Search

Immunoglobulin G SB 4 sb -related disease (IgG SB 4 sb -RD) is an immune-mediated fibroinflammatory disease that causes specific pathological, serological, and clinical findings and affects multiple organ systems. Thorax and abdominal computed tomography (CT) demonstrated pulmonary oedema, pleural effusion, mediastinal lymphadenopathy, and pericardial fluid that was 28 mm thick in the thickest part (Figure 1). [Extracted from the article]

The school gardens are defined as schools' external environment where the children are able to develop their social, physical, emotional and intellectual skills. Therefore, it is important that the planning and design of these places supply with children's physical, social and psychological needs, in this study, a sample of 10 elementary school playground in the city center of Edirne was carried out physical, cultural, and current situation analysis and the efficiency of school gardens have been produced. The current situation of the elementary school gardens was determined according to principles of landscape design, in this way proposals have been given to solve the existing problems. [ABSTRACT FROM AUTHOR]

Introduction: Medical education typically focuses on the dyadic interaction between patient and physician. However, there is another significant presence in the room that can also impact the patient's health outcomes: caregivers. This topic has been relatively underexplored until now, and there is insufficient information available regarding situations in different cultures. In this study, we aimed to separately examine the characteristics of patients that influence the frequency of being accompanied and those that affect patients' preferences regarding the presence of a companion., Methods: This cross-sectional study was conducted in family medicine clinic of a tertiary hospital. During a period of 15 days, a total of 285 patients who visited the clinic were administered the questionnaire face-to-face. Two logistic regression models were used for dependent variables of "actual" and "desired" situations of admitting to healthcare service with companion., Results: Of the participants, 167 (58.6%) were female, and the mean age was 36.8 ± 16.2 The sole significant factor, influencing actual visits to be occurred with a companion, was the solution for transportation issues (odds ratio [OR]: 26.25). It was found that unmarried individuals (single/divorced/widowed) (OR: 5.47), those with higher income (OR: 1.84), and older individuals (OR: 1.04) had a higher tendency to prefer visiting the clinic with companion while female are as opposite (OR: 0.50). Anxiety, perceived social support, and health literacy weren't associated with actual situation or desire to have companion., Conclusion: Patients have companions to address tangible issues. However, different factors may influence the desire to have a companion. There is a large group of individuals who, are accompanied at clinic visits against their wishes, indicating a conflict between being accompanied and the desire for one., Patient or Public Contribution: Our study was inspired by the unsolicited comments of patients made about their companions during clinical visits. Additionally, community provided valuable feedback during the pilot application phase, particularly in the development of the data form., (© 2025 The Author(s). Health Expectations published by John Wiley & Sons Ltd.)

Background: Psoriasis is a chronic, immune-mediated skin disease characterized by lifelong persistence and fluctuating symptoms. The clinical similarities among its subtypes and the diversity of symptoms present challenges in diagnosis. Early diagnosis plays a vital role in preventing the spread of lesions and improving patients' quality of life. Methods: This study proposes a hybrid model combining multiple transfer learning and ensemble learning methods to classify psoriasis subtypes accurately and efficiently. The dataset includes 930 images labeled by expert dermatologists from the Dermatology Clinic of Fırat University Hospital, representing four distinct subtypes: generalized, guttate, plaque, and pustular. Class imbalance was addressed by applying synthetic data augmentation techniques, particularly for the rare subtype. To reduce the influence of nonlesion environmental factors, the images underwent systematic cropping and preprocessing steps, such as Gaussian blur, thresholding, morphological operations, and contour detection. DenseNet-121, EfficientNet-B0, and ResNet-50 transfer learning models were utilized to extract feature vectors, which were then combined to form a unified feature set representing the strengths of each model. The feature set was divided into 80% training and 20% testing subsets and evaluated using a hard voting classifier consisting of logistic regression, random forest, support vector classifier, k-nearest neighbors, and gradient boosting algorithms. Results: The proposed hybrid approach achieved 93.14% accuracy, 96.75% precision, and an F1 score of 91.44%, demonstrating superior performance compared to individual transfer learning models. Conclusions: This method offers significant potential to enhance the classification of psoriasis subtypes in clinical and real-world settings.

Competing Interests: Declaration of interests We declare no competing interests.

LPIN1 deficiency is an autosomal recessive disease caused by biallelic mutations in LPIN1, where impaired fatty acid metabolism leads to stress in skeletal muscle, resulting in severe rhabdomyolysis, often triggered by fever, exercise, fasting, and anesthesia. It is the second most common cause of severe, recurrent episodes of rhabdomyolysis in early childhood which can result in serious morbidity and mortality. To date, 71 patients have been published in 20 clinical studies in the form of case series. We describe two previously unreported cases, one with a novel LPIN1 mutation that resulted in mortality, and another, to the best of our knowledge, with the first reported compartment syndrome managed with a favorable outcome in this disorder. Recognition of the complications including ventricular arrythmias, acute renal failure and compartment syndrome on the severe end of the spectrum may change the outcome and prognosis of this devastating condition., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2022. Published by Elsevier B.V.)

Sarcoidosis is an immune mediated granulomatous disease commonly affecting the lungs. Genome wide association studies identified many genomic regions that are shared among multiple immune mediated diseases. However, ANXA11 gene polymorphism rs1049550 is exclusively associated with sarcoidosis, making it a key gene of interest for sarcoidosis disease pathogenesis. However, sarcoidosis is a heterogeneous disease and contradictory findings for ANXA11 have been reported for disease phenotypes. We performed a case-control association study to investigate if ANXA11 associates with benign (Löfgren's syndrome (LS)) or chronic sarcoidosis and performed a meta-analysis on previously reported findings. A total of 262 sarcoidosis patients, of which 149 had LS and 113 chronic sarcoidosis, and 363 controls were genotyped for rs1049550. Meta-analysis included allele findings for rs1049550 from 6 additional studies. We found a significantly lower T allele frequency in sarcoidosis patients than in healthy controls (0.30 vs. 0.41, respectively, odds ratio (OR) 0.61, 95% confidence interval (CI) 0.48-0.77, p = 3 × 10 -5 ). In LS the T allele frequency of 0.33, and in chronic sarcoidosis the T allele frequency of 0.26 were significantly lower than in healthy controls (OR 0.69, 95% CI 0.52-0.92, p = 0.01 and OR 0.51, 95% CI 0.36-0.70, p = 4 × 10 -5 , respectively). Meta-analysis including previously published European, African American and Asian cohorts confirmed the association of rs1049550 with sarcoidosis and resulted in a pooled OR of 0.70 (CI 0.66-0.75, p = 3.58 × 10 -29 ). Presence of the T allele of rs1049550 in ANXA11 is protective for sarcoidosis, including benign and chronic phenotypes of the disease.

COVID-19 is a disease caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). The introduction of vaccines against COVID-19 caused great enthusiasm around the world as immunization might end the pandemic. However, it was previously stated that COVID-19 cases would rarely continue to occur despite immunization. Fourteen days after the second dose of the vaccine, a 66-year-old male patient with a negative COVID-19 PCR test result and high levels of IgG and low levels of IgM-A against SARS-CoV-2 was admitted to our intensive care unit (ICU) due to the clinical picture of Acute Respiratory Distress Syndrome (ARDS). We aimed to stress the need for continuing preventive measures in vaccinated individuals, too, by presenting the clinical findings of the patient, who was considered to have developed ARDS due to COVID-19, as high levels of IgG and IgM-A against SARS-CoV-2 were detected on day 8 during ICU admission., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

CXXC5 is a member of the zinc-finger CXXC family proteins that interact with unmodified CpG dinucleotides through a conserved ZF-CXXC domain. CXXC5 is involved in the modulation of gene expressions that lead to alterations in diverse cellular events. However, the underlying mechanism of CXXC5-modulated gene expressions remains unclear. Proteins perform their functions in a network of proteins whose identities and amounts change spatiotemporally in response to various stimuli in a lineage-specific manner. Since CXXC5 lacks an intrinsic transcription regulatory function or enzymatic activity but is a DNA binder, CXXC5 by interacting with proteins could act as a scaffold to establish a chromatin state restrictive or permissive for transcription. To initially address this, we utilized the proximity-dependent biotinylation approach. Proximity interaction partners of CXXC5 include DNA and chromatin modifiers, transcription factors/co-regulators, and RNA processors. Of these, CXXC5 through its CXXC domain interacted with EMD, MAZ, and MeCP2. Furthermore, an interplay between CXXC5 and MeCP2 was critical for a subset of CXXC5 target gene expressions. It appears that CXXC5 may act as a nucleation factor in modulating gene expressions. Providing a prelude for CXXC5 actions, our results could also contribute to a better understanding of CXXC5-mediated cellular processes in physiology and pathophysiology., (© 2021. The Author(s).)

C-C chemokine receptor 5 (CCR5) and polymorphisms in CCR5 gene are associated with sarcoidosis and Löfgren's syndrome. Löfgren's syndrome is an acute and usually self-remitting phenotype of sarcoidosis. We investigated whether the single nucleotide polymorphism (SNP) rs1799987 is associated with susceptibility for Löfgren's syndrome and has an effect on CCR5 expression on monocytes and function of CCR5. A total of 106 patients with Löfgren's syndrome and 257 controls were genotyped for rs1799987. Expression of CCR5 on monocytes was measured by flowcytometry. We evaluated calcium influx kinetics following stimulation upon N-formylmethionyl-leucyl-phenylalanine (fMLP) and macrophage inflammatory protein-1α (MIP-1α) on monocytes by measuring the median fluorescence intensity (MFI). The frequency of the G allele of rs1799987 was significantly higher in Löfgren's syndrome than in healthy controls ( p = 0.0015, confidence interval (CI) 1.22-2.32, odds ratio (OR) 1.680). Patients with a GG genotype showed higher CCR5 expression on monocytes than patients with the AA genotype ( p = 0.026). A significantly ( p = 0.027) lower count of patients with the GG genotype showed a calcium influx reaction to simulation upon MIP-1 α, compared with patients with the AA genotype. The rs1799987 G allele in CCR5 gene is associated with susceptibility to Löfgren's syndrome and with quantitative and qualitative changes in CCR5, potentially effecting the inflammatory response.

Purpose: 5-flourourasil (5-FU) is commonly used for early intraperitoneal chemotherapy in colorectal or appendiceal cancer patients with peritoneal carcinomatosis. Due to its effect, anastomosis healing can be impaired and leads to anastomotic leakage. In this study, we aimed to investigate the potential healing effect of platelet-rich plasma (PRP) on colonic anastomosis impaired by intraperitoneal 5-flourouracil application., Methods: After ten rats were sacrificed for preparing PRP, forty Wistar-albino rats were subjected to colonic anastomosis, and randomly allocated into four groups including 10 rats each. According to receiving PRP and/or 5-FU application, the groups were formed as control (C), 5-FU without PRP (CT), anastomosis with PRP (C-PRP), and 5-FU with PRP (CT-PRP). CT and CT-PRP groups also received 5-FU intraperitoneally on postoperative day 1 (POD 1). All animals were euthanized on pod 7. The body weight change, anastomotic bursting pressure (ABP), tissue hydroxiprolin (TH) and histopathological examination of each group were analyzed., Results: 5-FU application significantly reduced ABP levels when compared with group C, C-PRP and CT-PRP (for each comparison, p<0,01). PRP application in CT-PRP group raised the measure of ABP up to the levels of C group. Although tissue hydroxyproline levels (THL) levels of CT-PRP group were found higher than CT group, it was not significant (p=0.112). Microscopically, comparing with CT group, PRP application significantly promoted the healing of colonic anastomosis subjected to 5-FU application by improving tissue edema, necrosis, submucosal bridging and collagen formation (p<0.05). Tissue healing in CT-PRP group was observed as good as the control groups. (C, C-PRP, p=0.181, p=0.134; respectively)., Conclusion: PRP administration on colonic anastomosis significantly promotes the healing process of anastomosis in rats receiving 5-FU. This result encourages further clinical use of PRP to reduce the frequency of AL in patients receiving EPIC.

Background: Gestational diabetes mellitus (GDM) is defined as impaired glucose tolerance with onset during the second or third trimester of pregnancy., Aims: The purpose of this study was to investigate the prevalence of pregnant women who were not screened for gestational diabetes mellitus and compare the maternal and fetal outcomes of women who had undergone GDM screening., Methods: Women who refused to attend the gestational diabetes screening test (n = 162) at a maternity hospital in Ankara, Turkey, between October 2014 and January 2015 were included in this prospective cohort study. The control group (matched for age and body mass index) was recruited from women who agreed to have the gestational diabetes screening test (n = 194)., Results: Just 12% of pregnant women did not attend gestational diabetes screening test; these women were at higher risk for idiopathic polyhydramnios (P = 0.026). Prevalence of GDM was 8.8% (n = 17) in the control group and 30.9% (n = 50) in those who refused GDM screening. The maternal and fetal outcomes of GDM patients were similar in both groups. Women who did not attend GDM screening test had increased risk for mild idiopathic polyhydramnios in late gestation., Conclusions: Fasting and postprandial plasma glucose screening can replace gestational diabetes mellitus screening in women who refuse to have the glucose load test., (Copyright © World Health Organization (WHO) 2019. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).)

Remote synchronization (RS) is characterized by the appearance of phase coherence between oscillators that do not directly interact through a structural link in a network but exclusively through other units that are not synchronized or more weakly synchronized with them. This form of phase synchronization was observed initially in starlike motifs and later in random networks. In this paper, we report on an experimental setup for the analysis of RS in networks of Stuart-Landau oscillators and in particular investigate the behavior of tree structures focusing on the path to synchronization, that is, on the analysis of how synchronization emerges as the coupling strength increases from zero. We find that RS occurs in a region wherein further increases of the coupling strength lead to a direct transition to global synchronization but may also be observed in a second region, corresponding to lower coupling values, wherein it first emerges and then disappears, hallmarking a scenario that we denote as fading of remote synchronization. We show that this result is related to the behavior of pairs of remotely synchronized nodes observed in networks with more general topologies. Experiments are corroborated by numerical simulations confirming the major findings and providing further characterization of the phenomenon. We demonstrate that the distribution of natural oscillation frequencies and the parameter uncertainty in the links both play a fundamental role in shaping the behaviors observed.

Aim: The purpose of this study was to determine the mediating role that work alienation has in the effect of loneliness at the workplace on nurses' job performance., Background: The literature includes no research on the relationship between nurses' workplace loneliness, work alienation and job performance. The study used work alienation as a mediating variable, which adds to the originality of the study. This study was carried out to contribute to relevant field research., Methods: The study used a cross-sectional research design and surveyed 138 nurses working in a public hospital in Turkey. The data were analysed using descriptive statistical methods, Pearson correlation analysis and the PROCESS macro Model 4 in the regression analysis., Results: Workplace loneliness has a negative effect on job performance. This negative effect is magnified when work alienation is used as a mediating variable., Conclusion: Nurses' loneliness at the workplace and work alienation leads to a decline in their job performance., Implications for Nursing Management: Nursing managers should take into consideration that nurses' feelings of workplace loneliness and alienation can reduce the nurses' job performance. When managers create formal and informal support networks, it can reduce nurses' negative feelings of loneliness and alienation. Thus, helping nurses to perform better at work., (© 2018 John Wiley & Sons Ltd.)

17beta-estradiol (E2), the main circulating estrogen hormone, is involved in a wide variety of physiological functions ranging from the development to the maintenance of many tissues and organs. The effects of E2 on cells are primarily conveyed by the transcription factors, estrogen receptor (ER) alpha and beta. The regulation of responsive genes by the well-defined ER alpha in response to E2 relies on complex and highly organized processes that dynamically integrate functions of many transcription regulators to induce spatiotemporal alterations in chromatin state and structure. Changes in gene expressions result in cell-specific responses that include proliferation, differentiation and death. Deregulation of E2-ER alpha signaling contributes to the initiation and progression of target tissue malignancies. We aim here to provide a review of recent findings on dynamic transcriptional events mediated by E2-ER alpha with the anticipation that a better understanding of complex regulatory mechanisms underlying ER actions would be a critical basis for the development of effective prognostic tools for and therapeutic interventions against estrogen target tissue malignancies.

Objective: The objective of this study is to investigate the urinary neutrophil gelatinase-associated lipocalin (uNGAL) levels in the second trimester of pregnant patients at the time of gestational diabetes mellitus (GDM) screening., Materials and Methods: Urinary samples from 88 pregnant women who underwent gestational diabetes screening test were collected in late second trimester (24-28 weeks) prospectively. After an overnight fasting, 75 g GTT was performed. The blood samples were drawn for measurement of glucose, insulin, and HbA1c. The urinary and blood parameters were compared for pregnant women with or without gestational diabetes., Results: uNGAL levels were significantly elevated in pregnant women with gesting compared with the control groups (p < .014). There was a positive correlation between uNGAL and HbA1c levels (p = .001)., Conclusions: In the second trimester, at the time of GDM screening, high levels of uNGAL indicate tubular injury in GDM cases which seems to be a result of hyperglycemia. uNGAL may correlate with an inflammatory renal involvement in GDM.

Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Objective: To evaluate the effect of pre-pregnancy body mass index on maternal and perinatal outcomes among adolescent pregnant women., Methods: We conducted this prospective cross-sectional study on 365 singleton adolescent pregnancies (aged between 16 and 20 years) at a Maternity Hospital, between December 2014 and March 2015. We divided participants into two groups based on pre-pregnancy body mass index (BMI): overweight and obese adolescent (BMI at or above 25.0 kg/m) and normal weight (BMI between 18.5 and 24.99 kg/m) adolescent. We used multivariate analysis to evaluate the association of the risk of adverse pregnancy outcomes and pre-pregnancy BMI., Results: The prevalence of maternal overweight/obesity and normal weight was 34.6% (n = 80) and 65.4% (n = 261) in the study population, respectively. Compared with normal-weight teens (n = 234), overweight/obese teens (n = 71) were at higher risk for cesarean delivery (odds ratio [OR] 0.7, 95% confidence interval [CI] 0.4-1.4), preeclampsia (adjusted odds ratio [OR] 0.1, 95% confidence interval [CI] 0.02-0.9) and small of gestational age (odds ratio [OR] 0.2, 95% confidence interval [CI] 0.1-0.9)., Conclusion: BMI increased during pre-pregnancy could be an important preventable risk factor for poor obstetric complications in adolescent pregnancies, and for these patients prevention strategies (e.g., nutritional counseling, weight-loss, regular physical activity) for obesity are recommended before getting pregnant.

Objective: Fibromyalgia (FM) is a chronic disease characterized by widespread pain. Somatic complaints associated with the cardiovascular system, such as chest pain and palpitations, are frequently seen in FM patients. P and QT dispersions are simple and inexpensive measurements reflecting the regional heterogeneity of atrial and ventricular repolarization, respectively. QT dispersion can cause serious ventricular arrhythmias. The aim of the present study was to evaluate QT dispersion and P wave dispersion in patients with FM., Material and Methods: The study involved 48 FM patients who fulfilled the established criteria and 32 healthy controls (HC). A standard 12-lead electrocardiogram was performed on all participants. QT dispersion was defined as the difference between the longest and the shortest QT intervals. Similarly, the differences between the shortest and longest P waves were defined as P wave dispersion., Results: The QT dispersion and corrected QT dispersion were shorter in the FM group compared with the HC group (p<0.001 for both). In terms of the P wave dispersion value, there was no significant difference between the FM and HC groups (p=0.088)., Conclusion: Longer QT and P wave dispersions are not problems in patients with FM. Therefore, it may be concluded that fibromyalgia does not include an increased risk of atrial and/or ventricular arrhythmias., Competing Interests: No conflict of interest was declared by the authors.

Objectives: Venous thromboembolism (VTE) is an important cause of morbidity and mortality. A disintegrin and metalloprotease with thrombospondin type-1 repeats-13 (ADAMTS-13) is a metalloprotease that cleaves plasma von Willebrand factor (VWF) multimers. The presence of large VWF multimers in the plasma due to ADAMTS-13 deficiency is the main factor in the pathogenesis of thrombotic thrombocytopenic purpura. The present study aimed to investigate the relation of plasma levels of ADAMTS-13 and VWF antigen with VTE., Methods: The present study included 30 patients with VTE and age- and gender-matched 30 healthy subjects. Patients with any condition (diabetes, icterus, hyperlipidemia, physical, or surgical trauma, acute coronary syndrome, pregnancy, renal insufficiency, liver disease, malignancy, collagen tissue disease, chronic or acute inflammation, drug use affecting thrombocyte function) that could affect plasma VWF antigen or ADAMTS-13 levels were excluded. Plasma ADAMTS-13 and VWF antigen levels in the VTE and control groups were quantitatively determined by enzyme-linked immunosorbent assay method., Results: The median ADAMTS-13 level was 280 ng/ml (minimum-maximum, 70-1120 ng/ml) in the VTE group and 665 ng/ml (minimum-maximum, 350-2500 ng/ml) in the control group; the difference between the groups was significant (P < 0.0001). The mean VWF antigen level was 1750 ± 616 mU/ml in the patient group, which was significantly higher than that of the control group (950 ± 496 mU/ml) (P < 0.0001)., Conclusion: Significantly lower ADAMTS-13 levels and significantly higher VWF antigen levels were concluded to be the result of a pathological process rather than an etiological factor for VTE.

Rationale: Sarcoidosis is a multisystem disease of unknown cause. Löfgren's syndrome (LS) is a characteristic subgroup of sarcoidosis that is associated with a good prognosis in sarcoidosis. However, little is known about its genetic architecture or its broader phenotype, non-LS sarcoidosis., Objectives: To address the genetic architecture of sarcoidosis phenotypes, LS and non-LS., Methods: An association study in a white Swedish cohort of 384 LS, 664 non-LS, and 2,086 control subjects, totaling 3,134 subjects using a fine-mapping genotyping platform was conducted. Replication was performed in four independent cohorts, three of white European descent (Germany, n = 4,975; the Netherlands, n = 613; and Czech Republic, n = 521), and one of black African descent (United States, n = 1,657), totaling 7,766 subjects., Measurements and Main Results: A total of 727 LS-associated variants expanding throughout the extended major histocompatibility complex (MHC) region and 68 non-LS-associated variants located in the MHC class II region were identified and confirmed. A shared overlap between LS and non-LS defined by 17 variants located in the MHC class II region was found. Outside the MHC region, two LS-associated loci, in ADCY3 and between CSMD1 and MCPH1, were observed and replicated., Conclusions: Comprehensive and integrative analyses of genetics, transcription, and pathway modeling on LS and non-LS indicates that these sarcoidosis phenotypes have different genetic susceptibility, genomic distributions, and cellular activities, suggesting distinct molecular mechanisms in pathways related to immune response with a common region.

Aim. To investigate the role of a novel oxidative stress marker, thiol/disulphide homeostasis, in patients diagnosed with acute appendicitis (AA). Methods. In this study, seventy-one (43 male and 28 female) patients diagnosed with AA and 71 (30 male and 41 female) healthy volunteers were included. Age, gender, body mass index (BMI), haemoglobin (Hb), white blood cell (WBC), c-reactive protein (CRP), and thiol/disulphide homeostasis parameters (native thiol, total thiol, disulphide, disulphide/native thiol, native thiol/total thiol, and disulphide/total thiol ratios) were compared between the groups. Thiol/disulphide homeostasis was determined by a newly developed method by Erel and Neselioglu. Results. The native thiol, total thiol, and the native thiol/total thiol ratio levels were statistically significantly decreased in the AA compared with the control group (p < 0.001). Disulphide level and the ratios of disulphide/native thiol and disulphide/total thiol were higher in the AA group than in the control group (p < 0.001). There was a negative correlation of CRP with native thiol, total thiol, and native thiol/total thiol ratio while there was a positive correlation of CRP with disulphide/native thiol and disulphide/total thiol in the AA group. In the stepwise regression model, risk factors as disulphide/native thiol (OR = 1.368; p = 0.018) and CRP (OR = 1.635; p = 0.003) were determined as predictors of perforated appendicitis compared to the nonperforated group. Conclusion. This is the first study examining the thiol/disulphide homeostasis as a diagnostic aid in AA and establishing thiol/disulphide homeostatis balance shifted towards the disulphide formation due to thiol oxidation. Further studies are needed to optimize the use of this novel oxidative stress marker in AA.