Molecular identification of CTX-M, TEM and SHV β-lactamases in �Klebsiella pneumoniae isolated from respiratory system of patients in the ICU of educational hospitals in Tehran

Background: Extended-spectrum beta-lactamases (ESBL) producing isolates of Klebsiella pneumoniae which have been increased in the hospitals were resulting in limitation of therapeutic options. The aims of this study were to evaluate the antibiotic susceptibility pattern and presence of ESBL genes in clinical isolates of Klebsiella pneumoniae from patients admitted to the intensive care units (ICUs). Materials and Methods: In this descriptive cross-sectional study, a total of 65 Klebsiella pneumoniae strains were isolated from ICUs of educational hospitals in Tehran. Identification was performed using biochemical tests and the antimicrobial susceptibility was performed as recommended by the Clinical and Laboratory Standards Institute (CLSI). Molecular analysis of the ESBL genes was performed by Multiplex PCR (M-PCR). Results: Most of the isolates were resistant to Cotrimoxazole (72.3), Gentamicin (67.7) and Ampicillin (69.2) and the highest susceptibility was seen for Ciprofloxacin (50.8) Tetracycline (49.2), Imipenem (46.3) and Ceftriaxone (43.1). Among the ESBL-producing genes, blaCTX-M (55.3 ) was the most prevalent, followed by blaTEM (41.5 ) and blaSHV (10.7 ). The results showed that 1.5 of the isolates had concurrently blaTEM/ blaSHV and blaSHV/ blaCTX-M genes and 21.6 of isolates the blaTEM/ blaCTX-M genes. Conclusion: These findings reveal the high prevalence of multi drug resistant and ESBL-producing Klebsiella pneumoniae in patients hospitalized in ICUs and emphasize the need for appropriate infection control policies

Effectiveness of Problem-Focused Coping Strategies on the Burden on Caregivers of Hemodialysis Patients

Background: Studies have shown that family caregivers of hemodialysis patients experience high levels of burden. However, these caregivers are often neglected, and no studies are available on the effectiveness of coping strategies on the burden of care among these caregivers. Objectives: This study aimed to examine the effectiveness of problem-focused coping strategies (communication skills, anger management, and deep breathing) on the burden on caregivers of hemodialysis patients. Patients and Methods: A randomized controlled clinical trial was conducted on 76 family caregivers of hemodialysis patients referred to Shahid Hasheminejad hemodialysis center in Tehran, Iran. The subjects were equally allocated into two groups of 38. Through a coin-tossing method, caregivers of patients who referred on even or odd days of the week were randomly assigned into the intervention group or the control group, respectively. The intervention group received four training sessions on problem-focused coping strategies, but the control group did not receive any intervention. Both groups answered the caregiver’s burnout inventory at the start and six weeks after the last educational session. Descriptive statistics, chi-square, Fisher’s exact test, independent-samples t-test, and Mann-Whitney U test were used to analyze the data. Results: The majority of caregivers (54%) were in the age range of 35 - 55 years, female (68.4%), and married (70%). No significant difference was found between the baseline mean caregivers’ burden scores of the intervention and control groups (88.56 ± 11.74 vs. 84.97 ± 15.13, P = 0.308). However, the mean caregivers’ burden in the intervention group decreased, and the two groups were significantly different at the end of the study (58.77 ± 6.64 vs. 87.84 ± 11.74, P < 0.001). Conclusions: The current study showed the effectiveness of problem-focused coping strategies on reducing the burden on caregivers of hemodialysis patients. Authorities and policymakers in the healthcare system are responsible for developing strategies to integrate educational programs, such as the program implemented in the current study, into the country’s healthcare system

In ovo injection of organic zinc effects on hatching rate of broiler breeder hen eggs and productivity of broilers

The aim of this study was to investigate the effect of in ovo injection of organic zinc on the characteristics of broiler chickens and the performance of broiler chickens A total of 320 eggs from Ross 308 strain with an average weight of 65 grams were randomly divided into four groups, negative control (no injection), positive control (in ovo injection of 0.272 ml of normal saline solution) and two experimental groups, eggs in the first received in ovo injection of 0.272 mg of organic zinc whereas in the second the eggs were injected with 0.544 mg of the same organic zinc. The injection was done in the amniotic sac on the 10th day of incubation. The effect of injection on hatching traits and then on functional traits, blood parameters, immune response, carcass characteristics and cecal microbial population of resulting broilers were measured. The results showed that the percentage of hatched broiler chickens in the zinc-treated groups was significantly lower compared to the two control groups. However, the intraocular injection of zinc caused a significant increase in the final weight gain of the birds and their feed consumption. Blood parameters were also affected in experimental treatments and blood glucose increased and blood triglyceride, cholesterol and lipoproteins decreased compared to negative and positive control (P&lt;0.01). On the other hand, no statistically significant difference was observed in the immune response, microbial population and carcass characteristics among the experimental groups. In conclusion, the intra egg injection of organic zinc can show favorable results in the performance indicators of broiler chickens, although it had no effect on the immune response and microbial population

The occurrence of riddled basins and blowout bifurcations in a parametric nonlinear system

In this paper, a two parameters family $F_{\beta_1,\beta_2}$ of maps of the plane living two different subspaces invariant is studied. We observe that, our model exhibits two chaotic attractors $A_i$, $i=0,1$, lying in these invariant subspaces and identify the parameters at which $A_i$ has a locally riddled basin of attraction or becomes a chaotic saddle. Then, the occurrence of riddled basin in the global sense is investigated in an open region of $\beta_1\beta_2$-plane. We semi-conjugate our system to a random walk model and define a fractal boundary which separates the basins of attraction of the two chaotic attractors, then we describe riddled basin in detail. We show that the model undergos a sequence of bifurcations: "a blowout bifurcation", "a bifurcation to normal repulsion" and "a bifurcation by creating a new chaotic attractor with an intermingled basin". Numerical simulations are presented graphically to confirm the validity of our results.Comment: 26 pages, 15 figure

A multiscale deep learning model for elastic properties of woven composites

Time-consuming and costly computational analysis expresses the need for new methods for generalizing multiscale analysis of composite materials. Combining neural networks and multiscale modeling is favorable for bypassing expensive lower-scale material modeling, and accelerating coupled multi-scale analyses (FE2). In this work, neural networks are used to replace the time-consuming micromechanical finite element analysis of unidirectional composites, representing the local material properties of yarns in woven fabric composites in a multiscale framework. Leveraging the fast multiscale data generation procedure, we presented a second neural networks model to estimate the elastic engineering coefficients of a particular weave architecture based on a broad range of dry resin and fiber properties and yarn fiber volume fraction. As an outcome, this paper provides the user with a generalized, neural network-based approach to tackle the balance of computational efficiency and accuracy in the multiscale analysis of elastic woven composites