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Hohenstein C, Merz S, Eppler F, Arslan V, Ayvaci BM, Ünlü L. Emergency airway management: an EUSEM statement with regard to the guidelines of the Society of Critical Care Medicine. Eur J Emerg Med 2024; 31:83-85. [PMID: 38100641 PMCID: PMC10901228 DOI: 10.1097/mej.0000000000001114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 12/17/2023]
Affiliation(s)
- Christian Hohenstein
- Department of Emergency Medicine, Zentralklinik Bad Berka, University of Marburg, Faculty of Medicine, Bad Berka
| | - Sabine Merz
- Red Cross Villingen-Schwenningen, Villingen-Schwenningen
| | - Fabian Eppler
- Faculty of Medicine, University of Mainz, Mainz, Germany
| | - Volkan Arslan
- Department of Emergency Medicine, Hacettepe University Medicine Faculty, Ankara
| | - Bariş Murat Ayvaci
- Department of Emergency Medicine, University of Health Sciences Prof. Dr. Cemil Taşcioğlu City Hospital, Istanbul, Turkey
| | - Luca Ünlü
- Faculty of Medicine, Karl-Landsteiner University of Health Sciences, Krems a.d. Donau, Austria
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Uguz I, Ohayon D, Arslan V, Sheelamanthula R, Griggs S, Hama A, Stanton JW, McCulloch I, Inal S, Shepard KL. Flexible switch matrix addressable electrode arrays with organic electrochemical transistor and pn diode technology. Nat Commun 2024; 15:533. [PMID: 38225257 PMCID: PMC10789794 DOI: 10.1038/s41467-023-44024-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 11/28/2023] [Indexed: 01/17/2024] Open
Abstract
Due to their effective ionic-to-electronic signal conversion and mechanical flexibility, organic neural implants hold considerable promise for biocompatible neural interfaces. Current approaches are, however, primarily limited to passive electrodes due to a lack of circuit components to realize complex active circuits at the front-end. Here, we introduce a p-n organic electrochemical diode using complementary p- and n-type conducting polymer films embedded in a 15-μm -diameter vertical stack. Leveraging the efficient motion of encapsulated cations inside this polymer stack and the opposite doping mechanisms of the constituent polymers, we demonstrate high current rectification ratios ([Formula: see text]) and fast switching speeds (230 μs). We integrate p-n organic electrochemical diodes with organic electrochemical transistors in the front-end pixel of a recording array. This configuration facilitates the access of organic electrochemical transistor output currents within a large network operating in the same electrolyte, while minimizing crosstalk from neighboring elements due to minimized reverse-biased leakage. Furthermore, we use these devices to fabricate time-division-multiplexed amplifier arrays. Lastly, we show that, when fabricated in a shank format, this technology enables the multiplexing of amplified local field potentials directly in the active recording pixel (26-μm diameter) in a minimally invasive form factor with shank cross-sectional dimensions of only 50×8 [Formula: see text].
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Affiliation(s)
- Ilke Uguz
- Electrical Engineering Department, Columbia University, New York, 10027, NY, USA.
| | - David Ohayon
- Organic Bioelectronics Laboratory, Biological and Environmental Science and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, 23955-6900, Saudi Arabia
| | - Volkan Arslan
- Electrical Engineering Department, Columbia University, New York, 10027, NY, USA
| | | | - Sophie Griggs
- Department of Chemistry, University of Oxford, Oxford, OX1 3TA, UK
| | - Adel Hama
- Organic Bioelectronics Laboratory, Biological and Environmental Science and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, 23955-6900, Saudi Arabia
| | - John William Stanton
- Electrical Engineering Department, Columbia University, New York, 10027, NY, USA
| | - Iain McCulloch
- Physical Science and Engineering Division, KAUST, Thuwal, 23955-6900, Saudi Arabia
- Department of Chemistry, University of Oxford, Oxford, OX1 3TA, UK
| | - Sahika Inal
- Organic Bioelectronics Laboratory, Biological and Environmental Science and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal, 23955-6900, Saudi Arabia
| | - Kenneth L Shepard
- Electrical Engineering Department, Columbia University, New York, 10027, NY, USA
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Batur A, Karaca MA, Arslan V, Boz M, Ibrahimov Z, Erbil B, Onur MR. Prognostic role of optic nerve sheath diameter in stroke in emergency department, A case control study. Niger J Clin Pract 2023; 26:863-870. [PMID: 37635568 DOI: 10.4103/njcp.njcp_1770_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Background Sonographic measurement of optic nerve sheath diameter (ONSD) can reflect intracranial pressure (ICP) indirectly and determine the neurology intensive care unit (NICU) requirement and mortality in acute ischemic stroke (AIS). Aim To demonstrate the effectiveness of ONSD to determine mortality, morbidity, and NICU requirement on patients with the AIS. Methods The sonographic ONSD measurements were performed on each patient with AIS, over 18 years old. All patients were categorized according to the Oxfordshire Community Stroke Project (OCSP) classification system. MRI images were examined for increased ICP, and the patients were categorized into two groups as increased ICP (i-ICP) and normal ICP. The ONSD results were evaluated in terms of classifications, outcomes, and prognosis of the patients. Results One hundred and five patients were included and 31 (35.2%) were in the i-ICP group. The median ONSDs were 5.26 mm in the i-ICP group and 4.62 mm in the normal ICP group (P < 0.001). The median ONSDs were 5.13 mm in the NICU group and 4.69 mm in the neurology ward (NW) group (P = 0.001). The total anterior circulation infarction (TACI) subgroup had higher ONSDs than the others (TACI: 5.27 mm; PACI: 4.73 mm; POCI: 4.77 mm; and LACI: 4.64 mm, P < 0.001). The NICU requirements were higher in the TACI subgroup. The median ONSD was 5.42 mm in the deceased group (survived: 4.77 mm, P < 0.001). Conclusion ONSD may be favorable for predicting the increased ICP and the NICU requirement in OCSP subgroups. Moreover, ONSD can be used to foresee the mortality of AIS.
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Affiliation(s)
- A Batur
- Department of Emergency Medicine, Hacettepe University, Faculty of Medicine, 06120 Altindag Ankara, Turkey
| | - M A Karaca
- Department of Emergency Medicine, Hacettepe University, Faculty of Medicine, 06120 Altindag Ankara, Turkey
| | - V Arslan
- Department of Emergency Medicine, Hacettepe University, Faculty of Medicine, 06120 Altindag Ankara, Turkey
| | - M Boz
- Department of Emergency Medicine, Hacettepe University, Faculty of Medicine, 06120 Altindag Ankara, Turkey
| | - Z Ibrahimov
- Department of Emergency Medicine, Hacettepe University, Faculty of Medicine, 06120 Altindag Ankara, Turkey
| | - B Erbil
- Department of Emergency Medicine, Hacettepe University, Faculty of Medicine, 06120 Altindag Ankara, Turkey
| | - M R Onur
- Radiology, Hacettepe University, Faculty of Medicine, 06120 Altindag Ankara, Turkey
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Batur A, Arslan V, Engin MÇ, Arslan Ş, Köse A. Which is the most appropriate anterior glenohumeral dislocation reduction technique among three different techniques? A prospective, randomized clinical trial. Jt Dis Relat Surg 2022; 34:144-150. [PMID: 36700276 PMCID: PMC9903102 DOI: 10.52312/jdrs.2023.879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/14/2022] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES This study aims to compare three glenohumeral dislocation (GHD) reduction techniques in terms of pain and reduction time and to offer clinicians an idea of the selection of the most appropriate technique. PATIENTS AND METHODS This multi-center, prospective, randomized clinical study included a total of 90 patients (55 males, 35 females; median age: 29 years; range, 22 to 41 years) who had isolated anterior GHD without complication between December 2019 and December 2021. The patients were divided into three equal groups (traction-countertraction [TCT], external rotation [ExR], and Cunningham) using the block randomization method, and reductions were performed. Pre-reduction, intra-reduction, and post-reduction Visual Analog Scale (VAS) scores, reduction times, success rates, and complication rates were analyzed. RESULTS There was no statistically significant difference among the groups in terms of age (p=0.414), sex (p=0.954), pre-reduction VAS (p=0.175), and post-reduction VAS (p=0.204). The median intra-reduction VAS values in the TCT, the external rotation, and the Cunningham groups were 8 (range, 7 to 9), 5 (range, 4 to 7), and 4 (range, 2.75 to 5), respectively (p<0.001). The median reduction time and IQR were 105 (range, 82.5 to 120) sec for TCT, 270 (range, 232.5 to 300) sec for ExR, and 630 (range, 540 to 780) sec for Cunningham (p=0.001). CONCLUSION The fastest, but most painful technique is TCT, while the longest and the least painful technique is Cunningham. An inverse relationship is found between time and pain. Based on these findings, it seems to be reasonable to leave the choice of the ideal reduction technique to the clinician. The clinician should choose the technique to be used according to the conditions in the emergency department.
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Affiliation(s)
- Ali Batur
- Hacettepe Üniversitesi Tıp Fakültesi, Acil Tıp Anabilim Dalı, 06230 Altındağ, Ankara, Türkiye.
| | - Volkan Arslan
- Department of Emergency Medicine, Hacettepe University, Faculty of Medicine, Ankara, Türkiye
| | - Muhammet Çağatay Engin
- Department of Orthopedics and Traumatology, Atatürk University, Faculty of Medicine, Erzurum, Türkiye
| | - Şenol Arslan
- Department of Emergency Medicine, Erzurum Regional Training and Research Hospital, Erzurum, Türkiye
| | - Ahmet Köse
- Department of Orthopedics and Traumatology, Erzurum Regional Training and Research Hospital, Erzurum, Türkiye
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Elloian J, Jadwiszczak J, Arslan V, Sherman JD, Kessler DO, Shepard KL. Flexible ultrasound transceiver array for non-invasive surface-conformable imaging enabled by geometric phase correction. Sci Rep 2022; 12:16184. [PMID: 36171424 PMCID: PMC9519534 DOI: 10.1038/s41598-022-20721-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/16/2022] [Indexed: 11/12/2022] Open
Abstract
Ultrasound imaging provides the means for non-invasive real-time diagnostics of the internal structure of soft tissue in living organisms. However, the majority of commercially available ultrasonic transducers have rigid interfaces which cannot conform to highly-curved surfaces. These geometric limitations can introduce a signal-quenching air gap for certain topographies, rendering accurate imaging difficult or impractical. Here, we demonstrate a 256-element flexible two-dimensional (2D) ultrasound piezoelectric transducer array with geometric phase correction. We show surface-conformable real-time B-mode imaging, down to an extreme radius of curvature of 1.5 cm, while maintaining desirable performance metrics such as high signal-to-noise ratio (SNR) and minimal elemental cross-talk at all stages of bending. We benchmark the array capabilities by resolving reflectors buried at known locations in a medical-grade tissue phantom, and demonstrate how phase correction can improve image reconstruction on curved surfaces. With the current array design, we achieve an axial resolution of ≈ 2 mm at clinically-relevant depths in tissue, while operating the array at 1.4 MHz with a bandwidth of ≈ 41%. We use our prototype to image the surface of the human humerus at different positions along the arm, demonstrating proof-of-concept applicability for real-time diagnostics using phase-corrected flexible ultrasound probes.
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Affiliation(s)
- Jeffrey Elloian
- Department of Electrical Engineering, Columbia University, 500 W 120th St., New York, NY, 10027, USA
| | - Jakub Jadwiszczak
- Department of Electrical Engineering, Columbia University, 500 W 120th St., New York, NY, 10027, USA
| | - Volkan Arslan
- Department of Electrical Engineering, Columbia University, 500 W 120th St., New York, NY, 10027, USA
| | - Jeffrey D Sherman
- Department of Electrical Engineering, Columbia University, 500 W 120th St., New York, NY, 10027, USA
| | - David O Kessler
- Department of Emergency Medicine, Morgan Stanley Children's Hospital of New York Presbyterian at Columbia University Medical Center, New York, 10032, USA
| | - Kenneth L Shepard
- Department of Electrical Engineering, Columbia University, 500 W 120th St., New York, NY, 10027, USA. .,Department of Biomedical Engineering, Columbia University, 1210 Amsterdam Avenue, New York, NY, 10027, USA.
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Arslan V. Comparison of the Effects of Aspergillus niger and Aspergillus ficuum on the Removal of Impurities in Feldspar by Bio-beneficiation. Appl Biochem Biotechnol 2019; 189:437-447. [PMID: 31049882 DOI: 10.1007/s12010-019-03029-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 04/22/2019] [Indexed: 10/26/2022]
Abstract
Depending on its purity, feldspar has a wide application in industry. Fungi play an important role in the feldspar purification. A bacterial leaching study of feldspar sample from Aydin, Turkey, was conducted to obtain a suitable raw material for industrial applications. XRD analyses indicated that albite (NaAlSi3O8) with minor amounts of orthoclase (KAlSi3O8), quartz (SiO2), muscovite (KAl2(Si3AlO10)(OH)2), rutile (TiO2), and small quantities of weathered clay minerals. This study evaluates bacterial leaching treatment to iron removal from feldspar using Aspergillus niger and Aspergillus ficuum to attain a product suitable for industrial uses. These funguses were tested for organic acid (oxalic and citric acid) production and leaching capabilities of feldspar. The leaching performances of two funguses were compared. Bacterial leaching experiments were performed in 500-mL Erlenmeyer flask at 30 ± 2 °C and 180 rpm agitation under aseptic conditions. In bacterial leaching experiments using A. niger and A. ficuum, 70.13% and 85.09% of the total iron oxides in the feldspar were removed, respectively. As a result, the final iron oxide concentrations in bacterial leaching experiments using A. niger and A. ficuum were 0.095% and 0.047%, respectively (at 5% w/v pulp density, temperature 30 ± 2 °C, A. niger 3 × 107 spores, A. ficuum 5 × 107 spores, and particle size < 63 μm). The use of fungi to remove iron from feldspar has the potential to be an effective method for upgrading the content and the commercial value of the feldspar. The experimental results of this study have provided significant opportunity to use biotechnological approach for producing the feldspar as a feed material for the high-quality ceramic industry.
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Affiliation(s)
- Volkan Arslan
- General Directorate of Minerals Research and Exploration, 42250, Konya, Turkey.
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Aslaner MA, Eroğlu SE, Batur A, Arslan V. Emergency medicine physicians' perspectives on subspecialty training: A national survey. Turk J Emerg Med 2018; 18:119-122. [PMID: 30191191 PMCID: PMC6107973 DOI: 10.1016/j.tjem.2018.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 01/14/2018] [Accepted: 01/21/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Subspecialty training (sST) is an accepted educational model for the branches that have completed the maturation period. At the end of a rapid growth and reaching its limits, we wanted to determine the emergency medicine (EM) physicians' thoughts about subspecialty training in EM in Turkey. METHOD This is a national cross-sectional survey study conducted in November 2017. Participants were physicians who were receiving or who had completed emergency medicine education. RESULTS The response rate was 32% (n = 607) in the study. The rate of attending physicians was 45.1%, resident physicians were 40.2%, and academic staff were 14.7%. Among all the EM physicians, 85.2% noted the need for sST, 9.6% were uncertain about the need, and 5.3% found the need unnecessary. The most frequently requested trainings were toxicology (72.5%), traumatology (71.3%), and critical care (67.4%). After sST, 48.9% of EM physicians requested to work both in the emergency department and in the other relevant department, 36.1% requested to work full-time in the emergency department, and 14.9% requested to work full-time in the other relevant department. CONCLUSION The great majority of EM physicians believed in the need for sST in Turkey. There were two primary reasons for wanting to apply for sST: first, and most frequently, was the contribution to advanced training, and second, was avoiding problems in the daily practice of EM.
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Affiliation(s)
| | - Serkan Emre Eroğlu
- Department of Emergency, Umraniye Training and Research Hospital, İstanbul, Turkey
| | - Ali Batur
- Clinic of Emergency, Erzurum Training and Research Hospital, Erzurum, Turkey
| | - Volkan Arslan
- Department of Emergency, Ankara Training and Research Hospital, Ankara, Turkey
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Turan O, Kurt RE, Arslan V, Silvagni S, Ducci M, Liston P, Schraagen JM, Fang I, Papadakis G. Can We Learn from Aviation: Safety Enhancements in Transport by Achieving Human Orientated Resilient Shipping Environment. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.trpro.2016.05.132] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Melendez JA, Arslan V, Fischer ME, Wuest D, Jarnagin WR, Fong Y, Blumgart LH. Perioperative outcomes of major hepatic resections under low central venous pressure anesthesia: blood loss, blood transfusion, and the risk of postoperative renal dysfunction. J Am Coll Surg 1998; 187:620-5. [PMID: 9849736 DOI: 10.1016/s1072-7515(98)00240-3] [Citation(s) in RCA: 360] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND We have previously demonstrated that maintenance of a low central venous pressure (LCVP) combined with extrahepatic control of venous outflow reduced the overall blood loss during major hepatic resections. This study examined the overall outcomes and, in particular, renal morbidity associated with a large series of consecutive major liver resections performed with this approach. In addition, the rationale for the anesthetic management to maintain LCVP was carefully reviewed. STUDY DESIGN All major hepatectomies performed between December 1991 and April 1997 were reviewed. The prospective Hepatobiliary Surgical Service database was merged with the Memorial Hospital Laboratory and Blood Bank databases to yield the nature of the operation, blood loss, blood product transfusions, outcomes, and levels of preoperative, postoperative, and discharge serum creatinine and blood urea nitrogen. RESULTS A total of 496 LCVP-assisted major liver resections were performed, with no intraoperative deaths and an in-hospital mortality rate of 3.8%. The median blood loss was 645 mL. Sixty-seven percent of the patients did not require perioperative blood transfusion during surgery and the immediate 12 hours after surgery. The median number of blood transfusions was 2. Only 3% of the patients experienced a persistent and clinically significant increase in serum creatinine possibly attributable to the anesthetic technique. Renal failure directly attributable to the anesthetic technique did not occur. CONCLUSIONS Major resection with LCVP allowed easy control of the hepatic veins before and during parenchymal transection. The anesthetic technique, designed to maintain LCVP during the critical stages of hepatic resection, not only helped to minimize blood loss and mortality but also preserved renal function.
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Affiliation(s)
- J A Melendez
- Department of Anesthesiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10024, USA
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