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Kağan Tur,1 Aydın Güçlü2 1Ahi Evran University Faculty of Medicine, Internal Medicine Department, Kirsehir, Turkey; 2Ahi Evran University Faculty of Medicine, Nephrology Department, Kirsehir, TurkeyCorrespondence: Kağan Tur, Ahi Evran University Faculty of Medicine, Internal Medicine Department, Kirsehir, Turkey, Tel +90 5057733927, Email kaantur542@gmail.com; kagan.tur@ahievran.edu.trIntroduction: This study aimed to investigate the relationship between the Malnutrition Inflammation Score (MIS) and the C-reactive protein/albumin ratio (CAR) in patients undergoing hemodialysis (HD).Materials and Methods: Sixty-six End-Stage Renal Disease (ESRD) patients on maintenance hemodialysis were recruited for the study. Malnutrition Inflammation Score, biochemical parameters, and C-reactive protein/albumin ratio were analyzed.Results: The mean age of the participants was 56.47 ± 17.3 years. A statistically significant positive correlation was found between the CRP/albumin ratio and MIS ≥ 7 (r = 0.413, p = 0.026), CRP and MIS ≥ 7 (r = 0.388, p = 0.038) and a negative correlation between albumin and MIS (r = − 0.511, p = 0.005). Additionally, MIS was negatively correlated with hemoglobin (r = − 0.412, p = 0.026) and creatinine (r = − 0.568, p = 0.001), while a positive correlation was found between MIS and ferritin (r = 0.584, p = 0.001) for MIS ≥ 7. A multiple regression ANOVA model confirmed a significant association between CAR, CRP, albumin, and MIS (F = 6.432, p = 0.002), with significant contributions from CAR (p = 0.003), albumin (p = 0.008), and CRP (p = 0.003).Conclusion: Our study is the first to show an independent association between CAR and MIS in hemodialysis patients. The CRP/albumin ratio can serve as a valuable indicator of malnutrition in this population, providing a reliable tool for assessing nutritional status.Keywords: malnutrition inflammation score, malnutrition, CRP/albumin ratio, hemodialysis

Porosity is one of the major problems in casting operations and there are several discussions in the literature about the porosity formation in aluminum castings. Bifilms are the defects that are introduced into the melt by turbulence. They can be detected with reduced pressure test and presented numerically by measuring bifilm index. The measure of bifilm index is the sum of total oxide length given in millimeters from the cross-section of reduced pressure test sample solidified under 0.01 MPa. In this work, low pressure die casting (LPDC) unit was built in an attempt to enhance the producibility rate. The unit consists of a pump housing that was placed inside the melt in the melting furnace where the pressure was applied instead of the whole melt surface. It was observed that the melt quality of A356 alloy was deteriorated over time which had led to higher porosity. This was attributed to the increased oxide thickness of the bifilm by the consumption of air in between the folded oxides. A relationship was found between bifilm index and pore formation. [ABSTRACT FROM AUTHOR]

Recyclability is one of the great features of aluminium and its alloys. However, it has been typically considered that the secondary aluminium quality is low and bad. This is only because aluminium is so sensitive to turbulence. Uncontrolled transfer and handling of the liquid aluminium results in formation of double oxide defects known as bifilms. Bifilms are detrimental defects. They form porosity and deteriorate the properties. The detection and quantification of bifilms in liquid aluminium can be carried out by bifilm index measured in millimetres as an indication of melt cleanliness using Reduced Pressure Test (RPT). In this work, recycling efficiency and quality change of A356 alloy with various Ti additions have been investigated. The charge was recycled three times and change in bifilm index and bifilm number was evaluated. It was found that when high amount of Ti grain refiner was added, the melt quality was increased due to sedimentation of bifilms with Ti. When low amount of Ti is added, the melt quality was degraded. [ABSTRACT FROM AUTHOR]

Articular cartilage defects heal very poorly and lead to degenerative arthritis. Existing medications cannot promote healing process; cartilage defects eventually require surgical replacements with autografts. As there is not enough source of articular cartilage that can be donated for autografting, materials that promote cartilage regeneration are important in both research and clinical applications. Tissue engineering involves cell growth on biomaterial scaffolds in vitro. These cells are then injected into cartilage defects for biological in vivo regeneration of the cartilage tissue. This review aims first to provide a brief introduction to the types of materials in medicine (biomaterials), to their roles in treatment of diseases, and to design factors and general requirements of biomaterials. Then, it attempts to sum up the recent advances in engineering articular cartilage; one of the most challenging area of study in biomaterials based tissue engineering, as an example to the research on regenerative solutions to musculoskeletal problems with an emphasis on the biomaterials that have been developed as scaffolds for cartilage tissue engineering. The definitive goal on cartilage regeneration is to develop a system using biomimetic approach to produce cartilage tissue that mimics native tissue properties, provides rapid restoration of tissue function, and is clinically translatable. This is obviously an ambitious goal; however, significant progress have been made in recent years; and further advances in materials design and technology will pave the way for creating significantly custom- made cellular environment for cartilage regeneration. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: A double-blind retrospective study was carried out at our oral and maxillofacial surgery department to assess speech and esthetics of primary cheiloplasty in patients operated for unilateral complete cleft lip, alveolus and palate. Materials and Methods: Total sample size was 60. All were operated for unilateral complete cleft lip, alveolus and palate. Age range was between 1 and 21 years. Results of surgeries performed by two surgeons were assessed. The speech of all these patients was judged by a single speech therapist who was unaware of the operating surgeon. All patients were assessed for articulatory errors, namely, omission, distortion, substitution, addition and intelligibility. Sixty-eight words in local language (Kannada) were selected by the speech pathologist. All patients were subdivided into three age groups: ≤5 years, 6–10 years and ≥11 years. The cheiloplasty was assessed using VLS (V: vermilion, L: lip, S: scar) scale for vermilion, lip and scar patterns. Results and Conclusion: Patients undergoing palatoplasty in ≤1 year showed good articulation between the age of 5 and 10 years. Articulation and intelligibility was maximum in patients ≥11 years. Patients at this age try various compensatory mechanisms to overcome communication disabilities. Based on the VLS scale, scarring was the least in all patients. Vermilion and lip patterns showed satisfactory results in most of the patients.

Background : Accurate and rapid detection of COVID-19 remains critical for clinical management, especially in resource-limited settings. Current diagnostic methods face challenges in terms of speed and reliability, creating a need for complementary AI-based models that integrate diverse data sources. Objectives : This study aimed to develop and evaluate a multi-modal machine learning model that combines clinical biomarkers and chest X-ray images to enhance diagnostic accuracy and provide interpretable insights. Methods : We used a dataset of 250 patients (180 COVID-19 positive and 70 negative cases) collected from clinical settings. Biomarkers such as CRP, ferritin, NLR, and albumin were included alongside chest X-ray images. Random Forest and Gradient Boosting models were used for biomarkers, and ResNet and VGG CNN architectures were applied to imaging data. A late-fusion strategy integrated predictions from these modalities. Stratified k-fold cross-validation ensured robust evaluation while preventing data leakage. Model performance was assessed using AUC-ROC, F1-score, Specificity, Negative Predictive Value (NPV), and Matthews Correlation Coefficient (MCC), with confidence intervals calculated via bootstrap resampling. Results : The Gradient Boosting + VGG fusion model achieved the highest performance, with an AUC-ROC of 0.94, F1-score of 0.93, Specificity of 93%, NPV of 96%, and MCC of 0.91. SHAP and LIME interpretability analyses identified CRP, ferritin, and specific lung regions as key contributors to predictions. Discussion : The proposed multi-modal approach significantly enhances diagnostic accuracy compared to single-modality models. Its interpretability aligns with clinical understanding, supporting its potential for real-world application.

Background: Eyelash serums, both prescription and over-the-counter, are gaining popularity for enhancing the appearance of eyelashes through various biologically active molecules. Categorized into prostaglandin analogs and non-prostaglandin analogs, these serums claim increased strength, length, luster, and thickness. Current United States law also requires no efficacy or safety assessments by the Food and Drug Administration before approving products for consumer use, potentially posing health risks for patients seeking over-the-counter eyelash enhancements., Aims: Our aims include exploring proposed benefits and adverse effects associated with eyelash serums, while providing evidence-based clinical recommendations on their use. We aim to contribute valuable insights to the understanding of eyelash serums and their respective safety considerations., Methods: The authors conducted a comprehensive electronic search across databases including PubMed, Embase, Cochrane Central, and Google Scholar to evaluate eyelash serum ingredients. Articles were evaluated by two independent researchers for relevance, and the ingredients discussed were analyzed and given clinical recommendations for eyelash serums based off the Oxford Centre for Evidence-Based Medicine., Results: Results highlight bimatoprost's efficacy, supported by numerous studies evaluating safety and adverse effects. Other prostaglandin ingredients show potential benefits, but further studies are encouraged to enhance the understanding of respective safety profiles. While non-prostaglandins ingredients show promising data, more studies are needed due to a lack of formal evidence in eyelash serum use., Conclusion: As the cosmeceutical market for eyelash serums is growing, dermatologists need to be knowledgeable about evidence-based information regarding prescription and over-the-counter eyelash serum products before making recommendations to patients., (© 2024 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)

Ovarian ischemia is a gynecological emergency that occurs as a result of ovarian torsion, affects women of reproductive age, and reduces ovarian reserve. The current study was designed to investigate the effect of boric acid taken in different ways on histopathological changes, autophagy, oxidative stress, and DNA damage caused by ischemia and reperfusion in the ovary of adult female rats. We established seven groups of 70 adult female rats: untreated control, intraperitoneal boric acid group (IpBA), oral boric acid group (OBA), ischemia/reperfusion group (ischemia/2 h reperfusion; OIR), ischemia/reperfusion and local boric acid group (OIR + LBA), ischemia/reperfusion and intraperitoneal boric acid group (OIR + IpBA), and ischemia/reperfusion and oral boric acid group (OIR + OBA). On the 31st day of the experimental procedure, both ovaries were harvested for histologic (hematoxylen and eosin and Masson trichrom), biochemical (ELISA and AMH, MDA, SOD, and CAT analyses), and comet evaluation. In the OIR group, hemorrhage, edema, inflammation, and diminished follicle reserve were seen in the ovary. Boric acid treatment reduced the ovarian ischemia/reperfusion damage, and the follicles exhibited similar morphological features to the control group. Moreover, boric acid treatment decreased the levels of Hsp70, NF-KB, COX-2, and CD31, which increased as a result of OIR. On the other hand, SCF and AMH levels, which decreased as a result of OIR, increased with boric acid treatment. The levels of autophagy markers (Beclin-1, LC3, and p62) reached values close to those of the control group. According to the biochemical findings, it was concluded that boric acid is also effective on oxidative stress, and the AMH level was particularly high in the OIR + OBA group, consistent with the immunohistochemical staining result. In addition, it was observed that the DNA damage caused by OIR reached values close to those of the control group, especially in the OBA after OIR. This study showed the therapeutic effects of boric acid on OIR injuries; thus, boric acid may be a potential therapeutic agent for ovarian protection and fertility preservation in cases that may cause ovarian torsion., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Chronic spontaneous urticaria (CSU) is an inflammatory skin disease with intricate mechanisms. This study comprehensively assessed markers from diverse metabolic pathways, including novel inflammatory indicators, to evaluate their potential for diagnosing and monitoring CSU., Materials and Methods: In the study involving 90 CSU patients and 90 healthy controls, the levels of albumin, high-density lipoprotein (HDL), fibrinogen, uric acid, D-dimer, C-reactive protein (CRP), and white blood cells (WBC) values were analyzed. The D-dimer/albumin ratio (DAR), fibrinogen/albumin ratio (FAR), and uric acid/HDL ratio (UHR), considered novel inflammatory markers, were calculated. The Urticaria Activity Score 7 (UAS7) was also calculated. Pearson chi-squared test, Mann-Whitney U test, Spearman correlation coefficient, and univariate logistic regression analysis were employed for data analysis., Results: In the patient group, significant elevations were observed in DAR, FAR, fibrinogen, CRP, D-dimer, and UHR values. Additionally, albumin, HDL, and uric acid values exhibited significant decreases. HDL and albumin provided the most accurate results in the univariate logistic regression analysis. CRP had less accuracy, FAR exhibited greater accuracy than fibrinogen, and DAR demonstrated higher accuracy than D-dimer. There was no statistically significant correlation between the UAS7 and parameters. The considerable correlation of CRP with other parameters, except D-dimer, was also remarkable., Conclusions: Indicators from diverse metabolic pathways, including albumin, HDL, uric acid, fibrinogen, D-dimer, and CRP, can be valuable in assessing CSU. In particular, FAR and DAR are emerging as potential markers to consider in the assessment of CSU., (© 2024 The Authors. International Journal of Dermatology published by Wiley Periodicals LLC on behalf of the International Society of Dermatology.)

Background  The evolution of medical school curricula, characterized by truncated preclinical periods and reduced emphasis on ophthalmology, presents formidable obstacles to early exposure for aspiring medical students. The constraints imposed by the coronavirus disease 2019 pandemic further exacerbated the limitations on opportunities, compelling the implementation of innovative initiatives aimed at augmenting students' ophthalmology education through virtual means. Purpose  This article assesses the impact of an Ophthalmology Virtual Externship (OVE) on medical students' knowledge, interest, confidence, and seeking mentorship in ophthalmology. Materials and Methods  A total of 76 students voluntarily participated in the program. The OVE encompassed four virtual sessions, facilitated by 4th year medical students employing a near-peer mentorship framework. The initiative was tailored for 2nd and 3rd year medical students and was conducted under the supervision of a faculty member. All participating students completed both pre- and postexternship surveys utilizing a 7-point Likert scale to gauge their levels of interest, confidence, and inclination toward mentorship opportunities in the field of ophthalmology. Furthermore, assessments of ophthalmology knowledge were administered prior to and subsequent to the externship participation. The degree of satisfaction derived from the OVE experience was also evaluated. Results  Participation in the OVE significantly elevated confidence in knowledge ( p  < 0.001) and mentorship interest ( p  = 0.029). Ophthalmology knowledge test scores also notably improved post-OVE across all participants, irrespective of prior experience ( p  < 0.001), with the most significant increase observed among 2nd and 3rd year students ( p  < 0.0001). After OVE participation, 73% of students expressed intent to pursue ophthalmology opportunities, including mentorship or research. The OVE received an average Likert score of 6.35 out of 7 for student satisfaction. Conclusion  The OVE serves as a virtual learning instrument beneficial for 2nd and 3rd year students with a proclivity for ophthalmology, offering a means to circumvent curriculum-related constraints. Moreover, given the decline in formal ophthalmic education, our study contributes to future research assessing the effectiveness of an OVE in addressing ophthalmic knowledge gaps among all medical students., Competing Interests: Conflict of Interest None declared., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Background: Psoriasis is a chronic inflammatory and papulosquamous dermatological disorder. While previous studies have discussed certain inflammatory markers for diagnosing and monitoring psoriasis, there is an absence of comprehensive research encompassing both novel and traditional inflammatory markers, as well as metabolic markers, in relation to psoriasis., Methods: A total of 209 individuals participated, including 54 psoriasis patients and 155 controls. Psoriasis Area Severity Index (PASI) was calculated for the patient group. Potential predictive markers for psoriasis were identified: Uric acid/HDL ratio (UHR), D-dimer/albumin ratio (DAR), fibrinogen/albumin ratio (FAR), erythrocyte sedimentation rate, CRP, WBC, HOMA-IR, and vitamin D levels. Differences between groups and correlations with PASI and each other were analyzed using the Mann-Whitney U test and Spearman correlation coefficient., Results: The results indicate that the patient group exhibited statistically significantly higher levels of UHR, FAR, CRP, WBC, and HOMA-IR. Upon analyzing the correlations between PASI and the identified markers, statistically significant positive correlation with WBC and negative correlation with vitamin D were observed. The correlations of PASI with other markers did not reach statistical significance. It should be underlined that our study was conducted in a predominantly mild-to-moderate patient population., Conclusions: The absence of specificity of these markers for psoriasis limits their practical application. However, the development of new objective measures by using them in combination with specific data such as PASI will provide significant benefits in terms of disease diagnosis, follow-up, and treatment., (© 2023 The Authors. International Journal of Dermatology published by Wiley Periodicals LLC on behalf of the International Society of Dermatology.)

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that is characterized by recurrent, painful nodules, sinus tract formation, and scarring. We report the case of a 20-year-old female with the abrupt onset of Hurley stage I HS following the implantation of a levonorgestrel intrauterine device (IUD) and complete remission of disease following the removal of the device one year later. To our knowledge, this is the first documented case of long-term remission of HS after the removal of levonorgestrel IUD. We also provide a concise overview of HS and suggested primary interventions for obstetrics and gynecology providers., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Hengy et al.)

Interface dermatitis is a type of dermatological insult to the dermo-epidermal skin junction. When this reaction causes secondary dermatosis that occurs distally on the body, it is known as autosensitization or autoeczematization. Here, we present the case of a middle-aged gentleman, with a medical history including human immunodeficiency virus, non-adherent to highly active antiretroviral therapy, initially presenting due to chronic recurring cellulitis on the left lower leg that had become progressively erythematous and tender to palpation. A few days later, he developed an intensely pruritic, papular rash on his face and chest. Following further investigation, he reported using Neosporin ointment on the leg rash prior to admission which had then caused allergic contact dermatitis. Ultimately, the patient was diagnosed with acute interface dermatitis due to Neosporin use, which led to a secondary autosensitization reaction involving his head, neck, and arms. This case illustrates the importance of thorough history taking and clinical suspicion to appropriately diagnose this phenomenon, further demonstrating the temporal association between allergic contact dermatitis and autosensitization., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Bathla et al.)

Objective: To understand patient and nurse views on usability, design, content, barriers and facilitators of hospital whiteboard utilisation in patient rooms., Design: Multimethods study., Setting: Adult medical-surgical units at a quaternary care academic centre., Participants: Four hundred and thirty-eight adult patients admitted to inpatient units participated in bedside surveys. Two focus groups with a total of 13 nurses responsible for updating and maintaining the whiteboards were conducted., Results: Most survey respondents were male (55%), ≥51 years of age (69%) and admitted to the hospital ≤4 times in the past 12 months (90%). Over 95% of patients found the whiteboard helpful and 92% read the information on the whiteboard frequently. Patients stated that nurses, not doctors, were the most frequent user of whiteboards (93% vs 9.4%, p<0.001, respectively). Patients indicated that the name of the team members (95%), current date (87%), upcoming tests/procedures (80%) and goals of care (63%) were most useful. While 60% of patients were aware that they could use the whiteboard for questions/comments for providers, those with ≥5 admissions in the past 12 months were significantly more likely to be aware of this aspect (p<0.001). In focus groups, nurses reported they maintained the content on the boards and cited lack of access to clinical information and limited use by doctors as barriers. Nurses suggested creating a curriculum to orient patients to whiteboards on admission, and educational programmes for physicians to increase whiteboard utilisation., Conclusion: Bedside whiteboards are highly prevalent in hospitals. Orienting patients and their families to their purpose, encouraging daily use of the medium and nurse-physician engagement around this tool may help facilitate communication and information sharing., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Although common, the impact of low-cost bedside visual tools, such as whiteboards, on patient care is unclear., Purpose: To systematically review the literature and assess the influence of bedside visual tools on patient satisfaction., Data Sources: Medline, Embase, SCOPUS, Web of Science, CINAHL, and CENTRAL., Data Extraction: Studies of adult or pediatric hospitalized patients reporting physician identification, understanding of provider roles, patient-provider communication, and satisfaction with care from the use of visual tools were included. Outcomes were categorized as positive, negative, or neutral based on survey responses for identification, communication, and satisfaction. Two reviewers screened studies, extracted data, and assessed the risk of study bias., Data Synthesis: Sixteen studies met the inclusion criteria. Visual tools included whiteboards (n = 4), physician pictures (n = 7), whiteboard and picture (n = 1), electronic medical record-based patient portals (n = 3), and formatted notepads (n = 1). Tools improved patients' identification of providers (13/13 studies). The impact on understanding the providers' roles was largely positive (8/10 studies). Visual tools improved patient-provider communication (4/5 studies) and satisfaction (6/8 studies). In adults, satisfaction varied between positive with the use of whiteboards (2/5 studies) and neutral with pictures (1/5 studies). Satisfaction related to pictures in pediatric patients was either positive (1/3 studies) or neutral (1/3 studies). Differences in tool format (individual pictures vs handouts with pictures of all providers) and study design (randomized vs cohort) may explain variable outcomes., Conclusion: The use of bedside visual tools appears to improve patient recognition of providers and patient-provider communication. Future studies that include better design and outcome assessment are necessary before widespread use can be recommended., (© 2017 Society of Hospital Medicine)