BACKGROUND Vasoactive medications are commonly administered for afterload reduction and arterial hypertension treatment in patients after cardiac surgery. A systematic review and meta-analysis were conducted to determine the effects of sodium nitroprusside and nicardipine on hemodynamics and cardiac performance in this population. METHODS A systematic review of published manuscripts was performed to identify studies of patients who received sodium nitroprusside and nicardipine as part of the treatment for arterial hypertension or afterload reduction after cardiac surgery. A meta-analysis was then conducted to determine the effects of sodium nitroprusside and nicardipine on hemodynamics and cardiac performance. The following parameters were captured blood pressure, heart rate, right atrial pressure, systemic vascular resistance, and stroke volume. RESULTS In total, five studies with 571 patients were pooled for these analyses. Systolic blood pressure, diastolic blood pressure, and mean arterial blood pressure were similar in both groups. The cardiac index was greater with nicardipine while mean pulmonary artery pressure was lower with sodium nitroprusside. CONCLUSION Nicardipine and sodium nitroprusside have similar abilities in reducing afterload in the postoperative cardiac population. Statistically significant differences were found in pulmonary artery pressure and cardiac index. It may be beneficial to consider nicardipine for afterload reduction in patients with a low cardiac index. © 2020 Wiley Periodicals, Inc.BACKGROUND The right gastroepiploic artery (RGEA) is a useful in-situ graft, and skeletonization is effective to prevent spasm and achieve good patency. To harvest the skeletonized RGEA easily, ultrasonic scalpel has been widely used, but the tip shape of conventional ultrasonic device was not optimal for this procedure. Recently, a novel hybrid ultrasonic/bipolar energy device (THUNDERBEAT Open Fine Jaw [TOFJ]) has been developed and is widely used in general surgery. SURGICAL TECHNIQUE The operator holds forceps in left hand and TOFJ in right hand, incises the anterior layer of the omentum, and extends the incision distally along the RGEA. The side branches and satellite veins were sealed and cut. Because the tip of the TOFJ is well-designed to easily grasp and peel off the tissue, there is no need to change instruments throughout the procedure. After the dissection was advanced distally, the proximal side was subsequently dissected.  https://www.selleckchem.com/products/aminoguanidine-hydrochloride.html  CONCLUSIONS This novel device is useful for harvesting skeletonized RGEA. © 2020 Wiley Periodicals, Inc.Acute aortic dissection is uncommon, but can turn into a fatal disease if not managed quickly. A 49-year-old male fighter pilot presented to us after sudden excruciating chest pain during a flight at the moment of an acute spiral down action. A contrast-enhanced computed tomography angiography showed Stanford type A aortic dissection that required surgical ascending aorta and hemiarch replacement with uneventful postoperative recovery and 10-year follow-up. Here, we presented the first report of a previously healthy pilot developed acute aortic dissection in the sky. Physicians should be aware of such a case that might happen more common with rapid aviation progress. © 2020 Wiley Periodicals, Inc.Brassinosteroids (BRs) are known to improve salt tolerance of plants, but not in all situations. Here, we show that a certain concentration of 24-epibrassinolide (EBL), an active BR, can promote the tolerance of canola under high salt stress, but the same concentration is disadvantageous under low salt stress. We define this phenomenon as hormonal stress-level-dependent biphasic (SLDB) effects. The SLDB effects of EBL on salt tolerance in canola are closely related to H2 O2 accumulation, which is regulated by polyamine metabolism, especially putrescine (Put) oxidation. The inhibition of EBL on canola under low salt stress can be ameliorated by repressing Put biosynthesis or diamine oxidase activity to reduce H2 O2 production. Genetic and phenotypic results of bri1-9, bak1, bes1-D, and bzr1-1D mutants and over-expression lines of BRI1 and BAK1 in Arabidopsis indicate that a proper enhancement of BR signaling benefits plants in countering salt stress, whereas excessive enhancement is just as harmful as a deficiency. These results highlight the involvement of crosstalk between BR signaling and Put metabolism in H2 O2 accumulation, which underlies the dual role of BR in plant salt tolerance. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.The aim of this study was to develop and test the reliability of an instrument to evaluate the quality of clinical teaching among dental school faculty. Fourth-year dental students' perspectives on effective clinical teaching were first collected in focus group meetings. An 11-item questionnaire to assess seven domains of clinical teaching was developed based on the collected student perspectives and a medical model. All 374 third- and fourth-year dental students at one U.S. dental school in 2015 were invited to evaluate four clinical instructors whom they felt were strong role models and four clinical instructors whom they felt would benefit from constructive criticism. The survey was completed by 139 students (37.2% response rate); they evaluated 96 dental instructors. The results showed that the survey demonstrated strong internal reliability, with Cronbach's alpha values of >0.95 for each of the seven domains. In addition, there was significant agreement between groups the interclass correlation (ICC) ranged from 0.97 to 0.99. These results suggest that the clinical faculty evaluation instrument developed in this study is a reliable method that can be used to evaluate dental faculty members. This system can be a valuable guide for clinical faculty members and administrators in assessing and improving clinical teaching effectiveness. © 2019 American Dental Education Association.The aims of this study were to determine the convergence angles of posterior teeth prepared by dental students at the University of Toronto for lithium disilicate glass-ceramic (LDGC) CAD/CAM crowns and to investigate their effect on loss of retention rate. A total of 280 preparations for posterior monolithic LDGC CAD/CAM crowns were performed on 270 patients (169 women and 101 men). Crowns were cemented with RelyX Unicem and Calibra Universal resin cements. Mesial, distal, and angle of convergence were measured on the bitewing radiographs. Cemented crowns were followed for up to six years. Data were analyzed for tooth type and location and for operator experience. The results showed the majority of convergence angles were greater than the recommended guidelines but fell within a clinically acceptable range (20 to 24 degrees). However, angles of convergence for mandibular molar preparations were highest (28.06±5.50 degrees), while maxillary premolars exhibited the lowest values (24.72±6.59 degrees). No significant difference was found between the results of dental students and foreign-trained dentists.