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Background: Mycosis fungoides (MF) is the most common cutaneous T-cell lymphoma. Skin-directed therapies, including phototherapy, are the first-line treatment modalities. Psoralen plus ultraviolet A light photochemotherapy (PUVA) is quite effective in controlling the disease; however, long-term adverse effects, particularly carcinogenesis, are the cons of this treatment., Objective: There are various studies on the negative impact of PUVA on skin cancer in patients with autoimmune skin diseases. The data on the long-term effects of phototherapy on MF patients are scarce., Methods: All MF cases that received PUVA alone or combined with other treatments at a single tertiary center were analyzed. This study compared the development of non-melanoma skin cancers, melanoma, and solid organ tumors in MF patients with at least 5-year follow-up data with age- and sex-matched controls., Results: A total of 104 patients were included in the study. Ninety-two malignancies were detected in 16 (15.4%) patients, and six developed multiple malignancies. Skin cancers consisted of 56 basal cell carcinomas, 16 Bowen's disease, four squamous cell carcinomas, three melanomas, two basosquamous cell carcinomas, one Kaposi sarcoma, and one keratoacanthoma were found in nine (8.7%) patients. Eight patients developed three solid cancers and six lymphomas. The risk of developing skin cancer was associated with the total number of PUVA sessions (<250 vs ≥250 sessions; hazard ratio (HR) 4.44, 95% confidence interval (CI) 1.033-19.068; p = .045). 9 (13.2%) of 68 patients who had follow-ups for at least 5 years developed skin cancer. Compared to an age- and sex-matched cohort, the prevalence of new skin cancer was considerably greater (p = .009)., Conclusions: Patients with MF are predisposed to develop secondary malignancies, and continual exposure to PUVA may potentiate this risk. Annual digital dermoscopic follow-up in MF patients treated with UVA is advised for early diagnosis and treatment of secondary cutaneous malignancies., (© 2023 The Authors. Photodermatology, Photoimmunology & Photomedicine published by John Wiley & Sons Ltd.)

Background: The aim of the present study is to evaluate and analyze the daily clinical practice for male urethral stricture disease (MUSD) among urologists., Methods: Considering the latest guidelines on urethral stricture disease, a survey was developed regarding the various treatment options and preferences in different sites of male urethral stricture disease. The survey was sent to urologists via e-mail and phone application., Results: A total of 266 urologists completed the survey and were included in the final analysis. In regard to workplace, 62 (23.3%), 58 (21.8%), 71 (26.7%), and 75 (28.2%) respondents worked in university hospitals, training and research hospitals, state hospitals, and private practice hospitals, respectively. In regard to the diagnostic method used in male urethral strictures, 88.7% of the participants would choose uroflowmetry + postvoiding residual (UF + PVR), and 64.6% would choose retrograde urethrography (RUG). Direct vision internal urethrotomy (DVIU) was the most frequently chosen method in penile urethral strictures (PUS), being chosen by 72.9%. Direct vision anterior internal urethrotomy was the most common method for both ≤2 cm and >2 cm strictures, 63.1%, and 30.8%, respectively. The most preferred graft for augmentation urethroplasty was buccal mucosa (75.8%). Endoscopic incision/resection (transurethral resection (TUR)) is the most frequently applied treatment method for posterior urethral/vesicourethral anastomotic strictures (86.4%)., Conclusions: The present study clearly shows that most urologists still prefer DVIU and urethral dilatation to urethroplasty in MUSD, which contradicts current guidelines. Urologists should be encouraged to perform urethroplasty and/or refer patients to experienced centres for recurrent MUSD., Competing Interests: Given their roles as Reviewer Board members, Oguz Ozden Cebeci and Serdar Geyik had no involvement in the peer-review of this article and have no access to information regarding its peer-review., (© 2023 The Author(s).)

The study reported here aimed to develop and optimize the S-SNEDDS tablet of bosentan (BOS) and to investigate its pharmacokinetic and biodistribution properties. The BOS-loaded SNEDDS have been developed and characterized in a previous study. The BOS-loaded SNEDDS formulation was converted to S-SNEDDS using Neusilin® US2. The S-SNEDDS tablets were obtained using the direct compression technique, and in vitro dissolution, in vitro lipolysis, and ex-vivo permeability studies of the tablets were performed. The S-SNEDDS tablet and reference tablet (Tracleer®) were administered to male Wistar rats at 50 mg/kg dose by oral gavage in fasted and fed state conditions. The biodistribution of the S-SNEDDS tablet was investigated in Balb/c mice using fluorescent dye. The tablets were dispersed in distilled water before administration to animals. The relationship between in vitro dissolution data and in vivo plasma concentration was examined. The S-SNEDDS tablets showed 2.47, 7.49, 3.70, and 4.39 increases in the percentages of cumulative dissolution in FaSSIF, FeSSIF, FaSSIF-V2, and FeSSIF-V2, respectively, when compared to the reference, and increased the C max and AUC 2.65 and 1.28-fold and 4.73 and 2.37-fold in fasted and fed states, respectively, when compared to the reference. S-SNEDDS tablets also significantly reduced interindividual variability in both fasted and fed states (p < 0.05). The XenoLight™ DiR and VivoTag® 680XL labeled S-SNEDDS tablet formulation increased the real-time biodistribution in the body by factors of 2.4 and 3.4 and organ uptake and total emission increased by factors of 2.8 and 3.1, respectively. The IVIVR has been successfully established for S-SNEDDS tablets (R 2  > 0.9). The present study confirms the potential of the S-SNEDDS tablet to enhance the in vitro and in vivo performance of BOS., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Zeynep Safak Teksin reports financial support was provided by Scientific and Technological Research Council of Turkey. Zeynep Safak Teksin reports a relationship with Scientific and Technological Research Council of Turkey that includes: funding grants. Zeynep Safak Teksin has patent #TR201915787 issued to Zeynep Safak Teksin. Duygu Yilmaz Usta - Gazi University]., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Breast cancer research has focused on the early detection and treatment of breast cancer. Axillary lymph node status is essential for primary breast cancer staging, recurrence, and survival. The current quest for precision medicine is to identify predictive markers that offer the advantage of individualized treatment options. This study aimed to investigate the value of inflammatory indices in predicting positive sentinel nodes in breast cancer. We studied 602 patients with early-stage breast cancer who underwent sentinel lymph node biopsies (SLNB) at the Bülent Ecevit University General Surgery Clinic. We obtained data, including the clinical and demographic characteristics of the patients, such as age, histological type, and sentinel lymph nodes. Neutrophil, lymphocyte, platelet, and monocyte counts were obtained from preoperative complete blood count test data from the patient registry. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic inflammatory index (SII), and sentinel lymph node biopsy were analyzed. Sentinel LAP was negative in 391 (65%) patients and positive in 211 (35%). In the receiver operating characteristic curve analysis, no significant difference was found between SLNB positivity and negativity in terms of NLR, PLR, LMR, or SII. In contrast to previous research, NLR, PLR, LMR, or SII did not affect SLNB positivity prediction in our study., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

In this investigational study, the fracture and bending performance of reinforced concrete beams (R-C-Bs) with varying proportions of plastic waste (PW), considered as fine aggregate (FA), were assessed via experimental and numerical examination. To achieve this aim, altered concrete series were designed, with the aggregate sizes changed within the range of 0 to 25 mm. To enhance the concrete, PW was selected to be used in combination with aggregate material measuring 0 to 5 mm in particle size, as an alternative FA, with proportions of 0%, 5%, 15%, 30%, and 45%. Experiments were performed to examine the performance of the R-C-Bs. It was found that a 30% PW proportion offered the optimum results in terms of displacement capability. Furthermore, ANSYS v.19 software was chosen to form 3D finite element models (F-E-Ms) of R-C-Bs to be compared with the experimental data. The experimental and 3D F-E-M investigations offered remarkably close-fitting bending and rupture performances. Then, a structure was modeled using SAP2000, and the strength of the R-C-Bs was then used in an RC structural model. The results show that the forces on the construction caused reductions while also increasing the PW proportion. Moreover, it was realized that the F-E-M simulations and experiments produced tiny cracks with highly matched formations.

Objectives: While the positive correlation was shown in a few studies which investigated the relationship between obesity and pentraxin-3 (PTX-3) levels, different findings were obtained in other studies. We aimed to determine PTX-3 levels in obese and healthy children, and their relationship with Metabolic Syndrome (MetS) criteria., Methods: 105 children and adolescents were considered as the study population. Participants were divided into three groups; obese and MetS (OM+), obese and non-MetS (OM-) and the control group. Fasting glucose, blood lipids and PTX-3 levels were measured. Ultrasonography was performed to detect hepatic steatosis. MetS and hepatic steatosis were investigated by dividing the patients into two groups according to PTX-3 levels., Results: The study population consisted of 37 patients with OM+; 35 patients with OM- and 33 healthy children. OM+ patients had higher fasting insulin (p<0.001), homeostatic model assessment for insulin resistance (p<0.001), triglyceride (p<0.001) and lower high-density lipoprotein (p=0.001). The PTX-3 level was higher in the OM+ group compared to both OM- group and the control group (p=0.002). When two groups were generated according to PTX-3 level, a higher frequency of MetS was detected in the high PTX 3 group than in all three major MetS diagnostic criteria groups. Moreover, there was more hepatic steatosis in the high PTX-3 group independent from obesity and MetS., Conclusions: Higher PTX-3 levels were present in children and adolescent obese patients with MetS., (© 2023 Walter de Gruyter GmbH, Berlin/Boston.)

Background: Intravenous immune globulin (IVIg) is frequently used in some neurological diseases and is also the first-line therapy in Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, and multifocal motor neuropathy. We aimed to evaluate the frequency and characteristics of headaches, which is one of the most common side effects of IVIg treatment., Methods: Patients who received IVIg treatment for neurological diseases were prospectively enrolled in 23 centers. Firstly, the characteristics of patients with and without IVIg-induced headaches were analyzed statistically. Then, patients with IVIg-induced headaches were classified into three subgroups determined by their history: no primary headache, tension-type headache (TTH), and migraine., Results: A total of 464 patients (214 women) and 1548 IVIg infusions were enrolled between January and August 2022. The frequency of IVIg-related headaches was 27.37% (127/464). A binary logistic regression analysis performed with significant clinical features disclosed that female sex and fatigue as a side effect were statistically more common in the IVIg-induced headache group. IVIg-related headache duration was long and affected daily living activities more in patients with migraine compared to no primary headache and TTH groups (p = 0.01, respectively)., Conclusion: Headache is more likely to occur in female patients receiving IVIg and those who develop fatigue as a side effect during the infusion. Clinicians' awareness of IVIg-related headache characteristics, especially in patients with migraine, may increase treatment compliance., (© 2023. Fondazione Società Italiana di Neurologia.)

Objective: To evaluate growth, tolerance and safety outcomes with use of an extensively hydrolyzed casein-based formula (eHCF) in infants with cow's milk protein allergy (CMPA)., Methods: A total of 226 infants (mean ± SD age: 106.5 ± 39.5 days, 52.7% were girls) with CMPA who received eHCF comprising at least half of the daily dietary intake were included. Data on anthropometrics [weight for age (WFA), length for age (LFA) and weight for length (WFL) z -scores] were recorded at baseline (visit 1), while data on infant feeding and stool records, anthropometrics and Infant Feeding and Stool Patterns and Formula Satisfaction Questionnaires were recorded at visit 2 (on Days 15 ± 5) and visit 3 (on Days 30 ± 5)., Results: From baseline to visit 2 and visit 3, WFA z -scores (from -0.60 ± 1.13 to -0.54 ± 1.09 at visit 2, and to -0.44 ± 1.05 at visit 3, p  < 0.001) and WFL z -scores (from -0.80 ± 1.30 to -0.71 ± 1.22 at visit 2, and to -0.64 ± 1.13 at visit 3, p  = 0.002) were significantly increased. At least half of infants never experienced irritability or feeding refusal (55.7%) and spit-up after feeding (50.2%). The majority of mothers were satisfied with the study formula (93.2%), and wished to continue using it (92.2%)., Conclusions: In conclusion, eHCF was well-accepted and tolerated by an intended use population of infants  ≤ 6 months of age with CMPA and enabled adequate volume consumption and improved growth indices within 30 days of utilization alongside a favorable gastrointestinal tolerance and a high level of parental satisfaction., Competing Interests: AS and SE are Abbott employees. The remaining 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., (© 2023 Kansu, Urganci, Bukulmez, Kutluk, Gulcu Taskin, Sahin Keskin, Igde, Molon, Dogan, Sekerel, Yuksek, Bostanci, Gerenli, Polat, Dalgic, Ayyildiz, Usta, Basturk, Yuce Kirmemis, Tuna Kirsaclioglu, Gulerman, Alptekin Sarioglu and Erdogan.)

The aim of this study was to examine the factors affecting the shuttle walking test (SWT) in patients with chronic obstructive pulmonary disease (COPD). A total of 29 patients with COPD (the COPD group) and a healthy group (HG) of 34 women aged between 55 and 74 years were included in the study. After the pulmonary function profiles of the participants were assessed, and the SWT was performed. Walking distances, walking speeds, and SWT levels (SWT-L) were determined with the SWT. Before and after the SWT, the heart rate (HR), oxygen saturation level (SPO 2 ), and Borg scale (perceived exertion (BSe) and dyspnea (BSd)) results were analyzed with a paired sample t -test. The dyspnea levels during activity of daily living were determined with the Medical Research Council (MRC) dyspnea scale, and the relationship between MRC dyspnea (MRCD) and walking distance, speed, and SWT-L was tested using multiple linear regression and Pearson correlation analysis. The walking distance, speed, and SWT-L were lower in the COPD group ( p < 0.001) than in the HG. The HR values before and after the SWT changed significantly in the COPD group and the HG ( p < 0.001), and the effect size was higher in the COPD group. Although the BSe and BSd results before and after the SWT in the COPD group increased significantly ( p < 0.001), they did not change in the HG. There was a highly negative correlation between MRCD and walking distance, speed, and SWT-L in the COPD group ( p = 0.002, p = 0.000, and p = 0.001, respectively), but no correlation was found in the HG. The results showed that the HR, perceived exertion, and dyspnea levels of women with COPD whose respiratory functions were lower than the HG were significantly affected on the SWT.

Central serous chorioretinopathy (CSCR) is a chorioretinal disease that is characterized by central vision loss and is usually seen in middle-aged males. It has been associated with the use of various drugs, including corticosteroids and phosphodiesterase inhibitors. We present the case of a 36-year-old male who developed CSCR after a few weeks of irregular use of quetiapine for his sleep problems. The clinical findings of the patient improved shortly after he stopped using the drug, and at the end of the two-month period complete recovery was observed. Quetiapine is an atypical antipsychotic that exerts its effects on dopamine and serotonin receptors. There are studies showing that these neurotransmitters may play a role in the control of choroidal vascular permeability, which is the underlying cause of CSCR. Therefore, we believe that quetiapine may have a causal relationship with CSCR. To our knowledge, this is the first case report documenting full recovery from quetiapine associated CSCR., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2023 Durmaz Engin et al.)

Background/aim: Recent studies imply the significance of promoter CpG methylation as a biomarker for various cancer types in different genes. ALX3 is one of the candidate genes with prominent promoter methylation status change. In this study, the methylation status of ALX3 gene promoter and its expression was analyzed in lung cancer cell lines and clinical samples from The Cancer Genome Atlas Program (TCGA) program., Materials and Methods: Methylation status was screened using the COBRA Assay, and gene expression in two cancer (A549 & H1299) and one normal (Beas 2B) lung cell lines was determined using RT-PCR., Results: ALX3 gene promoter was found to be hypermethylated in both lung cancer cell lines compared to normal cells. However, no difference in the expression of this gene was observed. In addition to our in vitro findings, DNA Methylation and RNA-seq data of 413 adenocarcinoma samples from TCGA-LUAD dataset were analyzed. ALX3 gene was found to be hypermethylated in tumor compared to normal samples. Interestingly, the expression level of ALX3 gene in tumors was found to be higher than that in normal samples., Conclusion: ALX3 gene promoter hypermethylation could serve as a biomarker in lung cancer., (Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background: HPV 18 is one of the important oncogenic types. HPV 18 is generally evaluated together with HPV 16 and/or high-risk HPV types in light microscopic studies. The purpose of this study was to evaluate the impact of only HPV 18 on the nucleus/cytoplasm ratio, and chromosomal and nuclear degenerative changes in liquid-based samples., Materials and Methods: Eighty liquid-based cervical samples were used in this retrospective study. These smears were prepared by HPV Deoxyribonucleic Acid (DNA) detection and genotyping with the Cobas 4800 HPV system. Forty HPV 18 infected and forty smears with no infection agent were evaluated for chromosomal (nuclear budding, micronuclei), nuclear degenerative changes (membrane irregularity, nuclear enlargement, hyperchromasia, abnormal chromatin distribution, binucleation (BN), karyorrhexis (KR), karyolysis (KL), karyopyknosis (KP)), and cytologic findings (koilocyte (KC), cells with perinuclear PR) using light microscopy. Cellular diameters were evaluated using image analysis software. Statistical analysis was performed with Statistical Package for Social Sciences (SPSS) 19.0. p values < .05 were considered significant., Results: The statistically significant difference between the presence of HPV 18 and karyorrectic cell, KC, nuclear membrane irregularity, enlargement, the mean nuclear width and height ( p < 0.05). No cellular changes other than those mentioned were observed., Conclusions: The present study is significant in that, it reveals the relationship between only and particularly HPV 18 and nucleus/cytoplasm ratio, and chromosomal and nuclear degenerative changes in liquid-based cytology. HPV 18 affects KR, koilocytosis, nuclear membrane irregularity, enlargement, and nuclear diameters. Light microscopic analysis of these abnormalities increases the sensitivity and specificity of cytology in the evaluation of cellular pictures due to HPV 18., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Cytology.)

Objectives: To complement our previous findings regarding effect of ureteral access sheath (UAS) use, we checked RIRSearch database for patients who operated without using UAS. The aim of the study was to understand these new data better by comparing outcomes of retrograde intrarenal surgery (RIRS) that continued sheathless after a failed UAS insertion vs those planned and completed sheathless. Materials and Methods: Data of 195 patients who underwent sheathless RIRS for kidney and/or ureteral stones between 2011 and 2021 were retrieved from the database. Patients divided into two groups: cases who were planned and completed sheathless ( n  = 110, Group 1) and those who proceeded without UAS after insertion failure ( n  = 85, Group 2). After propensity score matching (PSM), each group consisted of 76 patients. Results: After PSM, stone-free rate for Group 1 (90.8%) was significantly higher than stone-free rate of Group 2 (76.3%) in sheathless RIRS ( p  = 0.02). Also postoperative complication rate was significantly lower in Group 1 (10.5%) than in Group 2 (27.6%) ( p  = 0.007). In Group 2, median operating time was longer (60 minutes, interquartile range [IQR]: 40-80) and more unplanned auxilliary procedure (22.4%) was needed than Group 1 (45 minutes, IQR: 40-50 and 3.9%) (both p  = 0.001). Stone burden (odds ratio [OR]: 1.002, p  = 0.019) and stone density (OR: 1.002, p  = 0.003) were associated with high risk of residual stones after RIRS. Higher hydronephrosis grades were associated with increased stone-free rates (OR: 0.588 for residual stone risk, p  = 0.024). Cases who completed sheathless by dusting all available stones, as planned preoperatively, were more likely to have stone-free status after RIRS than those who proceeded sheathless after UAS insertion failure (OR: 2.645, p  = 0.024). Conclusions: Operation course after UAS insertion failure may be more challenging. In cases who performed without using UAS, surgeons who proceed with procedure sheathless after UAS insertion failure may more frequently run into complications and may fail achieving stone-free status compared with sheathless-planned cases.

Objective: "Fear-avoidance behavior" means that the individual avoids a specific activity or movement due to the perception that it may cause injury. Fear of movement associated with pain can reduce individuals' adaptation to exercise programs. This situation may cause individuals to refrain from taking action and increase the existing limitation. Our aim is investigating of Fear-Avoidance Beliefs Questionnaire (FABQ) in patients with neck pain and creating a questionnaire option for clinicians and researchers to evaluate the fear-avoidance behavior in neck pain in Turkish., Methods: The sample of the research was comprised 175 patients between the ages of 18-65, who have a complaint of neck pain that lasted for at least 3 months. The test was applied on patients with neck pain and no treatment, with an interval of 2-7 days. The Visual Analog Scale (VAS), Neck Disability Index (NDI), and Nottingham Health Profile (NHP) were applied on the participants to evaluate the validity of the FABQ., Results: Accordingly, between FABQ and NHP (r=0.227), pain (NHPP) (r=0.214), emotional reactions (r=0.220), and physical activity (NHPPA) (r=0.243), a weak relationship was observed. A weak correlation was observed between physical activity (FABQ-PA) which are subscales of the FABQ questionnaire and NDI (r=0.210), NHPP (r=0.205), and NHPPA (r=0.267)., Conclusion: FABQ is a valid and reliable tool for patients with neck pain. In our study, a weak relationship was detected between FABQ, NDI, and NHP, as like VAS., Competing Interests: No conflict of interest was declared by the authors., (© Copyright 2023 by Istanbul Provincial Directorate of Health.)

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and the third leading cause of cancer-related deaths worldwide. Despite recent advances in treatment options, therapeutic management of HCC remains a challenge, emphasizing the importance of exploring novel targets. MALT1 paracaspase is a druggable signaling molecule whose dysregulation has been linked to hematological and solid tumors. However, the role of MALT1 in HCC remains poorly understood, leaving its molecular functions and oncogenic implications unclear. Here we provide evidence that MALT1 expression is elevated in human HCC tumors and cell lines, and that correlates with tumor grade and differentiation state, respectively. Our results indicate that ectopic expression of MALT1 confers increased cell proliferation, 2D clonogenic growth, and 3D spheroid formation in well differentiated HCC cell lines with relatively low MALT1 levels. In contrast, stable silencing of endogenous MALT1 through RNA interference attenuates these aggressive cancer cell phenotypes, as well as migration, invasion, and tumor-forming ability, in poorly differentiated HCC cell lines with higher paracaspase expression. Consistently, we find that pharmacological inhibition of MALT1 proteolytic activity with MI-2 recapitulates MALT1 depletion phenotypes. Finally, we show that MALT1 expression is positively correlated with NF-kB activation in human HCC tissues and cell lines, suggesting that its tumor promoting functions may involve functional interaction with the NF-kB signaling pathway. This work unveils new insights into the molecular implications of MALT1 in hepatocarcinogenesis and places this paracaspase as a potential marker and druggable liability in HCC., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest with the contents of this article., (Copyright © 2023 Elsevier Inc. All rights reserved.)

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.

The V57E pathological variant of the mitochondrial coiled-coil-helix-coiled-coil-helix domain-containing protein 10 (CHCHD10) plays a role in frontotemporal dementia. The wild-type and V57E mutant CHCHD10 proteins contain intrinsically disordered regions, and therefore, these regions hampered structural characterization of these proteins using conventional experimental tools. For the first time in the literature, we represent that the V57E mutation is pathogenic to mitochondria as it increases mitochondrial superoxide and impairs mitochondrial respiration. In addition, we represent here the structural ensemble properties of the V57E mutant CHCHD10 and describe the impacts of V57E mutation on the structural ensembles of wild-type CHCHD10 in aqueous solution. We conducted experimental and computational studies for this research. Namely, MitoSOX Red staining and Seahorse Mito Stress experiments, atomic force microscopy measurements, bioinformatics, homology modeling, and multiple-run molecular dynamics simulation computational studies were conducted. Our experiments show that the V57E mutation results in mitochondrial dysfunction, and our computational studies present that the structural ensemble properties of wild-type CHCHD10 are impacted by the frontotemporal dementia-associated V57E genetic mutation.

Objectives: Several examination techniques have been described for the diagnosis of leg deep vein thrombosis. These previously described examination techniques aim to detect muscle pain that occurs secondary to increased pressure in the posterior compartment of the leg. However, to the best of our knowledge no studies investigated the frequency of muscle pain on the anterior compartment in patients with leg deep vein thrombosis the objective of this study is to investigate the prevalence of muscle pain in the anterior compartment., Methods: The patients who were diagnosed with acute deep vein thrombosis were included in this prospective cross-sectional study. Each patient was examined using the techniques that determine the pain on the posterior compartment as well as using the technique we described to detect muscle pain on the anterior compartment., Results: Two hunderd forty three patients were enrolled in the study. Among those, both distal and proximal deep vein thrombosis was present in 128 (52.7%) patients. 75% of them had muscle pain in the anterior compartment., Conclusion: The results suggested that examination of muscle pain in anterior compartment of leg in patients with both proximal and distal deep vein thrombosis can be used as an additional physical examination techniques for early diagnosis.

Aim: The frequency of olfactory dysfunction in patients with Multiple Sclerosis (MS) has revealed very different results in studies. Some studies have shown that olfactory dysfunction may be associated with cognitive impairment and poor quality of life. In these studies, different odor tests and cognitive tests were used and different results were obtained., Materials and Methods: Forty literate patients over the age of 18 and 24 healthy volunteers of similar age and education were included in the study. Sniffin' Sticks Odor Test, California Verbal Learning Test II, Symbol Digit Modalities Test, Revised Brief Visuospatial Memory Test, Trail-Making Test, Quality of Life Short Form-36, Fatigue Impact Scale, Beck Depression Inventory, and Beck Anxiety Inventory were applied to the individuals., Results: Olfactory dysfunction was detected in 50 % of the patients. High disability rate, low cognitive functions, low quality of life, and fatigue were identified as the factors affecting olfactory function negatively. Odor discrimination and identification abilities were associated with disability level and cognitive functions, whereas quality of life was linked to odor threshold scores. The olfactory function and cognitive abilities of patients with progressive MS (n = 5) were worse than those of patients with relapsing remitting MS (n = 35)., Conclusion: Olfactory dysfunction is common in patients with MS and is associated with disability and quality of life. Olfactory function can be used in the follow-up of patients and olfactory dysfunction deserves further study as a metric that might emerge as a biomarker., Competing Interests: Conflict of Interest No conflict of interest was declared by the authors., (Copyright © 2023 Elsevier B.V. All rights reserved.)

The G66V pathological variant of the coiled-coil-helix-coiled-coil-helix domain-containing protein 10 (CHCHD10), mitochondrial, plays a role in Jokela type spinal muscular atrophy. The wild-type and G66V mutant-type CHCHD10 proteins contain intrinsically disordered regions, and therefore, their structural ensemble studies have been experiencing difficulties using conventional tools. Here, we show our results regarding the first characterization of the structural ensemble characteristics of the G66V mutant form of CHCHD10 and the first comparison of these characteristics with the structural ensemble properties of wild-type CHCHD10. We find that the structural properties, potential of mean force surfaces, and principal component analysis show stark differences between these two proteins. These results are important for a better pathology, biochemistry and structural biology understanding of CHCHD10 and its G66V genetic variant and it is likely that these reported structural properties are important for designing more efficient treatments for the Jokela type of spinal muscular atrophy disease., (© 2023 Wiley Periodicals LLC.)

COVID-19 may cause the release of systemic inflammatory cytokines resulting in severe inflammation. PARP-1 has been identified as a nuclear enzyme that is activated by DNA strand breaks. It has been suggested that PARP-1 has a role in the cytokine storm shown as a cause of mortality in COVID-19, and its inhibition may adversely affect the replication of SARS -CoV-2. We aimed to investigate the relationship between PARP-1 gene polymorphisms and the clinical severity of COVID-19. rs8679 TT genotype was found to increase with the COVID-19 disease severity. The 3'UTR polymorphism rs8679 may cause PARP-1 activity as a result of viral replication increase by changing the binding site of antiviral or anti-inflammatory miRNAs. PARP-1 may affect the severity of COVID-19 by cytokine release and maybe a possible treatment target., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Impacted canines, which play an important role in smile aesthetics and functional occlusion, can lead to dental and skeletal malocclusions. In this study the aim was to evaluate the relationship between impacted maxillary canines and malocclusion. A total of 151 patients comprising 101 females and 50 males aged between 13 and 33 years were included. The groups were divided based on age, gender, skeletal and dental classification, and sector classification. Angular and linear measurements were performed on lateral cephalometric and panoramic radiographs. In panoramic radiographs, the vertical distance of the impacted canine to the occlusal plane and the angle between it and the bicondylar plane were measured and sector classification was performed according to its relationship with the root of the lateral incisor. Skeletal classification was performed according to the ANB angle on lateral cephalometric radiographs and dental classification by molar relationship via the intraoral photographs. The Chi-square test analyzed independent qualitative and quantitative data using Kruskal-Wallis and Man-Whitney U tests. The statistical significance level was accepted as p < 0.05. According to the intraclass correlation test, an excellent positive correlation was found with 0.985 for canine distance and 0.993 for canine angle between the repeated measurements. The impaction of the maxillary right canine was significantly highest in females and lowest in males. The impacted canine angle was significantly highest in sector 1 and lowest in sector 4. Distance to the occlusal plane was significantly higher in dental Class II and sector 4. It was observed that there was a considerable relationship between impacted maxillary canines and malocclusion; bilateral impacted canines were more frequent in skeletal Class III, and the distance of impacted canines to the occlusal plane increased while their angles decreased both in dental Class II and from sectors 1 to 4.

The concept of sustainable development provides for the search for environmentally friendly alternatives to traditional materials and technologies that would reduce the amount of CO 2 emissions into the atmosphere, do not pollute the environment, and reduce energy costs and the cost of production processes. These technologies include the production of geopolymer concretes. The purpose of the study was a detailed in-depth analytical review of studies of the processes of structure formation and properties of geopolymer concretes in retrospect and the current state of the issue. Geopolymer concrete is a suitable, environmentally friendly and sustainable alternative to concrete based on ordinary Portland cement (OPC) with higher strength and deformation properties due to its more stable and denser aluminosilicate spatial microstructure. The properties and durability of geopolymer concretes depend on the composition of the mixture and the proportions of its components. A review of the mechanisms of structure formation, the main directions for the selection of compositions and processes of polymerization of geopolymer concretes has been made. The technologies of combined selection of the composition of geopolymer concrete, production of nanomodified geopolymer concrete, 3D printing of building structures from geopolymer concrete, and monitoring the state of structures using self-sensitive geopolymer concrete are considered. Geopolymer concrete with the optimal ratio of activator and binder has the best properties. Geopolymer concretes with partial replacement of OPC with aluminosilicate binder have a denser and more compact microstructure due to the formation of a large amount of calcium silicate hydrate, which provides improved strength, durability, less shrinkage, porosity and water absorption. An assessment of the potential reduction in greenhouse gas emissions from the production of geopolymer concrete compared to the production of OPC has been made. The potential of using geopolymer concretes in construction practice is assessed in detail.

Objectives: Elastography is considered a novel technique in the assessment of placenta parenchymal elasticity and very few data present the feasibility of elastography on human fetal tissue. This study aims to investigate the feasibility of fetal liver and placenta elastography and differences in pregnancies with GDM., Methods: Fifty-five women with GDM and 40 women with uncomplicated pregnancy as the control group was enrolled prospectively in this case-control study. Fetal liver VTIQ and placenta VTIQ elastography were performed between 25 and 39 weeks of pregnancy., Results: Mean placenta thickness at the level of umbilical cord insertion was significantly higher in the GDM group than in the control group (p=0.034). VTIQ elastography elasticity velocity (kPa) examinations revealed similar mean placenta and mean fetal liver stiffness in both groups. A weak to moderate correlation was observed between the mean elasticity of the placenta and the mean elasticity of the fetal liver (r=0.310; p=0.004)., Conclusions: Elastography may provide valuable information of especially on fetal tissue development and pathology. While placenta and fetal liver VTIQ elastography are feasible in pregnancy, the diagnostic value of these examinations in GDM is not certain and it seems to be that significant differences in SWE examinations that reflect structural changes in fetal tissue or placenta are more prominent in more chronic conditions such as type 1 and type 2 diabetes mellitus., (© 2023 Walter de Gruyter GmbH, Berlin/Boston.)

Borrelia miyamotoi is a tick-borne zoonotic agent that causes hard tick-borne relapsing fever, an emerging disease in humans. Some small mammalian and bird species are reported to be reservoirs of B. miyamotoi. This study aims to examine Borrelia species present in rodents captured from rural areas of Turkey. Blood samples of rodents were initially screened with Borrelia 16S rRNA qPCR. The Borrelia flaB gene was subsequently amplified by conventional PCR, after which all positive samples were sequenced. Borrelia miyamotoi was observed in nine out of 536 blood samples (1.7%) collected from wild rodents. Phylogenetic analysis showed that all positive samples belonged to the European genotype clade of B. miyamotoi. PCR positivity was 5.3%, 3.7%, and 1.8% in Apodemus uralensis, Apodemus flavicollis, and Myodes glareolus, respectively. Borrelia burgdorferi sensu lato that causes Lyme borreliosis in humans could not be detected in the rodents. In this study, presence of B. miyamotoi DNA is reported for the first time in rodents in Turkey., (Copyright © 2023. Published by Elsevier GmbH.)

Current artificial ligaments based on polyethylene terephthalate (PET) are associated with some disadvantages due to their hydrophobicity and low biocompatibility. In this study, we aimed to modify the surface of PET using polyethylene glycol (PEG)-terminated polystyrene (PS)-linoleic nanoparticles (PLinaS-g-PEG-NPs). We accomplished that BMP-2 in two different concentrations encapsulated in nanoparticles with an efficiency of 99.71 ± 1.5 and 99.95 ± 2.8%. While the dynamic contact angle of plain PET surface reduced from 116° to 115° after a measurement periods of 10 s, that of PLinaS-g-PEG-NPs modified PET from 80° to 17.5° within 0.35 s. According to in vitro BMP2 release study, BMP-2 was released 13.12 ± 1.76% and 45.47 ± 1.78% from 0.05 and 0.1BMP2-PLinaS-g-PEG-NPs modified PET at the end of 20 days, respectively. Findings from this study revealed that BMP2-PLinaS-g-PEG-NPs has a great potential to improve the artificial PET ligaments, and could be effectively applied for ACL reconstruction.

Purpose: The qualitative study was conducted to determine the breastfeeding experiences of mothers working in radiation areas in hospitals. Materials and Methods: The study was conducted in Turkey between December 2022 and February 2023 through in-depth interviews held with 13 mothers who met the inclusion criteria. The content analysis method was used in the analysis of the data. Results: As a result of the analyses of the data obtained in the interviews, four themes regarding the breastfeeding experiences of health professionals working in radiation environments in hospitals were identified. These themes were institutional/administrative obstacles, support systems, unhealthy childcare, and feeling of incompetence as a mother. The main theme of unhealthy childcare consisted of four categories, which were low-quality breast milk, toxic breast milk, frequent diseases, and future risk of cancer. The main theme of feeling of incompetence as a mother was composed of three categories, which were fear, feeling of guilt, and "Am I a mother?" The theme of institutional/administrative obstacles consisted of three categories, namely working environment, working duration, and awareness of managers. Finally, the theme of support systems included two categories, positive perceptions and negative perceptions. Conclusion: In this study, it was determined that the mothers who worked in radiation areas in hospitals experienced problems due to individual, social, and institutional factors. The main concern of the mothers was found to be hurting their infants with their breast milk. Suitable working environments and the adequacy of practices related to daycare centers, social support, and motherhood rights are the main needs of working mothers aiming to keep breastfeeding their infants.

The aim of the study is to determine the effect on death anxiety of loneliness in the elderly during the COVID-19 pandemic. The population of this study that is descriptive and cross-sectional type consist of 354 elderly who meet the inclusion criteria from three different associations operating for charitable purposes in a city center located in north-west Turkey. The average score of Loneliness Scale of Elderly (LSE) of the elderly was determined as 11.39 ± 5.31, and the average score of Death Anxiety Scale (DAS) of the elderly was determined as 8.54 ± 4.82. According to these results, it was found that the elderly experienced acceptable levels of loneliness and moderate death anxiety. A statistically significant difference was found in the LSE and DAS scores of the elderly according to their age, marital status, education status, chronic illness status and living at home with relatives. In addition, during the COVID-19 epidemic, the scale scores of the elderly who have increased worries, who have a hobby at home, and who communicate with their relatives via social media/mobile phones were found to be statistically significant (p < 0.05).

Background: The aim of this prospective, randomized, controlled study was to evaluate the analgesic effect of US-guided Pectoral (PECS) I blocks on postoperative analgesia after TIVAP insertion., Methods: A hundred-twenty patients were included in this study. The patients were divided into two groups: Group PECS and Group INF (infiltration). A total 0.4 mL kg -1 0.25% bupivacaine was injected to below the middle of the clavicle in the interfascial space between the pectoralis major and minor muscles for PECS-1. The skin and deep tissue infiltration of the anterior chest wall was performed with 0.4 mL kg -1 0.25% bupivacaine for INF group. Tramadol and paracetamol consumption, visual analog scale pain scores were recorded at 0, 1, 4, 12, and 24 h postoperatively., Results: The use of the PECS in TIVAP significantly decreased the amount of paracetamol used in the first 24 h postoperatively ( p < 0.001). There was a statistically significant difference in the number of tramadol rescue analgesia administered between the groups ( p < 0.001) There was no significant difference between the groups in terms of the VAS scores at 0 and 24 h. However, VAS scores at 1, 4, and 12 h were found to be significantly lower in patients who underwent PECS than in those who received infiltration anesthesia ( p < 0.001)., Conclusions: This study shows that US-guided PECS-1 provides adequate analgesia following TIVAP insertion as part of multimodal analgesia. The PECS-1 significantly reduced opioid consumption.

Histologically aggressive micropapillary thyroid carcinomas (PTMC) subtypes are thought to be associated with an aggressive clinical course. However, evidence for unfavorable clinical outcomes in patients with aggressive PTMC subtypes is not clear. In this study, we intended to determine the difference in clinical outcomes between patients with aggressive and non-aggressive PTMC subtypes. In this multicenter cohort study, the computer-recorded clinical and histopathological data of patients who underwent thyroid surgery between January 2000 - January 2021 in 9 referral centers and were diagnosed as PTMC were analyzed. A total of 1585 patients [female 1340 (84.5%), male 245 (15.5%), mean age 47.9±11.63 years), with a mean follow-up time of 66.55±37.16 months], were included in the study. Ninety-eight cases were diagnosed as aggressive and 1487 as non-aggressive subtypes. Persistent/recurrent disease was observed in 33 (33.7% )and 41 (2.8%) patients with aggressive and non-aggressive subtypes (p<0.001). Diseases-free survival rates were markedly lower in patients with aggressive than in those with non-aggressive PTMC subtypes (66.3 vs. 94.8%, log-rank p<0.001). Moreover, in multivariate analysis, aggressive histology was an independent predictor of persistent/recurrent disease, after controlling for other contributing factors (HR 5.78, 95% CI 3.32-10, p<0.001). Patients with aggressive PTMC subtypes had higher rates of incomplete biochemical and structural response than patients with non-aggressive subtypes as well (p<0.001). Aggressive PTMC subtypes share many characteristics with histologically identical tumors>1 cm in size. Therefore, the histopathological subtype of PTMC should be taken into consideration to tailor a personalized management plan., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Background: The association of cognition with hand grip and pinch strength has been well-recognized in older adults. The authors sought to explore: (1) associations among forward head posture (FHP), cognition, and hand grip and pinch strength in older adults; and (2) the mediator role of FHP in these pathways using structural equation modeling (SEM)., Methods: This cross-sectional study included 88 older adults (70.5% male; mean age = 68.75±3.87 years). Cognition was assessed by the Mini-Mental State Examination (MMSE), head posture by the Craniovertebral Angle (CVA) obtained from photographic analysis, hand grip strength by a handheld dynamometer, and pinch strength by a pinch meter. Using the two SEMs, a potential mediator role of the CVA was investigated. While the MMSE was addressed as an independent variable in both models, hand grip and pinch strength were addressed as dependent variables in model 1 and model 2, respectively., Results: The correlations between the CVA and MMSE (r = 0.310), hand grip strength (r = 0.370), and pinch strength (r = 0.274 to 0.292) were statistically significant (p < 0.001). In addition, significant associations were found between the MMSE and hand grip and pinch strength, ranging from 0.307 to 0.380 (p < 0.001). The mediation analysis showed that the standardized total (β = 0.41, p < 0.001) and indirect (mediated) effects (β = 0.12, p = 0.008) of the MMSE on hand grip strength were significant in model (1) The results were similar for model (2) The standardized total (β = 0.39, p = 0.001) and indirect effects (β = 0.10, p = 0.026) of the MMSE on pinch strength were significant. As a partial mediator in both models, the CVA explained 29% and 26% of the total effect in models 1 and 2, respectively., Conclusions: The CVA was associated with the MMSE, hand grip strength, and pinch strength, and CVA partially mediates the association of the MMSE with grip and pinch strength in older adults, indicating that cognition had an effect on grip and pinch strength through an indirect path via head posture. This finding reveals that evaluating head posture and providing corrective therapeutic interventions as needed may be beneficial in reducing the negative impact of decreased cognition on motor functions in older adults., (© 2023. The Author(s).)

(i) Objective: Changes in the mesiodistal axial angulations of teeth with orthodontic treatment have been a topic of interest in orthodontics for many years, although it has not been clarified enough yet. Therefore, this present study aimed to compare mesiodistal axial angulations of canine and first molar teeth by measuring from pre- and post-treatment panoramic radiographs in different types of orthodontic malocclusions. (ii) Materials and Methods: In the study, the mesiodistal axial angulation angles of the lower-upper canines (teeth numbered 13, 23, 33, and 43) and first molars (teeth numbered 16, 26, 36, and 46) were compared on panoramic radiographs taken pre- (T0) and post- (T1) orthodontic treatment of 353 patients: 237 female (mean age 14.74 ± 2.96) and 116 male (mean age 14.44 ± 2.50), who had not received any prior orthodontic treatment. The groups were formed according to pre-/post-treatment, gender, angle classification, skeletal classification, bilaterally first premolar extraction/non-extraction, and the use/non-use of miniscrews in the extraction cases. The mesiodistal angulations between the long axes of both the lower and upper canines and first molars and the interorbital plane were measured separately and recorded. The reliability analysis between the repeated measurements was evaluated using the intraclass correlation coefficient (ICC). For statistical analysis, a paired sample t -test and Wilcoxon test were used for the normally and non-normally distributed data, respectively. For the between-groups comparison, independent sample t -test and one-way ANOVA were used for normally distributed data, while the Mann-Whitney U and Kruskal-Wallis tests were used for non-normally distributed data. A value of p < 0.05 was considered statistically significant. (iii) Results: ICCs showed excellent reliability, ranging from 0.804 to 0.913 in other teeth, yet were good in tooth 43 (ICC = 0.712). Regardless of the groups, statistically significant differences were found between the T0 and T1 angulations for all teeth, except teeth 13 and 16. In all groups, the increase in the angulations of teeth 33 and 43 and the decrease in the angulations of teeth 36 and 46 (except skeletal class 3) were found to be statistically significant. The T0 and T1 angulation changes in the miniscrews in the used and non-used groups in extraction cases were similar to the differences found in all teeth, regardless of the groups. There was no significant difference between gender, skeletal classes, and angle classes in the amounts of change in the mesiodistal angulations. (iv) Conclusion: It was concluded that orthodontic treatment caused significant changes in the mesiodistal axial angulation of the canine and the first molar teeth. Furthermore, the fact that the angulations tended to increase in the lower canine teeth and decrease in the lower first molar teeth revealed the importance of tooth movement control, especially in orthodontic mechanics in the mandibula.

Objective: Oxidative stress is closely related to the development of atherosclerosis and acute coronary syndromes. In this study, we aimed to examine the relationship between hemogram indices and oxidative stress parameters in patients with ST-segment elevation myocardial infarction., Methods: A single-centered, prospective, and cross-sectional study was performed in 61 patients with ST-segment elevation myocardial infarction. Before coronary angiography, in the blood samples taken from the peripheral vein, hemogram indices and oxidative stress parameters such as total oxidative status, total antioxidant status, and oxidative stress index were examined. We examined a total of 15 hemogram indices., Results: Most of the study patients were male (78%), and the mean age was 59.3 �� 12.2 years. Mean corpuscular volume value was found to be negatively and moderately signi���cantly correlated with total oxidative status and oxidative stress index values (r = ���0.438, r = ���0.490, P <��0.001). A negative and moderate signi���cant correlation was found between mean corpuscular hemoglobin and total oxidative status and oxidative stress index values (r = ���0.487, r = ���0.433, P < 0.001). Red cell distribution width value was found to be positively and moderately correlated with total oxidative status (r = 0.537, P < 0.001). Red cell distribution width was also found to be moderately and statistically signi���cantly correlated with oxidative stress index value (r = 0.410, P = 0.001). In receiver operating characteristic analysis, mean corpuscular volume, mean corpuscular hemoglobin, and red cell distribution width levels have been successful in predicting total oxidative status and oxidative stress index., Conclusions: We conclude that mean corpuscular volume, mean corpuscular hemoglobin, and red cell distribution width levels predict oxidative stress in patients with ST-segment elevation myocardial infarction.

Introduction: Migraine and tension-type headache (TTH) are important health problems because cause loss of workforce, affect quality of life and are frequently associated with anxiety and depression. Illness perception is defined as a cognitive aspect of illness. The aim of this study is to determinethe relationship of migraine and TTH with quality of life, illness perception, anxiety and depression., Materials and Methods: Demographic information and headache characteristics of 160 patients (80 migraine, 80 TTH) who has applied to our hospital's neurology outpatient clinics were recorded. Hospital anxiety depression scale, illness perception questionnaire and quality of life short form-36 (SF-36) were applied to these patients., Results: Headache severity and duration were higher in migraine patients. Migraine sufferers believed that their illness would last longer and the results would be worse. Negative emotional representations were more common in TTH patients. Understanding of the disease was higher in younger and those with higher levels of education. Social functionality and bodily pain scores were worse than those of TTH patients. Headache severity and duration were higher in women. Anxiety and depression were associated with headache frequency, duration, and severity. It was determined that the severity, duration and frequency of headache also affected the quality of life., Conclusion: Informing patients in detail about their diseases and increasing their education level can contribute to the improvement of headache representations. In addition, screening and treatment of anxiety and depression may be other interventions that can improve patients' adherence to treatment and quality of life.

Purpose: Comparison of the efficacy of monthly anti-VEGF versus dexamethasone (DEX) implant in patients with diabetic macular edema (DME) whose macular edema persists despite three doses of anti-VEGF therapy., Materials and Methods: This retrospective study included 94 eyes of 94 patients with central macular thickness (CMT) > 300 μm despite previously receiving three doses of anti-VGEF (aflibercept or ranibizumab) injections between January 2014 and January 2019. The patients were divided into four groups. The first and second groups were the patients who received three more doses of initial anti-VGEF treatment after the initial anti-VGEF treatment. The third and fourth groups were patients switched to intravitreal dexamethasone implants. Patients were followed up every month for six months after the injection. The primary outcome measures were best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) at six months., Results: The mean age of the patients included in the study was 64.64 ± 7; there were 58 men (61.7%) and 36 women (38.3%). There was no statistically significant difference between the groups regarding age, stage of retinopathy, and lens status. When CMT, BCVA, and IOP were assessed among the four groups at the end of the sixth month, no statistical difference between the groups was found. There was no need for medical intervention despite the statistically significant increase in IOP at the end of the sixth month compared to the third month in the dexamethasone implanted groups. In contrast to the decrease in CMT, which was statistically significant in all four groups at the end of the sixth month compared to the third month, the increase in BCVA was not statistically significant in any of the four groups at the end of the sixth month., Conclusion: According to the results of our study, there is no superiority between continuing with existing anti-VEGF or switching to a dexamethasone implant after three doses of anti-VEGF., (© 2023. The Author(s).)

Aim: The aim of this descriptive and cross-sectional study was to determine the knowledge and practices of nurses related to the prevention of peripheral intravenous therapy (PIT) complications, and to identify the influencing factors., Methods: The study adopted a cross-sectional and descriptive design and was conducted between April and August of 2018 with a total of 214 clinical nurses. The data collection tools employed were a 12-item sociodemographic questionnaire and a 16-item questionnaire on knowledge and practices related to the prevention of peripheral intravenous therapy complications., Results: The mean knowledge scores of the nurses were found to be 81.54 ± 12.06 (min: 50, max: 100). No statistically significant difference was found to exist between the scores, and the variables of the nurses' gender, length of employment in the health profession, type of work, training received related to PIT complications, and self-competence level in PIT complications., Conclusion: The nurses were found to have high knowledge levels; however, their practices for preventing PIT complications differed. Standardized practice procedures and workplace training are needed in order to transform nurses' knowledge into practice with regard to the prevention of PIT complications.

This study quantifies the environmental risk of a coal-fired thermal power plant during operation by using environmental monitoring data, site surveys, and documented evidence. The following criteria are assessed: emissions (CO, SO 2 , NO x , PM 10 ), impact on aquatic ecosystem (fish protection at cooling water intake and cooling water discharge temperature), and waste management (fly ash and bottom ash). Fuzzy sets were defined for each criterion, taking environmental regulatory context as an expert judgment. A survey was conducted with multiple stakeholders to determine the relative importance of risk factors. The survey results showed that the most concerned risks are SO 2 and NO x emissions. The proposed method estimates the risk of each environmental criterion separately and then accumulates them into an environmental risk index (ERI). Accordingly, we assessed the Catalagzi coal-fired power plant, which has been in operation on the Black Sea coast in northwestern Turkey. For this case study, the ERI resulted in a value of 0.78 (on a scale of 0-1), showing high environmental risk to the facility. Moreover, the applicability of the proposed framework was tested in several existing coal-fired power plants using simultaneous measurements. All studied coal-fired power plants in Turkey have unacceptable pollutants (PM 10 , SO 2 , and NO x ) concentration levels indicating high health risk potential. The application of the integrated environmental risk assessment framework showed that new environmental regulations are needed in Turkey to specify more strict emission limits and to monitor CO 2 , fine particulate matter emissions, cooling water discharge, and fish protection at cooling water intake., (© 2022 Society for Risk Analysis.)

Management of gastric cancer is still challenging due to resistance to current chemotherapeutics and recurrent disease. Moreover, green- synthesized zinc oxide nanoparticles (ZnO-NPs) using natural resources are one of the most promising therapeutic agents for anticancer therapy. Here we report the facile green synthesis and characterization of ZnO-NPs from Teucrium polium (TP-ZnO-NP) herb extract and the anticancer activities of these nanoparticles on gastric cancer cells. Facile green synthesis of TP-ZnO-NP was achieved using zinc acetate dihydrate. For the characterization of TP-ZnO-NP, UV-vis spectroscopy, FTIR, SEM, XRD and EDX analyses were performed. Antiproliferative and anticancer activities of TP-ZnO-NP were explored using the HGC-27 gastric cancer cell line model. MTT cell viability and colony formation assays were used for the analysis of cell proliferation and migration. Wound healing assay was used to analyze the migration capacities of cells. Annexin V/PI double staining, DNA ladder assay, and Acridine orange/Ethidium bromide staining were performed to analyze the induction of apoptosis. qPCR was used to determine gene expression levels of apoptotic and epithelial to mesenchymal transition marker genes. The aqueous extract of TP served as both a reducing and capping agent for the successful biosynthesis of zinc oxide nanoparticles. Remarkably, synthesized TP-ZnO-NPs were found to have significant antiproliferative and anticancer activities on HGC-27 gastric cancer cells. Collectively, current data suggest that TP-ZnO-NP is a novel and promising anticancer agent for future therapeutic interventions in gastric cancer., 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 © 2022 Elsevier B.V. All rights reserved.)

Background: The core components (CCs) of infection prevention and control (IPC) from World Health Organization (WHO) are crucial for the safety and quality of health care. Our objective was to examine the level of implementation of WHO infection prevention and control core components (IPC CC) in a developing country. We also aimed to evaluate health care-associated infections (HAIs) and antimicrobial resistance (AMR) in intensive care units (ICUs) in association with implemented IPC CCs., Methods: Members of the Turkish Infectious Diseases and Clinical Microbiology Specialization Association (EKMUD) were invited to the study via e-mail. Volunteer members of any healt care facilities (HCFs) participated in the study. The investigating doctor of each HCF filled out a questionnaire to collect data on IPC implementations, including the Infection Prevention and Control Assessment Framework (IPCAF) and HAIs/AMR in ICUs in 2021., Results: A total of 68 HCFs from seven regions in Türkiye and the Turkish Republic of Northern Cyprus participated while 85% of these were tertiary care hospitals. Fifty (73.5%) HCFs had advanced IPC level, whereas 16 (23.5%) of the 68 hospitals had intermediate IPC levels. The hospitals' median (IQR) IPCAF score was 668.8 (125.0) points. Workload, staffing and occupancy (CC7; median 70 points) and multimodal strategies (CC5; median 75 points) had the lowest scores. The limited number of nurses were the most important problems. Hospitals with a bed capacity of > 1000 beds had higher rates of HAIs. Certified IPC specialists, frequent feedback, and enough nurses reduced HAIs. The most common HAIs were central line-associated blood stream infections. Most HAIs were caused by gram negative bacteria, which have a high AMR., Conclusions: Most HCFs had an advanced level of IPC implementation, for which staffing was an important driver. To further improve care quality and ensure everyone has access to safe care, it is a key element to have enough staff, the availability of certified IPC specialists, and frequent feedback. Although there is a significant decrease in HAI rates compared to previous years, HAI rates are still high and AMR is an important problem. Increasing nurses and reducing workload can prevent HAIs and AMR. Nationwide "Antibiotic Stewardship Programme" should be initiated., (© 2023. The Author(s).)

Backgrounds: Pain management is one of the most important factors affecting the success of pediatric dentistry. Therefore, new needle- and pain-free local anesthesia techniques have been developed in parallel with technological advancements. The purpose of this study is to compare the pain perception and dental anxiety levels associated with a needle-free injection system (Comfort-in™) and the classic needle method during treatment-required infiltration anesthesia in children., Methods: This randomized controlled crossover split-mouth clinical study included 94 children who required dental treatment with local anesthesia using a dental needle or needle-free injection system for the bilateral primary molars. The Wong-Baker Scale (WBS) was used to measure pain perception at different times, and the Modified Child Dental Anxiety Scale (MCDAS) was used to measure the anxiety level of the child. A statistical software package was used to process the data. Statistical significance was set at P < 0.05., Results: There was no significant difference between the needle-free injection system and dental needle method during the induction stage for filling and pulpotomy (P > 0.05). "Pain on postoperative 1st day" was similar in both types of anesthesia (P = 0.750)., Conclusions: The needle-free injection system was as effective as the dental needle method. The Comfort-in™ system was an acceptable alternative for patients during the postoperative period. Understanding how pain management may be provided during local anesthesia administration and a child's fear and anxiety regarding the dentist may lead to better dental compliance., Competing Interests: DECLARATION OF INTEREST: The authors declare no potential conflicts of interest with respect to authorship and/or publication of this article., (Copyright © 2023 Journal of Dental Anesthesia and Pain Medicine.)

Objective: To determine the mechanistic roles of oxidative stress, inflammation, and genotoxicity parameters in patients with work-related asthma (WRA) and silicosis., Methods: Thirty-eight healthy office workers, 27 employees with a history of exposure and no disease, 24 employees with WRA, and 23 employees with silicosis were included in this study. Superoxide dismutase, catalase, glutathione peroxidase, malondialdehyde, and interleukins (IL) 17, 23, and 27 levels were measured in the serum. Genotoxic damage was evaluated by calculating the frequency of micronuclei in swab samples and 8-hydroxy-2'-deoxyguanosine in serum., Results: Serum superoxide dismutase, catalase, glutathione peroxidase, malondialdehyde, 8-hydroxy-2'-deoxyguanosine, and IL-17, IL-23, and IL-27 levels were found to be statistically significantly higher in the exposure, WRA, and silicosis groups compared with the control group. The frequency of micronuclei in buccal epithelial cells of the patient group was found to be significantly higher than that of the control group., Conclusion: These results may provide information for molecular mechanisms and early diagnosis of WRA and silicosis and will be a guide for taking precautions in the early period., Competing Interests: Conflict of interest: None declared., (Copyright © 2022 American College of Occupational and Environmental Medicine.)

(i) Objective: The present study aimed to compare the electrochemical corrosion resistance of six different types of fixed lingual retainer wires used as fixed retention appliances in an in vitro study. (ii) Methods: In the study, two different Ringer solutions, with pH 7 and pH 3.5, were used. Six groups were formed with five retainer wires in each group. In addition, 3-braided stainless steel, 6-braided stainless steel, Titanium Grade 1, Titanium Grade 5, Gold, and Dead Soft retainer wires were used. The corrosion current density ( i corr ), corrosion rate (CR), and polarization resistance ( R p ) were determined from the Tafel polarization curves. (iii) Results: The corrosion current density of the Gold retainer group was statistically higher than the other retainer groups in both solutions ( p < 0.05). The corrosion rate of the Dead Soft retainer group was statistically higher than the other retainer groups in both solutions ( p < 0.05). The polarization resistance of the Titanium Grade 5 retainer group was statistically higher than the other retainer groups in both solutions ( p < 0.05). As a result of Scanning Electron Microscope (SEM) images, pitting corrosion was not observed in the Titanium Grade 1, Titanium Grade 5 and Gold retainer groups, while pitting corrosion was observed in the other groups. (iv) Conclusion: From a corrosion perspective, although the study needs to be evaluated in vivo, the Titanium Grade 5 retainer group included is in this in vitro study may be more suitable for clinical use due to its high electrochemical corrosion resistance and the lack of pitting corrosion observed in the SEM images.

The aim of this study was to evaluate the relationship between skeletal sagittal nasal profile morphology and sagittal skeletal malocclusions. Regarding lateral cephalometric films, the study was conducted in a total of 135 individuals without any prior orthodontic treatment (mean age of 17.91 ± 1.91), including 49 males (mean age 17.91 ± 1.16) and 86 females (mean age 17.78 ± 1.91 years). The groups were divided into two groups as male and female according to gender, and three groups as skeletal Class 1, Class 2, and Class 3 according to the Steiner's ANB angle. In addition, skeletal groups were compared within groups by dividing into two groups of male and female. A total of eight parameters, three skeletal sagittal angular (SNA, SNB, and ANB angles), four nasal linear (R-A, N-A, N-ANS, and N-R distances) and one nasal angular (N1-N2/N2-R angle), were measured on each cephalometric film. The arithmetic mean and standard deviation of all measured nasal parameters were calculated. For statistical analysis, independent sample t-test and one-way analysis of variance (One-Way ANOVA) were used for normally distributed data, and Mann Whitney U and Kruskal Wallis tests were used for data that did not show normal distribution. For statistical analysis, p < 0.05 was considered significant. R-A, N-A, and N-ANS linear nasal parameters differed significantly between the male and female groups, which were evaluated regardless of the skeletal groups, with a higher rate in males ( p < 0.05). N-R linear nasal parameter showed a statistically significant difference between skeletal malocclusion groups, which were evaluated regardless of gender. N-R distance was found to be significantly longer in skeletal Class 3 individuals than in Class 1 and 2 individuals ( p < 0.05). There was no statistically significant difference in nasal bone concavity angle in all groups ( p > 0.05). R-A and N-A linear nasal parameters showed statistically significant differences between male and female sex groups in all skeletal malocclusion classes ( p < 0.05). At first, results showed that males had longer measurements than females in all linear nasal parameters. Second, longer measurements were found in all linear nasal parameters in skeletal Class 3 individuals than those in skeletal Class 1 and Class 2 individuals. Third, the nasal bone concavity angle was greater in skeletal Class 2 individuals than the others.

The transport of dust from the Middle East and African deserts affects European and Asian countries at certain times of the year, especially in spring. Turkey is one of these countries, and many dust storm events have occurred in the first half of 2022, which have affected especially the southeastern part of Anatolia. Apart from threatening human health, dust and sand particles, which are described as particulate matter, may possibly affect Global Positioning System (GPS) signals. The purpose of this research is to look into the effects of particulate matter less than 10 μm (PM10) on GPS-estimated precipitable water vapor (PWV). Hourly PM10 and PWV data between April 1, 2022, and June 10, 2022, were utilized. Four different extreme dust concentration events and a benchmark period were investigated separately. Hourly data results showed that correlation coefficients vary according to events, wind directions, and the distance between GPS stations and air quality monitoring stations. Also, other meteorological parameters that affect PWV, such as temperature, relative humidity, and pressure, were investigated and found to have no anomalies that could affect PWV. Hourly and daily correlation coefficients in the benchmark period were significantly lower compared to dusty days, which indicates that there is no real correlation between PM10 and PWV concentrations in clear air conditions. Only with the increase of PM10 to extreme levels does the relationship show itself. Therefore, this study suggests that for all GPS applications, such as positioning or PWV estimation, PM10 concentrations should be considered., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

The aim of this study was to compare the demineralizations of the enamel surfaces around different types of orthodontic brackets in an artificial cariogenic environment. A total of 90 extracted human maxillary first premolar teeth were used in this in vitro study. The teeth were divided into 6 groups, 5 study and 1 control, each consisting of 15 samples. Victory metal, Gemini metal, Clarity self-ligating ceramic, APC Clarity Advanced ceramic and Clarity Advanced ceramic brackets (3M Unitek, Monrovia, Calif) used in the study groups were bonded to the teeth with the direct technique. The gingival, occlusal and proximal enamel surfaces adjacent to the brackets were measured with a DIAGNOdent pen (KaVo, Biberach, Germany) (T0). Then, the teeth were placed in a cariogenic suspension environment containing Streptococcus mutans , sucrose and artificial saliva. The teeth were removed from the cariogenic suspension at the end of 28 days. Enamel surfaces were remeasured with DIAGNOdent and the values were recorded (T1). Whether the obtained data were homogeneously distributed or not was determined by the Kolmogorov-Smirnov test, within-group comparisons were performed with the Wilcoxon test, and between-group comparisons were performed with Mann-Whitney U and Kruskal-Wallis tests. Significance level was accepted as p < 0.05. In all groups, the demineralization values of the enamel surfaces in the gingival, proximal and occlusal surfaces adjacent to the brackets were significantly higher in the T1 period than in the T0 period ( p < 0.05). In the T1 period of Gemini metal, Clarity self-ligating ceramic and Clarity advanced ceramic bracket groups, the demineralization values of the proximal enamel surfaces were found to be significantly higher than the Victory metal and APC Clarity Advanced ceramic bracket groups ( p < 0.05). In the T1 period, the demineralization values of the occlusal enamel surfaces of the Victory metal, APC Clarity Advanced ceramic bracket groups and control group were significantly lower than the Gemini metal, Clarity self-ligating ceramic and Clarity Advanced ceramic bracket groups ( p < 0.05). Significant increases in enamel demineralization values were observed as a consequence of increased retention areas for microbial dental plaque on enamel surfaces adjacent to the bracket. Considering the importance of minimizing enamel demineralization in fixed orthodontic treatments, less enamel demineralization in Victory metal and APC Clarity Advanced ceramic bracket groups showed that these brackets can be preferred in patients with poor oral hygiene.

Bracket failure is one of the most important problems encountered during fixed orthodontic treatment. For this reason, different types of adhesive agents have been developed over the years. Consequently, the aim of this study was to evaluate the shear bond strength of brackets bonded to teeth etched with a conventional acid etching method in a laboratory environment by using different types of adhesive agents and comparing the number of shear strokes. Sixty human maxillary premolars were divided into three groups and Gemini stainless steel metal brackets (3M Unitek, Monrovia, CA, USA) were bonded to all teeth. In Group 1, Transbond™ XT Primer (3M Unitek, Monrovia, CA, USA) and Transbond™ XT Light Cure Adhesive Paste composite (3M Unitek, Monrovia, CA, USA) were used. In Group 2, BracePaste® MTP Primer (American Orthodontics, Sheboygan, CA, USA) and BracePaste® Adhesive composite (American Orthodontics, Sheboygan, WI, USA) were used. In Group 3, Ortho Solo™ Primer (Ormco, Orange, CA, USA) and Grengloo™ Adhesive composite (Ormco, Brea, CA, USA) were used. The samples were subjected to a shear test with a closed-loop controlled, low-cycle fatigue machine with a capacity of 10 N and a crosshead speed of 300 mm/min. The number of shear strokes of the brackets was recorded. According to the Kruskal−Wallis and Mann−Whitney U tests performed on the data obtained, statistically significant differences were found between the groups in terms of the numbers of shear strokes (p < 0.05). Significantly higher numbers of shear strokes and higher shear bond strengths were observed in Group 3 compared with Group 1 and Group 2 (p < 0.05). There was no statistically significant difference between the numbers of shear strokes for Group 1 and Group 2 samples (p > 0.05). To conclude the study, it was observed that the type of adhesive used had an effect on the bond strength of the bracket and that the Grengloo™ adhesive agent showed higher shear bond strength. It was observed that BracePaste® Adhesive and Transbond™ XT Light Cure Adhesive Paste adhesive agents had similar shear bond strengths.

Purpose: Ionizing radiation causes oxidative stress induced tissue damage as well as a decline in reproduction incidence. The purpose of our study was to evaluate the effects of L-carnitine on radiation-induced uterine injury., Materials and Methods: Thirty Wistar albino rats were classified into five groups. Physiological saline was administered intraperitoneally to the control group. A single dose of 8.3 Gy whole body X-irradiation was applied to the radiation-1 and radiation-2 groups. These groups were sacrificed on the 6th hour and 4th day, respectively, after irradiation. Radiation-1 + L-carnitine and radiation-2 + L-carnitine groups received a daily dose of 200 mg/kg L-carnitine in addition to the same dose of irradiation. L-carnitine was also applied one day before and four days after irradiation., Results: L-carnitine therapy partially blocks the depletion of the deep glands and radiation-induced flattening of the glandular epithelium and endometrial surface. Proinflammatory cytokines such as IL-1β, IL-6 and TNF-α were found to be significantly expressed in the uterus tissue of irradiated mice. In the radiation groups, NFκB and PARP-1 expressions in uterine tissue was significantly increased compared to L-carnitine treated and the control groups. It was observed that the oxidative stress index increased in the radiation groups, but decreased in the L-carnitine applied groups., Conclusions: Our findings showed that L-carnitine has a positive effect on radiation-induced uterine damage. L-carnitine may be a potential safe radio protective agent during radiotherapy for pelvic cancer provided the tumor is not protected from radiation damage to the same extent as the normal tissue is. However, prospective clinical trial studies are necessary to understand its efficacy.