Search

Objective: To produce a bibliographic source by compiling the most-cited articles about stress urinary incontinence to guide researchers for novel research topic ideas in urogynecology., Study Design: We analyzed 200 most-cited articles (T200) between 1995-2022 by reviewing the Institution for Scientific Information (ISI) - Web of Science (WOS) and PubMed databases about the stress urinary incontinence. The time span-effect of publications was normalized by calculating average citations per item (ACI) index for each article. The publications were sub-classified by the publication year, journals, countries, surgical methods, and departments., Results: The median for total citation numbers and the ACI indices of T200 were 35 and 5 respectively. The top-cited articles were mostly published in USA with 91 articles (46.5 %) followed by Italy (22, 11 %), and United Kingdom (21, 10.5 %). Among T200, 149 were original research, 44 reviews, 4 meta-analyses, and 3 editorial articles. Further, 59 were about surgical procedures (of which 28 were about TOT-TVT comparison). M. Serati and L. Bruker were the most contributing authors to T200 with 19 articles. On the top of T200, the article of Pierre A. Clavien et al. (2009) sits with 6201 citations, published in the journal of "Annals of Surgery"., Conclusions: We suggest that the most-cited articles commonly conducted in the high-income countries, mostly published between 2014-2018. Best of our knowledge, this is the first study analyzing the most-cited 200 publications in urogynecology field under two different perspectives of two different disciplines, namely urology and obstetrics and gynecology., 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: Although family history of psychiatric disorders has often been considered potentially useful in understanding clinical presentations in patients, it is less clear what a positive gambling family history means for people with gambling disorder. We sought to understand the clinical impact of having a first-degree relative with gambling disorder in a sample of adults with gambling disorder., Methods: Data from 455 participants (aged 18-65 years) who had participated in previous pharmacological and psychotherapeutic clinical trials for gambling disorder were pooled in a secondary analysis. Demographic and clinical variables were compared between those who did versus did not have one or more first-degree relative(s) with gambling disorder. Additionally, we examined whether a family history of gambling disorder was associated with treatment outcome., Results: 223 (49.0%) participants had at least one first-degree family member(s) with gambling disorder. In terms of clinical variables, family history of gambling disorder was significantly associated with being female, having an earlier age of gambling onset, longer duration of untreated gambling illness, a greater likelihood of developing legal problems secondary to gambling, and higher rates of alcohol use disorder in family members. Family history of gambling disorder was also associated with a greater gambling symptom improvement from pharmacotherapy., Conclusions: These results indicate that gamblers with a first-degree family member with a gambling disorder may have a unique clinical presentation and better response to treatment interventions.

Introduction: The negative effects of post-COVID-19 restrictions have been detected in students' mental well-being due to internet addiction, changing habits, despair and uncertainty. Students' academic success is expected to be affected by social media addiction, loneliness, depression, life satisfaction, problem solving skills and academic self-efficacy factors. This study aimed to determine the level of social media addiction and the effects of these factors on the academic success of university students and define their interactions with each other., Methods: Four hundred nineteen questionnaires were collected between October-December 2022 at Bingöl University, Türkiye. Descriptive statistics, independent t-test, One-Way ANOVA, correlation and multiple linear regression methods were used to analyze data with the help of the SPSS 22 software., Results: Middle level grade (GPA) average (71,17 ± 9,69 out of 100), low level social support from friends and family members (34,6%), spending more than 4 h on social media (42,5%), middle level social media addiction, moderate depression level (51,31%-PHQ > 10), mild loneliness and slight dissatisfaction with life were found among students. Furthermore, high academic self-efficacy, moderate agreement with academic performance and good problem-solving skills were indicated in the survey results. Significant differences, such as higher life satisfaction among males and higher depression among females, were measured. Academic self-efficacy scale, problem solving skills and satisfaction with life had a negative correlation with social media addiction and depression, while a positive correlation with academic performance measures. Problem solving skills, satisfaction with life, fourth class vs. others and living alone vs. others were positive predictors of the academic self-efficacy. Meanwhile, loneliness was a negative predictor of the academic self-efficacy, while higher problem-solving skills and being female were positive factors leading to a higher GPA., Discussion: The fact that the participants were only students from Bingöl University limits the ability to generalize the results. Policymakers could implement social and problem-solving skills training to develop better academic programs and cognitive-behavioral therapy for students' academic success., 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 © 2024 Aslan and Polat.)

The coronavirus disease 2019 (COVID-19) has raised concerns about the potential complications it may cause in pregnant women. Therefore, biomarkers that can predict the course of COVID-19 in pregnant women may be of great benefit as they would provide valuable insights into the prognosis and, thus, the management of the disease. In this context, the objective of this study is to identify the biomarkers that can predict COVID-19 progression in pregnant women, focusing on composite hemogram parameters and systemic inflammatory and spike markers. The population of this single-center prospective case-control study consisted of all consecutive pregnant women with single healthy fetuses who tested positive for COVID-19 and who were admitted to Bakirköy Dr Sadi Konuk Training and Research Hospital in Istanbul, Turkey, a COVID-19 referral hospital, between April 2020 and March 2021, with an obstetric indication, during their second or third trimester. The control group consisted of consecutive pregnant women with a single healthy fetus who were admitted to the same hospital within the same date range, had demographic and obstetric characteristics matching the patient group, but tested negative for COVID-19. The patient and control groups were compared in terms of platelet-to-lymphocyte ratio (PLR), platelet-to-neutrophil ratio (PNR), and neutrophil-to-lymphocyte ratio (NLR), and systemic inflammatory and spike markers, including C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), cluster of differentiation 26 (CD26), and B7 homolog 4 (B7H4). There were 45 (51.1%) and 43 (48.8%) pregnant women in the patient and control groups, respectively. There was no significant difference between the groups in demographic and obstetric characteristics (P > .05). The PNR, PLR, and CRP values were significantly higher in the patient group than in the control group (P < .05). On the other hand, there was no significant difference between the groups in IL-6, IL-10, CD26, and B7H4 levels (P > .05). The findings of our study showed that specific inflammatory markers, such as CRP, PLR, and PNR, can potentially predict the course of COVID-19 in pregnant women. However, more comprehensive, well-controlled studies are needed to corroborate our study's findings and investigate other potential inflammatory markers., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Introduction: HaNDL syndrome is a transient and rare condition that presents with neurological deficit and headache accompanied by lymphocytosis on cerebrospinal fluid (CSF) analysis. It is usually characterized by spontaneous recovery without neurological sequelae. This is a benign condition, which has not yet been adequately defined and includes many diseases in the differential diagnosis. We indicated 2 different cases that applied with acute neurological findings., Case Report: Two patients who were admitted to our hospital with transient neurological deficits and headaches were evaluated. There was no significant pathology in cranial imaging and EEG reports. Lymphocytic pleocytosis was observed in CSF. Patients were followed up with attacks but were discharged without deficits. We diagnosed the patients with HaNDL syndrome with clinical features, imaging, and laboratory findings., Conclusion: HaNDL is an underdiagnosed syndrome and it should be considered especially for young patients with headaches is prominent without a risk factor for ischemia, recurrent episodes with neurological symptoms, CSF pleocytosis, and normal imaging findings.Therefore, we wanted to raise awareness for the existence of this rare disease which is a waste of time by performing unnecessary tests and therapies during the diagnosis period., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Hemorrhagic complications may be seen following reperfusion therapy with rtPA and/or thrombectomy after acute ischemic stroke (AIS). Neutrophils, lymphocytes, and platelets have important roles in the inflammatory and immune responses that develop in these patients. We investigated time‑dependent changes in blood cells, NIHSS and mRS values according to type of reperfusion therapy in AIS patients who developed cerebral hemorrhage. In AIS patients who underwent rtPA and/or thrombectomy and developed cerebral hemorrhage within the first 24 hours after treatment, leukocyte, neutrophil, lymphocyte, platelet counts and their ratios were recorded on admission, 1st, 3rd, and 7th days. NIHSS values on admission, 3rd days and mRS values on admission, discharge, and the 3rd month were recorded. These values were compared according to the type of reperfusion therapy. Out of 436 AIS patients, rtPA was applied in 50.5%, thrombectomy in 28.2%, and rtPA+thrombectomy in 21.3%. Hemorrhage developed in 25.5% of the patients. Patients treated with thrombectomy had a greater rate of cerebral hemorrhage. Pre‑stroke mRS values were lower in all therapy types than mRS scores at discharge and the 3rd month. The NIHSS scores did not differ significantly in 3 days. Depending on the type of reperfusion treatment, there are a few time‑dependent significant changes observed in the blood cell counts and ratios. In conclusion, there is a relation between the type of reperfusion therapy and the time‑dependent changes in blood cells and ratios as well as mRS scores among AIS patients who have undergone rtPA and/or thrombectomy and developed cerebral hemorrhage.

Objective: To evaluate the effect of informing patients undergoing diagnostic office hysteroscopy via a video 24 h before the procedure and determine the changes in pain scores, channel transit time, the degree of difficulty of the procedure, and physiological parameters., Design: Single-blind randomized controlled trial., Setting: The study was conducted between September 1, 2021 and April 1, 2022 at the University of Health Sciences Bakirkoy Dr. Sadi Konuk Training and Research Hospital., Participants: A total of 134 patients aged 18-65 years who needed diagnostic office hysteroscopy., Interventions: Participants were randomized into two groups, the standard information group (Group 1: controls), and the video information + standard information group (Group 2). After office hysteroscopy, a visual analog scale (VAS) and Likert scale were used to assess pain and the degree of difficulty of the procedure, respectively. Physiological parameters were evaluated before and after the procedure., Main Outcome Measure: To determine the effect of video-based multimedia information administered 24 h before office hysteroscopy on post-procedure pain., Results: The mean VAS score of the group that watched the training video (3.02 ± 1.88) was significantly lower than the control group (4.72 ± 2.54) who did not watch the training video (p < 0.001). The mean cervical channel transit time in seconds (sec) during the procedure was found to be significantly higher in the control group (21.57 ± 15.10 s) than in the video-watching group (p = 0.011). There was no significant difference between the groups in terms of physiological parameters and the degree of ease of the procedure., Conclusion: Our study has shown that informing patients in a pre-procedure video is an effective approach that shortens the duration of the channel transit time and reduces pain., (© 2023 Japan Society of Obstetrics and Gynecology.)

Purpose: To compare outcomes of mechanical thrombectomy (MT) for acute ischemic stroke (AIS) in patients with atrial fibrillation (AF) taking warfarin or direct oral anticoagulants (DOACs)., Methods: A total of 71 consecutive patients with AF who underwent MT due to AIS between January 2018 and December 2021 were retrospectively analyzed. Patients were grouped as warfarin versus DOAC group. CHA 2 DS 2 -VASc, HAS-BLED, The National Institutes of Health Stroke Scale (NIHSS) at the time of admission and at 24 h, successful recanalization, post- MT complications and technical properties of MT were evaluated. Patients were divided into a good prognosis group, and a mortality group according to the 90th day mRS., Results: HAS-BLED score was significantly higher in DOAC group (p = 0.006) There were no significant differences in stroke severity, successful recanalization rates, post-procedural complications and mRS 90th day scores between patients with warfarin and DOACs. CHA 2 DS 2 -VASc, NIHSS at admission and NIHSS on the 24th hour scores were significantly lower in the good mRS group (p = 0.012, p = 0.002, p < 0.001, respectively)., Conclusion: MT is safe and effective in patients receiving warfarin or DOACs. HASBLED and CHA 2 DS 2 -VASc scores can help to predict functional outcome after MT., Competing Interests: Conflict of interest The authors declare that they have no potential conflict of interest regarding the investigation, authorship, and/or publication of this article., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Dysbiosis of the gut microbiota is associated with the pathogenesis of intestinal diseases such as inflammatory bowel disease, irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), and metabolic disease states such as allergies, cardiovascular diseases, obesity, and diabetes. SIBO is a condition characterized by an increased number (>1 × 10 3 CFU) of abnormal bacterial species in the small intestine. Interest in SIBO has gained importance due to increased awareness of the human microbiome and its potential relationships with human health and disease, which has encouraged new work in this area. In recent years, standard antibiotic regimens (rifaximin and metronidazole) have been used to treat SIBO, but solo antibiotics or their derivatives are insufficient. In this study, the therapeutic effects of the probiotic form, which contains coconut oil and traces of peppermint-lemon-patchouli essential oil, were evaluated on the Dysbiosis-Based Rat SIBO Model. There are significant differences between sick and healthy rats ( p = 0.014), between sick rats and rats treated with the oil mix plus probiotic mix protocol ( p = 0.026), and between rats treated with only the probiotic and only oil protocols ( p = 0.030) in the evaluation of TNF-α levels. Histologically, villi distortion and loss of crypts, epithelial shedding and necrotic changes in the apical regions of the villi, and inflammatory cell infiltrations extending to the lamina propria and submucosa were observed in sick rats. Mitotic figures in villus epithelium and crypts were observed in rats treated with 9.2 × 10 9 CFU/1000 mg/coconut oil + trace amounts of peppermint-lemon-patchouli essential oil and a probiotic mixture (oil + probiotic mix protocol). A regression of inflammatory reactions and an increase in goblet cells were observed. A decrease was observed in inflammation markers in sick rats. On the other hand, the oil plus probiotic mix protocol recovered digestive system defects in the animals caused by dysbiosis. In the future, these treatment approaches can be effective in the treatment of SIBO.

Objective: In the present study, we investigated the expression of CD56, ADAM17 and FGF21 antibodies (Ab), which we think have an effect on the pathophysiology of preeclampsia (PE), in pregnant patients with healthy placentas and placentas with PE. The expression of these antibodies has been investigated in a limited amount of former research, but their role in PE has not yet been clarified. With this study, we aimed to contribute to the elucidation of the pathophysiology of PE and the detection of new target molecules for treatment. Materials and Methods: Parturients with singleton pregnancy at 32 weeks or above without any maternal or fetal pathology who were admitted to the Department of Obstetrics and Gynecology, Zonguldak Bülent Ecevit University Practice and Research Hospital between 11 January 2020 and 7 January 2022 were included in the present study. Pregnant women with coexisting disease or a pathology related to the placenta (ablation placenta, vasa previa, hemangioma, etc.) were excluded. CD56, ADAM17 and FGF21 antibodies were histopathologically and immunohistochemically detected in 60 placentas with PE (study group) and 43 healthy placentas (control group). Results: CD56, ADAM17 and FGF21 proteins were all more intensely expressed in preeclamptic placentas and a statistically significant difference was found between the two groups for all three antibodies ( p < 0.001). Deciduitis, perivillous fibrin deposition, intervillous fibrin, intervillous hemorrhage, infarct, calcification, laminar necrosis and syncytial node were found to be significantly more common in the study group ( p < 0.001). Conclusions: We observed that CD56, ADAM17 and FGF21 expressions increased in preeclamptic placentas. These Ab may be responsible for the pathogenesis of PE, which can be illuminated with further studies.

Purpose: The aim of the study was to investigate changes in serum sphingolipid levels and high density lipoprotein (HDL) subtypes with relation to low-density lipoprotein cholesterol (LDL-C), non-HDL-C and triglyceride (TG) levels in type 2 diabetes mellitus (T2DM) patients., Methods: Blood was obtained from 60 patients with T2DM. Levels of sphingosine-1-phosphate (S1P), C16-C24 sphingomyelins (SMs), C16-C24 ceramides (CERs), and C16 CER-1 P were determined by LC-MS/MS. Serum concentrations of cholesterol ester transfer protein (CETP), lecithin-cholesterol acyltransferase (LCAT) and apolipoprotein A-1 (apoA-I) were analyzed by enzyme-linked immunosorbent assay (ELISA). HDL subfraction analysis was performed by Disc polyacrylamide gel electrophoresis., Results: C16 SM, C24 SM, C24-C16 CER and C16 CER-1 P levels were significantly increased in T2DM patients with LDL-C above 160 mg/dL, compared to those with LDL-C below 100 mg/dL. A significant correlation was observed between C24:C16 SM, C24:C16 CER ratios and LDL-C, non HDL-C levels. Higher serum levels of C24 SM, C24-C18 CER and C24:C16 SM ratio was seen in obese T2DM patients (BMI>30) compared to those with BMI 27-30. Patients with fasting TG levels below 150 mg/dL had significantly increased HDL-large and significantly decreased HDL-small fractions compared to those with fasting TG levels above 150 mg/dL., Conclusion: Obese dyslipidemic T2DM patients had increased levels of serum sphingomyelins, ceramides and HDL-small fractions. The ratio of serum C24:C16 SM, C24:C16 CER and long chain CER levels may be used as diagnostic and prognostic indicators of dyslipidemia in T2DM., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Purpose: The predicting bleeding complications in patients undergoing stent implantation and the subsequent dual antiplatelet therapy (PRECISE-DAPT) score predicts the risk of bleeding in patients with dual antiplatelet therapy (DAPT) after percutaneous coronary interventions (PCIs). Patients with carotid artery stenting (CAS) are also treated with DAPT. In this study, we aimed to investigate the performance of the PRECISE-DAPT score in predicting bleeding in patients with CAS., Methods: Patients who had CAS between January 2018 and December 2020 were retrospectively enrolled. The PRECISE-DAPT score was calculated for each patient. The patients were divided into two groups based on their PRECISE-DAPT score: low < 25 and high ≥ 25. Bleeding and ischemia complications and laboratory data among the two groups were compared., Results: A total of 120 patients with a mean age of 67.3 ± 9.7 years were included. Forty-three patients had high PRECISE-DAPT scores, and 77 patients had low PRECISE-DAPT scores. Six patients developed bleeding events during the six-month follow-up, and five of them were in the PRECISE DAPT score ≥ 25 group. The difference between the two groups regarding bleeding events at six months was significant (P = 0.022)., Conclusion: The PRECISE-DAPT score might be used for predicting the bleeding risk in patients with CAS, and the bleeding rate was significantly higher in patients with a PRECISE-DAPT score ≥ 25., (© 2023. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).)

Background: Trichotillomania (TTM) and skin picking disorder (SPD) result in significant psychosocial burden. Despite this burden, however, risk factors related to the development of these disorders remain unclear. The present study assessed temperament in a well-characterized sample of adults with TTM or SPD., Methods: A total of 202 adults age 18 to 65 were enrolled; 44 had TTM, 30 had SPD, and 128 served as controls. Participants completed the self-report Tridimensional Personality Questionnaire (TPQ) to examine the severity of TTM and SPD symptoms, quality of life, and temperament. Group differences were characterized and correlations with other measures were examined., Results: Compared to controls, those with TTM or SPD scored significantly higher on harm avoidance and its subscales, with TTM associated with higher scores than SPD. Those with TTM or SPD scored significantly higher on only 1 measure of novelty seeking (extravagance). Higher TPQ harm avoidance correlated with worse hair pulling severity and worse quality of life., Conclusions: The temperament traits of participants with TTM or SPD differed in significant ways from controls; those with TTM or SPD generally demonstrated similar trait profiles. A dimensional approach to the personalities of those with TTM or SPD may offer insight and provide clues to treatment strategies.

This study aimed to find the prevalence of stress, anxiety, depression, and PTSD; differences according to demographic variables; and predictors of mental health problems during the second wave of the coronavirus disease (COVID-19) pandemic in Turkey. Differences in exposure to COVID-19 during the first and second waves of the pandemic among students were compared. A total of 754 students from seven universities in different parts of Turkey participated in the survey between November and December 2020. Perceived Stress Scale (PSS-10), Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), Checklist-Civilian Version (PCL-C) scale measuring posttraumatic stress disorder (PTSD), and Satisfaction with Life Scale (SWLS) were used to measure the mental well-being of students. Descriptive statistics, one-way ANOVA, correlations, and multinomial logistic regression methods were used to analyze the data. The prevalence of high stress, high generalized anxiety (GAD-7 ≥ 10), high depression symptoms (PHQ-9 ≥ 10), and high PTSD in the total sample were 84.2, 36.2, 55.0, and 61.2%, respectively. High perceived stress, moderate generalized anxiety disorder, mild depression symptoms, high severity PTSD, and moderate satisfaction were found among students in Turkey. Religiosity and spirituality have significant negative correlations with anxiety, depression, and PTSD. Religiosity level, gender, relationship status, year of study, physical activity, symptoms of coronavirus, death of a close relative, job loss, and economic status are significant parameters for predicting psychological problems of students in Turkey., 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 Aslan and Çınar.)

This study aimed to explore the role of the cerebellum on the somatosensory temporal discrimination (STD) process. Twenty healthy volunteers were enrolled in the study. Each participant was included in three different transcranial direct current stimulation (tDCS) sessions as anodal, cathodal, and sham sessions in randomised order. Anodal and cathodal cerebellar tDCS (cTDCS) were given for 20 min at an intensity of 2 mA. The results of the study indicate no effect of cTDCS on STD. Although the study results show that cTDCS does not affect STD, because of the restricted sample size of the study, it is useful and necessary to investigate this relationship more in depth in a larger healthy subject population using different cTDCS methodologies., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The main goal of this study was to identify whether changes and new applications were positively or negatively influencing safety performance among health-sector workers. The research is based on the opinion of 16 selected occupational health and safety (OHS) experts who evaluated five main groups of questions by the analytic hierarchy process (AHP). The results were compared to the same questionnaire's results applied previously at three main hospitals in Bingöl, Turkey. The results presented are predictable, such as that of private hospitals having better control and pressure on applying the OHS system; experts gave higher priority to OHS training; and staff considered that working according to OHS criteria was the most important problem. Caring about others' safety and protecting one's own life, being knowledgeable about risks, having practical OHS training and cooperation are other important criteria according to the experts.

Background: A cross-sectional study was performed to examine life satisfaction differences between university students from nine countries during the first wave of the COVID-19 pandemic. A cross-national comparison of the association between life satisfaction and a set of variables was also conducted., Methods: Participants in the study were 2349 university students with a mean age of 23 years (M = 23.15, SD = 4.66). There was a predominance of women (69.26%) and individuals studying at the bachelor level (78%). The research was conducted between May and July 2020 in nine countries: Slovenia (n=209), the Czech Republic (Czechia)(n=308), Germany (n=267), Poland (n=301), Ukraine (n=310), Russia (n=285), Turkey (n=310), Israel (n=199), and Colombia (n=153). Participants completed an online survey involving measures of satisfaction with life (SWLS), exposure to COVID-19, perceived negative impact of coronavirus (PNIC) on students' well-being, general self-reported health (GSRH), physical activity (PA), and some demographics (gender, place of residence, level of study). A one-way ANOVA was used to explore cross-national differences in life satisfaction. The χ 2 independence test was performed separately in each country to examine associations between life satisfaction and other variables. Bivariate and multivariate logistic regressions were used to identify life satisfaction predictors among a set of demographic and health-related variables in each of the nine countries., Results: The level of life satisfaction varied between university students from the nine countries. The results for life satisfaction and the other variables differed between countries. Numerous associations were noted between satisfaction with life and several variables, and these showed cross-national differences. Distinct predictors of life satisfaction were observed for each country. However, poor self-rated physical health was a predictor of low life satisfaction independent of the country., Conclusions: The association between life satisfaction and subjective assessment of physical health seems to be universal, while the other variables are related to cross-cultural differences. Special public health attention should be focused on psychologically supporting people who do not feel healthy., (© 2021. The Author(s).)

Background: Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder which often proves refractory to current treatment approaches. Transcranial direct current stimulation (tDCS), a noninvasive form of neurostimulation, with potential for development as a self-administered intervention, has shown potential as a safe and efficacious treatment for OCD in a small number of trials. The two most promising stimulation sites are located above the orbitofrontal cortex (OFC) and the supplementary motor area (SMA)., Methods: The aim of this feasibility study is to inform the development of a definitive trial, focussing on the acceptability, safety of the intervention, feasibility of recruitment, adherence and tolerability to tDCS and study assessments and the size of the treatment effect. To this end, we will deliver a double-blind, sham-controlled, crossover randomised multicentre study in 25 adults with OCD. Each participant will receive three courses of tDCS (SMA, OFC and sham), randomly allocated and given in counterbalanced order. Each course comprises four 20-min stimulations, delivered over two consecutive days, separated by at least 4 weeks' washout period. We will collect information about recruitment, study conduct and tDCS delivery. Blinded raters will assess clinical outcomes before, during and up to 4 weeks after stimulation using validated scales. We will include relevant objective neurocognitive tasks, testing cognitive flexibility, motor disinhibition, cooperation and habit learning., Discussion: We will analyse the magnitude of the effect of the interventions on OCD symptoms alongside the standard deviation of the outcome measure, to estimate effect size and determine the optimal stimulation target. We will also measure the duration of the effect of stimulation, to provide information on spacing treatments efficiently. We will evaluate the usefulness and limitations of specific neurocognitive tests to determine a definitive test battery. Additionally, qualitative data will be collected from participants to better understand their experience of taking part in a tDCS intervention, as well as the impact on their overall quality of life. These clinical outcomes will enable the project team to further refine the methodology to ensure optimal efficiency in terms of both delivering and assessing the treatment in a full-scale trial., Trial Registration: ISRCTN17937049 . (date applied 08/07/2019). Recruitment (ongoing) began 23rd July 2019 and is anticipated to complete 30th April 2021., (© 2021. The Author(s).)

This study aimed to reveal differences in exposure to coronavirus disease (COVID-19) during the first (W1) and the second (W2) waves of the pandemic in six countries among university students and to show the prevalence and associations between exposure to COVID-19 and coronavirus-related post-traumatic stress syndrome (PTSD) risk during W2. The repeated cross-sectional study was conducted among university students from Germany, Poland, Russia, Slovenia, Turkey, and Ukraine (W1: n = 1684; W2: n = 1741). Eight items measured exposure to COVID-19 (regarding COVID-19 symptoms, testing, hospitalizing quarantine, infected relatives, death of relatives, job loss, and worsening economic status due to the COVID-19 pandemic). Coronavirus-related PTSD risk was evaluated by PCL-S. The exposure to COVID-19 symptoms was higher during W2 than W1 among students from all countries, except Germany, where, in contrast, the increase in testing was the strongest. Students from Poland, Turkey, and the total sample were more frequently hospitalized for COVID-19 in W2. In these countries, and Ukraine, students were more often in quarantine. In all countries, participants were more exposed to infected friends/relatives and the loss of a family member due to COVID-19 in W2 than W1. The increase in job loss due to COVID-19 was only noted in Ukraine. Economic status during W2 only worsened in Poland and improved in Russia. This was due to the significant wave of restrictions in Russia and more stringent restrictions in Poland. The prevalence of coronavirus-related PTSD risk at three cutoff scores (25, 44, and 50) was 78.20%, 32.70%, and 23.10%, respectively. The prediction models for different severity of PTSD risk differed. Female gender, a prior diagnosis of depression, a loss of friends/relatives, job loss, and worsening economic status due to the COVID-19 were positively associated with high and very high coronavirus-related PTSD risk, while female gender, a prior PTSD diagnosis, experiencing COVID-19 symptoms, testing for COVID-19, having infected friends/relatives and worsening economic status were associated with moderate risk.

The student population has been highly vulnerable to the risk of mental health deterioration during the coronavirus disease (COVID-19) pandemic. This study aimed to reveal the prevalence and predictors of mental health among students in Poland, Slovenia, Czechia, Ukraine, Russia, Germany, Turkey, Israel, and Colombia in a socioeconomic context during the COVID-19 pandemic. The study was conducted among 2349 students (69% women) from May-July 2020. Data were collected by means of the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-8), Perceived Stress Scale (PSS-10), Gender Inequality Index (GII), Standard & Poor's Global Ratings, the Oxford COVID-19 Government Response Tracker (OxCGRT), and a sociodemographic survey. Descriptive statistics and Bayesian multilevel skew-normal regression analyses were conducted. The prevalence of high stress, depression, and generalized anxiety symptoms in the total sample was 61.30%, 40.3%, and 30%, respectively. The multilevel Bayesian model showed that female sex was a credible predictor of PSS-10, GAD-7, and PHQ-8 scores. In addition, place of residence (town) and educational level (first-cycle studies) were risk factors for the PHQ-8. This study showed that mental health issues are alarming in the student population. Regular psychological support should be provided to students by universities., (© 2021. The Author(s).)

The mental health of young adults, particularly students, is at high risk during the COVID-19 pandemic. The purpose of this study was to examine differences in mental health between university students in nine countries during the pandemic. The study encompassed 2349 university students (69% female) from Colombia, the Czech Republic (Czechia), Germany, Israel, Poland, Russia, Slovenia, Turkey, and Ukraine. Participants underwent the following tests: Patient Health Questionnaire (PHQ-8), Generalized Anxiety Disorder (GAD-7), Exposure to COVID-19 (EC-19), Perceived Impact of Coronavirus (PIC) on students' well-being, Physical Activity (PA), and General Self-Reported Health (GSRH). The one-way ANOVA showed significant differences between countries. The highest depression and anxiety risk occurred in Turkey, the lowest depression in the Czech Republic and the lowest anxiety in Germany. The χ 2 independence test showed that EC-19, PIC, and GSRH were associated with anxiety and depression in most of the countries, whereas PA was associated in less than half of the countries. Logistic regression showed distinct risk factors for each country. Gender and EC-19 were the most frequent predictors of depression and anxiety across the countries. The role of gender and PA for depression and anxiety is not universal and depends on cross-cultural differences. Students' mental health should be addressed from a cross-cultural perspective.

Objective: To determine flap success rate and complications in patients who underwent microvascular free tissue reconstruction after major head and neck ablative surgery and to report the improvement in the results., Methods: Medical records of 124 patients who were operated on in 2012 to 2019 were retrospectively reviewed. Indications for different free flap types, success rates and re-exploration rates, donor site morbidities, and reasons for flap loss were analyzed. Patients were divided into two groups to identify the effects of the anticoagulant and the antiaggregant treatments on postoperative results., Results: There were 127 flaps in 124 patients, including two different free flaps each in three patients that were harvested and used in the same surgical session. Of the total 127 flaps, 82 (64.6%) were radial forearm flaps, 39 (30.7%) were fibula flaps, and 6 (4.7) were rectus abdominis flaps. Four patients were re-explored for flap perfusion problems, and 18 patients were re-explored for hematoma drainage (n=22/124, %17.3). The rate of hematoma and re-exploration was higher in patients who received anticoagulant and antiaggregant treatments synchronously (p=0.02). Three flaps were lost, and the overall success rate was 97.6%. Two patients died from perioperative complications. No major complications were observed at the donor site; minor complications were observed in 30 patients., Conclusion: The success rate for the 127 flaps in 124 patients were found comparable to those reported in the literature. These results show that successful outcomes can be achieved with experience and a head and neck team dedicated to improving the results in microsurgical reconstruction, and flap failure rarely occurs if perioperative care of the patients is given meticulously., Competing Interests: Conflict of Interest: No potential conflict of interest relevant to this article was reported., (©Copyright 2021 by Official Journal of the Turkish Society of Otorhinolaryngology and Head and Neck Surgery.)

Background Insulin-induced hypoglycemia has been demonstrated to prolong the corrected QT (QTc) interval. Prolongation of the QTc interval, especially in diabetic patients using insulin, can cause fatal ventricular arrhythmias. The aim of this study was to evaluate the effects of metoprolol, diltiazem, and pilocarpine on hypoglycemia-induced QTc prolongation. Methods Thirty male rats were randomly distributed into the following five groups: Group 1 (1 mL/kg saline, n=6), Group 2 (40 U/kg crystalline insulin + saline, n=6), Group 3 (40 U/kg crystalline insulin + 1 mg/kg metoprolol, n=6), Group 4 (40 U/kg crystalline insulin + 0.8 mg/kg pilocarpine, n=6), and Group 5 (40 U/kg crystalline insulin + 2 mg/kg diltiazem, n=6). Three hours after insulin injection, the blood glucose level was measured in all groups. Blood glucose <40 mg/dl was defined as hypoglycemia. Electrocardiograms (ECG) were taken in lead I (DI), and QTc was calculated by using Bazett's formula. Results Group 2 (insulin + saline) showed that it had a significantly prolonged QTc interval as compared to the control group (p<0.0001). However, treatments of the rats with metoprolol, pilocarpine, and diltiazem significantly prevented prolongation of the QTc interval as compared to the insulin + saline group (p<0.005, p<0.005, and p<0.01, respectively). Conclusion The findings of the present study demonstrated the efficacy of metoprolol, pilocarpine, and diltiazem in the prevention of hypoglycemia-induced QTc prolongation in male rats., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Cagiltay et al.)

The background of this article is to develop formulations consisting of natural raw materials that are effective in diaper rash by taking advantage of the medicinal properties of zinc oxide, natural oils, and beeswax. The purpose of this research was to determine the appropriate amounts of the constituents of the formulation and to determine the optimum formulation by comparing the margin of safety (MoS), and microbiological and physicochemical properties of the best formulation. For this purpose, parameters such as pH, rheological behavior, hydrophilic and lipophilic balance (HLB), zeta potential, and polydispersity index were analyzed and evaluated to determine the optimum formulation. Besides, microbiological reproduction and 3-month stability studies of the developed product were carried out, and it has been proven that the developed product maintains both microbiological and stability properties throughout its shelf life. Furt hermore, whether each raw material used in the selected optimum formulation remained within MoS values was evaluated according to exposure doses in the literature. Whether it maintains the desired properties throughout the shelf life was evaluated by stability studies. In this article, eight different zinc oxide-based formulations for preventing diaper rash were developed, and their physicochemical properties were examined to optimize cream formulations. baby barrier cream (BBC)-8 was chosen as the ideal formula by comparing all the parameters obtained as a result of the analysis. As a result of the optimization studies of the BBC-8 formulation, the pH value was 7.2, the viscosity property was pseudoplastic-type flow, the particle size was 533.2 nm ± 6.93, and the zeta potential was -30.9 mV ± 0.72. The theoretical safety assessment of each constituent has been made according to the European Union Cosmetics Directives. According to the calculations made on each raw material in BBC-8 according to the directives, the MoS value was found to be more than 230. For the stability studies, no microbiological growth was observed at the end of the 3-month stability studies at 25 and 40°C. In terms of the development of future natural cosmetic product formulations and the defi nition of "natural formulation," it gives hope to prepare a safer cosmetic product for baby rash creams that do not contain preservatives, perfumes, and dyes and consists of natural oils and zinc oxide.

Objectives: This study aimed to investigate the wound healing activity of liposomal Carpobrotus edulis powder extract (CEPE) formulation on incisional and excisional wounds in rat., Background: In the event of any damage, the damaged tissue undergoes a process of regenerating itself, which is called wound healing., Methods: Centella asiatica extract (CAE) was used as the reference molecule in the study. The wound healing process was tested by using the excisional and incisional wound model. On the 12th day of the study, maximum stress, stress, % of elongation values were evaluated in the incisional wound. Also; histological parameters and macroscopic photographic analyses were evaluated in the excisional wound., Results: In the photo evaluations, the improvement was more prominent in both CAE and CEPE groups than in the control group. Histological evaluation showed that CEPE group had significant wound healing activity compared to the control and CAE groups. Axial tensile-elongation experiments in incisional wound tissue show that there was no significant difference between CAE and CEPE groups., Conclusion: Liposomal formulations of C.edulis extract were found to have positive effects on the healing process, both on excisional and incisional wound tissues (Tab. 2, Fig. 3, Ref. 30).

Students have been highly vulnerable to mental health issues during the COVID-19 pandemic, and researchers have shown that perceived stress and mental health problems have increased during the pandemic. The aim of this study was to reveal the prevalence of perceived stress and mental health among students during the pandemic and to explore predictors of stress levels. A cross-sectional study was conducted on a sample of 358 undergraduates from 14 universities in Turkey, including 200 female students (56%). The measurements used in the study were the Generalized Anxiety Disorder 7-item (GAD-7) scale, Patient Health Questionnaire (PHQ-8), Satisfaction with Life Scale (SWLS), Perception of COVID Impact on Student Well-Being (CI), Perceived Stress Scale (PSS-10), Physical Activity Scale (PA), and a sociodemographic survey. Students reported high perceived stress, mild generalized anxiety, and low satisfaction with life. More than half of the students met the diagnostic criteria of GAD (52%) and depression (63%). Female and physically inactive students had higher PSS-10 levels. A hierarchical linear regression model showed that after controlling for gender and negative CI, anxiety and physical inactivity significantly predicted high perceived stress. The study shows that students' mental health during the pandemic is at high risk.

Background: The 2019 novel coronavirus (2019-nCoV) represents an ongoing major global health crisis with a potentially unprecedented death toll and socio-economic impact in the modern era. Measures taken to reduce the rate of transmission are too unprecedented, but are deemed necessary. The extensive strain on public health services has meant that individual agency is increasingly called for. To support this, there is a need to review policy and procedure governing the food and commerce industries in particular. Additionally, it is necessary to convey a more comprehensive and nuanced understanding of relevant diet and lifestyle factors to both healthcare practitioners and the general public., Scope and Approach: To our knowledge, a review of possible additional measures for healthcare proffesionals, which includes the possible nutritional management COVID-19 pandemic does not yet exist.Key Findings and Conclusions: This review identifies i) changing trends in consumer awareness and purchasing patterns in response to COVID-19, and their potential future implications for the food and food-commerce industry ii) problematic elements of policy relevant to the outbreak of COVID-19, including the handling of wild-life and food-commerce, ii) newly emergent technologies in food science which represent viable and cost-effective means to reduce the risk of transmission of coronavirus, such as anti-microbial packaging, iii) important nutritional considerations with regard to coronavirus disease prevention and management, including nutrition in early infancy, and the role of select micronutrients (vitamins and minerals), phytochemicals and probiotics in conferring protection against both viral infection and pathogenicity., Competing Interests: 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., (© 2020 Elsevier Ltd. All rights reserved.)

Background and Aims: Various reactive oxygen radicals and inflammatory mediators emerge in ischemic stroke, and changes occur in the number of leukocytes and platelets. Variations in the counts and ratios of these cells may be related to the early and late course and prognosis of stroke. In this study, the relationship between changes in counts or ratios of neutrophil, lymphocyte, platelet, and National Health Institute Stroke Scale (NIHSS) scores was investigated in patients who presented with an ischemic stroke and treated with recombinant tissue plasminogen activator (rtPA) and/or thrombectomy., Methods: Changes in neutrophil, lymphocyte, platelet counts; neutrophil-to-leukocyte ratio (NLR), neutrophil-to-lymphocyte ratio, platelet-to-leukocyte ratio (PLR), and platelet-to- lymphocyte ratio between day of admission (day 0), and 1 st , 3 rd , and 7 th days after application of treatment modalities in 296 patients presented with acute ischemic stroke who underwent rtPA within the first 4,5 hours and / or thrombectomy within 6 hours after stroke and the relationship between these changes and the NIHSS (National Health Institute Stroke Scale) scores were evaluated retrospectively., Results: In our study, leukocyte and neutrophil counts were higher on the first day after acute ischemic stroke. Platelet counts decreased on the 1 st and 3 rd days relative to baseline values. Lymphocyte values decreased on day 1, 3 and 7 compared to day 0. There was a significant increase in neutrophil-to-lymphocyte ratios at day 1 and 3 compared to day 0. On the 7 th day, neutrophil-to-lymphocyte ratios were significantly lower. There was an increase in platelet-to-lymphocyte ratios at day 1 compared to day 0. The increase in NLR values was more evident on day 1. The increase in PLR on the 7 th day was also significant. The patients who underwent rtPA and/or thrombectomy had significantly lower NIHSS scores at the 72 th hour of the stroke compared to the NIHSS values at hospital admissions. A positive correlation was found between NIHSS difference values and neutrophil-to-lymphocyte and platelet-to-lymphocyte percent changes., Conclusions: There are dynamic changes in platelet, neutrophil, lymphocyte counts and ratios in early period after treatment with rtPA and/or thrombectomy in acute ischemic stroke. Variations in the counts and ratios of these cells may be related to NIHSS, which determines the degree of neurological damage of stroke., Competing Interests: Declarations of competing interest None, (Copyright © 2020 Elsevier Inc. All rights reserved.)

Identifying the nutritional and health properties of Helianthus tuberosus, and learning more about this valuable species. It is believed that increased consumption of Jerusalem artichoke (JA) products is related to low blood pressure. One of many questions to answer is whether supplementation of inulin and inulin derivatives obtained from Helianthus tuberosus tubers and aerial parts can be used as antidiabetic, anti-carcinogenic, anti-fungistatic, anti-constipation, body mass-reducing, metabolism-improving agents. We ran a search in Medline, Web of Science, Scopus, Agricola, EBSCO - Food Science Source, Europe PMC, PBL, Cochrane Central Register of Controlled Trials until March 2020. We also browsed reference lists of articles and previous reviews. No language limitations were applied. Jerusalem artichoke (JA) has multiple applications thanks to its rich chemical composition, resistance to biotic and abiotic factors, as: functional food, bioactive ingredient, raw material for the production of ethanol and butanol, succinic, citric and lactic acid. It can be used in medicine and the pharmaceutical industry, because it contains anti-fungistatic, anti-carcinogenic and antioxidant components, and the production of the raw material is easy and inexpensive. It also lowers high cholesterol, triglycerides and high glucose levels; facilitates weight loss; detoxes the organism (e.g. alcohol, heavy metals, radionuclides); lowers uric acid levels; has immunostimulating properties; protects the gastric mucosa, prevents constipation; prevents acne; improves metabolism in lipid disorders; reduces body mass; has cytotoxic properties in breast cancer. It also helps in cardiovascular diseases, chronic infectious diseases; chronic fatigue syndrome; gut flora disorders; immune system disorders. A number of Jerusalem artichoke-derived products were discussed.

Purpose: The aim of this study was to evaluate the corrosion resistance of the specimens produced by five different commercial metal laser sintering (MLS) systems with their recommended Co-Cr alloy powders., Materials and Methods: The MLS machines and the alloy powders used were, ProX 100-ST2724G (St-Pro), Mysint 100-EOS SP2 (SP2-Mys), EOSINT 270-EOS SP2 (SP2-EOS), SLM 100-Starbond CoS (SB-SLM), and MLab Cusing-Remanium® Star (RS-MLab), respectively. Eight specimens from each group were prepared. Open circuit potential (E ocp ) and electrochemical impedance spectroscopy (EIS) measurements of polished surfaces of the specimens were conducted in a three-electrode cell using a potentiostat-galvanostat in Fusayama-Meyer artificial saliva (AS). Specimens from each group were immersed in AS and de-ionized water for seven days. E ocp , charge transfer resistance (R ct ) values, and released ions (µg/cm 2 × 7d) in different solutions were determined. The specimen surfaces were observed with SEM/EDS. Results were analyzed statistically., Results: E ocp values have shifted to potentials that are more positive over time. Steady-state E ocp values were from high to low as follows, SB-SLM, SP2-Mys, SP2-EOS, RS-MLab, and ST-Pro, respectively. After 60 mins, RS-MLab specimens had the highest R ct value, followed by SP2-Mys, SB-SLM, SP2-EOS, and ST-Pro. In all groups, ion release was higher in AS than that in de-ionized water., Conclusion: There were small differences among the corrosion resistances of the Co-Cr alloy specimens produced with MLS systems; meanwhile, the corrosion resistances were quite high for all specimens., (© 2020 The Korean Academy of Prosthodontics.)

Background: Limited data are available on serum levels of different sphingomyelin (SM) and ceramide (CER) species in acne vulgaris (AV)., Objectives: This study aimed to identify circulating levels of neutral sphingomyelinase activity (N-SMase), ceramide-1-phosphate (C1P), sphingosine-1-phosphate (S1P), C16-C24 SMs and C16-C24 CERs in AV patients and controls., Material and Methods: Serum was collected from 30 AV patients and 20 age, gender-matched control subjects. Serum levels of C16-C24 SMs and C16-C24 CERs were determined by an optimized multiple reaction monitoring (MRM) method using ultra fast-liquid chromatography (UFLC) coupled with tandem mass spectrometry (MS/MS). Serum activity of N-SMase was assayed by standard kit methods, C1P and S1P levels were determined by enzyme-linked immunosorbent assay (ELISA)., Results: A significant increase was observed in serum levels of C16 SM in patients with AV compared to controls. No significant difference was found in C18 and C24 SM levels between the two groups. Very-long-chain C24 CER was significantly decreased in AV patients compared to controls. Long chain C16-C20 CER levels showed no significant difference between AV patients and controls. A significant positive correlation was found between serum total cholesterol levels and all measured SMs and CERs in both the control and patient groups. Patients with AV had increased circulating levels of C16 SM, C1P and lower circulating levels of C24 CER compared to healthy controls, which may provide prognostic value for the disease., Conclusions: Future studies are needed to understand the role of altered sphingolipid levels in the pathophysiology of AV., (© 2019 by the Association of Clinical Scientists, Inc.)

Objective: Besides its hematopoietic function, erythropoietin (EPO) may protect tissues from degenerative disorders. As such, EPO and its receptors were revealed in nonhematopoietic cells, including stromal and endometrial epithelial cells. However, the role of EPO in endometrial disorders is still unknown. Here, we aimed to examine the role of EPO and its receptor activation in the development of endometriosis in rats., Material and Methods: Animals were treated with EPO, darbepoietin (the synthetic form of EPO) or EPO’s receptor activator, methoxy polyethylene glycol-epoetin beta (MIRCERA), after development of endometriosis. Endometriosis was induced by estrogen-administration following surgical attachment of endometrial surface on the inner abdominal wall. Treatments were started 3 weeks after induction of endometriosis and continued for the following 3 weeks. For the analysis of recurrence of endometriosis, additional analyses were conducted 3 weeks after cessation of treatments., Results: As compared with vehicle-treated animals, lesion size was reduced significantly and recurrence of endometriosis was not observed in all treatment groups. Histopathologic examination revealed that EPO and darbepoietin were more effective than MIRCERA- and vehicle-treated animals., Conclusion: Here we provide evidence that EPO is a promising candidate for the treatment of endometriosis. Our histopathologic results in particular indicate that EPO is more effective than its receptor activator MIRCERA in the development endometriosis.

Background: This study aimed to determine early postoperative changes of serum sphingomyelin (SM) and ceramide (CER) species following laparoscopic sleeve gastrectomy (LSG)., Methods: Twenty obese patients [mean body mass index (BMI) 45,64 ± 6,10 kg/m 2 ] underwent LSG and normal weight control patients (mean BMI 31,51 ± 6,21 kg/m 2 ) underwent laparoscopic cholecystectomy. Fasting blood samples were collected prior to surgery, at day 1 and day 30 after surgery. Circulating levels of C16-C24 SMs, C16-C24 CERs and sphingosine-1-phosphate (S1P) were determined by an optimized multiple reaction monitoring (MRM) method using ultra fast-liquid chromatography (UFLC) coupled with tandem mass spectrometry (MS/MS). Serum activity of neutral sphingomyelinase (N-SMase) was assayed by standard kit methods, and ceramide-1-phosphate (C1P) levels were determined by enzyme-linked immunosorbent assay (ELISA). Lipid profile, routine biochemical and hormone parameters were assayed by standard kit methods. Insulin sensitivity was evaluated using homeostatic model assessment for insulin resistance (HOMA IR)., Results: A significant decrease was observed in serum levels of very-long-chain C24 SM, very-long-chain C22-C24 CERs, HOMA-IR, N-SMase and C1P in LSG patients after postoperation day 1 and day 30 compared to preoperation levels. At 30 days postsurgery, BMI was reduced by 11%, fasting triglycerides were significantly decreased, and insulin sensitivity was increased compared to presurgery values. A significant positive correlation was found between HOMA-IR and serum levels of C22-C24 CERs in LSG patients., Conclusion: We conclude that very long chain CERs may mediate improved insulin sensitivity after LSG.