USCID fourth international conference

Presented at the Role of irrigation and drainage in a sustainable future: USCID fourth international conference on irrigation and drainage on October 3-6, 2007 in Sacramento, California.Includes bibliographical references.Application of different irrigation management practices plays a considerable role in water saving to achieve potential yields. On the other hand, network water distribution schedule is a governing factor in this regard. In current study conducted in Mahabad plain in North West of Iran, four different irrigation managements on sugarbeet cultivation including traditional farmer's management, Furrow Deepening, Reduced Discharge per Deepened Furrow, and Alternate Furrow Irrigation have been studied in real farmers' fields measuring 10.2 hectares. Participatory management approach has been used while working in farmers' fields. Soils textures are silty clayey. Results of studies indicate that water used has been reduced considerably while higher root and sugar yields are obtained due to better on-farm water management practices. Water Use Efficiency, in kg of yield per m3 of water used, increased considerably under alternate furrow irrigation management in comparison to what obtained under traditional management. Results show application of alternate furrow irrigation in sugarbeet cultivation not only resulted in lesser water use per hectare, but also it increased both root and sugar yields and, consequently, higher water use efficiency was obtained. Assessments have been made on irrigation schedule imposed by the irrigation network and its effects on actual water requirements. Results show that the delivery schedule practiced in the network in incapable of delivering the actual amount of water requirement for the dominant crop of the scheme. Suggestions are made to the network operator to improve overall network efficiency including revisions on water resources planning and allocation and/or improve network operation system

Effect of different surface treatments on the shear bond strength of nanofilled composite repairs

Background. Repairing aged composite resin is a challenging process. Many surface treatment options have been proposed to this end. This study evaluated the effect of different surface treatments on the shear bond strength (SBS) of nano-filled composite resin repairs. Methods. Seventy-five cylindrical specimens of a Filtek Z350XT composite resin were fabricated and stored in 37°C distilled water for 24 hours. After thermocycling, the specimens were divided into 5 groups according to the following surface treatments: no treatment (group 1); air abrasion with 50-μm aluminum oxide particles (group 2); irradiation with Er:YAG laser beams (group 3); roughening with coarse-grit diamond bur + 35% phosphoric acid (group 4); and etching with 9% hydrofluoric acid for 120 s (group 5). Another group of Filtek Z350XT composite resin samples (4×6 mm) was fabricated for the measurement of cohesive strength (group 6). A silane coupling agent and an adhesive system were applied after each surface treatment. The specimens were restored with the same composite resin and thermocycled again. A shearing force was applied to the interface in a universal testing machine. Data were analyzed using one-way ANOVA and post hoc Tukey tests (P < 0.05). Results. One-way ANOVA indicated significant differences between the groups (P < 0.05). SBS of controls was significantly lower than the other groups; differences between groups 2, 3, 4, 5 and 6 were not significant. Surface treatment with diamond bur + 35% phosphoric acid resulted in the highest bond strength. Conclusion. All the surface treatments used in this study improved the shear bond strength of nanofilled composite resin used

Takotsubo Cardiomyopathy Precipitated by Tapering of Anxiolytic Medication: A Case Report

Takotsubo cardiomyopathy is a transient apical ballooning of the left ventricle typically with electrocardiographic changes and enzyme release without evidence of obstructive coronary artery disease. It typically occurs in postmenopausal women and may have a predilection for patients with anxiety disorders. The following is a case in which we believe takotsubo cardiomyopathy was induced by the tapering of antianxiety medications. We feel that health care professionals should be aware of this possibility in such a patient population especially when they have demonstrated cardiovascular symptomatology

The racial disparity among post transcatheter aortic valve replacement outcomes: A meta-analysis

Background: Racial disparities have been well described in cardiovascular disease. However, the impact of race on the outcomes post - Transcatheter aortic valve replacement (TAVR) remains unknown. Objective: We aim to evaluate the disparity among the race (black and white) post - TAVR. Methods: We systematically searched all electronic databases from inception until September 26, 2022. The primary outcome was in-hospital all-cause mortality, and secondary outcomes was myocardial infarction (MI), acute kidney injury (AKI), permanent pacemaker implantation (PPI) or ICD, stroke, vascular complications, and major bleeding. Results: A total of three studies with 1,02,009 patients were included in the final analysis. The mean age of patients with white and black patients was 82.65 and 80.45 years, respectively. The likelihood of in-hospital all-cause mortality (OR, 1.01(95 %CI: 0.86–1.19), P = 0.93), stroke (OR, 0.83(95 %CI:0.61–1.13), P = 0.23, I2 = 46.57 %], major bleeding [OR, 1.05(95 %CI:0.92–1.20), P = 0.46), and vascular complications [OR, 0.92(95 %CI:0.81–1.06), P = 0.26), was comparable between white and black patients. However, patients with white race have lower odds of MI (OR, 0.65(95 %CI:0.50–0.84), P < 0.001), and AKI (OR, 0.84(95 %CI:0.74–0.95), P = 0.01) and higher odds of PPI or ICD (OR, 1.16(95 %CI: 1.06–1.27), P < 0.001, I2 = 0 %) compared with black race patients. Conclusion: Our findings suggest disparity post - TAVR outcomes existed, and black patients are at higher risk of MI and AKI than white patients.Key Clinical Message: • What is already known on this topic: Disparity has been witnessed among patients with cardiovascular disease. However, no studies have drawn a significant association among post-TAVR patients' outcomes • What this study adds: Among patients who underwent TAVR, there is a difference in the adverse outcomes between black and white race patients. White patients have a lower risk of post-procedure MI and AKI compared with Black patients. • How this study might affect research, practice, or policy: These disparities need to be addressed, and proper guidelines need to be made along with engaging patients with better medical infrastructure and treatment options.

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

BackgroundEstimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period.Methods22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution.FindingsGlobal all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations.InterpretationGlobal adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic