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Purpose: To evaluate the microvascular changes in the macular and peripapillary area after intravitreal dexamethasone implant in diabetic macular edema (DME)., Material and Methods: We included 31 eyes of 31 patients treated with a single dose dexamethasone implant for DME. All subjects underwent swept-source optical coherence tomography (OCT) and OCT angiography imaging before (T0), and one month (T1), two months (T2), and four months (T4) after dexamethasone injection. The foveal avascular zone (FAZ) area of superficial and deep capillary plexus (SCP and DCP) was calculated by delineating the FAZ border using the measurement tool of the device. The vessel density (VD) of SCP and DCP and choriocapillaris (CC) in the macular and peripapillary area were automatically calculated., Results: There was an insignificant reduction in FAZ area measurements of SCP after dexamethasone injection in DME patients (p = 0.846). The FAZ area of DCP were significantly smaller compared to T0 measurements at T1, T2, and T4 (p = 0.013, p = 0.031, and p = 0.029, respectively). The mean average parafoveal VD measurements were significantly decreased after dexamethasone injection in SCP and DCP (p = 0.004, p = 0.005). The peripapillary VD in retinal capillary plexuses and choriocapillaris showed no significant difference after dexamethasone injection., Conclusion: Intravitreal dexamethasone leads to a significant FAZ area decrease in DCP with a reduction in parafoveal VD measurements. In addition, no significant VD changes were observed in the peripapillary area after dexamethasone. These findings indicate that dexamethasone may improve macular ischemia with no significant effects on peripapillary microvasculature in DME patients.

Background: During the coronavirus disease 2019 (COVID-19) pandemic, the world has a large number of reported COVID-19 cases and deaths. Information on characteristics and mortality rate of pediatric intensive care unit (PICU) cases with COVID-19 remains limited. This study aims to identify the risk factors for mortality related to COVID-19 in children admitted to PICU., Methods: A retrospective multicenter cohort study was conducted between March 2020 and April 2021 at 44 PICUs in Turkey. Children who were 1 month-18-year of age with confirmed COVID-19 admitted to PICU were included in the study. Children with multisystem inflammatory syndrome and asymptomatic for COVID-19 were excluded., Results: Of 335 patients with COVID-19, the median age was 6.8 years (IQR: 1.2-14) and 180 (53.7 %) were male, 215 (64.2 %) had at least one comorbidity. Age and gender were not related to mortality. Among 335 patients, 166 (49.5%) received mechanical ventilation, 17 (5.1%) received renal replacement therapy and 44 (13.1 %) died. Children with medical complexity, congenital heart disease, immunosuppression and malignancy had significantly higher mortality. On multivariable logistic regression analysis, organ failure index [odds ratio (OR): 2.1, 95 confidence interval (CI): 1.55-2.85], and having congenital heart disease (OR: 2.65, 95 CI: 1.03-6.80), were associated with mortality., Conclusions: This study presents detailed data on clinical characteristics and outcomes of patients with COVID-19 admitted to PICU in the first pandemic year in Turkey. Our study shows that having congenital heart disease is associated with mortality. In addition, the high organ failure score in follow-up predict mortality., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Several animal species, including ants, have been reported to be capable of predation on ticks. However, determining factors in most interactions between ticks and predators have not yet been fully deciphered. We hypothesized that the ant species Lasius alienus, which is unknown whether it has any impact on ticks, may exhibit predation on the eggs of tick species Hyalomma marginatum, H. excavatum, and Rhipicephalus bursa, and that the tick egg wax can be the main determinant in possible predation. In the study, 6300 tick eggs with the natural wax coating (waxed/untreated) and 2700 dewaxed tick eggs, the wax of which was removed in the laboratory, were repeatedly presented to the foraging workers belonging to three different ant nests in their natural habitat. Depending on the tick species and trials, the rate of the eggs carried by the ants ranged from 12.8 to 52.1% in the waxed and from 59.8 to 78.4% in the dewaxed eggs. It was observed that the dewaxing process both increased the interest of the ants in the eggs and resulted in a reduction in the variation associated with tick species. This study showed that L. alienus has a predatory effect on tick eggs, the severity of this impact is closely associated with the tick species, the tick-associated difference is caused by the species-specific property of the egg wax, and the variety in the protective effects of the wax seems to be an evolutional result of the biological and ecological adaptation process of the species., (© 2022. The Author(s).)

The study aimed to generate a fused deep learning algorithm that detects and classifies the relationship between the mandibular third molar and mandibular canal on orthopantomographs. Radiographs ( n = 1880) were randomly selected from the hospital archive. Two dentomaxillofacial radiologists annotated the data via MATLAB and classified them into four groups according to the overlap of the root of the mandibular third molar and mandibular canal. Each radiograph was segmented using a U-Net-like architecture. The segmented images were classified by AlexNet. Accuracy, the weighted intersection over union score, the dice coefficient, specificity, sensitivity, and area under curve metrics were used to quantify the performance of the models. Also, three dental practitioners were asked to classify the same test data, their success rate was assessed using the Intraclass Correlation Coefficient. The segmentation network achieved a global accuracy of 0.99 and a weighted intersection over union score of 0.98, average dice score overall images was 0.91. The classification network achieved an accuracy of 0.80, per class sensitivity of 0.74, 0.83, 0.86, 0.67, per class specificity of 0.92, 0.95, 0.88, 0.96 and AUC score of 0.85. The most successful dental practitioner achieved a success rate of 0.79. The fused segmentation and classification networks produced encouraging results. The final model achieved almost the same classification performance as dental practitioners. Better diagnostic accuracy of the combined artificial intelligence tools may help to improve the prediction of the risk factors, especially for recognizing such anatomical variations.

The purposes of this study were to evaluate the clinical effects of microfracture (MFX) performed for Outerbridge grade 3 or 4 focal cartilage lesion during the same surgery with arthroscopic anterior cruciate ligament (ACL) reconstruction and to analyze the major determinants of these potential effects on the clinical outcome. The clinical and radiographic data of 119 patients were evaluated. The mean follow-up time was 32.6 ± 6 months. Isolated arthroscopic ACL reconstruction was performed in 70 patients (Group 1), whereas MFX for Outerbridge grade 3 or 4 chondral lesion during ACL surgery was performed in 49 patients (Group 2). Visual analogue scale (VAS) score, Lysholm knee score, and Tegner activity scale were the instruments used as outcome measures to evaluate the clinical status of the patients. Routine X-ray and MRI were also performed for all patients pre-operatively as well as at the latest follow-up visit. Lineer regression analysis was performed to determine major factors predicting the poorer clinical outcome. Clinical outcomes were similar between isolated ACL reconstruction and combined procedure. On the other hand, according to lineer regression analysis, cartilage lesion size > 2 cm 2 and > 5 degrees of varus alignment were detected as the major determinants leading to poorer outcomes in combined ACL reconstruction and MFX.Level of evidence: III - Retrospective Comparative Study., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Microbiota composition may play a role in the development, prognosis, or post-infection of COVID-19. There are studies evaluating the microbiota composition at the time of diagnosis and during the course of COVID-19, especially in adults, while studies in children are limited and no study available in children with multisystem inflammatory syndrome in children (MIS-C). This study was planned to compare intestinal microbiota composition in children diagnosed with MIS-C and acute COVID-19 infection with healthy children. In this prospective multicenter study, 25 children diagnosed with MIS-C, 20 with COVID-19 infection, and 19 healthy children were included. Intestinal microbiota composition was evaluated by 16 s rRNA gene sequencing. We observed changes of diversity, richness, and composition of intestinal microbiota in MIS-C cases compared to COVID-19 cases and in the healthy controls. The Shannon index was higher in the MIS-C group than the healthy controls (p < 0.01). At phylum level, in the MIS-C group, a significantly higher relative abundance of Bacteroidetes and lower abundance of Firmicutes was found compared to the control group. Intestinal microbiota composition changed in MIS-C cases compared to COVID-19 and healthy controls, and Faecalibacterium prausnitzii decreased; Bacteroides uniformis, Bacteroides plebeius, Clostridium ramosum, Eubacterium dolichum, Eggerthella lenta, Bacillus thermoamylovorans, Prevotella tannerae, and Bacteroides coprophilus were dominant in children with MIS-C. At species level, we observed decreased Faecalibacterium prausnitzii, and increased Eubacterium dolichum, Eggerthella lenta, and Bacillus thermoamylovorans in children with MIS-C and increased Bifidobacterium adolescentis and Dorea formicigenerasus in the COVID-19 group. Our study is the first to evaluate the microbiota composition in MIS-C cases. There is a substantial change in the composition of the gut microbiota: (1) reduction of F. prausnitzii in children with MIS-C and COVID-19; (2) an increase of Eggerthella lenta which is related with autoimmunity; and (3) the predominance of E. dolichum is associated with metabolic dysfunctions and obesity in children with MIS-C., Conclusions:  Alterations of the intestinal microbiota might be part of pathogenesis of predisposing factor for MIS-C. It would be beneficial to conduct more extensive studies on the cause-effect relationship of these changes in microbiota composition and their effects on long-term prognosis., What Is Known: • Microbiota composition may play a role in the development, prognosis, or post-infection of COVID-19.  • However, the number of studies on children is limited, and no study on multisystem inflammatory syndrome in children is currently available (MIS-C)., What Is New: • In individuals with MIS-C, the composition of the gut microbiota changed dramatically. • Decreased Faecalibacterium prausnitzii have been observed, increased Eggerthella lenta, which was previously linked to autoimmunity, and predominance of Eubacterium dolichum which was linked to metabolic dysfunction and obesity., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Breast cancer is the most common cancer in women ın the world. Many anticancer drugs are currently used clinically have been isolated from plant species or are based on such substances. Linalool is aromatic compounds from the monoterpene group. It is the main constituents of essential oils and show antiproliferative, antioxidant, and antiseptic properties. The aim of this study was to investigate the antiproliferativeand apoptotic, effects of linalool in MCF-7 and MDA-MB-231 human breast cancer cells. MCF-7 and MDA-MB-231 human breast cancer cells were treated with different concentrations of linalool (100, 200, 400, 600, 800, 1000 µM) at 24 h and 48 h. MTT assay for cell proliferation and Annexin V assay for apoptosis was done. The morphology of breast cancer cells was investigated by lıght mıcroscope and scanning electron microscope (SEM). The study show that linalool significantly induced apoptosis in all groups as dose and time-dependent (p < .05). Linalool has apoptotic and antiproliferative properties in a concentration and time-dependent manner in breast cancer cells. The cytotoxic effects of linalool on MCF-7 and MDA-MB-231 human breast cancer cells was found to be associated with apoptotic cell death. Linalool was more effective on MCF-7 human breast cancer cells in smaller amounts.

Fetal electrocardiography (fECG) has gotten widespread interest in the last years as technology for fetal monitoring. Compared to cardiotocography (CTG), the current state of the art, it can be designed in smaller formfactor and is thus suited for long-term and unsupervised monitoring. In the present study we evaluated a wearable system which is based on CSEM's cooperative sensors, a versatile technology that allows for the measurement of multiple biosignals and an easy integration into a garment or patch. The system was tested on 25 patients with singleton pregnancies and an age of gestation ≥ 37 weeks. To reject unreliable fetal heart rate (fHR) estimations, the signal processing algorithm provides a signal quality index. In 12 out of 21 patients available for analysis, a good performance of fHR estimations was obtained with a mean absolute error < 5 bpm and an acceptance rate >70%. However, the remaining 9 patients showed low acceptance rates and high errors. Besides investigating the source of these high errors, future work includes the investigating improved signal processing algorithms, different body positions and the use of dry electrodes. Clinical Relevance - The aim of this work is to develop a wearable system that can be offered in hospitals as an alternative to cardiotocography, or as a home monitoring tool for at risk fetuses, in the era of evolving telemedicine.

This work presents a method to minimize the inadvertent cutting of tissues in surgeries involving bone drilling. We present electrical impedance measurements as an assistive technology to image-guided surgery to achieve online guidance. Proposed concept is to identify and localize the landmarks via impedance measurements and then use this information to superimpose the estimated drilling trajectory on the offline maps obtained by pre-operative imaging. To this end., we propose an asymmetric electrode geometry., split electrodes., capable of distinguishing impedance variations as a function of rotation angle. The feasibility of the proposed approach is verified with numerical analysis. A probe with stainless steel electrodes has been fabricated and tested with a technical phantom. Although the results are impacted by a non-ideality in the phantom., we could show that the variation of impedance as a function of rotation angle can be used to localize the regions with different impedivities. Clinical Relevance- Presented approach may be used to minimize the inadvertent cutting of tissues in surgeries involving bone drilling.

This retrospective study aims to determine the more predictive ovarian reserve marker when there is discordance between anti-Müllerian hormone (AMH) and antral follicle count (AFC) in patients with diminished ovarian reserve (DOR). Patients who underwent ICSI because of DOR were divided into three groups. Group 1: patients with low AMH (<1.1 ng/ml) and AFC ( n  < 7), group 2: patients with low AMH (<1.1 ng/ml) and normal AFC ( n  ≥ 7) and group 3: patients with normal AMH (≥1.1 ng/dl) and low AFC ( n  < 7). Demographic values, follicle output rate (FORT) score and follicle to oocyte index (FOI) score of the groups were compared. Totally, 662 cycles were enrolled in the study. There were 418 cycles in group 1, 167 cycles in group 2 and 77 cycles in group 3. As the primary result, FORT and FOI scores were higher in group 3 than the other two groups. Median FORT Score with quartiles: group 1: 100 (66-150), group 2: 71 (57-100), group 3: 136 (96-200), p <.01 - median FOI score with quartiles: group 1: 83 (50-140), group 2: 71 (40-100), group 3: 116 (66-216), p <.01. In conclusion, serum AMH level has more predictive value for stimulation success if there is discordance with AFC.Impact Statement What is already known on this subject? Female age, serum Anti-Müllerian Hormone (AMH) levels, and antral follicle count (AFC) are commonly used to assess ovarian reserve and predict response to ovarian stimulation. AMH and AFC are both positively correlated with ovarian reserve. What do the results of this study add? If there is discordance between AFC and AMH in patients with diminished ovarian reserve (DOR), the ovarian response is better in patients with high AMH and low AFC than the patients with low AMH and high AFC. What are the implications of these findings for clinical practice and/or further research? It is important to assess both AFC and AMH before controlled ovarian hyperstimulation, to predict ovarian response in DOR patients, rather than assessing AFC or AMH alone.

Aim: Brain arteriovenous malformations (AVMs) are congenital anomalies that present as intracranial hemorrhage or epilepsy. AVMs often remain clinically silent for extended periods. Although AVM treatment methods are controversial, three treatment strategies are usually combined or applied alone: surgical removal, embolization and stereotactic radiosurgery. We compared clinical and radiological outcomes in intracranial AVM patients treated via surgical resection with and without prior embolization., Materials and Methods: Patients who did (30 patients) and did not (30 patients) undergo endovascular embolization before surgical resection at the İzmir Katip Çelebi University Atatürk Training and Research Hospital Neurosurgery Clinic from 2011 to 2019 were included in this retrospective, cohort study. Symptoms at diagnosis, comorbidities and clinical (AVM and Spetzler-Martin grade) and morphological characteristics were assessed., Results: A mean one-year follow-up assessed outcomes using the modified Rankin score, and imaging studies assessed AVM obliteration post-procedure. Mean operation times for surgical resection with and without embolization were 166.50 ± 32.02 and 204.47 ± 26.66 min, respectively. Mean patient hospitalization periods for surgical resection with and without embolization were 8.43 ± 3.60 and 12.00 ± 5.51 days, respectively., Conclusion: Among patients who underwent surgical resection, significant operation time and hospitalization time differences were observed in favor of patients who underwent embolization, indicating that preoperative embolization is a safe and beneficial method for treating ruptured and non-ruptured AVMs.

Introduction: There have been some significant changes regarding healthcare utilization during the COVID-19 pandemic. Majority of the reports about the impact of the COVID-19 pandemic on diabetes care are from the first wave of the pandemic. We aim to evaluate the potential effects of the COVID-19 pandemic on the severity of diabetic ketoacidosis (DKA) and new onset Type 1 diabetes presenting with DKA, and also evaluate children with DKA and acute COVID-19 infection., Methods: This is a retrospective multi-center study among 997 children and adolescents with type 1 diabetes who were admitted with DKA to 27 pediatric intensive care units in Turkey between the first year of pandemic and pre-pandemic year., Results: The percentage of children with new-onset Type 1 diabetes presenting with DKA was higher during the COVID-19 pandemic ( p < 0.0001). The incidence of severe DKA was also higher during the COVID-19 pandemic ( p < 0.0001) and also higher among children with new onset Type 1 diabetes ( p < 0.0001). HbA1c levels, duration of insulin infusion, and length of PICU stay were significantly higher/longer during the pandemic period. Eleven patients tested positive for SARS-CoV-2, eight were positive for new onset Type 1 diabetes, and nine tested positive for severe DKA at admission., Discussion: The frequency of new onset of Type 1 diabetes and severe cases among children with DKA during the first year of the COVID-19 pandemic. Furthermore, the cause of the increased severe presentation might be related to restrictions related to the pandemic; however, need to evaluate the potential effects of SARS-CoV-2 on the increased percentage of new onset Type 1 diabetes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Kiral, Kirel, Havan, Keskin, Karaoglan, Yildirim, Kangin, Talay, Urun, Altug, Kesici, Tufan, Kacmaz, Bozan, Azapagasi, Uysal Yazici, Ozturk, Yesilbas, Karaguzel, Kaya, Barlas, Duyu, Boyraz, Sevketoglu, Akcay, Hancili, Guven, Dursun, Ulgen Tekerek, Ozcifci, Yazici, Turanli, Kendirli, Kahveci, Yetimakman, Citak, Şik, Bingol, Aygun, Durak, Yilmaz, Bugrul, Sari, Tekguç, Albayrak, Yener, Agin, Soydan, Yildizdas, Dilek, Yalindag, Incekoy-Girgin, Alacakir, Tutunculer, Arslanaoglu, Aydin, Bilgin, Simsek and Dinleyici.)

Pressure from environmental nongovernmental organizations and the public has accelerated research on the development of innovative and renewable polymers and additives. Recently, biobased "green" plasticizers that can be covalently attached to replace toxic and migratory phthalate-based plasticizers have gained a lot of attention from researchers. In this work, we prepared an azide-functionalized soybean oil derivative (AzSBO) and investigated whether it can be used as a plasticizer. We covalently attached AzSBO to an electron-deficient triple-bond-containing polyester via a metal-free azide-alkyne click reaction. The thermal, mechanical, and solvent absorption behaviors of different amounts of azidated oil-containing polyesters were determined. Moreover, the plasticization efficiency of AzSBO was compared with the commercial plasticizers bis(2-ethylhexyl) phthalate and epoxidized soybean oil. At relatively lower AzSBO ratios, the degree of cross-linking was higher and thus the plasticization was less pronounced but the solvent resistance was significantly improved. As the ratio of AzSBO was increased, the glass transition temperature of the pristine polymer decreased up to 31 °C from 57 °C. Furthermore, the incorporation of AzSBO also improved the thermal properties and 20% AzSBO addition led to a 60 °C increase in the maximum weight loss temperature., Competing Interests: The authors declare no competing financial interest., (© 2022 The Authors. Published by American Chemical Society.)

Introduction: Sarcomas with mesenchymal origin located in the abdominal cavity or retroperitoneal space are rare. They might reach large dimensions due to the non-specific and late onset of clinical symptoms. In this study we aim to provide the outcomes of 38 cases. Methods: Thirty-eight patients, whose data had been registered and analyzed completely in a prospective manner, were enrolled in the study. Demographic Findings, Primary-Recurrent Status of the disease, surgical method applied (R0-1-2), additional organ resections, Morbidity and Mortality rates, HIPEC application, Histopathological results and overall survival outcomes during follow-up were evaluated in the enrolled cases. Results: Thirty-eight (38) patients were operated on due to soft tissue sarcomas located in the abdominal and retroperitoneal area. The mean age of patients was 57.63 +- 15.38. The localization rates of retroperitoneal, abdominal and visceral tumors were 28%, 58%, and 12%, respectively. The mean tumor size was 12.96 cm +- 9.62. Twenty-seven patients (71%) underwent R0 resection, 7 patients (18%) underwent R1 resection, 4 patients (10%) underwent R2 resection. Additionally, sarcomatosis was detected in 6 patients and these patients underwent Cytoreductive Surgery+HIPEC. The first 30-day mortality and morbidity rates were 10.5% (4 patients) and 44% (17 patients), respectively. Conclusion: Surgery is the gold standard treatment of this condition. The most important stage in the management of the condition is the discussion of these cases in multidisciplinary teams in centers experienced in this disease in terms of prognosis and local recurrence and deciding on the treatment strategy based on these discussions., (Celsius.)

Cancer stem cells (CSCs), which represent the root cause of resistance to conventional treatments, recurrence, and metastasis, constitute the critical point of failure in cancer treatments. Targeting CSCs with dendritic cell (DC)-based vaccines have been an effective strategy, but sialic acids on the surface of DCs limit the interaction with loaded antigens. We hypothesized that removal of sialic acid moieties on immature DCs (iDCs) could significantly affect DC-CSC-antigen loading, thereby leading to DC maturation and improving immune recognition and activity. The lysate of CD44 + /CD24 -/low breast CSCs (BCSCs) was pulsed with sialidase-treated DCs to obtain mature dendritic cells (mDCs). The roles of cytoskeletal elements in antigen uptake and dendritic cell maturation were determined by immunofluorescence staining, flow cytometry, and cytokine measurement, respectively. To test the efficacy of the vaccine in vivo, CSCs tumor-bearing mice were immunized with iDC or mDC. Pulsing DCs with antigen increased the expression levels of actin, gelsolin, talin, WASp, and Arp2, especially in podosome-like regions. Compared with iDCs, mDCs expressed high levels of CD40, CD80, CD86 costimulatory molecules and increased IL-12 production. Vaccination with mDC: i) increased CD8+ and CD4 + T-cell numbers, ii) prevented tumor growth with anti-mitotic activity and apoptotic induction, iii) suppressed metastasis by decreasing Snail, Slug, and Twist expressions. This study reveals for the first time that sialic acid removal and loading with CSC antigens induces significant molecular, morphological, and functional changes in DCs and that this new DC identity may be considered for future combined immunotherapy strategies against breast tumors., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Gout is an inflammatory arthritis characterized by the deposition of monosodium urate (MSU) crystals in the joints or soft tissue. MSU crystals are potent inflammation inducers. Melatonin (MLT) is a powerful endogenous anti-inflammatory agent and effective in reducing cellular damage. In the present study, possible underlying mechanisms associated with anti-inflammatory and antioxidative effects were investigated in rats with gouty arthritis and melatonin deprivation treated with MLT. Fifty-six rats were divided into seven groups: control, sham control, pinealectomy (PNX), MSU (on the 30th day, single-dose 20 mg/ml, intraperitoneal), MSU + MLT (10 mg/kg/day for 30 days, intraperitoneal), MSU + PINX and MSU + PINX + MLT. PNX procedure was performed on the first day of the study. As compared to the controls, the results showed that MSU administration caused significant increases in oxidative stress parameters (malondialdehyde and total oxidant status). Besides, significant decreases in antioxidant defense systems (glutathione, superoxide dismutase and total antioxidant status) were observed. A statistically significant increase was found in the mean histopathological damage score in the groups that received MSU injection. It was found that histopathological changes were significantly reduced in the MSU + MLT group given MLT. In our study, it was determined that many histopathological changes, as well as swelling and temperature increase in the joint, which are markers of inflammation, were significantly reduced with MLT supplementation. These results suggest that melatonin ameliorates MSU-induced gout in the rat through inhibition of oxidative stress and proinflammatory cytokine production., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Alzheimer's disease (AD) is by far the most common cause of cognitive impairment in older adults. Current treatments are entirely focused on the symptoms of AD. A complex etiology for AD has been proposed recently, in which AD leads in elevated levels of inflammation. We previously studied digoxin's involvement in the sporadic-AD intracerebroventricular (ICV)-streptozotocin (STZ) animal model due to its anti-inflammatory and neuroprotective characteristics. 18 adult sprague-dawley rats were split into three groups: control (n = 6), STZ + Saline (n = 6), and STZ + Digoxin (n = 6). Twelve AD-induced rats were split into two groups using stereotaxy five days after STZ injection (3 mg/kg) into both lateral ventricles: one group got digoxin (0.1 mg/kg/day, i.p.) for three weeks, while the other group received saline. Following treatment, each subject was subjected to a passive avoidance learning (PAL) test, followed by brain tissue harvesting. The levels of tumor necrosis factor-alpha (TNF-α) and choline acetyl transferase (ChAT) were measured in the brain, and neurons were counted using Cresyl violet staining in cornu ammonis-1 (CA1) and cornu ammonis-3 (CA3) cornu ammonis (CA3). ICV-STZ significantly shortened PAL latency, increased brain TNF-α levels, decreased brain ChAT activity, and decreased hippocampus neuron number. On the other hand, digoxin significantly reduced all of these STZ-induced deleterious effects. Digoxin significantly rescued rats from memory loss caused by ICV-STZ by decreasing hippocampal cell death, neuroinflammation, and cholinergic deficiency. These findings suggest that digoxin may be beneficial in treating cognitive impairment and Alzheimer's disease., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Salt water adversely affects human health and plant growth. In parallel with the increasing interest in non-contact determination of salt concentration in water, a novel approach is proposed in this study. In the proposed approach, S parameter measurements, which show the scattering properties of electromagnetic waves, are used. First, the relationship between salt concentration in water and permittivity values, a distinguishing feature for liquids, is shown. Then, based on the derived correlations from a set of S parameter measurements, it is shown that the salt concentration in water can be predicted. Finally, after exactly determining the relations of permittivity, salt concentration and S parameter, a system that allows non-contact determination of salt concentration is proposed. Since the proposed system makes its prediction using a classifier, decision tree algorithms are employed for this purpose. In order to evaluate the appropriateness and success of the algorithms, a set of classification experiments were held using various water samples with different levels of salt concentration. The results of the classification experiments show that the Hoeffding tree algorithm achieved the best results and is the most suitable decision tree algorithm for determining the salt concentration of liquids. For this reason, the proposed non-contact approach can be used to determine the salt concentration in water reliably and quickly if its hardware and software components can be embedded into a prototype system.

Aims: The objective of the present study was to investigate the presence of SARS-CoV-2 in aerosol and COVID-19 contamination distance asssociated with ultrasonic scaling and tooth preparation., Methods: Twenty-four patients with COVID-19 were included in this study. Removal of supragingival plaque with ultrasonic instruments for 10 minutes and high-speed air-turbine using for the simulation of cutting the maxillary right canine tooth with a round diamond bur for 5 minutes were performed. Patients were randomly assigned to 2 groups: In group A, medium-volume suction was used during treatment. In group B, high-volume suction with an aerosol cannula was added to medium-volume suction. Prior to treatment, 5 glass petri dishes containing viral transport medium were placed in the operating room. After treatment, petri dishes were immediately delivered to a microbiology laboratory for real-time polymerase chain reaction (RT-PCR) analysis., Results: RT-PCR test results were negative for all specimens in group B. However, 5 positive test results for COVID-19 were detected in group A specimens., Conclusions: Suction with an aerosol cannula is very important to prevent COVID-19 viral contamination via aerosol. In addition, a high-volume suction capacity (air volume) of 150 mm Hg or 325 L/min is sufficient for elimination of viral contamination. Thus, high-volume suction should be used during dental treatments in COVID-19 patients., (Copyright © 2021. Published by Elsevier Inc.)

The aim of this study was to evaluate whether antral follicle size has any value with respect to antral follicle count (AFC) in predicting ovarian response to controlled ovarian stimulation. Patients who were considered to be normal responders based on their ovarian reserve markers were consecutively recruited. Total AFC was the number of 2-10 mm follicles in both ovaries. Antral follicles were separated into two subgroups according to the size: 2-5 mm and 6-10 mm follicles. Patients were divided into two main groups according to ovarian response to COS. Group 1 (suboptimal response, 4-9 oocytes retrieved, n  = 61) and Group 2 (normal responders, ≥10 oocytes retrieved, n  = 65). Demographic parameters were comparable between the groups. The number of 2-5 mm follicles was significantly lower in the suboptimal response group (5 [4:7] and 8 [6:10], respectively, p  < .001). The ratio of 2-5 mm follicles to total antral follicles was also significantly lower in Group 1 (44.4% and 75%, respectively, p  < .001). The ratio of small antral follicles was positively correlated with ovarian response ( r  = 0.587, p  < .001). In conclusion, the ratio of small (2-5 mm) antral follicles could be a more specific predictive marker than AFC for ovarian response.IMPACT STATEMENT What is already known on this subject? Prediction of the ovarian response during ovarian stimulation is commonly based on antral follicle count and anti-mullerian hormone. The ovarian response may be inadequate even in patients with normal antral follicle count and anti-mullerian hormone. What do the results of this study add? A high ratio of small-size (2-5 mm) basal antral follicles is a predictive factor for higher ovarian response to ovarian hyperstimulation. What are the implications of these findings for clinical practice and/or further research? To obtain optimal ovarian response, the antral follicles should be evaluated initially in a more detailed and systematic way by taking their sizes into consideration in addition to their counts. Small antral follicle count rather than whole antral follicle count may be beneficial for optimising the ovarian response. Future studies may determine the cut off values of small antral follicle count for high/poor ovarian response.

Objective: To investigate whether the frequency of uterine cavity abnormalities in PCOS patients higher than the normo-ovulatory patients., Study Design: This retrospective cohort study was conducted at the ART center of a tertiary university hospital. A total of 103 patients; 51 PCOS, and 52 male factor infertility were enrolled in the study between the years 2011-2019. HSG images of all patients were numbered and evaluated by ten senior reproductive endocrinologists and surgeons whom were blinded to the research and choose the most appropriate figure for each patient's HSG image and marked the shape of cavity according to the ASRM and ESGE/ESHRE classification. Results and demographic parameters were compared between PCOS and male factor infertility groups., Results: The percentage of the normal uterine cavity was significantly lower in the PCOS group than control group as 51 % and 66.7 %, 77 % and 94.2 % according to the ASRM and ESHRE/ESGE classifications, respectively. The frequency of Partial Septate Uterus (ESHRE-ESGE U2a / ASRM Va, 21.6% vs 5.8 % p < 0.05), Complete Septate Uterus (ESHRE-ESGE U2b / ASRM Vb, 7.8% vs 0% p < 0.01) and Dysmorphic Uterus (ESHRE-ESGE U1c) / ASRM VII) 3.9 % vs 0p < 0.05) were significantly higher in PCOS patients than controls. The frequency of arcuate uterus classified as VI in ASRM and considered as normal in ESHRE/ESGE was 16 % and 17.3 % in PCOS and control groups, respectively, without statistically significant difference., Conclusions: This study provides that, compared to the healthy population, the frequency of uterine cavity abnormality is clearly higher in PCOS patients., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Purpose: To evaluate the ability of subgluteal sciatic nerve block (SSNB) to provide pain control during endovascular treatment of below-the-knee (BTK) occlusions., Materials and Methods: This randomized prospective controlled study evaluated 60 consecutive adult patients who underwent endovascular treatment for BTK occlusions. The patients were randomized into 2 equal groups; the SSNB group underwent SSNB in the subgluteal space under ultrasound guidance, while the control group received fentanyl as an analgesic. The visual analog scale (VAS) and Face, Legs, Activity, Cry, Consolability (FLACC) scale scores were recorded., Results: Compared with the control group, the SSNB group showed significantly lower median VAS (0 [range, 0-30] vs 70 [range, 20-100], P < .001) and median FLACC scale (0 [range, 0-2] vs 6 [range, 3-10], P < .001) scores. There was no statistically significant difference between the 2 groups regarding the remaining parameters. There was a very strong correlation between the VAS and FLACC scale scores in both the SSNB (r = 0.805, P < .001) and control (r = 0.950, P < .001) groups. The procedure time and total balloon inflation time correlated with the VAS (r = 0.411, P = .024, and r = 0.402, P = .031, respectively) and FLACC scale (r = 0.431, P = .017, and r = 0.414, P = .022, respectively) scores in the control group but not in the SSNB group (r = 0.364, P = .056, and r = 0.300, P =.085, respectively, for correlation with VAS score and r = 0.730, P = .068, and r = 0.704, P = .075, respectively, for correlation with the FLACC scale score)., Conclusions: SSNB is a highly effective and safe pain management modality for the endovascular treatment of BTK occlusions., (Copyright © 2021 SIR. Published by Elsevier Inc. All rights reserved.)

Objectives: Reverse transcription polymerase chain reaction (RT-PCR) testing is indispensable in management of the coronavirus disease 2019 (COVID-19) pandemic. However, with the emergence of new variants of severe acute respiratory syndrome coronavirus-2, the cause of COVID-19, the screening capacity of RT-PCR testing is overburdened, and new strategies and capabilities need to be established. One option is pooled RT-PCR testing., Design: This study used various mixtures of COVID-19 samples known to be negative and positive, and investigated the impact of pool size and mixture level on final cycle threshold (Ct) values. More specifically, 5, 10 and 20 negative samples were combined with one, two or three low Ct or high Ct positive samples., Results: Average baseline Ct and numbers of high and low Ct samples in the pool were found to be the main drivers of the final Ct value, making detectability easier. Pool size was not significantly associated with final Ct, but was suggestive., Conclusions: A pooled RT-PCR testing strategy does not reduce the sensitivity of RT-PCR, and thus provides a practical way to expand RT-PCR screening capacity in pandemic management. The pool size was not found to be significant, so it is recommended that a pool size of 20 would be a practical number to reduce the time taken to obtain the results and the cost of RT-PCR testing., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Diabetic neuropathy (DN) is the most common degenerative complication associated with Diabetes Mellitus. Despite widespread awareness about DN, the only effective treatments are blood glucose control and pain management. The aim of the current study was to determine the effect of intramuscular adipose-derived mesenchymal stem cell (AMSC) transplantation on sciatic nerves in DN using EMG and histological analyses. A total of 27 mice were randomly divided into three groups: control group, DN group and AMSC group. In EMG, CMAP amplitude in the sciatic nerves was lower, but distal latency was higher in the DN group compared with the control group. CMAP amplitude in the sciatic nerves was higher in the AMSC group compared with the DN group. Distal latency in the sciatic nerve was lower in the AMSC group compared with the DN group. Histologic examination of the tissues in the animals treated with AMSC showed a remarkable improvement in microscopic morphology. Fluorescence microscopy analyses demonstrated that intramuscularly transplanted AMSC was selectively localized in the sciatic nerves. Transplantation of AMSC increased protein expression of S100, cdk2, NGF and DHH, all of which, interfered with DN onset in sciatic nerves. The findings of the present study suggest that AMSC transplantation improved DN through a signal-regulatory effect on Schwann cells, neurotrophic actions and restoration of myelination.

The objective of this study was to assess the effect of rescue in vitro maturation and immediate intracytoplasmic sperm injection (ICSI) application on fertilisation success and early embryonic development of metaphase I (MI) oocytes. This was a retrospective cohort study including 2425 sibling oocytes in 259 ICSI cycles. ICSI was performed on 104 GV (germinal vesicle) oocytes which had reached the metaphase II (MII) stage (Group 1) and 231 MI oocytes which had reached the MII stage (Group 2) following IVM (in vitro maturation). Immediate ICSI was applied following oocyte aspiration on 292 MI stage (Group 3) and 1798 MII stage oocytes (Group 4). Normal fertilisation rates in Groups 1, 2, 3 and 4 were 51.9%, 39%, 30.1% and 59.5%, respectively. The rates of blastocyst development per oocyte and per zygote were calculated as 3.8%, 3.0%, 6.8%, 14.1% and 7.4%, 7.7%, 22.7%, 23.6% for Groups 1, 2, 3 and 4, respectively. The blastocyst development rate was significantly higher in the MI-ICSI group compared with other immature oocytes. Even though performing ICSI on the oocytes at the MI stage on the day of oocyte aspiration resulted in lower fertilisation rates, it was associated with significantly higher rates of blastocyst development.

Aim: Vertebral compression fractures (VCF) occur most commonly at the thoracolumbar junction (TLJ). Balloon kyphoplasty (BKP) is an effective method of bone remodeling in these cases. In this study, we evaluate the parameters that affect bone retropulsion and restoration in TLJ VCF without neurological deficits., Material and Methods: Thirty-one of Frankel E and AO A3-4 type VCFs fractures at the TLJ, with bone retropulsion into the spinal canal, from 2017 to 2020, were evaluated retrospectively. Data was gathered on patient demographics and medical histories. Measurements of anterior vertebral heights, posterior vertebral heights, local kyphotic angles, spinal cord area, and bone retropulsion into the spinal canal (BRC) were evaluated preoperatively, early postoperatively, and late postoperatively., Results: In those patients who underwent early surgery ( 4 weeks postfracture), a significantly greater increase in anterior vertebral heights was seen between early postoperative and preoperative measurements than in patients who underwent late surgery ( 4 weeks postfracture) (p = 0.016). At the six-month follow-up, a significantly greater decrease in local kyphotic angle measurements was seen in patients over 65 years of age than those under 65 (p = 0.023). Comparison of local kyphotic angles between sexes revealed a significant decrease in measurements at follow-up in female patients (p = 0.029). Both early postoperative and late postoperative local kyphotic angle measurements of patients with a body mass index (BMI) ≥25 were significantly lower than those of patients with a BMI 25 (p = 0.012)., Conclusion: The restoration of vertebral angles and heights with the maximum level of BKP can effectively reduce BRC.

One of the most common complications of diabetes is diabetic nephropathy (DN). Uncontrolled hyperglycemia leads to histopathologic alterations in the kidney that prevent normal renal function. This study aimed to explore the effects of crocin treatment via virtue of its numerous beneficial properties in streptozotocin-induced pinealectomized diabetic rats. The pinealectomy procedure was conducted on the first day of the study. On the 30th day following pinealectomy, streptozotocin (STZ) (50 mg/kg) was administered intraperitoneally in Wistar rats for induction of diabetes. Diabetes was confirmed on the 3rd day following STZ administration by determining the glucose levels. Daily crocin treatment intraperitoneally for 15 days (50 mg/kg) ameliorated impaired renal oxidant/antioxidant balance, reduced TGF-β1 immuno-staining around tubules, and promoted improvement of renal architecture. Moreover, crocin administration improved altered renal function parameters, including serum Cr and BUN, and also increased creatinine clearance. In conclusion, the protective effects of crocin on diabetic nephropathy might be associated with its powerful antioxidant properties, its ability to improve tissue antioxidant status, and its ability to prevent inflammatory pathways., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Children with chronic neurological diseases, including cerebral palsy (CP), are especially susceptible to vaccine-preventable infections and face an increased risk of severe respiratory infections and decompensation of their disease. This study aims to examine age-appropriate immunization status and related factors in the CP population of our country. This cross-sectional prospective multicentered survey study included 18 pediatric neurology clinics around Turkey, wherein outpatient children with CP were included in the study. Data on patient and CP characteristics, concomitant disorders, vaccination status included in the National Immunization Program (NIP), administration, and influenza vaccine recommendation were collected at a single visit. A total of 1194 patients were enrolled. Regarding immunization records, the most frequently administrated and schedule completed vaccines were BCG (90.8%), hepatitis B (88.9%), and oral poliovirus vaccine (88.5%). MMR was administered to 77.3%, and DTaP-IPV-HiB was administered to 60.5% of patients. For the pneumococcal vaccines, 54.1% of children received PCV in the scope of the NIP, and 15.2% of children were not fully vaccinated for their age. The influenza vaccine was administered only to 3.4% of the patients at any time and was never recommended to 1122 parents (93.9%). In the patients with severe (grades 4 and 5) motor dysfunction, the frequency of incomplete/none vaccination of hepatitis B, BCG, DTaP-IPV-HiB, OPV, and MMR was statistically more common than mild to moderate (grades 1-3) motor dysfunction (p = 0.003, p < 0.001, p < 0.001, p < 0.00, and p < 0.001, respectively). Physicians' influenza vaccine recommendation was higher in the severe motor dysfunction group, and the difference was statistically significant (p = 0.029).Conclusion: Children with CP had lower immunization rates and incomplete immunization programs. Clinicians must ensure children with CP receive the same preventative health measures as healthy children, including vaccines. What is Known: • Health authorities have defined chronic neurological diseases as high-risk conditions for influenza and pneumococcal infections, and they recommend vaccines against these infections. • Children with CP have a high risk of incomplete and delayed immunization, a significant concern given to their increased healthcare needs and vulnerability to infectious diseases. What is New: • Influenza vaccination was recommended for patients hospitalized due to pneumonia at a higher rate, and patients were administered influenza vaccine more commonly. • Children with CP who had higher levels of motor dysfunction (levels 4 and 5) were more likely to be overdue immunizations., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Aim: To reveal the reliability and validity of the Turkish Lumbar Spine Instability Questionnaire for evaluating patients with lumbar instability and low back pain., Material and Methods: A total of 100 patients with low back pain participated in the study. Test-retest and internal consistency analyses were used to assess the reliability of the questionnaire, and correlation analysis was used to determine its validity. For correlation analysis, the total scores of the Lumbar Spine Instability Questionnaire, Visual Analog Scale, Bournemouth Questionnaire, Tampa Scale of Kinesiophobia, and Roland Morris Disability Questionnaire were compared., Results: Reliability analysis showed that the internal consistency value of the questionnaire was 0.818, and the intraclass correlation coefficient (ICC) value was 0.839. Pearson correlation analysis showed that the questionnaire had a good correlation with the Tampa Scale of Kinesiophobia (0.520) and a stronger correlation with the Visual Analog Scale (0.702), Roland Morris Disability Questionnaire (0.767), and Bournemouth Questionnaire (0.667)., Conclusion: Our results confirmed that the Turkish version of the Lumbar Spine Instability Questionnaire is reliable and valid.

Introduction: The aim of this study was to compare posterior subtenon triamcinolone (PSTA) application and intravitreal dexamethasone phosphate (DEX) implant in the treatment of diabetic macular edema (DME) in vitrectomized eyes., Methods: This retrospective study included 64 (48.12%) patients who received PSTA and 69 (51.88%) patients who received DEX implants in DME treatment after vitrectomy. Best corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) were analyzed before injection; at 1, 3, and 6 months after injection. The postinjection values were statistically compared with the preinjection value., Results: All postinjection CMT values in both groups were lower than the preinjection value (p < 0.05 for all). There were statistically significant increases in all postinjection BCVAs of the DEX group and postinjection 1-month BCVA of the PSTA group (p < 0.05 for all). However, there was no significant difference in BCVA values of the PSTA group at 3 and 6 months after injection (p > 0.05 for both). There was no statistically significant difference in all postinjection IOP values of the PSTA group (p > 0.05 for all). However, significant increases in IOP were observed in the DEX group at 1 and 3 months after injection (p < 0.05 and p = 0.02, respectively). The number of additional injections between the 3rd and 6th months after the initial injection was statistically higher in the PSTA group (p = 0.006)., Conclusion: Both intravitreal DEX and PSTA administration are effective in the treatment of DME after vitrectomy. However, visual improvement persisted longer, and the need for additional injections was less in patients who received DEX., (© 2022 S. Karger AG, Basel.)

Objective: To investigate the clinical outcomes of three surgical approaches for ectopia lentis in Marfan syndrome (MS) patients who had undergone crystalline lens removal with posterior chamber intraocular lens (IOL) implantation techniques comprising the intrascleral fixation of IOL, sutured scleral fixation of IOL, and IOL implantation with the use of a Cionni capsular tension ring (CTR)., Methods: This is a retrospective comparative study, including 35 eyes of 21 patients who underwent the intrascleral fixation of IOL (group 1), scleral IOL fixation with the Z-suture (group 2), and IOL implantation with the use of a Cionni CTR (group 3) following crystalline lens removal. The surgical indications were as follows: no improvement in visual function after eyeglasses or contact lens application due to excessive irregular astigmatism and advanced crystalline lens decentration in which the edge of the crystalline lens came up to the optical axis, or dislocation of the crystalline lens resulting in aphakia and secondary glaucoma due to lens dislocation. The surgical outcomes and complications due to surgery were compared between the groups., Results: The mean age of the patients in the study was 12.3 ± 8.7 years (5-32 years). There were 10 eyes in group 1, 13 eyes in group 2, and 12 eyes in group 3. Visual acuity improved significantly in each group after surgery. Ocular residual astigmatism did not differ significantly between the groups ( p  = 0.51)., Conclusion: There were no significant differences between the three surgical approaches in the current study in terms of the postoperative results and complications.

Background: The albumin-globulin ratio (AGR) could be a prognostic biomarker in patients with cancer, although the data is limited in patients treated with immune-checkpoint inhibitors (ICIs)., Objectives: We aimed to evaluate the association between AGR and survival in ICI-treated patients., Methods: The data of 212 advanced-stage patients were retrospectively evaluated in this cohort study. The association between AGR with overall (OS) and progression-free survival (PFS) were evaluated with multivariate analyses. Additionally, receptor operating curve (ROC) analysis was conducted to assess the AGR's predictive power in the very early progression (progression within two months) and long-term benefit (more than twelve months survival)., Results: The median AGR was calculated as 1.21, and patients were classified into AGR-low and high subgroups according to the median. In the multivariate analyses, patients with lower AGR (< 1.21) had decreased OS (HR: 1.530, 95% CI: 1.100-2.127, p= 0.011) and PFS (HR: 1.390, 95% CI: 1.020-1.895, p= 0.037). The area under curve of AGR to detect early progression and long-term benefit were 0.654 (95% CI: 0.562-0.747, p= 0.001) and 0.671 (95% CI: 0.598-0.744, p< 0.001), respectively., Conclusions: In our experience, survival with ICIs was impaired in patients with lower AGR. Additionally, the AGR values could detect the very early progression and long-term benefit ICIs.

Objectives: The aim of the study was to investigate the relationship between back pain and thoracic vertebral deformities and arthropathy in patients with COPD who underwent thorax CT scans to screen for lung nodules and cancer., Materials and Methods: The data of patients who underwent thoracic CT and pulmonary function tests (PFTs) between July 2019 and February 2020 were retrospectively reviewed. The patients were divided into two groups: the COPD (n = 64) and control groups (n = 101), according to the PFT results. The CT images were evaluated for vertebral deformities, osteoporosis and thoracic vertebral joint arthropathy, and the Spinal Deformity Index (SDI) was calculated., Results: Back pain was detected in 43.7% of the COPD patients and 20.9% of the controls. The patients with COPD had significantly higher rates of costotransverse, intervertebral, facet joint arthropathy, and osteoporosis than did the control group (P < .001). The OR analyses showed that the presence of a vertebral deformity (OR 4.42, 95% CI 2.26 - 8.63, P < .001), of facet joint arthropathy (OR 3.6, 95% CI 2.83-4.58, P < .001), and of costotransverse arthropathy (OR 2.20, 95% CI 1.47-2.77, P < .001) were associated with the presence of back pain. Although a strong positive correlation was found between the SDI and pain score, a moderate negative correlation was found between the FEV1% values and pain score., Conclusions: Back pain was present in patients with COPD and was related to vertebral deformities and facet and costotransverse joint arthropathy. Additional studies are required to clarify the relationships of back pain with musculoskeletal system diseases, including cervical and lumbar spine arthropathy and vertebral deformities., (© 2021 John Wiley & Sons Ltd.)

The one-host biological north form / ecotype of Hyalomma scupense Schulze, 1919 (Acari, Ixodidae) is reported for the first time in Turkey herein. Following the first detection of the tick, a longitudinal field study was carried out to fill gaps in the data concerning its biological features. This study also aimed to determine how the monthly activation dynamics of this relatively cold climate-adapted species is characterized under the influence of the warm summer subtype of the Mediterranean climate. During this study, which was carried out on a monthly basis in 2014, H. scupense was found on cattle from 5 out of 18 villages screened in Thrace (the European part of Turkey). The field study revealed that i) this north ecotype of H. scupense exhibits winter one-host behavior beginning in October (with larval stages) and ending in April (with engorged adults); ii) engorged females detach from the cattle, drop on the floors of barns during night and accumulate on piled bedding contaminated with slurry manure; iii) in the late spring, engorged females lay eggs, and larvae hatch in the same area; and iv) larvae become active in autumn as the weather grows cooler. The results indicated that although one-host H. scupense is known to be distinctly adapted to cold conditions, it can also be effectively established in relatively temperate regions and complete its life cycle with some modifications in the timing of its monthly activation dynamics., (Copyright © 2021. Published by Elsevier B.V.)

Objective: To determine the predictive value of cryopreserved embryos during single fresh blastocyst transfer., Methods: This retrospective cohort study was conducted at a tertiary university hospital ART center. Patients who underwent a single fresh blastocyst transfer were selected from the electronic database. Patients with diminished ovarian reserve, uterine pathology, advanced age (>40 years) were excluded from the study. Patients were divided into two groups. Group A consisted of patients with only one available embryo for the fresh transfer. Group B consisted of patients with cryopreserved embryos apart from the fresh transferred embryo. Demographic and embryology parameters, pregnancy results were compared., Results: Demographic values, ovarian reserve parameters were comparable between groups. The number of the picked-up oocyte, metaphase-2 oocyte, and two-pronucleus embryo was lower in Group A. Positive pregnancy rates were two-fold higher in Group B (23.4% vs. 50.9% p  < .01). Pregnancy results did not change depending on the number of cryopreserved embryos in Group B., Conclusion: According to our results, the presence of cryopreserved embryos results in higher pregnancy rates in patients with fresh blastocyst embryo transfer independent from the woman's age and ovarian reserve. Thus, these results may help us to predict the implantation rate before embryo transfer.

Background: Thrombospondin type 1 domain-containing 7A (THSD7A) has emerged as a new potential molecular tool for multiple tumors since that THSD7A was detected to be expressed in various malignant tumor types including colorectal cancer (CRC). Thus, we investigated the correlation between THSD7A expression and pathologic determinants of azoxymethane (AOM)-induced CRC in a rat model., Methods: A total of 30 rats were included in the study (experimental group; n = 15, control group; n = 15). Azoxymethane was administered to the experimental group weekly as subcutaneous injections at a dose of 15 mg/kg bodyweight for 3 weeks. Five months later, 42 tumors were obtained in the study group and histopathologic evaluation of CRC tumors for THSD7A was performed by immunohistochemical staining. Thrombospondin type 1 domain-containing 7A expression was classified according to staining levels., Results: While 28.6% of the colonic tumors were stained as negative, mild-moderate and strong staining was determined in 61.9% and 9.5% of the tumors, respectively. Thrombospondin type 1 domain-containing 7A expression levels inversely correlated with Ki-67 expression (P < .001) and tumor grade (P =.02). Receiver operating characteristic analysis showed Ki-67 staining ≥20.5% was determined as a cut-off value for negatively stained THSD7A tumors with 91% sensitivity and 69% specificity (P = .001, area under curve: 0.822). Moreover, higher Ki-67 expression was found to be associated with higher tumor grade (P < .001), presence of lymphatic invasion (P = .003), and higher T stage (P = .003)., Conclusion: Negative staining for THSD7A seems to be linked to invasive pathologic determinants in AOM-induced CRC in rats.

Doxorubicin (DOX) is a well-known chemotherapeutic drug for most malignancies including breast cancer and leukemia whilst the usage of DOX is limited owing to its cardiotoxicity. In the present study, we aimed to investigate the effects of crocin on doxorubicin-induced cardiotoxicity in rats. Forty rats were randomly divided into four groups: (a) control [received normal saline as a dose of 1 ml/kg by intraperitoneal injection (ip) for 15 days], (b) crocin (received crocin as a dose of 40 mg/kg/24h by ip for 15 days), (c) DOX (received DOX as a dose of 2 mg/kg/48h by ip in six injection, cumulative dose 12 mg/kg), and (d) DOX+crocin (received DOX as a dose of 2 mg/kg/48h by ip in six injection, and crocin as a dose of 40 mg/kg/24h i.p for 15 days). As compared to the controls, the results showed that DOX administration caused significant increases in lipid indices [triglyseride (TG), low-dencity lipoproteins (LDL) (p<0.001), and very low-dencity lipoproteins (VLDL) (p<0.005)], oxidative stress parameters [malondialdehyde (MDA) and total oxidant status (TOS) (p<0.001)] and cardiac markers [creatine kinase-muscle/brain (CK-MB) and cardiac troponin I (cTnI) (p<0.001)]. Besides, significant decreases in antioxidant defense systems [glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), and total antioxidant status (TAS) (p<0.001)] were observed. The present study also demonstrated that co-administration of crocin with DOX significantly ameliorated the lipid profile (p<0.005), cardiac markers (p<0.005), and oxidative stress indices (p<0.001) as compared to DOX group. Histopathologically, significant increase in the mean histopathological damage score (MHDS) was found in the DOX group as compared to the controls (p<0.001). In contrast, the administration of crocin with DOX alleviated MHDS in myocardium (p<0.001). Taken together, our results reveal that crocin might be a cardioprotective agent in DOX-treated patients for cancer., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Granulosa cells are the cell population who have an increasing importance in the female genital system and reproduction. Thus, nowadays in vitro studies to address these cells are also gaining importance and attracts researcher's attention. The aim of our study is to develop a more feasible, low-cost granulosa cell isolation and culture method compared to methods defined so far. Granulosa cells were isolated from follicular fluids obtained from both healthy women donors (n = 19) and polycystic ovary syndrome (n = 15) applied to in vitro fertilization treatment process. Granulosa cells were isolated by using Lymphosep® separation fluid that was not used for this purpose before. The isolated cells were cultured in suitable culture dishes with a mixture of BIO-AMFTM-1 and DMEM/F12 in the first seeding and only complete DMEM/F12 in the following feeds. Complete medium contains only 5% fetal calf serum, 4% L-glutamine and 1% penicillin-streptomycin-amphotericin. The new methods we have developed in granulosa cell isolation and in vitro culture have been successful. Reduction in supplement types and amount; improved the proliferation rate of the granulosa cells in culture. Our new methods of isolation and cell culture for granulosa cells from healthy women, have been also successful in samples of polycystic ovarian patients. With these developed methods, granulosa cells, which belong to humans and have an important role in the ovary, could be isolated and subsequently be maintained to reproduce (proliferate) more easily and cheaper., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: In our study, we aimed to investigate the effect of immunosuppressive therapy after liver transplantation on activities of daily living and fear of death during the COVID-19 pandemic., Methods: This study was conducted as a cross-sectional study with the participation of 213 liver transplant patients hospitalized in the liver transplant center of a university hospital. The data analysis was performed with IBM SPSS (Statistical Package for the Social Sciences) Statistics 25., Results: Katz's Activities of Daily Living (ADL) were semi-independent and the total score was 11.07 ± 1.59, and the Death Attitude Profile-Revised (DAP-R) total score was 152.23 ± 5.34. It was determined that the DAP-R score was around 150 points in the minimum and maximum score ranges of Katz ADL after liver transplantation., Conclusions: High fear of death threatens resilience and can make patients feel lonely, helpless, sad, abandoned and stressed. Clinicians should spend more time with their patients., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Gastrointestinal microbiome dysbiosis may result in harmful effects on the host, including those caused by inflammatory bowel diseases (IBD). The novel probiotic BIOHM, consisting of Bifidobacterium breve, Saccharomyces boulardii , Lactobacillus acidophilus , L. rhamnosus , and amylase, was developed to rebalance the bacterial-fungal gut microbiome, with the goal of reducing inflammation and maintaining a healthy gut population. To test the effect of BIOHM on human subjects, we enrolled a cohort of 49 volunteers in collaboration with the Fermentation Festival group (Santa Barbara, CA, USA). The profiles of gut bacterial and fungal communities were assessed via stool samples collected at baseline and following 4 weeks of once-a-day BIOHM consumption. Mycobiome analysis following probiotic consumption revealed an increase in Ascomycota levels in enrolled individuals and a reduction in Zygomycota levels ( p value < 0.01). No statistically significant difference in Basidiomycota was detected between pre- and post-BIOHM samples and control abundance profiles ( p > 0.05). BIOHM consumption led to a significant reduction in the abundance of Candida genus in tested subjects ( p value < 0.013), while the abundance of C. albicans also trended lower than before BIOHM use, albeit not reaching statistical significance. A reduction in the abundance of Firmicutes at the phylum level was observed following BIOHM use, which approached levels reported for control individuals reported in the Human Microbiome Project data. The preliminary results from this clinical study suggest that BIOHM is capable of significantly rebalancing the bacteriome and mycobiome in the gut of healthy individuals, suggesting that further trials examining the utility of the BIOHM probiotic in individuals with gastrointestinal symptoms, where dysbiosis is considered a source driving pathogenesis, are warranted.

Objective: The aim of this study to investigate the benefits of patient-based 3-dimensional (3D) cerebral arteriovenous malformation (AVM) models for preoperative surgical planning and education., Methods: Fifteen patients were operated on for AVMs between 2015 and 2019 with patient-based 3D models. Ten patients' preoperative cranial angiogram screenings were evaluated preoperatively or perioperatively via patient-based 3D models. Two patients needed emergent surgical intervention; their models were solely designed based on their AVMs and used during the operation. However, the other patients who underwent elective surgery had the modeling starting from the skull base. These models were used both preoperatively and perioperatively. The benefits of patients arising from treatment with these models were evaluated via patient files and radiological data., Results: Fifteen patients (10 males and five females) between 16 and 66 years underwent surgery. The mean age of the patients was 40.0±14.72. The most frequent symptom patients observed were headaches. Four patients had intracranial bleeding; the symptom of admission was a loss of consciousness. Two patients (13.3%) belonged to Spetzler-Martin (SM) grade I, four (26.7%) belonged to SM grade II, eight (53.3%) belonged to SM grade III, and one (6.7%) belonged to SM grade IV. The mean operation duration was 3.44±0.47 hours. Three patients (20%) developed transient neurologic deficits postoperatively, whereas three other patients died (20%)., Conclusion: Several technological innovations have emerged in recent years to reduce undesired outcomes and support the surgical team. For example, 3D models have been employed in various surgical procedures in the last decade. The routine usage of patient-based 3D models will not only support better surgical planning and practice, but it will also be useful in educating assistants and explaining the situation to the patient as well.

Objective: Peripheral nerve injuries occur mostly as a result of mechanical trauma. Due to the microvascular deterioration in peripheral nerve damage, it becomes challenging to remove free oxygen radicals. Gallic acid is a powerful antioxidant with anti-inflammatory effects and a free radical scavenger. The purpose of the study is to show that gallic acid contributes to the restorative effect in mechanical nerve damage, considering its antioxidant and anti-inflammatory effects., Methods: Thirty male Sprague Dawley albino mature rats were included in the study. Ten of them constituted the control group, 10 out of 20 rats for which sciatic nerve damage was caused, constituted the saline group, and 10 formed the gallic acid group. Post-treatment motor functions, histological, immunohistochemical, and biochemical parameters of the rats were evaluated., Results: Compared to the surgery+saline group, lower compound muscle action potential (CMAP) latency, higher CMAP amplitude, and higher inclined plane test values were found in the surgery+gallic acid group. Similarly, a higher nerve growth factor (NGF) percentage, a higher number of axons, and a lower percentage of fibrosis scores were observed in the surgery+gallic acid group. Finally, lower tissue malondialdehyde (MDA) and higher heat shock protein-70 (HSP-70) values were determined in the surgery+gallic acid group., Conclusion: Gallic acid positively affects peripheral nerve injury healing due to its anti-inflammatory and antioxidant effects. It has been thought that gallic acid can be used as a supportive treatment in peripheral nerve damage.

Objectives: The aim of the study was to investigate the efficiency of susceptibility-weighted magnetic resonance (MR) imaging (SWIs) in differentiating endometriomas from haemorrhagic ovarian cysts., Materials and Methods: Between July 2017 and January 2019, 89 ovarian cystic lesions (57 endometriomas and 32 haemorrhagic cysts) that were identified as complicated cystic lesions on ultrasonography (US) and underwent lower abdominal MRI with susceptibility weighting were retrospectively evaluated. Final diagnoses were obtained with surgical pathological correlation and radiological-clinical follow-up. Two radiologists blinded to the final diagnoses retrospectively reviewed the images in consensus. The signal intensity on T1- and T2-weighted images and curved linear or punctate signal void areas on SWI were noted for the presence of lesions., Results: Forty of the 57 endometriomas demonstrated the defined MRI criteria, including a cystic hyperintensity on T1-weighted images and hypointensity on T2-weighted images. The remaining 17 lesions did not demonstrate these criteria on conventional MR images. SWI showed punctate or curved linear signal void areas in 53 of 57 endometriomas (92.9%) and none of the haemorrhagic cysts. The sensitivity, specificity and accuracy of SWI in differentiating endometrioma from haemorrhagic cyst were 92.9%, 100.0%, and 95.5%, respectively., Conclusions: The addition of the SWI sequence to conventional MRI can help distinguish endometriomas from haemorrhagic ovarian cysts., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Study Objective: This study aimed to evaluate the presence of anovulation in adolescents with primary dysmenorrhea (PD)., Design: Prospective cohort study., Setting: Hacettepe University Children's Hospital, Adolescent Medicine outpatient clinic between September 2018 and September 2019., Participants: Healthy female adolescents (between 11 and 18 years of age), with regular menstruation with a score of 1-3 according to the Numerical Rating Scale (NRS) and grade 0 (no limitation for daily activities, no analgesic need and systemic symptoms) according to the Verbal Multidimensional Scoring System (VBSS) were recruited as a control group. The participants who met the diagnostic criteria for PD with an NRS score ≥4, had analgesic need in at least the last 3 menstrual cycles, had defined moderate-to-severe PD according to VMSS (Grade 2-3), and had analgesic need every time were accepted as the PD group., Intervention and Main Outcome Measures: For the determination of ovulation, suprapubic pelvic ultrasound and luteal SP levels were used. The first day of menstruation (DOM) was accepted as the first day of the menstrual cycle. The participants were called to the outpatient clinic for a total of 3 visits during 1 cycle; the first visit was for the suprapubic pelvic ultrasound imaging on the 12 th -18 th DOM, the second visit was for the first SP level measurement on the 21 st -24 th DOM, and the third visit was for the second SP level measurement on the 28 th -31 st DOM, if the next expected menstruation has not started yet. Participants' anthropometric measurements, menstrual history, family history of dysmenorrhea, and additional symptoms accompanying pain were recorded., Results: Anovulatory cycle rates according to 2 different references for SP threshold values (3 and 5 ng/mL) were 31.7% and 36.6% in the PD group, and 44.4% and 55.6% in the control group, respectively (P = .250, P = .095). In the PD group, NRS scores were similar for the ovulatory and anovulatory cycles for both SP threshold values (P = .320, P = .205). When the reference value for SP threshold was accepted as ≥5 ng/mL, the NRS score was significantly higher in the ovulatory group (P = .0017). When the distribution percentages of SP levels were evaluated among all participants, the median value was 5.5 ng/mL., Conclusion: Contrary to classical information, anovulatory cycles are not rare in PD patients, and pain severity is at the same level in these cycles. The pathogenesis of PD in adolescents requires further study., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The first etiologically confirmed cases of Crimean-Congo hemorrhagic fever (CCHF) in humans were detected in Turkey in 2002. Since then, thousands of cases have been reported from different parts of the country. Hyalomma (Hy.) marginatum is considered the main vector tick of CCHFe in Turkey, and the primary infection route for humans is known to be the tick bite. This study was carried out between January 2013 and December 2014 in Thrace, Turkey, to determine monthly prevalence and intensity of tick infestation in cattle and, ultimately, to predict the related risk of human exposure to ticks and tick-borne diseases. During the study, 1,701 cattle in 24 villages were screened for ticks; 24,012 adult ticks, 1,887 nymphs, and 766 larvae were encountered on 1,228 of these cattle. On the 1,318 cattle that routinely grazed in the daytime, Hy. marginatum was the most predominant species, with an infestation prevalence of 73.6% and an average tick intensity of 16.1 on the infested cattle. In order of prevalence (%) in the grazing cattle, Hy. marginatum was followed by Rhipicephalus (R.) bursa (32.7%), R. turanicus (%29.5), Ixodes (I.) ricinus (15.1%), Haemaphysalis (Ha.) parva (10.4%), Ha. inermis (10%), Ha. punctata (6.5%), and Dermacentor (D.) marginatus (2.3%). The obtained data were discussed in terms of the infestation characteristics of the observed tick species, the drivers that may affect these characteristics, and the features of possible relationship between Hy. marginatum infestation in the cattle and CCHF cases among humans in the area., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Priapism is a clinical condition that rarely presents with leukemia in childhood. Management of priapism treatment can become more complex and difficult when accompanied by acute leukemia. We presented a 16 years old child with t-cell acute lymphoblastic leukemia (ALL) who developed priapism. Due to the failure of conservative methods and intracavernosal drainage, we performed epidural blockade which has limited data reported with successful results in the literature before shunt surgery., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Purpose: This study aimed to compare the clinical, radiological, aesthetic and economic outcomes of extension pin block technique and extension orthosis in closed mallet fractures with more than 1/3 of articular surface involvement without subluxation (Wehbe and Schneider classification type IB and IC)., Materials and Methods: Thirty-nine patients (11 women and 28 men; mean age: 40.9±11.5 years) who had mallet fractures were retrospectively reviewed. Twenty-one patients were treated with the extension pin block technique, and the remaining 18 were treated with the extension orthosis. Fracture classification, measurement of articular surface involvement, presence of subluxation, and the fragment displacement were performed according to the Wehbe and Schneider classification. Crawford's criteria, extension lag, distal interphalangeal joint (DIPJ) range of motion, dorsal bump, and visual analog scale were evaluated. Fracture union, articular incongruity, and all other complications were followed and analyzed. The Michigan Hand Questionnaire (MHQ) was used to evaluate the aesthetic perception of the patient's finger. Direct and indirect costs were calculated for each treatment method., Results: At the final follow-up (mean: 18.4±6.2 months), there was no significant difference with respect to clinical outcomes between groups (p=0.335) and pain (p=0.131). Fracture union was achieved in all cases. Both extension lag (p=0.150) and DIPJ flexion (p=0.261) were not different between groups. Dorsal bump was more frequent in the conservative treatment group (p=0.048). Aesthetic scores were similar between groups (p=0.477), but female patients rated significantly lower aesthetic scores than males (p=0.003) regardless of the treatment method. The direct medical (p=0.001), indirect (p=0.009) and cumulative costs (p=0.001) were significantly higher in surgical treatment group. One pin tract infection, one nail dystrophy, and one joint space narrowing were seen in the surgical treatment group versus none in the conservative treatment group (p=0.698)., Conclusions: Conservative treatment does not result in inferior clinical, radiographic and aesthetic outcomes compared to surgical fixation in closed mallet fractures with more than 1/3 of articular surface involvement without subluxation. Extension orthosis which is non-invasive, and cheap, maybe the treatment of choice in closed mallet fractures., Level of Evidence: IV; Retrospective cohort., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Purpose: The objective of the present study was to compare the efficacy of axitinib and nivolumab in metastatic renal cell carcinoma (mRCC) previously treated with targeted therapy., Methods: A total of 79 patients were enrolled (39 patients in axitinib group, 40 patients in nivolumab group). Survival outcomes of patients, progression-free survival (PFS), and overall survival (OS) were estimated using the Kaplan-Meier method and compared with the log-rank test. The associations between potential prognostic variables and OS were evaluated in univariate and multivariate Cox regression analyses., Results: The median PFS and OS of all cohort were 8.1 and 36.6 months, respectively. Higher PFS and OS were evaluated in axitinib group than nivolumab group (PFS: 9.4 months vs 6.3 months, p=0.386; OS: 38.2 months vs 36.6 months, p=0.671, respectively). Patients treated with axitinib had numerically higher objective response rate (ORR) and disease control rate (DCR) than those treated with nivolumab (ORR: 43.6% vs 27.6%, p=0.157, DCR: 74.4% vs 62.5%, p=0.157, respectively). Multivariate analysis revealed that the independent predictors of OS were higher tumor grade (hazard ratio [HR]: 6.178, p=0.004), worse response to axitinib and nivolumab (HR:4.902, p=0.011), the presence of lung metastasis (HR:15.637, p=0.002) and the presence of liver metastasis (HR:12.010, p=0.001)., Conclusion: Comparable survival outcomes were detected in the axitinib and nivolumab groups. However, head to head comparisons are needed to highlight the relative efficacy of these therapies in mRCC.