Search

Objective: To evaluate the cardiovascular risk status of patients with endometriosis using serum lipid parameters and atherogenic indices. Materials and methods: The study was retrospective, single-centric, case-control study, involving a total of 190 women, including 95 cases and 95 control groups. Blood parameters, inflammatory markers as serum pan-immune-inflammation value, systemic immune-inflammation index, systemical inflammation-response index, and the atherogenic indices as Atherogenic Index of Plasma (AIP), Castelli Risk Index I and II (CRI-I and II), and the Atherogenic Coefficient (AC) were calculated. Results: Triglyceride (TG) levels among serum lipid parameters (103.09 ± 54.17 vs 77.52 ± 23.37, p

Introduction: Recent studies showed the connection between cerebrospinal fluid (CSF) and deep cervical lymph nodes (dCLN) via lymphatic vessels (LV)s. These LVs accompany dural sinuses, cranial nerves, and arteries. The present study aimed to show in addition to the main trunk of the middle meningeal artery (MMA) whether the anterior and posterior branches of MMA; the anterior (AMA) and posterior (PMA) meningeal arteries also have a role in brain lymphatic drainage in humans. Materials and method: Samples of the middle meningeal artery (MMA) and its two main branches (anterior and posterior), anterior and posterior meningeal arteries (AMA and PMA) were obtained from 3 cadavers and 6 autopsies. Podoplanin (PDPN) (lymphatic endothelial marker) and CD31 (vascular endothelial marker) immunohistochemistry (IHC) were applied to 5 μm thick transverse sections and counterstained with hematoxylin. Furthermore, western blotting techniques were applied to the same tissue samples in 3 autopsy cases to demonstrate the presence of PDPN. Results: We observed the presence of the LVs along the main trunk of MMA and its two branches, AMA, and PMA. The LVs along the MMA (main trunk) had a larger diameter range than its branches and the AMA and PMA. The diameter of LVs of the PMA was larger than AMA. Furthermore, fluid channels with varying diameters and densities were closely localized to the LVs. The western blot PDPN protein expression confirmed IHC results. Conclusion: The LVs along the main trunk, anterior and posterior branches of the MMA, AMA, and PMA also provide an extracranial pathway for thought drainage of waste from the brain tissue in humans. Thus, the organization of the extracranial transport of LVs of the brain should be well-defined for understanding the role of lymphatic drainage in various neurological diseases.

Objective: The pivotal prognostic determinant for recurrence and survival in surgically treated gastric cancer (GC) patients remains the lymph node status. Despite the adoption of D2 lymph node dissection as the standard approach in recent years, its association with increased morbidity in elderly patients raises concerns. This study aims to explore the prognostic significance of the Positive Lymph Node Ratio (PLNR) score in the context of recurrence and survival among elderly patients with surgically treated GC. Material and method: A retrospective review of files about surgically treated patients with GC was conducted. The prognostic impact of the PLNR score on overall survival (OS) was assessed through Receiver Operating Characteristic (ROC) analysis. Results: The cut-off value for the PLNR, determined through ROC analysis, was identified as 0.138. This value serves as a crucial threshold, as it distinguishes patients with a higher risk of poor outcomes. Patients with a PLNR score of 0.138 or below exhibited a median OS of 111 months, whereas those with a PLNR score above 0.138 had a significantly lower median OS of 22 months (p = 0.004). Conclusion: Our findings revealed that the PLNR emerged as an independent predictor of survival and recurrence in patients undergoing GC resection.However, it's important to note that while valuable, the PLNR system has limitations. It does not encompass the T stage, a key factor in cancer staging. Therefore, it cannot be a direct substitute for the comprehensive information TNM staging provides. It should be used as a supplementary tool in predicting prognosis, particularly in elderly patients unsuitable for standard lymph node dissection.

Given that numerous genetic disorders, driven by diverse pathogenic mechanisms, may be amenable to recombinant adeno-associated virus (rAAV)-delivered gene therapies, the sustained innovation of rAAV-based therapeutic modalities is crucial. The progression and severity of genetic diseases can be reduced by targeting the toxic transcripts of a defective gene using microRNA (miRNA)-based miQURE technology delivered within an AAV vector. By adapting the delivered cassette, it may be possible to simultaneously regulate the expression profile of multiple genes involved in the pathogenesis of complex genetic diseases. The established miQURE gene silencing strategy was expanded by concatenating several miQURE molecules in a single construct, resulting in the novel linQURE platform. Here, a proof of mechanism is established by demonstrating that linQURE technology enables the concomitant expression of two synthetic miRNAs in vitro and in vivo, allowing more efficient downregulation of their disease-causing mRNA targets. This approach supports the development of multi-targeting therapeutic strategies, enabling gene therapy products to adapt to more complex multigenic indications, thus expanding the toolbox of readily available gene therapies.

Today, as in every life-threatening disease, early diagnosis of brain tumors plays a life-saving role. The brain tumor is formed by the transformation of brain cells from their normal structures into abnormal cell structures. These formed abnormal cells begin to form in masses in the brain regions. Nowadays, many different techniques are employed to detect these tumor masses, and the most common of these techniques is Magnetic Resonance Imaging (MRI). In this study, it is aimed to automatically detect brain tumors with the help of ensemble deep learning architectures (ResNet50, VGG19, InceptionV3 and MobileNet) and Class Activation Maps (CAMs) indicators by employing MRI images. The proposed system was implemented in three stages. In the first stage, it was determined whether there was a tumor in the MR images (Binary Approach). In the second stage, different tumor types (Normal, Glioma Tumor, Meningioma Tumor, Pituitary Tumor) were detected from MR images (Multi-class Approach). In the last stage, CAMs of each tumor group were created as an alternative tool to facilitate the work of specialists in tumor detection. The results showed that the overall accuracy of the binary approach was calculated as 100% on the ResNet50, InceptionV3 and MobileNet architectures, and 99.71% on the VGG19 architecture. Moreover, the accuracy values of 96.45% with ResNet50, 93.40% with VGG19, 85.03% with InceptionV3 and 89.34% with MobileNet architectures were obtained in the multi-class approach.

Global demand for vegetable oil is projected to expand to 28 Mt by 2028. Oilseed rape (OSR) is the predominant oilseed crop in Europe. Its nutritional value is determined by seed oil content and fatty acids (FAs) composition. Insect pollination increases seed oil content, however, its benefit on FAs composition remains unknown. In this study, we address this gap by investigating the variation of OSR seed oil content and FAs composition along a gradient of bee abundance in farmed OSR fields. We used a pollinator exclusion experiment to disentangle the contribution of pollination processes, i.e. wind, self and insect pollination. We show that bees improved OSR nutritional value by increasing amount of poly-unsaturated FAs and decreasing the amount saturated and trans-saturated FAs. In addition, oil content was higher in seeds with than without access to pollinators. Our study provides for the first time, to the best of our knowledge, evidence that insect pollination enhances the quality value of OSR oil by affecting FAs composition. Such effect implies potential negative consequences with any further decline of pollinator abundance. More investigations are also needed to better understand the mechanisms by which insect pollination affects FAs composition, and the way to enhance such mechanisms.

A combination of electrical circuit design and the Finite Automation model leads to improved efficiency in terms of memory usage, computation time, and overall performance. LLC resonant converters are known for their high efficiency and ability to convert DC voltage from solar panels into the desired AC voltage for grid-tied or off-grid PV systems. However, designing, testing, and implementing LLC in a PV system requires careful consideration of various factors, including voltage and current requirements, resonant frequency, and compliance with standards and regulations. Eight cases are taken for this purpose with a special case of a 3kW-PV module. The major parameters for the LLC resonant Converter were 480-500V. as output voltage for 36-40V. input voltage range with a 39V. nominal voltage. The calculated coefficients for these values were as follows: A = C = 7.29, B = -50.58, D = -0.25, and E = -11. Combining LLC circuit design with FA, it is providing 94.5 % efficiency through selecting precise parameters that minimized overall calculated losses such as conductive and switching types. The right path and accepted words for different cases are given to provide several solutions with the correct path of design. ZVS and ZCS have been obtained through precise selection process of phase shift between Half Bridge of LLC circuit achieved by this design.

Diabetes mellitus (DM) is a prominent contributor to morbidity and mortality in developed nations, primarily attributable to vascular complications such as atherothrombosis occurring in the coronary arteries. Aldose reductase (ALR2), the main enzyme in the polyol pathway, catalyzes the conversion of glucose to sorbitol, leading to a significant buildup of reactive oxygen species in different tissues. It is therefore a prime candidate for therapeutic targeting, and extensive study is currently underway to discover novel natural compounds that can inhibit it. Cucumis melo (C. melo) has a long history as a lipid-lowering ethanopharmaceutical plant. In this study, compounds derived from C. melo were computationally evaluated as possible lead candidates. Various computational filtering methods were employed to assess the drug-like properties and ADMET (absorption, distribution, metabolism, excretion, and toxicity) profiles of the compounds. The compounds were subsequently addressed to analysis of their interactions, molecular docking, and molecular dynamics simulation studies. When compared to the conventional therapeutic compounds, three compounds exhibited enhanced binding affinity and intra-molecular residue interactions, resulting in increased stability and specificity. Consequently, four potent inhibitors, namely PubChem CIDs 119205, 65373, 6184, and 332427, have been identified. These inhibitors exhibit promising potential as pharmacological targets for the advancement of novel ALR-2 inhibitors.

Cholesterol is a major lipid of the animal realm with many biological roles. It is an important component of cellular membranes and a precursor of steroid hormones and bile acids. It is particularly abundant in nervous tissues, and dysregulation of cholesterol metabolism has been associated with neurodegenerative diseases such as Alzheimer's and Huntington's diseases. Deciphering the pathophysiological mechanisms of these disorders often involves animal models such as mice and Drosophila. Accurate quantification of cholesterol levels in the chosen models is a critical point of these studies. In the present work, we compare two common methods, gas chromatography coupled to flame-ionization detection (GC/FID) and a cholesterol oxidase-based fluorometric assay to measure cholesterol in mouse brains and Drosophila heads. Cholesterol levels measured by the two methods were similar for the mouse brain, which presents a huge majority of cholesterol in its sterol profile. On the contrary, depending on the method, measured cholesterol levels were very different for Drosophila heads, which present a complex sterol profile with a minority of cholesterol. We showed that the enzyme-based assay is not specific for cholesterol and detects other sterols as well. This method is therefore not suited for cholesterol measurement in models such as Drosophila. Alternatively, chromatographic methods, such as GC/FID, offer the required specificity for cholesterol quantification. Understanding the limitations of the quantification techniques is essential for reliable interpretation of the results in cholesterol-related research.

This study investigates the ballistic impact response of two armor steels (Armox Advance and Ramor 500) and a structural wear-resistant steel (Hardox 450) in monolithic, double-layered, and perforated plate configurations. As ammunitions, 7.62 mm NATO Ball, 7.62 × 51 AP (armor piercing), and 12.7 mm APM2 bullets were used in the ballistics tests. The tests were performed per EN 1522/1523 ballistic test standards and at FB6 and FB7 levels. The results showed different perforation behaviors for different plate configurations. All the monolithic plates were perforated with 7.62 mm AP bullets except for Armox Advance. Double-layered plate configurations, on the other hand, showed resistance to penetration. Among those, only the Ramor500 + Ramor 500 double-layered plate configuration was perforated by 7.62 mm AP bullets. All the pre-perforated plate configurations resulted in total protection regardless of ammunition type and plate materials.

Aim:: To present the body of evidence behind the International Continence Society (ICS) educational module on “Practice of uroflowmetry in adults” which consists of a PowerPoint® presentation. Methods:: This evidence review has been prepared by a working group instituted by the ICS Urodynamics Committee. The method used included systematic literature review, consensus formation by the members of the Working Group, and review by members of the ICS Urodynamics Committee core panel. Results:: A total of 104 articles were included in this systematic review. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Evidence analysis was conducted along the following themes: physiology of voiding, pathophysiology of lower urinary tract dysfunction, technique of uroflowmetry, quality check of the uroflowmetry test, interpretation and reporting of uroflowmetry findings. Conclusions:: Uroflowmetry is the most commonly utilized diagnostic test in the evaluation of adults presenting with lower urinary tract symptoms. The practice of uroflowmetry exhibits variations which might lead to inconclusive or inaccurate assessments. The ICS educational module on the Practice of Uroflowmetry in Adults provides up-to-date and evidence-based guidance in an effort to establish standards in the technique, interpretation, and reporting of uroflowmetry.

Summary: Background: SARS-CoV-2-neutralizing antibodies (nABs) showed great promise in the early phases of the COVID-19 pandemic. The emergence of resistant strains, however, quickly rendered the majority of clinically approved nABs ineffective. This underscored the imperative to develop nAB cocktails targeting non-overlapping epitopes. Methods: Undertaking a nAB discovery program, we employed a classical workflow, while integrating artificial intelligence (AI)-based prediction to select non-competing nABs very early in the pipeline. We identified and in vivo validated (in female Syrian hamsters) two highly potent nABs. Findings: Despite the promising results, in depth cryo-EM structural analysis demonstrated that the AI-based prediction employed with the intention to ensure non-overlapping epitopes was inaccurate. The two nABs in fact bound to the same receptor-binding epitope in a remarkably similar manner. Interpretation: Our findings indicate that, even in the Alphafold era, AI-based predictions of paratope-epitope interactions are rough and experimental validation of epitopes remains an essential cornerstone of a successful nAB lead selection. Funding: Full list of funders is provided at the end of the manuscript.

For the development and testing of autonomous driving technologies, there is a need for a robust and reliable testbed infrastructure that can support the deployment and testing of multiple applications from different tenants’s in parallel. We propose a multi-tenancy approach for autonomous driving testbeds to address this issue. In our approach, multiple users are able to deploy and test their applications on a shared infrastructure without interfering with each other. We have developed a tool called Kufast for the automation of the deployment process and the isolation of each tenants resources. This tool allows users to deploy their applications quickly and easily without advanced technical skills, and provides a user-friendly Command Line Interface.

Asking questions is a key characteristic of creativity and an important component of the creative process. Although much evidence has supported the association between asking questions and creativity, less research has examined the nature of questions asked by creative persons. In this study, we investigated the relation between creativity indicators—fluency and originality—and three types of questions: Open- vs. Closed-Ended questions, Possibility thinking, and Temporal thinking. To examine these relationships, we conducted four sets of analyses using questions posed by a sample of undergraduate students (n = 165) in two divergent thinking tasks (i.e., Activity 1 – Asking Questions and Activity 6 – Unusual Questions) from two different forms (i.e., Form A and Form B) of an earlier version of the Torrance Tests of Creative Thinking—Verbal. Results indicated that participants with higher originality and fluency scores were more likely to ask Open-Ended Questions. Additionally, creativity indicators were significantly associated with Possibility Thinking Questions in Activity 6, and Temporal Thinking Questions in Form A – Activity 1. We discussed the implications of the findings and potential reasons for varied results.

Using ground raw perlite through alkali activation to produce various construction materials such as plaster, grouting, and concrete can provide economic and environmental advantages by reducing Portland cement consumption. It is aimed to produce cementless pastes and cementless mortars based on the alkali activation of raw perlite and standard sand for this study. Perlite and alkali activators (NaOH and Na2SiO3) were used as binding materials to produce cementless paste and mortar. In addition, aerated lightweight pastes and mortars were produced using hydrogen peroxide (H2O2) as a blowing agent. Thus, the aeration mechanism of the sample was examined, and the changes in apparent density, compressive strength, and flexural strength values were determined. At the same time, the thermal conductivity properties of aerated paste and mortars were investigated. Geopolymers in various Water/Perlite and H2O2/Perlite ratios were produced, and their thermal conductivity, apparent density, compressive and flexural strength were contrasted. The experimental finding revealed that adding 0.25% H2O2 (by mass of perlite) to the mixtures enabled the production of lightweight pastes and mortars with lower density and lower thermal conductivity coefficient without a significant loss of ultimate strength. The developed perlite based aerated geopolymer is a eco-friendly and energy efficient solution to the buildings. Based on the results, H2O2/Perlite% above 0.5% and water/Perlite% above 45% should be avoided for both paste and mortars. In order to obtain optimum results in terms of workability, strength, density, and thermal conductivity, it is recommended that the H2O2/Perlite ratio for all samples should be 0.25% and the Water/Perlite percentage should be 40%.

Objective: We aimed to investigate whether there is a relationship between diaphragm thickness and disease severity in Covid-19 pregnant subgroups. Material and methods: In this prospective study 100 pregnant patients were enrolled. Thickness of the diaphragm muscle at end-expiration was measured using B-Mode US. Hemoglobin,WBC, NLR, procalcitonin and LDH levels were measured. Results: There was a statistically significant difference between the groups in terms of diaphragm thickness, and the diaphragm thickness was thinner in the severe disease group (p

Crystalline iron boride (Fe2B) nanoparticles were successfully synthesized with magnesiothermic reduction reactions triggered by mechanochemical synthesis (MCS) and purified using selective hydrochloric (HCl) acid leaching. Various parameters of MCS were investigated in detail to optimize the synthesis conditions. First, Fe2O3/B/Mg powder mixtures were blended and milled for various durations (up to 8 h) using a high-energy ball mill until Fe2B formation was complete. For the milling optimization, two different ball-to-powder weight ratios (BPRs) were employed: 10/1 and 15/1. Different sizes of milling balls as MCS media were used to investigate their effects on the Fe2B formation. After the MCS experiments, powders were purified with a 4 M hydrochloric acid (HCl) solution to leach out the MgO by-product phase and to obtain pure Fe2B particles. Based on all the optimization studies, Fe2O3/B/Mg powders milled for 6 h using one φ 14.3 mm ball and five φ 12.4 mm balls with a 10/1 BPR and purified were selected as ideal products. Microstructural, thermal, rheological and magnetic properties were determined for the optimum Fe2B nanoparticles. This optimum batch comprising pure Fe2B nanoparticles (with an average size of 35 nm) was tested for biocompatibility (up to 72 h with 200 μg/mL) and specific absorption rate (SAR up to 55 °C) to evaluate its use in biomedical applications. The dose and time-dependent cytotoxicity of poly (acrylic acid) coated Fe2B nanoparticles (PAA-Fe2B) were investigated with cancerous HeLa, MCF7, A549 and MDA-MB-231 and healthy Vero E6 cells. PAA-Fe2B nanoparticles were found to be cytocompatible with Vero E6 cells, HeLa and MCF7 cancer cells. The SAR value of the Fe2B nanoparticles was determined as 9.15 W/g, so the synthesis mechanism and some properties of Fe2B nanoparticles were successfully proposed for possible biomedical applications.

This paper examines whether the financial reporting quality of audit clients is affected more by the national culture of the home country of an international parent audit firm or the national culture of its affiliates' host country. The study uses 111,949 firm-year observations for 16,444 unique industrial firms across 51 countries from 2009 to 2019. Financial reporting quality is proxied by accrual-based earnings management. The national culture of the countries in which the parent firm's head office and foreign affiliates are located is represented by the Hofstede Model of Cultural Dimensions. The results demonstrate that the national culture of parent firm's home country has a more significant impact on earnings management than the national culture of the foreign affiliates' country. Findings also support the homogeneity hypothesis on the association between international parent firms and their affiliates. The global audit network, which is dominated by this international parent firm, has common cultural characteristics. The results remain unchanged after the different home country assumptions, alternative sampling procedures, endogeneity, and firm- and country-level factors are controlled.

Background: Since breast cancer is less common in men than in women, data on the use of new therapeutic agents, including cyclin-dependent kinase 4–6 (CDK 4–6) inhibitors, are limited in patients with metastatic hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) male breast cancer. Therefore; we aimed to investigate the treatment responses of metastatic HR+, HER2-male breast cancer patients treated with CDK 4–6 inhibitors in a multicenter real-life cohort. Methods: Male patients with a diagnosis of HR+ and HER2-metastatic breast cancer, treated with any CDK 4–6 inhibitor, were included in the study. Demographic and clinical characteristics of the patients were recorded. We aimed to determine progression-free survival (PFS) time, response rates and drug related side effects. Results: A total 25 patients from 14 institutions were recruited. The mean age at diagnosis was 57 years. Median follow-up was 19.53 (95% CI: 14.04–25.02) months. The overall response rate was 60%. While the median PFS was 20.6 months in the whole cohort, it wasn't reached in those using CDK 4–6 inhibitors in first line and 10 months in the subsequent lines (p:0.009). No new adverse events were encountered. Conclusion: In our study, we found that CDK 4–6 inhibitors are effective and safe options in men with HR+ and HER2-metastatic breast cancer as in women. Our results support the use of CDK 4–6 inhibitor-based combinations in the first-line treatment of HR+ and HER2-metastatic male breast cancer.

Introduction: Aminoglycosides are widely known for their ototoxic side effects. Nevertheless, they are potent antibiotics used in the treatment of life-threatening conditions because of the current concern for antibiotic resistance. We hypothesized that creatine supplements which are believed to improve mitochondrial antioxidant defense system and maintain optimal energy homeostasis may improve the ototoxic side effects. Objective: This study aimed to investigate the protective effects of creatine monohydrate against ototoxicity induced by amikacin in rats in an experimental animal model, using distortion product otoacoustic emissions and auditory brainstem response. Methods: Twenty healthy rats were assigned to four groups (5 rats in each): the control group, the creatine monohydrate group, the amikacin group and the amikacin + creatine monohydrate group. The creatine monohydrate group received creatine at a dose of 2 g/kg once daily via gastric gavage for 21 days. The amikacin group received amikacin at a dose of 600 mg/kg by intramuscular injections once daily for 21 days. The amikacin + creatine monohydrate group received intramuscular injections of amikacin (600 mg/kg) once daily for 21 days and creatine monohydrate (2 g/kg) once daily via gastric gavage for 21 days. The control group received nothing. The distortion product otoacoustic emissions and auditory brainstem response measurements were performed on all rats on days 0, 7, 21. Results: Regarding auditory brainstem response values, a significant increase in the auditory threshold was observed in the amikacin group on day 21 (p 0.05). When we compare distortion product otoacoustic emissions values, there was no significant difference between the amikacin and amikacin+creatine monohydrate groups on day 7 (p > 0.05), However significantly greater distortion product otoacoustic emissions values were observed in the amikacin+creatine monohydrate group on day 21 compared to the amikacin group (p

This paper reports on the in-situ synthesis, optimization, characterization and cytotoxicity tests of multi-layer graphene (MLG) encapsulated Fe/Fe2O3 nanoparticles (Fe/Fe2O3@C core–shell nanostructures) by spray drying-assisted chemical vapor deposition (CVD) using iron-nitrate/silica-based precursors. The influences of CVD reaction temperature, holding time, CH4/H2 gas flows and pressure on the synthesis of MLG encapsulated Fe/Fe2O3 nanoparticles were investigated. CVD-synthesized powders were purified using acid leaching to remove residual silica and probable uncoated Fe/Fe-oxide phases. XRD analyses revealed the presence of FCC (Fe,C), BCC Fe, graphite/graphene and trace amount of Fe2O3 phases. Raman spectra confirmed the existence of MLG shells. TEM indicated that MLG (from at least 3 to maximum of 35 layers) wrapped around the metallic cores ranged between 4 and 85 nm. Purification of nanoparticles did not degrade, dissolve or create discontinuity on the MLG structure. VSM measurements showed that nanoparticles obtained from the optimized conditions (900 °C, 100 ml/min CH4/H2, 50 mbar) had a soft ferromagnetic behavior with low saturation magnetization (∼85 emu/g) and coercivity (∼552 Oe) values. Optimized MLG encapsulated Fe/Fe2O3 nanoparticles were successfully suspended in water using a poly(acrylic acid) coating. Aqueous MLG encapsulated Fe/Fe2O3 nanoparticles were cytocompatible below 100 μg/ml at short incubation times, and showed the potential to be used in biomedical applications.

Introduction: Intraprocedural coronary angiography is recommeded in patients undergoing ablation in aortic cusps to assess the relation of catheter tip and coronary ostia. In this report, we present our experience in selective coronary angiography through the radiofrequency catheter during premature ventricular contraction (PVC) ablation. Methods and results: We prospectively recruited 43 consecutive patients who underwent PVC ablation in the aortic cusps between March 2018 and April 2021. We performed coronary angiography through the contact force (CF)-sensing ablation catheter at the ablation site. Successful ablation was achieved in 38 (88%) of patients. No technical problems occurred after the contrast injection and ablation parameters were within the normal values, without any change of impedance and CF-sensing values and neither electrogram signal quality after contrast injection. No complications occurred during the procedure, hospital stay, and during one-year follow-up (15.3 ± 3.1 months). Conclusion: Selective coronary angiography through the CF-sensing ablation catheter to assess the relation between the ablation site and the coronary ostia is feasible and no minor or major complications occurred in our experience.

The logistics center concept has been discussed in the literature for over four decades. Logistics centers simplify the logistics network and have many advantages, such as lower transportation costs, an economy of scale, and integrated service capabilities. We propose a spatial multi-criteria decision-making model for new logistic centers in metropolitan areas. The first focus of the study is identifying the logistic concerns, defining the factors affecting the replacement decisions and determining the weights of the factors in metropolitan areas with many expert opinions. The second focuses on spatial analysis to locate new logistics centers serving urban areas. We present a case study in Istanbul, the most populous metropolis in Europe, to demonstrate the applicability and exhibit efficacy of the method proposed in this study. Outputs of the study pointed out where the convenient places are to locate new logistics centers.

Evaluating lipid profiles in human tissues and biofluids is critical in identifying lipid metabolites in dysregulated metabolic pathways. Due to various chemical characteristics, single-run lipid analysis has not yet been documented. Such approach is essential for analyzing pathology-related lipid metabolites. Age-related macular degeneration, the leading cause of vision loss in western countries, is emblematic of this limitation. Several studies have identified alterations in individual lipids but the majority are based on targeted approaches. In this study, we analyzed and identified approximately 500 lipid species in human biofluids (plasma and erythrocytes) and ocular tissues (retina and retinal pigment epithelium) using the complementarity of hydrophilic interaction liquid chromatography (HILIC) and reversed-phase chromatography (RPC), coupled to high-resolution mass spectrometry. For that, lipids were extracted from human eye globes and blood from 10 subjects and lipidomic analysis was carried out through analysis in HILIC and RPC, alternately. Furthermore, we illustrate the advantages and disadvantages of both techniques for lipid characterization. RPC showed greater sensitivity in hydrophobicity-based lipid separation, detecting diglycerides, triglycerides, cholesterol, and cholesteryl esters, whereas no signal of these molecules was obtained in HILIC. However, due to coelution, RPC was less effective in separating polar lipids like phospholipids, which were separated effectively in HILIC in both ionization modes. The complementary nature of these analytical approaches was essential for the detection and identification of lipid classes/subclasses, which can then provide distinct insights into lipid metabolism, a determinant of the pathophysiology of several diseases involving lipids, notably age-related macular degeneration.

Objective: The aim of our study was to investigate the relationship between extreme values of first trimester screening markers and adverse obstetric outcomes. Materials and methods: Our study was conducted by examining the prenatal and postnatal perinatal records of 786 singleton gestations between the ages of 18–40, who applied to Prof. Dr. Cemil Taşçıoğlu City Hospital outpatient clinics for first-trimester screening for aneuploidy, between January 1, 2017 and December 31, 2019. Results: The presence of small for gestational age (SGA) was found to be statistically significant for the

Background: This study aimed to measure the levels of anxiety and burnout among healthcare workers, including attending physicians, residents, and nurses in intensive care units during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This is a cross-sectional survey analysis of healthcare workers in our institution. Data were collected on demographic variables, COVID-19 symptoms and test, disease status, anxiety level (assessed by the Beck Anxiety Inventory), and burnout level (measured by the Maslach Burnout Inventory). Subscales of the burnout inventory were evaluated separately. Results: A total of 104 participants completed the survey. Attending physicians, residents, and nurses constituted 25%, 33.7%, and 41.3% of the cohort, respectively. In comparison to untested participants, those tested for COVID-19 had a lower mean age (p = 0.02), higher emotional exhaustion and depersonalization scores (p = 0.001, 0.004, respectively), and lower personal accomplishment scores (p = 0.004). Furthermore, moderate to severe anxiety was observed more frequently in tested participants than untested ones (p = 0.022). Moderate or severe anxiety was seen in 23.1% of the attending physicians, 54.3% of the residents, and 48.8% of the nurses (p = 0.038). Emotional exhaustion, personal accomplishment, and depersonalization scores differed depending on the position of the healthcare workers (p = 0.034, 0.001, 0.004, respectively). Conclusion: This study revealed higher levels of anxiety and burnout in younger healthcare workers and those tested for COVID-19, which mainly included residents and nurses. The reasons for these observations should be further investigated to protect their mental health.

Background: Corona Virus Disease 2019 (COVID-19) in pregnant women has important impacts on perinatal and neonatal outcomes. However, there are a limited number of studies investigating the effect of the pandemic period on newborns. With this study, we aimed to determine the impact of the 2020 COVID-19 outbreak on prenatal care, obstetric outcomes, neonatal mortality and morbidity. Methods: The retrospective results of patients hospitalized to the Tertiary Neonatal Intensive Care Unit between 1 March and 30 May 2020, the first peak period of the pandemic in our country, were compared with the data of the same period of the previous year. Results: A total of 307 cases were included in our study. The mean gestational weeks of the neonates hospitalized in the Neonatal Intensive Care Unit during the COVID-19 period were higher than those in the control group (p: 0.003). During the pandemic period, an increase was found in the frequency of pregnant women presenting to obstetric emergency services in emergencies requiring acute intervention (p: 0.01). Compared to the control group, there was an increase in the number of infants with small for gestational age (SGA) diagnosis, 5th-minute Apgar score of 0.05). Conclusions: During the COVID-19 pandemic, it was shown that pregnant women disrupted their regular antenatal care, and more pregnant women were admitted to the obstetric emergency department with emergencies requiring acute intervention. This led to an increase in the number of cases diagnosed with SGA and hypoxic-ischemic encephalopathy in newborns. Our results will be useful for better management of current and future pandemic periods.

Background/aim: Viral infections of the respiratory tract are generally related to many factors such as excessive production of cytokines, inflammation, cellular death, redox imbalance or oxidative stress. The aim of this study was to determine the serum levels of thiol and IMA in patients with severe COVID-19 pneumonia to evaluate oxidative stress. Study design: This was a prospective, sectional cohort study conducted at a pandemics hospital between 01.01.2022 and 01.02.2022. Methods: A total of 153 patients who had been confirmed with severe COVID-19 pneumonia in the emergency unit were prospectively analyzed. The control group was formed by 50 healthy volunteers with similar age and no chronic disease history. Thiol and IMA levels were statistically compared both in the patient and the control groups, and within the patient groups (survived and non-survival). Results: While 96 out of 153 patients had survived, 57 patients had non-survival. There was a statistically significant distinction between the survived and non-survival patients with regard to Thiol and IMA levels (p < 0.001). The thiol levels in the patient group were significantly lower compared to the control group, and the IMA levels were significantly higher (p < 0.001). The sensitivity, specificity and NPV were 70.2%, 86.5% and 83% when thiol cut-off value was ≤345.2 μmol/L (AUC: 0.886, p < 0.001). The sensitivity, specificity and NPV were 70.2%, 85.4% and 82.8% when the IMA cut-off was >302.9 ABSU (AUC: 0.875, p < 0.001). Conclusions: Our results demonstrate that thiol and IMA levels may be used as bioindicators for risk classification and mortality in patients with serious COVID-19 pneumonia.

Summary: Analysis of the surfaceome of a blood cell subset requires cell sorting, followed by surface protein enrichment. Here, we present a protocol combining magnetically activated cell sorting (MACS) and surface biotinylation of the target cell subset from human peripheral blood mononuclear cells (PBMCs). We describe the steps for isolating target cells and their in-column surface biotinylation, followed by isolation and mass spectrometry analysis of biotinylated proteins. The protocol enables in-column surface biotinylation of specific cell subsets with minimal membrane disruption. : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.

A facile and label-free detection method based on the formation of the G-quadruplex structure of Thioflavin T and a DNA sequence was developed for rapid and sensitive detection of copper (Cu2+) ion. The DNA sequence with many guanine (G) repeats has the potential to form a G-quadruplex structure and exhibits high selectivity to Cu2+. ThT promotes the formation of the G-quadruplex structure resulting in high fluorescence intensity because of its fluorescence molecular rotor characteristic. As opposed to, when the DNA sequence binds to its target in the presence of Cu2+, conformational changes occur, resulting in ThT dissociation and a substantial decrease in fluorescence intensity. By virtue of this change, unlabeled, low-cost, sensitive, and selective detection of Cu2+ was achieved and not interfered by many other ions. The proposed method has high sensitivity and selectivity, with a detection limit of 30.7 nM, allowing it to directly measure Cu2+ in contaminated water samples in a wide linear range from 0.1 to 100 µM with a high recovery rate.

A broad range of evidence has confirmed that natural products and essential oils might have the potential to suppress COVID-19 infection. Therefore, this study aimed to develop an oral/throat spray formulation for prophylactic use in the oral cavity or help treatment modalities. Based on a reference survey, several essential oils, a cold-pressed oil, and propolis were selected, and cytotoxicity and antiviral activity of each component and the developed spray formulation were examined against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection using Vero E6 cells. Anti-inflammatory, antimicrobial, and analgesic activities as well as mutagenicity and anti-mutagenicity of the formulation were analysed. Forty-three phenolics were identified in both propolis extract and oral/throat spray. The spray with 1:640-fold dilution provided the highest efficacy and the cytopathic effect was delayed for 54 h at this dilution, and the antiviral activity rate was 85.3%. A combination of natural products with essential oils at the right concentrations can be used as a supplement for the prevention of SARS-CoV-2 infection.

Objective:: Urinary retention after non-urological surgery is a common morbidity, yet its​ etiology and treatment approaches are still a matter of debate. The primary aims of this study are to evaluate the management of urinary retention after non-urological surgeries, determine the predictors of prognosis, and report follow-up data. Methods:: Patients who were referred to the urology clinic at a single center due to postoperative urinary retention between December 2014 and November 2021 were included. Demographical, clinical, and surgical parameters were recorded. In all patients, a urethral catheter was kept in-situ for at least 5 days after urinary retention. In case of persistent urinary retention after catheter removal, clean intermittent catheterization (CIC) was recommended. Results of the patients who spontaneously regained micturition after conservative treatment and those with persistent urinary retention were compared. Results:: Among 95 patients, the median age was 65 (24–90) years. In 75 patients (78.9%), spontaneous micturition returned with conservative management (Group 1). Twenty patients (21.1%) required CIC due to persistent urinary retention (Group 2). The percentages of males in Group 1 and 2 were 81.3% and 50% respectively (p

The study aimed to investigate the suitability of some food wastes for use in the production of herbal tea and to reveal their properties in terms of bioactive component content, some physical properties and sensory quality. Three new blends consisting of banana, pomegranate, mandarin, eggplant and red onion peels, walnut shell, cherry stalk and corn tassel were infused at different temperatures (70 and 100 °C) and time (3, 4 and 5 min). Corn tassel tea, which has a high phenolic component content (677.7 mg GAE/L), received less sensory acceptance due to its bitter aftertaste. Therefore, walnut shell tea containing moderate phenolic content was the most preferred tea blend. Significant effects of different infusion temperatures and times on the color indices of teas were also demonstrated. The sensory properties of samples infused for 3 min were more acceptable. The highest correlation coefficients were calculated between total phenolic compounds and subjective odor parameters. Utilization of mandarin, pomegranate, banana, eggplant and red onion peels, walnut shell, corn tassel and cherry stalk in formulating a functional and an alternative food product can be attractive to consumers and industrial producers due to their affordability and high bioactivity.

Background: The objective was to assess the knowledge level, attitude, and practice of health care workers towards standard precautions, and to identify the related factors. Furthermore, it was attempted to identify the proportion of having the experience of needle stick injuries (NSIs) and associated factors among participants. Methods: A cross-sectional study was conducted in a teaching hospital among 233 health workers using a self-administrated questionnaire. The questionnaire included eight knowledge items, seven practice items, and five attitude items. Based on the mean score of each category, responses were grouped into “satisfactory” and “unsatisfactory”. Univariate, bivariate, and multivariable logistic regression analyses were done. Results: The mean age of the participants 32.95 (SD ± 9.70) and 62.2% of them were women. 57.5% of the staff had a satisfactory level of correct knowledge (>5 correct answers), 37.3% had a satisfactory positive attitude (>3 correct answers), and 30.9% had a satisfactory practice (>3 correct answers) towards standard precautions. The occupation was one of the predictors as doctors were less likely to have satisfactory knowledge and practice compared to nurses (OR = 0.269, 95% CI: 0.10–0.70 and OR = 0.248, 95% CI: 0.08–0.77, respectively). Out of 174 participants, 31.6% of them reported experiencing NSIs and support staff were 71% less likely to experience NSIs compared to nurses & paramedics. Conclusion: The findings revealed a substandard adherence of standard precautions among participants, which highlighted the necessity of the provision of a periodic, tailored training program based on the occupation and risk exposure.

Spatial changes of FAs in the retina in response to different dietary n-3 formulations have never been explored, although a diet rich in EPA and DHA is recommended to protect the retina against the effects of aging. In this study, Wistar rats were fed for 8 weeks with balanced diet including either EPA-containing phospholipids (PLs), EPA-containing TGs, DHA-containing PLs, or DHA-containing TGs. Qualitative changes in FA composition of plasma, erythrocytes, and retina were evaluated by gas chromatography-flame ionization detector. Following the different dietary intakes, changes to the quantity and spatial organization of PC and PE species in retina were determined by LC coupled to MS/MS and MALDI coupled to MS imaging. The omega-3 content in the lipids of plasma and erythrocytes suggests that PLs as well as TGs are good omega-3 carriers for retina. However, a significant increase in DHA content in retina was observed, especially molecular species as di-DHA-containing PC and PE, as well as an increase in very long chain PUFAs (more than 28 carbons) following PL-EPA and TG-DHA diets only. All supplemented diets triggered spatial organization changes of DHA in the photoreceptor layer around the optic nerve. Taken together, these findings suggest that dietary omega-3 supplementation can modify the content of FAs in the rat retina.

Summary: Background: Anal fissure which is defined as a longitudinal tear in anoderm under the dentate line is one of the most common benign diseases of anorectal area, and due to the severe pain during the defecation and emotional stress that it causes may reduce people's quality of life. There are several treatment methods such as medical substances and surgical procedures. In this retrospective study, we aimed to evaluate the safe and adequate option of lateral internal sphincterotomy (LIS) in chronic anal fissure treatment. Methods: This study is a retrospective study in which 417 patients who were treated for chronic anal fissure were included. Results: Of 417 patients included in the study, 228 (54.7%) were female and the mean ± SD age was 36.1 ± 8.96 years (ranging from 17 to 73 years). Major complaints of patients; pain, bleeding, constipation, pruritus, perianal discharge.Recurrence occurred in 15 patients (3.6%) (12 males, three females) and eight patients (1.9%) developed incontinence (four with gas, four with soiling and seven females, one male). The complaints of all patients with gas incontinence and a patient with fluid incontinence regressed, whereas three patients had permanent fluid incontinence. Conclusion: LIS is still the gold standard for the treatment of chronic anal fissure when the physicians would like to avoid recurrence and obtain the best pain relief. Keywords: Chronic anal fissure, Incontinence, LIS, Recurrence, Satisfaction

Introduction: The human population is aging at an astonishing rate. The aim of this study is to capture a situation snapshot revealing the proportion of individuals aged 65 years and over among inpatients in healthcare institutions in Turkey and the prevalence and type of infections in this patient group in order to draw a road map. Materials and Methods: Hospitalized patients over 65 years at any of the 62 hospitals in 29 cities across Turkey on February 9, 2017 were included in the study. Web-based SurveyMonkey was used for data recording and evaluation system. Results: Of 17,351 patients 5871 (33.8%) were ≥65 years old. The mean age was 75.1 ± 7.2 years; 3075 (52.4%) patients were male. Infection was reason for admission for 1556 (26.5%) patients. Pneumonia was the most common infection. The median length of hospital stay was 5 days (IQR: 2–11 days). The Antibiotic therapy was initiated for 2917 (49.7%) patients at the time of admission, and 23% of the antibiotics prescribed were inappropriate. Healthcare-associated infections developed in 1059 (18%) patients. Urinary catheters were placed in 2388 (40.7%) patients with 7.5% invalid indication. Conclusion: This study used real data to reveal the proportion of elderly patients in hospital admissions. The interventions done, infections developed during hospitalization, length of hospital stay, and excessive drug load emphasize the significant impact on health costs and illustrate the importance of preventive medicine in this group of patients.

Background: Sexual activity is an important indicator of quality of life and is significantly impaired in patients with heart failure (HF). Cardiac resynchronization therapy (CRT) has positive effects on cardiac dysfunction and endothelial dysfunction that lead to erectile dysfunction (ED). We aimed to evaluate whether CRT may improve sexual activity in patients with HF. Methods: In total, 136 patients (mean age 61.8 ± 12.8 years) were evaluated for the study. All patients filled the Sexual Health Inventory for Men (SHIM) questionnaire for evaluation of their erectile functions before CRT device implantation. One hundred eighty days after CRT device implantation, the patients were re-evaluated with SHIM questionnaire. Results: In the whole study population, SHIM test scores were significantly increased after CRT (12.99 ± 3.22 vs. 18.03 ± 5.00; p

Concrete is currently among the most widely used materials all around the world. The main advantages of concrete include durability, versatility, and high compressive strength, but significant disadvantages include low tensile strength, low shear strength, and low ductility. To eliminate these disadvantages, longitudinal and transverse reinforcements are usually preferred. Steel is widely used as a reinforcement material in the world, but there is still research underway to find alternative materials. In recent decades, composite materials have been used to reinforce concrete instead of steel materials. This study focuses on Intraply Hybrid Composites (IHCs), which are had an important place in the composite industry and examines how these composites affect concrete beams as far as their shear strength is concerned. For this purpose, A length of 2 m RC beams, with no transverse reinforcement (RC2.0), is prepared and then reinforced with three IHCs, Aramid-Carbon (AC2.0), Glass-Aramid (GA2.0) and Carbon-Glass (CG2.0). After U-shape strengthening, the specimens are inspected in four-point bending tests and the effects of the IHCs are investigated on the shear strength of the beams. The experimental results show that there is an increase of 4.36%, 10.62%, and 15.28% in the ultimate load capacity of AC2.0, CG2.0, and GA2.0, respectively, compared to reference specimen, RC2.0. Furthermore, the type of hybrid composite has a direct impact on the failure modes of the RC beams. Consequently, the IHCs can provide a significant contribution to the structural behavior of RC beams.

Objective: Autoimmune cytopenia is observed in many hematological malignancies, whereas immune thrombocytopenia is rarely observed in plasma cell dyscrasias, such as multiple myeloma. On the other hand, cytopenias secondary to myelosuppression due to lenalidomide use are frequently observed, whereas immune thrombocytopenia is a rarer complication. Case report: A 63-year-old female patient without any known disease was performed bone marrow biopsy in January 2019 due to anemia and high sedimentation rate. She was diagnosed with IgG-kappa type multiple myeloma and administered four cycles of bortezomib-cyclophosphamide-dexamethasone treatment. She went into remission after this treament and was then performed autologous stem cell transplantation followed by a consolidation therapy comprising 2 cycles of bortezomib-lenalidomide-dexamethasone treatment. Subsequently, she was administered lenalidomide maintenance therapy with regular follow-up visits. Isolated thrombocytopenia was observed in the patient in her last follow-up visit and was therefore hospitalized for further examination. No schistocyte was observed in the peripheral smear as well as no rouleaux formation. It was determined that her LDH (lactate dehydrogenase) levels were normal and that she did not have organomegaly. The results of the Coombs test, in addition to the results of hepatitis B, hepatitis C, HIV (Human Immunodeficiency Virus), EBV (Ebstein-Barr Virus), and ANA (antinuclear antibody) tests, which were run in order to determine whether she had any viral diseases, came out as negative. Post-transfusion purpura was ruled out in the patient as she had no history of transfusion in the last three months. She was then performed bone marrow biopsy, since her platelet count did not increase after discontinuation of lenalidomide treatment despite the fact that she was given platelet suspension transfusion. Subsequently, it was was determined that her megakaryocyte count increased, whereas her plasma cell ratio was less than 5%. In view of the foregoing, she was pre-diagnosed with lenalidomide-related immune thrombocytopenia, and was thus given 1 gr of methylprednisolone for 3 days followed by the administration of methylprednisolone at a daily dose of 1 mg/kg for 5 days. However, a sufficient increase in her platelet count could not be achieved with the said treatment. Therefore, she was administered eltrombopag therapy instead, since she was refractory to other treatments that could have been administered as a replacement treatment, such as IVIG (Intravenous Immunoglobulin), rituximab or cyclophosphamide. The patient, whose platelet count increased after the administration of eltrombopag therapy, was then discharged with full recovery. Conclusion: The aim of this case report is to demonstrate that lenalidomide-associated immune thrombocytopenia should also be considered when there is isolated thrombocytopenia in patients with multiple myeloma without a decrease in other cell lines.

ABSTRACT: Recently, the US FDA and Association of American Feed Control Officials approved Black Soldier Fly larvae (BSFL) as a feed ingredient for poultry. The objectives of this work were 1) to evaluate the nutritional profile of BSFL oil and meal in laying hens, and 2) measure the impact of the BSFL treatments on hen performance and egg quality. In 2 experiments, BSFL oil and meal were fed to replicate hens from 43 to 47 wk and from 51 to 55 wk of age. The hens were fed isocaloric, isonitrogenous diets with 3 treatment levels of BSFL oil (1.5, 3, and 4.5%, Exp. 1) or BSFL meal (8, 16 and 24%, Exp. 2). Data were analyzed by one-factor ANOVA for the main effect of diet and Tukey's multiple comparison for mean separation when significant. Exp. 1 results suggest BSFL oil could readily substituted for soybean oil with commercial hens at inclusion levels up to 4.5%. ADFI, BW, egg production, FCR, and egg weight were not impacted by the oil treatments (P > 0.05). Yolk color among hens fed the BSFL oil was greater averaging 7.88 compared to 7.37 from Control hen eggs (P = 0.0001). Exp. 2 diet formulation replaced soybean oil and meal with BSFL meal, and some additional corn was used in the higher BSFL diets. Diet amino acid balance at the highest level of inclusion (24% BSFL meal) indicates arginine and tryptophan are limiting and ADFI, BW and egg production were reduced (P < 0.05). Egg production averaged 85.14% for the Control, 8 and 16% BSFL meal hens and was significantly greater than hens fed 24% meal at 77.01%. However, 8 and 16% BSFL meal levels had no negative impact on performance and were not significantly different than the Controls. Yolk color was again higher among the meal treatments compared to the control (P = 0.0351). These experiments indicate that BSFL oil and meal can be used as dietary energy, protein and amino acids for hen maintenance, egg production and yolk coloration, although there may be upper limits of dietary inclusion.

The difference in stiffness between cylindrical and dome regions of a filament wound composite pressure vessel may cause undesirable bending in the cylinder-dome transition region. Because of the bending, strain distribution may be non-uniform in the transition region. Therefore, accurate modeling that captures non-uniform strain distribution in the transition region is crucial for a safe pressure vessel design. In this study, a pressure vessel with a metallic liner was designed. Three identical pressure vessels were manufactured. One of the vessels was cut for detailed geometric investigation. The section of the transition region was investigated using an optical microscope. The termination of each hoop layer and resin pockets under the helical layers were clearly observed at the micro-scale. Also, measurement of layer by layer thickness and fiber volume fraction were performed. Other vessels were pressurized until the burst pressure. Fiber direction strain was measured using strain gauges that were mostly attached to the transition region to capture the non-uniform strain distribution. Two finite element models were created to analyze the transition region. The first finite element model was created with design parameters. The second finite element model was established by considering the findings obtained from the microscopic analysis. Strain distributions obtained from the strain gauges and finite element analyses were compared. In contrast to the first finite element model, strain distribution in the transition region was perfectly matched with the second finite element model. Thus, important aspects of analyzing the transition region of a pressure vessel were addressed for designers.