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Protecting the material surfaces from deposits and insoluble sludge particles extends the engine life and reduces waste. Lubricant detergents in engine oils are essential additive technologies that prevent deposit formation in internal combustion engines. In this study, the effect of sulfonate detergent on deposit formation in a passenger car engine is investigated with experimental and multiscale molecular modeling methods to present a unified approach. First principles density-functional theory calculations, statistical sampling methods, all-atom molecular dynamics simulations, and coarse-grained simulations are examined to elucidate deposit control mechanism of sulfonate detergents. Analysis of the results reveals that sludge particles in the drain oil are similar in structure to piston deposits, and they might be the precursors of the piston deposits. Main factor for controlling the sludge particle deposition is the prevention of their colloidal aggregation at the microscale in the base oil matrix. Aggregation can be mitigated by the intercalation of detergent polar groups between the particles. This is followed by the extension of hydrophobic tails into the oil phase, which decreases further aggregation via formation of a repulsive layer., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Objectives: Plant extracts are important natural resources that may have antimicrobial and antibiofilm effects against pathogens. This study was conducted to investigate the in vitro antimicrobial activities of methanol extracts of some medicinal plants ( Achillea nobilis subspecies neilreichii (A. Kern.) Velen., Aetheorhiza bulbosa (L.) Cass, Allium paniculatum L, Asphodelus aestivus Brot., Ballota nigra L., Cistus laurifolius L., Cistus salviifolius L., Dioscorea communis (L.) Caddick and Wilkin, Galium verum L., Hypericum triquetrifolium Turra, Paliurus spina-christi Mill., Primula vulgaris Huds. subspecies rubra (Sm.) Arcang., Ranunculus arvensis L. and Teucrium polium L.) from Balıkesir province in Türkiye., Materials and Methods: Preliminary antimicrobial activity screening was conducted for all extracts. Antibiofilm activity studies were conducted on mature Candida albicans biofilms. Moreover, the cytotoxicities of A. paniculatum flower extract on A549 and Vero cell lines were determined using a colorimetric tetrazolium-based assay., Results: A. paniculatum flower, P. vulgaris root, C. laurifolius, C. salviifolius , and A. nobilis displayed good activity [minimum inhibitory concentrations (MIC): 9.75, 156, 312, 312 and 312 μg/mL, respectively] against C. albicans American Type Culture Collection 10231. Biofilm studies were conducted on these plant extracts. The methanol extract of A. paniculatum flower decreased the number of C. albicans [colony-forming unit (CFU)/mL] in mature biofilm statistically at 32 x MIC and higher concentrations ( p < 0.01). A. paniculatum flower extract had a cytotoxic effect (killing more than 50% of cells) at high concentrations, and its effect on Vero cells was similar to that on A549 cells., Conclusion: This study demonstrated the importance of the methanol extract of A. paniculatum flower as a natural alternative against C. albicans infections, including biofilms., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (Copyright© 2024 The Author. Published by Galenos Publishing House on behalf of Turkish Pharmacists’ Association.)

Essential oil content of and phenolic compounds flower-fruit, root, and aerial parts of Heracleum pastinacifolium subsp. incanum were analysed by GC/MS and LC/MS methods, respectively. Antidiabetic, anticholinesterase, and antioxidant activities of flower-fruit, root, aerial parts methanol extracts were evaluated. Apiole (35.0%), myristicine (72.2%), and myristicine (15.1%) were found as major compounds of fruit-flower mixture, root, aerial part essential oils, respectively. Hesperidin was found the highest amount in aerial part and flower-fruit extracts with 8904.2621 ng/mL and 11558.3634 ng/mL values, respectively. Fruit-flower extract showed the highest activity against α -glucosidase (24%). Root extract demonstrating the highest activity (18%) against AChE enzyme. Flowers-fruits mixture methanol extract had a higher % inhibition value on ABTS ·+ and DPPH • . Flowers-fruits mixture methanol extract was rich in total phenol, total tannin, and protein content. All the extracts were determined as genetoxically safe according to the results of Ames/ Salmonella , Escherichia coli WP2 and Allium cepa assays.

Objective: Electrocardiographic left ventricular hypertrophy (ECG LVH) holds significant clinical importance in cardiovascular disease. Pathological processes that lead to left ventricular hypertrophy (LVH) also induce remodeling and impair left atrial (LA) function. Atrial function can be assessed using speckle-tracking echocardiography. This study investigates the potential impact of ECG LVH on LA strain., Methods: A total of 62 individuals diagnosed with LVH, based on the echocardiographic left ventricular mass index, were included. ECG LVH was assessed using established protocols: the Sokolow-Lyon voltage criteria (SV1 + RV5/RV6 > 35 mm), Cornell voltage criteria (RaVL + SV3 > 28 mm for men and > 20 mm for women), and the Cornell product criteria [(SV3 + RaVL + (for women 8 mm)] x QRS duration > 2440 mm x ms). Participants were categorized into two groups based on the presence or absence of ECG LVH. The relationship between LA strain measures and ECG characteristics was explored., Results: The study population had a median age of 58.3 ± 10.1 years, with 40.3% being female, 91.9% hypertensive, and 35.5% diabetic. Nineteen patients (30.6%) were identified with ECG LVH based on Sokolow-Lyon voltage, Cornell voltage, or Cornell product criteria. These patients exhibited significantly reduced LA reservoir, conduit, and contraction strains (P < 0.001). Statistically significant correlations were observed between all three phases of LA strain measures and Sokolow-Lyon voltage (reservoir r = -0.389, P < 0.01; conduit r = -0.273, P < 0.05; contraction r = -0.359, P < 0.01), Cornell voltage (reservoir r = -0.49, P < 0.001; conduit r = -0.432, P < 0.001; contraction r = -0.339, P < 0.01), and Cornell product (reservoir r = -0.471, P < 0.001; conduit r = -0.387, P < 0.01; contraction r = -0.362, P < 0.01)., Conclusion: ECG LVH is associated with impaired LA strain, validating its use as an effective tool for predicting LA dysfunction.

The transmembrane helices of receptor tyrosine kinases (RTKs) have been proposed to switch between two different dimeric conformations, one associated with the inactive RTK and the other with the active RTK. Furthermore, recent work has demonstrated that some full-length RTKs are associated into oligomers that are larger than dimers, raising questions about the roles of the TM helices in the assembly and function of these oligomers. Here we probe the roles of the TM helices in the assembly of EphA2 RTK oligomers in the plasma membrane. We employ mutagenesis to evaluate the relevance of a published NMR dimeric structure of the isolated EphA2 TM helix in the context of the full-length EphA2 in the plasma membrane. We use two fluorescence methods, Förster Resonance Energy Transfer and Fluorescence Intensity Fluctuations spectrometry, which yield complementary information about the EphA2 oligomerization process. These studies reveal that the TM helix mutations affect the stability, structure, and size of EphA2 oligomers. However, the effects are multifaceted and point to a more complex role of the TM helix than the one expected from the "TM dimer switch" model., Competing Interests: Conflict of 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 The Authors. Published by Elsevier Inc. All rights reserved.)

The interactions between proteins in membranes govern many cellular functions. Our ability to probe for such interactions has greatly evolved in recent years due to the introduction of new fluorescence techniques. As a result, we currently have a choice of methods that can be used to assess the spatial distribution of a membrane protein, its association state, and the thermodynamic stability of the oligomers in the native milieu. These biophysical measurements have revealed new insights into important biological processes in cellular membranes., 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.)

Background: The objective of this study was to evaluate the biomechanical stability of a medially placed nitinol staple compared to two crossed-screws in the first TMT-1 joint fusion in a cadaveric cyclic loading model., Methods: Seven matched pairs (N = 7) of lower limb cadaveric specimens were utilized. TMT-1 joints from each donor were fixed with a medially placed nitinol staple or dorsally placed two 3.5 mm partially threaded cannulated crossed-screws. Specimens were tested in a 4-point bending setting with increasing cyclic forces., Results: The mean plantar gapping was not significantly different between the two groups at any loading stage below 200 N. Specimens fixed with a nitinol staple failed at a mean load of 305 ± 57 N. Conversely, those fixed with crossed-screws failed at 373 ± 86 N. (P = .09)., Conclusion: There was no statistical difference between a medially placed nitinol staple and dorsally placed crossed-screws in failure loads and plantar gapping under cyclic loads at the TMT-1 joint, however, the staple fixation was much more variable., Level of Evidence: Level V, basic science study, biomechanics., Competing Interests: Declaration of Competing Interest All the authors declare no conflict of interest., (Copyright © 2024 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.)

Objective: It has been reported that chronically critical patients and patients at high risk of death have moderate to high levels of thirst distress. It was planned as a descriptive and cross-sectional study to determine thirst distress in palliative care patients. Methods: A Patient Information Form, the Thirst Severity Form, and the Thirst Distress Scale were used for data collection. The research was carried out between March 2023 and July 2023 with 157 patients hospitalized in the palliative care services of a state hospital and a training and research hospital in Istanbul, Turkey. Results: Of the patients, 51.6% were female. The mean thirst distress score of the patients was 23.96 ± 5.096. Of the patients, 0.6% had no thirst distress; 7.6% had mild, 48.4% had moderate, 38.9% had high, and 4.5% had severe thirst distress. Thirst scores of patients who were illiterate and did not smoke or drink alcohol were high ( P  < .05). The thirst distress score of patients fed with percutaneous endoscopic gastrostomy was higher than that of patients fed with total parenteral nutrition. There was a positive weak correlation between age and thirst distress score, a negative very weak correlation between fluid balance and thirst distress score, and a positive moderate correlation between Visual Analog Scale and thirst distress. Conclusion: Thirst distress was found to be at moderate and high levels in palliative care patients. In patients, thirst should be routinely assessed, and necessary interventions should be planned., 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 purpose of the study was to determine the predictive value of platelet-to-lymphocyte ratio (PLR) and Aspartate transaminase (AST)/alanine transaminase (ALT) ratio (De Ritis ratio) for recurrence and progression in non-muscle-invasive bladder cancer (NMIBC)., Methods: A total of 231 patients who underwent transurethral tumor resection between 2016 and 2022 were retrospectively analyzed. Preoperative test results, including AST, ALT, platelet, and lymphocyte counts, were used to calculate the PLR and De Ritis ratio. Univariate and multivariate analyses were performed to identify the predictive factors associated with recurrence and progression., Results: Based on the ROC curve, 1.19 and 1.21 were identified as the optimal cut-off values of the De Ritis ratio for recurrence and progression, respectively. Furthermore, PLR cut-off values for recurrence and progression were 114 and 118, respectively. There is a significant difference in recurrence-free survival (RFS) and progression-free survival (PFS) between the groups of patients with high and low De Ritis ratios (p = 0.028 and p = 0.021, respectively). In multivariate analysis, De Ritis ratio ≥ 1.19 and European Organization for Research and Treatment of Cancer (EORTC) high recurrence risk were determined to be significant predictors of tumor recurrence. Multivariate analysis also determined that T1 pathological stage, high tumor grade, European Organization for Research and Treatment of Cancer (EORTC) high progression risk, and De Ritis ratio ≥ 1.21 were risk factors for tumor progression., Conclusion: In our study, the preoperative De Ritis ratio represented an independent predictive factor for recurrence and progression in non-muscle invasive bladder cancer. The use of this biomarker in combination with other diagnostic/predictive tools might help urologists improve the clinical decision-making process in the future., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Avcı et al.)

Objectives: This study aimed to compare the course of anxiety change in children who used headphones during cast removal with controls in midterm follow-up., Patients and Methods: Sixty-six patients who underwent forearm fracture treatment with closed reduction and long arm casting between June 2021 and March 2023 were retrospectively reviewed. Patients were divided into two groups based on the use of headphones (n=27; 21 males, 6 females; mean age: 8.0±1.8 years; range, 6 to 12 years) or not (n=39; 27 males, 12 females; mean age: 8.9±1.8 years; range, 6 to 12 years) during cast removal with an oscillating saw. Primary outcome measures included preprocedure, postprocedure, and six-month anxiety assessments with the State-Trait Anxiety Inventory., Results: There was an acute increase in the mean state anxiety scores after the procedure, which returned to below baseline at the six-month follow-up in the headphone (31.4±8.3, 33.3±8.7, and 25.1±4.1, respectively) and control groups (34.9±11.1, 37.4±9.5, and 27.3±5.3, respectively). The mean trait anxiety scores before the procedure, after the procedure, and at six months remained similar in the headphone (33.6±3.0, 34.6±3.2, and 32.4±2.8; p>0.05) and control groups (34.1±2.7, 33.7±3.0, and 33.7±3.0, p>0.05)., Conclusion: This study suggests that the acute anxiety during cast removal did not create anxiety sequelae in the sixth month regardless of headphone use.

Aims: To investigate the extent of bone development around the scaffold of custom triflange acetabular components (CTACs) over time., Methods: We performed a single-centre historical prospective cohort study, including all patients with revision THA using the aMace CTAC between January 2017 and March 2021. A total of 18 patients (18 CTACs) were included. Models of the hemipelvis and the scaffold component of the CTACs were created by segmentation of CT scans. The CT scans were performed immediately postoperatively and at least one year after surgery. The amount of bone in contact with the scaffold was analyzed at both times, and the difference was calculated., Results: The mean time between the implantation and the second CT scan was two years (1 to 5). The mean age of the patients during CTAC implantation was 75 years (60 to 92). The mean scaffold-bone contact area increased from 16% (SD 12.6) to 28% (SD 11.9). The mean scaffold-bone distance decreased from a mean of 6.5 mm (SD 2.0) to 5.5 mm (SD 1.6). None of the CTACs were revised or radiologically loose., Conclusion: There was a statistically significant increase of scaffold-bone contact area over time, but the total contact area of the scaffold in relation to the acetabular bone remained relatively low. As all implants remained well fixed, the question remains to what extend the scaffold contributes to the observed stability, in relation to the screws. A future design implication might be an elimination of the bulky scaffold component. This design modification would reduce production costs and may optimize the primary fit of the implant., Competing Interests: W. H. C. Rijnen reports education grants (paid to Radboud University Medical Center) from Stryker, not related to this study., (© 2024 The British Editorial Society of Bone & Joint Surgery.)

Enhanced recovery after surgery (ERAS) protocols challenge the conventional and rigid methods of surgery and anesthesia and bring about novel changes that are quite drastic. The core principle of the protocol is to minimize the metabolic disturbance caused by surgical injury, facilitate the restoration of functions in a brief period, and promote the resumption of normal activity at the earliest. To compare the outcomes of ERAS and standard protocol for patients who have undergone radical cystectomy (RC) with ileal conduit urinary diversion. This prospective randomized controlled study was performed between 2015 and 2023. The 77 patients were divided into two groups ERAS (n=39) and Standard (n=38) by sequential randomization. These two groups are divided according to protocols of bowel preparation, anesthesia, and postoperative nutrition. The clinical and demographic characteristics of the patients, and the American Society of Anesthesiologists (ASA) and Eastern Cooperative Oncology Group (ECOG) scores were recorded. Perioperative findings, the degree of complications according to the Clavien-Dindo classification, and the total cost of treatment were recorded and analyzed. Length of hospital stay (18.82±9.25 day vs 27.34±15.05 day), and cost of treatment (2168,2±933$ 2879±1806$) were higher in the standard group. The rate of nausea and vomiting and the use of antiemetics were higher in the ERAS group compared to the standard group. In patients undergoing RC, the ERAS protocol was found to shorten the duration of hospitalization and reduce the total cost of hospital stay., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Çetin et al.)

Considering the increasing use of the transcatheter aortic valve implantation (TAVI) procedure, the relationship of contrast-induced nephropathy (CIN) with post-TAVI mortality has become important. The Mehran score was developed to detect the risk of CIN development after cardiac intervention. We aimed to compare the role of the modified Mehran score, which can be calculated pre-procedure, in predicting CIN development and compare it with the original Mehran score. We retrospectively collected data from TAVI procedures at our institution between December 2016 and June 2021; of 171 patients, 44 (25.7%) had CIN. We found no association between contrast media volume and CIN (387 ± 120 vs 418 ± 139 mL, P = .303). High and very high modified Mehran score and preoperative C-reactive protein (CRP) level were independent risk factors for CIN development after TAVI procedure. The area under curve (AUC) was .686 with 95% CI: .591-.780 and P < .001, and also, with a cut-off point of >7.5 points, there was 79.5% sensitivity and 63.0% specificity; otherwise, with a cut-off point of >9.5 points, there was 54.5% sensitivity and 71.7% specificity, for the modified Mehran score. The modified Mehran score comes into prominence compared with the original Mehran score since it can be calculated pre-procedure., 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: This study has been conducted to investigate the non-invasive diagnostic journey of patients with a transthyretin amyloid cardiomyopathy (aTTR-CM) in Turkey, identify the challenges and uncertainties encountered on the path to diagnosis from the perspectives of expert physicians, and develop recommendations that can be applied in such cases., Methods: This study employed a three-round modified Delphi method and included 10 cardiologists and five nuclear medicine specialists. Two hematologists also shared their expert opinions on the survey results related to hematological tests during a final face-to-face discussion. A consensus was reached when 80% or more of the panel members marked the "agree/strongly agree" or "disagree/strongly disagree" option., Results: The panelists unanimously agreed that the aTTR-CM diagnosis could be established through scintigraphy (using either 99mTc-PYP, 99mTc-DPD, or 99mTc-HMPD) in a patient with suspected cardiac amyloidosis (CA) without a further investigation if AL amyloidosis is ruled out (by sFLC, SPIE and UPIE). In addition, scintigraphy imaging performed by SPECT or SPECT-CT should reveal a myocardial uptake of Grade ≥2 with a heart-to-contralateral (H/CL) ratio of ≥1.5. The cardiology panelists recommended using cardiovascular magnetic resonance (CMR) and a detailed echocardiographic scoring as a last resort before considering an endomyocardial biopsy in patients with suspected CA whose scintigraphy results were discordant/inconclusive or negative but still carried a high clinical suspicion of aTTR-CM., Conclusion: The diagnostic approach for aTTR-CM should be customized based on the availability of diagnostic tools/methods in each expert clinic to achieve a timely and definitive diagnosis., 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., (© 2024 Çavuşoğlu, Başarıcı, Tüfekçioğlu, Özpelit, Özdemir, Sivrikoz, Altay, Değertekin, Dinçer, İkitimur, Kahveci, Bozkurt, Erkılıç, Kaya, Beksaç, Salihoğlu and Tokgözoğlu.)

Introduction: Periodontitis, a chronic inflammatory disease associated with dental biofilm, poses a significant threat to oral health. This study explores the roles of interleukin 1β (IL-1β) and nesfatin-1 in periodontal diseases, aiming to contribute to the molecular understanding of their pathogenesis., Material and Methods: A diverse cohort of 62 participants was recruited, spanning ages 20 to 60, and categorized into healthy, gingivitis, and periodontitis groups. Clinical measurements, including plaque index, gingival index, probing pocket depth, and bleeding on probing, were conducted. Gingival crevicular fluid (GCF) samples were collected for IL-1β and nesfatin-1 analysis using enzyme-linked immunosorbent assay (ELISA). Statistical analysis employed Kruskal-Wallis and Spearman correlation tests., Results: Significant differences in oral hygiene habits were observed among groups, particularly in the 40-60 age range. Clinical indices showed variations, with the highest IL-1β levels in the periodontitis group and the lowest nesfatin-1 levels. Correlation analysis revealed positive associations between IL-1β, nesfatin-1, and oral indices., Conclusions: While providing valuable insights, we acknowledge this study's limitations, including a cross-sectional design and a specific age range. Future research should employ longitudinal designs and larger cohorts, and explore broader inflammatory markers, genetic influences, and confounding variables for a more comprehensive understanding of periodontal diseases. The findings underscore the complex interplay between inflammatory markers and periodontal health., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Termedia.)

Background: Atrial fibrillation (AF) is the main arrhythmia associated with thromboembolic complications and cognitive impairment. In this study, we aimed to evaluate the relationship between cognitive impairment and different scoring systems developed for AF to improve the medical follow-up of cognitive impairment., Methods: Between January 2019 and December 2020, 124 patients between the age of 30 and 80 years, diagnosed with AF for at least 5 years and complaining about memory impairment during cardiological follow-up, were included in the study. The patients were divided into two groups based on their cognitive status as assessed by the Mini-Mental State Examination group 1 consisted of 52 patients with cognitive impairment and group 2 comprised 72 patients without cognitive impairment., Results: The ATRIA bleeding score had a positive moderate correlation ( r = 0.454, P < 0.001), the ATRIA stroke score had a strong correlation ( r = 0.738, P < 0.001), and the SAMe-TT 2 R 2 score had a strong correlation ( r = 0.688, P < 0.001) with cognitive impairment. However, CHADS 2 and CHA 2 DS 2 VASc scores were not statistically correlated with cognitive impairment. According to the receiver operating characteristic (ROC) curve, the area under the curve (AUC) of the ATRIA bleeding score was 0.761 with a 95% confidence interval (CI) of 0.678-0.844 and P < 0.001; also, for the ATRIA stroke score, AUC was 0.930 with a 95% CI of 0.886-0.974 and P < 0.001. In addition, for the SAMe-TT 2 R 2 score, AUC was 0.895 with a 95% CI of 0.838-0.952 and P < 0.001. In the pairwise comparison of AUC on ROC curves, the ATRIA stroke score and the SAMe-TT 2 R 2 score were statistically similar ( P = 0.324). ATRIA bleeding, ATRIA stroke, and SAMe-TT 2 R 2 scores were greater than CHADS 2 stroke score ( P : 0.0004, P < 0.0001, and P < 0.0001, respectively), but CHA 2 DS 2 -VASc and CHADS 2 stroke scores were statistically similar ( P : 0.402)., Conclusion: Both ATRIA stroke and SAMe-TT 2 R 2 scoring systems can provide a better correlation than CHADS 2 and CHA 2 DS 2 -VASc scores in patients with AF to evaluate their cognitive status. These two scores can be more useful to monitor the patients with AF for medical follow-up of cognitive status., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Annals of Indian Academy of Neurology.)

This study aimed to evaluate the utility of the systemic immune-inflammation index (SII) in predicting the development of Cardiac Implantable Electronic Device (CIED) infections. A retrospective analysis was performed using the medical records of 2185 patients who underwent CIED (including de novo, revision, or upgrade) implantation at our institution from January 2012 to December 2019. We recorded CIED infections and risk factors according to the patient, device, and procedural characteristics during the median 28.7 months (6.2-56.8) follow-up. CIED infections were identified in 52 patients. Diabetes, chronic renal disease, SII before implantation, new cardiac resynchronization therapy (CRT) implantation, CRT-battery replacement, revision or upgrade, and the number of previous procedures were independent predictors of CIED infections. The area under the curve (AUC) of SII to predict CIED infection was .733 (95% CI: .654-.811). A raised SII may be a useful predictor of CIED infection., 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.

The aim of this study is to determine the effects of 50% of 96 h LC 50 (5.25 ppm) diazinon on the expression of superoxide dismutase (SOD) enzyme genes ( sod1 , sod2 , and sod3b ) and SOD enzyme activity at the end of 24, 48, 72, and 96 h in platyfish liver and gill tissues. To this end, we determined the tissue-specific distribution of sod1 , sod2 , and sod3b genes and performed in silico analyses in platyfish ( Xiphophorus maculatus ). It was determined that malondialdehyde (MDA) level and SOD enzyme activity were increased in the liver [(43.90 EU mg protein -1 (control), 62.45 EU mg protein -1 (24 h), 73.17 EU mg protein -1 (48 h), 82.18 EU mg protein -1 (72 h), 92.93 EU mg protein -1 (96 h)] and gill [(16.44 EU mg protein -1 (control), 33.47 EU mg protein -1 (24 h), 50.38 EU mg protein -1 (48 h), 64.62 EU mg protein -1 (72 h), 74.04 EU mg protein -1 (96 h)] tissues of platyfish exposed to diazinon, while the expression of the sod genes was down-regulated. The tissue-specific distribution of the sod genes varied, with the tissues and the sod genes expression were being predominant in the liver (628.32 in sod1 , 637.59 in sod2 , 888.5 in sod3b ). Thus, the liver was considered a suitable tissue for further gene expression studies. Based on the phylogenetic analyses, platyfish sod genes can be reported to be orthologs of sod / SOD genes from other vertebrates. Identity/similarity analyses supported this determination. Conserved gene synteny proved that there are conserved sod genes in platyfish, zebrafish, and humans.

Objective: A 1-day point prevalence study was planned to obtain country data by determining the clinical characteristics, follow-up and treatment methods of coronavirus disease 2019 (COVID-19) cases that required intensive care unit (ICU) treatment in the second year of the pandemic., Material and Methods: All patients who were hospitalized in the ICUs due to COVID-19 between March 11, 2022, 08.00 am, and March 12, 2022, 08.00 am, were included in the study. Demographic characteristics, intensive care and laboratory data, radiological characteristics, and follow-up results of the patients were recorded., Results: A total of 811 patients from 59 centers were included in the study, 59% of the cases were male, and the mean age was 74 ± 14 years. At least one comorbid disease was present in 94% of the cases, and hypertension was the most common. When ICU weight scores were examined, Acute Physiology and Chronic Health Evaluation-II: 19 (15-27) and Sequential Organ Failure Assessment: 7 (4-10) were seen. Sepsis was present in 37% (n = 298) of cases. PaO2/FiO2 ratios of the patients were 190 the highest and 150 the lowest and 51% of the cases were followed via invasive mechanical ventilation. On the study day, 73% bilateral involvement was seen on chest x-ray, and ground-glass opacities (52%) were the most common on chest tomography. There was growth in culture in 40% (n = 318) of the cases, and the most common growth was in the tracheal aspirate (42%)., Conclusion: The clinical course of COVID-19 is variable, and ICU follow-up was required due to advanced age, comorbidity, presence of respiratory symptoms, and widespread radiological involvement. The need for respiratory support and the presence of secondary infection are important issues to be considered in the follow-up. Despite the end of the second year of the pandemic and vaccination, the high severity of the disease as well as the need for follow-up in ICUs has shown that COVID-19 is an important health problem.

Signaling bias is the ability of a receptor to differentially activate downstream signaling pathways in response to different ligands. Bias investigations have been hindered by inconsistent results in different cellular contexts. Here we introduce a methodology to identify and quantify bias in signal transduction across the plasma membrane without contributions from feedback loops and system bias. We apply the methodology to quantify phosphorylation efficiencies and determine absolute bias coefficients. We show that the signaling of epidermal growth factor receptor (EGFR) to EGF and TGFα is biased towards Y1068 and against Y1173 phosphorylation, but has no bias for epiregulin. We further show that the L834R mutation found in non-small-cell lung cancer induces signaling bias as it switches the preferences to Y1173 phosphorylation. The knowledge gained here challenges the current understanding of EGFR signaling in health and disease and opens avenues for the exploration of biased inhibitors as anti-cancer therapies., (© 2023. The Author(s).)

Fresh green leafy vegetables (FGLVs) are consumed either garden-fresh or by going through very few simple processing steps. For this reason, foodborne diseases that come with the consumption of fresh products in many countries have prioritized the development of new and reliable technologies to reduce food-related epidemics. Cold plasma (CP) is considered one of the sustainable and green processing approaches that inactivate target microorganisms without causing a significant temperature increase during processing. This review presents an overview of recent developments regarding the commercialization potential of CP-treated FGLVs, focusing on specific areas such as microbial inactivation and the influence of CP on product quality. The effect of CP differs according to the power of the plasma, frequency, gas flow rate, application time, ionizing gases composition, the distance between the electrodes and pressure, as well as the characteristics of the product. As well as microbial decontamination, CP offers significant potential for increasing the shelf life of perishable and short-shelf-life products. In addition, organizations actively involved in CP research and development and patent applications (2016-2022) have also been analyzed., (© 2023 The Authors. Comprehensive Reviews in Food Science and Food Safety published by Wiley Periodicals LLC on behalf of Institute of Food Technologists.)

Aquaculture species are often exposed to acute stressors such as low water levels and handling during routine aquaculture procedures. This might result in oxidative stress by the increased reactive oxygen species (ROS)' production ( e.g. , superoxide anion). The harmful effects of ROS are eliminated by a defense system, referred antioxidant defense system (ADS). sod1 is the first gene involved in the ADS. Therefore, we cloned and characterized the open reading frame of the sod1 in brown trout. Then, we determined the effects of low water level and handling stress on sod1 mRNA expression in the liver and gills at 0 min, 1 and 2 h. The total RNA isolated was used to synthesize cDNA for RT-qPCR analysis. Phylogenetic tree, identity/similarity percentages, genomic organization, and conserved gene synteny analyses were applied to characterize Sod1/ sod1 . While low water level stress upregulated sod1 expression in the liver compared to the control group, no significant differences were observed in the gills between experimental groups. However, brown trout differently responded to handling stress at different time intervals in both tissues. Transcriptional differences were also noted between the sexes. This study contributes to the current understanding of the molecular mechanism between oxidative stress and ADS.

Purpose: Our aim was to investigate the association of prognostic nutritional index (PNI) score with erectile dysfunction (ED), therefore, we prospectively evaluated the relationship between penile doppler ultrasonography (PDU) findings, PNI and Sexual Health Inventory for Men (SHIM) scores in patients with ED., Methods: A total of 414 patients' characteristics, laboratory findings, SHIM and PNI scores were recorded. The PNI is calculated using the formula: 10 × serum albumin + 0.005 × total lymphocyte count. PDU was performed in patients with a SHIM score of 17 and below, while patients with a SHIM score ≥ 18 were recruited for the control group. Correlation analysis was performed to evaluate the relationship between PNI, SHIM scores and PDU parameters. The predictive value of variables for severe ED was assessed with regression analysis., Results: A significant difference was demonstrated between the ED subgroups and control group for total cholesterol (p = 0.04), serum albumin (p = 0.03), total lymphocyte count (p = 0.02), BDI score (p < 0.001), and PNI score (p = 0.03). A strong positive correlation between PNI score and PSV (rho = 0.73; p = 0.001), a moderate negative correlation between PNI score and EDV (rho = - 0.54; p = 0.02), and a moderate positive correlation between PNI and SHIM scores (rho = 0.61; p = 0.02) were demonstrated. PNI score ≤ 40 (OR: 3.49; p = 0.01), age (OR: 2.15; p = 0.03) and total cholesterol (OR: 2.03; p = 0.04) were determined as significant predictors of severe ED in multivariate analysis., Conclusion: Our results demonstrated that PNI score is significantly lower in patients with severe and moderate ED. It has been also revealed that the PNI score is an independent predictive factor for severe ED., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Objective: Hexapod external fixator systems allow simultaneous deformity correction in multiple planes as well as limb lengthening. The aim of this study is to evaluate the accuracy of a hexapod frame (smart correction frame) in different types of tibial deformities requiring correction with or without lengthening., Methods: A total of 54 tibial angular deformities and limb length discrepancies operated with a hexapod frame between January 2015 and January 2021 were classified into four groups: "Group A ( n  = 13): only lengthening," "Group B ( n  = 14): lengthening and uniplanar correction," "Group C ( n  = 16): only uniplanar correction," and "Group D ( n  = 11): biplanar correction." The accuracy of angular deformity correction/lengthening was calculated by dividing the actual correction/lengthening achieved after frame removal by the preoperative planned lengthening/correction., Results: The lengthening accuracy in Group A and Group B was 96.3 ± 7.1% and 95.7 ± 5.9%, respectively ( P  = 0.685). The angular deformity correction accuracy was 85.1 ± 9.9% for Group B, 85.2 ± 13.9% for Group C, and 80.2 ± 18.4% for Group D ( P  = 0.852). A revision program was performed in six cases (1 in Group B, 1 in Group C, and 4 in Group D) for full correction of the deformities., Conclusion: The accuracy of tibial lengthening is high with the hexapod frame and is minimally affected by simultaneous deformity correction; however, the accuracy of angular correction slightly reduces as the deformity becomes more complex. Surgeons should be aware that reprogramming may be required after complex deformity correction., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

This study aimed to investigate lower urinary tract symptoms (LUTS) in Turkish adult women and to compare toileting behaviors in women with and without LUTS. This cross-sectional study was conducted in 815 women. The International Consultation on Incontinence Modular Questionnaire - Female LUTS and a toileting behaviors form, created by the authors, were used in evaluations. Nearly 50 % of the women had at least one LUTS, 45.8 % had storage symptoms, 7.4 % had voiding symptoms, and 20.2 % had incontinence symptoms. The rates of premature urination, straining during urination, delayed urination, and sitting on the toilet while urinating were higher in women with LUTS than in women without LUTS ( p  < .05). The rate of squatting on the toilet while urinating was lower in women with LUTS than those without LUTS ( p  < .05). Various LUTS were common in adult women. Some toileting behaviors such as premature urination, straining during urination, delayed urination, and sitting on the toilet while urinating were higher in women with LUTS compared to women without LUTS. Since the rate of unhealthy toilet behaviors is higher in women with LUTS, it is important to know unhealthy toilet behaviors in the management of LUTS and to organize training programs to prevent these behaviors and LUTS.

Patent foramen ovale closure is recommended for patients who are at risk for recurrent paradoxical embolism and cryptogenic stroke. The standard technique of patent foramen ovale closure is established from the femoral vein. However, alternative methods may be necessary for patent foramen ovale closure as in every interventional procedure. A 45-year-old female patient with an intramural giant uterine myoma had a history of recurrent deep vein thrombosis and stroke. A diffuse thrombus was detected in both iliac veins associated with inferior vena cava compression of the myoma. Also, a patent foramen ovale was revealed on echocardiography as a cause of embolic events. Hysterectomy was initially planned by gynaecology, but due to the possible risk of embolisation of inferior vena cava thrombus and stroke after removal of the compressive mass during hysterectomy, initial patent foramen ovale closure and then hysterectomy was scheduled in the Gynecology-Cardiology-Cardivascular Surgery council. Patent foramen ovale closure was performed via the right jugular vein approach. But because of the tight left atrial ostium of the patent foramen ovale, the catheter could not pass to the left atrium from the right atrium. With an anchor of a 5.0 × 15 mm coronary balloon over a 0.014-inch guidewire to the pulmonary vein, we were able to reach the left atrium. The patent foramen ovale was closed successfully, and the patient underwent a hysterectomy after closure without any embolic event. The patient was asymptomatic at 6 months of control.

Background/Aim: YouTube provides information on several health-conditions including lipedema. The aim of this study was to investigate the properties, quality, and quantity of YouTube videos on lipedema. Methods: We explored YouTube using the key word lipedema and the initial top 50 videos were included to review. The properties comprising informers, target, and domains of videos covering number of views, likes, dislikes, duration, viewing rate (VR), and video power index (VPI) were recorded. A modified DISCERN tool and global quality scale (GQS) were used to assess the reliability and quality of videos, respectively. Results: The top 50 videos had a mean of 35,805 views, 282 likes, 12 dislikes, and 30 comments. The mean VPI (96.4) and VR (63.8%) were high. The videos were generally uploaded by health professionals for patient/public and health professional targets with the same ratio (50%). The majority of video contents was related to general information (68%) followed by surgical treatment (62%). Only a small ratio of their content (22%) was about nonsurgical management. The reliability and quality of the videos were intermediate to low. The median DISCERN and GQS scores were higher in the videos uploaded by health professional group compared with nonhealth professionals, but the number of views, VPI, and VR were similar between the groups with regard to the source. Conclusion: YouTube videos on lipedema are mostly provided by health professionals targeting both public/patients and health care providers but the content is limited and the quality and reliability of them were low to intermediate. Therefore, the lipedema specialists are suggested to work together to create up-to-date, high-quality, accessible online educational content to meet the needs of both patients/public and the health professionals. In addition, control mechanisms and careful peer reviewing of the videos informed by nonhealth professionals are warranted to avoid misleading information.

Introduction: Sodium-glucose co-transporter 2 (SGLT-2) inhibitors have been shown to reduce the risk of atrial fibrillation (AF) occurrence in patients with diabetes mellitus (DM). In this prospective study, we aimed to analyze the effect of SGLT-2 inhibitors as an add-on therapy to metformin on P wave indices and atrial electromechanics in patients with type 2 DM., Methods: A total of 144 patients enrolled. Electrocardiographic indices were recorded on admission and at 3rd and 6th month of the combination therapy. P wave indices and atrial electromechanical coupling intervals were measured and compared., Results: Although decrease in P wave dispersion (62.78 ± 9.59 vs. 53.62 ± 10.65; p = .002) became significant at 6th month of combination therapy, significant decreases in P wave terminal force in V 1 (37.79 ± 3.45 vs. 32.01 ± 5.74; p = .035), left atrial volume index (35.87 ± 6.57 vs. 31.33 ± 7.31; p = .042), left sided intra-atrial electromechanical delay (32.09 ± 9.17 vs. 27.61 ± 8.50; p = .016), right sided intra-atrial electromechanical delay (31.82 ± 4.92 vs. 27.65 ± 8.05; p = .042), and interatrial electromechanical delay (29.65 ± 7.52 vs. 25.96 ± 4.30; p = .044) were seen as early as 3rd month of treatment. Besides, there was no statistically significant difference between Empagliflozin and Dapagliflozin subgroups in terms of mentioned parameters., Conclusion: SGLT-2 inhibitors as an add-on therapy to metformin were shown to significantly improve P wave indices and atrial electromechanics in type 2 DM patients as early as the 3rd month of treatment. It was thought that this may be one of the underlying mechanisms of the decrease in the frequency of AF with the use of SGLT2 inhibitors., (© 2023 Wiley Periodicals LLC.)

This work investigated the effects of the usage of colored corn as a replacement for 50% and 100% yellow corn in the diet of Japanese quail. Two hundred and forty-day-old Japanese quails were indiscriminately separated into four experimental groups consisting of six replicates each containing 10 quails. Experimental groups designed: the control group (C) (basal diet-0% colored corn, vaccinated), negative control group (NC) (basal diet-0% colored corn, no vaccine), 50% CC group (basal diet-50% colored corn, vaccinated), and 100% CC group (basal diet-100% colored corn, vaccinated). At the end of the 35-day period, the highest body weight and body weight gain (BWG) were recorded in the 50% CC (P < 0.05). The highest feed intake (FI) was recorded in the 100% CC group, the lowest FI in C (P > 0.05), and the best feed conversion ratio (FCR) in the 50% CC group (P < 0.05). While L* was not affected, a* and b* values were significantly affected by feeding colored corn (P < 0.05). Meat pH, cooking loss (CL), and water holding capacity (WHC) values were significantly affected, and the highest pH and CL values were in the C group and the highest WHC value in NC (P < 0.05). Colored corn had no influence on MDA 7th concentration of breast meat. The antibody titers against NDV were significantly superior in the vaccinated groups than in the NC (P < 0.05). In conclusion, the use of colored corn in quail had an affirmative effect on meat quality and growth performance but not on the immune response of quail against NDV., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Objectives: In this study, we aimed to identify the most frequently reported claims after total hip arthroplasty (THA) and the reasons put forward by the plaintiffs., Patients and Methods: Between January 2011 and December 2020, data of a total of 74 cases (21 males, 53 females; mean age: 53.7±12.8 years; range, 29 to 83 years) obtained from the Turkish Forensic Medicine Institute were retrospectively analyzed. Claims for litigation, demographic data, data regarding the identity of the accused and the hospital setting were recorded., Results: The most common reason for lawsuits was death (n=15; 20.3%), followed by nerve injury (n=13; 17.6%), and eight patients had more than one complaint. According to the forensic medicine reports, malpractice was detected in 10 (12.5%) of the cases. Among the hospital types, only nerve injury made a significant difference among all complaint sources in different hospital settings (p=0.003)., Conclusion: In our study, death was the most common reason for lawsuits regarding malpractice accusations after THA, which is different from medical malpractice allegations throughout the world.

The molecular characteristics and tissue disruption of 10 fatty acid-binding protein (fabp) genes in gilthead seabream (Sparus aurata) were investigated, and their expression levels were found in the fish fed diets with different vegetable oil (VO) sources, which may explore the potential function of fabp genes in S. aurata. For this purpose, the open reading frames of fabp genes involved in the transport and ß-oxidation of fatty acids (FA) were molecularly cloned and characterized. S. aurata was then exposed to a two-staged feeding trial (the grow-out period following a wash-out period) at low water temperatures. In the grow-out period, the fish were fed diets containing 50% and 100% ratios of various VOs for 60 days, and in the wash-out period, the fish were fed a diet containing 100% fish oil (FO) for 30 days. It has been determined that (a) S. aurata and vertebrate fabp/FABP genes are orthologues; (b) spatio-temporal differences in tissue-specific patterns of fabp genes differ importantly; for instance, the difference between the highest and lowest values reaches 13 × 10 5 -fold in the fabp10a; and (c) VO-based diets upregulated fabp transcript levels in the liver and muscle with some exceptions, such as liver fabp11a and muscle fabp7a. Gene expressions of only the hepatic fabp7b and fabp10a genes were diminished at the end of the wash-out period. In this study, the authors provide further evidence that dietary FAs affect fabp mRNA expressions in S. aurata. This might be useful in the nutritional control of fabp genes to maintain lipid homeostasis in marine fish fed VO-based diets at low water temperatures., (© 2023 Fisheries Society of the British Isles.)

Although strain tolerance to high product concentrations is a barrier to the economically viable biomanufacturing of industrial chemicals, chemical tolerance mechanisms are often unknown. To reveal tolerance mechanisms, an automated platform was utilized to evolve Escherichia coli to grow optimally in the presence of 11 industrial chemicals (1,2-propanediol, 2,3-butanediol, glutarate, adipate, putrescine, hexamethylenediamine, butanol, isobutyrate, coumarate, octanoate, hexanoate), reaching tolerance at concentrations 60%-400% higher than initial toxic levels. Sequencing genomes of 223 isolates from 89 populations, reverse engineering, and cross-compound tolerance profiling were employed to uncover tolerance mechanisms. We show that: 1) cells are tolerized via frequent mutation of membrane transporters or cell wall-associated proteins (e.g., ProV, KgtP, SapB, NagA, NagC, MreB), transcription and translation machineries (e.g., RpoA, RpoB, RpoC, RpsA, RpsG, NusA, Rho), stress signaling proteins (e.g., RelA, SspA, SpoT, YobF), and for certain chemicals, regulators and enzymes in metabolism (e.g., MetJ, NadR, GudD, PurT); 2) osmotic stress plays a significant role in tolerance when chemical concentrations exceed a general threshold and mutated genes frequently overlap with those enabling chemical tolerance in membrane transporters and cell wall-associated proteins; 3) tolerization to a specific chemical generally improves tolerance to structurally similar compounds whereas a tradeoff can occur on dissimilar chemicals, and 4) using pre-tolerized starting isolates can hugely enhance the subsequent production of chemicals when a production pathway is inserted in many, but not all, evolved tolerized host strains, underpinning the need for evolving multiple parallel populations. Taken as a whole, this study provides a comprehensive genotype-phenotype map based on identified mutations and growth phenotypes for 223 chemical tolerant isolates., Competing Interests: Declaration of competing interest All authors declare no competing interests., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background and Purpose: Long-term follow-up of young patients following cemented primary THA is scarce. Therefore, we analyzed the survival of all consecutive primary THAs in patients under 25 years performed at our institute., Patients and Methods: All primary THAs performed in patients younger than 25 years in our tertiary care institute between 1988 and 2015 were included (n = 119). Cemented fixation was used in all patients. In the case of acetabular bone deficiencies, reconstruction was performed using impaction bone grafting (IBG). We used Kaplan-Meier analysis to determine the survival of the primary THA with endpoints revision for any reason and aseptic loosening., Results: The mean age at the primary THA was 20 years. The most prevalent diagnosis was avascular necrosis (31%). The mean follow-up of the primary THA was 11 years (range 0-32). 2 patients (2 hips) were lost to follow-up. 16 revisions were registered. The survival of any component for endpoint revision for any reason was estimated at 92% (95% confidence interval [CI] 84-96) and 81% (CI 67-90) at 10- and 15-year follow-up, respectively. The survival of any component for endpoint revision for aseptic loosening was 99% (CI 93-100) and 88% (CI 71-95) at 10 and 15 years, respectively. 3 hips were revised due to infection., Conclusion: Favorable long-term outcomes of primary THA in very young patients can be obtained using cemented fixation and IBG.

Background: Coronavirus disease 2019 (COVID-19) is an infection resulting in very high morbidity and mortality rates globally. Limited data are available on the cardiovascular manifestations in these patients. The aim of this study was to analyse the daily troponin I and D-dimer levels and their impact on the need for intensive care and on mortality rates of COVID-19-infected patients., Methods: Two-hundred and five patients who were hospitalised between 20 March and 5 May 2020, with a diagnosis of moderate-to-severe COVID-19 pneumonia, were analysed retrospectively. Serum troponin I and D-dimer levels were recorded for at least 10 days after admission., Results: The average age was higher in the group of patients who died compared to the group who were discharged (67.79 ± 14.9 vs 56.87 ± 18.15 years, respectively, p < 0.001). The presence of hypertension, diabetes mellitus, previous coronary bypass surgery, heart failure, chronic renal failure and chronic obstructive pulmonary disease statistically significantly affected mortality rates ( p = 0.003, 0.004, 0.045, 0.02, 0.003, 0.007, respectively). The first 10 days of measurements of troponin I and D-dimer were associated with intensive care requirements and mortality ( p < 0.001). Both troponin I and D-dimer were higher in the group who died compared to the patients requiring intensive care. Troponin I values of ≥ 16.05 pg/ml on the seventh day were related to the need for intensive care [area under the curve (AUC) 0.896, sensitivity 78.6%, specificity 78.3%, p < 0.001). Troponin I values ≥ 30.25 pg/ml on the ninth day were related to mortality (AUC 0.920, sensitivity 89.5%, specificity 89.3%, p < 0.001). D-dimer values ≥ 878 hg/ml on the second day were associated with intensive care need (AUC 0.896, sensitivity 78.6%, specificity 78.3%, p < 0.001). D-dimer values ≥ 1 106 hg/ml on the 10th day were associated with mortality (AUC 0.817, sensitivity 68.4%, specificity 65.2%, p < 0.001). It was observed that hospitalisation periods ≥ 9.5 days were associated with mortality (AUC 0.738, sensitivity 68.4%, specificity 65.9%, p < 0.001)., Conclusions: We showed that hospitalisations ≥ 9.5 days in duration were related to increased mortality rates. Troponin I and D-dimer follow-up values in the serum were more effective than other inflammatory markers in predicting mortality and the need for intensive care. A high troponin I value should alert the clinician in terms of clinical deterioration.

Background: A new clinical manifestation called post or long coronavirus disease (p/l COVID) has walked into our lives after the acute COVID-19 phase. P/l COVID may lead to myocardial injury with subsequent cardiac problems. Diagnosing these patients quickly and simply has become more important due to the increasing number of patients with p/l COVID., Objectives: We compared strain echocardiography (SE) parameters of patients who suffered from atypical chest pain and had sequel myocarditis findings on cardiac magnetic resonance (CMR). We aimed to investigate the value of SE for detection of myocardial involvement in patients with p/l COVID., Methods: A total of 42 patients were enrolled. Our population was separated into two groups. The CMR(-) group (n = 21) had no myocardial sequelae on CMR, whereas the CMR(+) group had myocardial sequelae on CMR (n = 21). The predictive value of SE for myocarditis was also evaluated by age-adjusted multivariate analysis. P values < 0.05 were considered statistically significant., Results: When compared with left ventricular ejection fraction (LVEF), global longitudinal strain (GLS) and global circumferential strain (GCS) had a stronger relationship (LVEF, p = 0.05; GLS, p < 0.001; GCS, p < 0.001) with p/l COVID associated myocardial involvement. GLS < 20.35 had 85.7% sensitivity and 81% specificity; GCS < 21.35 had 81% sensitivity and 81% specificity as diagnostic values for myocardial sequelae detected with CMR. While there was no difference between the groups in terms of inflammatory markers (C-reactive protein, p = 0.31), a difference was observed between biochemical markers, which are indicators of cardiac involvement (brain natriuretic peptide, p < 0.001)., Conclusion: SE is more useful than traditional echocardiography for making diagnosis quickly and accurately in order not to delay treatment in the presence of myocardial involvement.

Objectives: The aim of the study was to investigate whether clavicular symmetry was a valid assumption and to assess the factors that could predict clavicular asymmetry., Patients and Methods: Between January 2021 and April 2021, a total of 100 consecutive patients (61 males, 39 females; mean age: 63.6±15.5 years; range, 27 to 94 years) whose both clavicles were adequately seen on chest computed tomography (CT) were retrospectively analyzed. Clavicular lengths were measured on three-dimensional (3D) reconstruction of chest CTs by two independent orthopedic surgeons on two separate occasions. The longest distance passing the straight line between the most lateral part of the clavicle at the acromioclavicular joint and the most medial point of the clavicle on the sternoclavicular joint was given as the clavicle length after adjusting tilt of convertible 3D CTs. Clavicular length difference was calculated by subtracting the short clavicle's length from the long clavicle's length. Patients' age and sex were noted. The calculated clavicular length differences were assigned into three groups: ≤5 mm, >5 mm and ≤10 mm, and >10 mm., Results: The mean right and left clavicle lengths were 13.9±1.3 cm and 14.1±1.2 cm, respectively (p<0.001). A total of 29 patients (29%) had >5 mm clavicle asymmetry and six patients (6%) had more than 10 mm clavicular length difference. Age, sex, and clavicular length were not associated with the clavicular length difference., Conclusion: Our study results showed that 29% of the patients had >5 mm clavicular length asymmetry. The clavicular symmetry may not be a valid assumption in the decision making for the surgical treatment of mid-shaft clavicle fractures; thus, this assumption may lead to maltreatment. More factors that can predict clavicle asymmetry should be investigated in future studies.

Objective: Pollen-food allergy syndrome (PFAS) is an IgE-mediated allergic reaction to certain foods due to prior sensitization to pollen allergens. The data about the prevalence of PFAS in adults in Turkey is not sufficiently reported. Our objective was to investigate the frequency and clinical features of PFAS in adult patients with seasonal allergic rhinitis (SAR)., Patients and Methods: A total of 222 patients with SAR were enrolled in our outpatient allergy clinic at Hacettepe University, during a ten-month period. A questionnaire was used to evaluate patients and to categorize those who experienced obvious allergy symptoms consistent with PFAS. Atopy was assessed by a standard skin prick test panel including common aeroallergen extracts., Results: Among 222 patients with a diagnosis of SAR, 31 had patient reported PFAS (31/222, 14%). Among them, 23 (74.2%) were females, and their mean age was 32.29±9.24 years. The most common symptoms were isolated oropharyngeal symptoms (58.1%), followed by urticaria (51.6%) after culprit food ingestion. The most frequent culprit foods were eggplant, walnut, kiwi, peach, and melon. The predominant sensitizing aeroallergen was grass pollen., Conclusions: PFAS can be frequently observed in adults who are followed up for SAR. The most frequently involved foods are eggplant, walnut, kiwi, peach, and melon in Ankara Province. The symptoms of PFAS are usually localized in the oropharyngeal area and are self-limited.

Objective: The purpose of the study was to look at the connection between newborn intensive care requirements in low-risk pregnancies and maternal blood pregnancy-associated plasma protein (PAPP-A) and free human chorionic gonadotropin (hCG) levels, which are elements of screening tests within the first trimester., Materials and Methods: In the delivery unit of our hospital, pregnant women between the years of 18 and 35 had singleton pregnancies who delivered between 37 and 41 weeks of pregnancy between July 2021 and January 2022 were split into 2 groups. One hundred eighty two pregnant women with infants who required neonatal intensive care (NICU) were enrolled in the first group, whereas 890 pregnant women with infants who did not require NICU were enrolled in the second. These two groups' maternal blood PAPP-A and free hCG levels, which are among the first trimester screening procedures, were examined. Additionally, subgroup analysis were performed in terms of cesarean section indications and NICU admission indications. Logistic regression analysis and ROC analysis were performed with related variables for estimating NICU need., Results: The mean serum PAPP-A value was found to be 0.91±0.34 multiples of the median (MoM) in the blood taken from the infant mothers who needed NICU, while the mean serum PAPP-A value in the blood taken from infant mothers who did not need NICU was 1.12±0.59 MoM (p<0.000). The PAPP-A MoM mean of the group with Apgar 5th minute score ≥8 (1.09±0.57) was higher than the PAPP-A mean (0.84±0.27) of the Apgar 5th minute score <7 group (p=0.013). According to the results of our study, in groups with a PAPP-A value below 0.95, the possibility of increased NICU need of newborns is higher., Conclusion: The low serum PAPP-A level, which is used as a screening test among pregnant women, demonstrates that it is successful in predicting perinatal outcomes in the low-risk pregnancy group., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2022 by Turkish Society of Obstetrics and Gynecology | Turkish Journal of Obstetrics and Gynecology published by Galenos Publishing House.)

Resistance towards cancer treatment represents a major clinical obstacle, preventing cure of cancer patients. To gain mechanistic insights, we developed a model for acquired resistance to chemotherapy by treating mice carrying patient derived xenografts (PDX) of acute lymphoblastic leukemia with widely-used cytotoxic drugs for 18 consecutive weeks. In two distinct PDX samples, tumors initially responded to treatment, until stable disease and eventually tumor re-growth evolved under therapy, at highly similar kinetics between replicate mice. Notably, replicate tumors developed different mutations in TP53 and individual sets of chromosomal alterations, suggesting independent parallel clonal evolution rather than selection, driven by a combination of stochastic and deterministic processes. Transcriptome and proteome showed shared dysregulations between replicate tumors providing putative targets to overcome resistance. In vivo CRISPR/Cas9 dropout screens in PDX revealed broad dependency on BCL2, BRIP1 and COPS2. Accordingly, venetoclax re-sensitized derivative tumors towards chemotherapy, despite genomic heterogeneity, demonstrating direct translatability of the approach. Hence, despite the presence of multiple resistance-associated genomic alterations, effective rescue treatment for polychemotherapy-resistant tumors can be identified using functional testing in preclinical models., (© 2022. The Author(s).)

Background: The European Network for Drug Allergy (ENDA) proposed a consensus document for hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) in 2011. A subgroup of patients with NSAIDs-exacerbated respiratory disease (NERD) develop urticaria/angioedema type reactions in response to NSAIDs. The Kalyoncu classification might be a novel option to classify patients with NSAID hypersensitivity (NH). In this study, we compare the ENDA and the Kalyoncu classifications., Methods: This study enrolled a total of 196 patients. NH reaction types were categorized as asthma, rhinitis, urticaria/angioedema and anaphylaxis. Based on the reaction history and oral provocation test findings, patients were grouped according to ENDA and Kalyoncu classifications., Results: The mean age of the 196 patients was 40.32±13.28 years, and 130 (66.3%) of them were female. Under the ENDA and Kalyoncu classifications, the most common NH subgroups were NERD (32%), and isolated NH (34.2%), the least prevalent NH subgroups were single NSAID-induced delayed reactions (SNIDR) (1.5%), and pseudo Samter's syndrome (11.7%)., Conclusions: Our research revealed that the Kalyoncu classification is more descriptive of patients with NERD exhibiting urticaria/angioedema-type reactions. It also provides future risk assessment for development of NERD. For controversial cases, the Kalyoncu classification can be utilized as a new complimentary option alone or in conjunction with ENDA classification., Competing Interests: The authors declare no potential conflicts of interests with respect to research, authorship and/or publication of this article.

The fall webworm (FWW), Hyphantria cunea Drury (Lepidoptera: Erebidae), is an invasive and polyphagous insect pest of many economically important crops such as hazelnuts, apple, and mulberry. Recently, there have been an increasing number of reports about the damaging activities of FWW from hazelnut growing areas of Turkey indicating that currently existing control methods fail to satisfy the expectations of growers. Entomopathogenic nematodes (EPNs) in the Steinernematidae and Heterorhabditidae (Nematoda: Rhabditida) families and the symbiotic bacteria they carry in their intestine have a great potential for the management of many agriculturally important pests. In this study, the symbiotic bacteria of local EPN species (Heterorhabditis bacteriophora AVB-15, Steinernema feltiae KCS-4S, and Steinernema bicornotum MGZ-4S) recovered from the central Anatolia region was characterized using recA gene region as Photorhabdus luminescens, Xenorhabdus bovienii and Xenorhabdus budapestensis. The contact (25, 50, 100, 200 IJs/Petri) and oral efficacies of the infective juveniles (IJs) (25, 50, 100, 200 IJs/leaf) of these EPN isolates determined on 3rd/4th instar larvae, and cell-free supernatants from the identified symbiotic bacteria were evaluated separately on the 3rd and 4th larval instars of FWW in Petri dish environment under laboratory conditions (25 ± 1 °C, 60% of RH). In the Petri dish bioassays of EPN species, the most pathogenic isolate at the 1st DAT and 4th DAT was S. feltiae which caused 50% mortality at the highest concentration (200 IJs/Petri) and the highest mortality rate (97.5%) were achieved at 4th DAT by H. bacteriophora AVB-15 isolate. Surprisingly, the mortality rates were generally higher at the lowest concentrations and 82.5% mortality were reached 4th DAT by S. bicornotum at the lowest concentration (25 IJs/leaf) in the leaf bioassays. Mortality rates were higher in both Petri dish and filter paper efficacies of cell-free supernatants at the 2nd DAT and the highest mortality (87.5%) was reached in the contact efficacy studies when applied X. bovienii KCS-4S strain. The results suggest that the tested EPN species and CFSs have good potential for biological control of the larvae of FWW and can contribute to the IPM programs of FWW. However, the efficacy of both IJs of EPNs and CFSs of their symbiotic bacteria on larvae of FWW requires further studies to verify their efficiency in the field., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background/aim: We have designed an adjustable bone plate (ABP) which allows bone shortening and lengthening after fixation, which is a property not present in any of the plate systems available today. The aim of the current study was to examine the new ABP's segmental bone transfer capability for the treatment of a segmental bone defect in an animal model., Materials and Methods: Five sheep had ABPs attached to 10 of their tibias and bone defects of 15 mm in size were created. The pinion mechanism was moved with a manual screwdriver at a rate of 1mm/day for 15 days starting 3 days postoperatively. The animals were euthanized 3 months postoperatively, and the defect site and the transferred segment were evaluated by radiological and histological examination., Results: The radiological results revealed successful transfers of 14.6 ± 1.2 mm of bone segment on all tibia defects without any complications. The histological evaluation showed new bone formation in both the extension and the docking sites. No rupture or breakage was observed within the plates., Conclusion: We have presented the potential of a new generation ABP for use in segmental bone transfer in an animal model as well as for future clinical applications., Competing Interests: Conflict of interest statement: The authors declare that they have no conflicts of interest., (© TÜBİTAK.)

Introduction: Primary immunodeficiency diseases (PIDs) are a group of heterogeneous disorders that result from one or more immune system abnormalities and have a wide range of clinical manifestations., Aim: To evaluate the demographic, clinical, and radiological features of adult patients with PID., Material and Methods: We retrospectively reviewed the data of adult patients with PID who had been receiving immunoglobulin therapy at the adult allergy and immunology outpatient clinic between November 2017 and April 2022., Results: Of the 23 patients included, 4 (17.4%) were females and 19 (82.6%) were males. The mean age was 38.7 ±16.2 (range: 18-75) years. Time of delay in the diagnosis of immunodeficiency was 14.9 ±15.7 (range: 0.5-49) years. The most common complaint on admission was sinopulmonary infection, and 65% of the patients had bronchiectasis. A total of 6 patients had a history of lymphoma, and 3 of them were diagnosed during the study period. Recurrence of lymphoma was observed in 1 patient., Conclusions: Patients with PID frequently have findings related to more than one organ system, and the diagnosis is often delayed in adults. Recognition and increased awareness of these manifestations is essential for early diagnosis and reducing morbidity and mortality., Competing Interests: The author declares conflict of interest., (Copyright: © 2022 Termedia Sp. z o. o.)

Aims: The aim of this study is to report the long-term outcomes of instrumented femoral revisions with impaction allograft bone grafting (IBG) using the X-change femoral revision system at 30 years after introduction of the technique., Methods: We updated the outcomes of our previous study, based on 208 consecutive revisions using IBG and the X-change femoral revision system in combination with a cemented polished stem, performed in our tertiary care institute between 1991 and 2007. Kaplan-Meier survival analyses were used to determine the survival rate of the revisions with endpoint revision for any reason and aseptic loosening. Secondary outcomes were radiological loosening and patient-reported outcome measures., Results: Mean age at revision total hip arthroplasty (THA) was 64.9 years (30 to 86). The most prevalent diagnosis for the femoral revision was aseptic loosening. At review in May 2021, 81 patients (85 hips) were still alive and 118 patients (120 hips; 58%) had died. Three patients (3 hips; 1%) were lost to follow-up at 11, 15, and 16 years after surgery, respectively. Data of all deceased and lost patients were included until final follow-up. The mean follow-up was 13.4 years (0 to 28). During the follow-up, 22 re-revisions were performed. The most common reason for re-revision was infection (n = 12; 54%). The survival with endpoint re-revision for any reason was 86% (95% confidence interval (CI) 79 to 91) at 20 years and 74% (95% CI 43 to 89) at 25 years after surgery. The survival for endpoint re-revision for aseptic loosening was 97% (95% CI 91 to 99) after both 20 and 25 years., Conclusion: We conclude that femoral IBG is a valuable technique that can reconstitute femoral bone loss in the long term. After 25 years of follow-up, few re-revisions for aseptic loosening were required. Also, the overall revision rate is very acceptable at a long follow-up. This technique is especially attractive for younger patients facing femoral revisions with extensive bone loss.Cite this article: Bone Joint J  2022;104-B(9):1039-1046.

Objective: MicroRNAs have been explored as potential biomarkers for many pathological processes including coronary artery disease. In this study, we aimed to compare the circulating levels of selected atherosclerosis-associated miRNAs in patients with a history of early-onset coronary artery disease with that of age- and sex-matched healthy controls and older patients with late-onset coronary artery disease., Methods: Study population consisted of 30 patients with early onset coronary artery disease, 31 age- and sex-matched healthy controls, and 30 patients with late-onset coronary artery disease. Plasma levels of 13 microRNAs (endothelial cell-related miR-126, -92a/b; vascular smooth muscle cell-related miR-145; inflammation-related miR-16, -21, -125b, -146a/b, -147b, -150, -155; lipometabolism-related miR-27b, -122, -370) were evaluated by using real-time polymerase chain reaction., Results: In patients with early onset coronary artery disease, plasma expressions of the lipometabolism-related miR-27b, miR-122; inflammation-related miR-125b, miR-146a/b, miR-147b, miR-150, miR-155; and VSMC-related miR-145 were significantly downregulated and endothelial cell-related miR-126 was significantly upregulated compared to age- and sexmatched healthy controls. Circulating microRNA profile of patients with early onset coronary artery disease was also different from that of older patients with late-onset coronary artery disease. Plasma levels of miR-21, miR-27b, miR-122, miR-125b, miR-146b, miR-147b, and miR-155 were lower and plasma levels of miR-16 and miR-92a were higher in patients with early onset coronary artery disease compared to older patients with late-onset coronary artery disease., Conclusion: MicroRNAs are promising biomarkers for early onset coronary artery disease.

Background: Subtrochanteric femur fractures are unstable injuries due to strong muscle forces on the proximal femur. The ideal fixation device is controversial in the treatment of subtrochanteric femur fractures in children. The aim of this study is to evaluate the clinical and radiological outcomes of subtrochanteric femur fractures in children treated with an adult proximal humerus plate., Methods: A total of 9 patients [mean age at surgery, 8.3 years (range: 7 to 12); mean follow-up period, 28.1 months (range: 12 to 56)] who underwent surgery due to a subtrochanteric femur fracture and treated with an adult proximal humerus between January 2017 and December 2021 were retrospectively evaluated. Four of the patients had a pathological fracture associated with a benign bone tumor while 5 patients had a nonpathological fracture. The clinical and radiological outcomes were assessed using the Flynn scoring system at the latest follow-up. Time to union and complications were recorded., Results: All patients demonstrated a solid fusion of the fracture site and were able to bear full weight at the latest follow-up. The mean time to union was 8.2 weeks (range: 6 to 10). Based on the Flynn scoring system at the latest follow-up, seven patients had excellent clinical outcomes and two patients had satisfactory outcomes. Two patients had limb length discrepancy, and one patient had coxa valga and a limb length discrepancy of 16 mm. There were no patients with nonunion, infection, implant failure, osteonecrosis of the femoral head, and heterotopic bone formation., Conclusion: This study suggests that the adult proximal humerus plate may be an effective alternative fixation option in the treatment of subtrochanteric femur fractures in children, including pathological fractures., Level of Evidence: Level IV, Case series., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: To evaluate the clinical results of amniotic membrane transplantation alone or in combination with adjuvant therapies in conjunctival fornix reconstruction., Materials and Methods: The clinical results of patients who presented to our clinic between 2002 and 2016 due to conjunctival fornix obliteration and underwent amniotic membrane transplantation alone or in combination with additional treatments were retrospectively analyzed. The Foster and Mondino classifications were used to grade fornix obliteration. In all cases, the area of conjunctival defect formed after symblepharon lysis was covered with amniotic membrane. In advanced fornix obliteration, amniotic membrane transplantation was combined with 0.04% mitomycin-C (MMC), oral mucosal transplantation, fornix formation (anchoring) sutures, symblepharon ring, eyelid surgery, fibrin glue, and limbal autograft. Deep and scarless restoration of the fornix was considered surgical success., Results: Twenty-two men and 5 women with a mean age of 45.54±4.17 years were included in the study. The etiology of fornix obliteration was mechanical trauma in 16 cases, chemical burn in 6 cases, recurrent pterygium in 3 cases, thermal burn in 1 case, and recurrent chalazion surgery in 1 case. Indications for amniotic membrane transplantation were socket insufficiency in 12 cases, cosmetic reasons in 4 cases, keratoplasty preparation in 3 cases, ptosis in 3 cases, entropion in 2 cases, strabismus in 2 cases, and diplopia in 1 case. The mean follow-up period was 45.04±8.4 months. Twenty-four of 27 cases (88.8%) were successful, while 3 (12.2%) failed due to recurrence of symblepharon., Conclusion: Amniotic membrane transplantation is a successful method when used alone in the reconstruction of early-stage conjunctival fornix obliteration and provides safe and effective results in advanced-stage fornix obliteration when performed in combination with topical 0.04% MMC, oral mucosal transplantation, and limbal autograft surgeries.

Background: The aim of this study was to determine the factors affecting procedure failure in revision thyroidectomy surgery., Methods: A total of 148 patients applied with revision surgery were separated into 2 groups according to the surgical success status. Comparisons were made of the 2 groups of patients where residual tissue was totally excised (Group 1, n:132) and patients where residual tissue could not be completely excised (Group 2, n:16). The patients were examined in respect of factors affecting the success of the procedure., Results: The patients comprised 133 (89.9%) females and 15 (10.1%) males with a mean age of 49.68±12.02 years. Surgical failure was observed in 7 patients as the lesion could not be determined despite the use of intraoperative USG, and in 9 patients because of weak signal or signal loss. The determination of residual tissue ≤25mm on preoperative USG examination was seen to have a significant negative effect on surgical success (r=-0.329, p0.001). The patient having undergone ≥3 previous operations was determined to have a negative effect on surgical success (r=-0.229, p=0.005), and nerve damage on the opposite side to the lesion in a previous surgical procedure was determined to be the most important factor with a negative effect on surgical success (r=-0.571, p<0.001). In multinomial logistic regression analysis of the factors affecting success, the preoperative presence of nerve damage in the contralateral lobe to the lesion (OR: 33.11, 95% CI: 4.22-192.28, p<0.001) and lesion size ≤25 mm (OR: 10.10, 95% CI: 3.54-75.01, p=0.001) were determined to contribute significantly to surgical failure., Conclusion: The results of this study clearly showed that as residual tissue size ≤25mm and contralateral nerve damage in the preoperative ultrasonographic evaluation are associated with surgical failure, alternative treatment methods such as radioactive iodine ablation may be preferred in these patients.

Purpose: We aimed to investigate the efficacy and safety of single-dose autologous serum eye drops (ASEDs) for treatment of persistent corneal epithelial defects (PEDs)., Methods: About 34 eyes of 26 patients treated from March 2016 to May 2020 with a single dose of ASEDs for PEDs that did not respond to conventional treatment were retrospectively evaluated. Patient demographics, predisposing factors, size, and duration of the PED, duration of treatment, and dosage of ASEDs, PED healing time, success rate of the ASED treatment, and follow-up time after the onset of ASED treatment were recorded. Autologous serum eye drops (20%) were prepared by diluting the serum with preservative-free artificial tears in single-dose vials. Vials were stored at -20°C and used daily after dissolving., Results: The mean patient age was 47.0 ± 18.5 years, and 13 (50%) of the patients were male. The most common indication for ASEDs was PED after keratoplasty. The mean duration of ASED treatment was 8.5 ± 6.3 months, and mean follow-up time was 22.8 ± 12.2 months. Autologous serum eye drop treatment was effective in 25 (73.5%) eyes and partially effective in 5 (14.7%) eyes. None of the eyes displayed complications related to the treatment., Conclusion: In patients with PED for whom conservative treatment is insufficient, ASEDs prepared by dilution with preservative-free artificial tears in single-dose vials and administered based on the daily use principle appear to be effective and safe.

Endometriosis is an oestrogen-dependent chronic disease, which is commonly regarded as a disease of reproductive-aged women. We aimed to evaluate the sexual function with Female Sexual Function Index (FSFI) in women with endometriosis who received dydrogesterone for 6 months. A total of 79 women with endometriomas were recruited in the study group and received 10 mg dydrogesterone tablets orally for 6 months. FSFI and visual analog scale (VAS) scores for each patient before and after treatment were recorded. When before treatment VAS scores and after treatment VAS scores (5.7 ± 1.27, 3.97 ± 1.01, respectively) were compared, a significant decrease was observed ( p  = .001). A significant increase in mean orgasm scores (3.23 ± 0.6 vs. 3.57 ± 0.65, p  = .01) and means satisfaction scores (3.85 ± 0.48 vs. 4.10 ± 0.38, p  < .001) were observed. In addition, means desire scores were also significantly higher following treatment ( p  = .01). In conclusion, this study showed that FSFI scores were increased after 6 months of dydrogesterone treatment in patients with endometriosis. Desire, satisfaction, orgasm and pain scores improved significantly, and sexual dysfunction decreased after treatment.Impact statement What is already known on this subject? Endometriosis is a chronic inflammatory disease associated with severe dysmenorrhoea, pelvic pain, dyspareunia, painful gastrointestinal symptoms and sub-fertility are among the symptoms. These symptoms can be responsible for a significant decrease in the quality of life scores of the patients. Dydrogesterone is a synthetic progesterone derivative, which suppresses oestrogen levels and ovulation. Dydrogesterone's effect on pain relief in endometriosis patients has already been shown, but it's role on the sexual dysfunction observed in women with endometriosis has not yet been questioned. What do the results of this study add? To the best of our knowledge this is the first study showing the effects of dydrogesterone on sexual function in patients with endometriosis. What are the implications of these findings for clinical practice and/or further research? Dydrogesterone can safely be used in medical treatment of endometriosis not only for pain relief but also patients with additional complaints such as sexual dysfunction can benefit from this treatment. Future studies with larger cohorts and long-term follow-ups are needed to validate our results.