Customized clinical practice guidelines for management of adult cataract in Iran

Purpose: To customize clinical practice guidelines (CPGs) for cataract management in the Iranian population. Methods: First, four CPGs (American Academy of Ophthalmology 2006 and 2011, Royal College of Ophthalmologists 2010, and Canadian Ophthalmological Society 2008) were selected from a number of available CPGs in the literature for cataract management. All recommendations of these guidelines, together with their references, were studied. Each recommendation was summarized in 4 tables. The first table showed the recommendation itself in clinical question components format along with its level of evidence. The second table contained structured abstracts of supporting articles related to the clinical question with their levels of evidence. The third table included the customized recommendation of the internal group respecting its clinical advantage, cost, and complications. In the fourth table, the internal group their recommendations from 1 to 9 based on the customizing capability of the recommendation (applicability, acceptability, external validity). Finally, customized recommendations were sent one month prior to a consensus session to faculty members of all universities across the country asking for their comments on recommendations. Results: The agreed recommendations were accepted as conclusive while those with no agreement were discussed at the consensus session. Finally, all customized recommendations were codified as 80 recommendations along with their sources and levels of evidence for the Iranian population. Conclusion: Customization of CPGs for management of adult cataract for the Iranian population seems to be useful for standardization of referral, diagnosis and treatment of patients. © 2015 Journal of Ophthalmic and Vision Research | Published by Wolters Kluwer - Medknow

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990�2015: a systematic analysis for the Global Burden of Disease Study 2015

Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors�the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25 over the same period. All risks jointly evaluated in 2015 accounted for 57·8 (95 CI 56·6�58·8) of global deaths and 41·2 (39·8�42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million 192·7 million to 231·1 million global DALYs), smoking (148·6 million 134·2 million to 163·1 million), high fasting plasma glucose (143·1 million 125·1 million to 163·5 million), high BMI (120·1 million 83·8 million to 158·4 million), childhood undernutrition (113·3 million 103·9 million to 123·4 million), ambient particulate matter (103·1 million 90·8 million to 115·1 million), high total cholesterol (88·7 million 74·6 million to 105·7 million), household air pollution (85·6 million 66·7 million to 106·1 million), alcohol use (85·0 million 77·2 million to 93·0 million), and diets high in sodium (83·0 million 49·3 million to 127·5 million). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation. © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY licens

Performance of Profiled Vertical Reflective Parallel Noise Barriers with Quadratic Residue Diffusers

The paper presents the results of an investigation on the acoustic performance of vertical profile parallelbarrierswith quadraticresiduediffuser tops andfaces.A2D boundaryelement method (BEM) is used to predict the barrier insertion loss. The results of rigid and with absorptive coverage are also calculated for comparisons. Using QRD on the top surface and faces of all vertical profile parallel barrier models presented here is found to improve the efficiency of barriers compared with fully absorptive equivalent parallel barrier at the examined receiver positions. It is found that reducing the design frequency of QRD shifts the performance improvement towards lower frequency, and therefore the most efficient model for vertical profile parallel traffic noise barrier is a setup treated with QRDs tuned to around 400 Hz. The overall performance improvement by the above diffusive barrier is predicted to be 5.8 dB (A) compared to its rigid equivalent barrier. It is also found that if increase in absorption coefficient of QRD by well reduction destroys the effect of wells in resonance; it will also have negative effect on the performance of parallel QRD barrier and will reduce the overall A-weighted insertion loss of the reactive barriers

Contribution Of Quadratic Residue Diffusers To Efficiency Of Tilted Profile Parallel Highway Noise Barriers

This paper presents the results of an investigation on the acoustic performance of tilted profile parallel barriers with quadratic residue diffuser (QRD) tops and faces. A 2D boundary element method (BEM) is used to predict the barrier insertion loss. The results of rigid and with absorptive coverage are also calculated for comparisons. Using QRD on the top surface and faces of all tilted profile parallel barrier models introduced here is found to improve the efficiency of barriers compared with rigid equivalent parallel barrier at the examined receiver positions. Applying a QRD with frequency design of 400 Hz on 5 degrees tilted parallel barrier improves the overall performance of its equivalent rigid barrier by 1.8 dB(A). Increase in the treated surfaces with reactive elements shifts the effective performance toward lower frequencies. It is found that by tilting the barriers from 0 to 10 degrees in parallel set up, the degradation effects in parallel barriers is reduced but the absorption effect of fibrous materials and also diffusivity of the quadratic residue diffuser is reduced significantly. In this case all the designed barriers have better performance with 10 degrees tilting in parallel set up. The most economic traffic noise parallel barrier which produces significantly high performance, is achieved by covering the top surface of the barrier closed to the receiver by just a QRD with frequency design of 400 Hz and tilting angle of 10 degrees. The average A-weighted insertion loss in this barrier is predicted to be 16.3 dB (A)

Performance of PRD Welled Surfaces in T Shape Noise Barriers for Controlling Environmental Noise

"n "n "nBackgrounds and Objectives: There is a considerable notice in the use of noise barriers in recent years. Noise barriers as a control noise solution can increase the insertion loss to protect receivers. This paper presents the results of an investigation about the acoustic efficiency of primitive root sequence diffuser (PRD) on environmental single T-shape barrier."nMaterials and Methods: A 2D boundary element method (BEM) is used to predict the insertion loss of the tested barriers. The results of rigid and with quadratic residue diffuser (QRD) coverage are also predicted for comparison."nResults: It is found that decreasing the design frequency of PRD shifts the frequency effects towards lower frequencies, and therefore the overall A-weighted insertion loss is improved. It is also found that using wire mesh with reasonably efficient resistivity on the top surface of PRD improves the efficiency of the reactive barriers; however utilizing wire meshes with flow resistivity higher than specific acoustic impedance of air on the PRD top of a diffuser barrier significantly reduces the performance of the barrier within the frequency bandwidth of the diffuser. The performance of PRD covered T-shape barrier at 200 Hz was found to be higher than that of its equivalent QRD barriers in both the far field and areas close to the ground. The amount of improvement compared made by PRD barrier compared with its equivalent rigid barrier at far field is about 2 to 3 dB, while this improvement relative to barrier model .QR4. can reach up to 4- 6 dB."nConclusion: Employing PRD on the top surface of T-shape barrier is found to improve the performance of barriers compared with using rigid and QRD coverage at the examined receiver locations

Production and characterization of egg yolk antibody (IgY) against recombinant VP8 - S2 antigen

Bovine Rotavirus and Bovine Coronavirus are the most important causes of diarrhea in newborn calves and in some other species such as pigs and sheep. VP8 subunit of rotavirus is the major determinant of the viral infectivity and neutralization. Spike glycoprotein of coronavirus is responsible for induction of neutralizing antibody response. Studies showed that immunoglobulin of egg yolk (IgY) from immunized hens has been identified to be a convenient source for specific antibodies for using in immunotherapy and immunodiagnostic to limit the infections. In this study, chimeric VP8-S2 gene was designed using by computational techniques. The chimeric VP8-S2 gene was cloned and sub-cloned into pGH and pET32a (+) vectors. Then, recombinant pET32a-VP8-S2 vector was transferred into E. coli BL21 CodonPlus (DE3). The expressed protein was purified by Ni-NTA chromatography column. Hens were immunized with the purified VP8-S2 protein three times. IgY was purified from egg yolks using polyethylene glycol precipitation method. Activity and specificity of anti-VP8-S2 IgY were detected by dot-blotting, Western-blotting and indirect ELISA. We obtained anti-VP8-S2 IgY by immunizing hens with the recombinant VP8-S2 protein. The anti-VP8-S2 IgY was showed to bind specifically to the chimeric VP8-S2 protein by dot-blotting, Western-blotting analyses and indirect ELISA. The result of this study indicated that such construction can be useful to investigate as candidates for development of detection methods for simultaneous diagnosis of both infections. Specific IgY against the recombinant VP8-S2 could be recommended as a candidate for passive immunization against bovine rotavirus and bovine coronavirus

Evaluation of IFN-γ and TGFβ1 Genes Expression in Guinea Pigs Vaccinated with Foot-and-Mouth Disease Type O Inactivated Vaccine

Foot-and-mouth disease (FMD) is a severely contagious viral disease in cloven-hooved animals that it causes considerable economic losses in livestock productivity. Vaccination is one of the most effective procedures for control of FMD. One of vaccines performances is stimulating expression of some immune system genes, which called cytokines. In this study, expression changes of IFN-γ and TGFβ1 genes were evaluated in vaccinated guinea pigs with FMD type O inactivated vaccine. Blood samples were collected from vaccinated and control (no vaccinated) guinea pigs in three distinct times. After blood sampling, RNA was extracted and converted to cDNA. For measuring IFN-γ and TGFβ1 genes expression, relative Real-time PCR procedure was used. The results showed that expression of IFN-γ and TGFβ1 genes in the second and third blood sampling were significantly increased in comparison to the first blood sampling. Because increasing of cytokines expression is an indicative of the immune system response, these genes can be used as indicators for testing effects of the recombinant vaccines

Introducing the Standard and Chart to Measure and Control the Motorcycle Noise Level

Background and Objectives: Sound of motorcycles plays an important role in noise pollution in big cities. This is due to the lack of national law or standards to control the noise of domestic and also imported motorcycles. This study tries to introduce a practical limit value in different stage of motorcycle life cycle by assessing their noise pollution. Materials and Methods: First the motorcycles noise standards at different countries were studied and they were compared with the results from noise level of 622 motorcycles in 3 different groups. The sample volume in each group corresponds to the amount of their annual production rate. Then using statistical tests, a limit was determined in which 90% of the domestic motorcycles can be covered. The limit is proposed as the standard for domestic motorcycle noise.Results: The limit for motorcycles of groups 1, 2 and 3were 84, 86 and 87 dB (A) ,respectively in the TA stage. For the COP stage (Conformity of Production), the limit increases according to certain formula. In the end, a flowchart was proposed as a standard method for measuring the sound of motorcycles in the TA and COP stages was proposed.Conclusion: Noise level of the domestic motorcycles is at least 9 dB (A) higher than the noise limit value of European motorcycle. If European limit value is considered for producing the national motorcycle, 90% of them will get out of production cycle and this would not be practical

Study of Genetic Diversity in Iranian Turkmen Horse by Four Microsatellite Markers

The aim of this study was to assess the genetic diversity of Iranian Turkmen Horse using microsatellite markers (HMS02, HMS03, HMS07 and AHT04). Blood samples were collected from 51 Turkmen horses in Khorasan Shomali province, Iran. Genomic DNA was extracted and then standard Polymerase Chain Reaction performed to amplify the microsatellite markers using specific primers. The PCR products were electrophoresed on 8% polyacrylamide gel. The results have demonstrated that the number of alleles in these loci varied from 9 to 12 with mean value of 10.5. HMS02 and HMS07 had the highest (12) and the lowest (9) number of alleles, respectively. HMS02 had the highest (0.8847) and HMS03 had the lowest (0.8039) heterozygosity rates. Also, polymorphic information content (PIC) was the highest (0.86) in HMS07and the lowest (0.77) in HMS03. Finally, the highest and the lowest value of Shannon index were estimated in HMS07 and AHT04, respectively. Results have shown that these four microsatellite loci have high polymorphism and can be used as suitable molecular markers in genetic studies

Evaluation of cytokine mRNA expression in vaccinated guinea pigs with foot-and-mouth disease type O inactivated vaccine

Foot-and-mouth disease (FMD) is a severely contagious viral disease that mainly affects cloven-hoofed livestock and wildlife. This study quantifies the cytokines mRNA expression of vaccinated guinea pigs with FMD type O inactivated vaccine. Blood samples were collected from eight guinea pigs at 7 and 28 days after the first vaccination. Extracted mRNAs were reverse-transcribed into cDNA and analyzed for quantification of IFN-γ, TNF-α and IL-10 expression using relative real-time PCR assay. Our results showed that all of the genes were upregulated. The expression of TNF-α and IL-10 genes significantly increased (P<0.05) in day 28th in comparison to the day 7th post the first vaccination. It can be concluded that the vaccine induced immune responses by increasing expression of the cytokines. Therefore, effects of DNA vaccines on immune system also may be evaluated using these genes