A ANÁLISE DO DISCURSO CRÍTICO DA REPRESENTAÇÃO DE GÊNERO NOS LIVROS DE INGLÊS DE HIGH SCHOOLS IRANIANO: : O MODELO FAIRCLOUGH EM FOCO

The present study adopted an exploratory critical discourse analysis (CDA) approach to examine gender representation in Iranian government mandatory high school ELT textbooks using Fairclough model. Considering the model, female and male characters’ visibility, semantic, domestic, and social roles, activities, and pictorial representations in the textbooks were scrutinized. These factors were described, interpreted, and explained both qualitatively and quantitatively. Additionally, a semi-structured interview was conducted with 30 experienced high school educators and their responses were coded, scrutinized, and interpreted. The findings revealed the permanence of male dominance in the textbooks and that the gender bias in educational materials would have strong socio-cultural effects on students’ mind sets, future careers, and fields of study. The findings highlight the must to address gender inequalities as one of the most crucial socio-cultural concerns of Iran EFL educational textbooks.O presente estudo adotou uma abordagem exploratória de análise crítica do discurso (CDA) para examinar a representação de gênero nos livros didáticos de ELT do ensino médio obrigatório do governo iraniano usando o modelo Fairclough. Considerando o modelo, a visibilidade dos personagens femininos e masculinos, papéis semânticos, domésticos e sociais, atividades e representações pictóricas nos livros didáticos foram escrutinados. Esses fatores foram descritos, interpretados e explicados qualitativa e quantitativamente. Além disso, uma entrevista semiestruturada foi realizada com 30 educadores experientes do ensino médio e suas respostas foram codificadas, examinadas e interpretadas. As descobertas revelaram a permanência do domínio masculino nos livros didáticos e que o viés de gênero nos materiais educacionais teria fortes efeitos socioculturais nas mentalidades dos alunos, futuras carreiras e campos de estudo. As descobertas destacam a necessidade de abordar as desigualdades de gênero como uma das preocupações sócio-culturais mais cruciais dos livros didáticos educacionais de EFL do Irã

Global systematic review of primary immunodeficiency registries

Introduction During the last 4 decades, registration of patients with primary immunodeficiencies (PID) has played an essential role in different aspects of these diseases worldwide including epidemiological indexes, policymaking, quality controls of care/life, facilitation of genetic studies and clinical trials as well as improving our understanding about the natural history of the disease and the immune system function. However, due to the limitation of sustainable resources supporting these registries, inconsistency in diagnostic criteria and lack of molecular diagnosis as well as difficulties in the documentation and designing any universal platform, the global perspective of these diseases remains unclear. Areas covered Published and unpublished studies from January 1981 to June 2020 were systematically reviewed on PubMed, Web of Science and Scopus. Additionally, the reference list of all studies was hand-searched for additional studies. This effort identified a total of 104614 registered patients and suggests identification of at least 10590 additional PID patients, mainly from countries located in Asia and Africa. Molecular defects in genes known to cause PID were identified and reported in 13852 (13.2% of all registered) patients. Expert opinion Although these data suggest some progress in the identification and documentation of PID patients worldwide, achieving the basic requirement for the global PID burden estimation and registration of undiagnosed patients will require more reinforcement of the progress, involving both improved diagnostic facilities and neonatal screening.Peer reviewe

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Etude de l’accumulation d’un antibiotique bactéricide par des bactéries tolérantes en lien avec la persistance bactérienne

Aminoglycoside (AG) is a family of antibiotic which target bacterial ribosome. Few examples of this family are neomycin, gentamicin and streptomycin. When these antibiotics bind to ribosomes, they cause miscoding or inhibit protein synthesis which consequently leads to cell death. Although discovery of these antibiotics was more than half a century ago, there are many facts about AGs’ action mechanism which remain unknown. AG accumulation in the bacterial cells happens in three steps. First step is cell membrane attachment. This step is driven by an electrostatic interaction with the cationic AGs. Second step is an energy dependent phase I (EDPI). In EDPI, the antibiotic enters into the cytoplasm and reaches ribosomes, causing miscoding and production of misfolded proteins. EDPI depends on cellular energy level, however to date the mechanism by which AGs pass through membranes and enter cytoplasm is unknown. The third step is energy dependent phase II (EDPII) in which the antibiotic enters into the cytoplasm in larger amount due to damages in the membrane that resulted from EDPI. The aim of this PhD was to create new tools to study the interaction of AGs with bacteria and apply the methodology to study fast growing bacteria as well as persister cells. We have made fluorescently-tagged AGs with preserved bactericidal properties. We used these conjugates to track down the interaction of AG at single cell level by fluorescence microscopy. We combined fluorescence microscopy and fluorescence-activated cell sorting (FACS) analysis to measure AGs accumulation in the cells at different time points to capture the kinetics of antibiotic penetration. This study showed that there are two accumulations patterns for the drug in cells: in the first step there is a peripheral accumulation, which corresponds to specific binging to cell membrane. Next there is a cytoplasmic accumulation in which the antibiotic in entering into the cytoplasm. According to microscopy time laps study, low levels of cytoplasmic accumulation is tolerated by cells and did not cause cell death. Using FACS analysis, we used an inhibitor of EDPI and EDPII and proved that with this technique we can distinguish different steps of AGs accumulation. During protocol adjustment steps we found that AGs can enter into the cytoplasm as a result of mechanosensation and activation of mechanosensitive (MS) channels. These channels have already been shown to have affinity to AG and here this is a first time that we observed that mechanical manipulation of cells lead to opening of MS channel causing massive cytoplasmic accumulation. This unpredictable result may lead us to a better understanding of the mechanism of AG entrance into the cytoplasm. After studying AG accumulation in fast growing cells, we studied AG tolerance for non-growing cells, which are called persisters. Persisters are antibiotic tolerant sub-population among susceptible bacterial cell population. Persisters are non-growing, dormant cells which tolerate high concentrations of antibiotic. In the absence of antibiotic, they exit this dormant state and grow into an antibiotic susceptible population. By fluorescence microscopy we showed that persister cells have peripheral accumulation of AG. Thanks to our methodology, we have a powerful tool by which we can determine the patterns of AG accumulation. Prior to this study, it was only possible to know the levels of accumulation and not the corresponding patterns. We applied the method to investigate AG accumulation in two mutants of E. coli, which are less tolerant to AG and defined their pattern of accumulation. Finally, we developed a coated microfluidic system, which is adapted to our antibiotics for studying in real time drug accumulation by persister cells.Les aminoglycosides (AG) sont une famille d’antibiotiques qui ciblent le ribosome bactérien. À titre d’exemple il s’agit de la néomycine, la gentamicine et la streptomycine. Quand ces antibiotiques se fixent au ribosome, ils provoquent des erreurs de lectures ou inhibent la synthèse des protéines, ce qui conduit à la mort cellulaire. Même s’ils ont été découverts il y a plus d’un demi-siècle, de nombreux aspects de leur mode d’action restent inconnus. L’accumulation des AG dans les bactéries se passe en trois étapes. La première consiste en une interaction électrostatique avec la membrane. La deuxième est une phase I énergie-dépendante (EDPI). Les antibiotiques rentrent dans le cytoplasme, atteignent les ribosomes, ce qui cause des erreurs de lecture et donc la production de protéines mal repliées. EDPI dépend du niveau énergétique de la cellule et le mécanisme d’entrée à travers les membranes reste inconnu. La troisième étape est la deuxième phase énergie-dépendante (EDPII), où l’antibiotique pénètre dans le cytoplasme en grande quantité par des membranes endommagées lors de la phase I. Le but de cette thèse était de créer de nouveaux outils afin d’étudier l’interaction des AG avec les bactéries et d’appliquer la méthodologie à des bactéries en phase rapide de croissance ou bien en état de persistance. Nous avons synthétisé des conjugués fluorescents des AG aux propriétés bactéricides. Avec ces conjugués nous avons analysé l’interaction des AG avec les bactéries à l’échelle de la cellule unique par microscopie de fluorescence. Nous avons combiné cette technique avec la cytométrie de flux (FACS) pour évaluer la cinétique d’accumulation. Cette étude démontre qu’il y a deux types d’accumulation : une à la périphérie avec interaction à la membrane et une deuxième où l’antibiotique est localisé dans le cytoplasme. Notre analyse démontre aussi que de faibles niveaux d’antibiotiques dans le cytoplasme sont tolérés et n’inhibent pas la croissance cellulaire. En utilisant un inhibiteur des phases EDPI et EDPII nous démontrons que cette technique permet de distinguer les différentes étapes de l’accumulation. Au cours d’ajustements du protocole, nous avons découvert que les AG peuvent entrer dans le cytoplasme par mechano-sensation et activation de canaux mécanosensibles (MS). Ces canaux sont connus pour avoir une affinité pour les AG. Ici pour la première fois nous montrons qu’une manipulation mécanique ouvre les canaux et stimule une entrée massive d’antibiotiques. Ce résultat inattendu pourrait permettre de mieux comprendre le mécanisme d’entrée des AG dans le cytoplasme. Après avoir étudié l’accumulation des AG dans les cellules en croissance nous avons étudié la tolérance aux AG pour les bactéries en phase de dormance : les cellules persistantes. Elles forment une sous-population parmi une population sensible. Elles sont en dormance et tolèrent de fortes doses d’antibiotiques. En absence d’antibiotique elles sortent de l’état de dormance pour reformer une population sensible à l’antibiotique. Par microscopie de fluorescence, nous montrons que les cellules persistantes ont une accumulation périphérique d’AG. Grâce à notre méthodologie, nous avons un outil performant pour identifier les différents états d’accumulation des AG. Avant cette étude il était seulement possible de connaître les niveaux d’accumulation mais la localisation de l’antibiotique demeurait inaccessible. Nous avons avec cette méthode étudié deux mutants d’E. coli, qui sont moins tolérants aux AG et identifié leurs caractéristiques d’accumulation. Enfin, nous avons développé un système de microfluidique adapté à l’étude de nos conjugués fluorescents pour étudier en temps réel l’accumulation par les cellules persistantes

Etude de l’accumulation d’un antibiotique bactéricide par des bactéries tolérantes en lien avec la persistance bactérienne

Aminoglycoside (AG) is a family of antibiotic which target bacterial ribosome. Few examples of this family are neomycin, gentamicin and streptomycin. When these antibiotics bind to ribosomes, they cause miscoding or inhibit protein synthesis which consequently leads to cell death. Although discovery of these antibiotics was more than half a century ago, there are many facts about AGs’ action mechanism which remain unknown. AG accumulation in the bacterial cells happens in three steps. First step is cell membrane attachment. This step is driven by an electrostatic interaction with the cationic AGs. Second step is an energy dependent phase I (EDPI). In EDPI, the antibiotic enters into the cytoplasm and reaches ribosomes, causing miscoding and production of misfolded proteins. EDPI depends on cellular energy level, however to date the mechanism by which AGs pass through membranes and enter cytoplasm is unknown. The third step is energy dependent phase II (EDPII) in which the antibiotic enters into the cytoplasm in larger amount due to damages in the membrane that resulted from EDPI. The aim of this PhD was to create new tools to study the interaction of AGs with bacteria and apply the methodology to study fast growing bacteria as well as persister cells. We have made fluorescently-tagged AGs with preserved bactericidal properties. We used these conjugates to track down the interaction of AG at single cell level by fluorescence microscopy. We combined fluorescence microscopy and fluorescence-activated cell sorting (FACS) analysis to measure AGs accumulation in the cells at different time points to capture the kinetics of antibiotic penetration. This study showed that there are two accumulations patterns for the drug in cells: in the first step there is a peripheral accumulation, which corresponds to specific binging to cell membrane. Next there is a cytoplasmic accumulation in which the antibiotic in entering into the cytoplasm. According to microscopy time laps study, low levels of cytoplasmic accumulation is tolerated by cells and did not cause cell death. Using FACS analysis, we used an inhibitor of EDPI and EDPII and proved that with this technique we can distinguish different steps of AGs accumulation. During protocol adjustment steps we found that AGs can enter into the cytoplasm as a result of mechanosensation and activation of mechanosensitive (MS) channels. These channels have already been shown to have affinity to AG and here this is a first time that we observed that mechanical manipulation of cells lead to opening of MS channel causing massive cytoplasmic accumulation. This unpredictable result may lead us to a better understanding of the mechanism of AG entrance into the cytoplasm. After studying AG accumulation in fast growing cells, we studied AG tolerance for non-growing cells, which are called persisters. Persisters are antibiotic tolerant sub-population among susceptible bacterial cell population. Persisters are non-growing, dormant cells which tolerate high concentrations of antibiotic. In the absence of antibiotic, they exit this dormant state and grow into an antibiotic susceptible population. By fluorescence microscopy we showed that persister cells have peripheral accumulation of AG. Thanks to our methodology, we have a powerful tool by which we can determine the patterns of AG accumulation. Prior to this study, it was only possible to know the levels of accumulation and not the corresponding patterns. We applied the method to investigate AG accumulation in two mutants of E. coli, which are less tolerant to AG and defined their pattern of accumulation. Finally, we developed a coated microfluidic system, which is adapted to our antibiotics for studying in real time drug accumulation by persister cells.Les aminoglycosides (AG) sont une famille d’antibiotiques qui ciblent le ribosome bactérien. À titre d’exemple il s’agit de la néomycine, la gentamicine et la streptomycine. Quand ces antibiotiques se fixent au ribosome, ils provoquent des erreurs de lectures ou inhibent la synthèse des protéines, ce qui conduit à la mort cellulaire. Même s’ils ont été découverts il y a plus d’un demi-siècle, de nombreux aspects de leur mode d’action restent inconnus. L’accumulation des AG dans les bactéries se passe en trois étapes. La première consiste en une interaction électrostatique avec la membrane. La deuxième est une phase I énergie-dépendante (EDPI). Les antibiotiques rentrent dans le cytoplasme, atteignent les ribosomes, ce qui cause des erreurs de lecture et donc la production de protéines mal repliées. EDPI dépend du niveau énergétique de la cellule et le mécanisme d’entrée à travers les membranes reste inconnu. La troisième étape est la deuxième phase énergie-dépendante (EDPII), où l’antibiotique pénètre dans le cytoplasme en grande quantité par des membranes endommagées lors de la phase I. Le but de cette thèse était de créer de nouveaux outils afin d’étudier l’interaction des AG avec les bactéries et d’appliquer la méthodologie à des bactéries en phase rapide de croissance ou bien en état de persistance. Nous avons synthétisé des conjugués fluorescents des AG aux propriétés bactéricides. Avec ces conjugués nous avons analysé l’interaction des AG avec les bactéries à l’échelle de la cellule unique par microscopie de fluorescence. Nous avons combiné cette technique avec la cytométrie de flux (FACS) pour évaluer la cinétique d’accumulation. Cette étude démontre qu’il y a deux types d’accumulation : une à la périphérie avec interaction à la membrane et une deuxième où l’antibiotique est localisé dans le cytoplasme. Notre analyse démontre aussi que de faibles niveaux d’antibiotiques dans le cytoplasme sont tolérés et n’inhibent pas la croissance cellulaire. En utilisant un inhibiteur des phases EDPI et EDPII nous démontrons que cette technique permet de distinguer les différentes étapes de l’accumulation. Au cours d’ajustements du protocole, nous avons découvert que les AG peuvent entrer dans le cytoplasme par mechano-sensation et activation de canaux mécanosensibles (MS). Ces canaux sont connus pour avoir une affinité pour les AG. Ici pour la première fois nous montrons qu’une manipulation mécanique ouvre les canaux et stimule une entrée massive d’antibiotiques. Ce résultat inattendu pourrait permettre de mieux comprendre le mécanisme d’entrée des AG dans le cytoplasme. Après avoir étudié l’accumulation des AG dans les cellules en croissance nous avons étudié la tolérance aux AG pour les bactéries en phase de dormance : les cellules persistantes. Elles forment une sous-population parmi une population sensible. Elles sont en dormance et tolèrent de fortes doses d’antibiotiques. En absence d’antibiotique elles sortent de l’état de dormance pour reformer une population sensible à l’antibiotique. Par microscopie de fluorescence, nous montrons que les cellules persistantes ont une accumulation périphérique d’AG. Grâce à notre méthodologie, nous avons un outil performant pour identifier les différents états d’accumulation des AG. Avant cette étude il était seulement possible de connaître les niveaux d’accumulation mais la localisation de l’antibiotique demeurait inaccessible. Nous avons avec cette méthode étudié deux mutants d’E. coli, qui sont moins tolérants aux AG et identifié leurs caractéristiques d’accumulation. Enfin, nous avons développé un système de microfluidique adapté à l’étude de nos conjugués fluorescents pour étudier en temps réel l’accumulation par les cellules persistantes

Clinical efficacy and quality of life under micronutrients in combination with methotrexate therapy in chronic plaque of psoriatic patients

Background/objectives: Psoriasis is a common dermatologic disorder, with fluctuating response to treatments. We aimed to investigate the efficacy of methotrexate (MTX) plus micronutrient supplement (MM) compare to MTX only on Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) in psoriasis patients in a double-blinded clinical trial study. Materials and methods: A total number of 30 psoriasis patients who had lesions up to 20 percent of body skin involvement were divided randomly into two groups. Group A were treated by oral methotrexate and group B were received the MTX plus one tablet of micronutrient supplement daily for 12 weeks. Clinical response (scaling, erythema, involvement and thickness of patient's lesion), PASI score and DLQI index were recorded baseline and after 12 weeks. PASI-50, PASI-75, and PASI-90 evaluated as indicators of clinical improvements. Results: PASI 50/75/90 response rates were 100%, 73.3%, 40% in group B and they were 66.6%, 40%, 20% in group A respectively. Both treatments were effective and caused significant improvements in PASI score and DLQI (P < 0.05). Group B showed a noticeable and more rapid reduction of PASI score, scaling and involvement of lesions compared to group A (P = 0.04; P = 0.01; P = 0.03, respectively). The decline of DLQI in group B (6.80 ± 2.33) was higher than that in group A (5.40 ± 2.84). Conclusion: Daily usage of supplements along with methotrexate is safe and concomitant with the significant reduction of PASI score and improvement of DLQI compared to the usage of MTX alone

Nursing core competencies for postresuscitation care in Iran: a qualitative study

Objective This study explored nurses’ perceptions of the core competencies required for providing postresuscitation care in both in-hospital and out-of-hospital cardiac arrest.Design Qualitative conventional content analysis.Participants 17 nurses selected with purposeful sampling method.Setting Three educational hospitals in northwest of Iran.Data collection and analysis Semi-structured interviews were used for data collection and they were analysed using conventional content analysis.Results Seven main categories have emerged from the data. The core competencies for nurses providing postresuscitation were identified as: quality assurance, providing evidence-based care, monitoring and presence, situation management, professionalism, positive attitude and providing family centred care.Conclusions The postresuscitation period is a unique and critical time requiring highly competent nursing care. Several core competencies for providing high-quality nursing care during postresuscitation period were identified through nurses’ experience in caring for patients postresuscitation

Nurses' experiences of provision family‐centred care in the postresuscitation period: A qualitative study

Abstract Aim This study aimed to explore nurses' experiences of providing family‐centred care in the postresuscitation period. Design An exploratory‐descriptive qualitative design was used. Methods In this qualitative study, in‐depth, semi‐structured interviews were conducted with 22 nurses in three educational hospitals. There were six participants who completed follow‐up interviews to resolve questions generated during initial interviews. Data were analysed using conventional content analysis. Results Five main categories were extracted: continuous monitoring, facilitation of attendance, involvement in care, informing and emotional support. Despite the lack of organizational policies and guidelines, nurses explained how they work to provide family‐centred care for families, especially those they assessed as having less possibility of aggressive behaviour and those with a better understanding of their loved one's condition. To provide postresuscitation family‐centred care, nurses facilitated family attendance, involved them in some basic nursing care, and provided information and emotional support to the family members. Conclusion Nurses attempted to follow the basic principles of family‐centred care in the postresuscitation period. However, to improve the provision of care by nurses, it is necessary to embed family‐centred care principles in institutional policies and guidelines and to conduct training for nurses. Implications for the Profession Iranian nurses are interested in engaged families in the postresuscitation period. Correct implementations of such care that include all families need institutional policies and guidelines. Patient or Public Contribution No patient or public contribution

Coronary Risk Factors in Patients with Coronary Artery Ectasia : A Case-Control Study from Iran

Coronary artery ectasia is a rare finding in angiography. We investigated the prevalence of coronary artery ectasia and assessed cardiovascular risk factors as probable influencing factors in this disease in our region. This study was conducted from October 2007 to March 2010 on 2500 patients visiting Imam Reza and Qaem and Razavi hospitals, Mashhad, Iran who had chest pain and were selected for angiographic studies. The study was based on reviewing angiographic films besides filling in questionnaires. 103 coronary artery ectasia cases showing 4% prevalence for this kind of coronary involvement were selected as the study group and compared with 62 patients with atherosclerosis and no ectasia as the control group. Mean age of the study and control group was 57.6 and 54.1yrs, respectively indicating a statistically significant difference (p=0.032). The study and control groups showed no significant difference based on sex, smoking history and mean Body Mass Index (BMI). However, a BMI above 25 had a significantly higher prevalence in the study group (p=0.036). Mean hs-CRP and homocystein levels were 3.4 and 11.8 in the study group and 2.3 and 8.3 in the control group, respectively, both revealing a significant difference (p=0.002, p&lt;0.001). Hyperlipidemia in ectasia patients in comparison to controls was significantly more prevalent (p=0.001). The prevalence of coronary artery ectasia was 4% and cardiovascular risk factors in ectasia cases included: hyperlipidemia, high hs-CRP, and homocystein