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Abstract: In this study, we sought to determine whether proteinuria after renal transplantation was associated with cardiovascular disease (CVD), patient survival, and long-term allograft survival. One hundred twenty-six patients included 102 males and 24 females of mean age 30.7 ± 8.9 years. Their mean follow-up was 63.21 ± 19.9 months. All patients were evaluated for CVD, namely, ischemic heart disease, cerebrovascular disease, and peripheral vascular disease. Proteinuria was defined as urinary protein ≥500 mg/d which persisted for >6 months after transplantation. We retrospectively examined pre- and posttransplant data, including sex, age at transplantation, smoking, pretransplant dialysis duration, donor status, number of acute rejection episodes, body mass index, systolic and diastolic blood pressure levels, lipid profile and other biochemical parameters, immunosuppressive regimens, as well as pulse steroid dose. Proteinuria was significantly associated with CVD (P = .001; RR = 6.43; confidence interval [CI] 2.15–19.22). Patients with proteinuria showed significantly lower graft survival rates than those without proteinuria (58.62% vs 80.41%; P = .02). The mean time to appearance of proteinuria was 14.1 ± 11.4 months (range, 1–36 months). There was no significant association between proteinuria and patient survival. Patients with persistent proteinuria displayed a greater number of acute rejection episodes (1.20 ± 1.17 vs 0.62 ± 0.85; P = .004) and higher pulse steroid dosages (4380.0 ± 3123.4 vs 2800.0 ± 2766.7; P = .022). In conclusion, persistent proteinuria is a strong risk factor for CVD among renal transplant patients. Therefore, an etiologic search and antiproteinuric strategy should be considered routinely to improve patient and graft outcomes. [Copyright &y& Elsevier]

Diabetic ketoacidosis (DKA) is a common medical emergency situation. In rare cases, glycemic changes associated with the menstrual cycle may create a predisposing factor for DKA. In the absence of facilitating factors that may cause DKA, catamenial DKA should be considered. In the patients with catamenial DKA, increasing the insulin dose 1-2 days before menstruation may prevent the development of hyperglycemia or DKA associated with menstrual cycle. In this study, we present a 21-year-old female with type 1 diabetes mellitus (DM) that recurrently applied to our hospital due to DKA a few days prior to menstrual bleeding. [ABSTRACT FROM AUTHOR]

Introduction. Fahr's syndrome is an infrequent disorder characterized by bilateral symmetrical calcification of basal ganglia and the cerebral cortex. It can be seen genetic, idiopathic, or secondary to endocrine diseases. This disease is related to different metabolic disorders particularly with diseases of the parathyroid gland. Case 1. A 63-year-old female patient applied to our clinic due to having hypoparathyroidism with bilateral basal ganglia calcification in head computed tomography(CT). She had subtotal thyroidectomy 25 years ago. In the neurological examination, mild symmetrical parkinsonism was determined. In laboratory examination Ca:8 mg/dL (8.6- 10.2), P:5.1 mg/dL (2.3-4.5), PTH:9.53 pg/mL (15-65) were detected. Calcitriol 0.25 µ/day was added to her treatment. Her parkinsonism disappeared after the treatment. Case 2. A 49-year-old male patient was consulted when he was admitted to the department of neurology in our hospital. The physical examination demonstrated the characteristics of Albright's hereditary osteodystrophy. The neurological examination shows bilateral symmetrical bradykinesia, dysphagia, and moderate dysarthria. In the laboratory examination PTH: 46.5 ng/L(15-65), Ca:8.6 mg/dL (8.6-10.2), P:2.7 mg/dL (2.3-4.5) were detected and were all within the normal ranges. Consequently, pseudopseudohypoparathyroidism was decided as a diagnosis. G protein alpha subunit mutation (Gsa) was not detected due to technical limitations. Conclusion. When a patient is diagnosed as Fahr's syndrome, we should keep in mind parathyroid disorders. Fahr's syndrome must be evaluated in patients showing intracranial calcification accompanied by parathyroid diseases. [ABSTRACT FROM AUTHOR]

Background Development of inhibitors is the most serious complication in haemophilia A treatment. The assessment of risk for inhibitor formation in new or modified factor concentrates is traditionally performed in previously treated patients ( PTPs). However, evidence on risk factors for and natural history of inhibitors has been generated mostly in previously untreated patients ( PUPs). The purpose of this study was to examine cases of de novo inhibitors in PTPs reported in the scientific literature and to the EUropean HAemophilia Safety Surveillance ( EUHASS) programme, and explore determinants and course of inhibitor development. Methods We used a case series study design and developed a case report form to collect patient level data; including detection, inhibitor course, treatment, factor VIII products used and events that may trigger inhibitor development (surgery, vaccination, immune disorders, malignancy, product switch). Results We identified 19 publications that reported 38 inhibitor cases and 45 cases from 31 EUHASS centres. Individual patient data were collected for 55/83 (66%) inhibitor cases out of 12 330 patients. The median (range) peak inhibitor titre was 4.4 (0.5-135.0), the proportion of transient inhibitors was 33% and only two cases of 12 undergoing immune tolerance induction failed this treatment. In the two months before inhibitor development, surgery was reported in nine (22%) cases, and high intensity treatment periods reported in seven (17%) cases. Conclusions By studying the largest cohort of inhibitor development in PTPs assembled to date, we showed that inhibitor development in PTPs, is on average, a milder event than in PUPs. [ABSTRACT FROM AUTHOR]

The photoconducting properties of graphene–cobalt phthalocyanine organic semiconductor photodiodes were investigated. GO doped cobalt phthalocyanine (CoPc) thin films were prepared with various graphene oxide (GO) contents. The electrical properties of the diodes were analyzed by using current–voltage and capacitance/conductance–voltage measurements. The reverse current of the diodes increases with the increasing illumination intensity. The transient photocurrent, photocapacitance, and photoconductance measurements of the diodes were also investigated. The photocurrent, capacitance and conductance increase after illuminating and returns to original value after turning off the illumination. Graphene–cobalt phthalocyanine based on optoelectronic device exhibited both a photodiode and photocapacitor behavior under solar light illuminaton. [ABSTRACT FROM AUTHOR]

Abstract: Aims: We sought to evaluate influences of oxidative stress (OS) on rHuEPO requirements in hemodialysis patients without chronic inflammation. Methods: Sixty-eight hemodialysis patients and 46 healthy controls underwent measurements plasma levels of antioxidative agents, such as glutathione peroxidase (GPX), superoxide dismutase (SOD), and oxidative compounds including malonyldialdehyde (MDA). We retrospectively analyzed the last 3 months’ rHuEPO requirements, iron indices, and CRP levels. Results: Plasma levels for SOD, GPX, and MDA were 974.4 ± 216.4 U/gHb, 44.4 ± 13.6 U/gHb, 10.0 ± 2.0 nmol/mL, respectively yielding results that were different from healthy controls (P < .0001). Increased OS negatively correlated with hemoglobin levels (P < .0001) and positively correlated with rHuEPO requirements (P < .01). Increased antioxidative capacity positively correlated with hemoglobin levels (P < .0001) and negatively correlated with rHuEPO requirements (P < .0001). For further analyses, hemodialysis patients were subgrouped according to rHuEPO requirements as group I (lowest 1/3, n = 23), group II (moderate 1/3, n = 23) and group III (highest 1/3, n = 22). Group III displayed the highest MDA (P < .05), the lowest SOD (P < .0001), and comparable GPX (P < .05) levels. Group III also had the highest CRP and the lowest albumin levels compared with the others (P < .01). Conclusion: OS has strong adverse influences on rHuEPO responses of HD patients with “normal” CRP levels, but it should not be forgotten that CRP levels in the “normal” range may still reflect ongoing microinflammation. [Copyright &y& Elsevier]

The possibility of exercise-induced myocardial ischemia due to mitral valve prolapse (MVP) in the absence of coronary artery disease was evaluated with single-photon emission computed tomographic analysis using thallium-201 and technetium-99m sestamibi in 72 patients with MVP. Exercise electrocardiography was positive in 5 patients (8%), but single-photon emission computed tomography was found to be normal in all patients, and exercise-induced chest pain, electrocardiographic changes, and arrhythmias were found not to be related to myocardial ischemia in patients with MVP. [ABSTRACT FROM AUTHOR]

Abstract: Alport’s syndrome, a hereditary disorder characterized by a combination of nephritis and deafness, was first described in 1927. Herein, we have presented 20 cases of Alport’s syndrome in renal transplant recipients. Between November 1975 and September 2006, we performed 1602 transplantations. 22 including 20 recipients (1.24%) with Alport’s syndrome. The recipients were 16 males and 4 females of overall mean age 21.3 ± 5.6 years (range, 14–35 years). Seventeen received kidneys from living-related and 5 from cadaveric donors. We retrospectively assessed recipient features: age, gender, physical examination, routine blood biochemistry, histopathological results, and audiometric test results, as well as postoperative complications in each of these 20 recipients. Ten instances of acute rejection occurred in 8 recipients. There were 3 postoperative complications, all of which were lymphoceles. We had no vascular or urinary system complications. At the time of this report, 19 recipients are alive; the other 1 died due to Kaposi’s sarcoma. Sixteen recipients display good renal function and creatinine levels ranging from 0.8 to 2.9 mg/dL during a mean follow-up of 8.4 ± 4.8 years (range, 1 to 20 years). Three of 19 recipients returned to hemodialysis at 17, 13, and 6 years after their first graft, respectively. Retransplantation was performed on 2 recipients at 18 and 7 years, respectively, after their first transplantation. In conclusion, although the number of patients in our series was small, in light of their uneventful postoperative periods and the good posttransplantation renal function in our recipients, we consider Alport’s syndrome recipients as good candidates for transplantation. [Copyright &y& Elsevier]

Background: Brain drain is the migration of trained professionals and scientists from low and middle-income countries to live and work in better conditions in high-income countries. The brain drain and brain drain intentions of qualified nurses have become a global burning issue for healthcare sustainability in low and middle-income countries. In Türkiye, the idea of brain drain has increased among nurses and nursing students. Realizing the factors affecting brain drain intention and how to manage them are crucial for proper planning, health equity, and positive patient outcomes in health care., Objectives: To verify a hypothesized model examining the factors contributing to brain drain intentions among nursing students., Design: A cross-sectional study., Settings and Participants: Data were collected from 528 undergraduate nursing students from a health sciences faculty with an online questionnaire sent through a link between December 16, 2021, and February 28, 2022., Methods: A hypothesized model was tested using path analysis., Results: Income level (middle) and income level (low) were indirectly and inversely related to attitudes towards brain drain through the mediating role of satisfaction with life. Sense of belonging to the occupation significantly mediated the indirect effect of concern regarding working conditions (yes) on attitudes towards brain drain. The direct effect of satisfaction with life on attitudes towards brain drain was significant. Sense of belonging to the occupation was indirectly and positively related to attitudes towards brain drain through the mediating role of satisfaction with life. In contrast, the direct effect of the sense of belonging to the occupation on attitudes towards brain drain was not statistically significant., Conclusion: Faculties and governments should consider that brain drain intention is a good predictor of future brain drain. To reduce nursing students' brain drain intentions, policy-driven changes in nurses' working conditions and psychological support for satisfaction with life and a sense of belonging to the occupation in their own country are required., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: This study aims to evaluate the relationship between volumetric measurements of residual tumor via magnetic resonance imaging (MRI) and pathologic complete response (pCR) in rectal cancer patients undergoing neoadjuvant chemoradiotherapy (nCRT)., Methods: Patients with locally advanced rectal cancer who had pelvic MRI for clinical staging and completed nCRT followed by radical resection were included. Two experienced radiologists measured tumor volume on MRI obtained before and after nCRT. We compared the pre- and post-CRT tumor volume and measured tumor volume reduction rates., Results: The median value of tumor volume reduction rate in all patients was 64.7% (min-max - 81.1-98.1%). When the relationship between tumor volume and tumor regression grade (TRG) after nCRT was assessed, it was found that 18 of 21 (86%) patients with a good response (TRG 1) had a post-CRT tumor volume of ≤ 8 cm3 (p = 0.001). While 9 of 10 patients with pCR after nCRT had a tumor volume of ≤ 8 cm3, one patient had pCR despite having a tumor volume greater than 8 cm3 (p = 0.015)., Conclusion: The correlation between post-nCRT residual tumor volume and pCR underscores the potential of volumetric MRI as a predictive tool in tailoring rectal cancer treatment. For patients with residual tumor volumes greater than 8 cm 3 , extending neoadjuvant chemotherapy as part of TNT may enhance the likelihood of achieving pCR. This approach advocates for a more personalized treatment strategy, potentially optimizing outcomes for rectal cancer patients., Competing Interests: Declarations Ethical Approval Ethical approval was received from the Gazi University Ethics Commission on 3.3.2023. Informed Consent Patient consent was waived as this study included only review of existing data without contact with or direct involvement of patients in the study. Institutional Review Board Statement The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Ethics Committee of Gazi University Medical Faculty. Conflict of Interest The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This study explores the production of bio-nutrients from bioactive compound-rich spent coffee grounds (SCG) and biochar (BC) through composting after inoculation with a biological agent and its impact on the growth performance of garden cress and spinach. The SCG was composted with six doses of BC (0, 5, 10, 15, 20, and 25%). The compost with 10% BC exhibited the best maturity, humification, and phytotoxicity index values of dissolved organic carbon (DOC), humification index (E4/E6), and germination index (GI). A metagenome analysis showed that compost starter enhanced the bacterial community's relative abundance, richness, and diversity in SCG and BC treatments. This improvement included increased Patescibacteria , which can break down noxious phenolic compounds found in SCG and BC. The BC enriched the compost with phosphorus and potassium while preserving the nitrogen. In plant growth experiments, the total chlorophyll content in compost-treated garden cress and spinach was 2.47 and 4.88 mg g -1 , respectively, which was significantly greater ( p ≤ 0.05) than in unfertilized plants and similar to the plants treated with traditional fertilizer. Overall, the results show that the compost of SCG + BC was well-suited for promoting the growth of garden cress and spinach, providing adequate nutrients as a fertilizer for these leafy vegetables.

Background: This study aimed to describe our clinical experience with surgical approaches and patient management for traumatic multiple-level continuous and noncontinuous thoracolumbar spinal fractures., Methods: We retrospectively evaluated patients with continuous and noncontinuous multiple-level thoracolumbar fractures who were operated on by the same surgical team from 2019 to 2021. These patients were divided into two groups: Group 1 (n=12, continuous fractures) and Group 2 (n=14, noncontinuous fractures). We assessed the patients' age, gender, fracture levels, fracture type, classification according to the AO (Arbeitsgemeinschaft für Osteosynthesefragen) Spine Thoracolumbar Fracture Classification, status of posterior ligament damage, presence of additional traumatic pathology, status of decompression via laminectomy, levels of stabilization and fusion, preoperative and postoperative neurological status, presence of cervical trauma, duration of operation, amount of blood loss, duration of hospitalization, and lordosis and kyphosis angles in terms of fusion status and postoperative follow-up over two years. The study excluded patients over the age of 65, those with single-level fractures, and pathological fractures caused by osteoporosis, infection, or spinal tumors., Results: Gender, age, neurological status, application of laminectomy, surgical complications, status of cervical fracture, duration of operation, amount of blood loss, duration of hospitalization, lordosis, and kyphosis angles were uniformly distributed between the groups. All patients underwent fusions, ranging from three to eight, with a median of two (range 2-4) fracture levels, and a median of five instrumented vertebrae, ranging from four to seven. Significant differences between the two groups were observed in terms of operation duration (p=0.001), blood loss (p=0.010), duration of hospitalization (p=0.003), number of fusions (p<0.001), and instrumented vertebral segments (p=0.011)., Conclusion: Thus, a surgical approach involving decompression, vertebral fusion screws, allografts, and bone substitutes can enhance surgical outcomes for patients with continuous and noncontinuous vertebral fractures.

Immune checkpoint inhibitors (ICIs) can trigger immune-related adverse events (irAEs). The appearance pattern of irAEs, who is prone to them, and their mechanisms are still uncertain. In this study, we aimed to monitor patients initiated on ICIs for endocrinological aspects and to investigate the potential predictive markers in the development of endocrine-irAEs. The study prospectively included 43 patients with metastatic disease scheduled for anti-PD-1/L1 therapy. Endocrinological follow-up was conducted at specified intervals as well as in response to any additional reported complaints. Serum concentrations of CXCL10, IL-1beta, and IL-17A were measured prior to ICI and during the endocrine-irAEs. A total of 39.5% of the patients experienced endocrine-irAEs, with a median onset time of 3 months. Among patients, 34.9% developed thyroid-related adverse events, and 4.6% experienced hypophysitis. Thyroid autoantibodies were associated with a higher incidence of thyroid-related irAEs (P = 0.004). In the irAE group, median pre-ICI CXCL10 and baseline thyroid stimulating hormone (TSH) levels were significantly higher, baseline total testosterone level in men was lower than in the non-irAE group (P < 0.05), whereas IL-1beta and IL-17A levels did not differ (P > 0.05). Serum CXCL10, IL-1beta, and IL-17A concentrations did not differ significantly pre-ICI and during adverse events (P > 0.05). Pre-ICI CXCL10 concentration was correlated positively with anti-TPO levels in patients with at least one thyroid autoantibody positivity (r = 0.706, P = 0.01) and negatively with baseline total testosterone level of men (r = 0.509, P = 0.002). Our results suggest that higher pre-ICI serum CXCL10 and TSH levels might have a predictive role in the development of endocrinopathies. Besides, baseline thyroid antibody measurements could be beneficial in predicting thyroid dysfunction.

Purpose: The presence of right ventricular dysfunction indicates a higher risk status in patients with pulmonary embolism (PE). The RV strain evaluated by speckle-tracking echocardiography seems to be more reliable method in the evaluation of RV dysfunction as compared to standard echocardiographic measures. In this study, we aimed to determine the value of myocardial-work indices in evaluating serial changes of RV function in acute PE., Methods: Our study comprised 83 consecutive acute PE patients who admitted to our tertiary cardiovascular hospital. Echocardiography was performed within the first 24-hours of hospitalization, and RV and LV myocardial-work parameters were obtained along with standard echocardiographic parameters. The change in the RV/LVr detected on tomography was selected as the primary outcome measure, and its' predictors were analyzed with classical linear regression and a generalized additive model (GAM)., Results: Among the LV-RV strain and myocardial work parameters, the RV global longitudinal strain (GLS) has borderline statistical significance in predicting the RV/LVr change whereas the RV global work efficiency (RV-GWE) strongly predicted RV/LVr change (p: 0.049 and <0.001, respectively)., Conclusion: In this study, classical linear regression and GAM analyses showed that RV-GWE seems to offer a better prediction of RV/LVr change in patients with acute PE., (© 2024 Wiley Periodicals LLC.)

This study focuses on enhancing the structural, thermal, and dielectric properties of poly(vinylidene fluoride) (PVDF) nanocomposites loaded with graphene oxide (GO) and graphene (G), synthesized via solution casting. Characterization techniques, including X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, and thermogravimetric analysis (TGA), revealed significant enhancements due to the nanofillers. The crystallinity of PG composites increased to 60.39% from 49.21% in neat PVDF, transitioning from α to β phases, which is beneficial for high-performance electronics and energy storage. PG composites showed a dielectric constant ( ε ') of 10.50, higher than those of neat PVDF ( ε ' = 7.54) and PGO composites ( ε ' = 8.56). The dielectric loss (tan  δ ) for PG was low at 0.15, suitable for electronics. The AC conductivity of PG composites (2.22 × 10 -7 S cm -1 ) was higher than those of neat PVDF (1.09 × 10 -7 S cm -1 ) and PGO (1.65 × 10 -7 S cm -1 ), enhancing their suitability for flexible electronics. Thermal stability assessments showed that PG composites had the highest degradation temperature at 471.04 °C, indicating improved thermal resistance. These enhancements are due to the effective dispersion and interaction of graphene-based nanofillers within the PVDF matrix. This study demonstrates that incorporating nanofillers into polymer composites significantly advances materials science by enhancing the dielectric properties for various industrial applications.

Background: Growth differentiation factor-15 (GDF-15), a member of the TGF-β superfamily, is overexpressed in various cancers and facilitates immune evasion by inhibiting T-cell activation. GDFATHER-TRIAL's phase 2a results demonstrated promising outcomes when combining the GDF-15 neutralizing antibody visugromab (CTL002) with nivolumab, enhancing the response to immunotherapy. This study evaluated the prognostic significance of GDF-15 expression in non-small cell lung cancer (NSCLC) tumor tissues in terms of immunotherapy response., Methods: This retrospective study included 50 patients with metastatic NSCLC treated with nivolumab at Gazi University Hospital between January 2021 and July 2023. GDF-15 expression was evaluated using immunochemistry staining and categorized based on the intensity of cytoplasmic or membranous staining. Samples were divided into a low expression group (scores 0 and 1) and a high expression group (scores 2 and 3). The primary outcomes were progression-free survival (PFS) and overall survival (OS), which were analyzed using Kaplan‒Meier and Cox proportional hazards models. Objective response rates were assessed in secondary outcomes., Results: Of the 50 patients, 43 were men (86%), with a median age of 63.9 years. Half of the patients exhibited low GDF-15 expression. High GDF-15 expression correlated with shorter PFS and OS. The median PFS was 7.8 months for the low-expression group versus 4.4 months for the high-expression group (HR, 0.41; 95% CI, 0.20-0.83; p = 0.013). The median OS was 18.1 months for the low-expression group compared to 11.8 months for the high-expression group (HR, 0.36; 95% CI, 0.16-0.78; p = 0.007). The objective response rate was significantly greater in the low GDF-15 group (52%) than in the high GDF-15 group (24%) (p = 0.040)., Conclusion: Elevated GDF-15 expression in NSCLC tumor tissues is associated with poorer response to nivolumab, suggesting that GDF-15 is a potential prognostic biomarker for immunotherapy efficacy. These findings warrant further validation through prospective studies to optimize treatment strategies for NSCLC patients., (© 2024. The Author(s).)

Early determination of changes in myocardial functions is essential for the protection of cardiovascular diseases. This study aimed to evaluate myocardial work parameters in healthy individuals who developed an exaggerated hypertensive response during the treadmill exercise test procedure. The study included a total of 64 patients for whom an exercise electrocardiography test was planned for functional capacity evaluation. The study population was divided according to the presence of exaggerated hypertensive response to exercise (EBPRE) (SBP/DBP ≥210/105 mmHg in males ≥190/105 mmHg in females) and normal blood pressure response to exercise (NBPRE). Patients' echocardiographic evaluations were made at rest, and myocardial work parameters were calculated. There was no statistical difference between the groups (NBPRE vs. EBPRE, respectively) in terms of left ventricular 2,3 and 4 chamber strains and global longitudinal strain (GLS) values (-20.6 ± -2.3, -19.7 ± -1.9, p:.13; -21.3 ± -2.7, -21 ± -2.4, p:.68; -21.2 ± -2.2, -21.2 ± -2.3, p:.93; and -20.8 ± -1.5, -20.4 ± -1.5, p:.23, respectively). Global constrictive work (GCW), global waste work (GWW), and global work efficiency (GWE) were not statistically different between the two groups (2374 ± 210, 2465 ± 204, p:.10; 142 ± 64, 127 ± 42, p:.31; 94.3 ± 2.5, 95.1 ± 1.5, p:.18, respectively). In contrast, global work index (GWI) parameters were different between the two groups (2036 ± 149, 2147 ± 150, p < .001). The GWI was independently associated with EBPRE (odds ratio with 95% 3.32 (1.02-11.24), p = .03). The partial effect plots were used for GWI to predict EBPRE, according to the results, an increase in GWI predicts probability of exaggerated hypertensive response. In conclusion, Myocardial work analyses might be used to identify early signs of myocardial involvement in normotensive patients with EBPRE., (© 2024 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC.)

Due to their antibacterial activity, chitosan‑carbon dot composites possess great potential for pharmaceuticals, medicine, and food preservation. Conducting a comprehensive study of the interactions between chitosan, carbon dots, and bacteria is crucial to understanding the processes behind applying these composites. This study aimed to immobilize carbon dots (C-dots) synthesized from Elaeagnus angustifolia fruits on chitosan and glass microbeads' surfaces, to characterize the test materials obtained after synthesis and immobilization, and to investigate their antibacterial potentials. C-dot synthesis was carried out from water extract in an acidic medium with the help of microwave irradiation, and their structural and optical properties were characterized by TEM, XRD, FT-IR, UV-vis, Zeta potential, and fluorescence methods. The surface of the glass microbeads was first activated and functionalized with surface amine groups with a silaning agent. C-dots were immobilized on both glass and chitosan microbeads using a crosslinking agent. Antibacterial potentials of nine different test materials, obtained before or after immobilization, were evaluated both qualitatively (MIC and MBC) and quantitatively (GI 50 ) on E. coli, S. typhimurium, B. subtilis, and S. aureus, with the standard broth microdilution method. FT-IR and SEM-EDX analyses showed that C-dots were immobilized on chitosan (˂1 mm) and glass (˂100 μm) microbead surfaces. C-dots reduced the cell viability by ~25 % on S. typhimurium and B. subtilis (MIC = 25 mg/mL). It was also found that the highest antibacterial effect was recorded for C-dots-glass microbeads, which had a toxic effect of 43 % on S. aureus. In addition, binding C-dots to glass microbeads increased the antibacterial effect selectively in Gram-positive bacteria, while binding to chitosan microbeads was effective in all bacteria. The study showed that the antibacterial potential of C-dots-chitosan microbeads is more effective than C-dots-glass microbeads. C-dots could be used as carbon-based nanomaterials in antibacterial surface preparation once immobilized., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Respiratory infections caused by coronaviruses (CoVs) have become a major public health concern in the past two decades as revealed by the emergence of SARS-CoV in 2002, MERS-CoV in 2012, and SARS-CoV-2 in 2019. The most severe clinical phenotypes commonly arise from exacerbation of immune response following the infection of alveolar epithelial cells localized at the pulmonary blood-air barrier. Preclinical rodent models do not adequately represent the essential genetic properties of the barrier, thus necessitating the use of humanized transgenic models. However, existing monolayer cell culture models have so far been unable to mimic the complex lung microenvironment. In this respect, air-liquid interface models, tissue engineered models, and organ-on-a-chip systems, which aim to better imitate the infection site microenvironment and microphysiology, are being developed to replace the commonly used monolayer cell culture models, and their use is becoming more widespread every day. On the contrary, studies on the development of nanoparticles (NPs) that mimic respiratory viruses, and those NPs used in therapy are progressing rapidly. The first part of this review describes in vitro models that mimic the blood-air barrier, the tissue interface that plays a central role in COVID-19 progression. In the second part of the review, NPs mimicking the virus and/or designed to carry therapeutic agents are explained and exemplified.

The rapid spread of COVID-19 infection and its negative effects on human health caused a great change in oncology practice. Although oncologists respond quickly to this change, anxiety caused by pandemics in some patients prevented cancer treatment. Although patients know that delaying cancer treatment can be life-threatening, they are concerned about contacting the hospital because they are afraid of becoming infected with COVID-19. Here, we would like to present three patients with delayed admission to the hospital to draw attention to the harmful consequences of COVID-19 fear in the community. These patients with cancer-related anxiety may exaggerate protective attitudes during the pandemic process, leading to delayed oncological treatment and poor prognosis of the patient., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Postgraduate education programs in clinical pharmacy have become widespread in Türkiye. This study aimed to identify factors associated with the intention of Turkish clinical pharmacists and candidates (who were graduates and students of postgraduate clinical pharmacy programs) to provide pharmaceutical care., Methods: This prospective observational study was conducted between June 2021 and May 2022. After searching relevant studies, an expert panel discussion, translation, cultural adaptation, and a pilot study developed a 52-item Turkish scale based on the Theory of Planned Behavior (TBP). Cronbach alpha for each construct was calculated after an explanatory factor and test-retest reliability analysis. An online survey link was sent to all graduates or candidates of postgraduate clinical pharmacy programs in Türkiye. After univariate regression analysis, the multiple linear regression model was performed., Results: One hundred fifty-six participants completed the survey (response rate: 59.1%). The Cronbach's alpha for attitude (9 items), subjective norm (6 items), perceived behavioural control (5 items), self-efficacy (6 items), intention (11 items) and past behaviour (15 items) were 0.945, 0.720, 0.751, 0.864, 0.934 and 0.955 respectively. The multiple linear regression analysis found a higher score of the subjective norm (p = 0.016), a higher score of self-efficacy (p < 0.001), younger age (p < 0.001) and having PhD (p = 0.038) were associated with increased intention score., Conclusions: It was shown that higher self efficacy and positive beliefs of their peers and other healthcare professionals were associated with their higher intention score for providing pharmaceutical care. Younger age and having a PhD were other factors associated with their intention to provide pharmaceutical care., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Purpose: The aim of our study is to evaluate whether serum Klotho/FGF-23 and apelin-13 can be used as new biomarkers for detection of development of nephropathy., Methods: In this cross-sectional study, 88 type 2 diabetes mellitus (T2DM) patients and 38 healthy controls were included. The mean duration of T2DM was 11.4 ± 9.7 years. T2DM individuals were categorized into two groups as group 1 with e-GFR < 60 mL/min/1.73 m 2 and group 2 with e-GFR > 60 mL/min/1.73 m 2 . They were also divided into two groups according to their 24 h urine albumin levels, classifying them as follows: normoalbuminuria if less than 30 mg/day and albuminuria if more than 30 mg/day., Results: Mean serum Klotho levels in the T2DM group were observed to be significantly higher than in the control group. Serum apelin-13 levels were observed to be significantly lower in the T2DM group compared to the control group (p < 0.001). In the diabetic group, apelin-13 levels were positively correlated with age, waist circumference, and albuminuria while they were negatively correlated with e-GFR. Apelin-13 levels were seen to be significantly higher in group 1 (p < 0.001)., Conclusion: Apelin-13 levels were found to be significantly higher in individuals with diabetic nephropathy than in those without diabetic nephropathy. In the diabetic group, a significant relationship was detected between apelin-13 levels and albumin excretion. Based on these findings, we consider that serum Klotho and apelin-13 levels may have a protective effect on diabetic nephropathy and can additionally be used as a biomarker to predict diabetic nephropathy., (© 2023. The Author(s), under exclusive licence to Hellenic Endocrine Society.)

In recent years, the widespread use of neonicotinoids in agricultural areas has caused environmental pollution due to its lower toxicity to mammals. Honey bees, which are considered as biological indicators of environmental pollution, can carry these pollutants to the hives. Forager bees returning from sunflower crops that have been treated with neonicotinoids treated sunflower fields cause residue accumulation in the hives, which reason colony-level adverse effects. This study analyses neonicotinoid residues in sunflower ( Helianthus annuus ) honey sampled by beekeepers from Tekirdag province. Honey samples have been subjected to liquid-liquid extraction methods before liquid chromatography-mass spectrometry (LC-MS/MS). The method validation was carried out to fulfill all the necessary requirements of procedures SANCO/12571/2013. Accuracy was in the range of 93.63-108.56%, for recovery in the range of 63.04-103.19%, and for precision in the range 6.03-12.77%. Detection and quantification limits were determined according to the maximum residue limits of each analyte. No neonicotinoid residues were found above the maximum residue limit in the sunflower honey samples analysed., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Nurullah Ozdemir and Mustafa Necati Muz.)

Purpose: This study aimed to evaluate clinical pharmacist's contribution to the pneumococcal vaccination rate by providing education to cancer patients in hospital settings., Methods: This study was conducted in 2 tertiary-care hospitals' medical oncology outpatient clinics. Patients over 18 years of age and diagnosed with cancer for less than 2 years, in remission stage, and have not previously received the pneumococcal vaccine were included. Patients were randomized to intervention and control groups. The intervention group was provided vaccination education and recommended to receive the PCV13 vaccine. The control group received routine care. Patients' knowledge about pneumonia/pneumococcal vaccine, Vaccine Attitude Examination Scale (VAX) score, and vaccination rates were evaluated at baseline and 3 months after the education., Results: A total of 235 patients (intervention: 117, control: 118) were included. The mean age ± SD was 57.86 ± 11.88 years in the control and 60.68 ± 11.18 years in the intervention groups. The numbers of correct answers about pneumonia/pneumococcal vaccine (p = 0.482) and VAX scores (p = 0.244) of the groups were similar at baseline. After the intervention, the median (IQR) number of correct answers in intervention group [10(3)] was higher than control group [8(4)] (p < 0.001). After the education, the total VAX score (mean ± SD) was less in intervention group (33.09 ± 7.018) than the control group (36.07 ± 6.548) (p = 0.007). Three months after the education, 20.2% of the patients in the intervention and 6.1% in the control groups were vaccinated with pneumococcal vaccine (p = 0.003)., Conclusions: The pneumococcal vaccination rate in cancer patients has increased significantly by the education provided by a clinical pharmacist in hospital settings., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

In this research paper, the generalized projective Riccati equations method (GPREM) is applied successfully to procure the soliton solutions of the local M-fractional longitudinal wave equation (LWE) arising in mathematical physics with dispersion caused by the transverse Poisson's effect in a magneto-electro-elastic circular rod (MEECR). Applying a wave transformation to the local M-fractional LWE, the equation can be turned into a set of algebraic equations. Solving the algebraic equation system, we procure the soliton solutions of the local M-fractional LWE. Both the obtained solution functions in the study and the graphical simulations depicted for these functions. It will assist researchers working in this field in the physical interpretation of this equation. Moreover, the reported solutions propose a rich platform to examine the local M-fractional LWE., Competing Interests: The authors declare no conflict of interest., (© 2023 The Author(s).)

Background: Aimed to investigate in an animal model the efficacy of humic acid by showing its antioxidant and anti-apoptotic effect comparing with the histopathological and neurological outcomes for the hypoxic-ischemic brain injury., Methods: 28 Wistar-Albino rats who were on the 7th postnatal day and weighting between 9 and 19 g randomly divided into four groups with developed HIE model under the gas anesthesia. 20 mg/kg and 10 mg/kg intraperitoneal HA were given to Group I and II respectively. Saline was given to Group III and the sham group was Group IV. The brain tissues were stained with cresyl-violet histochemistry for grading neuronal cell injury and caspase immunohistochemistry., Results: The neuronal cell injury was statistically lower in all neuroanatomical lands in HA treatment groups. The degree of ischemia was significantly smaller in HA groups. Caspase-3 immunoreactivity was decreased in the HA groups compared with the saline group. When the groups were compared, there were no serious neuronal injury in Group I., Conclusions: This is the first study which investigates the role of HA in HIE model. HA reduces apoptosis and neuronal injury in cerebral tissue of the rats. This findings suggest that HA may be viable protective agent against HIE.

Alpha-terpineol, popular monoterpenoid alcohol, is known to cause cytotoxicity in a few cancer cells or to have antioxidant activity, but underlying mechanisms or apoptotic processes in yeast cell death should be understood. We used the fission yeast (Schizosaccharomyces pombe) as a unicellular model to monitor cellular toxicology and physiological mechanisms for the involvement of alpha-terpineol in cell death. Alpha-terpineol caused Reactive oxygen species (ROS) overproduction and following cytotoxicity and apoptosis in a dose-dependent manner. The effect of oxidative stress was proved using sod1 and sod2 mutants (antioxidant-limited cells), and the results showed that apoptosis was caused by alpha-terpineol-driven oxidation. In addition, resorcinol, a herbal extract from medicinal plants, showed protective activity against alpha-terpineol cytotoxicity. Survival rates, apoptotic cell death ratios, oxidation levels, and antioxidant gene expressions were completely altered; surprisingly sod1 and sod2 levels dramatically increased. However, sod2 was highly upregulated in response to resorcinol treatment with alpha-terpineol. The potential role of the Sod2 enzyme was proved using sod2 mutant cells that do not have a mitochondrial radical-clearing activity. Consequently, the dose-dependent and ROS-mediated cytotoxic/apoptotic effects of alpha-terpineol and the Sod2-dependent protective and antioxidant effects of resorcinol were demonstrated in unicellular model organism S. pombe by this study., (© The Author(s) 2022. Published by Oxford University Press on behalf of FEMS.)

In this study, organic-inorganic hybrid nanoflowers were synthesized using methanolic extracts of the medicinal plants Ajuga chamaepitys subsp. chia var. chia, Achillea wilhelmsii, Bongardia chrysogonum, Malva sylvestris, Phlomis grandiflora var. grandiflora, Verbascum sp. together with copper ions (Cu 2+ ). The synthesized plant extract based-inorganic hybrid nanoflowers (PE-ihNFs) of A. chamaepitys subsp. chia var. chia (Ac-ihNFs), A. wilhelmsii (Aw-ihNfs), B. chrysogonum (Bc-ihNFs), M. sylvestris (Ms-ihNFs) P. grandiflora var. grandiflora (Pg-ihNFs), and Verbascum sp. (Vs-ihNFs) were characterized by Scanning Electron Microscopy (SEM), Energy-Dispersive X-ray (EDX), Fourier transform infrared spectrometry (FTIR), and X-Ray Diffraction (XRD). Also, several enzymes were selected to evaluate the enzyme inhibition activities of the synthesized PE-ihNFs. For the first-time, enzymes, tyrosinase, α-amylase and α-glucosidase, acetyl and butyryl cholinesterase inhibition activities of the PE-ihNFs with comparison to their plain plant extracts were evaluated in vitro. Results show that the among all the analyzed PE-ihNFs, demonstrated better α-glucosidase & α-amylase enzyme inhibition activity compared to the plain extracts. These initial studies are promising for the synthesis of these hybrid nanoflowers containing medicinal plant extracts, which might have commercial applications in the pharmaceutical and dermo-cosmetics industries., (© 2022 Wiley-VHCA AG, Zurich, Switzerland.)

Background: Healthcare professionals' vaccine recommendation is the most effective method to increase vaccination rates of the community. The vaccine counseling and recommendation behavior of pharmacists, who are among the easily accessible healthcare professionals, are influenced by their knowledge and attitudes about vaccines., Aim: It was aimed to investigate community pharmacists' knowledge, attitudes, and practices regarding commonly used vaccines., Methods: A cross-sectional study was conducted as an online survey with a sample of 1100 community pharmacists in Turkey. Pharmacists were invited to participate in the study by phone calls. A structured survey, which consists of 40 questions to assess the knowledge, attitudes, and practices regarding vaccines, was sent to the e-mail addresses of pharmacists who volunteered to participate in the study., Findings: A total of 430 pharmacists completed the survey. Thirty percent of pharmacists had lack of knowledge about vaccination during pregnancy, whereas 52.2% and 31.4% of pharmacists believed that tetanus and influenza vaccines should be provided during pregnancy, respectively. Nearly 89% of pharmacists recommended vaccines to patients, mainly for influenza vaccine (83.9%). Only 31.5% of pharmacists had been vaccinated against influenza in the last season, whereas 50.5% had never been vaccinated. Pharmacists who had been vaccinated with influenza vaccine had a high rate of recommending influenza vaccines to the patients., Conclusion: The present study found that vaccination among pharmacists in Turkey and their knowledge on vaccination during pregnancy were low. Further education of pharmacists to improve their knowledge and attitudes toward vaccines is needed.

Undernutrition is a growing public health challenge affecting growth and development during adolescence in many low- and middle-income countries. This scoping review maps the evidence on adolescent undernutrition (stunting, thinness and micronutrient deficiencies) in South Asia and highlights gaps in knowledge. Using Arksey and O'Malley's framework and the Joanna Briggs Institute Reviewers' Manual, the search included electronic bibliographic databases (Medline (OVID), Embase, Cochrane Library, Web of Science, CINAHL, PsycInfo, and Scopus) as well as various grey literature sources published up to March 2019. In total, 131 publications met the inclusion criteria of this review. All the included evidence used quantitative data and 115 publications used a cross-sectional design. Nearly 70% ( n = 86) of the included publications were conducted in India. Prevalence of undernutrition was reported based on different growth references and cut-offs. Evidence is divided into publications that included an intervention component ( n = 12) and publications that did not include an intervention component ( n = 116), and presented in a narrative synthesis. This scoping review provides a wide range of publications on adolescent undernutrition in South Asia and identifies future research priorities in the field.

Background: The aetiology of heart failure may have different effects on right ventricular (RV) function, pulmonary pressures and RV afterload. Pulmonary arterial capacitance (PAC) and pulmonary artery pulsatility index (PAPi) are novel haemodynamic indices used in determining RV afterload and RV function, respectively. We aimed to investigate whether there was a difference in PAC and PAPi between ischaemic cardiomyopathy (ICMP) and non-ischaemic cardiomyopathy (NICMP) in patients with end-stage heart failure., Methods and Results: A total of 215 subjects undergoing evaluation for heart transplantation or left ventricular (LV) assist device were classified into two groups: ICMP ( n  = 101) and NICMP ( n  = 114). The patients with LV ejection fraction ≤ 25% were included in the study. ICMP group had lower PAC and higher PAPi values compared to NICMP group [1.25 (0.82-1.86) vs. 1.58 (1.02-2.21), p  = 0.002 and 3.4 (2.2-5.0) vs. 2.5 (1.7-4.0); p  = 0.007]. Pulmonary vascular resistance, pulmonary artery systolic and mean pressure were higher in ICMP group compared to NICMP group [3.5 ± 1.8 vs. 2.9 ± 2.3, p  = 0.004; 59.0 (42.0-73.0) vs. 46.0 (37.0-59.0), p  < 0.001, 35.0 (27.0-46.0) vs. 31.0 (23.0-39.0), p  = 0.002]. The patients with ICMP had higher tricuspid annular plane systolic excursion and less RV dilatation. ICMP was an independent risk factor for pulmonary hypertension (OR: 4.02, 95% CI: 1.13-14.24, p  = 0.031)., Conclusion: ICMP was associated with lower PAC and higher PAPi. These results indicated that an ischaemic aetiology is associated with higher RV afterload and better RV function in the end-stage heart failure.

Purpose: To investigate retrobulbar blood flow changes in the short posterior ciliary arteries (SPCAs) in patients with pseudoexfoliation glaucoma (PEG) and primary open-angle glaucoma (POAG)., Methods: In this prospective study, there were 22 eyes in the PEG group, 28 eyes in the POAG group, and 28 eyes with senile cataract in the control group. Peak systolic velocity (PSV), end-diastolic velocity (EDV), mean velocity (Vm), and resistivity index (RI) parameters of the temporal and nasal SPCAs were compared between the study groups., Results: Mean temporal PSV, EDV, and Vm value were significantly lower in both the POAG group and the PEG group ( P = 0.049, P = 0.004, P = 0.020), respectively. Temporal SPCA RI values were not significantly different between the groups ( P = 0.115)., Conclusion: There are retrobulbar blood flow changes in glaucomatous compared to nonglaucomatous eyes. However, SPCAs blood flow characteristics are similar between PEG and POAG subtypes., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Current Ophthalmology.)