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It is important to protect the soil and groundwater from the pollution originating from leachate. Compacted clay soils is a favorable and economic method to protect groundwater and soil against contamination. In this study, compaction tests of leachate was done by using Modified Proctor method. The effects of microbial activity on the permeability of compacted clay soils were analyzed and the obtained data were applied to k-Nearest Neighbors (k-NN) method to predict the permeability of soils in landfill sites. k-NN method, which is a non-parametric distance-based machine learning method and widely used in classification and regression problems was applied to model the relationship between the microorganisms and the permeability. By using k-NN classification method, total heterotrophic bacteria and fungi microorganisms correctly classified the permeability variance as 78.59% and 77.31% success rate, respectively. Also, k-NN modelling was set on regression mode to predict permeability value and produced similar success rates in regression similarity with the actual value. Although, fecal coliforms and fecal streptococci microorganisms had neutral or negative contribution on analyses. For prediction accuracy and regression analysis, the k-NN method was considered for modeling the data. The results of the k-Nearest Neighbors method proved that it is a promising tool for predicting permeability of compacted clay by using microbial activity. [ABSTRACT FROM AUTHOR]

Abstract Background The DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, 4th edition Textrevision) highlights the especially poor outcomes of early-onset conduct disorder (CD). The strong link between the patient's age at treatment and its efficacy points the importance of early intervention. Risperidone is one of the most commonly studied medications used to treat CD in children and adolescents. The aim of this study is to obtain preliminary data about the efficacy and tolerability of risperidone treatment in otherwise typically developing preschool children with conduct disorder and severe behavioral problems. Method We recruited 12 otherwise normally developing preschoolers (ten boys and two girls) with CD for this study. We could not follow up with 4 children at control visits properly; thus, 8 children (six girls, two boys; mean age: 42.4 months) completed the study. We treated the patients with risperidone in an open-label fashion for 8 weeks, starting with a daily dosage of 0.125 mg/day or 0.25 mg/day depending on the patient's weight (20 kg children: 0.25 mg/day). Dosage titration and increments were performed at 2-week interval clinical assessments. The Turgay DSM-IV Based Disruptive Behavior Disorders Child and Adolescent Rating & Screening Scale (T-DSM-IV-S) as well as the Clinical Global Impression Scale (CGI) assessed treatment efficacy; the Extrapyramidal Symptom Rating Scale (ESRS) and laboratory evaluations assessed treatment safety. Results The mean daily dosage of risperidone at the end of 8 weeks was 0.78 mg/day (SD: 0.39) with a maximum dosage of 1.50 mg/day. Based on the CGI global improvement item, we classified all patients as "responders" (very much or much improved). Risperidone was associated with a 78% reduction in the CGI Severity score. We also detected significant improvements on all of the subscales of the T-DSM-IV-S. Tolerability was good, and serious adverse effects were not observed. We detected statistically significant prolactin level increments (p < 0.05), but no clinical symptoms associated with prolactinemia. Conclusion The results of this study suggest that risperidone may be an effective and well-tolerated atypical antipsychotic for the treatment of CD in otherwise normally developing preschool children. The findings of the study should be interpreted as preliminary data considering its small sample size and open-label methodology.

In this research, cellulose acetate (CA) and CA nanocomposite membranes, reinforced with mass fractions of cellulose nanofibrils (CNF), are prepared using the phase separation technique. The membranes are extensively characterized using several techniques: Fourier Transform Infrared (FTIR) spectroscopy confirms the chemical structures, while Scanning Electron Microscopy (SEM) reveals their surface morphology. Mechanical characterization is conducted to explore the mechanical behavior of the membranes under wet and dry conditions through tensile testing. The mechanical properties of CA and CA-CNF membranes are also estimated using the Mori-Tanaka mean-field homogenization method and compared to experimental findings. The flux performance for pure and dam water, assessed at 3 bar, demonstrates that CNF reinforcement notably enhances the CA membrane's performance, particularly in flux rate and fouling resistance. The CA membrane shows high efficiency in removing Fe 2+ , Ba 2+ , and Al 3+ from dam water, while CA-CNF membranes exhibit a varied range of removal efficiencies for the same ions, with the 0.5 wt % CNF variant showing superior resistance to surface fouling. Additionally, while CNF increases tensile strength and stiffness, it leads to earlier failure under smaller deformations, especially at higher concentrations. This research provides a detailed assessment of CA and CA-CNF membranes, examining their chemical, structural, and mechanical properties alongside their effectiveness in water treatment applications., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Obesity is an important healthcare issue caused by abnormally increased adipose tissue because of energy-intake overcoming energy expenditure. Disturbances in the physiological function of adipose tissue mediate the development of diabetes. It is a metabolic disease that results from decreased insulin-levels and/or changes in the insulin action mechanism. Tumor Necrosis Factor-Associated Apoptosis-Inducing Ligand(TRAIL), which is a member of the Tumor Necrosis Factor(TNF)-family with an important role in adipose tissue biology, is included in many studies with its ability to induce apoptosis in cancer cells, but the number of human-studies conducted on the gene related to its protective-role against diabetes and obesity at this level is insufficient. Our study was carried out as a case and control and included three groups (80 diabetic obese, 80 non-diabetic obese, and 80 healthy individuals as the control group). The Real-Time-PZR(RT-qPZR), and DNA Sanger-Sequencing Methods were used for gene expression and gene squences. As a result of the analyses, TRAIL gene expression level was found to be higher in the controls than in the diabetic-obese and non-diabetic-obese group. This change in TRAIL gene expression suggests that TRAIL maybe a protective factor against diabetes. The presence of rs781673405, rs143353036, rs1244378045, rs767450259, rs759369504, rs750556128, and rs369143448 mutations, which was determined with the Sequencing-Method, was shown for the first time in the present study. In addition, it is the first study in which human TRAIL gene-expression and sequencing were performed together. We believe that these data will make an important contribution to the literature., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Age-related macular degeneration (AMD) is an eye disorder that can lead to visual impairment in elder patients, and current treatments include repeated injections of monoclonal antibody-based antivascular endothelial growth factor (anti-VEGF) agents. This study investigates the potential of a nanoformulation of a peptide anti-VEGF molecule for neovascular AMD. Anti-VEGF peptide HRHTKQRHTALH (HRH), which has high affinity to VEGF-Fc receptor, was used as the bioactive agent to control neovascularization of the retina. The nanoformulation consisting of hyaluronic acid nanogel was generated by incorporating divinyl sulfone and cholesterol to increase the stability and control the size of the nanodrug. The encapsulation efficacy of nanogel was 65%, and drug release was 34.72% at the end of 192 h. Obtained nanogels were efficiently internalized in 15 min by human umbilical vascular endothelial cells (HUVECs) and ARPE-19 cells, and results indicate that nanoformulation is not toxic to ARPE-19 cells, whereas it inhibits HUVEC proliferation owing to anti-VEGF peptide in the nanogel structure. In the coculture experiment in which retinal penetration was modeled, it was observed that the nanogel reached HUVECs and negatively affected their proliferation without disturbing the monolayer of ARPE-19 cells. In vivo experiments with chick chorioallantoic membrane revealed that nanogel formulation has higher antiangiogenesis activity compared to free HRH. Additionally, in an oxygen-induced retinopathy model, the excessive growth of blood vessels was notably suppressed in mice treated with HRH-loaded nanogel. This research indicates that nanogels formulated in this study are promising candidates as a topical treatment for AMD.

Objective: We aimed to evaluate the risk of hepatitis B virus reactivation in rheumatic patients using anti-tumor necrosis factor-alpha drugs and the awareness of physicians about hepatitis B virus reactivation., Methods: Demographic characteristics, pre- and post-treatment hepatitis markers, and laboratory parameters of patients receiving anti-tumor necrosis factor-alpha therapy in our rheumatology clinic were retrospectively examined., Results: A total of 448 patients, 240 (53.6%) female and 208 (46.4%) male, were evaluated. Their mean age was 48.02±14.64 years. While HBsAg was examined in 443 (98.9%) patients before treatment, 7 (1.6%) patients were found to be HBsAg positive. While anti-HBc IgG was examined in 405 (90.4%) patients, it was positive in 69 (17%) patients. HBs Ag (total 446-99.6%) test was performed in three patients who were not tested for HBsAg before the treatment, and anti-HBc total (431-96.2% total) test was performed in 26 patients who were not tested for anti-HBc total. All HBsAg positive patients and 17 (24.6%) of those with previous hepatitis B received antiviral treatment. While the median follow-up period of the patients was 24 (6-60) months, no patient developed hepatitis B virus reactivation., Conclusion: The screening rates and awareness of physicians providing anti-tumor necrosis factor-alpha therapy for hepatitis B virus infection were found to be higher compared to similar studies. Hepatitis B virus reactivation did not develop in any patient. Since the risk of hepatitis B virus reactivation is low, especially in patients with previous hepatitis B, it would be more appropriate to follow up the patients without giving antiviral prophylaxis.

Polymeric membranes are widely used in water treatment because of their ease of fabrication and low cost. The flux and purification performance of membranes can be significantly improved by incorporating appropriate amounts of nanomaterials into the polymeric membrane matrices. In this study, neat poly(ether sulfone) (PES), PES/nano copper oxide (CuO), and PES/nano zinc oxide (ZnO) membranes are fabricated via phase inversion. The pure water flux of the neat PES membrane, which is 355.14 L/m 2 ·h, is increased significantly with the addition of nano-CuO and nano-ZnO, and the pure water fluxes of the nanocomposite membranes vary in the range of 392.65-429.74 L/m 2 ·h. Moreover, nano CuO and nano ZnO-doped PES nanocomposite membranes exhibit higher conductivity, color, total organic carbon, boron, iron, selenium, barium, and total chromium removal efficiencies than neat PES membranes. The membrane surfaces examined by Scanning Electron Microscopy (SEM) after water filtration revealed that those containing 0.5% wt. nano CuO and nano ZnO are more resistant to fouling than the membrane surfaces containing 1% wt. nano CuO and nano ZnO. Based on the results of this study, 0.5% wt. nano ZnO-doped PES membrane is found to be the most suitable membrane for use in water treatment due to its high pure water flux (427.14 L/m 2 ·h), high pollutant removal efficiency, and high fouling resistance. When the mechanical properties of the membranes are examined, the addition of CuO and ZnO nanoparticles increases the membrane stiffness and modulus of elasticity. The addition of 0.5% and 1% for CuO leads to an increase in the modulus of elasticity by 57.95% and 324.43%, respectively, while the addition of 0.5% and 1% for ZnO leads to an increase in the modulus of elasticity by 480.68% and 1802.43%, respectively. At the same time, the tensile strength of the membranes also increases with the addition of nanomaterials., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Ocular neovascularization is a hallmark of several sight-threatening diseases, including diabetic retinopathy and age-related macular degeneration. Currently, available treatments are limited and often associated with side effects. Therefore, a novel approach to ocular neovascularization treatment through utilization of polymersomes from self-assembled sphingosine-grafted hyaluronic acid (HA-Sph) amphiphilic polymers is presented. The polymersomes are generated in spherical morphologies and sizes between 97.95 - 161.9 nm with homogenous size distributions. Experiments reveal that HA-Sph polymersomes, with concentrations ≥150 µg mL -1 , significantly inhibit the proliferation of human umbilical vein endothelial cells (HUVECs), while concurrently promoting the proliferation of retinal pigment epithelial cells. The polymersomes demonstrate gradual disintegration in vitro, leading to sustained release of sphingosine, which prolongs the inhibition of HUVEC proliferation (from 87.5% at 24 h to 35.2% viability at 96 h). The efficacy of polymersomes in inhibiting angiogenesis is confirmed through tube formation assay, revealing a substantial reduction in tube length compared to the control group. The findings also validate the ocular penetration capability of polymersomes through ex vivo whole porcine eye ocular penetration study, indicating their suitability for topical administration. Potentially, HA-Sph polymersomes can be harnessed to develop intricate drug delivery systems that protect the retina and effectively treat ocular diseases., (© 2024 The Authors. Macromolecular Bioscience published by Wiley‐VCH GmbH.)

Familial mediterranean fever (FMF) is a genetic autoinflammatory disease typically diagnosed in childhood. In this study, we aimed to investigate the demographic, clinical, and genetic characteristics of patients aged 18 years and older who were diagnosed with FMF. Patients diagnosed with FMF between 2014 and 2022 at Karadeniz Technical University Faculty of Medicine Hospital were included in the study. Patients were divided into 2 groups based on the age of disease onset. Group I included patients with adult-onset (ages 18-40), while group II comprised patients with late onset (ages 40 and above). Subsequently, the 2 groups were compared. A total of 150 patients with a mean age of 32 (18-79) were included in the study. There were 116 patients in group I and 34 (22.7%) in group II. The most common presenting complaint was abdominal pain (91.3%), and the most prevalent complication was amyloidosis (4.7%). No significant differences were observed between age groups regarding clinical findings and symptoms. The most frequent homozygous mutations were M694V (9.3%) and R202Q (1.8%), while the heterozygous mutations were M694V (37.3%) and R202Q (35.5%), respectively. The rate of M694V gene positivity in the adult-onset group was significantly higher compared to the lateonset group (52.9% and 25%, respectively, P = .020). There does not appear to be a significant difference in clinical signs and symptoms between adult-onset and late-onset FMF patients. The higher rate of M694V gene positivity in the adult-onset group suggests that the M694V mutation may be responsible for the early expression of the disease.

In this study, membranes blended with polysulfone (PSU) and polyetherimide (PEI) polymers in different ratios were fabricated. Their potential to remove pollutants from rivers, which are a potential drinking water source, was investigated. Scanning electron microscopy analysis revealed that the PSU membranes had a dense and homogeneous layer, whereas the addition of PEI formed a spongy substrate. The water content of the fabricated membranes varied between 5.37 and 22.42%, porosities 28.73-89.36%, contact angles 69.18-85.81%, and average pure water fluxes 257.25-375.32 L/m 2 h. The blended membranes removed turbidity, chloride, alkalinity, conductivity, sulfate, iron, manganese, and total organic carbon up to 98.32, 92.28, 96.87, 90.67, 99.58, 94.63, 97.48, and 79.11%, respectively. These results show that when PEI was added to the PSU polymer, the filtration efficiency increased owing to an increase in the hydrophilicity of the membranes. Blending these two polymers enabled the optimization of membrane properties such as permeability, selectivity, and mechanical strength. In addition, membrane fabrication processes are simple and incur low costs., Competing Interests: The authors declare there is no conflict., (© 2024 The Author This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (CC BY 4.0), which permits copying, adaptation and redistribution, provided the original work is properly cited (http://creativecommons.org/licenses/by/4.0/).)

Background and Aim: The aims of the present study were to evaluate the real-life efficacy and tolerability of glecaprevir (GLE)/pibrentasvir (PIB) in the treatment of patients with chronic hepatitis C (CHC)., Materials and Methods: Between May 2019 and May 2022, 686 patients with CHC, treated with GLE/PIB combination from 21 participating centers in Turkiye, were enrolled in the study., Results: All patients were Caucasian, and their median age was 56 years. At the start of GLE/PIB treatment, the median serum Hepatitis C virus RNA and serum alanine amino transaminase (ALT) levels were 6.74 log10 IU/mL and 47 U/L, respectively. Fifty-three percent of the patients were infected with genotype 1b, followed by genotype 3 (17%). Diabetes was the more common concomitant disease. The sustained virological response (SVR12) was 91.4% with intent-to-treat analysis and 98.5% with per protocol analysis. The SVR12 rates were statistically significant differences between the patients who were i.v. drug users and non-user (88.0% vs. 98.8%, p=0.025). From the baseline to SVR12, the serum ALT levels and Model for End-Stage Liver Disease score were significantly improved (p<0.001 and p=0.014, respectively). No severe adverse effect was observed., Conclusion: GLE/PIB is an effective and tolerable treatment in patients with CHC., Competing Interests: The authors have no conflict of interest to declare., (© Copyright 2023 by Hepatology Forum.)

This research focuses on the production and characterization of pristine polyacrylonitrile (PAN) as well as halloysite nanotube (HNT)-doped PAN ultrafiltration (UF) membranes via the phase inversion technique. Membranes containing 0.1, 0.5, and 1% wt HNT in 16% wt PAN are fabricated, and their chemical compositions are examined using Fourier transform infrared (FTIR) spectroscopy. Scanning electron microscopy (SEM) is utilized to characterize the membranes' surface and cross-sectional morphologies. Atomic force microscopy (AFM) is employed to assess the roughness of the PAN/HNT membrane. Thermal characterization is conducted using thermal gravimetric analysis (TGA) and differential thermal analysis (DTA), while contact angle and water content measurements reveal the hydrophilic/hydrophobic properties. The pure water flux (PWF) performance of the porous UF water filtration membranes is evaluated at 3 bar, with porosity and mean pore size calculations. The iron (Fe), manganese (Mn), and total organic carbon (TOC) removal efficiencies of PAN/HNT membranes from dam water are examined, and the surfaces of fouled membranes are investigated by using SEM post-treatment. Mechanical characterization encompasses tensile testing, the Mori-Tanaka homogenization approach, and finite element analysis. The findings offer valuable insights into the impact of HNT doping on PAN membrane characteristics and performance, which will inform future membrane development initiatives., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

The performance of the membranes can be improved by adding the appropriate amount of nanomaterials to the polymeric membranes that can be used for water/wastewater treatment. In this study, the effects of polyvinylpyrrolidone (PVP), the impact of different amounts (0.5% and 1% wt.) of cellulose nanofibril (CNF), and the combined effects of PVP-CNF on the properties/performance of the polyethersulfone-based (PES-based) membrane are investigated. All PES-based ultrafiltration (UF) membranes are manufactured employing the phase inversion method and characterised via Fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM), and the relevant techniques to determine the properties, including porosity, mean pore size, contact angle, water content, and pure water flux tests. Furthermore, the thermal properties of the prepared membranes are investigated using thermal gravimetric analysis (TGA) and differential thermal analysis (DTA) techniques. Experimental and numerical methods are applied for the mechanical characterisation of prepared membranes. For the experimental process, tensile tests under dry and wet conditions are conducted. The finite element (FE) method and Mori-Tanaka mean-field homogenisation are used as numerical methods to provide more detailed knowledge of membrane mechanics., (© 2023 The Authors.)

Background: Healthcare professionals are exposed to the stress of the pandemic in the highest level and try to cope with the long-term psychological consequences., Aim: This study mainly aimed to compare the anxiety and depression levels of resident doctors (RDs) who cared and did not care for coronavirus disease 2019 (COVID-19) patients at the University Hospital, which has been serving as a pandemic hospital during the COVID-19 outbreak., Subjects and Methods: To proceed with this study, 100 RDs were included this study between March 15 and June 1, 2020. Patient Health Questionnaire (PHQ-9) was used to measure the depression levels and the Beck Anxiety Inventory (BAI) was used to measure the anxiety levels of the RDs who participated in the study., Results: The analysis of the responses showed that there were 49 RDs treating COVID-19 patients and 51 RDs not treating COVID-19 patients. The proportions of the RDs who had higher PHQ-9 and BAI scores were significantly greater in the RDs treating COVID-19 patients than in those not treating., Conclusion: Our study highlights that front-line RDs have higher levels of anxiety and depression than back-line RDs., Competing Interests: None

Background: The course of hepatitis C disease has changed with the use of direct-acting antiviral drugs in the treatment of the disease. The aim of this study was to evaluate the real-life efficacy and safety of the sofosbuvir/ledipasvir drug regimen in the treatment of patients with genotype 1b., Methods: Treatment-naive or -experienced 49 genotypes 1b patients treated with sofosbuvir/ledipasvir participated in the study. Laboratory and hepatitis C virus RNA values were evaluated at baseline, week 12, and week 24 of treatment (36th week for those who received 24 weeks of treatment)., Results: The sustained virologic response rate was 100% in patients who completed treatment. At the end of the study, there was a significant decrease in alanine transaminase, aspartate transaminase, gamma-glutamyl transferase, and alpha-fetoprotein levels (P = .000014, P = .000581, P = .000012, and P = .000821), respectively. Renal function tests (creatinine, estimated glomerular filtration rate) worsened (P = .003 and P = .007, respectively). Hepatocellular carcinoma (HCC) was developed in 2 patients during post-treatment follow-up. In Kaplan-Meier analysis, the probability of not developing HCC was 86.5% at 26 months., Conclusion: The sofosbuvir/ledipasvir combination is effective in treating genotype 1b chronic hepatitis C with high sustained virologic response rates. Because there are few drug interactions, it may be a suitable option for patients taking multiple medications or who are transplant recipients. Renal function should be monitored closely during and after treatment, as there is a risk of worsening renal function after treatment.

Objective: To investigate the factors leading to the development of gastrointestinal bleeding (GIB) by comparing patients with diabetes mellitus Type 2 (T2DM) with dyspeptic complaints without GIB; and patients with T2DM who had GIB, regardless of the presence of helicobacter pylori., Study Design: Analytical study., Place and Duration of Study: Department of Endocrinology and Gastroenterology, Faculty of Medicine, Karadeniz Technical University, from January 2018 to June 2019., Methodology: The patients were divided into GIB and dyspepsia groups. After the identification of patients in both groups, demographic characteristics, drugs, comorbidities, presence of diabetic macro- and micro-vascular complications, and endoscopic findings were examined retrospectively for each patient., Results: There were 106 patients, with 53 patients in each group. Mean age was significantly higher in the GIB group compared to the dyspepsia group (p<0.001). Body mass index (BMI) was significantly lower in the GIB group (p<0.001). Frequency of congestive heart failure (CHF), chronic kidney disease (CKD), and cerebrovascular disease (CVD), heart valve disease, and cardiac arrhythmia was significantly higher in GIB group (p <0.05 for all). No significant correlation was found between acetylsalicylic acid (ASA) use and GIB (p=0.103). The use of nonsteroidal anti-inflammatory drugs (NSAID), novel oral anticoagulants (NOAC), and clopidogrel was significantly higher in the GIB group (p=0.032, p=0.031, and p=0.032, respectively). Proton pump inhibitor (PPI) use was significantly higher in the dyspepsia group (p=0.002)., Conclusion: Age, and poly medications were associated with increased frequency of GIB. The use of ASA, when not administered with other agents that may induce GIB, does not increase the risk of developing GIB in obese T2DM patients younger than 65 years of age, who have increased HbA1c levels. Key Words: Type 2 diabetes mellitus, Dyspepsia, Gastrointestinal bleeding, Acetylsalicylic acid, Risk factors, Obesity, Medication.

Many treatment methods are used to remove iron and manganese from water. Aeration and membrane filtration are two of these methods. In this study, Fe 2+ and Mn 2+ removal by aeration with different catalysts and instead of simple membrane filtration applied in other studies, the aerated-submerged membrane systems were evaluated separately. When Fe(OH) 3 was applied in the aeration step and complete oxidation of Fe 2+ was obtained after 27 min, while complete Mn 2+ oxidation was obtained in 76 min. However, when MnO 2 was applied in the aeration step, complete oxidation of Fe 2+ and Mn 2+ was relatively slow (36 and 110 min, respectively). According to the results obtained from the aerated membrane system, Fe 2+ and Mn 2+ removal were extended by Fe(OH) 3 via adsorption/surface oxidation. It is clearly shown from the flux, resistance results, scanning electron microscope (SEM) and Fourier transform infrared (FT/IR) spectroscopy observation that manganese oxides were deposited mainly in membrane pores forming membrane fouling by small flocs, while iron oxide particles were deposited on the membrane surface. Although the flux performance of PT PES membrane was higher than HF PP membrane, fouling resistance of HF PP membrane was higher than PT PES.

Gastrointestinal endoscopy is the primary method used for the diagnosis and treatment of gastric polyps. The early detection and removal of polyps is vitally important in preventing cancer development. Many studies indicate that a high workload can contribute to misdiagnosing gastric polyps, even for experienced physicians. In this study, we aimed to establish a deep learning-based computer-aided diagnosis system for automatic gastric polyp detection. A private gastric polyp dataset was generated for this purpose consisting of 2195 endoscopic images and 3031 polyp labels. Retrospective gastrointestinal endoscopy data from the Karadeniz Technical University, Farabi Hospital, were used in the study. YOLOv4, CenterNet, EfficientNet, Cross Stage ResNext50-SPP, YOLOv3, YOLOv3-SPP, Single Shot Detection, and Faster Regional CNN deep learning models were implemented and assessed to determine the most efficient model for precancerous gastric polyp detection. The dataset was split 70% and 30% for training and testing all the implemented models. YOLOv4 was determined to be the most accurate model, with an 87.95% mean average precision. We also evaluated all the deep learning models using a public gastric polyp dataset as the test data. The results show that YOLOv4 has significant potential applicability in detecting gastric polyps and can be used effectively in gastrointestinal CAD systems. Gastric Polyp Detection Process using Deep Learning with Private Dataset., (© 2021. International Federation for Medical and Biological Engineering.)

Background: Phosphatase and tensin homolog (PTEN) germline mutations are associated with cancer syndromes (PTEN hamartoma tumor syndrome; PHTS) and in pediatric patients with autism spectrum disorder (ASD) and macrocephaly. The exact prevalence of PTEN mutations in patients with ASD and macrocephaly is uncertain; with prevalence rates ranging from 1% to 17%. Most studies are retrospective and contain more adult than pediatric patients, there is a need for more prospective pediatric studies., Methods: We recruited 131 patients (108 males, 23 females) with ASD and macrocephaly between the ages of 3 and 18 from five child and adolescent psychiatry clinics in Turkey from July 2018 to December 2019. We defined macrocephaly as occipito-frontal HC size at or greater than 2 standard deviations (SD) above the mean for age and sex on standard growth charts. PTEN gene sequence analysis was performed using a MiSeq next generation sequencing (NGS) platform, (Illumina)., Conclusion: PTEN gene sequence analyses identified three pathogenic/likely pathogenic mutations [NM&#95;000314.6; p.(Pro204Leu), (p.Arg233*) and novel (p.Tyr176Cys*8)] and two variants of uncertain significance (VUS) [NM&#95;000314.6; p.(Ala79Thr) and c.*10del]. We also report that patient with (p.Tyr176Cys*8) mutation has Grade 1 hepatosteatosis, a phenotype not previously described. This is the first PTEN prevalence study of patients with ASD and macrocephaly in Turkey and South Eastern Europe region with a largest homogenous cohort. The prevalence of PTEN mutations was found 3.8% (VUS included) or 2.29% (VUS omitted). We recommend testing for PTEN mutations in all patients with ASD and macrocephaly., (© 2021 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals LLC.)

Objective: The purpose of this study was to determine hepatitis B virus (HBV) screening rates in patients receiving anti-tumor necrosis factor (TNF)-α therapy and the frequency of HBV reactivation in patients with resolved hepatitis B virus infection (hepatitis B surface antigen [HBsAg] negative, hepatitis B core antibody [Anti-HBc] positive)., Patients and Methods: Data from 1834 patients who underwent anti-TNF-α therapy in the Rheumatology, Gastroenterology and Dermatology Departments of our hospital between 2010 and 2020 were retrospectively analyzed. Within 6 months before the initial anti-TNF-α therapy, performing a HBsAg and/or anti-HBc test is defined as HBV screening. HBV reactivation is defined as the presence of detectable serum HBV DNA or HBsAg seroconversion from negative to positive., Results: The overall HBV screening rate was 82.3% before starting anti-TNF-α therapy. There was an increasing trend in HBV screening rates during the years analyzed (64% in 2010, 87.4% in 2019) (P < .001). Before anti-TNF-α therapy was initiated, 272 patients were HBsAg negative and anti-HBc positive. Among these patients, HBV reactivation did not occur in 31 patients who received antiviral prophylaxis, whereas HBV reactivation occurred in only 1 (0.4%) of the 241 patients who did not receive antiviral prophylaxis., Conclusion: Hepatitis B virus screening rates prior to starting anti-TNF-α therapy were relatively high, and its trend was increased by year. HBV reactivation because of anti-TNF-α use rarely occurred in patients with resolved HBV infection. Further studies are needed on whether routine anti-HBc screening and/or HBV DNA follow-up are necessary in these patients aside from HBsAg., (© 2020 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)

Programmed death-ligand 1 (PD-L1) is suggested to be a predictive biomarker in non-small-cell lung carcinoma (NSCLC). However, the differential expression of PD-L1 in primary lung tumor vs. synchronous metastases, especially brain metastasis (BM), remains unclear. This study assessed the concordance of PD-L1 expression on tumor cells and tumor-infiltrating lymphocytes (TILs) and CD8+ TIL intensity between primary lung tumors and synchronous BMs from 24 NSCLC patients. PD-L1, CD3, and CD8 positivity was determined by immunohistochemistry (IHC). PD-L1 scoring was based on the proportion of tumor cells with membranous expression of PD-L1 and the cutoff values <1%, 1-49%, and ≥50%. CD3 and CD8 positivity in TILs was evaluated semi-quantitatively and the proportion of CD3+/CD8+ TILs was determined. PD-L1 expression on tumor cells and TILs was evaluated in relation to CD3+/CD8+ TIL proportions and the intensity of CD8+ TILs between the paired primary lung and BM tissues. In the primary lung tumors, PD-L1 positivity was observed in 25%, 37.5%, and 37.5% cases for the cutoff values <1%, 1-49%, and ≥50%, respectively. PD-L1 expression on tumor cells was strongly correlated between the paired primary lung and BM tissues, in all cutoff groups. However, PD-L1 expression on TILs and the proportion of CD3+/CD8+ TILs were not strongly correlated in all three groups between the paired primary lung tumors and BMs. The intensity of CD8+ TILs was concordant in only 54.16% of the paired primary lung tumors and BMs. This study showed a high concordance of PD-L1 expression in neoplastic cells between primary NSCLC and synchronous BMs.

The eye is a complex organ consisting of several protective barriers and particular defense mechanisms. Since this organ is exposed to various infections, genetic disorders, and visual impairments it is essential to provide necessary drugs through the appropriate delivery routes and vehicles. The topical route of administration, as the most commonly used approach, maybe inefficient due to low drug bioavailability. New generation safe, effective, and targeted drug delivery systems based on nanocarriers have the capability to circumvent limitations associated with the complex anatomy of the eye. Nanotechnology, through various nanoparticles like niosomes, liposomes, micelles, dendrimers, and different polymeric vesicles play an active role in ophthalmology and ocular drug delivery systems. Niosomes, which are nano-vesicles composed of non-ionic surfactants, are emerging nanocarriers in drug delivery applications due to their solution/storage stability and cost-effectiveness. Additionally, they are biocompatible, biodegradable, flexible in structure, and suitable for loading both hydrophobic and hydrophilic drugs. These characteristics make niosomes promising nanocarriers in the treatment of ocular diseases. Hereby, we review niosome based drug delivery approaches in ophthalmology starting with different preparation methods of niosomes, drug loading/release mechanisms, characterization techniques of niosome nanocarriers and eventually successful applications in the treatment of ocular disorders.

Due to the resistance to drugs, studies involving the combination and controlled release of different agents are gradually increasing. In this study, two different active ingredients, known to have antibacterial and antiparasitic activities, were encapsulated into single polymeric nanoparticles. After co-encapsulation their antibacterial and antileishmanial activity was enhanced approximately 5 and 250 times, respectively. Antibacterial and antileishmanial activities of caffeic acid phenethyl ester and juglone loaded, multifunctional nanoformulations (CJ4-CJ6-CJ8) were also evaluated for the first time in the literature comparatively with their combined free formulations. The antibacterial activity of the multifunctional nanoformulation (CJ8) were found to have a much higher activity (MIC values 6.25 and 12.5 μg ml -1 for S. aureus and E. coli, respectively) than all other formulations. Similar efficacy for CJ8 was obtained in the antiparasitic study against the Leishmania promastigotes and the IC 50 was reduced to 0.1263 μg ml -1 . The high activity of multifunctional nanoparticles is not only due to the synergistic effect of the active molecules but also by the encapsulation into polymeric nanoparticles. Therefore, it has been shown in the literature for the first time that the biological activity of molecules whose activity is increased by the synergistic effect can be improved with nanosystems.

In this study, four different membranes were fabricated by using polyetherimide and polyacrylonitrile polymers, N-methyl-2-pyrrolidone and polyvinylpyrrolidone (PVP) via phase inversion method to improve the membrane performance in fruit juice wastewater (FJWW) treatment. The addition of PVP to the casting solution increased membrane hydrophilicity, water content, contact angle, porosity, Fourier transform infrared spectroscopy peaks, membrane thickness, average roughness and viscosity of cast solutions compared to the bare membrane. It can be said that the addition of a lower polymer concentration and PVP intensively increases the pure water flux of the membrane. However, as the flux increased, a small decrease in FJWW rejection was observed.

Objective: Methylphenidate is the first-choice medication for the Pervasive Developmental Disorders (PDDs), and comorbid Attention Deficit Hyperactivity Disorder (ADHD). But this approach generally results with poor outcomes, and increased adverse effects. It is aimed to investigate the comparison of cases who diagnosed with PDDs and Mild Mental Retardation (MR) and cases with pure ADHD in terms of the clinical response to MPH. Also we aimed to investigate the relations between CES-1 polymorphism gene and the clinical response to MPH., Methods: For clarifying this we searched for three polymorphisms (Arg199/His, Ser75/Asn, and Ile49/Val) in carboxylesterase-1 gene (CES-1) in the saliva of patients diagnosed with PDD+ADHD. Also, we assessed the clinical response to MPH by dimensional approach using the Attention Deficit Hyperactivity Disorder Rating Scale IV and Clinical Global Impression-Improvement scale., Results: PDD+ADHD groups had significantly higher Arg199/His polymorphism, and clinically responded poorer with symptoms sometimes even worsening to the MPH treatment compared with "pure" ADHD and ADHD+MR groups., Conclusion: This is the first study that an association between Arg199/His polymorphism in CES1 and altered treatment response to MPH in patients with PDD that presents with symptoms of ADHD.

Background: Obsessive-compulsive disorder (OCD) is a relatively frequent disease in childhood, which is generally treated with selective serotonin reuptake inhibitors (SSRIs) and/or clomipramine and cognitive behavioral therapy (CBT). However, nearly half of the cases are treatment resistant. Aripiprazole was shown to be beneficial in augmentation therapy in treatment-refractory OCD. This study evaluated its effectiveness as a single agent in these cases., Methods: Sixteen children (nine girls, seven boys), who were nonresponders to treatment with at least two types of SSRIs and CBT, were administered 12 weeks of aripiprazole treatment with a mean dose of 4.75 mg/day (range: 2-7.5 mg/day). Treatment outcomes were evaluated by the Childhood Yale-Brown Obsessive Compulsive Scale (CY-BOCS), and the Clinical Global Impressions-Severity and Improvement (CGI-S and CGI-I) scales., Results: Children with a mean age of 10.9±2.9 years had severe obsessive compulsive symptoms at baseline, and >80% of them had another comorbid psychiatric disease. Significant improvements in symptoms were achieved after 12 weeks of aripiprazole treatment, which were evaluated by significant decreases in symptom scores in the CY-BOCS, and improvements in CGI-I scores., Conclusions: This very small study of aripiprazole, given to children with OCD resistant to at least 12 weeks treatment with at least two SSRIs and CBT, demonstrated striking improvement in CGI scores (all subsets, p≤0.002) for 13 of 16 children, and halved all CY-BOCS subscores after ∼12 weeks of treatment.

The aims of this study were to evaluate the neuropsychological characteristics of the restrictive (R) subtype according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition and the attention-deficit/hyperactivity disorder (ADHD) combined (CB) type and predominantly inattentive (PI) type subtypes and to evaluate whether methylphenidate (MPH) affects neurocognitive test battery scores according to these subtypes. This study included 360 children and adolescents (277 boys, 83 girls) between 7 and 15 years of age who had been diagnosed with ADHD and compared the neuropsychological characteristics and MPH treatment responses of patients with the R subtype-which has been suggested for inclusion among the ADHD subtypes in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-with those of patients with the PI and CB subtypes. They did not differ from the control subjects in the complex attention domain, which includes Continuous Performance Test, Stroop test, and Shifting Attention Test, which suggests that the R subtype displayed a lower level of deterioration in these domains compared with the PI and CB subtypes. The patients with the CB and PI subtypes did not differ from the control subjects in the Continuous Performance Test correct response domain, whereas those with the R subtype presented a poorer performance than the control subjects. The R subtype requires a more detailed evaluation because it presented similar results in the remaining neuropsychological evaluations and MPH responses.

Objective: The aim of this study was to compare the effect of methylphenidate (MPH) versus MPH + parent training in children with ADHD and oppositional defiant disorder/conduct disorder (ODD/CD) over a 12-month period., Method: After careful screening, 120 children diagnosed with ADHD + ODD/CD were included in the study. Treatment consisted of ongoing medication management for 12 months, with or without participation in a parent-training program beginning after the 1st month. Participants were not randomly assigned to treatment groups because of ethical, practical, and methodological reasons., Results: Data analyses revealed that mother-child relationship improvements and symptom severity did not benefit from parent training., Conclusion: The results of this study highlighted the positive role of MPH in ADHD. No significant effects were observed after the addition of parent training to MPH treatment. Clinicians should carefully follow patients' improvements and titrate the MPH dosage during long-term treatment.

Background: The DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, 4th edition Textrevision) highlights the especially poor outcomes of early-onset conduct disorder (CD). The strong link between the patient's age at treatment and its efficacy points the importance of early intervention. Risperidone is one of the most commonly studied medications used to treat CD in children and adolescents. The aim of this study is to obtain preliminary data about the efficacy and tolerability of risperidone treatment in otherwise typically developing preschool children with conduct disorder and severe behavioral problems., Method: We recruited 12 otherwise normally developing preschoolers (ten boys and two girls) with CD for this study. We could not follow up with 4 children at control visits properly; thus, 8 children (six girls, two boys; mean age: 42.4 months) completed the study. We treated the patients with risperidone in an open-label fashion for 8 weeks, starting with a daily dosage of 0.125 mg/day or 0.25 mg/day depending on the patient's weight (<20 kg children: 0.125 mg/day; >20 kg children: 0.25 mg/day). Dosage titration and increments were performed at 2-week interval clinical assessments. The Turgay DSM-IV Based Disruptive Behavior Disorders Child and Adolescent Rating & Screening Scale (T-DSM-IV-S) as well as the Clinical Global Impression Scale (CGI) assessed treatment efficacy; the Extrapyramidal Symptom Rating Scale (ESRS) and laboratory evaluations assessed treatment safety., Results: The mean daily dosage of risperidone at the end of 8 weeks was 0.78 mg/day (SD: 0.39) with a maximum dosage of 1.50 mg/day. Based on the CGI global improvement item, we classified all patients as "responders" (very much or much improved). Risperidone was associated with a 78% reduction in the CGI Severity score. We also detected significant improvements on all of the subscales of the T-DSM-IV-S. Tolerability was good, and serious adverse effects were not observed. We detected statistically significant prolactin level increments (p < 0.05), but no clinical symptoms associated with prolactinemia., Conclusion: The results of this study suggest that risperidone may be an effective and well-tolerated atypical antipsychotic for the treatment of CD in otherwise normally developing preschool children. The findings of the study should be interpreted as preliminary data considering its small sample size and open-label methodology.