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Objective: The present study aimed to evaluate the clinical benefits and drawbacks of administering ECMO/ECLS therapies to drug-intoxicated patients.Methods: From inception until April 30, 2024, an extensive search was performed on four main databases:PubMed, Web of Science, Cochrane Library, and EMBASE. There was no restriction on the search period. Onlythe studies that reported survival to hospital discharge rates, adverse events, and the utilization of ECMO/ECLSin the treatment of intoxicated patients were included. On the other hand, articles that did not report adverseevents or hospital discharge rates as outcomes, as well as studies published in languages other than English,were excluded. The evaluated outcomes were the rate of survival to hospital discharge rate and the incidenceof adverse events associated with ECMO therapy. The Newcastle Ottawa scale was employed to appraise eachstudy to determine its methodological quality. The Comprehensive Meta-Analysis (CMA) software (version3.0) for statistical analysis was used, with the random effects model (due to high heterogeneity among thestudies) and a 95% confidence interval.Results: From a total search of 2216 search results, only 10 studies were included. The pooled analysis from10 studies indicated that ECMO therapies among drug-overdosed/poisoned patients were associated witha significant survival to hospital discharge rate of 65.6% ([95% CI: 51.5%-77.4%], p=0.030). However, theoutcomes were highly heterogeneous (I2=83.47%), which could be attributed to the use of several medicinesby different studies. In contrast, ECMO therapies among drug-overdosed patients were associated with asignificant incidence rate of adverse events of 23.1% ([95% CI: 12.3%-39.2%], p=0.002). However, the pooledanalysis had a significant heterogeneity (I2=70.27%).Conclusion: Despite various health complications, extracorporeal membrane treatment enhanced survival tohospital discharge with good neurological outcomes. Hence, it was a viable, effective, and feasible alternativefor managing drug-induced intoxication in patients.

Background/Aim: This study was designed to elucidate the relationship between the AIS 90 thoracic score, which is commonly used to assess the severity of trauma in trauma patients, and the relatively limited studies and data available on the Glucose Potassium Ratio (GPR). Additionally, the study aims to highlight the superiority, if any, of GPR in terms of trauma severity and prognosis, along with the Neutrophil Lymphocyte Ratio (NLR), which plays an important role in trauma severity and prognosis. Material-Methods: Between June 2020 and June 2022, individuals aged 18 and older admitted to the emergency department with isolated thoracic trauma were included in the study. Data pertaining to these patients were retrospectively analyzed with the AIS 90 thoracic score serving as the reference point. The retrospective screening data of the patients enrolled in the study facilitated the categorization of individuals into three groups based on criteria delineating outpatient treatment, hospitalization and admission to the intensive care unit. The mean values of the GPR and the NLR across these three groups were assessed utilizing Analysis of Variance (ANOVA). Tukey tests were used for homogeneous groups and Tamhane tests were used for non-homogeneous groups to determine specific groups that caused significant differences. ANOVA homogeneity was checked by the Levene test and if homogeneity could not be achieved, the Welch test was used. Results: The analysis of 89 patients with isolated thoracic trauma revealed no statistically significant difference in the GPR values between the three groups (Levene p < 0.05, ANOVA p=0.025). However, further exploration through Tukey multiple comparisons indicated that the observed significant difference was attributable to patients admitted to the intensive care unit. Likewise, a statistically significant difference was observed between the three groups in the analysis of NLR values. (Levene p=0.252, Welch p=0.028). Following Tukey’s multiple comparisons, it was determined that the significant difference could be attributed to patients hospitalized in the intensive care unit. Conclusion: The findings of the study support the conclusion that individuals with an AIS 90 thoracic score above 3 and who need to be admitted to intensive care show higher GPR values than other groups. The association between high GPR values and heightened lung parenchymal injury was evident. Consequently, it can be inferred that a high GPR value may serve as an indicator of lung parenchymal damage, suggesting a greater need for intensive care unit admission in such patients.

A differentiated science activity was created for gifted students. The focus is on Sustainable Development Goal 15 (SDG-15) for life on land, enhancing engagement, self-regulated learning skills, and scientific creativity in gifted students. The activity spanned eight lesson hours, with tasks encouraging observation, inquiry, and creative thinking. Evaluation included achievement, process, and product forms, along with teacher observations and student feedback. Differentiating the learning environment and process through the utilization of Metaverse and immersive virtual reality technologies is crucial as it affords gifted students the chance to explore novel strategies in differentiated science education. In this particular context, three 3D scenes were created and imported into the Imedu Metaverse platform. Students used laptops to view 3D scenes at three separate occasions. During their visits, they examined living and non-living components of the forest ecosystem, including natural life and environmental conditions. Students experienced immersion with Oculus Quest 2 VR headsets. Following this encounter, they participated in querying procedures. Before and after utilizing applications within the Metaverse, efforts were made to enhance awareness of SDG-15 and foster scientific creativity.

Objective: This study aimed to compare the clinical risks and outcomes of COVID-19 and influenza.Methods: The search for relevant articles was conducted using both a database search method and a manualsearch, which involved searching through the reference lists of articles related to the topic for additional studies.The Quality assessment was carried out using the Newcastle Ottawa tool, and the data analysis was conductedusing the Review Manager Software (RevMan 5.4.1).Results: The meta-analysis results indicated that COVID-19 patients had similar lengths of hospital stays(SMD: -0.25; 95% CI: -0.60-0.11; p=0.17). However, COVID-19 patients had significantly higher mortality rates(RR: 0.28; 95% CI: 0.21-0.37; p

Heart failure (HF) is a structural and functional disease that affects millions of people worldwide. The role of inflammation has been demonstrated in many diseases. However, the impact of the Systemic Inflammatory Response Index (SIRI) and the Systemic Immuno-Inflammation Index (SII) on mortality in HF patients has not been adequately investigated. Therefore, in this study, we aimed to demonstrate the effect of SIRI and SII on mortality in patients diagnosed with HF.

In the literature longevity and comfort are evaluated in terms of entropy generation and export rates. When people cannot export entropy, they experience discomfort. Effect of bedding, pajamas and levels of body coverage have been assessed in 270 cases by referring to body weight and height of 25 years old women. By 160 cm tall and 50 kg women, at 0 °C of room temperature, entropy export rates were 6.0x10--3 and 7.4x10--3 W/kg K, while they were sleeping on their back and on the side, respectively. The results showed that entropy export became more difficult as the body temperature approached the room temperature. Textile properties, including heat transfer and wicking rates of sweat removal were also important while exporting the entropy. The results of this study may be employed while designing beds or beddings, pajamas and comforters to achieve a more comfortable sleeping environment. [ABSTRACT FROM AUTHOR]

Background and purpose: Erectile dysfunction is a common issue among adult males involving difficulty in maintaining an erection, and it is often treated with fast-acting, low-side-effect drugs like avanafil (AVN), among other phosphodiesterase-5 inhibitors. Hence, developing fast, simple, and sensitive methods to detect AVN is crucial. Experimental approach: This study conducts an electroanalytical inquiry and provides a new voltammetric method for accurately analyzing AVN utilizing a boron-doped diamond (BDD) electrode without any modifications. Key results: In the Britton-Robinson buffer (BR, 0.04 mol L-1, pH 4.0), cyclic voltam­metry showed a clearly defined and irreversible anodic peak at around +1.44 V relative to Ag/AgCl. The pH of the solution was shown to have an impact on the voltammetric signals of the oxidation peaks. A good linear response for AVN quantification was achieved using square-wave voltammetry. This was done in a 0.04 mol L-1 BR (pH 4.0) solution at a potential of +1.33 V (vs. Ag/AgCl). The method exhibited a wide dynamic range of 0.5 to 30.0 μg mL-1 (1.0 to 62 µmol L-1) and a low limit of detection of 0.14 μg mL-1 (0.29 µmol L-1). The method proposed demonstrated suitability for determining AVN content in pharmaceutical formulations. The accuracy of the approach was demonstrated by comparing the results obtained using the developed method with those achieved using the UV-Vis spectrometry method. Conclusion: Our method simplifies the analytical process by eliminating the need for electrode modification, reducing both time and resource requirements while enhancing overall feasibility.

Abstract Background Differentiating sepsis from non-infectious systemic inflammatory response syndrome (SIRS) is challenging. Biomarkers like procalcitonin (PCT) aid early risk assessment and guide antibiotic use. This study aims to ascertain PCT's accuracy as a sepsis biomarker among adult emergency department admissions. Method The PRISMA guidelines were followed to search for relevant articles in five electronic databases between April 14th and August 4th, 2023: PubMed, Cochrane Library, ProQuest, EMBASEs, and ScienceDirect. Studies had to be published in English to avoid directly translating scientific terms. Besides, the inclusion criteria were based on the diagnosis of sepsis in adult patients admitted to an emergency department. QUADAS-2 tool provided by the Review Manager version 5.4.1 was utilized to assess the risk of bias in included studies. STATA (v. 16) software was used to perform the meta-analysis. Results Ten of 2457 studies were included. We sampled 2980 adult sepsis patients for the under-investigated role of PCT in ED sepsis diagnosis. PCT emerged as the primary early diagnostic biomarker with high levels (29.3 ± 85.3 ng/mL) in sepsis patients. Heterogeneity in outcomes, possibly due to bias in cohort and observational studies, was observed. Conclusion PCT tests offer moderate accuracy in diagnosing sepsis and stand out for rapidly and precisely distinguishing between viral and bacterial inflammations.

Background: Renal colic is a frequently encountered condition in the emergency department (ED), characterized by the sudden and severe onset of flank pain. To assess the risk of cardiac arrhythmia in patients with renal colic, electrocardiography (ECG) was used to investigate several ventricular arrhythmia characteristics, such as the Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio.Objective: This study aimed to investigate the role of the Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio as cardiac arrhythmia stimulators in patients with renal colic. By evaluating these parameters, the risk of developing cardiac arrhythmia in individuals with renal colic could be better understood.Methods: The study included patients who presented to the tertiary emergency department with renal colic over a period of six months, from June 10, 2022, to December 31, 2022. Upon admission, all patients underwent an ECG, and measurements of QT interval and Tp-e interval were conducted in leads D2 and V5. These measurements served as indicators for assessing the potential risk of cardiac arrhythmia in patients with renal colic.Results: The levels of D2 TPE were significantly elevated in patients experiencing renal colic attacks compared to both the pain-free period and the control group (p=0.036). Additionally, the levels of D2 Tpe and QTc were significantly higher during the renal colic attack period as well as the pain-free period when compared to the control group (p=0.041).Conclusions: The Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio may potentially be associated with fatal ventricular arrhythmias in patients who present to emergency departments with renal colic pain.

Introduction: Scombroid poisoning is a condition that occurs after ingestion of seafood and can cause cardiac and respiratory effects, shock, and life-threatening conditions, as well as gastrointestinal findings caused by increased histamine levels. Case Report: The detailed history of the 80-year-old male patient who presented to the emergency department with chest pain, nausea and vomiting revealed that he had consumed an excessive amount of anchovies 10 hours prior to admission. On follow-up, the patient's blood pressure was 142/66 mmHg and heart rate was 48/min. Bradycardia, PR interval prolongation and ST depressions were observed on the initial ECG. No troponin elevation was observed during the patient's follow-up in the emergency department, and the patient was treated with antihistamines, steroids, and fluid resuscitation, and his condition was assessed as scombroid toxicity. The follow-up ECG of the patient whose symptoms resolved after treatment showed that the bradycardia had resolved, the heart rhythm was 65 bpm, the PR interval prolongation had returned to normal, and the signs of first-degree AV block had resolved. Conclusion: While tachycardia and bronchospasm have been observed in scambroid poisoning in the literature, in our case bradycardia was observed to develop as a result of vagal stimulation due to increased histamine. Increased histamine levels can cause life-threatening situations by producing bradycardia, which can develop into asystole with vagal nerve impulses. The use of antihistamines in the treatment of bradycardia, which is one of the effects of histamine, shows a good prognosis, as in our case.

Criminal behavior in children emerges as a result of a complex process. If the criminal behavior is repetitive and preventive interventions are not applied, it can also lead to the emergence of criminal behavior in adulthood. In our study, we aimed to compare the parental temperament characteristics of juvenile delinquents with those of non-offending children of similar age and gender. The study group included parents of 69 juvenile delinquents aged between 12 and 15, while the control group consisted of parents of 73 non-offending children of the same age range. Data was collected using a demographic information form prepared by researchers and the TEMPS-A (Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire) Temperament Scale. The study group included 37 fathers and 32 mothers, while the control group included 40 fathers and 33 mothers. Parents in the study group had less education than those in the control group, and psychopathology was more common. The study group's parents experienced more legal issues on average. In comparison to the control group, fathers in the study group scored higher for cyclothymic temperament, hyperthymic temperament, and irritable temperament. Compared to the control group, mothers in the study group scored higher on all temperamental variables. The fathers' assessments of their depressive and anxious temperaments did not differ significantly. Fathers in the study group scored higher on the cyclothymic, hyperthymic, and irritable temperament scales. There was a considerable difference in the prevailing temperament type between the groups. Moms in the research group had significantly higher temperament scores than those in the control group. [Med-Science 2023; 12(4.000): 1358-63]

Key Clinical Message Septic pulmonary embolism (SPE) can originate from unusual sources like small boils, warranting consideration of diverse etiologies in respiratory distress. Prompt diagnosis, tailored antibiotics, and vigilant complication management optimize outcomes. Early recognition and treatment of minor infections, especially in diabetes are crucial.

Objective: The prevalence of obesity has increased over the past three decades. Proopiomelanocortin (POMC) neurons in the hypothalamic arcuate nucleus (ARC) play a vital role in induction of satiety. Chronic consumption of high-fat diet is known to reduce hypothalamic neuronal sensitivity to hormones like leptin, thus contributing to the development and persistence of obesity. The functional and morphological effects of a high-calorie diet on POMC neurons and how these effects contribute to the development and maintenance of the obese phenotype are not fully understood. For this purpose, POMC-Cre transgenic mice model was exposed to high-fat diet (HFD) and at the end of a 3- and 6-month period, electrophysiological and morphological changes, and the role of POMC neurons in homeostatic nutrition and their response to leptin were thoroughly investigated. Methods: Effects of HFD on POMC-satiety neurons in transgenic mice models exposed to chronic high-fat diet were investigated using electrophysiological (patch-clamp), chemogenetic and Cre recombinase advanced technological methods. Leptin, glucose and lipid profiles were determined and analyzed. Results: In mice exposed to a high-fat diet for 6 months, no significant changes in POMC dendritic spine number or projection density from POMC neurons to the paraventricular hypothalamus (PVN), lateral hypothalamus (LH), and bed nucleus stria terminalis (BNST) were observed. It was revealed that leptin hormone did not change the electrophysiological activities of POMC neurons in mice fed with HFD for 6 months. In addition, chemogenetic stimulation of POMC neurons increased HFD consumption. In the 3-month HFD-fed group, POMC activation induced an orexigenic response in mice, whereas switching to a standard diet was found to abolish orexigenic behavior in POMC mice. Conclusions: Chronic high fat consumption disrupts the regulation of POMC neuron activation by leptin. Altered POMC neuron activation abolished the neuron's characteristic behavioral anorexigenic response. Change in nutritional content contributes to the reorganization of developing maladaptations.

Abstract Norepinephrine (NE) is a well-known appetite regulator, and the nor/adrenergic system is targeted by several anti-obesity drugs. To better understand the circuitry underlying adrenergic appetite control, here we investigated the paraventricular hypothalamic nucleus (PVN), a key brain region that integrates energy signals and receives dense nor/adrenergic input, using a mouse model. We found that PVN NE level increases with signals of energy deficit and decreases with food access. This pattern is recapitulated by the innervating catecholaminergic axon terminals originating from NTSTH-neurons. Optogenetic activation of rostral-NTSTH → PVN projection elicited strong motivation to eat comparable to overnight fasting whereas its inhibition attenuated both fasting-induced & hypoglycemic feeding. We found that NTSTH-axons functionally targeted PVNMC4R-neurons by predominantly inhibiting them, in part, through α1-AR mediated potentiation of GABA release from ARCAgRP presynaptic terminals. Furthermore, glucoprivation suppressed PVNMC4R activity, which was required for hypoglycemic feeding response. These results define an ascending nor/adrenergic circuit, NTSTH → PVNMC4R, that conveys peripheral hunger signals to melanocortin pathway.

Abstract Background Most patients with hip fractures are elderly patients with comorbidities, and well-managed pain management is associated with positive postoperative outcomes. In recent years, new indications for regional anesthesia techniques have been defined, and they have found more place in clinical practice. Herein we investigate the effect of US-guided PENG block on positioning pain and compare that effect to intravenous opioid in patients undergoing surgery under spinal anesthesia for hip fractures. Additionally, we sought to investigate the effect of PENG block on pain scores, opioid intake, time to first analgesic requirement, and quality of recovery within the first 24 h following surgery. Methods In this study, patients were divided into the PENG (n = 42) and control group (n = 42) one hour prior to surgery. A team who was blinded to the assigned groups, collected and evaluated all data such as spinal anesthesia positioning pain, postoperative pain, opioid requirement. Results Patients that underwent PENG had statistically significantly lower NRS scores after interventions, immediately before positioning, at positioning and at end of spinal anesthesia. Pain scores during positioning for spinal anesthesia were statistically significantly lower in the PENG group than in the control group (p

In this study, the effects of exercise applied to sedentary individuals and the use of pomegranate–black carrot juice on minerals, fatty acids and some biochemical parameters were examined. Twenty healthy sedentary men participated in this study. This research consisted of three stages. Blood samples were taken from the participants before this study (Baseline), after the participants exercised (60 min/day) for 10 days (Exerciseonly), after the participants were given pomegranate–black carrot juice mixture (100 mL/100 mL) along with exercise (60 min/day) for 10 days (Exercise+supp). While AST and ALT levels increased in the Exerciseonly phase, they showed a relative decrease in the Exercise+supp phase. It was determined that Mg level in the Exerciseonly phase decreased compared to the Baseline and the Exercise+supp phase. It was determined that the Zn level in the Exercise+supp phase increased compared to the Zn level in the Exerciseonly phase. It was determined that 6:0, 12:0 and 14:0 fatty acid levels increased in the Exerciseonly phase compared to the Baseline. A decrease was detected in the Exerciseonly phase compared to the Baseline 18:2n6c, 18:3n6 and 18:3n3 fatty acid levels. It can be said that exercise and the use of pomegranate–black carrot juice mixture in sedentary individuals have supportive and corrective effects on serum mineral, fatty acids and some biochemical parameters.

Aim: After the outbreak of Coronavirus Disease 2019 (COVID-19), new headaches have been reported to develop or worsen among healthcare workers who regularly wear personal protective equipments. In this study, we investigated the possible relationship between de-novo (new-onset) headache features associated with the mask used and pre-existing and exacerbated headaches. It is the first study on this subject on behalf of Somalia. Methods: This is a cross-sectional study conducted at the Mogadishu COVID-19 pandemic hospital, Somalia, with volunteer healthcare workers. Data were collected through a questionnaire. Participants were asked 15 questions in the survey and Pearson-chi-square test was used as statistics. Results: This study was conducted with 200 healthcare workers working in the hospital, 114 (57%) were male, 86 (43%) were female, and the mean age was 28. Participants 90 (45%) used surgical masks, 32 (16%) filtered masks (N95), 78 (39%) both; majority of 109 (54.5%) wore masks for more than 6 hours a day. Pre-existing headache was reported by78(39%) of the subjects. 55(70%) of those with pre-existing headache reported aggravation of their headache. Statistically significant relationship was found between duration of mask use and aggravation of pre-existing headache. De-novo headache characteristics were throbbing 21(20%), pressing 31(29%), unilateral 19(18%), and 35(33%) bilateral. A statistically significant relationship was also found between the duration of use of face mask and the development of de-novo headache, regardless of mask type. Conclusion: As per our study, prolonged use of face masks during COVID-19 pandemics was associated with de-novo headaches and exacerbation of pre-existing headache. This situation, which has caused complaints as healthcare professionals and some patients continue to wear masks, will continue to be investigated.

Objective. The study was conducted to investigate the effectiveness of reformer pilates exercises on symptoms and quality of life in children with bladder and bowel dysfunction (BBD). Methods. Children diagnosed as having BBD by a physician and aged between 5-18 years were included in this study. They were divided into two groups: urotherapy group (control) and reformer pilates group (study). Written consent was obtained from both the children and the parents. Children in both groups received a standardized urotherapy. The study group also had 30 minutes of reformer pilates exercise sessions for 2 days a week. BBD symptoms were assessed using the Voiding Disorder Symptom Scoring (VDSS) and Bladder and Bowel Dysfunction Questionnaire (BBDQ). Quality of life was assessed using the Pediatric Incontinence Questionnaire (PinQ). Assessments were performed before and 8 weeks after the reformer pilates exercises. Results. The study included 25 children (10 [40%] boys and 15 [60%] girls). Their median age was 9 years and their body mass index was 17.58 kg/m2. Of these 25 children, 16 were born by normal delivery, 9 of whom were delivered by cesarean section. None of the children used diapers during the day, but 10 of them continued to use diapers at night. The control (n = 16) and study (n = 9) groups were similar in terms of physical properties. The VDSS, BBDQ, and PinQ scores were significantly decreased in both groups (p < 0.05). The decrease in BBDQ and VDSS scores were more prominent in the study group than in the control group. The clinical trial registration number of this study is NCT05779709 (ClinicalTrials.gov.) Conclusion. Reformer pilates exercises can provide additional benefits in the treatment of children with BBD as they were effective in reducing BDD symptoms and enhancing quality of life.

The settlements occurred in building foundations depend on many soil parameters. Thus, these parameters make the solution both difficult and complex during the calculating process. Therefore, finite element programs use the subgrade reaction coefficient to facilitate the foundation solution. Two different methods, which are Winkler method and Pseudo coupled method, are used in the basic solutions with the coefficient of subgrade reaction. While the Winkler method can be solved with a single field, the pseudo method can be solved with 2 or more fields. In this study, a 10 story building with a 36 m x 36 m square foundation was separately designed on four different sand soils. Two of these soils are classified as C and the others are classified as D according to Eurocode 8. The foundation of this building built on four different soils was divided into six different areas (one region, two regions, three regions, five regions, seven regions, 10 regions). Consequently, 24 analyzes were performed by using the ETABS program. According to the results obtained from these analyzes, while it is appropriate to use the Winkler method in weak sand soils for rigid foundation acceptance, it is more appropriate to use the Pseudo-coupled method in dense sand soils. Pseudo-coupled method should be used in flexible foundation solutions built on weak sand soils. The Winkler method should be used for flexible foundations built on dense sand soils. In the Pseudo-coupled method, the highest settlements were obtained in the two-region solutions. An optimum number of fields was found to be 7 for Pseudo-coupled method.

BackgroundAthletes in certain sports aim to gain an advantage by competing in a lower body mass class instead of competing in their own body mass class. This study aims to reveal certain physiologic and strength changes in elite male boxers who lost body mass rapidly before the competition.Methods30 thirty boxers who were aged between 19-24 years and having a mean age of 7.4 years participated in the study. To evaluate the effect of short-term dietary intake interventions on body composition and muscle strength before the competition, boxers were divided into three groups: control (C), exercise+diet1 (E+D1) and exercise+diet2 (E+D2) groups. The dietary habits of the participants were controlled and they participated in the training program. The data of the study consisted of variables such as body mass, height, regional muscle mass, body fat percentage, biceps and femur bicondylar circumference measurements before the competitions. Isometric strength measurements of knee extensors and flexors and shoulder internal and external rotators were also recorded.ResultsPhysiologic parameters such as body mass change, BMI level, body fat percentage and leg muscle ratios of E+D2 were significantly decreased compared to C and E+D1 groups. Furthermore, submaximal and maximal strength production in knee extensors and flexors as well as shoulder internal and external rotators were significantly decreased in E+D2 compared to C and E+D1 groups.ConclusionThe tendency to lose body mass quickly in a short of time may give the desired results in terms of BMI, body mass and fat percentage, but it may cause strength losses in boxers during the competition period.

BackgroundAcute aortic dissection (AAD) is a life-threatening medical condition with high early fatality. Therefore, a prompt and precise diagnosis, which can be achieved through invasive and non-invasive techniques is vital. Echocardiography, unlike MRI and CT, is accessible in emergency units and bedside-compatible. The recommended echocardiographic techniques for AAD are transthoracic and transoesophageal echocardiography (TTE and TOE). Therefore, our review compares their diagnostic roles in AAD.MethodsStudies relevant to our topic were attained through a database search and manual scrutiny of references lists of articles obtained from the electronic databases. The Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2) has been used for quality assessment. All quantitative analyses were performed using either STATA 16 or Comprehensive Meta-Analyst software.ResultsThe search strategy yielded 1,798 articles, of which only 11 were eligible for inclusion. Our subgroup analysis showed that conventional TTE had a sensitivity and specificity of 85.35% and 84.51% for the diagnosis of Stanford type A AAD and was 45.89% sensitive and 87.05% specific for the diagnosis of type B AAD. However, the subgroup analysis shows that contrast-enhancement of TTE results in a sensitivity and specificity of 93.30% and 97.60% for diagnosis of type A AAD, and 83.60% and 94.50% for diagnosis of type B AAD, respectively. On the other hand, conventional TOE was 93.64% sensitive and 95.50% specific for the diagnosis of type A AAD, 99.80% sensitive and 99.87% specific for the diagnosis of type B AAD. Moreover, our analyses show that TTE has pooled false negative and positive rates of 28.6% and 18.6%, while TOE has shown false negative and positive rates of 2.4% and 4.3%, respectively.ConclusionTOE is the more favorable diagnostic tool for AAD diagnosis than TTE. However, it cannot be used as a stand-alone diagnostic tool since misdiagnosis cases are being reported. Contrast-enhanced TTE can also diagnose AAD since it provides similar results to conventional TOE.

Summary: Opioids are generally known to promote hedonic food consumption. Although much of the existing evidence is primarily based on studies of the mesolimbic pathway, endogenous opioids and their receptors are widely expressed in hypothalamic appetite circuits as well; however, their role in homeostatic feeding remains unclear. Using a fluorescent opioid sensor, deltaLight, here we report that mediobasal hypothalamic opioid levels increase by feeding, which directly and indirectly inhibits agouti-related protein (AgRP)-expressing neurons through the μ-opioid receptor (MOR). AgRP-specific MOR expression increases by energy surfeit and contributes to opioid-induced suppression of appetite. Conversely, its antagonists diminish suppression of AgRP neuron activity by food and satiety hormones. Mice with AgRP neuron-specific ablation of MOR expression have increased fat preference without increased motivation. These results suggest that post-ingestion release of endogenous opioids contributes to AgRP neuron inhibition to shape food choice through MOR signaling.

This research aims to examine the views of gifted secondary school students about the metaverse and their risk perceptions toward the digital environment. In this context, the study group consisting of 55 gifted students was determined through purposive sampling. A survey was used to collect participants' views on the metaverse, and the "Virtual World Risk Perception Scale" was used to measure the risks they felt in digital environments. A mixed method was used in this research. Content analysis was used in the qualitative data analysis, and the ANOVA test and t-test were used in the quantitative data analysis. The findings obtained in the analysis showed that while students defined the metaverse as a virtual universe, virtual reality, commerce, and socializing place. It was seen that the place where they met this concept was social media. While the students stated that the use of metaverse in education could have advantages, such as motivation, fun learning experience, and contribution to personal development, they mentioned disadvantages, such as health problems, addiction, safety, ethics, and disconnection from real life. Virtual world risk perceptions did not differ according to gender and class level. Students who did not have metaverse experience stated that the digital environment had a risk regarding corruption compared to those with experience.

ObjectiveThere have been continuous discussions over the ethics of using AI in healthcare. We sought to identify the ethical issues and viewpoints of Turkish emergency care doctors about the use of AI during epidemic triage.Materials and methodsTen emergency specialists were initially enlisted for this project, and their responses to open-ended questions about the ethical issues surrounding AI in the emergency room provided valuable information. A 15-question survey was created based on their input and was refined through a pilot test with 15 emergency specialty doctors. Following that, the updated survey was sent to emergency specialists via email, social media, and private email distribution.Results167 emergency medicine specialists participated in the study, with an average age of 38.22 years and 6.79 years of professional experience. The majority agreed that AI could benefit patients (54.50%) and healthcare professionals (70.06%) in emergency department triage during pandemics. Regarding responsibility, 63.47% believed in shared responsibility between emergency medicine specialists and AI manufacturers/programmers for complications. Additionally, 79.04% of participants agreed that the responsibility for complications in AI applications varies depending on the nature of the complication. Concerns about privacy were expressed by 20.36% regarding deep learning-based applications, while 61.68% believed that anonymity protected privacy. Additionally, 70.66% of participants believed that AI systems would be as sensitive as humans in terms of non-discrimination.ConclusionThe potential advantages of deploying AI programs in emergency department triage during pandemics for patients and healthcare providers were acknowledged by emergency medicine doctors in Turkey. Nevertheless, they expressed notable ethical concerns related to the responsibility and accountability aspects of utilizing AI systems in this context.

This study aimed to examine the changes in physical activity levels of women according to some variables. Housewives (HW) and working women (WW) in certain institutions in Malatya voluntarily participated in the study. The volunteering participants were divided into two groups, WW (N=175) and HW (N=175), based on employment status. The International Physical Activity Questionnaire (IPAQ) short form was used to determine the physical activity levels of the participants in the study. According to the data obtained in the study, it was seen that the metabolic equivalent of task (MET) of the research group did not differ according to age, body mass index (BMI) and merital status, however the working status of the women affected their MET scores and the HW’s had a higher physical activity level than WW. It was seen that the inactive lifestyle habits of the working women in the research group affected their physical activity levels and they were not very active in the living areas left behind from the business life.

In this work, we present a methodology to shape a fisheye-specific representation space that reflects the interaction between distortion and semantic context present in this data modality. Fisheye data has the wider field of view advantage over other types of cameras, but this comes at the expense of high radial distortion. As a result, objects further from the center exhibit deformations that make it difficult for a model to identify their semantic context. While previous work has attempted architectural and training augmentation changes to alleviate this effect, no work has attempted to guide the model towards learning a representation space that reflects this interaction between distortion and semantic context inherent to fisheye data. We introduce an approach to exploit this relationship by first extracting distortion class labels based on an object's distance from the center of the image. We then shape a backbone's representation space with a weighted contrastive loss that constrains objects of the same semantic class and distortion class to be close to each other within a lower dimensional embedding space. This backbone trained with both semantic and distortion information is then fine-tuned within an object detection setting to empirically evaluate the quality of the learnt representation. We show this method leads to performance improvements by as much as 1.1% mean average precision over standard object detection strategies and .6% improvement over other state of the art representation learning approaches.

Establishing a Stroke Center During the COVID-19 Pandemic: First-year Experiences Abstract Objective: This study examines the data of patients of ischemic stroke who underwent intravenous thrombolytic therapy and/or mechanical thrombectomy after applying to the emergency department of a newly opened hospital in our country during the COVID-19 pandemic. Methods: The files of 85 consecutive patients who were hospitalized in the Stroke Centre of XXXXXX with a diagnosis of acute ischemic stroke between January and December 2020 who underwent intravenous thrombolytic therapy and/or mechanical thrombectomy were retrospectively reviewed. Results: Symptom-to-door times (p

Summary: Resting metabolic rate (RMR) adaptation occurs during obesity and is hypothesized to contribute to failed weight management. Angiotensin II (Ang-II) type 1 (AT1A) receptors in Agouti-related peptide (AgRP) neurons contribute to the integrative control of RMR, and deletion of AT1A from AgRP neurons causes RMR adaptation. Extracellular patch-clamp recordings identify distinct cellular responses of individual AgRP neurons from lean mice to Ang-II: no response, inhibition via AT1A and Gαi, or stimulation via Ang-II type 2 (AT2) receptors and Gαq. Following diet-induced obesity, a subset of Ang-II/AT1A-inhibited AgRP neurons undergo a spontaneous G-protein “signal switch,” whereby AT1A stop inhibiting the cell via Gαi and instead begin stimulating the cell via Gαq. DREADD-mediated activation of Gαi, but not Gαq, in AT1A-expressing AgRP cells stimulates RMR in lean and obese mice. Thus, loss of AT1A-Gαi coupling within the AT1A-expressing AgRP neuron subtype represents a molecular mechanism contributing to RMR adaptation.

This study aimed to evaluate the viscoelastic properties of lower-extremity muscles in pediatric hemophilia (FVIII-IX) patients. The study included 20 severe- and moderate-type right-dominant hemophilia patients diagnosed with hemophilia A–B and 20 healthy children. Viscoelastic properties (tone, stiffness, elasticity) of the lower-extremity muscles were measured using a MyotonPRO device. The physical characteristics of the pediatric hemophilia patients (mean age: 11.9 ± 3.95 years) and the control group (mean age: 12.6 ± 3.41 years) were found to be similar. A difference was observed only in the elasticity of the right vastus lateralis (p < 0.05) by means of the viscoelastic properties of the lower-extremity muscles. The results were similar in other muscle groups (p > 0.05). The dominant-side vastus lateralis muscle elasticity (the ability of the muscle to regain its original shape after contraction or removal of an external force) of hemophilia patients was found to be lower compared to healthy children. The fact that 45% of hemarthroses occur in the knee joint and that recurrent bleeding may affect the flexibility of the vastus lateralis, which is the main muscle within the quadriceps muscle group and responsible for the stabilization of the patella, can be associated with the study results.

Objective: Sleep behaviors have not been well investigated in individuals with idiopathic scoliosis (IS). This study aimed to investigate sleep quality and daytime sleepiness in individuals with IS and investigate the relationship between sleep parameters and curve magnitude, trunk deformity severity, pain, and emotional status in adolescents with IS. Material and Methods: Ninety-one participants between the ages of 10 and 19 years with IS were included. Sleep quality was evaluated using the Pittsburgh sleep quality index (PSQI), and daytime sleepiness was assessed with Epworth sleepiness scale (ESS). Pain was assessed using the short-form McGill pain questionnaire; the presence or severity of depressive feelings was evaluated using the Beck depression scale. Results: The majority of the participants (64.8%) had poor sleep quality, while daytime sleepiness was within normal limits in most participants (85.7%).The frequency of participants without pain (52.7%) was similar to participants with pain (47.3%). The prevalence of participants with depressed mood was 35.2%. Participants with poor sleep quality were more likely to have a higher sensorial index (p

Background and Study Aim. This study investigated the effects of HIIT (high-intensity interval training) implementations on some serum elements, resting heart rate, total body weight, and BMI parameters in tennis players. Material and Methods. The study group consisted of 20 athletes (aged 18-22) who were actively playing tennis. The athletes were divided into experimental (n=10) and control (n=10) group. To assign participants to these groups homogeneously, preliminary measurements were made before the study, and the results were used for clustering analysis. While the control group continued their regular tennis training, the experimental group was given additional HIIT three days a week besides regular tennis training. Measurements of BMI, resting heart rate, and body weight were taken, and serum samples were collected before and after training from both groups. The SPSS package program was used in data analysis. The level of significance was set at p0.05). The within-group measurements of sodium, calcium, resting heart rate, weight and BMI levels decreased in the experimental group in the post-test, while iron levels were higher in the post-test compared to the pre-test value (p0.05). Conclusions. Training remodelled with HIIT implementation can affect athletes' element levels, BMI, total body weight, and resting heart rate. In addition, the increase in iron levels due to HIIT in the experimental group was important. We believe that this may affect both muscle contraction functions and the efficiency performance output. Lastly, due to the decrease of calcium and sodium elements with HIIT implementations, we suggest that HIIT applications should not be performed unsupervised. In addition, by tracking the element levels of athletes, they should be supported with supplements or nutritional meals in line with expert advice when necessary.

La semilla de calabaza (Cucurbita pepo L.) es alta en aceite, proteína, y ácidos grasos no saturados (AENS), y es una importante fuente de nutrición y ganancias a nivel global. Este artículo provee información a potenciales consumidores sobre el perfil nutricional y los beneficios a la salud de cultivares seleccionados de semillas de calabaza.

Objective: Serotonin (5HT) is a well-known anorexigenic molecule, and 5HT neurons of dorsal raphe nucleus (DRN) have been implicated in suppression of feeding; however, the downstream circuitry is poorly understood. Here we explored major projections of DRN5HT neurons for their capacity to modulate feeding. Methods: We used optogenetics to selectively activate DRN5HT axonal projections in hypothalamic and extrahypothalamic areas and monitored food intake. We next used fiber photometry to image the activity dynamics of DRN5HT axons and 5HT levels in projection areas in response feeding and metabolic hormones. Finally, we used electrophysiology to determine how DRN5HT axons affect downstream neuron activity. Results: We found that selective activation of DRN5HT axons in (DRN5HT → LH) and (DRN5HT → BNST) suppresses feeding whereas activating medial hypothalamic projections has no effect. Using in vivo imaging, we found that food access and satiety hormones activate DRN5HT projections to LH where they also rapidly increase extracellular 5HT levels. Optogenetic mapping revealed that DRN5HT → LHvGAT and DRN5HT → LHvGlut2 connections are primarily inhibitory and excitatory respectively. Further, in addition to its direct action on LH neurons, we found that 5HT suppresses GABA release from presynaptic terminals arriving from AgRP neurons. Conclusions: These findings define functionally redundant forebrain circuits through which DRN5HT neurons suppress feeding and reveal that these projections can be modulated by metabolic hormones.

Conditions of existing bridges are often problematic issues and expensive to resolve for many countries. In order to anticipate and reduce these problems, the combination of various general and local factors causing degradation needs to be identified in the early stage. The identification of these problems reveals the need for local research and detailed inspection for bridges. Reinforced Concrete Bridges in Albania were built at different standards in different periods and were exposed to rapidly increasing and changing traffic loads in the last three decades. This situation made the structural assessment of the bridges inevitable in the local conditions. Although the existing condition of these bridges had not been clearly defined, after democratization and joining the European Council (the 1990s), new bridges were rapidly built and existing bridges were strengthened with different methods. In this context, the structural condition of existing reinforced concrete bridges in Albania was examined in this study. The condition of Albanian bridges was presented in this paper based on visual inspection of 104 bridges covering the total length of 7271.6 m along 263 km road from different parts of the country, concentrating on local causes of deteriorations. The main causes of the defects are figured out in the study as traffic load, natural force, aging, lack of maintenance, and last but not least construction and design deficiencies. The study concludes that the general physical condition of the bridges is poor, so the services provided by the bridges are potentially at risk. The results obtained at the end of this study may be valid for countries with similar features, e.g., other Balkan countries.

Fiber reinforced polymer (FRP) strengthening in circular columns is known to be more effective than in rectangular and square columns because of the uniform distribution of confining pressure. This study explores the effectiveness of using carbon-FRP anchors to improve the confinement of square reinforced concrete (RC) columns strengthened with FRP. Sharp corners in non-circular columns cause stress concentration on the corners, reducing the effectiveness of strengthening. To address this, the study examines the impact of three different anchor configurations on two sizes of FRP-strengthened square columns. The results show that the proposed anchors distribute stresses to a greater extent, resulting in a more uniform distribution of stresses and better confinement. For the best performance, it is proposed that the anchor fans surround the corners of the cross section. Experimental findings and finite element analysis results using the Concrete Damage Plasticity model in the ABAQUS material library match.

Objective:To investigate the effect of perturbation training (PT) on balance, walking, and lumbar stabilization in patients with multiple sclerosis.Methods:Ten patients were given manual PT twice a week for 6 weeks. Romberg (RT), Sharpened Romberg (SR), and single leg stance test (SLST) were performed for static balance. Dynamic balance was assessed with functional reach test (FRT), lateral reach test [dominant (LRT-D) and non-dominant (LFR-ND)], and four square step test (FSST). The Falls Efficacy Scale International (FES-I) was used to evaluate the fear of falling. Timed up and go (TUG) test and pressure biofeedback stabilization were used to assess the functional mobility and lumbar stabilization.Results:The results of SR and SLST were significantly increased after the treatment (p0.05). Significant differences were found in the values of FRT and LRT-ND. The results of LRT-D and FSST were not changed with the treatment. The fear of falling decreased after the treatment but was not statistically significant (p>0.05). After the treatment, the TUG duration improved in participants (p=0.01). No difference was found in the PBS duration between the pre and post-treatment (p>0.05).Conclusion:This study revealed that manual PT without computerized systems in the clinic may improve static and dynamic balance, walking, and fear of falling. Additionally, the effect of PT on lumbar stabilization in MS was not determined in our study. Major conclusions were limited by the small sample size; however, the observed results may contribute to designing future trials.

Thrombosis in the inferior vena cava (IVC) is a rare but serious condition that can lead to significant morbidity and mortality. We present a case report of a 39-year-old male who presented to the emergency department with right flank pain that had progressed to severe back pain, bilateral flank pain, scrotal pain, and leg pain over the course of two days. The pain was severe enough to affect his daily activities. Laboratory investigations revealed a D-dimer level of 17 ng/mL, creatinine level of 110 µmol/L, and a white blood cell count of 10 × 109/L with a CRP level of 5 mg/L. Urine analysis was positive for blood. Doppler ultrasound of both legs showed deep vein thrombosis extending from the external iliac veins to the distal veins of both legs. Further investigation with computed tomography of the abdomen revealed a large thrombus in the distal vena cava extending to the renal artery and both external and internal iliac veins. The patient was diagnosed with Factor V Leiden syndrome based on genetic testing, which revealed a heterozygous mutation in the F5 gene. He was successfully treated with low molecular weight heparin and warfarin, and after five days of hospitalization, he was discharged with warfarin for long-term anticoagulation. This case report emphasizes the importance of considering IVC thrombosis in patients with a constellation of symptoms, including scrotal pain, and the role of genetic testing in identifying underlying hypercoagulable states.

INTRODUCTION: Siberkondria is the behavior of people looking for information about their health on the internet in a repetitive and continuous manner. This concept is more common in the field of mental health in recent years due to the more use of technology in our daily lives. In this study, it was aimed to examine the demographic variables that affect cyberchondria behavior and to investigate the related concepts. METHODS: A total of 430 people, 254 women and 176 men, participated in this study. A questionnaire form including demographic data form, Cyberchondria Severity Scale, Anxiety Sensitivity Index-3, Intolerance to Uncertainty Scale and Somatosensory Amplification Scale was applied to the participants. RESULTS: Cyberchondria mean scores were found to be significantly higher for female participants (t(428)=3,445; p

In this reported work, an anodically pretreated boron-doped diamond (BDD) electrode was used for the inexpensive, simple and quick detection of a natural dye, lawsone. Lawsone had a well-defined, irreversible and diffusion-controlled oxidation peak at approximately +0.19 V in phosphate buffer solution (PBS, 0.1 M, pH 2.5) using cyclic voltammetry (CV). The oxidation peak heights of lawsone were significantly increased in PBS using the cationic surfactant cetyltrimethylammonium bromide (CTAB). Under optimized experimental conditions, the calibration curve was linear over a concentration range of 0.1–5.0 μM with detection limit of 0.029 μM in 0.1 M PBS (pH 2.5) containing 0.1 mM CTAB by using square-wave voltammetry (SWV). To evaluate the practical applicability of the BDD electrode, it was used for the quantification of lawsone in commercial henna, a natural dye made from the leaves of the henna plant.

In this study, the electrochemical determination of the amodiaquine (ADQ) drug was evaluated using an electrochemically pretreated boron-doped diamond (BDD) electrode due to the enhanced surface activity. The cyclic voltammogram results of ADQ were given as single reversible and diffusion-controlled peaks at +0.48 V for the oxidation peak and +0.05 V for the reduction peak (vs. Ag/AgCl) in Britton-Robinson (BR) buffer at pH 8.0. The peak potential and current signals of ADQ were evaluated at the surface of the BDD electrode using instrumental parameters to develop a simple method for ADQ detection. Also, the effect of an anionic surfactant, sodium dodecyl sulfate (SDS), on the adsorption applicability of the BDD electrode significantly increased the stripping voltammetric determination of ADQ. Under the optimal conditions chosen and employing square-wave adsorptive stripping voltammetry at the BDD electrode, ADQ was determined at + 0.34 V (vs. Ag/AgCl) at the open-circuit condition in BR buffer at pH 8.0 in the presence of 2·10–4 mol l–1 SDS. Furthermore, analytical parameters showed the linear relationship for ADQ determination in the concentration range of 0.1–20.0 μg ml–1 (2.2·10–7 – 4.3·10–5 mol l–1), with a detection limit of 0.03 μg ml–1 (6.5·10–8 mol l–1). The proposed approach can be applied to determine ADQ in water samples.

The paper presents a complete collection of data and its preliminary statistical analysis obtained from the first phase of a large soil study on how to improve strawberry production and achieve sustainable and high-quality harvests through sensor-assisted real-time field monitoring. Six real-time loggers were placed in an operational commercial strawberry farm in Central Florida for the entirety of a harvest season from soil preparation to planting to harvesting. Along with temporally high-resolution soil sensory measurements including water content, electrical conductivity, and temperature, strawberries were harvested from each of the six locations on three separate occasions for their objective physicochemical characteristics to be monitored and recorded in a food chemistry lab. The primary goal of this paper is to introduce the dataset to the food science and engineering research community and present the results of its preliminary statistical analysis in identifying which factors correlate with one another. Based on the findings of this paper, while there exists a weak correlation between the quality of the harvest and the water content of the soil immediately preceding it, there were several cases where statistically significant differences exist between the soil sensory measurements from different locations which did not replicate the same differences in their corresponding harvest qualities.