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PURPOSE To evaluate long-term morbidity and mortality among unilateral, nonsyndromic Wilms tumor (WT) survivors according to conventional treatment regimens. METHODS Cumulative incidence of late mortality (≥ 5 years from diagnosis) and chronic health conditions (CHCs) were evaluated in WT survivors from the Childhood Cancer Survivor Study. Outcomes were evaluated by treatment, including nephrectomy combined with vincristine and actinomycin D (VA), VA + doxorubicin + abdominal radiotherapy (VAD + ART), VAD + ART + whole lung radiotherapy, or receipt of ≥ 4 chemotherapy agents. RESULTS Among 2,008 unilateral WT survivors, 142 deaths occurred (standardized mortality ratio, 2.9, 95% CI, 2.5 to 3.5; 35-year cumulative incidence of death, 7.8%, 95% CI, 6.3 to 9.2). The 35-year cumulative incidence of any grade 3-5 CHC was 34.1% (95% CI, 30.7 to 37.5; rate ratio [RR] compared with siblings 3.0, 95% CI, 2.6 to 3.5). Survivors treated with VA alone had comparable risk for all-cause late mortality relative to the general population (standardized mortality ratio, 1.0; 95% CI, 0.5 to 1.7) and modestly increased risk for grade 3-5 CHCs compared with siblings (RR, 1.5; 95% CI, 1.1 to 2.0), but remained at increased risk for intestinal obstruction (RR, 9.4; 95% CI, 3.9 to 22.2) and kidney failure (RR, 11.9; 95% CI, 4.2 to 33.6). Magnitudes of risk for grade 3-5 CHCs, including intestinal obstruction, kidney failure, premature ovarian insufficiency, and heart failure, increased by treatment group intensity. CONCLUSION With approximately 40% of patients with newly diagnosed WT currently treated with VA alone, the burden of late mortality/morbidity in future decades is projected to be lower than that for survivors from earlier eras. Nevertheless, the risk of late effects such as intestinal obstruction and kidney failure was elevated across all treatment groups, and there was a dose-dependent increase in risk for all grade 3-5 CHCs by treatment group intensity.

Tüm dünyayı büyük ölçüde etkileyen Covid-19 salgını, virüsün yayılma hızı sebebiyle pandemi sürecini beraberinde getirmiştir. Pandeminin ilanı ile virüsün yayılma hızını en aza indirebilmek için ülkeler çeşitli tedbirler almıştır. Pandemide alınan önlemler pek çok sektörü olumsuz etkilemiş olup, en çok zarar görenlerden biri de yiyecek-içecek sektörü olmuştur. Bu nedenle işletmelerin kriz döneminde ne gibi önlemler alacakları ve krizi nasıl çözecekleri oldukça önemli bir konu haline gelmiştir. İşletmelerin ve çalışanların pandemi sürecinden en az hasarla çıkmaları, alınan önlemlerin sektörde tutunabilmeleri için yeterli olup olmadığı ve pandemi sonrası sektörün durumu çalışmanın konusunu belirlemiştir. Çalışma, Antalya ilinde faaliyet gösteren yiyecek-içecek işletmelerindeki yöneticiler ve mutfak personelleri ile görüşme tekniği kullanılarak gerçekleştirilmiştir. Katılımcıların görüşleri doğrultusunda pandemi sürecinin sektör açısından zor bir süreç olduğu, pandeminin bir getirisi olan “Yeni Normal” kavramına uyum sağlamakta zorlandıkları, ekonomik sıkıntılar sebebiyle işletmelerin neredeyse kapatılma boyutuna geldiği ve sektörün geleceği hakkında katılımcıların karamsar oldukları anlaşılmıştır. Pandemi sürecinde ve sonrasında sektörü ayakta tutabilmek adına alınabilecek bazı önlemlere çalışma içerisinde yer verilmiştir.

Background The messenger RNA (mRNA)–based vaccines BNT162b2 and mRNA-1273 are more than 90% effective against coronavirus disease 2019 (Covid-19). However, their comparative effectiveness ...

The contribution of each of the ligaments in preventing the arch loss, hindfoot valgus, and forefoot abduction seen in progressive collapsing foot deformity (PCFD) has not been well characterized. An improved understanding of the individual ligament contributions to the deformity would aid in selecting among available treatments, optimizing current surgical techniques, and developing new ones. In this study, we evaluated the contribution of each ligament to the maintenance of foot alignment using a finite element model of the foot reconstructed from computed tomography scan images. The collapsed foot was modeled by simulating the failure of all the ligaments involved in PCFD. The ligaments were removed one at a time to determine the impact of each ligament on foot alignment, and then restored one at a time to simulate isolated reconstruction. Our findings show that the failure of any one ligament did not immediately lead to deformity, but that combined failure of only a few (the plantar fascia, long plantar, short plantar, deltoid, and spring ligaments) could lead to significant deformity. The plantar fascia, deltoid, and spring ligaments were primarily responsible for the prevention of arch collapse, hindfoot valgus, and forefoot abduction, respectively. Moreover, to produce deformity, a considerable amount of attenuation in the spring, tibiocalcaneal, interosseous talocalcaneal, plantar naviculocuneiform, and first plantar tarsometatarsal ligaments, but only a small amount in the plantar fascia, long plantar, and short plantar ligaments was needed. The results of this study suggest that the ability of a ligament to prevent deformity may not correlate with its attenuation in a collapsed foot.

Supplemental material, sj-docx-1-jop-10.1177_02698811231166460 for Estimating the per-protocol effect of lithium on suicidality in a randomized trial of individuals with depression or bipolar disorder by Alejandro Szmulewicz, Arin Madenci, Ryan Ferguson, Matthew H Liang, Robert Lew, Ira R Katz and Miguel A Hernán in Journal of Psychopharmacology

Supplemental material, sj-docx-1-jop-10.1177_02698811231166460 for Estimating the per-protocol effect of lithium on suicidality in a randomized trial of individuals with depression or bipolar disorder by Alejandro Szmulewicz, Arin Madenci, Ryan Ferguson, Matthew H Liang, Robert Lew, Ira R Katz and Miguel A Hernán in Journal of Psychopharmacology

Objective: This study aims to determine the frequency of central post-stroke pain (CPSP) in a patient population with stroke as well as investigating the relationship between CPSP and patients' clinical/demographic characteristics, pain intensity, functional status, and quality of life. Methods: The study included 150 patients, who had a stroke and were aged 18 years and above. Demographic data of the patients, time since onset, and etiology, localization of the cerebral lesion, affected side, ambulation status, and Brunnstrom stages were recorded. Douleur neuropathique 4 questions (DN4) were used to assess the presence of CPSP. Visual Analog Scale (VAS) was used for pain intensity, functional ambulation scale (FAS) was used for ambulation status, Barthel Index (BI) was used for functional status, and the stroke impact scale (SIS) was used for quality of life. Results: The mean age of the patients was 67±11.5 years, 54.7% was male, and 45.3% was female. CPSP was evaluated in 15.3% of patients. There was no significant difference between the affected side of the body and age, gender, time since onset, BI scores, and ambulation status of patients according to their CPSP status (p>0.05). There was no statistically significant difference between SIS sub-parameter scores and the presence of CPSP (p>0.05). In correlation analysis, a significant relationship was found between Barthel Indexes and all SIS domains except memory and emotion (p

This study presents the bond-based (BB) peridynamics (PD) with stretch and rotation kinematics for modeling the linear elastic deformation of a composite laminate. The laminate experiences only in-plane and transverse shear deformations and disregards the transverse normal deformation. The PD equilibrium equation for a laminate is derived under the assumption of small deformation and is solved by employing implicit techniques. The in-plane PD forces are expressed by considering the PD bond interactions among the points. The forces arising from the interaction of adjacent layers are expressed by considering a pointwise approach that utilizes PD differential operator (PDDO) in conjunction with the shear-lag theory. The micro-moduli associated with stretch and rotation are directly related to the constitutive relations between stress and strain components in continuum mechanics. It is restricted to only one constraint on the material constants leading to a fixed value of in-plane shear modulus. The capability of this approach is demonstrated by considering progressive failure in a quasi-isotropic laminate with a pre-existing crack. It employs critical stretch, the critical skew (relative rotation) angle and critical delamination angle in the bond breakage criteria.

Hizmet odaklı bir sektör olan turizm sektörü turistler açısından sürekli güncel kalmak durumundadır. Bu durum alternatif turizm çeşitlerine olan ilgiyi artırmaktadır. Gastronomi turizmi dikkat çeken bir alternatif turizm çeşidi olarak kabul edilmekte olup yerel yiyecekler gastronomi turizmi açısından oldukça önemli görülmektedir. Yerel yiyecekler turistlerin yöre halkının kültürünü anlamasında oldukça büyük bir etkendir. Aynı zamanda yerel yiyecekler turistler üzerinde yarattığı motivasyon unsurları ile turistlerin tekrar ziyaret niyetlerini de etkilemektedir. Bu araştırma Van ilinde Van kahvaltısını tadan yerli turistler üzerinde gerçekleştirilmiş ve turistlerin tekrar ziyaret etme niyetlerinin belirlenmesi amaçlanmıştır. Verilerin toplanması için anket tekniği kullanılmış olup veriler sapan analizi ve normallik testinin ardından faktör analizi ve regresyon analizi ile değerlendirilmiştir. Araştırmada tekrar ziyaret niyetine ilişkin yerel yiyecek tüketim motivasyonları “Kültürel Deneyim”, “Heyecan Arayışı”, “Duyusal Çekicilik”, “Bireyler Arası İlişki” ve “Sağlık Beklentisi” olmak üzere 5 boyut altında değerlendirilmiştir. Çalışma sonucunda “Heyecan Arayışı” boyutunun turistlerin uzun dönemde tekrar ziyaret etme niyetleri üzerinde anlamlı bir etkisi olduğu belirlenirken, kısa dönemde tekrar ziyaret etme niyeti üzerinde “Sağlık Beklentisi” boyutunun anlamlı bir etkisi olduğu görülmüştür., HiTourism industry which is based on service has to stay updated for tourist. This case increases the interest on alternative tourism types. Gastronomy torurism is considered as a remarkable alternative tourism kind and therefore local food is very important. Local food is an important way for tourists to understand local people’s culture. Also local food affects tourists so they may want to visit that place again. This research was applied on the torists who tested “Van Breakfast” and aimed to find whether they want visit again. Questionnaire was done to collect data. The data was evalvated by sling analysis, normality test and regression analysis. In this research, the tourists motivation for local food were evalvated by” Culture Experience”, “Need for Thrill”, “Sensory Appeal”, “Relationship among People” and “Expectation for Health”. In the result of the research, “Need for Thrill” is expected to be important on tourists wishes for revisit in long term. “Expectation for Health” is expected to be important in short term.

Prior studies assessing colorectal cancer survival have reported better outcomes when operations are performed at high-volume centers. These studies have largely been cross-sectional, making it difficult to interpret their estimates. We aimed to assess the effect of facility volume on survival following proctectomy for rectal cancer. Using data from the National Cancer Database, we included all patients with complete baseline information who underwent proctectomy for non-metastatic rectal cancer between 2004 and 2016. Facility volume was defined as the number of rectal cancer cases managed at the treating center in the calendar year prior to the patient’s surgery. Overall survival estimates were obtained for facility volumes ranging from 10 to 100 cases/year. Follow-up began on the day of surgery and continued until loss to follow-up or death. A total of 52,822 patients were eligible. Patients operated on at hospitals with volumes of 10, 30, and 50 cases/year had similar distributions of grade, clinical stage, and neoadjuvant therapies. 1-, 3-, and 5-year survival all improved with increasing facility volume. One-year survival was 94.0% (95% CI: 93.7, 94.3) for hospitals that performed 10 cases/year, 94.5% (95% CI: 94.2, 94.7) for 30 cases/year, and 94.8% (95% CI: 94.5, 95.0) for 50 cases/year. Five-year survival was 68.9% (95% CI: 68.0, 69.7) for hospitals that performed 10 cases/year, 70.8% (95% CI: 70.1, 71.5) for 30 cases/year, and 72.0% (95% CI: 71.2, 72.8) for 50 cases/year. Treatment at a higher volume facility results in improved survival following proctectomy for rectal cancer, though the small benefits are less profound than previously reported.

Background Aim: This study was conducted to determine the efficacy of medical agents currently used or potentially used in the medical treatment of meconium ileus and to contribute to the medical treatment of meconium ileus. Materials and method In our study, meconium causing meconium ileus or normal meconium obtained voluntarily from healthy newborns at birth was used. A total of 2 g meconium sample was placed in each test tube. Six experimental groups were formed by adding saline solution, N-acetylcysteine, amidotrizoate, pancreatic enzymes, fibrinolytic enzyme, and probiotic bacteria on the meconium samples. All experimental groups were kept at 36 °C and over 90% humidity for 6 h. The resulting mixtures were centrifuged at 2500 rpm for 5 min. The solid gel-like part and the liquid part were separated. The volumes of the liquid portions and the weights of the gel portions were measured. Gels were placed on a glass substrate to compare the flowability of the gel portions. After 30 min, how much the gel-like meconiums moved from the starting point was recorded. Liquid volumes were measured in milliliters (ml), weights in grams (g), and distance in millimeters (mm). Results It was determined that the solid part weights of N-acetylcysteine and amidotrizoate groups increased, while the solid part weights of the other groups decreased. It was determined that the decrease in solid part weights was mostly in the probiotic bacteria group. Test correlation between liquid fraction volume and solid weight was statistically determined. The group that moved the most on the glass substrate was the N-acetylcysteine group. Conclusions Our study also showed that the gastrographin and NAC groups do indeed attract liquid to solid meconium. They cause an increase in solid part weight. Probiotic bacteria and pancreatic enzymes were found effective in terms of movement on the glass surface in the meconium samples they were applied to. The fibrinolytic enzyme produced for in vivo environment was found to be ineffective in the in vitro environment in our study. We think that pancreatic enzymes and probiotic bacteria can also be used in the medical treatment of meconium ileus.

This study presents a coupled peridynamics (PD) and finite element (FE) approach to simulate the process of failure due to cyclic loading based on the kinetic theory of fracture (KTF). It specifically leads to the prediction of number of load cycles to crack initiation and its propagation path. The PD representation of the equilibrium equations and the stress–strain relations are derived based on the PD least square minimization (PD LSM) method. The PD governing equations are constructed by using MATRIX27 element in the ANSYS framework and solved by employing an implicit method. The PD interactions are considered in the region of potential failure sites; otherwise, traditional finite elements are employed in the discretization of the domain. The coupling between the MATRIX27 elements and traditional finite elements are achieved through the coupled degrees of freedom (DOF) command available in the ANSYS framework. The verification of the coupled PD-FE approach is demonstrated by comparison against the FE prediction of displacement fields in a plate with and without a hole under tension. Its validity for predicting crack growth is established by simulating compact tension experiments under cyclic loading. The predictions capture the number of cycles to failure as well as the crack propagation paths.

This study presents a peridynamic (PD) simulation of compression-after-impact (CAI) of a laminate in two subsequent stages of impact and compressive type of loading. In the first stage, a transient analysis is performed that simulates the motion of a rigid impactor hitting a laminate resulting in matrix and delamination damage. After the impactor rebounds and the transient effects due to impact die out, the simulation continues for additional time steps under compressive in-plane loading resulting in further damage and eventual structural failure of the laminate. The PD simulations effectively capture the deformation fields and damage patterns due to impact and subsequent compressive loading until failure. The predictions are consistent with the experimentally observed damage patterns due to impact and subsequent compressive failure load.

Background: The CSP590 randomized trial was designed to estimate the effect of lithium on suicidality. After a third of the intended number of participants were enrolled, the hazard ratio of suicidality was 1.10 (95% CI: 0.77, 1.55). Based on this, the trial was stopped for futility. However, only 17% of patients adhered to the specified protocol. Aims: The objective was to estimate the per-protocol effect of lithium on suicidality, that is, the effect of adhering to the treatment strategies as specified in the protocol. Methods: We stopped individuals’ follow-up if/when they showed evidence of nonadherence. We then conducted the analysis in the restricted sample, adjusting for prognostic factors that predict adherence via inverse probability weighting. The primary outcome was the 12-month risk of suicidality (including death from suicide, suicide attempt, interrupted attempt, hospitalization specifically to prevent suicide). Results: The estimated 12-month risk of suicidality was 18.8% for lithium, and 24.3% for placebo. The risk ratio was 0.78 (95% CI: 0.43, 1.37) and the risk difference −5.5 percentage points (95% CI: −17.5, 5.5). Results were consistent across sensitivity analyses. Conclusions: With one-third of the targeted sample size, lithium effects (compared with placebo) ranging between a 17.5% reduction and a 5.5% increase in the risk of suicidality were highly compatible with the data. Thus, a protective effect of lithium on suicidality among patients with bipolar disorder or major depressive disorder cannot be ruled out. Trials should incorporate adequate per-protocol analyses into the decision-making processes for stopping trials for futility.

Currently, pultruded glass fibre-reinforced polymer (pGFRP) composites have been extensively applied as cross-arm structures in latticed transmission towers. These materials were chosen for their high strength-to-weight ratio and lightweight characteristics. Nevertheless, several researchers have discovered that several existing composite cross arms can decline in performance, which leads to composite failure due to creep, torsional movement, buckling, moisture, significant temperature change, and other environmental factors. This leads to the composite structure experiencing a reduced service life. To resolve this problem, several researchers have proposed to implement composite cross arms with sleeve installation, an addition of bracing systems, and the inclusion of pGFRP composite beams with the core structure in order to have a sustainable composite structure. The aforementioned improvements in these composite structures provide superior performance under mechanical duress by having better stiffness, superiority in flexural behaviour, enhanced energy absorption, and improved load-carrying capacity. Even though there is a deficiency in the previous literature on this matter, several established works on the enhancement of composite cross-arm structures and beams have been applied. Thus, this review articles delivers on a state-of-the-art review on the design improvement and mechanical properties of composite cross-arm structures in experimental and computational simulation approaches.

In this study, the main goal of this study was to understand the effect of carbon nanotube (CNT) additives on the elastic behaviors of textile-based composites. The materials have three phases: carbon fiber fabric, epoxy matrix, and carbon nanotubes. Different weight fractions of CNTs were used (0% as a reference, 0.3%). Mechanical tests were performed, such as tension and three-point bending beam tests. In addition, the composite material damages were examined in detail. The experimental results show that the samples with CNT carried 9% and 23% more axial tensile force and bending capacity on average than those with NEAT. Besides, it was understood that adding 0.3% by weight of MWCNT increases the tensile modulus by approximately 9%. Finally, the mechanical tensile and bending tests are supported by analytical solutions successfully applied in the literature.

This study presents a novel unsupervised convolutional Neural Network (NN) architecture with nonlocal interactions for solving Partial Differential Equations (PDEs). The nonlocal Peridynamic Differential Operator (PDDO) is employed as a convolutional filter for evaluating derivatives the field variable. The NN captures the time-dynamics in smaller latent space through encoder-decoder layers with a Convolutional Long-short Term Memory (ConvLSTM) layer between them. The ConvLSTM architecture is modified by employing a novel activation function to improve the predictive capability of the learning architecture for physics with periodic behavior. The physics is invoked in the form of governing equations at the output of the NN and in the latent (reduced) space. By considering a few benchmark PDEs, we demonstrate the training performance and extrapolation capability of this novel NN architecture by comparing against Physics Informed Neural Networks (PINN) type solvers. It is more capable of extrapolating the solution for future timesteps than the other existing architectures., 23 pages, 15 figures, submitted to Computer Methods in Applied Mechanics and Engineering

Infantile hypertrophic pyloric stenosis is the narrowing of the pyloric duct due to hypertrophy of the pylorus. The disease manifests itself with gushing and non-bile vomiting in babies after feeding. If early diagnosis is not provided and treatment is delayed, dehydration, severe malnutrition, weight loss and acid-base imbalance may develop, and may even result in death. In this case report, we present a three-month and eight-day-old male baby who was admitted to the emergency department with complaints of non-bile vomiting and abdominal distension for three days.

This study presents a new bond-based peridynamic approach for modeling the elastic deformation of isotropic materials with bond stretch and rotation, thus removing the constraint on the Poisson’s ratio. The resulting PD equilibrium equations derived under the assumption of small deformation are solved by employing implicit techniques. The bond constants associated with stretch and rotation kinematic are directly related to the constitutive relations of stress and strain components in continuum mechanics. Also, the expressions for the critical stretch and critical relative rotation are derived in terms of mode I and mode II critical energy release rates, respectively. Lastly, it does not require a surface correction procedure, and the displacement and traction type boundary conditions are directly imposed without introducing fictitious regions in the domain. The capability of this approach is first demonstrated by capturing the correct deformation of plate type structures under general loading conditions. Subsequently, its capability for failure prediction is established by simulating the response of a double cantilever beam (DCB) under mode I type loading and compact shear specimen under mode II type loading.

Tüketicilerin helal gıda konusunda algı ve tutumları ülkeler ve bölgeler arasında farklılık gösterebilen sosyal, kültürel, ekonomik, yasal ve politik faktörlere bağlıdır. Bu kapsamda tüketicilerin helal gıda konusunda satın alma davranışları hakkındaki farkındalıklarını, algılarını ve tutumlarını incelemek politika önerisinde bulunulması açısından gereklidir. Bu nedenle Konya ilinde tüketicilerin helal gıda konusundaki bilinç düzeylerinin ve algılarının belirlenmesi, helal gıda konusundaki duyarlılıkların ölçülmesi ve helal gıda satın almaya etki eden sosyo-ekonomik faktörlerin belirlenmesi çalışmanın temel amacıdır. Bu amaca yönelik olarak Konya ilinde basit tesadüfi örnekleme yöntemine göre belirlenen 383 kişi ile tüketici anketi yapılmıştır. Yapılan çalışmada tüketici talep yapısını incelemek için tüketicilerin sosyo-ekonomik özelliklerine göre helal gıda ürünlerine tutum ve algıları beşli likert ölçeği ile analiz edilmiş olup helal gıda tüketimi ile tüketicilerin sosyo-ekonomik özellikleri arasındaki ilişkinin belirlenmesi için Mann-Whitney U testi ve Kruskal-Wallis testleri yapılmıştır. Yapılan analizlere göre tüketicilerin gelir ve eğitim düzeyleri artıkça daha fazla helal gıda satın alacakları tahmin edilmiştir. Sonuç olarak Konya ilinde tüketicilerin helal gıda ürünlerinde bilinç düzeylerinin yüksek olduğu ve helal gıda tüketimi konusunda duyarlılıklarının arttığı belirlenmiştir.

Elyaf takviyeli polimer (FRP) donatılar korozyona karşı direnç, ağırlıkça yüksek mukavemet oranı, iyi yorulma özellikleri ve kullanım kolaylığı gibi avantajlar nedeniyle, alternatif olarak tercih edilmekte ve kullanımı giderek artmaktadır. İnşaat mühendisliği uygulamalarında düşük maliyetlerinden dolayı en yaygın olarak Cam-FRP (GFRP) donatılar kullanılmaktadır. Son zamanlarda, kiriş ve kolonlarda kullanılan çelik donatılar yerine Cam FRP donatılar ve çelik ile Cam FRP donatının birlikte kullanıldığı “Hibrit” donatı düzeni üzerinde birçok araştırma yapılmıştır. Bu çalışmada; Cam FRP ve Hibrit donatıların betonarme kirişlerde geleneksel çelik donatılara göre avantajları araştırılmıştır. Çelik çubuklardan ve farklı sayıda cam çubuklardan oluşan betonarme kirişler üretilmiştir. Üretilen betonarme kirişlere dört nokta eğilme testleri yapılmıştır. Deney sonucu her üç numune için yaklaşık eşit maksimum yük taşıma kapasitesi elde edilmiştir. Bununla birlikte, çelik donatılı ve hibrit donatılı kiriş, gevrek bir davranış sergilerken, GFRP donatılı kiriş sünek bir davranış sergilemiştir. Tamamen GFRP donatılı numunenin enerji emme kapasitesi diğer numunelere göre ciddi oranda artış gösterdi. Numunelerde oluşan hasarları açıklamak için hasar analizi sunuldu.

Objective The aim of this study was to determine the role of thiol/disulfide homeostasis (TDH) parameters which are new oxidative stress markers for the diagnosis of acute appendicitis (AA) in children with abdominal pain complaints. Methods A total of 40 patients with AA and 45 patients with abdominal pain were included in this study. Two groups were compared in terms of age, gender, white blood cell count, neutrophil-to-lymphocyte ratio, C-reactive protein (CRP), appendix diameter, and TDH parameters (native and total thiol levels, native thiol/total thiol ratio [antioxidant parameters] and disulfide level, disulfide/native thiol ratio, and disulfide/total thiol ratio [oxidant parameters]). Results Compared with the abdominal pain group, it was found that disulfide level, disulfide/native thiol, and disulfide/total thiol ratios (p Conclusion To our knowledge, the present study is a first in the literature in which TDH parameters were used in children with AA compared with the abdominal pain group. We thought that these parameters may be useful as new biomarkers supporting AA diagnosis in children.

Background We evaluated population characteristics of serum 25-hydroxyvitamin D (25(OH)D) levels and determined the influence of age, gender and season in an extensive dataset. Materials and methods Laboratory results of 103,509 adults and 19,186 children were retrospectively evaluated. Study group was classified regarding ages as; 60 years for adults and 0–1, 1–12 months,1–3, 4–6, 7–9, 10–12, 13–15 and 16–18 years for children. Seasonal values were also determined. Levels were measured by Architect i1000 SR (Abbott Diagnostics, USA). Results The median (2.5–97.5 percentiles) of 25(OH)D levels were 38.75 (9.5–158.25) nmol/L for adults and 43.25 (11.25–125.5) nmol/L for children. There were significant gender differences for both adults and children. Values differed significantly among age subgroups (p’s Conclusion The rate of 25(OH)D deficiency was remarkable during the whole year. This will provide large-scale data about 25(OH)D status in Turkish people and may contribute to the prevention and treatment of this condition for better healthcare outcomes.

SUMMARY OBJECTIVE: Obesity is one of the etiological factors of sleep disorders (e.g., obstructive sleep apnea and restless leg syndrome). The aim of this study was to determine the effect of obesity on sleep quality by using the Pittsburgh Quality İndex and Berlin Question are and evaluate the association of sleep with anthropometric and metabolic parameters. METHODS: A total of 76 patients (41 females and 35 males) between the ages of 18 and 70 years with a body mass index >30 kg/m2 were included in this study. Homeostatic model assessment-insulin resistance, hemoglobin A1c, alanine aminotransferase, aspartate transaminase, total cholesterol, low-density lipoprotein, triglyceride, high-density lipoprotein, and thyroid-stimulating hormone levels were analyzed. Sleep quality was evaluated with the Pittsburgh Sleep Quality Index, Berlin Questionnaire, and the Restless Leg Syndrome Questionnaire. RESULTS: A significant correlation was observed between Pittsburgh sleep quality index and body mass index, neck circumference, body fat index, muscle mass, hip and waist circumference, hemoglobin A1c, and homeostatic model assessment-insulin resistance (ps

Patients with longstanding progressive collapsing foot deformity often develop osteoarthritis of the ankle, midfoot, or hindfoot joints, which can be symptomatic or lead to fixed deformities that complicate treatment. The development of deformity is likely caused by ligament degeneration and tears. However, the effect of individual ligament tears on changes in joint contact mechanics has not been investigated.A validated finite element model of the foot was used to compare joint contact areas, forces, and pressures between the intact and collapsed foot, and to evaluate the effect of individual ligament tears on joint contact mechanics.Collapsing the foot resulted in an increase in contact pressure in the subtalar, calcaneocuboid, tibiotalar, medial naviculocuneiform, and first tarsometatarsal joints but a decrease in contact pressure in the talonavicular joint. Rupture of the spring ligament was the main contributor to increased calcaneocuboid and subtalar joint contact pressures and decreased medial naviculocuneiform and first tarsometatarsal joint contact pressures, as well as talonavicular subluxation. Deltoid ligament rupture was the primary source of increased contact pressure in the medial naviculocuneiform, first tarsometatarsal, and tibiotalar joints.Degenerative tearing of the ligaments in flatfoot deformity leads to increased joint contact pressures, primarily in the calcaneocuboid, subtalar, and tibiotalar joints, which has been implicated in the development of osteoarthritis in these joints. An improved understanding of the relationship between ligament tears and joint contact pressures could provide support for the use of ligament reconstructions to prevent the development of arthrosis.