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The sources of air pollution are classified as point, line and surface sources. Motor vehicle pollution is modelled as a line source. Hitherto, studies of air pollution have emphasized surface pollution caused by fossil fuel burning for the purposes of obtaining energy and heating, and motor vehicle pollution studies are usually concentrated on land vehicles. In this study, the effect of aircraft emissions on the environment is considered from two different aspects: during cruising, and during landing, take-off and the taxiing. Air pollution caused by aircraft is also estimated for the year 2000, and the pollution caused during cruising is given globally. The contribution of the Istanbul Ataturk airport to surface air pollution is estimated. In addition, the pollution caused by motor vehicles and aircraft are compared, and the variation and the spread of the pollution under certain meteorological conditions are studied. [ABSTRACT FROM AUTHOR]

Owing to the rapidly growing and inefficient usage of fuel, air pollution has increased in Istanbul. The levels are affected by the weak dispersion conditions in the city. The strength of the inversion can be explained by the temperature difference between the top and bottomboundaries and their height. In this study, nighttime surface inversion heights have been found to range between 84 m and 419 m. The meanheight of the inversions was found to be less than 300 m in winter months. This behaviour indicates a poor ventilation and high pollutionpotential in the city. [ABSTRACT FROM AUTHOR]

Measurements of micrometeorological variables were made for a complete annual cycle using an automatic weather station and two energy budget-Bowen ratio systems at a field site adjacent to the Santa Cruz River in southern Arizona. These data were used to provide the basis ofan estimate of the evaporation from a one-mile long losing reach of a riparian corridor in this semi-arid environment. A remotely sensed map of vegetation cover was used to stratify the corridor into five categories of surface cover. The total evaporation was calculated as the area-weighted average of the measured evaporation for sampled areas of the two most common covers, and appropriate estimates of evaporation for the less common covers. Measurements showed a substantial, seasonally dependent evaporation from the taller, deep-rooted ripariancover in the study reach, while the short, sparse vegetation provided little evaporation. In terms of the volume of water evaporated fromthe study reach, the evaporation from irrigated agriculture accountsfor almost half of the total loss, while the majority of the remaining evaporation is from the taller riparian vegetation covers, with about one-quarter of the total loss estimated as coming from obligatoryphreatophytes, primarily cottonwood. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to compare the tissue dissolving capacities of sodium and calcium hypochlorite [NaOCl and Ca(OCl) 2 ] solutions applied without activation or with two irrigant activation methods., Materials and Methods: One hundred and eight dentin cavities were prepared. Preweighed tissue pieces were placed in these dentin cavities, and samples were divided into nine groups of twelve. In groups 1, 2, and 3, NaOCl was used with non-activation (NA), passive ultrasonic (PUA), and laser activation (LA). With the same techniques, Ca(OCl) 2 was used in groups 4, 5, and 6, and distilled water was used in groups 7, 8, and 9. The weight loss of tissue samples was calculated and analyzed using Two-way ANOVA and Duncan tests., Results: Distilled water groups showed no tissue dissolution in any conditions. NaOCI and Ca(OCI) 2 showed statistically similar dissolving effectiveness when used with the same technique. Activated groups dissolved significantly greater tissue than non-activated ones, the highest in LA., Conclusions: Ca(OCI) 2 can be an alternative to NaOCl; for both, the first choice of activation may be the LA., (© 2024. The Author(s).)

A squamous odontogenic tumor (SOT) is an epithelial locally benign neoplasia derived from the periodontium of the jaws. It is considered a lesion of low incidence. Predominantly, it affects the mandible, although both jaw bones may be involved. Here, we discuss the malignant clinical evolution of an SOT lesion in an 80-year-old female patient. The patient exhibited an expansive triangular lesion at the inferior right quadrant. Surgery was performed and an SOT was diagnosed (2019). Two years after, the lesion grew, and the analysis of the biopsy revealed SOT malignization with pleomorphic atypical squamous cells, characteristics of a squamous cell carcinoma (2021). Massive DNA sequencing of formalin-fixed-paraffin-embedded specimens of the initial and relapsed tumors indicated pathogenic mutations in RET and POLE genes in both tumors, loss of ALK , and gain of CDKN1B and MAP2K in the relapse. In addition, the clinical, radiographic, and microscopic features of this neoplasm are discussed and compared with those already published. The case presented contributes to the better understanding of this SOT tumor entity and to indicates its malignant evolution, together with its biological behavior and its histologic, clinical, and radiographic features. Also, it aims to stress the importance of deeper genetic analyses in rare diseases to uncover mutations that help to select a personalized treatment.

Background and Objective: Eliminating intracanal Enterococcus faecalis ( E. faecalis ) is challenging because of its ability to penetrate deep dentinal tubules and its high resistance to many chemicals. This study evaluated the effectiveness of conventional needle irrigation and three different irrigant activation methods in reducing E. faecalis . Methods: The root canals of extracted teeth were shaped, contaminated with E. faecalis , and incubated for three weeks. They were randomly allocated to four experimental groups of 15 teeth each according to the final irrigation method: group 1, conventional needle irrigation; group 2, passive ultrasonic (PU) irrigation; group 3, XP-endo Finisher (XPF); and group 4, laser-activated (LA) irrigation. Bacterial samples were taken and cultured before and after these final irrigation procedures. The colony-forming units were counted, and the bacterial reduction percentages of each group were calculated. The Kruskal-Wallis and Dunnet tests were used for statistical analysis. Results: All irrigant activation methods were significantly more effective than conventional needle irrigation. Although the LA group generated more negative samples than PU, there was no statistically significant difference between the LA and PU groups. LA was significantly more effective than the XPF, whereas PU and XPF were statistically similar. Conclusions: Within the limitations of this study, the final irrigation with LA and PU showed the best reductive effect on E. faecalis colonies. Considering that the LA group had more negative samples, it may be chosen as an alternative to enhance root canal disinfection, especially in difficult cases.

Colon specific delivery of therapeutics have gained much attention of pharmaceutical researchers in the recent past. Colonic specific targeting of drugs is used not only for facilitating absorption of protein or peptide drugs, but also localization of therapeutic agents in colon to treat several colonic disorders. Among various biopolymers, guar gum (GG) exhibits pH dependent swelling, which allows colon specific release of drug. GG also shows microbial degradation in the colonic environment which makes it a suitable excipient for developing colon specific drug delivery systems. The uncontrolled swelling and hydration of GG can be controlled by structural modification or by grafting with another polymeric moiety. Several graft copolymerized guar gum derivatives are investigated for colon targeting of drugs. The efficacy of various guar gum derivatives are evaluated for colon specific delivery of drugs. The reviewed literature evidenced the potentiality of guar gum in localizing drugs in the colonic environment. This review focuses on the synthesis of several guar gum derivatives and their application in developing various colon specific drug delivery systems including matrix tablets, coated formulations, nano or microparticulate delivery systems and hydrogels., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Effective pain management is vital in critical care settings, particularly post-surgery. Clinicians should maintain objective and efficient standards to assess pain in a patient-centered manner, in order to effectively manage this complex issue. A newer technology, the nociception level (NOL) index, shows promise in achieving this task through its multi-parameter evaluation., Methods: This study was a prospective, controlled, randomized trial involving two groups of patients (n=30 each) in a diverse intensive care unit. Participants were over 18 years old with American Society of Anesthesiology scores ranging from I to III and were scheduled for critical care follow-up after general anesthesia. All subjects followed a standard analgesia protocol that included rescue analgesia. Drug administration was guided by a numeric rating scale and the critical care pain observation tool in the Control Group, while it was guided by nociception level index monitoring in the NOL Group., Results: Pain scores between the two groups did not significantly differ. However, within the NOL Group, pain scores and noci-ception values displayed a strong positive correlation. Notably, total analgesic consumption was significantly lower in the NOL Group (p=0.036)., Conclusion: Monitoring pain using the nociception level index is an effective method for detecting pain compared to standard pain scores utilized in critical care. Its guidance facilitates personalized analgesic titration. Additionally, the potential of nociception level index guidance to reduce the duration of intensive care and hospital stays may be linked to its effects on delirium, a connection that awaits further exploration in future studies.

Transcatheter aortic valve replacement (TAVR) has emerged as a well-established treatment option for eligible patients with severe aortic stenosis. This study aimed to investigate the correlation between abdominal fat tissue volumes, measured using computed tomography (CT), and all-cause mortality in patients undergoing TAVR. The study included 258 consecutive patients who underwent TAVR at a single center between September 2017 and November 2020. During the preoperative preparation, CT scans were used to perform a semi-quantitative measurement of abdominal fat components. Body mass index (BMI) for each participant was calculated. The relationship between fat parameters and overall survival was determined using multivariable Cox proportional hazards models. Participants had a mean age of 76.8 ± 7.8 years, of whom 32.9% were male. The median follow-up period was 12 months, during which 38 patients (14.7%) died. Both the survivor and non-survivor groups showed comparable risk factors. Regarding transabdominal fat volume parameters, deceased individuals exhibited significantly lower values. However, no significant differences were observed in BMI and transabdominal area measurements. Among transabdominal fat parameters, only subcutaneous fat volume [adjusted Hazard Ratio (aHR) = 0.83, p = 0.045] and total fat volume (TFV) [aHR = 0.82, p = 0.007] were identified as significant predictors of reduced all-cause mortality. Furthermore, TFV demonstrated the highest discriminative performance with a threshold of ≤ 9.1 L (AUC = 0.751, p < 0.001, sensitivity 71.1%, specificity 70.9%). Preoperative CT-based abdominal fat volume parameters, particularly TFV, can serve as potential predictors of survival in patients undergoing TAVR., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

The transition from a single portal to a double portal can be complex, necessitating time and training to minimize complications that rely on the operator's skill. Needle therapy is a simple method for treating symptoms that has several benefits. Consequently, this innovative strategy aims to introduce an intermediate technique that enables surgeons to perform therapeutic procedures during single-port arthroscopy., (Copyright © 2024 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Objectives: To research the effects of blood cortisol and hemoglobinA1c (HBA1C) levels on mortality in patients admitted to the intensive care unit (ICU) and whether these factors could be used as reliable indicators for mortality risk assessment in these patients., Methods: After receiving approval from the ethics committee, 79 patients admitted to ICU were included in the study. From patient files, we collected data on demographics (age, gender), presence of diabetes mellitus, and levels of cortisol, HbA1C, glucose, and lactate measured during hospitalization, along with acute physiology and chronic health evaluation (APACHE) II scores calculated within the first 24 hours. In our study, we planned to investigate the relationship between patients' cortisol and HbA1C levels and mortality., Results: A total of 79 patients were included in the study. The mortality rate of the patients included in the study was 65.8%. In the model established with all variables, only cortisol level ( p =0.017) and APACHE II score ( p =0.005) were defined to affect mortality., Conclusion: Cortisol levels at the time of admission to the ICU were found to affect mortality and can be considered a predictive factor, while HBA1C levels showed no such effect. Our findings indicate that neither cortisol nor HBA1C levels had an impact on the duration of mechanical ventilation or length of stay in the ICU., (Copyright: © Saudi Medical Journal.)

Glycated hemoglobin (GHb) found in mammals undergoes irreversible damage when exposed to external redox agents, which is much more vulnerable than its normal counterpart hemoglobin (Hb). Besides the oxygen regulation throughout the body, Hb plays a vital role in balancing immunological health and the redox cycle. Photoinduced ultra-fast electron transfer phenomena actively participate in regulation of various kind of homeostasis involved in such biomacromolecules. In the present study we have shown that a well-known mutagen Ethidium Bromide (EtBr) reduces GHb in femtosecond time scale (efficiently) upon photoexcitation after efficient recognition in the biomolecule. We have performed similar experiment by colocalizing EtBr and Iron (Fe(III)) on the micellar surface as Hb mimic in order to study the excited state EtBr dynamics to rationalize the time scale obtained from EtBr in GHb and Hb. While other experimental techniques including Dynamic Light Scattering (DLS), Zeta potential, absorbance and emission spectroscopy have been employed for the confirmation of structural perturbation of GHb compared to Hb, a detailed computational studies involving molecular docking and density functional theory (DFT) have been employed for the explanation of the experimental observations., (© 2024 Wiley-VCH GmbH.)

Background: Alcohol is a good and environment-friendly fuel that can be microbially produced, capable of eliminating many of the limitations of the present-day fossil fuels. However, the inherent toxic nature of alcohols to the microbial cells leads to end-product inhibition that limits large-scale alcohol production by fermentation. Fundamental knowledge about the stress responses of microorganisms to alcohols would greatly facilitate to improve the microbial alcohol tolerance. The current study elucidates and compares the changes in the membrane proteome of Escherichia coli in response to a range of alcohols., Results: Although alcohol toxicity increased exponentially with alcohol chain length (2-6 carbon), similar stress responses were observed in the inner and outer membrane proteome of E. coli in the presence of 2-, 4- and 6-carbon alcohols at the MIC 50 . This pertains to: (1) increased levels of inner membrane transporters for uptake of energy-producing metabolites, (2) reduced levels of non-essential proteins, associated with anaerobic, carbon starvation and osmotic stress, for energy conservation, (3) increased levels of murein degrading enzymes (MltA, EmtA, MliC and DigH) promoting cell elongation and 4) reduced levels of most outer membrane β-barrel proteins (LptD, FadL, LamB, TolC and BamA). Major outer membrane β-barrel protein OmpC, which is known to contribute to ethanol tolerance and membrane integrity, was notably reduced by alcohol stress. While LPS is important for OmpC trimerisation, LPS release by EDTA did not lower OmpC levels. This suggests that LPS release, which is reported under alcohol stress, does not contribute to the reduced levels of OmpC in the presence of alcohol., Conclusions: Since alcohol primarily targets the integrity of the membrane, maintenance of outer membrane OmpC levels in the presence of alcohol might help in the survival of E. coli to higher alcohol concentrations. The study provides important information about the membrane protein responses of E. coli to a range of alcohols, which can be used to develop targeted strategies for increased microbial alcohol tolerance and hence bioalcohol production., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Objective: Several studies have reported an increase in platelet (PLT) count with chronic inflammation in the presence of obesity. Mean platelet volume (MPV) is an important marker for PLT activity. Our study aims to demonstrate if laparoscopic sleeve gastrectomy (LSG) has any effect on PLT, MPV and white blood cells (WBCs)., Methods: A total of 202 patients undergoing LSG for morbid obesity between January 2019 and March 2020 who completed at least 1 year of follow-up were included in the study. Patients' characteristics and laboratory parameters were recorded preoperatively and were compared in the 6 th and 12 th months., Results: Two hundred and two patients (50% - female) with a mean age of 37.5 ± 12.2 years and mean pre-operative body mass index (BMI) of 43 (34.1-62.5) kg/m 2 underwent LSG. BMI regressed to 28.2 ± 4.5 kg/m 2 at 1 year after LSG (P < 0.001). The mean PLT count, MPV and WBC during the pre-operative period were 293.2 ± 70.3 10 3 cells/μL, 10.22 ± 0.9 fL and 7.8 ± 1.9 10 3 cells/μL, respectively. A significant decrease was seen in mean PLT count, with 257.3 ± 54.2 10 3 cell/μL (P < 0.001) at 1 year post-LSG. The mean MPV was increased at 6 months 10.5 ± 1.2 fL (P < 0.001) and remained unchanged at 1 year 10.3 ± 1.3 fL (P = 0.9). The mean WBC levels were significantly decreased with 6.5 ± 1.7 10 3 cells/μL (P < 0.001) at 1 year. At the end of the follow-up, weight loss showed no correlation with PLT and MPV (P = 0.42, P = 0.32)., Conclusion: Our study has shown a significant decrease in circulating PLT and WBC levels while MPV remained unchanged after LSG.

Significant progress has been made in both valves and delivery systems (DSs) for transcatheter aortic valve replacement (TAVR) procedures. We aimed to present one-year real-life data regarding TAVR procedures using Portico transcatheter heart valves (THVs) with new-generation, low-profile FlexNav DSs. This retrospective, single-center study enrolled 169 consecutive patients (mean age: 75.8 years, 68% females) with severe aortic stenosis undergoing TAVR with Portico THVs and FlexNav DSs between 2020 and 2021. We evaluated safety and efficacy outcomes, following the VARC-3 consensus, periprocedurally and at 30 days and 1 year. Procedural success was observed in 95.9% of cases, and no procedural mortality occurred. At 30 days, the rates of all-cause mortality, cardiovascular mortality, and neurological events were 4.7%, 3.6%, and 3.0%, respectively. Additionally, major vascular complications, acute kidney injury, and bleeding were recorded at rates of 11.2%, 14.8%, and 7.7%, respectively. The 1-year data showed all-cause mortality, cardiovascular mortality, and neurological event rates of 10.7%, 8.3%, and 7.7%, respectively. The moderate paravalvular leak and permanent pacemaker rates at 1 year were 2.6% and 12.2%, respectively. This real-life data provided evidence of positive outcomes and high technical success with Portico THVs and FlexNav DSs. Furthermore, we found low rates of mortality and neurological events, with satisfactory hemodynamic and functional results.

Squamous cell carcinomas arise from stratified squamous epithelia. Here, a comparative analysis based on recent studies defining the genetic alterations and composition of the stroma of oral and cutaneous squamous cell carcinomas (OSCC and CSCC, respectively) was performed. Both carcinomas share some but not all histological and genetic features. This review was focused on how mutations in tumor suppressor genes and protooncogenes cooperate to determine the differentiation, aggressiveness, and metastatic potential of OSCC and CSCC. In fact, driver mutations in tumor suppressor genes are more frequently observed in OSCC than CSCC. These include mutations in TP53 (encoding pP53 protein), CDKN2A (encoding cyclin dependent kinase inhibitor 2A), FAT1 (encoding FAT atypical cadherin 1), and KMT2D (encoding lysine methyltransferase 2D), with the exception of NOTCH (encoding Notch receptor 1), whose mutation frequency is lower in OSCC compared to CSCC. Finally, we describe the differential composition of the tumor microenvironment and how this influences the aggressiveness of each tumor type. Although both OSCC and CSCC tumors are highly infiltrated by immune cells, high levels of tumor-infiltrating lymphocytes (TILs) have been more frequently reported as predictors of better outcomes in OSCC than CSCC. In conclusion, OSCC and CSCC partially share genetic alterations and possess different causal factors triggering their development. The tumor microenvironment plays a key role determining the outcome of the disease.

Brain-Computer Interfaces (BCIs) have become increasingly popular in recent years due to their potential applications in diverse fields, ranging from the medical sector (people with motor and/or communication disabilities), cognitive training, gaming, and Augmented Reality/Virtual Reality (AR/VR), among other areas. BCI which can decode and recognize neural signals involved in speech and handwriting has the potential to greatly assist individuals with severe motor impairments in their communication and interaction needs. Innovative and cutting-edge advancements in this field have the potential to develop a highly accessible and interactive communication platform for these people. The purpose of this review paper is to analyze the existing research on handwriting and speech recognition from neural signals. So that the new researchers who are interested in this field can gain thorough knowledge in this research area. The current research on neural signal-based recognition of handwriting and speech has been categorized into two main types: invasive and non-invasive studies. We have examined the latest papers on converting speech-activity-based neural signals and handwriting-activity-based neural signals into text data. The methods of extracting data from the brain have also been discussed in this review. Additionally, this review includes a brief summary of the datasets, preprocessing techniques, and methods used in these studies, which were published between 2014 and 2022. This review aims to provide a comprehensive summary of the methodologies used in the current literature on neural signal-based recognition of handwriting and speech. In essence, this article is intended to serve as a valuable resource for future researchers who wish to investigate neural signal-based machine-learning methods in their work.

Introduction Familial Mediterranean fever (FMF) is a recessively inherited disease characterized by recurrent attacks of fever and sterile polyserositis. Recently, some proteins originating from adipose tissue have been demonstrated to play a critical role in the inflammatory process. Asprosin is a new adipokine secreted by adipose tissue, and proinflammatory cytokines have been determined to increase with the decrease of circulating asprosin. This study was designed to evaluate the level of asprosin in the acute attack and attack-free period in FMF patients. Materials and methods A total of 65 FMF patients were evaluated for this cross-sectional case-control study. Those who were obese and had concomitant diabetes mellitus, hypertension, heart failure, and rheumatological disease were excluded from the study. The patients were divided into two groups: attack-free period and attack period. Fifteen healthy individuals who were not obese and had no additional disease were included as the control group. Demographic data, gene analyses, laboratory findings, and symptoms were recorded at the time of diagnosis. Serum asprosin level was studied by enzyme-linked immunosorbent assay test in the outpatient clinic controls of the patients. Asprosin levels and other laboratory findings were compared between the attack, attack-free, and control groups. Results Of the patients included in the study, 50% were in the attack period, and 50% were in the free-attack period. The mean age of the FMF patients was 34±10 years. Asprosin level in the control [median (interquartile range (IQR))=30.4 (21.5-57.7) ng/mL] group was significantly higher than the attack [median (IQR)=21.5 (17.5-28) ng/mL] and attack-free [median (IQR)=19(18.7-23) ng/mL] groups (p=0.001). C-reactive protein and sedimentation levels were significantly higher in the attack group compared to the other two groups (p<0.001). There was a moderate correlation between C-reactive protein and asprosin levels (Ro=-0.314, p=0.01). The cut-off value of serum asprosin level was determined as 21.6 ng/mL; sensitivity was 78%, and specificity was 77% (p<0.001). Conclusion The study demonstrated that the serum asprosin levels of FMF patients with acute attack were lower than those in the attack-free periods and healthy controls. Asprosin is likely to have a role in the anti-inflammatory cascade., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Sipahioglu et al.)

Introduction: Custodiol (histidine-tryptophan-ketoglutarate) and repetitive blood cardioplegia are the solutions for myocardial protection and cardiac arrest. In this study, we aimed to compare immunohistochemical analysis, clinical outcomes, and cardiac enzyme values of Custodiol and blood cardioplegia groups., Methods: This was a randomized prospective study consisting of 2 groups and 20 patients, 10 patients for each group, who underwent mitral and mitral/tricuspid valve surgery. Group 1 was formed for Custodiol cardioplegia and group 2 for blood cardioplegia. Perioperative and postoperative cardiac events were recorded, cardiac enzymes were analyzed with intervals, and myocardial samples were taken for immunohistochemical analysis. Recorded data were statistically evaluated., Results: There was no significant difference for the Custodiol and blood cardioplegia groups in perioperative and postoperative cardiac performance and adverse events. Cardiac enzyme analysis showed no significant difference between groups. However, two parameters (eNOS, Bcl-2) were in favor of the Custodiol group in immunohistochemical studies. Custodiol performed better in cellular oxidative stress resistance and cellular viability., Conclusion: Clinical outcomes and cardiac enzyme analysis results were similar regarding myocardial protection. However, Custodiol performed better in the immunohistochemical analysis.

Current models infer that the microtubule-based mitotic spindle is built from GDP-tubulin with small GTP caps at microtubule plus-ends, including those that attach to kinetochores, forming the kinetochore-fibres. Here we reveal that kinetochore-fibres additionally contain a dynamic mixed-nucleotide zone that reaches several microns in length. This zone becomes visible in cells expressing fluorescently labelled end-binding proteins, a known marker for GTP-tubulin, and endogenously-labelled HURP - a protein which we show to preferentially bind the GDP microtubule lattice in vitro and in vivo. We find that in mitotic cells HURP accumulates on the kinetochore-proximal region of depolymerising kinetochore-fibres, whilst avoiding recruitment to nascent polymerising K-fibres, giving rise to a growing "HURP-gap". The absence of end-binding proteins in the HURP-gaps leads us to postulate that they reflect a mixed-nucleotide zone. We generate a minimal quantitative model based on the preferential binding of HURP to GDP-tubulin to show that such a mixed-nucleotide zone is sufficient to recapitulate the observed in vivo dynamics of HURP-gaps., (© 2022. The Author(s).)

Motivation: Lattice light-sheet microscopy (LLSM) is revolutionizing cell biology since it enables fast, high-resolution extended imaging in three dimensions combined with a drastic reduction in photo-toxicity and bleaching. However, analysis of such datasets still remains a major challenge., Results: Automated tracking of kinetochores, the protein complex facilitating and controlling microtubule attachment of the chromosomes within the mitotic spindle, provides quantitative assessment of chromosome dynamics in mitosis. Here, we extend existing open-source kinetochore tracking software (KiT) to track (and pair) kinetochores throughout prometaphase to anaphase in LLSM data. One of the key improvements is a regularization term in the objective function to enforce biological information about the number of kinetochores in a human mitotic cell, as well as improved diagnostic tools. This software provides quantitative insights into how kinetochores robustly ensure congression and segregation of chromosomes during mitosis., Availability and Implementation: KiT is free, open-source software implemented in MATLAB and can be downloaded as a package from https://github.com/cmcb-warwick/KiT. The source repository is available at https://bitbucket.org/jarmond/kit (tag v2.4.0) and under continuing development., Supplementary Information: Supplementary data are available at Bioinformatics online., (© The Author(s) 2022. Published by Oxford University Press.)

Background: Telogen effluvium (TE) is a common form of non-scarring alopecia, characterized by excessive shedding of telogen club hairs., Objectives: The aim of the present study was to investigate patient characteristics, laboratory parameters, and treatment strategies in TE., Methods: Electronic records of 3028 patients were retrospectively analyzed. Demographic and clinical data, as well as serum parameters screening for iron, vitamin B12, vitamin D, folate and zinc deficiencies, thyroid function, and ANA titers, were evaluated., Results: In the study group, the most frequently performed test type was serum ferritin level (82.3%), followed by complete blood count (81%), both of which revealed that 6.2% of the patients had iron deficiency anemia. 4.6% of the patients had thyroid dysfunction. In screened patients, vitamin and mineral deficiencies were as follows: vitamin D (72.2%), vitamin B12 (30.7%), folate (4.4%), and zinc (2.1%). Women were more likely to be prescribed vitamin D replacement therapy. Iron replacement was the most frequently ordered treatment, comprising 37.5% of total prescriptions., Conclusion: To the best of our knowledge, this is the most comprehensive retrospective study having the largest number of patients with TE. Our results will not only help to augment knowledge about TE, but also provide a diagnostic algorithm for the laboratory and clinical workup of patients with TE., (© 2021 Wiley Periodicals LLC.)

Emerging biomanufacturing technologies have revolutionized the field of tissue engineering by offering unprecedented possibilities. Over the past few years, new opportunities arose by combining traditional and novel fabrication techniques, shaping the hybrid designs in biofabrication. One of the potential application fields is skin tissue engineering, in which a combination of traditional principles of wound dressing with advanced biofabrication methods could yield more efficient therapies. In this study, a hybrid design of fiber-reinforced scaffolds combined with gel casting is developed and the efficiency for in vivo wound healing applications is assessed. For this purpose, 3D fiber meshes produced by melt electrowriting are selectively filled with photocrosslinkable gelatin hydrogel matrices loaded with different growth factor carrier microspheres. Additionally, the influence of the inclusion of inorganic bioactive glass particles within the composite fibrous mesh is evaluated. Qualitative evaluation of secondary wound healing criteria and histological analysis shows that hybrid scaffolds containing growth factors and bioactive glass enhances the healing process significantly, compared to the designs merely providing a fiber-reinforced bioactive hydrogel matrix as the wound dressing. This study aims to explore a new application area for melt electrowriting as a powerful tool in fabricating hybrid therapeutic designs for skin tissue engineering., (© 2022 Wiley-VCH GmbH.)

Background: The study aims to demonstrate whether weight loss with a low-calorie diet before laparoscopic sleeve gastrectomy (LSG) may affect the outcomes., Materials and Methods: A total of 305 patients undergoing primary LSG were included in the study. Each patient adopted a low-calorie diet (1000 calories) before LSG. The patients were stratified into two groups. Group A: Those who lost 3% or more of their total body weight loss (TBWL), Group B: Those who lost <3% of their TBWL. Two groups were compared in terms of operative time, length of hospital stay, complications and weight loss outcomes., Results: One hundred and five patients (35%) were in Group A and 200 patients were in Group B. Median weight loss was 4 kg (3-20 kg). Pre-operative mean body mass index (BMI) was 40 ± 7.4 kg/m 2 in Group A and 41 ± 5.9 kg/m 2 in Group B (P = 0.06). At 1 year after the surgery, BMI regressed to 29.7 ± 4.9 kg/m 2 in Group A and to 27 ± 4.2 kg/m 2 in Group B (P < 0.001). One hundred and twenty-nine patients who completed 2 years of follow-up, mean BMI regressed to 29.4 ± 4.1 kg/m 2 in Group A (n = 46) and to 27.2 ± 4.5 kg/m 2 in Group B (n = 83) (P < 0.001). In Group B, one patient experienced post-operative bleeding. No other complications were observed in the study. There was no significant difference between the groups in terms of operative time (P = 0.53) and length of hospital stay (P = 0.9)., Conclusion: Weight loss before LSG does not improve post-operative weight loss., Competing Interests: None

Critical care ultrasound has earned its place not just as a further investigation step but as a bedside physical assessment and monitoring tool. Its potential to become the twenty-first-century stethoscope has proved its accuracy by many protocols so far.

Introduction: The prognostic value of objective nutritional indexes has been demonstrated in many diseases. This study evaluated the prognostic value of these indexes in patients who underwent transcatheter aortic valve replacement (TAVI)., Material and Methods: Totally, 119 consecutive patients who underwent TAVI between January 2016 and December 2018 were evaluated. All patients were followed-up for one year. Objective nutritional index (geriatric nutritional risk index [GNRI], prognostic nutritional index [PNI]) and controlling nutritional status [CONUT]) scores were calculated before TAVI., Results: Mean age of the study population was 77.1 ± 7.8 years (59.7% female). During one-year follow-up, 31 (26.1%) deaths were observed. In a Kaplan-Meier analysis, mortality rates were significantly increased in patients with lower GNRI and PNI and higher CONUT scores (50.01% vs. 4.4%; p  < .001, 48.1% vs. 15.2%; p  < .001, 57.5% vs. 12.8%; p  < .001, respectively). Pairwise comparisons of the ROC curves demonstrated that the GNRI score was a significantly better predictor of mortality than the PNI and CONUT scores (area under curve; 0.898, 0.664, and 0.722, respectively, for both; p  < .001). According to Cox proportional hazard analyses, the GNRI (hazard ratio [HR]: 0.898) and STS (HR: 1.359) score were independently associated with increased 1-year mortality (for all p  < .05)., Conclusion: The GNRI, PNI and CONUT scores were associated with 1-year all-cause mortality in patients who underwent TAVI. The predictive value of the GNRI score was significantly better than the PNI or CONUT scores. Assessment of the GNRI should be considered before TAVI.

Introduction: In this study, we aimed to investigate the impact of transcatheter aortic valve implantation (TAVI) on serum apelin levels in patients with severe symptomatic aortic valve stenosis (AS)., Methods: Forty-six consecutive patients (76.9±7.4 years, n=27 women) who underwent TAVI and 45 age- and sex-matched control subjects were included in the study. Echocardiographic parameters, serum apelin, pro-brain natriuretic peptide (Pro-BNP), and troponin I levels were compared between the groups. In addition, the preprocedural and first-month follow-up echocardiographic parameters and serum apelin values of TAVI patients were compared., Results: Serum median troponin I and Pro-BNP levels were significantly higher and serum apelin levels were significantly lower in TAVI patients before TAVI procedure than in the control subjects (P<0.001, for all). Median troponin I and Pro-BNP levels were significantly decreased and apelin levels were significantly increased after TAVI procedure compared to the peri-procedural levels. There was a significant and moderate negative correlation between Pro-BNP and apelin levels measured before and after TAVI procedure. A statistically significant and strong negative correlation was found between aortic valve area and Pro-BNP level before TAVI procedure, while a statistically significant but weak positive correlation was found between valve area and apelin level., Conclusion: In our study, apelin levels were significantly lower and Pro-BNP levels were higher in AS patients compared with the control group. Moreover, after TAVI procedure, a significant increase in apelin levels and a significant decrease in Pro-BNP levels were observed. There was also a negative and moderate correlation between apelin and Pro-BNP levels.

Purpose: To compare the effect of general anesthesia (GA) and regional anesthesia (RA) on f-URS outcomes and surgeon comfort., Material and Methods: The study was conducted between June 2017 to January 2018 and data collection was applied in a prospective, randomized fashion. 120 patients participated in the study and were divided into RA group (n=56) and GA group (n=64). Demographic, operative and post-operative parameters of patients were analysed. The end point of this study was the effect of two anesthesia regimens on the comfort of the surgeon, and the comparability of feasibility and safety against perioperative complications., Results: The study including 120 randomized patients, 14 patients were excluded from the study and completed with 106 patients (45 in RA group and 61 in GA group). No difference was detected between the two groups in terms of preoperative data. During the monitorization of operative vital signs, 3 patients in RA group experienced bradycardia, and this finding was significant when compared with GA group (p=0.041). Additionally, 2 patients in RA group experienced mucosal tears and 1 patient experienced hemorrhage during the operation, but no complications were observed in the GA group (p=0.041). Postoperative surgeon comfort evaluation revealed statistically significant results in favor of GA group (p=0.001)., Conclusions: Both GA and RA are equally effective and safe anesthesia methods for f-URS procedures. However, RA group showed significantly increased likelihood of bradycardia and mucosal injury during surgery, and significantly decreased surgeon comfort during surgery., Competing Interests: None declared., (Copyright® by the International Brazilian Journal of Urology.)

Background: Pulmonary artery perfusion during cardiopulmonary bypass (CPB) is a known but rarely used technique in adult cardiac surgery. In this study, we aimed to investigate biochemical and histopathological effects of pulmonary artery perfusion during CPB on lung functions., Methods: Between May 2014 and August 2014, all patients (n = 24) who gave informed consent for participating this study with inclusion criteria were included. Patients undergoing isolated coronary artery bypass grafting were sequentially randomized to conventional CPB (control group, n = 12) and conventional CPB with selective pulmonary artery perfusion (study group, n = 12). Lung functions were monitored using PF ratio, alveolar-arterial oxygen gradient, and lactate levels. A small sample tissue from the left lung was excised for histopathologic examination. Immunocytochemistry analysis was performed using anti-rabbit polyclonal vascular endothelial growth factor (VEGF), rabbit polyclonal inducible nitric oxide synthase (i-NOS), and BCL-2 antibodies., Results: Postoperative course of the patients were uneventful without any clinical outcome differences in terms of cardiopulmonary complications, ventilation time and hospital stay. Pulmonary perfusion group had significantly better oxygenation values after extubation and at postoperative 24-hour. Electron microscopy examinations revealed better preservation of the alveolar wall integrity with pulmonary perfusion. The intensity of VEGF, i-NOS, and BCL-2 antibody expressions in bronchial epithelial cells were more prominent in the pulmonary perfusion group., Conclusions: Pulmonary artery perfusion during aortic cross-clamping provides better oxygenation and preservation of the wall alveolar integrity after coronary artery bypass grafting surgery. This technique can be used as a protective strategy to minimize CPB-induced lung injury in adult cardiac surgery., (© 2020 Wiley Periodicals LLC.)

Objectives: This study assessed the feasibility and outcomes of performing robotic cardiac surgery without lung isolation using single-lumen (SL) endotracheal tube intubation., Methods: Between 2013 and 2017, 132 patients underwent robotically-assisted atrial septal defect closure. A retrospective analysis was performed of 23 patients (11 males, mean age 30.9 ± 5 years) who underwent robotic surgery with double-lumen (DL) endotracheal tube intubation (group 1) compared with 109 patients (57 males, mean age 32.4 ± 7.5 years) undergoing the same procedure with SL endotracheal intubation (group 2). The patient groups were compared in terms of demographic characteristics, operative data, and complications. The technical feasibility of the robotic procedure without lung isolation was evaluated., Results: There were no mortality, intraoperative complication, and conversion. Mean total anesthesia time was significantly decreased in the SL intubation group (238.3 ± 22.4 vs 227.2 ± 21.2 minutes; P = .025). First-pass intubation success was significantly higher in the SL intubation group (17 [73.9%] vs 98 [89.9%] patients; P = .032). Mean ventilation time (10.9 ± 5.3 hours), intensive care unit stay (16.8 ± 10.1 hours), and the length of hospital stay (3.8 ± 1.2 days) was significantly decreased in patients with SL tube (P < .05). Unilateral reexpansion pulmonary edema was observed in five (21.7%) patients with DL tube, whereas no patient with SL tube had this complication., Conclusions: SL endotracheal tube intubation without lung isolation is a feasible and safe airway alternative in robotic cardiac procedures. This approach resulted in shorter anesthesia time, ventilation time and the length of hospital stay. Port placement and robotic set-up can be uneventfully performed without lung isolation., (© 2020 Wiley Periodicals, Inc.)

The molecular stress caused by a drug administered to treat a disorder on healthy cells appears as a side effect. In this study, we aim to understand the potential of hexagonal boron nitrides (hBNs) as a therapeutic agent to relieve the cellular stress exerted by drugs. First, the cytotoxicity of hBNs and their possible degradation product, boric acid (BA), on the embryonic mouse hippocampal cell line mHippo E-14 was assessed in a wide concentration range (4.4-440 μg ml -1 ) of boron including hBNs and BA for 24 and 72 h exposure. Then, cell cycle, reactive oxygen species generation, cell death mechanism and apoptotic body formation in nuclei with hBN and BA exposure were evaluated at increased concentrations and incubation times. Finally, the cells, exposed to doxorubicin (DOX), an anti-cancer chemotherapy drug, to exert oxidative stress, were treated with hBNs and BA. The results indicate that hBNs decrease the oxidative stress at the concentrations that are nontoxic to cells. The study suggests that hBNs can open new venues for their investigation to reduce or eliminate the adverse effects of toxic drugs used in the treatment of several fatal diseases including neurological disorders and cancer with their slow degradation feature.

Background: This study aimed to examine the effect of pulsatile flow pattern on tissue perfusion, particularly cerebral tissue perfusion, at pre-determined intervals during CPB, as well as its effects on postoperative morbidity and mortality., Methods: This retrospective study included 134 adult patients, who underwent cardiac surgery with cardiopulmonary bypass (CPB). Patients were grouped based on the flow pattern used during CPB: non-pulsatile CPB group (N = 82) and pulsatile CPB group (N = 52). Cerebral oxygen saturation, arterial pH and arterial lactate levels were measured at four time points, during the operation and the 2 groups were compared with regard to changes over time as well as differences in postoperative outcomes., Results: The 2 groups were similar, in terms of mean values and intraoperative changes in cerebral oxygen saturation and arterial pH. Non-pulsatile CABG group had significantly higher arterial lactate levels over the measurement period, which was not affected by the timing of the measurements. Postoperative drainage, duration of ventilation and duration of hospital stay significantly were higher and postoperative blood urea nitrogen significantly was lower in the non-pulsatile CPB group. Other postoperative outcomes were similar across the groups., Conclusion: Findings of this study do not support the superiority of pulsatile flow pattern during CPB, in terms of cerebral oxygen saturation or postoperative mortality/morbidity. Further and larger comparative studies are warranted before pulsatile blood flow pattern can be established as a routine clinical method.

Aim: In this study, we aimed to investigate the superiority of right pericardial window (RPW) versus posterior pericardial drain placing for the parameters of pericardial effusion and the postoperative complications at the patients who has undergone cardiac surgery., Materials and Methods: Between July and September 2018, 120 adult patients (mean age 50.30 ± 14.61) who underwent cardiac surgery without the necessity of opening the pleura were included in the study. In Group 1, the RPW was opened (n = 60), and Group 2 posterior pericardial drainage tube was placed without RPW (n = 60). Risk factors and postoperative complication were evaluated and compared between the Groups., Results: Cardiac tamponade occurrence was not significantly different between the Groups (Group 1, n = 0 and Group 2, n = 3, p = 0.079). Postoperative transthoracic echocardiographic controls revealed significant pericardial effusion in Group 2 (6.90 mm ± 13.02 mm) compared to Group 1 (2.30 mm ± 5.60 mm) (p = 0.013). Postoperative creatinine levels were 0.75 ± 0.26 in Group 1 and 0.88 ± 0.36 in Group 2 (p = 0.022). A significant decrease in glomerular filtration rate was observed in Group 2 (102.7 ± 24.5 and 91.2 ± 28, p = 0.019). Postoperative acute renal failure was significantly higher in Group 2 compared to Group 1 (p < 0.001). Postoperative new onset atrial fibrillation occurred in 4 patients in Group 1 and 8 in Group 2 (p = 0.224). The duration of intensive care unit stay was 36.00 ± 22.31 h in Group 1 and 53.60 ± 59.50 h in Group 2 (p = 0.034). Development of pneumothorax, pneumonia and pleural effusion were not statistically different between the Groups (p = 0.079, 0.171, 0.509)., Conclusion: RPW application is more effective on preventing postoperative complications in cardiac surgery instead of placing drains in posterior pericardium.

Scaffold-based tissue engineering approaches have been commonly used for skin regeneration or wound healings caused by diseases or trauma. For an ideal complete healing process, scaffold structures need to meet the criteria of biocompatibility, biodegradability, and antimicrobial properties, as well as to provide geometrical necessities for the regeneration of damaged tissue. In this study, design, synthesis and characterization of a three dimensional (3D) printable copolymer based on polycaprolactone-block-poly(1,3-propylene succinate) (PCL-PPSu) including anti-microbial silver particles is presented. 3D printing of PCL-PPSu copolymers provided a lower processing temperature compared to neat PCL, hence, inclusion of temperature-sensitive bioactive reagents into the developed copolymer could be realized. In addition, 3D printed block copolymer showed an enhanced hydrolytic and enzymatic degradation behavior. Cell viability and cytotoxicity of the developed copolymer were evaluated by using human dermal fibroblast (HDF) cells. The addition of silver nitrate within the polymer matrix resulted in a significant decrease in the adhesion of different types of microorganisms on the scaffold without inducing any cytotoxicity on HDF cells in vitro. The results suggested that 3D printed PCL-PPSu scaffolds containing anti-microbial silver particles could be considered as a promising biomaterial for emerging skin regenerative therapies, in the light of its adaptability to 3D printing technology, low-processing temperature, enhanced degradation behavior and antimicrobial properties.

The toxicity of accumulated α-synuclein plays a key role in the neurodegeneration of Parkinson's disease (PD). This study has demonstrated that iron in varying concentrations (up to 400 µM) causes an increase in α-synuclein content in SH-SY5Y cells associated with mitochondrial depolarization, decreased cellular ATP content and loss of cell viability during incubation up to 96 h. Knocking-down α-synuclein expression prevents cytotoxic actions of iron, which can also be prevented by cyclosporine A (a blocker of mitochondrial permeability transition pore). These results indicate that iron cytotoxicity is mediated by α-synuclein acting on mitochondria. Likewise siRNA mediated knock-down of Parkin causes an accumulation of α-synuclein accompanied by mitochondrial dysfunction and cell death during 48 h incubation under basal conditions, but these changes are not further aggravated by co-incubation with iron (400 µM). We have also analyzed mitochondrial dysfunction and cell viability in SH-SY5Y cells under double knock-down (α-synuclein and Parkin concurrently) conditions during incubation for 48 h with or without iron. Our results tend to suggest that iron inactivates Parkin in SH-SY5Y cells and thereby inhibits the proteasomal degradation of α-synuclein, and the accumulated α-synuclein causes mitochondrial dysfunction and cell death. These results have implications in the pathogenesis of sporadic PD and also familial type with Parkin mutations., (© 2020 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.)

This study reports our initial experience with robotic-assisted partial anomalous pulmonary venous connection (PAPVC) repair. From May 2013 through September 2018, 20 patients (12 male and 8 female) underwent robotic-assisted repair of a right-sided (n = 19) or a left-sided (n = 1) PAPVC. The mean age was 24.6 ± 9.4 years (range 14-44) and the mean body mass index was 22.3 ± 4.6. Seventeen patients had a right-sided supra-cardiac PAPVC with sinus venosus atrial septal defect, two had a right-sided cardiac PAPVC to the right atrium and one had a left-sided cardiac PAPVC to the coronary sinus. Associated anomalies included patent foramen ovale (n = 2) and left persistent superior vena cava (n = 1). All patients were operated on successfully. No conversion to mini-thoracotomy or sternotomy was needed. Cardiopulmonary bypass and aortic clamping times were 114.8 ± 17.3 (range 90-150) and 66.5 ± 15.8 (range 44-90) minutes, respectively. Repair techniques included the single-patch repair with baffle through right atriotomy (n = 16), the 2-patch repair (n = 1) using lateral transcaval incision and intracardiac re-routing (n = 3). The mean ventilation time was 4.2 ± 1.2 h and hospital stay was 3.1 ± 0.1 days. No phrenic nerve injury, sinus node dysfunction, re-exploration or blood transfusion was noted. No residual shunting or venous obstruction was found on echocardiograms. Follow-up was a mean of 1.7 years (range 3-36 months). There was no follow-up mortality. Totally, endoscopic robotic-assisted PAPVC repair is a feasible procedure in selected adult patients. It is a less invasive alternative to traditional incisions, mini-thoracotomy and endoscopic approaches. In the future, new generation robotic devices may offer an alternative for younger patients with this pathology.

Objectives: The aim of this randomized clinical trial was to assess the effect of solvent use during the removal of root canal filling on postoperative pain after retreatment., Materials and Methods: Ninety patients scheduled for root canal retreatment were randomly assigned to one of the following two groups according to the root canal filling removal procedure used: ProTaper retreatment (Dentsply Maillefer, Ballaigues, Switzerland) instruments or ProTaper retreatment instruments in combination with gutta-percha solvent. A single operator performed the retreatments in a single visit. The incidence and intensity of the postoperative pain were rated on a numeric rating scale by patients at 24, 48, and 72 h after retreatment. The analgesic tablet intake number was also recorded. Data were analyzed using Mann‑Whitney U, Wilcoxon, and chi-square tests., Results: For the intensity of postoperative pain, the difference between the two groups was not statistically significant. Moreover, no statistically significant difference was found between the two groups in terms of analgesic medication intake (P > 0.05)., Conclusions: The processes involving the use and non-use of a solvent in the removal of root canal fillings were found to be equivalent in terms of postoperative pain intensity and analgesic intake., Clinical Relevance: Some in vitro studies claimed that the use of a gutta-percha solvent in the removal of root canal fillings tends to reduce postoperative pain since extrusion of debris was significantly less. This randomized clinical trial indicates that the removal of root canal fillings with or without the use of a solvent was associated with equivalent postoperative pain intensity and analgesic intake. This study is registered in the www.ClinicalTrials.gov database with the identifier number NCT03756363.

Functional and stimuli-responsive nanofibers with an enhanced surface area/volume ratio provide controlled and triggered drug release with higher efficacy. In this study, chemotherapeutic agent Rose Bengal (RB) (4,5,6,7-tetrachloro-2', 4',5',7'-tetraiodofluoresceindisodium)-loaded water-soluble polyvinyl alcohol (PVA) nanofibers were synthesized by using the electrospinning method. A thin layer of poly(4-vinylpyridine- co -ethylene glycol dimethacrylate) p(4VP- co -EGDMA) was deposited on the RB-loaded nanofibers (PVA-RB) via initiated chemical vapor deposition (iCVD), coating the fiber surfaces to provide controllable solubility and pH response to the nanofibers. The uncoated and [p(4VP-co-EGDMA)-PVA] coated PVA-RB nanofiber mats were studied at different pH values to analyze their degradation and drug release profiles. The coated nanofibers demonstrated high stability at neutral and basic pH values for long incubation durations of 72 h, whereas the uncoated nanofibers dissolved in <2 h. The drug release studies showed that the RB release from coated PVA-RB nanofibers was higher at neutral and basic pH values, and proportional to the pH of the solution, whereas the degradation and RB release rates from the uncoated PVA-RB nanofibers were significantly higher and did not depend on the pH of environment. Further analysis of the release kinetics using the Peppas model showed that while polymer swelling and dissolution were the dominant mechanisms for the uncoated nanofibers, for the coated nanofibers, Fickian diffusion was the dominant release mechanism. The biocompatibility and therapeutic efficiency of the coated PVA-RB nanofibers against brain cancer was investigated on glioblastoma multiforme cancer cells (U87MG). The coated PVA nanofibers were observed to be highly biocompatible, and they significantly stimulated the ROS production in cells, increasing apoptosis. These promising results confirmed the therapeutic activity of the coated PVA-RB nanofibers on brain cancer cells, and encouraged their further evaluation as drug carrier structures in brain cancer treatment., (Copyright © 2019 Sayin, Tufani, Emanet, Genchi, Sen, Shemshad, Ozdemir, Ciofani and Ozaydin Ince.)

Objectives: Type A aortic dissection (TAD), which consists of an intimal tear in the aorta, necessitates emergency surgery. Various risk factors related to aortic dissection have been defined in the literature. According to our hypothesis, a narrower angle of ascending aortic curvature (AAAC) may be an additional risk factor in relation to aortic dissection due to the increased force applied to the aortic wall., Methods: Patients undergoing ascending aortic surgery due to an ascending aortic aneurysm (AsAA) (n = 105) and patients undergoing such surgery because of the occurrence of TAD (n = 101) were enrolled in this study. The AAAC was measured using Cobb's method; the measurements were made on all patients by just 1 cardiovascular radiologist using 3-dimensional computerized tomographic imaging. This measurement was made indirectly by using the aortic valve and brachiocephalic artery to avoid obtaining misleading data as a result of distortions due to dissection. A statistical comparison was also performed relating the traditional risk factors for TAD to other clinical and echocardiographic parameters: the diameter of the ascending aorta and the AAAC., Results: The AAAC was found to be narrower statistically in the TAD group (α = 76.2° ± 17.5°) than it was in the AsAA group (α = 92.9° ± 13°) (P < 0.001). Furthermore, mean ascending aortic diameter (P = 0.019), the presence of a bicuspid aorta (P = 0.007) and aortic valve stenosis (P = 0.005) were higher in the AsAA group. According to multivariable analyses, a narrower AAAC is a significant predictor for the development of TAD (odds ratio 0.93, 95% confidence interval 0.91-0.95; P < 0.001). Overall hospital mortality from various causes including stroke, myocardial infarction, bleeding or renal failure was 13% in the TAD group and 7% in the AsAA group., Conclusions: According to this study, the AAAC was significantly smaller in aortic dissection patients than in aortic aneurysm patients. This may be related to higher shear stress and elevated pressure on the ascending aorta in patients with a narrower AAAC. Thus, a narrower AAAC may be an additional risk factor in the development of TAD. Therefore, we may need to be more careful in terms of looking for the development of aortic dissection in patients with narrower AAAC., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Introduction: This study aimed to evaluate the feasibility and efficacy of robotically assisted, minimally invasive mitral valve surgery combined with left atrial reduction for mitral valve surgery and elimination of atrial fibrillation (AF)., Methods: Eleven patients with severe mitral regurgitation, AF, and left atrial enlargement who underwent robotic, minimally invasive surgery between May 2013 and March 2018 were evaluated retrospectively. The da Vinci robotic system was used in all procedures. The patients' demographic data, electrocardiography (ECG) findings, and pre- and postoperative transthoracic echocardiography findings were analyzed. During follow up ECG was performed at postoperative 3, 6, and 12 months additionally at the 3rd month trans thoracic echocardiography was performed and functional capacity was also evaluated for all patients., Results: All patients underwent robotic-assisted mitral valve surgery with radiofrequency ablation and left atrial reduction. Mean age was 45.76±16.61 years; 7 patients were male and 4 were female. Preoperatively, mean left atrial volume index (LAVI) was 69.55±4.87 mL/m2, ejection fraction (EF) was 54.62±8.27%, and pulmonary artery pressure (PAP) was 45.75±9.42 mmHg. Postoperatively, in hospital evaluation LAVI decreased to 48.01±4.91 mL/m2 (P=0.008), EF to 50.63±10.13% (P>0.05), and PAP to 39.02±3.11 mmHg (P=0.012). AF was eliminated in 8 (72%) of the 11 patients at the 1st postoperative month. There were significant improvements in functional capacity and no mortality during follow-up., Conclusion: Left atrial reduction and radiofrequency ablation concomitant with robotically assisted minimally invasive mitral valve surgery can be performed safely and effectively to eliminate AF and prevent recurrence.

Bulging subaortic septum in hypertrophic cardiomyopathy is a potential risk factor for systolic anterior motion after mitral valve repair. Systolic anterior motion may cause postoperative mitral regurgitation and left ventricular outflow tract obstruction despite conservative management. During "minimally invasive endoscopic" and "robotic" mitral repair procedures, systolic anterior motion is prevented with concomitant septal myectomy through the mitral valve orifice. Technically, the exposure of the bulging subaortic septum is traditionally done with detachment of the anterior mitral leaflet from its annulus, leaving a 2-mm rim of leaflet attached to the annulus. The leaflet is then sutured after myectomy. As an alternative technique in robotic surgery, the exposure of the subaortic septum is feasible without anterior leaflet incision with the use of dynamic atrial retractor in mitral repair procedures. Here, we present a patient who underwent concomitant robotic mitral valve repair with posterior chordal implantation, ring annuloplasty, and septal myectomy without anterior leaflet incision using the da Vinci surgical system.

The cytotoxicity of dopamine on cultured cells of neural origin has been used as a tool to explore the mechanisms of dopaminergic neurodegeneration in Parkinson's disease. In the current study, we have shown that dopamine induces a dose-dependent (10-40 μM) and time-dependent (up to 96 h) loss of cell viability associated with mitochondrial dysfunction and increased intra-cellular accumulation of α-synuclein in cultured SH-SY5Y cells. Dopamine-induced mitochondrial dysfunction and the loss of cell viability under our experimental conditions could be prevented by cyclosporine, a blocker of mitochondrial permeability transition pore, as well as the antioxidant N-acetylcysteine. Interestingly, the dopamine effects on cell viability and mitochondrial functions were significantly prevented by knocking down α-synuclein expression by specific siRNA. Our results suggest that dopamine cytotoxicity is mediated by α-synuclein acting on the mitochondria and impairing its bioenergetic functions.