A comparative study on the effect of limestone particle size on performance, ileal digestibility of calcium and phosphorus, and bone characteristics in broilers and pullets

1. The effects of limestone particle size on growth performance, gastrointestinal tract (GIT) traits, ileal morphology, duodenal gene expression of calbindin, apparent ileal digestibility coefficients (AIDC) of calcium (Ca) and phosphorus (P) and tibia characteristics in broilers and pullets were assessed in broilers and pullets. These birds have different growth rates and likely different responses to parameters, such as particle size.2. A total of 240 chicks aged one day, 120 Ross 308 female broilers, and 120 Hy-Line pullets were allocated randomly into four treatments in a 2 × 2 factorial arrangement with two bird types (broilers vs. pullets) and two limestone particle sizes (<0.5 mm versus 1-2 mm) to give six replicates containing 10 chicks in each from 1 to 21 d of age.3. Feed intake and weight gain were greater (P < 0.001) and feed per gain (FCR) was better (P < 0.001) in broilers compared to pullets from 1 to 21 d of age. Greater villus width (P < 0.01), villus height (P < 0.001) and crypt depth (P < 0.01) were seen for broilers compared to pullets.4. Pullets fed coarse Ca particles had higher calbindin gene expression at 21 d of age (P = 0.05). Both AIDC of Ca and P were higher (P < 0.001) in broilers compared to pullets. The AIDC of Ca from 0.463 to 0.516 was increased (P < 0.05) by feeding coarse limestone particles. A significant interaction was found between bird type and limestone particle size (P < 0.01), where pullets fed coarse Ca particles had higher bone P concentration in tibia than broilers.5. Broilers had better ileum absorptive capacity and growth performance compared to pullets. The AIDC of Ca and P was higher in broilers than in pullets. Increased limestone particle size elevated villus height, AIDC of Ca and concentration of P in the tibia.

Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry

AIMS

The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation.

METHODS AND RESULTS

Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin.

CONCLUSION

The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.

P-388 Isolation and characterization of human uterine fluid lavage-derived extracellular vesicles by three different methods for optimal embryo transfer timing discovery

Study question

What is the suitable method for isolating extracellular vesicles (EVs) from a small volume of Uterine Fluid Lavage (UFL)?

Summary answer

It seems that the qEV column can help in faster, precise, and gentle isolation of EVs from small amounts of UFL.

What is known already

Several studies have discovered that existing EVs in the UFL, which are informative carriers, reflect cytological and molecular conditions of the uterine environment. The relative amounts of the EV components are different in various physiological situations. So, they are the ideal source for precise molecular analysis of the uterine condition to identify the Window of Implantation (WOI) for appropriate embryo transfer (ET) timing. There is limited information describing the most efficient method for EV isolation from a low-volume sample of biological fluids. In particular, EV separation from some biological fluids such as UFL is more complicated because of the viscosity.

Study design, size, duration

The study was conducted in two steps; first, the pre-implantation UFL sampling effect was studied on the implantation and clinical pregnancy rates. UFLs were obtained from 20 IVF Frozen Embryo Transfer (FET) patients as the case group. The control group consisted of 20 FET patients without lavage. In the second step, UFLs (n = 30) were collected and pooled. The EVs were extracted by ultracentrifugation (UC), Sucrose cushion (Suc), and Size-exclusion chromatography (by the qEV column) methods.

Participants/materials, setting, methods

First, UFL was collected two days before frozen blastocyst ET from the case group using an intrauterine insemination catheter attached to a syringe. Then, patients were compared with control at the seventh week. Second, EVs were extracted from pooled UFL samples and characterized by Dynamic Light Scattering (DLS), Scanning Electron Microscopy (SEM), and Western Blot (WB). Albumin contamination was detected by SDS-PAGE. Total RNA was extracted, and Real-time PCR was performed for six housekeeping genes.

Main results and the role of chance

A comparison between case and control groups indicated no significant difference for implantation and clinical pregnancy rates. Moreover, we have confirmed the presence of EVs in UFL that were successfully isolated, by the UC, Suc, the qEV methods. The SEM images showed that the collected vesicles were morphologically spherical. The DLS analysis revealed that the intensity peak of isolated particles with the UC and Suc methods were 281 nm and 216 nm, respectively. Extracted EVs using the qEV technique were smaller and homogenized in size, with an intensity peak of 67.7 nm. SDS-PAGE of EVs showed a weaker albumin band in the qEV column (with a 100 kDa filter) method than the UC, Suc, and qEV column (with a 30 kDa filter) methods. Although, their quantification showed no significant differences. WB analysis indicated common EV markers (D81, CD9, CD63, and TSG101) showed better expression using the qEV extraction technique. But CD9 and TSG101 had lower expression levels in EVs isolated using Suc and UC, respectively. Calnexin was not detected in the isolated EVs. The GAPDH, 18SrRNA, ACTIN, GUSB, HMBS, and YWHAZ genes were detected by real-time PCR in all three EV extraction methods. The 18SrRNA gene showed better CT values.

Limitations, reasons for caution

Uterine fluid samples collection from qualified study groups and the patient’s follow-up for ensuring successful implantation and clinical pregnancy are time-consuming. The low volume of uterine fluid lavage sample and consequently the low number of extracellular vesicles inside it was also the limitation of this study.

Wider implications of the findings

Endometrial receptivity assay is difficult to study non-invasively. Herein, endometrial secretome EVs as a minimally invasive source for uterine environment molecular assessment is presented. High-throughput analysis of EV components can offer biomarkers for individual determination of ET timing, providing an additional method to use with transvaginal-ultrasonography for assessing endometrial receptivity.

Trial registration number

not applicable

AB1528-HPR FULL BODY HAPTIC BODYSUIT - AN INSTRUMENT TO MEASURE THE RANGE AND SPEED OF MOTION IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS (axSpA) - PRELIMINARY RESULTS

Background

Movement of the spine is restricted in axial spondyloarthritis (axSpA) [1]. Spine function is usually assessed by the Bath Ankylosing Spondylitis Metrology Index (BASMI), which is based on a limited set of defined motions that are measured semiquantitatively in the spatial dimension but not in the temporal dimension. Sensor-based measurement of spine function in axSpA patients is in its infancy but may provide a deeper and more detailed understanding of the impact of axSpA on the impairment of spine function [2,3]. In theory, unbiased full body assessment of spine motion may open a new dimension in function analysis in axSpA.

Objectives

To test if a of a full-body based haptic capturing of spine motion is technically feasible and can pick up the measurements of BASMI items 1-5. Furthermore, we aimed to investigate whether such measurements are accurate and reproducible comparing to BASMI scores done by rheumatologists. Lastly, we sought to measure velocity of spine movements to allow spatiotemporal analysis of motion.

Methods

For full-body haptic assessment of spine motion a full-body haptic suit (Teslasuit; VR Electronics Ltd, London) was used that consists of a smart textile two-piece bodysuit that not only captures range and speed of motion but also provides biometric and haptic feedback. This device is currently tested in clinical trials (https://teslasuit.io/rehabilitation/) but has not been tested in rheumatic diseases such as axSpA [4]. Since there is no pre-defined technical solution for measuring BASMI, we used the integrated inertial measurement units (IMUs) of the suit (Figure 1a). The suit is recording the position and rotations of its IMUs and is transforming the raw data to position coordinates and joint angle of the bones. We implemented an algorithm that is accessing the sensor data and is calculating the BASMI measurements as well as velocity. Assessment were done in healthy individuals. BASMI was obtained 3 times by teslasuit followed by standard BASMI measurement by 2 independent rheumatologists. In addition, rotational movements with their maximum torso speed to evaluate angular velocity were performed (Figure 1b). Measurements were compared using absolute values and relative standard deviation (which is the standard deviation normalized by the mean).

Results

Five healthy individuals (all males, age: 27.6 ± 1.8 years, height: 178 ± 5 cm; weight 70.0 ± 8.0 kg) were assessed. Teslasuit measurements were well tolerated. Technically, we were able to calculate BASMI item 3 and 5, finger-to-floor distance and the velocity of the spine movement using the position data of hand, talus and upper back sensors (Figure 1a, b). Due to absence of sensors at the head and the required back areas, BASMI 1, 2, 4 could only partially be captured and require further programming, which is currently performed. Only marginal differences were detected regarding the relative standard deviations of measurements between teslasuit and rheumatologists (BASMI 3: rheumatologists 8,5%: suit 10%; BASMI 5: rheumatologists 5,4%: suit 4,9%) (Figure 1c). The speed of spinal motion could be measured with an average angular velocity of 172.2 degrees/sec over the entire rotation motion and an average maximum angular velocity of 417.2 degrees/sec.

Conclusion

This study shows that full-body haptic-suits can capture spinal motion including parts of the BASMI score. In addition, they allow to measure the speed of spinal movement, which might be an important and so far unrecognized factor to test the impact of axSpA on spinal function. Based on these results, full-body haptic-suits will be tested in axSpA patients in the future. Furthermore, technical solutions are currently developed to implement the remaining BASMI scores into the suit as well as connections from the suit to virtual reality devices for patients and doctors.

References

[1]Sieper, J. and D. Poddubnyy, Axial spondyloarthritis. Lancet 2017.

[2]Gardiner, P.V., et al., Rheumatology (Oxford) 2020.

[3]Kiefer, D., et al., S J Rheumatol 2022.

[4]Caserman, P. et al Sensors (Basel) 2021.

Acknowledgements

This work was (partly) funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) – SFB 1483 – Project-ID 442419336, EmpkinS.

Disclosure of Interests

None declared

Internal dosimetry studies of 177Lu-BBN-GABA-DOTA, as a cancer therapy agent, in human tissues based on animal data

The goal of using radiopharmaceuticals for therapeutic purposes is twofold: first, the most damage to cancer cells and, second, the most negligible dose transfers to healthy tissues. As ¹⁷⁷Lu has the potential to cure a wide range of malignancies due to its varied range of beta energies, ¹⁷⁷Lu-BBN-GABA-DOTA has been developed for therapeutic applications. In addition, ¹⁷⁷Lu-BBN-GABA-DOTA can be over-expressed on gastrin-releasing peptide (GRP) receptors of the prostate, breast, small cell lung cancer, gastric, and colon tumors. The purpose of this study was to calculate the amount of dose absorption in human body organs using medical internal radiation dose (MIRD) and GATE code methods, after animal injection. In this study, the amount of absorbed dose in different organs (spleen, kidney, Lung, Pancreas, Heart, Adrenal, Intestine, Stomach, and Liver) were calculated for 1-MBq accumulation of ¹⁷⁷Lu-BBN-GABA-DOTA in source organs (spleen, kidney, Lung, Pancreas, Heart, Adrenal, Intestine, Stomach, and Liver) using Monte Carlo Simulation (GATE code) with Zubal phantom. Moreover, compared with MIRD method, the results of the simulation showed considerable consistency. It was estimated that a 1-MBq administration of ¹⁷⁷Lu-BBN-GABA-DOTA to the human body would result in an absorbed dose of 1.07E-02 mGy and 4.97E-02 (MIRD method) and 1.26E-02 mGy and 5.19E-02 (Gate code) in the Pancreas and adrenal 120 h after injection, respectively. The highest and lowest percentage differences between MIRD and Gate results are related to the Pancreas and spleen, respectively. Finally, the results showed that there is a good agreement between MIRD method and Gate code simulation for absorbed dose estimation.

Prevalence of ESBL and AmpC genes in E. coli isolates from urinary tract infections in the north of Iran

Beta-lactam resistance in Gram-negative bacteria, especially Escherichia coli, is a main clinical problem. It is often caused by the production of β-lactamases, particularly extended-spectrum β-lactamases (ESBLs) or AmpC enzymes. This study was undertaken to characterize ESBL and AmpC producers among Escherichia coli isolates from urine samples. During six months, 263 E. coli isolates were detected by standard biochemical tests. The isolates were screened for ESBL production by the double-disk synergy test using Ceftazidime (30 μg) and Cefotaxime (30 μg) disks and confirmed by combined disk diffusion test using Clavulanic acid. AmpC production was confirmed by an AmpC disk test based on filter paper disks impregnated with EDTA. The presence of genes encoding TEM, SHV, CTX-M, CIT, FOX, MOX, ACC, and EBC were detected by PCR. 263 E. coli isolates were selected for the combined disk (Ceftazidime, Cefotaxime, and Clavulanic acid) assay in the disk agar diffusion test. In the combined disk assay, among 263 isolates, 121 (46%) isolates were detected as ESBLs, and none of the isolates were AmpC producers. PCR performed on all ESBL producers and blaSHV, blaTEM, and blaCTX-M were detected in 42 (34.7%), 44 (36.4%), and 47 (38.8%) cases, respectively. Also, from 48 Isolates with zone diameters of less than or equal to 18 mm to Cefoxitin, 7 (14.6%), 4 (8.3%), and 9 (18.8%) cases contained MOX, EBC, and CIT genes, respectively. DHA, FOX, and ACC genes were not detected in any sample. Since pathogens evolve in the hospital setting, updating local data, such as this research, offers scientific evidence to improve the outcome of nosocomial infections.

Community-based cardiovascular disease prevention programmes and cardiovascular risk factors: a systematic review and meta-analysis

OBJECTIVES

This study aimed to summarise the effect of community-based intervention programmes on the prevention of cardiovascular disease (CVD) by reducing cardiometabolic risk factors.

STUDY DESIGN

This was a systematic review and meta-analysis.

METHODS

A systematic search in the PubMed database and screening of reference lists aimed to identify community-based CVD prevention programmes from inception up to April 2020. The mean differences and standard deviations for CVD risk factors, including blood pressure, lipid profile, blood glucose and body weight indices, were extracted and pooled using a random effects model.

RESULTS

Screening of 11,889 titles/abstracts and full texts resulted in 48 studies being included in this review. The meta-analysis showed that community-based programmes have led to considerable decreases in systolic blood pressure (weighted mean difference [WMD] = -2.90 mm Hg, 95% confidence interval [95% CI]: -3.63, -2.16), diastolic blood pressure (WMD = -2.21 mm Hg, 95% CI: -3.12, -1.29), serum levels of low-density lipoprotein cholesterol (LDL-C; WMD = -8.88 mg/dl, 95% CI: -12.84, -4.92), triglycerides (WMD = -8.40 mg/dl, 95% CI: -12.10, -4.70), total cholesterol (WMD = -2.96 mg/dl, 95% CI: -3.10, -2.81) and fasting blood glucose (WMD = -2.06 mg/dl, 95% CI: -3.02, -1.10). A moderate decrease in body weight was also found with community-based CVD prevention programmes. However, community-based CVD prevention programmes were not associated with any significant changes in serum levels of high-density lipoprotein.

CONCLUSIONS

The present study indicates that community-based strategies have successfully led to an improvement in CVD risk factors, particularly by reducing blood pressure, serum levels of LDL-C and triglycerides, obesity indices and blood glucose. The impact of these programmes on CVD is modified by the type of intervention and by different cultural and physical environments.

Effect of lateral crural cut overlay and medial crural cut and overlay in creating and maintaining tip projection and rotation: a randomised single-blind trial

Lateral crural cut and overlay (LCC) or medial crural cut and overlay (MCC) are two of the many techniques applied to ensure an adequate nasal tip projection and rotation, but little evidence supports their long-term efficacy. Fifty-four rhinoplasty candidates were studied prospectively in this randomised clinical trial. The subjects were randomly divided into two groups according to the use of LCC or MCC. The outcome measures were gaining and maintaining tip projection and rotation in the long term. Standardised photographs taken before and at three and 12 months after surgery were used to compare nasolabial angle and projection between groups. Patients' satisfaction with the cosmetic results and nasal obstruction were evaluated using the Standardised Cosmesis and Health Nasal Outcomes Survey (SCHNOS). LCC and MCC were each used in 26 cases. Preoperatively, the nasolabial angle, tip projection, and other characteristics were not significantly different between the groups. There was no significant difference in tip rotation stability (p = 0.624) and projection (p = 0.329) between the groups postoperatively, but patients' satisfaction with the cosmetic results was significantly higher in the MCC group (p = 0.046). It seems that both LCC and MCC are effective techniques in rhinoplasty. Compared with LCC, the use of MCC in qualified hands may increase the patients' satisfaction with the cosmetic results.

Effect of Isoflurane versus Propofol on the Early Outcome of Living Donor Adult Kidney Transplantation

Background

Optimizing anesthetic management for the best possible outcome is essential in kidney transplantation (KT).

Objective

To evaluate the difference in grafted kidney function and early kidney transplant outcome when the pairs of donor-recipient were anesthetized with isoflurane compared to propofol.

Methods

Thirty-eight pairs of kidney transplant donor-recipient were anesthetized with isoflurane, and 22 pairs were anesthetized with propofol. Blood urea nitrogen (BUN), serum creatinine (SCr), estimated glomerular filtration rate (eGFR) were assessed in the preoperative period, on the first postoperative day, before discharge from the hospital, and 6 months after KT. Short-term (6 months) outcomes of KT were assessed by the incidence of delayed graft function, acute rejection episodes, and graft failure.

Results

There was no statistically significant difference between the two groups in the serial measurements of SCr, BUN, eGFR, and the early outcomes (6 months) after surgery. Interestingly, donor warm ischemic time in the propofol group was significantly longer than in the isoflurane group (4.05±1.02, 2.93±0.87 minutes, respectively) (p=0.001). Moreover, postoperative hospital stay in the propofol group were significantly shorter compared to the isoflurane group (9.63±2.96, 11.78±4.91 days, respectively) (p=0.02).

Conclusion

There were no significant differences in transplanted kidney function and the early outcome of kidney transplantation between the two study groups. However, earlier hospital discharge after surgery in the propofol group suggests that propofol may be a more appropriate anesthetic choice in these patients.

Feedback-based Self-improving CNN Algorithm for Breast Cancer Lymph Node Metastasis Detection in Real Clinical Environment

Digital pathology can be thought of as a model composed of 3 main elements; classification algorithm, Graphical User Interface (GUI) and the pathologists. Currently there is only a one way interaction from the classification algorithm to the pathologist. This paper, proposes an additional backward path which is a new feedback-based method, aimed to improve the performance of the classification algorithms by utilizing the feedback of the pathologists. The GUI developed for this purpose, is aimed to be simple and adaptive to different classification algorithms. The method showed significant improvement in the classification performance of the applied Convolutional Neural Network (CNN) algorithm. The 25% quantile of the probability score of the predictions increased from 0.48 to 0.89 and the median of the data increased from 0.95 to 0.99.

The effect of dietary coenzyme Q10 on plasma metabolites and hepatic gene expression in broiler breeder hens

1. This study was performed to evaluate the effects of dietary supplementation of coenzyme Q10 (CoQ10) on laying rate, body weight, plasma metabolites and some liver gene expression in broiler breeder hens. 2. A total of 128 broiler breeder hens (Arbor Acres Plus, 47 weeks of age) were randomly distributed to four dietary groups supplemented with different levels of CoQ10 (0, 300, 600 or 900 mg/kg diet) with four replicates of eight hens each. During 47-54 weeks of age, laying rate, egg mass and body weight were recorded weekly. To assay plasma biochemical indicators, blood samples were collected at 54 weeks of age. At the end of the experiment, for evaluating the abdominal fat weight, liver weight and expression of the adiponectin and proliferator-activated receptor-α (PPAR-α) genes in the liver, eight hens per treatment were selected, weighed and humanely killed by decapitation. 3. Dietary supplementation of CoQ10 linearly decreased abdominal fat weight, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities by increased levels of CoQ10. The plasma levels of glucose, cholesterol and alkaline phosphatase (ALP) activity were quadratically decreased by increased levels of CoQ10. The best plasma levels of glucose, cholesterol and ALP activity were estimated at 562.5, 633.3 and 517.8 mg CoQ10/kg diet, respectively. Adiponectin and PPARα gene expression exhibited a linear increased by increased levels of CoQ10. 4. In conclusion, addition of CoQ10 to the diet influenced lipid metabolism and expression of the adiponectin and PPAR-α genes, which might be partially due to the improvement in mitochondrial metabolism and energy production. However, further studies are necessary to determine the effects of CoQ10 on these indicators in broiler breeder hens during ageing.

Grain source and chromium supplementation: Effects on health, metabolic status, and glucose-insulin kinetics in Holstein heifer calves

Carbohydrate-rich diets may increase urinary excretion of chromium (Cr) and the need to supplement the diet with Cr to meet animal requirements. The present study was performed to examine the effect of the type of grain (corn vs. barley) and Cr-methionine supplementation on health-related variables, blood levels of metabolites and hormones related to energy metabolism, and insulin sensitivity in Holstein calves. Forty-eight newborn heifers (3 d of age) were assigned randomly to 4 diets in a 2 × 2 factorial arrangement. Experimental diets were either corn-based (CBD) or barley-based (BBD) diets supplemented with 0 or 0.05 mg/kg of metabolic body weight. Chromium was provided in milk before weaning (d 3-73 of age) and in prewarmed water after weaning (d 74-94 of age). There was no interaction between the type of grain and Cr on the health-related variables and blood metabolites and hormones. Type of grain did not affect fecal score, respiration rate, and rectal temperature; however, there were tendencies for higher diarrhea occurrence (odds ratio = 1.69) and lower chance of having pneumonia (odds ratio = 0.49) in calves fed BBD versus CBD despite longer duration of diarrhea (0.54 d) and shorter days with pneumonia (0.63 d) in calves fed BBD. Calves supplemented with Cr had lower fecal score during the preweaning and overall periods and respiration rate throughout the study. Supplemental Cr decreased the duration (0.63 d) and chance of having pneumonia (odds ratio = 2.01). Calves fed BBD had lower blood levels of urea N during the postweaning period, with no changes in other blood variables between CBD and BBD. Tendencies were detected for lower blood levels of β-hydroxybutyric acid during the preweaning and overall periods and higher cortisol in Cr-supplemented calves. Chromium supplementation increased insulin clearance rate and decreased the time to half-maximal concentration and the area under the curve in BBD but not CBD calves. The calves were generally healthy, and the type of grain did not affect the health and blood variables related to energy metabolism. However, Cr supplementation increased fecal consistency, decreased respiration rate and days with pneumonia, and increased insulin sensitivity when added to BBD.

The ESC ACCA EAPCI EORP acute coronary syndrome ST-elevation myocardial infarction registry

Aims 

The Acute Cardiac Care Association (ACCA)–European Association of Percutaneous Coronary Intervention (EAPCI) Registry on ST-elevation myocardial infarction (STEMI) of the EurObservational programme (EORP) of the European Society of Cardiology (ESC) registry aimed to determine the current state of the use of reperfusion therapy in ESC member and ESC affiliated countries and the adherence to ESC STEMI guidelines in patients with STEMI.

Methods and results 

Between 1 January 2015 and 31 March 2018, a total of 11 462 patients admitted with an initial diagnosis of STEMI according to the 2012 ESC STEMI guidelines were enrolled. Individual patient data were collected across 196 centres and 29 countries. Among the centres, there were 136 percutaneous coronary intervention centres and 91 with cardiac surgery on-site. The majority of centres (129/196) were part of a STEMI network. The main objective of this study was to describe the demographic, clinical, and angiographic characteristics of patients with STEMI. Other objectives include to assess management patterns and in particular the current use of reperfusion therapies and to evaluate how recommendations of most recent STEMI European guidelines regarding reperfusion therapies and adjunctive pharmacological and non-pharmacological treatments are adopted in clinical practice and how their application can impact on patients’ outcomes. Patients will be followed for 1 year after admission.

Conclusion 

The ESC ACCA-EAPCI EORP ACS STEMI registry is an international registry of care and outcomes of patients hospitalized with STEMI. It will provide insights into the contemporary patient profile, management patterns, and 1-year outcome of patients with STEMI.

Prevalence of intestinal parasites in food handlers of the city of Saqqez in 2016

This study was aimed at determining the prevalence of parasitic infections among the food handlers of Saqqez County in 2016. Stool samples collected from 1530 food handlers. All samples were examined by both direct technique and sedimentation technique using formalin-ethyl acetate for detecting the intestinal parasites. Of total participants, 1462 (95.6%) were male and 62 (4.4%) female. Intestinal parasitic infections were found in 92 (6.01%) individuals. The highest infection rate was due to Giardia lamblia (4.1%) and the lowest associated with Endolimax nana, Iodamoeba butschlii, and Hymenolepis nana (0.1%). No significant correlation between the intestinal parasitic infections and age, gender, education level, gastrointestinal signs and symptoms, and the type of profession, was established. The results of the present study revealed that only a small number of food handlers in Saqqez County were infected with intestinal parasites with G. lamblia as the most common cause of infection. More strict health control for those working in food industries is of vital importance and continuous education to improve the level of general health in these people is undoubtedly considered as a key determinant towards lower number of parasitic infections.

The use of aortic balloon occlusion in traumatic shock: first report from the ABO trauma registry

PURPOSE

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique for temporary stabilization of patients with non-compressible torso hemorrhage. This technique has been increasingly used worldwide during the past decade. Despite the good outcomes of translational studies, clinical studies are divided. The aim of this multicenter-international study was to capture REBOA-specific data and outcomes.

METHODS

REBOA practicing centers were invited to join this online register, which was established in September 2014. REBOA cases were reported, both retrospective and prospective. Demographics, injury patterns, hemodynamic variables, REBOA-specific data, complications and 30-days mortality were reported.

RESULTS

Ninety-six cases from 6 different countries were reported between 2011 and 2016. Mean age was 52 ± 22 years and 88% of the cases were blunt trauma with a median injury severity score (ISS) of 41 (IQR 29-50). In the majority of the cases, Zone I REBOA was used. Median systolic blood pressure before balloon inflation was 60 mmHg (IQR 40-80), which increased to 100 mmHg (IQR 80-128) after inflation. Continuous occlusion was applied in 52% of the patients, and 48% received non-continuous occlusion. Occlusion time longer than 60 min was reported as 38 and 14% in the non-continuous and continuous groups, respectively. Complications, such as extremity compartment syndrome (n = 3), were only noted in the continuous occlusion group. The 30-day mortality for non-continuous REBOA was 48%, and 64% for continuous occlusion.

CONCLUSIONS

This observational multicenter study presents results regarding continuous and non-continuous REBOA with favorable outcomes. However, further prospective studies are needed to be able to draw conclusions on morbidity and mortality.

Prevalence of UTI among Iranian infants with prolonged jaundice, and its main causes: A systematic review and meta-analysis study

INTRODUCTION

An extremely variable and high prevalence of urinary tract infection (UTI) in infants with prolonged jaundice has been reported in Iran. However, there is no research from the area that has attempted to estimate pooled prevalence of UTI from considerably diverse evidence. Therefore, this systematic review and meta-analysis study aimed to estimate the prevalence of UTI in infants with prolonged jaundice who were admitted into clinics or hospitals in Iran.

METHODS

A systematic review and meta-analysis was conducted of published articles on UTI prevalence in infants with prolonged jaundice in Iran. Electronic databases were searched, including Web of Sciences, PubMed/Medline, Scopus, Iranian Scientific Information Database (SID) and Iranmedex, for both English and Persian language articles published between January, 2000 and March, 2017. All possible combinations of the following keywords were used: jaundice, icterus, hyperbilirubinemia during infancy, infection and neonatal. Nine studies that reported prevalence of UTI in infants with prolonged jaundice were included. The overall prevalence of UTI was estimated using random-effects meta-analysis models.

RESULTS

A total of 1750 infants were pooled to estimate the overall prevalence of UTI in infants with prolonged jaundice. The prevalence reported by the studies included in this literature review was extremely variable and ranged 0.6-53.9%. The overall prevalence was 11% (95% Confidence Interval (CI): 5.0-18.0), and Escherichia coli was found to be the main cause of UTI.

CONCLUSION

The overall prevalence of UTI was 11%, and E. coli was the main cause of UTI in infants with prolonged jaundice. Screening of UTI should be considered for infants with prolonged jaundice.

Longitudinal association of metabolic syndrome and dietary patterns: A 13-year prospective population-based cohort study

BACKGROUND AND AIMS

Diet is a potential factor contributing to the development of the Metabolic Syndrome (MetS). This longitudinal study with repeated measurements of dietary intake was thus conducted to examine the longitudinal association between major dietary patterns and risk of MetS.

METHODS AND RESULTS

The study was conducted within the framework of the Isfahan Cohort Study (ICS), in which 1387 participants were followed from 2001 to 2013. Validated food frequency questionnaire, anthropometric measurements, blood pressure, fasting serum lipids and blood sugars were evaluated in three phases of the study. Mixed effect Logistic and Cumulative Logit regressions were applied to evaluate the longitudinal associations between dietary patterns change and MetS and number of MetS components. Three dietary patterns were identified: Healthy, Iranian and Western dietary patterns. After adjustment for potential confounders, the higher scores of Healthy diet were inversely associated with the risk of MetS and number of MetS components (OR: 0.50, 95% CI: 0.36-0.70, OR: 0.52, 95% CI: 0.39-0.70, respectively). The greater adherence to the Iranian diet was positively associated with the risk of MetS and number of MetS components (OR: 1.28, 95% CI: 1.01-1.65, OR: 1.45, 95% CI: 1.16-1.81, respectively). The Western dietary pattern did not show any significant associations.

CONCLUSION

Adherence to a Healthy diet was associated with lower risk of MetS even in a developing country setting. However, the Iranian diet was positively associated with the risk of MetS. These results may guide the development of improved preventive nutrition interventions in this adult population.

Overview and evaluation of different nuclear level density models for the 123I radionuclide production

The ¹²³I radionuclide (T_1/2 = 13.22 h, β+ = 100%) is one of the most potent gamma emitters for nuclear medicine. In this study, the cyclotron production of this radionuclide via different nuclear reactions namely, the ¹²¹Sb(α,2n), ¹²²Te(d,n), ¹²³Te(p,n), ¹²⁴Te(p,2n), ¹²⁴Xe(p,2n), ¹²⁷I(p,5n) and ¹²⁷I(d,6n) were investigated. The effect of the various phenomenological nuclear level density models such as Fermi gas model (FGM), Back-shifted Fermi gas model (BSFGM), Generalized superfluid model (GSM) and Enhanced generalized superfluid model (EGSM) moreover, the three microscopic level density models were evaluated for predicting of cross sections and production yield predictions. The SRIM code was used to obtain the target thickness. The ¹²³I excitation function of reactions were calculated by using of the TALYS-1.8, EMPIRE-3.2 nuclear codes and with data which taken from TENDL-2015 database, and finally the theoretical calculations were compared with reported experimental measurements in which taken from EXFOR database.

Investigation of the thermal performance of natTe target for 124I production in the RARS cyclotron

Regarding the low thermal conductivity of natTe element, the provision of an effective cooling system is one of the critical issues in cyclotron targetry to prevent melting of target matter during the irradiation to 124I production via natTe(p,xn)124I reaction. Heat transfer on Te target and efficiency of cooling fluid in the solid target system have been simulated based on a Finite Element Analysis (FEA) code for the thermal behavior of the target during the irradiation and under different beam currents, coolant flow rates, substrate matters and target geometry. The results on the routinely used solid target in Radiation Application Research School (RARS) cyclotron showed that in a 3 m/s coolant flow rate, by using a fined-cooling system and a nickel substrate coated on copper backing plate, the irradiation beam current can be raised up to 180 μA without any risk of melting. The cooling flow rates greater than 3 m/s do not noticeably improve the heat dispersion of target layer. As expected, a linear increase was observed for the temperature and temperature gradient of plates in the beam currents of 100–300 μA.

Association of pre- and early post-transplant serum amino acids and metabolites of amino acids and liver transplant outcome

The aim of the present study was to investigate association of serum amino (AA) acids and metabolites of AAs with post-transplant outcome in liver transplant recipients. Eighty-nine patients with end-stage liver diseases and available pre- and early post-transplant serum were characterised as patients with (GI) and without one-year mortality (GII) and patients with and without early graft dysfunction (EAD). A panel of pre- and early post-transplant serum levels of AAs and early and metabolites of tryptophan were measured using tandem mass spectrometry. Patient groups had significantly higher pre-transplant serum levels of phenylalanine, tryptophan, and tryptophan metabolites than healthy controls (for all p<0.001). Pre-transplant serum levels of all these parameters were significantly higher in GI than in GII (for all p<0.001). GI had a higher MELD score and re-transplantation number than GII (p≤0.005 for both investigations). Serum bilirubin on day 5 and serum phenylalanine on day 10 post-transplant were associated parameters of mortality, whereas day 1post-transplant phenylalanine and kynurenine and female gender were associated parameters of EAD. Our results indicate that pre- and early post-transplant levels of phenylalanine, tryptophan and metabolites of tryptophan are increased in patients and are associated with EAD and one-year mortality in liver transplant recipients.

A novel method of combined detector model for gamma-ray densitometer: Theoretical calculation and MCNP4C simulation

This study focuses on investigating a new model of combined backscatter and transmission method for nuclear densitometer. In this method for density measurement, a true combination of transmission and backscatter methods was studied and related equations were developed. The MCNP4C code was used for simulation of this combined detector model (CDM) and by applying theoretical calculations, density equation was corrected for the proposed nuclear densitometer. In the new method presented here, the buildup effect was estimated by an online system that was improved in our laboratory and was replaced by a new conceptual calculation. Hence, for the purpose of buildup reduction, there was no need for the shield around the detector, as it was monitored and reduced online. Furthermore, this study showed that the RSQ function could be improved by the CDM. The measurement technique proposed in this study has a better linearity trend than the transmission technique. Thus, the ability of CDM to improve the accuracy of the nuclear densitometer was shown.

Cardiovascular Risk Factors in Iranian Adults according to Educational Levels: Isfahan Healthy Heart Program

There is abundant evidence that the socioeconomic status (SES) is inversely associated with CVD risk factors. The objective of this study is to describe the distribution of CVD risk factors according to educational level in Iranian adults. A cross-sectional survey was performed on subjects over the age of 19 in three cities. Demographic data, as well as information on educational level and smoking habits was obtained and then height, weight and blood pressure measurement and blood sampling were arranged. Data was analyzed by the Mantel-Haenszel, Kendalls T correlation and multivariate analysis test. Of 9587 subjects, 48% were men and 52% were women, with mean ages of 39.0±15.3 and 38.8±14.5 years, respectively. All CVD risk factors showed an inverse relationship with educational level in all subjects, except for smoking and low HDL-C in women. High TC and LDL-C and low HDL-C were inversely related to educational level (P<0.05); however, this relationship was not significant with Mantel-Haenszel test in men. The association between CVD risk factors and educational level in women was stronger than in men. The differences found between CVD risk factors with educational level are important and should be considered in programs designed to increase level of education in order to lower CVD risk factors. Asia Pac J Public Health 2005: 17(1): 9-14.

Investigation of LiF, Mg and Ti (TLD-100) Reproducibility

LiF, Mg and Ti cubical TLD chips (known as TLD-100) are widely used for dosimetry purposes. The repeatability of TL dosimetry is investigated by exposing them to doses of (81, 162 and 40.5 mGy) with 662keV photons of Cs-137. A group of 40 cubical TLD chips was randomly selected from a batch and the values of Element Correction Coefficient (ECC) were obtained 4 times by irradiating them to doses of 81 mGy (two times), 162mGy and 40.5mGy. Results of this study indicate that the average reproducibility of ECC calculation for 40 TLDs is 1.5%, while these values for all chips do not exceed 5%.

Static standing, dynamic standing and spasticity in individuals with spinal cord injury

STUDY DESIGN

This was a cross-over efficacy study design.

OBJECTIVE

To determine spasticity differences between static and dynamic standing training in individuals with spinal cord injury (SCI).

SETTING

Vancouver, Canada.

METHODS

Ten individuals with SCI who could stand with or without bracing or supports participated in both dynamic and static standing training (one session each, 2 days apart) using a Segway. The primary outcome was spasticity as measured by Visual Analog Scale (VAS), Modified Ashworth Scale (MAS) and electromyography (EMG) of the quadriceps, hamstrings, adductors and gastrocnemius.

RESULTS

There was no statistically detectable difference in spasticity between dynamic and static standing training in individuals with SCI as measured by VAS, MAS or EMG, although there was a trend towards decreased spasticity after the dynamic training.

CONCLUSION

There is no significant difference in spasticity outcomes between static and dynamic standing training on a Segway for individuals with SCI.

SPONSORSHIP

This research was funded by Natural Sciences and Engineering Research Council of Canada and International Collaboration on Repair Discoveries.

Numerical modeling of drug delivery in a dynamic solid tumor microvasculature

The complicated capillary network induced by angiogenesis is one of the main reasons of unsuccessful cancer therapy. A multi-scale mathematical method which simulates drug transport to a solid tumor is used in this study to investigate how capillary network structure affects drug delivery. The mathematical method involves processes such as blood flow through vessels, solute and fluid diffusion, convective transport in extracellular matrix, and extravasation from blood vessels. The effect of heterogeneous dynamic network on interstitial fluid flow and drug delivery is investigated by this multi-scale method. The sprouting angiogenesis model is used for generating capillary network and then fluid flow governing equations are implemented to calculate blood flow through the tumor-induced capillary network and fluid flow in normal and tumor tissues. Finally, convection-diffusion equation is used to simulate drug delivery. Three approaches are used to simulate drug transport based on the developed mathematical method: without a vascular network, using a static vascular network, and a dynamic vascular network. The avascular approach predicts more uniform and higher drug concentration than vascular approaches since the simplified assumptions are implemented in this method. The dynamic network which uses more realistic assumptions predicts more irregular blood vessels, high interstitial pressure, and more heterogeneity in drug distribution than other two approaches.

Awareness of Religious Leaders' Fatwa and Willingness to Donate Organ

BACKGROUND

It is believed that religious leaders' positive attitude towards organ donation can be an effective factor in Muslims' inclination to donate organs.

OBJECTIVE

To assess the knowledge of freshmen students in Mashhad University of Medical Sciences about religious leaders' fatwa on organ donation and its effect on their willingness to donate organs.

METHODS

This cross-sectional study was conducted in 2013 on 400 freshmen of various medical disciplines, selected using a simple random sampling in Mashhad, Iran. Data were collected by a valid and reliable researcher-made questionnaire. Data were analyzed by multiple logistic regression analysis.

RESULTS

41.5% of the students were aware of religious authorities' views on organ donation and 55.6% were willing to donate organs. Participants' main reasons for lack of willingness to donate organs included the fear of organ donation before the brain death is confirmed (52%), unwillingness to disfigure their body (51%), and belief in the burial of organs (50%). The willingness to organ donation for students who were aware of religious leaders opinion was more than twice more than those who were not (OR: 2.56, 95% CI: 1.75-4.52). Also, female gender, the Shia religion and awareness of the correct definition of brain death were associated factors affecting the desire to donate organs, although their effects were not statistically significant on regression model.

CONCLUSION

A considerable proportion of students were not aware of the religious leaders' fatwa on organ donation. The most important factor for the desire to donate organs was the awareness of religious leaders' fatwa. Therefore, it seems necessary that religious leaders' fatwa be known to all by appropriate methods.