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Objective: Chimeric antigen receptor (CAR)-T cell therapy is a new immunotherapy approach that has started to been used in recent years and is developing rapidly. CAR-T cells, which are used as an immunotherapy treatment, destroy the tumor cell both directly and by increasing the release of cytokines. Our aim in this study is to evaluate inpatient CAR-T cell therapy patients in our clinic in line with cytokine release syndrome (CRS) and CAR-T related encephalopathy syndrome (CRES) management and to guide clinical practices by sharing the nursing interventions we apply in the management of CAR-T cell post-treatment toxicities. Methods: Thirteen patients who received CAR-T cell therapy between 2020 and 2023 were included in this descriptive study. Following CAR-T cell infusion, the following nine-day period was retrospectively examined from the patients’ files. CRS toxicity findings that might occur after CAR-T cell infusion, CRES toxicity findings, cognitive findings recorded in the CARTOX-10 neurological evaluation form, as well as treatment methods and nursing interventions applied, were evaluated and recorded. Results: When we evaluated the CAR-T cell infusion toxicity findings, 38.46% of the patients had CRS stage 1, 30.79% had CRES stage 2, 15.38% had dysgraphia, 23.07% had cognitive impairment, 7.69% had somnolence and contraction in the arm and shoulder muscles were detected in 7.69%. It was determined that two patients were transferred to the intensive care unit due to both CRS and CRES toxicity findings. Conclusion: The role of nurses is important in monitoring and managing toxicity after CAR-T cell infusion, which is a new treatment option, in determining the patient’s clinical status changes, in the care of the patient, and in expanding the knowledge base on this subject.

Background After a case of stroke, intracranial pressure (ICP) must be measured and monitored, and the gold standard method for that is through an invasive technique using an intraventricular or intraparenchymal device. However, The ICP can also be assessed through a non-invasive method, comprised of the measurement of the optic nerve sheath diameter (ONSD) through ultrasound (US). Objective To evaluate the ICP of patients who underwent wide decompressive craniectomy after middle cerebral artery (MCA) infarction via preoperative and postoperative ONSD measurements. Methods A total of 17 patients, aged between 34 and 70 years, diagnosed with malignant MCA infarction with radiological edema and mid-line shift, who underwent decompressive surgery, were eligible. From the records, we collected data on age, sex, preoperative and postoperative Glasgow Coma Scale (GCS) scores, National Institutes of Health Stroke Scale (NIHSS) score, the degree of disability in the preoperative period and three months postoperatively through the scores on the Modified Rankin Scale (MRS), and the preoperative and postoperative midline shift measured by computed tomography (CT) scans of the brain. Results Preoperatively, the mean GCS score was of 8 (range: 7.7–9.2), whereas it was found to be of 12 (range 10–14) on the first postoperative day (p = 0.001). The mean preoperative NIHSS score was of 21.36 ± 2.70 and, on the first postoperative day, it was of 5.30 ± 0.75 (p

Background/Aim: Periodontal diseases are inflammatory diseases that occur against microbial pathogens. Cytokines are biologically active molecules involved in this inflammatory process. This study aims to evaluate interleukin-1 beta (IL-1b) and interleukin-6 (IL-6) cytokine levels in the gingival crevicular fluid (GCF) of individuals with stage III grade C (SIIIGC) periodontitis, gingivitis (G) and periodontally healthy (PH). Material and Methods: A total of 64 individuals, including 22 PH, 22 G and 20 SIIIGC periodontitis were included in this study. Plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment loss (CAL) parameters were evaluated. GCF samples were analyzed by enzyme-linked immunosorbent assay (ELISA) kits. Results: IL-1b and IL-6 levels in the GCF were significantly higher in the SIII-GC periodontitis group compared to the other groups (P 0.05). GCF IL-1b and IL-6 levels were positively associated with the whole mouth and sampling area clinical periodontal parameters (P < 0.001). Conclusions: GCF IL-1b and IL-6 total amounts are effective in determining the regions and individuals under risk in SIII-GC periodontitis. Moreover, GCF IL-1b and IL-6 levels were seen to be effective determinants in differentiating gingivitis and periodontitis.

Aim: Subarachnoid hemorrhage (SAH) is a serious disease, and it is thought that melatonin may have positive effects after SAH. Bilateral resection or blockage of superior cervical ganglions has constant effects on melatonin levels. Animal models with bilateral superior cervical ganglionectomy (SCG) show the role of superior cervical ganglion on melatonin and give clues about simple precautions which may help to prevent unfavorable outcomes in SAH patients. The aim of this study is to examine how melatonin levels change in SAH and SCG models. Material and Methods: Forty-two Sprague Dawley male rats weighing 200-250 g were used in the study and randomly divided into six groups. Arterial blood samples were collected 24 hours after the procedure in all groups. Serum melatonin levels of the groups were studied. Results: A significant difference in blood melatonin levels was observed between SAH and SCG groups, and against the control group. There was no significant difference between the melatonin levels in SCG group and SAH+SCG group (p=0.983). The mean blood melatonin level of the SAH group was higher than the SCG (p

Iron (Fe) deficiency in plants is one of the widespread problems limiting agricultural production. Generating crops more tolerant to Fe deficiency by genetic engineering or breeding is of great interest but challenging due to the knowledge gaps in general plant Fe homeostasis. Although several genes involved in Fe homeostasis have been identified, characterization of their roles is mainly limited to specific organs at specific developmental stages of the plant, where their mutants show the most striking phenotype. Vacuolar Iron Transporter 1 (VIT1) is a well-known gene that has been characterized for its function in the mature seed of Arabidopsis thaliana. VIT1 is an Fe transporter that determines the correct distribution of Fe storage in this organ. The study aimed to explore new physiological functions for VIT1. As a first step, Arabidopsis thaliana plants that contain PromoterVIT1: GUS constructs were used to study the temporal and spatial expression of the gene throughout the plant’s lifecycle. GUS histochemical staining revealed the VIT1 promoter is active in the mature leaves and mature reproductive organs. VIT1 promoter activity in the stamen increased developmentally and was limited to tapetum and guard cells in the pollen sac. In the female organ, VIT1 promoter activity increased as the pistil developed into a silique. Although all the silique exhibited staining, staining density was higher in the peduncle, replum, and stigma regions. Inside the developing silique, funicles were heavily stained. Furthermore, in silico analyses of VT1 transcriptome and protein levels confirmed flower and the silique are hot spots for VT1 activity. Thus, the results may suggest a possible involvement of VT1 protein in several stages of the reproductive system, specifically in the flowering and in the fruit development.

Öz: Destinasyonlarda turizm faaliyetlerinin gelişmesi, olumlu/olumsuz çevresel, ekonomik ve sosyo-kültürel etkiler yaratmaktadır. Turizmin gelişmesi ve geliştikten sonra sürekliliğinin olması ise o bölgedeki yerel halkın tutum ve davranışlarına bağlıdır. Yerel halkın turizmin etkilerini algılama yönü ve düzeyi turizme olan desteğini etkilemektedir. Bu araştırmada, turizmin olumlu ve olumsuz etkilerinin yerel halkın turistlerin varlığına ilişkin algılarını nasıl etkilediği ve yerel halkın toplumsal yaşam kalitesi üzerindeki etkisinin ne olduğu belirlenmeye çalışılmıştır. Araştırmada veriler turizmin etkileri ölçeğinin ve toplumsal yaşam tatmini ölçeğinin yer aldığı bir anket ile toplanmıştır. Anket, Mart 2019 ayında kolayda örnekleme yöntemi ile İğneada yerel halkına uygulanmıştır. Veri toplama süreci sonunda 188 geçerli ankete ulaşılmıştır. Geçerlilik ve güvenirlik analizlerine bağlı olarak hipotezleri test etmek için çoklu regresyon analizleri gerçekleştirilmiştir. Analiz sonuçları turizmin olumlu çevresel ve sosyo-kültürel etkilerinin yerel halkın toplumsal yaşam kalitesini arttırdığını göstermektedir. Turizmin olumlu etkileri yerel halkın turistlerin bölgeye yararlı oldukları yönündeki düşüncelerini güçlendirmektedir. Ayrıca turizmin olumsuz çevresel ve sosyo-kültürel etkileri turistlerin bölge için zararlı oldukları yönündeki yerel halkın algısını güçlendirirken, turizmin olumsuz ekonomik etkileri turistlerin zararlı oldukları yönündeki yerel halkın algısını zayıflatmaktadır. Abstract: The development of tourism activities in destinations creates positive / negative environmental, economic and socio-cultural effects. The development of tourism and its continuity after development depend on the attitudes and behaviors of the local people residing in that region. The direction and level of perception of the effects of tourism by the local people affect their support for tourism. In this study, it is aimed to reveal how the positive and negative effects of tourism affect the local people'sperception of the presence of tourists and what the impact of these effects is on the local people’s community quality life. The data in the study were collected by a questionnaire including the scale of tourism effects and social life satisfaction scale. The survey was applied to the local people of Iğneada using the convenience sampling method in March 2019. At the end of the data collection process, 188 valid questionnaires were reached. Multiple regression analyzes were performed to test the hypotheses based on validity and reliability analyzes. Analysis results show that the positive environmental and socio-cultural effects of tourism increase the quality of social life of the local people. The positive effects of tourism strengthen the localpeoples' opinion that tourists are beneficial to the region. While the negative environmental and socio-cultural effects of tourism strengthen the perception of the local people that tourists are harmful for the region, the negative economic effects of tourism weaken the perception of the local people that tourists are harmful.

Objective:Hematopoietic stem cell transplantation (HSCT) might have early and late complications. One of the major problem is sleep disturbances. The aim of this study is to evaluate sleep quality of the patients who are undergoing hematopoietic stem cell transplantation, prevent the problems that may be faced according to outcome of the research and determine the nursing approaches in order to prevent for problems.Materials and Methods:This prospective study was performed in the adult bone marrow transplantation unit. The study sample consisted of 59 patients. The Pittsburg Sleep Quality index (PSQI) form was completed by the researchers. For statistical analysis, IBM SPSS Statistics 22 program used.Results:A total of 59 patients 44.1% were female, 55.9% were male. According to the distribution of PSQI total scores on the administration day 42.4%, first week 50.8% on the second week 50.8% of the patients had poor sleep quality. After the discharge, PSQI total scores indicated that at the first week 32.2%, second week 27.1% and the third week 25.4% of the patients had poor sleep quality. During the hospitalization period poor sleep quality significantly increased.Conclusion:It was observed that sleep quality was significantly impaired during the period of HSCT. For this reason, it is important to get information on the history of sleep quality and clinical follow-up by nurses when transplant patients are admitted to the clinic. Improving the care plan for the nurses on the sleep problems can positively affect the quality of life of the patients.

Drug-drug interactions (DDIs) are termed as alteration of drug response with concurrent use of another drug. DDIs which are responsible from 20-30% of all adverse drug reactions lead to preventable morbidity and mortality, prolonged hospital stay and higher financial burden. The aim of this retrospective study was evaluation of prevalence and severity of potential DDIs in inpatient settings. We conducted this study between February-April 2019 in inpatient services of Farabi Hospital of Karadeniz Technical University. Data which consist of patient demographic features and drugs used by patients were obtained from patient files and case sheets. In this study, 25 patients (68% female; 32% male) were included; the mean age of the subjects was 63.32 ± 15.72 years. The drugs were analyzed for the potential DDIs using Lexi-Interact Online which is available on the www.uptodate.com. According to our results the prevalence of potential DDIs which involve alimentary tract and metabolism drugs (n=69, 27.4%) followed by cardiovascular system drugs (n =43; 17.06 %) were common among the drugs. The average number of drugs received in the units were similar. The total number of pDDIs determined as 204, and the mean number of pDDIs per patient was 8.16±6.4 in the units. It is identified that among the total drug interactions 76.5% in the risk category C (monitor therapy), 15.2% in the risk category B (no action needed), and 4.4% in the risk category D (consider therapy modification). The highest total number of pDDIs were identified in the patients of chest diseases unit. Furosemide (n=24, 11.8%) followed by salbutamol (n=21, 10.3%) and the furosemide-budesonide (n=5, 2.5%) combination were the most prevalent drugs which involved in pDDIs. These results indicate the importance of critical evaluation of the patients medication order in the hospital and the urgency of developing strategies to improve drug safety. [Med-Science 2020; 9(2.000): 389-92]

One third of people suffer from anemia, with iron (Fe) deficiency being the most common reason. The human diet includes seeds of staple crops, which contain Fe that is poorly bioavailable. One reason for low bioavailability is that these seeds store Fe in cellular compartments that also contain antinutrients, such as phytate. Thus, several studies have focused on decreasing phytate concentrations. In theory, as an alternative approach, Fe reserves might be directed to cellular compartments that are free of phytate, such as plastids. However, it is not known if seed plastid can represent a major Fe storage compartment in nature. To discover distinct types of Fe storage in nature, we investigated metal localizations in the seeds of more than twenty species using histochemical or X-ray based techniques. Results showed that in Rosids, the largest clade of eudicots, Fe reserves were primarily confined to the embryo of the seeds. Furthermore, inside the embryos, Fe accumulated specifically in the endodermal cell layer, a well-known feature that is mediated by VACUOLAR IRON TRANSPORTER1 (VIT1) in model plant Arabidopsis thaliana. In rice, Fe enrichment is lost around the provasculature in the mutants of VIT1 orthologs. Finally, in Carica papaya, Fe accumulated in numerous organelles resembling plastids; however, these organelles accumulated reserve proteins but not ferritin, failing to prove to be plastids. By investigating Fe distribution in distinct plant lineages, this study failed to discover distinct Fe storage patterns that can be useful for biofortification. However, it revealed Fe enrichment is widely conserved in the endodermal cell layer in a VIT1-dependent manner in the plant kingdom.

The laminar flow air-conditioning system with 100% fresh air is used in almost all operating rooms without discrimination in Turkey. The laminar flow device which is working with 100% fresh air should be absolutely used in Type 1A operating rooms. However, there is not mandatory to use of 100% fresh air for Type 1B defined as places performed simpler operation. Compared with recirculating laminar flow, energy needs of the laminar flow with 100 % fresh air has been emerged about 40% more than re-circulated air flow. Therefore, when a recirculating laminar flow device is operated instead of laminar flow system with 100% fresh air in the Type 1B operating room, annual energy consumption will be reduced. In this study, in an operating room with recirculating laminar flow, optimal conditions have been investigated in order to obtain laminar flow form by analyzing velocity distributions at various supply velocities by using computational fluid dynamics method (CFD).

This study presents pioneering data on how adult early bilinguals (heritage speakers) and late bilingual speakers of Turkish and German process grammatical evidentiality in a visual world setting in comparison to monolingual speakers of Turkish. Turkish marks evidentiality, the linguistic reference to information source, through inflectional affixes signaling either direct (-DI) or indirect (-mIş) evidentiality. We conducted an eye-tracking-during-listening experiment where participants were given access to visual ‘evidence’ supporting the use of either a direct or indirect evidential form. The behavioral results indicate that the monolingual Turkish speakers comprehended direct and indirect evidential scenarios equally well. In contrast, both late and early bilinguals were less accurate and slower to respond to direct than to indirect evidentials. The behavioral results were also reflected in the proportions of looks data. That is, both late and early bilinguals fixated less frequently on the target picture in the direct than in the indirect evidential condition while the monolinguals showed no difference between these conditions. Taken together, our results indicate reduced sensitivity to the semantic and pragmatic function of direct evidential forms in both late and early bilingual speakers, suggesting a simplification of the Turkish evidentiality system in Turkish heritage grammars. We discuss our findings with regard to theories of incomplete acquisition and first language attrition.

The plasticizer di(2-ethylhexyl) phthalate (DEHP) is suspected to induce antiandrogenic effects in men via its metabolite mono(2-ethylhexyl) phthalate (MEHP). However, there is only little information on the kinetic behavior of DEHP and its metabolites in humans. The toxikokinetics of DEHP was investigated in four male volunteers (28-61y) who ingested a single dose (645±20μg/kg body weight) of ring-deuterated DEHP (DEHP-D(4)). Concentrations of DEHP-D(4), of free ring-deuterated MEHP (MEHP-D(4)), and the sum of free and glucuronidated MEHP-D(4) were measured in blood for up to 24h; amounts of the monoesters MEHP-D(4), ring-deuterated mono(2-ethyl-5-hydroxyhexyl) phthalate and ring-deuterated mono(2-ethyl-5-oxohexyl) phthalate were determined in urine for up to 46h after ingestion. The bioavailability of DEHP-D(4) was surprisingly high with an area under the concentration-time curve until 24h (AUC) amounting to 50% of that of free MEHP-D(4). The AUC of free MEHP-D(4) normalized to DEHP-D(4) dose and body weight (AUC/D) was 2.1 and 8.1 times, that of DEHP-D(4) even 50 and 100 times higher than the corresponding AUC/D values obtained earlier in rat and marmoset, respectively. Time courses of the compounds in blood and urine of the volunteers oscillated widely. Terminal elimination half-lives were short (4.3-6.6h). Total amounts of metabolites in 22-h urine are correlated linearly with the AUC of free MEHP-D(4) in blood, the parameter regarded as relevant for risk assessment., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Phthalates like di-n-butyl phthalate (DnBP) and diisobutyl phthalate (DiBP) are commonly used as plasticisers, enteric coatings in medications and their metabolites (MnBP respectively MiBP) are suspect of adverse endocrine activities. The aim of this study was to determine kinetical data in humans after the application of a drug containing 3600 microg of DnBP and to quantify main metabolites of DnBP and DiBP with and without glucuronidase treatment. Since commonly glucuronides do not exhibit endocrine activity it is of interest to determine the potentially active metabolite like free MnBP and MiBP for a valid risk assessment. After the application of one capsule containing 3600 microg of DnBP to 17 volunteers 78% (median of 2248 microg of total MnBP) of administered DnBP was found within 24h in urine. After 24h the levels of MnBP in urine were comparable to concentrations before administration showing a fast elimination. In contrast to controls in all urine samples collected within 24h after the administration of the drug free MnBP was observed with a median of 4% of total MnBP. In controls total MnBP and MiBP were found in median concentration of 23 microg/24h and about 50 microg/24h, respectively and therefore environmental exposure to DnBP is only 1% compared to medication. Since an uptake of 3600 microg in only one capsule is already above the tolerable daily intake (TDI) for DnBP of 10 microg/kg b.w. from a preventive health protection DnBP should be replaced in medical drugs.

Purpose: PET imaging has been recently introduced for investigating the type 1 angiotensin II receptor (AT(1)R) in vivo. The goal of the present study was to investigate the effects of acute and chronic exposure to angiotensin converting enzyme inhibitors (ACEI) on the AT(1)R in the dog kidney., Methods: Animals were imaged at baseline, after acute intravenous ACEI treatment and after a chronic 2-week exposure to an oral ACEI. Control animals were imaged at identical time points in the absence of ACEI treatment., Results: In vivo AT(1)R binding expressed by K (i) was increased in the renal cortex by chronic ACEI treatment (p < 0.05). In vitro measurements of AT(1)R density (B (max)) also revealed significant increases in AT(1)R in isolated glomeruli (p < 0.05). Plasma renin activity was increased, but angiotensin II (Ang II) and the Ang II/Ang I ratio showed a weak correlation with chronic ACEI treatment, consistent with an Ang II escape phenomenon., Conclusion: This study reveals, for the first time, that chronic ACEI treatment increases AT(1)R binding in vivo in the dog renal cortex.

The angiotensin II subtype 1 receptor (AT(1)R) has been linked to the development and progression of renovascular hypertension. In this study we applied a pig model of renovascular hypertension to investigate the AT(1)R in vivo with positron-emission tomography (PET) and in vitro with quantitative autoradiography. AT(1)R PET measurements were performed with the radioligand [(11)C]KR31173 in 11 control pigs and in 13 pigs with hemodynamically significant renal artery stenosis; 4 were treated with lisinopril for 2 weeks before PET imaging. The radioligand impulse response function was calculated by deconvolution analysis of the renal time-activity curves. Radioligand binding was quantified by the 80-minute retention of the impulse response function. Median values and interquartile ranges were used to illustrate group statistics. Radioligand retention was significantly increased (P=0.044) in hypoperfused kidneys of untreated (0.225; range: 0.150 to 0.373) and lisinopril-treated (0.237; range:0.224 to 0.272) animals compared with controls (0.142; range:0.096 to 0.156). Increased binding of [(11)C]KR31173 documented by PET in vivo was confirmed by in vitro autoradiography. Both in vivo and in vitro binding measurements showed that the effect of renal artery stenosis on the AT(1)R was not abolished by lisinopril treatment. These studies provide insight into kidney biology as the first in vivo/in vitro experimental evidence about AT(1)R regulation in response to reduced perfusion of the kidney. The findings support the concept of introducing AT(1)R PET as a diagnostic biomarker of renovascular disease.

Purpose: The appetite suppressants fenfluramine and dexfenfluramine were widely prescribed before being withdrawn from the market in 1997. Both drugs are known to have the potential to damage brain serotonin (5-HT) axons and axon terminals in animals, including nonhuman primates. This study used quantitative positron emission tomography (PET) with [(11)C] McN5652, a serotonin transporter (SERT) ligand to determine whether humans previously exposed to fenfluramines showed reductions in SERT binding parameters., Procedures: Subjects previously treated with fenfluramines for weight loss (N = 15) and age-matched controls (N = 17) underwent PET studies with [(11)C] McN5652. Global and regional distribution volumes (DVs) of [(11)C] McN5652 were compared in the two subject groups using parametric statistical analyses., Results: Compared to controls, subjects previously exposed to fenfluramines had significant reductions in [(11)C]McN5652 binding in 14 of 15 regions of interest, more than four years after drug discontinuation., Conclusions: These results are the first to provide direct evidence for fenfluramine-induced 5-HT neurotoxicity in humans.

Aim: The goal of this study was to investigate the binding characteristics of [(11)C]KR31173 and its applicability for PET studies of the AT(1) receptor (AT(1)R)., Methods: Ex vivo biodistribution and pharmacology were tested in mice. PET imaging was performed in mice, beagle dogs and a baboon. To assess nonspecific binding, PET imaging was performed both before and after pretreatment with a potent AT(1)R antagonist. In the baboon, PET imaging was also performed with the previously developed radioligand [(11)C]L-159,884 for comparison., Results: Ex vivo biodistribution studies in mice showed specific binding rates of 80-90% in the adrenals, kidneys, lungs and heart. Specific binding was confirmed in mice using small animal PET. In dogs, renal cortex tissue concentration at 75-95 min postinjection (pi) was 63 nCi/ml per millicurie at a specific binding rate of 95%. In the baboon renal cortex, tissue activity at 55-75 min pi was 345 nCi/ml per millicurie. In the baboon the specific binding of [(11)C]KR31173 was higher (81%) than the specific binding of [(11)C]L-159,884 (34%)., Conclusion: [(11)C]KR31173 shows accumulation and significant specific binding to the AT(1)R in the kidneys of mice, dogs and baboon. These findings suggest that this radioligand is suited for imaging the renal cortical AT(1)R in multiple species.

(+/-)3,4-Methylenedioxymethamphetamine (MDMA, 'Ecstasy') is a widely used illicit drug that produces toxic effects on brain serotonin axons and axon terminals in animals. The results of clinical studies addressing MDMA's serotonin neurotoxic potential in humans have been inconclusive. In the present study, 23 abstinent MDMA users and 19 non-MDMA controls underwent quantitative positron emission tomography (PET) studies using [11C]McN5652 and [11C]DASB, first- and second-generation serotonin transporter (SERT) ligands previously validated in baboons for detecting MDMA-induced brain serotonin neurotoxicity. Global and regional distribution volumes (DVs) and two additional SERT-binding parameters (DV(spec) and DVR) were compared in the two subject populations using parametric statistical analyses. Data from PET studies revealed excellent correlations between the various binding parameters of [11C]McN5652 and [11C]DASB, both in individual brain regions and individual subjects. Global SERT reductions were found in MDMA users with both PET ligands, using all three of the above-mentioned SERT-binding parameters. Preplanned comparisons in 15 regions of interest demonstrated reductions in selected cortical and subcortical structures. Exploratory correlational analyses suggested that SERT measures recover with time, and that loss of the SERT is directly associated with MDMA use intensity. These quantitative PET data, obtained using validated first- and second-generation SERT PET ligands, provide strong evidence of reduced SERT density in some recreational MDMA users.