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Abstract Background The original version of the Childhood Health Assessment Questionnaire (CHAQ30orig) suffers from a ceiling effect and hence has reduced clinical validity. The purpose of this study was to evaluate the effect of adding eight more demanding items (CHAQ38) and a new categorical response option (CATII) on discriminant validity and score distribution in a European patient sample. Methods Eighty-nine children with Juvenile Idiopathic arthritis (JIA) and 22 healthy controls, aged 7-16 years, were recruited from eight centres across Europe. Eight new CHAQ items and scoring option were translated back and forth for the countries in which they were not already present. Demographic, clinical, and CHAQ data were collected on-site. Subsequently, five different scoring methods were applied, i.e. the original method (CHAQ30orig) and four alternatives. These alternatives consisted of the mean item scores for the 30 and 38-question versions with either the original (CATI), or the new categorical response option (CATII). The five versions were tested for their ability to distinguish between patients and controls. Furthermore score distributions were evaluated and visualized by box and whisker plots. Results Two CHAQ revisions with the new response option showed poor discriminative ability, whereas one revised version (CHAQ38CATI) had comparable discriminative ability comparable to the original CHAQ. A profound ceiling effect was observed in the original scoring method of the CHAQ (27%). The addition of eight more demanding items and application of a plain mean item score reduced this significantly to 14% (χ2 = 4.21; p < 0.05). Conclusions Revising the CHAQ by adding eight more demanding items and applying a plain mean item scoring (CHAQ38CATI) maintained discriminant ability and reduced the ceiling effect in a European patient sample. The new categorical response option (CATII) seemed promising, but was less able to distinguish children with JIA from healthy controls and had less favourable distribution characteristics. The CHAQ38CATI is advocated for future use in mildly affected JIA patients.

Purpose The present study was to investigate if five values that are part of the hemogram analysis routinely checked before heart surgeries can be used as a high-quality, quick, low-cost, and easy-to-use outcome predictor. Methods This investigation was a retrospective, observational, cross-sectional study. Univariate and multivariate logistic regression was used to identify independent predictors for combined adverse events. We enrolled 1500 consecutive patients who underwent elective, on-pump, open-heart surgery from 2011 to 2014. Preoperative hemogram evaluation, red cell distribution width (RDW), mean platelet volume (MPV), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR) were recorded. We classified combined adverse events (CAE) as (1) myocardial infarction, (2) cardiac reoperation, (3) prolonged mechanical ventilation, (4) prolonged hospital stay, (5) rehospitalization, or (6) mortality. Results It was found that several parameters obtained as part of the hemogram, namely RDW, MPV, PLR, and NLR, can predict, individually or in combinations, the outcomes in open-heart surgery patients. It was found that the prediction success of NLR (4.8 fold) was higher compared to RDW (1.8 fold) and MPV (1.5 fold). When the prediction success of the combined parameters was investigated, the NLR-RDW (4.7 fold) pair was found higher in the prediction of CAE occurrence. The predictive success of the triple combination of NLR-MPV-RDW (5.5 fold) was higher than other combinations. Conclusions The triple combination of parameters obtained as part of the hemogram, NLR-RDW-MPV, indicated a much more predictive power than two parameters coupled. This combination of three parameters, NLR-RDW-MPV, is to be considered as a sensitive, high-quality, low-cost outcome prediction marker for cardiac surgery patients that is less time consuming and easy to use., Author(s): Bahar Aydinli[sup.1] , Asli Demir[sup.2] , Çigdem Yildirim Güçlü[sup.3] , Demet Bolükbasi[sup.2] , E. Utku Ünal[sup.4] , Rabia Koçulu[sup.2] , Gokçe Selçuk[sup.2] Author Affiliations: (1) Department of Anesthesia, Mersin [...]

ABSTRACTRedox adaptation causes poor prognosis by adapting cancer cells to excessive oxidative stress. Previously, we introduced an oxidative stress-resistant metastatic prostate cancer (mPC) model (LNCaP-HPR) that redox adaptation reduced the effect of Cabazitaxel (Cab), the last taxane-derivative for metastatic castration-resistant PC (mCRPC). Whereas, we investigated for the first time whether there is an association between the altered apoptotic effect and pro-oxidant efficacy of Cab on the redox adaptation in PC cells with different phenotypes, including LNCaP mPC, LNCaP-HPR, C4–2 mCRPC, and RWPE-1 cells. Cab was shown pro-oxidant efficacy proportionally with the apoptotic effect, more prominent in the less aggressive LNCaP cells, by increasing the endogenous ROS, mitochondrial damage, and inhibiting nuclear ROS scavengers, p-Nrf2 and HIF-1α. However, the pro-oxidant and apoptotic effect was lower in the LNCaP-HPR and C4–2 cells, indicating that the drug sensitivity of the cells adapted to survive with more ROS was reduced via altered regulation of redox adaptation. Additionally, unlike LNCaP, Cab caused an increase in the p-NF-κB activation, suggesting that the p-NF-κB might accompany maintaining survival with the increased ROS in the aggressive PC cells. Moreover, the cytotoxic and apoptotic effects of Cab were less on RWPE-1 cells compared to LNCaP but were closer to those on the more aggressive LNCaP-HPR and C4–2 cells, except for the changing pro-oxidant effect of Cab. Consequently, this study indicates the variable pro-oxidant effects of Cab on redox-sensitive proteins, which could be a target for improving Cab’s apoptotic effect more in aggressive PC cells.

Introduction Axial spondyloarthritis has characteristic clinical features such as enthesitis, sacroiliitis and spondylitis, and extra-articular manifestations. Sacroiliitis (SI) occurs as a result of inflammation of the sacroiliac joint. Magnetic resonance imaging (MRI) of sacroiliac (SI) joints is used to detect early sacroiliitis. Sometimes, there can be variations in the interpretation of MRI findings of the SI joint among observers. Our aim was to investigate the inter-observer agreement among the observers. Materials and methods The study included the MRI results of 1150 patients who were diagnosed with active or chronic sacroiliitis based on the findings from sacroiliac MRIs, or whose MRI was deemed indicative of sacroiliitis by the rheumatologist. 1150 MRIs were re-evaluated by a different and expert radiologist. Results Out of the total 1150 patients investigated within the scope of this study. A statistically significant disparity emerged between the assessments provided by the expert radiologists and those obtained from outsourced radiologist evaluations. Conclusion The diagnosis of spondyloarthropathy may be delayed for some reasons. If the patient's clinic and MRI report are not consistent, the patient should not be removed from follow-up.

Purpose: This study was conducted to determine the effect of obesity awareness on gynecological cancer and reproductive health awareness in women. Materials and Methods: This study is a cross-sectıonal study. The sample of the study consisted of overweight and obese women. Data were collected using the introductory information form, obesity awareness scale, and gynecological cancers awareness scale via a Google form. Results: Obesity was found to have a statistically significant association with reproductive health, including the risk for pregnancy and baby, uterus, ovary and breast cancer, menstrual irregularity, age of first menstruation, polycystic ovary syndrome, cesarean section risk, preeclampsia, gestational diabetes, stillbirth risk, birth defects, the chance of conception, the success of fertility treatment, early menopause, osteoporosis, baby weight, and iron deficiency anemia. The total mean score Obesity Awareness Scale and Gynecologic Cancer Awareness Scale was significantly higher among those who believed in this association. A highly significant positive correlation was observed between total and sub-dimension mean scores of women's Obesity Awareness Scale and Gynecologic Awareness Scale. Conclusion: It has been determined that obesity awareness in women is related to reproductive health and gynecological cancer awareness.

This study was carried out to determine the variation of bark thickness in a single tree in Natural Crimean Pine (Pinus nigra Arnold. subsp. pallasiana (Lamb.) Holmboe). Anatolian Black Pine is a thick-barked species. For this reason, it is important to reveal the values given for the volume, volume increase, and allowable cut of the species in a more reliable way. On the other hand, when it comes to technological developments to benefit from the bark in different ways in the future, determining the inventory values is another feature that makes the aforementioned species important. All these reasons bring Anatolian Black Pine to the forefront in terms of crustal thickness studies. In this direction, within the scope of the study, the relationships between breast height diameter and bark allowance, section height, and bark thickness parameters in different height groups for young and old trees were evaluated by the regression analysis method. The results obtained revealed that there were statistical differences between the diameter of the breast height diameter and the bark allowance, and between the section height and the bark thickness in terms of tree age and height groups.

Introduction: Recent research into multiple sclerosis (MS) has focused on the role of microRNAs (miRNAs) in the development of the disease. This study was designed to analyze miR-146a expression in whole blood and fecal samples of patients with MS. The study aimed to analyze clinical data using the miR-146a expression values obtained. Subjects and Methods: This study included patients with relapsing–remitting MS (RRMS) (n = 53), clinically isolated syndrome (CIS) (n = 15), and healthy controls (n = 26). Total RNA was isolated from the participants' whole blood and fecal samples. RNA extraction was performed using QIAamp RNA Blood Mini Kits for blood samples and RNeasy PowerMicrobiome Kits for feces. miR-146a expressions were studied using real-time polymerase chain reaction. Finally, relative expression was correlated with clinicopathologic factors. Results: MiR-146a expression was significantly decreased in the whole blood (P < 0.001) and fecal samples (P = 0.036) of patients with RRMS. There was no significant difference in the miR-146a expression rate between patients with CIS and controls. Moreover, the miR-146a expression level in patients with RRMS was decreased compared with those with CIS (P < 0.001). A significant association was determined between miR-146a expression and sex in blood samples. When sex stratification was applied to expression values obtained from fecal samples, miR-146a expression was downregulated only in females (P = 0.008). Discussion: miRNAs play an essential role in maintaining the stable course of MS, and this process has some sex-specific differences. Expression of fecal miR-146a may be used as a biomarker to diagnose and predict prognosis in patients with RRMS.

We show that the typical X-ray outburst light curve of Aql X-1 can be reproduced by accretion onto a neutron star in the frame of the disk instability model without invoking partial accretion or the propeller effect. The knee and the subsequent sharp decay in the X-ray light curve can be generated naturally by taking into account the weak dependence of the disk aspect ratio, h / r , on the disk mass-flow rate, ${\dot{M}}_{\mathrm{in}}$ , in the X-ray irradiation flux calculation. This ${\dot{M}}_{\mathrm{in}}$ dependence of h / r only slightly modifies the irradiation temperature profile along the hot disk in comparison to that obtained with a constant h / r . Nevertheless, this small difference has a significant cumulative effect on the hot disk radius, leading to a much faster decrease in the size of the hot disk and thereby to a sharper decay in the X-ray outburst light curve. The same model also produces the long-term evolution of Aql X-1, consistent with its observed outburst recurrence time and typical light curve. Our results imply that the source accretes matter from the disk in the quiescent state as well. We also estimate that the dipole moment of the source μ ≲ 4 × 10 ^26 G cm ^3 ( B ≲ 4 × 10 ^8 G at the surface).