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The increase in impermeable surfaces within the urban areas contributes to local and regional-scale climate changes. This phenomenon, called \"Urban Heat Island,\" is observed as the temperature in urban areas is higher than rural areas and natural landscape areas on the urban fringe. In recent years, advances in remote sensing and geographic information system technologies have enabled the urban heat island effect to be determined more quickly, economically, and accurately. In this study, the rapidly increasing urbanization in Konya, Türkiye and the resulting urban heat island effect have been analyzed. The study consists of four steps. In the first step, land surface temperatures for 1990 and 2022 of Konya city center were determined using the thermal band of Landsat-5 TM and Landsat-8 OLI satellite images. Then, satellite images were classified using the maximum likelihood method to determine land use and land cover in Konya. The effects of land use types and urban growth on urban heat island were examined. The Normalized Difference Vegetation Index (NDVI) and Normalized Difference Built-Up Index (NDBI) analyses were examined the statistical relationships between land surface temperature. The last step, the urban heat island effects of different types of regions in the city center of Konya were determined based on their urban form, texture, structure, landscape, and planning strategy. As a result of the study, measures that can be taken especially in spatial planning and design policies have been identified to reduce and prevent the urban heat island in Konya.

Background:Pulmonary arterial hypertension (PAH) is a pathology characterized by pulmonary vasoconstriction, vascular remodeling, and hypertrophy in the medial layer of muscular arteries. It is a serious complication of connective tissue disease (CTD).Objectives:Although there is a considerable amount of comprehensive research in the literature on PAH associated with CTD, there is limited literature on PAH associated with Mixed Connective Tissue Disease (MCTD) which forms an important subgroup within this group. Our study investigates the prevalence and prognosis of MCTD in patients diagnosed with PAH.Methods:Our study is a retrospective cohort study approved by the ethics committee under decision no: 2022/09-13, involving the pulmonary hypertension (PH) cohort of our hospital. Between 2010 and 2023, it was identified that there were 296 patients aged 18 and over with PH in our center. Patients with a single admission to the clinic in the PH cohort and those diagnosed with Takayasu arteritis and primary antiphospholipid antibody syndrome (APS) were excluded from the study. The study was conducted on 96 patients diagnosed with idiopathic PAH (IPAH) and CTD-PAH from the remaining 221 patients. ANA (-) IPAH diagnosed patients were categorized as Group A, ANA (+) IPAH diagnosed patients as Group B, and CTD-PAH diagnosed patients as Group C for statistical analysis. In the initial stage, the groups were compared in terms of demographic data, prognostic factors, overall survival time, and mortality rate. In the subsequent stage, within the CTD-PAH group, patients diagnosed with MCTD were compared with patients with Systemic Sclerosis (SSc) and other CTDs [Systemic Lupus Erythematosus (SLE), Primary Sjögren’s Syndrome (pSS), and Rheumatoid Arthritis (RA)] using the same parameters.Results:In our cohort study with 96 patients, 41 were identified in Group A, 11 in Group B, and 44 in Group C. Detailed demographic and clinical characteristics of the groups are summarized in Table 1. Throughout the cohort follow-up, the overall mortality rate of patients was 57.3% and no significant difference in mortality rate was observed when compared between the groups (p=0.094). The overall survival time of Group C was significantly shorter than that of Group A (p=0.047. When the distribution of CTD subgroups within Group C was examined, 7 patients were diagnosed with MCTD, 27 with SSc, and 11 with other CTDs (SLE, pSS, and RA). MCTD patients were found to receive a diagnosis of PAH at an earlier age compared to SSc patients (p=0.022). Table 2 includes a comparison of the demographic and clinical characteristics of MCTD and other CTDs. No significant difference was observed in terms of mortality rate among MCTD, SSc and other CTD groups (p=0.059). However, the overall survival time of SSc patients was significantly longer than that of other CTD patients (p=0.009). The overall survival time of MCTD patients did not show a significant difference when compared to the SSc and other CTD groups.Conclusion:In our study, the prevalence of MCTD-PAH was found to be higher compared to the literature (1,). It was observed that MCTD-PAH patients demonstrated a similar prognosis to other patients within the CTD group. Additionally, the survival time of CTD-PAH patients was found to be shorter than that of IPAH patients.REFERENCES:[1] Jeon CH, Chai JY, Seo Y Il, Jun JB, Koh EM, Lee SK. Pulmonary hypertension associated with rheumatic diseases: baseline characteristics from the Korean registry. Int J Rheum Dis [Internet]. 2012 Oct [cited 2023 Mar 17];15(5).Acknowledgements:NIL.Disclosure of Interests:None declared.

The aim of this study was to compare the accuracy of limited cone beam computed tomography (LCBCT), an image plate system and F-speed film in assessing the depth of proximal carious lesions. Radiographs of a dry mandible with sound and carious teeth were obtained with all three methods. In 41 molar and premolar proximal surfaces, 2 observers independently measured lesion depth on the images from the three modalities. The correlation of measurements was assessed with Pearson’s correlation analysis. Results from imaging modalities and histological sectioning (gold standard) were compared using Bland-Altman plots. Overall comparison of the depth measurements from the imaging modalities and the gold standard was done using repeated-measures ANOVA. Pairwise comparisons of systems were done by the Bonferroni t test. The correlation between the measurements of the two observers was 0.977 for film, 0.997 for image plate system and 0.998 for LCBCT. Bland-Altman plots revealed that LCBCT agreed very closely with the gold standard while the agreement between the latter and the image plate – or film – images was moderate. The mean difference and 95% limits of agreement between LCBCT and the gold standard were smaller than those between either image plate or F-speed film and the gold standard. The LCBCT method appears as a promising tool for detection and monitoring of proximal carious lesions.

Methods Seventy consecutive patients with pulmonary arterial hypertension were assessed via echocardiography and right heart catheterization (RHC).

Case A 27 years old, female was referred to our PAH outpatient clinic due to the increased pulmonary artery pressure detected at echocardiography. Pulmonary angiography revealed distal pulmonary artery stenosis at segmental or lobar segments of both pulmonary arteries.

The study aimed to examine the effects of inspiratory muscle training (IMT) in patients with pulmonary hypertension (PH). A total of 24 patients with PH were included in the randomized controlled evaluator-blind study. IMT was performed at 40% to 60% of the maximal inspiratory pressure for 30 min/d, 7 d/wk (1 day supervised) for 8 weeks. Respiratory muscle strength, dyspnea, diaphragm thickness (DT), pulmonary functions, 24-hour ambulatory blood pressure (BP), arterial stiffness, exercise capacity, upper extremity functional exercise capacity, physical activity levels, fatigue, anxiety-depression levels, activities of daily living (ADL), and quality of life were evaluated. A total of 24 patients (treatment = 12, control = 12) completed the 8-week follow-up. There was no significant difference between the patient groups in terms of demographic and clinical characteristics (p >0.05). Considering the change between the groups in the treatment and control groups, brachial and central BP, dyspnea, respiratory muscle strength, DT in total lung capacity, knee extension muscle strength, functional exercise capacity, upper extremity functional exercise capacity, physical activity, ADL, fatigue, anxiety, and quality of life improved in favor of the IMT group (p <0.05). In conclusion, IMT has improved brachial and central BP, dyspnea, respiratory muscle strength, DT in total lung capacity, knee extension muscle strength, functional exercise capacity, upper extremity functional exercise capacity, physical activity, ADL, fatigue, anxiety, and quality of life compared with the control group. IMT is an effective method in cardiopulmonary rehabilitation for patients with PH.

Several protective therapies have been developed to prevent contrast-induced nephropathy (CIN). We aimed to investigate the efficacy of sodium bicarbonate by comparing 2 other regimens, including combination of N-acetylcysteine (NAC) plus sodium chloride and sodium chloride alone, to prevent CIN in patients undergoing cardiovascular procedures. We prospectively enrolled 264 patients who were scheduled for cardiovascular procedures and had a baseline creatinine level >1.2 mg/dL. The patients were assigned 1 of 3 prophylactic regimens: infusion of sodium bicarbonate, sodium chloride, sodium chloride plus oral NAC (600 mg bid). Contrast-induced nephropathy was defined as an increase in serum creatinine level >25% or 0.5 mg/dL after 48 hours. There were no significant differences among groups regarding baseline demographic properties and nephropathy risk factors. The change in creatinine clearance was significantly better in the sodium bicarbonate group than other 2 groups ( P = .007). The incidence of CIN was significantly lower in the sodium bicarbonate group (4.5%) compared with sodium chloride alone (13.6%, P = .036) and tended to be lower than in the combination group (12.5%, P = .059). After adjusting the Mehran nephropathy risk score, the risk of CIN significantly reduced with sodium bicarbonate compared with sodium chloride alone (adjusted risk ratio 0.29, P = .043). Hydration with sodium bicarbonate provides better protection against CIN than the sodium chloride infusion does alone. Combination therapy of NAC plus sodium chloride did not offer additional benefit over hydration with sodium chloride alone.

Temperature sensitivity is found in all multicelleular organisms, as well as in most primitive life forms. The ubiquity of this temperature sensitivity is an indicator of its effects at the multicellular, cellular and molecular levels [1]. Previous studies have shown that temperature-based regulation is present in the transcriptional process [2]. RNA Thermometers, temperature-sensitive sequences, have been shown to act on heat-shock genes to regulate temperature-dependant systems in many organisms [3,4]. The goal of this study was to characterize the shifts in the functioning of these RNA Thermometers at various temperatures. In addition, using the principle of transcriptional thermoregulation, an automated temperature-responsive system stimulating inverse endothermic and exothermic enzymatic reactions for heat stabilization was proposed. The endothermic enzymatic reaction was designated as the breakdown of urea, reflecting the function of urease, and the exothermic reaction was designated as the breakdown of hydrogen peroxide, reflecting the function of catalase [5]. The proposed system was built upon the translation of urease and the inhibition of catalase translation at higher temperatures, and the inverse at lower temperatures. As RNA Thermometers can be used only to drive transcription at higher temperatures, the installation of a lac-regulated 2-way system was suggested. This system would also provide a synthetic solution to thermoregulation and the current systems employed today. This system could be applied where the current thermoregulatory systems prove insufficient and could be further developed and optimized to replace them in the future.

This prospective, randomized, double-blind study was designed to compare the recovery characteristics of remifentanil and fentanyl in combination with propofol for direct current cardioversion. Patients undergoing elective cardioversion received either intravenous fentanyl 1 μg/kg (n=33) or remifentanil 0.25 μg/kg (n=30) and propofol was titrated to a Ramsay sedation score of 5 by slow intravenous injection. Heart rate, systolic, diastolic and mean blood pressures decreased significantly following sedation in both groups but did not show a significant difference between the groups. Time to answer a question (306±83 vs 383±131s, mean±SD, P=0.014) and time to sit up (412±90 vs 511±126s, P=0.002) were significantly shorter in the remifentanil group compared to the fentanyl group. Side-effects and patient discomfort were similar for both groups. Remifentanil can be used as a suitable supplement to propofol for direct current cardioversion and may provide a faster recovery profile than fentanyl.