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The exponential growth in demand for housing has resulted in a greater focus on rapid construction methods that adhere to circular economy principles. 3D concrete printing is becoming a powerful tool to find solutions to the common challenges of affordable housing for more people, rapid construction, and the digitalization of the construction industry. However, a coherent synthesis of green and digital initiatives has not yet been achieved. For 3D printable materials, recycling of materials that have reached the end of their service life should also be enabled and supported, in line with circular economy goals that prioritize waste reduction and maximization of resource efficiency. With these objectives in mind, the current study focuses on the development of a one-part 3D printable alkali-activated mortar (3DPM) derived from brick masonry waste (BMW). BMWs were used as the main precursor and filler phase, whereas materials such as ground granulated blast furnace slag, kaolin clay, and limestone have been utilized to enhance/control the mechanical and rheological properties. To investigate the evolution of alkali-activation and the effect of anisotropy, the macromechanical properties of the developed 3DPM were investigated by compressive strength, flexural strength, split tensile, and direct tensile tests. The micromechanical properties were analyzed using X-ray fluorescence spectrometry (XRF), X-ray diffraction (XRD), Fourier transform infrared (FTIR), thermogravimetry (TG), differential scanning calorimetry (DSC), scanning electron microscopy and energy dispersive X-ray spectroscopy (SEM/EDX), and computed tomography (MicroCT) tests. Overall, the results revealed the presence of anisotropy, which can be reduced by optimizing the layer height. Through this optimization, reductions in pore content and distribution, validated by MicroCT, indicated that the disadvantage of the weak interlayer bond zone in stress transfer could be diminished. Micromechanical analysis showed that the gel formation responsible for the strength was the calcium-based gel structures. Considering these findings, it is believed that the BMW-based 3DPM can be an important alternative for the digitalization of the construction industry and its transition to a circular economy.

Teknolojik gelişmeler ve pandemi gibi zorunlu durumlar nedeniyle yeni iş modelleri ve bu iş modellerine göre yeni yönetim anlayışları geliştirmek gerekmektedir. Uzaktan çalışma da yeni bir yönetim anlayışı gerektiren iş modellerinden biridir. Uzaktan çalışma ortamı bankalara maliyetleri düşürme, çalışan bağlılığı, yetenekleri elde tutma ve yetenek kazanımı bakımından avantajlar sağlayabilmektedir. Özellikle pazarda rekabetçi avantajı kazanmak isteyen katılım bankalarının uzaktan çalışma ortamına entegre olabilmeleri için çalışanların tutum ve algılarının en az işletmelerin belirleyecekleri yönetim anlayışı ve uygulamalar kadar önem kazanmaktadır. Bu çalışmanın amacı katılım bankalarındaki çalışanların uzaktan çalışma tutumları ve dönüşümcü liderlik algılarının örgütsel bağlılık üzerindeki etkisini birlikte incelemektir. Bu anlamda uzaktan çalışma tutumu, dönüşümcü liderlik ve örgütsel bağlılık ilişkilerini ayrı ayrı inceleyen literatüre katkı sunulmaktadır. Bu çalışma için nicel araştırma tasarımı benimsenmiştir. Araştırmanın verileri, Türkiye’deki katılım bankalarında çalışan 520 kişiden rastgele örnekleme yöntemi ve çevrimiçi anket tekniğiyle toplanmıştır. Çalışanlardan 61 tanesi sadece ofis ortamında çalıştıkları için doldurdukları anketler kapsam dışı bırakılmıştır. Araştırmadaki veriler yapısal eşitlik modellemesi kullanılarak AMOS 23 programı ile analiz edilmiştir. Araştırmanın bulguları, katılım bankası çalışanlarının uzaktan çalışma tutumu ve dönüşümcü liderlik algılarının örgütsel bağlılık üzerinde pozitif ve anlamlı yönde etkilediği sonucuna ulaşılmıştır.

Nowadays, lipid nanoparticles have gained profound interest in chemical and biomedical engineering. The rapid development of therapeutic nanosystems has led to a need to design suitable approaches to synthesize bio-carriers for efficient drug delivery. Microfluidic methods provide an excellent opportunity to acquire desirable nanoparticle properties, including stability, size, shape, and size distribution, which are often challenging to obtain using conventional bulk synthesis methods. Rapid mixing is a crucial factor in the nanoprecipitation process as it influences the size and size distribution of the nanoparticles. Within this regard, in this work, we report an ultrafast acoustofluidic micromixer to synthesize liposome nanoparticles, which have been widely investigated in the literature as drug carriers due to their biocompatibility and biodegradability. This research has also investigated the influence of glycerol addition to the solvent to control the size of the liposomes. Our findings indicate that utilizing the acoustofluidic platform resulted in the production of nanoscale liposomes with small mean sizes compared to the hydrodynamic flow-focusing (HFF) method. Furthermore, the inclusion of glycerol led to a significant reduction in liposome size. These results emphasize the potential of the proposed approach for the efficient and precise synthesis of liposome nanoparticles with improved characteristics, which can be utilized in various biomedical and drug delivery applications.

As the effects of anthropogenic climate change, the frequency and severity of heat waves and drought are increasing day by day in many parts of the world. Droughts and heat waves are often interrelated disasters. Prolonged heat waves often cause drought to occur and/or exacerbate existing drought. These types of disasters cause great losses and damages especially in agricultural production. In this study; By examining the examples of drought and heat wave disasters in different parts of the world, the effects of these disaster types on agricultural production have been tried to be explained. Within the scope of this study, disaster reports, magazines, books and internet news were examined. According to the data obtained; It was determined that crop production, animal production, natural resources, human capital and economy were negatively affected. It has been observed that especially yield and product loss are experienced in cultivated products. It has been determined that there are situations such as a decrease in the yield of fresh grass in the pasture areas and the disappearance of the pasture areas. Losses in cultivated crops for forage crops and fresh grass in pasture areas cause an increase in feed prices and serious problems in feed supply. The increase in feed prices and the problems experienced in the supply of feed cause yield loss in animal products and a decrease in the number of animals fed. Economically, it has been determined that there are effects such as price increase, production cost increase, and decrease in exports.

Epilepsy is characterized by the occurrence of epileptic events, ranging from brief bursts of interictal epileptiform brain activity to their most dramatic manifestation as clinically overt bilateral tonic–clonic seizures. Epileptic events are often modulated in a patient-specific way, for example by sleep. But they also reveal temporal patterns not only on ultra- and circadian, but also on multidien scales. Thus, to accurately track the dynamics of epilepsy and to thereby enable and improve personalized diagnostics and therapies, user-friendly systems for long-term out-of-hospital recordings of electrical brain signals are needed. Here, we present two wearable devices, namely ULTEEM and ULTEEMNite, to address this unmet need. We demonstrate how the usability concerns of the patients and the signal quality requirements of the clinicians have been incorporated in the design. Upon testbench verification of the devices, ULTEEM was successfully benchmarked against a reference EEG device in a pilot clinical study. ULTEEMNite was shown to record typical macro- and micro-sleep EEG characteristics in a proof-of-concept study. We conclude by discussing how these devices can be further improved and become particularly useful for a better understanding of the relationships between sleep, epilepsy, and neurodegeneration.

Introduction Extravasation injuries are one of the most feared complications of intravenous drug administration. The most common drugs associated with extravasation injury include chemotherapy agents and contrast media. Natural course of vesicant extravasation is discomfort, pain, swelling, inflammation, and ultimately skin ulceration. While diligence is the principle approach in prevention, immediate bed-side measures are as important in controlling the extent of tissue damage. Various options, either medical or interventional are next steps in treatment of the condition including antidotes, volume dilution, flushing, suction, hyperbaric oxygen therapy, and surgery. Materials and methods 12 male Wistar albino rats were divided into two groups; one group received fat injections following subdermal doxorubicin infiltration in their right thighs, while other group received saline injection following subdermal doxorubicin infiltration in their right thighs for dilution. Left thighs of both groups were left untreated following subdermal doxorubicin infiltration. Total area of necrosis, as well as resultant epidermal thicknesses were assessed. Histological analyses were conducted using modified Verhofstad scoring system for comparison. Results Mean necrotic area was significantly smaller in the fat injection group compared to other groups. Median Verhofstad score was lesser in the fat injection group as well. Median epidermal thickness, on the other hand, was greater in the fat injection group. Conclusion Injection of fat grafts following vesicant extravasation might be beneficial in preventing the progression of tissue damage, if employed early.

Aim of the study Biologic reconstruction using tumor-bearing bone autografts devitalized by liquid nitrogen or extracorporeal irradiation (oncological sterilization) is a safe and effective method in musculoskeletal surgery. The purpose of this study was to examine the effects of these two oncological sterilization methods on nerve recovery. Methods A total of 48 rats were randomly divided into 3 groups as autograft, irradiation and liquid nitrogen groups. A nerve defect created in the right sciatic nerve was reconstructed with an autograft obtained from the nerve itself. Group I underwent reconstruction with standard nerve autograft. Group II and Group III underwent reconstruction with devitalized nerve autograft treated through extracorporeal irradiation and liquid nitrogen, respectively. The left sciatic nerves of the rats served as control. Electromyography, motor function test and histomorphological analysis were performed to assess the nerve recovery on the 3rd (early stage) and 4th months (late stage). Results Electrophysiological assessment revealed better results in irradiation group compared with liquid nitrogen group in terms of myelinization and axonal regeneration. Motor performance of the autograft group was slightly better than the other groups. Histologically, autograft group demonstrated better results compared with other groups. Late-stage assessments revealed high rates of myelinization in the graft segment in liquid nitrogen group and in the segment distal to the graft in irradiation group. Conclusions This study has demonstrated that nerve autografts treated by oncological sterilization methods may be used for nerve reconstruction in limb salvage surgery. However, further studies are needed to clarify the applicability of these methods.

The presence of organophosphorus compounds (OPs) in the environmental counterparts has become an important problem because of their toxicity. In this study, the photocatalytic degradation reactions of the three OPs with hydroxyl radical were investigated by both experimental and quantum chemical methods. Photocatalytic degradation kinetics of the examined organophosphorus compounds were investigated under UV-A irradiation using TiO2 as the photocatalyst. The effects of the initial concentrations on the degradation rate have been examined. There was an observable loss of OPs in the presence of TiO2 photocatalyst under UV-A at 0.2 g TiO2 per 100 mL. The quantum chemical calculations have been carried out by the density functional theory (DFT) at B3LYP/6-31g(d) level. The reaction pathways were modelled to find the most probable mechanism for OPs with the OH radical and to determine the primary intermediates. The rate constants of the eight reaction paths were calculated by the transition state theory. Conductor-like polarizable continuum model (CPCM) was used as the solvation model with the intention of understanding the water effect. The theoretical results were in agreement with experimental ones.

Serkan Tulgar,1 Muhammed Enes Aydin,2,3 Ali Ahiskalioglu,2,3 Alessandro De Cassai,4 Yavuz Gurkan5 1Maltepe University Faculty of Medicine, Department of Anesthesiology and Reanimation, Istanbul, Turkey; 2Ataturk University School of Medicine, Department of Anaesthesiology and Reanimation, Erzurum, Turkey; 3Clinical Research, Development and Design Application and Research Center, Ataturk University School of Medicine, Erzurum, Turkey; 4Anaesthesiology and Intensive Care, University Hospital of Padua, Padua, Italy; 5Koc University, Faculty of Medicine Department of Anesthesiology and Reanimation, Istanbul, TurkeyCorrespondence: Serkan TulgarMaltepe University Hospital, Maltepe, Istanbul, TurkeyTel +905055423985Email serkan.tulgar@maltepe.edu.trAbstract: Defined in the last decade, erector spinae plane block (ESPB) is one of the more frequently used interfacial plans, and it has been the most discussed block among the recently defined techniques. Lumbar ESPB administered at lumbar levels is relatively novel and is a new horizon for regional anesthesia and pain practice. In this article, we aim to explain and introduce different approaches and explain the possible mechanism of action of lumbar ESPB. The objective of this review is to analyze the case reports, clinical and cadaveric studies about lumbar ESPB that have been published to date. We performed a search in “Pubmed” and “Google Scholar” database. After a selection of the relevant studies, 59 articles were found eligible and were included in this review. While we believe that lumbar ESPB is reliable and easy, we suggest that its efficacy and indications should be verified with anatomical and clinical studies, and its safety should be confirmed with pharmacokinetic studies. Moreover, the possibility of complications must be considered.Keywords: lumbar erector spinae block, regional anesthesia, interfascial plane blocks

Here, the authors show that the resolution and speed limitations in broadband photo-acoustic spectroscopy can be overcome by combining dual-comb spectroscopy with photo-acoustic detection. This enables broadband detection and allows for rapid and sensitive multi-species molecular analysis across all wavelengths of light.

Background: Carbon monoxide (CO) poisoning is associated with direct cardiovascular toxicity. QT dispersion (QTd) of the ECG is an indirect measure of heterogeneity of ventricular repolarization, which may contribute to ventricular arrhythmias. Our aim was to study QTd in patients with acute CO poisoning.Methods: CO intoxication was confirmed by arterial blood gas analysis. A control group consisted of age- and sex-matched individuals admitted to the hospital for unrelated clinical conditions. 12-lead ECG's were recorded on admission and repeated 1 week after discharge from the hospital. QT dispersion was defined as the difference between the greatest and the least QT intervals in any of the 12 leads.Results: Seventeen intoxicated patients, aged 5-46 years, had mean carboxyhemoglobin levels of 22.5 +/- 11.1%. On admission, corrected QT intervals of the intoxicated patients were significantly increased compared to the control group (431 +/- 18 ms vs. 404 +/- 28 ms, P = 0.008), but not the QT interval (358 +/- 25 ms vs. 345 +/- 20 ms, P = 0.17). Mean QTd and cQTd values (46 +/- 15 ms and 62 +/- 13 ms) of the intoxicated patients were significantly increased compared to the control group (17 +/- 4 ms and 33 +/- 15 ms, P < 0.0001 for both). Both QTd and cQTd decreased significantly after discharge from the hospital (P = 0.0001).Conclusion: Although QT dispersion increased in patients with CO poisoning, none of ECG's showed ventricular arrhythmia. Increased QTd in the absence of QT interval prolongation may have a lowered arrhythmogenic potential of CO poisoning. [ABSTRACT FROM AUTHOR]

Disaster is an event that results in serious physical and death of large number of people, because of earthquake, tsunami, flood, landslide, volcano eruption, hurricane, hose, airplane accidents, train accidents, nuclear power plant accidents, explosions and terrorist attacks. Urban search and rescue works are important for finding people and animals trapped under the collapsed structure after the collapse of buildings as a result of earthquakes, terrorist attacks and landslides. The initiation of urban search and rescue activities in the first hours of the disaster increases the rate of live removal of the stranded. The survival rate of the victims 50% decreases, after the first 24 hours. According to the data obtained from numerous cases especially related to earthquakes, it was stated that 50-95% survivors after the disaster were rescued by the local people within the first 24-48 hours. However, there is need for professional teams to reach the victims who are trapped under rubble and are difficult to access. Secondary collapses due to aftershocks and other causes in the collapsed structure (collapses during removal or fixation of debris, and collapses due to the search of relatives on the debris of the relatives, etc.), dangerous leakage of gas, and leakage of access routes to the casualty. These are threats to the safety of urban search and rescue teams. These threats prevent search and rescue personnel from being effective and efficient in urban search and rescue activities. In urban search and rescue activities, local people and professional teams, as well as actors such as dogs, robots, seismic and acoustic (listening) devices and imaging devices are also involved. Each of these actors can be used effectively and efficiently in different tasks and urban search and rescue activities, but it has the characteristics of completing each other. In this study, the positions of disaster volunteers, professional search and rescue personnel, search and rescue dogs, listening and video search devices and robots in search and rescue activities were investigated.

Serkan Tulgar,1 Ali Ahiskalioglu,2 Alessandro De Cassai,3 Yavuz Gurkan41Department of Anesthesiology and Reanimation, Faculty of Medicine, Maltepe University, Istanbul, Turkey; 2Department of Anaesthesiology and Reanimation, School of Medicine, Ataturk University, Erzurum, Turkey; 3Section of Anaesthesiology and Intensive Care, Department of Medicine (DIMED), University of Padua, Padua, Italy; 4Department of Anesthesiology and Reanimation, Faculty of Medicine, Koç University, Istanbul, TurkeyCorrespondence: Serkan Tulgar Fakültesi Maltepe, Üniversitesi Hastanesi, 39 Feyzullah Caddesi, Maltepe, Istanbul, TurkeyTel +90 505 542 3985Email serkantulgar.md@gmail.comAbstract: Erector spinae plane block (ESPB) is a newly described interfascial plane block, and the number of articles on the bilateral application of ESPB is increasing in the literature. In this paper, in addition to analyzing bilateral ESPB cases and studies published so far, we aimed to review the relevant anatomy, describe the mechanism of spread of the injectant, demonstrate varying approaches to ESPB, and summarize case reports and clinical trials, as well as provide current insight on this emerging and popular block. Randomized controlled studies, comparative studies of ESPB versus other methods, and pharmacokinetic studies of bilateral applications must be the next step in clearly understanding bilateral ESPB.Keywords: bilateral erector spinae block, regional anesthesia, interfascial plane blocks

Background: Depolarizing and non-depolarizing muscle relaxants possess many untoward side effects. In most patients endotracheal intubation may be performed with a propofol and alfentanil combination. The purpose of this study was to compare the effect on intraocular pressure (IOP) and haemodynamics of endotracheal (ET) intubation or laryngeal mask (LMA) insertion during total intravenous anaesthesia (TIVA) without the use of muscle relaxants.Methods: In a randomised study, 20 patients scheduled for elective orthopaedic surgery were assigned to two groups of 10 patients. Anaesthesia was induced with i.v. alfentanil 40 micrograms/kg and propofol 2.5 mg/kg. LMA insertion or ET intubation was achieved by the same anaesthesiologist. Airway score, insertion score, patient response and haemodynamics were recorded. IOP measurements were recorded before and after induction, 1 and 2 min after ET intubation or LMA insertion, and 1 and 2 min after extubation.Results: Mean arterial pressure and heart rate after insertion of the airway management devices was significantly higher than induction values in the ET group (P < 0.05), while during 2-3 min no significant changes were observed in LMA group. In all patients following propofol and alfentanil induction, IOP was significantly lower than preinduction values (P < 0.001). IOP following extubation was significantly higher than preinduction values in the ET group, but not in the LMA group (P < 0.001).Conclusion: During TIVA without the use of muscle relaxants neither LMA insertion nor ET intubation increased the IOP, but ET extubation did. [ABSTRACT FROM AUTHOR]

Purpose. The aim of the study is to examine the possible therapeutic effects of a known cardiac glycoside, digoxin, on a rat model of MTX-induced hepatotoxicity. Methods. The study was conducted on twenty-four male rats. While eighteen rats received a single dose of 20 mg/kg MTX to obtain an injured liver model, six rats constituted the control group. Also, the eighteen liver toxicity model created rats were equally divided into two groups, one of which received digoxin 0.1 mg/kg/day digoxin (Group 1) and the other group (Group 2) was given saline (% 0.9NaCl) with a dose of 1 ml/kg/day for ten days. Following the trial, the rats were sacrificed to harvest blood and liver tissue samples to determine blood and tissue MDA, serum ALT, plasma TNF-α, TGF-β, IL-6, IL-1-Beta, and PTX3 levels. Results. MTX’s structural and functional hepatotoxicity was observable and evidenced by relatively worse histopathological scores and increased biochemical marker levels. Digoxin treatment significantly reduced the liver enzyme ALT, plasma TNF-α, TGF-β, PTX3, and MDA levels and decreased histological changes in the liver tissue with MTX-induced hepatotoxicity in the rat model. Conclusion. We suggest that digoxin has an anti-inflammatory and antihepatotoxic effect on the MTX-induced liver injury model.

Abstract Purpose To analyze the effect of calcitriol treatment on acute colitis in an experimental rat model. Methods A total of 24 adult Sprague Dawley albino rats were randomly separated into 3 equal groups: control group (n:8), colitis group (n:8), calcitriol administered group (n:8). A single dose of acetic acid (1 ml of 4% solution) was administered intrarectally to induce colitis. Group 1 was given 1 ml/kg 0.9% NaCl intraperitoneally; rats belonging to Group 2 were administered calcitriol 1 µg/kg for 5 days. Results Plasma tumor necrosis factor alpha, Pentraxin 3, and malondialdehyde levels were significantly lower in the calcitriol administered colitis group than in the standard colitis group (p

Abstract Purpose To examine the therapeutic effect of external adenosine on an acetic acid-induced acute ulcerative colitis model in rats. Methods Thirty male mature rats were divided into three groups as control, acute colitis (AC) and AC+adenosine group (AC+AD). AC was induced by rectal administration of 4% acetic acid (AA). 5mg/kg/day adenosine was performed i.p for 4 weeks to AC+AD group. Rectum and colon were excised for microscopic and histopathological histopathologic evaluations, and immunohistochemical analysis of nuclear factor kappa B (NF-kB). Blood samples were collected for biochemical detection of TNF-α, Pentraxin-3 and malondialdehyde (MDA) levels. Results AC group had generalized hyperemia and hemorrhage with increased macroscopic and histopathological scores compared with control (P

Objective: The aim of this study was to report our results of lunate excision combined with capitohamate fusion in the treatment of Kienböck's stage IIIB/IIIC disease. Methods: A total of 7 patients with a mean age 35.2 (SD 11.5) years were enrolled in the study. Pain was the principal reason for surgery. All operations were carried out by the same senior surgeon. Patients were evaluated in terms of range of motion, DASH and VAS scores, satisfaction, and grip/tip/palmar/key pinch strength compared with contralateral sides. Preoperative carpal height indexes and findings of osteoarthritis were determined radiographically and compared with postoperative evaluations. Results: Mean duration of follow up was 15.2 months. Mean DASH and VAS scores were 13.8 2.7 and 2 1.1 respectively. The mean patient satisfaction score was 3.2 0.4 over 4 points. The mean grip strength in the operated hands was 66.4%, palmar pinch was 75.1%, tip pinch was 71.8% and key pinch was 70.4% when compared to the contralateral unaffected sides. The mean flexion range in the operated hands was 58.8%, extension range was 60.3%, radial deviation range was 65.2% and ulnar deviation range was 65.7% when compared to the contralateral sides. There was no significant difference between preoperative and postoperative carpal height ratios (p = 0.086). Conclusions: Our early term results indicate that lunate excision combined with capitohamate fusion may be an alternative treatment option in patients with stage IIIB and IIIC Kienböck's disease. Level of Evidence: Level IV, Therapeutic study. Keywords: Capitate bone, Excision, Fusion, Hamate, Kienböck's diseasse, Lunate bone

Background and Objective Supreme laryngeal mask airway ( S- LMA) has been improved in recent years, but comparative studies with a sizeable number of paediatric patients are limited in number. In this study, oropharyngeal leak pressures ( OLPs) were compared between S- LMA and Pro Seal laryngeal mask airway ( P- LMA) in paediatric patients. Methods After obtaining approval from the ethics committee and written informed consent from the relatives of the patients, 60 patients, from 9 months to 5 years of age and 10-20 kg in weight, who were recommended for elective surgery were included in this prospective and randomised study. The patients were assigned to the S- LMA and P- LMA groups. OLP, insertion times, success rates, ease of airway device placement, fibre optical assessment, success rates and insertion times of an orogastric tube ( OGT) were compared. Results P- LMA was placed successfully in all the patients. One patient was intubated in the S- LMA group. The outcomes of a total of 59 patients were analysed. The insertion times of the airway devices were shorter in the S- LMA group than in the P- LMA group ( S- LMA; 12.2 ± 2.9, P- LMA; 15.4 ± 3.7 s) ( P = 0.001). The first insertion attempts of airway device placement were similar. The OLPs were similar ( P- LMA; 17.2 ± 2.3, S- LMA; 16.4 ± 1.7 cm H2O). The fibre-optically determined anatomic position was better in the P- LMA group ( P = 0.02). The insertion time of the OGT was shorter with S- LMA than with P- LMA ( P = 0.01). Conclusion Our findings suggest that S- LMA has OLPs similar to those of P- LMA in paediatric patients and that S- LMA provides successful positive pressure ventilation. [ABSTRACT FROM AUTHOR]

Background: The objective of this study was to evaluate the influence of single vs. dual control during an ultrasound-guided lateral sagittal infraclavicular block on the efficacy of sensory block and the time of block onset. Methods: In a prospective manner, 60 adult patients scheduled for distal upper limb surgery were randomly allocated to single (Group S) or double stimulation (Group D) groups. A local anesthetic (LA) mixture of 20 ml of levobupivacaine 5 mg/ml and 20 ml of lidocaine 20 mg/ml with 5 μg/ml epinephrine (total 40 ml) was administered in both groups. In the Group S following a median, an ulnar or a radial nerve response, the entire LA was administered at a single site. In Group D 10 ml of LA was administered following the electrolocation of the musculocutaneous nerve and 30 ml LA was injected following median, ulnar or radial nerves. A successful block was defined as analgesia or anesthesia of all five nerves distal to the elbow. Sensory and motor blocks were tested at 5-min intervals for 30 min. Results: The block was successful in 27 patients in Group S and 28 patients in Group D. The time from starting the block until satisfactory anesthesia was significantly shorter in Group D than in Group S (19.3 vs. 23.2 min) ( P<0.05). Total sensory scores were significantly higher in the double stimulation group at 20 and 30 min after the block performance ( P<0.05). Conclusions: Although the block performance time was longer in the double stimulation group, block onset time and extent of anesthesia were more favorable in the double stimulation group. [ABSTRACT FROM AUTHOR]

A 25-year-old female developed permanent, fluctuating sensorineural hearing loss (SNHL), disabling vertigo, and tinnitus following an uneventful spinal anesthesia for cesarean section. At her first visit to the ear-nose-throat (ENT) department approximately 2 months postoperatively, pure-tone thresholds revealed profound SNHL on the right side whereas thresholds were within normal limits on the left side. The recruitment score (SISI) was 95% at 2000 Hz on the right side. Directional preponderance towards the right and the right canal paresis were evidenced by bithermal caloric testing. At follow ups the pure tone thresholds have shown some improvement, but fluctuating SNHL, disabling vertigo attacks, and tinnitus have remained. These findings imply a cochlear pathology causing endolymphatic hydrops possibly induced by lumbar puncture for spinal anesthesia. [ABSTRACT FROM AUTHOR]

Objective: There is a strong relationship between the cancer stem cells (CSCs) and poor prognosis, metastasis and recurrence. In addition to this CSCs are resistant to chemotherapy and radiotherapy. Therefore, current treatment approaches may be ineffective to elimination of CSCs. The tumor cells have various adaptations for escaping from immune cells. The human leukocyte antigen (HLA) -G, which expressions restricted with fetal tissues and HLA-E are kind of tumor immune evasive adaptations. In this study, we aimed to investigate the relationship between the CSCs and immune evasive adaptations of breast tumors.Methods: We immunohistochemically evaluated that the expressions of cluster of differentiation (CD) 44, CD133, Homeobox protein Nanog, octamerbinding transcription factor (Oct) 3/4, HLA-G and HLA-E in the advanced stage breast cancer tissues (n=10) and the non-malignant breast biopsies (n=10).Results: We detected that the significantly increased expressions of especially Nanog (p

Inflammation is mechanistically involved in the development of Peyronie’s disease (PD). The aim of this study is to assess the relevance of serum pentraxin 3 (PTX3) and interleukin-6 (IL-6) concentrations in PD. The study enrolled 40 patients with PD in the acute phase and 40 healthy controls. Plasma PTX3 and IL-6 concentrations were evaluated in 40 patients in the acute phase of PD and 40 healthy controls by enzyme-linked immunosorbent assay. Serum concentrations of both PTX3 and IL-6 were significantly higher in the PD patients than in the control group (p=0.001 and p=0.001, respectively). There was a significant correlation between concentration of PTX3 and painful erections. IL-6 concentrations were significantly higher in patients with erectile dysfunction. IL-6 and PTX3 levels showed no correlation with age, serum C-reactive protein, degree of curvature, and disease duration. IL-6 trans-signaling and PTX3 amplification at the site of inflammation could have a role in pathophysiological mechanisms of PD. Biological drugs may be used for treatment during the acute phase of the disease based on this mechanism.

Despite advances in understanding of peripheral nerve injuries and regeneration and advances in surgical techniques, successful outcomes cannot be guaranteed after reconstructive surgery. Platelet-rich plasma (PRP) has been reported to have positive effects on nerve regeneration, as well as on tissue healing. The present study was designed to evaluate the effect of PRP on nerve-grafted defects. Sprague–Dawley rats were divided into four surgery groups (n=7 in each). A 1-cm long nerve defect was created in the upper thigh and then reconstructed using a nerve autograft in all groups. The wet muscle weights, electromyographic findings, and histomorphologic changes were evaluated 10 weeks later. As shown by both the electromyographic (p

Neurology is focused on a model where patients receive their care through repeated visits to clinics and doctor’s offices. Diagnostic tests often require expensive and specialized equipment that are only available in clinics. However, this current model has significant drawbacks. First, diagnostic tests, such as daytime EEG and sleep studies, occur under artificial conditions in the clinic, which may mask or wrongly emphasize clinically important features. Second, early detection and high-quality management of chronic neurological disorders require repeat measurements to accurately capture the dynamics of the disease process, which is impractical to execute in the clinic for economical and logistical reasons. Third, clinic visits remain inaccessible to many patients due to geographical and economical circumstances. Fourth, global disruptions to daily life, such as the one caused by COVID-19, can seriously harm patients if access to in-person clinical visits for diagnostic and treatment purposes is throttled. Thus, translating diagnostic and treatment procedures to patients’ homes will convey multiple substantial benefits and has the potential to substantially improve clinical outcomes while reducing cost. NeuroTec was founded to accelerate the re-imagining of neurology and to promote the convergence of technological, scientific, medical and societal processes. The goal is to identify and validate new digital biomarkers that can close the last mile in neurology by enabling the translation of personalized diagnostics and therapeutic interventions from the clinic to the patient’s home.

Human-used antibiotics are eliminated from the body with little or no transformation at all. Traces of eliminated antibiotics enter the receiving environment directly since they cannot be treated in prevalent wastewater treatment facilities. Thus, wastewaters containing traces of antibiotics have to be treated accordingly. Lincomycin is subsequently isolated from Streptomyces lincolnensis. Lincomycin and its derivatives are antibiotics exhibiting biological activity against Gram-positive bacteria, and are natural antibiotics in the environment as pollutants. This study aims to predict the degradation mechanism of lincomycin molecule in the gaseous phase and aqueous media. Probable reaction path of lincomycin molecule with OH radicals was analyzed. Optimized geometry was calculated via Gauss View 5. Subsequently, the lowest energy status was determined through geometric optimization via Gaussian 09 program. Aiming to determine the intermediates in photocatalytic degradation mechanism of lincomycin, geometric optimization of the molecule was realized through DFT method. Activation energy for the probable reaction path was calculated, and their most stable state from the thermodynamic perspective determined for the gaseous phase and aqueous media. Impact of water solvent was investigated using the conductor-like screening solvation model (COSMO). The predicted mechanism was confirmed by comparison with experimental results on simple structures reported in literature.

Lung sounds acquired by stethoscopes are extensively used in diagnosing and differentiating respiratory diseases. Although an extensive know-how has been built to interpret these sounds and identify diseases associated with certain patterns, its effective use is limited to individual experience of practitioners. This user-dependency manifests itself as a factor impeding the digital transformation of this valuable diagnostic tool, which can improve patient outcomes by continuous long-term respiratory monitoring under real-life conditions. Particularly patients suffering from respiratory diseases with progressive nature, such as chronic obstructive pulmonary diseases, are expected to benefit from long-term monitoring. Recently, the COVID-19 pandemic has also shown the lack of respiratory monitoring systems which are ready to deploy in operational conditions while requiring minimal patient education. To address particularly the latter subject, in this article, we present a sound acquisition module which can be integrated into a dedicated garment; thus, minimizing the role of the patient for positioning the stethoscope and applying the appropriate pressure. We have implemented a diaphragm-less acousto-electric transducer by stacking a silicone rubber and a piezoelectric film to capture thoracic sounds with minimum attenuation. Furthermore, we benchmarked our device with an electronic stethoscope widely used in clinical practice to quantify its performance.

Abstract This review summarizes the role of melatonin (MLT) in defense against toxic-free radicals and its novel effects in the development of the nervous system, and the effect of endogenously produced and exogenously administered MLT in reducing the degree of tissue and nerve injuries. MLT was recently reported to be an effective free radical scavenger and antioxidant. Since endogenous MLT levels fall significantly in senility, these findings imply that the loss of this antioxidant could contribute to the incidence or severity of some age-related neurodegenerative diseases. Considering the high efficacy of MLT in overcoming much of the injury not only to the peripheral nerve but also to other organs, clinical trials for this purpose should be seriously considered.

A 65-year-old female patient presented to the emergency clinic with abdominal pain, meteorism, and intermittent rectal bleeding. Colonoscopy was performed, and a hepatic flexure tumor was detected. Histopathological examination of biopsy revealed adenocarcinoma. Thoracoabdominal CT was performed for staging, and a spiculated contour mass was found incidentally on the left breast. Mammography and ultrasonography were performed for the cause of these findings, and suspicious lesions of malignancy were seen in the left breast. Invasive ductal carcinoma was detected in core needle biopsy samples from lesions. In the multidisciplinary council consisting of oncologist, pathologist, radiologist, and general surgery specialist, it was decided to perform breast operation first and then colon operation, followed by adjuvant chemotherapy. In the first operation, left total mastectomy and sentinel lymph node biopsy were performed. One week after her initial operation, the patient underwent right hemicolectomy. After operations, the patient did not develop postoperative complications and was sent to medical oncology department for adjuvant chemotherapy.

The most severe side effect of prolonged MTX treatment is hepatotoxicity. The aim of this study is to investigate the effect of lactulose treatment on MTX-induced hepatotoxicity in a rat model. Twenty-four male rats were included in the study. Sixteen rats were given a single dose of 20 mg/kg MTX to induce liver injury. Eight rats were given no drugs. 16 MTX-given rats were divided into two equal groups. Group 1 subjects were given lactulose 5 g/kg/day, and group 2 subjects were given saline 1 ml/kg/day for 10 days. The rats were then sacrificed to harvest blood and liver tissue samples in order to determine blood and tissue MDA, serum ALT, plasma TNF-α, TGF-β, and PTX3 levels. Histological specimens were examined via light microscopy. Exposure to MTX caused structural and functional hepatotoxicity, as evidenced by relatively worse histopathological scores and increased biochemical marker levels. Lactulose treatment significantly reduced the liver enzyme ALT, plasma TNF-α, TGF-β, PTX3, and MDA levels and also decreased histological changes in the liver tissue with MTX-induced hepatotoxicity in the rat model. We suggest that lactulose has anti-inflammatory and antifibrotic effects on an MTX-induced liver injury model. These effects can be due to the impact of intestinal microbiome.

PURPOSE: To investigate whether chitosan application over colonic anastomosis line, provide reinforcement, and subsequently improve anastomotic healing. METHODS: Forty eight Wistar albino female rats were used and were randomly divided into four groups, 12 rats in each: The control groups (1 and 3) received no further treatment. The experimental groups (2 and 4) received chitosan application over the colonic anastomosis. After sacrifying rats at the end of the experiment (either on day three or on day seven, depending on the group), colonic bursting pressure, a hihydroxyproline level and histopathologic characteristics of the perianastomotic tissue were examined. RESULTS: At three days, chitosan and control groups had similar values for histopathologically. On day seven, chitosan group had significantly higher mean score of collagenization (p=0.007) and a significantly higher bursting pressure (p=0.038). CONCLUSION: Our study emphasizes the positive effect of chitosan in the process of collagenation in colonic anastomosis healing.OBJETIVO: Investigar se a aplicação de quitosana em anastomose colônica promove resistência à tração e consequentemente a melhora na cicatrização. MÉTODOS: Foram utilizados 48 ratos Wistar fêmeas distribuídos em quatro grupos, 12 ratos em cada. Grupos controle (1 e 3) não receberam tratamento. Grupos experimento (2 e 4) receberam aplicação de quitosana na anastomose colônica. Após eutanásia após 3º ou 7º dias foram examinadas a tensão, o nível de hidroxiprolina e aspectos histopatológicos da anastomose. RESULTADOS: Após três dias os grupos controle e quitosana não apresentaram alterações histopatológicas. No sétimo dia o grupo quitosana apresentou significante elevação do escore de colagenização (p=0,007) e da tensão de ruptura (p=0,038). CONCLUSÃO: A quitosana apresentou bons resultados nos processos de colagenização e cicatrização de anastomose colônica.

In this study, the leading activities of Turkish Economy whose changes in their structure of production, value-added and employment are interrelated with the other activities of the economy, are found by using the input-output model which is presented and called as an 'Application of the General Equilibrium Theory' by Leontief. For this purpose; firstly theoretical foundations of the input-output model are examined. After that, 59 activities of the 2002 Input-Output Table of the Turkish Economy are aggregated at 52 sectors and classified into three categories as Ricardo Sectors, High-Technology Sectors and Heckscher-Ohlin Sectors like Dasgupta and Chakraborty did for the Indian Economy in 2005. Then, the leading, key or strong activities of the economy that are more interrelated with other activities are calculated and found by the Static Leontief Model which is used by the Traditional Methods as the techniques to calculate the linkage effects like Chenery-Watanabe and Rasmussen methods to determine the sectors having the highest priority at investment policies according to the Hirschmanian Unbalanced Growth Model. As a result of the interpretation of Leontief Model, using the traditional methods of Chenery-Watanabe and Rasmussen while calculating the linkage effects rather than the hypothesis extraction methods like Strassert's Original Extraction Method, Cella's Extraction Method, Sonis' Pure Linkage Method and Dietzenbacher and Van der Linden's Method or a SAM (Social Accounting Method) model which does not omit the income generating process (distributing income among primary factors and households as a result of production) of a sector, in Turkey, the Heckscher-Ohlin Sectors mostly seen in the manufacturing industry which Kaldor refers as the engine of growth, are stronger than the other sectors.

Phthiriasis palpebrarum is an uncommon cause of blepharoconjunctivitis in which Pthirus pubis infest the eyelashes. We report a case of unilateral phthiriasis palpebrarum with crab louse. A 45-year-old man presented with conjunctival hyperaemia and moderate itching associated with irritation, and crusty excretions of the eyelashes in the left eye. Careful slit-lamp examination revealed many lice and nits in left eye and mild conjunctival hyperaemia. No abnormality was found in the right eye. On dermatologic examination, only one louse was found at the pubic area. The patient was treated effectively with petrolatum jelly (Vaseline) and 1% permethrin shampoo (Kwellada 1% shampoo). At the end of the first week no louse or nit was present on eyelashes and pubic area.

Endometriosis is defined as an ectopic implantation of uterine mucosal tissue outside the uterine cavity, usually in the pelvis. The areas of the pelvis most frequently affected are the peritoneum, the ovaries, the poch of douglas and the uterosacral ligaments. In this paper, we report an extremely rare case with an extraov arian large endometriotic cyst originated from the peritoneum overlying the bladder. Endometriotic cyst should be kept in mind as a possible diagnosis in the presence of an extraovarian pelvic mass.