Persistent reduction in the age adjusted mortality rate from aortic valve surgery in the United State with elimination of gender gap in recent years.

BACKGROUND: Advancement in the surgical techniques should translate into better outcome. The goal of this study was to evaluate mortality trends from aortic valve surgery in the United State using large inpatient database. METHOD: The Nationwide Inpatient Sample (NIS) database was used to calculate the age-adjusted mortality rate from aortic valve surgery from 1988 to 2011 in the United State using ICD-9 coding for aortic valve surgery. RESULTS: We found that age adjusted mortality rate from aortic valve surgery gradually decreased from 1988 until end of study in 2011 to the lowest level with elimination of gender gap that was seen in the early years. For men, age adjusted mortality rate from aortic valve surgery in 1988 was 438 per 100,000 with steady reduction to the lowest level of 214 per 100,000 in 2011 which remained unchanged from 2007. For women, age adjusted mortality from aortic valve surgery was 620 per 100,000 in 1988 with steady reduction to the lowest level of 235 per 100,000 in 2011 which also remained unchanged since 2007. CONCLUSION: Age adjusted mortality from aortic valve surgery has been gradually decreasing in the last decade and remained stable at the lowest rates in recent years suggesting improvement in surgical technics and post-surgical care

A review of the reclaiming of rubber waste and recent work on the recycling of ethylene-propylene-diene rubber waste

Rubbers do not decompose easily and therefore disposal of rubber waste is a serious environmental concern. Raw material costs, diminishing natural resources, and the growing awareness of environmental issues and sustainability have made rubber recycling a major area of concern. Reclaiming and recycling rubber waste is a major scientific and technological challenge facing rubber scientists today. This paper reviews a number of important areas related to the reclaiming, characterizing, testing and recycling of rubber waste. These include: chemical and microbial devulcanization with particular emphasis on main chain scission and kinetics of chemical devulcanization reactions; the cutting-edge techniques for reclaiming devulcanized rubber waste by the action of large shearing forces, heat and chemical agents: and analytical techniques and methods for characterizing composition and testing of devulcanized rubber waste, respectively. In addition, some aspects of the recycling of devulcanized ethylene-propylene-diene rubber (EPDM) waste will be reported. EPDM is used extensively in automotive components world-wide and recycling the rubber at the end of its useful service life is of major importance to manufacturers of automotive components

Common Aeroallergens in Patients with Asthma and Allergic Rhinitis Living in Southwestern Part of Iran: Based on Skin Prick Test Reactivity

Aeroallergens continue to have a key role in the pathogenesis of asthma and allergic diseases and have recently received increased attention in medical research throughout the world. The prevalence of aeroallergens vary in different regions, depending on the type of climate. The aim of the present study was to determine prevalence of the sensitivity to aeroallergens among patients with asthma and allergic rhinitis (AR), based on skin prick test (SPT) reactivity in the province of Bushehr, Iran. In this cross-sectional study, 743 patients were enrolled. The participants had asthma and AR and reacted to at least one allergen with SPT. Skin prick test with standard extracts including house dust mites (HDMs), animal dander, molds and pollens were performed on patients according to the herbal geography of the area. The male to female ratio and mean age of the patients were 1.03 and 27.6± 15.4 year, respectively. Out of 567 patients with AR, the common aeroallergens were HDMs (88.5%), molds (82.9%), animal dander (79.5%), weeds (77.6%), trees (75.5%) and grass pollen (71.5%). Moreover, among 176 patients with asthma, the prevalence of aeroallergens were HDMs (90.5 %), molds (80.7%), animal dander (77.5%), weeds (73.3%), trees (73.3%) and grass pollen (67.9%). The sensitivity to animal dander, Chenopodium album and Russian thistle pollens were significantly associated with the severity of AR. Moreover, sensitivity to animal dander such as cat and feather of birds, cockroach, Bermuda grass and Chenopodium album pollens were significantly associated with the severity of asthma. The results of this study revealed that HDM was the most common sensitizing aeroallergen in patients with asthma and AR. Molds and animal dander as indoor allergens were also common aeroallergens. We suggest that the hot weather and ambient humidity in the region may be the main cause of the change in the pattern of SPT reactivity

Whole Plant Temperature Manipulation Affects Flavonoid Metabolism and the Transcriptome of Grapevine Berries

Among environmental factors, temperature is the one that poses serious threats to viticulture in the present and future scenarios of global climate change. In this work, we evaluated the effects on berry ripening of two thermal regimes, imposed from veraison to harvest. Potted vines were grown in two air-conditioned greenhouses with High Temperature (HT) and Low Temperature (LT) regimes characterized by 26 and 21\ub0C as average and 42 and 35\ub0C as maximum air daily temperature, respectively. We conducted analyses of the main berry compositional parameters, berry skin flavonoids and berry skin transcriptome on HT and LT berries sampled during ripening. The two thermal conditions strongly differentiated the berries. HT regime increased sugar accumulation at the beginning of ripening, but not at harvest, when HT treatment contributed to a slight total acidity reduction and pH increase. Conversely, growing temperatures greatly impacted on anthocyanin and flavonol concentrations, which resulted as strongly reduced, while no effects were found on skin tannins accumulation. Berry transcriptome was analyzed with several approaches in order to identify genes with different expression profile in berries ripened under HT or LT conditions. The analysis of whole transcriptome showed that the main differences emerging from this approach appeared to be more due to a shift in the ripening process, rather than to a strong rearrangement at transcriptional level, revealing that the LT temperature regime could delay berry ripening, at least in the early stages. Moreover, the results of the in-depth screening of genes differentially expressed in HT and LT did not highlight differences in the expression of transcripts involved in the biosynthesis of flavonoids (with the exception of PAL and STS) despite the enzymatic activities of PALs and UFGT being significantly higher in LT than HT. This suggests only a partial correlation between molecular and biochemical data in our conditions and the putative existence of post-transcriptional and post-translational mechanisms playing significant roles in the regulation of flavonoid metabolic pathways and in particular of anthocyanins

Iranian clinical practice guideline for amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegeneration involving motor neurons. The 3–5 years that patients have to live is marked by day-to-day loss of motor and sometimes cognitive abilities. Enormous amounts of healthcare services and resources are necessary to support patients and their caregivers during this relatively short but burdensome journey. Organization and management of these resources need to best meet patients' expectations and health system efficiency mandates. This can only occur in the setting of multidisciplinary ALS clinics which are known as the gold standard of ALS care worldwide. To introduce this standard to the care of Iranian ALS patients, which is an inevitable quality milestone, a national ALS clinical practice guideline is the necessary first step. The National ALS guideline will serve as the knowledge base for the development of local clinical pathways to guide patient journeys in multidisciplinary ALS clinics. To this end, we gathered a team of national neuromuscular experts as well as experts in related specialties necessary for delivering multidisciplinary care to ALS patients to develop the Iranian ALS clinical practice guideline. Clinical questions were prepared in the Patient, Intervention, Comparison, and Outcome (PICO) format to serve as a guide for the literature search. Considering the lack of adequate national/local studies at this time, a consensus-based approach was taken to evaluate the quality of the retrieved evidence and summarize recommendations

Recent advances in possible effects of bread types and enrichment on appetite during Ramadan fasting

Introduction: Bread is the staple food of most Muslims and can be considered to be a component with a remarkable effect on satiety and appetite during Ramadan fasting. This study aimed to present the recent advances in investigating the effect of different types of bread and enrichments on satiety and appetite. Methods: In this paper, articles focusing on the effect of various bread types (including enriched bread) on satiety and appetite, particularly during fasting were reviewed. Articles were found in databases such as ISI, PubMed and Google Scholar. Results: Different bread types with lower glycemic index are recommended for Ramadan fasting, especially for the Sahur meal, due to better satiety and sglycemic control. In addition, fermentable dietary fibers, such as arabinoxylans, β-glucan, fructans, and resistant starch, can influence appetite through fermentation in the colon by saccharolytic bacteria and gastrointestinal tract releasing hormones changes. Consumption of wholemeal bread results in the moderation of satiety and starvation. Barely, oat and rye breads demonstrate the better improvement of satiety compared to white wheat bread due to their higher fiber content, probiotic ingredients and steadier glycemia. On the other hand, use of protein-rich breads can result in delayed gastric emptying, steadier insulin levels and higher satiety. Beta-glucan enrichment shows similar significant results in terms of reducing hunger and increasing satiety by influencing the appetite and satiety and regulating hormones such as insulin, ghrelin and PYY. Fiber enrichment and probiotics (Fructo-oligosaccharides/Inulin) could also be considered in this regard. Conclusion: During Ramadan fasting, barley bread, oat bread and wholegrain wheat bread could be suggested as the preferred bread types to be incorporated into the main meals to improve satiety and decrease hunger feeling

Prevalence and risk factors of seizure in children with acute bacterial meningitis: an update epidemiologic study

Abstract Objective The current study aimed to investigate the prevalence and risk factorsof seizure in acute bacterial meningitis. Materials & MethodsIn the present study, a total of 180 children (age range, 2 months to 14 years) with acute bacterial meningitis, were separated into two groups based on the diagnosis of seizure. The study was conducted in Mashhad (Iran) from 2002 to 2016. Results Seizure occurred in 37.4% of children with bacterial meningitis. Streptococcus pneumonia (S. pneumonia) was the most common organism. Most of the children with seizures (53.7%) had more than one episode. Also, 35% of patients had neurologic complications. Complications were more related to the seizure occurrence, the number of episodes, prolonged seizure, and being younger than 12 months. Age categories of less than 1 year and 1-5 year were associated with increased risk of seizure (odds ratio: 4.33 and 6.54, respectively). The more episode of seizure was associated with more complications (odds ratio: 6.33). Conclusion The prevalence of seizure in acute bacterial meningitis was 37.4%. Because of association between seizure and complication, it is necessary to pay more attention to the exact and on-time diagnosis of bacterial meningitis