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Introduction: As the life expectancy at birth improved, the increase in the elderly population, one of the most vulnerable groups in society, brings about some problems. Frailty is a condition that increases the risk of progressive deterioration in physiological functioning, hypersensitivity to stress and adverse health outcomes. Frailty is quite common in older people. In frail older people, recovery from illnesses is delayed and the likelihood of sequelae is increased. If frailty is recognized early, the likelihood of disease sequelae and mortality can be reduced. Objectives: This study was conducted to determine the relationship between psychological resilience and quality of life on frailty in individuals aged 65 years and older admitted to hospital. Methods: The study group of this cross-sectional study consisted of 504 people who applied to an outpatient clinic at a university hospital. The Tilburg Frailty Scale, the Connor Davidson Psychological Resilience Scale Short Form and the EQ-5D-3L General Quality of Life Scale were used. The Kolmogorov-Simirnov test, the chi-square test, the Spearman correlation analysis and the multivariate logistic regression were used to analyse the data. Results: 292 of the participants in the study group were men. Their ages ranged from 65 to 90 years, and the mean was 70.5±4.9 years. Scores on the Tilburg Frail Scale ranged from 0 to 14, and the mean was 6.3±2.7 points. In the study, 71.1% of participants were classified as frail. It was determined that there was a moderate negative correlation between the results of the Tilburg Frailty Scale and the results of the Connor Davidson Psychological Resilience Scale (r= -0.436) and the EQ-5D-3L VAS Scale (r=-0.608) and a strong positive correlation between the results of the EQ-5D-3L Index Scale (r=0.729)(for each p<0.001). According to multivariate logistic regression, people who did not exercise regularly were 2,33 times more frail than those who did, and people who had a health problem that required bed rest were 2,18 times more frail than those who did not. Conclusions: It was found that the frailty of people aged 65 and over is at a moderate level. An improvement in psychological resilience and general quality of life as well as an improvement in general health reduces frailty. It is recommended that people aged 65 and over to be physically active and to protect from situations that may require prolonged bed rest. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Ovarian cancer forms 4% of all cancers and approximately 23% of all gynecological cancers in women and is responsible for the 47% of deaths related to cancers of the genital tract of women. Tumor markers are the biochemical substances which can be detected in the presence of tumors. Generally they are either the products of tumoral tissues or secreted from the normal cells which are in the interaction with tumoral ones. The present authors attempted to determine the efficacy of the tumor marker CA-125 and HE4 to differentiate the malign cases from the benign adnexal masses. A total of 76 patients with the appropriate criteria were included in the study. They were divided into three groups; healthy control group (n=31), ones with benign masses (n=23), and ones with malign ovarian masses (n=22). In the study, when the cut-off values were accepted as 55I U/ml for CA-125 and 150 pM for HE4 in differentiation of benign and malign groups, the sensitivity was found as 59.09%, specificity 91.3%, PPV 86.67% and NPV 70% LR = +6.8. This combination gives one false positive result to every five positive cases which were detected as high. With the combination of CA-125 and HE4, the value of sensitivity was found decreased as expected, although the value of the specificity increased. [ABSTRACT FROM AUTHOR]

In our study, the social skills, academic competence and problem behaviors of children with cochlear implants in primary school first, second and third grade were compared with their normal peers and the relationships between social skills, academic competence, problem behaviors and language skills were investigated. For this purpose, 32 cochlear implanted (research group) and 160 healthy classmates (control group) were included. In this study, Social Skills Rating System (SSRS) Inventory Teacher version, standardized to Turkish by Sucuoğlu and Özokçu (2005), applied by teachers of children. Also, receptive and expressive language skills of cochlear implanted children assessed with Turkish Expressive and Receptive Language Test (TİFALDİ). As a result of statistical analysis, significant differences were found in favor of the control group between the SSRS subscales of the study group and the control group. The study group was divided into two groups as early (before 2 years) and late (after 2 years) implants, and when SSRS subscale scores of 3 groups were statistically compared, the difference between the study group and the control group was found as late cochlear implant group. In the analysis of the correlation between TİFALDİ Receptive Language, Expressive Language subtests and SSRS subscales of the study group, a significant positive correlation was found between the scores of the Receptive Language Subtest and the Academic Competence subscale while a significant positive correlations were found between the scores of the Expression Language Subtests and Social Skills and Academic Competence Subscales. It was also found that the scores of SSRS subscales showed significant correlations among themselves. [ABSTRACT FROM AUTHOR]

Adult cochlear implant users' expectations and outcomes are varied among them. The factors impact on cochlear implant outcomes also differentiates than the pediatric group. Such as duration of hearing loss, the configuration of hearing loss, and duration of hearing aid use are essential in pre-implant assessment. However, there are other essential variables that involve cognitive abilities for example verbal learning, visual memory, and auditory memory. In the rehabilitation process, holistic approach is appropriate for comprehensive evaluation. Materials and Methods:In this study, 15 cochlear implant users, who are older than 18 years old, were participated. In the inclusion criteria is using cochlea implant at least 6 months regularly. Before and after cochlear implantation following tests were used: adult sentence recognition test, word identification test, auditory memory test, Auditory- Verbal Learning Test, Glasgow Benefit Inventory, Montreal Cognitive Assessment and Draw a Clock Test. Result: All patients showed significant improvement in all tests. Sentence recognition and word recognition scores were improved as expected. The patients also reported that their life quality increased after cochlear implantation. Patients' adaptation was improved to memory tests after CI. Some of them still need rehabilitation support for memory. The holistic approach is needed to increase cochlear implant users' satisfaction after surgery. This approach helps us to understand patients' needs and expectations. After surgery optimal development can be achieved in all cognitive areas and quality of life in adults. [ABSTRACT FROM AUTHOR]

Objectives: Antibacterial-resistant gram-negative hospital-acquired infections result in significant morbidity and mortality. In clinical trials, ceftolozane/tazobactam (C/T) has been effective against these infections; however, real-world findings are limited., Methods: SPECTRA was a global, retrospective, observational inpatient study of adults treated with C/T for ≥48 h, conducted between 2016 and 2020. The primary objective was to describe real-world utilisation of C/T: socio-demographic, clinical characteristics, prescribing patterns, clinical outcomes, and healthcare resource utilisation in hospitalised patients treated with C/T., Results: In total, 617 patients from 7 countries met inclusion criteria. Most (82.7%) had ≥1 comorbidity. The most common medical conditions where C/T was used were pneumonia (29.5%), sepsis (20.4%), complicated intra-abdominal infection (15.1%), and complicated urinary tract infection (14.4%). The most common pathogens were Pseudomonas aeruginosa (87.4%) and Escherichia coli (8.2%). Median C/T treatment duration was 11 days. Clinical success occurred in 67.3% of patients (including those with 'unknown' status in the denominator). In a separate analysis that excluded those with 'unknown' status, clinical success ranged from 94.1% in patients with bacteraemia to 58.9% with sepsis. Overall, 18.8% of patients had documented microbiologic response. All-cause in-hospital mortality was 21.2%; infection-related mortality was 7.6%. Median hospital length of stay was 42 days (30 days for those who received early C/T therapy [before pathogen identification] vs. 48 days for definitive therapy [after identification])., Conclusions: These data elucidate real-world utilisation and prescribing patterns of C/T in a diverse patient population with complex medical conditions and various profiles of pathogen resistance between 2016 and 2020., (Copyright © 2025 Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA., The Author(s). Published by Elsevier Ltd.. All rights reserved.)

This study aimed to optimize an alternative frozen dessert formulation using the response surface method (RSM). The formulation utilized oat-based milk substitute (OBMS) due to its desirable texture, sensory appeal, and nutritional benefits for vegans and lactose intolerant individuals. Xanthan gum (XG) was also incorporated to enhance the rheological properties of the dessert. With a coefficient of consistency of 192.58 Pa.s and a hysteresis field of 10,999 Pa/s, the ice cream formulation with the greatest rheological structure was discovered to be the combination of 20% oats, 0.5% xanthan gum (XG), and pasteurized at 65 °C. It also showed <10% melting in the first 10 min, confirming that it has a very stable structure. At the same pasteurization conditions and XG ratios, it was observed that rheological stability decreased with increasing oat milk addition. However, the shear thinning behavior of frozen dessert was improved by creating a more complex network structure with increasing XG concentration. The overrun values of the frozen desserts ranged from 21.55% to 34.63%, with the majority being statistically similar. The vegan frozen dessert formulation obtained with 40% oats, 0.37% XG and pasteurization at 60 °C showed a high level of sensory acceptance. This research contributes to the field of vegan food product development by providing innovative rheological and sensory alternatives to traditional frozen desserts using oats and XG., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

It has been reported that the clinical symptoms of functional dyspepsia (FD) exacerbate upon stress while the gender-related factors have been incompletely understood. This study aims to investigate the role of sex in chronic heterotypic stress (CHS)-induced autonomic and gastric motor dysfunction. For CHS, the rats were exposed to the combination of different stressors for 7 consecutive days. Subsequently, electrocardiography was recorded in anesthetized rats to evaluate heart rate variability (HRV) for the determination of autonomic outflow and sympathovagal balance. Solid gastric emptying (GE) was measured in control and CHS-loaded male and female rats. The immunoreactivities of catecholaminergic cell marker tyrosine hydroxylase (TH), choline acetyltransferase (ChAT), corticotropin releasing factor (CRF), and estrogen receptor (ER-α/β) were evaluated in medullary and pontine brainstem sections by immunohistochemistry. Compared with the controls, CHS significantly delayed GE in males but not in females. There was no significant sex-related difference in parasympathetic indicator HF under either control or CHS conditions. Sympathetic indicator LF was significantly higher in control females compared to the males. The higher sympathetic output in females was found to be attenuated upon CHS; in contrast, the elevated sympathetic output was detected in CHS-loaded males. No sex- or stress-related effect was observed on ChAT immunoreactivity in the dorsal motor nucleus of N.vagus (DMV). In males, greater number of TH-ir cells was observed in the caudal locus coeruleus (LC), while they were more densely detected in the rostral LC of females. Regardless of sex, CHS elevated immunoreactivity of TH throughout the LC. Under basal conditions, greater number of TH-ir cells was detected in the rostral ventrolateral medulla (RVLM) of females. In contrast, CHS remarkably increased the number of TH-ir cells in the RVLM of males which was found to be decreased in females. There was no sex-related alteration in TH immunoreactivity in the nucleus tractus solitarius (NTS) of control rats, while CHS affected both sexes in a similar manner. Compared with females, CRF immunoreactivity was prominently observed in control males, while both of which were stimulated by CHS. ER-α/β was found to be co-expressed with TH in the NTS and LC which exhibit no alteration related to either sex or stress status. These results indicate a sexual dimorphism in the catecholaminergic and the CRF system in brainstem which might be involved in the CHS-induced autonomic and visceral dysfunction occurred in males., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Antimicrobial resistance is a major global public health challenge, particularly with the rise of carbapenem-resistant Enterobacterales (CRE) and Pseudomonas aeruginosa (CRPA). This study aimed to describe the characteristics of CRE and CRPA infections in Eastern Europe, focusing on Bulgaria, Croatia, Czechia, Greece, Hungary, Poland, Romania, Serbia, Slovakia, and Slovenia., Methods: Following MOOSE and PRISMA guidelines, a systematic literature review of articles published between 1 November 2017 and 1 November 2023 was conducted using the MEDLINE, Embase, Web of Science, CDSR, DARE, and CENTRAL databases. The search strategy used a combination of free text and subject headings to gather pertinent literature regarding the incidence and treatment patterns of CRE and CRPA infections. A total of 104 studies focusing on infections in both children and adults were included in this review., Results: This review revealed a significant prevalence of carbapenem-resistant Gram-negative isolates and underscored the effectiveness of imipenem/relebactam and ceftazidime/avibactam (CAZ/AVI) against Klebsiella pneumoniae carbapenemase-producing Enterobacterales and of ceftolozane/tazobactam, imipenem/relebactam and ceftazidime/avibactam against non-metallo-β-lactamase-producing CRPA strains., Conclusions: This study highlights the urgent need for comprehensive measures to combat the escalating threat of CRE and CRPA infections in Eastern European countries. At the same time, it shows the activity of the standard of care and new antimicrobials against carbapenem-resistant Gram-negative pathogens in Eastern Europe. Clinical real-world data on the treatment of carbapenem-resistant infections in Eastern Europe are needed.

Background: Allergen-specific immunotherapy, a unique inducer of tolerance, may result in T cell exhaution., Aims: To investigate how the duration of house dust mite (HDM) subcutaneous immunotherapy (SCIT) affects the expression of major immune checkpoint (ICP) molecules on the surface of CD4 + T-helper and regulatory T (Treg) cells., Study Design: Cross-sectional study., Methods: We enrolled 28 children with HDM-induced allergic rhinitis (AR) and six controls. The study participants were divided into six groups: one group each of patients in their first, second, and third years of HDM-SCIT; one group each comprising those in the first year following HDM-SCIT and those on pharmacotherapy; and the control group. The expression of ICPs on CD4 + T and Treg cells was determined using flow cytometry, and plasma levels of soluble ICPs were estimated by ELISA., Results: Our results revealed a significant increase in the expression of cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) and lymphocyte activation gene 3 (LAG-3) on CD4 + T cells during the second and third years of SCIT, respectively. Additionally, a strong correlation was observed between the expression of CTLA-4 and T cell immunoglobulin and mucin domain containing molecule-3 in CD4 + T cells. Furthermore, we observed a significant correlation between the expressions of programmed cell death protein-1, CTLA-4, T cell Immunoreceptor with Immunoglobulin and Immunoreceptor Tyrosine-Based Inhibitory Motif domain, and LAG-3 on both CD4 + T and Treg cells. A robust correlation was observed between the plasma levels of soluble ICPs., Conclusion: HDM-SCIT induces CD4 + T cell exhaution, which may contribute to tolerance induction in children with AR., Competing Interests: Conflict of Interest: The authors declare that they have no conflict of interest.

Purpose: The purpose of this study was to investigate the relations between functional hearing, language, social, bilateral coordination and manual dexterity skills in children with early cochlear implants (CIs)., Methods: Thirty children with CIs were included in this study. The manual dexterity and bilateral coordination development of the participants were evaluated with Manual Dexterity and Bilateral Coordination subtests of Bruininks-Oseretsky Motor Proficiency-2 (BOT-2). Their language skills were assessed by the Test of Early language Development-3. To assess the functional hearing of participants the Functioning After Pediatric Cochlear Implantation scale (FAPCI) was administered their caregivers. Also, the Social Skills Evaluation Scale was administered to participants' teachers to asses their social skills., Results: There were significant correlations between participants' receptive and expressive language skills, Manual Dexterity, and FAPCI scores (p < 0.05). There were also significant relationships between the SSES and FAPCI scores of the participants (p < 0.05). However, the Bilateral Coordination subtest did not show any significant correlation with any of the measurements (p > 0.05)., Conclusion: The results suggest that the language, manual dexterity and functional hearing abilities of children with CIs are closely related. Although, there were no significant correlations between all of the measurement, it is important to look beyond hearing and speech evaluations to assess the whole child., (© 2024. The Author(s).)

Background: Currently available risk stratification models for acute pulmonary embolism (PE) include hemodynamic status, cardiac biomarkers, right ventricle (RV) dysfunction on imaging, and clinical scores. Focusing on the length-tension relationship of the ventricle might have a superior predictive capability over RV dysfunction in terms of mortality and classification of patients with acute PE. In this study, our hypothesis suggests that the tricuspid annular plane systolic excursion (TAPSE)/systolic pulmonary artery pressure (sPAP) ratio has superior predictive capability for in-hospital mortality in patients with acute PE compared to TAPSE or sPAP as distinct measures., Methods: This single-center study comprised retrospectively evaluated 703 patients referred to our tertiary cardiovascular center with acute PE. We divided patients into quartiles based on the TAPSE/sPAP ratio. Different models were developed to quantify the predictive relationship between in-hospital death and echocardiographic measurements. A base model was created with variables including risk status and RV/LV ratio >1. Then, to evaluate the predictive contribution of each measurement; TAPSE/sPAP, TAPSE, and sPAP were sequentially added to the base model. After that, the performance of each model was evaluated., Results: Predictive and discriminative power was the highest in model containing TAPSE/sPAP. There was still a significant inverse association between TAPSE/sPAP and the risk of in-hospital death even after adjusting for risk status and RV/LV ratio >1. Receiver operating characteristic curve analysis for TAPSE/sPAP revealed the best cut-off value as 0.34., Conclusion: The outcomes of our study reveal that the ratio of TAPSE/sPAP serves as a more potent predictor of mortality than either of the 2 measurements taken separately. The interpretation and utilization of the TAPSE/sPAP cut-off value in acute PE can assist in identifying patients at risk of deterioration and guide the consideration of more intensive treatment options across all risk groups.

Background: Information about the development of cognitive skills and the effect of sensory integration in children using auditory brainstem implants (ABIs) is still limited., Objective: This study primarily aims to investigate the relationship between sensory processing skills and attention and memory abilities in children with ABI, and secondarily aims to examine the effects of implant duration on sensory processing and cognitive skills in these children., Methods: The study included 25 children between the ages of 6 and 10 years (mean age: 14 girls and 11 boys) with inner ear and/or auditory nerve anomalies using auditory brainstem implants. Visual-Aural Digit Span Test B, Marking Test, Dunn Sensory Profile Questionnaire were applied to all children., Results: The sensory processing skills of children are statistically significant and positive, and moderately related to their cognitive skills. As the duration of implant use increases, better attention and memory performances have been observed (p < .05)., Conclusion: The study demonstrated the positive impact of sensory processing on the development of memory and attention skills in children with ABI. It will contribute to evaluating the effectiveness of attention, memory, and sensory integration skills, and aiding in the development of more effective educational strategies for these children., (© 2024 The Author(s). Brain and Behavior published by Wiley Periodicals LLC.)

Purpose: This study aims to evaluate school-age language skills and auditory performance in different listening situations in children with cochlear implants and auditory brainstem implants., Method: The study included 60 children between the ages of 5 and 9 years with cochlear implants (CI) and auditory brainstem implants (ABI). The volunteer children were divided into two groups: bimodal CI-ABI and bilateral CI users. Test of Language Development: Primary (TOLD-P:4), which assesses components of language such as phonology, morphology, syntax and semantics, was used to evaluate school-age language skills. Children's Auditory Performance Scale (CHAPS) was used to measure their listening performance in quiet, noisy, multi-stimulus environments and their auditory attention and memory skills in daily life. The correlations between language and auditory performance were analyzed and compared between the two groups., Results: Children with ABI showed poorer performance in school-age language skills and auditory performance in different listening environments (p < 0.05). Significant correlations were between school-age language skills and auditory performance (p < 0.05)., Conclusion: Improved auditory performance is crucial for the development of school-age language skills. To improve auditory performance in children with ABI in different listening environments, assistive listening devices, acoustic environmental arrangements, informative activities, etc., should be used., (© 2024. The Author(s).)

Purpose: The purpose of this study was to compare the language, cognitive, and speech in noise (SiN) perception abilities of children with cochlear implants (CIs) to those of their peers with NH by grouping them according to their implantation period (12-18 months/19-24 months) and unilateral/bilateral CI use., Methods: The sample comprised 50 children with cochlear implants (CIs) and 20 children with normal hearing (NH), ages 6-9 years. Children's language, cognitive, and speech in noise (SiN) perception skills were assessed., Results: Children with CIs between 12 and 18 months and 19 and 24 months performed more poorly than children with NH on language, verbal memory (VM), verbal-short-term memory (V-STM), verbal working memory (V-WM), rapid naming, and speech in noise (SiN) perception abilities measures (p < 0.001). In addition, children with CIs between 19 and 24 months performed worse on rapid naming and V-WM tasks than children with CIs between 12 and 18 months (p < 0.017). Children with unilateral and bilateral CI performed more poorly than children with NH on language, VM, V-STM, V-WM, rapid naming, and SiN perception abilities assessments (p < 0.001). Additionally children with unilateral CI users performed poorly than children with bilateral CI users on SiN perception (p < 0.017)., Conclusions: In children with congenital hearing loss (CHL), cochlear implantation between 12 and 18 months or sequential bilateral implantation is not sufficient for these children to perform like their NH peers in language, cognitive, and SiN perception abilities. In addition, intervention approaches should focus not only on increasing language skills, but also on cognitive abilities., (© 2024. The Author(s).)

We assessed 160 patients who received imipenem/cilastatin/relebactam for ≥2 days. At treatment initiation, the median Charlson Comorbidity Index was 5, 45% were in the intensive care unit, and 19% required vasopressor support. The in-hospital mortality rate was 24%. These data advance our understanding of real-world indications and outcomes of imipenem/cilastatin/relebactam use., (Copyright © 2024 Merck & Co., Inc., Rahway, NJ, USA. Published by Elsevier Ltd.. All rights reserved.)

Objective: This study aimed to investigate the validity and reliability of the Turkish version of the Children's Home Inventory for Listening Difficulties - (C.H.I.L.D) questionnaire., Methods: The study included 121 children with cochlear implants and their families aged 3-12 years and 171 children with normal hearing and their families. Confirmatory factor analysis (C.F.A.) was used to assess construct validity, Cronbach's alpha was used to analyze internal consistency and test-retest reliability was also investigated., Results: The reliability coefficients of the entire C.H.I.L.D family member (C.H.I.L.D-FM) and children version (C.H.I.L.D-C) were 0.983, 0.978, and Cronbach's coefficients were 0.992, 0.992, and the corrected item-total correlations increased from 0.989 to 0.994 and from 0.988 to 0.994, respectively. The scale's construct validity was excellent, according to the CFA analyses. The goodness-of-fit indexes (for the parent's version 0.892 and for the child's version 0.867) demonstrated a good fit for the single-factor construct, with only the normed fit index revealing an acceptable fit., Conclusion: The Turkish version of the C.H.I.L.D is a reliable and valid evaluation test for children and their family members.

Purpose: This study aimed to evaluate attention, memory, and language skills in children with auditory brainstem implants and cochlear implants., Methods: This study included 20 children with auditory brainstem implants (ABI) and 20 cochlear implanted (CI) children between the ages of 6 years and 8 years 11 months and their families. "Test of Language Development: Primary (TOLD-P:4)" was used to assess language skills, "STROOP Test, Visual-Aural Digit Span (VADS) test, and Cancellation Test" were used to evaluate attention and memory skills. In addition, the functional outcomes of hearing skills in daily life were scored by "Auditory Behavior in Everyday Life (ABEL) scale". The significance level was determined as 0.05., Results: Children with ABI showed lower language skills than children with CI in terms of TOLD-P:4 language test scores, STROOP sub-test completion times, and the VADS and Cancellation test scores (p < 0.05). In addition, statistically significant correlations were found between language, attention, memory skills, and auditory behavior scale., Conclusions: This study is one of the limited numbers of studies investigating cognitive processes in children with ABI. Since attention and memory are correlated with language skills, it is recommended that the development of cognition should be considered in follow-up and intervention approaches of children with ABI and/or CI., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)