Search

Fuel cells, one of the clean energy sources, is quite remarkable for energy production. In this context, catalysts are needed for the electrochemical reactions of DMFCs (direct methanol fuel cells) to work efficiently. In this study, Pt and Pt@Ti-MOF (Pt@MIL-125) NPs (nanoparticles) catalysts were synthesized by chemical synthesis. The Ti-MOF (MIL-125) structure was synthesized using the solvothermal method, and the effect of Ti-MOF on methanol oxidation was investigated. The results showed that Pt@Ti-MOF NPs provided 9.45 times more electrocatalytic activity for methanol oxidation compared to Pt NPs. In addition, Ti-MOF doping was shown to increase the stability and durability by long-term tests. The study provides important results on how MOF-supported structures behave electrochemically. The results show that Ti-MOF provides very high potential in MOR applications and is promising for use as an anode catalyst in DMFC systems., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Objective: The primary aim of this study was to conduct a comparative analysis of homicide cases and their perpetrators with psychotic illnesses in Italy and Turkiye, identifying the extent to which country-specific factors influence offender profiles and crime-scene characteristics., Method: This cross-national chart review study recruited individuals with psychotic illnesses from forensic psychiatric centers in Italy and Turkiye who were referred for criminal responsibility assessments. Data were collected on the offenders' background characteristics, psychiatric history, victim profiles, and crime-scene details., Results: Compared to the Italian sample, a higher prevalence of hospitalizations, contact with mental health services, and past offending history prior to the index homicide in the Turkish sample highlight inadequate community mental health care and monitoring systems, as well as insufficient supervision by the criminal justice system in Turkiye. Turkish offenders were less likely to exhibit organized crime scenes and post-crime behavior, with fewer stressors preceding the offense, suggesting a greater role of positive psychotic symptoms in their homicidal acts., Conclusion: Despite certain similarities, the differences between the two samples highlight the impact of sociocultural, healthcare, and legal systems on offender profiles and crime-scene characteristics. These findings emphasize the need for tailored mental health services, forensic psychiatric assessments and legal supervision that take into account country-specific factors., Competing Interests: Declaration of competing interest The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

This research explores the development and evaluation of breakfast cereals formulated from pearl millet (P-1) and finger millet (F-1) flours, with a focus on their nutritional composition and potential anti-obesity properties. The techno-functional properties were assessed, revealing that P-1 exhibited a bulk density of 0.40 ± 0.01 g/ml and a true density of 0.61 ± 0.03 g/ml, while F-1 showed a bulk density of 0.54 ± 0.03 g/ml and a true density of 0.65 ± 0.02 g/ml. The Carr index and Hausner ratio were significantly higher in P-1 (40.33 ± 0.41 and 1.68 ± 0.03, respectively) compared to F-1 (22.3 ± 0.3 and 1.31 ± 0.02, respectively). Both flours demonstrated comparable water absorption indices, but P-1 had superior foaming capacity and stability. Nutritional analysis indicated that P-1 contained 12.64% moisture, 6.02% fat, 10.29% protein, 63.94% carbohydrates, 2.38% ash, and 2.75% fibre, whereas F-1 had 8.92% moisture, 1.78% fat, 8.65% protein, 73.65% carbohydrates, 1.77% ash, and 4.04% fibre. Composite flours (PF-1, PF-2, PF-3) exhibited varying compositions: PF-1 had 9.86% moisture, 5.83% fat, 11.62% protein, 66.04% carbohydrates, 2.19% ash, and 3.03% fibre; PF-2 had 10.79% moisture, 3.87% fat, 10.01% protein, 68.97% carbohydrates, 2.05% ash, and 3.37% fibre; PF-3 had 9.87% moisture, 2.84% fat, 9.33% protein, 71.12% carbohydrates, 1.92% ash, and 3.74% Fiber. Antioxidant activity was higher in F-1 (80.63%) compared to P-1 (59.58%), with PF-1, PF-2, and PF-3 showing 64.84%, 70.14%, and 75.4%, respectively. Lipase and amylase inhibition capacities were 73.15% and 28.66% for P-1, 28.31% and 30.65% for F-1, and varied for composites: PF-1 (79.12% lipase, 46.41% amylase), PF-2 (50.75% lipase, 53.15% amylase), and PF-3 (39.51% lipase, 41.84% amylase). These findings underscore the distinct nutritional and functional properties of these flours, highlighting their potential in obesity management., Competing Interests: Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Objective: Mechanisms of sleep disorders in fibromyalgia (FM) patients, such as insomnia, early morning awakenings and poor quality sleep, have not yet been proven and no consistent and effective treatment is yet available. The aim of this study was to investigate the pineal gland volume and the relationship between total fiber count, total fiber volume and total fiber length of the spinoreticular tract involved in regulation of sleep and wakefulness in terms of the mechanism of sleep disturbance., Methods: This study included only female cases, 31 with fibromyalgia and 31 controls. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Tractography of targeted pathway from brain diffusion MR images was calculated in DSI Studio program and the volume of the pineal gland was calculated in ITK-SNAP program., Results: The mean volume of the pineal gland was higher in control group (218.84±64.45 mm 3 ) than in fibromyalgia group (174.77±48.65 mm 3 ), which was statistically significant (p=0.004). However, there was no statistically significant difference between two groups in total spinoreticular tract (TSRT), total volume (TSRTV), TSRT FA, TSRT MD, TSRT AD and TSRT RD of spinoreticular tract, which is involved in the regulation of sleep and wakefulness (p>0.05)., Conclusion: In conclusion, it is thought that the endocrine system may be more related to sleep disturbance in individuals with FM than central nervous system. Therefore, we believe that it may be more appropriate to work on the endocrine system rather than neural system in the treatment of sleep disturbance in patients with FM.

The main objective of this study was to investigate the effects of commercial probiotic Bacillus sp. supplementation on seabream Sparus aurata larviculture under culture conditions. In this context, Bacillus was supplemented via rotifer feeding and water and its effects on pancreatic and intestinal enzyme activities as well as aquaculture parameters were evaluated during early life development. In the experimental group, as probiotic three Bacillus sp. spores was introduced via rotifer and larval culture tanks, while the larvae in control group did not feed any probiotic supplementation. At the end of the experiment on 40 days after hatching (DAH), the probiotic-supplemented group exhibited better growth performance and there were statistically differences between in groups of probiotic-treated and control regarding growth parameters (p < 0,01), despite insignificant of survival rate (p > 0.05). In terms of enzymatic expressions, S. aurata larvae receiving probiotic supplementation through rotifers demonstrated noteworthy (p < 0.05) enhancements in specific activities of pancreatic and intestinal enzymes, except for amylase (p > 0.05), when compared to the control group. It is concluded that the administration of Bacillus sp. as probiotic bacteria through rotifer supplementation and water intake demonstrates significant positive impacts on both growth parameters and specific activities of main pancreatic and intestinal enzymes of seabream larvae., (© The Author(s) 2024. Published by Oxford University Press on behalf of Applied Microbiology International.)

Inflammatory bowel disease (IBD) comprises chronic inflammatory conditions with complex mechanisms and diverse manifestations, posing significant clinical challenges. Traditional animal models and ethical concerns in human studies necessitate innovative approaches. This review provides an overview of human intestinal architecture in health and inflammation, emphasizing the role of microfluidics and on-chip technologies in IBD research. These technologies allow precise manipulation of cellular and microbial interactions in a physiologically relevant context, simulating the intestinal ecosystem microscopically. By integrating cellular components and replicating 3D tissue architecture, they offer promising models for studying host-microbe interactions, wound healing, and therapeutic approaches. Continuous refinement of these technologies promises to advance IBD understanding and therapy development, inspiring further innovation and cross-disciplinary collaboration., Competing Interests: Declaration of interests The authors have no interests to declare., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Striae distensae (SD) are a prevalent dermatological concern of women and approximately 90% of pregnant women experience these stretch marks. Fractional microneedle radiofrequency (FMR) and fractional CO2 laser (FCL) have gained substantial attention in the treatment of SD. In clinical studies, a clear superiority between FMR and FCL treatments is not found due to limited studies and sample sizes. In this systematic review and meta-analysis, a search of English-language articles was performed on PubMed, employing various combinations of keywords "fractional CO2 laser," "microneedle radiofrequency," and "striae". Studies that compared the treatments of FMR and FCL for SD and provided data regarding professional evaluation of improvement, patient self-assessment, and/or the presence of post-inflammatory hyperpigmentation (PIH) were included. We analyzed the incorporated studies utilizing both random and fixed-effects models to estimate pooled odds ratios (OR) and 95% confidence intervals (CI). Professional assessments of improvement showed no statistically significant difference between the FMR and FCL groups (OR: 1.27; 95% CI: 0.49-3.31). Similarly, patient self-assessments of improvement did not exhibit a significant difference (OR: 0.72; 95% CI: 0.13-3.90). However, the development of PIH was significantly less frequent in the FMR group when compared to the FCL group (OR: 0.24; 95% CI: 0.08-0.70). Both FMR and FCL demonstrate comparable performance in terms of improving lesions, as assessed by both healthcare professionals and patients. However, FCL is associated with a higher risk of developing PIH. This finding can guide clinicians especially who prefer a single treatment., (© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

Aim: Shoulder pain is the third most prevalent musculoskeletal condition that impairs function. Subacromial impingement syndrome is among the most typical causes of shoulder pain. The aim of this study was to evaluate inter-machine reliability of acromiohumeral distance measurements performed with standard ultrasound and wireless ultrasound devices in patients with subacromial impingement syndrome., Material and Methods: A total of 61 participants diagnosed with subacromial impingement syndrome were included. Acromiohumeral distance was measured with wireless and standard ultrasound devices in a neutral position and at 60-degree abduction, respectively. The inter-machine intraclass correlation coefficient, standard error of measurements, and minimum detectable changes were calculated., Results: Inter-machine reliability measured in the neutral position was excellent (ICC = 0.97, 95% CI = 0.95-0.98); the standard error of measurement was 0.23 mm, and the minimum detectable change was 0.63 mm. Inter-machine reliability measured at 60 degrees abduction was excellent as well (ICC = 0.96; 95% CI; 0.93-0.97). The standard error of measurements was 0.20 mm, and the minimum detectable change was 0.55 mm. The mean difference between the two machines was 0.04 mm for the neutral position and 0.02 mm for the 60-degree abduction position., Conclusions: The study showed that wireless ultrasound devices were similar to standard ultrasound devices in measuring the acromiohumeral distance in patients with subacromial impingement syndrome. The findings could contribute to a significant improvement in the clinical use of wireless ultrasound devices., Competing Interests: Conflict of interest The authors declare no conflict of interest in relation to the writing and/or publication of this article., (© 2024 Burak Tayyip Dede et al., published by Sciendo.)

Background: The present study aimed to compare the outcomes of simultaneous bilateral total knee arthroplasty (simBTKA) and staged bilateral total knee arthroplasty (stgBTKA) across different age groups, with a specific focus on patients under and over 65 years old., Methods: A retrospective cohort study design was employed to analyze the medical records of patients who underwent simBTKA or stgBTKA between August 2018 and May 2023. Patients were categorized into 4 groups based on age and surgical approach. Various outcome measures including knee extension strength, patient-reported outcome measures (PROMs), length of stay (LOS), operating room time (ORT), and complication rates were evaluated., Results: The study included a total of 162 patients, with 48 patients in the simBTKA group and 114 patients in the stgBTKA group. Across all age groups, simBTKA resulted in a significantly shorter LOS and ORT than stgBTKA (p < 0.05). However, there were no significant differences in PROMs or in knee extension strength between the two surgical approaches. The complication rates were comparable between the groups, with no reported deaths within one year after surgery., Conclusion: Compared with stgBTKA, simBTKA demonstrated superior efficacy in terms of reduced hospitalization duration and ORT, irrespective of age. Both surgical approaches yielded comparable clinical outcomes and complication rates across all age groups. Overall, the findings suggest that simBTKA is a viable option for appropriately selected patients, offering outcomes comparable to those of stgBTKA, with the added benefit of reduced hospitalization time and operating room utilization., (© 2024. The Author(s).)

This study aims to investigate the changes in bioenergetic pathway contributions during repeated sprint exercises with an increasing number of repetitions. Twelve male amateur soccer players executed a single 20 m sprint and three repeated-sprint protocols (5 × 20 m, 10 × 20 m, 15 × 20 m with 15-second rest intervals), analyzing oxidative, glycolytic, and ATP-PCr energy pathways using the PCr-LA-O2 method. Findings revealed a significant decline in energy expenditure and performance outputs as the number of sprint repetitions increased. While the oxidative and ATP-PCr pathways' energy contributions significantly rose with more sprints, the glycolytic pathway's contribution notably increased only up to the 10 × 20 m protocol, then stabilized. Although the ATP-PCr pathway's energy contribution decreased slightly from sprints 1-5 to 11-15, it remained significantly higher than the oxidative and glycolytic pathways throughout. Initially, glycolytic contribution surpassed oxidative in sprints 1-5, equaled it in sprints 6-10, and fell below in sprints 11-15. Glycolytic activity, a major energy source initially (about 36%), diminished substantially with more sprints (below 7% in the 15th sprint). This indicates that the decrease in non-mitochondrial pathway energy, particularly glycolytic, outstrips the aerobic system's increased tolerance. These findings offer physiological insights into the relationship between performance decrement and bioenergetic metabolism in repeated sprints., (© 2024. The Author(s).)

Congenital hypothyroidism is the most common preventable cause of intellectual disability. Therefore, the majority of developed countries have aimed to diagnose cases early through screening programs. In these screening programs, levels of thyroid-stimulating hormone (TSH) and free thyroxine are examined in dried blood spots taken between days 3 and 5 of life. While many countries accept TSH threshold value of 8 mU/L, there is still no consensus on the ideal TSH threshold value. As no twin studies on the TSH threshold value have been conducted previously, this study was planned. Eight pairs of twins were included in the study, with one of the twins having plasma TSH value ≥8 mU/L and the other <8 mU/L, measured between days 3 and 5 of life. The study aimed to investigate whether determining threshold TSH value of 8 mU/L would be beneficial by comparing somatic growth, mental development, and neuromotor development between twins. The age, gender, gestational weeks, birth weights, height, weight, and initial TSH values taken between days 3 and 5 of all cases were recorded. The patients' plasma Vitamin B12, folate, 25-OH Vitamin D, ferritin, and hemoglobin levels were measured. After that, they were evaluated by a child and adolescent psychiatry. Finally, the Denver Developmental Test was applied to the cases. There was no significant impairment in somatic growth, mental development, and neuromotor development in the long-term outcomes of cases with plasma TSH ≥ 8 mU/L compared to those with plasma TSH < 8 mU/L among the twins participating in our study., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Many successful osteotomies have been reported for the treatment of acetabular dysplasia. However, triple pelvic osteotomy remains a technically challenging procedure with potential for significant complications. This study examined a series of Tönnis periacetabular osteotomy (TPAO) procedures performed using the modified Stoppa approach to treat acetabular dysplasia in adolescents., Objective: To describe the radiographic outcomes, complications, and early functional results of TPAO using the modified Stoppa approach for acetabular dysplasia in adolescents., Methods: This study included 16 patients (20 hips) who underwent TPAO using the modified Stoppa approach for symptomatic acetabular dysplasia. The characteristics of the patients and the surgical procedure were discussed. The radiologic outcome was evaluated using the lateral center-edge (CE) and Tönnis roof angles. Perioperative data including surgery duration, blood loss, and complications were recorded. Complications were also discussed., Results: The mean age of the patients was 11.5±1.1 (10 to 13) years. The mean preoperative anteroposterior CE angle was 14.7±3 degrees (7 to 19 degrees), and the mean postoperative angle was 35.7±3.1 degrees (30 to 42 degrees; P<0.001). The mean preoperative Sharp's angle was 55.9±5.4 degrees (48 to 65 degrees), and the postoperative mean was 33±5 degrees (24 to 40 degrees; P<0.001). The mean Tönnis angle before and after osteotomy was 23.3±7.1 degrees (17 to 36 degrees) and 7.1±2 degrees (4 to 10 degrees), respectively (P<0.001). The mean operative time was 42.2±10.3 minutes with a mean blood loss of 167.7±50.3 mL. One patient sustained a bladder injury as a major complication., Conclusions: The use of TPAO with the intrapelvic modified Stoppa approach in the treatment of hip dysplasia provides the benefits of a single incision, access to 2 hips in the same session, positional advantage, and abductor function preservation. Early results are satisfactory and safe., Level of Evidence: Level IV., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose: The aim of this study was to systematically review the use of automated detection systems for identifying bone lesions based on CT and MRI, focusing on advancements in artificial intelligence (AI) applications., Materials and Methods: A literature search was conducted on PubMed and MEDLINE. Data were extracted and grouped into three main categories, namely baseline study characteristics, model validation strategies, and the type of AI algorithms., Results: A total of 10 studies were selected and analyzed, including 2,768 patients overall with a median of 187 per study. These studies utilized various AI algorithms, predominantly deep learning models (6 studies) such as Convolutional Neural Networks. Among machine learning validation strategies, K-fold cross-validation was the mostly used (5 studies). Clinical validation was performed using data from the same institution (internal testing) in 8 studies and from both the same and different (external testing) institutions in 1 study, respectively., Conclusion: AI, particularly deep learning, holds significant promise in enhancing diagnostic accuracy and efficiency. However, the review highlights several limitations, such as the lack of standardized validation methods and the limited use of external datasets for testing. Future research should address these gaps to ensure the reliability and applicability of AI-based detection systems in clinical settings., (© 2024. Italian Society of Medical Radiology.)

Objective: In this study, we aimed to obtain real-life data on the use of antimyeloma agents, which significantly increase overall survival (OS) in multiple myeloma (MM) patients, in primary plasma cell leukemia (pPCL) patients with a poor prognosis., Materials and Methods: Data from 53 patients who were diagnosed with pPCL between 2011-2020 and who used at least one proteasome inhibitor (PI) and/or immunomodulatory (IMID) agent were analyzed retrospectively. Depending on the year of pPCL diagnosis, 20% leukocytes or ≥2×109/L plasma cells in the peripheral blood were used., Results: The median age of the patients was 58 years, and 23 (43.4%) patients were over 65 years of age. For first-line treatment, PI or IMID alone was used in 31 (58.5%) patients, and PI and IMID were used simultaneously in 15 (28.3%) patients. Additionally, 21 (39.6%) patients received transplantation, and 13 (24.5%) patients received maintenance treatment. The median progression-free survival was 4 (1-42) months. When patients whose primary disease was refractory to first-line therapy were excluded, the duration of treatment was 6.5 months. The median OS was 15 months, with a median follow-up of 15 months. Only 7 (13.2%) of the patients were alive at the last follow-up visit. Those with higher beta-2 microglobulin levels and ISS stage 3 and nontransplant patients receiving first-line treatment had shorter OS (p=0.005, p=0.02 and p=0.008, respectively). Otherwise, the concomitant use of PIs and IMIDs, the addition of chemotherapy to induction therapy, and the response to induction therapy or maintenance therapy did not affect OS., Conclusion: In our study, as in previous similar studies, we could not see the increased survival trend in pPCL which is observed in MM. New studies are needed for pPCL patients, which is likely to increase with the new diagnostic criteria, based on current agents and information in MM.

Background: This study explores the role of apoptosis, autophagy, and oxidative DNA damage in influencing the cytotoxic impact of lycopene on HeLa cells., Material and Methods: Cell viability following exposure to varying lycopene concentrations was determined using an XTT assay. ELISA measured key cell death proteins (Bax, BCL-2, etc.), while immunofluorescence staining visualized LC3β (autophagy) and 8-oxo-dG (DNA damage)., Results: Lycopene significantly killed HeLa cells in a dose-dependent way (IC50 = 10 μM). Subsequent examinations conducted with the IC50 dose of lycopene demonstrated a notable elevation in the expression levels of apoptotic proteins, such as cleaved caspase 3, cleaved PARP, and Bax ( p  < 0.001). Additionally, treatment with this substance led to an increase in the levels of 8-oxo-dG ( p  < 0.001), a widely acknowledged biomarker indicative of oxidative DNA damage. Furthermore, a significant rise ( p  < 0.05) in LC3β protein levels, a well-established indicator of autophagy activation, was noted., Conclusion: This study suggests lycopene's potential to fight cervical cancer by triggering programmed cell death (apoptosis) and cellular self-digestion (autophagy). These findings highlight lycopene as a promising candidate for future cervical cancer treatments.

In this study, a new ferrocene-decorated cyclotriphosphazene compound ( 4 ) was obtained by the interaction of ferrocene chalcone with azide end groups ( 2 ) and spirophosphazene ( 3 ) bearing alkyne groups using the click method. The structures of all compounds were confirmed using Fourier transform infrared, 1 H, 13 C APT, and 31 P NMR, and MS techniques. The optical band gaps of compounds were measured, showing values of 4.75 eV for 3 , 3.53 eV for 2 , and 3.46 eV for final product 4 . The optical band gap of compound 4 calculated by density functional theory is 3.28 eV. The electrical properties of the compounds were investigated against the frequency. The results showed that the conduction mechanism is based on the hopping model. New types of diodes were prepared by using compounds 2 and 4 . The current-voltage characteristics of the compound 4 diode showed good rectification behavior. The rectification ratio of the heterojunction diode was calculated as 629. The ideality factors were 3.35 for 2 and 7.57 for 4 . The barrier heights were 0.68 and 0.92, respectively. Under sunlight (20-100 mW/cm 2 ), both diodes exhibited photodiode properties, with compound 4 being more sensitive to light. This indicates that the diodes can be used in optoelectronic devices due to their photoconductive behavior.

Phosphate-solubilizing fungus (PSF) strain alaromyces funiculosus was investigated for phosphorus solubilization, utilizing a range of pH levels and phosphate sources, followed by data confirmation through artificial intelligence modeling. T. funiculosus strain was exposed to five different phosphate sources [Ca 3 (PO 4 ) 2 , FePO 4 , CaHPO 4 , AlPO 4 , and phytin] at different pH levels (4.5, 5.5, 6.5, 7.0, and 7.5). ANOVA, Pareto charts, and normal plots were used for analyzing the data. Artificial intelligence-based multilayer perceptron (MLP), random forest (RF) and extreme gradient boosting (XGBoost) models were used for data validation and prediction. Five-fold more phosphate (P) solubility by T. funiculosus was registered as compared to the control. The maximum soluble P was found at pH 4.5 (318324 ppb) and CaHPO 4 (444045 ppb). Combination of phytin × 4.5 pH yielded the highest dissolved phosphorus (1537988 ppb), followed by 127458 ppb from the control × 4.5 pH. Pareto chart and normal plot analysis showedthe negative impact of pH (B), pH × F/C (fungus/control) × P-Source (ABC), and F/C (A) factor. Whereas pH × P-Source (AC) and P-Source (C) has positive impact on P solubility. The maximum R 2 scores showed the order of RF (0.944) > MLP (0.938) > XGBoost (0.899). T. funiculosus strain has a grain potential for sustainable use for different types of phosphate sources. Application AI/ML models based on different performance metrics predicted the validated the attained results. In future research, it is recommended to check the efficacy of developed strategy under field conditions and to check the impact on soil and plant., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: It has been reported that 43.6% of ankle fractures are accompanied by posterior malleolus fractures. The aim of this study is to define a safe zone for posterior malleolus fractures by determining the locations of the important anatomical structures in this region. Additionally, it aims to identify the trans-Achilles passage line for Kirschner wire insertion through a posteroanterior approach for posterior malleolus fragments., Methods: Six below-knee amputee fresh-frozen leg cadavers were used in this study. A trans-Achilles Kirschner wire was applied to the cadavers in the posteroanterior direction under the guidance of fluoroscopy. The areas where the Kirschner wire passed were dissected, and their proximity to vital anatomical structures was measured., Results: In all cadavers, the transverse thickness of the Achilles tendon at the level of the trans-Achilles Kirschner wire was 15.5 mm and the trans-Achilles Kirschner wire application was 18.6 mm from the sural nerve, 16 mm from the posterior tibial tendon, and 12.16 mm from the flexor digitorum longus muscle. It was performed 15.16 and 14.6 mm from the posterior tibial artery and vein, 12.3 mm from the tibial nerve, 13.6 mm from the tibiofibular joint, and 55.5 mm from the insertion site of the Achilles tendon to the calcaneus and at a sufficient distance from vital anatomical structures., Conclusions: The proposed trans-Achilles percutaneous surgical technique is safe from neurovascular structures for fixing posterior malleolar fractures. However, the long-term clinical outcomes of this technique need to be explored., Level of Evidence: Level III, A cadaveric study., (© 2024. The Author(s).)

Objective: This study aimed to investigate the epidemiological, clinical, laboratory, and radiological characteristics of children diagnosed with Hashimoto's thyroiditis and to present the experiences of a referral center., Materials and Methods: This study included 200 pediatric patients diagnosed with Hashimoto's thyroiditis between January 2020 and May 2024 at a single center. The data were extracted and compiled from the participants' medical records, including clinical information, physical examination findings, laboratory test results, and radiological imaging., Results: Mean age of the study population was 11.3 ± 3.2 years at diagnosis, with a female predominance. At the time of clinical presentation, 8.5% of the study participants were 6 years of age or younger. The majority of patients, comprising 39.5% of the cohort, exhibited euthyroid thyroid function. Additionally, 33.5% of the patients were classified as having subclinical hypothyroidism, 22% demonstrated overt hypothyroidism, and 5% presented with hyperthyroidism. Approximately one-third of the study participants were referred for further evaluation due to the identification of abnormal thyroid function test results during routine screening examinations. 48% of the patients had a documented family history of thyroid disease. At diagnosis, 39.5% were prepubertal. The rate of overt hypothyroidism was higher in prepubertal patients compared to pubertal patients (41.8% vs. 9.1%, P < .005). Mean gland volume SDS was 2.61 ± 3.69, and 45.5% had goiter. Thyroid nodular lesions were identified in 5.5% of the study participants. Fine-needle aspiration biopsy was performed on five patients, revealing benign findings in three cases and atypia of undetermined significance in the remaining two cases., Conclusion: Patints with subclinical hypothyroidism who have a baseline TSH level exceeding 8.5 mIU/L at initial presentation and do not receive treatment are likely to progress to overt hypothyroidism during subsequent follow-up. Prepubertal cases were more frequently observed compared to previous reports, and the course of hypothyroidism was more severe in prepubertal patients. These findings suggest a potential shift towards earlier onset of autoimmunity in children. Further studies are warranted to substantiate this observation.

We present a challenging case at our facility involving a 70-year-old female with a history of hypertension who was diagnosed with malignant ovarian neoplasia. Preoperative imaging revealed a 6 x 6 x 2.5 cm mass in liver segment 6, initially suspected to be metastatic disease. The patient had undergone a laparoscopic cholecystectomy 11 years prior. Despite repeated biopsies and a high fluorodeoxy-glucose (FDG) uptake value of 9.87 on positron emission tomography-computed tomography (PET-CT), the exact nature of the mass remained undetermined. However, during a total abdominal hysterectomy and bilateral salpingo-oophorectomy, an excisional biopsy of the liver lesion identified it as an abscess formed around a gallstone, presumably spilled during the previous cholecystectomy. This case highlights a rare but significant diagnostic challenge, wherein a gallstone shed during gallbladder surgery mimicked a metastatic liver mass. It underscores the importance of considering a patient's surgical history in differential diagnoses, especially when encountering atypical abdominal masses.

Rationale: Bilateral distal clavicle fractures (BDCF) are exceedingly rare types of fractures. This study aimed to evaluate the surgical treatment under a single anesthesia for trauma-induced BDCF (Neer type II) through a case report., Patient Concerns: The patient brought to the emergency department due to a motor vehicle accident exhibited severe pain, tenderness, swelling, and deformity in both shoulder regions upon physical examination. No significant pain or tenderness was detected in other areas of the body. There were also no signs of additional neurological deficits or vascular pathology in the extremities., Diagnoses: Radiographic examinations led to a diagnosis of BDCF (Neer type II)., Interventions: Surgical intervention involved the simultaneous application of a neutral-angled hook plate to both clavicles via open reduction., Outcomes: Postoperative radiographs taken at the 12th week demonstrated complete healing in both fractures and no functional limitations in shoulder movements., Lessons: BDCF can compromise the stability of the shoulder girdle, necessitating surgical intervention with anatomical reduction and rigid fixation., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Fluorescent glucose sensors often utilize nanotechnology to detect glucose in a sensitive and targeted manner. Nanoscale materials increase the sensitivity and efficiency of sensors by better understanding and managing the properties and interactions of the structure to be sensed. Nitrogen-doped carbon quantum dots (N-CQD), which work with the concept of fluorescence quenching or switching on because of specific processes in the presence of glucose, are one type of nanoscale material added to these sensors. In the field of biological material identification, this state-of-the-art technology is recognized as a useful tool. In this work, copper nanostructure-supported nitrogen-doped carbon quantum dots (Cu@N-CQDs) were synthesized by the hydrothermal method. The shape and structure of the fabricated materials were characterized using fluorescence (FL) spectrophotometry, Fourier Transform Infrared spectroscopy (FT-IR), transmission electron microscopy (TEM), X-ray diffraction, and UV-visible spectrophotometry (UV-vis). The proposed sensor has a linear range of 0-140 μM and a limit of detection (LOD) of 29.85 μM, showing high sensitivity and selectivity for glucose sensing by FL. The developed sensor was successfully applied to detect glucose and demonstrated the potential of Cu@N-CQDs as promising candidates for designing sensors for glucose measurement., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Objective: To elucidate the effect of virtual reality video application on fistula puncture-associated pain in patients undergoing hemodialysis., Design: Attention controlled and assessor-blinded randomized trial., Materials and Methods: Attention controlled and assessor-blinded randomized trial was conducted 28 patients at the hemodialysis center of City Hospital. The patients in the intervention group ( n  = 14) participated in 12 hemodialysis sessions with virtual reality video application under the researcher's supervision. The patients in the control group ( n  = 14) received a 6-min training session on diet compliance. The Sociodemographic Form and Visual Analog Scale were used to collect data in person at various time points: baseline (t0), during the 1st to 12th hemodialysis sessions (t1-t12), and 1 week after implementation (t13)., Results: Virtual reality video application helped in effectively decreasing pain over time, as revealed by significant differences in the measurements at t1-t12 and t13 ( p  < 0.05). Time-based variations in within-group differences revealed that the median fistula puncture-associated pain values were significantly higher at baseline and t13 measurements in the intervention group ( p  < 0.05). In contrast, no significant differences were observed in the median fistula puncture-associated pain values in the control group ( p  < 0.05)., Conclusion: In patients undergoing hemodialysis, the application of virtual reality helps decrease fistula puncture-associated pain values. Advances in technology, particularly virtual reality, may play a vital role in shaping the future of healthcare., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: Familial Mediterranean Fever (FMF) is a hereditary autoinflammatory disease affecting both genders in reproductive age. In this study, we aimed to investigate the relation between FMF and pregnancy on both maternal and fetal aspects., Material and Methods: In this retrospective, single-center, descriptive study we analysed total of 95 pregnancies of 40 FMF patients. Clinical and demographic data were obtained from patients' records. To prevent recall bias, only the last pregnancy of each patient was evaluated for disease activity and use or revision of medications during pregnancy., Results: The median age of the patients at diagnosis was 22 and the first pregnancy age was 26 years. The median duration of FMF at last pregnancy was 8 (0-23) years. Eight (20%) patients had at least 1 pregnancy via assisted reproductive techniques (IVF), while 34 (85%) patients had at least 1 spontaneous pregnancy. While 32 patients were in remission (80%) before pregnancy, 8 were clinically active (20%). Improvement in clinical course and attack frequency during pregnancy was observed in 23 patients (57.5%), stable course in 10 (25.0%), and worsening in 7 (17.5%). The rate of live birth was 70.0%, abortus was 28.9%, preterm labor was 8.1%, pre-eclampsia was 5.0%, and only 1 achondroplasia as congenital fetal abnormality was observed., Conclusion: FMF did not constitute a contraindication for pregnancy. The most important obstetric problems, complications, and negative fetal outcomes in the course of pregnancy are increased IVF requirement, abortion, and cesarean rates. There is no increase in the risk of congenital malformations due to FMF itself or use of colchicine., Competing Interests: Declaration of competing interest No conflict of interest was declared by the authors and the study has not been presented in any platform before., (Copyright © 2024. Published by Elsevier B.V.)

In this study, the effects of chitosan-coating on maintaining the integrity and stability of the membrane, structural, and morphological changes, and the release of loaded peptides inside nanoliposomes during various in vitro release, thermal, freeze-thaw, shear, and dehydration (spray-drying) tensions were evaluated. Among different peptidic fractions (100, 30, and 10 kDa), the Arthrospira derived PF-30 kDa showed a higher nutritional and biological value. PF-30kDa was loaded successfully (EE ~ 90 %) inside nanoliposomes (NLs) and its stabilization was done with chitosan coating (0.1-0.8 %). Nanochitosomes (NCs-0.4 %) had more structural stability (size, EE, and biological activity) at different temperatures, freeze-thaw tension, and digestive system. The placement of peptides in the vesicle structure was confirmed by FTIR analysis. Also, the changes in the morphological states, agglomeration, or destruction of the liposome membrane (SEM, AFM, and TEM) were evaluated before and after the tensions. Membrane coating led to the transformation of freeze-dried liposomes (FD-NLs) from thin, porous, and fragile layers to thick plates, rough and resistant structures (FD-NCs). These characteristics led to maintaining physical stability, homogeneity, zeta potential, and EE of nanoparticles (freeze and spray-dried) after reconstitution. The results of this study will effectively contribute to the production of solidified delivery systems with long-term durability, bioavailability, and biological activity of loaded nutrients and drugs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The current study focused on optimizing the extraction parameters of terebinth seed proteins from cold-pressed terebinth oil byproducts to maximize protein purity and protein yield. The isolated proteins were characterized to evaluate their properties; thus revealing the valorization potential of these byproducts. Response surface methodology was used to detect the effect of three extraction parameters (pH, temperature, and time). The protein isolates were studied for their physicochemical and functional characteristics. The results indicated that an extraction pH of 8, a temperature of 50°C, and an extraction period of 60 min are optimum conditions for obtaining protein isolates with the highest purity. On the other hand, it was demonstrated that an extraction pH of 12, a temperature of 46.4°C, and an extraction duration of 102.4 min were optimum conditions for the maximum protein yield. The proteins produced under these two sets of conditions, referred to as TRP (terebinth protein with maximum purity) and TRY (terebinth protein with maximum yield), respectively, exhibited comparable oil absorption capacity (OAC), foaming, emulsifying capabilities, and stability. Both proteins showed the highest solubility at pH 11, and their zeta potentials approached zero at pH 4, indicating proximity to their isoelectric points. However, FRAP and DPPH assays showed that TRP and TRY offered low antioxidative capacity. The high β-sheet content in TRP and TRY suggests enhanced thermal stability but reduced digestibility of these proteins. Therefore, in addition to protein enrichment, TRP and TRY protein isolates can be utilized in muffins and other food applications thanks to their favorable oil absorption, foaming and emulsifying capacities, and thermal stabilities., (© 2024 The Author(s). Journal of Food Science published by Wiley Periodicals LLC on behalf of Institute of Food Technologists.)

Objective: Despite advances, myelomeningocele remains a major cause of mortality and disability. This study aims to analyze factors influencing mortality and suggest ways to reduce it., Methods: We reviewed 173 patients who underwent surgery for myelomeningocele from January 2010 to December 2021. Variables affecting mortality were categorized into patient-related and indirectly related factors. Data were collected through patient file reviews and phone interviews with parents., Results: Mortality is influenced by multiple factors: female gender (3.2-fold increase), paraplegia (3.1-fold increase), absence of tethered cord release surgery (9.4-fold increase), scoliosis (4.2-fold increase), and renal failure (5.28-fold increase). Defect size and father's education level also significantly impact mortality. The overall mortality rate was 20.8 %, with hydrocephalus being the leading cause., Conclusion: Mortality and disability in myelomeningocele patients remain high, with over 50 % of deaths being preventable. Effective management could significantly improve mortality rates. Long-term studies are crucial for advancing research in this field., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Biobanking of tissue from clinically obtained kidney biopsies for later analysis with multiomic approaches, such as single-cell technologies, proteomics, metabolomics, and the different types of imaging, is an inevitable step to overcome the need of disease model systems and toward translational medicine. Hence, collection protocols that ensure integration into daily clinical routines by the usage of preservation media that do not require liquid nitrogen but instantly preserve kidney tissue for both clinical and scientific analyses are necessary. Thus, we modified a robust single-nucleus dissociation protocol for kidney tissue stored snap-frozen or in the preservation media RNAlater and CellCover. Using at first porcine kidney tissue as a surrogate for human kidney tissue, we conducted single-nucleus RNA sequencing with the widely recognized Chromium 10X Genomics platform. The resulting datasets from each storage condition were analyzed to identify any potential variations in transcriptomic profiles. Furthermore, we assessed the suitability of the preservation media for additional analysis techniques such as proteomics, metabolomics, and the preservation of tissue architecture for histopathological examination including immunofluorescence staining. In this study, we show that in daily clinical routines, the preservation medium RNAlater facilitates the collection of highly preserved human kidney biopsies and enables further analysis with cutting-edge techniques like single-nucleus RNA sequencing, proteomics, and histopathological evaluation. Only metabolome analysis is currently restricted to snap-frozen tissue. This work will contribute to build tissue biobanks with well-defined cohorts of the respective kidney disease that can be deeply molecularly characterized, opening up new horizons for the identification of unique cells, pathways and biomarkers for the prevention, early identification, and targeted therapy of kidney diseases. NEW & NOTEWORTHY In this study, we addressed challenges in integrating clinically obtained kidney biopsies into everyday clinical routines. Using porcine kidneys, we evaluated preservation media (RNAlater and CellCover) versus snap freezing for multi-omics processing. Our analyses highlighted RNAlater's suitability for single-nucleus RNA sequencing, proteome analysis and histopathological evaluation. Only metabolomics are currently restricted to snap-frozen biopsies. Our research established a cryopreservation protocol that facilitates tissue biobanking for advancing precision medicine in nephrology.

Background: Avian species have played a pivotal role in developmental hematopoiesis research, leading to numerous critical discoveries. Avian influenza, particularly the H5N1 strain, poses a significant threat to poultry and has zoonotic potential for humans. Infections often result in abnormal hematologic profiles, highlighting the complex interplay between avian diseases and hematopoiesis. Many avian diseases can suppress immune cells in the bone marrow (BM), impacting immune responses. Studying hematopoietic stem cells (HSCs) in avian BM is crucial for understanding these processes and developing effective vaccines and protection strategies for both avian and human health., Methods: This study adapted methods from mouse studies to isolate avian HSCs as Lineage-negative (Lin-) cells. These isolated cells were further identified as Lin-Sca1+c-Kit+ (LSK) and were found to be more prevalent than in control groups. RT-PCR analyses were conducted, showing that genes like MEIS1 and TSC1 were upregulated, while SIRT1, FOXO1, and AHR were downregulated in these stem cells. Screening for LSK markers revealed ten unique surface antigens in the Sca1+c-Kit+ cell populations, including highly enriched antigens such as CD178, CD227, and CD184. Additionally, studies on quail HSCs demonstrated that similar labeling techniques were effective in quail BM., Results: The research demonstrated that the identification of avian HSC-specific surface antigens provides valuable insights into the pathogenesis of avian influenza and other diseases, enhancing our understanding of how these diseases suppress HSC function. Notably, the upregulation of MEIS1 and TSC1 genes in LSK cells underscores their critical roles in regulating hematopoietic processes. Conversely, the downregulation of SIRT1, FOXO1, and AHR genes provides important clues about their roles in differentiation and immune response mechanisms., Discussion: The findings of this study deepen our understanding of the effects of avian diseases on the immune system by identifying surface markers specific to avian HSCs. The suppression of HSC function by pathogens such as influenza highlights the importance of understanding these cells in developing targeted vaccines. These results represent a significant step towards improving global health security by mitigating risks associated with avian pathogens., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: Inflammatory low back pain (IBP) is a typical feature of spondylarthritis (SpA). IBP can be caused by infections, drugs, and different malignancies. Among cancers, hematologic malignancies and solid tumors can cause IBD either paraneoplastically or through metastasis. In this study, we aimed to present the demographic and clinical characteristics of our patients who presented with IBP in the last 10 years and whose final diagnosis was malignancy., Methods: Thirty-four patients who presented with inflammatory low back pain in the last 10 years and were diagnosed with malignancy as the final diagnosis were included in the study. Thirty-six patients, diagnosed as axial SpA, with similar age-sex ratio of 1:1 from each center were included as the control group., Results: Hematologic malignancies were multiple myeloma, acute leukemia, and lymphoma in descending order. Solid tumors were breast cancer, lung cancer, bone tumors, prostate, colon, embryonal carcinoma, and malignancy of unknown primary. In malignancy-related low back pain, the hematologic/solid ratio was similar (18/16), the interval between symptom and diagnosis was shorter, and biomarkers' results such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum lactate dehydrogenase (LDH) levels were significantly higher than the control group., Conclusion: Malignancy-related low back pain differs from SpA patients with a more severe clinical picture, higher acute phase reactants levels, and higher LDH values. Malignancies must be kept in mind in the differential diagnosis, and in order to validate our findings, the results of larger case series are needed, especially in terms of causative malignancies. Key Points • In malignancy-related inflammatory low back pain, the hematologic/solid ratio was similar, the interval between symptom and diagnosis was shorter, and acute phase reactant levels and LDH levels were significantly higher. • Malignancy-related inflammatory low back pain differs from axial SpA patients with a more severe clinical picture, higher acute phase reactants levels, and higher LDH values. • Malignancies must be kept in mind in the differential diagnosis of axial SpA., (© 2024. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)

Objective: Human sexual dimorphism in physical strength manifests itself in men having a greater muscle mass than women, reflecting ancestral roles in competition, protection, and provisioning. Prenatal testosterone exposure, approximated via the second-to-fourth digit ratio (2D:4D), is linked to increased muscular strength in both sexes, indicating a developmental influence. Previous research has shown that both physical strength and 2D:4D have facial shape correlates, especially in men, but most studies have focused on Western populations and one trait. We therefore hypothesized a broader relationship between facial shape and both physical strength and 2D:4D., Materials and Methods: In this study, we quantified the association between facial shape, handgrip strength (HGS), and 2D:4D in a non-Western Turkish sample (72 men, 55 women; Md = 22 y, SIR = 1.8 y) using two dimensional geometric morphometrics. Thirty-eight somatometric and 32 semi-landmarks were digitized on facial photographs taken in frontal view. Physical strength was assessed via handgrip strength (HGS), and the second digit length was divided by the fourth digit length to calculate 2D:4D., Results: Both HGS and 2D:4D were significantly associated with shape in both sexes, but only in men did they explain a significant amount of facial variation. Thin-plates spline deformation grids and geometric morphometric morphs visualized the facial shape changes related to variations in handgrip strength, 2D:4D, and sexual dimorphism, enabling trait comparisons., Conclusion: This study contributes a comparative sample from the Middle East, which is indispensable to discern universalities from Western peculiarities. It provides evidence to better understand the biological basis of facial traits, which can potentially serve as increasingly relevant social cues in today's online and digital environments., (© 2024 The Author(s). American Journal of Human Biology published by Wiley Periodicals LLC.)

Objective: To evaluate the accuracy and determine the factors influencing trauma CT interpretation proficiency among emergency medicine (EM) residents in Turkey through the TraCT-EM study (Interpretation of Trauma CT by EMergency Physicians)., Methods: This nationwide, multicenter, cross-sectional study was conducted in 29 academic emergency departments (EDs) from April 2023 to March 2024. A total of 401 senior EM residents participated in the study, each interpreting a standardized set of 42 trauma CT series (cranial, maxillofacial, and cervical) derived from seven patients. Interpretation accuracy was assessed, and factors predicting interpretation failure were analyzed using univariate and multivariate regression models., Results: The median accuracy rate of residents was 64.9 %, with higher accuracy in normal CT findings. Using the Angoff method, 14 % of residents scored below the passing threshold. Factors associated with interpretation failure included shorter interpretation times (OR, 0.97; 95 % CI, 0.95-0.99), lower self-confidence in detecting serious pathologies (OR, 2.50; 95 % CI, 1.42-4.42), reliance on in-hospital radiology department reports (OR, 3.45; 95 % CI, 1.47-8.05), and receiving final radiology reports for CT scans (OR, 3.30; 95 % CI, 1.67-6.52), and lack of in-department training programs (OR, 2.51; 95 % CI, 1.34-4.70)., Conclusion: The TraCT-EM study highlighted a 65 % accuracy rate for senior EM residents in trauma CT interpretation, with specific predictors of failure identified. These findings suggest a need for tailored radiology education strategies to enhance training and competency in trauma CT interpretation for EM residents. Further optimization of educational programs could address these gaps, ultimately improving patient outcomes in trauma care., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Synthesis of novel agro-industrial wastes/sodium alginate/bovine gelatin-based polysaccharide hydrogel beads, micromeritic/morphometric characteristics of the prepared formulations, greenhouse trials using controlled-release microencapsulated fertilizers, and acute fish toxicity testing were conducted simultaneously for the first time within the scope of an integrated research. In the present analysis, for the first time, 16 different morphometric features, and 32 disinct plant growth traits of the prepared composite beads were explored in detail within the framework of a comprehensive digital image analysis. The hydrogel beads composed of 19 different agro-industrial wastes/materials were successfully synthesized using the ionotropic external gelation technique and CaCl 2 as cross-linker. According to micromeritic characteristics, the ionotropically cross-linked beads exhibited 77.86 ± 3.55 % yield percentage and 2.679 ± 0.397 mm average particle size. The dried microbeads showed a good swelling ratio (270.02 ± 80.53 %) and had acceptable flow properties according to Hausner's ratio (1.136 ± 0.028), Carr's index (11.94 ± 2.17 %), and angle of repose (25.03° ± 5.33°) values. The settling process of the prepared microbeads was observed in the intermediate flow regime, as indicated by the average particle Reynolds numbers (169.17 ± 82.81). Experimental findings and non-parametric statistical tests reveal that dried fertilizer matrices demonstrated noteworthy performance on the cultivation of red hot chili pepper plant (Capsicum annuum var. fasciculatum) according to the results of greenhouse trials. Surface morphologies of the best-performing fertilizer matrices were also characterized by Scanning Electron Microscopy. Moreover, the static fish bioassay experiment confirmed that no abnormalities and acute toxic reactions occurred in shortfin molly fish (Poecilia sphenops) fed with dried leaves of red hot chili pepper plants grown with formulated fertilizers. This study showcased a pioneering investigation into the synthesis of microcapsules using synthesized hydrogel beads along with digital image processing for bio-waste management and sustainable agro-application., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background and Purpose: It was aimed to investigate the effects of massage with or without aromatherapy given to patients after colorectal cancer surgery on symptom management in the first three postoperative days., Materials and Methods: This study was carried out with a pretest-posttest randomized controlled design. The study included the aromatherapy massage group (AG; n = 30), the classical massage group (MG; n = 30), and one control group (CG; n = 30). A blend of sweet almond oil, lavender, chamomile, and ginger oil was used in AG. Massage was applied to the foot area, and 20 min of classical massage was performed. Before the pretest, the participants were blinded by not informing them about their group allocations. The analyses were carried out using parametric methods., Results: Postoperative pain varied significantly over time in all three groups (AG: p = 0.007; η 2  = 0.150/MG: p = 0.008; η 2  = 0.559/CG: p = 0.017; η 2  = 0.132). Anxiety was found to differ between CG and AG and between CG and MG (p < 0.05). In all three groups, nausea-vomiting scores significantly decreased over time (AG: p = 0.002; η 2  = 0.211/MG: p = 0.004; η 2  = 0.164/CG: p = 0.021; η 2  = 0.125). Sleep quality was significantly higher in the massage groups than in the control group only on the second postoperative day (p = 0.011)., Conclusion: Aromatherapy massage had no significant effect on pain, fatigue, nausea, or vomiting compared to MG and CG, and sleep quality was higher in the massage groups compared to CG only on the second postoperative day. On the first three postoperative days, the post-intervention anxiety levels of AG and MG were lower than those of CG., Clinicaltrials: GOV.ID: NCT04810299., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: This study aimed to investigate the fetal modified (mod)-myocardial performance index (MPI) for fetal cardiac function in placenta percreta (PPC) pregnancies with placenta previa (PP) and assess neonatal outcomes., Materials and Methods: This study included 104 pregnant women: 52 with PPC and 52 as the control group. Mod-MPI measurements and neonatal outcomes were evaluated in all cases., Results: The PPC group had a significantly lower left ejection time (p = 0.044) and significantly higher mod-MPI (p = 0.001) than the control group. The optimal mod-MPI predictive cut-off value at the neonatal intensive care unit (NICU) admission in the PPC group was 0.53 with 53.8% specificity and 88.5% sensitivity (p = 0.019). The optimal mod-MPI predictive cut-off value at the 5th APGAR score below 7 in the PPC group was 0.55 with a specificity of 67.7% and a sensitivity of 76.2% (p = 0.016)., Conclusion: Fetal MPI was higher in pregnant women with PPC compared to the control group. Among the PPC cases, those with MPI above a certain predictive level showed more frequent NICU admissions and lower APGAR scores., (© 2024 Wiley Periodicals LLC.)

Background: Nijmegen breakage syndrome (NBS) is an autosomal recessive DNA repair disorder that manifests through increased genomic instability, malignancy, and cellular and humoral immunodeficiencies. The prognosis for NBS patients is poor due to their increased susceptibility to fatal infections and lymphoproliferative malignancies. Currently, there is no specific treatment for NBS, though allogeneic hematopoietic stem cell transplantation (HSCT) has been performed and documented as case series to demonstrate the utility of transplantation., Methods: A 14-year-old girl with NBS and haploidentical HSCT from her older brother due to recurrent lung infection was referred for liver transplantation (LT) due to liver cirrhosis, hepatopulmonary syndrome (HPS), and suspicion of liver malignancy. It was decided to perform LT using the living donor who had previously donated for HSCT., Results: Living donor left lobe LT was successfully performed from her brother. The patient experienced no complications in the early postoperative period and was discharged on the seventh postoperative day. Pathological examination of extracted liver has shown "intermediate cell carcinoma" in two foci. After 1 year LT, the patient has had an uneventful course in terms of LT complications and infection, with minimal immunosuppression., Conclusions: NBS patients have an increased prevalence of malignancies, including primary hepatic malignancy, but most are managed medically or with limited resections. Transplantation in these patients can be curative for hepatic malignancy with a favorable safety profile., (© 2024 Wiley Periodicals LLC.)

Aim: In our study, we aimed to investigate the value of fetal epicardial fat thickness (EFT) and modified myocardial performance index (mod-MPI) in fetal growth restriction (FGR) that develops after the 32nd week of gestation., Materials and Methods: Fifty-six pregnant women who met the inclusion and exclusion criteria were included in the study and were divided into two groups: pregnancies diagnosed with FGR after the 32nd week of gestation (FGR group) and those without (control group). Demographic and obstetric histories, ultrasonographic and clinical characteristics, fetal EFT and mod-MPI values, and neonatal outcomes of the groups were recorded, and comparisons were made between the groups. Additionally, the diagnostic performance of fetal EFT value in late FGR was investigated., Results: The FGR group had fetal EFT that was statistically significantly lower (1.11 ± 0.21 vs. 1.34 ± 0.23, p = 0.001). The FGR group had a significantly lower isovolumetric contraction time (ICT) (31.04 ± 6.88 vs. 35.14 ± 7.58, p = 0.048). The two groups' isovolumetric relaxation time (IRT), ejection time (ET), and mod-MPI values (p values 0.871, 0.55, and 0.750, respectively) were comparable. Receiver operating characteristic (ROC) analysis at a cutoff of 1.2 revealed 76.1% sensitivity and 74.2% specificity, respectively, for the diagnostic performance of the fetal EFT value in late-onset FGR. There was a positive predictive value (PPV) and negative predictive value (NPV) of 64.0% and 83.8%, respectively., Conclusion: We found that fetal EFT was significantly lower in FGR and may be useful in diagnosing FGR. However, we observed that mode-MPI did not change in FGR., (© 2024 Wiley Periodicals LLC.)

Purpose: To assess corneal sensitivity and the ocular surface in patients undergoing primary femtosecond laser in situ keratomileusis (FS-LASIK) and those undergoing FS-LASIK retreatment under the same flap due to residual refractive error., Setting: Ekol Eye Hospital, Izmir, Turkey., Design: Prospective case series., Methods: 19 patients with previous FS-LASIK who had myopic and astigmatic refractive error were included in the study group, and 19 age-matched and sex-matched patients undergoing FS-LASIK for the first time as the control group. Corneal sensitivity, Schirmer test, tear film break-up time (TBUT), Oxford grading scheme for ocular surface staining, and Ocular Surface Disease Index (OSDI) were measured preoperatively and at postoperative 1 week and 1, 3, and 6 months., Results: The mean refractive correction in the study and control groups, respectively, was 2.18 ± 0.78 diopters (D) (range: 1.00 to 3.50) and 2.76 ± 1.20 D (range: 1.00 to 4.50; P = .07). Corneal esthesiometry results in the study and control groups, respectively, were 6.10 ± 12.55 vs 9.90 ± 11.50 mm at 1 week ( P = .001), 41.95 ± 6.98 vs 45.09 ± 5.88 mm at 1 month ( P = .004), 56.09 ± 3.37 vs 56.19 ± 2.52 mm at 3 months ( P = .8), and 58.60 ± 2.01 vs 58.80 ± 1.39 mm at 6 months ( P = .5). Significant difference between the 2 groups in Schirmer test score that disappeared at postoperative 3 months and in TBUT and ocular surface staining that disappeared at 6 months, whereas the statistically significant difference in OSDI score persisted at 6 months ( P = .03) was detected., Conclusions: Corneal surface sensitivity and ocular surface health are more impaired in patients undergoing FS-LASIK retreatment due to residual refractive error., (Copyright © 2024 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)

The prognosis of patients with advanced HCC can vary widely depending on factors such as the stage of the cancer, the patient's overall health, and treatment regimens. This study aimed to investigate survival outcomes and associated factors in patients with hepatocellular carcinoma (HCC). In this retrospective study, data from 23 medical oncology clinics were analyzed. Progression-free survival (PFS) and overall survival (OS) values were estimated using the Kaplan-Meier method. Prognostic factors associated with survival which were identified in univariate analysis were subsequently evaluated in a multivariate Cox-regression survival analysis was conducted using the backward stepwise (Conditional LR) method to determine the independent predictors of PFS and OS. Of 280 patients, 131 received chemotherapy and 142 received sorafenib, 6 received atezolizumab plus bevacizumab and 1 received nivolumab for first-line setting. The median follow-up time was 30.4 (95%CI 27.1-33.6) months. For-first line, median PFS was 3.1 (95%CI2.7-3.5) months, and it was significantly longer in patients who received sorafenib or atezolizumab-bevacizumab or nivolumab (PFS 5.8 (95%CI 4.2-7.5) than in those received chemotherapy (PFS 2.1 (95%CI 1.9-2.3) in the first-line setting (p < 0.001). Multivariate analysis revealed that male gender (HR: 2.75, 95% CI: 1.53-4.94, p = 0.01), poor ECOG performance score (HR: 1.88, 95% CI: 1.10-3.21, p = 0.02), higher baseline AFP level (HR: 2.38, 95% CI: 1.54-3.67, p < 0.001) and upfront sorafenib treatment (HR,0.38; 95% CI: 0.23-0.62, p < 0.001) were significantly associated with shorter PFS. The median OS was 13.2 (95%CI 11.1-15.2) months. It was significantly longer in patients who received sorafenib or atezolizumab-bevacizumab or nivolumab in the first-line setting followed by TKIs (sorafenib or regorafenib, OS 18.6 (95%CI 13.8-23.5)) compared to those who received chemotherapy (OS 10.3 (95%CI 6.6-14.1)) in the first-line setting. The multivariate analysis revealed that upfront chemotherapy treatment approach, male gender (HR: 1.77, 95% CI: 1.07-2.94, p = 0.02), poor ECOG performance score (HR: 1.96, 95% CI: 1.24-3.09, p = 0.004) and Child-Pugh score, presence of extrahepatic disease (HR: 1.54, 95% CI: 1.09-2.18, p = 0.01), and higher baseline AFP value (HR: 1.50, 95% CI: 1.03-2.19, p = 0.03) were significantly associated with poor prognosis. Additionally, regarding of treatment sequence, upfront sorafenib followed by regorafenib showed a significantly lower risk of mortality (HR: 0.40, 95% CI: 0.25-0.66, p < 0.001). Sorafenib followed by regorafenib treatment was associated with a significantly lower risk of mortality rather than upfront sorafenib followed by BSC group or upfront chemotherapy followed by TKIs. These findings underscore the importance of the optimal treatment sequences to improve survival in patients with advanced HCC.

Objective: Saphenous vein graft disease (SVGD) remains a challenging issue for patients with coronary artery bypass grafting (CABG). It is associated with poor outcomes and atherosclerosis is the major cause of SVGD. Uric acid to albumin ratio (UAR) is a new marker which associated with cardiovascular mortality. We aim to evaluate the relationship between the SVGD and UAR., Methods: We retrospectively enrolled 237 patients who underwent elective coronary angiography (CAG) for stable angina or positive stress test results >1 year after CABG. The patients were divided into two groups; SVGD (+) patients and SVGD (-) patients. The SVGD was defined as presence of at least 50% stenosis in at least 1 SVG., Results: UAR were significantly higher in the SVGD (+) group ( P  < 0.001). Similarly, Hs-CRP, white blood cell count, and neutrophil count were significantly higher in SVGD (+) group ( P  = 0.03, P  = 0.027 P  = 0.01, respectively). In multivariate logistic regression analysis, time interval after CABG [OR = 1.161, 95% confidence interval (CI) 1.078-1.250; P  < 0.001] and UAR (OR = 2.691, 95% CI 1.121-6.459; P  < 0.001) were found to be independent predictors of SVGD., Conclusion: Our results suggested that UAR could be a simple and available marker to predict SVGD in patients with CABG who underwent elective percutaneous coronary intervention., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: To conduct a translation and validation study of the Chronic Orchialgia Symptom Index (COSI), which has 12 questions in three domains pain (P), sexual symptoms (SS), and quality of life (QoL), in the Turkish language., Material and Methods: The study included a total of 175 patients diagnosed with chronic scrotal content pain (CSCP) between January 2023 and January 2024. In addition to demographic data, the scores obtained on the COSI questionnaire and Visual Analog Scale (VAS) were recorded. Internal consistency was assessed using Cronbach alpha coefficients. Reliability was evaluated using the test-retest correlation method., Results: The mean age of the patients was 37.2 ± 14.1 years and the median (IQR) duration of pain was 5.5 (9) months. The median total COSI score was determined as 13 (13) and the median subscores were 7 (7) for P, 1 (2) for SS, and 5 (6) for QoL. The test-retest correlation coefficient for each item was determined to be higher than r  = 0.80 ( p  < 0.001). The Cronbach alpha values for the subscores were 0.80 for P, 0.71 for SS, and 0.80 for QoL. There was determined to be a statistically significant positive correlation between the VAS score and the COSI P, SS, QoL, and total scores ( r : 0.63, p  < 0.001; r  = 0.32, p  < 0.001; r  = 0.56, p  < 0.001; r  = 0.59, p  < 0.001, respectively). The optimal cutoff point of the COSI total score was determined to be 16.5 points (AUC:0.77, p  < 0.001) for the determination of patients experiencing severe pain (⩾ 7.5) according to the VAS score., Conclusion: The Turkish version of the COSI questionnaire is a valid, reliable, and repeatable questionnaire that can be used to evaluate the effects of symptom severity in patients with CSCP., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Aim: The main aim of this study was to evaluate the effectiveness of 18 F-fluorodeoxyglucose ( 18 FDG) positron emission tomography/computerized tomography (PET/CT) parameters in predicting the Kristen rat sarcoma viral oncogene( KRAS ) mutation status of patients with colon cancer. Materials and Methods: Between April 2013 and December 2020, 79 patients who were diagnosed with colon cancer by colonoscopy underwent staging 18 FDG PET/CT with this diagnosis and met all the inclusion criteria were included in this study. Clinical and prognostic features and also imaging ( 18 FDG PET/CT and magnetic resonance imaging) reports of the patients were collected and analyzed retrospectively. Results: KRAS mutation was seen in 32 of patients (40.5%). No significant difference was observed between KRAS mutant and wild-type patients in terms of clinical features (tumor location, findings regarding metastasis, T stage, and tumor differentiation grade in patients who underwent surgery) and overall survival. Progression-free survival was significantly shorter in KRAS mutant patients ( p = 0.018). Primary tumor standardized uptake value (SUV mean ) was significantly higher in KRAS mutant cases in the whole group ( p = 0.024) and in patients in whom KRAS analysis was performed only in the primary lesion ( p = 0.036). The cutoff value for predicting KRAS mutation status was 7.01 g/mL (area under the curve [AUC]: 0.650, confidence interval [CI] 95%, 0.56-0.74). Conclusions: When colon and rectal cancer cases were evaluated separately, the primary tumor SUV mean value was significantly higher in KRAS mutant colon cancer cases. However, its effectiveness in predicting KRAS mutation status was low, similar to other parameters in the literature.

Objective: We aimed to investigate differences between HPV-16 mono- and HPV-16/18 co-infections in terms of cervical dysplasia and invasive cancer., Methods: This multicentre, retrospective study spanned from December 2017 to December 2020, involving women who visited gynaecological oncology clinics for colposcopy with either HPV-16 or HPV-16/18 positivity. A total of 736 patients, 670 in Group 1 (HPV-16 positivity) and 66 in Group 2 (HPV-16/18 positivity), were compared for the presence of CIN2+ lesions detected by colposcopic biopsy or endocervical curettage (ECC). Exclusions included hysterectomized patients, those with prior gynaecological cancers, and patients with HPV positivity other than types 16 and 18., Results: Among the included patients, 42.4% had a diagnosis of CIN2+ lesions. The cytology results demonstrated abnormal findings in 45.3% in Group 1 and 42.2% in Group 2, with no significant difference between the groups. ECC revealed CIN2+ lesion in 49 (8.7%) patients in group 1, while only 1 (1.7%) patient had CIN2+ lesion in group 2. There was no difference between 2 groups in terms of ECC result (p = 0.052). In group 1, 289 (43.1%) patients had CIN2+ lesion, while 23 (34.8%) patients had CIN2+ lesions in group 2. There was no difference between group 1 and 2 in terms of diagnosis of CIN2+ lesions (p = 0.19)., Conclusion: This multicentre retrospective study found no significant differences between HPV-16 mono- and HPV-16/18 co-infections regarding cervical pathologies. Larger studies are needed to validate and further explore these findings., (© 2024 John Wiley & Sons Ltd.)

High-fructose corn syrup (HFCS) has been a subject of intense debate due to its association with cardiovascular risks. This study investigates the potential protective effects of selenium (Se) supplementation against cardiac damage induced by HFCS. Thirty-two male Wistar albino rats were divided into four equal groups: control, CS (20%-HFCS), CS with Se (20%-HFCS, 0.3 mg/kg-Se), and Se (0.3 mg/kg-Se) only. After a 6-week period, heart and aorta tissues were collected for histopathological, immunohistochemical, biochemical, and genetic analyses. HFCS consumption led to severe cardiac pathologies, increased oxidative stress, and altered gene expressions associated with inflammation, apoptosis, and antioxidant defenses. In the CS group, pronounced oxidative stress within the cardiac tissue was concomitant with elevated Bcl-2-associated X protein (Bax) expression and diminished expressions of B-cell-lymphoma-2 (Bcl-2), nuclear factor erythroid 2-related factor 2 (Nrf2), peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC1-α), and silenced information regulator 1 (SIRT1). Se supplementation mitigated these effects, showing protective properties. Immunohistochemical analysis supported these findings, demonstrating decreased expressions of caspase-3, tumor necrosis factor-alpha (TNF-α), IL-1β, and vascular endothelial growth factor (VEGF) in the CS + Se group compared to the CS group. The study suggests that Se supplementation exerts anti-inflammatory, antioxidant, and antiapoptotic effects, potentially attenuating HFCS-induced cardiovascular toxicity. These findings highlight the importance of dietary considerations and selenium supplementation in mitigating cardiovascular risks associated with HFCS consumption., (© 2024. The Author(s).)

Background: This study sought to examine the effect of antithrombotic use on clinical outcomes in non-variceal upper gastrointestinal bleeding (UGIB)., Methods: Patients consecutively diagnosed with non-variceal UGIB between February 2019 and September 2020 were divided into two groups based on their antithrombotic use: users and non-users. Using propensity score matching (PSM) and multivariable regression analyses, the impact of antithrombotic use prior to UGIB presentation on clinical outcomes was examined., Results: In the entire cohort, there were 210 and 260 patients in the antithrombotic user and non-user groups, respectively. Using PSM analysis with seven covariates, two matched groups of 157 patients were created at a 1:1 ratio. In the matched cohort, despite their longer hospital stays and a higher rate of intensive care unit admissions, the patients in the user group had lower 30- and 90-day mortality rates (4.5% vs. 14.0 %; p = 0.003 and 8.9% vs. 18.5 %; p = 0.014, respectively). In the entire cohort, multivariable analyses adjusted for confounding factors revealed that antithrombotic use was associated with lower risks of in-hospital (adjusted OR: 0.437; 95 % CI: 0.191-0.999), 30-day (adjusted OR: 0.261; 95 % CI: 0.099-0.689), and 90-day (adjusted OR: 0.386; 95 % CI: 0.182-0.821) mortality., Conclusion: Antithrombotic use prior to UGIB presentation was found to be an independent protective factor for all-cause mortality., Competing Interests: Conflict of interest The authors have no conflict of interest to disclose., (Copyright © 2024 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

The prevalence of concomitant deep vein thrombosis (DVT) and its impact on 30-day outcomes in Hispanic patients with acute pulmonary embolism (PE) is unknown. We retrospectively studied a cohort of Hispanic patients admitted for acute PE to determine the relationship of concomitant DVT to clot burden on chest computer tomography (CT), right heart strain, and 30-day mortality. We identified 391 patients admitted with acute PE; 168 (42.9%) had concomitant DVTs on admission; 39 patients (9.9%) died during the 30-day follow-up: 12 patients without concomitant DVT and 27 with concomitant DVT, respectively ( p < .001). The presence of a proximal DVT independently predicted 30-day mortality even after adjusting for age, gender and admission PE severity index scores (PESI) (hazard ratio [HR] 2.0; 95% confidence interval [CI]: 1.4-3.0, p = .001). Proximal DVTs remained a significant predictor of 30-day mortality in patients with low and intermediate PESI scores (HR 2.5; 95% CI: 1.1-6.0, p = .035). The prevalence of concomitant DVT in Hispanic patients presenting with acute DVT is relatively lower than other ethnic groups. However, a proximal location of a DVT is of significant prognostic relevance. Hispanic patients with acute PE should routinely undergo compression doppler ultrasonography (CDUS) of the lower extremities., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: The aim of this study was to investigate the demographic and molecular characteristics, overall survival (OS), cancer-specific survival (CSS), and prognostic factors affecting the survival of patients with single primary breast cancer (SPBC) and patients with multiple primary cancers in their life time in which one of them is breast cancer (MPC)., Methods: Using data from SEER 17 Research Plus, patients with breast cancer diagnosed between 2010 and 2019 were included in this study. Race, marital status, laterality, tumor size, molecular subtype, grade, stage, radiotherapy-chemotherapy treatment, and surgery data were analyzed in the data obtained after excluding patients with missing values. Kaplan-Meier survival analysis was used for survival analysis, and Cox regression analysis was used to evaluate the prognostic factors., Results: 573175 patients were included in the study. The mean age of MPC patients was significantly higher than SPBC patients (65.99 ± 12.68, 60.33 ± 13.47, P < .001, respectively). Patients with SPBC had significantly more hormone receptor (HR)-positive/Her2 positive, HR-negative/Her2-negative, and HR-negative/Her2-positive molecular subtypes; patients with MPC had more HR-positive/Her2-negative subtypes ( P < .001). Grade 3 tumor status, locoregional spread, and distant metastasis were significantly higher in SPBC patients ( P < .001). Overall survival and CSS rates were significantly higher in SPBC patients ( P < .001). In MPC patients, overall hazard ratio was 1.631 times higher than SPBC, and the cancer-specific hazard ratio was 1.096 times higher (95% CI [1.606-1.656], 95% CI [1.071-1.121], respectively)., Conclusion: Although patients with SPBC have worse prognostic tumor characteristics, OS and CSS rates are better than patients with MPC., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.