Neck Diameter Research Articles

Опыт выращивания посадочного материала Thuja occidentalis ᾽Smaragd᾽ с ЗКС по технологии «Контейнер в контейнере»

In the Russian nursery industry, there are certain standards for planting material developed for all types of plants that dictating clear requirements for nursery products, in case of deviation from which, the competitive-ness of the nursery in the plant market decreases. In order to grow healthy planting material that meets all the required standards, it is necessary to apply modern cultivation technologies that provide all the conditions for the uniform development of the aboveground and underground parts of the plant, without any disease. This article discusses the experience of growing Thuja occidentalis ‘Smaragd’ planting material with a closed root system in containers. Observations on the condition of 180 containerized seedlings on three experimental sites in the nursery - an open area, a shaded area and a "Pot-in-pot" technology area were made. Measurements of substrate temperature in containers throughout the day, biometric indicators of seedlings – plant height, root neck diame-ter, root length and density were analyzed. All the advantages and disadvantages of the "Pot-in-pot" system, dif-ferences from the classical cultivation are shown, and the influence of this method on the physiology and productivity of plants is determined.

Влияние стимулятора роста растений (янтарной кислоты), сроков черенкования на укореняемость зеленых черенков груши и айвы

The article highlights the research results on the rooting of green pear and quince cuttings in the first and second decades of June. Green cuttings were taken from mother shrubs and treated with the plant growth stimulator of succinic acid. As the pear and quince cuttings took roots, we determined the rooting ability of rootstocks, number of standard rootstocks, height of the rooted rootstocks, diameter of the conditional root neck, number of roots, length of the root system. The rootstocks of pear PG 12 (k), PG 2, PG 17-16, PG 333 and quince VA 29, Severnaya demonstrated the best indicators of rooting ability, number of standard rootstocks, diameter of the conditional root neck, number and length of roots.

The Formation Mechanism of Ordered Mesoporous Carbon with Network-Structure: A Novel Support Material for Pt-Based Catalysts in PEFC Cathodes

INTRODUCTIONTo achieve carbon neutrality in the upcoming sustainable society, it is crucial to utilize hydrogen as a fuel in the transportation sector. Fuel cell vehicles are expected to play an important role in the future hydrogen society, but there are still challenges to be overcome before their widespread adoption. For example, Pt/C-based catalysts used in PEFC cathodes have an issue with poisoning of the Pt due to direct contact with the ionomer, especially during low-load operation. Recently, a new approach using accessible-pore carbons has been proposed, where Pt is placed at an appropriate position within the nanopores of a carbon support to suppress ionomer poisoning of Pt [1]. In order to realize this concept, it is essential to design a mesoporous carbon support that possesses nanopores with appropriate size and proper ordering. We have developed an ordered mesoporous carbon with a hierarchical network structure (Net-OMC) consisting of small OMC particles of several tens of nm in size, which are connected to form a network structure with well-developed primary pores. The Net-OMC exhibited highly ordered nanopores on the surface of the OMC primary particles, with a pore size ca. 5 nm and an interpore distance of ca. 8 nm. Pt nanoparticles were loaded selectively within the Net-OMC nanopores by the selective Pt-deposition technique developed by our research group. Pt/Net-OMC catalyst exhibited higher mass activity and durability for the ORR in comparison with those for a commercial Pt/CB catalyst [2]. In this study, the formation mechanism of Net-OMC and the relationship between the catalytic properties of Pt/Net-OMC and its pore structure was investigated in detail.EXPERIMENTALNet-OMC powder was synthesized with resol-nonionic surfactant micelles as a carbon source and structure-directing agent. Resol-F127 (nonionic surfactant) micelles were synthesized by mixing phenol, formaldehyde, water and F127 with sodium hydroxide. After hydrothermal treatment of the mixture, the resulting solid was filtered and washed thoroughly and dried under vacuum. The obtained powder was carbonized at 700 ºC followed by annealing at 1000 ºC. Pt was deposited on the Net-OMC powder by selective deposition techniques. Cyclic voltammetry and linear sweep voltammetry were carried out in N2-saturated and O2-saturated 0.1 M HClO4 solution at 25 ºC using the conventional rotating disk electrode (RDE) technique. Potential step cycling measurements simulating load cycling between 0.6 V and 1.0 V vs. RHE were carried out according to the FCCJ protocol. Coating of the catalyst on a glassy carbon disk substrate was carried out by an electrospray (ES) coating technique developed by our group [3]. N2 adsorption measurements at liquid nitrogen temperature were carried out. The morphology of the Pt/ns-OMC was observed by scanning transmission electron microscopy (STEM).RESULTS AND DISCUSSIONSTEM images for the ordered mesoporous carbon particles with network structure (Net-OMC) with varying concentration during hydrothermal synthesis are shown in Figure 1. In Fig. 1(a), the network structure formed by connection of OMC primary nanoparticles with developed macropores is clearly observed. The OMC nanoparticles were tightly connected via a thick necking structure. From the high magnification image (Fig. 1(a), inset), highly ordered nanopores were observed on the surface of the OMC particles. The OMC primary particle size and the connecting neck diameter changed with the resol micelle concentration during the hydrothermal treatment. When the concentration of the micelle solution was decreased, both the primary particle size and necking length decreased. At a concentration of 1.8 mmol l-1, the formation of monodisperse particles with roughly the same size from the resol-F127 micelle particles was observed, as estimated by dynamic light scattering analysis. Thus, it is believed that the Net-OMC structure is formed through the self-assembly of micelle particles during the hydrothermal synthesis. The controllable network structure of Net-OMC is expected to provide a favorable porous structure of the catalyst layer for the MEA measurement even during high-load operation.

Feasibility, Safety, and efficacy of endovascular treatment for M1 hilltop Aneurysms: A retrospective study

ObjectiveThis retrospective study aimed to evaluate the feasibility, safety, and efficacy of endovascular treatment (EVT) for M1 hilltop aneurysms, a specific M1 segment subtype located at the highest point of the middle cerebral artery (MCA). MethodsThe study included 54 patients with M1 hilltop aneurysms who underwent EVT between December 2017 and [end date]. Treatment decisions were based on angiographic findings and patient characteristics. Clinical and radiological data were reviewed, and outcomes were assessed using the Raymond-Roy classification (RRC) and modified Rankin Scale (mRS). Follow-up radiological examinations were conducted at specific intervals. ResultsEVT was successful in all 54 cases. Immediate postprocedural angiograms showed favorable occlusion (RRC I or II) in 59.3% and aneurysm remnants (RRC III) in 40.7%. Procedure-related complications occurred in 7.4% of patients, including thromboembolism and ICA dissection, with no permanent neurological impairment. During a mean 18.2-month follow-up, no neurological deterioration or aneurysmal rupture occurred. Most patients showed stable/improved occlusion on follow-up imaging, with a 14% recurrence rate. Retreatment was required in 2% of cases. ConclusionsEVT appears feasible, safe, and effective for treating M1 hilltop aneurysms. It resulted in favorable occlusion and low recurrence/retreatment rates. Neck diameter and stent usage influenced immediate outcomes and recurrence. Larger studies with longer follow-ups are needed to validate these findings further.

The prolonged influence of stimulants on the growth of three-year-old Korean pine (Pinus koraiensis Siebold et Zucc.) seedlings

Relevance. Currently, one of the main tasks in forestry is to obtain high–quality planting material. Studies are being conducted on accelerated cultivation of coniferous and deciduous plants in forest nurseries with the use of growth stimulants that positively affect seed germination, the growth of biometric indicators, the safety and survival of plants. In this regard, the use of plant growth stimulants, which also include “Zircon” and “Ferovit”, is relevant.Methods. The effect of root feeding with Ferovit and Zircon preparations on morphometric parameters of three-year-old Korean cedar seedlings (Pinus koraiensis Siebold et Zucc.) was studied. Venue: nursery of the Mountain Taiga Station — branch of the Federal Research Center for Biodiversity of Terrestrial Biota of East Asia FEB RAS in 2019—2022. Parameters such as the height of seedlings, height gain, root neck diameter, root length and biomass were studied.Results. It was found that a significant effect is provided by a variant of root fertilization of seedlings with the use of “Zircon” and “Ferovit” at a concentration of 1.5 ml / 3 l of water solution. The indicators of the height of seedlings compared to the control increased by 126.1%, height increase — by 136.7%, root neck diameter — by 20%, root length — by 21.8%, biomass — by 252.1%.

Use of physician-modified inverted limb in conjunction with Zenith fenestrated stent graft to rescue failed previous endovascular and open repair

ObjectiveTo evaluate outcomes and performance of inverted limbs (ILs) when used in conjunction with Zenith fenestrated stent grafts (Zfens) to treat patients with short distance between the lowest renal artery (RA) and aortic or graft bifurcation (A/GB). MethodsThis study was a multicenter, retrospective review of prospectively maintained database of patients with complex aortic aneurysms, failed endovascular aneurysm repair (EVAR), or open surgical repair (OSR) with short distance between LRA and A/GB treated using a combination of Zfen and an IL between 2013 and 2023. Endpoints included technical success, aneurysm sac regression, long-term device integrity, and target vessel patency. We defined technical success as implantation of the device with no endoleak, conversion to an aorto-uni-iliac or OSR. ResultsDuring this time, 52 patients underwent endovascular rescue of failed repair. Twenty (38.5%) of them required relining of the failed repairs using IL due to lowest RA to A/GB length restrictions. Two patients had undergone rescue with a fenestrated cuff alone but developed type III endoleaks. One patient with no previous implant had a short distance between the lowest RA and aortic bifurcation to accommodate the bifurcated distal device, and two patients had failed OSR or anastomotic pseudoaneurysms. The majority (94%) were men with a mean age of 76.8 ± 6.1 years. The mean aortic neck diameter and aneurysm size were 32 ± 4 cm and 7.2 ± 1.3 cm, respectively. The median time laps between initial repair and failure was 36 months (interquartile range [IQR], 24-54 months). Sixteen patients (80%) were classified as American Society of Anesthesiologists class III, whereas four were class IV. Seventy-eight vessels were targeted and successfully incorporated. Technical success was 100%, and median estimated blood loss was 100 mL (IQR, 100-200 mL). Mean fluoroscopy time and dose were 61 ± 18 minutes and 2754 ± 1062 mGy, respectively. Average hospital length of stay was 2.75 ± 2.15 days. Postoperative complication occurred in one patient who required lower extremity fasciotomy for compartment syndrome. At a median follow-up of 50 months (IQR, 18-58 months), there were no device migration, components separation, aneurysmal related mortality, and type I or type III endoleak. Aneurysm sac regression (95%) or stabilization (5%) was observed in all patients, including in four patients (25%) with type II endoleak. ConclusionsThe use of IL in conjunction with Zfen to treat patients with short distance between the lowest RA and A/GB is safe, effective, and has excellent long-term results. The technique expands the indication of Zfen, especially in patients with failed previous EVAR.

Predicting incomplete occlusion of intracranial aneurysms treated with flow diverters using machine learning models.

Intracranial saccular aneurysms are vascular malformations responsible for 80% of nontraumatic brain hemorrhage. Recently, flow diverters have been used as a less invasive therapeutic alternative for surgery. However, they fail to achieve complete occlusion after 6 months in 25% of cases. In this study, the authors built a tool, using machine learning (ML), to predict the aneurysm occlusion outcome 6 months after treatment with flow diverters. A total of 667 aneurysms in 616 patients treated with the Pipeline embolization device at a tertiary referral center between January 2011 and December 2017 were included. To build the predictive tool, two experiments were conducted. In the first experiment, six ML algorithms (support vector machine [SVM], decision tree, random forest [RF], k-nearest neighbor, XGBoost, and CatBoost) were trained using 26 features related to patient risk factors and aneurysm morphological characteristics, and the results were compared with logistic regression (LR) modeling. In the second experiment, the models were trained using the top 10 features extracted by Shapley additive explanation (SHAP) analysis performed on the RF model. The results showed that the authors' tool can better predict the occlusion outcome than LR (accuracy of 89% for the SVM model vs 62% for the LR model), even when trained using a subset of the features (83% accuracy). SHAP analysis revealed that age, hypertension, smoking status, branch vessel involvement, aneurysm neck, and larger diameter dimensions were among the most important features contributing to accurate predictions. In this study, an ML-based tool was developed that successfully predicts outcome in intracranial aneurysms treated with flow diversion, thus helping neurosurgeons to practice a more refined approach and patient-tailored medicine.

Endovascular repair for abdominal aortic aneurysms involving visceral arteries: Effectiveness and contributing factors

ObjectiveAbdominal aortic aneurysms (AAA) involving branches of the visceral arteries mainly refer to AAA with flat renal artery (neck length ≤5 mm) or beyond the renal artery, and the branch of the visceral arteries needs to be reconstructed during treatment. Endoluminal repair (EVR) surgery refers to the isolation of AAA with less surgical trauma through vascular puncture, guidewire, catheter, stent and double suturer technology. However, postoperative endoleak is a complication specific to open surgery. This study aimed to analyze the efficacy of EVR for AAA involving visceral vessels (AAA-Vs) and the factors influencing the occurrence of postoperative endoleak. MethodsA total of 106 patients with AAA-Vs in our hospital during the period of January 2018 to January 2022 were distinguished as the observation group (received EVR, n = 48) and the control group (received laparotomy, n = 58). The operation time, intraoperative bleeding, intraoperative blood transfusion, postoperative intensive care unit (ICU) observation time, postoperative food-taking time, first time out of bed, hospital stay, complications and the one-year mortality of two groups were compared. According to the occurrence of postoperative endoleak, the patients underwent endoluminal repair surgery were graded as non-endoleak group (n = 39) and endoleak group (n = 9). The clinical data, including aneurysm anatomical conditions (proximal neck length, neck diameter, proximal neck angle), tumor shape (normal, calcification, mural thrombus), and internal iliac artery embolism of two groups were compared. Logistic regression analysis was employed to analyze the risk factors of endoleak after EVR of AAA. ResultsThe operation time, intraoperative blood loss, intraoperative blood transfusion, postoperative ICU observation time, postoperative food-taking time, first time out of bed and hospitalization days were sharply lower in the observation group than the control group (P < 0.001). There existed no significant difference in the proportion of pulmonary complications, cardiac complications and electrolyte disorders between two groups (P > 0.05). The observation group had much lower incidence of incision infection complications than the control group (P < 0.05). The one-year mortality rate in the observation group was 10.42 %, markedly lower than 25.86 % in the control group (P < 0.05). The incidence of endoleak in the observation group was 18.75 %, while no internal endoleak occurred in the control group (P < 0.05). The proportion of male patients, smoking history, internal iliac artery embolism, and the level of tumor neck length and proximal tumor neck angle in the endoleak group were memorably higher in comparison with the non-endoleak group (P < 0.05). Logistic regression analysis revealed that the length of the neck and the angle of the proximal neck were independent risk factors for postoperative endoleak of AAA (P < 0.05). In conclusionEVR was effective for AAA-Vs with the advantages of small trauma, rapid recovery, low complication rate and high safety. The diameter of the aneurysm neck and the angle of the proximal aneurysm neck were the risk factors for the occurrence of endoleak after EVR. It was necessary to fully evaluate the aneurysm before operation to help reduce the incidence of endoleak.

Responses of Growth and Root Vitality of Fokienia hodginsii Seedling to the Neighbor Competition in Different Heterogeneous Nutrient Environments

Fokienia hodginsii is characterized by shallow and developed lateral roots with no obvious taproot. It can be used as a pioneer tree species for opening up barren land and as a mixed species for creating plantation forests. During the growth process of F. hodginsii seedlings, they are often exposed to heterogeneous nutrient environments and competition for nutrients, water, and space from neighboring plants, which have significant impacts on the growth of F. hodginsii. These impacts are most directly reflected in the root vitality of F. hodginsii, whose physiological changes embody the plant’s adaptability to different heterogeneous nutrient environments and neighbor competition. Herein, high-quality one-year-old F. hodginsii seedlings were subjected to three planting patterns to simulate different competition patterns. The three planting patterns were also exposed to three heterogeneous nutrient environments and a homogeneous nutrient environment (control) to determine the differences in the F. hodginsii seedling growth and root vitality under different heterogeneous nutrient environments and planting patterns. The F. hodginsii seedling height, ground diameter (root neck diameter), and root biomass under the heterospecific neighbor condition were significantly higher than under the single-plant condition. Across heterogeneous nutrient environments, the average seedling height in the N heterogeneous environments was higher than in the P and K heterogeneous environments. The root biomass in the P heterogeneous environment was slightly higher than in the N heterogeneous environment and significantly higher than in the homogeneous and the K heterogeneous environments. Moreover, the average F. hodginsii seedling root vitality under the heterospecific neighbor was the highest, and the root vitality in the N heterogeneous environment was the highest under each planting pattern. The F. hodginsii root catalase (CAT) and peroxidase (POD) activities under the competition patterns were significantly higher than under the single-plant condition. Additionally, the superoxide dismutase (SOD) activity under single-plant was higher than under the competition patterns. At the same time, the F. hodginsii root malondialdehyde (MDA) content was the highest under the conspecific neighbor. Relative to the homogeneous environment, the root CAT, SOD, and POD activities were increased in the N and P heterogeneous environments. The CAT, SOD, and POD activities were highest in the P heterogeneous environment, while the K heterogeneous environment had the highest average MDA content. From the results of principal component analysis, when F. hodginsii seedlings were in N and P heterogeneous nutrient environments and heterospecific neighbor, their growth, root biomass accumulation, and root activity indexes reached better levels.

THE PROLONGED INFLUENCE OF ROOT TOP DRESSING OF KOREAN PINE (PINUS KORAIENSIS) ANNUAL-BIENNIAL SEE DLINGS WITH GRO WTH STIMULANTS ON THEIR BIOMETRIC INDICATORS AT EIGHT YEARS OF AGE

In the article the analysis of the prolonged influence of root top dressing of annual and biennial Korean pine (Pinus koraiensis Siebold et Zucc.) seedlings with the growth stimulants Сrezacin, Zircon and Epin-Extra on their biometric indicators at eight years of age is presented. It was established, that root top dressing with the growth stimulants Krezacin and Zircon had the greatest stimulating effect on the growth of height, increase in height and diameter of the root neck of seedlings. Epin-Extra is less effective.

Long-term clinical outcomes of EVAR within IFU compared to outside IFU

Abstract Background Endovascular aneurysm repair (EVAR) has been used worldwide to treat abdominal aortic aneurysm (AAA). Outcomes after EVAR between within instruction for use (IFU) and outside IFU are still controversial. We analyzed long term outcomes of EVAR within IFU compared to EVAR outside IFU and baseline clinical/anatomical characteristics that influence outcomes of EVAR. Methods We collected data from 766 patients (mean age 71.0 ± 12.5 years, male 90.2%) who underwent EVAR for infrarenal AAA between August 1997 and July 2021 at two centers in Korea. The primary endpoint was aneurysm related mortality (ARM) during follow up. The secondary outcomes were endoleak, reintervention and aneurysm sac enlargement. Results The mean AAA diameter is 59.0 ± 12.2 mm. The proportion of patients underwent EVAR outside IFU was 62.7% (n=466). Neck angle &amp;gt; 60 degree was the most common outside IFU criterion (n=210, 27.4%). The median clinical and imaging follow-up duration was 36.5 and 51.0 months, respectively. Total 110 patients (14.8%) had complications during follow up. The outside IFU group had more complications compare to the within IFU group (p=0.033). Overall mortality rate was 8.8% (n=60). ARM occurred in 0% of patients with EVAR within IFU and in 7 (1.5%) of patients with EVAR outside IFU (p=0.041), respectively. There was no significant difference in incidence of endoleak (28.5 vs. 23.1%, p=0.173), reintervention rate (8.4 vs. 9.3%, p=0.688) and aneurysm sac enlargement (23.6 vs. 23.4%, p=0.957) between patients underwent EVAR within IFU and outside IFU group. In multivariate analysis, proximal neck diameter &amp;gt; 28 mm was independent risk factor for ARM (HR, 9.132; 95% CI, 1.684 – 49.516, P=0.010). In addition, proximal neck angle &amp;gt; 60 degree was independent risk factor for endoleak (HR, 1.553; 95% CI, 1.042 – 2.314, P=0.031) and reintervention (HR, 2.297; 95% CI, 1.333 – 3.955, P=0.003). Neck length &amp;lt; 10 mm and neck diameter &amp;gt;28 mm were risk factors for aneurysm sac enlargement (HR, 4.363; 95% CI, 1.252 – 15.211, P=0.021 and HR, 3.148; 95% CI, 1.261 – 7.859, P=0.014). Age over 75 was also a risk factor for endoleak (HR, 2.491; 95% CI, 1.666 – 3.726, P=0.000) and aneurysm sac enlargement (HR, 3.150; 95% CI, 1.536 – 6.458, P=0.002). Conclusions Our study showed EVAR outside IFU is associated higher ARM compared to EVAR within IFU. In addition, neck angulation was risk factor for endoleak and reintervention. Clinicians should be caution when they perform EVAR outside IFU and select optimal patient for successful EVAR.

Effect of Bio Char and Amino Acid (Steam) on Growth and Green Yield of Onion (Allium cepa L.) Variety (Karbala)

The experiment was carried out in the vegetable field of Horticulture and Landscape Department / College of Agriculture and Forestry / University of Mosul, during 2021-2022 season to investigate the effect of administration of bio char in three doses (0, 3.5, 7, 10.5 t. Ha-1) and three Concentrations of Amino acid(Steam)(0, 10, 15 ml.L-1)on growth and green yield of onion variety (Karbala) The experiment was designed according to randomized complete block design (RCBD) with three replications. The results showed that : Adding the bio char in doses of 7 t. Ha-1 to the soil significantly increased several growth and yield properties(bulbs number, leaves number, bulb diameter, fresh and dry weight of leaves and roots, plant yield, and biological yield). Spraying amino acid (Steam) at 15 ml.L-1 doses gave the highest values of plant height, fresh and dry weight of leaves and roots per plant, diameter of bulb neck. But highest values of average weight of bulb and biological yield was from spraying amino acid (Steam) at 10 ml.L-1 doses. The combination treatments between bio char and amino acid (Steam) show a significant effect in some vegetative growth and yield parameters of onion.

Woven Endo Bridge shape modification contributes to decrease in adequate occlusion rate after Woven Endo Bridge implantation for wide-neck bifurcation intracranial aneurysms.

Recently, a novel device, the Woven Endo Bridge (WEB), was developed for wide-neck bifurcation intracranial aneurysms (WNBAs). The aim of this study is to investigate factors that contribute to adequate occlusion (AO) after the operation using detailed radiological images. The subjects were 29 patients with 29 aneurysms who received WEB implantation for WNBAs between December 2020 and April 2022. We assessed the contributing factors to AO by retrospectively comparing the AO group and non-AO group. The mean age was 64.6 ± 13.1years, and 18 were female (62.1%). The mean aneurysm dome width, aneurysm height, and aneurysm neck diameter were 4.8 ± 0.6mm, 5.1 ± 0.6mm, and 3.7 ± 0.6mm, respectively. After about 6months, 22 of 29 patients (75.9%) had AO. Complications were observed in 2 patients (6.9%), renal artery injury in one, and minor cerebral infarction in another, but the modified Rankin scale scores of both patients remained unchanged. Multivariate analysis extracted only WEB shape modification (WSM) as a contributing factor to AO (odds ratio: 0.912, p = 0.0287). WEB implantation for WNBAs was a treatment modality with acceptable efficacy and safety. WSM was the only significant factor contributing to non-AO after the treatment. We should clarify the mechanisms or causes of WSM to achieve AO after WEB implantation in future.

Obezite Cerrahisi Hastalarında Obstrüktif Uyku Apne Sıklığı

Objective: Obesity is one of the most important risk factors and also consequences of obstructive sleep apnea (OSA). Weight loss and positive airway pressure therapy are the main approaches in the treatment of OSA. In this study, it was aimed to evaluate the prevalence of OSA in obesity patients scheduled for bariatric surgery.&#x0D; Methods: In the University Hospital Obesity Center, 141 consecutive patients who were candidates for bariatric surgery in 2015 were clinically evaluated preoperatively for sleep-related respiratory disorders. Preoperative polysomnographic examination was recommended to all cases.&#x0D; Results: Of 141 bariatric surgery candidates with a mean age of 37±10 years, and 103 (73%) were female. The mean body mass index of the cases was 46.9±6.4 kg/m2. Among the major symptoms of OSA, snoring was present in 119 (84.4%), daytime sleepiness in 63 (44.7%) and witnessed apnea in 49 (34.8%) patients. OSA was detected because AHI&gt;5/hour was found in 75.7% (84/111) of the patients who accepted the polysomnographic evaluation. 24.3% (27/111) of the cases who underwent polysomnography had non OSA, 29.7% (33/111) mild OSA, 17.1% (19/111) moderate OSA, and 28.8% (32 /111), severe OSA was detected. AHI was positively correlated with age (p=0.003), neck and waist diameter (p

A Ratio Between Infrarenal and Suprarenal Aortic Diameters Corrects for Absolute Aortic Diameter Variations due to Patients' Sex and Body Size.

Aortic diameters may differ significantly between patients with different gender and body size. The aim of this study was to relate absolute aortic diameters to age, sex, height, and weight of the patients and to correct for these factors by calculating the ratio between the infrarenal and the suprarenal aortic diameters. A total of 458 patients who underwent elective endovascular aneurysm repair (EVAR) between 2004 and 2018 were included. The aortic anatomy in this group of elective EVAR patients was compared with a control group of 75 patients without an abdominal aortic aneurysm (AAA). The aortic diameter was measured at 4 suprarenal points and 4 infrarenal points. Ratios were calculated by dividing the mean infrarenal neck diameter by 4 suprarenal measurements. Patients in the aneurysm group had significantly larger suprarenal and infrarenal aortic diameters. The ratios between the mean infrarenal neck diameter and all 4 suprarenal measurements were larger in the AAA group than in the control group. In both groups, there was a significant correlation between the mean infrarenal neck diameter and sex, height, weight, and body surface area (BSA). However, in both groups, all 4 ratios between the mean infrarenal neck diameter and suprarenal aortic diameters were not correlated with age, sex, height, weight, or BSA, except for the ratio between the mean infrarenal neck diameter and the aortic diameter measurement proximal to the upper renal artery, which was correlated to weight and BSA in the control group. The mean infrarenal neck diameter is correlated with sex, height, weight, and BSA. However, when the suprarenal aortic diameter was used as an internal control for the mean infrarenal neck diameter, we were able to correct for these variations in aortic diameters due to sex and body size. The clinical relevance of this ratio in patients treated by EVAR has yet to be assessed in future research. In the assessment for EVAR suitability the absolute diameter of the aneurysm neck is taken into account. We believe that using absolute diameters is not the appropriate way to assess this suitability, but that patient characteristics such as age, gender and body size, should be factored into this assessment. In this paper, we show that suprarenal and infrarenal aortic diameters are both significantly increased in patients with an aneurysm compared with patients without an aneurysm. Besides, we found that mean infrarenal aortic diameter is correlated with sex, height, weight, and body surface area. Finally, we propose a new ratio system, using suprarenal diameters as an internal control, to correct for aortic diameter variations due to sex and body size.

Risk factor analysis of femoral avascular necrosis after operation for Tönnis grade IV developmental dysplasia of the hip.

We explored the risk factors for avascular necrosis (AVN) after surgery using open reduction, pelvic osteotomy, and femoral osteotomy for Tönnis grade IV developmental dysplasia of the hip (DDH). In this retrospective study, we collected data of patients with Tönnis grade IV DDH treated with open reduction and pelvic osteotomy combined with femoral osteotomy from January 2012 to May 2020. The patients were divided into the AVN group and non-AVN group using the Kalamchi-MacEwen classification system. The clinical and imaging data of the two groups were collected, and the possible risk factors were included in the analysis. Univariate and multivariate logistic regression analyses were used to identify the independent risk factors and odds ratios of AVN. In all, 254 patients (mean age; 2.6±0.9 years, 278 hips) were included. The mean follow-up time was 3.8±1.5 years. A total of 89 hips (32%) were finally classified as AVN (Kalamchi-MacEwen II-IV). Univariate analysis showed significant associations with AVN for age (p=0.006), preoperative femoral neck anteversion (FAV) (p<0.001), femoral osteotomy length to dislocation height ratio (FDR) <1 (p<0.001), and the epiphyseal ossific nucleus diameter to the neck diameter ratio (ENR) <50% (p=0.009). Multivariate logistic regression analysis showed that only excessive preoperative FAV (OR: 1.04; 95% CI: 1.02-1.05; p<0.001) and FDR<1 (OR: 3.58; 95% CI: 2.03-6.31; p<0.001) were independent risk factors for femoral head necrosis. Excessive preoperative FAV and FDR<1 are important risk factors for femoral AVN after open reduction, pelvic osteotomy, and femoral osteotomy for Tönnis grade IV DDH. For children with DDH with high dislocation and excessive FAV, clinicians should fully evaluate their condition and design more personalized treatment programs to prevent AVN.

How does the recurrence-related morphology characteristics of the Pcom aneurysms correlated with hemodynamics?

Posterior communicating artery (Pcom) aneurysm has unique morphological characteristics and a high recurrence risk after coil embolization. This study aimed to evaluate the relationship between the recurrence-related morphology characteristics and hemodynamics. A total of 20 patients with 22 Pcom aneurysms from 2019 to 2022 were retrospectively enrolled. The recurrence-related morphology parameters were measured. The hemodynamic parameters were simulated based on finite element analysis and computational fluid dynamics. The hemodynamic differences before and after treatment caused by different morphological features and the correlation between these parameters were analyzed. Significant greater postoperative inflow rate at the neck (Qinflow), relative Qinflow, inflow concentration index (ICI), and residual flow volume (RFV) were reported in the aneurysms with wide neck (>4 mm). Significant greater postoperative RFV were reported in the aneurysms with large size (>7 mm). Significant greater postoperative Qinflow, relative Qinflow, and ICI were reported in the aneurysms located on the larteral side of the curve. The bending angle of the internal carotid artery at the initiation of Pcom (αICA@PCOM) and neck diameter had moderate positive correlations with Qinflow, relative Qinflow, ICI, and RFV. The morphological factors, including aneurysm size, neck diameter, and αICA@PCOM, are correlated with the recurrence-inducing hemodynamic characteristics even after fully packing. This provides a theoretical basis for evaluating the risk of aneurysm recurrence and a reference for selecting a surgical plan.

Foliar application of chitosan and plant probiotic bacteria influencing the growth, productivity and bulb storage life of onion

Onion having several health promoting phytochemical contents is an important spices in most of the countries of the world as well as vegetables in particular and chitosan and plant probiotic bacteria are few proven natural growth enhancing agents. Here, three bio-stimulants namely Chitosan (100 and 200 ppm), Paraburkholderia BRRh-4 bacteria (1.5 × 109 CFU mL-1) and Clybio (0. 1%) in singly as well as combining one another were applied at twelve different treatment combinations including control with the aim of investigating the below and above ground vegetative growth, bulb productivity and post-harvest storage performance of onion cv. “Taherpuri”. The experiment was set up in Randomized Complete Block Design (RCBD) maintaining three replicates and conducted during November 2019 to June 2020 where the bio-stimulant formulations were sprayed in the foliage at 20, 40 and 60 days after transplanting (DAT). Reproductive behaviors of the onion cultivar differed significantly among the treatments and those were the resultants of statistically varied vegetative performances recorded at 30, 60 and 90 DAT. Chitosan @ 100 ppm + Clybio (0.1%) + Paraburkholderia BRRh-4 (1.5 × 109 CFU mL-1) combination exhibited statistical superiority over the other treatments in terms of plant height (53.230 cm), number of leaves (10.13/plant), leaf length (41.20 cm) and diameter (10.33 mm), number of roots (32.53/plant), root length (12.23 cm), neck and bulb diameter (11.20 mm and 4.83 cm, respectively) and bulbing ratio (0.23) at 90 DAT. While, shoot and root growth didn’t vary significantly at earlier stages (at 30 DAT). Again, the highest yield (3.36 kg/plot and 10.45 t/ha) was also obtained from Chitosan @ 100 ppm + Clybio (0.1%) + Paraburkholderia BRRh-4 (1.5 × 109 CFU ml-1) treatment. The combination of chitosan and probiotic bacteria had significant influence on post-harvest storage qualities of onion where the longest shelf life/marketable life (8.17 months) with the lowest physiological weight loss and bulb rotting at 90 days after harvest was administered in Chitosan @ 100 ppm + Clybio (0.1%) + Paraburkholderia BRRh-4 (1.5 × 109 CFU mL-1) treatment. Besides the best treatment, Chitosan @ 100 ppm + Clybio (0.1%) and Chitosan @ 100 ppm + Paraburkholderia BRRh-4 (1.5 × 109 CFU mL-1) produced statistically superior results over control for onion growth and development. Therefore, chitosan and plant probiotic bacteria can be judiciously used for quality onion production in the warm and humid areas of the world

The impact of large proximal aortic neck on endovascular aneurysm repair outcomes

Background: This study aims to investigate the effect of large proximal aortic neck diameter on post-endovascular aneurysm repair clinical outcomes. Methods: A total of 180 patients (168 males, 12 females; mean age: 69.9±7.4 years; range, 46 to 88 years) who underwent elective endovascular aneurysm repair between June 2016 and September 2021 were retrospectively analyzed. According to the proximal infrarenal aortic neck diameter, the patients were divided into two groups: Group 1 (&lt;25 mm; normal aortic neck) and Group 2 (≥25 mm; pre-aneurysmatic aortic neck). Patient characteristics, proximal infrarenal aortic neck diameter measurements with computed tomography angiography, and clinical outcomes were recorded. The primary endpoint was to assess post-endovascular aneurysm repair aortic neck dilatation, mortality, endoleaks, overall survival, type 1a endoleaks-free survival, and eventfree survival regarding the groups. Results: There was no statistically significant difference in early mortality (p=0.55) and type 1a endoleak incidence between the groups (p=0.55). In Group 1, the mean change in diameter A (proximal infrarenal level) was 2.89±1.74 mm (p=0.01), and it was 2.31±2.1 mm in diameter B (proximal pre-aneurysm-sac level) (p=0.01). The mean change in Group 2 was 2.8±3.4 mm for diameter A (p&lt;0.01) and 2.22±2.3 mm for diameter B (p&lt;0.01). Aortic neck dilatation rates were similar between the groups (p=0.82 for diameter A; p=0.78 for diameter B). The five-year survival, event-free survival, and type 1a endoleak-free survival were also similar (p=0.54, p=0.26, p=0.24, respectively). Conclusion: Our study results showed that patients with &lt;25 mm and ≥25-mm aortic neck diameters had similar mid-term results and aortic neck dilatation ratio. Endovascular aneurysm repair outcomes can be improved with careful patient and graft selection, and early intervention for complications.

Selectively Irradiation of the Supraclavicular Area in Nasopharyngeal Carcinoma Treated with Intensity Modulated Radiotherapy

The application of intensity-modulated radiotherapy (IMRT) has significantly improved the locoregional control and overall survival of patients with nasopharyngeal carcinoma (NPC), but how to deescalate the intensity of treatment to further reduce the side effects while ensuring the efficacy is the main concern of clinicians. Decreasing radiation volume is one of the hot research topics. Whole-neck irradiation is recommended for patients with cervical lymph node involvement, which includes levels IVb and Vc. Since the implementation of IMRT in our clinic, patients with only upper cervical lymph node invasion have not been irradiated in the levels IVb and Vc, and the regional control rate is comparable to that of other centers. This study intends to retrospectively analyze the feasibility of omitting levels IVb and Vc in patients with only upper cervical lymph node invasion, and provide a basis for the revision of international guideline for the delineation of the clinical target volume (CTV). Patients with histologically confirmed NPC who completed IMRT successfully at our attending group between January 2014 to March 2018 were candidates for this study. Other eligibility criteria for analysis were as follows: (1) The first patient without distant metastasis; (2) Only patients with upper cervical lymph node invasion (only N1, N2, because the maximum diameter of the upper neck 6cm diagnosed as N3 patients were not included) (AJCC staging system, 8th edition); (3) Having complete baseline imaging data; (4) Over 3 months of follow-up; (5) Patients without previous history of malignant tumor and secondary cancer. According to the delineation of CTV in our protocol for patients with stage N1 and N2, levels IVb and Vc are not irradiated (i.e., retaining the original supraclavicular area). The main endpoints of the study were regional recurrence-free survival (RRFS) and recurrence rates in levels IVb and Vc. In all, 363 patients with NPC and median follow-up of 61.9 months (range, 3.67-93.3) met the study inclusion criteria and comprise the dataset for the analysis. The overall survival, survival without local recurrence, survival without regional recurrence, and survival without distant metastasis at 3 and 5 years were 94.6% and 91.1%, 97.7% and 96.5%, 98.6% and 98.0%, 93.5% and 91.1%. At the final follow-up, 11 cases showed regional recurrence, and only one case (0.28%) showed recurrence in regions IVb and Vc, which were field recurrences, while the rest were intra-field recurrences. Omitting levels Ⅳb and Ⅴc IMRT should be safe and feasible for patients who only had involvement of upper neck LNs. Further well-designed multicenter prospective trials should be conducted to confirm our results and further optimize the recommendation of the International Guideline.