One-Year Efficacy of Expanded Polytetrafluoroethylene Vascular Graft in Eighty-Three Hemodialysis Patients

<p class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong><span style="mso-bidi-language: FA;">Purpose:</span></strong><span style="mso-bidi-language: FA;"> To evaluate the patency and efficacy of expanded Polytetrafluoroethylene (ePTFE) vascular graft in hemodialysis patients.</span></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong><span style="mso-bidi-language: FA;">Materials and Methods:</span></strong><span style="mso-bidi-language: FA;"> In a prospective study from January 1999 to January 2001 at Sina hospital 41 patients underwent implantation of 6-mm vascular grafts and 42 underwent implantation of 8-mm grafts in order to make vascular assess for hemodialysis. They were followed up to 12 months, observing the complications. </span></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong><span style="mso-bidi-language: FA;">Results:</span></strong><span style="mso-bidi-language: FA;"> Mean patients’ age was 52.2 years. Thirty-seven of them were females and 46 were males. Over a 12 months period of follow-up, 12 cases of graft infection (14.5%), 21 cases of thrombosis (25.3%), 7 cases with both complications (8.4%), and 1 case of pseudoaneurism (1.2%) were observed. One-year patency rate was 34.9%. Diabetes was the only factor associated with lower patency rate (27% versus 57%, p<0.05).</span></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong><span style="mso-bidi-language: FA;">Conclusion:</span></strong><span style="mso-bidi-language: FA;"> ePTFE vascular graft seems to be an appropriate substitute for arteriovenous fistula as a vascular assess in hemodialysis patients. Educating patients and good care can decrease the rate of infection, thrombosis, and other complications, resulting in a better patency and lower morbidity rate.</span></span></span></p&gt

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. Methods We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. Findings Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. Interpretation As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed. Funding Bill & Melinda Gates Foundation

Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020

Background The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods For this analysis, we constructed burden-weighted dose–response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15–95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15–39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0–0) and 0·603 (0·400–1·00) standard drinks per day, and the NDE varied between 0·002 (0–0) and 1·75 (0·698–4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0–0·403) to 1·87 (0·500–3·30) standard drinks per day and an NDE that ranged between 0·193 (0–0·900) and 6·94 (3·40–8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3–65·4) were aged 15–39 years and 76·9% (73·0–81·3) were male. Interpretation There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. Funding Bill & Melinda Gates Foundation

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

The relationship between organizational culture and components of knowledge management among Iranian nurses

The knowledge management is one of the achievements of knowledge era. Today, it has attracted the attention of successful organizations. The corporate culture change is one of the most important aspects of knowledge management system. However, this study aimed to investigate the relationship between organizational culture and knowledge management among nurses in hospitals of Zahedan University of Medical Sciences. This was cross-sectional (correlation) study. Using simple random sampling method, 250 nurses were selected as sample from hospitals of Zahedan University of Medical Sciences. The data were collected using a questionnaire which consisted of three parts: Demographic data, Denison's organizational culture, and Lawson's knowledge management; its reliability was determined to be higher than 90 percent. Sing SPSS 15, the data were analyzed using descriptive (frequency, chart, mean) and analytic (Spearman correlation coefficient) statistics. The findings showed that all measures of organizational culture have similar mean scores; the organizational culture dimensions suggested stability and external focus in organization. Among the knowledge management subscales, the knowledge organization and knowledge retention had the highest (10.7) and lowest (9.8) mean, respectively. Also, there was significant and positive relationship between organizational culture and knowledge management of nurses (P < 0.001). It was concluded that the participatory culture increased the flexibility of nurses in meeting the needs of patients. However, the knowledge management would play an important role in achieving the main mission of hospital

Effects of Hexaconazole on Quantitative and Qualitative Characteristics of Two Soybean Cultivars under Water Deficit Stress Conditions

In order to investigate the effect of Hexaconazole (HEX) on quantitative and qualitative characteristics of two soybean (Glycine max L.) cultivars under water deficit stress, an experiment was conducted in the Faculty of Agriculture of Tarbiat Modares University in the year 2010-2011 as a factorial experiment in randomized complete block design arrangement. Factors examined in this study were soybean cultivars (L17 and Clark63), HEX concentration (0 and 35 mg/L) and water deficit stress levels (optimum irrigation and water deficit stress based on depletion of 60% of available soil moisture). Chlorophyll content, Fv/Fm, seed yield, yield components, biological yield, harvest index, protein and oil percentage of seeds were investigated. Results showed that water deficit stress and HEX application had significant effect on the most of traits and the cultivars showed different responses to the treatments. In both water treatments, HEX increased the yield of both cultivars but under water deficit stress increase in seed yield of L17 (35.99%) was higher than Clark63 (14.53%) in comparison with non- HEX application. Among the effective factors on seed yield, number of pods per plant had the highest share in the seed yield. Under water deficit condition, seed protein percent of Clark63 increased (6.14%) in response to HEX treatment but in L17 the content of protein was not affected by HEX. Oil percentage of seeds was not affected by any of the treatments. In both cultivars, HEX increased resistance to water deficit stress and the cultivars showed different responses to HEX treatment and under water deficit the yield response of L17 to HEX was more notable, although this combination improved the grain quality of clark63