Application of DNA barcodes and spatial analysis in conservation genetics and modeling of Iranian Salicornia genetic resources.

Iran is one of the origins of some Salicornia species. Nevertheless, comprehensive research has not been conducted on genetic potential, distribution, selection of populations, and the economic utilization of Salicornia in Iran. In the current study, Salicornia was collected based on the previous data available for 26 different geographical locations of provinces in Iran. We examined Salicornia plants' universality DNA barcodes, including rbcL, matK, trnH-psbA, and ITS, and their species identification abilities and identified six species groups. Subsequently, accurate modeling of distributed areas was provided with MAXENT and highlighted the valuable information on the diversity of specific geographical regions, conservation status of existing species, prioritization of conservation areas, and selection of Agro-Ecological areas. Together, this type of integrative study will provide useful information for managing and utilizing Salicornia genetic resources in Iran.

Impact of Traumatic Brain Injury on Clinical Institute Withdrawal Assessment Use in Trauma Patients: A Descriptive Study.

BACKGROUND: Alcohol withdrawal syndrome (AWS) and traumatic brain injury (TBI) present with similar signs and symptoms, yet their treatment strategies differ greatly. AWS treatment includes the Clinical Institute Withdrawal Assessment (CIWA) protocol, which grades withdrawal signs and symptoms. A major purpose of CIWA is to guide the addition and titration of central nervous system (CNS) depressants, most commonly benzodiazepines. Conversely, best practice is to avoid these same CNS depressants in the setting of TBI. Thus, patients with TBI presenting with AWS risk may receive undesirable interventions that could worsen outcome. OBJECTIVE: To describe the relationship of TBI diagnosis with CIWA protocol scores and intervention implementation. DESIGN: Retrospective cohort observational study. SETTING: Single university-based, level one trauma center. PATIENTS: Three hundred seventy-five patients with head trauma or AWS classification, identified through the trauma center's trauma registry. INTERVENTIONS: CIWA protocol and related medication use. MAIN OUTCOME MEASURES: Frequency of elevated CIWA score, length of CIWA administration, and medication administration incidence were abstracted from patients' medical records. RESULTS: The percentage of elevated CIWA scores increased significantly with TBI severity, from 4.5%(0-60) in the No TBI group, up to 12.5% (0-36) in the Mild TBI group, 27.1% (0-57) in the Moderate TBI group, and 50.0% (14-77) in the Severe TBI group. Nominally, lorazepam use showed a similar pattern of escalation with TBI severity, but it did not reach statistical significance. Haloperidol use did significantly escalate with higher TBI severity. No group differences were observed for total lorazepam equivalents or length on the CIWA protocol. CONCLUSIONS: TBI diagnosis and higher TBI severity level correlate with higher CIWA scores, but neither increased nor decreased benzodiazepine usage was observed. Antipsychotic use did escalate with TBI diagnosis and severity. The risks versus benefits of minimizing benzodiazepines in patients with TBI who are at risk for AWS warrant future study.

Innovation of High-risk Infants Follow-up Surveillance System in Iran.

BACKGROUND: Early childhood development is one of the most social determinants of health that must be notified in order to reducing social gap and inequity. In spite of increasingly developing intensive neonatal care wards and decreasing neonatal mortality rate, there is no follow-up surveillance system to identify high-risk infants (HRI) and their health problems for timely intervention after discharge. This study was carried out to design and pilot high-risk infant follow-ups (HRIFs) surveillance system, in Alzahra Hospital, a tertiary level center of Tabriz University of Medical Sciences (TUOMS), in 2012-2013. METHODS: In this qualitative research after studying international documents, consensus about criteria of HRIs accomplished by focus group discussion. Then, Delphi agreement technique was used to finalizing assessment timetable. In the second phase, we piloted the designed surveillance system in Alzahra Hospital, a tertiary level center of TUOMS. Pilot study was implemented by follow-up team organized in designed model at the first phase of the study. Then, the findings of the pilot study were being assessed by an expert panel. If the members agreed on made decisions, they were being placed on the agenda of the national committee of development care of newborns for final approval. RESULTS: High-risk infants follow-up surveillance system was designed in following steps: Defining of evidence-based criteria of HRIs, organizing the follow-up team, regulating the organs and neurodevelopment assessment timetable, publishing a health certificate notebook for HRIs, and designing Access database software for data collection, report and evaluation. CONCLUSIONS: We designed and piloted HRIFs surveillance system, so this system was institutionalized in Alzahra Hospital, finally. It can be prepared to apply in the whole country, after detecting the quantitative outcomes and developing the program in East Azarbijan.