Comparison home care service versus hospital-based care in patients with diabetic foot ulcer: an economic evaluation study

Introduction: Providing health care to patients at home could be causing the mortality and readmission rates reduction in addition to satisfaction of both patients and health care providers increase. The aim of this study was to assess the cost-effectiveness of home care service compared to hospital based care in patients with diabetic foot ulcer. Methods: An economic evaluation study and a trial study were simultaneously conducted in Iran. In trial phase, patients with diabetic foot ulcer were randomly assigned to the home care or hospital care. The Cost and Quality of life data were determined as measures of the study. Incremental cost-effectiveness ratio was calculated for comparative purposes. The model consisted of five stages of the disease. The Tree Age Pro 2009 and R software�s were used for data analysis. Results: 120 patients were enrolled in our trial; among which 30 patients were in home care service group and 90 patients in hospital based care group. The rate of ulcer size reduction in hospital based care was significant (P value = 0.003) in comparison with home care service. The total cost of the home care and hospital strategies were 1720.4 US, 3940.3 US and the total effectiveness were 0.31 and 0.29, respectively. The incremental cost-effectiveness ratio (ICER) was 117,300 US per quality-adjusted life year for home care intervention compared to hospital based care. Based on ICER plane home care treatment will be placed on the southeastern quadrant of the Cost-Effectiveness Plane, and is suggested as a more dominant treatment alternative. Conclusions: Regarding current evidence, home care strategy for patients suffering diabetic foot ulcer enjoys more cost effectiveness compared to hospital care. It is suggested that healthcare policy makers determine the tariff for health care services for disease groups according to the activity based costing approach. © 2020, Springer Nature Switzerland AG

Egg yolk cholesterol, egg quality, and performance in response to copper–methionine chelates and alfalfa powder supplementation in Nick chick laying hen diets

This experiment was designed to investigate the effects of different levels of copper–methionine chelates and alfalfa powder on egg yolk cholesterol content, egg quality, and performance in laying hens. In this experiment, a total of 100 laying hens (Nick Chick strain, from 109 to 117 weeks of age) were arranged into five experimental treatments, consisting of 2 different dietary alfalfa powder and 2 different copper chelate levels in a (2x2) factorial completely randomized design (CRD). The treat-ments groups included: T1 Control (Corn and soybean meal), treatments T2 (3% alfalfa powder+50 mg/kg copper-methionine chelate), T3 (3% alfalfa powder+100 mg/kg copper-methionine chelate), T4 (6% alfalfa powder+50 mg/kg copper-methionine chelate) and T5 (6% alfalfa powder+100 mg/kg cop-per-methionine chelate). The results of this study have shown that, different levels of alfalfa powder and copper-methionine chelate in laying hens diet except feed conversion ratio and shell-less eggs, oth-er performance parameters were not substantially affected by the level of 3% alfalfa powder through-out of experimental period (P>0.05). Moreover, different levels of alfalfa powder and copper-methionine chelate except egg yolk color had no significant effect on internal and external egg quality traits during the whole experimental period (P>0.05). As well as, the egg yolk color index was signifi-cantly increased by increasing the level of alfalfa powder in the laying hens’ diet (P<0.001). The high-est egg yolk color index was observed in treatment 5 which (containing 6% alfalfa powder+ 100 mg / kg copper-methionine chelate in per kg of diet). Meanwhile, the treatment group that received (6% al-falfa powder+100mg/kg copper- methionine chelate) the egg yolk cholesterol concentration was signif-icantly decreased compared to the control group (P<0.001). Therefore, addition of alfalfa powder and copper methionine chelate to the diet of laying hens reduced egg yolk cholesterol and increased egg yolk color

Human health risk assessment due to ambient PM10 and SO2 by an air quality modeling technique

Exposure to air pollutants may be an important environmental risk factor for human health. The main objective of this study was to assess the health impacts of exposure to particulate matter of aerodynamic diameter <= 10 mu g (PM10) and to sulfur dioxide (SO2) using the AirQ2.2.3 software developed by the WHO European Center for Environment and Health. Daily concentrations of PM10 and SO2 were used to assess the health effects. With regard to the mortality, the results showed that 3.9 (95 CI: 3.3-4.5) of total, 4.2 (95 CI: 2.7-9.05) of cardiovascular, and 6.2 (95 CI: 4.2-16.9) of respiratory mortality were related to PM10 concentrations above 10 mu g/m(3), respectively. In addition, 1.7 (95 CI: 1.3-2.06) of total, 3.4 (95 CI: 0.78-5.0) of cardiovascular, and 2 (95 CI: 2.5-5.7) of respiratory death were attributed to SO2 levels higher than 10 mu g/m(3), respectively. Given these findings, urgent policy decisions are needed to reduce the death caused by air pollution, and better quantification studies are recommended. (C) 2017 Institution of Chemical Engineers. Published by Elsevier B.V. All rights reserved

Molecular detection of anaplasma marginale and Anaplasma ovis (Rickettsiales: Anaplasmataceae) in ixodid tick species in Iran

The present study was conducted as the first molecular detection of Anaplasma species in tick samples based on the sequencing of major surface proteins 4 (msp4) gene fragments in different parts of Iran. A total of 130 tick specimens were collected from Hormozgan, Lorestan, and Guilan, Iran, within 2015 to 2017. Hyalomma asiaticum, Hyalomma dromedarii, Rhipicephalus sanguineus, and Rhipicephalus (Boophilus) species were identified in different geographical regions. An amplicon of 464-bp msp4 of Anaplasma was amplified using polymerase chain reaction in various tick species. Three sequences, including one Anaplasma marginale from R. (Boophilus) species and two Anaplasma ovis from Rhipicephalus sanguineus, were obtained after sequencing. It is concluded that bovine and ovine anaplasmosis agents are present in tick samples in Iran. The use of the gene families of six major surface proteins for the detection of various Anaplasma species is recommended. © 2020 by Razi Vaccine & Serum Research Institute

Antibiotic resistance, biofilm formation, and biofilm-associated genes among Stenotrophomonas maltophilia clinical isolates

Objective: The purpose of the present study was to investigate the antimicrobial susceptibility pattern, biofilm production, and the presence of biofilm genes among the S. maltophilia clinical isolates. A total of 85 clinical isolates of S. maltophilia were collected from patients referred to several hospitals. Susceptibility to antibiotics was investigated by disc diffusion method according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). By the crystal violet staining method, the capability of biofilm formation was examined. The genes associated with biofilm production were investigated by the PCR-sequencing techniques. Results: All isolates were resistant to doripenem, imipenem, and meropenem. Minocycline, trimethoprim/sulfamethoxazole and levofloxacin exhibited the highest susceptibility of 100, 97.65, and 95.29, respectively. The results of crystal violet staining assay showed that all isolates (100) form biofilm. Moreover, 24 (28.23), 32 (37.65), and 29 (34.12) of isolates were categorized as weak, moderate, and strong biofilm producers, respectively. Biofilm genes including rpfF, spgM and rmlA had an overall prevalence of 89.41 (76/85), 100 (85/85) and 84.71 (72/85), respectively. Rational prescribing of antibiotics and implementation of infection control protocols are necessary to prevent further infection and development of antimicrobial resistance. Combination strategies based on the appropriate antibiotics along with anti-biofilm agents can also be selected to eliminate biofilm-associated infections. © 2021, The Author(s)

Solid-state laser system for laser cooling of Sodium

We demonstrate a frequency-stabilized, all-solid laser source at 589 nm with up to 800 mW output power. The laser relies on sum-frequency generation from two laser sources at 1064 nm and 1319 nm through a PPKTP crystal in a doubly-resonant cavity. We obtain conversion efficiency as high as 2 W/W^2 after optimization of the cavity parameters. The output wavelength is tunable over 60 GHz, which is sufficient to lock on the Sodium D2 line. The robustness, beam quality, spectral narrowness and tunability of our source make it an alternative to dye lasers for atomic physics experiments with Sodium atoms

A Novel RSSI Prediction Using Imperialist Competition Algorithm (ICA), Radial Basis Function (RBF) and Firefly Algorithm (FFA) in Wireless Networks

This study aims to design a vertical handover prediction method to minimize unnecessary handovers for a mobile node (MN) during the vertical handover process. This relies on a novel method for the prediction of a received signal strength indicator (RSSI) referred to as IRBF-FFA, which is designed by utilizing the imperialist competition algorithm (ICA) to train the radial basis function (RBF), and by hybridizing with the firefly algorithm (FFA) to predict the optimal solution. The prediction accuracy of the proposed IRBF–FFA model was validated by comparing it to support vector machines (SVMs) and multilayer perceptron (MLP) models. In order to assess the model’s performance, we measured the coefficient of determination (R2), correlation coefficient (r), root mean square error (RMSE) and mean absolute percentage error (MAPE). The achieved results indicate that the IRBF–FFA model provides more precise predictions compared to different ANNs, namely, support vector machines (SVMs) and multilayer perceptron (MLP). The performance of the proposed model is analyzed through simulated and real-time RSSI measurements. The results also suggest that the IRBF–FFA model can be applied as an efficient technique for the accurate prediction of vertical handover

Microbiota derived short chain fatty acids promote histone crotonylation in the colon through histone deacetylases

The recently discovered histone post-translational modification crotonylation connects cellular metabolism to gene regulation. Its regulation and tissue-specific functions are poorly understood. We characterize histone crotonylation in intestinal epithelia and find that histone H3 crotonylation at lysine 18 is a surprisingly abundant modification in the small intestine crypt and colon, and is linked to gene regulation. We show that this modification is highly dynamic and regulated during the cell cycle. We identify class I histone deacetylases, HDAC1, HDAC2, and HDAC3, as major executors of histone decrotonylation. We show that known HDAC inhibitors, including the gut microbiota-derived butyrate, affect histone decrotonylation. Consistent with this, we find that depletion of the gut microbiota leads to a global change in histone crotonylation in the colon. Our results suggest that histone crotonylation connects chromatin to the gut microbiota, at least in part, via short-chain fatty acids and HDACs