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CRISPR/Cas9 is one of the most robust technologies for plant breeding enabling precise and efficient modifications in a genome. This technology is being used for the manipulation of target genes in a host to develop resistance against the plant pathogens. Cucumis sativus elF4E is one of the target genes playing a key role in viral infection during interaction with potyvirus viral proteins genome linked (VPg). Nevertheless, the allelic and positional effect of elF4E mutations in C. sativus is to be clarified in elF4E-VPg interaction. In addition, there are entanglements in the massive production of pathogen-resistant cultivars suitable for commercial production using CRISPR/Cas9 technology. Therefore, we targeted different positions of the elF4E in G27 and G247 inbred lines, using specific gRNA1 and gRNA2 for the first and third exons, respectively, and 1,221 transgene-free plants were selected in segregated T1 generation, where 192 G27 and 79 G247 plants had the least mutation at Cas9 cleavage site of gRNA1 or gRNA2. Crossing was performed to see allelic effects of elfF4E mutations in F1 populations, which were homozygous and heterozygous single (elF4E_1DEL or elF4E_3DEL) and double (elF4E_1-3DEL) mutants. Disease symptoms of watermelon mosaic virus (WMV), papaya ringspot virus (PRSV), and zucchini yellow mosaic virus (ZYMV) were evaluated in both non-edited and edited F1 plants, and we did not observe any symptom in homozygous elF4E_1-3DEL and elF4E_1DEL mutants. However, homozygous elF4E_3DEL was positive in reverse transcription polymerase chain reaction (RT-PCR), even if there were no significant symptoms on the inoculated leaves. ELISA and qRT-PCR indicated lower viral accumulation in homozygous elF4E_3DEL than heterozygous and non-edited plants. Regeneration and transformation protocols were also optimized comprehensively for both the genotypes. The average number of shoots/100 explants was determined for both G27 and G247 as 13.6 and 18.0, respectively. We could not detect any distinguishing difference between the non-edited and edited F1 plants for yield and morphology. Our results demonstrate an effective route for mass production of viral resistant cultivars of cucumber to WMV, ZYMV, and PRSV. In this way, the pathogen-resistant cultivars could be generated to reduce the losses caused by these pathogens in cucumber production.

Recently, infections caused by Aspergillus species have increased dramatically. Invasive aspergillosis (IA) is one of the most important causes of morbidity and mortality in immunocompromised patients, such as those with haematological malignancies who undergo chemotherapy, bone marrow and solid organ transplant recipients, and patients with other immunodeficiency. The most common species causing invasive infections include Aspergillus fumigatus, followed by Aspergillus flavus. Aspergillus nomius is an anamorphic species belonging to Aspergillus section Flavi, which currently include 22 species that can be grouped into seven clades (Aspergillus flavus, Aspergillus tamarii, Aspergillus nomius, Petromyces alliaceus, Aspergillus togoensis, Aspergillus leporis and Aspergillus avenaceus) based on morphological characters, sequence data, and extrolite profiles. These species may also produce toxic and carcinogenic aflatoxins. However, Aspergillus nomius is an emerging pathogen as a cause of IA; we found only two reported cases of invasive infection caused by this fungus in literature up till now. We reported a case of fungal rhinosinusitis caused by Aspergillus nomius in a child with aplastic anaemia and to our knowledge, it is the first case as an agent of rhinosinusitis. The isolate was identified by sequencing based methods.

Candida bloodstream infections are a significant cause of morbidity and mortality in hospitalized patients. The most important contribution of biofilm is the higher antifungal resistance than planktonic cells. We aimed to investigate the biofilm formation rate and antifungal susceptibility characteristics of our bloodstream isolates, and evaluate two different biofilm detection methods. A total of 200 bloodstream Candida isolates were included. The biofilms were formed on 96-well microtiter plates and measured by spectrophotometric percent transmittance and 2,3-bis(2- methoxy-4-nitro-5-sulfo-phenyl)-2H-tetrazolium- 5-carboxanilide colorimetric assay. In addition antifungal susceptibilities of these isolates were evaluated against caspofungin, anidulafungin and amphotericin B by reference method. Biofilm production rate was considerably high among our bloodstream isolates. The most important biofilm producer species was C. tropicalis; C. glabrata had the lowest biofilm production rate. The consistency rate between biofilm detection methods was 66%. Remarkable antifungal resistance was not observed among our isolates in general. In conclusion, biofilm production in Candida species is an important virulence factor, and its rate is considerably high in bloodstream isolates. At present, a standardized method has not been established to detect the biofilm formation.

Abstract Robots are becoming increasingly essential for traversing complex environments such as disaster areas, extraterrestrial terrains, and marine environments. Yet, their potential is often limited by mobility and adaptability constraints. In nature, various animals have evolved finely tuned designs and anatomical features that enable efficient locomotion in diverse environments. Sea turtles, for instance, possess specialized flippers that facilitate both long-distance underwater travel and adept maneuvers across a range of coastal terrains. Building on the principles of embodied intelligence and drawing inspiration from sea turtle hatchings, this paper examines the critical interplay between a robot’s physical form and its environmental interactions, focusing on how morphological traits and locomotive behaviors affect terrestrial navigation. We present a bioinspired robotic system and study the impacts of flipper/body morphology and gait patterns on its terrestrial mobility across diverse terrains ranging from sand to rocks. Evaluating key performance metrics such as speed and cost of transport, our experimental results highlight adaptive designs as crucial for multi-terrain robotic mobility to achieve not only speed and efficiency but also the versatility needed to tackle the varied and complex terrains encountered in real-world applications.

Abstract Background The aim of this study was to investigate whether the level of decrease in cerebral oxygen saturation during the valve placement phase of the transcatheter aortic valve implantation (TAVI) procedure under sedation has an effect on postoperative delirium (POD). Methods The study initially assessed 50 patients between the ages of 50 and 90 years with an indication for TAVI by the cardiac team. Regional cerebral oxygen saturation (rScO2) was measured using Near-infrared spectroscopy (NIRS) before the procedure (T1), during surgical field sterilization (T2), catheter placement (T3), wire manipulation (T4), valve placement (T5) and access site artery repair (T6). Confusion Assessment Method for The Intensive Care Unit (ICU-CAM) test was performed on intensive care unit and the presence of POD was questioned. Patients were divided into two groups as those without POD (Group 1) and those with POD (Group 2). Results The study was completed with 41 patients in total. While POD was present in 12 (29.3%) of the patients evaluated intensive care unit, POD was not observed in 29 (70.7%) patients. The rScO2 value measured at T5 was significantly lower in Group 2 compared to Group 1 (p

INTRODUCTION: Complete blood count (CBC)-derived indices such as neutrophil/lymphocyte (NLR) have been proposed as indicators of systemic inflammation. Modic changes are vertebral endplate lesions associated with low back pain. Modic type 1 changes (MC1s) are inflammatory in nature and more painful than MC2s. However, there are not enough studies on the relationship between MC1s and systemic inflammation. In this study, we aimed to investigate the relationship between MC1s and systemic inflammation by considering the CBC-derived indices. METHODS: This comparative study was conducted at Harran University Hospital between March 2023 and January 2024. In the study, 24 MC1s and 24 MC2s patients were compared in terms of demographic characteristics, pain severity, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), CBC cells and CBC-derived indices. RESULTS: The two groups were statistically similar in terms of age (p=0.111), gender (p=0.752), BMI (p=0.415), pain duration (p=0.860), CRP (p=0.341), ESR (p=0.412), CBC cells (p>0.05) and CBC-derived indices (p>0.05). Only MC1s patients had significantly higher low back pain severity than MC2s patients [7.5+-1.1 (5.0-10.0) vs 6.8+-1.2 (5.0-9.0), p=0.032]. However, no significant correlation was found between pain intensity and other parameters (p>0.05). DISCUSSION AND CONCLUSION: MC1s and MC2s patients are similar in terms of inflammation markers. The greater severity of low back pain in MC1s patients may be related to the local inflammatory nature of MC1s, but not to systemic inflammation. Management of low back pain caused by Modic changes should focus on local treatment approaches.

Objectives: To evaluate the clinical features of pediatric non-infectious uveitis (NIU) patients treated with adalimumab (ADA) and the efficacy of ADA in patients unresponsive to conventional immunosuppressive therapy. Materials and Methods: The records of 91 NIU patients aged ≤16 years who received ADA therapy were evaluated retrospectively. The patients’ demographic and clinical characteristics and treatment approaches were recorded. The efficacy of ADA in patients treated for at least 1 year after failure of conventional immunosuppressive treatment was evaluated by comparing the best corrected visual acuity (BCVA), severity of intraocular inflammation, uveitis flare-ups, topical and systemic corticosteroid (CS) use, and central macular thickness (CMT) values before and after ADA treatment. Results: The study included 103 eyes of 53 patients, of whom 29 (54.7%) were female. The mean age at presentation was 8.2±3.4 (range: 3-16) years. The mean follow-up period was 41.6±28.2 (range: 18-120) months. Twenty-six patients (49.0%) had anterior uveitis, 22 (41.5%) had intermediate uveitis, and 5 (9.4%) had panuveitis. The mean duration of ADA treatment was 23.0±13.7 (range: 12-60) months. Uveitis flare-ups developed in only 13 patients (24.5%) while on ADA treatment. When pre- and post-treatment periods were compared, the mean number of uveitis flare-ups, intraocular inflammation severity, mean dose of topical and systemic CS, and mean CMT values were significantly lower in the post-treatment period (p

Abstract BackgroundPneumonia is a leading cause of mortality in children aged

Robotic burrowing holds promise for applications in agriculture, resource extraction, and infrastructure development, but current approaches are ineffective, inefficient, or cause significant environmental disruption. In contrast, natural burrowers penetrate substrates with minimal disturbance, providing biomechanical principles that could inspire more efficient and sustainable mechanisms. A notable feature of many natural burrowers is their reliance on soft body compositions, raising the question of whether softness contributes to their burrowing success. This review explores the role of soft materials in biological burrowing and their implications for robotic design. We examine the mechanisms that soft-bodied organisms and soft robots employ for submerging and subterranean locomotion, focusing on how softness enhances efficiency and adaptability in granular media. We analyze the gaps between the capabilities of natural burrowers and soft robotic burrowers, identify grand challenges, and propose opportunities to enhance robotic burrowing performance. By bridging biological principles with engineering innovation, this review aims to inform the development of next-generation burrowing robots capable of operating with the efficiency and efficacy seen in nature.

ABSTRACT Aim This study examined the experiences of nursing students who attended hospital clinicals during the COVID‐19 pandemic. Design Study was conducted in a descriptive design. Methods A total of 21 nursing students from the second, third and fourth grades who attended hospital clinics in the spring semester of the 2020–2021 academic year and volunteered to participate in the study were included in the study. Purposive sampling method was used in the study. The themes obtained through content analysis of the interviews were listed and sub‐themes were created. The NVivo computer program was also used in the analysis of the study data. Results A total six main themes were identified in this study. These main themes are the psychological effects of COVID‐19 on students, the effects on their families, the effects on their clinical practice, the students' perspectives on the profession, the behaviours of the staff in the clinical area and the behaviours of patients/patient relatives. Patient or Public Contribution Today, different crisis situations such as pandemics can be encountered. It is important to understand and analyse the experiences of nursing students in difficult and crisis situations. It is clear that the psychological effects on nursing students are high in crisis situations. This study can form a basis for many factors such as preventing stress‐related problems in students in crisis situations, preventing them from leaving the profession and developing a positive view of the profession.

Objectives: Behçet uveitis (BU) is a potentially blinding disorder. The main determinant of visual prognosis is early and appropriate treatment that provides rapid suppression of inflammatory attacks, control of subclinical inflammation, and prevention of new attacks. Our study aimed to determine the Turkish uveitis specialists’ approach regarding the treatment choices and management of special situations such as pregnancy, vaccination, and surgical planning in BU patients, and to increase information sharing and raise awareness of issues where knowledge is lacking. Materials and Methods: A web-based survey including 16 questions about the treatment approach in ocular involvement of Behçet’s disease was sent via e-mail to uveitis specialists in Türkiye. Based on the answers of 49 ophthalmologists who responded to the survey, we evaluated the approaches of uveitis specialists in our country to initiating treatment, selecting therapeutic agents, monitoring, switching and stopping treatment, and special situations such as surgical planning, vaccination, and pregnancy in BU patients. Results: Uveitis specialists in our country mostly act in accordance with the guidelines in the decision to start treatment, selection of therapeutic agents, and monitoring the safety of treatment in BU. However, there is a lack of information about the therapeutic approach in pregnancy and vaccination practices. It was also observed that there is no consensus on the precautions to be taken before cataract surgery. Conclusion: Our study has shown that there is a need for more detailed and widespread information sharing on treatment in preparation for ocular surgery, safety monitoring, drug use during pregnancy, and vaccination in BU patients.

Background. We aimed to evaluate how the parameters used in the diagnosis of metabolic syndrome (MetS) and parameters such as epicardial adipose tissue (EAT) thickness, insulin resistance (IR), and serum uric acid (SUA) are affected according to the severity of obesity. Methods. A total of 120 obese patients aged 10-18 years were classified as class 1-2-3 according to their body mass index (BMI) score. SUA was measured and oral glucose tolerance tests were performed on all patients. MetS components were determined according to the International Diabetes Federation 2007 criteria. IR was calculated using homeostatic model assessment for insulin resistance (HOMA-IR) and whole body insulin sensitivity index (WBISI). Results. HOMA-IR was higher in the class 3 group than in the class 1 (p

Objective: Type 1 diabetes mellitus (T1DM) patients have an increased risk of developing cardiovascular disease. Our study aimed to compare epicardial fat thickness (EFT), carotid intima‐media thickness (cIMT), and arterial stiffness parameters such as pulse wave velocity (PWV), augmentation index (AI), which are well-known early markers of cardiovascular disease in adults, between children with T1DM and healthy individuals. Methods: One hundred fifteen children with T1DM and 87 age, gender, and anthropometric measurements-matched healthy children were included. The inclusion criteria for patients were having T1DM for at least 2 years and ages 8–18 years. Epicardial fat thickness and cIMT were assessed by the same pediatric cardiologist. Noninvasively, the Mobil-O-Graph® was used to evaluate PWV, AI (normalized to a heart rate of 75 beats/sec: AI@75), and the hemodynamic parameters. Results: Epicardial fat thickness and cIMT were higher (p9% group. A strong positive correlation was detected between mean cIMT and microalbuminuria (Rho=,925, p

Objective: Emergency department (ED) blood product requests are rising, but it is unclear if they are excessive. We aimed to examine the blood product requests and usage rates made by emergency physicians to determine whether the requests for blood products are excessive. Material and Method: This prospective, observational, and single-center study analyzed demographic data indications for blood transfusion, and transfusion rates of patients aged 18 years and older admitted to a tertiary adult emergency department in five months. Results: One thousand four hundred seventy-five blood product requests (with a mean of 6.92 units per patient) were examined. Of 63.1%, these requests were not used. The transfusion rates were 40.89 % for erythrocyte suspension, 25.61% for thrombocyte suspension, and 44.34% for fresh frozen plasma. The main indications for requesting blood products were gastrointestinal bleeding and anemia. Specifically, 30.04% of erythrocyte suspensions, 31.9% of thrombocyte suspensions, and 60.56% of fresh frozen plasma were used for patients with gastrointestinal bleeding. In trauma patients, 12.75% of requested erythrocyte suspensions, 0.083% of thrombocyte suspensions, and 13.89% of fresh frozen plasma were utilized. Conclusion: Excessive requests for blood products in the emergency department can misuse resources. The transfusion committee should develop specialized strategies and increase physician awareness to reduce unnecessary requests and optimize resource utilization.

The management of Gram-negative bacterial infections poses a significant challenge due to the emergence of highly effective antibiotic-resistant mechanisms, leading to treatment failures, particularly among hospitalized children. This patient population experiences elevated rates of both mortality and morbidity, and the available antibiotic options against these bacteria are limited. Carbapenems, such as meropenem, represent one of the choices for treatment. While meropenem is highly effective against Gram-negative bacteria, the prevalence of multidrug-resistant infections in hospitals has become a growing concern. In response to this challenge, exploring innovative strategies is crucial. One such strategy is the implementation of high-dose extended meropenem infusion treatment. Researchers propose that extended meropenem treatment may offer a viable solution to combat resistant bacteria. Despite a limited number of studies focusing on the effectiveness of this strategy in children, our comprehensive review of the literature revealed promising findings. Our examination specifically compared extended infusion with standard infusion approaches. The evidence suggests that extended infusion of meropenem provides more benefits compared to standard infusion methods. Researchers consistently reported positive results in their observations, with the exception noted in very low birth weight neonates and children with infections caused by carbapenem-resistant Enterobacteria and Acinetobacter baumannii spp. In conclusion, extended meropenem infusion treatment emerges as a promising option for managing resistant infections. However, it is essential to underscore the need for further studies to robustly support the observed benefits of this treatment regimen.

Objective: We aimed to delineate the distinctive characteristics that aid in distinguishing between Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C) with KD-like manifestations during the pandemic. Materials and Methods: We evaluated KD patients and MIS-C patients with KD-like symptoms admitted during the pandemic (between January 2021 and December 2022). Results: Thirty-three MIS-C patients and 15 KD patients were included. Kawasaki disease patients were younger than MIS-C patients (3.4 vs. 7.6 years). Rash (P = .044, 100% vs. 75.7%), oral mucosal changes (P = .044, 100% vs. 75.7%), and cervical lymphadenopathy (P = .001, 93.3% vs. 42.4%) were more common in KD. Multisystem inflammatory syndrome in children: patients had more hypotension (P = .002, 45.4% vs. 0), gastrointestinal (P < .001, 72.7% vs. 13.3%), and respiratory symptoms (P = .044, 24.2% vs. 0). Multisystem inflammatory syndrome in children patients also had low lymphocyte and thrombocyte counts and elevated levels of d-dimer, ferritin, and cardiac parameters, unlike KD patients. Multisystem inflammatory syndrome in children patients exhibited a notable reduction in left ventricular systolic function in echocardiography. Another significant difference with regard to management was the anakinra treatment, which was prescribed for MIS-C patients. Conclusion: Although MIS-C patients might display a clinical resemblance to KD, several features could help differentiate between MIS-C and classical KD. Specific clinical (hypotension, gastrointestinal, and respiratory symptoms) and laboratory (low lymphocyte and thrombocyte counts with higher C-reactive protein, ferritin, d-dimer, and cardiac parameters) features are characteristic of MIS-C. In addition, divergence in management strategies is evident between the 2 diseases, as biologic drugs were more prevalently employed in MIS-C patients than in classical KD patients.

Amaç: Bu çalışma hemodiyaliz tedavisi uygulanan bireylerin psikososyal bakım gereksinimlerini belirlemek amacıyla yapılmıştır. Bu özel popülasyonun ihtiyaçlarının değerlendirilmesi ve belirlenmesi önemli bir durumdur. Bu çalışmada hemodiyaliz hastalarının yaşadığı zorluklar genel olarak anlatılarak hemodiyaliz alan bireylerin yaşadığı sıkıntılar açık bir şekilde ortaya çıkarılmıştır. Yöntemler: Bu çalışma, betimleyici, fenomenolojik desende nitel olarak yapılmıştır. Çalışmada yarı yapılandırılmış anket formu kullanılmış ve 12 katılımcı çalışmaya dahil edilmiştir. Bulgular: Çalışmada 3 bağlam, 6 tema ve 38 alt tema ortaya çıkmıştır. Hastalığa bağlı gelişen sorunlar (komplikasyonlar ve semptomlar), bakıma yönelik ihtiyaçlar (size bakım vermesini istediğiniz sağlık çalışanı, tedavi ve bakıma yönelik gereksinimler, bakım vericinin özellikleri) hastalıkla başa çıkma mekanizmaları (destek sistemleri ve hastalıkla başa çıkma davranışları) olarak temalar belirlenmiştir. Sonuç: Çalışmada hemodiyaliz hastaları birçok psikososyal ve fiziksel sorunla karşılaştıklarını ifade etmiştir. Hemodiyaliz hastalarının psikososyal gereksinimlerinin belirlenmesi ve buna yönelik müdahalelerin uygulanması hastalığın seyrini olumlu yönde etkileyebilir. Bu psikososyal sorunların belirlenip gerekli müdahalelerin uygulanmasında en önemli rol hemşirelere düşmektedir. Hemşireler diyaliz hastalarının bakımında önemli görev ve sorumluluklara sahiptir. Etkili hemşirelik bakımı hastaların hastalıkla ilgili yan etkilerini azaltabilir ve yaşam kalitesini arttırabilir. Hasta merkezli hemşirelik bakımı hastaların diyaliz bakımının kalitesini ve hasta memnuniyetini artırabilir.

Objective(s): Investigating the ameliorative effects of melatonin on cytokine levels, apoptosis, and NF-κB immunoreactivity in rats with cerulein-induced acute pancreatitis.Materials and Methods: Thirthy-two Wistar Albino rats were divided into four groups: Control group which didn’t undergo acute pancreatitis induction and was left without treatment, pancreatitis group in which the acute pancreatitis was induced by 2 successive intraperitoneal doses of cerulein at a 2-hour interval (50 µg/kg and then 25 µg/kg), melatonin-treated pancreatitis group which was intraperitoneally administrated with 50 mg/kg of melatonin, 30 min before each cerulein injection, and melatonin group which was intraperitoneally administrated with 2 successive doses of melatonin (50 mg/kg each) at a 2-hour interval. Pancreatic tissue and blood samples were taken from animals of all groups. IL-1β, TNF-α, and IL-10 levels were determined in blood samples. Apoptosis was determined by the TUNEL assay and the NF-κB was detected immunohistochemically in acinar cells of the exocrine pancreatic portion.Results: IL-1β, TNF-α, and IL-10 levels in the acute pancreatitis group were significantly increased when compared to the control negative group. IL-1β and TNF-α levels in the melatonin-treated pancreatitis group were significantly lower than those of the acute pancreatitis group. While number of apoptotic cells and percentage of NF-κB immunopositive cells in the acute pancreatitis group were significantly increased compared to other groups and it was observed that these parameters were significantly reduced in the melatonin-treated pancreatitis group compared to the acute pancreatitis group.Conclusion: These findings suggest that melatonin administration can significantly reduce the severity of acute pancreatitis in rats.

Objectives:To report the ocular findings, laboratory results, and management of patients with tubulointerstitial nephritis and uveitis syndrome (TINU), whose numbers increased during the 2019 coronavirus disease (COVID-19) pandemic.Materials and Methods:Demographic characteristics, ophthalmic examination findings, laboratory results including polymerase chain reaction (PCR) test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), serum SARS-CoV-2 immunoglobulin G (IgG) antibody, and treatment of patients diagnosed with TINU between March 2020 and March 2022 were evaluated retrospectively.Results:The study included 19 eyes of 10 patients (6 female/4 male). The mean age was 13.5±2.4 years (range: 8-16 years). The mean follow-up duration was 13.5±6.1 months (range: 6-24 months). All patients presented with anterior uveitis. Anterior uveitis was bilateral in 9 patients (90%) and unilateral in 1 patient (10%). Posterior segment findings were normal in 8 patients (80%), and bilateral optic disc edema was observed in only 2 patients (20%). None of the patients had a previous SARS-CoV-2 infection and/or vaccination history. The SARS-CoV-2 PCR test was negative in all patients at presentation. The SARS-CoV-2 IgG antibody test was reactive in 7 patients (70%). Recurrent uveitis developed in 8 patients (80%) during follow-up. Systemic immunomodulatory therapy was required for the control of ocular inflammation in 7 patients (70%) with severe uveitis flare-ups.Conclusion:TINU is a multisystemic autoimmune disease, especially in response to environmental triggering factors such as viral infections. Although TINU is a rare disease, the number of cases increased during the COVID-19 pandemic. SARS-CoV-2 antibodies were detected at a significant rate of 70% in these patients, who did not have a history of SARS-CoV-2 infection and vaccination. Previous asymptomatic SARS-CoV-2 infection in children may be a triggering factor in the development of TINU.

If the billions of oligodendrocytes (OLs) populating the central nervous system (CNS) of patients could express their feelings, they would undoubtedly tell gene therapists about their frustration with the other neural cell populations, neurons, microglia, or astrocytes, which have been the favorite targets of gene transfer experiments. This review questions why OLs have been left out of most gene therapy attempts. The first explanation is that the pathogenic role of OLs is still discussed in most CNS diseases. Another reason is that the so-called ubiquitous CAG, CBA, CBh, or CMV promoters—widely used in gene therapy studies—are unable or poorly able to activate the transcription of episomal transgene copies brought by adeno-associated virus (AAV) vectors in OLs. Accordingly, transgene expression in OLs has either not been found or not been evaluated in most gene therapy studies in rodents or non-human primates. The aims of the current review are to give OLs their rightful place among the neural cells that future gene therapy could target and to encourage researchers to test the effect of OL transduction in various CNS diseases.

A 31-year-old male presented with a history of vitiligo and extensive ulcerative colitis who developed relapsing polychondritis (RPC) manifesting as bilateral auricular chondritis, nasal chondritis, and polyarthritis. Despite the initial antibiotic treatment, the patient’s symptoms persisted and worsened, necessitating the initiation of prednisolone therapy, which led to complete resolution of the chondritis and arthritis symptoms within 2 weeks. This case underscores the importance of considering RPC in patients with inflammatory bowel disease presenting with unexplained inflammatory symptoms involving cartilaginous structures.

Background: Passenger lymphocyte syndrome (PLS) causes immune-mediated hemolysis in solid and bone marrow transplant recipients. Donor-derived antibodies against the recipient erythrocyte drive the pathogenesis. It is a rare entity in kidney transplantation, and most of the cases are self-limited. Case presentation: A 36-year-old woman presented with fatigue 13 days after living donor renal transplantation. The operation was uneventful, and she was discharged with normal graft functions on the 11th day of transplantation Findings were consistent with cold agglutinin disease at her admission. However, the cold agglutinin test was negative. Eventually, she was diagnosed with PLS. Refractory intravascular hemolysis and frank hemoglobinuria were also present in the patient. Hemolysis was resistant to steroids, intravenous immunoglobulin (IVIG), and Rituximab. Because of life-threatening anemia related to refractory PLS, mycophenolate and tacrolimus were interrupted. However, hemolysis persisted. Following that, immunoadsorption (IA) treatment was obtained. Unfortunately, graft loss occurred due to rejection despite the resolution of PLS after IA. Conclusion: PLS is a rare and usually self-limited entity. Our case was an atypical refractory PLS that resembled cold agglutinin disease. Also, frank hemoglobinuria was observed related to severe intravascular hemolysis. These features have not been described before in PLS, to the best of our knowledge. Additionally, IA treatment had never been reported in the literature for PLS, as far as we know. Treatment and management could be a challenge in refractory PLS. Rituximab, IVIG, and extracorporeal treatments could be beneficial. It should be borne in mind that refractory PLS can cause graft and patient loss. Resumen: Antecedentes: El síndrome de linfocitos pasajeros (PLS) causa hemólisis inmunomediada en receptores de trasplantes sólidos y de médula ósea. Los anticuerpos derivados del donante contra el eritrocito receptor impulsan la patogénesis. Es una entidad rara en el trasplante de riñón y la mayoría de los casos son autolimitados. Presentación del caso: Una mujer de 36 años presentó fatiga 13 días después del trasplante renal de donante vivo. La operación transcurrió sin incidentes y fue dada de alta con las funciones normales del injerto el día 11 del trasplante. Los hallazgos coincidían con la enfermedad por crioaglutininas en el momento de su ingreso. Sin embargo, la prueba de crioaglutininas fue negativa. Finalmente, le diagnosticaron PLS. La paciente también presentó hemólisis intravascular refractaria y hemoglobinuria franca. La hemólisis fue resistente a los esteroides, la inmunoglobulina intravenosa (IgIV) y el rituximab. Debido a la anemia potencialmente mortal relacionada con PLS refractario, se interrumpieron el micofenolato y el tacrolimus. Sin embargo, persistió la hemólisis. A continuación, se obtuvo el tratamiento de inmunoadsorción (IA). Desafortunadamente, la pérdida del injerto ocurrió debido al rechazo a pesar de la resolución de PLS después de la IA. Conclusión: El PLS es una entidad rara y generalmente autolimitada. Nuestro caso fue un PLS refractario atípico que se asemejaba a la enfermedad por crioaglutininas. Además, se observó hemoglobinuria franca relacionada con hemólisis intravascular grave. Estas características no se han descrito antes en PLS, según nuestro leal saber y entender. Además, el tratamiento IA nunca se había informado en la literatura para PLS, hasta donde sabemos. El tratamiento y el manejo podrían ser un desafío en PLS refractarios. El rituximab, la IgIV y los tratamientos extracorpóreos podrían ser beneficiosos. Debe tenerse en cuenta que los PLS refractarios pueden provocar la pérdida del injerto y del paciente.

Aim: Disease-related immune dysfunction and/or treatment with immunosuppressive drugs may affect the course of coronavirus disease-2019 (COVID-19) infection in rheumatic patients. The aim of this study was to evaluate the course of COVID-19 infection and predictors of COVID-19 pneumonia in patients with rheumatological disease using biological or targeted therapies. Methods: This cross-sectional study was conducted between April 2022 and July 12, 2022. Demographic and clinical parameters and COVID-19-related data in patients with and without COVID-19 pneumonia were recorded and compared. Logistic regression analyses were performed to identify the predictors of COVID-19-related pneumonia. Results: A total of 110 patients (67 with spondyloarthritis, 25 with rheumatoid arthritis, 8 with familial Mediterranean fever, 5 with Takayasu arteritis, 3 with granulomatosis with polyangiitis, and 2 with Behçet’s disease) were included in the study. The mean age of 110 rheumatic patients was 47.27±12.77 years. Their mean body mass index (BMI) was 29.59±5.59 kg/m2, and 67.3% of them were female. Twenty-one (19.1%) patients had a history of COVID-19 pneumonia. The rates of hypertension (HT), diabetes mellitus, comorbidity status, comorbidity groups, cough, dyspnea, non-healing complaints, and COVID-19 treatment in addition to BMI, the total number of comorbidities, and the number of vaccines after COVID-19 infection were statistically different in the groups with and without pneumonia (for all, p

Background. Malnutrition increases the complications and mortality in critically-ill children. We performed a retrospective analysis to define the impact of malnutrition on the outcomes of multisystem inflammatory syndrome in children (MIS-C) due to COVID-19. Methods. Patients with MIS-C were evaluated for demographic features, anthropometric parameters, clinical findings and outcomes. Patients with z scores of body mass index (> 5 years) and weight-for-age (< 5 years) < -2 were considered malnourished. Sarcopenia was defined by total psoas muscle area (tPMA), calculated on abdominal computed tomography (CT) at the level of L3 and L4 vertebrae. The z scores 0.05). Conclusion. Children with MIS-C already had mild to severe malnutrition at admission. Rash and higher ferritin levels were more common in patients with malnutrition. In addition to anthropometric parameters, sarcopenia calculated using tPMA can be used to predict malnutrition in critically-ill children.

Objective:Our objective was to evaluate the association of benign prostatic hyperplasia (BPH) with each component of metabolic syndrome (MS), and determine which component plays the major risk for developing BPH.Materials and Methods:This cross-sectional observational study was performed on 203 male patients aged over 50, who came to the internal medicine outpatient clinics just for a check-up with/without any known disease. Forty-three of them were healthy control patients and the rest had only 1 criterion of MS. They were searched for the presence of BPH.Results:BPH prevalence ranged between 45.5-65.6% in the subgroups, there was no statistically significant difference in the presence of BPH between these groups. There was a slight positive correlation between glucose level and prostate volume. Triglyceride levels were positively correlated with Qmax and negatively correlated with the grade of hypertrophy. There was also a slight positive correlation between systolic blood pressure and prostate volumes, grade of hypertrophy, and IPSS scores.Conclusion:BPH prevalence was not different between MS components. We concluded that none of the MS components increase the occurrence of BPH by itself but when those metabolic disorders come together and form a syndrome, the prevalence of BPH increases.

Objective: Diffuse large B-cell lymphoma (DLBCL) is a biologically heterogeneous disease that is classified into germinal center B-cell (GCB) and non-GCB subtypes, which are prognostically different. The Hans algorithm is the most widely used tool based on CD10, BCL6, and MUM1 expression, but some cases with the non-GCB phenotype are still known to be misclassified. In this study, we investigate the extent to which GCET1, HGAL, and LMO2 protein expressions reflect GCB phenotype together with their roles in determining the GCB phenotype of DLBCL and their contributions to the performance of the Hans algorithm. Materials and Methods: Sixty-five cases of DLBCL-not otherwise specified, 40 cases of follicular lymphoma (FL), and 19 non-GC-derived lymphoma cases were included in this study. The DLBCL cases were grouped as CD10+ (Group A) or only MUM1+ (Group B), and the remaining cases constituted the intermediate group (Group C). GCET1, HGAL, and LMO2 expressions were evaluated. Results: In the FL group, GCET1, HGAL, and LMO2 were positive in 85%, 77.5%, and 100% of the cases, respectively. Among the non-GCderived lymphoma cases, all three markers were negative in cases of small lymphocytic lymphoma, plasmablastic lymphoma, peripheral T-cell lymphoma, and anaplastic large cell lymphoma. GCET1 and HGAL were negative in cases of marginal zone lymphoma (MZL) and mantle cell lymphoma (MCL). Two of the 3 MZL and 2 of the 4 MCL cases were positive for LMO2. In the DLBCL group, the number of cases with GCET1, HGAL, and LMO2 positivity was 18 (90%), 17 (85%), and 20 (100%), respectively, in Group A and 0 (0%), 2 (13.3%), and 2 (13.3%), respectively, in Group B. Considering these rates, when the cases in the intermediate group were evaluated, it was concluded that 13 cases typed as non-GCB according to the Hans algorithm may have the GCB phenotype. Conclusion: GCET1, HGAL, and LMO2 are highly sensitive markers for determining the germinal center cell phenotype and can increase the accuracy of the subclassification of DLBCL cases, especially for cases that are negative for CD10.

Objective: Different patch techniques were virtually always used in the surgery of pediatric patients with complete atrioventricular septal defects. In this study, we described our single center, single surgeon experiences and results about the classic single patch and double patch techniques to repair complete atrioventricular septal defects. Materials and Methods: This retrospective descriptive study included 30 patients who underwent intracardiac repair of complete atrioventricular septal defect in Ankara Bilkent City Hospital Department of Pediatric Cardiovascular Surgery. The study was conducted between February 2019 to December 2021. Patients in group S underwent surgery using the traditional single-patch method, while group D included patients who underwent repair using the double patch approach (n = 10). Patients’ demographic and clinical information was taken from institutional databases and medical records. Postoperative complications were recorded. Results: When the preoperative/postoperative insufficiency levels of the valves were compared with the Wilcoxon Signed rank test, the findings were not statistically significant for the left atrioventricular valves, but were statistically significant for the right atrioventricular valves. (p=0.02) When we compared postoperative valve regurgitation of both techniques with the Kruskall-Wallis test, no significant difference was found between postoperative valve regurgitation and function, independent of preoperative findings. Conclusion: Both operation techniques did not make a difference between operative or late mortality and morbidity. Depending on the surgeon’s experience, ventricular septal defect size does not play a restrictive role in the selection of the technique to be used. The single-patch and double patch method as described here is methodical, comprehensible, repeatable, and reasonably long-lasting.

This study examines the history, language, social, and economic transformation of the Yuruks living in the Yamanlar Village located in the Karşıyaka district, where there is relatively little information in the literature despite its proximity to the Izmir city center. Information collected from the Ottoman Era cemetery adjoining the village reveals that the Yamanlar Yuruks have lived here for at least 400 years. Mount Yamanlar, where the village is located, is of great importance because of its ancient history, as it witnessed the founding of Izmir (Smyrna). The social and economic lifestyle in the village has transformed as the city expanded toward residential areas atop Mount Yamanlar. The loss of traditional livelihood practices challenged the villagers and severely influenced their customs, which might be considered valuable pieces of cultural heritage. In this study, we conducted fieldwork, during which various data collection methods and techniques were employed to describe daily life in the village. Within the scope of this study, semi-structured and unstructured interviews were conducted with the local people, and an oral historical study was carried out. With this method, we aimed to present an ethnohistorical description of the Yamanlar Village by trying to establish a balance between the analysis of both written documents and oral data to make sense of the social and economic change it has undergone and to contribute to the literature on Izmir Yuruks.

Background. Relapses or new-onset IgA nephropathy (IgAN) have been documented in patients after vaccination against SARS-CoV-2; however, only one adult patient has been reported in whom pre-existing IgAN worsened during coronavirus disease 2019 (COVID-19). Case. We present the first pediatric case with biopsy-proven IgAN and genetically confirmed Alport syndrome, who developed end-stage kidney disease after an exacerbation of IgAN associated with COVID-19. The patient’s basal serum creatinine was 0.7-0.9 mg/dL before infection. He had not been vaccinated against COVID-19. He was admitted to the hospital with edema, hypertension, an elevated serum creatinine of 4.7 mg/dL, and massive proteinuria. Three months before admission, he had been admitted to another hospital with COVID -19 and an elevated serum creatinine (1.9 mg/dL), but no biopsy had been performed at that time. The kidney biopsy revealed IgAN with 50% fibrocellular crescents with sclerosed glomeruli, tubular atrophy, and interstitial fibrosis. His serum creatinine did not decrease even after five administrations of pulse steroids, and hemodialysis was initiated. Conclusion. In conclusion, COVID -19 may pose a high risk for exacerbation of pre-existing glomerular disease. It is therefore necessary to closely monitor the kidney function of patients with underlying glomerulonephritis during and after COVID-19 and consider an early biopsy if serum creatinine does not return to baseline levels. In addition, this case report highlights the clinical importance of the co-occurence of IgAN and Alport syndrome.

Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory condition involving the development of mass lesions of the affected organ, which can mimic many malignant disorders. IgG4-related autoimmune pancreatitis (AIP) is a common presentation form of IgG4-RD. Patients presenting with multiple mass lesions in the pancreas undergo aggressive surgeries with the misdiagnosis of pancreatic adenocarcinoma. A patient applied to the health center with back and stomach pain. She had two mass lesions involving the pancreatic head and tail; tumor markers were not significantly elevated. The patient underwent total pancreatoduodenectomy, total gastrectomy, and total splenectomy due to misdiagnosed pancreatic adenocarcinoma and developed severe morbidities afterward. She was diagnosed with IgG4-related AIP after surgery. On performing clinical suspicion the necessary diagnostic procedures for exclusion will protect patients from unnecessary surgeries that may lead to severe morbidities.

Crimean-Congo hemorrhagic fever (CCHF), endemic in certain regions of the world, is listed as a priority disease with pandemic potential. Since CCHF was first identified in Turkey, children have been known to experience milder disease than adults. However, during the COVID-19 pandemic, we observed an unusually severe disease course, including hemophagocytic lymphohistiocytosis (HLH). We examined cytokine/chemokine profiles of 9/12 case-patients compared with healthy controls at 3 time intervals. Interferon pathway–related cytokines/chemokines, including interleukin (IL) 18, macrophage inflammatory protein 3α, and IL-33, were elevated, but tumor necrosis factor-α, IL-6, CXCL8 (formerly IL-8), and cytokines acting through C-C chemokine receptor 2 and CCR5 were lower among case-patients than controls. Interferon pathway activation and cytokines/chemokines acting through CCR2 and CCR5 improved health results among children with severe CCHF. Children can experience severe CCHF, including HLH, and HLH secondary to CCHF can be successfully treated with intravenous immunoglobulin and steroid therapy.