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INTRODUCTION: The performance of the drilling process depends on the characteristics of the drilling equipment and surgeon’s skill. To our knowledge, no research has focused on multi-parameter analysis of the dynamic behaviour of drills during the drilling process. This study aimed to characterise the physical changes and effects of different drills attached to a robotic arm during drilling of artificial bones in a standardised experimental setup. MATERIALS AND METHODS: Drilling processes using three brands of drills attached to a robotic arm were compared in terms of thrust force, vibration, noise level, speed deviation, and temperature. A standardised experimental setup was constructed, and measurement data were analysed statistically. Identical artificial bones were drilled 10 times with each drill. RESULTS: Thrust force measurements, which varied through the cortex and medulla, showed expressive differences for each drill for maximum and mean values (p

Muon accelerators offer an attractive option for a range of future particle physics experiments. They can enable high energy (TeV+) high energy lepton colliders whilst mitigating the difficulty of synchrotron losses, and can provide intense beams of neutrinos for fundamental physics experiments investigating the physics of flavor. The method of production of muon beams results in high beam emittance which must be reduced for efficient acceleration. Conventional emittance control schemes take too long, given the very short (2.2 microsecond) rest lifetime of the muon. Ionisation cooling offers a much faster approach to reducing particle emittance, and the international MICE collaboration aims to demonstrate this technique for the first time. This paper will present the MICE RF system and its role in the context of the overall experiment.

Muon accelerators offer an attractive option for a range of future particle physics experiments. They can enable high energy (TeV+) high energy lepton colliders whilst mitigating the difficulty of synchrotron losses, and can provide intense beams of neutrinos for fundamental physics experiments investigating the physics of flavor. The method of production of muon beams results in high beam emittance which must be reduced for efficient acceleration. Conventional emittance control schemes take too long, given the very short (2.2 microsecond) rest lifetime of the muon. Ionisation cooling offers a much faster approach to reducing particle emittance, and the international MICE collaboration aims to demonstrate this technique for the first time. This paper will present the MICE RF system and its role in the context of the overall experiment.

The MuCool Experiment has been continuing to take data with 805 and 201 MHz cavities in the MuCool Test Area. The system uses rf power sources from the Fermilab Linac. Although the experimental program isprimarily aimed at the Muon Ionization Cooling Experiment (MICE), we have been studying the dependence of rf limits on frequency, cavity material, high magnetic fields, gas pressure, coatings, etc. with the general aim of understanding the basic mechanisms involved. The 201 MHz cavity, essentially a prototype for the MICE experiment, was made using cleaning techniques similar to those employed for superconducting cavities and operates at its design field with very little conditioning.

The rf R&D program for high-gradient, low frequency cavities to be used in muon cooling systems is underway in the Fermilab MUCOOL Test Area. Cavities at 805 and 201 MHz are used for tests of conditioning techniques, surface modification and breakdown studies. This work has the Muon Ionization Cooling Experiment (MICE) as its immediate goal and efficient muon cooling systems for neutrino sources and muon colliders as the long term goal. We study breakdown and dark current production under a variety of conditions.

Direct CP violation in nonleptonic hyperon decays can be established by comparing the decays of hyperons and anti-hyperons. For Xi decay to Lambda pi followed by Lambda to p pi, the proton distribution in the rest frame of Lambda is governed by the product of the decay parameters alXi alLam. The asymmetry A_Xi Lambda, proportional to the difference of alXi alLam of the hyperon and anti-hyperon decays, vanishes if CP is conserved. We report on an analysis of a fraction of 1997 and 1999 data collected by the Hyper CP (E871) collaboration during the fixed-target runs at Fermilab. The preliminary measurement of the asymmetry is AXiLam = [ -7 pm 12(rm stat) pm 6.2(rm sys) ] times 10-4, an order of magnitude better than the present limit.

A muon cooling channel calls for very high accelerating gradient RF structures to restore the energy lost by muons in the absorbers. The RF structures have to be operated in a strong magnetic field and thus the use of superconducting RF cavities is excluded. To achieve a high shunt impedance while maintaining a large enough aperture to accommodate a large transverse emittance muon beam, the cavity design adopted is a pillbox-like geometry with thin Be foils to terminate the electromagnetic field at the cavity iris. The possibility of using grids of thin-walled metallic tubes for the termination is also being explored. Many of the RF-related issues for muon cooling channels are being studied both theoretically and experimentally using an 805 MHz cavity that has a pillbox-like geometry with thin Be windows to terminate the cavity aperture. The design and performance of this cavity are reported here. High-power RF tests of the 805 MHz cavity are in progress at Lab G in Fermilab. The cavity has exceeded its design gradient of 30 MV/m, reaching 34 MV/m without external magnetic field. No surface damage was observed at this gradient. The cavity is currently under conditioning at Lab G with an external magnetic field of 2.5 T. We also present here a 201 MHz cavity design for muoncooling channels. The proposed cavity design is also suitable for use in a proof-of-principle Muon Ionization Cooling Experiment (MICE).

Objective: Indirect bilirubin exerts an antioxidant effect when increased mildly. This study aimed to investigate whether increased bilirubin levels lead to an oxidant effect in newborns with hyperbilirubinemia requiring phototherapy.Patients and Methods: The study included 30 term newborn infants aged 0-7 days with indirect hyperbilirubinemia requiring phototherapy and no comorbid disease as the study group. In addition, 30 term healthy newborn infants aged 0-7 days without indirect hyperbilirubinemia were employed as a control group. Serum triglyceride, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), serum paraoxonase (PON) levels and malondialdehyde (MDA) levels were compared between the groups.Results: Serum MDA, total bilirubin, and LDL and HDL levels were significantly higher and the serum PON level was significantly lower, in the study group compared with the controls (p  < 0.05).Conclusion: In newborns with hyperbilirubinemia requiring phototherapy, an increased bilirubin level causes oxidative stress by decreasing the level of serum PON and increasing the level of MDA. [ABSTRACT FROM AUTHOR]

The MuCool Test Area (MTA) at Fermilab is a facility to develop the technology required for ionization cooling for a future Muon Collider and/or Neutrino Factory. As part of this research program, feasibility studies of various types of RF cavities in a high magnetic field environment are in progress. As a unique approach, we have tested a RF cavity filled with a high pressure hydrogen gas with a 400 MeV proton beam in an external magnetic field (B = 3 T). Quantitative information about the number of protons passing through this cavity is an essential requirement of the beam test. The MTA is a flammable gas (hydrogen) hazard zone. Due to safety reasons, no active (energized) beam diagnostic instrument can be used. Moreover, when the magnetic field is on, current transformers (toroids) used for beam intensity measurements do not work due to the saturation of the ferrite material of the transformer. Based on these requirements, we have developed a passive beam diagnostic instrumentation using a combination of a Chromox-6 scintillation screen and CCD camera. This paper describes details of the beam profile and position obtained from the CCD image with B = 0 T and B = 3 T, and for high and low intensity proton beams. A comparison is made with beam size obtained from multi-wires detector. Beam transmission efficiency through a collimator with a 4 mm diameter hole is measured by the toroids and CCD image of the scintillation screen. Results show that the transmission efficiency estimated from the CCD image is consistent with the toroid measurement, which enables us to monitor the beam transmission efficiency even in a high magnetic field environment. [ABSTRACT FROM AUTHOR]

The fixed-target Main Injector Particle Production (MIPP) experiment, Fermilab E907, was designed to measure the production of hadrons from the collisions of hadrons of momenta ranging from 5 to 120 GeV/c on a variety of nuclei. These data will generally improve the simulation of particle detectors and predictions of particle beam fluxes at accelerators. The spectrometer momentum resolution is between 3% and 4%, and particle identification is performed for particles ranging between 0.3 and 80 GeV/c using dE/dx, time-of-flight, and Cherenkov radiation measurements. MIPP collected 1.42×106 events of 120 GeV Main Injector protons striking a target used in the Neutrinos at the Main Injector facility at Fermilab. The data have been analyzed and we present here charged pion yields per proton on target determined in bins of longitudinal and transverse momentum between 0.5 and 80 GeV/c, with combined statistical and systematic relative uncertainties between 5% and 10%., Physics

We have measured cross sections for forward neutron production from a variety of targets using proton beams from the Fermilab Main Injector. Measurements were performed for proton beam momenta of 58, 84, and 120 GeV/c. The cross section dependence on the atomic weight (A) of the targets was found to vary as Aα, where α is 0.46±0.06 for a beam momentum of 58 GeV/c and 0.54±0.05 for 120 GeV/c. The cross sections show reasonable agreement with FLUKA and DPMJET Monte Carlos. Comparisons have also been made with the LAQGSM Monte Carlo., Physics

Ankaferd BloodStopper (ABS) is an herbal extract which has been used historically as a haemostatic agent in traditional Turkish medicine. ABS comprises of standardized mixture of herbs T. vulgaris, G. glabra, V. vinifera, A. officinarum and U. dioica. Basic effect mechanism of ABS is the formation of an encapsulated protein web which represents the focus points for the vital erythrocyte masses. The haemostatic effects have been demonstrated by in vitro and in vivo studies. The aim of this study was to investigate the in vitro effects of the different times and doses of ABS on in vitro endothelial cell proliferation. Human umbilical cord obtained at Caesarean sections from Erciyes University hospital. After washing PBS, the cord vein lumen was filled with PBS containing 10 mg/ml collagenase and incubated 10 minute at 37°C. The contents of the vein were gently flushed out with an equal volume of 30 ml medium collected in a conical centrifuge tube then centrifugated at 1000 rpm for 10 minute yielded a small white pellet which was resuspended in culture medium. The cells were plated in 2 ml of medium at T-25 plastic flasks. The endothelial cells were passaged when confluent density was approached. After obtaining enough cells, the cells were counted by Thoma slide. Then cells were divided into control and five experimental groups. 5%, %25 ve %50 ABS were added to medium of each experimental group (n=16). After 48 hours culture period, the effects of ABS were determined by cell counting. It was microscopically observed that cells arised from the surface and adhered to each other after the ABS application to the HUVECs. Also, after 24 hours cells returned the normal growth and physiology. After 48 hours culture period, the effects of ABS were determined by cell counting. While the mean cell number of control group and experiment groups were 5.68x104 (±1.7), 6.56x104 (±1.09) 7.12x104 (1.14), 7.43x104 (±0.89) respectively. There was a reduction on cell number in experimental groups when compared to the control. This reduction was statistically significant (p<0.05). In this study, we observed that Ankaferd has dual diverse dynamic reversible actions depend on dose and concentration in the model of HUVEC. ABS might have a role on numerous cellular mechanisms as well as its hemostatic actions. [ABSTRACT FROM AUTHOR]

A major technological challenge in building a muon cooling channel is operating rf cavities in multitesla external magnetic fields. We report the first proof-of-principle experiment of a high pressure gas-filled rf cavity for use with intense ionizing beams and strong external magnetic fields. rf power consumption by beam-induced plasma is investigated with hydrogen and deuterium gases with pressures between 20 and 100 atm and peak rf gradients between 5 and 50 MV/m. The low pressure case agrees well with an analytical model based on electron and ion mobilities. Varying concentrations of oxygen gas are investigated to remove free electrons from the cavity and reduce the rf power consumption. Measurements of the electron attachment time to oxygen and rate of ion-ion recombination are also made. Additionally, we demonstrate the operation of the gas-filled rf cavity in a solenoidal field of up to 3 T, finding no major magnetic field dependence. All these results indicate that a high pressure gas-filled cavity is a viable technology for muon ionization cooling. [ABSTRACT FROM AUTHOR]

Abstract: Published measurements of semi-inclusive Λ production in p–Au collisions at the AGS are used to estimate the yields of singly strange hadrons in nucleus–nucleus (A–A) collisions. Results of a described extrapolation technique are shown and compared to measurements of K+ production in Si–Al, Si–Au, and Au–Au collisions at the AGS and net Λ production in S–S, S–Ag, Pb–Pb, and inclusive p–A collisions at the SPS. The extrapolations can account for more than 75% of the measured strange particle yields in all of the studied systems except for very central Au+Au collisions at the AGS where RQMD comparisons suggest large re-scattering contributions. [Copyright &y& Elsevier]

This Letter reports a search for charge-parity (CP) symmetry violating nonstandard interactions (NSI) of neutrinos with matter using the NOvA Experiment, and examines their effects on the determination of the standard oscillation parameters. Data from ν&#95;{μ}(ν[over ¯]&#95;{μ})→ν&#95;{μ}(ν[over ¯]&#95;{μ}) and ν&#95;{μ}(ν[over ¯]&#95;{μ})→ν&#95;{e}(ν[over ¯]&#95;{e}) oscillation channels are used to measure the effect of the NSI parameters ϵ&#95;{eμ} and ϵ&#95;{eτ}. With 90% CL the magnitudes of the NSI couplings are constrained to be |ϵ&#95;{eμ}|≲0.3 and |ϵ&#95;{eτ}|≲0.4. A degeneracy at |ϵ&#95;{eτ}|≈1.8 is reported, and we observe that the presence of NSI limits sensitivity to the standard CP phase δ&#95;{CP}.

A 13-year-old girl who had a kidney transplant four weeks prior presented with a 10-day history of fatigue, paleness, and headache. On physical examination, tachycardia and paleness were noted. Laboratory testing was notable for severe anemia and mild leukopenia and thrombocytopenia. Polymerase chain reaction (PCR) test for Epstein-Barr virus (EBV) and cytomegalovirus (CMV) were negative and for parvovirus B19 (PVB19) was positive. Despite lower immunosuppression and administration of intravenous immunoglobulin (IVIG) it persisted for 15 months, and frequent red blood cell transfusions were needed. PVB19 is a less common but significant complication. The patient's clinical course demonstrates the importance of this complication and the challenges in its management. A notable void exists in the literature regarding standardized treatment protocols for PVB19-induced recurrent anemia after kidney transplant. This case indicates the need for further research and consensus to guide effective clinical interventions in similar cases., (© 2024. The Author(s).)

Acute lymphoblastic leukemias are the most common malignancies in childhood. Although its etiology is still unclear, it is thought that disorders in oxidative stress metabolism may contribute to leukemogenesis. Advanced glycation end products (AGEs) are formed as a result of the non-enzymatic binding of sugars to biomolecules. Oxidation reactions are triggered through AGE-Receptor (RAGE) interaction, resulting in the formation of reactive oxygen species. These can play crucial roles in cancer pathogenesis and leukemogenesis. It is thought that sRAGE (soluble RAGE) is the end product of glycation and circulates freely in the circulation by binding to RAGE ligands. We investigate novel leukemia biomarkers and focus on soluble RAGE (sRAGE) for acute lymphoblastic leukemia (ALL) diagnosis and prognosis. Thirty children (1-17 years) diagnosed with ALL were included in the study. Patients were divided into standard, medium, and high risk groups according to the Berlin-Frankfurt-Münster (BFM) treatment protocol. Patients were evaluated twice; at the time of diagnosis and at the sixth month of remission. sRAGE and blood parameters were compared with healthy controls ( n = 30, 1-17 years). The sRAGE levels in ALL patients at diagnosis (138.7 ± 177.3 pg/mL) were found to be significantly higher than they were during the sixth month of remission (17.6 ± 21.1 pg/mL) and in healthy controls (22.2 ± 23.7 pg/mL). The cut-off value of the sRAGE level for the diagnosis of ALL was found to be 45 pg/mL in ROC analysis (sensitivity: 73.3%, specificity: 86.7%, AUC: 0.681). At the same time, the sRAGE level was found to be significantly higher in T-ALL patients (490.9 ± 236.9 pg/mL) than in B-ALL patients (84.5 ± 82.7 pg/mL). No significant difference was found in terms of the sRAGE level between standard (45.8± 33.1 pg/mL), medium (212 ± 222.1 pg/mL), and high (143.9 ± 111.5 pg/mL) risk group ALL patients classified according to the BFM protocol. Despite the fact that this was a small, single-center study, our findings highlight the potential use of sRAGE as a biomarker for diagnosing ALL and assessing response to treatment.

The inclusive electron neutrino charged-current cross section is measured in the NOvA near detector using 8.02×10^{20} protons-on-target in the NuMI beam. The sample of GeV electron neutrino interactions is the largest analyzed to date and is limited by ≃17% systematic rather than the ≃7.4% statistical uncertainties. The double-differential cross section in final-state electron energy and angle is presented for the first time, together with the single-differential dependence on Q^{2} (squared four-momentum transfer) and energy, in the range 1  GeV≤E&#95;{ν}<6  GeV. Detailed comparisons are made to the predictions of the GENIE, GiBUU, NEUT, and NuWro neutrino event generators. The data do not strongly favor a model over the others consistently across all three cross sections measured, though some models have especially good or poor agreement in the single differential cross section vs Q^{2}.

Objective: The aim of this study was to investigate the relationship between symptomatology and the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) cognitive profiles in Attention Deficit and Hyperactivity Disorder (ADHD), taking into account clinical heterogeneity., Method: The WISC-IV was administered to 60 children aged 6 to 13 years with ADHD who had not previously taken psychotropic medication. Conners Teacher-Rating Scale (CTRS-R/L) and Conners Parent-Rating Scale (CPRS-R/L) were completed by parents and teachers., Results: We found a statistically significant positive correlation between the symptoms of hyperactivity/impulsivity and PSI (Processing Speed Index). A statistically significant negative correlation was found between the CTRS-R/L's DSM-IV Inattentive subscale and PRI (Perceptual Reasoning Index). No relationship was found between the inattention or hyperactivity/impulsivity symptomatology with Working Memory Index (WMI). WMI stood out as the most frequently reported weakness among the four index scores., Conclusion: Considering the relationship between the cognitive domains of RDoC (Research Domain Criteria) and dimensions of HiTOP with the ADHD symptom clusters, the assessment of cognitive and behavioral symptoms may be useful for phenotyping ADHD. According to the CHC (Cattell-Horn-Carroll) theory; the positive correlation level between PSI, which is accepted as Gs, and hyperactivity/impulsivity symptoms in people with ADHD may be due to the fact that hyperactivity is one of the narrow cognitive domains of Gps.

Objectives: The aim of this study to compare the clinic efficacy and effects of osmotic release oral system-methylphenidate and atomoxetine on executive function in children and adolescents with attention deficit hyperactivity disorder by a open-label, prospective, randomized controlled trial., Methods: The study was performed by 95 cases between ages 6 and 12 years who were diagnosed as attention-deficit/hyperactivity disorder (ADHD) and also 40 control individuals. In this study, Conners' Teacher Rating Scale (CTRS) was used in order to evaluate the efficacy of the treatment. Executive functions were assessed by the performance-based neuropsychological tests and ecological behavioral rating scales. Stroop test, cancellation test, and serial digit learning test were applied to performance based neuropsychological tests. Behavior Rating Inventory of Executive Function tests (BRIEFs) were used as behavioral assessment scales., Results: Among the ADHD groups, a reduction of over 40% in the CTRS subtest scores used to evaluate the efficacy of the treatment was considered to be an improvement, and no significant difference was found for both drugs. Both Osmotic Release Oral System-Methylphenidate Hydrochloride (OROS-MPH) and atomoxetine (ATX) significantly improved scores in neuropsychological tests., Conclusion: Atomoxetine and OROS-MPH treatments have shown similar efficacy in clinical recovery and improvement on executive functions. However, disturbances in executive functions observed in children with ADHD are persistent despite treatment, when compared with the control group.

Aims: We aimed to determine parents' levels of anxiety and fear and suspicion in relation to the COVID-19 period and the possible predictive factors for these variables in families admitted to a child and adolescent psychiatry outpatient clinic of a university hospital in Turkey. In this way, it is hoped to contribute to the identification of priority target groups in psychosocial support services., Method: The research study group consisted of 600 patients aged 0-18 years and their parents who were referred to a child and adolescent psychiatry outpatient clinic of a university hospital. Parents completed the COVID-19-related psychological distress (CORPD) scale and the data recording form developed specifically for this study. All cases included in the study were examined by a child and adolescent psychiatrist for diagnostic evaluation and their current diagnoses were recorded., Results: Parents of children with any psychiatric diagnosis had higher suspicion scores on the CORPD scale and parents of children with high COVID-19-related anxiety also had higher anxiety and fear scores on the same scale. Logistic regression analysis revealed that negative changes in family relationships increased the risk of higher maternal COVID-19-related suspicion., Conclusions: The most important factors associated with parental high CORPD levels were negative changes in family relationships and children with high COVID-19-related anxiety. Children's high COVID-19-related anxiety levels were associated with living with a single parent or separation from parents, negative changes in family relationships, previous COVID-19 infection in the family, and changes in daily routines.

Background and Objectives: Multidisciplinary approach including psychiatric support, have come to the fore in the treatment of obesity. Food addiction and disordered eating behaviors are among major psychiatric problems that have important effects on both clinical manifestation and response to treatment. This study aimed to investigate correlates of food addiction among adolescents who are seeking treatment for obesity., Method: This study included 126 adolescents between 11 and 18 years of age, 48 patients in the "study group" who are seeking treatment for obesity (BMI for age greater than 95th percentile) and 78 adolescents (BMI for age under 85th percentile) in the "control group" who were reached via online survey. All participants were requested to complete self-report based measurement tools of Yale Food Addiction Scale (YFAS) and Eating Attitude Test-40 (EAT-40)., Results: 47.9% adolescents ( n  = 23) in the study group met food addiction diagnosis according to diagnostic evaluation of YFAS; which was significantly higher than 5.1% ( n  = 4) adolescents in the control group ( p  < 0.001). EAT-40 total scores and the scores in subscales of "anxiety of gaining weight," "dieting," and "thin body preoccupation" were significantly higher in the study group. Gender differences were observed when food addiction symptoms were correlated with eating attitudes among the study group., Conclusions: Comparing to the controls, food addiction and disordered eating behaviors were more common in adolescents seeking treatment for obesity. Gender differences in the correlates of food addiction symptoms imply that different approaches might be needed for psychological interventions.

Objective : This study examines non-suicidal self-injury (NSSI) behavior, its functions and associated factors like childhood trauma, alexithymia, empathy, and emotion regulation, in adolescents suffering from depression. Method : The study sample consisted of 67 adolescents; 11 boys (mean age = 14.94 ±1.45) and 56 girls (mean age = 14.72 ±1.48), all with major depressive disorder. Standard tests and measurements were used for data collection, including Beck Depression Inventory for identifying depression symptoms; Brief Symptom Inventory for screening psychiatric symptoms; Inventory of Statements About Self Injury (ISAS) to identify the lifetime frequency and functions of NSSI in subjects; Childhood Trauma Questionnaire to evaluate sexual, physical, and emotional abuse plus childhood neglect; Toronto Alexithymia Scale to assess difficulties in identifying and/or describing feelings; Basic Empathy Scale to measure empathy levels within the framework of basic emotions; and the Difficulty of Emotion Regulation Scale to determine the awareness and clarity of emotional response. Results : It was found that 64.1% of adolescents studied have had at least one NSSI to date. The most frequent intrapersonal functions associated with NSSI were Affect Regulation and Marking Distress, and the most common interpersonal functions were Toughness and Interpersonal Boundaries. According to a correlation analysis with ISAS scores, Affect Regulation was associated with obsession-compulsion, anxiety, difficulty identifying feelings and clarity scores. Marking Distress, generating a physical sign of feeling awful, was positively associated with Paranoid Ideation scores and negatively associated with Emotional Neglect scores. The Interpersonal Boundaries was positively associated with Childhood Physical Abuse and Impulse scores. Conclusions : NSSI is realized by different functions in the intrapersonal and interpersonal areas in adolescents with depression. Emotion regulation abilities, alexithymia, and childhood trauma are also associated factors or functions of NSSI.

This Letter reports results from the first long-baseline search for sterile antineutrinos mixing in an accelerator-based antineutrino-dominated beam. The rate of neutral-current interactions in the two NOvA detectors, at distances of 1 and 810 km from the beam source, is analyzed using an exposure of 12.51×10^{20} protons-on-target from the NuMI beam at Fermilab running in antineutrino mode. A total of 121 of neutral-current candidates are observed at the far detector, compared to a prediction of 122±11(stat.)±15(syst.) assuming mixing only between three active flavors. No evidence for ν[over ¯]&#95;{μ}→ν[over ¯]&#95;{s} oscillation is observed. Interpreting this result within a 3+1 model, constraints are placed on the mixing angles θ&#95;{24}<25° and θ&#95;{34}<32° at the 90% C.L. for 0.05  eV^{2}≤Δm&#95;{41}^{2}≤0.5  eV^{2}, the range of mass splittings that produces no significant oscillations at the near detector. These are the first 3+1 confidence limits set using long-baseline accelerator antineutrinos.

Autosomal recessive (AR) STAT1 deficiency is a severe inborn error of immunity disrupting cellular responses to type I, II, and III IFNs, and IL-27, and conferring a predisposition to both viral and mycobacterial infections. We report the genetic, immunological, and clinical features of an international cohort of 32 patients from 20 kindreds: 24 patients with complete deficiency, and 8 patients with partial deficiency. Twenty-four patients suffered from mycobacterial disease (bacillus Calmette-Guérin = 13, environmental mycobacteria = 10, or both in 1 patient). Fifty-four severe viral episodes occurred in sixteen patients, mainly caused by Herpesviridae viruses. Attenuated live measles, mumps, and rubella and/or varicella zoster virus vaccines triggered severe reactions in the five patients with complete deficiency who were vaccinated. Seven patients developed features of hemophagocytic syndrome. Twenty-one patients died, and death was almost twice as likely in patients with complete STAT1 deficiency than in those with partial STAT1 deficiency. All but one of the eight survivors with AR complete deficiency underwent hematopoietic stem cell transplantation. Overall survival after hematopoietic stem cell transplantation was 64%. A diagnosis of AR STAT1 deficiency should be considered in children with mycobacterial and/or viral infectious diseases. It is important to distinguish between complete and partial forms of AR STAT1 deficiency, as their clinical outcome and management differ significantly., (Copyright © 2021 by The American Association of Immunologists, Inc.)

Background: Zinc deficiency may exacerbate some pathologies and may also explain alterations in circulating concentrations of various molecules. Zinc has previously been reported to affect plasma concentrations of vitamin B 12 , homocysteine, and folate; however, the current evidence is inconclusive. We aimed to evaluate plasma zinc, hemoglobin, red blood cell count, mean corpuscular volume, ferritin, vitamin B 12 , folate, and homocysteine concentrations during and after zinc supplementation for treatment of zinc deficiency., Methods: This prospective, open-label, single-arm study included children who presented to outpatient clinics with symptoms of growth retardation, anorexia or frequent infections, and who were considered deficient based on plasma zinc concentrations (<70 mcg/dl). Zinc supplementation of 15 mg per day was administered to all participants, and fasting blood samples collected 3 months later were analyzed for plasma zinc, vitamin B 12 , homocysteine, and folate concentrations., Results: Eighty-three children (27 males and 26 females) admitted to the outpatient clinics with anorexia, growth retardation, and complaints of frequent infections. The mean age of the children was 9.64 ± 5.05 (min-max, 1-15) years, and the mean plasma zinc concentration before zinc supplementation was 61.7 ± 6.3 mcg/dl. Zinc concentrations were significantly elevated after zinc sulfate supplementation for 3 months, at 107.1 ± 18.8 mcg/dl (p < 0.01). Hemoglobin (p < 0.01), mean corpuscular volume (p < 0.01), and ferritin (p = 0.049) levels were significantly increased after zinc supplementation, but no significant difference was found in red blood cell count (p = 0.83). Vitamin B 12 and homocysteine concentrations were significantly decreased after zinc treatment (743.5 ± 498.8 vs 373.3 ± 128 mcg/dl p < 0.01; and 11.2 ± 5.3 vs 6.7 ± 3.4 mcg/dl p < 0.01, respectively). However, the change in folate concentrations was not significant (p = 0.05)., Conclusions: Anemia was not detected in patients with zinc deficiency, but ferritin level significantly increased after zinc treatment. Therefore, it can be said that zinc therapy has a positive effect on iron absorption. Elevations in vitamin B 12 and homocysteine may be associated with zinc deficiency, and these elevations may in turn influence the prognoses of liver, kidney, cardiorespiratory, and neoplastic conditions. This can be corrected through appropriate zinc supplementation., (Copyright © 2021 Elsevier GmbH. All rights reserved.)

Objective: This study aimed to assess the relationship between antioxidant enzymes such as glutathione peroxidase (GSH-Px), glutathione reductase (GSH-R), and paraoxonase (PON1) and carotid intima-media thickness (CIMT) and investigate susceptibility to atherosclerosis with decreasing antioxidant capacity in adolescent patients with iron deficiency (ID) and irondeficiency anemia (IDA)., Material and Methods: Twenty-five patients with IDA (14.9±1.8 years; 14 female and 11 male patients), 25 patients with ID (14.1±2.24 years; 13 female and 12 male patients) and 21 healthy controls (14.04±2.01 years; 11 female and 10 male individuals) were included in the study. Serum PON1, GSH-Px, GSH-R, and CIMT were measured in all cases. After 3-month oral iron therapy for the group with IDA, the same measurements were performed again., Results: CIMT was statistically significantly higher in patients with ID and IDA than in the control group (p<0.05). PON1, GSH-Px, and GSH-R activities decreased and were statistically significantly low in patients with IDA compared to the control group (p<0.05). Serum PON1 activity was statistically significantly lower in patients with ID than in the control group (p<0.05). Post-treatment PON1, GSH-Px, and GSH-R activities in patients with IDA got back to normal and were statistically significantly higher compared to pre-treatment values., Conclusions: Antioxidant capacity decreases in patients with IDA and ID, which causes atherosclerotic changes. Therefore, patients with iron deficiency must be treated without the development of iron-deficiency anemia.

Breakthrough detection is a crucial task to reduce the risks of damaging soft tissue bone drilling operations during orthopedic surgery. Conventional drills are not equipped with this function while the recent literature has offered this capability with high cost and complex modification needs. In this study, a new breakthrough detection approach based on closed-loop control characteristics of the drilling operation is proposed. A feature set containing closed-loop signals and force sensor data is created to train K-Nearest and Ensemble Classifier for breakthrough detection tasks with drilling the synthetic bone model and animal bone with a robot manipulator. The best accuracy of breakthrough detection with only closed-loop control signal attributes is achieved as 96.9 ± 0.8% for the synthetic bone model and 98.1 ± 0.2% for sheep femur bone. Breakthrough detection delay which included sampling and operation time of the method guarantees that the drill bit would stop with acceptable breakthrough range of 1.0413 mm. The proposed method can be used to detect breakthrough and also to estimate the state of the drill bit in robotic orthopedic bone drilling processes using only closed-loop signals so that it would be no need to use extra high-cost sensors.

Objectives: L-Thyroxine ingestion is rarely seen in children; here, we report our experience of it. This study describes the clinical characteristics and laboratory findings of acute L-thyroxine ingestion in children., Methods: This retrospective study enrolled patients treated for L-thyroxine ingestion at Kayseri Teaching Hospital between September 2013 and September 2016. Clinical characteristics and laboratory findings are described. Ethical approval was not obtained because the study was retrospective., Results: The incidence of L-thyroxine ingestion was 0.07% to 1.2% per year. There were 14 patients. Twelve patients were asymptomatic, but 2 (14.2%) exhibited tachycardia and hypertension. Thyroid hormone levels were elevated in 3 patients (21.4%). Eleven patients did not require medical treatment (78.4%); 3 did. No serious complication or death was observed., Conclusions: Acute ingestion has a benign course. Serious complications are uncommon but may appear several hours or days after ingestion; therefore, patients with L-thyroxine ingestion should be followed closely for 2 weeks.