Bicuspid Aortic Valve

Bicuspid aortic valve (BAV) is one of the most common congenital diseases, affecting 1–2% of the general population. Although most of them are sporadic, some familial cases have also been detected. BAV is a complex developmental and progressive pathology, which may present with various clinical findings from newborn to adulthood. It may be suspected during cardiac auscultation or may be diagnosed by echocardiography incidentally. Some BAV cases may remain symptomless for years, with findings like valvular stenosis, insufficiency, or dilatation in the ascending aorta, whereas some others may present with early severe aortic valve dysfunction, premature congestive heart failure, and aortic aneurysms even in the newborn period. Such heterogeneous presentations of BAV phenotypes may be associated with congenital, genetic, and/or connective tissue abnormalities. The natural course of BAV is nonpredictable, it may lead to severe morbidity and mortality

How Are Entrepreneurial Intentions Affected by Emotional Intelligence and Creativity?

Entrepreneurship is important for developed countries to sustain their welfare levels and for developing countries to increase their level of welfare. Many entrepreneurs contribute significantly to the national economy of their countries. The purpose of our research is to determine how graduate students' entrepreneurial intentions are related to emotional intelligence and what role creativity plays in this process. This quantitative research study was conducted with graduate students at a private university in the southwest region of the USA. The data were collected from 399 participants via an online survey and analyzed by completing a Structural Equation Modelling. The results showed that entrepreneurial intentions are affected directly and positively by problem-solving skills, emotional self-awareness, and impulse control. Additionally, we found that problem-solving skills affect creativity directly and positively while creativity does not have a direct effect on entrepreneurial intentions

Relationship Between Heart Rate Recovery and Mean Platelet Volume in Healthy Individuals

Heart rate recovery index (HRRI) and mean platelet volume (MPV) are two cardiovascular prognostic markers. Low HRRI and high MPV values have been observed in several diseases and conditions. However, the relationship between these two markers is unclear. In this study, the relationship between HRRI and MPV in healthy individuals is examined. Materials and Methods: The exercise tests performed between January and December 2020 were evaluated, and 120 individuals who met the study criteria were included in the present study. An abnormal HRRI was defined as a decrease in heart rate of 12 beats or more until one minute after the peak of exercise. Those with abnormal HRRI were defined as the study group (n=60), and those with normal HRRI as the control group (n=60). Results: A total of 120 healthy individuals were included in the study (54% female; mean age 40.14±7.90 years). High- er MPV values were detected in the study group when compared to the control group (10.27±0.10 fl vs. 9.44±0.12 fl; p<0.001). This significance continued in the logistic regression analysis (odds ratio=3.78, p<0.001). In addition, a moderate negative correlation was found between HRRI and MPV (r=-0.404, p<0.001). The MPV value of 10.25 fl was identified as an effective cutoff point for the prediction of abnormal HRRI (area under the curve [AUC]: 0.758; 95% confidence interval [CI]: 0.674–0.843). Conclusion: Healthy individuals with abnormal HRRI have elevated MPV levels. Additionally, a negative correlation be- tween MPV and HRRI in healthy subjects indicates a causal relation between MPV and autonomic dysfunction

Desain Pit Penambangan Batubara Blok C pada PT. Intibuana Indah Selaras Kabupaten Nunukan Provinsi Kalimantan Utara

Desain pit adalah suatu kegiatan dalam merencanakan kegiatan produksi pada tambang dengan metode yang digunakan adalah tambang terbuka. Tujuan dari penelitian ini, untuk mendapatkandesain pit yang ideal, dengan mengunakan metode penampang sayatan, penyebaran batubara, cadangan overburden, cadangan batubara, geometri bench dan stripping ratio. Metode penelitian yang digunakan untuk pembuatan desain pit adalah program autocad 2012 . Adapun data – data yang yang diperhatikan dalam pembuatan desain pit meliputi kestabilan lereng ( lebar bench, tinggi bench, kemiringan lereng dan endapan batubara). Dari hasil pengolahan data, maka didapatkan luas bukaan pit 75,8763 Ha, dengan nilai stripping ratio 11 : 1 dan desain pit penambangan batubara dengan geometri bench tinggi yaitu 7 meter, lebar bench 3 – 4 meter dan kemiringan 65 o. Dimana desain pit penambangan sampai pada kedalam 2 m di permukaan laut

Migrant Ridesharing Drivers in San Francisco: A Case of Blocked Mobility?

Migrants have long turned to self-employment in host country labor markets due to not only racial and ethnic prejudices, but also issues of local language proficiency and lack of recognition of the academic degree from the sending country. The taxi industry, one particular occupational niche dominated by migrants, has long been studied by scholars. However, the industry has evolved into a newer and understudied form of transportation: ridesharing. This study argues that in the case of the ridesharing industry, drivers did indeed turn to the occupation because of factors such as insufficient English language level and foreign academic degrees, but also age and personal family matters. Participants were attracted to the ridesharing industry in large part because of the flexibility and level of compensation provided. As a whole, participants saw ridesharing as the best option available to them in an otherwise unsuitable labor market

Ebstein’s Anomaly

Ebstein’s anomaly (EA), a rare congenital heart disease, results from the failure of delamination of tricuspid valve (TV) leaflets from the endocardium of the right ventricle (RV) and apical displacement, particularly of the septal and posterior leaflets of TV. The most commonly accompanying cardiac malformation is atrial septal defect. Most EA cases are sporadic; familial ones are rare. EA patients may present at any age. Symptoms result from TV regurgitation, RV dysfunction, inadequate left ventricular filling owing to ventricular septal bowing, inadequate pulmonary flow, and arrhythmias. Atrial tachyarrhythmias are the most common late complications. There have been more techniques of tricuspid repair reported in the literature than any other congenital or acquired cardiac lesion. Neonatal operation has a higher risk of mortality than the operations performed beyond infancy. Late survival rate and the quality of life for hospital survivors are excellent

An Overview of One Health Concept Focusing on Toxoplasmosis

The "One Health" concept is a universal approach to sustainably balancing and optimizing the health of humans, animals, and ecosystems. This approach is based on the health of humans, domestic and wild animals, and plants in a wider environment in which self-renewable ecosystems exist, with essential characteristics of integration, unifying and holistic perspective. Toxoplasmosis, one of the most common zoonotic infections in both terrestrial and oceanic ecosystems in the world, is an ideal model disease for the “One Health” approach. Toxoplasmosis is a zoonotic disease caused by the obligate intracellular pathogen protozoan Toxoplasma gondii. In the life cycle of T. gondii, the definitive host is domestic cats and felines, and the intermediate hosts are all mammals (including humans), birds and reptiles. The infected cats have primary importance and play a crucial role in the contamination of habitats in the ecosystems with T. gondii oocysts. Thus, ecosystems with domestic cats and stray cats are contaminated with cat feces infected with T. gondii oocytes. T. gondii positivity has been scientifically demonstrated in all warm-blooded animals in terrestrial and aquatic habitats. The disease causes deaths and abortions in farm animals, resulting in great economic losses. However, the disease causes great problems in humans, especially pregnant women. During pregnancy, it may have effects such as congenital infections, lesions in the eye and brain of the fetus, premature birth, intrauterine growth retardation, fever, pneumonia, thrombocytopenia, ocular lesions, encephalitis, and abortion. The mechanism of death and abortion of the fetus in a pregnant woman infected with T. gondii occurs as a result of complete disruption of the maternal immune mechanism. The struggle against toxoplasmosis requires the universal collaboration and coordination of the World Organization for Animal Health, the World Health Organization and the World Food Organization in the "One Health" concept and integrative approaches of all responsible disciplines. Establishing universal environmental safety with the prevention and control of toxoplasmosis requires the annihilation of the feces of the infected cats using suitable techniques firstly. Then routinely, the monitoring and treatment of T. gondii positivity in cats, avoiding contact with contaminated foods and materials, and development of modern treatment and vaccine options. Particularly, mandatory monitoring or screening of T. gondii positivity during the pregnancy period in humans should be done. It would be beneficial to replace the French model, especially in the monitoring of disease in humans. In this article, the ecology of toxoplasmosis was reviewed at the base of the "One Health" concept

Inappropriate antimicrobial use in Turkish pediatric hospitals: A multicenter point prevalence survey

Objectives: Although well-defined principles of rational antimicrobial use are available, inappropriate prescribing patterns are reported worldwide. Accurate information on the usage of antimicrobials, including factors associated with and influencing their use, is valuable for improving the quality of prescription practices. Methods: In this cross-sectional point prevalence survey, data on patients hospitalized in 12 different children's hospitals were collected on a single day. Appropriateness of prescription was compared between the types of antimicrobials prescribed, indications, wards, and presence of/consultation with an infectious disease physician (IDP). Results: A total 711 of 1302 (54.6%) patients evaluated were receiving one or more antimicrobial drugs. The antimicrobial prescription rate was highest in pediatric intensive care (75.7%) and lowest in the surgery wards (37.0%). Of the 711 patients receiving antimicrobials, 332 patients (46.7%) were found to be receiving at least one inappropriately prescribed drug. Inappropriate use was most frequent in surgery wards (80.2%), while it was less common in oncology wards (31.8%; p < 0.001). Respiratory tract infection was the most common indication for antimicrobial use (29.4%). Inappropriate use was more common in deep-seated infections (54.7%) and respiratory infections (56.5%). Fluoroquinolones were used inappropriately more than any other drugs (81.8%, p = 0.021). Consultation with an IDP appears to increase appropriate antimicrobial use (p = 0.008). Conclusions: Inappropriate antimicrobial use remains a common problem in Turkish pediatric hospitals. Consultation with an IDP and prescribing antimicrobial drugs according to microbiological test results could decrease the inappropriate use of antimicrobials

Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population.Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed.Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%).Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL