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A 4.1 kg male neonate with a diagnosis of double-inlet left ventricle with dextro-transposition of the great arteries was intubated shortly after birth due to respiratory insufficiency. The initial management consisted of a successful Stage I hybrid procedure. Persistent respiratory insufficiency led to cross-sectional imaging and bronchoscopy that demonstrated severe airway compression from a dilated main pulmonary artery. A Norwood procedure with Blalock–Thomas–Taussig shunt was performed at 1 month of age to relieve the airway obstruction. The patient was discharged home on room air at 2 months of age. This case highlights a unique single-ventricle anatomic variant with airway compression, which was successfully managed with deferred Norwood palliation.

The Digital Population Identity Application provides convenience for users to access and manage their population data digitally. Based on the increasing usage of the Digital Population Identity Application on the Google Play Store, various user reviews of the application have emerged. Therefore, sentiment analysis is needed to provide a deeper understanding of user perceptions and to classify user reviews of the Digital Population Identity Application. Sentiment analysis is a computational study of opinions, feelings, and emotions expressed in text, using the K-Nearest Neighbors method, which is a classification method based on the closest distance or similarity to objects in the training data. Using 5000 relevant review data from September 2022 to December 2023, after labeling them into positive, negative, and neutral sentiment classes, the results show 3581 negative sentiments, 1031 positive sentiments, and 388 neutral sentiments. Testing was conducted by applying the K-Nearest Neighbors method in the classification stage, testing this method by varying K values from 1 to 10. The best results were obtained with a training data ratio of 90% to testing data ratio of 10%. The best results were achieved at K values of 8, 9, and 10, with an accuracy of 81%, precision of 82%, recall of 95%, and an F1-Score of 88%. With a training data ratio of 70% to testing data ratio of 30%, the best results were obtained at K values of 6, 7, 8, 9, and 10, with an accuracy of 80%, precision of 81%, recall of 95%, and an F1-Score of 88%. Based on the results of this research, the K-Nearest Neighbors method can be used for sentiment classification of user reviews with good results.

The use of IoT devices has grown rapidly, leading to an increase in cyber attacks that pose greater security and privacy threats than ever before. One such threat is botnet attacks on IoT devices. An IoT botnet is a group of Internet-connected IoT devices infected with malware and remotely controlled by an attacker. Machine learning techniques can be employed to detect botnet attacks. The use of machine learning-based detection methods has been shown to be effective in identifying cyber attacks. The performance of the detection system in machine learning can be improved by utilizing data reduction methods. The data reduction process in classification is used to overcome the problem of scalability and computation resources in the IoT. This paper proposes a detection system using the Autoencoder reduction method and the Decision tree classification method. The test results demonstrate that the Deep Autoencoder algorithm can reduce data and memory usage from 1.62 GB to 75.9 MB, while also improving the performance of decision tree classification, resulting in a high level of accuracy up to 100%. The Autoencoder approach in conjunction with the Decision Tree exhibits superior capabilities compared to previous studies.

Previous research suggests that conservatives (right-wingers) tend to show more negativity bias than liberals (left-wingers) in several tasks. However, the majority of these studies are based on correlational findings and do not provide information on the cognitive underpinnings of this tendency. The current research investigated whether intuition promotes negativity bias and mitigates the ideological asymmetry in this domain in three underrepresented, non-western samples (Turkey). In line with the previous literature, we defined negativity bias as the tendency to interpret ambiguous faces as threatening. The results of the lab experiment revealed that negativity bias increases under high-cognitive load overall. In addition, this effect was moderated by the participants' political orientation (Experiment 1). In other words, when their cognitive resources were depleted, liberals became more like conservatives in terms of negativity bias. However, we failed to conceptually replicate this effect using time-limit manipulations in two online preregistered experiments during the COVID-19 pandemic, where the baseline negativity bias is thought to be already at peak. Thus, the findings provide no strong evidence for the idea that intuition promotes negativity bias and that liberals use cognitive effort to avoid this perceptual bias., Author(s): Metin Ege Salter [sup.1] , Firat Yavuz Duymaç [sup.1] , Onurcan Yilmaz [sup.1] , Hasan G. Bahçekapili [sup.2] , Mehmet Harma [sup.1] Author Affiliations: (1) grid.28455.3e, 0000 0001 2116 [...]

Pectus excavatum (PE) is the most common deformity among anterior chest wall abnormalities. Although many theories on the pathogenesis of PE have been described, the uncertainty is still going on whether it is a result of developmental, biochemical, or biomechanical reasons or their combination. The aim of this study was to evaluate the biochemical parameters that may cause or be associated with the development of PE between children with PE and their healthy peers. A total of 33 patients' medical records were retrospectively analyzed who followed up because of pectus excavatum between 2019 and 2021. A control group was formed from 32 healthy children from the hospital records with similar age and gender profiles as the patient group. The data from both groups were collected and statistically analyzed in terms of gender, age, and laboratory tests, including hemogram, Vit B12, Parathormone (PTH), Vit.D, Alkaline phosphatase (ALP), and serum Calcium (Ca) and Phosphor (P) levels. Compared to the control group, statistically, significantly higher serum ALP, P, and PTH levels with low Vit.B12 levels were detected. The significant difference in the levels of ALP, PTH, P, and Vit B12, which have an important place in the construction and development of osteochondral structures, may impair the remodeling capacity of the costosternal structure with the contribution of thoracic biomechanics. When PE deformity is noticed, if appropriate medical treatment such as vitamin and mineral supplements and diet regulation is applied to children in the follow-up process, the process can be slowed down, and the deformity can be alleviated. [Med-Science 2023; 12(1.000): 145-8]

An anal fissure is a common problem in children and it refers to a longitudinal tear or an ulcer in the anoderm. The conventional therapy for anal fissures has been warm sitz baths and lthe ocal application of analgesic ointments, stool softeners ,and behavioral therapy as necessary. Simple wound care may often be sufficient for the treatment of anal fissure, but a comprehensive approach is required for accompanying constipation. Between 2015-2022, a total of 263 children suffering from constipation and perianal pain were diagnosed with anal fissure (AF) based on physical examination. Anal fissure and constipation (AFC) questionnaire forms were retrospectively reviewed and results of routine management protocol were assessed which was focused on local wound care and dietary regulation. The ratio of children consuming more than 2-3 cups of packed beverages containing artificial sweeteners, colorants or corn syrup was found 63,89 % (n=167). Daily water consumtion of less than five glasses was 71.1% (n=187). Daily milk consuming was 71,86% (n=189). Stool withholding and soiling was found 57,41% (n=151) and 48,67% (n=128) respectively. In only four cases (1.52%), constipation persisted for more than eight weeks despite meticulous management and improvement was achieved with anal dilatation on the tenth week. It is possible to treat anal fissures successfully and in a reasonable duration with simple local care with prednisolone pomade and a strict diet arrangement that restricts the consumption of packed foods, beverages, snacks, and milk while promoting drinking water and raw fiber intake. [Med-Science 2023; 12(1.000): 319-23]

INTRODUCTION: Pilonidal sinus is a subcutaneous inflammatory disease most commonly seen in the sacrococcygeal region and is more common in boys. It is seen earlier in women because of the earlier onset of puberty and activation of sex hormones during this period. To the best of our knowledge there is a very limited research regarding the interrelation of insulin resistance levels and plonidal sinus disease (PSD). This study aims to determine the role of insulin resistance on the development of pilonidal sinus disease in female adolescents. METHODS: This retrospective study includes a patient group of 30 adolescent girls who were operated for PSD and a control group created from the hospital records with the same number. Free T3, T4, TSH, insulin and fasting blood sugar levels were recorded from the hospital data-base. Homeostasis model assessment of insulin resistance (HOMA-IR) score was calculated to describe the insulin resistance. Insulin resistance was defined when HOMA-IR score ≥ 2.86 in adolescents. RESULTS: The median age of the patients was 15.83+-1.86 years and twenty-five of them (%83.3) were accepted to be insulin resistant. According to our findings the levels of thyroid function tests (free T3, free T4, and TSH) did not vary substantially between patient and control groups (p>0.05). A strong correlation was found between PSD and high insulin (mean+-SD 19.46+-7.28; p

The importance of oxidative stress in the pathogenesis of burn injuries has been shown in various studies. Glutathione (GSH) and thiols have important roles in antioxidant protection and detoxification. The study aimed to investigate the relationship between pediatric burn trauma and GSH and thiol homeostasis. Twenty-nine children with thermal-burn injuries and 29 healthy peers are included in this prospective randomized study. Children with burn wounds of 15–25% of total body surface area (TBSA) were included in the patient group. The control group was created from healthy peers of both sexes. All children were 1–10 years of age. Serum GSH, oxidized glutathione (GSSG), redox ratio (GSH/GSSG), and thiol–disulfide (SS) tests were conducted in both groups, and the changes between admission and day 7 were analyzed in patients with burn injuries. The mean age was 4.09 ± 2.54 years for the patient group and 4.28 ± 2.55 years for the controls (p > 0.05). Total thiol (TT), native thiol (SH), and SS levels were significantly lower in the patient group than in the controls (TT = 291.69 ± 7.93 vs 346.79 ± 18.89 μmol/L, SH = 259.39 ± 7.90 vs 297.64 ± 12.81 μmol/L, SS = 16.15 ± 4.68 vs 24.58 ± 5.76 μmol/L; p < 0.001). SH/TT ratio was higher in the patient group (89.05 ± 3.00 vs 85.93 ± 3.01 μmol/L; p < 0.001). The SS/SH and SS/TT ratios were significantly lower in the patient group, while the SH/TT ratio was significantly higher (p < 0.001). The patients had significantly decreased GSH levels (26.12 ± 2.42 vs 34.80 ± 2.26) and GSH/GSSG ratios (1.69 ± 0.12 vs 3.05 ± 0.29) and increased GSSG levels (16.09 ± 0.34 vs 11.48 ± 1.17, p < 0.001 for all). The GSSG level and GSSG/SH and GSSG/TT ratios were higher in the patient group than in the controls while the SH, TT, and SS levels, and SS/SH and SS/TT ratios were lower in the patient group. Analysis of serum GSSG levels, and ratios with SH and TT homeostasis, might be useful in order to determine burn damage in children.

The objective of this study was to determine the effect of dietary energy source (fat vs. carbohydrate) in calf milk replacer (MR) on growth performance parameters and feed intake in rearing calves. In a randomized complete block design, 68 Holstein calves [40 females and 28 males; (mean ± SD) body weight (BW): 43.7 ± 1.43 kg] were assigned to 17 blocks of 4 calves based on birth date and parity of the dam. Within each block, calves were randomly assigned to 1 of 2 treatments: a high-lactose MR (HL; 17% fat; 44% lactose; n = 34), or a high-fat MR (HF; 23% fat; 37% lactose; n = 34). Lactose was exchanged for fat on a weight per weight basis, resulting in a 6% difference in metabolizable energy density per kilogram of MR. The feeding plan started with 6 L/d for 7 d, then 8 L/d for 35 d, 6 L/d for 7 d, and finally, 4 L/d for 7 d. Milk replacer allowances were offered in 2 meals per day at 140 g/L. Measurements included daily MR, starter and straw intakes, weekly BW, and blood metabolites, including nonesterified fatty acids (NEFA) and glucose, on wk 4, 6, 8, and 10. Increasing fat at the expense of lactose did not affect MR intake or solid feed intake during the preweaning and weaning periods. However, HF calves tended to consume more solid feed than HL calves during the postweaning period (2.63 ± 0.08 vs. 2.52 ± 0.08 kg/d). Additionally, average daily gain (HF = 0.78 ± 0.02, HL = 0.77 ± 0.02 kg/d) and final BW (HF = 98.8 ± 1.53, HL = 97.7 ± 1.57 kg) were not affected by MR composition. Nevertheless, NEFA concentration was higher in HF calves than in HL calves (0.21 ± 0.01 vs. 0.17 ± 0.01 mmol/L), and glucose concentration was higher in HF calves (6.52 ± 0.23 vs. 5.86 ± 0.23 mmol/L). Under the conditions of this study, HF calves consumed similar amounts of solid feed and grew comparably to the HL calves; however, the isonitrogenous replacement of lactose by fat had evident metabolic effects, such as increased blood NEFA and glucose concentrations.

The objectives of this study are divided into two things: a) to increase the learning activeness and b) to improve the learning outcomes of class 1A students using the index card match learning strategy in Arabic lessons at the KH. Syamsuddin durisawo ponorogo Islamic boarding school. This type of research is called "Classroom Action Research." This method has a significant influence on student activity. It improves student learning outcomes in Arabic lessons, and the number of students in class 1A is 28. This research aims to apply the index card match learning strategy to increase students' activeness and learning outcomes in Arabic subjects. Researchers used testing, observation, and documentation methods to obtain the necessary data. The research results are as follows: 1. The application of the index card match has achieved learning activeness in about 46% of 28 students, and the second stage of student activeness reaches 70% of 28 students. 2. The index card match strategy has achieved the learning outcomes. The student's score reaches 57%, and in the second stage, the student's score reaches 100% of the 28 students.

Apple (Malus pumila L) of the family Rosaceae, most cultivated fruit in temperate regions of the world and is used fresh or processed. The apple production is affected by several pathogens including fungi. The present study was designed to identify disease-causing agents that reduce fruit production in the district Qilla Abdullah of Balochistan, Pakistan, which is the main apple production area of the province. Three varieties of apple: ‘Tur-Kulu’ (‘Red Delicious’), ‘Shin-Kulu’ (‘Golden Delicious’), and ‘Kaja’ were selected. Infected leaf samples were collected from eight different sites of tehsil Gulistan, district Qilla Abdullah. The cultures of fungal micro-flora were grown on two media, potato dextrose agar (PDA), and malt extract agar (MEA) followed by incubation for one week. The resulting colonies were observed under a microscope and identified based on morphological characters. Predominant fungal species was identified through ITS marker and PCR amplification. The isolated pathogens belonged to Zygomycota and Ascomycota divisions. The pathogens found were Aspergillus niger, A. oryzae, A. terrus, Colletotrichum gloeosporioides, Fusarium oxysporum, Mucor spp., Penicillium expansum, and one species of Absidia as well as Rhizopus. Colletotrichum gloeosporioides were predominantly found in all varieties. Morphological and phylogenetic analysis confirmed the identity of Colletotrichum gloeosporioides. As a result of this study, the predominant pathogen species Colletotrichum gloeosporioides is one of the causes of leaf infection in apple varieties.

Introduction Children often present to primary care with functional abdominal pain (FAP) or irritable bowel syndrome (IBS), and around half still have abdominal complaints 1 year later. Hypnotherapy is an evidence-based treatment that is used in specialist care, but it lacks evidence in primary care. This study will investigate the (cost) effectiveness of home-based guided hypnotherapy for children with FAP or IBS in primary care.Methods and analysis We report the design of a pragmatic randomised controlled trial among children aged 7–17 years, diagnosed with FAP or IBS by their general practitioner (GP), with assessments over 12 months. The control group will receive care as usual (CAU) by their GP (eg, communication, education and reassurance), while the intervention group will receive CAU plus 3 months of home-based guided hypnotherapy via a website. The primary outcome will be the proportion of children with adequate relief from abdominal pain/discomfort at 12 months, analysed on an intention-to-treat basis. Secondary outcomes will include the adequacy of pain relief at 3 and 6 months, pain/discomfort severity, pain frequency and intensity, daily functioning and impact on function, anxiety and depression, pain beliefs, sleep disturbances, school absence, somatisation, and healthcare use and costs. We must include 200 children to determine a 20% difference in those with adequate relief (55% control vs 75% intervention).Ethics and dissemination The Medical Ethics Review Committee of the University Medical Center Groningen, the Netherlands, approved this study (METc2020/237). The results will be disseminated to patients, GPs and other stakeholders via email, a dedicated website, peer-reviewed publications and presentations at national and international conferences. We plan to collaborate with the Dutch Society of GPs to implement the results in clinical practice.Trial registration number NCT05636358.

BackgroundLiquid biopsies combine minimally invasive sample collection with sensitive detection of residual disease. Pediatric malignancies harbor tumor-driving copy number alterations or fusion genes, rather than recurrent point mutations. These regions contain tumor-specific DNA breakpoint sequences. We investigated the feasibility to use these breakpoints to design patient-specific markers to detect tumor-derived cell-free DNA (cfDNA) in plasma from patients with pediatric solid tumors.Materials and methodsRegions of interest (ROI) were identified through standard clinical diagnostic pipelines, using SNP array for CNAs, and FISH or RT-qPCR for fusion genes. Using targeted locus amplification (TLA) on tumor organoids grown from tumor material or targeted locus capture (TLC) on FFPE material, ROI-specific primers and probes were designed, which were used to design droplet digital PCR (ddPCR) assays. cfDNA from patient plasma at diagnosis and during therapy was analyzed.ResultsTLA was performed on material from 2 rhabdomyosarcoma, 1 Ewing sarcoma and 3 neuroblastoma. FFPE-TLC was performed on 8 neuroblastoma tumors. For all patients, at least one patient-specific ddPCR was successfully designed and in all diagnostic plasma samples the patient-specific markers were detected. In the rhabdomyosarcoma and Ewing sarcoma patients, all samples after start of therapy were negative. In neuroblastoma patients, presence of patient-specific markers in cfDNA tracked tumor burden, decreasing during induction therapy, disappearing at complete remission and re-appearing at relapse.ConclusionWe demonstrate the feasibility to determine tumor-specific breakpoints using TLA/TLC in different pediatric solid tumors and use these for analysis of cfDNA from plasma. Considering the high prevalence of CNAs and fusion genes in pediatric solid tumors, this approach holds great promise and deserves further study in a larger cohort with standardized plasma sampling protocols.

ObjectivePrior functional magnetic resonance imaging (fMRI) work has revealed that children/adolescents with disruptive behavior disorders (DBDs) show dysfunctional reward/non-reward processing of non-social reinforcements in the context of instrumental learning tasks. Neural responsiveness to social reinforcements during instrumental learning, despite the importance of this for socialization, has not yet been previously investigated.MethodsTwenty-nine healthy children/adolescents and 19 children/adolescents with DBDs performed the fMRI social/non-social reinforcement learning task. Participants responded to random fractal image stimuli and received social and non-social rewards/non-rewards according to their accuracy.ResultsChildren/adolescents with DBDs showed significantly reduced responses within the caudate and posterior cingulate cortex (PCC) to non-social (financial) rewards and social non-rewards (the distress of others). Connectivity analyses revealed that children/adolescents with DBDs have decreased positive functional connectivity between the ventral striatum (VST) and the ventromedial prefrontal cortex (vmPFC) seeds and the lateral frontal cortex in response to reward relative to non-reward, irrespective of its sociality. In addition, they showed decreased positive connectivity between the vmPFC seed and the amygdala in response to non-reward relative to reward.ConclusionThese data indicate compromised reinforcement processing of both non-social rewards and social non-rewards in children/adolescents with DBDs within core regions for instrumental learning and reinforcement-based decision- making (caudate and PCC). In addition, children/adolescents with DBDs show dysfunctional interactions between the VST, vmPFC, and lateral frontal cortex in response to rewarded instrumental actions potentially reflecting disruptions in attention to rewarded stimuli.

Objective: In the present study, we investigated the expression of CD56, ADAM17 and FGF21 antibodies (Ab), which we think have an effect on the pathophysiology of preeclampsia (PE), in pregnant patients with healthy placentas and placentas with PE. The expression of these antibodies has been investigated in a limited amount of former research, but their role in PE has not yet been clarified. With this study, we aimed to contribute to the elucidation of the pathophysiology of PE and the detection of new target molecules for treatment. Materials and Methods: Parturients with singleton pregnancy at 32 weeks or above without any maternal or fetal pathology who were admitted to the Department of Obstetrics and Gynecology, Zonguldak Bülent Ecevit University Practice and Research Hospital between 11 January 2020 and 7 January 2022 were included in the present study. Pregnant women with coexisting disease or a pathology related to the placenta (ablation placenta, vasa previa, hemangioma, etc.) were excluded. CD56, ADAM17 and FGF21 antibodies were histopathologically and immunohistochemically detected in 60 placentas with PE (study group) and 43 healthy placentas (control group). Results: CD56, ADAM17 and FGF21 proteins were all more intensely expressed in preeclamptic placentas and a statistically significant difference was found between the two groups for all three antibodies (p < 0.001). Deciduitis, perivillous fibrin deposition, intervillous fibrin, intervillous hemorrhage, infarct, calcification, laminar necrosis and syncytial node were found to be significantly more common in the study group (p < 0.001). Conclusions: We observed that CD56, ADAM17 and FGF21 expressions increased in preeclamptic placentas. These Ab may be responsible for the pathogenesis of PE, which can be illuminated with further studies.

Human papillomavirus (HPV) infections are an increasing cause of oropharyngeal squamous cell carcinomas (OPSCC). Integration of the viral genome into the host genome is suggested to affect carcinogenesis, however, the correlation with OPSCC patient prognosis is still unclear. Research on HPV integration is hampered by current integration detection technologies and their unsuitability for formalin‐fixed paraffin‐embedded (FFPE) tissues. This study aims to develop and validate a novel targeted proximity‐ligation based sequencing method (targeted locus amplification/capture [TLA/TLC]) for HPV integration detection in cell lines and FFPE OPSCCs. For the identification of HPV integrations, TLA/TLC was applied to 7 cell lines and 27 FFPE OPSCCs. Following preprocessing steps, a polymerase chain reaction (PCR)‐based HPV enrichment was performed on the cell lines and a capture‐based HPV enrichment was performed on the FFPE tissues before paired‐end sequencing. TLA was able to sequence up to hundreds of kb around the target, detecting exact HPV integration loci, structural variants, and chromosomal rearrangements. In all cell lines, one or more integration sites were identified, in accordance with detection of integrated papillomavirus sequences PCR data and the literature. TLC detected integrated HPV in 15/27 FFPE OPSCCs and identified simple and complex integration patterns. In general, TLA/TLC confirmed PCR data and detected additional integration sites. In conclusion TLA/TLC reliably and robustly detects HPV integration in cell lines and FFPE OPSCCs, enabling large, population‐based studies on the clinical relevance of HPV integration. Furthermore, this approach might be valuable for clonality assessment of HPV‐related tumors in clinical diagnostics. [ABSTRACT FROM AUTHOR]

ObjectiveIn the current study we investigated neurodevelopmental changes in response to social and non-social reinforcement.MethodsFifty-three healthy participants including 16 early adolescents (age, 10-15 years), 16 late adolescents (age, 15-18 years), and 21 young adults (age, 21-25 years) completed a social/non-social reward learning task while undergoing functional magnetic resonance imaging. Participants responded to fractal image stimuli and received social or non-social reward/non-rewards according to their accuracy. ANOVAs were conducted on both the blood oxygen level dependent response data and the product of a context-dependent psychophysiological interaction (gPPI) analysis involving ventromedial prefrontal cortex (vmPFC) and bilateral insula cortices as seed regions.ResultsEarly adolescents showed significantly increased activation in the amygdala and anterior insula cortex in response to non-social monetary rewards relative to both social reward/non-reward and monetary non-rewards compared to late adolescents and young adults. In addition, early adolescents showed significantly more positive connectivity between the vmPFC/bilateral insula cortices seeds and other regions implicated in reinforcement processing (the amygdala, posterior cingulate cortex, insula cortex, and lentiform nucleus) in response to non-reward and especially social non-reward, compared to late adolescents and young adults.ConclusionIt appears that early adolescence may be marked by: (i) a selective increase in responsiveness to non-social, relative to social, rewards; and (ii) enhanced, integrated functioning of reinforcement circuitry for non-reward, and in particular, with respect to posterior cingulate and insula cortices, for social non-reward.

Preservation of cancer biopsies by FFPE introduces DNA fragmentation, hindering analysis of rearrangements. Here the authors introduce FFPE Targeted Locus Capture for identification of translocations in preserved samples.