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Background: The surface properties of dental and orthopedic implants are directly related to their osseointegration rate. Coating and/or modifying the implant surface might reduce the time of healing. In this study, we aimed to examine the effects of a hybrid surface consisting of a brushite surface coating and cross-linked water-soluble eggshell membrane protein on the osseointegration of titanium (Ti) screws under in vivo conditions., Methods: Twenty Ti alloy screws were implanted monocortically in anteromedial regions of New Zealand rabbit tibiae. Ten screws were untreated and used as controls. The remaining 10 screws were coated with calcium phosphate and following cross-linked with ostrich eggshell membrane protein. All rabbits were sacrificed six weeks after the surgery. Peri-screw tissues were evaluated by micro-computed tomography (µ-CT), histological and histomorphometrical methods., Results: The μ-CT assessments indicated that the experimental group had significantly higher mean bone surface area (BSA) and trabeculae number (TbN) than those of the control group (p ˂ 0.05). Bone surface area (BV), trabecular separation (TbSp), trabecular thickness (TbTh), and bone mineral density (BMD) scores of the control and experimental groups were quite similar (p > 0.05). The vascularization score of the experimental group was significantly higher than the control group (4.29 vs. 0.92%). No sign of the graft-versus-host reaction was observed., Conclusion: Our findings reveal that coating Ti alloy implants with calcium phosphate cross-linked with ostrich eggshell membrane protein increases the osseointegration of Ti alloy screws by increasing the bone surface area, number of trabeculae and vascularization in the implant site.

1. The aim of this study was to utilise low-value spent hen meat and investigate the possibility of using chia (Salvia hispanica L.) as a mucilage-based edible film to prevent loss of quality in meat products. For this purpose, spent hen meat was reconstructed with the addition of transglutaminase (TGase) at different concentrations (0.5, 1 and 1.5%) and used to produce nuggets. These were covered with chia mucilage-based film and kept at 4°C for 7 d.2. The addition of transglutaminase and coating with film decreased meat pH (P < 0.01). Samples containing transglutaminase had higher thiobarbituric acid (TBA) value (P < 0.01), while the DPPH value of the samples was not affected by the transglutaminase and edible film (P > 0.05). Hence, mucilage-based edible film did not prevent or delay the oxidation of nuggets.3. Transglutaminase improved the texture characteristics of the nuggets and the edible film reduced fat retention in the samples. The combined use of transglutaminase and film decreased cooking loss and increased water holding capacity (P < 0.01). In the sensory analysis, nuggets with transglutaminase and film had more overall acceptability scores, although the results were not statistically significant.

New methods have been developed for the synthesis of the substituted quinolines and quinazolinones derivatives by utilizing N -(2-aminobenzoyl)benzotriazoles under mild reaction conditions. 3-Acyl-2-alkyl(aryl)-4-hydroxyquinolines were obtained in modarete yields by the reaction of N -(2-aminobenzoyl)benzotriazoles and diketones in the presence of tert -BuOK. 3-Acylamino-4(3 H ) quinazolinones were obtained in good yields via N -(2-aminobenzoyl)benzotriazoles, orthoester and hyrazides in one-pot., (© TÜBİTAK.)

Background: Bauhinia thonningii is a plant traditionally used against many human diseases such as gastric ulcers, fever, inflammations, coughs, dysentery, diarrhea, and malaria. In the present investigation, the cytotoxicity of methanol extract of Bauhinia thonningii leaves (BTL), fractions and the isolated phytoconstituents was determined in a panel of 9 human cancer cell lines including drug sensitive and multidrug-resistant (MDR) phenotypes. The acute and sub-chronic oral toxicity of BTL was investigated as well., Methods: Compounds were isolated using chromatographic techniques while their chemical structures were determined using spectroscopic methods. The resazurin reduction assay (RRA) was used to evaluate the cytotoxicity of samples, propidium iodide (PI) for apoptosis, 5,5',6,6'-tetrachloro-1,1',3,3'-tetraethylbenzimidazolylcarbocyanine iodide (JC-1) staining for mitochondrial membrane potential (MMP) analysis, 2´,7´-dichlorodihydrofluoresceine diacetate (H2DCFH-DA) staining for the quantification of reactive oxygen species (ROS), whereas Caspase Glo assays were combined by means of flow cytometry. Furthermore, the toxicological investigations were performed as recommended by the Organization for Economic Cooperation and Development (OECD)., Results: The botanicals as well as 6-C-methylquercetin-3,7-dimethyl ether (2), quercetin-3-O- L -rhamnopyranoside (5), quercetin-3-O-β-glucopyranoside (6), 6,8-C-dimethylkaempferol 3,7-dimethyl ether (7), and 6,8-C-dimethylkaempferol-3-methyl ether (8) had promising cytotoxic effects in the 9 tested cancer cell lines. The IC 50 values below 20 µg/mL (botanicals) or 10 µM (compounds) on at least 1/9 tested cancer cell lines were considered. The best cytotoxic effects with IC 50 values below 5 µM were achieved with compounds 7 against CEM/ADR5000 leukemia cells (2.86 µM) and MDA-MB-231-pcDNA breast adenocarcinoma cells (1.93 µM) as well as 8 against CCRF-CEM leukemia cells (3.03 µM), CEM/ADR5000 cells (2.42 µM), MDA-MB-231-pcDNA (2.34 µM), and HCT116 p53 -/- cells (3.41 µM). BTL and compound 8 induced apoptotic cell death in CCRF-CEM cells through caspase activation, alteration of MMP, and increased ROS production. BTL did not cause any adverse effects in rats after a single administration at 5000 mg/kg or a repeated dose of 250 mg/kg body weight (b. w.)., Conclusion: Bauhinia thonningii and its constituents are sources of cytotoxic drugs that deserve more in-depth studies to develop novel antiproliferative phytomedicine to fight cancer including resistant phenotypes., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Autogenous bone grafts are the gold standard for being used as graft materials in maxillofacial surgery. However, a limited amount of these materials is available from the donor site, and there is also more need for a larger operating area and a second surgery, which frequently leads to unreliable graft incorporation, tooth ankylosis, and root resorption. Therefore, newer bone graft substitutes have been developed as alternatives, among which eggshell powder has been introduced as a bone substitute. This study aimed to evaluate the biocompatibility, resorption kinetics, and osteoproductivity of the unprocessed, CMC-coated, and gelatin-coated ostrich eggshell particles., Methods: Four half-thickness calvarial defects were created in each animal. At the end of the 1st and 3rd months, the defected sites were investigated by clinical, histological, radiological and histomorphometrical methods., Results: Coating the eggshell particles with CMC and gelatin facilitated their surgical application and contributed to new bone formation. However, their newly formed bone rate at the 3rd month was lower than those of the unprocessed eggshell particles. The CMC coating was more effective than gelatin coating in the bone modeling process., Conclusion: Ostrich eggshell particles either in native form or coated with CMC could be used as a bone filler for supporting new bone formation and healing in treatment of osseous defects.

Investigation of the leaves of Bauhinia thonningii Schum led to the isolation and identification of a new flavonol derivative, 6-C-methylquercetin-3,4'-dimethyl ether ( 1 ) together with eleven known compounds ( 2 - 13 ), with two of them ( 10 and 11 ) obtained as a mixture. Their structures were established by extensive spectroscopic analyses. Antibacterial activity of compound 1 as well as the reference antibiotic, ciprofloxacin was tested on Gram-negative multidrug-resistant bacteria overexpressing active efflux pumps, and against methicillin-resistant strains of Staphylococcus aureus (MRSA). Samples were tested alone and in combination with an efflux pump inhibitor (EPI), phenylalanine-arginine- β -naphthylamide (PAßN). Results show that when compound 1 was tested alone, its inhibitory effects were obtained on 7/10 tested bacteria with the highest MIC value of 128 µg/mL whilst in the presence of EPI, this activity significantly increase in all the 10 bacteria. An interesting antibacterial activity was obtained with compound 1 against Klebsiella pneumoniae ATCC11296 (MIC of 4 µg/mL), KP55 and Staphylococcus aureus MRSA6 in the presence of the PaßN.

Purpose: The aim of this study is to compare functionality of vestibulo-ocular reflex (VOR) responses to evaluate the functional properties of the vestibular system and daily balance performance in children with dyslexia and children with normal development., Method: Fifteen participants diagnosed with dyslexia were included in the study group (SG), and 15 healthy participants were included in the control group (CG). All groups underwent Functional Head Impulse Test (f-HIT) and Pediatric Balance Scale (PBS). f-HIT was performed with at least 15 head impulses at 4000-5000-6000°/s 2 randomly to the right and left in the plane of the horizontal semicircular canal (SCC). Statistical analysis was performed using descriptive statistics and the Mann-Whitney U test., Results: SG percentage values were obtained lower than CG percentage values. Comparisons between the two groups showed that there was a significant difference in all parameters (4000-5000-6000°/s 2 and total) in the right-side stimulation, there was significant difference for 4,000 s 2 and total correct answers in the left side. In addition, although there was no significant difference between the groups in terms of the PBS score, the SG scores were lower ( p = 0.062)., Conclusions: As a novel test, f-HIT, revealed the difference in functionality of vestibular performance in the dyslexia group. In the dyslexia group, f-HIT may be helpful in evaluating and monitoring the vestibular system., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ölçek, Çelik, Başoǧlu, Kaymakçı and Gürlek.)

Purpose: This study aimed to investigate factors affecting digital game addiction in secondary school students during the COVID-19 pandemic and the effects of digital game addiction on cardiovascular health behavior., Design and Methods: This descriptive, correlational, and cross-sectional study was conducted with 619 secondary school students aged 10-14 years. Study data were analyzed using World Health Organization AnthroPlus and SPSS programs. Simple linear regression and multiple linear regression methods were used in the analysis process., Results: Findings showed that 43.6% of the students played digital games for more than two hours a day. Descriptive characteristics (gender, age, basal metabolic rate, educational status of parent, income status, etc.) and digital gaming habits of the students accounted for 37.0% of the variance in digital game addiction. Digital game addiction adversely affected cardiovascular health behavior and all its sub-dimensions., Conclusion: The first factor that predicted digital game addiction, in order of significance, was daily digital game playing time. Digital game addiction negatively affected the sedentary lifestyle sub-dimension of cardiovascular health behavior most. Digital game addiction may trigger an increase in the incidence of diseases such as diabetes, cancer, and especially cardiovascular diseases, at later ages., Practice Implications: Nurses, schools, and parents have critical responsibilities in preventing digital game addiction. Results of this research will make a remarkable contribution to the development of preventive services by revealing risk factors for digital game addiction and the effects of digital game addiction on cardiovascular health behavior., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to declare that are relevant to the content of this article., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Carbon sequestration in earth surface is higher than the atmosphere, and the amount of carbon stored in wetlands is much greater than all other land surfaces. The purpose of this study was to estimate soil organic carbon stocks (SOCS) and investigate spatial distribution pattern of Yuksekova wetlands and surrounding lands in Hakkari province of Turkey using machine learning and remote sensing data. Disturbed and undisturbed soil samples were collected from 10-cm depth in 50 locations differed with land use and land cover. Vegetation, soil, and moisture indices were calculated using Sentinel 2 Multispectral Sensor Instrument (MSI) data. Significant correlations (p≤0.01) were obtained between the indices and SOCS; thus, the remote sensing indices (ARVI 0.43, BI -0.43, GSI -0.39, GNDI 0.44, NDVI 0.44, NDWI 0.38, and SRCI 0.51) were used as covariates in multi-layer perceptron neural network (MLP) and gradient descent-boosted regression tree (GBDT) machine learning models. Mean absolute error, root mean square error, and mean absolute percentage error were 3.94 (Mg C ha -1 ), 6.64 (Mg C ha -1 ), and 9.97%, respectively. The simple ratio clay index (SRCI), which represents the soil texture, was the most important factor in the SOCS estimation variance. In addition, the relationship between SRCI and Topsoil Grain Size Index revealed that topsoil clay content is a highly important parameter in spatial variation of SOCS. The spatial SOCS values obtained using the GBDT model and the mean SOCS values of the CORINE land cover classes were significantly different. The land cover has a significant effect on SOC in Yuksekova plain. The mean SOCS for continuously ponded fields was 45.58 Mg C ha -1 , which was significantly different from the mean SOCS of arable lands. The mean SOCS in arable lands, with significant areas of natural vegetation, was 50.22 Mg C ha -1 and this amount was significantly higher from the SOCS of other land covers (p<0.01). The wetlands had the highest SOCS (61.46 Mg C ha -1 ), followed by the lands principally occupied by natural vegetation and used as rangelands around the wetland (50.22 Mg C ha -1 ). Environmental conditions had significant effect on SOCS in the study area. The use of remote sensing indices instead of using single bands as estimators in the GBDT algorithm minimized radiometric errors, and reliable spatial SOCS information was obtained by using the estimators. Therefore, the spatial estimation of SOCS can be successfully determined with up-to-date machine learning algorithms only using remote sensing predictor variables. Reliable estimation of SOCS in wetlands and surrounding lands can help understand policy and decision makers the importance of wetlands in mitigating the negative impacts of global warming., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The hybrid molecules bearing heterocyclic structures in the A or D rings of steroids have significant biological activity. 16 ( E )-Hetereoarylidene steroids were synthesized from the reaction of different heteroaromatic carbaldehydes and trans -Dehydroepiandrosterone (DHEA) in a basic medium. Then, synthesis of the N -formyl pyrazoline substituted new DHEA derivatives were carried out from the reaction of hydrazine hydrate and 16 ( E )-hetereoarylidene steroids. The structures of the synthesized compounds were elucidated by elemental analysis, FT-IR, 1 H NMR, and 13 C NMR spectroscopy. To investigate the activation pathway of synthesized N -formyl pyrazoline substituted steroid derivatives, a molecular docking study was performed on human cytochrome P450-(CYP17A1: PDB ID 5IRQ) with the help of the free AutoDock Vina. 100 ns molecular dynamic simulation process was performed to monitor the behavior of the complex structure formed by CYP17A1 and to calculate the stability over time of 2a and 2d (-9.8 kcal/mol), which gave the lowest value according to the results obtained in the molecular docking study with AutoDock Vina. Accordingly, RMSD, RMSF, Rg, and SASA analyzes of 2a and 2d were performed, and MMPBSA was calculated. Lastly, the ADMET (absorption, distribution, metabolism, excretion, and toxicity) analyses of the novel steroid derivatives were investigated.Communicated by Ramaswamy H. Sarma.

Purpose: This study compares in vitro remineralization potential and cytotoxicity of fluoride-free varnish combinations containing bioactive glass, eggshell, and membrane powder and fluoride varnish formulations on artificial caries lesions., Methods: Artificial caries lesions were formed in two windows on third molars. One of the windows was coated with one of the following varnish formulations: FV (fluoride varnish), F-BAGV (fluoride and bioactive glass containing varnish), BAGV (bioactive glass containing varnish), EPV (eggshell powder containing varnish), EMP-EPV (eggshell membrane protein and eggshell powder containing varnish), STMP-EMP-EPV (sodium trimetaphosphate-treated eggshell membrane protein and eggshell powder containing varnish). The samples were remineralized, then investigated under scanning electron microscopy, and elemental analyses were performed by X-ray dispersive analysis (EDX). In addition, the traditional colorimetric tetrazolium-based reduction assay (XTT) and the modern impedance-based real-time cell analysis system (RTCA) were used to investigate their cytotoxicity., Results: The varnish applied area's Ca/P ratio was lower than stoichiometric hydroxyapatite except for EPV (1.66) and STMP-EMP-EPV (1.67) groups. Undiluted extracts of all varnishes, 1:2 dilutions of FV and F-BAGV groups were cytotoxic in XTT assay. In RTCA, the normalised cell index of the EMP-EPV and STMP-EMP-EPV groups was higher than the control group., Conclusion: Bioactive glass, eggshell, eggshell membrane proteins and STMP-treated eggshell and eggshell membrane protein containing varnish have similar remineralizing effect to fluoride-containing varnish on demineralized enamel. Integrating biological or bioactive components instead of fluoride into the dental varnishes might reduce cytotoxicity., (© 2023. The Author(s), under exclusive licence to European Academy of Paediatric Dentistry.)

Objective: Most patients with coronavirus disease (COVID-19) have abnormalities of lymphocyte subsets. This study aimed to determine the distribution of lymphocytes in patients with various severity levels of COVID-19 and to describe the relationship between the CD4 + T helper and prognosis., Materials and Methods: Adult (>18 years old) patients with COVID-19 who followed up in a tertiary hospital were included in the study prospectively. Demographic and clinical characteristics of the patients were obtained from the hospital records. Peripheral flow cytometry was studied in patients with different severity of COVID-19 and different prognoses. Next, we analyzed the characteristics and predictive values of lymphocyte subsets in COVID-19 patients., Results: Totally 86 patients were included in the study, of which 21 (24.4%) had asymptomatic, 23 (26.7%) had mild/moderate, and 42 (48.8%) had severe/critical COVID-19. Severe/critical patients had lower lymphocyte levels and older age than asymptomatic patients ( p <0.001 and p <0.001, respectively). We determined that decreased CD4 + T cell ratio ( p <0.001) and CD4 + /CD8 + ratio ( p <0.001) were indicative of the severity of the disease. CD4 + T cell ratio on admission (odds ratio [OR]=0.858; p =0.033), day seven CD4 + T cell ratio (OR=0.840; p =0.029), and C-reactive protein (CRP) levels (OR=1.014; p =0.043) were prognostic factors for mortality. According to receiver operating characteristics (ROC) curve analysis, the area under the curve was greater than 0.9 for decreased CD4 + T cell ratio on admission and the seventh day., Conclusion: A low CD4 + T helper ratio predicts a poor prognosis. In combination with CRP, it can be used in clinical follow-up., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Infectious Diseases and Clinical Microbiology.)

Introduction: The electrical status epilepticus in sleep (ESES) accompanies a wide spectrum of focal and generalized epilepsies, which manifest with cognitive-linguistic regression. Both ESES and language impairment can be seen in self-limited focal epileptic syndromes of childhood (SFEC). The association between the presence of ESES pattern on the EEG and the severity of the language impairment has not been adequately clarified., Methods: Twenty-eight SFEC cases without intellectual and motor disabilities and 32 healthy children were recruited. Cases with active ESES (A-ESES, n=6) and without ESES pattern on EEG (non-ESES, n=22) were compared in terms of clinical features and linguistic parameters by both standard and descriptive assessment tools., Results: The only significantly different clinical feature in the A-ESES group was the increased prevalence of polytherapy. While most of the linguistic parameters were impaired in A-ESES and non-ESES groups compared to healthy controls, A-ESES patients differed from non-ESES patients only in terms of decreased complex sentence production, which was assessed by narrative analysis. A-ESES patients also showed trends toward producing lower numbers of words, nouns, verbs, and adverbs during narrative analysis. There were no differences among patients under polytherapy and monotherapy in terms of these language parameters., Conclusion: Our results show that ESES increases the negative effect of chronic epilepsy on complex sentence and word production. Linguistic distortions that are not reflected in objective tests can be detected by narrative tools. Complex syntactic production obtained by narrative analysis is an important parameter that extensively characterizes language skills in school-age children with epilepsy., Competing Interests: Conflict of Interest: The authors declared that there is no conflict of interest., (Copyright: © 2023 Turkish Neuropsychiatric Society.)

Molecular diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by real-time reverse transcription polymerase chain reaction (RT-PCR) in respiratory specimens is considered the gold standard method. This method is highly sensitive and specific but it has some limitations such as being expensive and requiring special laboratory equipment and skilled personnel. RapidFor™ Antigen Rapid Test Kit is a commercially available Ag-RDT which is produced in Turkey and designed to detect the nucleocapsid antigen of SARS-CoV-2 in nasopharyngeal swab samples. The aim of this study was to evaluate the performance of this novel SARS-CoV-2 antigen detection considering the RT-PCR method as the gold standard. Four hundred forty-four nasopharyngeal swab samples which were collected from the patients who met clinical criteria of COVID-19 from ten centers in Turkey between September 2020 and February 2021 were included in the study. All the nasopharyngeal swab samples were tested for SARS-CoV-2 RNA using commercial RT-PCR kits (Bioeksen and A1 Lifesciences, İstanbul, Turkey) according to the manufacturer's instructions. Viral loads were assessed according to the cycle threshold (Ct) values. RapidFor™ SARS-CoV-2 antigen test (Vitrosens Biotechnology, Istanbul, Turkey) was used to investigate the presence of SARS-CoV-2 antigen in all samples following the manufacturer's instructions. Out of 444 nasopharyngeal swab samples tested, 346 (77.9%) were positive and 98 (22.1%) were negative for SARS-CoV-2 RNA by RTPCR. Overall sensitivity of the RapidFor™. Antigen Rapid Test Kit was 80.3% whereas specificity was found to be 87.8%. Positivity rate of rapid antigen test in samples with Ct values over 25 and below 30 was 82.7%, while it increased to 95.7% in samples 20 ≤ Ct < 25 and reached 100% in samples with Ct values below 20. RapidFor™ SARS-CoV-2 Ag test might be a good choice in the screening of symptomatic and asymptomatic patients and their contacts for taking isolation measures early, with advantages over RT-PCR as being rapid, easy and being applicable in every laboratory and even at point of care., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Background: Cardiac involvement in multisystem inflammatory syndrome in children may have a spectrum ranging from mild disease to severe heart failure due to fulminant myocarditis. Cardiac involvement usually resolves after clinical recovery. However, the adverse effects of myocarditis on cardiac function after recovery are not fully known. This study aims to investigate cardiac involvement by performing cardiac magnetic resonance imaging (MRI) after the acute and recovery periods., Methods: 21 patients with clinical and laboratory signs of myocarditis, including left ventricular systolic dysfunction, mitral regurgitation, elevated troponin T, elevated N-terminal pro-B-type natriuretic peptide and electrocardiographic changes, who had given consent for cardiac MRI, underwent cardiac MRI after completion of the acute and recovery phases., Results: When compared to 16 patients with normal cardiac MRI, five patients with cardiac fibrosis on MRI were older, had greater body mass indexes, lower leucocyte counts, lower neutrophil counts, higher blood urea nitrogen levels and higher creatinine levels. Cardiac fibrosis on MRI was located in the posterior right ventricle insertion point and in mid ventricular septum., Conclusions: Adolescence and obesity appear as risk factors for the development of fibrosis as a late-term sequela of myocarditis. Furthermore, future studies reporting the follow-up data of patients with fibrosis are necessary to predict and manage adverse outcomes.

Aim: The primary aim of this study was to determine the risk factors for the occurrence of brachial plexus injury in cases of shoulder dystocia. Secondly, it was aimed to determine the factors affecting the occurrence of permanent sequelae in cases with brachial plexus injury., Subjects and Methods: ICD-10 codes were scanned from the records of patients who gave birth between 2012 and 2018, and the records of patients with brachial plexus injury and shoulder dystocia were reached. Shoulder dystocia cases with brachial plexus damage were accepted as the study group, and shoulder dystocia cases without brachial plexus damage were considered the control group. Shoulder dystocia patients with brachial plexus injury and without injury were compared for 2-year orthopedics clinic follow-up reports, surgical intervention, permanent sequelae status as well as birth data, maternal characteristics, and maneuvers applied to the management of shoulder dystocia., Results: Five hundred sixty births with shoulder dystocia were detected. Brachial plexus injury was observed in 88 of them, and permanent sequelae were detected in 12 of these patients. Maneuvers other than McRobert's (advanced maneuvers) were used more and clavicle fracture was seen more in the group with plexus injury (P < 0.05, P < 0.05, respectively). Logistic regression analysis was performed to determine the risk factors of brachial plexus injury. Brachial plexus injury was observed 4.746 times more in infants who were delivered with advanced maneuvers and 3.58 times more in infants with clavicle fractures at birth., Conclusion: In patients with shoulder dystocia, the risk of brachial plexus injury increased in deliveries in which advanced maneuvers were used and clavicle fracture occurred., Competing Interests: None

Background: The rehabilitation of classical peripheral vestibular disorders is long and costly. Recently, interactive systems based on virtual reality (VR) technology have reduced the cost of vestibular rehabilitation therapy (VRT) and made the process more enjoyable. This study aims to investigate the effects of VR-based VRT in patients diagnosed with peripheral vestibular hypofunction (PVH)., Methods: In this study, a VR-based VRT program that utilized Sony Playstation®4 VR Head Mounted Display was applied to 25 patients (between 18-60) diagnosed with PVH. PVH was diagnosed by evaluating the patients' clinical histories, the findings in the "Micromedical Technologies VisualEyes Spectrum" videonystagmography (VNG) and the "Micromedical Aqua Stim" model bithermal water caloric tests. VR-based VRT program was applied to the patients for 4 weeks, 2 sessions per week, 8 sessions in total. Each session lasted around 30 to 40 min. All patients underwent the Dizziness Handicap Inventory (DHI), Sensory Organization Test (SOT), Adaptation Test (ADT), Limits of Stability (LOS), and Rhythmic Weight Shift (RWS) before, after, and 8-week follow-up of the VRT program. In addition, the Cybersickness Survey was applied to the patients at the end of the VR-based VRT session every week., Results: The DHI mean scores of the patients were 54.60, 19.20, and 16.84, respectively, before, just after, and at the 8-week follow-up VRT (p < 0.001). The mean SOT composite score of the patients was obtained as 58.08 before VRT; 77.16 after VRT and 76.40 at 8-week after VRT (p < 0.000). On the other hand, the values in the 'movement velocity' and "direction control" parameters of the patients in LOS and RWS showed a significant improvement after VRT compared to before VRT (p < 0.000). From before VRT to 8 weeks after VRT, the patient's oscillation averages in the 'toes up' and 'toes down' positions in ADT reduced progressively (p < 0.000)., Discussion: This study demonstrates that implementing a VR-based VRT protocol may be an efficient option to improve posture stability and the quality of life in patients with PVH. In addition, VR-based vestibular rehabilitation therapy has shown to be effective for PVH patients in the mid-term.

Objective: Highly contagious character of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the lack of specific drugs have led many scientists worldwide to re-evaluate the molecules currently in use for other diseases/viruses. Thus, high-throughput screening with docking studies has the rationale to identify potential therapeutics from existing drug molecules. Conflicting results of the studies, including SARS-CoV-2 and human immunodeficiency virus (HIV) coinfected population, suggested a possible preventive effect of antiretroviral regimens they have been receiving., Materials and Methods: Interactions between the widely used antiretroviral molecules, in particular; abacavir, cobicistat, dolutegravir, elvitegravir, emtricitabine, lamivudine, raltegravir, and tenofovir, and the main proteins on SARS-CoV-2 that may be targeted for SARS-CoV-2 infection were analyzed using molecular docking studies., Results: Analysis of the compounds strikingly revealed that not the antiretroviral drugs but cobicistat and ritonavir, the inhibitors of cytochrome P450, had strong interactions with the main protease active site and RNA polymerase on SARS-CoV-2, as well as the active site of angiotensin-converting-enzyme 2, the protein that enables the entry of the virus into human cells., Conclusion: Our results suggest cobicistat and ritonavir may be used to prevent SARS-CoV-2 infection., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Infectious Diseases and Clinical Microbiology.)

Objective: The severe acute respiratory syndrome-coronavirus-2 pandemic is one of the largest of the recent times and can cause many symptoms including smell and taste disorders. In the literature, smell disorders caused by coronavirus disease-2019 (COVID-19) have been reported within a wide range from 3.2% to 98.3%. A small number of these studies demonstrated smell and taste disorders through objective tests. Our aim in this study was to determine the prevalence of smell and taste disorders in hospitalized patients due to COVID-19 infection., Methods: The study was carried out with 100 patients who were positive for real-time polymerase chain reaction and treated at the Kayseri City Hospital, and 100 healthcare worker relatives. We used the Connecticut Chemosensory Clinical Research Center test to evaluate the sense of smell. Sense of taste was evaluated using four different standardized bottles of preparations, and the results were scored according to the patients' statements., Results: Patient (Group 1) and control (Group 2) groups were compared for age, gender, smell and taste disorders. There were 39 women and 61 men in the patient group, and 40 women and 60 men in the control group. Mean age was 50.2±1.37 (range 21-70) years in Group 1 and 47.6±1.25 (range 18-70) years in Group 2, and there was no significant difference between the two groups. While the rate of smell disorder was 80% in Group 1, we found this rate as 35% in Group 2. Taste disturbance was identified in 38 patients, of whom 16 had mild hypogeusia, 17 had moderate hypogeusia, four had severe hypogeusia, and one patient had ageusia. We found that taste disorder was 38% in Group 1 and 3% in Group 2., Conclusion: Smell and taste dysfunctions are very common symptoms in COVID-19 patients. The results obtained using objective test methods are higher than the rates obtained from patient statements., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare., (©Copyright 2022 by Official Journal of the Turkish Society of Otorhinolaryngology and Head and Neck Surgery.)

Background: Remdesivir, which was first developed for the treatment of Ebola disease but failed to meet expectations, has become hope in the fight against the COVID-19 pandemic. This study aimed to evaluate risk factors for mortality and prognosis of adult moderate/severe COVID-19 patients treated with remdesivir, and safety and tolerability of 5 days of remdesivir treatment., Methods: This multicenter prospective observational study was conducted in 14 centers in Turkey. Pregnancy or breastfeeding, multiorgan failure, or usage of vasopressors for septic shock, ALT > 5 × the upper limit of the normal range, or eGRF <30 mL/min or dialysis and receiving favipiravir were the exclusion criteria of the study., Results: Among 500 patients, 494 patients were included in the study. On admission, 392 (79.3%) patients had moderate and 102 (20.6%) patients had severe COVID-19. The 28-day mortality was 10.1%. The median of the scores of the seven-category ordinal scale assessed on days 0, 3, 5, 7 were 4 and 3 on day 14. When the survival status of the patients was evaluated according to the time between the remdesivir start date and the end date of the symptoms, no statistically significant difference was found between the medians of the groups (p = 0.404). In multivariable analysis, age (OR, 1.05; 95%CI, 1.02-1.08; p = 0.003), SpO2 level on admission (OR, 3.03; 95%CI, 1.35-6.81; p = 0.007), heart rate (OR, 2.48; 95%CI, 1.01-6.07; p = 0.047), follow-up site at the hospital (clinic/ICU) (OR, 26.4; 95%CI, 11.6-60.17; p < 0.001) were independently associated with increased mortality. Grade 3 adverse event (AE) was observed in 4 (0.8%) patients. None of the patients experienced grade 4 or 5 AEs., Discussion: Remdesivir is a safe and well-tolerated drug and older age, low SpO2 level on admission, tachycardia, and ICU admission are independently associated with increased mortality among patients with moderate/severe COVID-19 receiving remdesivir treatment.

Background: This study aimed to investigate CURB-65, quick COVID-19 Severity Index (qCSI) and quick Sepsis Related Organ Failure Assessment (qSOFA) scores in predicting mortality and risk factors for death in patients with COVID-19., Methods: We retrospectively analyzed a total of 1919 cases for whom the rRT-PCR assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was positive. For mortality risk factors, univariate and multivariate logistic regression analyses were used. Receiver operator characteristics (ROC) analysis and Kaplan-Meier survival analysis were performed for CURB-65, qCSI and qSOFA scores., Results: The patients' average age was 45.7 (21.6) years. Male patients accounted for 51.7% (n=992). In univariate analysis, some clinical variables including age over 65 years and comorbid diseases such as hypertension, chronic kidney disease, malignancy, lymphopenia, troponin, lactate dehydrogenase (LDH) and fibrinogen elevation were associated with the mortality rate. In multivariate logistic regression analysis: Neutrophil lymphocyte ratio (NLR) 3.3 and above (OR, 9.1; 95% CI, 1.9-42), C-reactive protein (CRP)30 mg/L and above (OR, 4.1; 95% CI, 1.2-13.6), D-dimer 1000 ng/mL and above (OR, 4; 95% CI, 1.5-10.7) and age (OR, 1.11; 95% CI, 1.04-1.18-year increase) were identified as risk factors for mortality among COVID-19 patients. The CURB-65 and qCSI scores exhibited a high degree of discrimination in mortality prediction (AUC values were 0.928 and 0.865, respectively). Also, the qSOFA score had a moderate discriminant power (AUC value was 0.754)., Conclusion: CURB-65 and qSCI scores had a high discriminatory power to predict mortality. Also, this study identified CURB-65, qCSI and qSOFA scores, NLR, CRP, D-dimer level, and annual age increase as important mortality risk factors., (© 2022 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

One of the most significant challenges for detecting microbial life in thermal springs by conventional techniques such as culturing is these places' physicochemical (temperature, heavy metal content, pH, etc.) conditions. Data from several studies suggest that high-throughput DNA sequencing technologies can be used to perform more accurate and detailed microbiome analyses. The primary aim of this paper was to determine the microbiome in the thermal source by metabarcoding environmental DNA isolated from four different sources and reveal the reflection of differences caused by temperature and chemical content on the microbiome. DNA was extracted from water filtered with enclosed filters and using the Illumina high-throughput sequencing platform, V3 and V4 regions of the 16S rRNA gene were sequenced. The results showed a correlation between physicochemical conditions and microorganism composition of four different thermal springs. Springs with extremely high temperature (89-90 °C) were dominated by hyperthermophiles such as Hydrogenobacter and Thermus , while a spring with a high temperature (52 °C) was dominated by thermophiles such as Thermoanaerobaculum and Desulfurispora , and a spring with a low temperature (26 °C) and high salinity was dominated by halophiles and sulfur-oxidizers such as Hydrogenovibrio and Sulfirimonas . With this research, we observed many manipulable steps according to the work of interest. This study sought to obtain data that will help decide the right gene region and choose the optimal bioinformatic pipeline.

Some novel benzimidazole derivatives were synthesized and their antimicrobial activities were evaluated. Compounds 3a and 3b exhibited excellent antibacterial activity with MIC values <4 µg/mL against Staphylococcus aureus ATCC 29213 (MSSA) and Staphylococcus aureus ATCC 43300 (MRSA). Molecular docking analyzes of compounds with MIC values of 16 µg/mL and below against gram-positive bacteria and fungi were performed using FabH (β-ketoacyl-acyl carrier protein synthase III) as bacterial protein and CYP51 (sterol 14α-demethylase) as the fungal target protein. According to the molecular docking analysis, it was calculated that sufficient protein-ligand interaction energy was liberated between the compounds 2f, 3a, 3b, 3e and 3h and the antibacterial target protein FabH and strong interactions were formed between 2f and 3h and the antifungal target protein. According to RMSD, RMSF and MMPBSA measurements obtained from molecular dynamics, it is understood that compounds 3a and 3b maintain protein-ligand stability in silico physiological conditions.

Salvia ekimiana Celep & Doğan is an endemic species of Turkey. To our knowledge, the number of studies on biological activities and phytochemical profiling of this plant is quite limited. Therefore, this study aimed to analyze its activities and phytochemical content in detail. The qualitative-quantitative compositions were determined via spectrophotometric and chromatographic (LC-MS/MS and HPLC) techniques. 1,1-Diphenyl-2-picrylhydrazyl radical (DPPH • ) and 2,2'-Azino-bis 3-ethylbenzothiazoline-6-sulfonic acid (ABTS •+ ) radical scavenging and ascorbate-iron (III)-catalyzed phospholipid peroxidation experiments were performed to measure antioxidant capacity. Hyaluronidase, collagenase, and elastase enzyme inhibition tests were determined in vitro using a spectrophotometer. Antiproliferative activity was evaluated in human lung cancer (A549) and human breast cancer (MCF7) cells. The murine fibroblast (L929) cell line was used as a normal control cell. While the subextract rich in phenolic compounds was n -butanol extract, rosmarinic acid was defined as the main secondary metabolite. The highest antioxidant activity observed for the n -butanol subextract included the following: DPPH • EC50: 0.08±0.00 mg/mL, TEAC/ABTS: 2.19±0.09 mmol/L Trolox, MDA EC50: 0.42±0.03 mg/mL. The methanolic extract, the ethyl acetate, and n -butanol subextracts displayed significant inhibitory activity on collagenase, while the other subextracts did not show any inhibitory activity on hyaluronidase and elastase. Due to strong interactions with their active sites, molecular docking showed luteolin 7-glucuronide, apigenin 7-glucuronide, and luteolin 5-glucoside had the highest binding affinity with target enzymes. The chloroform subextract showed significant cytotoxicity in all cell lines. These novel results revealed that S. ekimiana has strong antioxidant, collagenase enzyme inhibitory, and cytotoxic potential.

Background: It is thought vaccines allowed for emergency use significantly reduce hospitalizations and emergency room visits. It is a matter of curiosity how many of the patients who come to the emergency department (ED) are vaccinated. We aimed to examine the characteristics of ED patients needing hospitalizations related to moderate and severe COVID-19 by vaccination status., Methods: A retrospective study of 559 rRT-PCR-confirmed SARS-CoV-2 infection cases with moderate or severe COVID-19 needing hospitalization was performed in August 2021. Univariate and multivariate logistic regression analyses were performed for factors associated with mortality., Results: The mean age of the patients was 60.8 ± 18.1 years old, and 54.2% (n = 303) of the patients were women. The most common comorbidities were hypertension (37.2%), diabetes mellitus (31.1%) and chronic obstructive pulmonary disease (13.8%), respectively. The number of patients with alpha variant was 399 (71.4%), and delta variant was 83 (14.8%). Fifty point 6% (n = 283) of the patients were fully vaccinated. The total number of patients who died in the study was 114 (20.4%), and the number of patients hospitalized in the intensive care unit was 168 (30.1%). The day between the last dose of vaccine and hospitalization was 117 ± 45.9 days. In multivariate logistic regression analysis: age (odds ratio (OR), 1.05; 95% confidence intervals (95% CI) 1.03-1.08- year increase), male gender (OR, 1.8; 95% CI, 1.1-2.9), presence of at least one comorbid disease (OR, 2; 95% CI, 1.1-3.7) and partial (OR, 0.24;95% CI, 0.09-0.6) and fully vaccinated status (OR, 0.1; 95% CI, 0.05-0.18) were associated with mortality among COVID-19 patients., Conclusions: In this study, age older than 65, unvaccinated, and comorbidities had significantly higher mortality. In multivariate regression analyses, age, vaccination status, comorbidities and the male gender were associated with mortality. Our study did not evaluate the vaccine efficacy but, a lower mortality rate was observed in those fully vaccinated with CoronaVac and Pfizer-BioNTech. Additionally, Alpha, Delta and other variants had the same mortality rates., Competing Interests: Declaration of Competing Interest None., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Chemical investigation of the methanol extract from the leaves of H. roeperianum led to the isolation of a new tetraoxygenated xanthone along with eleven known compounds including six xanthones, one polyketide, one flavonoid, one ferulic acid derivative and two pentacyclic triterpenoids. Their structures were established on the basis of 1D- and 2D-NMR, UV, IR, and MS experiments, and by comparison of their spectroscopic data with those of similar compounds reported in the literature. The new xanthone was tested against a panel of eight bacterial strains including six Gram-negative and two Gram-positive bacteria. As results, it exhibited weak antibacterial activity with MIC values ranging from 64 to 128 µg/mL.

Objective: The reasons for a high prevalence of asymptomatic or mild coronavirus disease (COVID-19) and rare severe disease in children have been explained by non-immune and immune mechanisms. This study aimed to evaluate the immune system's response to severe acute respiratory syndrome coronavirus 2 by investigating lymphocyte subsets., Materials and Methods: This study included 33 coronavirus disease positive children, of whom 12 had mild disease and 21 had an asymptomatic infection as the patient group and 26 ageand gender-matched healthy children as the control group. The demographic information, symptoms, physical examination findings, complete blood count, C-reactive protein (CRP), procalcitonin, and lymphocyte subsets were recorded in all subjects., Results: Leukocyte, lymphocyte, monocyte count, and hemoglobin levels of our pediatric coronavirus disease patients were similar to the control group. Neutrophil was lower in the coronavirus disease cases compared to the control group. CRP and procalcitonin levels of asymptomatic cases were similar to the control group. B cell count, CD8+ T cell count, and CD4/CD8 ratio (dividing the CD4 cell count by the CD8 cell count) ratio were similar in the patient and control groups. Natural killer, T cell, and CD4+ T cell counts were significantly higher in the whole patient group compared to the control group., Conclusion: One reason for mild severe acute respiratory syndrome coronavirus 2 infection in children may be an increase in some lymphocyte subsets such as natural killer cells, T cell, and CD4+ T cell. Understanding the answer to the question of why children develop more protective immunity to the virus could be an essential step for developing new treatments.

Background and Purpose: Candidemia remained important in the intensive care units (ICU) during the COVID-19 pandemic. This study aimed to investigate the clinical and laboratory data on candidemia in COVID-19 patients., Materials and Methods: The baseline characteristics, as well as laboratory and clinical findings of candidemia and non-candidemia patients, were compared. Candidemia was defined as the isolation of Candida spp. from blood cultures. The isolates were identified by VITEK® 2 (bioMérieux, France) commercial method. Antifungal susceptibility was assessed using the E-test method. Univariate and multiple binary logistic regression analyses were performed to compare the variables., Results: In total, 126 patients with the COVID-19 disease were included. Candidemia was diagnosed in 44 (35%) of the patients. The number of patients with diabetes mellitus and chronic renal failure was higher in the candidemia group. In the candidemia group, the duration of ICU stay of patients, the 30-day mortality rate, mechanical ventilation therapy, and systemic corticosteroids (Prednisone) usage were significantly higher in candidemia patients. Moreover, the median white blood cell, neutrophils, and lactate dehydrogenase were higher in the candidemia group.Univariate and multiple binary logistic regression analyses were performed to compare the variables. Isolated species were identified as Candida albicans (n=12, 41%), Candida parapsilosis (n=7, 24%), Candida glabrata (n=6, 21%), Candida tropicalis (n=3, 10%), and Candida dublinensis (n=1, 3%). In total, three isolates of six C. glabrata species had dose-dependent sensitivity to fluconazole, and one C. parapsilosis was determined to be resistant., Conclusion: The COVID-19 patients who are admitted to ICU have many risk factors associated with candidemia. The most common risk factors for the development of candidemia were mechanical ventilation, diabetes mellitus, neutrophilia, and low hemoglobin level. The most frequently isolated species was C. albicans . Moreover, caspofungin was found to be the most effective drug in vitro . No significant resistance pattern was detected against the isolated species. It should be noted that risk-stratified antifungal prophylaxis in the ICU is possible., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright: © 2021, Published by Mazandaran University of Medical Sciences on behalf of Iranian Society of Medical Mycology and Invasive Fungi Research Center.)

1. This study aimed to determine the effects of marination liquids prepared with citric acid (CA-0.5%), lemon (LJ-100%) and grapefruit (GJ-100%) juices on the pH, colour ( L*, a*, b* , Chroma, hue angle, total colour differences), cooking loss (CL), water holding capacity (WHC) and marinade absorption (MA) of chicken breast meat. Textural, microstructure (scanning electron microscopy (SEM), confocal laser scanning microscopy (CLSM)) and sensory properties were investigated.2. As a result of marination, there was a significant (P < 0.01) decrease in the CL and pH values and an increase in WHC and MA values of marinated meat. The L*, b* and chroma values of chicken breast meats marinated with all marinades increased significantly (P < 0.01).3. While CLSM showed that LJ gave rise to a partial deterioration in muscle fibres, SEM indicated that LJ had irregular muscle fibres, some fibres were broken and separated from each other. The lowest hardness value was established in the LJ group from texture analysis. In the sensory analysis, marinated samples generally received higher scores from panellists compared with the control.

Background: The COVID-19 pandemic has led to significant changes in the field of education, including not least of all the adoption of distance education, which nursing students have had limited experience with in Turkey., Purpose: This study aimed to determine the factors affecting nursing students' success in distance education and to evaluate their experiences during this process., Methods: The study was designed as a descriptive, cross-sectional study and involved the participation of 454 nursing who were members of the Student Nurses Association in Turkey. An evaluation form for assessing students' sociodemographic and distance education-related characteristics and the Distance Education Assessment Questionnaire for Nursing Students (DEAQNS) were used for data collection., Results: The students further reported that the main factors affecting the success of distance education were provision of preliminary information, proficiency level of technological software use, economic status, proficiency level of use of technological devices, and asynchronous learning., Conclusions: In order to increase the success of distance education, students need information on the protection of personal data and use of technological software and devices in the nursing curriculum., (Copyright © 2021. Published by Elsevier Inc.)

Background: Musculoskeletal disorders are a significant public health issue that negatively affects individuals and society both socially and economically, and increases the cost of care and cure., Objective: This study aimed to determine the musculoskeletal problems and risk factors of academicians who transitioned to provide distance education during the COVID-19 pandemic., Methods: The population of this descriptive cross-sectional study included academicians who worked in two public universities in Turkey. Ethical committee approval and institutional permissions were obtained between 1 and 28 February 2021. Data were collected using a personal information form, the Work Environment Evaluation Questionnaire, and the Musculoskeletal Pain Intensity Assessment Questionnaire. The data were analyzed using the number, percentage, independent group t-test, ANOVA test, and linear regression analysis (forward method). The analysis was interpreted at the 95% confidence level and 0.05 error margin., Results: Of the academicians, 78% were women, 54.6% were married, 80.6% did not regularly exercise, and 73.5% had more workload during the distance education period. Academicians mostly experienced discomfort about their eyes, necks, and waists, and an increase at a significant level was detected in their musculoskeletal system problems during the distance education period. Increasing workload, duration of mobile phone use, active time, having an ergonomic chair, and gender predicted the musculoskeletal system pain intensity by 20%., Conclusion: Musculoskeletal system problems are a significant public health issue. Academicians should be informed and consulted for the protection of musculoskeletal system health during the distance education period.

The aim of this study was to investigate the protective role of Urtica dioica seed (UDS) extract against azoxymethane (AOM)-induced colon carcinogenesis in rats. Thirty-two male Wistar albino rats were divided into four groups: Control, AOM, AOM + UDS, and UDS. The AOM and AOM + UDS groups were induced by AOM (15 mg/kg body weight) subcutaneously once a week for 10 weeks. AOM + UDS and UDS groups additionally received fed with pellets included 30 ml/kg UDS extract. At the end of the trial, blood and colon tissue samples were taken from the rats following necropsy. The gross and histopathological findings revealed that the administration of UDS extract significantly decreased lesions including aberrant cript foci, adenoma, and adenocarcinoma formation both numerically and dimensionally. Immunohistochemically, slight CEA and COX-2, strong Caspase-3 immune-expressions were detected in the group AOM + UDS compared to AOM group. Biochemical examinations indicated that a markedly increase in the malondialdehyde and fluctuated antioxidant defense system constituents levels such as reduced glutathione, glutathione s -transferase, glutathione peroxidase, superoxide dismutase were restored in AOM + UDS group. These results reveal that the UDS may act as a chemopreventive dietary agent, inducing apoptosis, resulting in a significant reduction of colon carcinogenesis.

Background: Coronavirus disease 2019 (COVID-19) is an ongoing global health threat. However, currently, no standard therapy has been approved for the disease., Objectives: To evaluate the clinical effectiveness of convalescent plasma (CP) in patients with acute respiratory distress syndrome (ARDS) due to COVID-19., Design and Setting: Retrospective study conducted at Kayseri City Education and Research Hospital, Kayseri, Turkey., Methods: The case group consisted of adult patients (> 18 years) with ARDS due to COVID-19 who received CP in combination with antiviral and supportive treatment. These patients were compared with others who only received antiviral and supportive treatment., Results: During the study period, a total of 30 patients with ARDS due to COVID-19 were included. Eleven patients (36%) received CP in combination with antiviral and supportive treatment, whereas nineteen patients (64%) in the control group only received antiviral and supportive treatment. On admission, the median age, demographic and clinical data and initial laboratory test results were similar between the groups (P > 0.05). On the 14th day of treatment, the laboratory values remained similar between the groups (P > 0.05). The mortality rates were not significantly different between the groups., Conclusion: CP treatment did not affect mortality or lead to clinical improvement for COVID-19 patients with ARDS.

The clinical course of COVID-19 is variable, with clinical manifestation ranging from 81% mild course to 14% severe course along with 5% critical course in patients. The asymptomatic course is reported to potentially range between 20% and 70% (avg. 33%). A more severe course is seen in the elderly, those with various chronic diseases, and the immunosuppressed, where the case fatality rate is higher in these risk groups. The disease progresses with various symptoms, such as fever, cough, shortness of breath, malaise, myalgia, taste and smell disorders, diarrhea, sore throat, headache, and conjunctivitis. The disease begins with shortness of breath, indicative of lung damage, after an average of 7 to 10 days, and progresses in ARDS, sepsis, and septic shock. Some patients quickly enter shortness of breath, while others gradually develop shortness of breath and chest tightness and burning. The risk factors for a poor prognosis are age, comorbidities, and changes in laboratory tests. Secondary bacterial and fungal infections frequently develop with steroids and immunosuppressants, especially in the intensive care unit. Frequent complications in hospitalized patients include pneumonia (75%), ARDS (15%), acute renal failure (9%), and acute liver injury (19%). An increased incidence of heart damage is observed, including acute heart failure, arrhythmias, and myocarditis. Of the patients hospitalized due to COVID-19, 10%–25% present with prothrombotic coagulopathy, resulting in venous and arterial thromboembolic events. The most common extrapulmonary symptom is neuropsychiatric involvement, frequently accompanied by insomnia, an impediment to remembering, and an altered state of consciousness. During the course of COVID-19, patients undergo some pathological changes (severe lymphopenia, high levels of C-reactive protein, D-dimer, ferritin, etc.) depending on the condition and exposure level of the affected systems as shown by various laboratory tests. The relevant tests are the guiding elements of risk assessment, clinical monitoring, disease severity, and prognosis setting and therapy decision-making processes., Competing Interests: none declared., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Purpose: This study aimed to investigate the relationship between oxidative stress levels in the tumor center, tumor edge, and healthy tissue., Methods: This study included a total of 53 patients with head and neck cancer. Samples of 5 × 5 × 5 mm were collected from the tumor center, tumor edge, and the healthy tissue. Total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) values were evaluated. (1) Oxidative stress values in the center and edge of all tumors and in healthy tissues were compared according to localization. (2) Tumors were divided into two groups as malignant (Group 1 [n = 28]: Laryngeal and tongue squamous cell cancers) and benign (Group 2 [n = 25]: Pleomorphic adenoma and Warthin tumors). The groups were compared according to the localization of the tissues., Results: The TOS value in the tumor edge was significantly higher than those in the tumor center and the healthy tissue. The TAS value in tissue located in the tumor edge was significantly higher than in the healthy tissue. The OSI value in the tumor edge was significantly higher than those in the tumor center and the healthy tissue. In all three localizations (tumor center, tumor edge, and healthy tissue), TOS and OSI values in Group 1 were significantly higher than Group 2., Conclusion: Oxidative stress values in the tumor edge are significantly higher than the center of the tumor and healthy tissue. In malignant tumors, oxidative stress values are significantly higher in all localizations compared to benign tumors., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Aim: To evaluate the immunogenicity and safety of the CoronaVac vaccine in patients with cancer receiving active systemic therapy. Methods: This multicenter, prospective, observational study was conducted with 47 patients receiving active systemic therapy for cancer. CoronaVac was administered as two doses (3 μg/day) on days 0 and 28. Antibody level higher than 1 IU/ml was defined as 'immunogenicity.' Results: The immunogenicity rate was 63.8% (30/47) in the entire patient group, 59.5% (25/42) in those receiving at least one cytotoxic drug and 100% (five of five) in those receiving monoclonal antibody or immunotherapy alone. Age was an independent predictive factor for immunogenicity (odds ratio: 0.830; p = 0.043). Conclusion: More than half of cancer patients receiving active systemic therapy developed immunogenicity.

In this study, biological activities of silver nanoparticles (AgNP) synthesized by green synthesis method using the fruit extract of Gilaburu ( Viburnum opulus L.) plant were investigated. The characterization of the synthesized AgNPs was performed by ultraviolet visible region spectroscopy (UV-Vis), Fourier transform - infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and X-ray diffraction (XRD) techniques. The crystal size was found to be 52.32 nm when the XRD data were calculated with the Debye-Scherrer's equation. The antimicrobial activities of extract and AgNPs were investigated by microdilution and disk diffusion methods. Antibiofilm activities were examined by the crystal violet technique. The cytotoxic effects of the extract and AgNPs against MCF-7(human breast cancer) and HUVEC (human umbilical vein endothelial cells) cell lines were evaluated by MTT assay. The IC50 valuesfor the HUVEC line were found to be 0.97 mg/mL (AgNP) and 85.24 mg/mL (extract), while the IC50 values for the MCF-7 line were determined as 0.022 μg/mL (AgNP) and 0.021 μg/mL (extract). To our knowledge, this is the first report to comprehensively examine the biological activities of V. opulus L. extract and biosynthetic AgNPs., Competing Interests: Conflict of interest The authors declare no conflict of interest., (© TÜBİTAK.)

Background: Diabetes mellitus (DM) increases mortality and morbidity in patients with coronavirus disease (COVID-19). In this study, it was aimed to assess factors influencing on COVID-19 pneumonia in hospitalized patients with diabetes and association with oral anti-diabetic drugs., Materials and Methods: This cross-sectional study included 432 patients with type 2 diabetes mellitus diagnosed with COVID-19. Data regarding clinical characteristics, demographic characteristics, intensive care unit (ICU) rate in patients admitted to ICU, laboratory results on day 1 and 7, thoracic computed tomography (CT) findings and oral anti-diabetic drugs used were extracted from medical records. In all patients, 75-days mortality was recorded. Data were assessed independently., Results: There was pneumonia in 386 (89.4%) of 432 patients with diabetes. The risk for pneumonia was markedly higher in patients on DPP-4 inhibitors; however, there was no significant among other oral anti-diabetic groups and subgroups. In addition, elevated CRP was linked to the increased risk for pneumonia. Only patients in the pneumonia group had SGLT-2 inhibitor use. During follow-up, 91 patients died. In Cox regression analysis, low Glasgow Coma Scale score, and increased lactate dehydrogenase levels were identified as significant independent risk factors for mortality., Conclusion: The study indicated that DPP-4 inhibitor used and elevated CRP level were associated with pneumonia development. Only patients in the pneumonia group had SGLT-2 inhibitor use. No oral anti-diabetics was found to be associated with COVID-19 related death., (Copyright © 2021 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

An unprecedented saponin is being reported herein together with five known compounds from the methanol extract of the roots of Albizia adianthifolia . The metabolites were obtained over repeated open column chromatography methods and spectroscopic followed by spectrometric techniques. The isolated compounds were tested against eleven Gram-negative bacteria including multidrug resistant strains. The results revealed considerable inhibition of the new saponin against the studied bacteria with MIC values ranging from 16 to 128 μg/mL.

Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Background: CoronaVac, an inactivated whole-virion SARS-CoV-2 vaccine, has been shown to be well tolerated with a good safety profile in individuals aged 18 years and older in phase 1/2 trials, and provided a good humoral response against SARS-CoV-2. We present the interim efficacy and safety results of a phase 3 clinical trial of CoronaVac in Turkey., Methods: This was a double-blind, randomised, placebo-controlled phase 3 trial. Volunteers aged 18-59 years with no history of COVID-19 and with negative PCR and antibody test results for SARS-CoV-2 were enrolled at 24 centres in Turkey. Exclusion criteria included (but were not limited to) immunosuppressive therapy (including steroids) within the past 6 months, bleeding disorders, asplenia, and receipt of any blood products or immunoglobulins within the past 3 months. The K1 cohort consisted of health-care workers (randomised in a 1:1 ratio), and individuals other than health-care workers were also recruited into the K2 cohort (randomised in a 2:1 ratio) using an interactive web response system. The study vaccine was 3 μg inactivated SARS-CoV-2 virion adsorbed to aluminium hydroxide in a 0·5 mL aqueous suspension. Participants received either vaccine or placebo (consisting of all vaccine components except inactivated virus) intramuscularly on days 0 and 14. The primary efficacy outcome was the prevention of PCR-confirmed symptomatic COVID-19 at least 14 days after the second dose in the per protocol population. Safety analyses were done in the intention-to-treat population. This study is registered with ClinicalTrials.gov (NCT04582344) and is active but no longer recruiting., Findings: Among 11 303 volunteers screened between Sept 14, 2020, and Jan 5, 2021, 10 218 were randomly allocated. After exclusion of four participants from the vaccine group because of protocol deviations, the intention-to-treat group consisted of 10 214 participants (6646 [65·1%] in the vaccine group and 3568 [34·9%] in the placebo group) and the per protocol group consisted of 10 029 participants (6559 [65·4%] and 3470 [34·6%]) who received two doses of vaccine or placebo. During a median follow-up period of 43 days (IQR 36-48), nine cases of PCR-confirmed symptomatic COVID-19 were reported in the vaccine group (31·7 cases [14·6-59·3] per 1000 person-years) and 32 cases were reported in the placebo group (192·3 cases [135·7-261·1] per 1000 person-years) 14 days or more after the second dose, yielding a vaccine efficacy of 83·5% (95% CI 65·4-92·1; p<0·0001). The frequencies of any adverse events were 1259 (18·9%) in the vaccine group and 603 (16·9%) in the placebo group (p=0·0108) with no fatalities or grade 4 adverse events. The most common systemic adverse event was fatigue (546 [8·2%] participants in the vaccine group and 248 [7·0%] the placebo group, p=0·0228). Injection-site pain was the most frequent local adverse event (157 [2·4%] in the vaccine group and 40 [1·1%] in the placebo group, p<0·0001)., Interpretation: CoronaVac has high efficacy against PCR-confirmed symptomatic COVID-19 with a good safety and tolerability profile., Funding: Turkish Health Institutes Association., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objective: To examine the efficacy of therapeutic plasma exchange (TPE) in patients critically ill with Crimean-Congo hemorrhagic fever (CCHF)., Methods: Patients with CCHF received supportive treatment (ST) or TPE. After laboratory and clinical evaluations, the patients were divided into mild, moderate, and severe CCHF groups according to the severity score index (SSI). To assess the efficacy of TPE, the incubation period, time of admission to hospital, hospitalization duration, mortality rate and times to recovery of the platelet count and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were compared between patients receiving ST and TPE., Result: A total of 119 confirmed CCHF cases was analyzed. The median SSIs were 7 in the TPE group and 5 in the ST group. The SSI stages, median incubation times and admission times were similar in the two groups. However, the duration of hospitalization was longer in the TPE group. The overall mortality rates were 9% (3 of 33 patients) in the TPE group and 16% (5 of 31 patients) in the ST group; the difference was significant. The platelet count recovered after a median of 6 (4-7) days in the ST group., Conclusion: The mortality rate was lower in the TPE group than in the ST group, but the duration of hospitalization and the time to platelet recovery were longer in the TPE group than in the ST group. TPE did not contribute significantly to the prognosis of patients with intermediate-severity CCHF. However, TPE might be efficacious in patients with severe CCHF., (© 2021 Wiley Periodicals LLC.)

We present demographic, clinical, laboratory characteristics and outcomes of the patients with solid malignancies and novel coronavirus disease (COVID-19) collected from the National COVID-19 Registry of Turkey. A total of 1523 patients with a current or past diagnosis of solid tumors and diagnosed with COVID-19 (confirmed with PCR) between 11 March and 20 May 2020 were included. The primary outcome was 30-day mortality. Median age was 61 (range: 18-94), and 752 (49%) were male. The most common types of cancers were breast (19.8%), prostate (10.9%) and colorectal cancer (10.8%). 65% of the patients had at least one comorbidity. At least one COVID-19-directed therapy was given in 73% of the patients.. Hospitalization rate of the patients was 56.6% and intensive care unit admission rate was 11.4%. Seventy-seven (5.1%) patients died within 30 days of diagnosis. The first multivariate model which included only the demographic and clinical characteristics showed older age, male gender and presence of diabetes and receipt of cytotoxic therapy to be associated with increased 30-day mortality, while breast and prostate cancer diagnoses were associated with lower 30-day mortality. In the second set, we further included laboratory parameters. The presence of leukocytosis (OR 6.7, 95% CI 3.3-13.7, P < .001), lymphocytopenia (OR 3,1, 95% CI 1,6-6,1, P = .001) and thrombocytopenia (OR 3,4 95% CI 1,5-8,1, P = .005) were found to be associated with increased 30-day mortality. Relatively lower mortality compared to Western countries and China mainly results from differences in baseline risk factors but may also implicate the importance of intensive supportive care., (© 2020 UICC.)

Ethnopharmacological Relevance: Piper capense is a medicinal spice whose fruits are traditionally used as aqueous decoction to heal several ailments such as trypanosomiasis, helminthic infections, and cancer., Aim of the Study: (1) To perform phytochemical investigation of the methanol extract of Piper capense; (2) to evaluate the cytotoxicity of botanicals (PCF, fractions PCFa-e), isolated phytochemicals on a broad panel of animal and human cancer cell lines; (3) to evaluate the induction of apoptosis of the most active samples., Material and Methods: Resazurin reduction assay (RRA) was used to determine the cytotoxicity of the studied samples. Cell cycle distribution (PI staining), apoptosis (annexin V/PI staining), mitochondrial membrane potential (MMP; JC-1) and reactive oxygen species (ROS; H 2 DCFH-DA) were measured by flow cytometry. Column chromatography (CC) was used for the purification of PCF, whilst nuclear magnetic resonance (NMR) spectroscopic and mass spectrometric (MS) analyses were applied for structural elucidation., Results: The phytochemical investigation of PCF led to the isolation of 11 compounds: licarin B (1), licarin A (2), 7-(1,3-benzodioxol-5-yl)-7,8-dihydro-8-methyl-5-(2-propenyl)-furo[3,2-e]-1,3-benzodioxole (3), nitidine isocyanate (4), 5-hydroxy-7,4'-dimethoxyflavone (5), cardamomin (6), sitosterol (7) and stigmasterol (8), β-sitosterol 3-O-β- D -glucopyranoside (9), oleanolic acid (10) and lupeol (11). Fraction PCFb, compound 2 and doxorubicin (as positive control drug) revealed cytotoxic effects towards the 18 tested cancer cell lines. The IC 50 values ranged from 6.1 μg/mL (against CCRF-CEM cells) to 44.2 μg/mL (against BRAF-V600E homozygous mutant melanoma cells) for PSCb; from 4.3 μM (against CCRF-CEM cells) to 21.8 μM (against HCT116 p53 -/- ) for compound 2 and from 0.02 μM (against CCRF-CEM cells) to 123.0 μM (against CEM/ADR5000 cells) for doxorubicin. PCFb and compound 2 induced apoptosis in CCRF-CEM cells mediated by activation of caspase 3/7, 8 and 9, MMP alteration and increased ROS production., Conclusion: Piper capense is a source of potent cytotoxic botanicals and phytochemicals that could help to fight various types of cancer including multidrug resistance phenotypes. PCFb and compound 2 should further be explored to develop new drugs to fight malignancies., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: In this study, we aimed to investigate the efficacy and safety of sofosbuvir-based therapies in the treatment of chronic hepatitis C in real-world clinical practice., Methods: Data from patients with chronic hepatitis C treated with SOF/LDV ± RBV or SOF/RBV in 31 centers across Turkey between April 1, 2017, and August 31, 2018, were recorded in a nationwide database among infectious disease specialists. Demographics, clinical, and virological outcomes were analyzed., Results: A total of 552 patients were included in the study. The mean age of the patients was 51.28 ± 14.2, and 293 (55.8%) were female. The majority had HCV genotype 1b infection (65%), 75.04% of the patients underwent treatment, and non-cirrhosis was present at baseline in 381 patients (72.6%). SOF/LDV ± RBV treatment was given to 477 patients and 48 patients received SOF/RBV according to HCV genotype. The total SVR12 rate was 99% in all patients. Five patients experienced disease relapse during the study and all of them were genotype 2. In patients infected with HCV GT2, SVR12 was 77.3%. SVR was 100% in all patients infected with other HCV genotypes. All treatments were well tolerated by patients without causing severe adverse events. Side effects and side effects-associated treatment discontinuation rates were 28.2% and 0.4%, respectively. Weakness (13.7%) was the common side effect., Conclusion: The present real-world data of 525 patients with HCV genotypes 1, 1a, 1b, 3, 4, and 5 who underwent SOF/LDV ± RBV treatment in Turkey demonstrated a high efficacy and safety profile. HCV GT2 patients should be treated with more efficacious treatment.

Introduction: There are a limited number of studies about the clinical findings of coronavirus infection in pediatric patients with asthma. We aimed to evaluate the clinical and laboratory characteristics of pediatric patients with asthma and healthy children without chronic disease who infected with SARS-CoV-2., Methods: This is a retrospective, case-control study comparing the asthma diagnosed and healthy children who were diagnosed as COVID-19 in our hospital between March 11 and November 10, 2020., Results: During the study period, 6,205 children were diagnosed with CO-VID-19 in our hospital. Only 54 (0.87%) patients had a diagnosis of asthma. The mean of the age was 10.5 years and 53.7% (n:29) of the patients with asthma were male. Cough, shortness of breath, emesis, and diarrhea were found to be significantly higher in asthma group than in the control group (respectively p = 0.002, 0.000, 0.002, 0.019, 0.015). Patients who were given SABA was significantly higher in asthma diagnosed patients (p = 0.000). Hospitalization was significantly higher in asthma group (p = 0.025), and the duration of hospitalization was significantly higher in control group (p = 0.034). There was no significant difference between the 2 groups in terms of requiring oxygen treatment and in laboratory findings between groups., Conclusion: This study revealed that pediatric patients diagnosed with asthma were in a mild clinic. According to these findings, asthma may not affect the course of the COVID-19 in children., (© 2021 S. Karger AG, Basel.)

The global cancer burden remains a serious concern with the alarming incidence of one in eight men and one in eleven women dying in developing countries. This situation is aggravated by the multidrug resistance (MDR) of cancer cells that hampers chemotherapy. In this study, the cytotoxicity of the methanol extract (HRB), fractions (HRBa, HRBb, and HRBa1-5), and compounds from the bark of Hypericum roeperianum (HRB) was evaluated towards a panel of 9 cancer cell lines. The mode of action of the HRB and trichadonic acid ( 1 ) was also studied. Column chromatography was applied to isolate the constituents of HRB. The cytotoxicity of botanicals and phytochemicals was evaluated by the resazurin reduction assay (RRA). Caspase-Glo assay was used to evaluate the activity of caspases, and reactive oxygen species (ROS) (H 2 DCFH-DA) were assessed by flow cytometry. Phytochemicals isolated from HRB were trichadonic acid ( 1 ), fridelan-3-one ( 2 ), 2-hydroxy-5-methoxyxanthone ( 3 ), norathyriol ( 4 ), 1,3,5,6-tetrahydroxyxanthone ( 5 ), betulinic acid ( 6 ), 3'-hydroxymethyl-2'-(4″-hydroxy-3″,5″-dimethoxyphenyl)-5',6':5,6-(6,8-dihydroxyxanthone)-1',4'-dioxane ( 7 ), and 3'-hydroxymethyl-2'-(4″-hydroxy-3″,5″-dimethoxyphenyl)-5',6':5,6-(xanthone)-1',4'-dioxane ( 8 ). Botanicals HRB, HRBa, HRBa2-4, HRBb, and doxorubicin displayed cytotoxic effects towards the 9 tested cancer cell lines. The recorded IC 50 values ranged from 11.43  µ g/mL (against the P-glycoprotein (gp)-overexpressing CEM/ADR5000 leukemia cells) to 26.75  µ g/mL (against HCT116 (p53 +/+ ) colon adenocarcinoma cells) for the crude extract HRB. Compounds 1 , 5 , and doxorubicin displayed cytotoxic effects towards the 9 tested cancer cell lines with IC 50 values varying from 14.44  µ M (against CCRF-CEM leukemia cells) to 44.20  µ M (against the resistant HCT116 (p53 -/- ) cells) for 1 and from 38.46  µ M (against CEM/ADR5000 cells) to 112.27  µ M (against the resistant HCT116 (p53 -/- ) cells) for 5 . HRB and compound 1 induced apoptosis in CCRF-CEM cells. The apoptotic process was mediated by enhanced ROS production for HRB or via caspases activation and enhanced ROS production for compound 1 . This study demonstrated that Hypericum roeperianum is a potential source of cytotoxic phytochemicals such as trichadonic acid and could be further exploited in cancer chemotherapy., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Michel-Gael F. Guefack et al.)

BACKGROUND Lhermitte-Duclos disease (LDD) is caused by a rare slow-growing mass in the cerebellum. LDD generally is experienced by young adults, but also it has been encountered in the pediatric population. Lhermitte and Duclos first described cerebellar dysplastic gangliocytoma in 1920. The first case they described included occipital headache, paroxysmal vertigo, falls, hearing problems, and memory deficits. Our patient had typical symptoms of the disorder such as headache, nausea, vomiting, blurred vision, and imbalance. The purpose of this case report was to describe the outcome of a computerized dynamic posturography (CDP) vestibular training program combined with home-based exercises designed to improve balance function and reduce the risk of falling by an individual with a posterior fossa tumor. CASE REPORT A 36-year-old male patient was diagnosed with dysplastic gangliocytoma/ganglioglioma according to magnetic resonance imaging, computed tomography, and pathology reports on March 28, 2016. The patient was treated by partial cerebellar tumor resection on April 7, 2016. After the operation, he reported severe imbalance, nausea, and vomiting for 1 month and visited the Audiology Department on October 20, 2016. The patient was evaluated with the CDP-sensory organization test (SOT) and his composite equilibrium score of this examination was 48, 31% below normal. We administered a 6-week posturography-assisted vestibular rehabilitation (VR) protocol (extending an hour per week) combined with a home-based exercise program twice in 2 years. In the second evaluation we applied in 2018, SOT composite equilibrium score increased to 72 after VR, reaching normal limits. After 2 years, his complaints slightly alleviated and his SOT scores were better when we compared the VR results in 2016. CONCLUSIONS We demonstrated that long-term VR may affect a patient with dysplastic cerebellar gangliocytoma (LDD) presenting imbalance or dizziness.

Infectious diseases remain as the significant causes of human and animal morbidity and mortality, leading to extensive outbreaks and epidemics. Acute respiratory viral diseases claim over 4 million deaths and cause millions of hospitalizations in developing countries every year. Emerging viruses, especially the RNA viruses, are more pathogenic since most people have no herd immunity. The RNA viruses can adapt to the rapidly changing global and local environment due to the high error rate of their polymerases that replicate their genomes. Currently, coronavirus disease 2019 (COVID-19) is determined as an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was first identified in 2019 in Wuhan. Herein we discuss emerging and reemerging respiratory viral infections till to SARS-CoV-2., (This work is licensed under a Creative Commons Attribution 4.0 International License.)