≤0.05).
Conclusion: The recombinant mature epsilon toxin had cytotoxic effects and could induce necrosis.
Inhibitory effects of probiotic Bacillus coagulans against MCF7 breast cancer cells
Authors: Dolati Masoumeh , Tafvizi Farzaneh , Salehipour Masoud , Komeili Movahed Tahereh , Jafari Parvaneh
Published: December 2021

Background and Objectives: Secondary metabolites in the supernatants of probiotic microorganisms have shown antican- cer effects. The present study was aimed to investigate the cytotoxicity of Bacillus coagulans supernatants and their role in apoptosis induction in MCF7 cancer cells.
Materials and Methods: The inhibition of MCF7 cancer cells by Bacillus coagulans supernatants was assessed by MTT assay at three exposure times of 24, 48, and 72 h. Apoptosis induction was explored by flow cytometry while the expression levels of bax, caspase 3, caspase 9, and bcl2 were examined by real-time PCR and compared with normal HFF cells.
Results: Bacillus coagulans supernatants exhibited inhibitory effects on MCF7 cells in a concentration-dependent and time-dependent manner; while lower cytotoxic effects were observed in normal HFF cells. The increase in the expression of bax, caspase 3, and caspase 9 genes and the decrease in the anti-apoptotic gene of bcl2, along with the flow cytometry results, confirmed the induction of apoptosis in the cancer cells.
Conclusion: Regarding the cytotoxic influence of Bacillus coagulans supernatants against breast cancer cells, this bacterium can be considered as a potential candidate for a novel therapeutic strategy with lower side effects which of course requires further investigations.
Biologically formed silver nanoparticles and in vitro study of their antimicrobial activities on resistant pathogens
Authors: Ali Asmaa R. , Anani Haneya A.A. , Selim Fatma M.
Published: December 2021

Background and Objectives: Silver nanoparticles (AgNPs) have been found to have multiple uses as antibacterial, anti- fungal and anti-biofilm agents because of their biological activities and safety. The present study was aimed to analyze the antimicrobial and anti-biofilm activities as well as the cytotoxic effect of AgNPs against different human pathogens.
Materials and Methods: AgNPs were synthesized using cell free supernatants of Escherichia coli (ATCC 25922), En- terococcus faecalis (ATCC 19433), Pseudomonas aeruginosa (ATCC 27856), Enterobacter cloacae (ATCC 13047) and Penicillium oxalicum strain, then were analyzed using UV/Vis Spectral Analysis, Transmission electron microscopy (TEM). Scanning Electron Microscope (SEM) and Energy Dispersive-X-ray Spectroscopy (EDX) analysis. Antimicrobial activities of biosynthesized AgNPs were assessed with selected antimicrobial agents against multidrug resistant bacteria and candida. Anti-biofilm and cytotoxicity assays of these biosynthesized AgNPs were also done.
Results: The synthesis of AgNPs were confirmed through observed color change and monitoring UV-Vis spectrum which showed homogeneous (little agglomeration) distribution of silver nanoparticles. TEM and SEM have shown that the parti- cle size ranged from 13 to 34 (nm) with spherical shape and a high signal with EDX analysis. Antibacterial and antifungal efficacy of antibiotics and fluconazole were increased in combination with biosynthesized AgNPs against resistant bacteria and candida. Significant reduction in biofilm formation was found better with Penicillium oxalicum AgNPs against biofilm forming bacteria.
Conclusion: Penicillium oxalicum has the best effect towards synthesizing AgNPs, for antimicrobial activities against resis- tant bacteria and candida, in addition to anti-biofilm activities against biofilm forming Staphylococcus aureus and E. coli and the safest cytotoxicity effect on (MRC-5) cell line.
Partial purification, characterization and immobilization of a novel lipase from a native isolate of Lactobacillus fermentum
Authors: Fathi Foruzan , Kasra-Kermanshahi Rouha , Moosavi-Nejad Zahra , Qamsari Elahe Mobarak
Published: December 2021

Background and Objectives: Due to the widespread use of lipase enzymes in various industries, finding native lipase pro- ducing microorganisms is of great value and importance. In this study, screening of lipase-producing lactobacilli from native dairy products was performed.
Materials and Methods: Qualitative evaluation of lipolytic activity of lipase-producing lactobacilli was performed in differ- ent media containing olive oil. A clear zone observation around the colonies indicated the lipolytic activity. The strain with the highest enzymatic activity was identified. Determination of optimal pH and temperature of lipase activity was measured by spectrophotometry using p-nitrophenyl acetate (ρ-NPA) substrate. Partial purification of lipase enzyme was performed using 20-90% saturation ammonium sulfate. Eventually, lipase was immobilized by physical adsorption on chitosan beads.
Results: Among screened lipolytic bacterial strains, one sample (5c isolate) which showed the highest enzymatic activity (5329.18 U/ml) was close to Lactobacillus fermentum. During characterization, the enzyme showed maximum activity in Tris-HCl buffer with pH 7, while remaining active over a temperature range of 5°C to 40°C. The results of the quantitative assay demonstrated that the fraction precipitated in ammonium sulfate at 20% saturation has the highest amount of lipolytic activity, with a specific activity of 22.0425 ± 3.6 U/mg. Purification folds and yields were calculated as 8.73 and 44%, respec- tively. Eventually, the enzyme was immobilized by physical adsorption on chitosan beads with a yield of 56.21%.
Conclusion: The high efficiency of enzyme immobilization on chitosan beads indicates the suitability of this method for long-term storage of new lipase from native 5c isolate.
The frequency of HIV-1 infection and surveillance drug-resistant mutations determination among Iranians with high-risk behaviors, during 2014 to 2020
Authors: Garshasbi Saba , Marjani Arezoo , Alipour Ali , Khanaliha Khadijeh , Esghaei Maryam , Fakhim Atousa , Bokharaei-Salim Farah
Published: December 2021

Background and Objectives: Human immunodeficiency virus (HIV) has various transmission routes. Instant antiretroviral therapy (ART) is the recommended treatment for HIV infection. Highly active antiretroviral therapy (HAART) significantly decreases the acquired immunodeficiency syndrome (AIDS) and AIDS-related co-morbidities. Notwithstanding the suit- ability of HAART, the antiretrovirals (ARVs) have adverse effects and antiretroviral drug resistance mutations are reported among those who receive ARVs. In this survey, the abundance of HIV-1 infection in Iranians with high-risk behaviors, and detection of the surveillance drug-resistant mutations (SDRMs) were evaluated.
Materials and Methods: This cross-sectional study was conducted on 250 individuals with high-risk behaviors from Sep- tember 2014 to February 2020. HIV-1 Ag/Ab in plasma samples was detected using enzyme immunoassay (EIA) kits. The conserved region of HIV-1 was detected in the plasma samples by real-time polymerase chain reaction (PCR) assay. Further- more, in individuals with positive HIV-1 RNA, HIV-1 viral load testing was performed. After amplification and sequencing of the HIV-1 protease, reverse transcriptase, and integrase genes, surveillance drug resistance mutation (SDRM) and phylo- genetic analysis were determined.
Results: Out of the 250 participants with high-risk behaviors, six (2.4%) were infected with HIV-1. According to the phy- logenetic analysis, the CRF35_AD (83.3% or 5/6) was the dominant subtype, followed by CRF01_AE (16.7% or 1/6). In this research, in none of the HIV-1 infected patients, SDRM for protease inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), and integrase inhibitors (INs) were observed. Nevertheless, in one of the patients, V179L mutation was detected which is a rare non-polymorphic mutation and is listed as a rilpivirine (RPV) -associated resistance mutation.
Conclusion: The results of the current survey revealed that 2.4% of people with high-risk behaviors are infected with HIV and the level of drug resistance mutations (DRMs) in these people is very low.
Subungual Glomus Tumor: A Review of 15 Cases Treated with Partial Nail Plate Excision Technique
Authors: Farzan Mahmoud , Neshan Mahdi , Farhoud Amir Reza , Abdoli Abbas
Published: December 2021

Background: Although there are various surgical methods for subungual glomus tumor treatment, there is no consensus on the optimal surgical approach.
Methods: We analyzed the outcomes of 15 patients treated with partial nail plate excision technique. The medial or lateral section of the nail plate was excised longitudinally based on the tumor location. After incision of the nail bed and tumor removal, the matrix was repaired carefully.
Results: In this study, 15 people, including 11 men and four women, were studied. The mean onset of symptoms until diagnosis was 88 months. In the postoperative evaluation, the mean follow-up was 20 months. Two patients had recurrent tumors, and one had postoperative nail deformity.
Conclusion: Meticulous nail bed repair and complete tumor excision are key treatment points needed to prevent nail deformity and recurrence.
Evaluation of Intra-Articular Injection of Bevacizumab on the Prevention of Physeal Bar Formation in Type 4 Salter Harris Model in Rats: A Pilot Study
Authors: Imani Zeinab , Milan Nesa , Nematian Hossein , Aghaghazvini Leila , Sedaghat Mojtaba , Ahadpour Sefidan Mohammad Bagher , Mirbagheri Alireza , Nabian Mohammad Hossein
Published: December 2021

Background: This study was designed to achieve a new method as a preventive treatment for complications of growth plate fractures. In this study, we investigate the effect of intra-articular injection of anti-vascular endothelial growth factor (anti-VEGF) antibody bevacizumab on the repair process of articular cartilage in a type 4 Salter Harris injury model.
Methods: A Salter Harris injury was created on the proximal tibial growth plate of 14 rats by a 1.8 mm drill. The rats were randomly classified into two groups: group LD, administration of high-dose intra-articular injection of bevacizumab (250 μg), and group HD, administration of low-dose intra-articular injection of bevacizumab (50 μg) after injury. The rats were killed 2 months postoperatively and their tibia underwent micro-computed tomography (CT) analysis, histological assessment, and measurement of tibial bone length.
Results: Bony bar formation was observed in 71% of the samples in the high-dose group and in 100% of the low-dose group. Relative increase in physeal cartilage thickness (P = 0.007) and decrease in bony bar formation (P = 0.029) were observed significantly in the high dose group. There was no significant difference in tibia length between the two groups (P = 0.150).
Conclusion: Intra-articular administration of bevacizumab demonstrated positive restorative effects. We suggest this method of treatment due to its potential of improving cartilage repair and capability to be used as a main or adjacent treatment in osteochondral defects.