Health care-associated infections, including device-associated infections, and antimicrobial resistance in Iran: The national update for 2018

Introduction. Surveillance of health care-associated infections (HAIs) is an essential part of an efficient healthcare system. This study is an update on incidence and mortality rates of HAIs in Iran in 2018. Methods. Almost all hospitals across the country (940 hospitals) entered the data of HAIs and denominators to the Iranian Nosocomial Infections Surveillance (INIS) software. Statistics were derived from INIS. Results. From 9,607,213 hospitalized patients, 127,953 suffered from HAI, 15.65% of whom died. The incidence rate of HAI was calculated as 4.2 per 1000 patient-days. Considering relative frequencies among HAIs, Pneumonia (29.1%) and UTIs (25.6%) were the most common types of infection. Ventilator-associated pneumonia (VAP) was the most frequent device-associated infection (DAI) 25.66 per 1000 ventilator-days, and had the highest mortality rate (43.08%). Incidence density of other DAIs was 5.43 for catheter-associated UTI and 2.86 for catheter-associated BSI per 1000 device-days. Medical ICUs had the highest incidence and percentage of deaths (15.35% and 37.63%, respectively). The most causative organisms were Escherichia coli, Acinetobacter baumannii, and Klebsiella pneumonia. The rate of methicillin-resistance Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and Klebsiella pneumoniae carbapenemase (KPC)-producing bacteria was about 49%, 57%, and 58% respectively. Conclusion. The findings indicate that HAIs in Iran require special attention, and further studies are needed to evaluate them more accurately, identify risk factors and preventive interventions

Beyond Codebook-Based Analog Beamforming at mmWave: Compressed Sensing and Machine Learning Methods

Analog beamforming is the predominant approach for millimeter wave (mmWave) communication given its favorable characteristics for limited-resource devices. In this work, we aim at reducing the spectral efficiency gap between analog and digital beamforming methods. We propose a method for refined beam selection based on the estimated raw channel. The channel estimation, an underdetermined problem, is solved using compressed sensing (CS) methods leveraging angular domain sparsity of the channel. To reduce the complexity of CS methods, we propose dictionary learning iterative soft-thresholding algorithm, which jointly learns the sparsifying dictionary and signal reconstruction. We evaluate the proposed method on a realistic mmWave setup and show considerable performance improvement with respect to code-book based analog beamforming approaches

Adipose Tissue-Derived Mesenchymal Stem Cells Alter Metabolites of Brain Cholesterol Homeostasis in An Alzheimer’s Model

Objective: Disruption of cholesterol homeostasis in Alzheimer’s disease (AD) plays a crucial role in diseasepathogenesis, making it a potential therapeutic target. Mesenchymal stem cells (MSCs) show promise in treatingcognitive impairment and provide a novel therapeutic approach. This study aims to investigate the effects of MSCs onspecific metabolites associated with brain cholesterol homeostasis in an AD rat model.Materials and Methods: In this experimental study, animals were divided into three groups: control, AD, andAD+MSCs. AD was induced using amyloid beta (Aβ) and confirmed through the Morris water maze (MWM) behaviouraltest and Congo red staining. MSCs were extracted, characterised via flow cytometry, subjected to osteoblast andadipose differentiation, and injected intraventricularly. The cholesterol metabolite levels were measured using gaschromatography-mass spectrometry (GC)-MS and compared among the groups.Results: Treatment with MSCs significantly improved memory function in the AD+MSCs group compared to theAD group and the number of beta-amyloid plaques decreased according to histological assessment. Disturbancesin the brain cholesterol metabolites that included desmosterol, 7-dehydrocholesterol, 24S-hydroxycholesterol,27-hydroxycholesterol and cholesterol were observed in the AD group compared to the control group. Treatment withMSCs resulted in significant alterations in the levels of these metabolites.Conclusion: The findings indicate that MSC therapy has the potential to improve AD by modulating brain cholesterolhomeostasis and promoting the differentiation of stem cells into nerve cells. The results emphasize the importance ofinvestigating the role of cholesterol metabolites in the context of MSC therapy to gain deeper insights into underlyingmechanisms of the therapeutic efficacy of MSCs in AD

Position Aided Beam Prediction in the Real World: How Useful GPS Locations Actually Are?

Millimeter-wave (mmWave) communication systems rely on narrow beams for achieving sufficient receive signal power. Adjusting these beams is typically associated with large training overhead, which becomes particularly critical for highly-mobile applications. Intuitively, since optimal beam selection can benefit from the knowledge of the positions of communication terminals, there has been increasing interest in leveraging position data to reduce the overhead in mmWave beam prediction. Prior work, however, studied this problem using only synthetic data that generally does not accurately represent real-world measurements. In this paper, we investigate position-aided beam prediction using a real-world large-scale dataset to derive insights into precisely how much overhead can be saved in practice. Furthermore, we analyze which machine learning algorithms perform best, what factors degrade inference performance in real data, and which machine learning metrics are more meaningful in capturing the actual communication system performance.Comment: Submitted to IEEE. Datasets and code files are available on the DeepSense website: https://deepsense6g.net

Patients' willingness to participate in a breast cancer biobank at screening mammogram.

To characterize patients' willingness to donate a biospecimen for future research as part of a breast cancer-related biobank involving a general screening population. We performed a prospective cross-sectional study of 4,217 women aged 21-89 years presenting to our facilities for screening mammogram between December 2010 and October 2011. This HIPAA-compliant study was approved by our institutional review board. We collected data on patients' interest in and actual donation of a biospecimen, motivators and barriers to donating, demographic information, and personal breast cancer risk factors. A multivariate logistic regression analysis was performed to identify patient-level characteristics associated with an increased likelihood to donate. Mean patient age was 57.8 years (SD 11.1 years). While 66.0 % (2,785/4,217) of patients were willing to donate blood or saliva during their visit, only 56.4 % (2,378/4,217) actually donated. Women with a college education (OR = 1.27, p = 0.003), older age (OR = 1.02, p < 0.001), previous breast biopsy (OR = 1.23, p = 0.012), family history of breast cancer (OR = 1.23, p = 0.004), or a comorbidity (OR = 1.22, p = 0.014) were more likely to donate. Asian-American women were significantly less likely to donate (OR = 0.74, p = 0.005). The major reason for donating was to help all future patients (42.3 %) and the major reason for declining donation was privacy concerns (22.3 %). A large proportion of women participating in a breast cancer screening registry are willing to donate blood or saliva to a biobank. Among minority participants, Asian-American women are less likely to donate and further qualitative research is required to identify novel active recruitment strategies to insure their involvement

Patients' willingness to participate in a breast cancer biobank at screening mammogram.

To characterize patients' willingness to donate a biospecimen for future research as part of a breast cancer-related biobank involving a general screening population. We performed a prospective cross-sectional study of 4,217 women aged 21-89 years presenting to our facilities for screening mammogram between December 2010 and October 2011. This HIPAA-compliant study was approved by our institutional review board. We collected data on patients' interest in and actual donation of a biospecimen, motivators and barriers to donating, demographic information, and personal breast cancer risk factors. A multivariate logistic regression analysis was performed to identify patient-level characteristics associated with an increased likelihood to donate. Mean patient age was 57.8 years (SD 11.1 years). While 66.0 % (2,785/4,217) of patients were willing to donate blood or saliva during their visit, only 56.4 % (2,378/4,217) actually donated. Women with a college education (OR = 1.27, p = 0.003), older age (OR = 1.02, p < 0.001), previous breast biopsy (OR = 1.23, p = 0.012), family history of breast cancer (OR = 1.23, p = 0.004), or a comorbidity (OR = 1.22, p = 0.014) were more likely to donate. Asian-American women were significantly less likely to donate (OR = 0.74, p = 0.005). The major reason for donating was to help all future patients (42.3 %) and the major reason for declining donation was privacy concerns (22.3 %). A large proportion of women participating in a breast cancer screening registry are willing to donate blood or saliva to a biobank. Among minority participants, Asian-American women are less likely to donate and further qualitative research is required to identify novel active recruitment strategies to insure their involvement

7-year outcomes in diabetic patients after coronary artery bypass graft in a developing country

Abstract Background Revascularization in diabetic patients with coronary artery disease remains a challenge in cardiology practice. Although clinical trials have reported the mid-term superiority of coronary artery bypass grafting (CABG) surgery over percutaneous coronary intervention in these patients, little is known about the long-term outcomes of CABG in diabetic patients compared to non-diabetics, particularly in developing countries. Methods Between 2007 and 2016, we recruited all patients who underwent isolated CABG in a tertiary care cardiovascular center in a developing country. The patients were followed at 3–6 months and 12 months after surgery, and then annually. The study endpoints were 7-year all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE). Results Of 23,873 patients (17,529 males, mean age 65.67 years) who underwent CABG, 9227 (38.65%) patients were diagnosed with diabetes. After adjustment for potential confounders, patients with diabetes experienced a 31% increase in MACCE seven years after surgery compared to the non-diabetic patients (HR = 1.31, 95% CI: 1.25–1.38, P-value < 0.0001). Meanwhile, diabetes contributes to a 52% increase in the risk of all-cause mortality after CABG (HR = 1.52, 95% CI: 1.42–1.61, P-value < 0.0001). Conclusions Our study showed a higher risk of all-cause mortality and MACCE at seven years in diabetic patients undergoing isolated CABG. The outcomes in the studied center in a developing country were comparable to western centers. The high incidence of adverse outcomes in the long term in diabetic patients implies that not only short-term but long-term measures should be taken to improve the CABG outcomes in this challenging patient population

Patients’ willingness to participate in a breast cancer biobank at screening mammogram

PURPOSE: To characterize patients’ willingness to donate a biospecimen for future research as part of a breast cancer-related biobank involving a general screening population. MATERIALS AND METHODS: We performed a prospective cross-sectional study of 4,217 women aged 21 to 89 years presenting to our facilities for screening mammogram between December 2010 and October 2011. This HIPAA-compliant study was approved by our institutional review board. We collected data on patients’ interest in and actual donation of a biospecimen, motivators and barriers to donating, demographic information, and personal breast cancer risk factors. A multivariate logistic regression analysis was performed to identify patient-level characteristics associated with an increased likelihood to donate. RESULTS: Mean patient age was 57.8 years (SD 11.1 years). While 66.0% (2785/4217) of patients were willing to donate blood or saliva during their visit, only 56.4% (2378/4217) actually donated. Women with a college education (OR=1.27, p=0.003), older age (OR=1.02, p<0.001), previous breast biopsy (OR=1.23, p=0.012), family history of breast cancer (OR=1.23, p=0.004), or a comorbidity (OR=1.22, p=0.014) were more likely to donate. Asian-American women were significantly less likely to donate (OR=0.74, p=0.005). The major reason for donating was to help all future patients (42.3%) and the major reason for declining donation was privacy concerns (22.3%). CONCLUSION: A large proportion of women participating in a breast cancer screening registry are willing to donate blood or saliva to a biobank. Among minority participants, Asian-American women are less likely to donate and further qualitative research is required to identify novel active recruitment strategies to ensure their involvement