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Aim: This study aims to reveal the current profile of personal and professional characteristics of nurse managers in Turkey. Method: The sample of this descriptive and cross-sectional study consisted of 1.222 nurse managers in Turkey. The data were collected through an online questionnaire and analyzed using descriptive statistics in SPSS 24.0 program. Results: Most of the nurses between the ages of 20-62 are married (74.7%) and have children (72.9%), take care of their children depending more on family support (49.3%), 64.9% owned a house and 62.9% owned a car. Of all, 43.6% have a bachelor's degree, 76.4% have a degree in nursing, and 30.9% are working in public hospitals and the position of first-line nurse manager (59.7%). The mean duration of professional experience of the nurse manager was 17.04+-7.67 and the mean duration of managerial experience was 7.40+-6.24. Most of them chose the nursing profession willingly (77.1%) and working with high performance (80.6%) was effective in becoming managers. More than half of the participants were not members of any professional organization (64.2%) or a trade union (67.5%), had not received any training in management (57.4%) or orientation training for managerial positions (57.9%). It has been determined that they are willing to participate in the management courses to be organized (91.7%), they mostly follow the legal regulations related to nursing (63.4%), and attend nursing-related congresses (53.3%) to support their professional and managerial development. Conclusion: This research provides important data in terms of identifying the personal and professional characteristics of nurse managers in Turkey and revealing their needs and expectations regarding their professional training and career development.

Introduction:It is essential to evaluate the activation and the articular and extra-articular damage during the Juvenile Idiopathic Arthritis(JIA) disease course. Objectives:This study aimed to evaluate the damage status and affecting factors in JIA patients. Methods:Juvenile Arthritis Damage Index articular(JADI-A) and extra-articular(E) were evaluated in 204 JIA patients who had been followed up for two years andmore. JADI-A and E affecting factors were assessed by univariate and multivariate logistic regression analysis. Results: In this study,127(62.6%) of the patients were female. The median age was 13(IQR: 11-16), and the age at diagnosis was 7(IQR: 4-10) years. The median follow-up time was 5(IQR: 4-8) years. Ninety-two(45.3%) patients had comorbid diseases. JADI-A were median:0(min-max: 0-24), JADI-E were median:0(min-max:0-4).The annual attacks number [OR:1,759 (CI:1,300-2,379],p:

Abstract Introduction and Objectives: Juvenile idiopathic arthritis (JIA) is a frequently seen chronic rheumatoid disease in childhood, which may cause disability and severely affect quality of life (QoL). The aim of present study was to assess relationships between disease activation and socio-cultural status of family, QoL, anxiety level, and depression level in patients with JIA and their parents. Methods: The study included 100 patients with JIA. The socio-demographic data were obtained from all patients. Child- and parent-reported PedsQL, Beck depression inventory (BDI), Kovacs' Child Depression Inventory (CDI), SCARED child version, CHAQ discomfort and disability scales were applied and JADAS-27 score was calculated in a cross-sectional manner. Then, we compared the characteristics of patients with the scales’ results. Results: JADAS-27, BDI, and CHAQ discomfort scores were higher and child- and parent-reported PedsQL scores were lower in patients with active disease than patients on remission (p

Attachment styles, defense mechanisms, and the underlying personality disorders’ personality beliefs are considered to be closely related to psychopathology. The aim of this study is to compare the scores of attachment styles, defense mechanisms, and personality beliefs variables in a non-clinical group and a clinical group diagnosed with depression, obsessive-compulsive, and anxiety disorder and to examine the relationships between these variables. A total of 178 participated in the study, 59 of which were in the clinical group and 119 in the nonclinical group. The Personality Belief Questionnaire-Short Form (PBQ-SF), The Defense Style Questionnaire-40 (DSQ-40), and Relationship Scales Questionnaire (RSQ) were applied to the participants. Avoidant, dependent, passive-aggressive, obsessive-compulsive (OC), antisocial, schizoid, paranoid, and borderline personality belief scores were found to be higher in the clinical group, while mature defense scores were significantly higher in the nonclinical group. On the other hand, there was no difference between the two groups in terms of attachment styles. According to multiple linear regression analysis results, attachment styles and defense mechanisms predicted personality disorder beliefs in the range of 19.5% to 33.5% for the clinical group and 22.7% to 46.9% for the nonclinical group. In conclusion, the findings suggest that attachment styles and defense mechanisms may contribute to the understanding of the etiological causes of personality disorders and may be helpful in the treatment of personality disorders.

Abstract Background Testicular torsion is an important pediatric problem and ischemia/reperfusion injury (IRI) is involved in its etiopathogenesis. Vanillic acid (VA) is a phenolic acid has strong antioxidant properties. To our knowledge, the ability of VA to reduce testicular IRI has not been previously investigated. It was therefore aimed to evaluate whether VA had a beneficial effect against testicular IRI model in rats for the first time. Twenty-four rats were segregated into four groups: sham control, torsion/detorsion (T/D), T/D + VA (50 mg/kg and 100 mg/kg). The levels of testicular oxidative stress, inflammation, endoplasmic reticulum (ER) stress and apoptosis markers were determined using colorimetric methods. Hematoxylin–eosin staining method was used in the histopathological evaluation. Results Oxidative stress, inflammation, ER stress and apoptosis levels were significantly higher in testicular tissues of rats with only IRI model (p

Background: For decades, knowledge about glomerular (patho)physiology has been tightly linked with advances in microscopic imaging technology. For example, the invention of electron microscopy was required to hypothesize about the mode of glomerular filtration barrier function. Summary: Super-resolution techniques, defined as fluorescence microscopy approaches that surpass the optical resolution limit of around 200 nm, have been made available to the scientific community. Several of these different techniques are currently in use in glomerular research. Using three-dimensional structured illumination microscopy, the exact morphology of the podocyte filtration slit can be morphometrically analyzed and quantitatively compared across samples originating from animal models or human biopsies. Key Messages: Several quantitative image analysis approaches and their potential influence on glomerular research and diagnostics are discussed. By improving not only optical resolution but also information content and turnaround time, super-resolution microscopy has the potential to expand the diagnosis of glomerular disease. Soon, these approaches could be introduced into glomerular disease diagnosis.

Neurological complications are frequently mentioned in the published reports regarding the coronavirus disease 2019 (COVID-19). Especially encephalopathy draws attention as the leading symptom or complication of COVID-19 in some reports. This article discussed a 3-year-old patient with bilateral lentiform and caudate nuclei involvement on brain imaging, who presented with mental status changes and acute muscular weakness, possibly due to COVID-19. To the best of our knowledge, this case is the first one showing pathological signal enhancement and edema in bilateral lentiform and caudate nuclei associated with COVID-19.

Abstract Performance of the UAVs for a particular application can be enhanced by hybrid design, where take‐off, hover, and landing happen like rotary‐wing UAVs, and flies like fixed‐wing UAVs. A backstepping controller and an adaptive backstepping controller are designed for trajectory tracking and payload delivery in a medical emergency or medical substance delivery like vaccine delivery in the presence of wind gust. Simulation results show that the backstepping controller effectively tracks the trajectory during the entire flight envelope, including take‐off, hovering, the transition phase, level flight mode, and landing. A comparison between Backstepping, Integral Terminal Sliding Mode (ITSMC) and Adaptive Backstepping controllers for payload delivery show that the adaptive backstepping controller effectively tracks the altitude and attitude. ITSMC is capable of tracking the desired trajectory for a change in the mass but has sluggish response. The backstepping controller generates a steady‐state error in altitude during the mass change in biplane quadrotor.

In this study carried out to determine the pollen characteristics of walnut, Bilecik, Chandler, Fernette, Fernor, Kaman 1, Pedro, Şebin, and Şen 1 varieties were used as material. As a result of scanning electron microscopy (SEM) examination it was stated that the pollen shapes were oblate spheroidal for all the walnut varieties. The pollen of the varieties exhibited diversity in pollen length (37.54–40.52 µm), width (41.10–45.02 µm), pori diameter (2.45–3.61 µm), distance between pori (11.28–14.41 µm) and spinules (0.54–0.73 µm), pore (16.40–23.00) and spinules (20.50–43.50) number, spinule width (0.18–0.26 µm) and length (0.09–0.28 µm). Results showed that in particular, the Fernor had the largest pore diameter, so their number per unit area was low. In contrast, Bilecik had the smallest pore diameter. Distance between pori of this variety was the least. Therefore, a large number of pori was observed on the surface. In addition, spinules sizes were determined to be larger in Şen 1, but smaller in Chandler variety than the others. In particular, these morphological properties of pollen can be used for identification of different varieties. Also, the pollen shape and exine patterning of the varieties studied were illustrated by SEM images.

Aim: Diagnostic biomarkers are needed for pediatric acute appendicitis (AA). We hypothesized that presepsin (soluble CD14 subtype), a biomarker for sepsis, can also be used in pediatric AA and aimed to investigate its diagnostic value in those patients. Materials and Methods: This prospective case-control study was conducted on children admitted to the Pediatric Emergency Department with suspected acute appendicitis. Serum levels of interleukin-6, and presepsin were statistically analyzed for their diagnostic values. Results: No remarkable demographic differences were present between the 41 cases and 47 controls. Clinical and routine laboratory findings were significantly positive for acute appendicitis in the cases compared to controls. ROC analysis indicated an AUC for presepsin as 0.999 (CI 95%: 0.890-0.993) and for interleukin-6 as 0.963 (CI 95%:0.949-1.000). The best cut-off point value for presepsin was at 739 pg/ml, corresponding to a sensitivity of 97.56% and a specificity of 100%. The best cut-off point value for interleukin-6 was at 19 pg/ml, corresponding to a sensitivity of 97.56% and a specificity of 90.32%. Conclusions: Our study results indicate that presepsin can be considered a biomarker for diagnosing appendicitis in pediatric cases. Future studies might better include the combination with other biomarkers in pediatric cases.

Abstract Hydroxyapatite (HA, Ca10PO4(OH)2) is a widely explored material in the experimental domain of biomaterials science, because of its resemblance with natural bone minerals. Specifically, in the bioceramic community, HA doped with multivalent cations (e.g., Mg2+, Fe2+, Sr2+, etc.) has been extensively investigated in the last few decades. Experimental research largely established the critical role of dopant content on mechanical and biocompatibility properties. The plethora of experimental measurements of mechanical response on doped HA is based on compression or indentation testing of polycrystalline materials. Such measurements, and more importantly the computational predictions of mechanical properties of single crystalline (doped) HA are scarce. On that premise, the present study aims to build atomistic models of Fe2+-doped HA with varying Fe content (10, 20, 30, and 40 mol%) and to explore their uniaxial tensile response, by means of molecular dynamics (MD) simulation. In the equilibrated unit cell structures, Ca(1) sites were found to be energetically favourable for Fe2+ substitution. The local distribution of Fe2+ ions significantly affects the atomic partial charge distribution and chemical symmetry surrounding the functional groups, and such signatures are found in the MD analyzed IR spectra. The significant decrease in the intensity of the IR bands found in the Fe-doped HA together with band splitting, because of the symmetry changes in the crystal structure. Another important objective of this work is to computationally predict the mechanical response of doped HA in their single crystal format. An interesting observation is that the elastic anisotropy of undoped HA was not compromised with Fe-doping. Tensile strength (TS) is systematically reduced in doped HA with Fe2+ dopant content and a decrease in TS with temperature can be attributed to the increased thermal agitation of atoms at elevated temperatures. The physics of the tensile response was rationalized in terms of the strain dependent changes in covalent/ionic bond framework (Ca–P distance, P–O bond strain, O–P–O angular strain, O–H bond distance). Further, the dynamic changes in covalent bond network were energetically analyzed by calculating the changes in O–H and P–O bond vibrational energy. Summarizing, the current work establishes our foundational understanding of the atomistic phenomena involved in the structural stability and tensile response of Fe-doped HA single crystals.

Abstract This study compared the effects on weight as well as on metabolic parameters and liver size of a very low-calorie ketogenic diet versus a Mediterranean diet in patients with morbid obesity preparing to undergo bariatric surgery. This prospective comparison study evaluated patients 18–65 years of age who enrolled for bariatric surgery. Study duration was limited to an immediate preoperative period of 15 days. The very low-calorie ketogenic diet incorporated 10–12 kcal/kg/day of energy and 1–1.2 g/kg of protein using Kalibra (Societa Dietetica Medica) (VLCKD-SDM). The Mediterranean diet (MD) included 15–20% protein, 45–50% carbohydrate, and 25–35% fat. Changes in body mass index (BMI), liver size, and anthropometric and metabolic measurements were assessed. Between January 2016 and March 2017, of 45 patients enrolled, 30 completed the study (VLCKD-SDM, n = 15; MD, n = 15). Respective median BMI loss after VLCKD-SDM was 2.7 kg/m2 versus MD 1.4 kg/m2 (p

Neisseria meningitidis, also known as meningococcus, is a relatively uncommon cause of invasive infection, but when it occurs, it is frequently severe and potentially life-threatening. A ten-year-old female patient developed a purpuric rash with fever. Upon arrival to the pediatric intensive care department, she was unconscious and in a poor general condition. We combined treatment with antibiotics, volume resuscitation, hydrocortisone, and CytoSorb.½ therapy resulted in a stabilization of hemodynamics, as well as control of hyperinflammation. We observed a significant decrease in vasopressor dosage in this patient.

This study was conducted to determine the changes in the physicochemical and microbiological qualities of the non-sulfited sun dried apricots (NSDAs) at three different moisture contents (MCs, 13.7, 23.5 and 27.0%) and at four different storage temperatures (4, 10, 20, and 30 °C) for 12 months in bulk and packaged samples. NSDAs were subjected to physical (moisture, water activity, pH and reflectance colour values), chemical (browning formation, β-carotene, and acidity), and microbial (counts for total aerobic mesophilic and psycrofilic bacteria, yeast and mould, xerofilic mould and yeast, osmophilic yeast, lactic acid bacteria, Enterobacteriaceae, Staphylococcus-Micrococcus spp.) analyses at one-month time intervals. Results indicated that while the fastest brown colour formation occurred in the samples containing 23.5% MC and stored at 30 °C, the browning decelerated below 10 °C. No significant change was observed in β-carotene contents of NSDAs during storage (P>0.05). After rehydration, osmophilic yeast count of NSDAs increased by 2.5 log colony-forming units (cfu/g). Significant reductions were observed in the microbial loads of the samples at 23.5 and 27.0% MCs with the decreasing water activity (P

In Turkey, the orchards are being established with the ‘Chandler’ walnut variety in different ecologies, nowadays. Plant nutrition applications are important for optimum yield and quality in terms of growing. In this study conducted at two different altitudes (51 and 740 m) in the orchard, foliar application as urea (5 gr/L), potassium nitrate (10 gr/L), borax (1 gr/L), manganese sulfate (2 gr/L) and zinc sulfate (1.5 gr/L) were sprayed for two years. Following the application, macro and micro nutrient content of kernel and fruit properties were determined. According to this, it was observed that foliar application of boron (B) in terms of nut weight and foliar application of potassium (K) in terms of kernel ratio ranked the first row. The shrinkage ratio, an important quality criterion for walnuts, was found to be low in the high altitude Demirci location (17.43%). However, in the low altitude Saruhanlı location, the shrinkage ratio was reduced with foliar K application. In addition, while all foliar applications had a positive effect on yield, the highest value was measured in Saruhanlı location (3.31 kg tree-1). The macro and micro nutrient content of kernel evaluated, there was an increase in nutrients in the second year, except for K, calcium (Ca) and magnesium (Mg). Phosphorus (0.29 and 0.27%), iron (30.64 and 6.24 ppm), copper (7.64 and 11.35 ppm), zinc (32.42 and 27.03 ppm) and manganese (25.77 and 30.05 ppm) contents of the grain were found to be significant for Demirci and Saruhanlı locations, respectively. Values in Demirci location were higher than Saruhanli location. Additionally, it was also revealed in interaction.

Son birkaç yıldır popüler hale gelen “gösterişçi duyarlılık”, aslen sinyal teorisinden türetilmiştir ve güvenilir olmayan sinyallerle ilişkilendirilen gösterişçi bir davranışa işaret etmektedir. Ağırlıklı olarak olumsuz bir ima ile vurgulanan bu terim, birey ya da kuruluşların, gerçek hayatta sahip oldukları şaibeli olan iyi niyetli düşünce ve inançlarını genellikle toplum nezdinde duyarlı, erdemli ve sorumlu bir şekilde algılanma amacı güderek, yüz yüze veya çeşitli medya araçları kanalıyla kolay yoldan çevrelerine duyurma davranışıdır. Bu çalışmada, gösterişçi duyarlılık kavramını etraflıca tanımlamak; bu kavramın çeşitli uygulamalarda nasıl sergilendiğini tespit etmek, böylelikle yerli literatürü genişletmek ve gelecekte yapılacak çalışmalara altyapı oluşturmak amaçlanmıştır. Çalışmada literatür taraması tekniğine başvurulmuştur. Araştırma sonucunda gösterişçi duyarlılık davranışının bireysel, örgütsel ve siyasal olmak üzere üç ana kategori altında gerçekleştirilen yaygın birçok faaliyet aracılığıyla sergilendiği anlaşılmıştır. Gösterişçi duyarlılık kavramı, Türkçe’ye argo bir kullanım olan “duyar kasma” şeklinde geçmiştir. Bu çalışmada hem günlük yaşamda hem de akademik alanda kullanımının daha uygun olduğu öngörülen, ayrıca Türk dilinin özenli kullanımına gölge düşürmeyecek bir kavram olan “gösterişçi duyarlılık” söz öbeğinin, “duyar kasma” söz öbeği yerine kullanılması önerilmektedir. Yeni bir terim olması sebebiyle bu konuda yapılmış çalışmaların kapsamı sınırlıdır. Türkçe literatürde ise bu terimi kapsamlı ele alan çalışmalara rastlanmamıştır. Derleme olarak hazırlanan bu çalışmanın, yerli literatüre katkı sunması beklenmektedir.

This study aims to investigate the impact of metacognitive awareness and self-efficacy beliefs of middle school students on their level of foreign language learning anxiety by using structural equation modelling. A total of 285 7th and 8th grade students from a middle school in Turkey during the 2018-2019 academic year were included in the study. In the study, Personal Information Form, Foreign Language Anxiety Scale, The Self-Efficacy Questionnaire for Children, and The Junior Metacognitive Awareness Inventory were used as data collection tools. As a result of the study, the descriptive statistics indicated that the students had moderate levels of metacognitive awareness, self-efficacy beliefs, and foreign language learning anxiety. According to the results obtained from the structural equation modelling, it was concluded that the metacognitive awareness levels of the students did not have a mediating effect on the relationship between the students' level of foreign language learning anxiety and self-efficacy beliefs. In conclusion, it was determined that metacognitive awareness, self-efficacy beliefs, and foreign language learning anxiety are individual differences which interact with each other and are of great importance in foreign language learning, and that metacognitive awareness and self-efficacy beliefs have the power to affect foreign language learning anxiety.

INTRODUCTION: Although there are limited data on the change of Tpeak-tend (Tpe), Tpe dispersion (Tpe-d) and Tpe/QT rate, which are new predictors of ventricular arrhythmias in acute ischemic stroke (AIS) and acute hemorrhagic stroke (AHS), these parameters have not been evaluated in the transient ischemic attack (TIA). The aim of this study is to evaluate the variation of these parameters by including the TIA and performing a more detailed electrocardiographic (ECG) analysis. METHODS: In this prospective study, patients were put into three groups as 30 with AIS (mean age, 61.17+-14.14 years; 15 women/15 men), 20 with AHS (mean age, 65.05+-9.50 years; 10 women/10 men), and 30 with TIA (mean age 58.10+-13.32 years; 15 women/15 men). Thirty sex- and age-matched healthy controls were recruited. Tp-e, Tpe-d and Tp-e/QT rate were calculated from 12-lead ECG. RESULTS: In AIS and AHS both previous and new arrhythmia parameters were significantly more prolonged, compared to controls and patients with TIA. The prolonged parameter was specific to the derivations of V5 and V6. A positive correlation was present between the age, and Tpe, QTcmax and QTd (r= 0.21, p= 0.028; r= 0.19, p= 0.032; and, r= 0.22, p= 0.013, respectively) DISCUSSION AND CONCLUSION: Our study revealed that ventricular repolarization parameters such as Tpe, Tpe-d and Tpe/QT do not change in TIA, however, both AIS and AHS increase these indexes. This may explain the increased risk of ventricular arrhythmias in acute stroke patients. Moreover, in acute stroke patients, leads V5 and V6 on the ECG appear to be suitable for assessing ventricular repolarization.

Abstract Modelling insulin-glucose homeostasis may provide novel functional insights. In particular, simple models are clinically useful if they yield diagnostic methods. Examples include the homeostasis model assessment (HOMA) and the quantitative insulin sensitivity check index (QUICKI). However, limitations of these approaches have been criticised. Moreover, recent advances in physiological and biochemical research prompt further refinement in this area. We have developed a nonlinear model based on fundamental physiological motifs, including saturation kinetics, non-competitive inhibition, and pharmacokinetics. This model explains the evolution of insulin and glucose concentrations from perturbation to steady-state. Additionally, it lays the foundation of a structure parameter inference approach (SPINA), providing novel biomarkers of carbohydrate homeostasis, namely the secretory capacity of beta-cells (SPINA-GBeta) and insulin receptor gain (SPINA-GR). These markers correlate with central parameters of glucose metabolism, including average glucose infusion rate in hyperinsulinemic glucose clamp studies, response to oral glucose tolerance testing and HbA1c. Moreover, they mirror multiple measures of body composition. Compared to normal controls, SPINA-GR is significantly reduced in subjects with diabetes and prediabetes. The new model explains important physiological phenomena of insulin-glucose homeostasis. Clinical validation suggests that it may provide an efficient biomarker panel for screening purposes and clinical research.

Abstract Background Busy rheumatologists, and busy patients as well as policy makers, require accurate, succinct, transparent, easily digested summaries of evidence and recommendations for management. Our objective was to develop an up-to-date evidence-based, consensus, clinical practice guidelines for treat-to-target management of rheumatoid arthritis in adults. Results Ninety-four (94.7%) of the expert committee completed the 2-round e-Delphi surveys. A total of 33 recommendation items, addressing the main rheumatoid arthritis (RA) domains, were identified. The level of agreement (rate 7–9), for the statements which reached consensus, ranged from 85 to 100%. Consensus was achieved on the wording of all the clinical practice guidelines identified by the scientific committee. A management algorithm for the management of rheumatoid arthritis have been developed. Conclusion These updated recommendations reflect the most recent evidence for the management of RA. It also outlines the multidisciplinary team role in enhancing the RA patients’ care. The recommendations offer strategies to achieve optimum treat-to-target outcomes. However, standards of care are defined based on the clinical data obtained for individual patients and are prone to modification. High-quality, broad scope evidence-based clinical practice guidelines offer a path for bridging the gap between best practice, policy, local settings and patients’ choice.

Enteroviruses are non-enveloped positive-sense RNA viruses that modulate cytoplasmic membranes for replication. To enlighten how enteroviruses assemble around nascent RNA genomes and get package into autophagosomes for release, Dahmane et al. perform cryo-electron tomography of poliovirus-infected cells. They find assembly intermediates that are only present on the cytosolic side of the replication compartment and provide evidence that host factor VPS34 is involved in progression of assembly intermediates.

Background: Tuberculosis elimination remains a significant global health challenge, despite the efforts made by governments and international organizations to control and eliminate the disease. The study objectives were to explore the global TB control efforts and highlight the possible challenges and implications in the way to TB elimination. Recommendations to add momentum to current health care efforts were also outlined. Methods: Relevant works of literature were retrieved from different journals and web pages. The electronic databases were searched using the key. Results: A review of the progress made over the past years in the control of TB has shown that the goal of TB elimination has not yet been achieved. The high burden of TB, limited access to TB diagnosis and treatment, drug-resistant TB, weak health systems particularly in low- and middle-income countries, socioeconomic factors, and lack of political commitment and resources are among the major challenges that have hindered the successful elimination of tuberculosis. Conclusions: a sustained and coordinated effort from governments, private sector, international organizations, and other stakeholders, including increased funding, political commitment, and a focus on addressing the root causes of TB transmission and disease burden are required to address these challenges.

Abiotic and biotic factors, especially microorganisms, play a role in the development of cave formations and the existence of unique characteristics of each cave. Due to the ecological conditions that characterize the cave environments, highly specialized microorganisms that are the main source of diverse bioactive compounds, inhabit these environments. The aim of this study is to determine the role and biotechnological potential of the bacteria isolated from Yarık Sinkhole located in Antalya (Turkey) by screening their ability to induce the CaCO3 precipitation, to hydrolyze urea, to induce calcite dissolution, and screening their possession of NRPS/PKS gene clusters. The most prevalent phylum is the Bacillota (synonym Firmicutes) (75.7 %), while the dominant species is Bacillus pumilus (33 %). All the isolates showed crystal formation on B4 agar medium, and the Energy dispersive X-Ray spectroscopy (EDS) analyses showed that the crystals are predominately composed of calcium, carbon and oxygen. Ninety-six (96 %) of our isolates have negative ureolytic activity. According to this result and having the ability to induce the CaCO3 precipitation, bac­teria in this environment use other biosynthesis pathways than urea hydrolysis. MgCO3 and CaCO3 were dissolved by 61 % and 59 % of the isolates, respectively. In addition, 5.9 % and 53.7 % of the isolates showed the possession of PKS and NRPS genes, respectively. This result reveals that our isolates have high in­dustrial and biotechnological potential. They may constitute good candidates for further biotechnological applications such as construction of bio-concretes, bioremediation, soil fertility, and production of biologically active secondary metabolites.

Nerve abscess is an infrequently reported complication of leprosy. It is also an uncommon first manifestation of leprosy. In this case, due to the absence of classic signs and symptoms, such as skin lesions, hypoesthesia, and loss of sensation, the swelling was clinically diagnosed as a peripheral nerve sheath tumour on initial presentation. The authors have described an unusual presentation of pure neuritic leprosy that showcased nerve abscess. Clinical presentation was swelling over the medial aspect of the right arm and ulnar aspect of the right forearm, and clawing of the fourth and fifth digits of the right hand, with no signs of inflammation present on the skin surrounding the swelling. Hansen’s disease with pure nerve involvement could not be considered as a differential diagnosis solely based on clinical examination, therefore posing a diagnostic challenge. On ultrasonography, the right ulnar nerve showed diffuse intermittent thickening and a heterogeneously hypoechoic fusiform area with internal echoes at the site of swelling indicating a nerve abscess. These led the authors to the diagnosis of leprosy with perineuronal abscess. Histopathology confirmed the diagnosis by revealing granulomas and acid-fast Hansen’s bacilli. The patient showed dramatic response to surgery, multidrug therapy, and systemic corticosteroids.

Type 2 diabetes mellitus (T2DM) is one of the most prevalent metabolic disorders worldwide. However, T2DM still remains underdiagnosed and undertreated resulting in poor quality of life and increased morbidity and mortality. Given this ongoing burden, researchers have attempted to locate new therapeutic targets as well as methodologies to identify the disease and its associated complications at an earlier stage. Several studies over the last few decades have identified exosomes, small extracellular vesicles that are released by cells, as pivotal contributors to the pathogenesis of T2DM and its complications. These discoveries suggest the possibility of novel detection and treatment methods. This review provides a comprehensive presentation of exosomes that hold potential as novel biomarkers and therapeutic targets. Additional focus is given to characterizing the role of exosomes in T2DM complications, including diabetic angiopathy, diabetic cardiomyopathy, diabetic nephropathy, diabetic peripheral neuropathy, diabetic retinopathy, and diabetic wound healing. This study reveals that the utilization of exosomes as diagnostic markers and therapies is a realistic possibility for both T2DM and its complications. However, the majority of the current research is limited to animal models, warranting further investigation of exosomes in clinical trials. This review represents the most extensive and up-to-date exploration of exosomes in relation to T2DM and its complications.

Background/objective: Parathyroid carcinoma is a rare entity presenting as parathyroid hormone (PTH) dependent hypercalcemia. Our objective was to report a case of metastatic parathyroid carcinoma in a middle-aged woman, who presented with refractory hypercalcemia and the strategies we used to induce remission. Case report: A 47 year old lady with a past history of a left superior parathyroid adenoma excision, presented with recurrent PTH dependent hypercalcemia. An ultrasonography of the neck and parathyroid scintigraphy were normal. Fluorodeoxyglucose-Positron Emission Tomography (FDG-PET) scan picked up metabolically active lesions in the lingular segment of the left lung and another lesion in the diaphragmatic pleura of the left hemi-thorax. Following metastectomy of the lung nodules, she developed symptomatic hypocalcemia with a reduction of serum PTH levels. The histopathology and immunoprofile were consistent with metastatic carcinoma. The PTH levels started rising 2 months after the surgery, with calcium levels remaining stable on cinacalcet, denosumab and cabozantinib. Discussion: Parathyroid carcinoma is a rare endocrine malignancy with typically indolent, yet progressive course. There is no consensus on the treatment and follow-up of parathyroid carcinoma, owing to its rarity. The greatest likelihood of cure is achieved if complete resection of all malignant tissue is successful at the time of initial surgery. Surgical reduction of the tumor mass may also render the patient's hypercalcemia more amenable to medical treatment with hydration, potent intravenous bisphosphonates, denosumab and cinacalcet. Conclusion: Surgical debulking of the metastatic lesions, followed by medical management of hypercalcemia offers promising results in the management of metastatic parathyroid carcinoma.

Cisplatin (CDDP) is an important chemotherapeutic agent, accumulation of which in kidney tissue causes nephrotoxicity and renal failure. The aim of this study was to evaluate, for the first time in the literature, the protective effect of dimethyl sulfoxide (DMSO) extract of Primula vulgaris leaf (PVE) against CDDP-induced nephrotoxicity in rats.The PVE content was characterized using liquid chromatography-mass spectrometry. Nephrotoxicity was induced with a single dose of CDDP (7.5 mg/kg). Thirty female Wistar-Albino rats were divided into five groups (control, DMSO, CDDP (7.5 mg/kg), CDDP + PVE (25 mg/kg), and CDDP + PVE (50 mg/kg)). Biochemical and histopathological analyses were then performed.Rutin, gallic acid, p-coumaric acid and protocatechuic acid were identified as major components of PVE. Total antioxidant status and glutathione (GSH) values increased significantly in the serum samples from the treatment group compared to the CDDP group, while blood urea nitrogen, creatinine, oxidative stress index, malondialdehyde (MDA), tumor necrosis factor-alpha (TNF-α), total oxidant status, and 8-hydroxy-2′-deoxyguanosine (8-OHdG) values decreased significantly. GSH levels increased significantly in the treatment group compared to the CDDP group, while TNF-α, caspase-3, 8-OHdG, MDA levels and damage scores decreased significantly.In conclusion, PVE exhibited strong protective effects through its anti-apoptotic, antioxidant, and anti-inflammatory activities against nephrotoxicity and oxidative damage caused by CDDP in rats.

While classified as endemic and endangered, the Toque Macaque (Macaca sinica) is also considered a nuisance species in certain habitats in Sri Lanka due to its increased interactions with humans and crop raiding. This study analyzed the activity budget and home range utilization of two M. sinica troops inhabiting two contrasting landscapes to shed light on the species' rather poorly understood behavioral responses under environments of differing levels of anthropogenic pressure. We observed two macaque troops; first in a landscape with lower anthropogenic pressure (LAP) in Yagirala, and second in an area of moderate anthropogenic pressure (MAP) in Korathota, Sri Lanka. We followed the troops for ten months and observed their behaviors using focal animal sampling. Both troops spent most of their time on foraging and locomotion. However, the Korathota (MAP) troop spent more time on vigilance behaviors than the Yagirala (LAP) troop, which spent more time on amicable behaviors. This suggests that time allocation to amicable behaviors by Toque Macaques is higher in areas with lower anthropogenic pressure. The home range size was significantly larger in Yagirala (LAP) troop. We further found a significant difference in average home range size across seasons in both troops (p=0.001) with larger home ranges in the dry season: 2.81ha in the wet season vs 3.98 ha in the dry season for MAP troop and 5.1ha in the wet season vs 8.66ha in the dry season for LAP troop. Findings suggest that the resource availability and the level of anthropogenic pressure influence the activity budget and home range size of Toque Macaques. The outcomes of this study may be instrumental in developing future management strategies for Toques Macaques in anthropogenic settings and reducing human-macaque conflict. Practical management and conservation efforts should reduce the availability of anthropogenic food sources to macaques while increasing the size of natural forest patches.

Background: Renal transplant adds survival benefits to end-stage renal disease patients over dialysis, and a similar concept applies to elderly patients. Some of the challenges of transplanting old patients may involve age-related cancers and comorbid conditions such as cardiovascular disease. Studies had shown that advanced age is associated with better outcomes compared to dialysis despite receiving poorer quality organs. Aim: This extended literature review aims to identify the common complications, outcomes, and survival benefits of kidney transplantation in the elderly population. Methods: An extended literature review was done to identify studies that compared elderly transplant recipients with the younger kidney transplant recipient population. The study population included elderly kidney recipients aged sixty and above and younger kidney recipients below the age of sixty. This literature review aims to discuss complications facing elderly kidney recipients and compare transplant outcomes to younger kidney recipients. PubMed, Midline, and google scholar databases were searched and papers meeting the pre-set inclusion criteria were identified. Results: A total of 212 papers were identified. After screening the results, 12 papers met the inclusion criteria and were included for review. 10/12 papers included patients' age cutoff point, one paper had cut-off age between 60 and 80 years, while the last paper recruited patients with ages above 70. Most of the studies mentioned young group age as below 60, 2/12 papers divided the young group into further subgroups of age. Two studies used paired donor organs for both young and elderly groups to eliminate donor bias. While other studies used living, deceased, or both living and deceased donors for both elderly and young groups. One study matched donor type and gender in both groups. The studies looked at patient and graft survival and complications. Elderly transplant patients suffered more hospitalization, infections, cardiovascular complications, malignancy, and surgical complications. Post-transplant diabetes was higher in the young recipient group in one study. Conclusion: In the case of elderly renal transplant recipients, the cut-off point for age to perform renal transplant is not clear but studies showed better survival and cost-effectiveness in elderly patients compared to patients on the waiting list even in older patient cohorts

The content of music is not always suitable for all ages. Industries that manage music content are looking for ways to help adults determine what is appropriate for children. Lyrics of songs have become increasingly inappropriate for kids and can negatively impact their mental development. However, it is difficult to filter explicit musical content because it is mostly done manually, which is time-consuming and prone to errors. Existing approaches lack the desired accuracy and are complex. This study suggests using a combination of machine learning and deep learning models to automatically screen song lyrics in this regard. The proposed model, called ELSTM-VC, combines extra tree classifier and long short-term memory and its performance is compared to other models. The ELSTM-VC can detect explicit content in English lyrics and can be useful for the music industry. The study used a dataset of 100 songs from Spotify for training, and the results show that the proposed approach effectively detects explicit lyrics. It can censor offensive content for children with a 96% accuracy. The performance of the proposed approach is better than existing approaches including machine learning models and encoding-decoding models.

Introduction The top research priority for cavernoma, identified by a James Lind Alliance Priority setting partnership was ‘Does treatment (with neurosurgery or stereotactic radiosurgery) or no treatment improve outcome for people diagnosed with a cavernoma?’ This pilot randomised controlled trial (RCT) aims to determine the feasibility of answering this question in a main phase RCT.Methods and analysis We will perform a pilot phase, parallel group, pragmatic RCT involving approximately 60 children or adults with mental capacity, resident in the UK or Ireland, with an unresected symptomatic brain cavernoma. Participants will be randomised by web-based randomisation 1:1 to treatment with medical management and with surgery (neurosurgery or stereotactic radiosurgery) versus medical management alone, stratified by prerandomisation preference for type of surgery. In addition to 13 feasibility outcomes, the primary clinical outcome is symptomatic intracranial haemorrhage or new persistent/progressive focal neurological deficit measured at 6 monthly intervals. An integrated QuinteT Recruitment Intervention (QRI) evaluates screening logs, audio recordings of recruitment discussions, and interviews with recruiters and patients/parents/carers to identify and address barriers to participation. A Patient Advisory Group has codesigned the study and will oversee its progress.Ethics and dissemination This study was approved by the Yorkshire and The Humber—Leeds East Research Ethics Committee (21/YH/0046). We will submit manuscripts to peer-reviewed journals, describing the findings of the QRI and the Cavernomas: A Randomised Evaluation (CARE) pilot trial. We will present at national specialty meetings. We will disseminate a plain English summary of the findings of the CARE pilot trial to participants and public audiences with input from, and acknowledgement of, the Patient Advisory Group.Trial registration number ISRCTN41647111.

IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score.

Introduction: Acute renal failure (ARF), which may occur as a result of hypovolemia, is frequently diagnosed in emergency departments. It is essential to determine these patients' volume status and fluid requirement. The aim of this study was to examine the change in the inferior vena cava (IVC) collapsibility index and perfusion index (PI) in order to evaluate fluid deficit, volume status, and response to fluid therapy in patients with prerenal ARF who presented with signs of hypovolemia. Materials and methods: The study sample included 104 patients diagnosed with prerenal ARF due to hypovolemia in our emergency department. After obtaining informed consent from the patients, intravenous (IV) fluid therapy (20 cc/kg IV infusion of 0.9% sodium chloride solution for 30 min) was initiated. The PI and IVC collapsibility index were measured before and after the treatment. Results: Of the patients included in this study, 56.7% were women. The mean age was 76.06 years. Of the patients, 46.2% had a history of multiple diseases. Avoidant/restrictive food intake disorder was the most common complaint (28.8%). The mean PI of the patients was 2.20 at admission, which increased to 3.27 after treatment. The mean IVC collapsibility index was 38.39 at admission, which decreased to 29.36 after treatment. There was a significant and negative correlation between the PI and IVC collapsibility index of the patients. Conclusions: Early diagnosis and treatment of ARF in emergency departments are critical. Serial measurements of the IVC collapsibility index and PI are helpful in monitoring patients’ response to fluid therapy.

Astragalus L. is a genus member of the Fabaceae family, representing about 3,000 species all over the world and 380 species in Turkey. Astragalus species have been used in traditional medicine for many years. Astragalus globosus Vahl, known as “top geven”, is a dwarf, scapose, perennial herb, Astragalus breviflorus DC., known as “yünlü geven”, is an extremely spiny dwarf shrub. These endemic species grow in the Turkish cities of Erzurum, Kars, and Van. This is the first phytochemical and cytotoxic investigation of Astragalus globosus Vahl and Astragalus breviflorus DC. The main extracts and sub-fractions from the plants were evaluated for in vitro cytotoxic and apoptotic activities. The IC50 values of dichloromethane, n-butanol, and water extracts of the aerial parts of A. globosus against the MCF-7 cell line were determined as 28.39, 868.60, and 1753.00 µg/mL. The values for the MDA-MB-231 cell line were 264.00, 620.30, and 1300.50 µg/mL, respectively. From A. globosus, the following were isolated: a flavone glycoside, diosmetin-7-O-rutinoside (1); and two flavonol glycosides, isorhamnetin-3-O-rutinoside (2) and quercetin-3-O-galactoside (3). From A. breviflorus, two phenolic acids, caffeic acid (4) and chlorogenic acid (5), and a flavan-3-ol, catechin (6), were isolated. Diosmetin-7-O-rutinoside was isolated from Astragalus species for the first time and showed the highest cytotoxic activities on the MCF-7 and MDA-MB-231 breast cancer cell lines with IC50 values of 13.65 and 12.89 μg/mL, respectively. Moreover, we observed that diosmin exerts cytotoxic effects by causing cell necrosis.

Objectives: To evaluate the effect of COVID-19 severity on maternal, perinatal, and neonatal outcomes in pregnant women infected with SARS-CoV-2. We also aimed to assess the effect of medical comorbidities on the severity of COVID-19. Methods: A retrospective cohort study was conducted on women who became infected with SARS-CoV-2 during pregnancy and delivered at Sultan Qaboos University Hospital, Oman, from 1 March 2020 to 31 December 2021. Results: A total of 118 pregnant women with COVID-19 and their 118 newborns were included in the study. Mean maternal age was 32.0 years, with 60.2% of women infected in the third trimester. The majority of the participants had mild symptoms. Eleven (9.3%) women had moderate infection needing inpatient care. Six (5.1%) with severe infection were admitted to intensive care unit. The chronic diseases among the participants were hypothyroidism, obesity, sickle cell disease, epilepsy, and diabetes. The mean gestational age at delivery was 37.0 weeks with 20.9% of women delivering by cesarean section out of whom 37.5% had moderate-to-severe COVID-19. The most common complications associated with COVID-19 severity were preterm labor (p =0.002), preeclampsia (p =0.002), and intrauterine fetal death (p =0.089). Of the total 118 newborns, 111 were singletons and six were twins. One fetus died and three singletons were lost to miscarriage. Placental histopathology conducted in 64 patients had no COVID-specific findings in most cases. Conclusions: Most pregnant women with COVID-19 infections had mild symptoms. The majority of women with moderate-to-severe infection were admitted for COVID-19 pneumonia. There was no direct effect of COVID-19 severity in neonatal outcomes or placental histopathology changes.

Nowadays, implants and prostheses are widely used to repair damaged tissues or to treat different diseases, but their use is associated with the risk of infection, inflammation and finally rejection. To address these issues, new antimicrobial and anti-inflammatory materials are being developed. Aforementioned materials require their thorough preclinical testing before clinical applications can be envisaged. Although many researchers are currently working on new in vitro tissues for drug screening and tissue replacement, in vitro models for evaluation of new biomaterials are just emerging and are extremely rare. In this context, there is an increased need for advanced in vitro models, which would best recapitulate the in vivo environment, limiting animal experimentation and adapted to the multitude of these materials. Here, we overview currently available preclinical methods and models for biological in vitro evaluation of new biomaterials. We describe several biological tests used in biocompatibility assessment, which is a primordial step in new material’s development, and discuss existing challenges in this field. In the second part, the emphasis is made on the development of new 3D models and approaches for preclinical evaluation of biomaterials. The third part focuses on the main parameters to consider to achieve the optimal conditions for evaluating biocompatibility; we also overview differences in regulations across different geographical regions and regulatory systems. Finally, we discuss future directions for the development of innovative biomaterial-related assays: in silico models, dynamic testing models, complex multicellular and multiple organ systems, as well as patient-specific personalized testing approaches.

BackgroundAsian Indians are at higher risk of cardiometabolic disease compared to other ethnic groups, and the age of onset is typically younger. Cardiac structure and function are poorly characterized in this ethnic group. In this study, we describe image-acquisition methods and the reproducibility of measurements and detailed echocardiography characteristics in two large Indian population-based cohorts (the New Delhi and Vellore Birth Cohorts) from India.MethodsThe IndEcho study captured transthoracic echocardiographic measurements of cardiac structure and function from 2,322 men and women aged 43–50 years. M-mode measurements in the parasternal long axis (PLAX) and 2-dimensional (2D) short axis recordings at the mitral valve, mid-papillary and apical level were recorded. Apical 2D recordings of two- three- and four-chamber (2C, 3C and 4C) views and Doppler images (colour, pulsed and continuous) were recorded in cine-loop format. Left ventricular (LV) mass, LV hypertrophy, and indices of LV systolic and diastolic function were derived.ResultsEchocardiographic measurements showed good/excellent technical reproducibility. Hetero-geneity across sites, sex and rural/urban differences in cardiac structure and function were observed. Overall, this cohort of South Asian Indians had smaller LV mass and normal systolic and diastolic function when compared with published data on other Asian Indians and the West, (LV mass indexed for body surface area: Delhi men: 68 g/m2, women 63.9; Vellore men: 65.8, women 61.6) but were within ethnic-specific reference ranges. The higher prevalence of obesity, diabetes and hypertension is reflected by the higher proportion of LV remodelling and lesser hypertrophy.ConclusionsOur study adds to scarce population-based echocardiographic data for mid-life Asian Indians. Compared to published literature on other ethnic groups, the Asian Indian heart is characterised by smaller cardiac dimensions and normal range systolic and diastolic function on a background of a high prevalence of hypertension, diabetes and cardiac disease at a relatively young age. This data will form the basis for further analyses of lifecourse, metabolic and body composition predictors of cardiac structure and function, and echocardiographic predictors of future mortality.ISRCTN registration number13432279

A spectrofluorimetric method was developed to determine residues of two β-blockers, atenolol (AT) and bisoprolol fumarate (BF), in Senegal's natural waters. The electronic absorption and fluorescence spectral properties of both β-blockers were investigated in several organic solvent mixtures [e.g., MeOH/H2O (60/40 v/v), cyclodextrins (β-cyclodextrin, HP-β-CD], and in the presence of surfactants (SDS, Triton X, Tween 80). After optimization, satisfactory analytical figures of merit were obtained for the determination of both β-blockers: concentration linear dynamic range of over one to two orders of magnitude, limits of detection (LODs) from 1.3 to 5.4 ng/ml for BF and from 1.2 to 3.7 ng/ml for AT, limits of quantification (LOQs) from 4.5 to 18.1 ng/ml for BF and from 4.0 to 12.5 ng/ml for AT. Relative standard deviations (RSDs) were between 2.1 and 5.3 %, according to the β-blockers. The spectrofluorimetric method was applied to the analysis of fortified river water and wastewater (effluent) collected in Senegal and France and spiked with both β-blockers. It yielded good recovery values, from 93.3 to 107.8 % for AT and from 97.4 to 108.9 % for BF. Our results demonstrated the simplicity, rapidity, and sensitivity of the spectrofluorimetric method to quantify residues of β-blockers in environmental waters.

Background: Diabetes mellitus (DM) is linked to an increased risk of cardiovascular disease and almost one-third of patients with acute myocardial infarction (AMI) may have undetected diabetes mellitus (DM) at the time of admission. Objectives: evaluate the impact of DM on the subtle changes in left ventricular (LV) function before and post revascularization in ischemic hypertensive patients. Patients and Methods: This was an observational prospective study performed at Qena University Hospital included 140 ischemic hypertensive patients . Patients were divided into two groups: (1) Diabetic group and (2) non diabetic group. A complete medical history, physical examination and laboratory tests were done as well as Trans thoracic Echocardiography (TTE) was done before and after PCI for each patient. Results: In this study, there was a statistically significant (p-value < 0.05) increase in LV GLS after PCI (-14.0 ± 3.6%) when compared with GLS before PCI (-13.7 ± 1.5%) in diabetic group and highly statistically significant(p-value < 0.001) increased GLS after PCI (-15.8 ± 1.1%) when compared with GLS before PCI (-14.2 ± 0.9%) in non-diabetic group. Also we found that after PCI, diabetic patients had a significant improvement in LV EF and dimensions than the non-diabetic group that resulted in highly significant increase in GLS. Conclusion: The presence of diabetes mellitus in ischemic hypertensive patients had an impact on subclinical LV function that has been improved after successful revascularization regardless the level of HbA1C.

This study explored the effects of the germination of red and white sorghum grains (Sorghum bicolor [Moench (L.)]) for up to seven days on various properties of the grain. Germination enriched sorghum’s nutritional and sensory qualities while mitigating existing anti-nutritional factors. The study employed Fourier-transformed infrared spectroscopy (FT-IR) and scanning electron microscopy techniques to support its findings. Germination increased protein and lipid content but decreased starch content. White sorghum grains showed elevated calcium and magnesium but decreased iron, potassium, and zinc. Red sorghum grains showed a consistent decrease in mineral content during germination. Germination also increased fiber and lignin values in both sorghum varieties. The results of the FT-IR analysis demonstrate that germination induced significant changes in the molecular structure of white sorghum samples after 24 h, whereas this transformation was observed in red sorghum samples at four days. Total phenolic content (TPC) in red sorghum ranged from 136.64 ± 3.76 mg GAE/100 g to 379.5 ± 6.92 mg GAE/100 g. After 72 h of germination, the germinated seeds showed a threefold increase in TPC when compared to ungerminated seeds. Similarly, the TPC of white sorghum significantly increased (p < 0.05) from 52.84 ± 3.31 mg GAE/100 g to 151.76 mg GAE/100 g. Overall, during the 7-day germination period, all parameters showed an increase, and the germination process positively impacted the functional properties that contributed to the health benefits of white and red sorghum samples.

A 57-year-old housewife presented with complaints of sudden onset of chest pain and dyspnea. Computed tomography angiography revealed saddle-shaped pulmonary emboli in the main pulmonary artery and its branches. Evaluation for the cause of pulmonary embolism revealed a heterogeneously enhancing lesion arising from the anterior aspect of the lower pole of the left kidney. She had no hematuria, flank pain, or any palpable abdominal mass. She underwent a left open radical nephrectomy with inferior vena cava thrombectomy. Given that only 10% of patients present with the classic triad, it is often difficult to diagnose renal cell carcinoma in the early stages. Therefore, a high index of suspicion in patients with atypical presentations can lead to an early diagnosis.

Objective:To evaluate the smell and taste impairment in Coronavirus disease-2019 (COVID-19) pediatric patients according to the disease severity.Method:Ninety polymerase chain reaction test-confirmed COVID-19 patients were enrolled from January 2021 to July 2021. Patients were categorized into three main groups according to the stage of disease (stage 1: Outpatients, stage 2: Inpatients, stage 3: Intensive care unit patients). There were 30 pediatric patients in each group. Subjects were evaluated with a questionnaire. Visual analog scale was used to evaluate smell and taste impairment patients.Results:The impairment of smell and taste were evaluated separately, and the rates were found to be 31.1% and 35.6%, respectively. The impairment of smell showed a statistically significant difference between the groups (p=0.002). The rate of smell impairment in the outpatients was found to be significantly higher than in the patients treated in the intensive care unit. The taste impairment did not show a statistically significant difference between the groups (p=0.109; p>0.01). Persistence of smell and taste impairment was found in 5.5% of the patients.Conclusion:The rate of smell impairment in the outpatients was found to be significantly higher than in the cases treated in the intensive care unit.

Abstract Background Lupus nephritis (LN) affects a substantial number of the patients living with Systemic lupus erythematosus (SLE), representing a major cause of morbidity and mortality. Patients with lupus nephritis should be referred to a lupus nephritis expert who can confirm the diagnosis, assess the level of disease activity, and offer guidance on treatment and monitoring of the disease, as well as its consequences and side effects. The aim of this guideline was to develop recommendations for the management of adult lupus patients, including lupus nephritis diagnosis, assessment, and monitoring. Nineteen key clinical questions were identified by scientific committee according to the Patient/Population, Intervention, Comparison, Outcomes and Timing (PICOT) approach. Literature review team performed a systematic review to summarize evidence advocating the benefits and harms of available pharmacologic and nonpharmacologic therapies for LN. Subsequently, recommendations were formulated. The level of evidence was determined for each section using the Oxford Centre for Evidence-based Medicine (CEBM) system. A 2-round Delphi process was conducted with 24 experts. All rounds were conducted online. A consensus was achieved on the direction and the strength of the recommendations. Results An online questionnaire was sent to an expert panel who participated in the two rounds (response rate 100%). At the end of round 2, a total of 19 recommendation items, categorized into 11 sections to address the main LN categories, were obtained. The percentage of those who agreed with the recommendations (ranks 7–9) ranged from 90.5 to 100%. The phrasing of all 19 clinical standards identified by the scientific committee was agreed upon (i.e., 75% of respondents strongly agreed or agreed). Conclusion These recommendations provide an updated consensus on the pharmacological treatment of lupus nephritis and strategies to reach optimal treat to target outcomes in common clinical scenarios, based on a combination of evidence and expert opinion. Best treatment decisions should be tailored to each individual patient situation.

Aim:The level of health literacy and cyberchondria of healthcare providers can affect service beneficiaries, and the influence of health literacy and cyberchondria on physical activity and body awareness remains unclear. The aim of this study was to determine the health literacy and cyberchondria levels of healthcare workers and examine their relationship with physical activity level and body awareness.Methods:This cross-sectional study was conducted between August and November 2021 on 168 healthcare professionals working at the university hospital. The Turkish Health Literacy scale (TSOY-32), Cyberchondria scale, Body Awareness Questionnaire (BAQ), and International Physical Activity Questionnaire-Short Form (IPAQ-SF) were used for outcome measurements.Results:The TSOY-32 and Cyberchondria scale total scores were 37.76±7.98 and 63.83±19.45, respectively. There were low positive and significant correlations with TSOY-32, BAQ (r=0.213, p=0.006) and IPAQ-SF (r=0.162, p=0.036), while a low negative correlation was found between cyberchondria level and BAQ (r=-0.179, p=0.022) and IPAQ-SF (r=-0.193, p=0.013).Conclusion:This study shows that, unlike predicted, health professionals did not have perfect health literacy and were found to have moderate cyberchondria. Physical activity and body awareness may affect increasing health literacy and reducing cyberchondria, which will empower individuals to make beneficial health decisions.

Objective: Inherited bleeding disorders are a group of congenital coagulopathies, arising due to protein deficiencies, which affect clotting, platelet function or fibrinolysis. Spontaneous gross hematuria or subclinical microscopic hematuria, which are often detected by chance, are relatively common in patients with coagulopathies. This study aims to evaluate the incidence, the causes and treatment modalities of hematuria in congenital factor deficiencies. Method: Data concerning the type of coagulation defect, the level of deficient factor, age of the patients with hematuria episodes, presence of inhibitor, ongoing treatment modality, the etiology of hematuria, the treatment approach to hematuria, the number of hematuria episodes has been collected from medical records and hemophilia dairies of patients between 1985 and 2015 and confirmed by phone calls. Six hundred twenty nine patients with congenital factor deficiencies followed were evaluated retrospectively. Results: Hematuria was seen in 10.1% of hemophilia A, 15.5% of hemophilia B, 3.8% of von Willebrand's disease patients and 7% of patients with other factor deficiencies. Hematuria was seen in 2 mild, 20 moderate and 29 severe factor VIII and IX deficiencies. In 7 of these patients inhibitor was positive. While no etiological reason for hematuria could be identified in 78% of these patients, 15.3% had nephrolithiasis, 1.7% had post streptococcal acute glomerulonephritis, 3.4% had urinary tract infection and 1.7% had a renal cyst. Conclusion: The study demonstrates that hematuria is relatively common in factor deficiencies, whereas further studies are needed to elucidate the causes and effects on renal function in children with coagulation deficiencies.

Neurofibromatosis type 1 (NF-1) is a significant autosomal dominant disorder with a wide spectrum of clinical findings. These signs (Café au lait spots, bone dysplasia, Lisch nodules) usually start to emerge after the first months of life and most are benign in nature. On the other hand, neoplasms (optic glioma, neurofibroma, malignant peripheral nerve sheath tumor, soft tissue sarcoma, leukemia, breast cancer) are a major cause of morbidity and mortality in NF-1 patients. Cancer risk during the lifetime of an NF-1 patient is almost 10 times more than a person without NF-1, but what drives these patients into cancer is still unknown. This study aims to analyze the possible association of clinical findings with malignancies in children with NF-1. Medical records of 55 children with NF-1 who were followed up in a tertiary care pediatric oncology clinic between January 2005 and December 2014 were analyzed. We assessed clinical and demographic characteristics of patients, as well as the NF-1 diagnostic criteria, NF-1 related complications, and malignancies. The NF-1 patients without malignancy were classified in Group 1 while patients with malignancy were in Group 2. Logistic regression analysis was used to determine the risk factors of malignancy in NF-1. The mean age was 7.68 ± 4.65 years. Female sex was dominant in both groups. Café au lait spots were present in all patients. Axillary-inguinal freckling was observed in 76.4% of patients, followed by neurofibromas in 30.9%, Lisch nodules in 29.1%, bone dysplasia in 14.5%, optic gliomas in 23.6%, and a history of first degree relative with NF-1 in 63.6%. Central nervous system (CNS) tumors were present in 40%. Tumors other than CNS tumors were acute myeloid leukemia and schwannoma. None of the diagnostic criteria was a risk factor for predisposing to malignancy by itself. Having >3 criteria was found to be the risk factor for malignancy in NF-1 (OR:5.891, CI 95%: 1.676-20.705, p=0.006). There are no clearly defined risk factors predicting occurance of malignancies in NF-1 at present. However, we found a higher risk of malignancy association in patients who meet more than 3 diagnostic criteria of NF-1.