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Type 2 neurologic complications of coronary artery bypass grafting (CABG) include postoperative cognitive dysfunction and delirium. Although relevant clinically, they are rarely properly recognized outside of dedicated research setting, as their identification is complex and time-consuming. The aim of this study was to examine the diagnostic potential of 4 novel brain-injury biomarkers for predicting these sequelae at the completion of off-pump CABG. A total of 100 consecutive patients scheduled for elective isolated off-pump CABG were enrolled. Control group of patients without neurological complications (n = 48) was compared separately to study groups diagnosed with postoperative cognitive dysfunction (n = 39) and delirium (n = 26). Serum concentrations of glial fibrillary acidic protein, neuroserpin, phosphorylated axonal neurofilament subunit H, and visinin-like protein 1 were evaluated at baseline, end of surgery, as well as on postoperative day 1 and 7. Increased end of surgery to baseline ratio of neuroserpin predicted the occurrence of both postoperative cognitive dysfunction (area under the curve = 0.655, 95% confidence interval 0.54-0.77) and delirium (area under curve = 0.643, 95% confidence interval 0.52-0.77). Concentrations of neuroserpin were significantly higher on postoperative day 7 compared with end of surgery and postoperative day 1 in all groups. Among novel biochemical markers of brain damage, neuroserpin may be a promising predictor of type 2 neurological complications and may express neuroregeneration after off-pump CABG, whereas glial fibrillary acidic protein, phosphorylated axonal neurofilament subunit H, and visinin-like protein 1 may not be suitable for this clinical setting. [ABSTRACT FROM AUTHOR]

Controversies remain on the increased rate of neurological events after small thoracotomy mitral valve surgery attributed to endoaortic balloon occlusion (EABO). Systematic literature search of databases identified 17 studies enrolling 6,643 patients comparing safety and effectiveness of EABO versus transthoracic clamp. In a meta-analysis, there was no difference in occurrence of cerebrovascular events, all-cause mortality, and kidney injury. EABO was associated with a significantly higher risk of iatrogenic aortic dissection (0.93% versus 0.13%; risk ratio, 4.67; 95% confidence interval, 1.62 to 13.49; p = 0.004) and a trend toward longer operative times. The data is limited to observational studies. [ABSTRACT FROM AUTHOR]

Copyright of Przegląd Socjologii Jakościowej is the property of Redakcja Przegladu Socjologii Jakosciowej and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this research was to optimize process of nanocrystallization of vanadate-phosphate glasses in order to reach as high electronic conductivity as possible. 90 V 2 O 5 ·10P 2 O 5 glasses were prepared by a standard melt-quenching technique under different synthesis conditions. The glass transition temperature, the crystallization temperature and the electric conductivity at RT is evidently correlated with the synthesis temperature. The samples were annealed at different temperatures. As a result of this optimization, a sample with σ(25 °C) = 0.7·10 -1 S/cm was synthesized. The microstructure of the sample consists of V 2 O 5 nanocrystallites with size within 15÷30 nm. The significant increase in the conductivity is discussed in terms of the Mott's model of electron hopping and a core-shell concept. The electrochemical measurements have shown that up to 3 moles of Li + ions can be inserted into 1 mole of V 2 O 5 . [ABSTRACT FROM AUTHOR]

Copyright of Psychiatria Polska is the property of Editorial Committee of Polish Psychiatric Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Neuropsychiatric complications of surgical coronary revascularization are inconspicuous but frequent and clinically relevant. So far, attempts to reduce their occurrence, such as the introduction of off-pump coronary artery bypass (OPCAB) grafting method, have not brought the desired results. The aim of this trial was to determine whether using any of the 2 selected modifications of OPCAB could decrease the incidence of these undesired sequelae. In this single-center, assessor- and patient-blinded, superiority, randomized controlled trial, 192 patients scheduled for elective isolated OPCAB were randomized to 3 parallel arms. The control arm underwent "conventional" OPCAB with vein grafts. The first study arm underwent anaortic OPCAB (ANA) with total arterial revascularization. The second study arm underwent OPCAB with vein grafts using carbon dioxide surgical field flooding (CO 2 FF). Outcomes included the incidence of postoperative delirium (PD) and early postoperative cognitive dysfunction (ePOCD). The incidence of PD was 35.9% in the control (OPCAB) arm, 32.8% in the CO 2 FF arm, and 12.5% in the ANA arm (χ2 [2, N = 191] = 10.17; P =.006). Post hoc tests revealed that the incidence of PD in the ANA arm differed from that in the OPCAB arm (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.09-0.68; P =.002). The incidence of ePOCD was 34.4% in the OPCAB arm, 28.1% in the CO 2 FF arm, and 9.5% in the ANA arm (χ2 [2, N = 191] = 11.58; P =.003). Post hoc tests revealed that the incidence of ePOCD differed between the ANA and OPCAB arms (OR, 0.20; 95% CI, 0.06-0.58; P <.001). Performing ANA significantly decreases the incidence of PD and ePOCD compared with "conventional" OPCAB with vein grafts, whereas CO 2 FF is inconsequential in this regard. These results, which probably reflect decreased delivery of embolic load to the brain in ANA, may have practical applicability in daily practice to improve clinical outcomes. Performing anaortic off-pump coronary artery bypass grafting (ANA) results in a 3-fold reduction in the incidence of postoperative delirium (PD) and early postoperative cognitive dysfunction (ePOCD) as compared with off-pump coronary artery bypass grafting with vein grafts (OPCAB), whereas performing off-pump coronary artery bypass with vein grafts using carbon dioxide surgical field flooding (CO 2 FF) is inconsequential in this regard. [Display omitted] [ABSTRACT FROM AUTHOR]

Objectives To investigate the potential beneficial effects of posterior pericardial drainage in patients undergoing heart surgery. Methods Multiple online databases and relevant congress proceedings were screened for randomized controlled trials assessing the efficacy and safety of posterior pericardial drainage, defined as posterior pericardiotomy incision, chest tube to posterior pericardium, or both. Primary endpoint was in-hospital/30 days' cardiac tamponade. Secondary endpoints comprised death or cardiac arrest, early and late pericardial effusion, postoperative atrial fibrillation (POAF), acute kidney injury, pulmonary complications, and length of hospital stay. Results Nineteen randomized controlled trials that enrolled 3425 patients were included. Posterior pericardial drainage was associated with a significant 90% reduction of the odds of cardiac tamponade compared with the control group: odds ratio (95% confidence interval) 0.13 (0.07-0.25); P < .001. The corresponding event rates were 0.42% versus 4.95%. The odds of early and late pericardial effusion were reduced significantly in the intervention arm: 0.20 (0.11-0.36); P < .001 and 0.05 (0.02-0.10); P < .001, respectively. Posterior pericardial drainage significantly reduced the odds of POAF by 58% ( P < .001) and was associated with significantly shortened (by nearly 1 day) overall length of hospital stay ( P < .001). Reductions in postoperative complications translated into significantly reduced odds of death or cardiac arrest ( P = .03) and numerically lower odds of acute kidney injury ( P = .08). Conclusions Posterior pericardial drainage is safe and simple technique that significantly reduces not only the prevalence of early pericardial effusion and POAF but also late pericardial effusion and cardiac tamponade. These benefits, in turn, translate into improved survival after heart surgery. [ABSTRACT FROM AUTHOR]

Objectives To assess the benefits and risks of off-pump coronary artery bypass (OPCAB) versus coronary artery bypass grafting (CABG) through a meta-analysis of randomized controlled trials (RCTs), and to investigate the relationship between outcomes and patient risk profile. Methods PubMed, Embase, the Cumulative Index of Nursing and Allied Health Literature, Scopus, Web of Science, Cochrane Library, and major conference proceedings databases were searched for RCTs comparing OPCAB and CABG and reporting short-term (≤30 days) outcomes. Endpoints assessed were all-cause mortality, myocardial infarction (MI), and cerebral stroke. Results The meta-analysis included 100 studies, with a total of 19,192 subjects. There was no difference between the 2 techniques with respect to all-cause mortality and MI (odds ratio [OR], 0.88; 95% confidence interval [CI], 0.71-1.09; P = .25; I 2 = 0% and OR, 0.90; 95% CI, 0.77-1.05; P = .19; I 2 = 0%, respectively). OPCAB was associated with a significant 28% reduction in the odds of cerebral stroke (OR, 0.72; 95% CI, 0.56-0.92; P = .009; I 2 = 0%). A significant relationship between patient risk profile and benefits from OPCAB was found in terms of all-cause mortality ( P < .01), MI ( P < .01), and cerebral stroke ( P < .01). Conclusions OPCAB is associated with a significant reduction in the odds of cerebral stroke compared with conventional CABG. In addition, benefits of OPCAB in terms of death, MI, and cerebral stroke are significantly related to patient risk profile, suggesting that OPCAB should be strongly considered in high-risk patients. [ABSTRACT FROM AUTHOR]

Objectives Sternal wound infections are serious postoperative complications that increase the length of hospital stay and healthcare costs. The benefit of implantable gentamicin-collagen sponges in reducing sternal wound infections has been questioned in a recent multicenter trial. We aimed to perform a comprehensive meta-analysis of studies assessing the efficacy of implantable gentamicin-collagen sponges in sternal wound infection prevention. Methods Multiple databases were screened for studies assessing the efficacy of implantable gentamicin-collagen sponges after heart surgery. The primary end point was sternal wound infection, and secondary end points were the occurrence of deep sternal wound infection, superficial sternal wound infection, mediastinitis, and mortality. Randomized controlled trials and observational studies were analyzed separately. By means of meta-regression, we examined the correlation between sternal wound infection and extent to which the bilateral internal thoracic artery was harvested. Results A total of 14 studies (N = 22,135, among them 4 randomized controlled trials [N = 4672]) were included in the analysis. Implantable gentamicin-collagen sponges significantly reduced the risk of sternal wound infection by approximately 40% when compared with control (risk ratio [RR], 0.61; 95% confidence interval [CI], 0.39-0.98; P = .04 for randomized controlled trials and RR, 0.61; 95% CI, 0.42-0.89; P = .01 for observational studies). A similar, significant benefit was demonstrated for deep sternal wound infection (RR, 0.60; 95% CI, 0.42-0.88; P = .008) and superficial sternal wound infection (RR, 0.60; 95% CI, 0.43-0.83; P = .002). The overall analysis revealed a reduced risk of mediastinitis (RR, 0.64; 95% CI, 0.45-0.91; P = .01). The risk of death was unchanged. A significant positive linear correlation ( P = .05) was found between the log RR of sternal wound infection and the percentage of patients receiving bilateral internal thoracic artery grafts. Conclusions Implantable gentamicin-collagen sponges significantly reduce the risk of sternal wound infection after cardiac surgery, with evidence consistent in randomized and observational-level data. However, the extent of this benefit might be attenuated in patients receiving bilateral internal thoracic artery grafts. [ABSTRACT FROM AUTHOR]

Hypothesis: Naturally extracted polysaccharides, such as guar gum, are promising candidates for environmentally friendly flotation reagents. It is hypothesized that the kinetics of collision of sub- to millimeter gas bubbles with a hydrophobic graphite surface, and the stability of thin liquid film formed between the bubble and surface is affected by an adsorbed layer of guar gum., Experiments: A combination of gravimetric (quartz crystal microbalance with dissipation) and imaging (atomic force microscopy) techniques was used to investigate the adsorption of guar gum on graphite surface, while high-speed camera imaging allowed for direct observation of the bubble collision process with guar gum-modified graphite surfaces with millisecond resolution., Findings: Atomic force microscope topography images revealed a guar gum concentration-dependent interconnected network of guar gum molecules adsorbed at graphite surface. These adsorbed molecules at low surface coverage, changed the wettability of the graphite surface, resulting in a film drainage time longer by an order of magnitude, while at higher surface coverage successfully prevented bubble attachment to the graphite surface. Most importantly, the adsorbed layer changed the strength of the bubble's bouncing off the graphite surface. This enhanced bubble bouncing can be correlated with the film drainage time and used to predict a successful bubble-particle attachment., 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 The Authors. Published by Elsevier Inc. All rights reserved.)

Wilson disease (WD) is a liver disorder characterized by improper copper metabolism. Although non-invasive tools are currently used to support diagnosis and management, this is still an area of unmet need, as patients present with a wide range of symptoms. Our aim was to investigate the potential utility of multiparametric magnetic resonance imaging (mpMRI) and quantitative magnetic resonance cholangiopancreatography (MRCP+) to support patient management. MRI examinations of 7 children and young adults aged 8-16 years (six at diagnosis) were performed alongside a standard of care clinical and histological examination. Images were quantitatively analyzed to derive metrics of liver (corrected T1 (cT1; fibro-inflammation), MR liver fat (proton density fat fraction; PDFF)), and biliary health (MRCP+). MRI-PDFF provided a more dynamic characterization of fat compared with that provided by ultrasound. Those with elevated histological scores of fibrosis, inflammation, and steatosis had elevated mpMRI values. MRCP+ managed to identify dilatations in the biliary tree which were not observed during the standard of care examination. mpMRI and MRCP+ metrics show early promise as markers to assess both liver and biliary health in Wilson disease. Investigations to understand and explore the utility of these markers are warranted and should be performed.

The existing literature on the rise velocities of air bubbles in aqueous surfactant solutions adsorbing at the water-air interface focuses mainly on large bubbles ( D > 1.2 mm). In addition, due to the way the bubbles in rising bubble experiments are formed, their size is dependent on interfacial tension (the lower the interfacial tension the smaller the bubble). In this paper, smaller air bubbles ( D < 505 ± 3 μm) are used to investigate the effect of the bubble size on the detection of two flotation frothers of different adsorption kinetics via bubble rise velocity measurements. We use an alternative method for bubble generation, allowing us to compare the rise velocity of bubbles of the same size in solutions of frothers of varying bulk concentration. The approach taken (ensuring consistent bubble size) ascertains that the buoyancy force component is kept constant when comparing the different solutions. As a consequence, any variations in the bubble rise velocity can be related to changes in the hydrodynamic drag force acting on a rising bubble. The interfacial behavior of frothers, i.e. the adsorption kinetics, interfacial activity and the maximum amount of molecules adsorbed at the interface, are determined from interfacial tension measurements and adsorption isotherms. The differences in the degree of tangential immobilisation caused by two different frothers are discussed in the context of differences in the structure of the dynamic adsorption layer, which is formed during the bubble rise.

Hypothesis: Odd-even effects in polysaccharide polyelectrolyte multilayers influence their hydration content and the chemical environment of the water within them., Experiments: Polysaccharide polyelectrolyte multilayers (PEMs) composed of pharmaceutical grade fucoidan and chitosan were studied under confinement using synchrotron FTIR microspectroscopy at increasing pressure, in order to isolate and measure infrared spectra of water within the PEM, without interference from bulk water. Complementary studies of the PEMs were carried out using lab-based in situ attenuated total reflectance Fourier transform spectroscopy (ATR FTIR) and quartz crystal microbalance with dissipation monitoring (QCM-D), as well as zeta potential measurements, to determine the quantity of adsorbed polymer, hydration content, film thickness, viscoelastic properties and surface charge during layer-by-layer deposition., Findings: The hydration of the PEM followed a saw-tooth profile, known as the odd-even effect, where the film increased hydration with fucoidan adsorption and dehydrated/densified with chitosan adsorption. The water structure within the film showed a lower degree of hydrogen bonding than water in the bulk electrolyte. However, the water structure/environment was independent of the terminating layer of the PEM, in spite of the alteration in percentage hydration water, indicating only a partial proof of the initial hypothesis for this multilayer system (hydration amount changes, hydration water environment does not)., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Introduction: Neurological injuries remain a major concern following coronary artery bypass grafting (CABG) that offsets survival benefit of CABG over percutaneous coronary interventions. Among numerous efforts to combat this issue is the development of off-pump CABG (OPCABG) that obviates the need for extracorporeal circulation and is associated with improved neurological outcomes. The objective of this study is to examine whether the neuroprotective effect of OPCABG can be further pronounced by the use of two state-of-the-art operating techniques., Methods and Analysis: In this randomised, controlled, investigator and patient blinded single-centre superiority trial with three parallel arms, a total of 360 patients will be recruited. They will be allocated in a 1:1:1 ratio to two treatment arms and one control arm. Treatment arms undergoing either aortic no-touch OPCABG or OPCABG with partial clamp applying carbon dioxide surgical field flooding will be compared against control arm undergoing OPCABG with partial clamp. The primary endpoint will be the appearance of new lesions on control brain MRI 3 days after surgery. Secondary endpoints will include the prevalence of new focal neurological deficits in the first 7 days after surgery, the occurrence of postoperative cognitive dysfunction at either 1 week or 3 months after surgery and the incidence of delirium in the first 7 days after surgery. Data will be analysed on intention-to-treat principles and a per protocol basis., Ethics and Dissemination: Ethical approval has been granted for this study. Results will be disseminated through peer-reviewed media., Trial Registration Number: NCT03074604; Pre-results., Date and Version Identifier: 10-Mar-2017 Original., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Radioguided surgery using 68-gallium labelled somatostatin analogues is a promising method for detection of small, intra-abdominal, neuroendocrine neoplasm (NEN). However, due to high background activity (physiological uptake in e.g. spleen, adrenal glands and kidneys) tumours of the tail and body of pancreas might be impossible to detect with hand-held gamma probe. Therefore a new concept of intraoperative PET/CT scan of the resected tissue can be helpful in determining whether the tumour has been excised within the margins of healthy tissue. A 71-year-old woman with primary, non-metastatic NEN of the tail of pancreas is described. The tumour was diagnosed using MRI and PET/CT scan. Before operation patient was administered intravenously 80 MBq of ⁶⁸Ga-DOTATATE. The surgery procedure was performed 60-180 minutes post injection. During the procedure pancreas was visualized, but the tumour could not be localized neither with palpation nor gamma probe. The tail of the pancreas was resected en bloc with spleen and adjacent lymph nodes. PET/CT scan of the tissue specimen was performed immediately followed by pathological examination. PET/CT scan of the resected tissue showed moderate activity in the tail of pancreas, and a small focus of high activity in the tail. Area of high SSTR expression in the tail corresponded with preoperative findings in MRI and whole-body PET/CT. Histopathological examination of the specimen confirmed the presence of neuroendocrine tumour grade 1. Immediate PET/CT scan of the surgical specimen can bring new quality to intraoperative assessment of completeness of resection of neuroendocrine tumours.