61 research outputs found

    Mn control in zinc electrowinning process by electrochemical means using Pb-Ag anode

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    Les conditions optimales pour l'élimination du dioxyde de manganèse (MnO2) en utilisant une anode Pb-0.7 pd% d'Ag ont été étudiées en utilisant des électrolytes simulant les conditions pour le fonctionnement de purification et d'extraction électrolytique. L'effet de la densité, de la température, du pH et de la concentration de manganèse sur l'efficacité du courant de formation de MnO2 et les tensions anodiques ont été étudiés à l'aide d'essais galvanostatiques. La spectroscopie d'émission atomique par plasma micro-ondes (MP-AES) a été utilisée pour mesurer la concentration d'ions manganèse dans les électrolytes. Des essais de voltamétrie linéaire à balayage (LSV) ont été menés pour étudier l'effet de la température et de la concentrations de Mn2+ sur la réaction de dégagement d'oxygène (OER) et la formation de MnO2. La microscopie électronique à balayage avec spectroscopie à dispersion d'énergie (SEM-EDS), la diffraction des rayons X (XRD) et la fluorescence X (XRF) ont été utilisées pour la caractérisation de surface et les compositions chimiques. Les résultats ont montrés que les conditions d'extraction électrolytiques fonctionnels pour éliminer le MnO2 consiste à utiliser la Pb-0.7 pd% d'Ag. L'efficacité de courant (CE) la plus élevée de l'élimination du manganèse était de 21 %, ce qui était obtenu dans l'électrolyte à pH 1 et à une densité de courant de 125 A m-2 à 40 °C après 2 h d'électrolyse. La valeur d'efficacité a été augmentée à 28 % à l'aide d'anodes neuves remplacées toutes les 30 minutes.The optimum conditions for manganese dioxide (MnO2) removal using Pb-0.7 wt.% Ag anode have been investigated using electrolytes simulating the purification and electrowinning operating conditions. The effect of current density, temperature, pH and manganese concentration on the current efficiency of MnO2 formation and anodic voltages have been studied using galvanostatic tests. Microwave plasma atomic emission spectroscopy (MP-AES) has been used to measure the concentration of manganese ions in the electrolytes. Linear sweep voltammetry (LSV) tests were conducted to study the effect of temperature and Mn2+ concentrations on oxygen evolution reaction (OER) and MnO2 formation. Scanning electron microscopy with energy dispersive spectroscopy (SEM-EDS), X-ray diffraction (XRD) and X-ray fluorescence (XRF) were used to study the surface characterizations and chemical compositions. The results revealed that the operating electrowinning conditions are more appropriate for MnO2 removal on Pb-0.7 wt.% Ag surface. The highest current efficiency (CE) of manganese removal was 21 % which obtained in the electrowinning electrolyte at pH 1 at 125 A m-2 at 40 °C after 2 h of electrolysis. The current efficiency value was increased to 28 % using fresh anodes replaced each 30 minutes

    Diabetes-Related Complication in Canada; Prevalence of Complication, Their Association with Determinants and Future Potential Cost-Effectiveness of Pharmacy-Based Intervention

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    In the 21st century, diabetes mellitus (DM) emerged as one of the most prevalent non-communicable diseases, and poses a major problem for every health system in the world. Its global prevalence has more than doubled in the last three decades. As diabetes has become more prevalent, the health programming designed to target diabetes patients has remained inadequate and only heightened the burden. This heightened burden has manifested itself in the increased risk of complications common among patients with diabetes. These complications vary widely, and are typically categorized as either micro-vascular or macro-vascular depending upon the size of blood vessels that are compromised. Due to the havoc that can ensue by either type of complication, the increased risk of diabetes-related complications has been recognized as a serious threat to population health. To gain insight into the threat posed and how it will likely present in the Canadian population, patient’s data from the diabetes component of Survey on Living with Chronic Diseases in Canada (SLCDC-DM-2011) was analyzed. This analysis revealed that among Canadian diabetes patients, 80.26 percent reported having at least one type of diabetes-related complication. The most frequently reported complications were high blood pressure (54.65%), cataracts (29.52%), poor circulation (21.68%), and heart disease (19.4%). This analysis also revealed the predictive role of socio-economic factors associated with diabetes-related complications in Canada. Being married, having a higher income, and having a higher level of education were protective against most complications. In contrast, low levels of physical activity and high levels of HbA1C were important risk factors for many diabetes–related complications. Identifying common diabetes-related complications, protective factors and risk factors is useful for combating the threat posed by diabetes-related complications. To combat this threat in practice, healthcare professionals will play a significant role in the control and management of diabetes and its complications. Diabetes is a chronic disease that needs long-term treatment, and thus multi-disciplinary teams will be required. Increasingly, pharmacists are being determined as having a prominent position on these teams due to their accessibility to the Canadian population, and their expanding scope of practice. This profession has contributed positively to the long-term prognosis of patients with diabetes, in part, by aiding in the control and management of the disease. This aid oftentimes comes in the form of pharmacy-based interventions. Pharmacy-based interventions include a variety of services aimed at enabling patients with diabetes to have better control of their condition. I conducted a systematic review and meta-analysis to evaluate the effects of pharmacy-based interventions on clinical and non-clinical outcomes associated with diabetes-related complications. Four main databases were searched. Based upon my meta-analysis, the standardized absolute mean difference in reduction of HbA1C (%) from baseline to the time of the last follow-up significantly favoured patients in the pharmacy-based intervention group compared to those receiving care as usual (0.96%; 95% CI 0.71: 1.22, P<0.001). In addition, the standardized absolute mean difference in reduction of BMI unit (kg/m2) was 0.61 (95% CI 0.20: 1.03, P<0.001) in favour of the pharmacy-based intervention group. Both of these results demonstrate the positive effect pharmacy-based interventions can have on clinical outcomes. However, there is a dearth of evidence about the effects of pharmacy-based interventions on non-clinical outcomes, including health care utilization and quality of life. Therefore, it was not possible to evaluate non-clinical outcomes associated with diabetes-related complications in the same way. Each year healthcare expenses incurred from diabetes and its complications total more than US827billion.Thishealthcarecostissignificant,andisonlyexpectedtogrowalongsidediabetesincreasingprevalence.Inlightofthis,adebateoverthecomparativeeffectivenessofthedifferentstrategiesusedtomanagediabetesanditscomplicationshasbeensparked.Thedevelopmentofanalyticmodelsthatcanbeusedastoolsindeterminingbudgetprioritizationandcosteffectivenessofinterventionsisbeginningtobeprioritized.Toconductaneconomicevaluationoftheseinterventions,simulationmodelsarenecessary.Thesemodelsestimatehealthoutcomes,suchaslifeyearssavedorQualityAdjustedLifeYears(QALYs)gained,andaccountforthecostsandhealthconsequencesassociatedwithdiabetes,itscomplicationsandriskfactors.Idevelopedahybrid(agentbased/systemdynamic)individuallevelmicrosimulationmodelusing2,931patientrecordsfromtheSLCDC2011.Thismodelextrapolatedtheeffectsofpharmacybasedinterventionsonhealthoutcomes,costsandhealthrelatedqualityoflife(HRQOL)overtimethroughtimevaryingriskfactorsofdiabetesrelatedcomplications.ThetreatmenteffectsofpharmacybasedinterventionsweremodeledasreductionsinHbA1clevels,BMI,systolicbloodpressureandLDL,allofwhichcanaffecttheriskofprogressinglongtermcomplications.Theannualcostsofdiabetesrelatedcomplications,aswellas,costsassociatedwithpharmacybasedinterventionfromasocietalprospective,werealsoconsidered.Usingthisdata,themicrosimulationmodelwasabletoestimatetheexpectednumberofmajorhealthevents(heartfailure,stroke,amputation,andblindness),QALYsoverapatientslifetime,thepatientseconomicburdenonthehealthcaresystem,andtheextenttowhichpharmacybasedinterventioncanmodifytheseoutcomes.Deterministicandprobabilisticsensitivityanalyseswereconductedtoevaluatetheuncertaintyaroundtheresults.Basedontheresultsfrommymicrosimulationmodel,apharmacybasedinterventioncouldavertatotalof155deathsassociatedwithcomplications,19heartfailures,159strokes,24amputationsand29blindnesseventsinapopulationof2,931patientsoverthenext50years.Inaddition,theinterventioncouldadd1,246additionallifeyears(0.42perpatients)and953additionalqualityadjustedlifeyears(0.32perpatients).Theinterventionwouldalsobecosteffectiveincomparisontousualcare,asindicatedbytheincrementaldiscountedcostperQALYgained(827 billion. This health care cost is significant, and is only expected to grow alongside diabetes’ increasing prevalence. In light of this, a debate over the comparative effectiveness of the different strategies used to manage diabetes and its complications has been sparked. The development of analytic models that can be used as tools in determining budget prioritization and cost-effectiveness of interventions is beginning to be prioritized. To conduct an economic evaluation of these interventions, simulation models are necessary. These models estimate health outcomes, such as life years saved or Quality Adjusted Life Years (QALYs) gained, and account for the costs and health consequences associated with diabetes, its complications and risk factors. I developed a hybrid (agent-based/system dynamic) individual-level micro simulation model using 2,931 patient records from the SLCDC-2011. This model extrapolated the effects of pharmacy-based interventions on health outcomes, costs and health-related quality of life (HRQOL) over time through time-varying risk factors of diabetes-related complications. The treatment effects of pharmacy-based interventions were modeled as reductions in HbA1c levels, BMI, systolic blood pressure and LDL, all of which can affect the risk of progressing long-term complications. The annual costs of diabetes-related complications, as well as, costs associated with pharmacy-based intervention from a societal prospective, were also considered. Using this data, the micro-simulation model was able to estimate the expected number of major health events (heart failure, stroke, amputation, and blindness), QALYs over a patient’s lifetime, the patient’s economic burden on the health care system, and the extent to which pharmacy-based intervention can modify these outcomes. Deterministic and probabilistic sensitivity analyses were conducted to evaluate the uncertainty around the results. Based on the results from my micro-simulation model, a pharmacy–based intervention could avert a total of 155 deaths associated with complications, 19 heart failures, 159 strokes, 24 amputations and 29 blindness events in a population of 2,931 patients over the next 50 years. In addition, the intervention could add 1,246 additional life-years (0.42 per patients) and 953 additional quality-adjusted life-years (0.32 per patients). The intervention would also be cost-effective in comparison to usual care, as indicated by the incremental discounted cost per QALY gained (3928). Overall, these results suggest that an integrated pharmacy-based intervention could be a cost-effective strategy to control and manage diabetes-related complications in Canada. This is promising and has important public health implications that should not be ignored

    The Prevalence of Shiga toxin-producing Escherichia coli in Patients with Gastroenteritis and Sources of Infections in Iran: A Systematic Review Study Protocol

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    Hemolytic Uremic Syndrome (HUS) is a leading cause of acute kidney injury in infants and children. The majority of HUS in children is secondary to Shiga toxin induced Escherichia Coli (STEC). Many countries have a strategy to identify the source of infection and annually estimate the rate of this infection but there is no prevention strategy to identify this infection in Iran.The aim of this study is to find the percentage of STEC identified in various samples, in addition to find the outcome of STEC infected patients in Iran.We will search PubMed, EMBASE, Google Scholar, Google, OVID, SCOPUS, Web of Sciences, IranMedex, MagIran, and SID, dociran, PDFiran, ganj.irandoc, and all online university database for thesis, and abstract books of regional or international congresses  between January 1985 and January 2016.One author will do the search screen for potentially eligible studies and two authors independently assess whether the studies meet the inclusion criteria. Discrepancies between the two authors will be resolved through discussion and arbitration by a third author. Data from the selected studies shall be extracted using a data collection form. The methodological quality of studies will be assessed using the STORBE checklist and risk of bias assessment tool developed by Hoy et al for assessing risk of bias for epidemiological studies. We will use random effects models to assess inter-study heterogeneity. Dichotomous data will be analyzed using relative risk and continuous will be assessed with data mean differences, both with 95% CIs.Keywords: Gastroenteritis; Humans; Iran; Prevalence; shiga Yoxin 2; shiga-Toxigenic Escherichia coli

    Possibility of using neural networks for moisture ratio prediction in dried potatoes by means of different drying methods and evaluating physicochemical properties

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    Potato cubes were dried by different drying methods.  After the end of drying process, the experimental data were first fitted to the four well-known drying models.  The results indicated that the logarithmic and page models performed better compared with the other models.  Also, in this study neural networks were used in order to possibly predict dried potato moisture ratio (y), based on three input variables of drying time, drying temperature and different methods.  The results revealed that, logsig function based on 10 neurons in the first hidden layer could perform as the best goodness configuration for predicting the moisture ratio.  The comparison of the obtained results of ANNs and classical modeling indicated that, the neural networks have a higher capability for predicting moisture ratio (R2 values 0.9972 and 0.996, respectively) compared with classical modeling.  Furthermore, the physicochemical properties of dried potato such as shrinkage, starch gelatinization temperature, color change, etc. were also determined.  Keywords: extraction kinetics, time constant, extract concentration, extraction yield, medicinal herbs

    Cost-Effectiveness Analysis of Intravascular Targeted Temperature Management after Cardiac Arrest in England

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    Background: Targeted temperature management (TTM) has been shown to improve neurological outcomes and survival in patients resuscitated from cardiac arrest; however, the cost effectiveness of multiple TTM methods is not well studied. Objective: This study aimed to evaluate the cost effectiveness of intravascular temperature management (IVTM) using Thermogard XP compared with surface cooling methods after cardiac arrest in the England from the perspectives of the UK national health service and Personal Social Services. Methods: We developed a multi-state Markov model that evaluated IVTM (Thermogard XP) compared with surface cooling using two different devices (Blanketrol III and Arctic Sun 5000) over a short-term and lifetime time horizon. Model input parameters were obtained from the literature and local databases. We assumed a hypothetical cohort of 1000 patients who required TTM after cardiac arrest per year in the England. The outcomes were costs (in £, year 2019 values) and quality-adjusted life-years (QALYs), discounted at 3.5% annually. Deterministic and probabilistic sensitivity analyses were undertaken to examine the effect of alternative assumptions and uncertainty in model parameters on the results. Results: The cost-effectiveness analysis determined that Thermogard XP resulted in direct cost savings of £2339 and £2925 (per patient) compared with Blanketrol III and Arctic Sun 5000, respectively, and a gain of 0.98 QALYs over the patient lifetime. The probabilistic sensitivity analysis demonstrated that the probability of Thermogard XP being cost saving would be 69.2% and 65.3% versus the Arctic Sun 5000 and Blanketrol III, respectively. Conclusion: Implementation of IVTM using Thermogard XP can lead to cost savings and improved patient quality of life versus surface cooling methods

    Acellular pertussis vaccine efficacy: An updated systematic review and meta-analysis

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    Background: Recent studies indicate an increased incidence of pertussis disease in recent years. The aim of this study was to evaluate the efficacy of the acellular vaccine for children (as a replacement of current whole cell vaccine in the Expanded Program on Immunization) and for high-risk adults in Iran through updating current best available evidence. Methods: We performed a systematic literature review in relevant databases we focused on previously published systematic reviews to select those that address our questions. The AMSTAR (assessing the methodological quality of systematic reviews) tool was used for screening available reviews. Then search in databases was done until Feb 2014 to update the evidence. We pooled results using meta-analysis methods by Stata statistical package. Results: Eleven systematic review articles were included in the initial evaluation. In the end, two systematic reviews on acellular vaccine booster doses and the acellular vaccine in children were selected as the baseline evidence. In the update phase, new clinical trials were screened, and the results were updated. Overall pooled estimate of relative efficacy of acellular to whole cell was 0.68 (95% CI, 0.55-0.81) for children immunization Pooled estimates for the efficacy of acellular versus placebo were 0.70 (95% CI, 0.60-0.80). Overall pooled estimate of efficacy of booster dose of acellular was 0.87(95% CI, 0.85-0.88) compared to placebo. In addition pooled estimate of acellular vaccine efficacy based on response to antigen was 0.78(95% CI, 0.64-0.93) in highrisk group. Conclusion: The results show higher performance and safety of the acellular vaccine in the prevention of pertussis in children versus the whole cell vaccine. Moreover, the efficacy of the acellular vaccine in high-risk adult groups is acceptable. This study provides evidence in favor of the introduction of an acellular vaccine to the national program of immunization. Studies on cost effectiveness and aspects of policy analysis are recommended

    No Evidence of Hepatitis C Virus Infection in Individuals with Cardiovascular Disease in Mashhad

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    Background and Aim: Hepatitis C virus (HCV) infection is one of the leading causes of morbidity and mortality worldwide. It has been hypothesized that a number of bacteria and viruses might be involved in the pathogenesis of cardiovascular disease. The aim of this study was to define the prevalence of HCV in patients with cardiovascular disease in comparison with a control group. Methods: In this study, 281 individuals including 143 cardiovascular patients and 138 healthy controls were assessed for identification of HCV antibodies. The data collection was done between April 2016 and February 2017. The prevalence of HCV antibodies was determined by the enzyme-linked immunosorbent assay (ELISA) method. Results: There was no HCV infection in both patients with or without cardiovascular disease. There was a significant direct correlation between cardiovascular diseases and mean level of FPG (Fasting plasma glucose) (p&lt;0.001). Also the Systolic and Diastolic blood pressures were significantly higher in the patients with cardiovascular disease (p&lt;0.001 and p=0.005, respectively). Conclusion: The results of this study show that no evidence of HCV infection is found among a group of cardiovascular patients in the city of Mashhad. *Corresponding Author: Zahra Meshkat; Email: [email protected] Please cite this article as: Shakeri Hoseinabad M, Aryan E, Ghayour Mobarhan M, Moohebati M, Abolbashari S, Gholoobi A, Houshyar Chechaklou A, Yaghoubi A, Meshkat M, Meshkat Z. No Evidence of Hepatitis C Virus Infection in Individuals with Cardiovascular Disease in Mashhad. Arch Med Lab Sci. 2021;7:1-5 (e13). https://doi.org/10.22037/amls.v7.3344

    Clinical outcome of autologous mononuclear cells transplantation for spinal cord injury: A systematic review and meta-analysis

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    Background: Cell-based therapies can be used to treat neurological diseases and spinal cord injuries. The aim of this study was to assess the clinical outcome of bone marrow derived mononuclear cells (BM-MNCs) transplantation in patients with spinal cord injuries. Methods: Following a systematic review to detect clinical intervention studies, a meta-analysis was done for pooling data to estimate the outcome of BM-MNCs transplantation. The percentage of the patients with improved ASIA scale from one grade to a higher grade was defined as the main outcome. By considering the study design and outcome measurement, two reviewers independently extracted the data. Results: Eight relevant primary studies were found; seven qualified studies, with a combined total of 328 patients were assessed by meta-analysis, including 314 ASIA-A, 13 ASIA-B, 94 cervical, 227 thoracic and 60 acute injuries. The percentage of the patients' improvement was tested by meta-analysis through random and fixed models. The overall percentage of all patients' improved ASIA scale after a one- year follow-up (95% CIs) was 43 (0.27-0.59). Conclusion: Data from published trials revealed that encouraging results were achieved by autologous BMMNCs for the treatment of spinal cord injury. However, the number of clinical trials included in the systematic review was too limited to reach a definite conclusion. More qualified clinical trials with standardized methods are needed to truly justify the outcome of this therapeutic modality in SCI patients

    Rotavirus infection in children with acute gastroenteritis in Iran: A systematic review and meta-analysis

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    © 2014, Isfahan University of Medical Sciences(IUMS). All rights reserved. Background: The recent studies show that Rotavirus is important cause of the acute gastroenteritis. The aim of this review is to estimate the number of Rotavirus infection among Iranian children by performing a systematic review and estimating a pooled data.Methods: We performed a systematic literature review in relevant databases including PUBMED, MEDLINE, OVID, SID, MAGIRAN, and IRANMEDEX. Search in databases was done in October 10, 2013. Meta-analysis was performed using the STATA statistical package version 11. We assessed heterogeneity by Q-test and used random model for pooling measures of proportion of Rotavirus infection among Iranian children with diarrhea (and 95% confidence intervals [CI]). Sub group analysis between in-patient and outpatient group were done and publication bias was assessed by Egger and Begg tests.Results: A total of 154 records were identified in our searching. There were 36 studies including a total of 15,368 children with diarrhea. Out of 15,368 children, 6,338 were positive for Rotavirus gastroenteritis. Overall pooled estimate of infection with Rotavirus among cases of gastroenteritis was 0.35 (95% CI, 0.28-0.41). Pooled estimates for hospitalized children and outpatient subgroups were 0.39 (95% CI, 0.30-0.48), and 0.31 (95% CI, 0.23-0.38), respectively.Conclusions: This study supports the importance of Rotavirus in the Iranian population such as common cause of diarrhea among children. Therefore, decision to adopt immunization programs to prevent Rotavirus infection might be helpful in Iran

    Frequency and severity of myocardial perfusion abnormalities using Tc-99m MIBI SPECT in cardiac syndrome X

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    BACKGROUND: Cardiac syndrome X is defined by a typical angina pectoris with normal or near normal (stenosis <40%) coronary angiogram with or without electrocardiogram (ECG) change or atypical angina pectoris with normal or near normal coronary angiogram plus a positive none-invasive test (exercise tolerance test or myocardial perfusion scan) with or without ECG change. Studies with myocardial perfusion imaging on this syndrome have indicated some abnormal perfusion scan. We evaluated the role of myocardial perfusion imaging (MPI) and also the severity and extent of perfusion abnormality using Tc-99m MIBI Single Photon Emission Computed Tomography (SPECT) in these patients. METHODS: The study group consisted of 36 patients with cardiac syndrome X. The semiquantitative perfusion analysis was performed using exercise Tc-99m MIBI SPECT. The MPI results were analyzed by the number, location and severity of perfusion defects. RESULTS: Abnormal perfusion defects were detected in 13 (36.10%) cases, while the remaining 23 (63.90%) had normal cardiac imaging. Five of 13 (38.4%) abnormal studies showed multiple perfusion defects. The defects were localized in the apex in 3, apical segments in 4, midventricular segments in 12 and basal segments in 6 cases. Fourteen (56%) of all abnormal segments revealed mild, 7(28%) moderate and 4 (16%) severe reduction of tracer uptake. No fixed defects were identified. The vessel territories were approximately the same in all subjects. The Exercise treadmill test (ETT) was positive in 25(69%) and negative in 11(30%) patients. There was no consistent pattern as related to the extent of MPI defects or exercise test results. CONCLUSION: Our study suggests that multiple perfusion abnormalities with different levels of severity are common in cardiac syndrome X, with more than 30 % of these patients having at least one abnormal perfusion segment. Our findings suggest that in these patients microvascular angina is probably more common than is generally believed
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