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Esma Kürklü-Gürleyen,1 Merve Öğüt-Erişen,1 Onur Çakır,1 Ömer Uysal,2 Gülsüm Ak1 1Department of Oral Surgery, Faculty of Dentistry, Istanbul University, 2Department of Biostatistics and Medical Informatics, Faculty of Medicine, BezmiÂlem Vakif University, Istanbul, Turkey Purpose: To assess 1) patient satisfaction of a mucoadhesive biopatch with citrus essential oil and 2) the change in pain severity and the oral health-related quality of life in patients with recurrent aphthous stomatitis. Patients and methods: Thirty-seven patients with recurrent aphthous stomatitis participated in the study. Baseline records of personal data, ulcer assessment, visual analog scale, and Oral Health Impact Profile-14 were documented. A mucoadhesive patch was applied over the ulcer. Patients were recommended more applications if pain continued. On the fifth day, a post-therapy assessment was made. Results: The mean visual analog scale scores at baseline and posttreatment were significantly different (7.3±2.11 and 4.9±2.6, respectively; P=0.001). The mean duration of pain reduced after patch application. The mean total Oral Health Impact Profile-14 scores before and after treatment showed a statistically significant difference (P=0.001). In total, 78.4% of patients reported a considerable improvement in oral functions after treatment (P=0.008). Conclusion: The mucoadhesive biopatch containing citrus essential oil resulted in satisfying pain alleviation and restoration of oral functions with a significant improvement in the oral health-related quality of life. Keywords: recurrent aphthous stomatitis, pain, quality of life, essential oil, biopatch, local therapy

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The study was conducted to determine the effect of 7-dehydrocholesterol loaded cyclodextrin (7-DHCLC) and cholesterol-loaded cyclodextrin (CLC) on changes of bull sperm motility during short term storage (+4°C). Collected ejaculates were pooled and divided into 7 groups, as following one control (C); three 7-DHCLC and the other three CLC concentrations. Diluted semen samples were transferred and stored at +4°C and sperm motility was analysed in determined intervals during three days storage period with computer aided sperm analyse (CASA) system. Motility decreased in all groups; however, 7-DHCLC and CLC groups motility decreased in the next two days gradually. But, CLC 1.5 mg/120x106 group were identified as the best groups for protecting motility in short time preservation. In conclusion, adding different rates of 7-DHCLC and CLC to semen extender preserved motility for three days in bull semen stored at +4°C.

Objective: The aim of this study was to investigate the effect of hypothermia (H) on skeletal ischemia-reperfusion (IR) injury in rats by measuring malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), nitric oxide (NO), and interleukin-1 beta (IL-1β) in muscle, and measureing immunohistochemical- inducible nitric oxide synthase (iNOS) staining of skeletal muscle.

Abstract Background Facial prostheses are intended to provide a non-operative rehabilitation for patients with acquired facial defects. By improving aesthetics and quality of life (QOL), this treatment involves reintegration of the patient into family and social life. The aim of this study was to evaluate the perception of QOL in adult patients with facial prostheses and to compare this perception with that of a control group. Methods The study participants consisted of 72 patients, who were divided into three equal-sized groups according to the type of prosthesis (OP- orbital prosthesis, AP- auricular prosthesis, NP - nasal prosthesis) and 24 healthy control participants without any congenital or acquired deformity of face or body. Clinical and socio-demographic data were gathered from each person’s medical chart. Participants completed the Turkish version of the World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF). Descriptive statistics, independent sample t-tests, Pearson's chi-square test, ANOVA, ANCOVA, and Pearson correlation were used to analyse the data. Results Compared with the control participants, patients with NP scored lower on the all domains of QOL and all three patient groups had lower scores on overall QOL and its domains of physical and environmental health. Patients with OP reported significantly lower physical health scores than those with AP, while patients with NP reported significantly lower overall QOL and psychological health scores than those with AP. Female patients had lower environmental domain scores than did male patients. The patient’s age and income correlated with social relationships QOL, while the patient’s income and the age of facial prosthesis were correlated with environmental QOL. Conclusion Patients with facial prostheses had lower scores in overall QOL, physical and environmental health domains than the control participants. Socio-demographic and clinical characteristics such as age, gender, income, localization of the defect, and age of facial prosthesis were associated with patients’ QOL. These findings may provide valuable information about the specific health needs of these patients that may affect their well-being. Further studies are needed to confirm these results. Use of the WHOQOL-BREF may provide valuable information for determining patients’ needs and priorities as well as for planning and developing comprehensive prosthetic rehabilitation programs.

Abstract Background In Turkey, formal pre-primary education for children 5- 6 years old provides the ideal setting for school-based oral health promotion programs and oral health care services. To develop effective oral health promotion programs, there is a need to assess this target group's subjective oral health needs as well as clinical needs. The Early Childhood Oral Health Impact Scale (ECOHIS) is a well-known instrument for assessing oral health quality of life in children aged 0-5 years old and their families. This study aimed to adapt the ECOHIS for children 5-6 years old in a Turkish-speaking community and to undertake a preliminary investigation of its psychometric properties. Methods The Turkish version of the ECOHIS was obtained with forward/backward translations, expert panels and pre-testing and it was tested in a convenience sample of 121 parents of 5- 6 year-old children attending nursery classes of three public schools. Data were collected through clinical examinations and self-completed questionnaires. The main analyses were carried out on the imputed data set. The validity of content, face, construct, discriminant and convergent and as well as the reliability of internal and test-retest of the ECOHIS were evaluated. Sensitivity analysis was performed to examine the effect of the complete case analysis for managing "Don't know" responses on the validity and reliability of the ECOHIS. Results The analysis of the imputed data set showed that Cronbach's alphas for the child and family sections were 0.92 and 0.84 respectively, and for the whole scale was 0.93. The intraclass correlation coefficient for test-retest was 0.86. The scale scores on the child and parent sections indicating worse quality of life were significantly associated with poor parental ratings of their child's oral health, high caries experience, higher gingival index scores and problem-orientated dental attendance, supporting its construct, convergent and discriminant validity. Sensitivity analysis showed that the mean imputation method and the complete case analysis did not have differing effects on the validity and reliability of the ECOHIS. Conclusions This study provided preliminary evidence concerning validity and reliability of the Turkish version of the scale among 5-6-year-old children. Future studies should be conducted on the ECOHIS to evaluate fully its psychometric properties in both community- based and clinically-based studies among parents of children younger than five. This study provides initial evidence that the ECOHIS aimed at children aged 0-5 years may be a useful tool for assessing the oral health quality of life in 6 year - old preschool children.

Foam rolling have gained popularity among elite athletes, but the effect of the speed parameter of foam rolling has not yet been determined. Our objective was to investigate the impact of different application speeds of foam roller on the mechanical properties of the quadriceps femoris muscle. Eighteen male professional basketball athletes (age 23 ± 4 years, body mass index 24.43 ± 1.59 kg/m 2 ) participated in this study. We used a crossover design to randomize the order of the treatment speeds (30 beats per minute-FAST, 15 beats per minute-SLOW, and a self-determined speed-SELF) with a one-week washout period between each session. We measured dominant quadriceps femoris muscle tone, elasticity, and stiffness using the Myoton device before and after the interventions. We found that the average rate for SELF was 33±10 beats per minute, making SELF the fastest. All application speeds showed similar results in pre-intervention measurements of the mechanical properties of the tissues ( P > 0.05). However, post hoc analysis revealed that a decrease was evident in SLOW compared to SELF in muscle tone in post-intervention measurements ( P = 0.037). Also, we noted that comparison of pre- and post-intervention on FAST and SLOW showed a significant reduction in muscle tone ( P = 0.002, P = 0.008). Slower foam rolling prior to training or competition may lead to a delay in the reaction time due to the reduction in tonus, that can increase the injury risks. Alternatively, the significant reduction in tonus may be useful in regulating the increased tonus after training and competition., (© Journal of Sports Science and Medicine.)

Context: When deciding to return to sport, literature usually uses evaluations based on physical abilities. But, current literature urges us to use more than physical performance evaluations. Classical dual-task testing methods do not simulate in-game loads and cannot sufficiently measure football players' dual-task capacity., Objective: The purpose of our study was to create a dual-task test that would simulate football players' in- game situations and measure their capacity., Design: Cross-sectional study., Setting: Football Pitch., Participants: Twenty-two football players (aged 17.37±0.52 years) who played in a professional club (U19, elite league) were recruited for our study., Interventions: Novel dual task test with questions containing scenarios from a football game to cognitively load players, while they are performing modified t-test., Main Outcome Measures: After the warm-up period, participants attended four tests in random order: juggling (foot) test, speed dribbling test, long passing test, and 'novel dual-task test'., Results: There was no significant relationship between physical performance parameters and dual task parameters (all ps>0.05). There was a significant increase in the completion time of modified t-test when performed under dual task condition (Z=-7.568, p<0.001). The increase in completion time was found as 2.14±1.29 seconds. This duration difference was calculated as 22.79±14.58%, as dual task cost., Conclusions: Our test provides a new method to measure athletes' dual task capacity, which is not related to physical performance and cannot be measured with current tests. This test also showed players with lower dual task ability could not keep up their performance under dual task conditions, such as passing a ball to a team-mate when being pressed by an opponent. Players with good dual task ability could maintain 1 their performance (got affected only up to 10%); players with poor dual task ability could not maintain their performance and got affected by up to 50% (with a mean of 22.79%).

Previous studies revealed that rapid eye movement (REM) parameters, such as REM latency (RL) and REM density (RD) could be used as electrophysiological markers of depression. Yet these finding should be re-tested in a comorbid-free and drug-free sample. The present systematic review and meta-analysis was conducted to investigate whether drug-free and comorbid-free patients with unipolar depression differentiate from controls with respect to the RL and RD. The PubMed and Web of Science databases were screened from inception to 23 January 2023 for case-control studies comparing RL and RD of patients with unipolar depression and controls. The primary outcome was the standard mean difference. The data were fitted with a random-effects model. Meta-regressions were conducted to investigate patient characteristics and effect size. Publication bias assessment was checked by Egger's Regression and funnel plot asymmetry. Among 43 articles accepted as eligible, 46 RL and 22 RD measurements were included in the meta-analysis. The results indicated shortened RL and increased RD in the patient group than controls. Neither Egger's regression nor funnel plot asymmetry were significant for publication bias. In conclusion, our results tested within drug-free and comorbid-free samples are in line with the literature., Competing Interests: Declaration of competing interest None declared., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The effects of the partial replacement of soybean with alternative local agri-industry by-products and black soldier fly (BSF) larvae meal on broiler growth performance, blood biochemistry, welfare, and, subsequently, economic performance of these diets were evaluated. A total of 524 day-old chicks from a local and a commercial strain were fed one of the three diets from the day of hatch to the slaughter age. The diets were the following: a soybean-based control diet, a diet in which soybean was partially replaced (SPR) with agri-industrial by-products, or a diet with BSF larvae meal added to the SPR (SPR + BSF). There was no effect of the diets on the slaughter weight, total feed consumption, and feed conversion of the chickens. The SPR + BSF diet reduced the blood glucose, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, protein, triglycerides, and cholesterol levels in the local chickens and the gamma-glutamyl transferase, protein, and creatinine levels in the commercial broilers. The negative effect of the SPR diet on plumage cleanliness in the commercial broilers was alleviated by the SPR + BSF diet, whereas 100% of the local birds presented either slight or moderate soiling. The results showed that, due to the high cost of the BSF larvae meal, the SPR + BSF diet was not economically feasible. In a further study, the price trends of BSF larvae will be examined from the standpoint of economic profitability conditions.

Background: In air pistol shooters, the number of studies evaluating the physical characteristics is very few. The purpose of this study was to examine the relationship of core, scapula, and shoulder girdle muscles endurance on performance in air pistol shooters and to determine the importance of the endurance parameters., Methods: Twenty-eight male air pistol shooters were included. The Closed Kinetic Chain Upper Extremity Stability Test, Upper Quarter Y Balance Test, Prone Bridge Test, Side Bridge Endurance Test, and The Scapular Muscle Endurance Test were used to evaluate the endurance of shoulder girdle, core, and scapular muscles. The relationships between endurance and shooting performance parameters were investigated., Results: A positive moderate correlation was found between the scapular muscle endurance test and the shooting performance (P=0.002 r=0.638). A significant regression equation was found for shooting scores (F(1.26)=11.975, P=0.02, R2=0.315). It was observed that the shooting score increased by 0.375 points for each unit increase of the Scapular Muscle Endurance Test. No statistically significant relationship was observed in other parameters (P>0.05)., Conclusions: In this study, core and shoulder girdle muscle endurances were not associated with shooting performance. Scapular muscle endurance may contribute positively to shooting performance. An exercise program to increase scapular muscles endurance can be beneficial for the performance of shooters.

Objective: There is no consensus about the optimal frequency of patient visits during the rehabilitation program after arthroscopic rotator cuff repair (ARCR). This study aimed to investigate the short- and long-term effects of high-frequency (HF) and low-frequency (LF) visits of the patients in the first 12 weeks of rehabilitation after ARCR., Methods: This was a quasi-randomized study with 2 parallel groups. Forty-seven patients with ARCR were included in 2 different patient visit frequency protocols (HF = 23, LF = 24) in 12 weeks of postoperative rehabilitation. Patients in the HF group visited the clinic twice a week, whereas patients in the LF group visited once every 2 weeks for the first 6 weeks and once a week for the following 6 weeks. Both groups performed the same exercise protocol. Outcome measurements were pain and range of motion measured at baseline; at the 3rd, 5th, 8th, 12th, and 24th weeks; and at 1-year follow-up. Shoulder function was assessed at the 12th and 24th weeks and at 1-year follow-up with an American Shoulder and Elbow Surgeons score., Results: There was a significant group × time interaction in pain intensity during the activity between the groups. The activity pain intensity was higher in the LF group (4.2 points) at 8 weeks post surgery than in the HF group (2.7 points) (mean difference: 1.5 points, P < .05), whereas it was similar in both groups at other time periods. The interaction term was not significant between the groups for pain intensity during rest and night through the 1-year follow-up. No group × time interactions were observed in shoulder range of motion and American Shoulder and Elbow Surgeons score over the postoperative period., Conclusion: Both rehabilitation programs at different visit frequencies after ARCR showed similar clinical results in the long term. A supervised, controlled rehabilitation program with LF visits in the first 12 weeks after surgery can be sufficient to achieve optimal clinical results and reduce rehabilitation-related costs after ARCR., Impact: This study highlights that LF treatment protocols under the supervision of the therapist can be adopted after the arthroscopic rotator cuff repair to achieve successful results while decreasing the treatment costs. Physical therapists should plan the treatment sessions efficiently for the compliance of the patients to the exercise treatment., Lay Summary: If you are a patient with arthroscopic rotator cuff repair, a supervised, controlled rehabilitation program with low-frequency visits in the first 12 weeks after surgery could help you achieve the best outcome and help lower the costs of rehabilitation. A total of 3 visits in the first 6 weeks might be sufficient (once every 2 weeks). More frequent visits (1-2 visits a week) should happen 6 to 12 weeks after the surgery., (© The Author(s) 2023. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: Psychiatric evaluations consist of both qualitative questions and quantitative assessments, sometimes questioning the same issue. The present study attempts to investigate the statistical equivalency of several close-ended questions of a procedural psychiatric examination and rating scales addressing a similar problem., Methods: The current retrospective analysis included 314 patients who made their first visit to a private psychiatry clinic. Subjects underwent a routine psychiatric examination, including close-ended questions and related clinical scales. Questions included sleep and sexual problems, problems in marriage, parent relationship problems, and childhood abuse. The related psychiatric scales were Jenkins Sleep Scale, Arizona Sexual Experience Scale, Dyadic Adjustment Scale, and Childhood Trauma Questionnaire, respectively. First, receiver operating curve analysis was conducted for each yes/no question and clinical scale. Then, area under curve sensitivity and specificity values were calculated. Multinomial logistic regression analysis was also performed to observe paired predictor variables., Results: Among clinical questionnaires, the receiver operating curve model provided good area under curve values as prediction criteria for Dyadic Adjustment Scale (0.78; P < . 001), Childhood Trauma Questionnaire (0.74; P < . 001), Childhood Trauma Questionnaire-physical abuse (0.826; P < . 001), Childhood Trauma Questionnaire-sexual abuse (0.828; P < . 001), Arizona Sexual Experience Scale (0.796; P < . 001), and Jenkins Sleep Scale (0.920; P < . 001). Multinomial logistic regression models also revealed good correct classification values for Dyadic Adjustment Scale-Childhood Trauma Questionnaire (61%), Childhood Trauma Questionnaire-Physical abuse-Childhood Trauma Questionnaire-Sexual abuse (87.6%), and Arizona Sexual Experience Scale-Jenkins Sleep Scale (67%)., Conclusion: When the symptoms are investigated in general terms, the present study reveals that an experienced clinician could rely on clinical questions as much as the quantitative scales in both clinical and research domains., Competing Interests: Declaration of Interests: The authors have no conflict of interest to declare., (2023 authors.)

Background: The polymorphisms in the region between 58 and 62 amino acids of the 194-amino acid CagL protein (CagL hypervariable motif) affect the binding affinity of CagL to integrin α5β1 (ITGA5B1) receptor in host epithelial cells and have an effect on the development of various gastrointestinal diseases. We aimed to evaluate the associations of gastroduodenal pathologies, with the polymorphisms of cagL gene of Helicobacter pylori (H. pylori) and also associations between vacA genotypes and cagL polymorphisms., Methods: A total of 19 gastric cancer, 16 duodenal ulcer, and 26 non-ulcer dyspepsia patients were included in this case-control study. All cases had H. pylori. A fragment of 651 bp from gene cagL (hp0539) and cagA, vacA genes was amplified by polymerase chain reaction. Purified polymerase chain reaction products were sequenced by Sanger sequencing, and nucleotide sequences were translated into amino acid sequences., Results: All of the H. pylori strains had cagL and cagA genes. In the 16 (84%) gastric cancer cases, the D58 amino acid polymorphism was significant than the 4 (15.4%) duodenal ulcer cases (P = .029), and the D58/K59 amino acid polymorphism was significant in 12 (63.1%) of the gastric cancer cases than 1 (3.85%) duodenal ulcer case (P = .008). D58/K59 and DKIGQ (n = 10; 52.63%) were the most common polymorphisms in the gastric cancer and were associated with the vacA genotype s1/m2, respectively (P = .022 and P = .008). The D58/K59 amino acid polymorphism was found to have a significant Odds Ratio (OR) value of 8.9 (P = .0017) in multivariate logistic regression analysis., Conclusions: The risk of gastric cancer development is 8.9 times higher with D58/K59 polymorphism.

We investigated the effect of low-intensity focused ultrasound (LIFU) on gene expression related to alcohol dependence and histological effects on brain tissue. We also aimed at determining the miRNA-mRNA relationship and their pathways in alcohol dependence-induced expression changes after focused ultrasound therapy. We designed a case-control study for 100 days of observation to investigate differences in gene expression in the short-term stimulation group (STS) and long-term stimulation group (LTS) compared with the control sham group (SG). The study was performed in our Experimental Research Laboratory. 24 male high alcohol-preferring rats 63 to 79 days old, weighing 270 to 300 g, were included in the experiment. LTS received 50-day LIFU and STS received 10-day LIFU and 40-day sham stimulation, while the SG received 50-day sham stimulation. In miRNA expression analysis, it was found that LIFU caused gene expression differences in NAc. Significant differences were found between the groups for gene expression. Compared to the SG, the expression of 454 genes in the NAc region was changed in the STS while the expression of 382 genes was changed in the LTS. In the LTS, the expression of 32 genes was changed in total compared to STS. Our data suggest that LIFU targeted on NAc may assist in the treatment of alcohol dependence, especially in the long term possibly through altering gene expression. Our immunohistochemical studies verified that LIFU does not cause any tissue damage. These findings may lead to new studies in investigating the efficacy of LIFU for the treatment of alcohol dependence and also for other psychiatric disorders., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Adverse childhood experiences create vulnerability to psychosis through biological and cognitive changes, and that may be observed as an increased emotional and psychotic response to daily life experiences in adulthood. This study aims to examine the effects of childhood maltreatment on psychotic patients' daily stress and emotional and psychotic intensity related to various experiences throughout the day. Daily activities and events, and emotional and psychotic intensity of forty-one psychotic patients were assessed with the Experience Sampling Method. The Childhood Trauma Questionnaire (CTQ) was used to evaluate childhood adversities. Multilevel regression analyses showed that all trauma subtypes, except for sexual abuse, were associated with increased psychosis and event-stress. Emotional maltreatment was the most associated trauma type with high negative and low positive affect and increased daily stress. Patients reported the highest stress and negative affect related to internal experiences but the lowest stress related to recreational actions. Social activities were also associated with higher positive affect and lower stress and psychosis, with the high CTQ group having greater stress in those activities. Our study demonstrates the negative impact of childhood trauma, especially emotional maltreatment, on daily stress and emotional and psychotic intensity in psychotic patients via different daily experiences., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflicts of interest., (Copyright © 2022. Published by Elsevier B.V.)

Context: The wall-slide exercise is commonly used in clinic and research settings. Theraband positioning variations for hip exercises have been investigated and used, but Theraband positioning variations for upper extremity wall-slide exercises, although not commonly used, have not been examined., Objective: To evaluate the effect of different Theraband positions (elbow and wrist) on the activation of the scapular and shoulder muscles in wall-slide exercises and compare these variations with each other and with regular wall-slide exercises for the upper limbs., Design: Descriptive laboratory study., Setting: University laboratory., Patients or Other Participants: A total of 20 participants (age = 23.8 ± 3 years, height = 176.5 ± 8.14 cm, mass = 75.3 ± 12.03 kg, body mass index = 24.23 ± 4.03) with healthy shoulders., Intervention(s): Participants performed wall-slide exercises (regular and 2 variations: Theraband at the elbow and Theraband at the wrist) in randomized order., Main Outcome Measure(s): Surface electromyographic activity of the trapezius (upper trapezius [UT], middle trapezius [MT], and lower trapezius [LT]), infraspinatus, middle deltoid (MD), and serratus anterior (SA) muscles., Results: Regular wall-slide exercises elicited low activity in the MD and moderate activity in the SA muscles (32% of maximal voluntary isometric contraction [MVIC] in the SA), whereas the Theraband-at-elbow and Theraband-at-wrist variations elicited low activity in the MT, LT, infraspinatus, and MD muscles and moderate activity in the SA muscle (46% and 34% of MVIC in the SA, respectively). The UT activation was absent to minimal (classified as 0% to 15% of MVIC) in all wall-slide exercise variations. The Theraband-at-wrist variation produced lower UT:MT, UT:LT, and UT:SA levels compared with the regular wall-slide exercise and Theraband-at-elbow variation., Conclusions: In shoulder rehabilitation, clinicians desiring to activate the scapular stabilization muscles should consider using the Theraband-at-wrist variation. Those seeking more shoulder-abduction activation and less scapular stabilization should consider using the Theraband-at-elbow variation of the upper extremity wall-slide exercise., (© by the National Athletic Trainers' Association, Inc.)

Purpose: This study evaluated the efficacy of treating periodontitis using subgingival nano-hydroxyapatite powder with an air abrasion device (NHAPA) combined with scaling and root planing (SRP)., Methods: A total of 28 patients with stage III periodontitis (grade B) were included in this study, although 1 was lost during follow-up and 3 used antibiotics. The patients were divided into a test group and a control group. All patients first received whole-mouth SRP using hand instruments, and a split-mouth approach was used for the second treatment. In the test group, the teeth were treated with NHAPA for 15 seconds at 70% power per pocket. Subgingival plaque samples were obtained from the 2 deepest pockets at the test and control sites before treatment (baseline) and 3 months after treatment. The full-mouth plaque index (PI), gingival index (GI), papillary bleeding index (PBI), bleeding on probing (BOP), probing depth (PD) and clinical attachment level (CAL) were recorded at baseline and at 1- and 3-month post-treatment. Real-time polymerase chain reaction was used to determine the colonisation of Treponema denticola ( Td ), Porphyromonas gingivalis ( Pg ), and Aggregatibacter actinomycetemcomitans in the subgingival plaque., Results: From baseline to the first month, the test group showed significantly larger changes in BOP and CAL (43.705%±27.495% and 1.160±0.747 mm, respectively) than the control group (36.311%±27.599% and 0.947±0.635 mm, respectively). Periodontal parameters had improved in both groups at 3 months. The reductions of PI, GI, BOP, PD, and CAL in the test group at 3 months were greater and statistically significant. The total bacterial count and Td and Pg species had decreased significantly by the third month in both groups ( P <0.05)., Conclusions: Applying NHAPA in addition to SRP improves clinical periodontal parameters more than SRP alone. Subgingival NHAPA may encourage clot adhesion to tooth surfaces by increasing surface wettability., Competing Interests: No potential conflict of interest relevant to this article was reported., (Copyright © 2022. Korean Academy of Periodontology.)

Background: Shoulder pain is a common symptom for non-traumatic shoulder pathologies and affects 4.7-66.7% of entire population. Even with the latest technological advantages, palpation still is a cost and time efficient tool to evaluate the shoulder pathologies. Our aim was to investigate and compare palpation findings in different shoulder pathologies., Method: We used first assessments of impingement syndrome (IS) (n = 205), rotator cuff tear (RCT) (n = 185) and frozen shoulder (FS) (n = 210) patients who received treatment between 2010 and 2019 years. Two experienced physiotherapists palpated predefined points: long head of biceps brachii, pectoralis minor, lateral intermuscular septum, proximal tendons of extensor group. These points categorized into "proximal", "mid-proximal", "mid-distal", "distal", "irregular". We also grouped patients by their BMIs., Results: We found RCT patients had higher BMI than IS and FS patients (p < 0.001, p = 0.001); more tender intermuscular septum points and night pain than IS patients (p = 0.001, p = 0.003) and more extensor group proximal tendon points than IS and FS patients (p < 0.001, p = 0.001). "No tenderness" group had lesser resting pain than distal group (p < 0.001) and lesser activity and night pain than middle-proximal, middle-distal, and distal groups (all ps < 0.002). Distal group had higher night pain than middle-proximal group (p = 0.003). Morbidly obese patients had higher night pain than normal and overweight patients (p = 0.003 and p = 0.009)., Conclusions: Tender point distribution varies depending on the pathology with biceps brachii being the most common. RCT patients had higher night pain related to more distal tender points. Patients with higher night pain had increased tenderness in septum intermuscular and extensor muscles' proximal tendons., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest regarding the publication of this article., (Copyright © 2020 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.)

Purpose: To search for the utility of DCE-MRP to differentiate between posttreatment enhancement (PT) and tumoral enhancement (TM) in high-grade glial tumors., Materials and Methods: Thirty-four patients with glioma (11 grade 3; 23 grade 4) were enrolled. Enhancement in the vicinity of the resection cavity demonstrated by DCE-MRP was taken into consideration. Based on the follow-up scans, reoperation or biopsy results, the enhancement type was categorized as PT or TM. Measurements were performed at the enhancing area near the resection cavity (ERC), nearby (NNA) and contralateral nonenhancing areas (CLNA). Perfusion parameters of the ERC were also subtracted from NNA and CLNA. Intragroup comparison (paired sample t -test) and intergroup comparison (Student's t -test) were made., Results: There were 7 PTs and 27 TMs. In the PT, the subtracted values of Ve and IAUC from the CLNA and NNA and the subtracted value of Kep from NNA were statistically different. In TM, all metrics were significantly different comparing the CLNA and NNA. Comparing PT with TM, Ktrans, IAUC, Kep, and subtracted values of Ktrans and IAUC from both NNA and CLNA were significantly different., Conclusions: In PT, only Ktrans values did not reveal any difference comparing NNA and CLNA. To differentiate PT from TM, Ktrans, Kep, IAUC, and subtracted values of Ktrans and IAUC from NNA and CLNA can be used. These findings are in concordance with literature., Competing Interests: All the authors report no conflicts of interest., (Copyright © 2022 Tolga Turan Dündar et al.)

Purpose: Pediatric surgeons are exposed to intense work-related activities, depending on their profession, including residency training. This study aims to investigate the musculoskeletal symptoms and analyze the relationship between musculoskeletal symptoms and the demographics, physical activity levels, and body mass index (BMI) of pediatric surgeons., Methods: A total of 82 pediatric surgeons (female, 20; male, 62) were included in this study. The musculoskeletal symptoms were determined using the Cornell Musculoskeletal Discomfort Questionnaire. The levels of physical activity were determined using the International Physical Activity Questionnaire., Results: The mean age of the participants was 48.97 ± 8.894 years, the mean BMI was 26.72 ± 4.12 kg/m 2 , and the mean working time after acquiring their specialty was 18.65 ± 9.83 years. The average surgery counts per week were 15.22 ± 12.17. Pediatric surgeons mostly complained from lower back pain, upper back pain, neck pain, and right and left shoulder pain. Surgeons with higher BMI had higher pain scores and received more treatment sessions., Conclusions: Pediatric surgeons' complaints are related to their total numbers of surgery. Higher BMI and lower physical activity seem to be the major contributing factors for developing musculoskeletal symptoms. The study results indicated that surgeons should keep their BMI levels to the optimum and increase their physical activity levels., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The integration of treatment of wastewater from agro-based industries with microalgae cultivation can reduce costs associated with cultivation while treating wastewater to meet the discharge limits for chemical quality of irrigation in agriculture and to obtain biofertilizers. Rose Oil Processing Effluent (ROPE) can be utilized as a growth medium for Chlorella sp. and thus can be used for biofertilizer production. The present study is aimed at determining the feasibility of the cultivation of Chlorella sp. in ROPE using a tubular photobioreactor with a capacity of 50 L and a raceway to treat ROPE while consuming less energy. The optimum mixing ratio ([ROPE/(ROPE + Bold Basal Medium (BBM)] × 100) was determined as 50% using 2-L Erlenmeyer flasks based on the COD removal efficiency. Better removal efficiencies with regard to COD, BOD 5 , NH 4 + -N, and NO 3 - -N were obtained from the raceway compared to the tubular photobioreactor. The effluents from both systems met the chemical quality of irrigation water. The results of the biomasses harvested from both systems in macro and microelements revealed that they have a potential as a biofertilizer in agriculture. The energetic analysis of the ROPE treatment using the tubular photobioreactor and raceway showed that the raceway system had a better net energy ratio while consuming less energy and producing more energy during cultivation. Overall, the raceway appeared to be a better option to treat ROPE with production of biofertilizer and irrigation water quality while consuming less energy., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Study Design: Prospective randomized comparative (controlled) study., Objective: Management of the severe postoperative back pain followed the major spinal surgeries remains a challenge. The search is going on to find simple, efficient, and reliable perioperative analgesia with low side effects. We aimed to investigate the efficacy of intraoperative freehand erector spinae plane block (ESBP) after spinal surgeries., Summary of Background Data: A few case reports and randomized controlled studies demonstrated the analgesic efficacy of ESPB in spinal surgeries. Up-to-date, no randomized controlled studies investigated the effectiveness of ESPB on spinal instrumentation surgeries., Methods: We randomly divided 56 consecutive adult patients who underwent posterior spinal instrumentation and fusion for spondylolisthesis into two groups. The study (ESPB) group (n = 28) received intraoperative freehand bilateral ESPB with a 20-mL mixture solution of 0.25% bupivacaine and 1.0% lidocaine equally divided into all operating levels. In the control group (n = 28), 20 mL physiological saline was injected. Postoperatively, we ordered 1 g paracetamol thrice/day, besides patient-controlled analgesia pumps with morphine. We performed a postoperative evaluation with a visual analog scale (VAS), morphine consumption, ESPB-related adverse effects, and postoperative length of hospital stay (PLOS)., Results: Morphine consumption was significantly higher in the controls within the first postoperative 24-hour 44.75 ± 12.3 mg versus 33.75 ± 6.81 mg in the ESPB participants (P < 0.001). Except for postoperative 24th-hour VAS (P = 0.127), all postoperative VAS scores recorded at all time-points were significantly higher in the controls (P < 0.05). In control individuals, the first analgesic demand time was shorter, and PLOS was longer (P < 0.001). Patient satisfaction was significantly higher in the ESPB group. We observed no significant difference regarding postoperative complications., Conclusion: Intraoperative ESPB as a part of multimodal analgesia was effective. For posterior instrumented patients with spondylolisthesis, it can relieve postoperative backache and reduce opioid consumption.Level of Evidence: 1., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background/aim: Familial Mediterranean fever (FMF) is a genetically recessive autoinflammatory disease caused by mutations in the Mediterranean fever (MEFV) gene. The aim of this study was to investigate the frequencies of the most common MEFV mutations among a sample of healthy individuals from the Havsa population of European Turkey, where FMF is less prevalent compared to Asian Turkey., Materials and Methods: The study group consisted of 263 unrelated healthy adults. All of the participants were analyzed for the M694V, V726A, M680I, and E148Q mutations in the MEFV gene., Results: In total, 25 of the 263 individuals carried MEFV mutations (9.5%). The observed allele frequencies were 1.5% for M694V (95% confidence interval [CI] 0.5-2.5), 2.6% for E148Q (95% CI 1.6-3.9), 0.5% for M680I (95% CI 0.0-1.1), and 0.0% for V726A. The frequencies of the M694V, M680I, and E148Q mutations were not significantly different from allele frequencies (approximately 20%) determined for other regions of Turkey where FMF is more prevalent., Conclusion: These data suggest that the positivity of the MEFV gene mutation tests have lower predictive value in a population with low FMF prevalence., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

This study investigated the effects of hamstring training methods on the passive viscoelastic properties of hamstring and quadriceps muscles and the relationship of these properties to lower extremity power, hamstring flexibility, and agility. A total of forty healthy individuals were recruited for this study. Participants performed Nordic hamstring exercises (n = 14), hamstring curl exercises (n = 14), or received neuromuscular electrical stimulation (NMES; n = 13) for eight weeks. Measurements were taken both before and one week after the interventions of the viscoelastic properties of hamstring and quadriceps muscles, strength, flexibility, agility, and lower extremity power. Nordic hamstring exercises increased hamstring muscle elasticity while decreasing quadriceps and hamstring muscle stiffness; whereas leg curl exercises increased quadriceps and hamstring muscle stiffness while decreasing quadriceps muscle tone (P < .05). Both strengthening methods increased agility, hamstring flexibility, and vertical jump. NMES produced no noticeable effects. Eccentric and concentric training methods had inverse effects on both hamstring and quadriceps muscles' viscoelastic parameters, but had similar improvements on performance parameters. Since changes in viscoelastic parameters of muscle could affect musculotendinous systems' compliance, clinicians should consider viscoelastic properties over performance parameters, when prescribing concentric or eccentric exercises., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Mucinous pancreatic cystic lesions (PCLs) express different mucin (MUC) types according to their histomorphologic types. High cystic fluid viscosity may help in the detection of mucinous PCLs. We hypothesized that high cystic fluid viscosity may be suggestive of a certain MUC type in mucinous PCLs., Methods: Prespecified MUC types (MUC1, MUC2, MUC4, MUC5AC, and MUC6) were evaluated in 18 definitively diagnosed mucinous PCLs with sufficient tissue material and prediagnostic cyst fluid viscosity evaluation-string sign (SS)-test. We evaluated the agreement of MUC expression with positive SS test results. Later, we compared cystic fluid carcinoembryonic antigen (CEA) between the prespecified MUC expressing and nonexpressing cyst types., Results: A total of 18 mucinous PCL patients, 11 females, with mean age ± SD (59.7 ± 13.3) were included. Almost all malignant mucinous PCLs expressed MUC1 (71.4%) (P = .023). We found no significant agreement between the prespecified MUC types and positive SS, except MUC4 which had mild agreement. Also, no significant relation was found between cystic fluid CEA levels and MUC expression (P = .584)., Conclusion: We did not detect a significantly moderate or good agreement between the prespecified MUC types and SS test. MUC1 was highly expressed in malignant mucinous cysts; however, it was incompatible with the SS test. MUC4 expression showed mild agreement with the SS test in a small number of patients.

Background/aims: The role of cyst fluid carcinoembryonic antigen (CEA) level in differentiating mucinous pancreatic cystic lesions (PCLs) is controversial. We investigated the role of cyst fluid CEA in differentiating low-risk (LR)-intraductal papillary mucinous neoplasms (IPMNs) from high-risk (HR)-IPMNs and LR-mucinous cystic neoplasms (MCNs)., Methods: This was a retrospective study of 466 patients with PCLs who underwent endoscopic ultrasound-guided fine-needleaspiration over a 7-year period. On histology, low-grade dysplasia and intermediate-grade dysplasia were considered LR, whereas high-grade dysplasia and invasive carcinoma were considered HR., Results: Data on cyst fluid CEA levels were available for 50/102 mucinous PCLs with definitive diagnoses. The median CEA (range) levels were significantly higher in HR cysts than in LR cysts (2,624 [0.5-266,510] ng/mL vs. 100 [16.8-53,445]ng/mL, p=0.0012). The area under the receiver operating characteristic curve (AUROC) was 0.930 (95% confidence interval [CI], 0.5-0.8; p<0.001) for differentiating LR-IPMNs from LR-MCNs. The AUROC was 0.921 (95% CI, 0.823-1.000; p<0.001) for differentiating LR-IPMNs from HR-IPMNs. Both had a CEA cutoff level of >100ng/mL, with a negative predictive value (NPV) of 100%., Conclusion: Cyst fluid CEA levels significantly vary between LR-IPMNs, LR-MCNs, and HR-IPMNs. A CEA cutoff level of >100ng/mL had a 100% NPV in differentiating LR-IPMNs from LR-MCNs and HR-IPMNs.