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The involvement of lymph nodes critically affects patient outcomes in prostate cancer. While traditional risk models use factors like stage and PSA levels, the detection of lymph node involvement through modalities like PET targeting PSMA with 68 Ga radiotracer plays a pivotal role in guiding treatments ranging from prostatectomy to pelvic radiotherapy. This study aims to create a deep learning model to predict lymph node involvement in intermediate to high-risk prostate cancer patients using 68 Ga-PSMA PET/CT imagery, radiomics features, and various clinical parameters. For this study, 68 Ga-PSMA PET/CT scans and corresponding clinical data from 229 prostate cancer patients were retrospectively collected. An artificial intelligence model, integrating PET/CT fusion images, clinical data, and radiomics features, was developed using a slice-wise feature extractor and MNASNet for spatial feature extraction. The model was trained on 181 cases and tested on 48 cases. To assess the model's performance, a reader study was conducted on a balanced subset of the test data with five radiation oncologists. Among the 229 intermediate to high-risk patients with localized prostate cancer evaluated, 67 (30%) had lymph node metastasis, while 162 were non-metastatic. The proposed AI model achieved a mean accuracy of 0.85±0.03 and an F1 score of 0.73±0.03. In the reader study, radiation oncologists' mean evaluations showed lower metrics (accuracy 0.71±0.08, F1 score 0.70±0.07), compared to the AI model's mean accuracy of 0.79±0.02 and F1 score of 0.76±0.02. Our findings demonstrate the potential benefits of the proposed model in the clinical setting, particularly in enhancing decision-making by doctors in scenarios with high variability between readers, such as lymph node metastasis prediction., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: While many studies have explored the direct impact of psychosocial factors on affective experiences, there remains a gap in understanding the specific factors that mediate the relationships between social support and affective outcomes., Objective: The present study aimed to investigate the mediating role of self-esteem in the association between social support and affective experiences among a sample of Turkish undergraduate students., Method: The study utilized an online survey to recruit 300 participants, with a majority of female participants (59.33 %). The age of the participants ranged from 18 to 28 years (M age  = 21.15; SD = 1.86). Participants completed the Multidimensional Scale of Perceived Social Support (Zimet et al., 1988), the Rosenberg Self-Esteem Scale (Rosenberg, 1965), and the Scales of Positive and Negative Experiences (Diener et al., 2010)., Results: The mediation model with bootstrapping technique analysis revealed that social support was significantly associated with self-esteem and positive affective experiences. Self-esteem was also significantly associated with both positive and negative affective experiences. Additionally, self-esteem was found to partially mediate the relationship between social support and both positive and negative affective experiences, indicating that self-esteem acted as a mediator in these associations., Conclusions: These findings contribute to our understanding of the association between social support, self-esteem, and affective experiences and have implications for the development and implementation of interventions aimed at enhancing the positive effects of social support and self-esteem on affective experiences among young adults., Competing Interests: Declaration of competing interest The authors declared no conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Significant diagnostic variability between and within observers persists in pathology, despite the fact that digital slide images provide the ability to measure and quantify features much more precisely compared to conventional methods. Automated and accurate segmentation of cancerous cell and tissue regions can streamline the diagnostic process, providing insights into the cancer progression, and helping experts decide on the most effective treatment. Here, we evaluate the performance of the proposed PathoSeg model, with an architecture comprising of a modified HRNet encoder and a UNet++ decoder integrated with a CBAM block to utilize attention mechanism for an improved segmentation capability. We demonstrate that PathoSeg outperforms the current state-of-the-art (SOTA) networks in both quantitative and qualitative assessment of instance and semantic segmentation. Notably, we leverage the use of synthetic data generated by PathopixGAN, which effectively addresses the data imbalance problem commonly encountered in histopathology datasets, further improving the performance of PathoSeg. It utilizes spatially adaptive normalization within a generative and discriminative mechanism to synthesize diverse histopathological environments dictated through semantic information passed through pixel-level annotated Ground Truth semantic masks.Besides, we contribute to the research community by providing an in-house dataset that includes semantically segmented masks for breast carcinoma tubules (BCT), micro/macrovesicular steatosis of the liver (MSL), and prostate carcinoma glands (PCG). In the first part of the dataset, we have a total of 14 whole slide images from 13 patients' liver, with fat cell segmented masks, totaling 951 masks of size 512 × 512 pixels. In the second part, it includes 17 whole slide images from 13 patients with prostate carcinoma gland segmentation masks, amounting to 30,000 masks of size 512 × 512 pixels. In the third part, the dataset contains 51 whole slides from 36 patients, with breast carcinoma tubule masks totaling 30,000 masks of size 512 × 512 pixels. To ensure transparency and encourage further research, we will make this dataset publicly available for non-commercial and academic purposes. To facilitate reproducibility and encourage further research, we will also make our code and pre-trained models publicly available at https://github.com/DeepMIALab/PathoSeg., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Mental health problems are currently diversifying, increasing the possibility of suicide. Exposure to psychological maltreatment is one of the factors that increases suicidal cognitions. In addition, psychological flexibility and meaning-centered approaches may be effective in coping with suicidal cognitions., Objective: A hypothesized model was tested to examine the relationships among psychological maltreatment, suicidal cognitions, psychological flexibility, and meaning-centered coping., Method: Data were collected from a sample of 652 participants. Mediation and moderation analyses were conducted to examine the mediating and moderating role of psychological flexibility and meaning-centered coping in the relationship between childhood psychological maltreatment and suicide cognitions among Turkish adults., Results: The results of the study indicated significant negative and positive relationships between psychological maltreatment, suicide cognitions, psychological flexibility, and meaning-centered coping. The findings suggest that psychological flexibility and meaning-centered coping have a serial mediating effect on the relationship between psychological maltreatment and suicide cognitions. Furthermore, according to the study results, psychological flexibility plays a moderating role both between psychological maltreatment and suicidal cognitions and between meaning-centered coping and suicidal cognitions., Conclusions: The study suggests that psychological maltreatment can be considered as a risk factor and meaning-centered coping and psychological flexibility as protective factors in suicide prevention studies., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Formalin-fixation and paraffin-embedding (FFPE) is a technique for preparing and preserving tissue specimens that has been utilized in histopathology since the late 19th century. This process is further complicated by FFPE preparation steps such as fixation, processing, embedding, microtomy, staining, and coverslipping, which often results in artifacts due to the complex histological and cytological characteristics of a tissue specimen. The term "artifacts" includes, but is not limited to, staining inconsistencies, tissue folds, chattering, pen marks, blurring, air bubbles, and contamination. The presence of artifacts may interfere with pathological diagnosis in disease detection, subtyping, grading, and choice of therapy. In this study, we propose FFPE++, an unpaired image-to-image translation method based on contrastive learning with a mixed channel-spatial attention module and self-regularization loss that drastically corrects the aforementioned artifacts in FFPE tissue sections. Turing tests were performed by 10 board-certified pathologists with more than 10 years of experience. These tests which were performed for ovarian carcinoma, lung adenocarcinoma, lung squamous cell carcinoma, and papillary thyroid carcinoma, demonstrate the clear superiority of the proposed method in many clinical aspects compared with standard FFPE images. Based on the qualitative experiments and feedback from the Turing tests, we believe that FFPE++ can contribute to substantial diagnostic and prognostic accuracy in clinical pathology in the future and can also improve the performance of AI tools in digital pathology. The code and dataset are publicly available at https://github.com/DeepMIALab/FFPEPlus., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Several breast reduction techniques have been introduced, and the reliability of these techniques has been demonstrated in clinical practice. However, it is still controversial how patients should be evaluated radiologically both preoperative and postoperative. This study aims to compare the radiological findings seen following reduction mammoplasty with two different techniques (inferior pedicle and superomedial pedicle), in connection with the surgical steps., Methods: Medical records of 141 patients and a total of 278 breasts who underwent breast reduction with the diagnosis of macromastia were retrospectively analyzed. Demographic and operative data such as age, type of pedicle, preoperative and postoperative nipple-areola complex (NAC) position, and NAC transfer distance were recorded. Radiological evaluation was performed by two radiologists experienced in breast imaging by reinterpreting preoperative and postoperative mammography images., Results: The rate of postoperative structural distortion (p < 0.001), thickened areola (p = 0.011), and retroareolar fibrotic band (p < 0.001) were observed to be significantly higher in the superomedial group. The risk of fat necrosis increases as the NAC transfer distance increases and a value of >9.5 cm in the NAC transfer distance can be considered as the cutoff value in terms of fat necrosis development, especially in those using superomedial pedicle technique., Conclusion: Surgical technique-specific benign radiological changes occur following reduction mammoplasty. However, these changes do not significantly affect the Breast imaging, reporting, and data system category. The localization of fat necrosis differs depending on the surgical technique, and the risk of fat necrosis increases as the NAC transfer distance increases, especially in those who have undergone superomedial pedicle breast reduction surgery., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Background: The purpose of this study is to evaluate the diagnostic performance of imaging techniques for the identification of groin hernias based on the type of hernia and to demonstrate the efficacy of an algorithm based on the surgeon and surgical technique., Materials and Methods: Medical records of 561 patients who were operated on for groin hernia were retrospectively analyzed. A total of 102 patients who had both pelvic computed tomography (CT) and ultrasonography (USG) recordings preoperatively and underwent transabdominal preperitoneal repair were included in the study., Results: A contralateral asymptomatic occult groin hernia was detected in 25.5% of all patients. The overall sensitivity of USG and CT on contralateral asymptomatic occult hernia was 42.3% and 65.4%, respectively. The sensitivity of USG according to the contralateral occult hernia type was 66.7%, 35.7%, 33.3%, and 50% for direct, indirect, femoral, and pantaloon hernias, respectively. The sensitivity of CT according to the contralateral occult hernia type was 0%, 57.1%, 100%, and 100% for direct, indirect, femoral, and pantaloon hernias, respectively., Conclusions: The handicap created by the variability in the diagnostic sensitivity of imaging modalities can be overcome with the choice of transabdominal preperitoneal repair in the surgical technique., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Histological artefacts in cryosectioned tissue can hinder rapid diagnostic assessments during surgery. Formalin-fixed and paraffin-embedded (FFPE) tissue provides higher quality slides, but the process for obtaining them is laborious (typically lasting 12-48 h) and hence unsuitable for intra-operative use. Here we report the development and performance of a deep-learning model that improves the quality of cryosectioned whole-slide images by transforming them into the style of whole-slide FFPE tissue within minutes. The model consists of a generative adversarial network incorporating an attention mechanism that rectifies cryosection artefacts and a self-regularization constraint between the cryosectioned and FFPE images for the preservation of clinically relevant features. Transformed FFPE-style images of gliomas and of non-small-cell lung cancers from a dataset independent from that used to train the model improved the rates of accurate tumour subtyping by pathologists., (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)

Ulcerative colitis (UC) belongs to the inflammatory bowel disease (IBD) family, which is mainly caused by inflammation of the tissue in the colon and rectum. The severity of this infection can radically affect the patient's overall well-being. Although there is no definitive treatment for this disease, diagnosis of the severity of the disease through colonoscopy imaging and the use of personalized treatment can prevent progression to more malignant stages. Inter- and intra-observer variability combined with the complex nature of UC infection makes medical assessment cumbersome. Diagnosis and treatment of UC can be made more accurate and robust if disease severity can be determined in a standardized and automated manner. Therefore, the development of a computerized tool that can be integrated into the clinical decision-making process of UC classification is of great importance. In this work, we present an automated UC classification method, UC-NfNet, complemented by a synthetic data generation pipeline aimed at classifying colonoscopy UC images. We show that our model quantitatively outperforms state-of-the-art classification models such as ConViT, Inception-v4, NFNets, ResNets and Swin Transformer. In an independent reader study of five gastroenterologists, the average agreement between the UC-NfNet and individual gastroenterologists was higher than the agreement between individual gastroenterologists. This robust evaluation of the proposed AI system paves the way for clinical trials of AI-assisted UC classification. The code and dataset are publicly available at https://github.com/DeepMIALab/UC-NfNet., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Objectives: Shame and guilt in polysubstance abusers are still understudied despite their significance in substance use disorders (SUD). The goal of the current study is to develop a better understanding of how shame and guilt interact among polysubstance abusers who are receiving residential treatment., Methods: The sample of two hundred four males with SUD admitted to five rehabilitation centers from two cities in Pakistan participated in this study. For comparison, 215 age-matched healthy individuals were recruited (control). All participants reported their scores on the state shame and guilt scale (SSGS) and demographic form. A cross-sectional study design was adopted., Results: The group with SUD reported greater activations on SGSS ( r = 0.79, p < 0.001) as compared to healthy (control) individuals ( r = 0.48, p < 0.001). Further, multivariate analysis indicated that people with SUD who were of older age, unemployed, living in a nuclear family system, with a higher level of education, and low income, experienced higher levels of shame and guilt. Multinomial logistic regression analysis revealed that people with SUD in the age group 41-60 years (OR 5.2, 95%CI 2.4-6.8), unemployed (OR 4.4, 95%CI 3.2-4.7), nuclear family system (OR 5.9, 95%CI 4.5-6.4) and low monthly income group (OR 5.4, 95%CI 3.5-5.8) had a significantly high risk of shame and guilt than the control group., Conclusion: Findings of the current study indicate an association between shame and guilt activation and SUD. These results suggest that polysubstance users may benefit from therapeutic interventions to avoid a generalization of shame and guilt toward their substance use. Reducing shame and guilt should be considered a priority in treating adults with multiple SUD., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Abbasi, Iqbal, Yan, Mubarik, Nadeem, Turan and Younas.)

Background: Hemorrhoidal disease is characterized by painless rectal bleeding and palpable swelling in the anus and very common in the society. In the presence of pain, it is called a complicated hemorrhoidal disease including conditions, such as thrombosed hemorrhoids, strangulation of the internal hemorrhoid, or accompanying anal fissure. Edema that develops as a result of impaired venous return is accepted as the main source of pathology in the development of strangulated internal hemorrhoidal disease, which is one of these complicated conditions., Case Presentation: This case report shows that strangulated hemorrhoidal disease can also develop due to a mechanical cause as a result of incarceration of the hemorrhoid into the accompanying perianal fistula tract., Key Words: Anorectal pain, Hemorrhoidal disease, Strangulated internal hemorrhoidal, Perianal fistula.

In the last decade, numerous supervised deep learning approaches have been proposed for visual-inertial odometry (VIO) and depth map estimation, which require large amounts of labelled data. To overcome the data limitation, self-supervised learning has emerged as a promising alternative that exploits constraints such as geometric and photometric consistency in the scene. In this study, we present a novel self-supervised deep learning-based VIO and depth map recovery approach (SelfVIO) using adversarial training and self-adaptive visual-inertial sensor fusion. SelfVIO learns the joint estimation of 6 degrees-of-freedom (6-DoF) ego-motion and a depth map of the scene from unlabelled monocular RGB image sequences and inertial measurement unit (IMU) readings. The proposed approach is able to perform VIO without requiring IMU intrinsic parameters and/or extrinsic calibration between IMU and the camera. We provide comprehensive quantitative and qualitative evaluations of the proposed framework and compare its performance with state-of-the-art VIO, VO, and visual simultaneous localization and mapping (VSLAM) approaches on the KITTI, EuRoC and Cityscapes datasets. Detailed comparisons prove that SelfVIO outperforms state-of-the-art VIO approaches in terms of pose estimation and depth recovery, making it a promising approach among existing methods in the literature., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The ultimate goal of life is happiness, according to Plato. Perhaps the most critical questions in the life of human beings have been on happiness and processes that affect happiness. The present study was planned during the COVID-19 pandemic; perhaps human beings are most needed for happiness. The original hypothetical model and the findings constitute the powerful and different aspects of the present study. This study determined a hypothetical model to examine the relationships among happiness, forgiveness, emotional reactivity, and emotional security. The participant group of the study consists of a total of 916 individuals from Turkey, 617 women, and 299 men. The age scale of the participants is between 18-25. Participants completed the Heartland Forgiveness Scale, the Emotional Security Scale, the Emotional Reactivity Scale, and the Oxford Happiness Scale. Mediation analysis was conducted using Hayes' (2017) process macro. According to the proposed model in the study, emotional reactivity mediates the relationship between forgiveness and happiness. As the individual's forgiveness increases, their emotional reactivity decreases, and as the emotional reactivity decreases, the individual's level of happiness increases., Competing Interests: Conflict of InterestNo conflict of interest was declared by the authors., (© The Author(s) 2022.)

Endomyocardial biopsy (EMB) screening represents the standard of care for detecting allograft rejections after heart transplant. Manual interpretation of EMBs is affected by substantial interobserver and intraobserver variability, which often leads to inappropriate treatment with immunosuppressive drugs, unnecessary follow-up biopsies and poor transplant outcomes. Here we present a deep learning-based artificial intelligence (AI) system for automated assessment of gigapixel whole-slide images obtained from EMBs, which simultaneously addresses detection, subtyping and grading of allograft rejection. To assess model performance, we curated a large dataset from the United States, as well as independent test cohorts from Turkey and Switzerland, which includes large-scale variability across populations, sample preparations and slide scanning instrumentation. The model detects allograft rejection with an area under the receiver operating characteristic curve (AUC) of 0.962; assesses the cellular and antibody-mediated rejection type with AUCs of 0.958 and 0.874, respectively; detects Quilty B lesions, benign mimics of rejection, with an AUC of 0.939; and differentiates between low-grade and high-grade rejections with an AUC of 0.833. In a human reader study, the AI system showed non-inferior performance to conventional assessment and reduced interobserver variability and assessment time. This robust evaluation of cardiac allograft rejection paves the way for clinical trials to establish the efficacy of AI-assisted EMB assessment and its potential for improving heart transplant outcomes., (© 2022. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Aim: Parathyroid surgery has witnessed a significant evolution with the introduction of more efficacious preoperative localization imaging techniques and the use of rapid intraoperative parathormone assays. Parathyroid surgery can now be performed with the minimum of invasion. Through the adaptation of the transoral endoscopic thyroidectomy vestibular approach (TOETVA), the technique has now been adopted for parathyroid surgery, known as the transoral endoscopic parathyroidectomy vestibular approach (TOEPVA). We present here the initial experiences of 11 centers carrying out TOEPVA surgery in Turkey., Materials and Methods: Participating in the study were 11 centers, all of which were tertiary care institutions carrying out endocrine surgery. A retrospective review was made of 35 primary hyperparathyroidism patients who underwent the TOEPVA procedure between July 2017 and January 2020., Results: Of the total 35 patients, 32 patients underwent the TOEPVA procedure successfully. All patients but one were female, and the mean age was 47.2 (20-73) years. According to localization studies, 18 of the lesions were lower left, 12 were lower right, 3 were upper right and 2 were upper left. The mean operative time was 116 (30-225) min, and three cases were converted to an open procedure. Simultaneous thyroidectomy was performed in seven cases. The average PTH level dropped to normal within 20 min. after the resection in all cases. The complication rate was 19% (ecchymosis, subcutaneous emphysema, nasal bleeding, surgical site infection and seroma). There were neither recurrent nerve palsies, nor mental nerve root or branch injuries. The average hospital stay was 1 day. No persistence was documented on follow up., Conclusion: TOEPVA is a "hidden scar" parathyroidectomy procedure that can be safely performed on parathyroid adenomas, in cases that have scar-related concerns. Having its own procedure-related complications, the procedure provides satisfactory objective results, particularly in centers experienced in endoscopic and endocrine surgery., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.)

Interest in autonomous vehicles (AVs) is growing at a rapid pace due to increased convenience, safety benefits and potential environmental gains. Although several leading AV companies predicted that AVs would be on the road by 2020, they are still limited to relatively small-scale trials. The ability to know their precise location on the map is a challenging prerequisite for safe and reliable AVs due to sensor imperfections under adverse environmental and weather conditions, posing a formidable obstacle to their widespread use. Here we propose a deep learning-based self-supervised approach for ego-motion estimation that is a robust and complementary localization solution under inclement weather conditions. The proposed approach is a geometry-aware method that attentively fuses the rich representation capability of visual sensors and the weather-immune features provided by radars using an attention-based learning technique. Our method predicts reliability masks for the sensor measurements, eliminating the deficiencies in the multimodal data. In various experiments we demonstrate the robust all-weather performance and effective cross-domain generalizability under harsh weather conditions such as rain, fog and snow, as well as day and night conditions. Furthermore, we employ a game-theoretic approach to analyse the interpretability of the model predictions, illustrating the independent and uncorrelated failure modes of the multimodal system. We anticipate our work will bring AVs one step closer to safe and reliable all-weather autonomous driving., Competing Interests: Competing interestsThe authors declare no competing interests., (© The Author(s) 2022.)

Purpose: Reactive oxygen species (ROS), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) have been shown in the pathogenesis of acrylamide neurotoxicity. Hippophae rhamnoides L. extract (HRE) has a cytoprotective effect by stabilizing the production of ROS, IL-1β and TNF-α. The objective of the article was to investigate the effect of HRE on acrylamide-induced brain damage in rats biochemically and histopathologically., Methods: To the HRE+acrylamide only (ACR) group (n=6) of the animals, HRE was administered orally at a dose of 50 mg / kg into the stomach by gavage. The same volume of solvent (olive oil) was administered orally to the ACR (n=6) and healthy (HG) (n=6) groups. One hour after HRE administration, acrylamide was given orally at a dose of 20 mg/kg to HRE+ACR and ACR groups in the same way. This procedure was repeated once a day for 30 days. At the end of this period, brain tissues extracted from animals killed with 50 mg/kg thiopental anesthesia were examined biochemically and histopathologically., Results: It has been shown that HRE prevents the increase of malondialdehyde (MDA), myeloperoxidase (MPO), IL-1β and TNF-α with acrylamide and the decrease of total glutathione (tGSH) and glutathione reductase (GSHRd) levels in brain tissue., Conclusions: HRE may be useful in the treatment of acrylamide-induced neurotoxicity.

This study, which covered a set of leaching processes at a few stages, investigated the inclusion of iron found in mill scale, which is a waste of the iron-steel industry, in the solution as FeCl x=2,3 in the presence of HCl and the conditions of using this solution with an oxidizing character in extraction of metals from chalcopyrite concentrate. Mill scale was treated with HCl, and an FeCl x solution was obtained at a 100% Fe solubility and 83.43% Fe 3+ conversion rate in the conditions of 60 min, 105 °C, 7 M HCl, and 1/10 solid-liquid ratio. This solution that was obtained was later used in copper extraction from a chalcopyrite concentrate. In the optimum conditions (120 min of leaching time, 105 °C of leaching temperature, 1/25 solid-liquid ratio, 400 rpm stirring speed), 95.04% of the copper was taken into the solution. In the leaching experiment in a medium containing mill scale + chalcopyrite and HCl at the same time, under the optimum conditions (120 min of leaching time, 105 °C of leaching temperature, 7 M HCl concentration, 1 g chalcopyrite concentrate, 1/25 solid-liquid ratio, 5 g mill scale, 400 rpm stirring speed), approximately 96% of copper was taken into the solution., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Recent COVID-19 pandemic has claimed millions of lives due to lack of a rapid diagnostic tool. Global scientific community is now making joint efforts on developing rapid and accurate diagnostic tools for early detection of viral infections to preventing future outbreaks. Conventional diagnostic methods for virus detection are expensive and time consuming. There is an immediate requirement for a sensitive, reliable, rapid and easy-to-use Point-of-Care (PoC) diagnostic technology. Electrochemical biosensors have the potential to fulfill these requirements, but they are less sensitive for sensing viruses/viral infections. However, sensitivity and performance of these electrochemical platforms can be improved by integrating carbon nanostructure, such as graphene and carbon nanotubes (CNTs). These nanostructures offer excellent electrical property, biocompatibility, chemical stability, mechanical strength and, large surface area that are most desired in developing PoC diagnostic tools for detecting viral infections with speed, sensitivity, and cost-effectiveness. This review summarizes recent advancements made toward integrating graphene/CNTs nanostructures and their surface modifications useful for developing new generation of electrochemical nanobiosensors for detecting viral infections. The review also provides prospects and considerations for extending the graphene/CNTs based electrochemical transducers into portable and wearable PoC tools that can be useful in preventing future outbreaks and pandemics., (Copyright © 2021 Elsevier B.V. All rights reserved.)

The Lindley distribution and its numerous generalizations are widely used in statistical and engineering practice. Recently, a power transformation of Lindley distribution, called the power Lindley distribution, has been introduced by M. E. Ghitany et al. who initiated the investigation of its properties and possible applications. In this article, new results on the power Lindley distribution are presented. The focus of this work is on the moment-(in)determinacy of the distribution for various values of the parameters. Afterwards, certain applications are provided to describe data sets of software metrics.

Deep learning techniques hold promise to develop dense topography reconstruction and pose estimation methods for endoscopic videos. However, currently available datasets do not support effective quantitative benchmarking. In this paper, we introduce a comprehensive endoscopic SLAM dataset consisting of 3D point cloud data for six porcine organs, capsule and standard endoscopy recordings, synthetically generated data as well as clinically in use conventional endoscope recording of the phantom colon with computed tomography(CT) scan ground truth. A Panda robotic arm, two commercially available capsule endoscopes, three conventional endoscopes with different camera properties, two high precision 3D scanners, and a CT scanner were employed to collect data from eight ex-vivo porcine gastrointestinal (GI)-tract organs and a silicone colon phantom model. In total, 35 sub-datasets are provided with 6D pose ground truth for the ex-vivo part: 18 sub-datasets for colon, 12 sub-datasets for stomach, and 5 sub-datasets for small intestine, while four of these contain polyp-mimicking elevations carried out by an expert gastroenterologist. To verify the applicability of this data for use with real clinical systems, we recorded a video sequence with a state-of-the-art colonoscope from a full representation silicon colon phantom. Synthetic capsule endoscopy frames from stomach, colon, and small intestine with both depth and pose annotations are included to facilitate the study of simulation-to-real transfer learning algorithms. Additionally, we propound Endo-SfMLearner, an unsupervised monocular depth and pose estimation method that combines residual networks with a spatial attention module in order to dictate the network to focus on distinguishable and highly textured tissue regions. The proposed approach makes use of a brightness-aware photometric loss to improve the robustness under fast frame-to-frame illumination changes that are commonly seen in endoscopic videos. To exemplify the use-case of the EndoSLAM dataset, the performance of Endo-SfMLearner is extensively compared with the state-of-the-art: SC-SfMLearner, Monodepth2, and SfMLearner. The codes and the link for the dataset are publicly available at https://github.com/CapsuleEndoscope/EndoSLAM. A video demonstrating the experimental setup and procedure is accessible as Supplementary Video 1., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Current capsule endoscopes and next-generation robotic capsules for diagnosis and treatment of gastrointestinal diseases are complex cyber-physical platforms that must orchestrate complex software and hardware functions. The desired tasks for these systems include visual localization, depth estimation, 3D mapping, disease detection and segmentation, automated navigation, active control, path realization and optional therapeutic modules such as targeted drug delivery and biopsy sampling. Data-driven algorithms promise to enable many advanced functionalities for capsule endoscopes, but real-world data is challenging to obtain. Physically-realistic simulations providing synthetic data have emerged as a solution to the development of data-driven algorithms. In this work, we present a comprehensive simulation platform for capsule endoscopy operations and introduce VR-Caps, a virtual active capsule environment that simulates a range of normal and abnormal tissue conditions (e.g., inflated, dry, wet etc.) and varied organ types, capsule endoscope designs (e.g., mono, stereo, dual and 360 ∘ camera), and the type, number, strength, and placement of internal and external magnetic sources that enable active locomotion. VR-Caps makes it possible to both independently or jointly develop, optimize, and test medical imaging and analysis software for the current and next-generation endoscopic capsule systems. To validate this approach, we train state-of-the-art deep neural networks to accomplish various medical image analysis tasks using simulated data from VR-Caps and evaluate the performance of these models on real medical data. Results demonstrate the usefulness and effectiveness of the proposed virtual platform in developing algorithms that quantify fractional coverage, camera trajectory, 3D map reconstruction, and disease classification. All of the code, pre-trained weights and created 3D organ models of the virtual environment with detailed instructions how to setup and use the environment are made publicly available at https://github.com/CapsuleEndoscope/VirtualCapsuleEndoscopy and a video demonstration can be seen in the supplementary videos (Video-I)., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objectives: The Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) was described in 2016 and had its case series published. This study aimed to present the largest TOETVA case series performed in Turkey., Material and Methods: Data from 52 patients who underwent TOETVA procedure between February 2018 and October 2019 were analyzed retrospectively. Demographic data, duration of operation, blood loss, rate of conversion to open surgery, radiological findings, pathological outcomes, and complications were analyzed., Results: All patients were female. Mean duration of the operation was 192 ± 45 minutes, mean blood loss was 39 ± 47 mL, and the ratio of surgical site infection was 6% (3/50). In two (4%) patients, TOETVA was converted to open surgery. Temporary and permanent recurrent laryngeal nerve (RLN) paralysis was observed in 2 (4%) and 0 patients, respectively. Temporary and permanent hypoparathyroidism was observed in 10 (20%) and 0 patients, respectively., Conclusion: TOETVA procedure is the most recently defined NOTES technique for endocrine surgery. In experienced healthcare centers, TOETVA can achieve outcomes similar and even better than the ones obtained with open surgery. The complication rates, durations of operation, surgical site infection, and blood loss parameters that we observed in our experience are similar to the ones reported in the literature., Competing Interests: Conflict of Interest: All authors declare that they have no competing interests., (Copyright © 2020, Turkish Surgical Society.)

Although wireless capsule endoscopy is the preferred modality for diagnosis and assessment of small bowel diseases, the poor camera resolution is a substantial limitation for both subjective and automated diagnostics. Enhanced-resolution endoscopy has shown to improve adenoma detection rate for conventional endoscopy and is likely to do the same for capsule endoscopy. In this work, we propose and quantitatively validate a novel framework to learn a mapping from low-to-high-resolution endoscopic images. We combine conditional adversarial networks with a spatial attention block to improve the resolution by up to factors of 8× , 10× , 12× , respectively. Quantitative and qualitative studies demonstrate the superiority of EndoL2H over state-of-the-art deep super-resolution methods Deep Back-Projection Networks (DBPN), Deep Residual Channel Attention Networks (RCAN) and Super Resolution Generative Adversarial Network (SRGAN). Mean Opinion Score (MOS) tests were performed by 30 gastroenterologists qualitatively assess and confirm the clinical relevance of the approach. EndoL2H is generally applicable to any endoscopic capsule system and has the potential to improve diagnosis and better harness computational approaches for polyp detection and characterization. Our code and trained models are available at https://github.com/CapsuleEndoscope/EndoL2H.

Background: Indocyanine green fluorescence (ICG) angiography has been used for many purposes including as part of a focused parathyroidectomy technique. Concomitant fluorescence of thyroid tissue may cause challenges defining parathyroid tissue during surgery, since ICG is not a selective fluorescent agent. On the other hand, cosmesis is still a big problem for patients due to the visible neck scars produced by the standard surgical technique. In this study, we described a novel technique to solve both these handicaps., Materials and Methods: Seven patients who underwent ICG fluorescence angiography-guided transoral endoscopic thyroidectomy and parathyroidectomy vestibular approach between February 2018 and July 2019 were included. Serum parathyroid hormone (PTH) levels were measured intraoperatively and on postoperative day 1. Fluorescent images were confirmed with intraoperative quick-PTH levels., Results: All operations were done successfully without conversion to open surgery. Intense and isolated parathyroid fluorescent images were achieved in all operations. All patients had a 50 % decrease between the baseline and final quick-PTH levels and the final quick-PTH levels were in the normal range in all. One of 7 patients had epistaxis due to nasotracheal intubation. One of 7 patients had seroma on post-operative day 5. None of patients had mental nerve injury, permanent hypocalcemia and temporary or permanent recurrent laryngeal nerve injury., Conclusion: ICG-guided transoral endoscopic thyroid and parathyroid surgery can be used in select patients to increase operative success in focused parathyroidectomy with excellent cosmetic outcome also noted., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Purpose: Renal infarction is a clinical condition which is caused by renal artery occlusion and leads to permanent renal parenchymal damage. In the literature, there are generally case reports on this subject, and few studies that include a large group of patients. Therefore, we aimed to present the data of a large group of patients who were diagnosed with acute renal infarction in our country in this retrospective study., Methods: The data of patients who were diagnosed with acute renal infarction according to clinical and radiological findings in Turkey in the last 3 years were examined. For this purpose, we contacted with more than 40 centers in 7 regions and obtained support from clinically responsible persons. Demographic data of patients, laboratory data at the time of diagnosis, tests performed for etiologic evaluation, given medications, and patients' clinical status during follow-up were obtained from databases and statistical analysis was performed., Results: One-hundred and twenty-one patients were included in the study. The mean age was 53 ± 1.4 (19-91) years. Seventy-one (58.7%) patients were male, 18 (14.9%) had diabetes, 53 (43.8%) had hypertension, 36 (30%) had atrial fibrillation (AF), and 6 had a history of lupus + antiphospholipid syndrome (APS). Forty-five patients had right renal infarction, 50 patients had left renal infarction, and 26 (21.5%) patients had bilateral renal infarction. The examinations for the ethiologies revealed that, 36 patients had thromboemboli due to atrial fibrillation, 10 patients had genetic anomalies leading to thrombosis, 9 patients had trauma, 6 patients had lupus + APS, 2 patients had hematologic diseases, and 1 patient had a substance abuse problem. Fifty-seven (57%) patients had unknown. The mean follow-up period was 14 ± 2 months. The mean creatinine and glomerular filtration rate (GFR) values at 3 months were found to be 1.65 ± 0.16 mg/dl and 62 ± 3 ml/min, respectively. The final mean creatinine and GFR values were found to be 1.69 ± 0.16 mg/dl and 62 ± 3 ml/min, respectively., Conclusions: Our study is the second largest series published on renal infarction in the literature. More detailed studies are needed to determine the etiological causes of acute renal infarction occurring in patients.

A reliable, real time localization functionality is crutial for actively controlled capsule endoscopy robots, which are an emerging, minimally invasive diagnostic and therapeutic technology for the gastrointestinal (GI) tract. In this study, we extend the success of deep learning approaches from various research fields to the problem of sensor fusion for endoscopic capsule robots. We propose a multi-sensor fusion based localization approach which combines endoscopic camera information and magnetic sensor based localization information. The results performed on real pig stomach dataset show that our method achieves sub-millimeter precision for both translational and rotational movements.

Purpose: Ultrasonography (US) is an inexpensive, noninvasive and easy imaging procedure to comment on the kidney disease. Data are limited about the relation between estimated glomerular filtration rate (e-GFR) and all 3 renal US parameters, including kidney length, parenchymal thickness and parenchymal echogenicity, in chronic kidney disease (CKD). In this study, we aimed to investigate the association between e-GFR and ultrasonographic CKD score calculated via these ultrasonographic parameters., Methods: One hundred and twenty patients with stage 1-5 CKD were enrolled in this study. The glomerular filtration rate was estimated by the Chronic Kidney Disease Epidemiology Collaboration equation. US was performed by the same radiologist who was blinded to patients' histories and laboratory results. US parameters including kidney length, parenchymal thickness and parenchymal echogenicity were obtained from both kidneys. All 3 parameters were scored for each kidney, separately. The sum of the average scores of these parameters was used to calculate ultrasonographic CKD score., Results: The mean age of patients was 63.34 ± 14.19 years. Mean kidney length, parenchymal thickness, ultrasonographic CKD score and median parenchymal echogenicity were found as 96.2 ± 12.3, 10.97 ± 2.59 mm, 6.28 ± 2.52 and 1.0 (0-3.5), respectively. e-GFR was positively correlated with kidney length (r = 0.343, p < 0.001), parenchymal thickness (r = 0.37, p < 0.001) and negatively correlated with CKD score (r = -0.587, p < 0.001) and parenchymal echogenicity (r = -0.683, p < 0.001). Receiver operating characteristic curve analysis for distinction of e-GFR lower than 60 mL/min showed that the ultrasonographic CKD score higher than 4.75 was the best parameter with the sensitivity of 81% and positive predictivity of 92% (AUC, 0.829; 95% CI, 0.74-0.92; p < 0.001)., Conclusion: We found correlation between e-GFR and ultrasonographic CKD score via using all ultrasonographic parameters. Also, our study showed that ultrasonographic CKD score can be useful for distinction of CKD stage 3-5 from stage 1 and 2. We suggested that the ultrasonographic CKD score provided more objective data in the assessment of CKD.

Since the development of capsule endoscopy technology, medical device companies and research groups have made significant progress to turn passive capsule endoscopes into robotic active capsule endoscopes. However, the use of robotic capsules in endoscopy still has some challenges. One such challenge is the precise localization of the actively controlled robot in real-time. In this paper, we propose a non-rigid map fusion based direct simultaneous localization and mapping method for endoscopic capsule robots. The proposed method achieves high accuracy for extensive evaluations of pose estimation and map reconstruction performed on a non-rigid, realistic surgical EsophagoGastroDuodenoscopy Simulator and outperforms state-of-the art methods.

Some authors have investigated the effects of oxidative stress in some process such as undergoing laparoscopic. However, the effect of upper gastrointestinal system endoscopy process on oxidative stress is unclear. We evaluated the short-term effect of upper gastrointestinal system endoscopy process on oxidative stress. Thirty patients who underwent endoscopy process and 20 healthy controls were enrolled in the prospective study. Serum total antioxidant capacity and total oxidant status measurements were measured before and after endoscopy process. The ratio percentage of total oxidant status to total antioxidant capacity was regarded as oxidative stress index. Before endoscopy process, serum total antioxidant capacity levels were higher, while serum total oxidant status levels and oxidative stress index values were lower in patients than controls, but this difference was not statistically significant (all, p > 0.05). After endoscopy process, serum total antioxidant capacity and total oxidant status levels were significantly higher in patients than before endoscopy process (both, p < 0.05). However, oxidative stress index values were slight higher in patients but this difference was not statistically significant (p > 0.05). We observed that serum TAC and TOS levels were increased in patients who underwent endoscopy process after endoscopy process. However, short-time upper gastrointestinal system endoscopy process did not cause an important change in the oxidative stress index. Further studies enrolling a larger number of patients are required to clarify the results obtained here.

Purpose: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were established showing the poor prognosis in some diseases, such as cardiovascular diseases and malignancies. The risk of mortality in patients with end-stage renal disease (ESRD) was higher than normal population. In this study, we aimed to investigate the relationship between NLR, PLR, and all-cause mortality in prevalent hemodialysis (HD) patients., Methods: Eighty patients were enrolled in study. NLR and PLR obtained by dividing absolute neutrophil to absolute lymphocyte count and absolute platelet count to absolute lymphocyte count, respectively. The patients were followed prospectively for 24 months. The primary end point was all-cause mortality., Results: Mean levels of neutrophil, lymphocyte, and platelet were 3904 ± 1543/mm(3), 1442 ± 494/mm(3), 174 ± 56 × 10(3)/mm(3), respectively. Twenty-one patients died before the follow-up at 24 months. Median NLR and PLR were 2.52 and 130.4, respectively. All-cause mortality was higher in patients with high NLR group compared to the patients with low NLR group (18.8 vs. 7.5 %, p = 0.031) and in patients with higher PLR group compared to patients with lower PLR group (18.8 vs. 7.5 %, p = 0.022). Following adjusted Cox regression analysis, the association of mortality and high NLR was lost (p = 0.54), but the significance of the association of high PLR and mortality increased (p = 0.013)., Conclusion: Although both NLR and PLR were associated with all-cause mortality in prevalent HD patients, only PLR could independently predict all-cause mortality in these populations.

Background: There are significant differences between countries in the mortality rates of haemodialysis (HD) patients. The extent of these differences and possible contributing factors are worthy of investigation., Methods: As of March 2009, all patients undergoing HD or haemodiafiltration for >3 months (n = 4041) in the Turkish clinics of the NephroCare network were enrolled. Data were prospectively collected for 2 years through the European Clinical Dialysis Database. Mean age ± standard deviation was 58.7 ± 14.7 years, 45.9% were female and 22.9% were diabetic. Comparison with US data was performed by applying an indirect standardization technique, using specific mortality rates for patients on HD by age, gender, race and primary diagnosis as provided by the 2012 US Renal Data System Annual Data Report as reference., Results: The crude mortality rate in Turkey was 95.1 per 1000 patient-years. Compared with the US reference population, the annual mortality rate for Turkey was significantly lower, irrespective of gender, age and diabetes. After adjustments for age, gender and diabetes, the mortality risk in the Turkish cohort was 50% lower than US whites [95% confidence interval (CI) 0.46-0.54, P < 0.001], 44% lower than US African-Americans (95% CI 0.52-0.61, P < 0.001) and 20% lower than Asian-Americans (95% CI 0.74-0.86, P < 0.05)., Conclusions: The annual mortality rate of prevalent HD patients was found to be significantly lower in the studied Turkish cohort compared with that published by the US Renal Data System Annual Data Report. Differences in practice patterns may contribute to the divergence.

Purpose: High fibroblast growth factor-23 (FGF-23) levels are associated with mortality and cardiovascular events in patients with chronic kidney disease. The aim of this cross-sectional study was to investigate the relationship between plasma FGF-23 levels and coronary artery calcification and carotid artery intima-media thickness (CA-IMT) in hemodialysis (HD) patients., Methods: In this cross-sectional study, plasma intact FGF-23 levels were measured in 229 patients who underwent coronary artery calcification scores (CACs) determined by multi-slice computerized tomography and CA-IMT assessed by using high-resolution color Doppler ultrasonography., Results: Median FGF-23 was 53.5 pg/ml (IQR 30.8-249.5). Median CACs was 98 (IQR 0-531), and the frequency of patients with severe calcification (CACs > 400) was 28.8%; 27.5% of cases had no calcification. Mean CA-IMT was 0.78 ± 0.20 mm, and the presence of carotid plaques was 51% with a mean length 2.1 mm. FGF-23 level was positively correlated with serum calcium (r = 0.337, p < 0.001), phosphate (r = 0.397, p < 0.001) and CACs (r = 0.218, p = 0.001). Neither CA-IMT nor the presence of carotid artery plaques correlated with FGF-23 levels. In adjusted ordinal regression analysis, FGF-23 level was an independent predictor for severe CACs together with age, gender, presence of diabetes, time on dialysis and CA-IMT (model r(2) = 0.44, p < 0.001). As a novel finding, the mean CACs was markedly higher in patients with FGF-23 level above median regardless of phosphate levels (p = 0.03)., Conclusions: In HD patients, plasma FGF-23 level is superior to phosphate in the prediction of coronary artery calcification. However, FGF-23 is not associated with carotid artery atherosclerosis in HD patients.

There is an increasing demand for flexible, skin-attachable, and wearable strain sensors due to their various potential applications. However, achieving strain sensors with both high sensitivity and high stretchability is still a grand challenge. Here, we propose highly sensitive and stretchable strain sensors based on the reversible microcrack formation in composite thin films. Controllable parallel microcracks are generated in graphite thin films coated on elastomer films. Sensors made of graphite thin films with short microcracks possess high gauge factors (maximum value of 522.6) and stretchability (ε ≥ 50%), whereas sensors with long microcracks show ultrahigh sensitivity (maximum value of 11,344) with limited stretchability (ε ≤ 50%). We demonstrate the high performance strain sensing of our sensors in both small and large strain sensing applications such as human physiological activity recognition, human body large motion capturing, vibration detection, pressure sensing, and soft robotics.

Aim: Obesity is known to be associated with many diseases in the long and short terms. Elevated oxidative stress contributes to the development of such obesity-related diseases as dyslipidemia, diabetes mellitus and hypertension. Levels of the endogenous antioxidants paraoxonase and arylesterase have been shown to decrease in such diseases. The purpose of this study was to investigate whether or not changes in lifestyle and metformin therapy would affect serum paraoxonase and arylesterase levels., Materials and Methods: The study was performed with 25 overweight, 26 obese and 25 morbidly obese patients aged 6-15 years as well as 27 healthy children. Serum paraoxonase (PON1) and arylesterase (ARE) activity levels and total cholesterol, triglyceride, low-density protein, high-density protein, very low-density protein, glucose, aspartate amino transferase and alanine amino transferase levels were measured. Enrolled patients were assessed at initial presentation and again at 6 months. No procedure was performed in the control group, while the overweight, obese and morbidly obese groups were recommended diet and exercise and given metformin therapy (insulin-resistant subjects only)., Results: Serum PON1 activity levels in patients with metabolic syndrome were significantly lower than those in individuals without metabolic syndrome (p<0.05), while lipid concentrations were significantly higher (p<0.05). Metabolic syndrome patients had higher serum glucose, total cholesterol, low-density protein, very low-density protein and triglyceride values compared to those of the control group but significantly lower high-density protein values (p<0.05). No difference was determined between the groups in terms of PON1 and ARE levels following diet and exercise and metformin therapy., Conclusion: Measurement of PON1 and ARE enzyme levels may be useful in monitoring the effectiveness of treatment aimed at reducing oxidative stress in obese children.

Untethered robots miniaturized to the length scale of millimeter and below attract growing attention for the prospect of transforming many aspects of health care and bioengineering. As the robot size goes down to the order of a single cell, previously inaccessible body sites would become available for high-resolution in situ and in vivo manipulations. This unprecedented direct access would enable an extensive range of minimally invasive medical operations. Here, we provide a comprehensive review of the current advances in biome dical untethered mobile milli/microrobots. We put a special emphasis on the potential impacts of biomedical microrobots in the near future. Finally, we discuss the existing challenges and emerging concepts associated with designing such a miniaturized robot for operation inside a biological environment for biomedical applications.

Objective: To investigate the relationship between Vitamin D deficiency and acute otitis media infection., Methods: The randomised, single-blind, case-control study was conducted at the Paediatric Department of Ataturk University, Erzurum, Turkey, from January to April 2010. It comprised ambulatory children diagnosed with acute otitis media and healthy controls. The subjects were divided into groups according to their serum 25-hydroxy vitamin D levels. SPSS 18 was used for statistical analysis., Results: Of the 169 subjects in the study, 88(52%) were the cases and 81(48%) were controls. The mean age of the cases was 6.21±3.4 years, and 6.18±3.12 years for the controls (p<0.951). Serum 25-hydroxy vitamin D levels in the cases and controls were 20.6±10.2 ng/mL and 23.8±10.3 ng/mL (p<0.05). There was no statistically significant difference between the groups in terms of parathormone and calcium levels (p>0.05)., Conclusion: Serum 25-hydroxy vitamin D levels being significantly lower in children diagnosed with acute otitis media compared to the controls in two otherwise similar groups suggests that Vitamin D deficiency plays a role in otitis media infection.

Background: Ovarian ischemia and reperfusion can lead to serious and irreversible health problems., Objectives: The aim of this study is to investigate the protective effect of agomelatine against ovarian ischemia/ /reperfusion injury in rats using biochemical methods., Material and Methods: Thirty female rats were divided into three groups (the number of animals in each group = 10), a control group in which ischemia/reperfusion was established (IRC), an ischemia/reperfusion + agomelatine (IRA) group and a healthy group given a sham operation (SG). Total glutathione (tGSH) and malondialdehyde (MDA) levels and glutathione peroxidase., Results: Biochemical results revealed MDA levels of 19.1 ± 2.03, 5.8 ± 1.5 and 5.5 ± 1.4 µmol/g protein in ovarian tissue in the IRC, IRA and SG groups, respectively. MPO activity in the IRC, IRA and SG groups was 7.87 ± 2.7, 4.0 ± 2.0 and 3.0 ± 1.0 U/g protein, respectively. tGSH levels were 1.87 ± 1.13, 4.37 ± 1.4 and 5.87 ± 1.64 nmol/g protein, respectively. GPx activity in the IRC, IRA and SG groups was 7.37 ± 1.68, 18.6 ± 3 and 17.75 ± 3.2 U/g protein, and SOD activity 31.1 ± 2.9, 45.3 ± 3.7 and 54 ± 4.2 U/g protein, respectively. The level of 8-OH/ /Gua, a product of DNA damage, was 2.18 ± 0.2 pmol/L in the IRC group, 1.28 ± 0.2 pmol/L in the IRA group and 0.93 ± 0.01 pmol/L in the SG group., Conclusions: Agomelatine prevented ovarian ischemia/reperfusion injury.

Background: This study investigated the effect of thiamine pyrophosphate (TPP) on oxidative liver damage induced in rats with high-dose paracetamol., Methods: Rats for this experiment were divided into the following groups: healthy control, paracetamol control, thiamine + paracetamol, TPP + paracetamol, and N-acetylcysteine + paracetamol. Oxidant and antioxidant parameters and liver function test levels were compared between the groups., Results: The results show that TPP and N-acetylcysteine with paracetamol equally prevented a rise in oxidants such as malondialdehyde and nitric oxide. They also prevented a decrease in enzymatic and nonenzymatic antioxidants such as glutathione, glutathione peroxidase, glutaredoxin, glutathione S-transferase, superoxide dismutase, and catalase in the rat liver., Conclusion: Thiamine pyrophosphate and N-acetylcysteine had a similar positive effect on oxidative damage caused by paracetamol hepatotoxicity. These findings show that TPP may be beneficial in paracetamol hepatotoxicity., (Copyright © 2014. Published by Elsevier B.V.)

Background: Nimesulide is a pharmacological agent and selective COX-2 inhibitor. It has anti-inflammatory, analgesic and antipyretic properties. The purpose of this study was to investigate the effect of nimesulide on oxidant/antioxidant, DNA mutation and COX-1/COX-2 activities in rat liver tissue with induced ischemia/reperfusion (I/R)., Methods: Before the experiment, rats were divided into four groups; liver ischemia/reperfusion (LIR), 50mg/kg nimesulide+liver ischemia/reperfusion (NLIR50), 100mg/kg nimesulide+liver ischemia/reperfusion (NLIR100) and a control group to be given a sham operation (SG). Malondialdehyde (MDA), total glutathione (GSH) levels and myeloperoxidase (MPO), COX-1/COX-2 enzyme activities and DNA damage product level results from liver tissues and serum AST and ALT levels were determined. The data obtained were compared with the results from the liver ischemia/reperfusion and sham operation groups., Results: MDA levels, MPO and COX-2 activities and products of DNA injury were significantly lower in the groups given nimesulide, and particularly the NLIR100 group, compared to the LIR group (p<0.05), while tGSH levels were significantly higher (p<0.05). There was no significant difference between the NLIR50 and NLIR100 groups and the LIR group in terms of COX-1 levels (p>0.05). AST and ALT levels were significantly lower in the other groups compared to the LIR group (p<0.05)., Conclusions: Nimesulide at 100mg/kg prevented oxidative liver damage induced with I/R significantly better than at a dose of 50mg/kg. These experimental findings indicate that nimesulide may be useful in the treatment of hepatic I/R damage., (Copyright © 2014 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.)

Obesity is known to lead to complications involving several systems. The basic mechanism in obesity-related complications is chronic inflammation and increased oxidative stress. Trace element levels in obese children may vary due to poor nutritional habits. The purpose of this study was to investigate the relation between serum paraoxonase (PON1) and arylesterase (ARE) levels, markers of the oxidant-antioxidant balance in the body, and serum zinc (Zn), copper (Cu), manganese (Mn), and selenium (Se) concentrations in obese children. Fifty-seven overweight patients aged 6-17 and 48 age- and sex-matched healthy children were included in the study. Serum PON1 and ARE activity levels were measured, together with Cu, Zn, Mn, Se, total cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein, very low-density lipoprotein, glucose, aspartate amino transferase, and alanine amino transferase levels. PON1 and ARE activity levels were significantly lower in obese patients compared to those in healthy individuals (P < 0.05). Various changes were determined in Cu, Zn, Mn, and Se levels between the study and control groups (P < 0.05). In terms of the relation between trace elements and PON1 and ARE levels, a significant positive correlation was determined between serum Se and PON1 levels in the study group (P < 0.05, r = 0.31). No significant correlation was determined between other trace element levels and PON1 and ARE levels (P > 0.05). In conclusion, the detection in our study of a positive correlation between Se and PON1 levels in obese children may be significant in terms of showing a relation between Se and antioxidant systems in obese children.

This study investigated the effect of thiamine pyrophosphate on oxidative damage associated with cardiotoxicity caused by cisplatin (CIS), an antineoplastic agent, in rats, and compared this with thiamine. Animals used in the study were divided into four groups of 6 rats each. These represented a control group receiving 5 mg/kg of CIS, study groups receiving 20 mg/kg of thiamine pyrophosphate plus 5 mg/kg of cisplatin (CTPG) or 20 mg/kg of thiamine plus 5 mg/kg of cisplatin and a healthy (H) group. All doses were administered intraperitoneally once a day for 14 days. Malondialdehyde, total glutathione and products of DNA injury results were similar in the CTPG and H groups (p > 0.05). Creatinine kinase, creatine kinase MB and troponin 1 levels were similar in the CTPG and H groups (p > 0.05). Thiamine pyrophosphate prevented CIS-associated oxidative stress and heart injury, whereas thiamine did not prevent these.

This study investigated whether or not the anesthetic effect of ketamine in rats is dependent on adrenal gland hormones. The study was performed on two main rat groups, intact and adrenalectomized. Rat were divided into subgroups and given appropriate doses of ketamine, metyrapone or metyrosine. Durations of anesthesia in the groups were then recorded. Endogenous catecholamine levels were measured in samples taken from peripheral blood. This experimental results showed that ketamine did not induce anesthesia in intact rats at doses of 15 or 30mg/kg, and that at 60mg/kg anesthesia was established for only 11min. However, ketamine induced significant anesthesia even at a dose of 30mg/kg in animals in which production of endogenous catecholamine (adrenalin, noradrenalin dopamine) was inhibited with metyrosine at a level of 45-47%. Ketamine at 60mg/kg in animals in which endogenous catecholamine was inhibited at a level of 45-47% established anesthesia for 47.6min. However, ketamine at 30 and 60mg/kg induced longer anesthesia in adrenalectomized rats with higher noradrenalin and dopamine levels but suppressed adrenalin production. Adrenalin plays an important role in the control of duration of ketamine anesthesia, while noradrenalin, dopamine and corticosterone have no such function. If endogenous adrenalin is suppressed, ketamine can even provide sufficient anesthesia at a 2-fold lower dose. This makes it possible for ketamine to be used in lengthy surgical procedures., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Autoimmune polyglandular syndrome (APS) is a rarely diagnosed condition characterized by a combination of two or more organ-specific autoimmune diseases and divided into a very rare juvenile (APS type I) and a relatively common adult type (APS II-IV). The major components of APS-I are hypoparathyroidism, adrenal failure, and mucocutaneous candidiasis. In addition to the classic triad, many other autoimmune diseases could be associated with the syndrome. We report an adolescent patient with psoriasis vulgaris and APS-I.

Aim: This study is a biochemical investigation of the effect of etoricoxib, a selective cyclooxygenase (COX)-2 inhibitor, on ischemia/reperfusion (I/R) injury experimentally induced in rat ovaries., Methods: Experimental animals were divided into four groups: (i) ovarian ischemia/reperfusion (IRG); (ii) 30 mg/kg etoricoxib + ovarian ischemia/reperfusion (EIRG-30); (iii) 60 mg/kg etoricoxib + ovarian ischemia/reperfusion (EIRG-60); and (iv) a sham operation (SG) control group., Results: The results showed levels of malondialdehyde in the IRG, EIRG-30, EIRG-60 and SG group ovarian tissue of 20.2 ± 3.4, 11.2 ± 3.2, 5.5 ± 1.9 and 3.8 ± 1.5 μmol/g protein, respectively. Myeloperoxidase activity for these groups was 24.2 ± 6.7, 13 ± 2.4, 4 ± 1.8 and 3.5 ± 1.9 U/g protein, and total glutathione levels were 1.6 ± 0.8, 4.5 ± 1.9, 6.5 ± 1.9 and 7.5 ± 2.4 nmol/g protein, respectively. COX-1 activity in IRG, EIRG-30, EIRG-60 and SG group rat ovarian tissue was 5.0 ± 2.8, 12.2 ± 2.4, 16.7 ± 2.8 and 17.5 ± 4.7 U/mg protein, and COX-2 activity was 18.3 ± 2.7, 3.5 ± 1, 1.8 ± 0.7 and 0.7 ± 0.3 U/mg protein, respectively., Conclusion: Etoricoxib prevented oxidative damage induced with I/R in rat ovarian tissue. This property of etoricoxib suggests that it can be clinically beneficial in the prevention of damage that may arise with reperfusion by detorsion for the protection of the ovaries against torsion., (© 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.)

The aims of this study were to evaluate serum vitamin D levels in cases of recurrent otitis media and investigate the effect of vitamin D therapy on the risk of re-occurrence of the disease. This prospective study was performed by comparing serum vitamin D levels in children with recurrent otitis media and healthy children. Eighty-four children between 1 and 5 years of age and diagnosed with recurrent otitis media were enrolled as the study group. One hundred-and-eight healthy children with similar demographic characteristics were enrolled as the control group. Patients were divided into groups according to their serum 25(OH) vitamin D levels. In patients with low initial serum vitamin D levels, vitamin D therapy was administered in addition to conventional treatment for otitis media. Mean serum 25(OH) vitamin D level in the study group was 11.4 ± 9.8 ng/mL Serum 25(OH) vitamin D levels were below 20 ng/mL in 69 % (n = 58) of cases in this group. In the control group, mean serum 25(OH) vitamin D level was 29.2 ± 13.9 ng/mL and was below 20 ng/mL in 30 % (n = 32) of cases. Comparison of serum 25(OH) vitamin D levels and PTH in the study and control groups revealed a statistically significant difference (p < 0.05). Treatment was initiated in cases diagnosed with vitamin D deficiency, and patients were followed up in due course. The only episodes detected over the course of 1-year follow-up were one attack in five patients and two attacks in two. We believe that co-administration of supplementary vitamin D together with conventional treatments is appropriate in the management of upper respiratory infections such as otitis media.

We demonstrate a Google Glass-based rapid diagnostic test (RDT) reader platform capable of qualitative and quantitative measurements of various lateral flow immunochromatographic assays and similar biomedical diagnostics tests. Using a custom-written Glass application and without any external hardware attachments, one or more RDTs labeled with Quick Response (QR) code identifiers are simultaneously imaged using the built-in camera of the Google Glass that is based on a hands-free and voice-controlled interface and digitally transmitted to a server for digital processing. The acquired JPEG images are automatically processed to locate all the RDTs and, for each RDT, to produce a quantitative diagnostic result, which is returned to the Google Glass (i.e., the user) and also stored on a central server along with the RDT image, QR code, and other related information (e.g., demographic data). The same server also provides a dynamic spatiotemporal map and real-time statistics for uploaded RDT results accessible through Internet browsers. We tested this Google Glass-based diagnostic platform using qualitative (i.e., yes/no) human immunodeficiency virus (HIV) and quantitative prostate-specific antigen (PSA) tests. For the quantitative RDTs, we measured activated tests at various concentrations ranging from 0 to 200 ng/mL for free and total PSA. This wearable RDT reader platform running on Google Glass combines a hands-free sensing and image capture interface with powerful servers running our custom image processing codes, and it can be quite useful for real-time spatiotemporal tracking of various diseases and personal medical conditions, providing a valuable tool for epidemiology and mobile health.

This study examines the effect of thiamine (TH) and thiamine pyrophosphate (TPP) on epileptic episode model induced in rats with caffeine. Animals were divided into groups and given TH or TPP at doses of 10, 30 or 50mg/kg intraperitoneally. Subsequently, all animal groups were injected intraperitoneally with caffeine at a dose of 300mg/kg. Time of onset of epileptic episode was recorded, and the latent period was calculated in seconds. At the end of the experiment, tGSH and MDA levels and SOD and MPO enzyme activities in extracted brain tissues were measured. Latent period duration in rats in the control group was 134±3.2s, compared to 144±13.9, 147±14.5 and 169±15.1s, respectively, in the TH10, TH30 and TH50 groups and 184±8.54, 197±9.1, 225±8.37s, respectively, in the TPP10, TPP30 and TPP50 groups. Latent period duration was 236±6.7 in the diazepam group. Oxidant products were significantly lower in the TPP10, TPP30, TPP50 and diazepam groups compared to the control group (P<0.05), while SOD activity and tGSH levels were significantly higher (P<0.05). There was no significant difference between the TH10, TH30, TH50 groups and the control group in terms of oxidant and antioxidant levels (P>0.05). In conclusions, TPP, especially at a dose of 50mg/kg, significantly prolonged the latent period from administration of caffeine to time of episode and prevented oxidative damage., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Background: The effects of antiepileptic drugs (AEDs) on bone metabolism and the endocrine system are not fully known, and publications on the subject are inconsistent., Objective: The study aimed to examine the mutual effects of valproic acid (VPA), carbamazepine (CBZ), and phenobarbital (PB)-AEDs frequently used in childhood-on bone mineral metabolism and thyroid function tests., Patients and Methods: Children monitored with a diagnosis of idiopathic epilepsy by the pediatric neurology clinic, using AEDs for at least 6 months and with episodes under control, were included in the study. Patients were divided into groups on the basis of the drugs used. Thyroid function tests and 25-hydroxyvitamin D or 25(OH)D levels were measured from blood specimens. The data obtained were then compared with those of the control group., Results: A significantly high level of subclinical hypothyroidism was seen in patients using VPA (p < 0.001). There was no significant difference between any of the three study groups and the control group in terms of 25(OH)D (p > 0.05)., Conclusions: Pediatric patients using AEDs, particularly VPA, should be monitored for subclinical hypothyroidism. VPA, CBZ, and PB have no effect on vitamin D levels., (Georg Thieme Verlag KG Stuttgart · New York.)

Various reasons such as malignancies and chronic infections may cause weight loss in kidney transplant patients. In this report, iron overload as a rare cause of weight loss in a kidney transplant patient is presented. Forty-seven-year-old male patient who transplanted from a deceased donor 5 years ago was hospitalized because of 20 kg of weight loss. In medical history, he had history of hemodialysis for 89 months and received 100-300 mg of intravenous iron therapy per week before transplantation and transfused eight units of blood. In physical examination, weight and height were 45 kg and 185 cm, respectively. Respiratory and cardiac auscultation was normal. Laboratory results revealed as follow: glucose 76 mg/dL, urea 60 mg/dL, creatinine 1.35 mg/dL, aspartate aminotransferase 74 U/L, alanine aminotransferase 77 U/L, C-reactive protein 2.59 mg/dL, albumin 3.3 g/dL, globulin 3.4 g/dL, white blood cells 3200/mm(3), hemoglobin 13.1 g/dL and platelets 190,000/mm(3). Chest and abdominal tomography didn't reveal any pathology. Portal Doppler ultrasound showed signs of early cirrhosis. Viral and autoimmune hepatitis markers were negative. Ferritin was 5300 ng/mL and transferrin saturation was 82%. In liver biopsy, hemosiderosis was diagnosed and heterozygous H63D gene mutation was detected. Totally, 19 units of phlebotomy were performed. Liver function tests and serum ferritin decreased gradually. At outpatient follow-up in 6 months, he returned to former weight. In conclusion, there can be several causes of weight loss in kidney transplant patients. Iron overload can come across as a rare cause of weight loss. In these patients, ferritin levels should be checked and diagnosis should be clarified by liver biopsy and gene mutation analysis.