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The objective of this study is to demonstrate the safety and reproducibility of our surgical technique for implanting decellularized vascular xenografts in the carotid artery of sheep. Acellular porcine carotid arteries were implanted as interposition xenografts in seven sheep. An intravascular shunt was used for cerebral protection, and a flowmeter was utilized to assess graft performance. There were no intraoperative deaths or postoperative neurological complications observed. Acute graft thrombosis occurred in one sheep during surgery, but was successfully managed with thrombectomy to restore blood flow. Post-implantation flowmetry and Doppler ultrasound confirmed graft functionality. Our study demonstrates the successful application of our surgical method for implanting decellularized vascular xenografts in the carotid artery of sheep. The implanted grafts maintained patency, normal blood flow, and favorable wound healing and neurological outcomes post-surgery. [ABSTRACT FROM AUTHOR]

Autologous vascular arterial or venous graft are not available in 10-40% of patients, due to vascular pathologies, and the utility of decellularized biological scaffolds would be a solution for those cases. The purpose of this research was to obtain a functional acellular xenograft, prior to in-vivo testing as a vascular graft in an experimental animal. Two batches of carotid vasculo-nervous bundles were collected from porcine models from a local slaughterhouse. The arterial grafts were dissected and isolated, obtaining carotid arteries with a caliber of 5–6 mm and a length of approximately 10–12 cm. Two decellularization protocols were used, immersion (n = 10) and perfusion (n = 9). The resulting grafts underwent histological examination, DNA analysis, electrophoresis and spectrophotometry. Due to severe tissue damage and friability, the batch that was decellularized using perfusion was not examined. The histological examination of grafts stained with hematoxylin-eosin and DAPI highlighted the absence of nuclei. Spectrophotometry revealed a 90% decellularization, and electrophoresis of revealed the migration band of the material extracted from the fresh tissue, as well as the absence of migration bands in the case of the material extracted from decellularized tissues. We successfully used the immersion protocol to obtain a functional acellular vascular graft, in contrast to perfusion decellularization, where intraluminal high pressures damage the extracellular matrix. [ABSTRACT FROM AUTHOR]

Histidine–tryptophan–ketoglutarate (HTK) cardioplegia is one of the most widely used methods of cardioplegia. This solution is hyponatremic compared to blood, and the rapid infusion of a substantial volume of hyponatremic solution will result in a notable reduction in serum natrium (Na) levels. The aim of this study was to analyze changes in serum Na concentration following HTK cardioplegia infusion in aortic valve surgery, and to investigate the association between hyponatremia and postoperative outcomes in patients who underwent aortic valve replacement surgery. This retrospective study involved 302 patients who underwent aortic valve replacement surgery between June 2023 and June 2024 at the Emergency Institute for Cardiovascular Diseases and Transplantation, Tîrgu Mureș, Romania. Based on their preoperative serum Na levels, the patients were divided into a low Na group (Na < 136 mEq/l) and a normal/high Na group (Na ≥136 mEq/l). Outcomes measured were operative short-term mortality, as well as in-hospital postoperative complications such as neurological impairment, surgical reintervention, new onset atrial fibrillation (AFib), and sustained ventricular fibrillation (VF) or ventricular tachycardia (VT). Before surgery, the mean Na concentration was 134.0 ± 1.3 mmol/l in the low Na group and 140.5 ± 3.2 mmol/l in the normal/high Na group. After surgery, the mean Na concentration decreased to 134.5 ± 3.4 mmol/l in the low Na group and to 135.5 ± 8.1 mmol/l in the normal/high Na group. Logistic regression analysis of the outcomes showed a significant association between low preoperative Na concentrations and surgical reintervention for hemorrhagic cause, being a risk factor (OR = 3.65; 95%CI 1.18–11.34; p = 0.025). The 7-day mortality was 7.6% in the low Na group vs. 1.1% in the normal/high Na group, and 30-day mortality was 10.9% in the low Na group vs. 1.6% in the normal/high Na group. We found a significant association between low preoperative Na levels and 7-day mortality (OR = 7.40; 95% CI 1.57–34.90; p = 0.011), as well as low preoperative Na levels and 30-day mortality (OR =7.36; 95% CI 2.05–26.42; p = 0.002). Our findings suggest that the occurrence of complications is primarily associated with preoperative rather than postoperative hyponatremia, even when there are minor deviations from the normal range. [ABSTRACT FROM AUTHOR]

Despite an improvement of water quality across Europe there are many pollution hotspots for both nitrates and PPPs, mainly due to agricultural activities. The BMPs and MMs to reduce pollution from agriculture are well known, and there are policy instruments in place to ensure drinking water standards, but the current approach has not been efficient enough. Within the H2020 Water Protect project the premise was that there is a need for a multi-actor, participatory approach to tackle the issue from a new angle, and to assess why the uptake of known BMPs and MMs was not better among farmers. Seven "Action Labs" were selected that represent major physical, socio-economical, cultural and farming settings across Europe. A methodology of multi-actor engagement was chosen but with different approaches due to the local context. Initially the level of farmers' awareness about water quality issues was matched to the observed uptake rates of BMPs and MMs. In a second survey barriers hindering the uptake of measures were identified. The first survey revealed a low general awareness on the potential pollution to drinking water sources. Despite this, between 24% to 88% of the surveyed farmers per Action Lab were already voluntarily adopting one quarter of the selected BMPs and MMs. The second survey demonstrated the need to address organisational, legislative, sociological and technical barriers. The lack of coordination between different institutional bodies promoting measures and the financial incentives needed to invest and operate these often-costly measures need to be considered. The multi-actor, participatory approach with its improved awareness and collaboration made it possible to identify the crucial factors for improvement - to build a social acceptance among all actors and communicate the issues and solutions from the start. Unlabelled Image • Protection of drinking water from nutrients and pesticides requires a good uptake of BMPs. • The uptake of BMPs was assessed by a participatory approach across Europe. • Barriers preventing the uptake of obligatory and voluntary BMPs were identified. • Barriers were related to policy tools at the national and European scale. • Social acceptance among all actors and communication was required right from the start. [ABSTRACT FROM AUTHOR]