Patent foramen ovale is not a benign pathology in patients undergoing off-pump coronary artery bypass: A word of caution

WOS: 000380575500087PubMed ID: 27423847We thank Bozinovski and Caton1 for their valuable article entitled ‘‘A Benign PFO in OPCAB Can Suddenly Take a Right Turn, but Maybe It Can’t Tolerate It.’’ They present a case with desaturation due to right-to-left shunt through a patent foramen ovale (PFO) during off-pump coronary artery bypass (OPCAB). Although rare, this is an extremely important problem in the OPCAB procedure. PFO is a frequent pathology with an estimated prevalence of 25%. 2 However, in cases without a known PFO, intermittent intra-atrial shunting due to an elevated right atrial pressure may be an important problem during OPCAB. Because most patients undergoing off-pump revascularization are high risk in terms of chronic obstructive pulmonary disease and elevated pulmonary artery pressures, opening of a PFO is not infrequent when the right atrial pressure increases. This is particularly evident in cases with left and posterior wall revascularization due to positioning of the heart leading to right atrial compression. These patients are not always capable of tolerating decreases in systemic oxygenation and cyanosis due to right-to-left shuntin

Bursa'da müzik geleneği ve T.R.T. repertuarındaki Bursa Türkülerinin müzikal analizi

06.03.2018 tarihli ve 30352 sayılı Resmi Gazetede yayımlanan “Yükseköğretim Kanunu İle Bazı Kanun Ve Kanun Hükmünde Kararnamelerde Değişiklik Yapılması Hakkında Kanun” ile 18.06.2018 tarihli “Lisansüstü Tezlerin Elektronik Ortamda Toplanması, Düzenlenmesi ve Erişime Açılmasına İlişkin Yönerge” gereğince tam metin erişime açılmıştır.Tarihinde başkent olma unvanını elinde bulunduran nadir şehirlerden biri olan Bursa, müzikkültürü açısından da zengin bir bölgedir. Müzik geleneklerinin oluştuğu Mehterhane,Mevlevihane, Dergâhlar, Camiler, Ahû Zaviyeleri, Âşık Kahvehaneleri benzeri mekanlarBursa'da şekillenen müziğin de göstergeleridir. Tezimizde söz konusu mekânlar vegörenekli yapılanmalar, Bursa'daki müzik gelenekleri bağlamında ele alınmaktadır.?Bursa'da Müzik Geleneği Ve T.R.T. Repertuarındaki Bursa Türkülerinin MüzikalAnalizi? adlı bu tez, bünyesinde müziği barındıran temel yapılanmalar ve Bursa müzikfolkloru bakımından kılavuz olabilecek bir ön çalışma niteliğindedir.Tezin araştırma safhasında dikkatli bir literatür taraması söz konusu olmuş, zaman zamanuzman görüşlerine başvurulmuştur. Ayrıca sesli ve görüntülü arşiv yanında nota arşivindende yararlanılmıştır. Tezin müzikal analiz kısmı, halk müziğinin resmû temsil kurumu olarakkabul edilmesi dolayısıyla T.R.T. Repertuarındaki Bursa Türküleri ile sınırlı tutulmaktadır.Türküler; icrâ tarzları ve icralarında kullanılan enstrümanlarla birlikte ele alınmakta, biçimolarak ezgi yapılanmalarına, makam ve dizi kullanımlarına, ritmik öğelerin durumlarına, sözunsurunun özelliklerine dayalı olarak analız edilmekte, her bir türkü için derlenebilenbilgiler ayrıca sunulmaktadır. Bunun yanında, türkülerin bazı özelliklerinin oranlarıylabelirlendiği tablolar oluşturulmakta, yapılan analız çalışmasının detaylarının Tezin sonuçkısmında verildiği Bursa müzik folkloruna dair müzikolojik tespitlerde bulunulmaktadır.Araştırma sonucunda; lk defa Osmanlı Devleti elinde Türkleşerek ona başkentlik yapmasıdolayısıyla Bursa, kültür ve müzik dokusu bakımından Osmanlı sanat okulunun en önemlibir parçalarından biridir. Bu kentteki en dikkat çekici müziği bünyesinde barındıranyapılanmalar başta Mehter, Cami ve Tekke müziği olarak iki kola ayrılan Türk din müziği,yarı dinû teşekküllerden sayılan Ahûliktir. Yüksek seviyeyi hedefleyen bu kurumlar halkınkurumlarıdır. Kullandıkları müzik de zaman içinde aynı paralellikleri taşıyan bir sistematikiçinde gelişmiştir. Müziği sosyal hayatın gerekleri içinde kullanan halk, başlangıçtasistematiğin oluşmasına bizzat kendisi zemin olurken, sonraki aşamada o sistematiğikullanan ve ondan etkilenen durumunda kalmaktadır ki Bursa müzik örneği bunun delilinioluşturmaktadır. Osmanlı klâsizminin kaynağının da znik Bursa, Bolu, Balıkesir gibiOsmanlı beyliğinin yerleştiği temel alanların müzik folklorunda aranması gerektiği, bubölgelerin yine Osmanlı ile Türkleşen Rumeli'ye de müzik bakımından örnek olduğusonucuna varılmıştır.Bursa,which is one of the rarest cities owning the reputation of being the capital city of theOttomans,is also in a special region in terms of the music culture.Janissary musician halls,shrines, Mevlevi houses, mosques, and ashik cafes are the signs of music which is shaped inBursa. The said places in our thesis have been inspected in the context of musicalconventions in Bursa.This thesis, named as ?Music Tradition In Bursa And Musical Analysis Of Bursa FolkSongs In TRT Repertoire? is a kind of preliminary work which could be a guide in terms ofbasic structures which host music in its body and Bursa musical folklore.At the study phase of the thesis, a careful literature scanning has been carried out and, timeby time, experts? opininions have been taken.Besides aural and visual archive,note archivehas been benefited from.The musical analsis part of the thesis has been kept restricted withBursa Folk Songs In T.R.T. repertoire as it is regarded as the official representationestablishment of folk music. The folk songs have been treated with their types ofperformance and the instruments used in performances, analysed stylistically according totheir melodic structurings, usages of mode and index, states of their rhytmic elements,features of lyric and the information compiled for every folk song has been presented.Inaddition to that, tables in which the features of some folk songs have been determined intheir proportions have been formed and musicological inspections based on Bursa MusicFolklore, whose details have been given place at the conclusion part of the thesis, have beenmade.As a result of the study, Bursa which became Turkish in the hands of the Ottomans andbeing the capital is one of the most significant parts of the Ottoman Art School in terms ofıts cultural and musical texture. The constructions which host the most conspicuous musicin that city,is Ahilik which is a kind of semi-religious music and Turkish Religious Musicwhich could be separated as mosque and shrine music.These institutions which aim highmusic are the institutions of the people.The music which they used, within time, developedin a systematic, which hosted the same parallelism. While the people who used the musicwithin the necessities of life occasioned the formation of the system at the beginning,became the ones who used the systematic and became affected by it later such as BursaMusic . It has been concluded that the source of Ottoman Classicism should be sought in themain regions like znik, Bursa, Bolu, Balıkesir where the Ottoman tribe settled and theseregions musically became precedent to Thrace which became Turkish with the Ottomans

Context-aware confidence sets for fine-grained product recognition

We present a new approach for fine-grained classification of retail products, which learns and exploits statistical context information about likely product arrangements on shelves, incorporates visual hierarchies across brands, and returns recognition results as “confidence sets” that are guaranteed to contain the true class at a given confidence level. Our system consists of three important components: 1) a nested hierarchy of product classes are automatically constructed based on visual similarities, 2) a confidence set predictor is trained based on class posteriors by using coarse-to-fine binary classifiers to discriminate each nested cluster of the hierarchy from the remainder of classes and a Bayesian network (BN) model that encodes the joint distribution of classifier scores with the fine-level class variable, and 3) n hidden Markov model (HMM) is trained with nested hidden states from the class hierarchy to model spatial transition across the nodes of product class hierarchy and resolve errors in the context-free confidence set results. Novel aspects of the proposed method include 1) combining confidence sets and context information via a HMM, 2) applying this concept to fine grained recognition of products arranged in retail shelves, and 3) presenting experimental results on four large datasets, collected from actual retail stores. We compare our approach with existing confidence set approaches and state-of-the-art convolutional neural networks classifiers including SENet-154, DenseNet-161, B-CNN, and Inception-Resnet-v2. Our approach performs comparably or better than state-of-the-art deep classifiers and exhibits high accuracy for relatively small confidence set sizes

Vision-based continuous Graffiti™-like text entry system

It is now possible to design real-time, low-cost computer version systems even in personal computers due to the recent advances in electronics and the computer industry. Due to this reason, it is feasible to develop computer-vision-based human-computer interaction systems. A vision-based continuous Graffiti™-like text entry system is presented. The user sketches characters in a Griffiti™-like alphabet in a continuous manner on a flat surface using a laser pointer. The beam of the laser pointer is tracked on the image sequences captured by a camera, and the corresponding written word is recognized from the extracted trace of the laser beam. © 2004 Society of Photo-Optical Instrumentation Engineers

Context-aware hybrid classification system for fine-grained retail product recognition

We present a context-aware hybrid classification system for the problem of fine-grained product class recognition in computer vision. Recently, retail product recognition has become an interesting computer vision research topic. We focus on the classification of products on shelves in a store. This is a very challenging classification problem because many product classes are visually similar in terms of shape, color, texture, and metric size. In shelves, same or similar products are more likely to appear adjacent to each other and displayed in certain arrangements rather than at random. The arrangement of the products on the shelves has a spatial continuity both in brand and metric size. By using this context information, the co-occurrence of the products and the adjacency relations between the products can be statistically modeled. The proposed hybrid approach improves the accuracy of context-free image classifiers such as Support Vector Machines (SVMs), by combining them with a probabilistic graphical model such as Hidden Markov Models (HMMs) or Conditional Random Fields (CRFs). The fundamental goal of this paper is using contextual relationships in retail shelves to improve the classification accuracy by executing a context-aware approach

Retail product recognition with a graphical shelf model (Çizgisel raf modeli ile perakende ürün tanıma)

Recently, retail product recognition has become an interesting computer vision research topic. The classification of products on shelves is a very challenging classification problem because many product classes are visually similar in terms of shape, color, texture, and metric size. In shelves, same or similar products are more likely to appear adjacent to each other and displayed in certain arrangements rather than at random. The arrangement of the products on the shelves has a spatial continuity both in brand and metric size. By using this context information, the co-occurrence of the products and the adjacency relations between the products can be statistically modeled. In this work, we present a context-aware hybrid classification system for the problem of fine-grained product class recognition. The proposed hybrid approach improves the accuracy of the context-free image classifiers, by combining them with a probabilistic graphical model based on Hidden Markov Models. The fundamental goal of this paper is to use contextual relationships in retail shelves to improve accuracy of the product classifier

Vitamin D Düzeyinin İnvaziv Elektrofizyolojik Parametrelere ve Atriyal Fibrilasyon İndüklenebilirliği’ne Etkisi

Deficiencies of Vitamin D (VitD) has been associated with coronary heart disease, hypertension and left ventricular hypertropy. However its effects on cardiac conduction system and atrial fibrillation (AF) predisposition have not been studied yet. In this study we aim to evaluate the effects of VitD on invasive electrophysiologic parameters and AF inducibility. Materials and Methods: This retrospective crosssectional study included 135 patients. Study population was divided into three group as VitD sufficient, VitD insufficient and VitD deficient according to baseline vitD levels. Patients’ invasive electrophysiologic parameters and induced AF episodes were recorded. Results: Corrected sinus node recovery time, baseline cycle length, atrial-His interval, His-ventricular interval and Wenckebach cycle length were lengthened in vitD deficient group but they didn’t reach statistical significance. The rate of AF inducibility was twice as likely in VitD deficient group than sufficient group, however, it also didn’t reach statistical significance. Conclusion: Baseline VitD levels were not associated with cardiac electrophysiologic parameters and AF inducibility. To demonstrate the role of VitD in cardiac conduction system and AF inducibility thoroughly, further studies such as addressing VitD replacement are warranted.Amaç: Vitamin D (vit D) eksikliği, koroner kalp hastalığı, hipertansiyon ve sol ventrikül hipertrofisi ile ilişkili bulunmuştur. Ancak kardiyak iletim sistemi ve atriyal fibrilasyon (AF) yatkınlığına etkisi henüz araştırılmamıştır. Bu çalışmada, VitD'nin invaziv elektrofizyolojik parametreler ve AF indüklenebilirliği üzerindeki etkilerini değerlendirmeyi amaçladık. Gereç ve Yöntem: Bu retrospektif kesitsel çalışma 135 hastayı içermektedir. Çalışma popülasyonu, temel vitD düzeylerine göre VitD yeterli, VitD yetersiz ve VitD eksikliği olmak üzere üç gruba ayrıldı. Hastaların invaziv elektrofizyolojik parametreleri ve uyarılan AF epizodları kaydedildi. Bulgular: Düzeltilmiş sinüs nodu iyileşme zamanı, bazal döngü uzunluğu, atriyal-His aralığı, His-ventriküler aralık ve Wenckebach siklus uzunluğu, vitD eksikliği olan grupta uzamış, ancak istatistiksel olarak anlamlı bulunmamıştır. AF indüklenebilirlik oranı, VitD eksikliği olan grupta, yeterli gruba göre iki kat daha fazlaydı., ancak istatistiksel olarak anlamlı değildi. Sonuç: Bazal VitD seviyeleri kardiyak elektrofizyolojik parametreler ve AF indüklenebilirliği ile ilişkili değildi. VitD'nin kardiyak iletim sistemindeki rolünü ve AF'nin indüklenebilirliğini tam olarak göstermek için VitD replasmanını da içeren daha ileri çalışmalar gereklidir

Mechanical Thrombectomy for Minor Stroke Patients (NIHSS<6) With Large Vessel Occlusion

INTRODUCTION: Large vessel occlusion can present with minor stroke in 30% of cases. Although the efficacy of mechanical thrombectomy in minor stroke National Institute of Health Stroke Scale (NIHSS<6) has been shown in subgroups of clinical trials, there is no randomized clinical trial focusing on this patient group. METHODS: 8 patients (3 female, 5 male) presenting with minor stroke (NIHSS<6) with large vessel occlusion on CT angiography were included. Thrombolytic treatment was administered in 5 patients presenting in 4.5 hours. Mechanical thrombectomy was performed within 6 hours in 5 patients and in 3 patients presenting beyond 6 hours. Modified treatment in cerebral ischemia (mTICI) 2b-3 was considered as successful recanalzation, functional outcome was evaluated at 90 day. RESULTS: 8 patients with ages between 40 and 81 years were included in the study. Successful recanalization (mTICI 2b-3) was achieved in all cases. 3 patients were not eligible for intravenous thrombolysis due to late arrival time. In these cases, after clinical deterioration occured mechanical thrombectomy was performed. 90 day mRS were 2, 4 and 5 in these 3 cases. 90 day modified Rankin Scale (mRS) were between 0-2 in all 5 patients treated within 6 hours. DISCUSSION AND CONCLUSION: Although there are few cases, our study demonstrated that mechanical thrombectomy is more efficaceous in minor stroke patients when performed earl, as demonstrated in other studies

3D printed microfluidic reactor for high throuhput chitosan nanoparticle synthesis

The major bottleneck for the commercialization of nanoparticle related technologies is the mass production of the nanoparticles. One approach to overcome this bottleneck is use of microfluidic devices. In this paper, a 3D printed, high throughput micro-reactor that is capable of synthesizing both chitosan and chitosan coated iron oxide nanoparticles is presented

Analysis of relation between alpha-fetoprotein and gastric cancer.

INTRODUCTION: It has been reported that Alpha-fetoprotein (AFP) producing gastric cancers have a worse prognosis than those not producing. We aimed to investigate gastric cancers patients in regards of AFP producing cancers incidence and pathological variables of those not producing AFP. METHODS: Patients who had diagnosed with gastric adenocarcinoma and hospitalized in general surgery ward for operation were enrolled to the study. Study was designed to collect data of gastric cancer patients in a prospective manner between dates 2014-2015 in Dursun Odabaş Health Center. Patients' blood samples were collected before and after surgery for analyzing AFP. The relation between serum levels of AFP and histopathological variables were analyzed. RESULTS: Totally 63 cases were evaluated. Increased AFP level was observed in 2 cases (incidence=3.17%). Serum AFPs were 1.520 ng/mL and 0.590 ng/mL in preoperative and postoperative period respectively (p<0.001). There were no relation between preoperative AFP levels and tumor stage and neurovascular invasion status. We observed that the correlation between preoperative AFP levels and number of metastatic lymph node was not significant (spearman's rho=-0.183, p=0.157). According to tumor location, there was significant difference in AFP levels (p=0.021). DISCUSSION AND CONCLUSION: AFP producing gastric cancers is rare between patients who referred to our center. Tumor stage and AFP levels seems unrelated. Distally located gastric cancers cases should be evaluated cautiously in patients whose AFP levels are in normal range