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Introduction: This study investigates into the drought-prone region of the Lake Balkhash basin, conducting a thorough analysis spanning 2 decades, emphasizing its significant impact on agriculture and water challenges in Central Asia. Beyond the specific focus on this region, the research aims to contribute valuable insights that extend our understanding of the broader implications of drought in the area.Methods: Utilizing MODIS satellite imagery, the study employs the Vegetation Health Index a comprehensive indicator combining the Vegetation Condition Index and Temperature Condition Index ranging from 0 (extreme aridity) to 100 (optimal moisture). The assessment of drought conditions from 2000 to 2020 includes probabilistic mapping, trend analysis, and Pearson’s correlation coefficients. Connections with hydrological factors, such as river water levels and the Balkhash Lake area, are explored, along with in-depth analyses of land use data and the GRACE dataset on water equivalent thickness, enhancing the study’s depth and reliability.Results: Drought affected approximately 44% of the Balkhash Lake Basin during the study period, impacting both Kazakhstan and China. Severe drought episodes occurred in 2000, 2008, 2014, and 2015, highlighting the region’s vulnerability. Analysis of drought trends revealed diverse patterns: 23% exhibited an increase, 17% showed a decrease, and 60% remained stable. Correlations between drought and hydrological parameters varied among stations, with positive correlations at Kapshagay and Shelek Stations, a weak correlation at Ayagoz Station, and a significant positive correlation at Lepsy despite the elevation.Discussion: This research underscores the intricate link between drought and hydrological factors in the Balkhash Lake Basin, emphasizing the need for precise water resource management and climate adaptation. Crucial strategies include proactive monitoring, tailored interventions, and the application of probabilistic drought mapping to enhance water supply management, contributing actionable insights for sustainable practices in the region.Conclusion: This study significantly advances our understanding of drought dynamics in the Balkhash Lake Basin, recommending adaptive strategies, site-specific interventions, and sustainable water management. The findings provide a crucial foundation for informed water resource decisions in Central Asia, emphasizing the importance of region-specific approaches to address diverse challenges posed by drought.

The article is devoted to the development of ecological tourism in the national parks of Belarus. The methodological basis of the study was a systematic scientific approach, comparative geographical, cartographic, expert assessment methods. As a result of the research, the data on environmental requirements for ecological tourism organisation in the national parks of the Republic of Belarus such as state environmental institutions "National Park "Narochansky", "National Park "Braslav Lakes", "National Park "Belovezhskaya Pushcha", "National Park "Pripyatsky" are systematized. Landscape features of the national park’s territories are considered as a factor determining the direction of ecotourism activities. The analysis of ecotourism infrastructure development, innovativeness and complexity of the offered tourist services is given. Prospective directions of development of domestic and international inbound ecological tourism in the national parks of Belarus are substantiated.

Abstract Proteinuria poses a substantial risk for the progression of chronic kidney disease (CKD) and its related complications. Kidneys excrete hundreds of individual proteins, some with a potential impact on CKD progression or as a marker of the disease. However, the available data on specific urinary proteins and their relationship with CKD severity remain limited. Therefore, we aimed to investigate the urinary proteome and its association with kidney function in CKD patients and healthy controls. The proteomic analysis of urine samples showed CKD stage-specific differences in the number of detected proteins and the exponentially modified protein abundance index for total protein (p = 0.007). Notably, specific urinary proteins such as B2MG, FETUA, VTDB, and AMBP exhibited robust negative associations with kidney function in CKD patients compared to controls. Also, A1AG2, CD44, CD59, CERU, KNG1, LV39, OSTP, RNAS1, SH3L3, and UROM proteins showed positive associations with kidney function in the entire cohort, while LV39, A1BG, and CERU consistently displayed positive associations in patients compared to controls. This study suggests that specific urinary proteins, which were found to be negatively or positively associated with the kidney function of CKD patients, can serve as markers of dysfunctional or functional kidneys, respectively.

The article is devoted to the development of ecological tourism in the national parks of Belarus. The methodological basis of the study was a systematic scientific approach, comparative geographical, cartographic, expert assessment methods. As a result of the research, the data on environmental requirements for ecological tourism organisation in the national parks of the Republic of Belarus such as state environmental institutions "National Park "Narochansky", "National Park "Braslav Lakes", "National Park "Belovezhskaya Pushcha", "National Park "Pripyatsky" are systematized. Landscape features of the national park's territories are considered as a factor determining the direction of ecotourism activities. The analysis of ecotourism infrastructure development, innovativeness and complexity of the offered tourist services is given. Prospective directions of development of domestic and international inbound ecological tourism in the national parks of Belarus are substantiated. [ABSTRACT FROM AUTHOR]

Background. Hashimoto’s thyroiditis (HT) is an auto-immune condition characterized with lymphocytic and fibroblastic infiltration of the thyroid gland. The rate of uric acid and HDL cholesterol – so called as uric acid to HDL ratio (UHR) has been shown to be elevated in inflammatory conditions diseases. We aimed to compare UHR and other laboratory parameters of the patients with HT to those values in healthy controls.

Proteinuria is a risk factor for chronic kidney disease (CKD) progression and associated complications. However, there is insufficient information on individual protein components in urine and the severity of CKD. We aimed to investigate urinary proteomics and its association with proteinuria and kidney function in early-stage CKD and in healthy individuals. A 24 h urine sample of 42 individuals (21-CKD and 21-healthy individuals) was used for mass spectrometry-based proteomics analysis. An exponentially modified protein abundance index (emPAI) was calculated for each protein. Data were analyzed by Mascot software using the SwissProt database and bioinformatics tools. Overall, 298 unique proteins were identified in the cohort; of them, 250 proteins belong to the control group with median (IQR) emPAI 39.1 (19–53) and 142 proteins belong to the CKD group with median (IQR) emPAI 67.8 (49–117). The level of 24 h proteinuria positively correlated with emPAI (r = 0.390, p = 0.011). The emPAI of some urinary proteomics had close positive (ALBU, ZA2G, IGKC) and negative (OSTP, CD59, UROM, KNG1, RNAS1, CD44, AMBP) correlations (r < 0.419, p < 0.001) with 24 h proteinuria levels. Additionally, a few proteins (VTDB, AACT, A1AG2, VTNC, and CD44) significantly correlated with kidney function. In this proteomics study, several urinary proteins correlated with proteinuria and kidney function. Pathway analysis identified subpathways potentially related to early proteinuric CKD, allowing the design of prospective studies that explore their response to therapy and their relationship to long-term outcomes.

Polycystic kidney disease (PKD) is a common inherited disease characterized by multiple cysts in kidneys and various extra renal manifestations. Molecular diagnosis plays a crucial role in confirming both the clinical diagnosis and preimplantation genetic diagnosis furthermore, selecting appropriate treatment options. This study aimed to expand the understanding of genetic mutations in patients with polycystic kidney disease and to improve the management of patients. The study included 92 patients with a clinical diagnosis of PKD based on renal ultrasound criteria. Targeted next-generation sequencing was performed using a custom panel kit. Of the 92 patients included in the study, pathogenic/likely pathogenic variants of the PKD1, PKD2 genes were detected in 37 patients (40.2%), while 8 patients (8.6%) had variants with uncertain clinical significance. After the additional assessment of pathogenic/likely pathogenic variants, it was found that 15 of the variants in PKD1 and 2 of the variants in PKD2 have not been reported in the literature previously. Additionally, pathogenic variants, 5 of which were novel, have been identified in different genes in 8 patients. This study presented the largest patient cohort conducted in Turkey. These findings were significant in expanding our understanding of the genetic variations associated with polycystic kidney disease. The study contrıbuted the literature data on polycystic kidney disease by reporting important findings that could pave the way for further investigations in the diagnosis, treatment, and management of the affected patients., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: Insulin treatment is fundamental to diabetes management. Basal insulin therapy reduces intraday glycemic fluctuations upon reaching a steady state. Besides better blood glucose regulation and achieving target HbA1c values in patients, it also offers protection from diabetes complications. In this review, we aimed to compare basal-acting insulins in light of the literature., Areas Covered: We reviewed current evidence related to diabetes treatment with basal insulins. This includes discussions on clinical trials and meta-analyses concerning first and second-generation ultra-long-acting basal insulins. Treatment indications for long-acting basal insulins, which have shown benefits and are considered superior or comparable to others in the literature, are derived from current clinical studies and meta-analyses, which form the basis of the recommendations in this review., Expert Opinion: First and second-generation basal insulins do not show much superiority over each other in terms of blood glucose regulation and reaching the target HbA1c. However, second-generation basal insulins cause fewer hypoglycemic events. We recommend using the appropriate basal insulin in patient-based, individualized treatments. Basal insulin Icodec may become more widely used over time, owing to its association with less hypoglycemia and a reduction in the number of injections.

Objectives: The objective of this study was to identify a parameter that can facilitate the diagnosis of prediabetes and predict the likelihood of its development in individuals at high risk., Methods: In this retrospective study, the study population was selected from Bolu Abant Izzet Baysal University Hospital's patients. Participants were divided into two groups, prediabetes and healthy group. We excluded individuals with certain conditions or taking certain medications. The study compared the ratios of uric acid to high-density lipoprotein (HDL) between the two groups and identified the optimal point of differentiation., Results: The study analyzed data from 228 individuals, including 125 with prediabetes and 103 healthy controls. Those with prediabetes had a significantly higher median UHR (0.13 (0.07-0.24) %) compared to healthy individuals (0.09 (0.05-0.16) %) (p < 0.001). Higher UHR values were associated with a greater risk of prediabetes. A UHR cut-off points greater than 0.11 % had a sensitivity of 74 % and specificity of 69 % in detecting prediabetes., Conclusion: The study provides evidence that UHR can serve as a practical and valuable diagnostic and screening tool for prediabetes (Tab. 2, Fig. 1, Ref. 23). Text in PDF www.elis.sk Keywords: serum uric acid, HDL cholesterol, UHR, prediabetes.

Comorbidity rates in the geriatric population have increased because of rising life expectancy; thus, patients have had to use more medications. Type 2 diabetes mellitus, one of the most common diseases, may influence the number of drugs used in geriatric patients. The present study was designed to investigate the association between the level of type 2 DM and polypharmacy. Fifty patients with type 2 diabetes over the age of 65 were included according to the inclusion criteria; 23 were well-controlled and 27 had poorly controlled diabetes. The groups were similar in terms of age, sex, WBC, Hb, Plt, AST, ALT, serum creatinine, fasting glucose, and eGFR levels. Patients with HbA1c values above 7.5 were classified as poorly controlled diabetes patients, and those below were considered well-controlled diabetes patients and were evaluated for inappropriate medication use. The number of medications used daily by the cases ( p < 0.001), the number of concomitant diseases ( p = 0.001), and the number of increased risks according to the Beers Criteria ( p = 0.02) were observed to be high in poorly controlled type 2 diabetes mellitus subjects. HbA1c levels were related to the number of medications (r = 0.4, p = 0.004), comorbidities (r = 0.28, p = 0.04), and the number of increased risks according to the Beers Criteria (r = 0.31, p = 0.014). In conclusion, the number of medications used in patients with poorly controlled type 2 diabetes mellitus was found to be more elevated than in individuals with well-controlled type 2 diabetes mellitus. The HbA1c values varied among patients regarding polypharmacy, comorbidities, and increased risks according to the Beers Criteria.

Germline mutations in BRCA1 and BRCA2 genes are mainly responsible for breast and/or ovarian cancer patients. Most of the mutations in these genes are single nucleotide changes or deletions/insertions of small numbers of bases, while a minority of mutations in these genes are large genomic rearrangements (LGRs). The frequency of LGRs in the Turkish population is not clearly known. Also insufficient awareness of the importance of LGRs in breast and/or ovarian cancer development can lead to some disruptions in patient management. So, we aimed to determine the frequency and distribution of the LGRs in the BRCA1/2 genes in the Turkish population. We investigated rearrangements of BRCA genes using multiplex ligation-dependent probe amplification (MLPA) analysis in 1540 patients with a personal and/or family history of breast and/or ovarian cancer or who had familial known large deletion/duplication and applied for segregation. The estimated overall frequency of LGRs in our group was 3,4% (52/1540) with 91% in BRCA1 gene and 9% in BRCA2 gene. 13 different rearrangements were detected (10 BRCA1, 3 BRCA2). To the best our knowledge, BRCA1 exon 1-16 duplication and BRCA2 exon 6 deletion have not been previously reported before. Our study results supported that the detection of rearrangements in BRCA genes is of great importance and it should be planned routinely in patients whose mutations cannot be detected by sequence analysis in screening programs., (© 2023. The Author(s), under exclusive licence to The Japan Society of Human Genetics.)

Background: The systemic inflammatory index (SII) is a new inflammatory marker that has been the subject of various studies in diseases with chronic inflammation. Diabetic nephropathy is a disease associated with chronic inflammation. We aimed to evaluate the relationship between SII and diabetic nephropathy., Methods: Patients with diabetes who applied to our outpatient clinic were included in the study. Diabetic patients were divided into two groups: those with diabetic nephropathy and those without. In addition, healthy individuals who applied to our clinic for general check-ups during these dates were included as the control group. The SII values and other characteristics of the three study groups were compared., Results: The median SII value for those with DKI was 584 (178-4819); for those without DKI, it was 282 (64-618); and for the control group, it was 236 (77.5-617) ( p < 0.001). SII was significantly and positively correlated with BMI, weight, blood glucose, HbA1c, CRP, and creatinine, and negatively correlated with the glomerular filtration rate (GFR) value. SII values higher than 336 have 75% sensitivity and 70% specificity in detecting DKI., Conclusion: The SII value can predict diabetic kidney injury in diabetics, and it can be used as an adjunctive diagnostic tool.

In this study, Event-Related Potential (ERP) analyzes were performed to detect cognitive impairments in PD with Deep Brain Stimulation (DBS). A total of 85 volunteers underwent ERP analysis and neuropsychological testing (NPT) to determine cognitive level. In ERP analyses, prolonged latencies were observed in PD groups. However, patients implanted with DBS showed a decrease in latencies, a decrease in symptoms and statistical improvements in both cognitive and attention skills. Considering all these data, ERP results are promising as a noninvasive method that can be used in both disease status and diagnosis of PD.

Objective: The time perspective of individuals with chronic disease is a little-studied parameter. Our aim is to examine multiple sclerosis (MS) patients' time perspective and factors that may affect time perspective and to research the correlation of past, present, and future perspectives., Methods: Demographic characteristics, the Zimbardo Time Perspective Inventory (ZTPI) score, and the expanded disability status scale score were recorded. Overall, 50 with MS were included in the study., Results: We found that there was a significant difference between present-fatalistic (x=3.18), and present-hedonistic (x=3.49), (p=0.017); also between present-fatalistic (x=3.18), and future (x=3.57), (p=0.011). There was no significant difference in ZTPI scores between gender, place of residence, marital status, number of attacks, or education level., Conclusion: MS patients focus mostly on the hedonistic dimension of the life than the fatalistic one in present time. We concluded that patients with MS focused mostly on the future. We found that our patients' present-fatalistic scores were lower, and the future was higher time perspective dimension., Competing Interests: No conflict of interest was declared by the authors., (© Copyright 2023 by Istanbul Provincial Directorate of Health.)

Introduction: Cerebral venous thrombosis (CVT) associated with pregnancy and puerperium has long been recognized, with poor information in terms of functional outcomes. Our objective was to analyze risk factors, clinical, imaging, and laboratory variables to predict functional outcome and death in this population., Methods: CVT registries from three referral centers from Pakistan, Turkey, and Mexico, recruiting prospective cases, were combined for CVT associated with pregnancy or puerperium. Datasets and variables were standardized. Demographic characteristics, presentation, risk factors, and functional outcomes in pregnancy/puerperium-related CVT were analyzed. Binary logistic regression was used to assess predictors of outcome. The main outcome was modified Rankin score >2 at 30 days and mortality at 30 days., Results: Five hundred fifty-three cases (median age 28 years [IQR 23-34]) of CVT associated with pregnancy and puerperium were included; 439 cases (79.4%) happened in the puerperium and 20.6% during pregnancy (53.5% occurred during the first trimester). Anemia (36.7%) and dehydration (22.9%) were the commonest obstetric risk factors identified. Predictors of poor outcome (mRS >2) were encephalopathy (OR 12.8, p < 0.001), cases from Mexican origin (OR 3.1, p = 0.004), fever/puerperal infection (OR 2.7, p = 0.02), and anemia (OR 2.2, p = 0.01). Cases from Mexican origin (OR 12.0, p = 0.003) and Encephalopathy (OR 7.7, p < 0.001), presented with the highest mortality association in the final adjusted model., Discussion/conclusion: In CVT associated with pregnancy and puerperium, encephalopathy, fever/puerperal infection, and anemia are associated with bad functional outcomes, meanwhile encephalopathy and cases from Mexican origin with higher mortality in the acute (30-days) of CVT onset. Anemia and infection are potential reversible predictors of poor outcome that clinicians should be aware of in order to prevent poor outcomes in these patients., (© 2022 S. Karger AG, Basel.)

Many multiple sclerosis (MS)-associated common risk variants as well as candidate low-frequency and rare variants have been identified; however, approximately half of MS heritability remains unexplained. We studied seven multiplex MS families, six of which with parental consanguinity, to identify genetic factors that increase MS risk. Candidate genomic regions were identified through linkage analysis and homozygosity mapping, and fully penetrant, rare, and low-frequency variants were detected by exome sequencing. Weighted sum score and polygenic risk score (PRS) analyses were conducted in MS families (24 affected, 17 unaffected), 23 sporadic MS cases, 63 individuals in 19 non-MS control families, and 1272 independent, ancestry-matched controls. We found that familial MS cases had a significantly higher common risk variation burden compared with population controls and control families. Sporadic MS cases tended to have a higher PRS compared with familial MS cases, suggesting the presence of a higher rare risk variation burden in the families. In line with this, score distributions among affected and unaffected family members within individual families showed that known susceptibility alleles can explain disease development in some high-risk multiplex families, while in others, additional genetic contributors increase MS risk., (© 2022. The Author(s).)

Earth's ecosystems are increasingly threatened by "hot drought," which occurs when hot air temperatures coincide with precipitation deficits, intensifying the hydrological, physiological, and ecological effects of drought by enhancing evaporative losses of soil moisture (SM) and increasing plant stress due to higher vapor pressure deficit (VPD). Drought-induced reductions in gross primary production (GPP) exert a major influence on the terrestrial carbon sink, but the extent to which hotter and atmospherically drier conditions will amplify the effects of precipitation deficits on Earth's carbon cycle remains largely unknown. During summer and autumn 2020, the U.S. Southwest experienced one of the most intense hot droughts on record, with record-low precipitation and record-high air temperature and VPD across the region. Here, we use this natural experiment to evaluate the effects of hot drought on GPP and further decompose those negative GPP anomalies into their constituent meteorological and hydrological drivers. We found a 122 Tg C (>25%) reduction in GPP below the 2015-2019 mean, by far the lowest regional GPP over the Soil Moisture Active Passive satellite record. Roughly half of the estimated GPP loss was attributable to low SM (likely a combination of record-low precipitation and warming-enhanced evaporative depletion), but record-breaking VPD amplified the reduction of GPP, contributing roughly 40% of the GPP anomaly. Both air temperature and VPD are very likely to continue increasing over the next century, likely leading to more frequent and intense hot droughts and substantially enhancing drought-induced GPP reductions., (© 2022 The Authors. Global Change Biology published by John Wiley & Sons Ltd. This article has been contributed to by US Government employees and their work is in the public domain in the USA.)

Phenylketonuria (PKU) is an autosomal recessive disorder of phenylalanine metabolism, mostly caused by PAH gene variants. The aim of this study was to identify the frequency of PAH gene variants in Turkish population with PKU. In 433 patients with PKU, PAH gene was examined using next generation sequencing (NGS) method. IVS10- 11G>A, p.R261Q, p.A300S, p.A403V, and p.T380 variants, which are the most common variants in this study, constituted 45,9% of the variants in our study. Nine novel variants p.A34V, K73Qfs*4, R157H, R261S, p.T266I, p.S310P, T328A, p.F351I, and K363N were identified. This study determines the most common PAH variants in Turkey and shows that PKU can be screened before marriage with the screening kits. Identification of the PAH gene variant spectrum is important for early diagnosis, understanding molecular mechanisms, clinical follow-up, treatment, and genetic counseling. And the novel variants found this study are important for further studies., (© 2022 Walter de Gruyter GmbH, Berlin/Boston.)

Myelination is crucial for the development and maintenance of axonal integrity, especially fast axonal action potential conduction. There is increasing evidence that glutamate signaling and release through neuronal activity modulates the myelination process. In this study, we examine the effect of manipulating glutamate signaling on myelination of oligodendrocyte (OL) lineage cells and their development in zebrafish (zf). We use the "intensity-based glutamate-sensing fluorescent reporter" (iGluSnFR) in the zf model (both sexes) to address the hypothesis that glutamate is implicated in regulation of myelinating OLs. Our results show that glial iGluSnFR expression significantly reduces OL lineage cell number and the expression of myelin markers in larvae (zfl) and adult brains. The specific glutamate receptor agonist, L-AP4, rescues this iGluSnFR effect by significantly increasing the expression of the myelin-related genes, plp1b and mbpa, and enhances myelination in L-AP4-injected zfl compared to controls. Furthermore, we demonstrate that degrading glutamate using Glutamat-Pyruvate Transaminase (GPT) or the blockade of glutamate reuptake by L-trans-pyrrolidine-2,4-dicarboxylate (PDC) significantly decreases myelin-related genes and drastically declines myelination in brain ventricle-injected zfl. Moreover, we found that myelin-specific ClaudinK (CldnK) and 36K protein expression is significantly decreased in iGluSnFR-expressing zfl and adult brains compared to controls. Taken together, this study confirms that glutamate signaling is directly required for the preservation of myelinating OLs and for the myelination process itself. These findings further suggest that glutamate signaling may provide novel targets to therapeutically boost remyelination in several demyelinating diseases of the CNS., (© 2021 The Authors. Journal of Neuroscience Research published by Wiley Periodicals LLC.)

Hospital visits and regular rehabilitation of chronic patients due to COVID-19 pose a risk. Therefore, patients with chronic illnesses who need regular rehabilitation have been victims of the pandemic process. Because of their fear of being infected, they were deprived of the chance of their symptoms being rehabilitated. Therefore, it is extremely important to rehabilitate individuals with chronic illnesses in need of rehabilitation through telerehabilitation. In this study, we aimed to show the effect of Cawthorne-Cooksey exercises to be applied through telerehabilitation on eye movements, vision, and quality of life in a patient suffering from diplopia due to multiple sclerosis (MS). It has been found that Cawthorne-Cooksey exercises improve the quality of life and reduce the complaints of diplopia in MS patients with diplopia. In addition, the patient verbally stated that his balance increased after Cawthorne-Cooksey exercises. As a result, Cawthorne-Cooksey exercises are a rehabilitation method that gives positive results in the treatment of diplopia and it is recommended to apply this method via telerehabilitation., (© 2021. Fondazione Società Italiana di Neurologia.)