The Mechanical Properties of 3D-Printed Polylactic Acid/Polyethylene Terephthalate Glycol Multi-Material Structures Manufactured by Material Extrusion.

The mechanical properties of polylactic acid (PLA), polyethylene terephthalate glycol (PETG), and PLA/PETG structures manufactured using the multi-material additive manufacturing (MMAM) method were studied in this work. Material extrusion additive manufacturing was used to print PLA/PETG samples with various PLA and PETG layer numbers. By varying the top and bottom layer numbers of two thermoplastics, the effect of layer number on the mechanical properties of 3D-printed structures was investigated. The chemical and thermal characteristics of PLA and PETG were investigated using Fourier transform infrared spectroscopy and differential scanning calorimetry. Tensile and flexural strength of 3D-printed PLA, PETG, and PLA/PETG samples were determined using tensile and three-point bending tests. The fracture surfaces of the samples were evaluated using optical microscopy. The results indicated that multi-material part containing 13 layers of PLA and 3 layers of PETG exhibited the highest ultimate tensile strength (65.4 MPa) and a good flexural strength (91.4 MPa). MMAM was discovered to be a viable way for producing PLA/PETG materials with great mechanical performance.

Trends in heart failure between 2016 and 2022 in Türkiye (TRends-HF): a nationwide retrospective cohort study of 85 million individuals across entire population of all ages.

Background: Data on the burden of heart failure (HF) outside western countries are limited, but available data suggest it may present differently in other countries. The aim of this study was to examine the incidence, prevalence, and survival rates of HF in Türkiye, with a specific focus on how these rates vary according to age, sex, comorbidities, and socioeconomic status (SES). Methods: We harnessed the extensive National Electronic Database of the Turkish Ministry of Health, covering Turkey's entire population from January 1, 2016, to December 31, 2022, to identify 2,722,151 cases of HF and their associated comorbidities using ICD-10 codes. Analyzing the primary endpoint of all-cause mortality, our study utilized anonymized data to examine patient demographics, comorbidities, socioeconomic status, and survival patterns, employing statistical techniques to delve into relationships and trends. The data were segmented by gender, socioeconomic status, and age, involving cross-tabulations and statistical metrics to explore connections, odds ratios, and survival rates. Findings: The estimated prevalence of HF was 2.114% in Türkiye at the end of 2022, with an annual incidence ranging between 3.00 and 6.06 per 1000 person years. Females were older than males (69.8 ± 13.9 years vs. 66.8 ± 13.9 years, respectively). The most common comorbidities were congenital heart diseases and anemia under the age of 20, and hypertension and atherosclerotic cardiovascular disease in the adult population. Only 23.6% (643,159/2,722,151) of patients were treated with any triple guideline-directed medical therapy (GDMT) and 3.6% (96,751/2,722,151) of patients were on quadruple GDMT. The survival rates for patients with HF at 1, 5, and 7 years were 83.3% (95% CI: 83.2-83.3), 61.5% (95% CI: 61.4-61.6), and 57.7% (95% CI: 57.6-57.8) among females, and 82.1% (95% CI: 82.0-82.2), 58.2% (95% CI: 58.1-58.3), and 54.2% (95% CI: 54.0-54.3) among males. Despite a tendency for an increase from the highest to the lowest SES, the prevalence of HF and mortality were paradoxically lowest in the lowest SES region. Interpretation: The prevalence, incidence, and survival rates of HF in Türkiye were comparable to western countries, despite the notable difference of HF onset occurring 8-10 years earlier in the Turkish population. Drug usage statistics indicate there is a need for effective strategies to improve treatment with GDMT. Funding: None.

A case of pseudogout attack after zoledronic acid treatment in primary hyperparathyroidism.

Pseudogout (PG) is an inflammatory arthropathy that develops due to the accumulation of calcium pyrophosphate dihydrate crystals in synovial structures. Herein, we present a 59-year-old male patient with PG developed as a result of zoledronic acid (ZA) infusion, which was administered due to primary hyperparathyroidism. The patient with parathyroid adenoma was given ZA since the calcium level did not decrease despite intravenous saline and loop diuretic. One day after ZA administration, the patient had severe pain, fever, and swelling in joints. The radiograph showed chondrocalcinosis. Calcium pyrophosphate deposition were observed in the arthrocentesis fluid under polarized light. The patient's symptoms regressed after anakinra and colchicine treatment. To the best of our knowledge, this is the first case report of a PG attack after ZA treatment for primary hyperparathyroidism. Additionally, there have been few cases of PG after bisphosphonate treatment for osteoporosis in the literature, signifying that more care should be taken when administering bisphosphonate therapy in patients with risk factors.

Biomechanical comparison of different suture materials with different techniques in tendon repair: An ex-vivo study.

OBJECTIVES: Sheep Achilles tendons are used as an effective preclinical model of flexor tendon repair in plastic surgery, due to their biomechanical properties, which are similar to humans. The aim of this study was to examine the efficacy and biomechanical outcomes of suture materials and tendon repair techniques in flexor tendon repair. MATERIAL AND METHODS: 72 sheep tendons were obtained for a total of 12 different scenarios. Tendons were repaired using 4 different suture types and 3 different suture techniques. After repair, the tendons were fixed at both ends and subjected to biomechanical tests. Ultimate Failure Load (UFL) and 2-mm Gap Load (GL) per scenario were compared statistically within and between groups. RESULTS: UFL and GL of all sutures were significantly different between the modified Kessler, Bunnell and Krackow techniques (P < 0.05), and between Monosorb, Ti-Cron and V-loc sutures (P < 0.05). UFL and GL according to repair technique were not significantly different for the Propilen suture (P > 0.05). CONCLUSION: When UFL and GL were considered together, our findings indicate that optimal strength scenarios were for the modified Kessler technique using Monosorb or V-loc sutures.

The outcome of peripartum cardiomyopathy patients-single center experience.

OBJECTIVE: Peripartum cardiomyopathy (PPCM) diagnosis made by excluding identifiable causes of heart failure (HF) and occurs end of the pregnancy or during the postpartum period of five months. It presents a clinical HF spectrum with left ventricular systolic dysfunction. BACKGROUND: The purpose of this study is to retrospectively evaluate the clinical characteristics, cardiac magnetic resonance (CMR) imaging features, and end-points consisting of left ventricle recovery, left ventricular assist device implantation, heart transplantation, and all-cause mortality. METHOD: Outpatient HF records between 2008 to 2021 were screened. Thirty-seven patients were defined as PPCM. Twenty-five patients had CMR evaluation at the time of diagnosis, and six patients were re-evaluated with CMR. RESULTS: The mean age was 30.5 ± 5.6 years, and the mean LVEF was 28.2% ± 6.7%. In 13(35.7%) patients, LVEF recovered during the follow-up course. The median recovery time was 281(IQR [78-358]) days. LVEF on CMR was 35.3 ± 10.5, and three patients exhibited late gadolinium enhancement(LGE) patterns. Sub-endocardial and mid-wall uptake pattern types were detected. 18(75%) patients met the Petersen left ventricle non-compaction cardiomyopathy(LVNC) criteria. Patients with NC/C ratio lower than 2.3 had lower LVEDVi and LVESVi (124.9 ± 35.4, 86.4 ± 7.5, p = .003; 86.8 ± 34.6, 52.6 ± 7.6, p = .006), respectively. The median follow-up time was 2129 (IQR [911-2634]) days. The primary endpoint-free 1-year survival was 88.9% (event rate 11.1%), and 5-year survival was 75.7% (event rate 24.3%). CONCLUSION: In a retrospective cohort of PPCM patients, 35.7% of patients' LVEF recovered, and the primary end-point of free-5-year survival was 75%. Twenty-five patients were assessed with CMR; three of four met the Petersen CMR-derived LVNC at initial evaluation.

Characteristics and long-term survival of patients with left ventricular non-compaction cardiomyopathy.

AIMS: Left ventricular non-compaction cardiomyopathy (LVNC) is a poorly understood entity resulting in heart failure. Whether it is a distinct form of cardiomyopathy or an anatomical phenotype is a subject of discussion. The current diagnosis is based on morphologic findings by comparing the compacted to non-compacted myocardium. The study aimed to compare demographic and prognostic variables of patients with dilated cardiomyopathy (DCM) and LVNC. Emphasis was given to cardiac magnetic resonance (CMR) imaging analysis. Data on survival were also assessed. METHODS AND RESULTS: We retrospectively evaluated the characteristics and outcomes of 262 non-ischaemic cardiomyopathy patients with LVNC and DCM phenotypes. Petersen's CMR criteria of non-compacted to the compacted myocardial ratio 2.3 were used to diagnose LVNC. The primary endpoint was a composite endpoint of major adverse cardiovascular events comprising cardiovascular-related death, left ventricular assisted device implantation, or heart transplantation. A total of 262 patients with CMR data were included in the study. One hundred fifty-five patients who fulfilled CMR criteria were diagnosed as LVNC. CMR findings revealed that LVNC patients had higher left ventricular end-diastolic (137.2 ± 51.6, 116.8 ± 44.6, P = 0.002) and systolic volume index (98.4 ± 49.5, 85.9 ± 42.7, P = 0.049). Cardiac haemodynamics, cardiac output (5.61 ± 2.03, 4.96 ± 1.83; P = 0.010), stroke volume (73.9 ± 28.8, 65.1 ± 25.1; P = 0.013), and cardiac index (2.85 ± 1.0, 2.37 ± 0.72; P < 0.0001), were higher in LVNC patients. Of all the 249 patients, 102 (40.9%) patients demonstrated late gadolinium enhancement (LGE). According to Petersen's criteria, the Kaplan-Meier survival outcome did not reveal significant differences (hazard ratio [HR]: 1.53, 95% confidence interval [CI]: [0.89-2.63], P = 0.11). The presence or pattern of LGE did not show significant importance for endpoint-free survival. Most of the sub-epicardial LGE pattern was found in LVNC patients (94.4%). When receiver operator characteristics analysis was applied to NC/C ratio to discriminate the primary endpoint, a higher NC/C ratio of 2.57 was associated with adverse events (HR: 1.90, 95% CI: [1.12-3.24], P = 0.016). CONCLUSIONS: Our study questions the criteria being used for the diagnosis of LVNC. Further evaluation of CMR variables and association of these findings with demographic variables and survival is mandatory.

Weiszfeld, tree-seed, and whale optimization algorithms comparison via locating transportation facilities with weightings considering the vulnerability and uncertainty.

Searching for an optimum transportation facility location with emergency equipment and staff is essential for a specific region or a country. In this direction, this study addresses the following problems. First, the performances of the Weiszfeld, tree-seed, and whale optimization algorithms are compared, which is the first of its kind in the literature. Second, a new approach that tests the importance parameters' effectiveness in searching for an optimum transportation facility location with emergency equipment and staff is proposed. The Weiszfeld algorithm finds viable solutions with compact data, but it may not handle big data. In contrast, the flexibility of the tree-seed and whale optimization algorithm is literally an advantage when the number of parameters and variables increases. Therefore, there is a notable need to directly compare those algorithms' performances. If we do, the significance of extending the number of parameters with multiple weightings is appraised. According to the results, the Weiszfeld algorithm can be an almost flexible technique in continuous networks; however, it has reasonable drawbacks with discrete networks, while the tree-seed and whale optimization algorithms fit such conditions. On the other hand, these three methods do not show a fluctuating performance compared to one another based on the locating transportation facilities, and thus they deliver similar performance. Besides, although the value of accuracy is high with the application of the conventional technique Weiszfeld algorithm, it does not provide a significant performance accuracy advantage over the meta-heuristic methods.

A possible interaction between favipiravir and methotrexate: Drug-induced hepatotoxicity in a patient with osteosarcoma.

INTRODUCTION: Favipiravir is an antiviral agent that is recently used for SARS-CoV2 infection. The drug-drug interactions of favipiravir especially with chemotherapeutic agents in a patient with malignancy are not well known. CASE REPORT: The patient diagnosed with metastatic osteosarcoma was given high dose methotrexate treatment, and favipiravir was started on the third day of the treatment with suspicion of SARS-CoV2 infection. Grade 3 hepatotoxicity developed after favipiravir.Management & outcome: The acute viral hepatitis panel and autoimmune liver disease panel were negative. The ultrasound of the abdomen was unremarkable for any hepatobiliary pathology. The all viral and hepatobiliary possible etiological factors were ruled out. The patient's liver enzymes increased just after (12 hours later) the initiation of favipiravir, and we diagnosed toxic hepatitis caused by favipiravir-methotrexate interaction. Therefore, methylprednisolone 1 mg/kg dose was started for a presumed diagnosis of toxic hepatitis. Hepatotoxicity completely regressed after favipiravir was discontinued. DISCUSSION: Favipiravir may inhibit methotrexate elimination by inhibiting aldehyde oxidase and its sequential use may cause hepatotoxicity in this case. The clinicians should keep in mind possible drug interactions while using new antiviral agents against SARS-CoV2 like favipiravir.

Global Scientific Outputs of Schizophrenia Publications From 1975 to 2020: a Bibliometric Analysis.

Schizophrenia is a choronic, complex and powerfully inherited mental illness that seriously affects quality of life. The illness is one of the most researched psychiatric disorders from past to present. This study aims to provide a holistic summary of the global scientific outputs through bibliometric analyses and reveal the trend topics. The articles published between the years 1975 and 2020 were downloaded from the Web of Science (WoS) database and analyzed using bibliometric methods. The literature review was conducted using the keyword ''schizophren*'' in the ''Research Area'' category. The relation between the number of publications of the countries and the Gross Domestic Products and Human Development Index values were analyzed using Spearman's correlation coefficient. The number of articles between the years 2021 and 2032 was estimated through linear regression analysis.There were 103,992 publications, 51,117 of which were articles. The number of studies has increased in direct proportion to the development level of the countries. Schizophrenia Research was the most active journal. The most used research topics are cognition, negative symptoms, bipolar disorder, antipsychotics, depression, clozapine, quality of life. Trend keywords used in recent years are 'inflammation', 'biomarker', 'oxidative stress', 'Brain Derived Neurotrophic Factor (BDNF)', 'social cognition', 'metacognition', 'motivation', 'social functioning', 'functioning', 'mental health', 'metabolic syndrome', 'functional connectivity', 'adherence' and 'recovery' indicated new research frontiers in this field. Although schizophrenia has not been fully elucidated, studies are growing like an avalanche. Our study includes the most up-to-date and most comprehensive data ever made in this field.

An international bibliometric study of scientific articles on intracranial aneurysms.

OBJECTIVES: The number of original scientific researches on intracranial aneurysms has risen over the last 30 years. Despite the rise in the number of articles, there is no up-to-date exhaustive bibliometric research in the literature. This study aimed to contribute to the literature via a bibliometric analysis of the original scientific researches on intracranial aneurysms published over the last 30 years. METHODS: The literature review was done using the Web of Science. All articles and its citations containing aneurysm keywords were analyzed in the "title" section of articles published in the research areas: Neurosciences Neurology during 1980-2019. Correlation analyses between the number of articles produced by the countries and their economic and development indicators of gross domestic product, and Human Development Index were analyzed using the Spearman correlation coefficient. Linear regression analysis was utilized to estimate the number of articles to be published in the future. RESULTS: There were a total of 21,673 publications on intracranial aneurysms. Of these publications, 13,371 (61.7%) were articles. The three countries that produced the most articles were the USA (4098), Japan (2668), and China (937). A statistically significant correlation was found between the development indicators of world countries and publication productivity (p<0.001). The three journals that produced the most publications were Neurosurgery, Journal of Neurosurgery, and American Journal of Neuroradiology. The most cited article was published in Journal of Neurosurgery. CONCLUSION: This bibliometric study provides a collection of data that will help design future research on intracranial aneurysms more efficiently and make innovations at greater speed.

Speckle tracking echocardiography and left ventricular twist mechanics: predictive capabilities for noncompaction cardiomyopathy in the first degree relatives.

In non-compaction cardiomyopathy (NCCM), there are several echocardiographic and cardiac magnetic resonance (CMR)-based quantitative diagnostic indices, current criteria mainly placed on morphological features, and none of the diagnostic indices includes left ventricular (LV) function. LV function and hemodynamics could be normal in NCCM patients. Evaluation of left ventricular function at the subclinical stage, strain echocardiographic parameters could be used alternative to standard echocardiographic examinations. The aim of this study to evaluate; NCCM patients, their first-degree relatives, ventricular motion patterns, strain characteristics, and the predictive capabilities of these features for early diagnosis of cardiomyopathy. This cross-sectional, case-control study included 32 NCCM patients, 30 first-degree relatives (father, mother, siblings and children) and 31 healthy volunteers. All patients evaluated with baseline echocardiography, strain measurements, and ventricular wall motion pattern. There were no differences between the groups in terms of age, weight, and body surface area. We observed a statistically significant decrease in ejection fraction (EF), fractional shortening (FS), E/E' and global strain values in patients' relatives compared to healthy volunteers (Patients' relatives: LVEF:60.9 ± 7.2%, FS:0.34 ± 0.07, E/E':7.51 ± 1.83, GLS: - 18.6 ± 3.6, GLSr: - 1.1 ± 0.1, GCS: - 17.1 ± 3.1, GCSr: - 1.2 ± 0.1, GRS:37.1 ± 6.2, GRSr:1.7 ± 0.1; all p values< 0.05). 'Rigid Body Rotation (RBR)' movement pattern was also observed in some of the patient's relative's like in the patients. RBR movement pattern determined patients; EF, longitudinal strain-strain rate, and basal layer rotation values were significantly lower, but radial strain values were higher with the RBR movement pattern (for all values p < 0.05). RBR movement pattern, deterioration of strain parameters, and accompanying echocardiographic features like LVEF, fractional shortening (FS), E/E' in patients' relative groups may contribute to reveal the subclinical status of disease and could be predictive for early diagnosis of cardiomyopathy.

Echocardiographic reference ranges for normal cardiac Doppler data in healthy Turkish population: ECHO-DOP-TR Trial.

AIM: Doppler echocardiography has become the standard imaging modality for diastolic function and provides pathophysiological insight into systolic and diastolic heart failure. In this study, we aimed to obtain normal echocardiographic Doppler parameters of healthy Turkish population. METHODS: Among 31 collaborating institutions from all regions of Turkey, 1154 healthy volunteers were enrolled in this study. Predefined protocols were used for all participants during echocardiographic examination and The American Society of Echocardiography and European Association of Cardiovascular Imaging recommendations were used for echocardiographic Doppler measurements. RESULTS: A total of 967 healthy participants were enrolled in this study after applying exclusion criteria. Echocardiographic examination was obtained from all subjects following predefined protocols. Mitral E wave velocity and E/A ratio were higher in females and decreased progressively in advancing ages. E wave deceleration time and A wave velocity were increased with aging. Assessment of tissue Doppler velocities showed that left ventricular lateral e', septal e', and septal s' were higher in younger subjects and in females. E/e' ratio was increased progressively with advancing decades. Right ventricular e' and s' were decreased but a' was increased with increasing age. Septal e' lower than 8 cm/s was 1.9% in the fifth decade and 13.7% in ages older than 50 years. The E/e' ratio greater than 15 (and also 13) was not found. CONCLUSION: This study, for the first time, provides echocardiographic reference ranges for normal cardiac Doppler data in healthy Turkish population which will be useful in routine clinical practice as well as in future clinical trials.

Efficiency and Safety of The Retrograde Intrarenal Surgery in Younger Compared to Elderly Patients.

OBJECTIVE: To determine the outcomes of retrograde intrarenal surgery (RIRS) and its complications in  both young and elderly patients. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Departments of Urology, University of Health Sciences, Ankara Research and Training Hospital, Ankara, and Çorum Hitit University, Çorum, Turkey from April 2019 to January 2020. METHODOLOGY: Patients with kidney stones up to 3 cm in maximal diameter on computarised tomography (CT) scan, were divided into two groups according to age (<60 vs. ≥60 years ). RIRS was performed. Demographics, clinical data, and complications were recorded and compared. RESULTS: Mean age of 78 patients was 52.47 ±13.28 years. There were no significant difference in gender, American Society of Anesthesiology (ASA) scores, operation time, number of multiple sessions, success rates of outcome and complication rates between groups. At the end of the first session, stone-free rates were 91.1% vs 87.9% in younger and elderly groups, respectively; while, after the second session, all patients were stone-free in both groups. Fever, hematuria (macroscopic, more than 24 hours), and perirenal hematoma were the observed complications. Postoperative hematocrit levels significantly decreased without any need of transfusion; there were significant differences in the preoperative and postoperative creatinine levels ( p=0.002) in the older group. CONCLUSION: RIRS is a safe and effective method for treating kidney stones up to 3 centimeter diameter in all age groups. Although hemorrhagic events are mostly clinically unremarkable, there is a risk of renal function impairment in older (≥60 years) patients. Preoperative hydration and postoperative close follow-up is important. Key Words: Retrograde intrarenal surgery, Elderly, Effectiveness, Safety.

The Use of Machine Learning Approaches for the Diagnosis of Acute Appendicitis.

Acute appendicitis is one of the most common emergency diseases in general surgery clinics. It is more common, especially between the ages of 10 and 30 years. Additionally, approximately 7% of the entire population is diagnosed with acute appendicitis at some time in their lives and requires surgery. The study aims to develop an easy, fast, and accurate estimation method for early acute appendicitis diagnosis using machine learning algorithms. Retrospective clinical records were analyzed with predictive data mining models. The predictive success of the models obtained by various machine learning algorithms was compared. A total of 595 clinical records were used in the study, including 348 males (58.49%) and 247 females (41.51%). It was found that the gradient boosted trees algorithm achieves the best success with an accurate prediction success of 95.31%. In this study, an estimation method based on machine learning was developed to identify individuals with acute appendicitis. It is thought that this method will benefit patients with signs of appendicitis, especially in emergency departments in hospitals.

The effect of atropine in preventing catheter-related pain and discomfort in patients undergoing transurethral resection due to bladder tumor; prospective randomized, controlled study.

BACKGROUND: Catheter-related bladder discomfort (CRBD) has been observed in many patients undergoing a urethral catheterization. CRBD may be so severe that the patients require additional analgesics. Muscarinic receptors are involved in the mechanism of CRBD. The aim of this study is to determine the effects of the antimuscarinic properties of atropine, which is frequently used in current practice on CRBD, by comparing it with sugammadex which has no antimuscarinic effects. METHODS: Sixty patients selected for transurethral resection due to bladder tumors were randomized into 2 groups: an atropine group and a sugammadex group, with no antimuscarinic effect. The patients were given rocuronium (0.6 mg/kg) as a neuromuscular- blocker. In addition to the frequency and severity of CRBD postoperatively at 0, 1, 6, 12, and 24 hours, postoperative numeric rating scale (NRS) scores, and postoperative nausea and vomiting were examined. RESULTS: The incidence of CRBD was significantly lower in the atropine group in all postoperative measurements. The score was found to be significantly lower in the atropine group when NRS measurements were performed at all time periods (P < 0.01). There was no difference between the groups in terms of nausea and vomiting (P > 0.05). CONCLUSIONS: Atropine is a cheap, easy-to-access, safe-to-use drug for reducing CRBD symptoms, without any observed adverse effects. Since it not only reduces CRBD symptoms but also has a positive effect on postoperative pain, it can be used safely to increase patient comfort in patients receiving general anesthesia and a urinary catheter.

[Ablation of ventricular tachycardia in a patient with a left ventricular assist device]. / Sol ventrikül destek cihazi olan bir hastada ventriküler tasikardi ablasyonu.

The use of a left ventricular assist device (LVAD) as a bridge to heart transplantation (HTx) or as a destination therapy in patients with a contraindication for HTx is increasing. However, nearly half of the patients with LVAD support experience a ventricular arrhythmia (VA) in the first year. The history of a pre-LVAD VA is one of the most powerful predictors of VA after LVAD implantation. The clinical experience and data about ablation of a VA in patients with an LVAD are limited. There are important issues to be considered before and during the procedure in LVAD patients compared to other VA ablation patients. This is a report of ablation of intractable ventricular tachycardia in a patient with a LVAD.

A Bibliometric Analysis of Publications on Spinal Cord Injury During 1980-2018.

BACKGROUND: Spinal cord injury (SCI) could cause motor, sensory loss, severe functional insufficiency, and social problems. This study aims to provide a holistic summary of the global scientific outputs about SCI through bibliometric analyses and reveal the trend topics. METHODS: All publications about SCI published between 1980 and 2018 in Web of Science (WoS) index were downloaded (Access date: 01.09.2019) and analyzed using bibliometric methods. In the Title search section in WoS, the documents with the words "spinal cord injury" were identified. Correlation analysis between SCI publication productivity and economic development indicators of the world countries were analyzed using the Spearman correlation coefficient. RESULTS: There were 20,322 publications, 13,662 of which were articles. The top 3 productive countries were the USA, China, and Canada. British Columbia (403; 2.9%), Toronto (401; 2.9%), and Miami (387; 2.8%) were the prominent cities. The top productive journals were Spinal Cord (1,399; 10.24%), Archives of Physical Medicine and Rehabilitation (835; 6.11%), and Journal of Neurotrauma (631; 4.61%). A statistically significant, high-level correlation was found between the number of publications about SCI and the countries' gross domestic product and gross domestic product per capita (r = 0.711, P < 0.001; r = 0.699, P < 0.001). CONCLUSIONS: This study provides a systematic analysis of SCI and could be a beneficial guide for clinicians and scientists.

Coronary tortuosity affects left ventricular myocardial functions: a 3D-speckle tracking echocardiography study.

Coronary artery tortuosity (CAT) is a common finding in coronary angiography, and is defined as three fixed bends during both systole and diastole in at least one epicardial coronary artery, with each bend showing a 45° change in vessel direction. The impact of CAT on the myocardial deformation has not been completely evaluated using 3D-STE. As a result of this, we aimed to assess the effects of CAT on LV functions using 3D-STE in the present study. Eighty-two patients with CAT and 80 age- and gender-matched controls who proved to have normal coronary angiograms were enrolled into the study. 3D-STE was performed and LV-GLS, LV-GCS, LV-GAS, and LV-GRS were obtained for every patient after coronary angiography. The LV-GLS was significantly depressed in the CAT ( +) group than in the control group (p = 0.001). ROC analysis was performed to find out ideal LV-GLS cut off value to predict the presence of CAT. A LV-GLS value of > - 17 has 81.3% sensitivity, 56.7% specificity to detect the presence of CAT. The present study is the first to focus on the assessing LV myocardial functions in patients with CAT by 3D-STE. CAT has a considerable negative effect on LV myocardial longitudinal deformation as evaluated by 3D strain parameters. Our results support that patients with CAT may have subclinical LV longitudinal deformation abnormalities even though they are apparently healthy.