Serious Failure Modes After EVAR Are Device Specific.

OBJECTIVES: Type I and III endoleaks following endovascular aneurysm repair (EVAR) can lead to catastrophic events that require major re-interventions. We reviewed our experience with aortic endograft re-interventions for type I and III endoleaks and other serious failures among different devices. METHODS: We retrospectively reviewed patients with a prior EVAR who underwent open conversion (OC) or major endovascular intervention (MEI) (re-lining, cuff/limb extension, parallel graft) for type I/III endoleaks at our institution from 2002 to 2019. Baseline characteristics, procedural details, re-interventions, and outcomes were collected. RESULTS: A total of 229 patients (194 men) underwent re-interventions for type I and III endoleaks after EVAR (90 OC, 139 MEI) for devices implanted between 1997 and 2019. Average age at re-intervention was 78±8.5 years. A total of 135 (59%) were implanted at our institution, whereas 93 (41%) were referred. Median time to re-intervention was 4 years with 25% to 75% interquartile range (IQR) of 2.2-6.6 years. There was no significant difference in baseline demographics or type of re-interventions (OC/MEI) between device types. 42/229 (18%) presented with ruptured aneurysms, 20/229 (9%) were symptomatic, whereas the rest presented with asymptomatic radiographic findings. Type 1A endoleak was present in 146/229 (63.8%-72 with proximal migration), type IB in 46/229 (20.1%), type IIIA in 37/229 (16.6%), type IIIB in 15/229 (6.5%), and persistent aneurysm sac growth with no radiographic evidence of an endoleak in 6/229 (2.6%). Devices included most commercial products: AFX, Excluder, AneuRx, Ancure, Endurant, and Zenith. A smaller number of investigational devices accounted for the rest. Type 1A endoleak was the most common indication for re-intervention among all devices except for AFX and ancure devices, proximal migration was a frequent presentation with AneuRx. AFX devices more frequently presented with a type III and ancure devices more frequently presented with a type IB endoleak. CONCLUSIONS: Serious failure modes after EVAR differ between endografts and occur throughout the follow-up period. This is important to guide targeted interrogation of surveillance studies and follow-up schedules, even for discontinued devices, as well as comparisons between various series and estimation of EVAR failure rates. CLINICAL IMPACT: Surveillance after EVAR is critical for long term success of the repair, understanding of the differential modes of failure of every graft available is important in the longitudinal evaluation of these endografts. Equally important is the understanding of the modes of failure of legacy endografts that are no longer on the market but still being followed, in order to be able to tailor a surveillance regiemn and the evntual repair if needed.

Cavity soliton inhibition of extreme events in lasers with injection.

Vortex mediated turbulence can be the key element in the generation of extreme events in spatially extended lasers with optical injection. Here, we study the interplay of vortex mediated turbulence and cavity solitons on the onset of extreme events in semiconductor lasers with injection. We first analyze and characterize these two features separately, spatiotemporal chaotic optical vortices for low values of the injection intensity and cavity solitons above the locking regime. In regimes where vortex mediated turbulence and cavity solitons coexist, localized peaks of light inhibit instead of enhancing the generation of rogue waves by locally regularizing the otherwise chaotic phase of the optical field. Cavity solitons can then be used to manipulate and control extreme events in systems displaying vortex mediated turbulence.

Potential benefits of early-life supplementation of liquid feed with fennel (Foeniculum vulgare) seeds or oregano (Origanum vulgare) leaves on growth, health, and blood metabolites in Holstein dairy calves.

This study was performed to determine the early-life (first month of age) supplementation of liquid feed with fennel seed powder (FSP) or oregano leaf powder (OLP) on growth performance, health, and blood biochemical attributes in preweaning dairy calves. Holstein female calves (n = 57; 1 d of age; 34.1 ± 0.97 kg of BW; mean ± SE) were assigned randomly to receive liquid feed (colostrum and milk) with no added herbal plants (CON) or supplemented with FSP (3 g/d) or OLP (30 g/d) during the first month of age. The calves received pooled colostrum (4.5 kg/d on the first 2 d of life; total solids = 25.0% ± 1.24; mean ± SD) and then pooled waste milk (6 kg/d from d 3 to 44, 5 kg/d from d 45 to 46, 4 kg/d from d 47 to 48, and 3 kg/d from d 49 to 50 of the trial; total solids = 12.54% ± 0.50) to ensure they receive same mixed liquid feed daily. The calves had unlimited access to the starter feed and fresh water and remained in the study until weaning on d 51 of age. The average mean temperature-humidity index was 70.1 units (ranging between 61.9 to 78.2) during the experiment, indicating a borderline degree of environmental heat-load. The amount of starter feed offered and refused was recorded daily. The calves were weighed immediately after birth and every 10 d thereafter, before the morning feeding. Jugular blood samples were taken immediately before and 24 h after colostrum feeding, at first month of age, and at weaning to quantify serum concentrations of glucose, urea N, cholesterol, triglycerides, total proteins, albumin, globulin, aspartate transferase, alanine transferase, total antioxidant status, and malondialdehyde. Health checks including rectal temperature, general appearance (on a 1-5 score system), fecal score (on a 1-5 score system), and bovine respiratory disease (BRD; scored using the University of Wisconsin Calf Health Chart) were performed daily, by a veterinarian who was unaware of the calf treatment allocations, for all calves over the study period. A repeated-measures ANOVA was used to compare growth performance and blood metabolites among treatment groups, and a logistic regression model using a binomial distribution (PROC GLIMMIX, SAS v. 9.4, SAS Institute Inc.) was used to assess the chance of elevated rectal temperature (≥39.4°C), general appearance (≥2), diarrhea (≥3), and BRD. A Poisson regression model (PROC GENMOD) was also used to test group differences in the experience of days with elevated rectal temperature and general appearance, and frequency and duration of diarrhea or BRD. Total nutrient intake (DM, CP, and ME, but not ether extract) originating from milk and starter feed was greater in OLP- (but not FSP-) supplemented calves compared with CON group, being partially associated with difference in milk refusal. Calves receiving FSP and OLP had greater average daily gain, BW gain, skeletal gain (withers height or heart girth, respectively), and feed efficiency compared with CON animals with no difference between FSP and OLP. Rectal temperature was lower in FSP- (but not OLP-) supplemented calves compared with CON animals. The CON animals had a greater chance of experiencing higher rectal temperature (≥39.4°C; odds ratio = 1.55 and confidence interval = 1.12-2.15 and odds ratio = 1.33 and confidence interval = 0.92-1.90, respectively, compared with FSP and OLP) and general appearance (≥2; odds ratio = 1.99 and confidence interval = 1.45-2.74 and odds ratio = 1.45 and confidence interval = 1.03-2.05), and diarrhea (odds ratio = 1.47 and confidence interval = 1.11-1.97 and odds ratio = 1.49 and confidence interval = 1.07-2.08) compared with those receiving FSP or OLP; with the chance of BRD being lower in FSP- (but not OLP-) supplemented versus CON animals (odds ratio = 1.59 and confidence interval = 1.13-2.23). As compared with OLP and CON groups, FSP treatment resulted in shorter days with elevated rectal temperature and general appearance. Supplementing FSP or OLP decreased the duration of diarrhea and BRD but not their frequency compared with CON. Duration of diarrhea was not different between FSP- or OLP-supplemented calves but calves supplemented with FSP had shorter days with BRD compared with OLP-supplemented calves. Of the blood constituents measured on d 30, concentration of aspartate transferase was higher in FSP- (but not CON) versus OLP-supplemented calves, indicating a transient liver tissue damage or dysfunction which was subsequently ameliorated. At weaning, blood concentration of triglycerides was higher in FSP and OLP groups compared with CON group. Supplementation of the liquid feed with FSP or OLP, especially FSP, had beneficial effects on calf growth performance and health. Further experiments are warranted for optimizing the dosage and duration of feeding FSP or OLP as feed additives for dairy calves.

Interleukin 13 gene polymorphism and susceptibility to asthma: a meta-regression and meta-analysis.

Summary: Background. Previously, lots of studies researched the association of Interleukin (IL) 13 gene polymorphisms and the risk of asthma, yielding incongruent outcomes. Objectives. To resolve the inconsistency among the different studies, we performed the most up-to-date meta-analysis of IL13 gene rs20541 and rs1800925 polymorphisms and susceptibility to asthma. Methods. After a systematic literature search up to September 2020, the pooled Odds Ratio (OR) and their corresponding 95% CI were extracted to determine the association level. Results. Overall, 45 (containing 10572 cases and 11575 healthy controls) and 31 (containing 10139 cases and 13304 healthy controls) case-control studies for rs20541 and rs1800925 polymorphisms, respectively, were retrieved. Pooled analysis indicated statistically significant association of rs20541 with asthma in the overall analysis. According to the subgroup analysis, significant association was detected between rs20541 polymorphism in European population across dominant model, allelic model, and GA vs. GG model. A strongly significant association between rs20541 polymorphism and asthma risk was identified in Asian population under all genetic models except heterozygote model. There was significant association between rs20541 polymorphism and asthma risk in dominant, allelic and heterozygote models for Caucasians. The rs1800925 SNP was associated with asthma risk in some genetic models for the overall, Asian, and European populations. Conclusions. Both rs20541 and rs1800925 polymorphisms of IL13 gene confers a risk factor for asthma in different populations.

Alleviation of halitosis by use of probiotics and their protective mechanisms in the oral cavity.

Regarding the relation of halitosis with oral infections and its effects on social relations between humans, the present study investigated the positive effects of probiotics on prevention or treatment of halitosis. The causative agents of halitosis are volatile sulphur compounds (VSCs), and halitosis is divided into oral and non-oral types according to the source of the VSCs. H2S and CH3SH are two main halitosis metabolites-produced following the degradation of proteins by bacteria in the mouth-however, CH3SCH3 has a non-oral origin, and is a blood neutral molecule. Just as much as halitosis is important in medicine, its psychological aspects are also considered, which can even lead to suicide. Today, the use of probiotics as a new therapeutic in many roles is in progress. Most probiotics are used for the treatment of gastrointestinal tract disorders, but various studies on the alleviation of halitosis by use of probiotics have reported satisfactory results. The genera Lactobacillus, Streptococcus and Weissella are among the most useful probiotics for the prevention or treatment of halitosis in the oral cavity.

The Effect of Porosity on Elastic Stability of Toroidal Shell Segments Made of Saturated Porous Functionally Graded Materials.

This research deals with the stability analysis of shallow segments of the toroidal shell made of saturated porous functionally graded (FG) material. The nonhomogeneous material properties of porous shell are assumed to be functionally graded as a function of the thickness and porosity parameters. The porous toroidal shell segments with positive and negative Gaussian curvatures and nonuniform distributed porosity are considered. The nonlinear equilibrium equations of the porous shell are derived via the total potential energy of the system. The governing equations are obtained on the basis of classical thin shell theory and the assumptions of Biot's poroelasticity theory. The equations are a set of the coupled partial differential equations. The analytical method including the Airy stress function is used to solve the stability equations of porous shell under mechanical loads in three cases. Porous toroidal shell segments subjected to lateral pressure, axial compression, and hydrostatic pressure loads are analytically analyzed. Closed-form solutions are expressed for the elastic buckling behavior of the convex and concave porous toroidal shell segments. The effects of porosity distribution and geometrical parameters of the shell on the critical buckling loads of porous toroidal shell segments are studied.

Dietary pattern, colonic microbiota and immunometabolism interaction: new frontiers for diabetes mellitus and related disorders.

In this review, the numerous possible mechanisms that provide supportive evidence for how colonic dysbiosis denotes metabolic dysfunction, dysregulates glucose homeostasis and leads to diabetes mellitus and related metabolic disorders are defined. Information was gathered from articles identified by systematic reviews and searches using Google, PubMed and Scopus. The composition of the colonic microbiota plays an integral role in maintaining host homeostasis by affecting both metabolic activities and underlying functional gene transcription in individuals with diabetes and related metabolic disorders. Increased colonic microbiome-derived concentrations of lipopolysaccharides, also known as 'metabolic endotoxaemia', as well as alterations in bile acid metabolism, short-chain fatty acids, intestinal hormones and branched-chain amino acid secretion have been associated with the diverse production of pro-inflammatory cytokines and the recruitment of inflammatory cells. It has been shown that changes to intestinal bacterial composition are significant even in early childhood and are associated with the pathogenesis of both types of diabetes. We hope that an improved understanding of related mechanisms linking the colonic microbiome with glucose metabolism might provide for innovative therapeutic approaches that would bring the ideal intestinal ecosystem to a state of optimal health, thus preventing and treating diabetes and related metabolic disorders.

Probiotics function and modulation of the immune system in allergic diseases

Allergic diseases have been a global problem over the past few decades. The effect of allergic diseases on healthcare systems and society is generally remarkable and is considered as one of the most common causes of chronic and hospitalized disease. The functional ability of probiotics to modulate the innate/acquired immune system leads to the initiation of mucosal/systemic immune responses. Gut microbiota plays a beneficial role in food digestion, development of the immune system, control/growth of the intestinal epithelial cells and their differentiation. Prescribing probiotics causes a significant change in the intestinal microflora and modulates cytokine secretion, including networks of genes, TLRs, signaling molecules and increased intestinal IgA responses. The modulation of the Th1/Th2 balance is done by probiotics, which suppress Th2 responses with shifts to Th1 and thereby prevent allergies. In general, probiotics are associated with a decrease in inflammation by increasing butyrate production and induction of tolerance with an increase in the ratio of cytokines such as IL-4, IL-10/IFN-Gamma, Treg/TGF-Beta, reducing serum eosinophil levels and the expression of metalloproteinase-9 which contribute to the improvement of the allergic disease's symptoms. Finally, it can be said that the therapeutic approach to immunotherapy and the reduction of the risk of side effects in the treatment of allergic diseases is the first priority of treatment and the final approach that completes the first priority in maintaining the condition and sustainability of the tolerance along with the recovery of the individual

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Probiotics function and modulation of the immune system in allergic diseases.

Allergic diseases have been a global problem over the past few decades. The effect of allergic diseases on healthcare systems and society is generally remarkable and is considered as one of the most common causes of chronic and hospitalized disease. The functional ability of probiotics to modulate the innate/acquired immune system leads to the initiation of mucosal/systemic immune responses. Gut microbiota plays a beneficial role in food digestion, development of the immune system, control/growth of the intestinal epithelial cells and their differentiation. Prescribing probiotics causes a significant change in the intestinal microflora and modulates cytokine secretion, including networks of genes, TLRs, signaling molecules and increased intestinal IgA responses. The modulation of the Th1/Th2 balance is done by probiotics, which suppress Th2 responses with shifts to Th1 and thereby prevent allergies. In general, probiotics are associated with a decrease in inflammation by increasing butyrate production and induction of tolerance with an increase in the ratio of cytokines such as IL-4, IL-10/IFN-γ, Treg/TGF-ß, reducing serum eosinophil levels and the expression of metalloproteinase-9 which contribute to the improvement of the allergic disease's symptoms. Finally, it can be said that the therapeutic approach to immunotherapy and the reduction of the risk of side effects in the treatment of allergic diseases is the first priority of treatment and the final approach that completes the first priority in maintaining the condition and sustainability of the tolerance along with the recovery of the individual.

Does the time from diagnostic biopsy to neoadjuvant chemotherapy affect the rate of pathologic complete response in stages I-III breast cancer?

Background: Studies in the adjuvant setting suggest that the timing of breast cancer diagnosis, surgery, and chemotherapy might affect outcomes. In the neoadjuvant setting, data exploring whether expeditious neoadjuvant chemotherapy (nac) after diagnosis improves the rate of pathologic complete response (pcr) in breast cancer are limited. Methods: Patients who received nac and completed treatment between May 2012 and December 2018 were identified from a prospectively collected database at BC Cancer. Time from diagnosis to start of nac was calculated. Patients were grouped into those who did and did not experience a pcr, and those who started nac within 28 days or after 28 days [time to nac (ttn)]. The association between pcr and ttn was tested using logistic regression. Results: In the time period studied, 482 patients who received nac were identified. After exclusions, 421 patients met the eligibility criteria. Median time from biopsy to chemotherapy was 33 days (range: 7-140 days). In 149 patients (35.4%), nac was received within 28 days of diagnosis (range: 7-28 days); in 272 patients (64.6%), it was received after more than 28 days (range: 29-140 days). The overall pcr rate was 31.8%. A trend toward a higher pcr rate, although not statistically significant, was observed in the group that initiated chemotherapy within 28 days (34.2% vs. 30.5%, p = 0.43). In the logistic regression model, rates of pcr were associated with receptor status, but not age, stage, or ttn. Conclusions: In the neoadjuvant setting, we observed no difference in the rate of pcr in patients who started nac within 28 days or after 28 days.

Risk factors and control strategies for silicotuberculosis as an occupational disease.

Silicotuberculosis is critical in community settings among workers and employees exposed to silica dust. Older age of entry (>30 years), male sex, infection with human immunodeficiency virus (HIV), exposure duration, smoking, chronic obstructive pulmonary disease, migration, the severity of the silicosis and the intensity of the exposure are potential risk factors. Lack of timely diagnosis and treatment for tuberculosis (TB) may also raise the rate of infection; previous treatment of TB is possibly associated with the development of silicotuberculosis in more than half of patients, increasing with age (>40 years). Identification of risk factors benefits not only the academic research community, but also the workers or employees and policy making. Some strategies can be implemented, such as controlling or reducing exposure to silica dust, ensuring continuity of treatment of TB or extended anti-TB treatment, management of the situation by occupational health professionals, prevention of oscillating migration, providing workers with compensation, training and education in occupational health, improving the quality of life of miners and workers, intensive medical surveillance and TB screening in routine health check ups, and policy making for higher immunity to inhibit inhalation of dust by workers or employees.

Semen supplementation with palmitoleic acid promotes kinematics, microscopic and antioxidative parameters of ram spermatozoa during liquid storage.

The purpose of the present experiment was to investigate the protective effects of palmitoleate on the quality of ram semen during low temperature liquid storage. Ejaculates were collected using the artificial vagina from four Qezel rams twice a week. Ejaculates were pooled, diluted with Tris-egg yolk extender without palmitoleate (control) or supplemented with 0.125 (P 0.125), 0.25 (P 0.25), 0.5 (P 0.5) and 1 (P 1) mM palmitoleate at a final concentration of 500 × 106 spermatozoa/ml. Total motility and forward progressive motility (FPM) as well as other spermatozoa kinematics were evaluated by computer-assisted sperm analysis. Moreover, viability and membrane functionality were determined in the spermatozoa. Additionally, amounts of malondialdehyde (MDA), total antioxidant activity (AOA), nitric oxide (NO) and superoxide dismutase (SOD) activities were evaluated in the medium and spermatozoa at 0, 24, 48 and 72 hr of storage. The palmitoleate supplementation resulted in a significant (p < .05) increase in total motility and FPM with the highest increase at 0.5 mM concentration for 72 hr. P 0.5 group also resulted in the highest percentage of membrane-intact spermatozoa (76.60 ± 1.95%) and viability (75.81 ± 1.34%) at 72 hr (p < .05). The amounts of MDA and NO were lower in P 0.125, P 0.25 and P 0.5 groups compared to control at 48 hr and 72 hr (p < .05). Higher amounts of AOA were obtained in palmitoleate-treated groups in medium and spermatozoa during storage time (p < .05). Furthermore, palmitoleate supplementation increased the SOD activities in spermatozoa compared to the control (p < .05). The results of the present experiment reveal that supplementation with 0.5 mM palmitoleate improves ram spermatozoa motion characteristics, AOA levels and SOD activities during liquid storage. Then, palmitoleate could be used as an antioxidant source during liquid storage of ram semen.

Comparison of outcomes after endovascular and open repair of abdominal aortic aneurysms in low-risk patients.

BACKGROUND: In randomized trials endovascular aortic aneurysm repair (EVAR) has been shown to have superior perioperative outcomes compared with open aneurysm repair (OAR). However, outcomes in patients at low risk of complications are unclear and many surgeons still prefer OAR in this cohort. The objective was to analyse perioperative and longer-term outcomes of OAR and EVAR in this low-risk group of patients. METHODS: All elective infrarenal EVARs and OARs in the Vascular Study Group of New England database were reviewed from 2003 to 2014. The Medicare scoring system was used to identity patients at low risk of perioperative complications and death. Perioperative and longer-term outcomes were analysed in this cohort. A Kaplan-Meier plot was constructed for evaluation of longer-term survival. Further propensity matching and multivariable analysis were performed to analyse additional differences between the two groups. RESULTS: Some 1070 patients who underwent EVAR and 476 who had OAR were identified. Mean(s.d.) age was 67·3(5·7) and 65·1(6·3) years respectively (P < 0·001). EVAR was associated with a lower overall perioperative complication rate (4·2 versus 26·5 per cent; P < 0·001). There was no difference in 30-day mortality (0·4 versus 0·6 per cent; P = 0·446). Overall survival at 3 years was similar after EVAR and OAR (92·5 versus 92·1 per cent respectively; P = 0·592). In multivariable analyses there was no difference in freedom from reintervention (odds ratio 1·69, 95 per cent c.i. 0·73 to 3·90; P = 0·220) or survival (hazard ratio 0·85, 0·61 to 1·20; P = 0·353). CONCLUSION: In patients predicted to be at low risk of perioperative death following aneurysm repair, EVAR resulted in fewer perioperative complications than OAR. However, perioperative mortality, reinterventions and survival rates in the longer term appeared similar between endovascular and open repair.

Effect of the rooster semen enrichment with oleic acid on the quality of semen during chilled storage.

Liquid storage of avian spermatozoa is currently being employed in programs utilizing the artificial insemination to optimize the management of genetically superior males. It is mandatory to use efficient semen storage techniques in order to prevent the reduction of the fertilizing ability of stored semen. The present study was designated to evaluate the effect of oleic acid on rooster semen quality stored at 4°C for 48 h. Semen was collected from 10 roosters twice a week. Good quality ejaculates were pooled and after dilution, the semen was enriched with 0 (control), 0.125 (O 0.125), 0.25 (O 0.25), 0.5 (O 0.5), and 1 (O1) millimolar oleate. Forward progressive motility and viability of spermatozoa were evaluated at 0, 24, and 48 h. Moreover, malondialdehyde (MDA) and total antioxidant activity (AOA) levels were measured in seminal plasma and spermatozoa at the mentioned time points. Motility was 80.33 ± 1.45, 80.00 ± 2.08, and 66.00 ± 2.30% at 24 h and 56.33 ± 1.45, 57.33 ± 2.18, and 41.33 ± 2.02% at 48 h in O 0.125, O 0.25, and control, respectively (P < 0.001). Total AOA concentrations of seminal plasma were significantly higher in oleate treated groups than the control at 24 and 48 h (P < 0.03). Moreover, concentrations of AOA in spermatozoa revealed that oleate treated group showed higher AOA values compared to the control group at 24 and 48 h (P < 0.001). MDA concentrations of seminal plasma and spermatozoa were lower in oleate treated groups in comparison with control group at 24 and 48 h (P < 0.05). In conclusion, rooster semen enrichment with low doses of oleate would exert beneficial effects on the quality of semen during cooled storage.

Outcomes of Endovascular Aortic Aneurysm Repair in Kidney Transplant Recipients: Results From a National Quality Initiative.

Contrast-induced nephropathy after endovascular aortic aneurysm repair (EVAR) in kidney transplant recipients (KTRs) can have devastating consequences. The Vascular Quality Initiative (VQI) database was queried to select all KTRs who underwent EVAR between January 2003 and December 2014. Our primary outcome was renal dysfunction, defined as acute kidney injury (AKI; elevation of serum creatinine >0.5 mg/dL from baseline) or new postoperative hemodialysis requirement. Within the EVAR VQI dataset, 40 patients were KTRs (40 of 17 213, or 0.2%). Renal dysfunction occurred in five of 40 patients in the KTR group in comparison to 779 of 17 173 patients in the nontransplanted group (12.5% versus 4.5%, p < 0.01). Emergent EVAR was required in 2 (5%) patients, one of whom required dialysis after surgery and subsequently died. One-year survival after EVAR was similar in the two groups (92.9% versus 93.1%, p = 0.73). KTRs who developed renal dysfunction had significantly lower preoperative estimated glomerular filtration rates (eGFRs) (29.5 versus 54.7, p = 0.007) and a significantly higher iodine:eGFR ratio (0.78 versus 0.39, p = 0.02) despite receiving a similar volume of contrast (70.0 versus 68.8, p = 0.97). Renal dysfunction is 3 times more frequent in KTRs treated with EVAR, though overall survival did not differ between the groups. Decreased preoperative eGFR and a higher iodine:eGFR ratio are associated with postoperative renal dysfunction.

Nuclear model calculation and targetry recipe for production of 110mIn.

(110m)In is potentially an important positron emitting that can be used in positron emission tomography. In this work, the excitation functions and production yields of (110)Cd(d, 2n), (111)Cd(d, 3n), (nat)Cd(d, xn), (110)Cd(p, n), (111)Cd(p, 2n), (112)Cd(p, 3n) and (nat)Cd(p, xn) reactions to produce the (110m)In were calculated using nuclear model code TALYS and compared with the experimental data. The yield of isomeric state production of (110)In was also compared with ground state production ones to reach the optimal energy range of projectile for the high yield production of metastable state. The results indicate that the (110)Cd(p, n)(110m)In is a high yield reaction with an isomeric ratio (σ(m)/σ(g)) of about 35 within the optimal incident energy range of 15-5 MeV. To make the target, cadmium was electroplated on a copper substrate in varying electroplating conditions such as PH, DC current density, temperature and time. A set of cold tests were also performed on the final sample under several thermal shocks to verify target resistance. The best electroplated cadmium target was irradiated with 15 MeV protons at current of 100 µA for one hour and the production yield of (110m)In and other byproducts were measured.

Changes in antibiotic use in a general surgery unit over a 5-year period.

Concerns have been expressed about the overuse of antibiotics in inpatient settings. We compared the pattern of antibiotic use in 2010 in a surgical unit of a university hospital in the Islamic Republic of Iran with similar data from 2006. Defined daily doses per 100 bed-days (DBD) were calculated. Overall use of antibiotics in our surgical unit increased significantly from a mean of 4.9 (SD 5.1) DBD in 2006 to 7.7 (SD 10.3) DBD in 2010. This increase was mainly due to increases in the use of antibiotics for treatment of infections; the prophylactic use of antibiotics did not show a significant increase. There was an increase in the consumption of ceftriaxone, imipenem, cefalotin, metronidazole and vancomycin, a decrease in the use of erythromycin and ceftazidime and no change in the use of ciprofloxacin and clindamycin. Ceftriaxone showed the greatest increase (5.1-fold) and erythromycin the sharpest decrease (8-fold) in use.

Evaluating success of no-scalpel vasectomy by ligation and excision with fascial interposition in a large prospective study in Islamic Republic of Iran.

The aims of this prospective, non-comparative study were to determine time to azoospermia and vasectomy success rate based on the results of semen analysis. A total of 334 men seeking vasectomy at a clinic in Urmia city, Islamic Republic of Iran were followed bi-weekly up to 24 weeks after vasectomy or until azoospermia was confirmed via semen analysis. The cumulative life table rate for azoospermia was 93/100 men (95% CI: 88.1 to 97.9). The median time to azoospermia was 10 weeks. By week 24 of follow-up, 3.3% of participants had failed to achieve azoospermia. One pregnancy was reported during the study period and attributed to user failure. The results suggest that men can begin to rely on vasectomy for contraception 12 weeks after no-scalpel vasectomy using fascial interposition performed by an experienced surgeon.

Evaluating success of no-scalpel vasectomy by ligation and excision with fascial interposition in a large prospective study in Islamic Republic of Iran

The aims of this prospective, non-comparative study were to determine time to azoospermia and vasectomy success rate based on the results of semen analysis. A total of 334 men seeking vasectomy at a clinic in Urmia city, Islamic Republic of Iran were followed bi-weekly up to 24 weeks after vasectomy or until azoospermia was confirmed via semen analysis. The cumulative life table rate for azoospermia was 93/100 men [95% Cl: 88.1 to 97.9]. The median time to azoospermia was 10 weeks. By week 24 of follow-up, 3.3% of participants had failed to achieve azoospermia. One pregnancy was reported during the study period and attributed to user failure. The results suggest that men can begin to rely on vasectomy for contraception 12 weeks after no-scalpel vasectomy using fascial interposition performed by an experienced surgeon