Objective: In this study, it was aimed to compare various parameters during surgery and postoperative cognitive functions in patients undergoing coronary artery bypass graft (CABG) surgery using different levels of perioperative oxygen. Methods: One hundred patients scheduled for elective CABG surgery were included in the study. The patients were divided into two groups according to arterial oxygen levels during surgery. In the normoxia group (NG) (n = 50), PaO2 was between ≥100mmHg and <180mmHg with at least 40% FiO2 mechanical ventilation (MV), and in the hyperoxia group (HG) (n = 50), PaO2 was ≥180 mmHg with 100% FiO2 MV. Hemodynamic parameters, peripheral oxygen saturation (SpO2), cerebral oxygen saturation (rSO2) measured from bilateral sensors, and blood gas values were recorded at the planned measurement times. Mini-mental state examination test (MMSE) was applied to the patients before and at the 12th, 24th hours; on the 1st, 3rd, 6th months after surgery. Results: Extubation time was found to be shorter in NG (p <0.05). Between the groups, rSO2 and mean arterial pressure (MAP) were found to be significantly lower in HG at the time of T4 measurement (p = 0.042, p = 0.038, respectively). MMSE values of the groups at the 1st, 3rd and 6th months were found to be significantly higher in NG (respectively p = 0.017, p = 0.014, p = 0.002). Conclusion: Hyperoxemia application during CABG may be associated with worse postoperative late-term cognitive functions. Keywords: cardiopulmonary bypass; hyperoxia; postoperative complications; cognitive function; spectroscopy, near-infrared.
Salt stress causes changes in root apoplastic barriers, such as the endodermis and the exodermis, and these changes are associated with variation in abiotic stress tolerance. We explored variation in root apoplastic barrier traits, O2 consumption and root and shoot Na+ and K+ content in a diverse collection of commercial and wild barley accessions subjected to non-saline (control) and saline treatments. Lignin and suberin deposition in endo- and exo-dermal cell walls varied between the accessions and in response to salt treatments. Twenty-two wild barley accessions formed an exodermis in response to salt treatments, whereas the commercial barley cultivar Barke did not develop an obvious exodermis. Accessions with pronounced root barrier deposition tended to have lower O2 consumption relative to the accessions with less obvious barriers. Treatment with abscisic acid enhanced suberisation and lead to a pronounced formation of an exodermis in wild barley accessions, whereas treatment with an ethylene precursor had no obvious effect on suberisation. Principal component analysis revealed associations between suberin deposition, root and shoot Na+ and K+, and root respiration. The variation in root apoplastic barrier traits within the barley accessions represents a useful resource for future crop breeding to improve environmental stress tolerance.
Abstract Objectives: In patients with chronic rhinosinusitis (CRS), olfactory dysfunction (OD) is a common complaint. The focus of this research was to evaluate the effectiveness of olfactory training (OT) in patients with CRS after sinonasal surgery. Design : Prospective controlled trial. Participants: We enrolled 111 Korean CRS patients who underwent sinonasal surgery. Main Outcome Measures: At baseline and three months after starting OT, both participants were assessed by an olfactory function test and endoscopy. The Korean version of the Sniffin’ stick II (KVSS-II) was used to perform the olfactory function test. A visual analog scale and the Mini-Mental State Examination were used to assess nasal and psychological functions. Over the course of three months, five odorants were used in OT (rose, lemon, cinnamon, orange, and peach). Results: Over a 12-week duration, OT increased olfactory activity in nearly 62 percent of subjects than in non-OT subjects. The OT group had significantly higher olfactory outcomes for the total KVSS-II and identification scores than the non-OT group between the initial and follow-up assessments. The initial score influenced the degree of olfactory improvement after OT. Conclusions: OT patients exhibited significantly higher total KVSS-II scores compared with non-OT patients after sinonasal surgery; in particular, the odor identification score was different between the two groups. The results of this study show that a 12-week period of repeated short-term exposure to various odors could be useful in enhancing olfactory activity in patients who underwent sinonasal surgery for the improvement of sensory-neural olfactory impairment.
Elderly individuals exhibit unbalanced bone marrow (BM) effector T cell subset differentiation, such as increased T helper (Th)-1 and T cytotoxic (Tc)-1 cell frequencies, but the underlying mechanism still unclear. Endothelial cells (ECs) , which are instructive components of the BM microenvironment, exhibit the phenotype of semi-professional antigen-presenting cells and regulate T cell recruitment and activation. Thus, we compared the frequency and function of BM ECs, especially their capacity to regulate effector T cell subsets, between young and old healthy individuals, and explored the underlying mechanism of this immunomodulatory discrepancy. Although the young and old EC percentages were comparable, young ECs showed less reactive oxygen species and better migratory and tube-forming abilities than old ECs. Notably, young ECs regulated T cells to differentiate into fewer Th1 and Tc1 cells than old ECs. Reduced T cell activation molecules and inflammatory cytokines in young BM ECs may be the possible mechanism.
Aim: Kidney transplant patients are amongst the high-risk groups for severe Covid 19. To date, no specific antiviral agent has been found uniformly effective against severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). Favipiravir, the recommended drug by The Turkish Ministry of Health, was uniformly supplied to all patients diagnosed to have COVID 19 with a positive nasopharyngeal swap PCR test. The aim of our study was to retrospectively compare our kidney transplant recipients who developed COVID-19 infection started on Favipiravir to those who did not use Favipiravir for the clinical course of the disease with a special emphasis on the occurrence of side effects/adverse events. Methods: Thirty-seven consecutive KT recipients with a median age of 46 years and of whom 62.2% were women; 8 deceased /29 living related donor, with a 8.0 (5.5-12.5) years median duration of transplantation were included in the study. Results: Twenty-six (70.3%) patients received Favipiravir, 11(29.7%) did not. There was no statistical significance in baseline demographic, clinical and laboratory findings between the groups except that the Favipiravir group was older and had a higher requirement of oxygen treatment. There was no statistically significant difference in the course and outcome of COVID-19 infection, in the occurrence of side effects/adverse events related to Favipiravir between the two groups. Laboratory data at baseline, day7 and 30 were also comparable between the groups. Conclusion: Although the efficacy of Favipiravir in the treatment of COVID-19 infection is currently controversial, Favipiravir can safely be used in kidney transplant patients.
A 79-year-old man was referred for severe cardiac decompensation. Chest radiography showed severe pulmonary edema, and transesophageal echocardiography revealed a large quantity of vegetation on all aortic valve leaflets with severe aortic valve regurgitation, heterogeneous cavities adjacent to the aortic annulus, and ventricular septal rupture. We performed thorough and extensive debridement of the aortic root; including the infected ventricular septum, reconstructed the ventricular septum and aortic root using autologous and bovine pericardial patches; and placed a bioprosthetic stented valve. The patient was discharged without any complications, and without recurrence of the endocarditis in the four years post-surgery.
Background and purpose The incretin hormone, glucose-dependent insulinotropic polypeptide (GIP), secreted by the enteroendocrine K-cells in the proximal intestine, may regulate lipid metabolism and adiposity but its exact role in these processes is unclear. Experimental approach We characterized in vitro and in vivo antagonistic properties of a novel GIP analogue, mGIPAnt-1. We further assessed the in vivo pharmacokinetic profile of this antagonist, as well as its ability to affect high-fat diet (HFD)-induced body weight gain in ovariectomized mice during an 8-week treatment period. Key results mGIPAnt-1 showed competitive antagonistic properties to the GIP receptor (GIPR) in vitro as it inhibited GIP-induced cAMP accumulation in COS-7 cells. Furthermore, mGIPAnt-1 was capable of inhibiting GIP-induced glucoregulatory and insulinotropic effects in vivo and has a favourable pharmacokinetic profile with a half-life of 7.2 hours in C57Bl6 female mice. Finally, sub-chronic treatment with mGIPAnt-1 in ovariectomized HFD mice resulted in a reduction of body weight and fat mass. Conclusion and Implications mGIPAnt-1 successfully inhibited acute GIP-induced effects in vitro and in vivo and sub-chronically induces resistance to HFD-induced weight gain in ovariectomized mice. Our results support the development of GIP antagonists for the therapy of obesity.
Microbial diversity and community function are related, and can be highly specialized in different gut regions. The cloacal microbiome of Sceloporus virgatus provides antifungal protection to eggshells during oviposition – a specialized function that suggests a specialized microbial composition. Here, we describe the S. virgatus cloacal microbiome from tissue and swab samples, and compare it to tissue samples from the gastrointestinal (GI) tract and oviduct, adding to the growing body of evidence of microbiome localization in reptiles. We further assessed whether common methods of microbial sampling – cloacal swabs and feces – provide accurate representations of these microbial communities and whether feces might “seed” the cloacal microbiome or impact the accuracy of cloacal swab sampling. We found that different regions of the gut had unique microbial community structures. The cloacal community, in particular, showed extreme specialization averaging 99% Proteobacteria (Phylum) and 83% Enterobacteriacaea (Family). Cloacal swabs recovered communities similar to that of lower intestine and cloacal tissues, but fecal samples had much higher diversity and a distinct composition (62% Firmicutes and 39% Lachnospiraceae) relative to all gut regions. Finally, we found that feces and cloacal swabs recover different communities, but cloacal swabs may be contaminated with fecal matter if taken immediately after defecation. These results serve as a caution against the assumption that fecal samples provide an accurate representation of the gut, and that although cloacal swabs can reflect a portion of the lower GI tract microbiome, they may also result in a mixed community of gut and fecal microbes.
Solar energy is increasingly used to produce electricity in Europe, but the environmental impact of constructing and running solar parks (SP) is not yet well studied. Solar park construction requires partial vegetation removal and soil leveling. Additionally, solar panels may alter soil microclimate and functioning. In our study of three French Mediterranean solar parks, we analyzed 1) effects of solar park construction on soil quality by comparing solar park soils with those of semi-natural land cover types (pinewood and shrubland) and abandoned croplands (abandoned vineyards); 2) the effect of solar panels on soil microclimate, CO2 effluxes and vegetation. We measured 21 soil properties of physical, chemical, and microbiological soil quality in one solar park and its surroundings to calculate integrated indicators of soil quality. We surveyed soil temperature and moisture, CO2 effluxes and vegetation below and outside solar panels of three solar parks. Soil aggregate stability was reduced by SP construction resulting in a degradation of soil physical quality. Soil chemical quality and a general indicator of soil quality were lower in anthropogenic (SP and abandoned vineyards) than in semi-natural (pinewood and shrubland) land cover types. However, differences between abandoned vineyards representing the pre-construction land cover type and solar parks were not significant. Solar panels reduced the soil temperature by 10% and soil CO2 effluxes by 50% but did not affect early successional plant communities. Long-term monitoring is needed to evaluate the effects of solar panels on vegetation.
The assessment of wildlife population sizes and their trends is one of the most important research fields in conservation biology, as it is used to identify vulnerability soon enough to implement measures in threatened species, or to set up sustainable harvesting rates in exploited populations. Yet, because field work is expensive, may be difficult in terms of logistics and because some populations of the same species may be monitored by different stakeholders, population status often rely on fragmented and heterogenous information on sub-populations collected through various monitoring programs. In this context, data integration, i.e. the simultaneous analysis of different datasets in a single modelling framework allows to get unbiased and more precise trend estimates than separated analysis that in turn may lead to more adequate management policies. In this study we developed an integrated state-space model to jointly model populations growth rates from individual counts and hunting bags data for three hunted species of mountain Galliformes in Italy. We examined population trends at various spatial scales and disentangled the potential effect of game management plans from biological factors. The integration of counts and bags succeeded in improving growth rate parameter precision and in reducing proxy-specific bias by increasing the sample size and extending data series length. On a 19-year basis, all three species exhibited negative mean growth rates. We did not find strong regional patterns for Rock ptarmigan and Rock partridge, as a likely consequence of prevailing effects of local environmental conditions on population growth rate. Black grouse eastern populations exhibited lower growth rate than western populations. Our paper demonstrates that an integrated model of different index of population size of game species can provide more accurate values than separate analysis, we advocate to consider such an approach for other wildlife monitoring cases for which data is scarce.
Background: Elevated red blood cell distribution width (RDW) levels were associated with mortality in patients with stable chronic obstructive lung diseases (COPD). There are limited data about RDW levels in COPD exacerbation. Aim/Objective: The association of the RDW levels with the severity of the acute exacerbation of COPD (AECOPD) were evaluated according to admission location, (outpatient-clinic, ward and intensive care unit (ICU). Methods: Cross sectional retrospective study designed in tertiary chest dieases hospital. COPD patients admitted to hospital outpatiens-clinic, ward and ICU due to AECOPD were included. Patients demographics, RDW, C-reactive protein (CRP), biochemistry values were recorded. RDW values were subdivided below 0.11% (low), above and equal 0.15% (high) and between 0.11-0.15% (normal). Neutrophile to lymphocyte ratio (NLR) and platelet to mean platelet volume (PLT-MPV) were also calculated. Recorded values were compared according to where AECOPD was treated. Results: 2771 COPD patients (33% female) and 1429 outpatients-clinic, 1156 ward and 186 ICU were enrolled in the study. The median RWD values in outpatients-clinic, ward and ICU were 0.16 (0.09-0.26), 0.07 (0.01-0.14) and 0.01 (0.00-0.07) respectively (p<0.001). In outpatient to ward and ICU, low RDW values were significantly increased (31%, 66%, 83% respectively) and high RDW values significantly decreased (54%, 24%, 10%) (p<0.001). According to attack severity, low RDW values were determined. Conclusion: Patients with AECOPD, lower RDW values should be considered carefully. Lower RDW can be used for decision of COPD exacerbation severity and follow up treatment response. What is already known about this topic; In current studies, elevated RDW levels were associated with mortality in patients with stable COPD. What does this article add; Currently , there are limited data about RDW levels in COPD exacerbation. In the present study, the association of the RDW levels according to the severity of AECOPD were evaluated due to admission location.
We reported a case with complaint of abdominal pain, nausea, vomiting, and oral intake intolerance due to a giant thoracoabdominal aortic aneurysm with contained leak and acute rupture within the circumferential mural thrombus which presented with upper gastrointestinal obstruction manifestation. The rupture led to the patient undergoing emergency aneurysm repair.
Cardiac Hydatid Cysts are uncommonly encountered entity of hydatid disease. Presentation may be with non-specific symptoms and sometimes with life threatening events. We present a rare case of a 9-year-old female who was diagnosed with a Cardiac Hydatid Cyst in the right ventricle, and underwent successful surgical excision
Background: The co-existence of chronic diseases (CD), a condition defined as multimorbidity (MM), is becoming a major public health issue. Understanding the general framework of MM diseases according to the well-known risk factors can assist in finding direct and indirect relationships among them. Therefore, we aimed to determine pattern and predicting risk factors of multi-morbidity in the Azar Cohort population using Structural Equation Model (SEM). Methods: In this study, the prevalence of MM in 15006 XXX cohort population was evaluated. MM was defined as the co-existence of two or more CDs. The information regarding socio-economic, demographic, sleeping habits, and physical activity were collected by questionnaires. A multi-group SEM was employed to model complex relationships between directly- and indirectly-observed variables. Results: The overall MM was seen in 28.8% of the population. The most prevalent chronic diseases were obesity, hypertension, depression, and diabetes, respectively. Obesity, depression, and diabetes were the most co-occurring CDs in our population. The SEM diagram indicated the overall effect of socio-demographic (predictors) and sleep and physical activity (mediators) on the number of CDs. The number of CDs in the active participants and those who sleep 6.6-7.3 hours/day was lower than the inactive participants and those who sleep ≤6.5 hours/day. Conclusions: According to our results, it seems that the reduction of MM is possible through promoting public health from an early age and for a wide range of socio-economic conditions, provided that the necessary support for general health is offered for the aging population.
The present paper attempts to study the causative physicochemical properties of the soils, which effectively portray its dispersive and deteriorating conditions, which have led to the formation of badlands in the Mandakini River watershed Chitrakoot area, India. Following investigations were made on the soil samples collected from the field: i) grain size distribution ii) various physicochemical properties and nutrient content of the soil. The clay minerals were detected and identified with the X-ray diffraction (XRD), Fourier transform infrared (FTIR), and High-Resolution Scanning Electron Microscopy (HRSEM). The spatial maps of all these parameters were prepared in a GIS environment, and overlay analysis was performed. The results show that the soil has a silt loam texture with high bulk density. The low values of plastic limit, liquid limit, and plasticity index show the non-cohesive nature of the soils. Higher bulk density has decreased the porosity as well as permeability in the soils. This impact on porosity and permeability has reduced the favourable conditions for vegetation, and the soils contain low organic matter. Apart from the bulk density, the presence of calcrete and illitic clay mineral (low in content) has also reduced the permeability of the soils, further increasing runoff. The overlay analysis based on the liquid limit, plasticity index, bulk density, and drainage frequency shows that the area is thoroughly affected by badland processes. Three zones were categorized as severe, very severe, and extremely severe depending upon their conditions gully channel processes.