Search

Background: The Medtronic SelectSecure Model 3830 lumenless lead (Medtronic, Inc., Minneapolis, MN) is commonly used for conduction system pacing (CSP). However, with this increased use, the potential need for transvenous lead extraction (TLE) also will increase. While extraction of endocardial 3830 leads is rather well described especially in pediatric and adult congenital heart disease population, there is very limited data on extraction of CSP leads. In the present study, we reported our preliminary experience on TLE of CSP leads and provided technical considerations., Methods: The study population comprised 6 consecutive patients (67% male; mean age 70 ± 22 years) with CSP leads (3830 leads), including left bundle branch pacing (LBBP) lead (n = 3) and His pacing lead (n = 3) undergoing TLE. Overall target leads were 17. The mean implant duration time of CSP leads was 97 ± 90 months [range 8-193)., Results: Manual traction was successful in 2 cases and mechanical extraction tools were required in the remaining cases. Sixteen leads (94%) were completely extracted, whereas incomplete removal was observed in one lead (6%) among 1 patient. Of note, in the only lead incompletely removed, we observed retention of < 1-cm remnant of lead material consisting of the screw of 3830 LBBP lead into the interventricular septum. No failure of lead extraction was reported and no major complications occurred., Conclusions: Our findings demonstrated that at an experienced center the success of TLE of chronically implanted CSP leads is high in the absence of major complications also when mechanical extraction tools are needed., (© 2023. The Author(s).)

The use of left ventricular assist devices (LVADs) is intended to treat patients with end-stage heart failure. Owing to technological advances, these devices are becoming more durable. However, LVADs may need to be exchanged when complications arise and heart transplantation is not possible. Indications for LVAD exchange (LVADE) include device thrombosis, device infections, and pump component failure. LVADE has historically been associated with a high risk of morbidity and mortality. In this review, we discuss the indications of LVADE, the decisional and technical aspects during surgery, and outcomes., Competing Interests: Conflict of interestThe authors declare that there is no conflict of interest., (© Indian Association of Cardiovascular-Thoracic Surgeons 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: Subcutaneous implantable cardioverter defibrillator (S-ICD) is a suitable alternative for transvenous ICD (TV-ICD) patients who have undergone transvenous lead extraction (TLE). Limited data are available on the outcome of S-ICD patients implanted after TLE. We assessed the safety, efficacy, and outcome of S-ICD implantation after TLE of TV-ICD., Methods: The study population consisted of 36 consecutive patients with a median age of 52 (44-66) years who underwent S-ICD implantation after TLE of TV-ICD., Results: Indications for TLE were infection (63.9%) and lead malfunction (36.1%). During a median follow-up of 31 months, 3 patients (8.3%) experienced appropriate therapy and 7 patients (19.4%) experienced complications including inappropriate therapy (n = 4; 11.1%), isolated pocket erosion (n = 2; 5.5%), and ineffective therapy (n = 1; 2.8%). No lead/hardware dysfunction was reported. Premature device explantation occurred in 4 patients (11%). Eight patients (22.2%) died during follow-up, six of them (75%) because of refractory heart failure (HF). There were no S-ICD-related deaths. Predictors of mortality included NYHA class ≥ 2 (HR 5.05; 95% CI 1.00-26.38; p = 0.04), hypertension (HR 22.72; 95% CI 1.05-26.31; p = 0.02), diabetes (HR 10.64; 95% CI 2.05-55.60; p = 0.001) and ischemic heart disease (HR 5.92; 95% CI 1.17-30.30; p = 0.01)., Conclusion: Our study provides evidences on the use of S-ICD as an alternative after TV-ICD explantation for both infection and lead failure. Mortality of S-ICD patients who underwent TV-ICD explantation does not appear to be correlated with the presence of a prior infection, S-ICD therapy (appropriate or inappropriate), or S-ICD complications but rather to worsening of HF or other comorbidities., (© 2022. The Author(s).)

Background: Surgical aortic valve replacement (SAVR) is still the gold standard for treating aortic valve stenosis (AVS). Its effectiveness has been extensively examined in terms of perioperative mortality, but its impact on overall health has received much less attention., Aims: To assess the physical performance, cognitive status, and health-related quality of life of elderly patients undergoing SAVR, in the short, medium and long term., Methods: This single-center prospective study enrolled patients aged > 70 years who underwent isolated SAVR for severe AVS. Data were collected on each participant's clinical status, physical performance, cognitive status, mood, and health-related quality of life. This multidimensional geriatric assessment was performed before surgery (T0), and again at 45 days (T1), 3 months (T2), 6 months (T3), and 12 months (T4) post-surgery. Baseline (T0) and follow-up (T2-T4) data were compared separately for patients grouped by gender using paired t-tests., Results: Data from a total of 35 patients were analyzed. Compared with the baseline (T0), nutritional status worsened at T1, then gradually improved through to T4. Physical performance, mood, and health-related quality of life improved significantly after surgery. Cognitive function showed no change through to T3, but then deteriorated at T4., Conclusions: Our results show that SAVR in patients over 70 years of age has a positive impact on nutrition, mood, and health-related quality of life. Cognitive function was not negatively affected in the short and medium term, although it deteriorated in the long term. SAVR also had a positive impact on the physical performance of our sample., (© 2021. The Author(s).)

Over the years, several devices have been created (and the development of many others is currently in progress) to be in permanent contact with blood: mechanical circulatory supports represent an example thereof. The hemocompatibility of these devices largely depends on the chemical composition of blood-contacting components. In the present work, an innovative material (hybrid membrane) is proposed to fabricate the inner surfaces of a pulsatile ventricular chamber: it has been obtained by coupling a synthetic polymer (e.g., commercial polycarbonate urethane) with decellularized porcine pericardium. The hemocompatibility of the innovative material has been preliminarily assessed by measuring its capacity to promote thrombin generation and induce platelet activation. Our results demonstrated the blood compatibility of the proposed hybrid membrane., (© 2021. The Author(s).)

We investigated the significance of tropospheric ozone as a factor explaining recent tree health (in terms of defoliation) and productivity (in terms of basal area increment, BAI) in 15 ICP Forests level I and one level II plots in alpine forests in Trentino (N. Italy). Mean daily ozone summer concentrations varied between 30 and 72 parts per billion (ppb) leading to large exceedance of concentration-based critical levels set to protect forest trees. Phytoxic ozone dose (POD 0 ) estimated at the level II plot over the period 1996-2009 was 31-61 mmol m -2 projected leaf area (PLA). The role of ozone was investigated taking into account other site and environmental factors. Simple linear regression, multiple linear regression (MLR, to study mean periodical defoliation and mean periodical BAI), and linear mixed models (LMM, to study annual defoliation data) were used. Our findings suggest that-regardless of the metric adopted-tropospheric ozone is not a significant factor in explaining recent status and trends of defoliation and BAI in the alpine region examined. Both defoliation and BAI are in turn driven by biotic/abiotic damage, nutritional status, DBH (assumed as a proxy for age), and site characteristics. These results contrast with available ozone-growth dose response relationships (DRRs) and other observational studies. This may be due to a variety of concurrent reasons: (i) DRRs developed for individual saplings under controlled condition are not necessarily valid for population of mature trees into real forest ecosystems; (ii) some observational studies may have suffered from biased design; and (iii) since alpine forests have been exposed to high ozone levels (and other oxidative stress) over decades, possible acclimation mechanisms cannot be excluded.

The upper vegetation belts like larch forests are supposed to be under great pressure because of climate change in the next decades. For this reason, the evaluation of the risks due to abiotic stressors like ozone is a key step. Two different approaches were used here: mapping AOT40 index by means of passive samplers and direct measurements of ozone deposition.Measurements of ozone fluxes using the eddy-correlation technique were carried out for the first time over a larch forest in Paspardo (I) at 1750 m a.s.l. Two field campaigns were run: the first one in 2010 from July to October and the second one in the following year from June to September. Vertical exchange of ozone, energy, and momentum were measured on a tower platform at 26 m above ground level to study fluxes dynamics over this ecosystem. Since the tower was located on a gentle slope, an "ad hoc" methodology was developed to minimize the effects of the terrain inclination. The larch forest uptake was estimated by means of a two-layer model to separate the understorey uptake from the larch one. Even if the total ozone fluxes were generally high, up to 30-40 nmol O 3  m -2  s -1 in both years, the stomatal uptake by the larch forest was relatively low (around 15% of the total deposition).Ozone risk was assessed considering the POD 1 received by the larch forest and the exposure index AOT40 estimated with both local data and data from the map obtained by the passive samplers monitoring.

The present study investigated the response to ozone (O 3 ) of two cultivars (cv.'Romana' and cv. 'Canasta') of irrigated lettuce grown in an open-top chamber (OTC) experiment in Mediterranean conditions. Two different levels of O 3 were applied, ambient O 3 in non-filtered OTCs (NF-OTCs) and -40% of ambient O 3 in charcoal-filtered OTCs (CF-OTCs), during four consecutive growing cycles. At the end of each growing cycle, the marketable yield (fresh biomass) was assessed while during the growing periods, measurements of the stomatal conductance at leaf level were performed and used to define a stomatal conductance model for calculation of the phytotoxic ozone dose (POD) absorbed by the plants.Results showed that O 3 caused statistically significant yield reductions in the first and in the last growing cycle. In general, the marketable yield of the NF-OTC plants was always lower than the CF-OTC plants for both cultivars, with mean reductions of -18.5 and -14.5% for 'Romana' and 'Canasta', respectively. On the contrary, there was no statistically significant difference in marketable yield due to the cultivar factor or to the interaction between O 3 and cultivar in any of the growing cycle performed.Dose-response relationships for the marketable relative yield based on the POD values were calculated according to different flux threshold values (Y). The best regression fit was obtained using an instantaneous flux threshold of 6 nmol O 3 m -2  s -1 (POD 6 ); the same value was obtained also for other crops. According to the generic lettuce dose-response relationship, an O 3 critical level of 1 mmol O 3 m -2 of POD 6 for a 15% of marketable yield loss was found.

Cryopreserved allogeneic conduits are the elective biocompatible choice among currently available substitutes for surgical replacement in end-stage valvulopathy. However, degeneration occurs in 15 years in adults or faster in children, due to recipient's immunological reactions to donor's antigens. Here, human aortic valves were decellularized by TRICOL, based on Triton X-100 and sodium cholate, and submitted to standard cryopreservation (TRICOL-human aortic valves (hAVs)). Tissue samples were analyzed to study the effects of the combined procedure on original valve architecture and donor's cell removal. Residual amounts of nucleic acids, pathological microorganisms, and detergents were also investigated. TRICOL-hAVs proved to be efficaciously decellularized with removal of donor's cell components and preservation of valve scaffolding. Trivial traces of detergents, no cytotoxicity, and abrogated bioburden were documented. TRICOL-hAVs may represent off-the-shelf alternatives for both aortic and pulmonary valve replacements in pediatric and grown-up with congenital heart disease patients.

The benefits of total arterial (TAR) versus conventional (CR) revascularization are controversial in the higher-risk cohort of elderly patients. Taking for granted its benefit on long-term survival, we evaluated the effect of TAR on safety (death, myocardial infarction, and stroke) of patients undergoing CABG. Between 2000 and 2009, 487 patients >75 years underwent isolated CABG at our institution (150 TAR and 337 CR). Patients with arterial free-grafts were excluded. After propensity matching, the outcomes of 131 TAR and 127 CR patients were compared. TAR patients had lower incidence of post-operative myocardial infarction (p = 0.025) and stroke (p = 0.005). They also experienced shorter intensive care unit (p = 0.046) and ward stay (p = 0.028), lower output of TnI (p = 0.035), and less wound complications (leg included) (p = 0.0001), while mortality was comparable (p = 0.57). In our cohort of elderly patients with multivessel disease, TAR was associated with lower rates of myocardial infarction, stroke, and shorter hospital stay.

Rising surface ozone (O 3 ) levels in China are increasingly emphasizing the potential threats to public health, ecological balance, and economic sustainability. Using a 1 km × 1 km dataset of O 3 concentrations, this research employs subpopulation demographic data combined with a population-weighted quality model. Its aim is to evaluate quantitatively the differences in O 3 exposure among various subpopulations within China, both at a provincial and urban cluster level. Additionally, an exposure disparity indicator was devised to establish unambiguous exposure risks among significant urban agglomerations at varying O 3 concentration levels. The findings reveal that as of 2018, the population-weighted average concentration of O 3 for all subgroups has experienced a significant uptick, surpassing the average O 3 concentration (118 μg/m 3 ). Notably, the middle-aged demographic exhibited the highest O 3 exposure level at 135.7 μg/m 3 , which is significantly elevated compared to other age brackets. Concurrently, there exists a prominent positive correlation between educational attainment and O 3 exposure levels, with the medium-income bracket showing the greatest susceptibility to O 3 exposure risks. From an industrial vantage point, the secondary sector demographic is the most adversely impacted by O 3 exposure. In terms of urban-rural structure, urban groups in all regions had higher levels of exposure to O 3 than rural areas, with North and East China having the most significant levels of exposure. These findings not only emphasize the intricate interplay between public health and environmental justice but further highlight the indispensability of segmented subgroup strategies in environmental health risk assessment. Moreover, this research furnishes invaluable scientific groundwork for crafting targeted public health interventions and sustainable air quality management policies., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

We sought to examine the efficacy in preventing surgical site infection (SSI) in cardiac surgery, using two different incise drapes (not iodine-impregnated and iodine-impregnated). A cost analysis was also considered. Between January 2008 and March 2015, 5100 consecutive cardiac surgery patients, who underwent surgery in our Institute, were prospectively collected. A total of 3320 patients received a standard not iodine-impregnated steri-drape (group A), and 1780 patients received Ioban(®) 2 drape (group B). We investigated, by a propensity matched analysis, whether the use of standard incise drape or iodine-impregnated drape would impact upon SSI rate. Totally, 808 patients for each group were matched for the available risk factors. Overall incidence of SSI was significantly higher in group A (6.5 versus 1.9 %) (p = 0.001). Superficial SSI incidence was significantly higher in group A (5.1 vs 1.6 %) (p = 0.002). Deep SSI resulted higher in group A (1.4 %) than in group B (0.4 %), although not significantly (p = 0.11). Consequently, the need for vacuum-assisted closure (VAC) therapy use resulted 4.3 % in group A versus 1.2 % in group B (p = 0.001). Overall costs for groups A and B were 12.494.912 € and 11.721.417 €, respectively. The Ioban(®) 2 offered totally 773.495 € cost savings compared to standard steri-drape. Ioban 2 drape assured a significantly lower incidence of SSI. Additionally, Ioban(®) 2 drape proved to be cost-effective in cardiac surgery.

Tissue engineering of heart valves investigates the possibility to create a fully compatible and biomimetic graft able to provide host cell repopulation like the native living valve. Decellularized aortic and pulmonary valves and synthetic polymers have been used to promote the creation of a native-like scaffold suitable to be colonized by cells either in vitro, in dynamic bioreactors or in vivo using different animal models. The herein presented research provides the intra-operative protocol and details of surgical technique. Porcine aortic valve conduits were decellularized and implanted in the right ventricular outflow tract of Vietnamese pigs.

This study examines defoliation and discoloration findings collected throughout the Italian Level I network between 1997 and 2000. Prior to this period no Quality Assurance procedures had been implemented, so that earlier findings cannot be considered reliable. The aim of the study is to compare different indices used in reporting findings, in order to determine the full potential and limitations of each. In international surveys, findings are normally expressed in terms of individual trees presenting a defoliation level greater than 25%; this criterion, however, has been challenged since it is not based on scientific evidence. By analysing the distribution of defoliationvalues (grouped in 5% classes) relating to the main species (Fagus sylvatica, Quercus pubescens, Quercus cerris, Picea abies), the study examines the behaviour of statistical indices such as the median, the mode and the mean. Instead of using the traditional 25% threshold to determine the part of the population with the highest defoliation values, a procedure is suggested whereby a different threshold can be determined for each species. It is established based on the 90 degrees percentile of cumulative defoliation values recorded over the four-year period. Each index used to report findings possesses its own information potential, and the findings may at times appear contradictory. The use of a combined defoliation and discoloration index (Ilce = Lacking Crown Equivalent Index) is also proposed, but the results obtained do not differ in substance from the results relating to defoliation alone. The functional limitations of this index are due mainly to the way the data are collected: for this reason suggestions are made on how to improve the procedure in future surveys.

Surface ozone is a damaging pollutant for crops and ecosystems, and the ozone-induced crop losses over India remain uncertain and a topic of debate due to a lack of sufficient observations and uncertainties involved in the modeled results. In this study, we have used the observational data from MAPAN (Modelling Air Pollution And Networking) for the first time to estimate the relative yield losses, crop production losses, and economic losses for the two major crops (wheat and rice). The detailed estimation has been done focusing on three individual suburban sites over India (Patiala, Tezpur, and Delhi) and compared with other related studies over the Indian region. We have used the concentration-based metric (M7, 7-h average from 09:00 to 15:59 h) along with the cumulative ozone exposure indices (AOT40, accumulated exposure over a threshold of 40 ppb) and applied the exposure-response (E-R) functions for the calculation of the crop losses. Our study shows that the yearly crop losses can reach the level of 12.4-40.8% and 2.0-11.1% for the wheat and rice crops, respectively, at certain places like Patiala in India. The annual economic loss can be as high as $4.6 million and $0.7 million for wheat and rice crops, respectively, even at individual locations in India. Our estimated %RYL (relative yield loss) lies in the range of 0.3 + /0.6 times the recent regional model estimates which use only the AOT40 metric. Region-specific E-R functions based on factors suitable for the Indian region needs to be developed., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

An international workshop on "Adapting Agriculture to Climate Change and Air Pollution" took place at Nanjing University of Information Science and Technology, Nanjing, China, during 23-27 October, 2023. Experts working in various multi-disciplinary areas of agroecosystem and environmental research gathered for academic communication and discussions. Two discussion groups focused on "agriculture under air pollution and climate change: current challenges and priorities for the future" and "adapting agriculture to air pollution and climate change: current status and next steps." Insights derived from the discussions are summarized in this article and include opinions about current issues, knowledge gaps' identification, and potential priorities and actions that could be taken. The first discussion mainly addresses ozone impact estimates; ozone metrics for impact and risk assessments; ozone monitoring; air pollution impacts and policy; and the pivotal role of agriculture and consumer choices. The second discussion covers adaptation and mitigation; greenhouse gases and energy efficiency; concerns about the link between adaptation and mitigation; local food, planetary-health diets and carbon footprint; irrigation and climate change adaptation; scientific evidence and policy-making; air pollution and crop adaptation; machine learning and crop modeling; and challenges faced by smallholder farmers and large-scale enterprises. Hence, this report could be useful for reseach, educational, and policy purposes, collating opinions of experts working in diverse research areas., Competing Interests: Declarations. Ethics approval: Not applicable. Consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Tomato is the second most valuable vegetable crop, and its susceptibility to tropospheric ozone (O 3 ) varies on the cultivar. Eight tomato cultivars with documented O 3 sensitivity were reevaluated using ethylenediurea (400 ppm EDU) to determine the effectiveness of EDU in assessing O 3 sensitivity under heavily O 3 -polluted tropical conditions. EDU helped in amending the growth, photosynthetic pigments, photosynthetic rate, stomatal conductance, and yield characteristics in the tomato cultivars. EDU reduced the lipid peroxidation and reactive oxygen species content, while enzymatic and non-enzymatic antioxidant responses differed across cultivars. The cultivar Superbug and Sel-7 (O 3 susceptible) performed better by employing more biomass and yield and exhibiting more potent antioxidative defense machinery mainly non-enzymatic antioxidants after EDU treatment. The higher value of total antioxidative potential (TAP) in O 3 susceptible cultivars suggested the adaptive resilience through EDU application against O 3 stress. EDU application greatly enhanced the photosynthetic rate in O 3 susceptible cultivars by increasing the stomatal conductance. Hence, both biophysical and biochemical responses were involved in protection against O 3 provided by EDU. Kashi chayan and VRT02 (O 3 tolerant) cultivars showed least response to EDU, due to their efficient inherent mechanisms in alleviating O 3 stress. Thus, EDU may be used as an efficient biomonitoring tool against O 3 -sensitive cultivars., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Formaldehyde is a prominent volatile organic compound and also considered as an indoor air pollutant. Chlorophytum comosum, an indoor plant, has been reported to metabolize indoor formaldehyde. But the phytotoxic effects of formaldehyde, being a pollutant, on C. comosum are not well explored. Furthermore, C. comosum responses that can be considered as markers at the physiological and biochemical level against formaldehyde stress are not yet investigated. Therefore, the current research study was aimed to evaluate such potential markers against formaldehyde in C. comosum. Briefly, C. comosum was exposed to 5-, 10-, and 20-ppm formaldehyde doses in an airtight glass chamber. Plant samples were then taken to analyze morpho-anatomical, physiological, and biochemical responses after short (2, 4, and 6 h), medium (12 and 24 h), and extended durations (48 and 96 h) for each tested dose. Application of 10 and 20 ppm formaldehyde doses leads to a significant incline in enzymatic antioxidants. Formaldehyde concentration of 10 ppm leads to a maximum increase in catalase (30.30 U/mg of protein), guaiacol peroxidase (135.64 U/mg of protein), and superoxide dismutase (44.76 U/mg of protein) compared to their respective controls. A significant change is also observed in non-enzymatic parameters, including total phenolic content, which ranged from 3.62 mg GAE/g (control) to 10.51 mg GAE/g, total antioxidants vary from 27.37% (control) to 85.05% in 20 ppm formaldehyde, respectively. However, formaldehyde application negatively affected the physiological responses of C. comosum by reducing its photosynthetic rate, transpiration rate, and stomatal conductance. Additionally, extended exposure of C. comosum to 10- and 20-ppm formaldehyde doses leads to visible leaf damage. Principal component analysis indicated that enzymatic parameters including SOD, CAT, and GPX and non-enzymatic parameters including MDA, TPC, TFC, TAOs, carotenoids, TSS, and intercellular CO 2 contributed the most to the total variance. Thus, these parameters have potential to serve as physiological and biochemical markers in C. comosum against formaldehyde stress., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Cardiac rupture (CR) is fatal mechanical complication of ST-segment elevation myocardial infarction (STEMI). We systematically analyzed the clinical features of STEMI patients with CR, as well as predictors and treatments associated with risk of CR in contemporary era. In this nationwide database, 49,284 patients admitted within 48 h after STEMI were enrolled, and were stratified according to CR status. We analyzed patients' clinical characteristics, case fatality rate, and independent correlates of CR. A total of 188 (0.38%) patients had CR, of which 42.6% died during hospitalization. Older age, female gender, higher heart rate, history of diabetes, and worse cardiac function were risk factors of CR in patients with STEMI, while a previous history of myocardial infarction was associated with a reduced risk of CR. CR patients were less likely to undergo primary percutaneous coronary intervention (PCI). After adjustment, primary PCI was associated with 56% decreased risk of CR (OR 0.44, 95% CI 0.29-0.67). This result was consistent in the propensity-score matching analysis and inverse probability of treatment weighting analysis. CR was associated with high in-hospital mortality among STEMI patients. Multiple factors were associated with CR occurrence, primary PCI was associated with lower risk of CR, indicating that early intervention targeting the risk factors and implementation of primary PCI may improve its prognosis. Clinical trial registration ClinicalTrials.gov; Number: NCT02306616; URL: www.clinicaltrials.gov., (© 2024. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).)

Vascularization is vital in bone tissue engineering, supporting development, remodeling, and regeneration. Lack of vascularity leads to cell death, necessitating vascularization strategies. Angiogenesis, forming new blood vessels, provides crucial nutrients and oxygen. Pre-vascularized gelatin-coated β-tricalcium phosphate (G/β-TCP) scaffolds show promise in bone regeneration and vascularization. Our study evaluates G/β-TCP scaffolds' osteogenic and angiogenic potential in vitro and a canine model with vascular anastomosis. Channel-shaped G/β-TCP scaffolds were fabricated using foam casting and sintering of a calcium phosphate/silica slurry-coated polyurethane foam, then coated with cross-linked gelatin. Buccal fat pad-derived stem cells (BFPdSCs) were seeded onto scaffolds and assessed over time for adhesion, proliferation, and osteogenic capacity using scanning electron microscopy (SEM), 4,6-diamidino-2-phenylindole (DAPI) staining, Alamar blue, and alkaline phosphatase (ALP) assays. Scaffolds were implanted in a canine model to evaluate osteogenesis and angiogenesis by histology and CT scans at 12 wk. Our studies showed preliminary results for G/β-TCP scaffolds supporting angiogenesis and bone regeneration. In vitro analyses demonstrated excellent proliferation/viability, with BFPdSCs adhering and increasing on the scaffolds. ALP activity and protein levels increased, indicating osteogenic differentiation. Examination of tissue samples revealed granulation tissue with a well-developed vascular network, indicating successful angiogenesis and osteogenesis was further confirmed by a CT scan. In vivo, histology revealed scaffold resorption. However, scaffold placement beneath muscle tissue-restricted bone regeneration. Further optimization is needed for bone regeneration applications., (© 2024. The Society for In Vitro Biology.)

Background: Transvenous lead removal (TLR) is associated with increased mortality and morbidity. This study sought to evaluate the impact of TLR on in-hospital mortality and outcomes in patients with and without CIED infection., Methods: From January 1, 2017, to December 31, 2020, we utilized the nationally representative, all-payer, Nationwide Readmissions Database to assess patients who underwent TLR. We categorized TLR as indicated for infection, if the patient had a diagnosis of bacteremia, sepsis, or endocarditis during the initial admission. Conversely, if none of these conditions were present, TLR was considered sterile. The impact of infective vs sterile indications of TLR on mortality and major adverse events was studied., Results: Out of the total 25,144 patients who underwent TLR, 14,030 (55.8%) received TLR based on sterile indications, while 11,114 (44.2%) received TLR due to device infection, with 40.5% having systemic infection and 59.5% having isolated pocket infection. TLR due to infective indications was associated with a significant in-hospital mortality (5.59% vs 1.13%; OR = 5.16; 95% CI 4.33-6.16; p < 0.001). Moreover, when compared with sterile indications, TLR performed due to device infection was associated with a considerable risk of thromboembolic events including pulmonary embolism and stroke (OR = 3.80; 95% CI 3.23-4.47, p < 0.001). However, there was no significant difference in the conversion to open heart surgery (1.72% vs. 1.47%, p < 0.111), and infection was not an independent predictor of cardiac (OR = 1.12; 95% CI 0.97-1.29) or vascular complications (OR = 1.12; 95% CI 0.73-1.72) between the two groups., Conclusion: Higher in-hospital mortality and rates of thromboembolic events associated with TLR resulting from infective indications may warrant further pursuing this diagnosis in patients., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

For the past 20 years, transcatheter aortic valve replacement (TAVR) has been the treatment of choice for symptomatic aortic stenosis. The transfemoral (TF) access is considered the gold standard approach for TAVR. However, TF-TAVR cannot be performed in some patients; thus, alternative accesses are required. Our review paper generalises the TAVR accesses currently available, including the transapical, transaortic, trans-subclavian/axillary, transcarotid, transcaval, and suprasternal approaches. Their advantages and disadvantages have been analysed. Since there is no standard recommendation for an alternative approach, access selection depends on the expertise of the local cardiac team, patient characteristics, and access properties. Each TAVR centre is recommended to master a minimum of one non-TF access alternative. Of note, more evidence is required to delve into the clinical outcomes of each approach, at both early and long-term (Figure 1)., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The study was performed to analyze the impact of seed pretreatment by static magnetic field (SMF) of 200 mT for 1 h on photosynthetic performance of soybean (Glycine max) seedlings under ambient ( a UV-B) and supplemental ultraviolet-B ( a+s UV-B) stress. Ambient and supplemental UV-B were found to decrease the plant growth, chlorophyll concentration, PSII efficiency, selected JIP-test parameters such as F v /F m , φEo, ΔV(I-P), PI ABS , PI total , and rate of photosynthesis in the leaves of soybean seedlings emerged from untreated (UT) seeds. a UV-B and a+s UV-B were observed to increase the synthesis of UV-B-absorbing substances (UAS), reactive oxygen species (ROS) like superoxide radical (O 2 ·- ) and hydrogen peroxide (H 2 O 2 ), antioxidants like ascorbic acid and α-tocopherol and decrease the nitrate reductase (NR) activity; subsequently, it results in a decreased rate of photosynthesis, biomass accumulation, and yield. However, our results provided evidence that SMF pretreatment increased the tolerance of soybean seedlings to UV-B radiation by increased NO content and NR activity; higher efficiency of PSII, higher values of φEo, ΔV(I-P), PI ABS , and PI total , decreased intercellular CO 2 concentration, lower  amount of UAS, ROS, and antioxidants that consequently improve the yield of soybean plants under a UV-B as well as a+s UV-B stress. Thus, our results suggested that SMF pretreatment mitigates the adverse effects of UV-B stress by the enhancement in photosynthetic performance along with higher NO content which may be able to protect the plants from the deleterious effects of oxidative stress caused by UV-B irradiation., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

The increasing emission of nitrogen oxides exerts large impacts on vegetation by raising surface ozone (O 3 ) concentrations and enhancing atmospheric nitrogen (N) deposition. We established a free-air O 3 concentration elevation and enhanced N deposition system (O 3 -N-FACE) in Beijing, China, to investigate long-term effects of elevated O 3 and N deposition on poplar plantation. Eight square plots with a side length of 16 m were randomly allocated to elevated O 3 (E-O 3 ) and ambient air (AA) treatments. Ozone generated by electric discharge in pure oxygen is mixed with clean and dry air, and released from small holes on the tubes installed above the plant canopy at a rate controlled to keep O 3 concentration in E-O 3 plots by 50% higher than that in AA plots. Each O 3 treatment plot consisted of four subplots with a factorial combination of 2 lines of poplar clones and 2 levels of N deposition rate. In enhanced N deposition subplots, we sprayed urea solution on the plantation floor at a rate of 60 kg ha -1 year -1 . We hereby present the system performances during the growing seasons of 2018 and 2019: the first 2 years of experiment. The mean daytime O 3 concentrations of E-O 3 plots were 38% and 31% higher than AA plots in 2018 and 2019, respectively. And, in 2019, the accumulated O 3 exposure over 40 ppb (AOT40) in E-O 3 plots was 70% higher than that in AA plots. The hourly mean O 3 concentrations in E-O 3 plots were within 20% of the target for 83% of time on average across the four E-O 3 plots. Within the E-O 3 plots, spatial distribution of the hourly O 3 concentration exhibited the maximum deviation at 24% in 2019. We concluded that performance of this system is better than other similar facilities for trees and suitable for a long-term experiment of enhanced O 3 and N., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

In the last three decades, ablation of atrial fibrillation (AF) has become an evidence-based safe and efficacious treatment for managing the most common cardiac arrhythmia. In 2007, the first joint expert consensus document was issued, guiding healthcare professionals involved in catheter or surgical AF ablation. Mounting research evidence and technological advances have resulted in a rapidly changing landscape in the field of catheter and surgical AF ablation, thus stressing the need for regularly updated versions of this partnership which were issued in 2012 and 2017. Seven years after the last consensus, an updated document was considered necessary to define a contemporary framework for selection and management of patients considered for or undergoing catheter or surgical AF ablation. This consensus is a joint effort from collaborating cardiac electrophysiology societies, namely the European Heart Rhythm Association, the Heart Rhythm Society (HRS), the Asia Pacific HRS, and the Latin American HRS., (© 2024. Heart Rhythm Society, the European Society of Cardiology, the Asia Pacific Heart Rhythm Society, and the Latin American Heart Rhythm Society.)

Purpose: Heart valve disease is commonly treated by minimally invasive procedures with guide wires and catheterization. The main purpose of this study is to find out whether an extension of the guide wire with a sensor can support the surgeon within the blood vessel to reduce X-ray necessity., Methods: A smart guide wire is developed by an extension with a flex-bending sensor to evaluate the sensor signal with and without "blood" flow at a constant compression force. Various surgically relevant investigations are performed. For assessment, the mean temporal average of the moving averaged filtered ADC signal and a subsequent FFT are carried out., Results: Results show that there is a smaller sensor signal when the applied force or bending at the sensor is higher. In all investigations, there was a different sensor signal. The flex-bending sensor can detect the effect of pulsatile flow. The smallest temporal averaged signal difference between reference and clamp in the front wire's tip is 1.09%. For example, the mean temporal average of the filtered ADC signal for different clinically relevant scenarios is between 2550 and 2900., Conclusions: The results show that the sensorized guide wire developed for catheterization can support aortic valve implementation. The sensor sensitivity is sufficient to detect even very small variations within the blood vessel and therefore is promising to support catheterization heart valve surgeries in future., (© 2024. CARS.)

The selection of the appropriate biomonitor species is a crucial criterion for biomonitoring on a broad spatial scale. Mosses Hypnum cupressiforme and Brachythecium spp. and lichen Evernia prunastri were sampled at 22 remote sites over Serbia aiming interspecies comparison of their bioconcentration capacities. The concentration of 16 potentially toxic elements (PTEs), Al, Ba, Cd, Co, Cr, Cu, Fe, Hg, Mn, Ni, P, Pb, S, Sr, V, and Zn, was measured in the samples. Between the co-located mosses, linear regression analysis (type II) showed significant determination coefficients only for a couple of the elements (Cd and S), while for H. cupressiforme vs. lichen, significant regression lines were obtained for a broader set of elements (Ba, Cd, Fe, Hg, Mn, Ni, Sr). The ratio of the PTEs in the mosses discovered higher concentrations in H. cupressiforme than in another moss at some sites and vice versa at other sites. According to the PTE ratios, H. cupressiforme accumulated much more element content than the lichen, but followed a similar spatial pattern. In addition, principal component analysis (PCA) pointed out a different grouping of the PTEs depending on the species tested. The poor correlation of the moss-moss data is perhaps because several species of the genus Brachythecium were sampled, which possibly influenced the average genus accumulation capacity. In addition, morphological features of the mosses (concave vs. flat leaflets, creeping vs. cushiony life form) presumably delegate differences in PTE accumulation. To conclude, it should be careful with using more biomonitor species, even of the same genus, within the same study., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The present study evaluates the development of visible injury related to phytotoxic ozone dose (PODy) in native tropical species Astronium graveolens Jacq. (Anacardiaceae) and validates the symptoms using structural markers attributed to oxidative burst and hypersensitive responses. Increasing POD 0 was associated with increasing O 3 visible injury using different metrics as the incidence (INC = number of injured plants/total number of plants × 100), severity (SF = number of injured leaves/total number of leaves on injured plant × 100), and severity leaflet (SFL = number of injured leaflets/total number leaflets injured plant × 100). The effective dose (ED), which represents the POD 0 dose responsible for inducing 20 (ED20), 50 (ED50), or 80% (ED80) of visible injury, were used to demonstrate that for this species, the response is similar even when the plants are exposed to diverse climate environments. Further investigation of the INC and SF index may help in long-term forest monitoring sites dedicated to O 3 assessment in forests, while the SFL index seems to be an excellent indicator to be used in the short term to investigate the effects of O 3., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Toxic trace elements from both, natural and anthropogenic origin, pose a threat to aquatic environments and marine wildlife due to their long-range transport, bioaccumulative nature, and biomagnification through the food chain. Being long-lived and migratory animals, sea turtles can be exposed to elevated levels of toxic elements, and are therefore considered sentinel species for chemical pollution. In this study, concentrations of trace elements (arsenic, cadmium, lead, mercury) were determined in tissues of 46 loggerhead sea turtles (Caretta caretta) stranded along Tyrrhenian and Ionian coasts of Calabria, in Southern Italy, between 2014 and 2020. Curved carapace length (CCL), curved carapace width (CCW), body mass (BM), and sex were determined and the correlations of these parameters with toxic elements concentrations were investigated. During necropsy, kidney, liver, and muscle tissues were collected and the concentration and distribution of metals determined. Muscle tissues showed the lowest toxic element burdens, except for As that showed the highest mean concentrations in this tissue. The kidney was the main accumulation organ for Cd, while similar levels of Hg and Pb were measured in kidney, liver, and muscle tissues. The risk assessment performed for Cd, Hg, and Pb in sea turtles' liver highlighted possible negative effects on sea turtles' health and the need for marine turtle toxicology researches. This is the first study reporting levels and distribution of toxic elements in tissues of Caretta caretta turtles from the Tyrrhenian and Ionian coasts of Calabria.

The anionic surfactant SLES (sodium lauryl ether sulfate) is an emerging contaminant, being the main component of foaming agents that are increasingly used by the tunnel construction industry. To fill the gap of knowledge about the potential SLES toxicity on plants, acute and chronic effects were assessed under controlled conditions. The acute ecotoxicological test was performed on Lepidum sativum L. (cress) and Zea mays L. (maize). Germination of both species was not affected by SLES in soil, even at concentrations (1200 mg kg -1 ) more than twice higher than the maximum realistic values found in contaminated debris, thus confirming the low acute SLES toxicity on terrestrial plants. The root elongation of the more sensitive species (cress) was instead reduced at the highest SLES concentration. In the chronic phytotoxicity experiment, photosynthesis of maize was downregulated, and the photosynthetic performance (PI TOT ) significantly reduced already under realistic exposures (360 mg kg -1 ), owing to the SLES ability to interfere with water and/or nutrients uptake by roots. However, such reduction was transient, likely due to the rapid biodegradation of the surfactant by the soil microbial community. Indeed, SLES amount decreased in soil more than 90% of the initial concentration in only 11 days. A significant reduction of the maximum photosynthetic capacity (Pn max ) was still evident at the end of the experiment, suggesting the persistence of negative SLES effects on plant growth and productivity. Overall results, although confirming the low phytotoxicity and high biodegradability of SLES in natural soils, highlight the importance of considering both acute and nonlethal stress effects to evaluate the environmental compatibility of soil containing SLES residues.

New critical levels for ozone based on accumulated flux through stomata (phytotoxic ozone dose, POD), for temperate perennial grassland (semi-)natural vegetation, have been agreed for use within the Convention on Long-Range Transboundary Air Pollution. These were based on data from several experiments conducted under naturally fluctuating environmental conditions that were combined and analysed to give linear dose-response relationships. Dose-response functions and flux-based critical levels were derived based on biomass and flower number. These parameters showed a statistically significant decline with increasing accumulated stomatal ozone flux. The functions and critical levels derived are based on sensitive species and can be used for risk assessments of the damaging effect of ozone on temperate vegetation communities dominated by perennial grassland species. The critical level based on flower number was lower than that for biomass, representing the greater sensitivity of flower number to ozone pollution.

Surface ozone and temperature trends were investigated using records from 2000 to 2021 in Southwestern Europe, at El Arenosillo observatory, focusing on June and December. The ozone trends for daily percentiles were increasing in June for lower percentiles (2.5 ± 1.2 ppb decade -1 for the 5th percentile) and decreasing for higher (- 2.2 ± 1.4 ppb decade -1 for the 95th percentile); in December, the trends were growing in the entire range of percentiles, with a peak of 2.2 ± 0.8 ppb decade -1 . A declining trend was obtained for the geopotential height at the pressure level of 850 hPa (Z850) in June while highlighting the upward trend in December (26.3 ± 6.5 m decade -1 ). The hourly trends for ozone and temperature were also explored in these months. In June, the nocturnal ozone trends were growing (4.0 ± 1.2 ppb decade -1 or 10% decade -1 at 8:00 UTC) associated with temperature rises while in the daytime, a decrease in temperature was observed along with an ozone decreasing trend (- 2.6 ± 1.6 ppb decade -1 or - 5% decade -1 at 18:00 UTC). Hourly ozone and temperature trends in December were increasing with peaks of 3.0 ± 0.9 ppb decade -1 (~ 8% decade -1 ) at 12:00 UTC and 1.6 ± 0.3 °C decade -1 at 19:00 UTC. Two representative scenarios of these months were studied. The ozone decreases in June could be associated with several factors, decreasing in temperatures and a possible weakening of the anticyclonic conditions leading to changes in the mesoscale processes' development. The strengthening of the Azores anticyclone in December could be enhancing the upward ozone trend observed. It is unknown whether the reversal ozone pattern trends found in this region are a local phenomenon; although we suggest that it could be happening on a larger scale as well, future studies should be carried out., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The aim of the present study was to evaluate the long-term safety and effectiveness of the subcutaneous implantable cardioverter defibrillator (S-ICD) when implanted intermuscularly in patients with end-stage renal disease and hemodialysis., Methods: This study is a retrospective analysis of 21 consecutive patients implanted with S-ICDs at three experienced centers in Germany with comorbid renal insufficiency requiring hemodialysis, as well as being at risk of sudden cardiac death. The S-ICD was placed intermuscularly in all patients. Follow-ups (FUs) were performed every 6 months., Results: The mean ± standard deviation FU duration was 60.0 ± 11.4 months, with a range of 39 to 78 months. There were no deaths due to arrhythmia, or device-associated infections and complications. Four patients (19.1%) died during FU due to respiratory insufficiency during dialysis, systolic heart failure, septic infection of the urogenital tract, and colorectal cancer, respectively. There were six non-device-related hospitalizations with a duration of 12.7 ± 5.1 days and a hospitalization rate of 4.1 per 100 patient years., Conclusions: In the long-term FU of this small population of seriously compromised hemodialysis patients at risk of sudden cardiac death, the intermuscularly implanted S-ICD system was safe and effective. No arrhythmic complications, device-associated infections, or complications compromised survival. These data are encouraging and support testing in a larger group of similarly compromised patients., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: The subcutaneous implantable cardioverter defibrillator (S-ICD) and leadless pacemaker (LP) are alternative options for patients at high risk of infection requiring ICD and pacing therapy. In this analysis, we described the simultaneous implantation of S-ICD and LP in patients with high infectious risk., Methods: The study cohort comprised patients referred to our institution for ICD implantation due to high-risk factors of infection., Results: Between 2018 and 2022, 13 patients were referred, including 11 with infected ICD and 2 for first ICD implantation in the presence of high-risk factors. In cases of infected ICD, successful extraction was performed using a mechanical dilatation technique. Reimplantation was delayed until resolution of infection with antibiotic therapy. The devices were implanted during a single procedure, with S-ICD implantation following LP placement for verification of sensing adequacy through surface ECG screening. Suitable vectors for sensing during inhibited and ventricular pacing were identified in all patients. Defibrillation testing was effective, and no issues with double counting or undersensing were observed. The postoperative period was uneventful, and during a median follow-up of 35 months, no complications or infections were reported. The median ventricular pacing percentage was 5%, and a single inappropriate shock episode due to myopotential interference was reported and resolved by reprogramming the sensing vector., Conclusion: Simultaneous implantation of S-ICD and LP is feasible and safe in patients at high risk of infection requiring both ICD and pacing therapy. This combined approach provides an effective solution for these patients., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Ozone pollution in 2019 in China is particularly severe posing a tremendous threat to the health of Chinese inhabitants. In this study, we constructed a more reliable and accurate 1-km gridded dataset for 2019 with as many sites as possible using the inverse distance weight interpolation method to analyze spatiotemporal ozone pollution characteristics and health burden attributed to ozone exposure from the perspective of different diseases and weather influence. The accuracy of this new dataset is higher than other public datasets, with the coefficient of determination of 0.84 and root-mean-square error of 8.77 ppb through the validation of 300 external sites which were never used for establishing retrieval methods by the datasets mentioned-above. The averaged MDA8 (the daily maximum 8 h average) ozone concentrations over China was 43.5 ppb, and during April-July, 83.9% of total grids occurred peak-month ozone concentrations. Overall, the highest averaged exceedance days (60 days) and population-weighted ozone concentrations (55.0 ppb) both concentrated in central-eastern China including 9 provinces (only 11.4% of the national territory); meanwhile, all-cause premature deaths attributable to ozone exposure reached up to 142,000 (54.9% of national total deaths) with higher deaths for cardiovascular and respiratory, and the provincial per capita premature mortality was 0.27~0.44‰. The six most polluted weather types in the central-eastern China are in order as follows: westerly (SW and W), cyclonic, northerly, and southerly (NW, N, and S) types, which accounts for approximately 73.2% of health burden attributed to daily ozone exposure and poses the greatest public health risk with mean daily premature deaths ranging from 466 to 610. Our findings could provide an effective support for regional ozone pollution control and public health management in China., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Research on climate-sensitive urban planning is important to improve the quality of city life. Cold climate cities should respect climatic characteristics to diversify outdoor uses and increase air quality to maximize the benefits of winter. This study is aimed to explore the impact of changing urban pattern on air pollution and outdoor human thermal comfort conditions (HTCCs) in a newly developed urban area in Şükrüpaşa neighbourhood, Erzurum, among the coldest cities in Turkey, with high PM 10 and low HTCCs levels. Sensitivity of urban development pattern to climate conditions and its suitability to eliminate the winter disturbances caused by HTCCs and air pollution were investigated by producing maps for HTCCs and air pollution using morphological, meteorological and spatial data and ENVI-met model in winter period of 2017 and 2022. It was found that newly developed areas increase the unfavourable conditions in terms of air quality, temperature and HTCCs due to the reasons like improper land uses, urban sprawl, high urban density and ventilation problems. In high-elevated cold cities, spatial planning and design principles should strictly be followed by incorporating climate knowledge and without revising the spatial decisions., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Aerosol-CCN characteristics and dynamics during a pre-monsoon dust storm (April 6-11, 2015) over a high-altitude site ((17.92°N, 73.66°E, and 1348 m above mean sea level (MSL)) in Western Ghats, India, has been studied using ground-based observations, satellite, and reanalysis datasets. Spatial distribution of dust surface mass concentration along with the back trajectory analysis showed the Arabian Desert area (Rub-Al-khali desert) as the source region and strong westerly winds transported the dust particles toward the Indian subcontinent. High values noticed in the surface PM 10 (PM 2.5 ), i.e., ~ 450 (~ 130) µg m -3 , MODIS AOD 550nm (0.6), and MERRA 2 dust surface mass concentration (5 × 10 -7  kg m -3 ) along MODIS true color images confirmed the dust storm event on April 6, 2015 over the observational site. Size-segregated aerosol number concentration measured from ground-based observations showed the dominance of Aitken, accumulation, and coarse mode particles during dust period. CCN concentrations at 0.1, 0.3, 0.5, 0.7, and 0.9% SS were analyzed. A low value of CCN concentration and activation fraction (~ 0.3) near surface was noticed during dust storm day, suggesting insoluble mineral dust particle being transported. Analyzed vertical velocity during pre-dust period showed downdraft between 900 and 750 hPa, suggesting dust transport from upper altitudes toward the observational site. WRF-Chem model simulation also captured the dust storm event, and the results are in good agreement with the observation with a significance of 95% confidence level., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The representativeness of ambient air quality of an in situ measurement is key in the use and correct interpretation of the measured concentration values. Though the horizontal representativeness aspect is generally not neglected in air pollution studies, a detailed, high-resolution vertical distribution of ambient air pollutant concentrations is rarely addressed. The aim of this study is twofold: (i) to explore the vertical distribution of ground-level ozone (O 3 ) concentrations measured at four heights above the ground-namely at 2, 8, 50, and 230 m-and (ii) to examine in detail the vertical O 3 concentration gradient in air columns between 2 and 8, 8 and 50, and 50 and 230 m above the ground. We use the daily mean O 3 concentrations measured continuously at the Košetice station, representing the rural Central European background ambient air quality observed during 2015-2021. We use the semiparametric GAM (generalised additive model) approach (with complexity or roughness-penalised splines implementation) to analyse the data with sufficient flexibility. Our models for both O 3 concentrations and O 3 gradients use (additive) decomposition into annual trend and seasonality (plus an overall intercept). The seasonal and year-to-year patterns of the modelled O 3 concentrations look very similar at first glance. Nevertheless, a more detailed look through O 3 gradients shows that they differ substantially with respect to their seasonal and long-term dynamics. The vertical O 3 concentration gradient in 2-230 m is not uniform but changes substantially with increasing height and shows by far the highest dynamics near the ground between 2 and 8 m, differing in both the seasonal and annual aspects for all the air columns inspected. We speculate that non-linear changes of both seasonal and annual components of vertical O 3 gradients are due to atmospheric-terrestrial interactions and to meteorological factors, which we will explore in a future study., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: While robotic-assisted hernia repair has increased the popularity of minimally invasive hernia surgery, selecting between the types of approaches is a challenge for both experts and novices alike. In this study, we compared a single surgeon's early experience transitioning from transabdominal hernia repair with sublay mesh in either the pre-peritoneal or retrorectus space (TA-SM) and enhanced-view totally extra-peritoneal (eTEP) ventral hernia repair in the peri-operative and long-term post-operative time periods., Methods: We conducted a retrospective review of 50 eTEP and 108 TA-SM procedures to collect demographics, intraoperative details, and 30-day and 1-year post-operative outcomes. Statistical analysis was performed utilizing Chi-square analysis, Fisher's test, and two sample t-tests with equal variances., Results: There were no significant differences in patient demographics or comorbidities. eTEP patients had larger defects (109.1 cm 2 vs. 31.8 cm 2 , p = 0.043) and mesh used (432.8 cm 2 vs. 137.9 cm 2 , p = 0.001). Operative times were equivalent (158.3 ± 90.6 min eTEP and 155.8 ± 65.2 min TA-SM, p = 0.84), but conversion to alternate procedure type was higher for the transabdominal approach (4% eTEP vs. 22% TA-SM, p < 0.05). Hospital stay was less in the eTEP cohort (1.3 days vs. 2.2 days, p < 0.05). Within 30 days, there were no significant differences in emergency visits or hospital readmissions. There was a greater propensity for eTEP patients to develop seromas (12.0% vs. 1.9%, p < 0.05). At 1 year, there was no statistically significant difference in recurrence rate (4.56% eTEP vs. 12.2% TA-SM, p = 0.28) respective to average time to recurrence (9.17 months eTEP vs. 11.05 months TA-SM)., Conclusion: The eTEP approach can be adopted safely and efficiently, and may have superior peri-operative outcomes including fewer conversions and reduced hospital stay., (© 2023. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

The adverse impact of climate change on crop yield has accelerated the need for identification of crop cultivars resistant to abiotic stress. In the present study, a cultivar assortment index (CAI) was generated for the evaluation of forty Amaranthus hypochondriacus cultivars response to elevated ozone (EO) concentrations (AO + 30 ppb) in Free Air Ozone Enrichment (FAOE) facility using the parameters viz. foliar injury, gaseous exchange attributes, namely, net photosynthetic rate, stomatal conductance, transpiration rate, intercellular carbon dioxide, and water use efficiency along with above ground biomass and grain yield attributes. The dataset was used to identify key indicator parameters responsive to EO through principal component analysis (PCA) and further transformed to obtain linear score and weighted score. The CAI varied from 70.49 to 193.43. Cultivars having CAI value less than 151 were ozone tolerant (OT) whereas cultivars with CAI values between 150 and 170 were moderately tolerant (MOT). The cultivars exhibiting CAI values above 170 were ozone sensitive (OS). The cultivars exhibited differential sensitivity to EO with IC-5994 (CAI = 187.26) being the most affected cultivar whereas IC-5576 (CAI = 83.38) and IC-5916 (CAI = 70.49) being the least affected ones. The CAI, based on linear score and weighted score, offers easy identification of ozone sensitive (OS) and ozone tolerant (OT) cultivars. This index could help researchers to define a clear and strong basis for identification of OT cultivars which will reduce the time required for preliminary screening and further evaluation of crop cultivars for the development of climate smart crops., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

We present the first reported case of extraction of a ventricular lead placed in the left bundle branch area with a double-loop design snare via the femoral approach without any complication. It was a 4-month-old lead whose extraction was not possible only with a conventional stylet via an implant vein approach, so we want to show that complete procedural success is possible., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The aim of this study was to assess the significance of post-operative troponin levels as a surrogate for left ventricular (LV) dysfunction measured by global longitudinal strain (GLS) in patients with dextro-transposition of the great arteries (d-TGA) who undergo an arterial switch operation (ASO), and to explore the LV GLS recovery in the mid-term follow-up period. Seventy-eight neonates were included, of whom 41 had troponin-I measurements and 37 had troponin-T measurements. The primary outcome of LV GLS was assessed and compared with healthy controls at the pre-operative stage and time of discharge, 3 months, 6 months and 12 months of age. Secondary outcomes included deaths or transplantations and other clinical markers such as length of hospital stay. D-TGA patients had worse LV GLS post-operatively compared to age-matched controls (p < 0.01) which improved by 12 months of age (p = 0.53). No association was found between changes in troponin-I or troponin-T levels and LV GLS at the time of discharge (r = 0.4, p = 0.64 and r = -0.5, p = 0.91, respectively). In addition, there were no deaths or transplantations in this cohort over a period of 12 months. LV GLS appears to worsen in the early post-operative period for d-TGA patients who undergo neonatal ASO but this recovers through the first post-operative year. Troponin levels have limited value in predicting early or midterm LV dysfunction and recovery., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Nitrogen (N) deficiency represents an important limiting factor affecting photosynthetic productivity and the yields of crop plants. Significant reported differences in N use efficiency between the crop species and genotypes provide a good background for the studies of diversity of photosynthetic and photoprotective responses associated with nitrogen deficiency. Using distinct wheat (Triticum aestivum L.) genotypes with previously observed contrasting responses to nitrogen nutrition (cv. Enola and cv. Slomer), we performed advanced analyses of CO 2 assimilation, PSII, and PSI photochemistry, also focusing on the heterogeneity of the stress responses in the different leaf levels. Our results confirmed the loss of photosynthetic capacity and enhanced more in lower positions. Non-stomatal limitation of photosynthesis was well reflected by the changes in PSII and PSI photochemistry, including the parameters derived from the fast-fluorescence kinetics. Low photosynthesis in N-deprived leaves, especially in lower positions, was associated with a significant decrease in the activity of alternative electron flows. The exception was the cyclic electron flow around PSI that was enhanced in most of the samples with a low photosynthetic rate. We observed significant genotype-specific responses. An old genotype Slomer with a lower CO 2 assimilation rate demonstrated enhanced alternative electron flow and photorespiration capacity. In contrast, a modern, highly productive genotype Enola responded to decreased photosynthesis by a significant increase in nonphotochemical dissipation and cyclic electron flow. Our results illustrate the importance of alternative electron flows for eliminating the excitation pressure at the PSII acceptor side. The decrease in capacity of electron acceptors was balanced by the structural and functional changes of the components of the electron transport chain, leading to a decline of linear electron transport to prevent the overreduction of the PSI acceptor side and related photooxidative damage of photosynthetic structures in leaves exposed to nitrogen deficiency., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Tropospheric ozone (O 3 ) is a long-range transboundary secondary air pollutant, causing significant damage to agricultural crops worldwide. There are substantial spatial variations in O 3 concentration in different areas of India due to seasonal and geographical variations. The Indo-Gangetic Plain (IGP) region is one of the most crop productive and air-polluted regions in India. The concentration of tropospheric O 3 over the IGP is increasing by 6-7.2% per decade. The annual trend of increase is 0.4 ± 0.25% year -1 over the Northeastern IGP. High O 3 concentrations were reported during the summer, while they were at their minimum during the monsoon months. To explore future potential impacts of O 3 on major crop plants, the responses of different crops grown under ambient and elevated O 3 concentrations were compared. The studies clearly showed that O 3 is an important stress factor, negatively affecting the yield of crops. In this review, we have discussed yield losses in agricultural crops due to rising O 3 pollution and variations in O 3 sensitivity among cultivars and species. The use of ethylene diurea (EDU) as a research tool in assessing the losses in yield under ambient and elevated O 3 levels also discussed. Besides, an overview of interactive effects of O 3 and nitrogen on crop productivity has been included. Several recommendations are made for future research and policy development on rising concentration of O 3 in India., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

In this study, the PM 2.5 and PM 10 concentrations from 367 cities in China were integrated with MODIS-retrieved aerosol optical depth (AOD) and Angstrom exponent (AE) data to explore the relationship between ground-measured surface particle concentrations and remote-sensing aerosol parameters. The impact of meteorological and topographical factors and seasonality were also taken into consideration and the partial least squares (PLS) regression model was adopted to evaluate the effects of surface particulate matter (PM) concentration and meteorological factors on the variation of aerosol parameters. PM concentrations and aerosol parameters all presented strong spatial disparity and seasonal patterns in China. After implementation of stringent clean air actions and policies, both the ground-measured and satellite-retrieved aerosol parameters revealed that the concentrations of suspended particles in China's cities declined dramatically from 2015 to 2018. The PM/AOD ratio showed conspicuous south-north and west-east differences. The ratio was strongly correlated to meteorological and topographic factors, and it tended to be higher in arid and less polluted regions. Moreover, the dominant factors affecting seasonal PM/AOD ratios varied among China's five regions. The correlations of daily PM-AOD were always strong in southwest China and in basin terrain (e.g., Sichuan Basin and Tarim Basin). In contrast, the PM-AOD correlation was found to be negative in some cities on the Tibetan Plateau because local relative humidity makes a greater contribution to AOD variation. Since the climate is arid and the ratio of coarse particles (e.g., PM 10 ) is much higher, PM tended to have a significantly negative correlation with AE in northwestern cities. Whereas in many southern cities, PM was positively correlated with AE because of the area's high relative humidity and aerosol hygroscopic properties., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The threat of desertification is considered a global concern that occurs in many environments in different parts of the world, where extensive lands are transformed gradually into desert or semi-desert areas, and this causes economic and health issues. Iraq and many other parts of the Middle East are facing desertification threats in the last twenty years. Despite the significance of this issue, relevant reviews are scarce. The removal of vegetation cover, overgrazing, deforestation in times of war, poor irrigation practices and water scarcity are some of the main causes of desertification in Iraq. Fighting desertification requires cooperative efforts including the utilization of innovative practices, biotechnological approaches, restoration of oases, continuous reforestation, and rehabilitation of agricultural lands. The objective of this review article is to discuss the causes of desertification and land degradation in Iraq, highlighting the main natural and human factors involved, and the consequent impact on the national security, economy, society, and health. In addition, it suggests recommendations for policies and actions that can be integrated to mitigate this problem., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Purpose: We aimed to study the characteristics of the membranous septum (MS) and its relationship with the aortic valve (AoV) and aortic annulus (AA) in patients who required PPM post-TAVR., Methods: We performed a retrospective case-control study of 144 patients undergoing TAVR from 2016 to 2018. Thirty-four patients, requiring PPM implantation, were compared with 34 matched controls who did not require pacing. The total MS length, supra-annular MS (SA-MS) length, infra-annular MS (IA-MS) length, angle between the plane of the AA and MS (AA-MS), and degree of AoV calcifications (AVC) were obtained from preoperative CT. AoV prosthesis implantation depth was obtained from intra-operative fluoroscopy., Results: There were no significant differences in valve type (self-expandable: 23 cases vs 25 controls, and balloon-expandable: 11 vs 9, p = 0.79), degree of AVC (0.65 cm 3 vs 0.82 cm 3 , p = 0.62), or implantation depth (7.76 mm vs 7.28 mm, p = 0.83). Compared to controls, there was no difference in total MS length (6.68 mm vs 6.06 mm, p = 0.97), but the IA-MS was significantly shorter (3.64 mm vs 4.56 mm, p = 0.02) and the SA-MS was significantly longer (2.73 mm vs 1.67 mm, p = 0.02) in patients requiring PPM. Patients requiring PPM also had a larger AA-MS angle (103.5° vs 96.7°, p = 0.01)., Conclusion: The position of the MS with respect to the AA and MS distance below the annular plane were more closely associated with post-TAVR conduction abnormalities requiring PPM than the absolute length of the MS. Patients undergoing TAVR with such anatomy have a higher risk of requiring PPM and should be monitored for developing these complications., (© 2021. Springer Science+Business Media, LLC, part of Springer Nature.)