Full-fat corn germ in diets for dairy cows as an alternative to ground corn.

The experiments reported in this research paper address the effects of replacing ground corn (GC) with full-fat corn germ (FFCG) on nutrient intake and digestibility, nitrogen utilization efficiency, performance, and predicted methane production in dairy cows fed cactus cladodes and sugarcane. We hypothesized that the inclusion of FFCG in the diet would not alter the performance of lactating cows but would reduce the predicted methane production in vivo. Ten multiparous Holstein cows at 90 ± 10 d of lactation and yielding 24.2 ± 3.5 kg milk/d were assigned to dietary treatments consisting of different levels of replacement of GC by FFCG (0; 25; 50; 75 and 100% of diet dry matter) in a replicated 5 × 5 Latin square design with 21-d periods. Methane production was predicted using an automated gas in vitro production system. Except for ether extract intake, which increased, the intake of all nutrients decreased linearly with the replacement of GC by FFCG. The digestibility of dry matter, organic matter and neutral detergent fiber reduced, whereas the digestibility of ether extract increased linearly with FFCG. There were no changes in the digestibility of crude protein. The nitrogen intake and daily excretion in urine and feces decreased, while nitrogen use efficiency increased linearly. There was no significant effect of diets on nitrogen balance or microbial protein synthesis and efficiency. The yield of protein, lactose and total solids in milk showed a quadratic behavior. On the other hand, milk fat yield and energy-corrected milk yield decreased linearly with the replacement of GC by FFCG. No effect on pH or ammonia nitrogen was observed. The production of methane (CH4, g/kg DM) and total CH4 (g/d), and CH4 intensity decreased linearly with the replacement of GC by FFCG. In conclusion, FFCG has been shown to be an effective source of fat to reduce methane production in dairy cows, partially supporting our initial hypothesis. However, as it decreases milk fat production, it is not recommended to replace more than 50% of GC by FFCG for lactating cows fed cactus cladodes and sugarcane.

Use of oyster mushrooms (Pleurotus ostreatus) for increased circularity and valorization of rapeseed residues.

In Europe, rapeseed is a common oilseed crop, resulting in the production of 20 million tons of rapeseed press cake yearly. This press cake can be further upcycled and a protein fraction can be extracted for food purposes, leaving de-proteinized fiber-rich residues. This study examined the use of these residues in the production of oyster mushrooms (Pleurotus ostreatus) and of the spent substrate as feed, since mushroom cultivation may improve the feed properties of substrate. In terms of mushroom production, the addition of rapeseed press residues was beneficial, giving significantly higher biological efficiency (BE = 93.1 ± 11.0%) compared with the control, sugar beet pulp substrate (70.0 ± 6.6%). This increase in productivity can most likely be explained by higher energy content in the substrate supplemented with lipid-rich rapeseed residues. Despite differences in BE between the substrates, high similarity was observed in lipid composition of the fruiting bodies (lipid profile dominated by linoleic acid (18:2), palmitic acid (16:0), and oleic acid (18:1)), and in protein and moisture content. After mushroom harvest, approximately 70% of the initial dry weight of both substrates remained as a possible feed source. Both substrates had significantly lower levels of carbohydrates and unchanged neutral detergent fiber content after mushroom harvest, and both gave lower in vitro digestibility, total gas production, and methane production. However, protein concentration differed between the substrates, with the highest concentration (15.8% of dry weight) found in spent substrate containing rapeseed press residues. The result of the present study suggests that the de-proteinized rapeseed press residue is a resource well-suited for use in the production of mushrooms and feed.

Effects of replacing wheat starch with glycerol on methane emissions, milk production, and feed efficiency in dairy cows fed grass silage-based diets.

To lower the effect of climate change from cattle production, we should aim at decreasing their enteric methane emissions per kilogram of milk or meat. Glycerol may be absorbed through the rumen epithelium and would consequently be less available to microbes in the rumen. Glycerol could thus supply dairy cows with energy for milk production without contributing much to methane production. This study evaluated the effect of replacing wheat starch with glycerol on milk production, feed intake, and methane emissions. Twenty-two Swedish Red cows in mid lactation were used in a switch-back, change-over experiment with 3 periods of 21 d. The 2 dietary treatments consisted of a total mixed ration based on (g/kg of dry matter) grass silage (605), rapeseed meal (120), and barley (70) and either wheat starch or refined glycerol (200) fed ad libitum. The glycerol diet resulted in higher dry matter intake (21.6 vs. 20.1 kg/d) and methane emissions (482 vs. 423 g/d) compared with the diet containing wheat starch, whereas no difference was found in energy-corrected milk yield (28.4 vs. 29.7 kg/d). These results indicate that when glycerol is mixed with the feed, it is available to rumen microbes to a larger extent than initially assumed. Compared with wheat starch, adding refined glycerol (200 g/kg of dry matter) to the feed of dairy cows does not seem to have the potential to decrease enteric methane emissions.

Evaluation of a gas in vitro system for predicting methane production in vivo.

Methane production from ruminant livestock varies with the diet as a result of factors such as dry matter intake, diet composition, and digestibility. To estimate the effect of dietary composition and feed additives, CH4 production can be measured in vitro as a first step because large numbers of samples can be incubated and analyzed at the same time. This study evaluated a recently developed in vitro method for prediction of in vivo CH4 production by examining the relationship between predicted and observed CH4 production values. A total of 49 different diets (observations), used in previous 13 in vivo studies, were selected to include diets varying in nutrient composition. Methane production was measured in all in vivo studies by respiration chambers or the GreenFeed system (C-Lock Inc., Rapid City, SD). Overall, the in vitro system predicted CH4 production well (R2 = 0.96), but the values obtained were slightly underestimated compared with observed in vivo values (mean 399 L/d compared with 418 L/d: root mean square prediction error = 51.6 L/d or 12.3% of observed mean). Further analysis of the effect on residuals showed no significant relationship between CH4 production and most factors known to affect CH4 production such as dry matter intake, digestibility, and dietary concentrations of fat and starch. However, some factors included in the model were not well predicted by the system, with residuals negatively related to neutral detergent fiber concentration and positively related to concentrate proportion. The in vitro system can thus be useful for screening diets and evaluation of feed additives as a first step that can be best interpreted when feeding cows at maintenance level.

Effects on enteric methane production and bacterial and archaeal communities by the addition of cashew nut shell extract or glycerol-an in vitro evaluation.

The objective of the study was to evaluate the effect of cashew nut shell extract (CNSE) and glycerol (purity >99%) on enteric methane (CH4) production and microbial communities in an automated gas in vitro system. Microbial communities from the in vitro system were compared with samples from the donor cows, in vivo. Inoculated rumen fluid was mixed with a diet with a 60:40 forage:concentrate ratio and, in total, 5 different treatments were set up: 5mg of CNSE (CNSE-L), 10mg of CNSE (CNSE-H), 15mmol of glycerol/L (glycerol-L), and 30mmol of glycerol/L (glycerol-H), and a control without feed additive. Gas samples were taken at 2, 4, 8, 24, 32, and 48h of incubation, and the CH4 concentration was measured. Samples of rumen fluid were taken for volatile fatty acid analysis and for microbial sequence analyses after 8, 24, and 48h of incubation. In vivo rumen samples from the cows were taken 2h after the morning feeding at 3 consecutive days to compare the in vitro system with in vivo conditions. The gas data and data from microbial sequence analysis (454 sequencing) were analyzed using a mixed model and principal components analysis. These analyses illustrated that CH4 production was reduced with the CNSE treatment, by 8 and 18%, respectively, for the L and H concentration. Glycerol instead increased CH4 production by 8 and 12%, respectively, for the L and H concentration. The inhibition with CNSE could be due to the observed shift in bacterial population, possibly resulting in decreased production of hydrogen or formate, the methanogenic substrates. Alternatively the response could be explained by a shift in the methanogenic community. In the glycerol treatments, no main differences in bacterial or archaeal population were detected compared with the in vivo control. Thus, the increase in CH4 production may be explained by the increase in substrate in the in vitro system. The reduced CH4 production in vitro with CNSE suggests that CNSE can be a promising inhibitor of CH4 formation in the rumen of dairy cows.

Investigating the effect of supplementing different levels of Isochrysis galbana on in vitro rumen fermentation parameters.

This study aimed to investigate the effect of supplementing Isochrysis galbana (I. galbana) at levels of 0 (control), 1, 2, 3, 4, and 5 (g/100 g DM) of the diet on the gas production kinetics, methane production, rumen fermentation parameters, and relative microbial population in vitro. Supplementation of I. galbana at high level (5 g/100 g DM) caused a significant decrease in total gas production (p < 0.05). High supplementation rates (4 and 5 g/100 g DM) decreased CH4 production relative to the control by 18.4% and 23.2%, respectively. Although rumen ammonia nitrogen (N-NH3) and total volatile fatty acids (VFA) concentrations were affected by dietary treatments, but the VFA profile did not changed. The relative proportion of protozoa and methanogenic archaea as well as Anaerovibrio lipolytica, Prevotella spp., Ruminococcus flavefaciens, and Fibrobacter succinogenes were decreased significantly as a result of microalgae supplementation. However, the relative abundance of Ruminococcus albus, Butyrivibrio fibrisolvens and Selenomonas ruminantium were significantly increased (p < 0.05), related to the control group. As well, the pH was not affected by dietary treatments. It was concluded that I. galbana reduced in vitro CH4 production and methanogenic archaea that its worth to be investigated further in in vivo studies.

Comparison the Range of Motion Following Early Versus Late Active Mobilization after Repairing Surgery on Flexor Tendon Injury in the Zone II: A Randomized Clinical Trial.

Background: Early or delayed mobilization of limb after flexor tendon rupture repairing has an effect on postoperative outcomes, however it is not yet clear whether early or late organ mobilization leads to more likelihood of recovery. We aimed to assess the effects of early and late active limb mobilization through rehabilitation after surgery on the range of motion and hand recovery. Methods: This randomized clinical study was performed in Sina Hospital, Tehran, Iran in 2022 on 80 patients with flexor tendon damage in the zone II, who underwent reconstructive surgery of superficial and deep tendons. Patients were randomly (using random number table) divided into two groups that for one group, rehabilitation was done early (starting after three days, n = 53) and for the other group, rehabilitation was done late (starting after three weeks, n = 27). The patients were examined postoperatively and following occupational therapy and the range of motion of their involved joints was calculated. Results: The means PIP extension Lag, PIP active flexion, DIP extension Lag, DIP active flexion and total active motion were all significantly higher in those patients planned for early mobilization as compared to those who considered for late mobilization(P=0.031). Such a significant difference was also revealed adjusting baseline parameters. Conclusion: Compared to the delayed start of hand flexor tendon mobility, the early start of these activities is associated with a much greater improvement in the movement function of this tendon.

Effects of wheat bran replacement with pomegranate seed pulp on rumen fermentation, gas production, methanogen and protozoa populations of camel and goat rumen using competitive PCR technique: An in vitro study.

BACKGROUND: Microbial populations in the rumen play an essential role in the degradation of Cellulosic dietary components and in providing nutrients to the host animal. OBJECTIVE: This study aims to detect the effect of pomegranate seed pulp (PSP) on rumen fermentation, digestibility and methanogens and the protozoa population (by competitive polymerase chain reaction [PCR]) of the camel and goat rumen fluid. MATERIALS AND METHODS: PSP was added to the experimental treatments and replaced by wheat bran (0%, 5% and 10%). Rumen fluid was collected from three goats and two camels according to the similarity of sex, breed, origin and time and used for three gas production studies. DNA extraction was performed by the RBB + c method, the ImageJ programme calculated band intensities (target and competing DNA), and line gradients were plotted based on the number of copies and intensity. RESULTS: Our result showed that diets did not significantly affect the methanogen and protozoa population. Animal species affected microbial populations so that both populations in camels were less than goats. The production of gas and volatile fatty acids was not affected by diets. These two parameters and NH3 concentration and methane production in goats were higher than in camel. The pH of digested dry matter and microbial protein in camels was higher than in goats. CONCLUSIONS: Therefore, the competitive PCR technique is an effective method for enumerating rumen microbiota. This supplementation can be considered a strategy to achieve performance and environmental benefits.

In Vitro Incubations Do Not Reflect In Vivo Differences Based on Ranking of Low and High Methane Emitters in Dairy Cows.

This study evaluated if ranking dairy cows as low and high CH4 emitters using the GreenFeed system (GF) can be replicated in in vitro conditions using an automated gas system and its possible implications in terms of fermentation balance. Seven pairs of low and high emitters fed the same diet were selected on the basis of residual CH4 production, and rumen fluid taken from each pair incubated separately in the in vitro gas production system. In total, seven in vitro incubations were performed with inoculums taken from low and high CH4 emitting cows incubated in two substrates differing in forage-to-concentrate proportion, each without or with the addition of cashew nutshell liquid (CNSL) as an inhibitor of CH4 production. Except for the aimed differences in CH4 production, no statistical differences were detected among groups of low and high emitters either in in vivo animal performance or rumen fermentation profile prior to the in vitro incubations. The effect of in vivo ranking was poorly replicated in in vitro conditions after 48 h of anaerobic fermentation. Instead, the effects of diet and CNSL were more consistent. The inclusion of 50% barley in the diet (SB) increased both asymptotic gas production by 17.3% and predicted in vivo CH4 by 26.2%, when compared to 100% grass silage (S) substrate, respectively. The SB diet produced on average more propionate (+28 mmol/mol) and consequently less acetate compared to the S diet. Irrespective of CH4 emitter group, CNSL decreased predicted in vivo CH4 (26.7 vs. 11.1 mL/ g of dry matter; DM) and stoichiometric CH4 (CH4VFA; 304 vs. 235 moles/mol VFA), with these being also reflected in decreased total gas production per unit of volatile fatty acids (VFA). Microbial structure was assessed on rumen fluid sampled prior to in vitro incubation, by sequencing of the V4 region of 16S rRNA gene. Principal coordinate analysis (PCoA) on operational taxonomic unit (OTU) did not show any differences between groups. Some differences appeared of relative abundance between groups in some specific OTUs mainly related to Prevotella. Genus Methanobrevibacter represented 93.7 ± 3.33% of the archaeal sequences. There were no clear differences between groups in relative abundance of Methanobrevibacter.

Effect of a Low-Methane Diet on Performance and Microbiome in Lactating Dairy Cows Accounting for Individual Pre-Trial Methane Emissions.

This study examined the effects of partly replacing grass silage (GS) with maize silage (MS), with or without rapeseed oil (RSO) supplementation, on methane (CH4) emissions, production performance, and rumen microbiome in the diets of lactating dairy cows. The effect of individual pre-trial CH4-emitting characteristics on dietary emissions mitigation was also examined. Twenty Nordic Red cows at 71 ± 37.2 (mean ± SD) days in milk were assigned to a replicated 4 × 4 Latin square design with four dietary treatments (GS, GS supplemented with RSO, GS plus MS, GS plus MS supplemented with RSO) applied in a 2 × 2 factorial arrangement. Partial replacement of GS with MS decreased the intake of dry matter (DM) and nutrients, milk production, yield of milk components, and general nutrient digestibility. Supplementation with RSO decreased the intake of DM and nutrients, energy-corrected milk yield, composition and yield of milk fat and protein, and general digestibility of nutrients, except for crude protein. Individual cow pre-trial measurements of CH4-emitting characteristics had a significant influence on gas emissions but did not alter the magnitude of CH4 emissions. Dietary RSO decreased daily CH4, yield, and intensity. It also increased the relative abundance of rumen Methanosphaera and Succinivibrionaceae and decreased that of Bifidobacteriaceae. There were no effects of dietary MS on CH4 emissions in this study, but supplementation with 41 g RSO/kg of DM reduced daily CH4 emissions from lactating dairy cows by 22.5%.

Enteric and Fecal Methane Emissions from Dairy Cows Fed Grass or Corn Silage Diets Supplemented with Rapeseed Oil.

This study evaluated potential trade-offs between enteric methane (CH4) emissions and CH4 emissions from feces of dairy cows fed grass silage or partial replacement of grass silage with corn silage, both with and without supplementation of rapeseed oil. Measured data for eight dairy cows (two blocks) included in a production trial were analyzed. Dietary treatments were grass silage (GS), GS supplemented with rapeseed oil (GS-RSO), GS plus corn silage (GSCS), and GSCS supplemented with rapeseed oil (GSCS-RSO). Feces samples were collected after each period and incubated for nine weeks to estimate fecal CH4 emissions. Including RSO (0.5 kg/d) in the diet decreased dry matter intake (DMI) by 1.75 kg/d. Enteric CH4 emissions were reduced by inclusion of RSO in the diet (on average 473 vs. 607 L/d). In 9-week incubations, there was a trend for lower CH4 emissions from feces of cows fed diets supplemented with RSO (on average 3.45 L/kg DM) than cows with diets not supplemented with RSO (3.84 L/kg DM). Total CH4 emissions (enteric + feces, L/d) were significantly lower for the cows fed diets supplemented with RSO. Total fecal CH4 emissions were similar between treatments, indicating no trade-offs between enteric and fecal CH4 emissions.

Challenges and opportunities to capture dietary effects in on-farm greenhouse gas emissions models of ruminant systems.

This paper reviews existing on-farm GHG accounting models for dairy cattle systems and their ability to capture the effect of dietary strategies in GHG abatement. The focus is on methane (CH4) emissions from enteric and manure (animal excreta) sources and nitrous oxide (N2O) emissions from animal excreta. We identified three generic modelling approaches, based on the degree to which models capture diet-related characteristics: from 'none' (Type 1) to 'some' by combining key diet parameters with emission factors (EF) (Type 2) to 'many' by using process-based modelling (Type 3). Most of the selected on-farm GHG models have adopted a Type 2 approach, but a few hybrid Type 2 / Type 3 approaches have been developed recently that combine empirical modelling (through the use of CH4 and/or N2O emission factors; EF) and process-based modelling (mostly through rumen and whole tract fermentation and digestion). Empirical models comprising key dietary inputs (i.e., dry matter intake and organic matter digestibility) can predict CH4 and N2O emissions with reasonable accuracy. However, the impact of GHG mitigation strategies often needs to be assessed in a more integrated way, and Type 1 and Type 2 models frequently lack the biological foundation to do this. Only Type 3 models represent underlying mechanisms such as ruminal and total-tract digestive processes and excreta composition that can capture dietary effects on GHG emissions in a more biological manner. Overall, the better a model can simulate rumen function, the greater the opportunity to include diet characteristics in addition to commonly used variables, and thus the greater the opportunity to capture dietary mitigation strategies. The value of capturing the effect of additional animal feed characteristics on the prediction of on-farm GHG emissions needs to be carefully balanced against gains in accuracy, the need for additional input and activity data, and the variability encountered on-farm.

Seaweed and Seaweed Bioactives for Mitigation of Enteric Methane: Challenges and Opportunities.

Seaweeds contain a myriad of nutrients and bioactives including proteins, carbohydrates and to a lesser extent lipids as well as small molecules including peptides, saponins, alkaloids and pigments. The bioactive bromoform found in the red seaweed Asparagopsis taxiformis has been identified as an agent that can reduce enteric CH4 production from livestock significantly. However, sustainable supply of this seaweed is a problem and there are some concerns over its sustainable production and potential negative environmental impacts on the ozone layer and the health impacts of bromoform. This review collates information on seaweeds and seaweed bioactives and the documented impact on CH4 emissions in vitro and in vivo as well as associated environmental, economic and health impacts.

In Vitro Evaluation of Different Dietary Methane Mitigation Strategies.

We assessed and ranked different dietary strategies for mitigating methane (CH4) emissions and other fermentation parameters, using an automated gas system in two in vitro experiments. In experiment 1, a wide range of dietary CH4 mitigation strategies was tested. In experiment 2, the two most promising CH4 inhibitory compounds from experiment 1 were tested in a dose-response study. In experiment 1, the chemical compounds 2-nitroethanol, nitrate, propynoic acid, p-coumaric acid, bromoform, and Asparagopsis taxiformis (AT) decreased predicted in vivo CH4 production (1.30, 21.3, 13.9, 24.2, 2.00, and 0.20 mL/g DM, respectively) compared with the control diet (38.7 mL/g DM). The 2-nitroethanol and AT treatments had lower molar proportions of acetate and higher molar proportions of propionate and butyrate compared with the control diet. In experiment 2, predicted in vivo CH4 production decreased curvilinearly, molar proportions of acetate decreased, and propionate and butyrate proportions increased curvilinearly with increased levels of AT and 2-nitroethanol. Thus 2-nitroethanol and AT were the most efficient strategies to reduce CH4 emissions in vitro, and AT inclusion additionally showed a strong dose-dependent CH4 mitigating effect, with the least impact on rumen fermentation parameters.

Compound- and context-dependent effects of antibiotics on greenhouse gas emissions from livestock.

The use of antibiotics in livestock production may trigger ecosystem disservices, including increased emissions of greenhouse gases. To evaluate this, we conducted two separate animal experiments, administering two widely used antibiotic compounds (benzylpenicillin and tetracycline) to dairy cows over a 4- or 5-day period locally and/or systemically. We then recorded enteric methane production, total gas production from dung decomposing under aerobic versus anaerobic conditions, prokaryotic community composition in rumen and dung, and accompanying changes in nutrient intake, rumen fermentation, and digestibility resulting from antibiotic administration. The focal antibiotics had no detectable effect on gas emissions from enteric fermentation or dung in aerobic conditions, while they decreased total gas production from anaerobic dung. Microbiome-level effects of benzylpenicillin proved markedly different from those previously recorded for tetracycline in dung, and did not differ by the mode of administration (local or systemic). Antibiotic effects on gas production differed substantially between dung maintained under aerobic versus anaerobic conditions and between compounds. These findings demonstrate compound- and context-dependent impacts of antibiotics on methane emissions and underlying processes, and highlight the need for a global synthesis of data on agricultural antibiotic use before understanding their climatic impacts.

An in vitro evaluation of browser and grazer fermentation efficiency and microbiota using European moose spring and summer foods.

Evolutionary morphological and physiological differences between browsers and grazers contribute to species-specific digestion efficiency of food resources. Rumen microbial community structure of browsers is supposedly adapted to characteristic nutrient composition of the diet source. If this assumption is correct, domesticated ruminants, or grazers, are poor model animals for assessing the nutritional value of food consumed by browsing game species. In this study, typical spring and summer foods of the European moose (Alces alces) were combined with rumen fluid collected from both dairy cows (Bos taurus) and from moose, with the aim of comparing fermentation efficiency and microbial community composition. The nutritional value of the food resources was characterized by chemical analysis and advanced in vitro measurements. The study also addressed whether or not feed evaluation based on in vitro techniques with cattle rumen fluid as inoculum could be a practical alternative when evaluating the nutritional value of plants consumed by wild browsers. Our results suggest that the fermentation characteristics of moose spring and summer food are partly host-specific and related to the contribution of the bacterial phyla Firmicutes and Bacteriodetes to the rumen microbial community. Host-specific adaptations of the ruminal microbial community structure could be explained from the evolutionary adaptations related to feeding habitats and morphophysiological differences between browsers and grazers. However, the observed overall differences in microbial community structure could not be related to ruminal digestion parameters measured in vitro. The in vitro evaluation of digestion efficiency reveals that equal amounts of methane were produced across all feed samples regardless of whether the ruminal fluid was from moose or dairy cow. The results of this study suggested that the nutritional value of browsers' spring and summer food can be predicted using rumen fluid from domesticated grazers as inoculum in in vitro assessments of extent of digestion when excluding samples of the white water lily root, but not of fermentation characteristics as indicated by the proportions of individual fermentation fatty acids to the total of volatile fatty acids.

An Iranian scoring system for diagnosing Buerger's disease.

Buerger's disease or thromboangiitis obliterans (TAO) seems to be common in IR Iran, The present study aimed to evaluate an Iranian population with Buerger's disease in order to suggest a diagnostic criterion for Buerger's disease based on the most frequent findings and to compare it with Papa diagnostic criteria. In a cross-sectional study, all patients with resting limb pain, limb ischemic ulcers, intermittent claudication and limb ischemia who referred to the Vascular Clinic of Sina Hospital during 2009-2011 were evaluated. The patients were allocated to Buerger's and non-Buerger's groups; Evaluating 122 patients (61 in each group), according to the model each clinical manifestations and risk factors in the patients with Buerger's disease obtained a score. Absent pulsation, abnormal distal Doppler sonography and ischemic ulcer were respectively present in 58 (95.1%), 58 (95.1%) and 49 (80.3%) individuals with Buerger's disease. Multivariate linear regression analysis and multivariate logistic regression analysis were used for modeling. Considering the model finding findings, diagnostic criteria including age, sex, smoking, Raynaud's phenomenon, abnormal proximal Doppler, diabetes mellitus and hyperlipidemia were suggested (R2=0.582); the sensitivity and specificity of the criteria was respectively 95.1% and 78.7%. Compared with Papa criteria, Kappa coefficient was measured at 0.66 with a P-value<0.001. It seems that the recommended criteria have an acceptable accuracy in diagnosing Buerger's disease, especially in the Iranian population; however, it is necessary to conduct more studies with larger sample sizes to evaluate the criteria, especially in other populations.