Safety and immunogenicity of an inactivated SARS-CoV-2 vaccine (FAKHRAVAC®) in healthy adults aged 18-55 years: Randomized, double-blind, placebo-controlled, phase I clinical trial

Background

The FAKHRAVAC®, an inactivated SARS-CoV-2 vaccine, was assessed for safety and immunogenicity.

Methods and findings

In this double-blind, placebo-controlled, phase I trial, we randomly assigned 135 healthy adults between 18 and 55 to receive vaccine strengths of 5 or 10 μg/dose or placebo (adjuvant only) in 0-14 or 0-21 schedules. This trial was conducted in a single center in a community setting. The safety outcomes in this study were reactogenicity, local and systemic adverse reactions, abnormal laboratory findings, and Medically Attended Adverse Events (MAAE). Immunogenicity outcomes include serum neutralizing antibody activity and specific IgG antibody levels.The most frequent local adverse reaction was tenderness (28.9%), and the most frequent systemic adverse reaction was headache (9.6%). All adverse reactions were mild, occurred at a similar incidence in all six groups, and were resolved within a few days. In the 10-µg/dose vaccine group, the geometric mean ratio for neutralizing antibody titers at two weeks after the second injection compared to the placebo group was 9.03 (95% CI: 3.89-20.95) in the 0-14 schedule and 11.77 (95% CI: 2.77-49.94) in the 0-21 schedule. The corresponding figures for the 5-µg/dose group were 2.74 (1.2-6.28) and 5.2 (1.63-16.55). The highest seroconversion rate (four-fold increase) was related to the 10-µg/dose group (71% and 67% in the 0-14 and 0-21 schedules, respectively).

Conclusions

FAKHRAVAC® is safe and induces a strong humoral immune response to the SARS-CoV-2 virus at 10-µg/dose vaccine strength in adults aged 18-55. This vaccine strength was used for further assessment in the phase II trial.Trial registrationThis study is registered with https://www.irct.ir; IRCT20210206050259N1.

Comparative Drug Solubility Studies Using Shake-Flask Versus a Laser-Based Robotic Method

Drug solubility is of central importance to the pharmaceutical sciences, but reported values often show discrepancies. Various factors have been discussed in the literature to account for such differences, but the influence of manual testing in comparison to a robotic system has not been studied adequately before. In this study, four expert researchers were asked to measure the solubility of four drugs with various solubility behaviors (i.e., paracetamol, mesalazine, lamotrigine, and ketoconazole) in the same laboratory with the same instruments, method, and material sources and repeated their measurements after a time interval. In addition, the same solubility data were determined using an automated laser-based setup. The results suggest that manual testing leads to a handling influence on measured solubility values, and the results were discussed in more detail as compared to the automated laser-based system. Within the framework of unavoidable uncertainties of solubility testing, it is a possibility to combine minimal experimental testing that is preferably automated with mathematical modeling. That is a practical suggestion to support future pharmaceutical development in a more efficient way.

ThoughtSource: A central hub for large language model reasoning data

Large language models (LLMs) such as GPT-4 have recently demonstrated impressive results across a wide range of tasks. LLMs are still limited, however, in that they frequently fail at complex reasoning, their reasoning processes are opaque, they are prone to 'hallucinate' facts, and there are concerns about their underlying biases. Letting models verbalize reasoning steps as natural language, a technique known as chain-of-thought prompting, has recently been proposed as a way to address some of these issues. Here we present ThoughtSource, a meta-dataset and software library for chain-of-thought (CoT) reasoning. The goal of ThoughtSource is to improve future artificial intelligence systems by facilitating qualitative understanding of CoTs, enabling empirical evaluations, and providing training data. This first release of ThoughtSource integrates seven scientific/medical, three general-domain and five math word question answering datasets.

Safety and efficacy of the FAKHRAVAC compared with BBIBP-Corv2 against SARS-CoV-2 in adults: a non-inferiority multi-center trial

BACKGROUND

We compared Fakhravac and BBIBP-Corv2 vaccines in a phase III trial.

METHOD

We conducted a multicenter, parallel-group, active-control, non-inferiority clinical trial with pragmatic considerations assessing the safety and efficacy of Fakhravac and BBIBP-Corv2 vaccines. We started with two randomized double-blind arms and added two non-randomized open-label arms (based on participant preference) because of slow recruitment. The adult population received 0.5 ml (10 µg per dose) intramuscular injections of Fakhravac or BBIBP-Corv-2 vaccines 21 days apart. The primary outcome was the occurrence of PCR-positive symptomatic Covid-19 disease 14 days or more after the second injection. A 10% non-inferiority margin to the reported 72.8% efficacy of BBIBP-Corv2 was assumed. Cox proportional hazard modeling was used to estimate hazard ratios and their 95% confidence intervals.

RESULT

We enrolled 24,056 adults in four groups (randomized-Fakhravac: 824, randomized-BBIBP-Corv2: 832; Non-randomized-Fakhravac: 19,429, Non-randomized-BBIBP-Corv2: 2971). All observed local and systemic adverse reactions were generally self-limited and resolved completely. We observed similar Serious Adverse Event (SAE) rates in the BBIBP-Corv2 (2.57, 95% CI 1.33-4.49) and Fakhravac (2.25, 95% CI 1.72-2.89) groups; none of which were related to the vaccines received. We recorded 9815 Medically Attendant Adverse Events (MAAE), 736 of which were categorized as somehow related. The rate of related MAAE in the Fakhravac was similar to the BBIBP-Corv2 groups (0.31 and 0.26 per 1000 person-day) in the randomized and considerably higher (0.24 and 0.07 per 1000 person-day) in the non-randomized arms. We observed 129 (35% of the 365 required by target sample size) events of PCR + symptomatic Covid-19 during four months of active follow-up in the randomized arm, demonstrating that those receiving the Fakhravac vaccine were significantly less likely (HR = 0.69; 95% CI 0.49-0.98) to be diagnosed with PCR + symptomatic Covid-19 compared with those receiving BBIBP-Corv2 vaccine. After adjusting for type I error using the O'Brien Fleming method, the Fakhravac vaccine was non-inferior to the BBIBP-Corv2 (assuming a 10% non-inferiority margin to the reported 72.8% BBIBP-Corv2 vaccine efficacy; HR < 1.35) (One-way test: HR = 0.66; 99.8% CI 0.38-1.15). In the non-randomized arm, the results were inconclusive (HR = 1.23; 95% CI 0.96-1.61). We observed 5 cases of hospitalized Covid-19 in the randomized arm, none of which occurred in the Fakhravac vaccine group. Those receiving the Fakhravac vaccine were four times less likely to go to the hospital because of a Covid-19 diagnosis (HR = 0.24; 95% CI 0.10-0.60). The vaccine efficacy of the Fakhravac vaccine is estimated to be 81.5% (95% CI 81-82.4%).

CONCLUSION

Fakhravac inactivated SARS-CoV-2 vaccine has comparable safety and efficacy to the BBIBP-Corv2 vaccine. Trial registration This study was registered with the Iranian Registry of Clinical Trials ( www.irct.ir : IRCT20210206050259N3).

Serum Levels of Indoxyl Sulfate and P-cresol in Type II Diabetic Patients With and Without Nephropathy

INTRODUCTION

Indoxyl sulfate (IS) and para-cresol (p-cresol) are uremic toxins with high protein bonding index that accumulate in the body with decreasing kidney function. The main purpose of the current investigation was to compare the concentration of p-cresol and IS in serum of the type II diabetic individuals with and without nephropathy.

METHODS

Fifty-five patients with type II diabetes mellitus were divided into two groups: case and control. The case group consisted of 26 diabetic patients with nephropathy (proteinuria and serum creatinine below 1.5 mg/dL) without any other kidney diseases. The control group included 29 patients without diabetic nephropathy. Patients with advanced heart disease, cerebrovascular accident and other inflammatory or infectious diseases were excluded. Five mL of venous blood was taken from each patient in the morning fasting state. Then other laboratory tests including serum uric acid and creatinine levels, serum urea nitrogen, lipids and glucose were measured by standard methods. P-Cresol and IS levels were measured by the spectrofluorimetric method after extraction. We also filled out a checklist with information regarding the duration of their disease, medication history (oral or injectable), and other demographic information. There were no significant differences between the two groups regarding the investigated factors Results. There were no significant difference among the investigated factors between the two groups (P > .05) except for the serum creatinine, proteinuria and estimated glomerular filtration rate, where the mean values of cases were considerably higher than those of the controls. Serum IS and p-cresol levels were also significantly higher in the case group (P < .05).

CONCLUSION

According to the findings, it seems that IS, and p-cresol may play a role in the development of diabetic nephropathy and other complications of diabetes mellitus.  DOI: 10.52547/ijkd.7266.

Intelligent modeling of hydrogen sulfide solubility in various types of single and multicomponent solvents

This study aims to study the solubility of acid gas, i.e., hydrogen sulfide (H₂S) in different solvents. Three intelligent approaches, including Multilayer Perceptron (MLP), Gaussian Process Regression (GPR) and Radial Basis Function (RBF) were used to construct reliable models based on an extensive databank comprising 5148 measured samples from 54 published sources. The analyzed data cover 95 single and multicomponent solvents such as amines, ionic liquids, electrolytes, organics, etc., in broad pressure and temperature ranges. The proposed models require just three simple input variables, i.e., pressure, temperature and the equivalent molecular weight of solvent to determine the solubility. A competitive examination of the novel models implied that the GPR-based one gives the most appropriate estimations with excellent AARE, R² and RRMSE values of 4.73%, 99.75% and 4.83%, respectively for the tested data. The mentioned intelligent model also performed well in describing the physical behaviors of H₂S solubility at various operating conditions. Furthermore, analyzing the William's plot for the GPR-based model affirmed the high reliability of the analyzed databank, as the outlying data points comprise just 2.04% of entire data. In contrast to the literature models, the newly presented approaches proved to be applicable for different types of single and multicomponent H₂S absorbers with AAREs less than 7%. Eventually, a sensitivity analysis based on the GPR model reflected the fact that the solvent equivalent molecular weight is the most influential factor in controlling H₂S solubility.

Phase II randomized, double blind, placebo controlled, clinical trial of safety and immunogenicity of an inactivated SARS-CoV-2 vaccine FAKHRAVAC in adults aged 18-70 years

BACKGROUND

The FAKHRAVAC®, an inactivated SARS-CoV-2 vaccine, was assessed for safety and immunogenicity in a phase II trial.

METHODS

We did a phase II, single-centered, randomized, double-blind, placebo-controlled clinical trial of the FAKHRAVAC inactivated SARS-CoV-2 vaccine on adults aged 18 to 70. The two parallel groups received two intramuscular injections of either a 10-µg vaccine or a placebo at 2-week intervals. The participants' immunogenicity responses and the occurrence of solicited and unsolicited adverse events were compared over the study period of up to 6 months. Immunogenicity outcomes include serum neutralizing antibody activity and specific IgG antibody levels.

RESULTS

Five hundred eligible participants were randomly (1:1) assigned to vaccine or placebo groups. The median age of the participants was 36 years, and 75% were male. The most frequent local adverse reaction was tenderness (21.29% after the first dose and 8.52% after the second dose), and the most frequent systemic adverse reaction was headache (11.24% after the first dose and 8.94% after the second dose). Neutralizing antibody titers two and four weeks after the second injection in the vaccine group showed about 3 and 6 times increase compared to the placebo group (GMR = 2.69, 95% CI 2.32-3.12, N:309) and (GMR = 5.51, 95% CI 3.94-8.35, N:285). A four-fold increase in the neutralizing antibody titer was seen in 69.6% and 73.4% of the participants in the vaccine group two and four weeks after the second dose, respectively. Specific ELIZA antibody response against a combination of S1 and RBD antigens 4 weeks after the second injection increased more than three times in the vaccine compared to the placebo group (GMR = 3.34, 95% CI 2.5-4.47, N:142).

CONCLUSIONS

FAKHRAVAC® is safe and induces a significant humoral immune response to the SARS-CoV-2 virus at 10-µg antigen dose in adults aged 18-70. A phase III trial is needed to assess the clinical efficacy.

TRIAL REGISTRATION

Trial Registry Number: Ref., IRCT20210206050259N2 ( http://irct.ir ; registered on 08/06/2021).

Comparison of the Safety and Immunogenicity of FAKHRAVAC and BBIBP-CorV Vaccines when Administrated as Booster Dose: A Parallel Two Arms, Randomized, Double Blind Clinical Trial

Purpose: This study was completed to assess the immunogenicity and safety of the FAKHRAVAC and BBIBP-CorV vaccines as a booster dose in the population with a history of receiving two doses of BBIBP-CorV vaccine. Methods: In this double-blind, parallel clinical trial, we randomly assigned healthy adults with a history of receiving two doses of the BBIBP-CorV vaccine, who then received either the FAKHRAVAC or BBIBP-CorV vaccine as a booster dose. The trial is registered in the Iranian Registry of Clinical Trial document depository (Code: IRCT20210206050259N4). Results: The outcomes that were monitored in this study were serum neutralizing antibody (Nab) activity, immunoglobulin G (IgG) level, local and systemic adverse reactions, serious adverse events, suspected unexpected serious adverse reactions, and medically attended adverse events. After administering vaccines to 435 participants, the most frequent local and systemic adverse reactions were tenderness and nausea in 23.7% and 1.4% of cases, respectively. All adverse events were mild, occurred at a similar incidence in the two groups, and were resolved within a few days. Conclusions: On the 14th day after the booster dose injection, the seroconversion rate (i.e., four-fold increase) of Nabs for seronegative participants were 87% and 84.6% in the FAKHRAVAC® and BBIBP-CorV groups, respectively. This study shows that the FAKHRAVAC® vaccine, as a booster dose, has a similar function to the BBIBP-CorV vaccine in terms of increasing the titer of virus-neutralizing antibodies, the amount of specific antibodies, and safety.

P-303 Supplementing IVM medium with mesenchymal stem cell-conditioned medium, L-carnitine, and Repaglinide to improve maturation and developmental competence of oocytes derived from normal and endometriosis mice

Study question

Does supplementing in vitro maturation (IVM) medium with bone marrow mesenchymal stem cell-conditioned medium (BMSC-CM), L-carnitine (LC), and Repaglinide (RG) enhance the developmental competence of oocytes derived from endometriosis-induced mice?

Summary answer

L-carnitine and BMSC-CM supplementation improved maturation and fertilization, and developmental competence of oocytes following IVF by modulating nitro-oxidative stress and accelerating nuclear maturation of oocytes.

What is known already

Endometriosis (EMS) is a detrimental condition of the female reproductive system affecting up to 15% of women of reproductive age. Oocytes retrieved from EMS-affected ovaries are more likely to fail IVM and to show altered morphology and lower cytoplasmic mitochondrial content. Mesenchymal stem cells (MSCs) secrete various types of cytokines, growth factors, bioactive factors, and tissue regenerative components into mesenchymal stem cell-conditioned medium. L-carnitine is an antioxidant playing an important role in cell metabolism and is crucial for fatty acid metabolism. Repaglinide (RG) is an anti-hyperglycemic medication that induces insulin secretion by attaching to β cells of the pancreas.

Study design, size, duration

To induce EMS, two groups of mice were used. The first group, as donor mice, were intraperitoneally injected with estradiol-17β depot for one week. Then, they were sacrificed on day 14, and their uterine horns were removed. The suspension including tissue fragments from uterine horns was injected intraperitoneally to the recipient mice group. To ensure the induction of EMS, ovaries of some mice in both normal and EMS groups were analyzed by histological examination.

Participants/materials, setting, methods

Adult female NMRI mice (6-8 weeks old) were divided into two normal and EMS-induced mice. Oocytes obtained from normal and EMS-induced mice were cultured in the IVM medium supplemented with RG, LC, and BMSC-CM for 24 hours. Subsequently, IVM, IVF, embryo development rates, blastocyst cell numbers were assessed. Moreover, the levels of reactive oxygen species (ROS), nitric oxide (NO), and total antioxidant capacity (TAC) of the IVM medium were evaluated.

Main results and the role of chance

Microscopic studies of ovarian tissue samples showed that folliculogenesis, quality of follicles, and oocyte quality reduced in the EMS-induced group. The IVM results represent that 0.3 mg/ml and 0.6 mg/ml of LC, and 25% and 50% of BMSC-CM enhanced the percentage of MII oocytes significantly. Indeed, the highest IVM rate in both the normal and EMS-induced mice was observed in the BMSC-CM 50% group. More importantly, 0.3 and 0.6 mg/ml of LC, and 25% and 50% of BMSC-CM treatments showed a dramatic decrease in ROS and NO levels and a significant enhancement in TAC levels compared to the control group. Our results also indicated that there was a substantial improvement in terms of IVF, cleavage, and blastocyst rates in all treatment groups compared to the control group. The highest blastocyst formation rate was obtained in 50% of the BMSC-CM group. In normal groups, there was a dramatic increase in the mean of total cell number and TE cells in 1µM RG, 0.3 and 0.6 mg/ml LC, 25% and 50% BMSC-CM. In EMS-induced groups, except for the 1M RG group, all treatment groups exhibited a significant difference in the mean total cell population and TE cells compared to the control group.

Limitations, reasons for caution

Due to limited laboratory facilities, the levels of growth factors, pro-inflammatory cytokines, anti-apoptotic, and antioxidants were not measured in the IVM medium. We, therefore, do not know which of the constituents of the BMSC-CM, in particular, had promoter effects on the oocyte maturation, fertilization, and developmental competence of IVF embryos.

Wider implications of the findings

These approaches may outline the clinical applications of LC and BMSC-CM in the assisted reproductive technology (ART) setting and pave the way to improve the maturation culture. Also, these findings can advance the efficiency of fertility outcomes in endometriosis-related infertile couples.

Trial registration number

N/A

O-185 Cryopreservation of Human Spermatozoa: Utilization of L-Proline as a Novel Additive to Improve Sperm Quality Following Freezing-Thawing Process

Study question

Does supplementation of human sperm freezing media with L-Proline improve sperm quality and DNA Integrity following the freezing-thawing process?

Summary answer

The inclusion of L-proline as a novel additive to human sperm cryopreservation media improves sperm parameters and DNA integrity via mitigating oxidative stress.

What is known already

Sperm cryopreservation is an essential aspect of assisted reproductive technique (ART) and male fertility preservation. Although frozen-thawed semen has great practical benefits for reproduction, it is widely reported that the cryopreservation process induces physical and chemical detrimental changes in sperm functions. Indeed, freezing induces nitro-oxidative stress, lipid peroxidation, DNA fragmentation, and apoptosis. L-proline plays versatile roles in osmotic protection and oxidative stress, cell signaling, programmed cell death, and nutrient adaptation. This multifunctional amino acid is a natural osmoprotectant and the protective effect of L-proline against freezing-thawing-induced damages in stallion and donkey spermatozoa have been reported.

Study design, size, duration

Thirty normozoospermic semen samples were collected by masturbation after 3–5 days of sexual abstinence from men who were referred to the IVF clinic of Kermanshah Motazedi Hospital from December 2020 to June 2021. Each prepared semen sample was aliquoted to 4. In aliquots 1 to 4, experimental concentrations of L-proline (0, 1, 2, and 4 mmol/L), were included in the freezing medium.

Participants/materials, setting, methods

30 normozoospermic, healthy, non-smoker men were enrolled. Sperm parameters (progressive motility, viability, and morphology) were assessed. Sperm chromatin quality was measured by Aniline blue (AB), Toluidine blue (TB), and Chromomycin A3 (CMA3) staining. DNA integrity was evaluated by the Sperm chromatin dispersion (SCD) test. Furthermore, the levels of reactive oxygen species (ROS), lipid peroxidation (LPO), and total antioxidant capacity (TAC) were determined in sperm freezing media. All assessments were conducted before cryopreservation and after thawing.

Main results and the role of chance

Our findings showed that sperm progressive motility and viability were significantly higher in the 4 mmol/L L-proline treated groups compared to the control groups (p = 0.003, p = 0.0200) respectively. The percentage of normal morphology was improved in L-Proline-treated groups. However, this improvement was not considerable (p &gt; 0.5). Moreover, the level of ROS production significantly diminished in the 4 mmol/L L-proline group compared to the control group (p &lt; 0.001). Besides, the level of TAC was significantly enhanced in the 4 mmol/L L-proline group by comparison to the control group (p &lt; 0.001). Furthermore, the results of AB and TB tests demonstrated that chromatin packaging after supplementation with 4 mmol/L L-proline significantly improved compared to the control group (p &lt; .0001). In this regard, there was a significant improvement between the 4 mmol/L   L-proline group and the control group in terms of CMA3 evaluation (p &lt; .0001). Also, there was a difference between the 4 mmol/L L-proline group and the control group in reducing the level of fragmented DNA. Although 4 mmol/L of Praline could diminish the SCD level compared to the control group, this amelioration was not statically significant (p = 0.053).

Limitations, reasons for caution

We were not able to perform further studies to verify the effects of L-proline on mitochondrial activity and membrane potential, and sperm apoptosis as well as to confirm the efficiency and safety of L-proline in terms of more indicators such as the in vitro embryonic development and live birth rate.

Wider implications of the findings

These findings can draw attention to the potential role of L-proline as a novel additive and antioxidant to human freezing medium in preserving sperm quality and protecting spermatozoa against ROS attack during sperm cryopreservation in infertility clinics.

Trial registration number

N/A

Improving the robustness and accuracy of biomedical language models through adversarial training

Deep transformer neural network models have improved the predictive accuracy of intelligent text processing systems in the biomedical domain. They have obtained state-of-the-art performance scores on a wide variety of biomedical and clinical Natural Language Processing (NLP) benchmarks. However, the robustness and reliability of these models has been less explored so far. Neural NLP models can be easily fooled by adversarial samples, i.e. minor changes to input that preserve the meaning and understandability of the text but force the NLP system to make erroneous decisions. This raises serious concerns about the security and trust-worthiness of biomedical NLP systems, especially when they are intended to be deployed in real-world use cases. We investigated the robustness of several transformer neural language models, i.e. BioBERT, SciBERT, BioMed-RoBERTa, and Bio-ClinicalBERT, on a wide range of biomedical and clinical text processing tasks. We implemented various adversarial attack methods to test the NLP systems in different attack scenarios. Experimental results showed that the biomedical NLP models are sensitive to adversarial samples; their performance dropped in average by 21 and 18.9 absolute percent on character-level and word-level adversarial noise, respectively, on Micro-F1, Pearson Correlation, and Accuracy measures. Conducting extensive adversarial training experiments, we fine-tuned the NLP models on a mixture of clean samples and adversarial inputs. Results showed that adversarial training is an effective defense mechanism against adversarial noise; the models' robustness improved in average by 11.3 absolute percent. In addition, the models' performance on clean data increased in average by 2.4 absolute percent, demonstrating that adversarial training can boost generalization abilities of biomedical NLP systems. This study takes an important step towards revealing vulnerabilities of deep neural language models in biomedical NLP applications. It also provides practical and effective strategies to develop secure, trust-worthy, and accurate intelligent text processing systems in the biomedical domain.

Post-COVID-19 hematologic complications: a systematic review

INTRODUCTION

COVID-19 crisis continues around the world. Some patients developed complications after the disease, which have been reported in limited studies. The aim of this study is to comprehensively assess the post-COVID hematologic complications in patients.

AREAS COVERED

We searched PubMed, Scopus and Google Scholar between January 2020 and August 2021 using related keywords. Evaluation of the articles was performed by two independent researchers. The extracted data included number of patients, age, type of hematological complication, duration of follow-up, response to treatment and prognosis.

EXPERT OPINION

Sixty five articles reported post-COVID hematologic complications. The most frequent hematologic complication in COVID-19 patients is thromboembolic events, which often occur in two forms: deep vein thrombosis (DVT) and pulmonary emboli (PE). In a group of patients after the diagnosis of COVID-19, a significant decrease in platelets was observed, which was attributed to the ITP induced by COVID-19. Hemolytic anemia and aplastic anemia have also been reported rarely in patients. Finally, post-COVID hematologic complications appear to go beyond thromboembolic events. Although these complications have been reported rarely, searching for methods to identify susceptible patients and prevent these complications could be the subject of future research.

In vitro maturation medium supplementation: utilization of repaglinide, L-carnitine, and mesenchymal stem cell-conditioned medium to improve developmental competence of oocytes derived from endometriosis mouse models

Endometriosis (EMS) is one of the most prevalent causes for female infertility. Herein, we investigated the effect of the repaglinide (RG), L-carnitine (LC), and bone marrow mesenchymal stem cell-conditioned medium (BMSC-CM) supplementation during in vitro maturation (IVM) on the quality, maturation, and fertilization rates, as well as embryonic quality and development of oocytes derived from normal and EMS mouse model. Immature oocytes were collected from two groups of normal and EMS-induced female NMRI mice at 6-8 weeks of age. Oocytes were cultured in IVM medium unsupplemented (control group), or supplemented with 1 M RG, 0.3 and 0.6 mg/mL LC, and 25 and 50% BMSC-CM. After 24 h of oocyte incubation, IVM rate and antioxidant status were assessed. Subsequently, the rates of fertilization, cleavage, blastulation, and embryonic development were assessed. Our results demonstrated that supplementation of IVM medium with LC and BMSC-CM, especially 50% BMSC-CM, significantly enhanced IVM and fertilization rates, and markedly improved blastocyst development and total blastocyst cell numbers in EMS-induced mice compared to the control group (53.28±0.24 vs 18.09±0.10%). Additionally, LC and BMSC-CM were able to significantly modulate EMS-induced nitro-oxidative stress by boosting total antioxidant capacity (TAC) and mitigating nitric oxide (NO) levels. Collectively, LC and BMSC-CM supplementation improved oocyte quality and IVM rates, pre-implantation developmental competence of oocytes after in vitro fertilization, and enhanced total blastocyst cell numbers probably by attenuating nitro-oxidative stress and accelerating nuclear maturation of oocytes. These outcomes may provide novel approaches to refining the IVM conditions that can advance the efficiency of assisted reproductive technologies in infertile couples.

The application of the loop-mediated isothermal amplification method for rapid detection of methicillin-resistant Staphylococcus aureus

Methicillin-resistant Staphylococcus aureus (MRSA) is an important problem associated with significant mortality and morbidity and well known as a predominant bacterial pathogen. The aim of this study was to identify MRSA strains. In this study (June 2018 to June 2019) isolates of S. aureus were obtained from patients referred to teaching hospitals of Ahvaz, Iran. All isolates were confirmed by conventional microbiological methods. In following, antimicrobial susceptibility testing (AST), MRSA screening, PCR detection of MRSA and LAMP assay were performed. Out of a total of 156 staphylococcal isolates, 126 isolates were identified as MRSA. Seventy-two (57.1%) MRSA isolates were recovered from wound. All MRSA isolates were sensitive to vancomycin, linezolid, teicoplanin, quinupristin-dalfopristin, and tigecycline. The results of LAMP showed 100% agreement with PCR. Sensitivity and specificity of the LAMP assays for the mecA genes were 100% and 100%, respectively. The LAMP assay is a rapid and simple method for the identifications of MRSA. Because of its performance without the need for specific instrumentation, this method can be easily employed in medical centers for the detection of mecA.

Moderate overfeeding of different sources of metabolizable energy and protein. II: Effects on inflammatory status of sheep in late pregnancy and growth trajectory of the offspring

Our objective was to evaluate the effects of moderate overfeeding of different sources of metabolizable energy (ME) and protein (MP) on inflammatory status of sheep in late gestation and short-term growth performance of the offspring. A total of 32 healthy pregnant Zell ewes (2.5 ± 1 years old, 42.19 ± 1.65 kg body weight [BW]) were selected 7 weeks before lambing. After receiving a ten-day adaptation diet, eight ewes were randomly allocated to each of the four treatments including: 1) The adaptation diet that fulfills ME and MP requirements, according to the National Research Council's (NRC, 2007) recommendations for late pregnant ewes (CON); 2) A diet with 10% higher levels of ME than CON, using corn grain for extra ME (HEC); 3) A diet with 10% higher level of ME compared to CON, using flaxseed for additional ME (HEF); and 4) A diet with a 10% higher level of MP than CON, using a rumen-protected lysin and methionine supplement (RP-Lys & Met) to supply extra MP (PRO). After lambing, ewes continued their dietary treatments until 30 days postpartum; however, the content of ingredients were proportionally increased to meet the recommended levels of energy and protein for lactating ewes (NRC, 2007). Blood samples from the ewes were taken on days -21, -14, and -7 before parturition. Colostrum yield and components were determined, and lamb's BW and milk intake (MI) were measured weekly until 28 days of age. Other growth performance indexes were computed accordingly. Blood samples from the offspring were taken on days 15 and 30 of life. The data was analyzed using SAS software (SAS Institute Inc., 9.4). Compared with the CON, HEF-fed ewes were the only group that had lower levels of oxidative stress and blood inflammatory markers at -7 d before parturition (P < 0.05). Concentrations of aminotransferases in CON-fed ewes were greater than other groups in late gestation (P ≤ 0.05). Offspring of HEF- and PRO-fed ewes had higher birth BW than lambs of the CON-fed group (3.71 and 4.11 vs. 3.01 ± 0.24, Kg for HEF, PRO, and CON, respectively). Except for week 2, lambs of CON-fed ewes had lower BW gain compared with the other offspring (P < 0.01). Lambs of PRO-fed ewes had greater levels of plasma immunoglobulin G (IgG, days 15 and 30 of life; P < 0.05) and MI (from week 2; P < 0.001) than other groups. In conclusion, regardless of the source, moderate overfeeding of ME/MP was more beneficial for the immune status of late pregnant dams and the offspring's performance than non-overfed ones.

Simple Determination of p-Cresol in Plasma Samples Using Fluorescence Spectroscopy Technique

The development of simple, fast, cheap and reliable analytical methods for tracing biological indicators is demanded through clinical investigations. Herein, we developed, for the first time, a cheap and specific method for the extraction and quantification of p-cresol (pC) in real plasma samples of chronic kidney disease (CKD). Plasma samples were prepared by hydrolyzing in an acidic medium to convert pCS (p-cresol sulfate) and p-Cresol glucuronide (pCG) to pC. Next, proteins of plasma samples were precipitated and then pC was extracted by acetonitrile (ACN) and saturated NaCl (as salting-out agent). Finally, fluorescence emissions were measured at λ_ex/λ_em = 280/310 nm. The specificity of the method was checked by testing various possible interfering agents. The obtained results revealed a specific determination of pC. Under optimal conditions, a linear range was detected from 0.5 to 30 µg/mL of pC with a lower limit of detection (LLOQ) of 0.5 µg/mL. The reliability of the method was checked by calculating the repeatability, selectivity, and accuracy of the developed method for pC determination in plasma samples. The application of the developed method was investigated for the detection of pC in a number of CKD patients. Due to the simplicity and selectivity, the developed method could be applied for routine analysis of pC concentrations in the plasma samples of CKD patients. In addition, the developed method showed great potential for developing a point-of-care testing (POCT) device.

P–061 Protective effect of melatonin against bleomycin, etoposide, and cisplatin (BEP) chemotherapy-induced testicular toxicity in Wistar rats: A biochemical, immunohistochemical and apoptotic genes based evidence

Study question

Does exogenous melatonin (MLT) attenuate BEP-induced damage in testicular cells and spermatogenesis in a dose-dependent manner?

Summary answer

Melatonin protected the testes against BEP-induced testis damage through ameliorating nitro-oxidative stress, apoptosis, and inflammation. However, there was no significant difference between melatonin-treated groups.

What is known already

Recently, the prevalence of testicular cancer (TC), accounting for the most common cancer among young people of reproductive age (15–40 years), has risen internationally. BEP chemotherapy has increased the 5-year survival rate of TC patients at all stages of testicular germ cell tumors to 90–95%. However, BEP creates a high incidence of male infertility and even long-term genotoxic effects, which emerges as a critical health issue. Melatonin is a well-known potent antioxidant with widespread clinical applications that recently has been giving increasing attention to its role in male sub/infertility.

Study design, size, duration

60 Adult male Wistar rats were randomly assigned to six groups (n = 10/group). Group 1, 3, and 4 were injected with vehicle, 10 and 20 mg/kg of melatonin, respectively. Other groups received one cycle of bleomycin, etoposide, and cisplatin for a total of 3 weeks with or without melatonin. Melatonin administration started daily one week before BEP initiation continued on days 2, 9, and 16; and one week after the completion of the BEP cycle.

Participants/materials, setting, methods

Bodyweight, testes weight, Sperm parameters (count, motility, viability, and morphology), testosterone hormone level, testicular histopathology, stereological parameters, testicular level of malondialdehyde (MDA), nitric oxide (NO), and total antioxidant capacity (TAC), the expression of Bcl–2, Bax, Caspase–3, p53, and TNF-α (Real-time PCR and immunohistochemistry) were evaluated at the end of the study (day 35).

Main results and the role of chance

Our findings showed that melatonin restores the BEP-induced reduction in the body and testes weight (P&lt;.05). the evaluation of quantitative analysis of the testes stereological procedures, QRT-PCR examination and immunohistochemical (IHC) staining revealed that melatonin reverses the BEP-induced impaired spermatogenesis (P&lt;.05). Furthermore, melatonin rectifies BEP-induced disturbance on sperm count, motility, viability, and morphology. The testosterone level in the BEP-treated group was decreased significantly by comparison with the control group (P&lt;.01). By contrast, co-administration of 10 and 20 mg/kg of melatonin could enhance the serum testosterone level significantly (P&lt;.05). Moreover, melatonin enhanced the antioxidant status of the testis by elevating TAC and ameliorating MDA and NO levels. More notably, QRT-PCR examination indicated that melatonin therapy suppressed BEP-induced apoptosis by modulating apoptosis-associated genes such as Bcl–2, Bax, Caspase–3, p53 in the testis (P&lt;.01). Besides, Co-administration of 10 and 20 mg/kg of melatonin with BEP regimen decreased significantly the population of p53 (54.21 ±6.18% and 51.83±8.45, respectively) and TNF-α positive cells (42.91±9.92% and 33.57±2.97, respectively) by comparison to the BEP group. Also, melatonin with low and high doses could enhance the expression of Bcl–2 protein in spermatogenic cells line (59.19±10.18%, 63.08±5.23, respectively) compared to the BEP-treated group.

Limitations, reasons for caution

Owing to limited laboratory facilities we were not able to perform further studies to verify the mechanism of melatonin in the specific targets by using transfection technique and transgenic.

Wider implications of the findings: These findings can draw attention to the clinical application of melatonin and also suggest that melatonin may be an attractive agent for attenuating chemotherapy-associated male sub/infertility. This indolamine also may shorten the fertility recovery period in patients undergoing chemotherapy with the BEP regimen.

Trial registration number

N/A

Explaining Black-Box Models for Biomedical Text Classification

In this paper, we propose a novel method named Biomedical Confident Itemsets Explanation (BioCIE), aiming at post-hoc explanation of black-box machine learning models for biomedical text classification. Using sources of domain knowledge and a confident itemset mining method, BioCIE discretizes the decision space of a black-box into smaller subspaces and extracts semantic relationships between the input text and class labels in different subspaces. Confident itemsets discover how biomedical concepts are related to class labels in the black-box's decision space. BioCIE uses the itemsets to approximate the black-box's behavior for individual predictions. Optimizing fidelity, interpretability, and coverage measures, BioCIE produces class-wise explanations that represent decision boundaries of the black-box. Results of evaluations on various biomedical text classification tasks and black-box models demonstrated that BioCIE can outperform perturbation-based and decision set methods in terms of producing concise, accurate, and interpretable explanations. BioCIE improved the fidelity of instance-wise and class-wise explanations by 11.6% and 7.5%, respectively. It also improved the interpretability of explanations by 8%. BioCIE can be effectively used to explain how a black-box biomedical text classification model semantically relates input texts to class labels. The source code and supplementary material are available at https://github.com/mmoradi-iut/BioCIE.

Comprehensive Review on Neuro-COVID-19 Pathophysiology and Clinical Consequences

Aside from the respiratory distress as the predominant clinical presentation of SARS-CoV-2 infection, various neurological complications have been reported with the infection during the ongoing pandemic, some of which cause serious morbidity and mortality. Herein, we gather the latest anatomical evidence of the virus's presence within the central nervous system. We then delve into the possible SARS-CoV-2 entry routes into the neurological tissues, with the hematogenous and the neuronal routes as the two utmost passage routes into the nervous system. We then give a comprehensive review of the neurological manifestations of the SARS-CoV-2 invasion in both the central and peripheral nervous system and its underlying pathophysiology via investigating large studies in the field and case reports in cases of study scarcity.

The Effects of the COVID-19 Pandemic on the Elderly: A Systematic Review

Objectives: The present study aimed to review the effects of the Coronavirus Disease 2019 (COVID-19) pandemic on the elderly. In this study, we reviewed topics, such as the causes of COVID-19severity in the elderly; the psychological problems of the elderly; the relationship between comorbidities and COVID-19 severity, and the comparison of COVID-19 with other pandemics. Methods & Materials: This systematic review study was conducted in 2020 by searching in international Internet search databases. Boolean Operator (AND, OR) was used for a combined search without a time limit. The search strategy was limited to Persian and English articles using the following keywords: “older adults, COVID-19, psychological problems, social isolation, elderly abuse, ageism”. Finally, based on the inclusion and exclusion criteria of the study, the remaining 58 studies were included in the study. Results: The results of the studies were extracted and the effects of the COVID-19 pandemic on the elderly were examined in 8 parts, as follows: Why COVID-19 is more common in the elderly and has more complications; what are the mortality and complications of COVID-19 in the elderly; COVID-19 and underlying diseases; psychological problems caused by COVID-19 in the elderly; COVID-19 and abuse in the elderly; COVID-19and ageism in the elderly; the comparison of COVID-19 with Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and influenza epidemics in the elderly, and care for the elderly during the COVID-19 pandemic. Conclusion: The COVID-19 pandemic poses serious challenges for the elderly globally. To address these challenges, everyone must work, from government officials to individuals and families. Governments should enact laws that minimize the potential age-related abuse and discrimination and provide equal opportunities for all society members, regardless of age or gender. Families should also be aware of the increasing social isolation of the elderly and keep in touch with them.

Investigating the anti-inflammatory effects of high molecular weight secretions from Limosilactobacillus reuteri PTCC 1655 on LPS-stimulated PMA-differentiated THP-1 cells

AIMS

This study was done to investigate the anti-inflammatory effects of high molecular weight secretions from Limosilactobacillus reuteri PTCC 1655 probiotic bacteria on lipopolysaccharide (LPS)-stimulated phorbol 12-myristate 13-acetate (PMA)-differentiated THP-1 cells.

METHODS AND RESULTS

After culturing the bacterium, the crude cell-free supernatant was fractionated on the basis of molecular weights using ultrafiltration. Also, a heat-killed and sonicated fraction was obtained from the biomass of the bacterial culture. All fractions were used to measure their anti-inflammatory effects on PMA-differentiated THP-1 cells following LPS stimulation by quantifying various cellular markers of inflammation. The results demonstrated that various L. reuteri PTCC 1655-derived fractions, especially the >100 kDa supernatant fraction decreased some of the inflammatory cytokines and mediators, including tumour necrosis factor-α, interleukin-1, nitric oxide, cyclooxygenase-2, matrix metalloproteinase-9 and interleukin-6, which are critical for the pathogenesis of some inflammatory diseases.

CONCLUSION

It is concluded that the L. reuteri PTCC 1655-derived high molecular weight fractions significantly reduce inflammation and therefore could be appropriate candidates for future medical studies.

SIGNIFICANCE AND IMPACT OF THE STUDY

Providing new insights about the significance of L. reuteri PTCC 1655-derived extracts and their potential to modulate inflammation.

Moderate over-feeding of different sources of metabolizable energy and protein improved gestational insulin resistance markers and maternal metabolic status of sheep around lambing

The objective of this study was to determine the effect of moderate over-nutrition of energy (using flaxseed as a source of n-3 fatty acids) and protein (using rumen-protected lysine and methionine) around parturition on prepartal insulin resistance (IR) and periparturient metabolic status and performance of ewes. For this purpose, 32 apparently healthy ewes (2.5 ± 1 years old, 42.19 ± 1.65 kg body weight (BW)) were randomly selected out of 200 pregnant Zell ewes on d 50 before the expected lambing. After receiving a ten-day adaptation diet, eight ewes were randomly allocated to one of the following four dietary treatments: 1) the adaptation diet that meets the metabolizable energy (ME) and protein (MP) requirements of ewes during late pregnancy as recommended by National Research Council = NRC (2007) (Control = CON). 2) A diet with 10% higher levels of ME than NRC (2007) recommendations using corn grain as a source of extra ME (HEC). 3) A diet with 10% higher levels of ME compared to NRC (2007) recommendations using flaxseed for additional ME (HEF). 4) A diet with a 10% higher level of MP than NRC (2007) recommendations using rumen-protected lysine and methionine as a source of extra MP (PRO). While the dietary treatments did not affect animals' dry matter intake (DMI), the CON ewes lost more BW starting from d 10 to d 30 relative to parturition compared to others (P < 0.05). Milk protein and fat yield (g/d) were significantly higher for PRO and HEF compared to HEC and CON ewes (P < 0.05). Moderately over-fed ewes with MP and ME had an improved insulin sensitivity (IS) compared to CON ones. The source of additional ME also impacted IR indices because HEC showed an enhancement in IS than HEF animals (P < 0.05). A lower IS in CON ewes was parallel with higher concentrations of plasma urea at prepartum (P < 0.01), lower levels of plasma cholesterol, triglyceride (P < 0.01) and glucose post-partum (P < 0.05), and a tendency for higher levels of beta-hydroxybutyrate (BHB) and non-esterified fatty acids (NEFA) in CON ewes during both pre- and post-partum periods. There were negative correlations between plasma urea, BHB, and NEFA with IR markers on d 7 prepartum in line with these results. Comparing data, we could not find a significant change in metabolic status among ewes fed with either PRO or HEF/HEC. In conclusion, the inclusion of 10% extra MP and ME could improve late gestation maternal IS and the metabolic status of dams around lambing.

Evaluating the frequency of carbapenem and aminoglycoside resistance genes among clinical isolates of Acinetobacter baumannii from Ahvaz, south-west Iran

Acinetobacter baumannii is one of the most important opportunistic challenging pathogens as a result of its ability to acquire resistance to broad range of antibiotics and cause a variety of severe nosocomial infections. We investigated the frequency of the aminoglycoside-modifying enzymes (AMEs) and oxacillinase genes among clinical isolates of A. baumannii collected from hospitalized patients in Imam Khomeini Hospital, Ahvaz city, Iran. This prospective cross-sectional study was performed on 80 clinical isolates of A. baumannii collected from patients referred to Imam Khomeini Hospital in Ahvaz, Iran. Initial identification of isolates as A. baumannii was performed using conventional bacteriologic tests, and final confirmation was carried out by PCR of bla_OXA-51-like gene and multiplex PCR of gyrB locus. MICs of different classes of antibiotics against these strains was measured by using VITEK 2 system. After extraction of genomic DNA, two groups of multidrug-resistant A. baumannii genes including AME (aadA1, aadB, aphA6 and aacC1) and oxacillinases (bla_OXA-23-like, bla_OXA-24-like, bla_OXA-51-like, bla_OXA-58-like and bla_OXA-143-like) were detected. According to antibiotic susceptibility testing, among 80 A. baumannii strains, 75 isolates (91.25%) were multidrug resistant. The results showed that colistin and tigecycline, with respective sensitivity rates of 97.5% (78/80) and 56.25% (45/80), had the highest effects. The presence of bla_OXA-51-like and gyrB genes was confirmed in all strains. Furthermore, bla_OXA-23-like and bla_OXA-24-like genes were found in 68.75% (55/80) and 20% (16/80) of isolates respectively, while no isolate harbored the bla_OXA-143-like gene. The frequency of genes encoding the AMEs including aadA1, aacC1, aphA6 and aadB were 11.25% (9/80), 16.25% (13/80), 22.5% (18/80) and 30% (24/80) respectively. Our findings indicate that the presence of the aadB and aphA6 is correlated with high resistance against amikacin and gentamicin. We found a very high resistance rate against most of the antimicrobial agents usually prescribed for severe infections caused by A. baumannii. Therefore, because of rapid emergence of resistance even for colistin or tigecycline, monotherapy should be avoided. These results show the importance of providing antibiotics correctly in intensive care units and following antibiotic stewardship protocols as the only effective strategies to attempt to control antibiotic resistance in healthcare settings.

Chlorhexidine alcohol versus povidone-iodine: The comparative study of skin disinfectants at the blood transfusion centers of Iran

OBJECTIVES

The skin disinfection in the blood donor's arm is a key step to minimize the risk of microbial contamination at blood donation sessions. Current study aimed to compare the efficacy of 2% chlorhexidine gluconate in 70% isopropyl alcohol (CHG/IPA) with povidone-Iodine (PI) at blood transfusion centers (BTCs) of Iran.

MATERIAL AND METHODS

Blood donors were selected to evaluate three commercial CHG/IPA disinfectants (N=300), prior the application at BTCs, and to compare the rate of positive skin cultures between CHG/IPA and PI in 31 BTCs (N=8578). The rate of positivity for PI over a 5-year period was also investigated. After application of a two-step disinfection procedure, the biochemical characteristics were checked in accordance with the conventional bacteriological methods. The Z-test analysis was used to compare the deviation between the positive microbial culture ratios.

RESULT

No donors had a positive culture after disinfection during the evaluation study. There was no difference in the rate of positivity between PI and CHG/IPA after disinfection (P>0.05). The rate of positivity for PI from 2012 to 2017 showed a decreasing trend. The rate of positivity was significantly higher in winter rather than summer (P<0.05).

CONCLUSION

The disinfection efficacy of CHG/IPA was equivalent to that of PI. The 5-year monitoring of PI at BTCs showed that the improvement in the rate of positive skin cultures possibly due to effectiveness of correcting actions.

Deep contextualized embeddings for quantifying the informative content in biomedical text summarization

BACKGROUND AND OBJECTIVE

Capturing the context of text is a challenging task in biomedical text summarization. The objective of this research is to show how contextualized embeddings produced by a deep bidirectional language model can be utilized to quantify the informative content of sentences in biomedical text summarization.

METHODS

We propose a novel summarization method that utilizes contextualized embeddings generated by the Bidirectional Encoder Representations from Transformers (BERT) model, a deep learning model that recently demonstrated state-of-the-art results in several natural language processing tasks. We combine different versions of BERT with a clustering method to identify the most relevant and informative sentences of input documents. Using the ROUGE toolkit, we evaluate the summarizer against several methods previously described in literature.

RESULTS

The summarizer obtains state-of-the-art results and significantly improves the performance of biomedical text summarization in comparison to a set of domain-specific and domain-independent methods. The largest language model not specifically pretrained on biomedical text outperformed other models. However, among language models of the same size, the one further pretrained on biomedical text obtained best results.

CONCLUSIONS

We demonstrate that a hybrid system combining a deep bidirectional language model and a clustering method yields state-of-the-art results without requiring labor-intensive creation of annotated features or knowledge bases or computationally demanding domain-specific pretraining. This study provides a starting point towards investigating deep contextualized language models for biomedical text summarization.

The Effect of Educational Intervention Based on PRECEDE Model on Promoting Skin Cancer Preventive Behaviors in High School Students

School-based education programs can be an effective way of educating adolescents about the dangers of exposure to sunlight and about preventive measures against this exposure and its relation to skin cancer. The aim of this study is to survey the effect of educational intervention based on the PRECEDE model on promoting skin cancer preventive behaviors in high school students of Fasa City, Fars Province, Iran. In this quasi-experimental study, 300 students (150 in experimental group and 150 in control group) in Fasa City, Fars Province, Iran, were selected in 2016-2017. The educational intervention for the experimental group consisted of six training sessions. A questionnaire consisting of demographic information, PRECEDE constructs (knowledge, attitude, self-efficacy, enabling factors, and social support), was used to measure skin cancer preventive behaviors before and 4 months after the intervention. Data were analyzed using SPSS 22 and paired t test, independent t test, and chi-square test at a significance level of p < 0.05. The mean age of the students was 16.05 ± 1.76 years in the experimental group and 16.20 ± 1.71 years in the control group. Four months after the intervention, the experimental group showed a significant increase in the knowledge, attitude, self-efficacy, enabling factors, social support, and skin cancer preventive behaviors compared to the control group. This study showed the effectiveness of the intervention based on the PRECEDE constructs in adoption of skin cancer preventive behaviors in 4 months post-intervention in students. Hence, this model can act as a framework for designing and implementing educational intervention for the prevention of skin cancer.

Detection of acute Toxoplasma gondii infection in pregnant women by IgG avidity and PCR analysis

During pregnancy, Toxoplasma gondii can be transmitted from mother to foetus and trigger a primary infection that may be symptomatic. It is important to distinguish between recently acquired and past infections to ensure proper treatment to minimize irreversible foetal injury. We used PCR of the B1 gene to evaluate the accuracy of T. gondii IgG antibody avidity testing in discriminating recent from past infection. In a cross-sectional study, T. gondii IgG and IgM antibodies were detected by enzyme linked fluorescence assay (ELFA) in 2120 serum samples from pregnant women referred to Karaj medical laboratories, February 2013 through March 2015 with 40 samples found positive. IgM-positive samples were evaluated by IgG avidity testing and PCR to amplify the B1 gene. Avidity studies indicated 20 samples with high IgG avidity, 15 with low IgG avidity, and five showing borderline values. The B1 gene was amplified in the borderline samples, with nine of the 15 showing low avidity. The B1 gene was not amplified in the high avidity sera. Our findings suggest that IgG avidity alone may not be sufficient to discriminate recent from past T. gondii infection and should not be used as the sole confirmatory test in pregnant women with IgG and IgM T. gondii antibodies. IgG avidity testing in combination with PCR may be more reliable for distinguishing between high- and low-risk infection and decrease the frequency of unnecessary treatment of pregnant women.

Quantifying the informativeness for biomedical literature summarization: An itemset mining method

OBJECTIVE

Automatic text summarization tools can help users in the biomedical domain to access information efficiently from a large volume of scientific literature and other sources of text documents. In this paper, we propose a summarization method that combines itemset mining and domain knowledge to construct a concept-based model and to extract the main subtopics from an input document. Our summarizer quantifies the informativeness of each sentence using the support values of itemsets appearing in the sentence.

METHODS

To address the concept-level analysis of text, our method initially maps the original document to biomedical concepts using the Unified Medical Language System (UMLS). Then, it discovers the essential subtopics of the text using a data mining technique, namely itemset mining, and constructs the summarization model. The employed itemset mining algorithm extracts a set of frequent itemsets containing correlated and recurrent concepts of the input document. The summarizer selects the most related and informative sentences and generates the final summary.

RESULTS

We evaluate the performance of our itemset-based summarizer using the Recall-Oriented Understudy for Gisting Evaluation (ROUGE) metrics, performing a set of experiments. We compare the proposed method with GraphSum, TexLexAn, SweSum, SUMMA, AutoSummarize, the term-based version of the itemset-based summarizer, and two baselines. The results show that the itemset-based summarizer performs better than the compared methods. The itemset-based summarizer achieves the best scores for all the assessed ROUGE metrics (R-1: 0.7583, R-2: 0.3381, R-W-1.2: 0.0934, and R-SU4: 0.3889). We also perform a set of preliminary experiments to specify the best value for the minimum support threshold used in the itemset mining algorithm. The results demonstrate that the value of this threshold directly affects the accuracy of the summarization model, such that a significant decrease can be observed in the performance of summarization due to assigning extreme thresholds.

CONCLUSION

Compared to the statistical, similarity, and word frequency methods, the proposed method demonstrates that the summarization model obtained from the concept extraction and itemset mining provides the summarizer with an effective metric for measuring the informative content of sentences. This can lead to an improvement in the performance of biomedical literature summarization.

Exposure to Visible Light Emitted from Smartphones and Tablets Increases the Proliferation of Staphylococcus aureus: Can this be Linked to Acne?

BACKGROUND

Due to rapid advances in modern technologies such as telecommunication technology, the world has witnessed an exponential growth in the use of digital handheld devices (e.g. smartphones and tablets). This drastic growth has resulted in increased global concerns about the safety of these devices. Smartphones, tablets, laptops, and other digital screens emit high levels of short-wavelength visible light (i.e. blue color region in the visible light spectrum).

MATERIAL AND METHODS

At a dark environment, Staphylococcus aureus bacteria were exposed to the light emitted from common tablets/smartphones. The control samples were exposed to the same intensity of light generated by a conventional incandescent light bulb. The growth rate of bacteria was examined by measuring the optical density (OD) at 625 nm by using a spectrophotometer before the light exposure and after 30 to 330 minutes of light exposure.

RESULTS

The growth rates of bacteria in both smartphone and tablet groups were higher than that of the control group and the maximum smartphone/control and tablet/control growth ratios were observed in samples exposed to digital screens' light for 300 min (ratios of 3.71 and 3.95, respectively).

CONCLUSION

To the best of our knowledge, this is the first study that investigates the effect of exposure to light emitted from digital screens on the proliferation of Staphylococcus aureus and its association with acne pathogenesis. Our findings show that exposure to short-wavelength visible light emitted from smartphones and tablets can increase the proliferation of Staphylococcus aureus.

Evaluation of the Effect of Radiofrequency Radiation Emitted From Wi-Fi Router and Mobile Phone Simulator on the Antibacterial Susceptibility of Pathogenic Bacteria Listeria monocytogenes and Escherichia coli

Mobile phones and Wi-Fi radiofrequency radiation are among the main sources of the exposure of the general population to radiofrequency electromagnetic fields (RF-EMF). Previous studies have shown that exposure of microorganisms to RF-EMFs can be associated with a wide spectrum of changes ranged from the modified bacterial growth to the alterations of the pattern of antibiotic resistance. Our laboratory at the nonionizing department of the Ionizing and Non-ionizing Radiation Protection Research Center has performed experiments on the health effects of exposure to animal models and humans to different sources of electromagnetic fields such as cellular phones, mobile base stations, mobile phone jammers, laptop computers, radars, dentistry cavitrons, magnetic resonance imaging, and Helmholtz coils. On the other hand, we have previously studied different aspects of the challenging issue of the ionizing or nonionizing radiation-induced alterations in the susceptibility of microorganisms to antibiotics. In this study, we assessed if the exposure to 900 MHz GSM mobile phone radiation and 2.4 GHz radiofrequency radiation emitted from common Wi-Fi routers alters the susceptibility of microorganisms to different antibiotics. The pure cultures of Listeria monocytogenes and Escherichia coli were exposed to RF-EMFs generated either by a GSM 900 MHz mobile phone simulator and a common 2.4 GHz Wi-Fi router. It is also shown that exposure to RF-EMFs within a narrow level of irradiation (an exposure window) makes microorganisms resistant to antibiotics. This adaptive phenomenon and its potential threats to human health should be further investigated in future experiments. Altogether, the findings of this study showed that exposure to Wi-Fi and RF simulator radiation can significantly alter the inhibition zone diameters and growth rate for L monocytogenes and E coli. These findings may have implications for the management of serious infectious diseases.

A label-free, PCR-free and signal-on electrochemical DNA biosensor for Leishmania major based on gold nanoleaves

Detection of leishmaniasis is important in clinical diagnoses. In the present study, identification of Leishmania parasites was performed by a label-free, PCR-free and signal-on ultrasensitive electrochemical DNA biosensor. Gold nanoleaves were firstly electrodeposited by an electrodeposition method using spermidine as a shape directing agent. The biosensor was fabricated by immobilization of a Leishmania major specific DNA probe onto gold nanoleaves, and methylene blue was employed as a marker. Hybridization of the complementary single stranded DNA sequence with the biosensor under the selected conditions was then investigated. The biosensor could detect a synthetic DNA target in a range of 1.0×10^-10 to 1.0×10^-19molL^-1 with a limit of detection of 1.8×10^-20molL^-1, and genomic DNA in a range of 0.5-20ngμL^-1 with a limit of detection of 0.07ngμL^-1. The biosensor could distinguish Leishmania major from a non-complementary-sequence oligonucleotide and the tropica species with a high selectivity. The biosensor was applicable to detect Leishmania major in patient samples.

Progression-free and overall survival in ovarian cancer patients treated with CVac, a mucin 1 dendritic cell therapy in a randomized phase 2 trial

Background

CAN-003 was a randomized, open-label, Phase 2 trial evaluating the safety, efficacy and immune outcomes of CVac, a mucin 1 targeted-dendritic cell (DC) treatment as a maintenance therapy to patients with epithelial ovarian cancer (EOC).

Methods

Patients (n = 56) in first (CR1) or second clinical remission (CR2) were randomized (1:1) to standard of care (SOC) observation or CVac maintenance treatment. Ten doses were administered over 56 weeks. Both groups were followed for progression-free survival (PFS) and overall survival (OS).

Results

Fifty-six patients were randomized: 27 to SOC and 29 to CVac. Therapy was safe with only seven patients with Grade 3–4 treatment-emergent adverse events. A variable but measurable mucin 1 T cell-specific response was induced in all CVac-treated and some standard of care (SOC) patients. Progression free survival (PFS) was not significantly longer in the treated group compared to SOC group (13 vs. 9 months, p = 0.36, hazard ratio [HR] = 0.73). Analysis by remission status showed in the CR1 subgroup a median PFS of 18 months (SOC) vs. 13 months (CVac); p = 0.69 (HR = 1.18; CI 0.52–2.71). However CR2 patients showed a longer median PFS in the CVac-treated group (median PFS not yet reached, >13 vs. 5 months; p = 0.04, HR = 0.32 CI). OS for CR2 patients at 42 months of follow-up showed a difference of 26 months for SOC vs. > 42 months for CVac-treated (as median OS had not been reached; HR = 0.17 (CI 0.02–1.4) with a p = 0.07).

Conclusions

CVac, a mucin 1-dendritic cell maintenance treatment was safe and well tolerated in ovarian cancer patients. A variable but observed CVac-derived, mucin 1-specific T cell response was measured. Notably, CR2 patients showed an improved PFS and lengthened OS. Further studies in CR2 ovarian cancer patients are warranted (NCT01068509).

Trial registration

NCT01068509. Study Initiation Date (first patient screened): 20 July 2010. Study Completion Date (last patient observation): 20 August 2013, the last patient observation for progression-free survival; 29 April 2015, the last patient was documented regarding overall survival.