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Fatih Tastekin,1 Ezgi Karatas,2 Ozgur Aydin,3 Figen Yargucu Zihni,1 Yasemin Kabasakal,1 Burcu Barutcuoglu,4 Gonca Karabulut1 1Ege University Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey; 2Ege University Faculty of Health Sciences, Department of Nutrition and Dietetics, Izmir, Turkey; 3Ege University Faculty of Medicine, Department of Internal Medicine, Izmir, Turkey; 4Ege University, Faculty of Medicine, Department of Clinical Biochemistry, Izmir, TurkeyCorrespondence: Fatih Tastekin, Ege University Faculty of Medicine, Department of Internal medicine, Division of Rheumatology, Bornova, Izmir, 35100, Turkey, Tel +90 232 444 13 43, 05433108870, Email fatihtastekin@gmail.comPurpose: Primary Sjögren’s syndrome (PSS) has many effects such as fatigue, pain, physical activity limitation and sleep disturbance, which limit patient’s daily and social lives. The aim of our study was to assess fatigue, depression, physical activity status and quality of life in patients with PSS, and to determine the relationship between these data and disease-related parameters.Patients and Methods: This study was conducted with 117 primary Sjögren’s syndrome patients. Demographic and anthropometric characteristics, disease activity (ESSDAI), quality of life scale (SF36), depression (Beck Depression Scale), physical activity status (International Physical Activity Questionnaire Short Form (IPAQ) score) and sleep status (Pittsburgh Sleep Quality Scale) of PSS patients were evaluated and relationships have been examined.Results: According to the results of our study, we found that sleep disorders are common in PSS patients (74.4%). Overweight patients, particularly higher lean mass sleep better (r:-0.201, p:0.043). Poor sleep causes fatigue (p=0.062) and depression (p=0.030). Sleep disturbance could not be explained by depressive state alone. However, after controlling for depression, the effect of sleep on fatigue seriously decreases (p=0.311). Exercise did not improve sleep quality (p=0.35) and the rate of poor sleep was higher among who exercised (p=0.192).Conclusion: Based on the results of our study, we believe that, treating depression in PSS patients is crucial for reducing fatigue. Patients need education on performing the correct exercises and weight gain should done in a professional manner. Gaining a deeper understanding of the multisystem involvement of the disease and the impact of exercise on the disease, will have positive effects on patient care and treatment decisions.Keywords: Sjogren’s syndrome, sleep disorders, quality of life, exercise

Residual stresses in cold extruded parts play an important role in both component lifetime and succeeding in manufacturing performance. When a cold extruded part is used directly, the lifetime of the part depends on the residual stresses induced during cold extrusion. On the other hand, if the part is exposed to post operations such as machining, residual stresses may cause distortions. Despite their importance, there are only a few residual stress measurement methods to assess axial residual stresses in full cylindrical thick components of massive forming. As high-energy X-ray and neutron diffraction methods are less available and considerably expensive, the contour method may be an alternative providing the accurate assessment of residual stresses without requiring specialized facilities. In the present work, residual stresses in cold extruded rods are determined via the contour method for various extrusion ratios. The finite element analyses for the same conditions are also carried out to provide the comparison to the contour method. The results indicate that the contour method can be a valuable candidate for the measurement of axial residual stresses in cold extruded thick components.

Abdullah Acikgoz,1 Ramazan Asci,2 Oguz Aydin,3 Hikmet Çavuş,4 Gamze Donmez,5 Recep Buyukalpelli2 1Department of Urology, School of Medicine, Kemerburgaz University, Istanbul, Turkey; 2Department of Urology, 3Department of Pathology, School of Medicine, Ondokuz Mayis University, Samsun, Turkey; 4Department of Urology, Medical Park Samsun Hospital, Samsun, Turkey; 5Department of Pathology, School of Medicine, Ondokuz Mayis University, Samsun, Turkey Abstract: The aims of this study conducted on rats were to determine mast cell (MC) proliferation on undescended testes (UDTs); whether there is a correlation between MC proliferation and testicular damage; and whether testicular damage can be prevented with administration of an MC blocker. Sixty-five newborn male rats were divided into three groups. During the neonatal period, unilateral UDTs were experimentally induced in Group 2 and Group 3. The rats in Group 3 were given 1 mg/kg/day ketotifen orally until the end of the study. Groups 2 (n=30) and 3 (n=15) were divided into groups of ten and five rats, respectively, each of which underwent bilateral orchiectomy in either the prepubertal, pubertal, or adult period. Group 1 (n=15) underwent a sham operation followed by bilateral orchiectomy, with five rats in each of the prepubertal, pubertal, and adult periods. Testicular MCs in the interstitial and subtubular areas, biopsy scores, interstitial connective tissue, seminiferous tubule (ST) diameters, and the basement membrane thickness of STs were evaluated. In Group 2 the ST diameters in the UDTs decreased, the number of MCs in the interstitial and subtubular areas increased, ST basement membranes thickened, and spermatogenesis decreased. The number of MCs in the interstitial and subtubular areas of the descended testes increased and spermatogenesis decreased. In Group 3, the number of MCs in the interstitial and subtubular areas decreased. In unilateral UDTs, the number of MCs in the interstitial and subtubular areas increased in both testes. Fibrosis developed in the ST basement membranes and interstitial areas, and spermatogenesis deteriorated. Testicular fibrosis may be prevented with administration of an MC blocker. Keywords: rat, unilateral undescended testis, MC, spermatogenesis, atrophic testis

OBJECTIVE: The frequency and mortality of candidemia remain important. Non-albicans Candida species such as C. auris are increasing. PATIENTS AND METHODS: A retrospective review of adult patients diagnosed with bloodstream infection due to Candida species in the 17 months between July 1, 2020, and December 1, 2021, was performed. Yeast colonies grown in culture were identified by matrix-assisted laser desorption/ionization time-of-flight. Antifungal susceptibility tests of Candida strains were performed with Sensititre YeastOne (TREK Diagnostic Systems Inc., Westlake, Ohio) kits, and minimum inhibitory concentration values were evaluated according to the Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) clinical breakpoints. RESULTS: In total, 217 patients (mean age 64.9±15.7 years) were included. C. albicans was the most common fungus (detected in 82 patients; 37.8%), followed by C. parapsilosis (17.1%), C. glabrata (15.2%), C. tropicalis (15.2%), and C. auris (9%). Candidemia developed in 175 (81.4%) of the cases during their intensive care unit stay. Fluconazole (41.0%) and caspofungin (36.4%) were the two most frequently used antifungal agents in antifungal therapy. There were 114 (52.3%) deaths in the study group. Mortality rates were found to be lower in patients infected with C. parapsilosis or C. auris. Age and previous COVID-19 infection were other important risk factors. When the 217 Candida spp. were examined, resistance and intermediate susceptibility results were higher when EUCAST criteria were used. While the two methods were found to be fully compatible only for fluconazole, a partial agreement was also observed for voriconazole. CONCLUSIONS: As our study observed, the COVID-19 pandemic brought increasing numbers of immunosuppressed patients, widespread use of antibacterials, and central venous catheters, increasing the frequency and mortality of candidemia cases. All health institutions should be prepared for the diagnosis and treatment of candidemia. In addition, C. auris, the frequency of which has increased in recent years, is a new factor that should be considered in candidemia cases. [ABSTRACT FROM AUTHOR]

Introduction: To assess changes in blood flow in the uterine, fetal cerebral, and umbilical arteries (UA) by Doppler ultrasound and alterations in the variability of fetal heart rate (FHR) as well as fetal cardiac performance by fetal echocardiography between the 7.00 a.m. and 7.00 p.m. periods in pregnancies ranging from 24 to 39 weeks. Methods: Fifty pregnant participants underwent a customized fetal examination on the same day during both study periods, including Doppler measurements of the umbilical artery pulsatility index (UA-PI), fetal middle cerebral artery-pulsatility index (MCA-PI), middle cerebral artery-peak systolic velocity (MCA-PSV), cerebroplacental ratio, uterine artery-pulsatility index (UtA-PI), FHR, and fetal movements as well as various Doppler parameters of the fetal heart such as left isovolumetric contraction and relaxation times, mitral E- and A-wave velocities, the E/A ratio, K-index, filling time, and the myocardial performance index. Results: During the PM period, there was a meaningful increase in the MCA-PSV compared with the AM period. Conversely, the resistance in the MCA, particularly the PI, was found to be lower than that in the AM period. In addition, the FHR measured in the PM period increased compared with that in the AM period. The maternal UtA-PI and fetal UA-PI examined in the AM and PM periods were comparable. In addition, when all cardiac parameters examined in the study periods were compared, no significant difference was observed. Conclusion: The findings reveal that Doppler parameters observed during the study periods may change during the day and that the fetal cardiac function parameters, previously not assessed together, may not change during the day. Subsequent investigations can validate these observations using serial measurements of Doppler parameters in healthy and complicated gravidas.

Although social anxiety disorder (SAD) is widespread and associated with significant distress, its etiology is not yet fully explored. We aimed to examine how metacognitions and mindfulness interact with SAD symptoms. 531 college students were enrolled in this study. Participants completed the Liebowitz Social Anxiety Scale (LSAS), the Metacognition Questionnaire-30 (MCQ-30), and the Five-Facet Mindfulness Questionnaire (FFMQ). A path analysis was run to explore the associations between test variables. A positive correlation was found between metacognition and SAD symptoms, while mindfulness negatively correlated with SAD symptoms and metacognition. In the established path model, metacognition had an indirect effect on SAD symptoms, which is partially mediated by mindfulness. Our findings imply that metacognitions and mindfulness may influence SAD symptoms among young adults. Mindfulness seems to have a prominent role in regulating metacognition's effects on SAD symptoms. Therefore, interventions that accurately target these factors may alleviate the symptoms of this debilitating psychological disturbance.

The aim of this study was to evaluate fetal lung maturation in term pregnant women with obesity and excessive gestational weight gain using the lamellar body count (LBC) test in amniotic fluid samples obtained during cesarean section. This retrospective study included women experiencing term pregnancies and undergoing cesarean delivery, categorized as normal weight (n=37), overweight (n=59), or obese (n=48) due to body mass index values of 18.5 to 24.9; 25 to 29.9; and ≥30, respectively, as well as presence of excessive weight gain during pregnancy. During cesarean delivery, amniotic fluid samples were obtained without contamination of blood or meconium. Lamellar bodies in these samples were quantified using a standard hematologic counter. No significant difference was found among the LBC of the normal weight, overweight, and obese groups [42 (32-60), 40 (26-63), and 43 (24-52) x103/µL; p=0.307], although there was a subtle decrease in the LBC of the obese group with excessive weight gain. Although it is noteworthy that the LBC in the amniotic fluid of mothers with obesity and excessive weight gain during pregnancy showed a partial decrease, this decrease did not reach statistical significance, likely due to the relatively low number of cases in the study groups. Additional research is warranted to elucidate the relationship between LBC alterations and the severity of obesity and weight gain during pregnancy. [Med-Science 2023; 12(4.000): 1278-83]

The study aimed to examine whether acute hyperglycemia, caused by the 75-g oral glucose tolerance test (OGTT) can produce fetal cardiac adverse effects that are detectable with fetal cardiac Doppler ultrasound in healthy low-risk pregnancies. Healthy low-risk pregnant women who underwent 75-g OGTT during the gestational period of 24 to 28 weeks were considered eligible and during the test, they were examined with fetal ultrasound at the fasting and 1- and 2-h timepoints. The study findings included the parameters of umbilical artery pulsatility index, uterine artery, fetal heart rate, middle cerebral artery (MCA) peak systolic velocity (MCA-PSV), MCA pulsatility index, and fetal cardiac Doppler parameters including myocardial performance index, left isovolumetric contraction and relaxation times, K-index, filling time, mitral E- and A-wave velocities, and E/A ratio. The data of 53 women without gestational diabetes mellitus were used for statistical analyses. There was no statistical significance among the three-time points of OGTT regarding all the Doppler parameters (p>0.05). The median MCA-PSV measured at the fasting of OGTT was significantly higher than the values measured at the first and second hour of OGTT [28 (22-42) vs. 26 (18-39) and 26 (18-38), respectively; p0.05). Overall, 75-g OGTT does not affect fetal cardiac Doppler parameters in healthy pregnant women except for abnormal findings of MCA-PSV. The results of the current study can provide significant support to clinicians in reducing the hesitations of women with low-risk pregnancies regarding gestational diabetes screening. [Med-Science 2023; 12(4.000): 1082-7]

Araştırmada, okul kütüphaneleri ve sınıf kitaplıklarının ortaokul öğrencilerinin okuma eğilimlerini karşılama açısından değerlendirilmesi amaçlanmaktadır. Araştırma nicel araştırma yöntemlerinden tarama modeline göre yürütülmüştür. Araştırmanın çalışma grubu, Giresun ilindeki bir ortaokulda farklı sınıf seviyelerinde (5, 6, 7 ve 8) eğitim gören öğrenciler arasından tesadüfi olarak seçilmiştir. Araştırmanın materyalleri de aynı ortaokulun kütüphanesinde ve sınıf kitaplıklarında bulunan kitaplardan oluşmaktadır. Öğrencilerin okuma eğilimleri, Okuma Eğilimi Anketi aracılığıyla toplanmıştır. Kütüphane ve kitaplıklardaki kitapların tür, konu ve yazar bilgileri araştırmacılar tarafından Kitap Sınıflama Formu’na işlenmiştir. Araştırma sonucunda, öğrencilerin okuma eğilimini destekleyen kitapların okul kütüphanesi ve sınıf kitaplıklarında yeterince yer bulmadığı tespit edilmiştir. Buna karşın öğrencilerin tercih etmedikleri kitapların kütüphanede ve kitaplıklarda daha fazla bulunduğu belirlenmiştir. Ulaşılan sonuçlar okul kütüphanesindeki ve sınıf kitaplıklarındaki kitapların tür, konu ve yazar açısından öğrencilerin okuma eğilimlerini yeterince karşılayamadığını ortaya koymuştur.

Production of the defect-free casting of aluminium alloys is the biggest challenge. Porosity is known to be the most important defect. Therefore, many cast parts are subjected to several non-destructive tests in order to check their acceptability. There are several standards, yet, the acceptance limit of porosity size and distribution may change according to the customer design and requirements. In this work, the aim was targeted to evaluate the effect of size, location, and distribution of pores on the tensile properties of cast A356 alloy. ANSYS software was used to perform stress analysis where the pore sizes were changed between 0.05 mm to 3 mm by 0.05 mm increments. Additionally, pore number was changed from 1 to 5 where they were placed at different locations in the test bar. Finally, bifilms were placed inside the pore at different sizes and orientations. The stress generated along the pores was recorded and compared with the fracture stress of the A356 alloy. It was found that as the bifilm size was getting smaller, their effect on tensile properties was lowered. On the other hand, as bifilms were larger, their orientation became the dominant factor in determining the fracture. [ABSTRACT FROM AUTHOR]

Introduction: Prevalence of obesity and associated diseases, including type 2 diabetes mellitus, dyslipidaemia and non‐alcoholic fatty liver disease (NAFLD), are increasing. Underlying mechanisms, especially in humans, are unclear. Bariatric surgery provides the unique opportunity to obtain biopsies and portal vein blood‐samples. Methods: The BARIA Study aims to assess how microbiota and their metabolites affect transcription in key tissues and clinical outcome in obese subjects and how baseline anthropometric and metabolic characteristics determine weight loss and glucose homeostasis after bariatric surgery. We phenotype patients undergoing bariatric surgery (predominantly laparoscopic Roux‐en‐Y gastric bypass), before weight loss, with biometrics, dietary and psychological questionnaires, mixed meal test (MMT) and collect fecal‐samples and intra‐operative biopsies from liver, adipose tissues and jejunum. We aim to include 1500 patients. A subset (approximately 25%) will undergo intra‐operative portal vein blood‐sampling. Fecal‐samples are analyzed with shotgun metagenomics and targeted metabolomics, fasted and postprandial plasma‐samples are subjected to metabolomics, and RNA is extracted from the tissues for RNAseq‐analyses. Data will be integrated using state‐of‐the‐art neuronal networks and metabolic modeling. Patient follow‐up will be ten years. Results: Preoperative MMT of 170 patients were analysed and clear differences were observed in glucose homeostasis between individuals. Repeated MMT in 10 patients showed satisfactory intra‐individual reproducibility, with differences in plasma glucose, insulin and triglycerides within 20% of the mean difference. Conclusion: The BARIA study can add more understanding in how gut‐microbiota affect metabolism, especially with regard to obesity, glucose metabolism and NAFLD. Identification of key factors may provide diagnostic and therapeutic leads to control the obesity‐associated disease epidemic. [ABSTRACT FROM AUTHOR]

The Southeast Asian genus Angustopila, currently comprising 13 nominal species, encompasses the world’s tiniest land snails. This work shows that there are far more species than previously suspected, and that this genus is in fact, a very speciose group of tiny snails widely distributed in Southeast Asia. Angustopila is revised based on type material of known species as well as 211 samples newly collected in China, Laos, Myanmar, Thailand and Vietnam. Altogether, 53 species and one subspecies are recognised, of which 42 species and subspecies are new to science: A. akrodon Páll-Gergely & Hunyadi, sp. nov., A. apiaria Páll-Gergely & Hunyadi, sp. nov., A. apiostoma Páll-Gergely & Vermeulen, sp. nov., A. apokritodon Páll-Gergely & Hunyadi, sp. nov., A. antidomedon Páll-Gergely & Hunyadi, sp. nov., A. babel Páll-Gergely & Vermeulen, sp. nov., A. bathyodon Páll-Gergely & Hunyadi, sp. nov., A. bidentata Páll-Gergely & Jochum, sp. nov., A. cavicola Páll-Gergely & Dumrongrojwattana, sp. nov., A. cicatricosa Páll-Gergely & Vermeulen, sp. nov., A. coprologos uninodus Páll-Gergely & Grego, ssp. nov., A. erawanica Páll-Gergely & Dumrongrojwattana, sp. nov., A. fratermajor Páll-Gergely & Vermeulen, sp. nov., A. fraterminor Páll-Gergely & Vermeulen, sp. nov., A. gracilis Páll-Gergely & Hunyadi, sp. nov., A. halongensis Páll-Gergely & Vermeulen, sp. nov., A. hyron Páll-Gergely & Vermeulen, sp. nov., A. maasseni Páll-Gergely & Vermeulen, sp. nov., A. majuscula Páll-Gergely & Hunyadi, sp. nov., A. margaritarion Páll-Gergely & Hunyadi, sp. nov., A. megastoma Páll-Gergely & Vermeulen, sp. nov., A. occidentalis Páll-Gergely & Hunyadi, sp. nov., A. oostoma Páll-Gergely & Vermeulen, sp. nov., A. papaver Páll-Gergely & Hunyadi, sp. nov., A. parallela Páll-Gergely & Hunyadi, sp. nov., A. prolixa Páll-Gergely & Hunyadi, sp. nov., A. pusilla Páll-Gergely & Hunyadi, sp. nov., A. pustulata Páll-Gergely & Hunyadi, sp. nov., A. quadridens Páll-Gergely & Vermeulen, sp. nov., A. rara Páll-Gergely & Hunyadi, sp. nov., A. reticulata Páll-Gergely & Hunyadi, sp. nov., A. somsaki Páll-Gergely & Hunyadi, sp. nov., A. steffeki Páll-Gergely & Grego, sp. nov., A. tetradon Páll-Gergely & Hunyadi, sp. nov., A. thersites Páll-Gergely & Vermeulen, sp. nov., A. tonkinospiroides Páll-Gergely & Vermeulen, sp. nov., A. tridentata Páll-Gergely & Hunyadi, sp. nov., A. tweediei Páll-Gergely & Hunyadi, sp. nov., A. uvula Páll-Gergely & Hunyadi, sp. nov., A. vandevenderi Páll-Gergely & Jochum, sp. nov., A. vitrina Páll-Gergely & Hunyadi, sp. nov., A. vomer Páll-Gergely & Hunyadi, sp. nov., A. werneri Páll-Gergely & Hunyadi, sp. nov. Angustopila subelevata Páll-Gergely & Hunyadi, 2015 is moved to the synonymy of Angustopila elevata (F. G. Thompson & Upatham, 1997), and A. singuladentis Inkhavilay & Panha, 2016 is a junior synonym of A. fabella Páll-Gergely & Hunyadi, 2015. Three species, namely A. elevata, A. fabella and A. szekeresi, are widespread over several hundred kilometres while some other species (A. huoyani, A. parallela sp. nov., A. cavicola sp. nov.) are known from just two sites a few hundred kilometres apart. All others are small range or single-site endemics. The reproductive anatomy of A. erawanica sp. nov. is described.

Introduction: The gut microbiome may contribute to the development of obesity. So far, the extent of microbiome variation in people with obesity has not been determined in large cohorts and for a wide range of body mass index (BMI). Here, we aimed to investigate whether the faecal microbial metagenome can explain the variance in several clinical phenotypes associated with morbid obesity.Methods: Caucasian subjects were recruited at our hospital. Blood pressure and anthropometric measurements were taken. Dietary intake was determined using questionnaires. Shotgun metagenomic sequencing was performed on faecal samples from 177 subjects.Results: Subjects without obesity (n = 82, BMI 24.7 ± 2.9 kg m-2 ) and subjects with obesity (n = 95, BMI 38.6 ± 5.1 kg m-2 ) could be clearly distinguished based on microbial composition and microbial metabolic pathways. A total number of 52 bacterial species differed significantly in people with and without obesity. Independent of dietary intake, we found that microbial pathways involved in biosynthesis of amino acids were enriched in subjects with obesity, whereas pathways involved in the degradation of amino acids were depleted. Machine learning models showed that more than half of the variance in body fat composition followed by BMI could be explained by the gut microbiome, composition and microbial metabolic pathways, compared with 6% of variation explained in triglycerides and 9% in HDL.Conclusion: Based on the faecal microbiota composition, we were able to separate subjects with and without obesity. In addition, we found strong associations between gut microbial amino acid metabolism and specific microbial species in relation to clinical features of obesity. [ABSTRACT FROM AUTHOR]