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In this study, experimental and thermodynamic analyses were used to investigate the use of fuel blends created by adding cerium oxide (CeO2) and aluminium oxide (Al2O3) nanoparticles to diesel/heavy fuel oil (HFO) fuel blends in a compression ignition engine. In the study, a single-cylinder compression ignition engine was tested at four different engine loads at a constant engine speed of 3000 rpm. The experiments measured engine power, fuel consumption, exhaust gas temperature, engine casing temperature and exhaust pollutants. Thus, a study on energy, efficiency and sustainability was carried out by comparing fuel blends. All fuel blends were subjected to energy and exergy efficiency, lost exergy and sustainability index calculations. The addition of nanoparticles to the fuel increases the energy loss compared to the D80F20 (80% Diesel + 20% HFO) fuel blend. Comparing D80F20AL100 (80% Diesel + 20% HFO + 100 ppm Al2O3) and D80F20CE100 (80% Diesel + 20% HFO + 100 ppm CeO2) fuel blends, the exergy loss of D80F20 fuel is 10.76% and 14.23% higher when the engine power is 4000 W, respectively. The energy efficiency of D80F20 fuel increases as more nanoparticles are added and reaches 12.60% and 12.80% for D80F20CE25 (80% Diesel + 20%HFO + 25 ppm CeO2) and D80F20CE100 fuels under 3000 W engine load, respectively. The inclusion of nanoparticles in diesel/HFO fuel blends gives results in line with the sustainability index.

Objective Obstructive sleep apnea syndrome (OSAS) is characterized by episodic cessations of breathing due to upper airway obstruction during sleep, which may cause disturbances in dietary patterns resulting from appetite-related hormonal changes. The aim of the present study was to investigate the relationship between OSAS and nutritional and dietary patterns.

IntroductionPsoriasis is a T-cell mediated autoimmune skin disease. HLA-C*06:02 is the main psoriasis-specific risk gene. Using a Vα3S1/Vβ13S1 T-cell receptor (TCR) from a lesional psoriatic CD8+ T-cell clone we had discovered that, as an underlying pathomechanism, HLA-C*06:02 mediates an autoimmune response against melanocytes in psoriasis, and we had identified an epitope from ADAMTS-like protein 5 (ADAMTSL5) as a melanocyte autoantigen. The conditions activating the psoriatic autoimmune response in genetically predisposed individuals throughout life remain incompletely understood. Here, we aimed to identify environmental antigens that might trigger autoimmunity in psoriasis because of TCR polyspecificity.MethodsWe screened databases with the peptide recognition motif of the Vα3S1/Vβ13S1 TCR for environmental proteins containing peptides activating this TCR. We investigated the immunogenicity of these peptides for psoriasis patients and healthy controls by lymphocyte stimulation experiments and peptide-loaded HLA-C*06:02 tetramers.ResultsWe identified peptides from wheat, Saccharomyces cerevisiae, microbiota, tobacco, and pathogens that activated both the Vα3S1/Vβ13S1 TCR and CD8+ T cells from psoriasis patients. Using fluorescent HLA-C*06:02 tetramers loaded with ADAMTSL5 or wheat peptides, we find that the same CD8+ T cells may recognize both autoantigen and environmental antigens. A wheat-free diet could alleviate psoriasis in several patients.DiscussionOur results show that due to TCR polyspecificity, several environmental antigens corresponding to previously suspected psoriasis risk conditions converge in the reactivity of a pathogenic psoriatic TCR and might thus be able to stimulate the psoriatic autoimmune response against melanocytes. Avoiding the corresponding environmental risk factors could contribute to the management of psoriasis.

Cleft foot is a rare congenital anomaly characterized by a central conical defect and deficiency of the foot rays. Syndactyly is the fusion of the skin with or without the bone of adjacent digits, and it may be associated with syndrome-related cleft foot. The aim of the treatment of cleft foot and syndactyly is to obtain a normal form and function by closing the cleft defect, obtaining symmetrical and cosmetic feet, allowing patients to wear normal shoes comfortably, and preventing collapse and angulation deformities of the toes. In this study, the treatment of congenital cleft foot and syndactyly coexistence is presented, and it is demonstrated that excess skin after soft-tissue syndactylization of the cleft foot can be used to reconstruct syndactyly defects.

The purpose of this study is to examine teachers' social justice-based practices, the outcomes of those practices, the leadership roles revealed in the process, and the problems experienced. The sample of the study consisted of 13 teachers who were reached through the snowball sampling method. 10 middle school and 3 primary school teachers working in three different provinces of Turkey were interviewed during the 2019-2020 school year. The data obtained were analysed through content analysis. According to the findings, social justice-based practices consisted of the stages: recognising the need, decision-making, examination of the examples, and support and evaluation. Teachers demonstrated leadership roles such as problem-solving, having a vision, developing empathy, and team building. These leadership roles enable the implementation process to begin. Issues such as bureaucratic procedures and the need for parent and teacher training were encountered during the practices. It was recommended that social justice-based training activities should be considered in teacher education and the collaboration with local authorities and relevant organisations in these practices should be supported.

Objective(s): The detrimental effects of high fructose consumption on metabolic health have been extensively studied. However, limited research has focused on the impact of fructose intake on neuroprotective mechanisms, specifically the expression of insulin receptor (INSR) and glucagon-like peptide-1 receptor (GLP-1R) in the hippocampus. Understanding the effects of fructose on these neuroprotective molecules can provide valuable insights into the potential role of fructose in hippocampal dysfunction. The goal of this study is to aim at the basal plasma levels of lipid profile, insulin, GLP-1, and HOMA-IR, as well as the mRNA and protein expression of neuroprotective molecules such as INSR and GLP-1R in Wistar rats fed a high fructose diet. Materials and Methods: Rats were separated into control (C) and high fructose (HF) groups. The HF group was given 20% fructose water to drink for 16 weeks. Results: Fructose ingestion significantly increased abdominal fat (C=1.24±0.08 g, HF=1.79±0.19 g, P0.05). Although INSR mRNA expression in the hippocampus was significantly lower in the HF group compared to the control group (P0.05). Furthermore, whereas INSR and GLP-1R protein levels in the experimental group were on a declining trend, this trend was not substantially different (P>0.05).Conclusion: These data suggest that fructose consumption may be harmful to the hippocampus by lowering the expression of INSR.

Fahrüddîn Benâkıtî, muhtemelen h. VII. yüzyılın ortalarından sonra Mâverâünnehir’e bağlı bir Türk yerleşim yeri olan Benâket’te dünyaya gelmiştir. İlhanlı Devleti’nin önemli şairlerinden birisi olan Benâkıtî aynı zamanda tarihçiliği ile de ön plana çıkmıştır. İlhanlı hükümdarlarından Gazan Han’ın (1295-1304) korumasına mazhar olup iltifat gören müellif onun yakın adamlarından biri olmayı başarmıştır. Olcaytu Han (1304-1316) zamanında saraydaki durumu kötüye gitse de Ebû Sa’id Bahadır Han (1317-1335) zamanında tekrardan yıldızı parlamıştır. Bu hükümdar tarafından bir tarih kitabı yazmakla görevlendirilen Benâkıtî, Târîh-i Benâkıtî adlı eserini tamamlayarak 1317 yılında Ebû Sa‘id Bahadır Han’a sunmuştur. Eser ihtiva etmiş olduğu bilgilerle bir umumî tarih olma özeliğini taşımıştır. Dokuz bölümden oluşan Târîh-i Benâkıtî’nin dördüncü bölümünde Abbasîlere bağlı hanedanlıklardan bahsedilmiştir. Bunlardan birisi de Ortaçağ Türk-İslâm devletlerinden olan Gaznelilerdir. Eser Gazneliler tarihi açısından oldukça muhtasar bir görünüm arz etmektedir. Bunun yanı sıra aktarmış olduğu bilgilerin tarihi açısından sıhhati de teyide muhtaçtır. Bu çalışmada eserin Gazneliler kısmı incelemeye tabi tutulmuştur. Bahsi geçen bölümün tercümesi yapılmış ve devrin diğer kaynakları ile mukayese edilerek değeri ortaya çıkarılmaya çalışılmıştır.

The aim of this study was to investigate the effects of peppermint (Mentha piperita L.) essential oil on duodenal and colonic contractions of broilers in vitro. For this purpose, 10 broiler intestines (42 days old) obtained from a slaughterhouse were brought to the laboratories by immersed in Krebs solution (NaCl, 118 mmol/L; KCl, 4.7 mmol/L; CaCl2, 2.5 mmol/L; MgSO4, 1 mmol/L; KH2PO4, 1 mmol/L; glucose, 11 mmol/L; NaHCO3, 25 mmol/L) at +4°C. Isolated duodenal and colon tissue strips were placed in a fourchannel, isolated organ bath system, where they were exposed to Krebs solution aerated with a gas mixture of 95% O2 - 5% CO2, at 39°C. The effect of peppermint essential oil (PEO) obtained by hydrodistillation method on spontaneous duodenum and colon contractions was evaluated in the concentration range of 0.1-1000 μg/mL. Subsequently, the effects of 300 and 1000 μg/mL PEO were reevaluated on acetylcholine-induced contractions after incubation with Nω-Nitro-L-arginine (L-NNA, NOS inhibitor) and Methylene Blue (MB, cGC inhibitor). It was determined that the PEO dose-dependently decreased the amplitude of spontaneous and acetylcholine-induced contractions in both isolated tissues. This relaxant effect persisted after L-NNA and MB incubations. In conclusion, PEO induced relaxation in isolated duodenum and colon intestinal smooth muscles not through the nitric oxide-sGMP pathway.

The infraorbital nerve is responsible for the sensory innervation of the lower eyelid, the lateral nose, the cheek, the upper lip, and the maxillary teeth. It passes along the infraorbital canal, which runs superior to the maxillary sinus. Dehiscence of the infraorbital canal and its ectopic course in the maxillary sinus is a rare variation. A nerve with these variations may be affected by pathologies in the maxillary sinus and this may constitute a rare cause of facial pain. In this report, we present the clinical symptoms of a 29-year-old male patient who had an infraorbital nerve with an ectopic course and dehiscence in light of the literature.

Objective:Kinesiophobia, which is defined as the fear of moving due to the fear of re-injury, impairing the quality of life of the patients, causes various degrees of disability and participation problems, adversely affects the treatment, and may cause the pain to become chronic and may predispose to depression. Severe pain and limitation of movement in a short time are common in muscle, joint and ligament pathologies of the shoulder, which is one of the most common problems of the upper extremity. We aimed to conduct this study in patients with a diagnosis of rotator cuff and adhesive capsulitis, anticipating that the presence and degree of kinesiophobia should be considered when planning treatment for shoulder diseases.Method:A total of 80 patients, aged 30-75 years, who had shoulder pain complaints for at least 1 month and applied to the outpatient clinic for rehabilitation, diagnosed with rotator cuff syndrome (n=40) and adhesive capsulitis (n=40) were included in the study. Pain degree of the patients, active joint range measurement of the painful shoulder, anxiety and depression, degree of disability and presence of kinesiophobia; it was evaluated with the numerical rating scale (NRS), the arm, shoulder and hand problems questionnaire (DASH), the hospital anxiety depression scale (HAD), and the Tampa kinesiophobia scale. The patients voluntary consent for the study and approval of University of Health Sciences Turkey, İstanbul Bakırköy Dr. Sadi Konuk Training and Research Hospital Ethics Committe with protocol number 2019-421 was obtained on 12.09.2019.Results:NRS with movement, at rest and sleep, HAD and TAMPA measurements of the cases did not show any statistically significant difference according to the groups (p>0.05). The DASH score of the cases in the adhesive capsulitis group was found to be statistically significantly higher than that of the cases in the rotator cuff syndrome group (p

Objective:The aim of this study was to investigate the effect of early pulmonary rehabilitation (PR) on the course of the disease, respiratory functions, physical activity, fatigue, and discharge time in Coronavirus disease-2019 (COVID-19) patients in the intensive care unit (ICU) setting.Method:A total of 31 patients (20 females, 11 males) with COVID-19 confirmed by real-time polymerase chain reaction who were admitted to the ICU were included. Demographic, clinical, and laboratory data of the patients were recorded. Physical activity, dyspnea, and fatigue of all patients were evaluated before and after PR program. All patients were evaluated on the day of PR in the ICU, the day of discharge from ICU to the ward, and on the day of discharge from hospital. Functional status was evaluated using the functional disability questionnaire (FDQ), the ambulation status using the functional ambulation classification (FAC), dyspnea using the modified Borg scale (MBS), and fatigue using the fatigue severity scale.Results:The mean length of ICU and hospital stay was 17.93±11.54 days and 18.29±8.41 days, respectively. The mean number of sessions was 8.87±7.66. The mean time from hospitalization to recovery was 13.00±9.62 days. Median FDQ and MBS scores were significantly higher during the ICU stay than the ward stay and at the time of discharge (p

Abstract A 37-old III gravida II para with two previous cesarean sections (CS) presented in 7 + 3 weeks of pregnancy with cervical ectopic pregnancy (CEP). At 12th week of pregnancy, a cerclage was performed to avoid cervical distention by the expanding placenta. Due to missing experience in CEP management and to avoid emergency operation, we recommended CS in 30th week of pregnancy due to unspecific pain of the patient. Vaginal bleeding never occured. After transverse laparotomy, the urinary bladder was sharply dissected from the anterior uterine and cervical wall. The baby was delivered by transverse cervicotomy caudally of the placenta. The placenta was left in situ. The patient then got prophylactic embolization of the uterine arteries to prevent further severe hemorrhage. 48 h later, ultrasound showed a floating, avascular placenta within a poor echogenic fluid-filled cervical space as well as macrohematuria. After re-laparotomy and cervicotomy at the same day, the placenta was completely and easily evacuated. A bladder injury was recognized and closed. We performed a cervical internal os plasty by inverting the cervical lips and suturing their distal ends on the proximal cervical tissue, resulting in complete bleeding cessation. Although, the patient got 8 erythrocyte concentrates at all, she was always in a stable condition without hemorrhagic shock. This case demonstrates for the first time a live-birth with uterus-conserving management in CEP.

Abstract Early-onset sepsis (EOS) is one of the leading causes of neonatal death and morbidity worldwide and timely initiation of antibiotic therapy is, therefore, of paramount importance. This study aimed to evaluate the predictive effect of lactate and base excess (BE) values in the cord arterial blood gas and the 6th hour of life venous blood gas analysis on clinical sepsis in newborns. This is a cohort case–control study. In this study, 104 cases were divided into clinical and suspected sepsis groups according to the evaluation at the 24th hour after delivery. Lactate and BE values were evaluated in the cord arterial blood gas analysis (ABGA) and at the postnatal 6th-hour venous blood gas. The cord ABGA and postnatal 6th-hour results were compared in the clinical and suspected sepsis groups. Clinical sepsis was found to be associated with a lactate value above 2 mMol/L at postnatal 6th-hour venous blood gas (p = 0.041). This association was the highest when the clinical sepsis group's postnatal 6th-hour lactate cut-off value was determined as 3.38 mMol/L (sensitivity 57.9% and specificity 68.5%) (p = 0.032). However, no association was found between clinical sepsis diagnosis and venous BE's value in cord ABGA at the postnatal 6th hour. We found that a venous lactate value above 3.38 mMol/L at the postnatal 6th hour was the cut-off value that could indicate early-onset clinical sepsis. However, none of the biomarkers used in diagnosing EOS can accurately show all cases.

The envelope (env) protein of SARS-CoV-2, a pivotal component of the viral architecture, plays a multifaceted role in viral assembly, replication, pathogenesis, and ion channel activity. These features make it a significant target for understanding virus–host interactions and developing vaccines to combat COVID-19. Recent structural studies provide valuable insights into the conformational dynamics and membrane topology of the SARS-CoV-2 env protein, shedding light on its functional mechanisms. The strong homology and highly conserved structure of the SARS-CoV-2 env protein shape its immunogenicity and functional characteristics. This study examines the ability of the recombinant SARS-CoV-2 env protein to stimulate an immune response. In this study, recombinant envelope proteins were produced using the baculovirus expression system, and their potential efficacy was evaluated in both in vivo and in vitro models. Our results reveal that the env protein of SARS-CoV-2 stimulates humoral and cellular responses and highlight its potential as a promising vaccine candidate for combating the ongoing pandemic.

The performance of soil nailed walls is evaluated based on lateral displacements, especially in high walls. In this study, the displacement behavior of nailed walls, which are frequently preferred in retaining wall systems in hard clayey soils, was examined by taking into account the corner effect. The nailed wall model was created using Plaxis 2D v.23, and the performance of the model was verified with the results of inclinometer measurements taken on-site. To assess the influence of excavation pit dimensions on the corner effect, 25 three-dimensional and 25 plane–strain slice models were created using Plaxis 3D v.23, and the effect of excavation pit dimensions on the plane–strain ratio (PSR) was determined. Then, analysis studies were carried out by creating 336 3D and 336 plane–strain slice models with variable parameters, such as slope angle (β), wall angle (α), nail length (L/H), excavation depth (H), and distance from the corner (xH). Its effects on PSR were determined. The interactions of the parameters with each other and PSR estimation were evaluated using machine learning (ML) methods: artificial neural networks (ANN), classifical and regression tree (CART), support vector regression (SVR), extreme gradient boosting (XGBoost). The proposed ML prediction methods and PSR results were compared with performance metrics and reliable results were obtained.