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Abstract Background The Obstetric Comorbidity Index (OBCMI) is an internationally validated scoring system for maternal risk factors intended to reliably predict the occurrence of severe maternal morbidity (SMM). This retrospective cohort study applied the OBCMI to pregnant women in Qatar to validate its performance in predicting SMM and cumulative fetal morbidity. Methods Data from 1000 women who delivered in July 2021 in a large tertiary centre was extracted from medical records. The OBCMI index included maternal demographics, pre-existing comorbidities, and various current pregnancy risk factors such as hypertension, including preeclampsia, intrauterine fetal death, prolonged rupture of membranes and unbooked pregnancies. SMM was based on the ACOG consensus definition, and the cumulative fetal morbidity (CFM) included fetal distress in labour, low APGAR and umbilical artery (UA) pH, admission to neonatal intensive care (NICU), and hypoxic-ischemic encephalopathy (HIE). A c-statistic or area under curve (AUC) was calculated to determine the ability of OBCMI to predict SMM and CFM. Results The median OBCMI score for the cohort was 1 (interquartile range- 0 to 2); 50% of women scored 0, while 85% (n = 842) had a score ranging from 0 to 2. Ten women (1%) scored ≥ 7; the highest score was 10. The incidence of SMM was 13%. According to the modified scoring system, the mean OBCMI score in those who developed SMM was 2.18 (± 2.20) compared to a mean of 1.04 (± 1.40) in those who did not (median 1, IQR:1–3 versus median 0, IQR: 0–2; p 90%); 1 in 4 and 1 in 6 women with OBCMI score ≥ 4 developed SMM and CFM, respectively. Conclusion The OBCMI performed moderately well in predicting SMM in pregnant women of Qatar and can be effectively used as a risk assessment tool to red-flag high-risk cases so that appropriate and timely multidisciplinary care can be initiated to reduce SMM and maternal mortality. The index is also helpful in predicting fetal morbidity; however, further prospective studies are required to validate OBCMI for CFM.

Objective: This study aimed to evaluate the general characteristics of geriatric cases aged ≥65 years, who presented at the Forensic Medicine Clinic due to trauma, and the severity of injury using trauma scoring systems. Methods: The study included all trauma cases over 65 years with a forensic report prepared in the Forensic Medicine Clinic between 2015 and 2021. Evaluations were made using the chi-square, Mann- Whitney U, and Kruskal-Wallis (post-hoc: Dunn-Bonferroni) tests. A value of p75 years were higher than in those aged ≤75 years (p

This study examines the Green Vision of Saudi Arabia and its efforts towards achieving sustainability in various domains such as energy, economy, tourism, and carbon emissions. The research uses time-series data from 2002 to 2020 to analyze the dynamic impacts of these variables. To achieve this, it employs a co-integration regression test, Granger causality relationships, and one-way and two-way causal effects between carbon emissions, tourism, economic growth, and energy use. The findings of the study provide valuable insights into the challenges and opportunities for sustainability in the kingdom, considering the goals of SDGs 8 and 13. This research contributes to the ongoing discourse on sustainable development in Saudi Arabia and offers significant insights for lawmakers, entrepreneurs, and researchers to influence the country's future direction. The research aims to guide strategic decision-making in line with Saudi Arabia's commitment to achieving a sustainable and resilient future by examining the interconnections between energy, economic growth, tourism, and carbon emissions.

Nanomedicines for drug delivery and imaging-guided cancer therapy is a rapidly growing research area. The unique properties of nanomedicines have a massive potential in solving longstanding challenges of existing cancer drugs, such as poor localization at the tumor site, high drug doses and toxicity, recurrence, and poor immune response. However, inadequate biocompatibility restricts their potential in clinical translation. Therefore, advanced nanomaterials with high biocompatibility and enhanced therapeutic efficiency are highly desired to fast-track the clinical translation of nanomedicines. Intrinsic properties of nanoscale covalent organic frameworks (nCOFs), such as suitable size, modular pore geometry and porosity, and straightforward post-synthetic modification via simple organic transformations, make them incredibly attractive for future nanomedicines. The ability of COFs to disintegrate in a slightly acidic tumor microenvironment also gives them a competitive advantage in targeted delivery. This review summarizes recently published applications of COFs in drug delivery, photo-immuno therapy, sonodynamic therapy, photothermal therapy, chemotherapy, pyroptosis, and combination therapy. Herein we mainly focused on modifications of COFs to enhance their biocompatibility, efficacy and potential clinical translation. This review will provide the fundamental knowledge in designing biocompatible nCOFs-based nanomedicines and will help in the rapid development of cancer drug carriers and theranostics.

Objective:Evaluation of children and adolescents pushed to crime should be different from adult offenders. In this study, it is aimed to analyze the qualities of children and adolescents pushed to crime and to discuss them in the light of the literature.Methods:Children who were evaluated in terms of criminal liability at Bolu Abant İzzet Baysal University Faculty of Medicine Department of Forensic Medicine and Bolu Forensic Medicine Branch Office between January 1, 2016 and December 31, 2018 were included in the study.Results:A total of 237 children and adolescents were included in the study. Of the cases, 76.8% (n=182) were male and 23.2% (n=55) were female. The mean age was 13.38±0.83. Of the cases, 80.6% were living in the nuclear family. Twenty-two cases (9.3%) were working in any job and sixty-four (27%) of the cases had one or more substance use history. Of the cases, 47.7% committed deliberate wounding crimes whereas 20.3% of cases committed burglary crimes. One hundred and fifty two cases (64.1%) committed a crime for the first time. One hundred and ten (46.4%) cases committed the crime together with a group of friends. Forty-seven cases (19.8%) had a psychiatric disorder. In 60.8% of the cases (n=144), it was reported that they had criminal responsibility.Conclusion:It is necessary to increase the number of child support centers and to develop effective intervention methods for juveniles pushed to crime in these centers, and more studies should be conducted on these issues.

Fluorescence imaging of amyloid beta (Aβ) polypeptide using a small‐molecule fluorophore is a practical system for Alzheimer's disease (AD) diagnosis in clinical and research fields. Herein, a molecular designing strategy for a new fluorogenic probe that equips bathochromic emission shift and enhanced binding affinity toward Aβ fibril through structural optimization is suggested. Thioflavin T (ThT)‐derived fluorescent dyes are developed by adjusting the hydrophobicity of electron donor moiety in D–π–A structures with biannulated ring expansion. Indeed, probes are tuned to have redshifted fluorescence emission wavelength and optimized binding affinities for Aβ fibrils in vitro and cortical imaging. Detection of background signal is minimized by maintaining the photophysical properties of twisted intramolecular charge transfer (TICT), resulting in significantly sensitive fluorogenic probes for outstanding bioimaging in AD.

The Dirichlet distribution as a multivariate generalization of the beta distribution is especially important for modeling categorical distributions. Hence, its applications vary within a wide range from modeling cell probabilities of contingency tables to modeling income inequalities. Thus, it is commonly used as the conjugate prior of the multinomial distribution in Bayesian statistics. In this study, the parameters of a bivariate Dirichlet distribution are estimated by entropy formalism. As an alternative to maximum likelihood and the method of moments, two methods based on the principle of maximum entropy are used, namely the ordinary entropy method and the parameter space expansion method. It is shown that in estimating the parameters of the bivariate Dirichlet distribution, the ordinary entropy method and the parameter space expansion method give the same results as the method of maximum likelihood. Thus, we emphasize that these two methods can be used alternatively in modeling bivariate and multinomial Dirichlet distributions.

Pica is the continuous consumption of non-nutritive and non-food items for at least one month. In this study, a 17-year-old boy pica case diagnosed with motor-mental retardation due to cerebral palsy was presented. It was learned that the case was exhibiting object swallowing behaviour. He was found dead in the field by his relatives. At the autopsy, a 3.5x3.0x2.5 cm foreign body (stone) that completely obstructed the upper part of the larynx lumen was removed. In addition, three foreign bodies were removed from the cecum region. The death was caused by mechanical asphyxia due to foreign body aspiration.

Background: The impact of high-risk surgery on tissue perfusion can be indirectly assessed by measuring lactate levels during surgery and intensive care unit (ICU) stay. While consistently high values are associated with poor prognosis, transient elevations do not mean poor clinical outcomes. Therefore, intraoperative and early postoperative blood lactate monitoring is essential for cancer patients. Aims and Objective: This study aimed to determine the risk factors of persistently elevated lactate levels in the intraoperative and postoperative period in patients with elective gastric cancer surgery. Materials and Methods: We retrospectively enrolled 293 patients who underwent curative resection for gastric cancer. Lactate values of all patients were examined during surgery and ICU-stay at 3rd, 6th, 12th, and 18th hours. All lactate values above 2 mmol/L were considered elevated. The patients were divided into two groups as those with perioperative persistently increased lactate levels and those without. Results: Of the 293 patients, 60 (20.5%) had higher lactate levels in the perioperative period. According to multivariate logistic regression analysis, the operative time had the highest significance rate (p = 0.020) out of two significant variables, followed by the BMI ≥ 30 kg/m2 (p = 0.048). Besides, patients with perioperative hyperlactatemia had prolonged hospital stays (p = 0.034). Conclusions: Operative time and obesity (BMI ≥ 30 kg/m2) were independent risk factors for persistent lactate elevation in the perioperative period. Also, perioperative hyperlactatemia extended the length of hospital stay.

The nature of dependence between random variables has always been the subject of many statistical problems for over a century. Yet today, there is a great deal of research on this topic, especially focusing on the analysis of nonlinearity. Shannon mutual information has been considered to be the most comprehensive measure of dependence for evaluating total dependence, and several methods have been suggested for discerning the linear and nonlinear components of dependence between two variables. We, in this study, propose employing the Rényi and Tsallis mutual information measures for measuring total dependence because of their parametric nature. We first use a residual analysis in order to remove linear dependence between the variables, and then we compare the Rényi and Tsallis mutual information measures of the original data with that the lacking linear component to determine the degree of nonlinearity. A comparison against the values of the Shannon mutual information measure is also provided. Finally, we apply our method to the environmental Kuznets curve (EKC) and demonstrate the validity of the EKC hypothesis for Eastern Asian and Asia-Pacific countries.

In this study; a case about three brothers exposed to long-lasting severe neglect and abuse up to cachexia and severe depression will be presented and discussed in the light of the literature data. It was learned from the statements of the suspect, mother and child victims that father worked at night shift, that a distant relative who began to live at their home to help with the expenses of the house for the last three years, had sexual and emotional relationship with the mother during the day, that although this person act well in the beginning but in time he left the three children hungry for several days in order to punish, hang them to the ceiling from their hands and feet, used physical violence like punch, beatings, extinguished illuminated cigarettes in their bodies, made skin burns by using a lighter and that father and mother turned a blind eye even knowing all that for a long time. It was reported that one day a second suspect who was brought by this suspect and stayed at home with them for two months, took the children into the bathroom with the purpose to wash them and that he applied anal sexual abuse to the younger child at the age of three years. In the examination it was determined that the four years old youngest brother was highly cachectic, unable to stand, unable to sit, lied constantly, had difficulties in talking, had decreased skin turgor and tone, was cachectic, had bruises, burns, scars in different parts of the body at different ages and an old fracture in the mandible was seen in the radiography. The 9-year-old middle brother testified likewise and strained and swollen appearance of abdomen, growth retardation, extensive bruising also on both cheeks and at the rear of the right thigh were determined in the examination. Ecchymosis and hematoma in both cheeks and left auricula was detected on the 11-year-old oldest brother. After a detailed evaluation it was found that the child was admitted to the hospital due to a fall, four years ago, due to activity and attention disorders six and four months ago. It is remarkable that child abuse and neglect incident was not detected in the examinations done at the hospital before. [Med-Science 2017; 6(4.000): 760-763]

Novel Coronavirus, also known as COVID-19, is a health emergency that is having an ever-growing impact on the global economy. COVID-19 has caused economic disruption at an unprecedented speed and scale. The economic costs it will bring to society can only be measured in times to come. Millions of people across the globe have already become unemployed, and similarly, millions of businesses have either shut down or are on the verge of collapse. It is a great challenge for policymakers to minimize the economic impact of COVID-19 and put the economy on a growth trajectory once again. Unfortunately, there is so far no country in the world that can be viewed as a role model for its economic response to the COVID-19 pandemic. The present study proposes Islamic finance as a potential tool to help affected economies safely pass through the economic crisis resulting from the pandemic. This study identifies a four-stage COVID-19 model and proposes ten innovative Islamic financial services for each stage of the pandemic. In addition, it analyzes how these services can be effectively utilized at different stages to overcome the economic damage caused by the pandemic.

Mycotic aneurysms constitute a small proportion of aortic aneurysms. Endovascular repair of mycotic aneurysms has been applied with good short-term and midterm results. However, the uncommon aortoenteric fistula formation remains a potentially fatal complication when repairing such infective aneurysms. We present the case of an 80-year-old woman with thoracic and abdominal aortic mycotic aneurysms, which were successfully treated with endografting. However, the patient presented 3 months later with upper gastrointestinal bleeding secondary to erosion of the thoracic graft into the oesophagus. The patient was treated conservatively due to the high risk of surgical repair. There is currently little exposure to the management of mycotic aortic aneurysms. If suspected, imaging of the entire vasculature will aid initial diagnosis and highlight the extent of the disease process, allowing for efficient management. Aortic endografting for mycotic thoracic aneurysms is a high-risk procedure yet is still an appropriate intervention. Aortoenteric fistulae pose a rare but severe complication of aortic endografting in this setting.

Bu çalışmada, Konya’da çocukluk çağmda meydana gelen ateşli silah yaralanmalarına bağlı ölümler incelenerek, olguların demografik özellikleri, kullanılan silah türü, orijin, yaralanan bölge, olay yeri, ölüm yeri, atış mesafesi, silahm ait olduğu kişi gibi verilerin değerlendirilmesi amaçlanmıştır. Bu amaçla, Konya Adli Tıp Şube Müdürlüğü ve Konya’ya bağlı ilçelerde adli tıp uzmanı tarafından 1999-2007 yılları arasında otopsisi yapılan olgular retrospektif olarak incelendi. 18 yaş ve altındaki 985 ölüm olgusunun 50’sinin (%5.1) ateşli silah yaralanması neticesinde meydana geldiği tespit edildi. Olguların yaşları 1 ile 18 arasında değişmekte olup, ortalama yaş 14.6+3.9 bulundu. 34(%68) olgu erkek, 16 (%32) olgu kız çocuk idi. Erkek, kız oranı 2.1:1 bulundu. Orijin 20(%40) olguda intihar, 17(%34) olguda kaza, 13(%26) olguda cinayet idi. 33(%66) olguda av tüfeği, 17(%34) olguda tabanca kullanılmıştı. 27(%54) olguda yalnızca kafa bölgesi, 10(%20) olguda yalnızca karın bölgesi yaralanmıştı. Ateşli silah yaralanmalarının 29’u (%58) ev içerisinde meydana gelmişti. 35(%70) olgu olay yerinde, 12(%24) olgu hastanede, 3(%6) olgu ise hastaneye kaldırılırken yolda ölmüştü. 24(%48) olgu bitişik ya da bitişiğe yakın mesafeden; 11 (%22) olgu yakın mesafeden; 15(%30) olgu ise uzak mesafeden yapılan atış nedeniyle kaybedilmişti. Kullanılan silah 24(%48) olguda, olgunun babasına aitti. Sonuç olarak, kullanımı giderek artan ateşli silahların evlerde bulundurulması nedeniyle, bu silahların çocukluk çağı ölümlerine yol açabildiği görülmektedir. Halkımızın; bulunduğu ortamda çocukların ateşli silahlara kolayca ulaşabilmeleri halinde, intihar veya kaza orijinli yaralanma ve ölüm olaylarının meydana gelebileceği, bu nedenle ev gibi yaşam alanlarında mümkün olduğunca ateşli silah bulundurulmaması, mutlaka bulunması gerekiyorsa çocukların ulaşamayacağı, yüksek konumlarda veya sağlam kilit altına alınmış alanlarda emniyetinin sağlanması gerektiği konusunda eğitilmesinin gerekli ve faydalı olduğunu düşünüyoruz. Anahtar kelimeler: Çocuk, ateşli silah, ölüm, adli tıp

Objectives: Premature ovarian insufficiency (POI) affects 1 in 10,000 children, with its molecular causes largely unknown. Adult studies suggest that low androgen levels induce ovarian insufficiency, but data on about this in children is limited. This study aims to assess the prevalence of low androgen levels in childhood POI and its relationship with adrenal insufficiency., Materials and Methods: Idiopathic POI adolescents were categorized into two groups based on DHEAS and total testosterone (TT) measured by chemiluminescence. Low androgen group (LAG) was defined using cut-offs according to Tanner pubarche staging. Demographic, clinical, and laboratory data were compared. Morning cortisol <7 mcg/dL and/or ACTH >96 or <5 pg/mL were planned to undergo ACTH stimulation testing, with a peak cortisol response <18 mcg/dL considered insufficient., Results: Forty-three adolescents, mean age 15.5 ± 1.3 years with a 46, XX karyotype, normal FMR1 mutation, FSH levels >40 mIU/mL, and low AMH levels were included. In 14 cases (37.8 %), DHEAS and TT were low. In the LAG, pubarche was absent in seven patients, and initial height SDS was significantly lower. Morning cortisol ranged from 7.9 to 23.5 mcg/dL, with an ACTH of 29.4 ± 9.7 pg/mL. No differences in adrenal steroids or correlations between DHEAS and ACTH were observed., Conclusions: Diminished androgen levels are prevalent in children with idiopathic POI. The potential for this condition to increase the risk of adrenal insufficiency and its impact on secondary ovarian insufficiency remains unclear. This study, the first of its kind in children, underscores the potential role of genetic factors in zona reticularis and ovarian development., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Novel denovo variants of exome sequences are major cause of pathogenic neurodevelopmental disorders with a dominant genetic mechanism that emphasize their heterogeneity and complex phenotypes. White Sutton syndrome and Gabriele-de-Vries syndrome are congenital neuro-impairments with overlap of severe intellectual disability, microcephaly, convulsions, seizures, delayed development, dysmorphism of faces, retinal diseases, movement disorders and autistic traits. POGZ gene codes for pogo transposable element-derived zinc-finger protein and YY1 gene regulates transcription, chromatin, and RNA-binding proteins that have been associated with White Sutton and Gabriele-de-Vries syndromes, in recent data. We present probands of two unrelated consanguineous families with complicated, unexplained neurocognitive syndromic characteristics clinically undiagnosed. Objectives of the study were to identify altered genetics and protein characteristics underlying molecular pathological pathways in both the patients. Whole exome sequencing identifies novel, denovo missense variant NM&#95;015100.4: c.776 C>T (p. Pro259Leu) in exons 19 of POGZ gene and non-frameshift variant NM&#95;003403.5: c.141&#95;143delGGA (p. Glu47del) in exon 1 of YY1 gene for White Sutton syndrome in eight years five-month-old girl and Gabriele-de-Vries syndrome in seven years eight months old boy residing in Rawalpindi and Chakwal districts of Punjab, Pakistan respectively. Protein modelling for identified variants predicts size and conformation modifications in mutated amino acid residues that lead to damaging effects in the conserved domains expressed as neurological pathophysiology. The present study widens the diversely ethnic and highly inbred gene pool of Punjab, Pakistan population for spontaneously originated deleterious mutations and contributes to the continuously expanding phenotypic canvas. Molecular genetic identification and personalized diagnosis for the patients suffering from complicated neurodevelopmental phenotypes, for better care, management of day-to-day activities and prolonged life span are the utmost hopes., Competing Interests: The authors declare that they have no competing financial interests or relationships that could influence the work presented in the study., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

Background: The coexistence of primary glomerulonephritis and autoimmune thyroid disease has not been investigated., Objective: This study aimed to assess thyroid morphology using sonography, determine the prevalence of autoimmune thyroid disorders, and evaluate thyroid function status in patients diagnosed with primary glomerulonephritis., Materials and Methods: This single-center cross-sectional and observational study included 58 consecutive patients with primary glomerulonephritis and 58 healthy controls (HC). All participants underwent thyroid examination through laboratory tests and thyroid ultrasonography. The findings were subsequently compared between the two groups., Results: Among the patients, 17.2% (n = 10) exhibited subclinical hypothyroidism, while 8.6% (n = 5) had overt hypothyroidism. None of the HCs showed overt hypothyroidism, whereas 3.4% (n = 2) of them exhibited subclinical hypothyroidism. Patients displayed significantly lower free triiodothyronine (FT3) levels than HCs (p < 0.001). A linear correlation was observed between patients' thyroid-stimulating hormone (TSH) levels and the degree of proteinuria (p = 0.044). Furthermore, thyroid volume (p < 0.001), hypoechogenicity (p < 0.001), heterogeneous structure (p < 0.001), pseudonodular hypoechoic infiltration (p = 0.05), and the presence of nodules (p < 0.001) were notably higher in patients compared to HCs., Conclusion: The prevalence of both overt and subclinical hypothyroidism, along with the frequency of nodular goiter, was found to be elevated in patients with primary glomerulonephritis. Considering that primary glomerulonephritis predominantly afflicts young individuals, and these patients bear the lifelong burden of chronic kidney disease, we underscore the significance of routine thyroid function tests and sonographic examinations for the early detection of thyroid disorders., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

This study aimed to examine the relationship between eating behavior, nutritional status and mental health. It is a cross-sectional study conducted on a sample of 360 healthy individuals aged 19-64 years. The General Health Questionnaire (GHQ-12) was used to evaluate mental health and the Three-Factor Eating Scale (TFEQ-R21) was used to assess eating behavior. The Healthy Eating Index-2015 (HEI-2015) score was calculated from participants' 24-hour food recalls as an indicator of diet quality. The mean age of the participants was 26.0±8.40 years, and 50.6% were female. Multivariate logistic regression model was performed. A statistically significant relationship was found between the participants' GHQ-12 score and both their emotional eating and uncontrolled eating scores (p < 0.001 for each). It was determined that individuals who had high levels of emotional eating and uncontrolled eating behaviors, along with higher dietary protein and lipid intake, and lower intake of long-chain fatty acids, were at a higher risk of mental health deterioration, according to the established model (R2 = 0.214). Dietary energy and nutrient intakes such as niacin, vitamin B12, folic acid, phosphorus, iron, sodium and carotene, as well as diet quality and BMI were not associated with mental health according to the model in this study. Eating behavior is associated with mental well-being, and nutritional status may be one of the underlying factors contributing to this association., Competing Interests: Declaration of competing interest None, (Copyright © 2025. Published by Elsevier Inc.)

Contrary to short-lived plasma cells, which survive only 3-5 days, long-lived plasma cells (LLPCs) contribute to the humoral memory of the body and thus also to many antibody-related diseases. The ability of plasma cells to persist over months, years, and even a lifetime has been demonstrated in vivo. Yet, the in vitro culture of human primary bone marrow-derived plasma cells has been limited to a few days. Here, we establish culture conditions for human primary bone marrow-derived plasma cells for 21 days. Plasma cells and stromal cells are isolated from human bone marrow and cultured in 2D or a 3D ceramic scaffold. The plasma cells' survival and antibody secretion depend on direct contact with stromal cells. The culture promotes CD19-negative PCs. Inhibition of the PI3K or NF-kappaB pathways using chemical inhibitors reduced the survival of the plasma cells. These results underline the supportive role of the stromal cells for the survival of the LLPC and confirm mechanisms that were identified in mouse LLPCs also for human LLPCs. The culture described here will promote further studies to deepen our understanding of the human LLPC., (© 2025 The Author(s). European Journal of Immunology published by Wiley‐VCH GmbH.)

Background: Triple-negative breast cancer (TNBC) is an aggressive type of breast cancer with a high recurrence rate. A new therapeutic intervention is urgently needed to combat this lethal subtype. The identification of biomarkers is also crucial for improving outcomes in TNBC., Method: The cell cytotoxicity of ML364 (2-(4-Methylphenylsulfonamido)-N-(4-phenylthiazol- 2-yl)-4-(trifluoromethyl)benzamide) was measured at different concentrations of ML364 in TNBC-treated and untreated cells. The 2DE and LC-MS/MS analysis were used for protein identification of differentially expressed proteins. Furthermore, the quantitation of gene expression was demonstrated using RT-qPCR. TIMER, HPA, and UALCAN databases were utilized for further analysis., Results: Differentially expressed proteins and genes after ML364 treatment in TNBC were found to be linked with the USP2 (ubiquitin specific peptidase 2)-mediated pathway. Our results demonstrate that differentially identified proteins, including PPA1, TRIM68, and FBXO46, could be a potential prognostic biomarker for TNBC. Further analysis through the UALCAN and HPA databasess showsthe high expression of these proteins in primary breast tumors, which is in contrast to normal. The induction of ML364 significantly reduced the expression of PPA1, TRIM68, and FBXO46 proteins and induced cell cytotoxicity in TNBC cells., Conclusion: This study provides an understanding of the USP2-mediated signaling pathway in TNBC, emphasizing the role of USP2 and its substrates with apoptotic genes. Our results offer insight into the USP2-mediated cellular mechanism after ML364 treatment in TNBC that could be a potential therapeutic candidate., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

The influence of plasticizer glycerol (GLY) on the mechanical, structural, and thermal properties of silk fibroin (SF)/sodium alginate (SA) biocomposite films was investigated in detail. As the SF/SA ratio increased up to 65%, the SF content significantly improved the Tensile strength (σ T ), Young's modulus (E y ) but reduced the elongation at break (ε b ). To modify and enhance the elasticity and flexibility of the biocomposite films, the GLY as a plasticizer was used at different ratio from 20 to 50% for each SF/SA biocomposite films. Although the extensibility of the films was improved greatly with increasing GLY ratio, σ T and E y reduced significantly. The effect was observed more apparently for the GLY ratio starting from 35%. It was also shown that crystallinity index in the Amide I region increased as the SF/SA ratio increased to 65%. Increasing SF content improved the thermal stability of the SF/SA biocomposites. The XRD results showed that crystallinity was increased as SF/SA ratio increased. Stress-relaxation of SF/SA (30%) biocomposite films plasticized with GLY revealed that each kind of plasticized films showed a viscoelastic behavior and a fast relaxation in the first stage (1-2 min) of the processes and then continued slowly. The GLY increased the extensibility and elasticity limit of the SF/SA (30%) composite films. During the strain recovery processes, the plasticized composite films recovered completely in a quite shorter time than that of unplasticized films. It was observed higher the GLY content, the recovery times became shorter., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: This study was carried out to reveal the relationship between contraceptive intents, religious attitudes, and spiritual resources of married Muslim women., Methods: The study was conducted using a descriptive-correlational design. The study was conducted with 273 participants between July and November 2023. To collect data, the Personal Information Form, Trait Sources of Spirituality Scale, Ok-Religious Attitude Scale, and Contraceptive Intent Questionnaire were used. The data were evaluated using Mann-Whitney U, Kruskal-Wallis, and Spearman correlation tests., Results: No significant relationship was found between the total and sub-scales of the Contraceptive Intent Questionnaire, Trait Sources of Spirituality Scale, and Ok-Religious Attitude Scale (p > 0.05). A positive and high correlation was detected between the total, emotion, relationship, and behavior sub-scales of the Trait Sources of Spirituality Scale and Ok-Religious Attitude Scale (p < 0.05). The contraceptive intent levels of women were found to be associated with some of their socio-demographic and obstetric variables (age, previous delivery method, sex of existing children, and contraceptive method used). The only variable that showed a significant relationship with all three scales was found to be the sex of the existing children of women., Conclusion: Some socio-demographic and obstetric characteristics of married Muslim women are related to the sex of the child they have, their contraceptive intents, spiritual resources, and religious attitudes. In contraceptive counseling services provided to Muslim women, their religious attitudes and spiritual resources should be taken into consideration., (© 2024 The Author(s). Public Health Nursing published by Wiley Periodicals LLC.)

Introduction: Scholars have asserted and provided evidence on the developmental benefits of prosocial behaviors on later academic performance and well-being. However, research directly examining these links in US Latine early adolescents and work that explains the positive link between prosocial behaviors and academic outcomes is scarce. The present study investigated whether social skills and self-efficacy mediate the positive relations between prosocial behaviors and US Latine early adolescents' educational performance., Method: Participants were 543 low-income, US Latine middle school students (M age  = 11.7, SD = 0.73; 275 girls) attending after-school programs. Measures of prosocial behaviors, social skills, self-efficacy, and academic performance were administered at three-time points., Results: Findings showed that prosocial behaviors were significantly and positively linked to later self-efficacy, which in turn, was subsequently positively linked to academic performance. In contrast, the paths among prosocial behaviors, social skills, and academic performance were not significant., Conclusion: The discussion focuses on the central role of self-efficacy in understanding the relations between prosocial behaviors and educational performance in US Latine early adolescents., (© 2024 Foundation for Professionals in Services to Adolescents.)

Background/Objectives: Renal cell carcinoma is an aggressive form of kidney cancer, contributing to an estimated 138,000 deaths globally in 2017. Traditional treatments like chemotherapy and radiation are generally considered ineffective. Additionally, CD47 has been identified as a crucial tumor antigen involved in the development and progression of various cancers, including renal cell carcinoma. The interaction of CD47 with SIRPα triggers a "don't eat me" signal to the macrophages, inhibiting phagocytosis. Much progress has been made in targeting CD47 for cancer immunotherapy in solid tumors (STs) and hematological malignancies. This study aimed to evaluate CD47 expression in malignant and benign renal cell tumors and compare it with prognostic histopathological parameters. Methods: We included 160 malignant and 26 benign tumors. The malignant tumors consisted of renal cell carcinoma (RCC) subtypes including 37 clear cell, 30 chromophobe, 30 papillary type 1, 29 papillary type 2, and 34 unclassified RCC cases. As for the benign tumors, we included 26 oncocytoma cases. All samples were stained with anti-CD47 antibodies by immunohistochemistry methods. Results: The statistical analysis yielded a significant correlation between CD47 expression and survival, metastasis, and capsule invasion for the unclassified RCC cases. We did not find any further significant correlation between CD47 expression and the studied parameters. Conclusions: To the best of our knowledge, our study is the first to research CD47 expression in benign and malignant renal carcinoma subtypes. Further large-scale studies are needed to determine the expression profile of CD47 in renal cell tumors.

This two-phase study aims to develop the Turkish version of the German Eating Behavior Scale (SEV-Tr), and to investigate the potential associations of health-conscious and weight-controlling eating behaviors with nutritional and health status. In the first phase, the original scale was adapted to the Turkish language and its validity and reliability were assessed in 299 healthy individuals aged 19-64 years. In the second phase, the SEV-Tr was retested in a study population of 110 healthy individuals, aged 19-64 years, and the potential associations between the SEV-Tr score, anthropometrical and biochemical measurements, and other eating behaviors assessed by the Three-Factor Eating Questionnaire (TFEQ-Tr21) were examined. Statistical analyses were performed using AMOS 20.00 and SPSS 22.0 software packages. A two-dimensional structure was identified for the SEV-Tr, and named 'health-conscious eating behavior' and 'weight- controlling eating behavior'. In the second phase, participants were clustered based on their weight-controlling and health-conscious eating behaviors (F = 59.46, p  = 0.01). Participants with lower health-conscious and weight-controlling eating behaviors had higher lean body mass ( p  = 0.03), serum triglyceride levels ( p  = 0.01), emotional eating behavior ( p  = 0.03), and lower cognitive restraint behavior ( p  = 0.01, p  < 0.05). Furthermore, participants with high levels of health-conscious eating behavior had higher serum HDL cholesterol ( r  = 0.23, p  = 0.02). Regression models suggested that lower levels of emotional eating and higher levels of cognitive restraint were associated with increased weight-controlling and health-conscious eating behaviors. This study provided a valid and reliable version of the SEV to assess the health-conscious and weight-controlling eating patterns in people from Turkish culture.

Background: Lymphedema is a chronic, progressive condition that has major physical and psychological consequences. It was aimed to examine the respiratory functions, respiratory muscle strength, physical activity level, and functionality of patients with lower extremity lymphedema and to compare them with healthy controls. Methods and Results: A total of 82 individuals (29.3% male, 70.7% female, with a mean age of 49.89 ± 15.07 years) with lower extremity lymphedema (Group 1) and healthy individuals (Group 2) were included. Respiratory functions of the participants were evaluated by spirometry, respiratory muscle strength by maximum oral pressure measurements, physical activity levels using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), functionality by Lower Extremity Functional Scale (LEFS) and Timed Up and Go test (TUG test). All respiratory function test measurements were lower in mean Group 1 than in Group 2 ( p < 0.05). While inspiratory muscle strength did not differ between the groups ( p > 0.05), expiratory muscle strength was lower in Group 1 than Group 2 ( p < 0.05). Although spent time and energy for sitting were higher in Group 1 ( p < 0.05), IPAQ vigorous-, moderate-, and light-intensity physical activity (MET-min/week) and IPAQ-total score did not differ between groups ( p > 0.05). In Group 1, mean of LEFS score was lower and TUG test (seconds) in Group 1 was longer compared to Group 2 ( p < 0.05). Conclusions: Respiratory functions, expiratory muscle strength, and functionality in patients with lower extremity lymphedema were adversely affected; however, inspiratory muscle strength and physical activity levels were similar to those of healthy controls.

Background: Adequate, balanced, and individualized nutrition, planned according to the patients' life expectancy in palliative care units, is crucial for maintaining essential functions., Aim: To determine the knowledge levels of nurses working in palliative care units regarding enteral nutrition practices and their perceptions of nutritional care quality in their units., Methods: This descriptive, cross-sectional study was conducted in 25 palliative care units located in Izmir, Türkiye, between June and September 2022. The study sample consisted of 205 nurses working in palliative care units. Data were collected using a Personal Information Form, an Enteral Nutrition Practices Knowledge Form, and the Nurses' Perceived Nutrition Care Quality Assessment Scale. The STROBE checklist was also utilized., Results: The study found that the majority of participating nurses (94.6%) were female, with 78.5% holding bachelor's degrees. The median knowledge score for enteral nutrition: 15 (range: 2-27), perceived care quality score: 36 (range: 9-45). Those with enteral nutrition training had significantly higher knowledge scores (p < .001); palliative care certificate showed no difference (p = .846). Nurses lacking nutrition counseling knowledge had lower perceived care quality scores (p = .001). Monthly tube feeding applications correlated positively with knowledge scores (r = .173, p = .013), unlike professional experience duration (p = .126) and time spent in palliative care (p = .839)., Conclusion: Nurses working in the palliative care unit find the quality of nutrition care provided to patients in their clinics to be sufficient, and the level of knowledge regarding enteral nutrition is at a moderate level. However, in questions related to nursing care such as fluid requirements during enteral nutrition with enteral solutions that affect both nutritional care and medical treatment, maintaining the opening of the jejunostomy tube, and enteral drug administration, correct response rates were low. Low correct response rates on specific issues highlight a need for targeted educational interventions., Competing Interests: Declerations. Ethics approval and consent to participate: Non-Interventional Clinical Studies Ethics Committee of Health Sciences University Tepecik Training and Research Hospital (Approval no. 2022/01–26, Approved date: 17.01.2022) approved the proposal. The study was conducted following the Declaration of Helsinki. The participants were informed of the study’s goal and given the assurance that their nonparticipation or withdrawal would not affect them negatively. The written consent forms were obtained from all participants. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Exposure of the developing brain to androgens during fetal life is known to affect sexual development, including postnatal sex and sexual orientation. However, these relationships are both multifactorial and unpredictable. It is generally assumed that congenital adrenal hyperplasia (CAH) has greater effects in women than in men due to non-physiological adrenal androgen excess. Outcome information on patients with CAH often indicates poor quality of life, general maladjustment, problems with sexuality, and decreased fertility. With advances in medical treatment and surgery and changes in societal perspectives on gender and sexuality, there is a need for greater consideration of quality of life factors, including socialization and sexuality.

Signs of virilization, such as clitoromegaly, labio-scrotal fusion, and urogenital sinus may be observed in females with 21-hydroxylase deficiency (21-OHD) and other rare virilizing forms of congenital adrenal hyperplasia (CAH). This makes sex determination difficult, and multiple reconstructive surgeries in the postnatal period may be required. As 21-OHD is an autosomal recessive disease, the chance of any child being affected is one in four and so only one in eight will be an affected female. The primary objective of antenatal diagnosis is to identify only the affected fetus in the early gestational weeks before the onset of genital organogenesis and to treat that case. Therefore, studies aimed at antenatal diagnosis and preventing adrenal androgen exposure in the female fetus with CAH have long been of interest. Antenatal steroid treatment is considered experimental and controversial for safety reasons in recent clinical guidelines. If antenatal treatment is to be used, it is recommended that it should be performed in experienced centers that can collect data on a large number of cases which will help to define the benefits and harms of treatment better. In the postnatal period, a severe deficiency of the 21-hydroxylase enzyme leads to life-threatening adrenocortical insufficiency in both sexes and varying degrees of pathology of the external genitalia in females. This condition is also associated with high mortality in the first days of life and an increased risk of incorrect sex assignment. Neonatal screening for 21-OHD CAH effectively detects the severe forms and reduces mortality, and it is instrumental in the correct sex assignment of female cases.

Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency accounts for approximately 95% of all CAH cases and is one of the most common inborn errors of metabolism. While glucocorticoid therapy has significantly improved patient outcomes, the focus has shifted towards managing the long-term effects. Numerous adverse outcomes have been associated with CAH, including those resulting from supraphysiological doses of glucocorticoid and mineralocorticoid replacement, excessive adrenal androgen secretion, and elevated levels of steroid precursors and adrenocorticotropic hormone (ACTH). Despite advances in treatment, long-term complications persist due to the inability to replicate physiological hormone secretion fully. In this review, we explore critical aspects of managing CAH, focusing on cardiometabolic health, bone integrity, fertility, and other significant long-term consequences, informed by the latest literature.

Background: The prognostic value of the neutrophil-lymphocyte ratio (NLR) in ischemic stroke remains debated due to cohort variability and treatment heterogeneity across studies. This study evaluates the relationship between admission NLR, stroke severity and 90-day outcomes in patients with anterior circulation large vessel occlusion (LVO) undergoing early, successful revascularization. Methods: A retrospective multicenter study was conducted with 1082 patients treated with mechanical thrombectomy for acute ischemic stroke. The relationship between admission NLR, baseline National Institutes of Health Stroke Scale (NIHSS), 24 h NIHSS and 90-day modified Rankin Scale (mRS) outcomes was analyzed using logistic regression. Results: Admission NLR correlated weakly but significantly with both baseline ( p = 0.018) and 24 h ( p = 0.005) NIHSS scores, reflecting stroke severity. However, multivariate analysis showed that higher 24 h NIHSS scores (OR 0.831, p = 0.000) and prolonged puncture-to-recanalization times (OR 0.981, p = 0.000) were independent predictors of poor 90-day outcomes, whereas NLR was not ( p = 0.557). Conclusions: Admission NLR is associated with stroke severity but does not independently predict clinical outcomes at 90 days in patients achieving early and successful revascularization. These findings underscore the critical role of inflammation in the acute phase of stroke but suggest that its prognostic value for long-term outcomes is limited in this context.

Continuing advancements in human pluripotent stem cell (hPSC)-derived complex three-dimensional (3D) cardiac tissues require the development of novel technologies or adaptation of existing technologies to understand the physiology of the derived 3D cardiac tissues. In this protocol, we describe the use of multielectrode array (MEA) and sharp electrode electrophysiology techniques to investigate the electrical properties of 3D cardiac organoids. This protocol deciphers the electrical behavior of 3D cardiac organoids at both the single-cell level and tissue level., Competing Interests: Declaration of interests J.C.W. reports he is a co-founder and scientific advisory board member of Greenstone Biosciences., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Cleft lip and/or palate (CLP) is the most common orofacial congenital disability, presenting significant medical, psychological, and social challenges. In Pakistan, the incidence of CLP is high, estimated at one in 523 live births, but accurate data are lacking due to the absence of a birth registry. Early diagnosis and intervention are crucial for improving outcomes. This study evaluated the impact of CLP on patients' quality of life in Karachi, comparing pre- and post-surgical phases., Methods: A sequential exploratory quantitative-qualitative mixed-methods study was conducted at two tertiary care hospitals in Karachi. In the quantitative phase, 280 patients with CLP, either awaiting or post-surgery, completed the Oral Health Impact Profile (OHIP-14) questionnaire to assess oral health-related quality of life (OHRQoL). Based on questionnaire responses, 30 participants were purposively selected for in-depth, semi-structured interviews exploring their experiences. Quantitative data were analyzed using SPSS version 25; qualitative data were analyzed thematically., Results: Quantitative findings revealed significant gender disparities in cleft types and correction status; females had a higher prevalence of unilateral cleft lip, while males had more cleft palate cases. Dental and oral health issues significantly affected daily activities, with higher impacts in cleft palate patients. OHRQoL varied by gender, cleft type, and correction status, with those post-surgery reporting poorer OHRQoL. Qualitative analysis identified six themes: Diagnosis and Early Treatment, Challenges and Impact, Postsurgical Experiences, Support Systems, Healthcare Experiences, and Future Perspectives. Inconsistencies in psychological support, accessibility and financial burdens were presented as significant issues. Sentiment analysis highlighted varied emotions, from despair to hope and gratitude., Conclusions: CLP significantly affects patients' quality of life in Karachi across multiple dimensions. Early diagnosis and surgical intervention are essential but often hindered by financial and accessibility issues. Psychological effects, including low self-esteem and social isolation, highlight the need for integrated mental health support. Family and community support are critical for patient resilience. A comprehensive approach addressing medical, psychological, social, and systemic factors is necessary to improve outcomes for individuals with CLP., Competing Interests: Declarations. Ethics approval and consent to participate: The study received ethical approval from the Research and Ethics Committee of Hamdard University Dental Hospital (1245-03-24) dated 07.03.24. Informed consent was obtained from all subjects. For participants under 18, consent was also secured from parents/legal guardian/s. All experiments were performed in accordance with relevant guidelines and regulations (such as the Declaration of Helsinki). Consent for publication: Not applicable. Competing interests: The authors declare that there is potentially no conflict of interest related to the article., (© 2024. The Author(s).)

Background: The field of transitional care for chronic conditions in adolescents, notably juvenile idiopathic arthritis (JIA), is rapidly growing. Transitioning these patients to adult healthcare systems presents significant challenges in practical implementation. Consequently, it would be appropriate for each country to develop a transition program tailored to its specific infrastructure. To pursue this goal, a Delphi study was conducted to identify the key components of transitional care in JIA., Methods: Three panels and two rounds were held consisting of adolescents and young adults, parents, and clinicians (pediatric or adult rheumatologists). As a result, feedback on acceptance of the key statements of transitional care was obtained using the Delphi method., Results: Out of 102 contacted, 88 (86.3%) participants responded to the Round 1 survey, which included 48 clinicians, 20 youths, and 20 parents. In Round 2, the number of clinicians dropped to 29, while the number of youths and parents remained constant. Based on expert opinions, 29 statements were selected for the first round. Statements that received ≥ 70% approval in the first round advanced to the next round. Sixteen statements did not achieve ≥ 70% approval. Of the remaining, 12 were reviewed in the second round, while four were excluded., Conclusion: Although consensus has been reached on the basic transitional care issues for JIA patients, several issues still need to be agreed upon. Acceptance and applicability of the final 20-item checklist in clinical practice are critical for advancing JIA transition care in Turkey., Competing Interests: Declarations. Ethics approval and consent to participate: Kocaeli University Ethics Committee approved the study protocol and adhered to the principles of the Declaration of Helsinki (2023/297). Consent for publication: Not applicable. Competing interests: The authors declare that they have no competing interests., (© 2024. The Author(s).)

Objective: In this study, we aimed to evaluate the potential effects of white tea (WT) in the atherosclerosis process characterized by oxidative stress, inflammation, and dyslipidemia. Methods: In our study, apolipoprotein E knockout (ApoE -/- ) mice (RRID: IMSR&#95;JAX:002052) and C57BL/6J mice (RRID: IMSR&#95;JAX:000664) were used. In the atherosclerosis model induced by an atherogenic diet (AD), WT was administered via oral gavage at two different concentrations. The animals were sacrificed by decapitation under anesthesia, and their serum and aortic tissues were collected. Total cholesterol (TC), triglyceride (TG), interleukin (IL)-1β, IL-6, IL-10, IL-12, tumor necrosis factor-α (TNF-α), interferon-γ, myeloperoxidase, paraoxonase-1, lipoprotein-associated phospholipase A2, oxidized low-density lipoprotein (Ox-LDL), lectin-like oxidized LDL receptor (LOX-1), a disintegrin, and metalloprotease (ADAM) 10 and 17 activities were determined via colorimetric, enzyme-linked immunoassay, and fluorometric methods. Results: WT supplementation decreased serum Ox-LDL, LOX-1, TC, and TG levels by approximately 50%. TNF- and IL-6 levels were reduced by approximately 30% in the aortic arch. In addition, ADAM10/17 enzyme activities were found to be reduced by approximately 25%. However, no change in the AD-induced fibrotic cap structure was observed in the aortic root. Conclusions: The findings indicate that white tea effectively reduced oxidative stress, inflammation, and dyslipidemia in atherosclerosis but does not affect atheroma plaque morphology.

In this study, two novel tetra-substituted manganese (III) phthalocyanines bearing (9H-carbazol-2-yl)oxy groups on peripheral (1) or non-peripheral (2) positions were prepared and used for modification of reduced graphene oxide (rGO) by applying a simple one-step electrodeposition technique for the first time. The manganese (III) phthalocyanines (MnPcs) were electropolymerized and graphene oxide was electrochemically converted into reduced graphene oxide simultaneously. Subsequently, an rGO-MnPc hybrid structure was formed directly on the NiF electrode (substrate) via layer-by-layer assembly. Additionally, the effect of substituent position on the charge storage capacity of the prepared hybrid capacitive candidates was investigated. The fabricated hybrid electrodes exhibited remarkable electrochemical performance due to the combination of manganese (III) phthalocyanines and reduced graphene oxide. The NiF/rGO 2 -2 electrode exhibited the highest specific capacitance (512.4 F g -1 ) at 0.5 A g -1 and the remained specific capacitance was obtained 88.1 % after 5000 consecutive charge-discharge cycles. An asymmetric supercapacitor (ASC) was constructed from rGO 2 -2 as the positive electrode and rGO as the negative electrode with a working potential of 1.5 V. The as-prepared device delivered a specific energy of 17.4 Wh kg -1 at 350 W kg -1 . Hence, manganese (III) phthalocyanine-reduced graphene oxide electrodes can be considered outstanding materials for energy storage applications in the future., (© 2024 Wiley-VCH GmbH.)

Background: Children with self-limited epilepsy with centrotemporal spikes often face language impairments and central auditory processing difficulties. The correlations between these issues, seizure timing, and neuropsychiatric challenges are not fully understood. This study delves into the connections between language impairments and central auditory processing difficulties in cases with self-limited epilepsy with centrotemporal spikes, examining their links with seizure occurrence and neuropsychiatric function., Materials and Methods: Patients with self-limited epilepsy with centrotemporal spikes were categorized based on seizure timing: group 1 experienced seizures postbedtime, and group 2 prewaking. Both, alongside controls, underwent the Turkish Expressive and Receptive Language Test (TIFALDI) for language skills, and the Frequency Pattern and Duration Pattern tests for central auditory processing difficulties. Neuropsychiatric assessments involved the Wechsler Intelligence Scale for Children-Revised, the Strengths and Difficulties Questionnaire, the Conners Parent Rating Scale-Revised Short, and the Barratt Impulsiveness Scale-11., Results: The study comprised 56 patients with self-limited epilepsy with centrotemporal spikes (ages 6-13) and 32 healthy controls. Both groups significantly lagged behind controls on the Frequency Pattern and Duration Pattern tests ( P  < .001). In the TIFALDI, the expressive language scores varied between group 1 and controls ( P  = .04) but not the receptive language scores or the test's expressive and receptive language results between group 2 and controls ( P  > .05). In the Strengths and Difficulties Questionnaire, group 1 diverged from controls in behavioral and kind and helpful behavior scores ( P  = .016 and P  = .012). Group 1's Barratt Impulsiveness Scale-11 values surpassed controls' ( P  = .038)., Conclusion: Children with self-limited epilepsy with centrotemporal spikes have a high central auditory processing difficulties prevalence, regardless of seizure timing. Those with postsleep seizures tend to confront expressive language difficulties, alongside issues in prosocial behavior and impulsivity., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ready-to-use supplemental foods (RUSF) are energy-dense meals formulated to prevent and treat moderate and severe childhood acute malnutrition (MAM and SAM) in high-risk settings. Although lifesaving, the degree and durability of weight recovery with RUSF is unpredictable. We examined whether environmental enteric dysfunction (EED) and gut microbiota perturbations are risk factors for RUSF failure in a birth cohort of 416 rural Pakistani children followed for growth, common childhood illnesses, and biomarkers from blood, urine, and stool. Infants who developed wasting (weight-for-length Z score <-2, n=187, 45%) during surveillance received Acha Mum (a chickpea-based RUSF) daily for eight weeks. Machine learning identified seven biomarkers that predicted RUSF response (n=75) vs. non-response (n=112) with 73% accuracy. Remarkably, gut microbiome composition predicted RUSF response with 93% (pre-supplementation) and 98% (post-supplementation) accuracy. Seven outliers whose microbiome falsely predicted positive response experienced extraordinary burdens of inflammation and illness during supplementation. These findings identify gut microbial signatures and biomarkers of gut and systemic inflammation as robust predictors of RUSF response in infants free from intercurrent illness during recovery, setting the stage for predictive models to guide precision use of RUSF and adjunct therapies in undernourished children.

This review explores the diverse applications of Bacillus thuringiensis (Bt) beyond its traditional role as a bioinsecticide. Bt produces a variety of compounds with distinct chemical structures and biological activities. These include antimicrobial agents effective against plant pathogens and bioactive compounds that promote plant growth through the production of siderophores, hormones, and enzymes. Additionally, Bt's industrial potential is highlighted, encompassing biofuel production, bioplastics, nanoparticle synthesis, food preservation, anticancer therapies, and heavy metal bioremediation. This critical analysis emphasizes recent advancements and applications, providing insights into Bt's role in sustainable agriculture, biotechnology, and environmental management., (Copyright © 2024 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.)

Study Objective: This study aimed to determine whether myocardial infarction (MI) could be safely diagnosed or excluded within 30 min instead of 1 h., Methods: This single-center, prospective, observational study included patients presenting with non-traumatic chest pain. Patients underwent a thorough evaluation, including medical history, physical exams, ECG, and serial hs-cTn T measurements at 0, 30, and 60 min. Patients were classified into STEMI or further evaluated for NSTEMI-ACS based on ECG results. The hs-cTn T tests placed patients into rule-in, observation, or rule-out groups. Diagnostic performance was assessed using sensitivity and negative predictive value (NPV) to rule out MI (primary endpoints) and specificity and positive predictive value (PPV) to rule in MI (secondary endpoints)., Results: 809 patients were analyzed, with a median age of 53 ± 15.9 years, 36.1 % of whom were women. MI was confirmed in 15.6 % of patients. The 0-h/30-min algorithm placed 457 patients in the rule-out group, 222 in observation, and 188 in the rule-in, while the 0-h/1-h algorithm placed 507, 141, and 161 patients, respectively. The 0-h/30-min and 0-h/1-h algorithms showed identical sensitivity [100 % (96.11 %-100 %) and 100 % (99.61 %-100.00 %), respectively] and NPV [100 %] for excluding MI. Both had high specificity in the rule-in group [94.83 % (92.95 %-96.34 %) and 92.31 % (90.08 %-94.17 %)]. The 0-h/30-min algorithm had a superior PPV [71.54 % (64.75 %-77.48 %)] compared to the 0-h/1-h algorithm [66.46 % (60.53 %-71.91 %)]., Conclusion: The 0-h/30-min algorithm is as effective as the 0-h/1-h algorithm in safely ruling out MI and may offer improved diagnostic efficiency in ruling in MI., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: C-reactive protein (CRP) is the most widely used marker of the systemic inflammatory response. An association between preoperative elevated levels and prognosis has been demonstrated for numerous tumors. The aim of this study was to investigate the association between preoperative CRP levels and survival in early-stage nonsmall cell lung cancer., Methods: Data from 915 consecutive patients who underwent complete resection for stage I and II nonsmall cell lung cancer were retrospectively analyzed. Recurrence-free survival (RFS) and overall survival (OS) according to preoperative CRP levels were evaluated by the Kaplan-Meier method. The Cox proportional hazards model and logistic regression analysis were used for multivariate analysis., Results: Five-year RFS and OS were 61.0% and 70.3% in the low CRP group (<4 mg/L) and 41.8% and 49.4% in the high CRP group (≥4 mg/L), respectively (P < 0.001). In univariate analysis, CRP levels were correlated with indicators of tumor burden and pulmonary comorbidity. In multivariate analysis, CRP levels were identified as an independent predictor of RFS and OS., Conclusions: Elevated preoperative CRP is associated with poor prognosis in patients with early-stage lung cancer. CRP may guide risk-adapted follow-up and adjuvant therapy decisions. As CRP elevation is also associated with nontumor related conditions patients need to be screened for coexisting comorbidities., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: To evaluate a regimen of inhaled Technosphere insulin (TI) plus insulin degludec in adults with type 1 diabetes, who prestudy were predominately using either an automated insulin delivery (AID) system or multiple daily insulin injections (MDI) with continuous glucose monitoring., Research Design and Methods: At 19 sites, adults with type 1 diabetes were randomly assigned to TI plus insulin degludec (N = 62) or usual care (UC) with continuation of prestudy insulin delivery method (N = 61) for 17 weeks., Results: Prestudy, AID was used by 48% and MDI by 45%. Mean ± SD HbA1c was 7.57% ± 0.97% at baseline and 7.62% ± 1.06% at 17 weeks in the TI group and 7.59% ± 0.80% and 7.54% ± 0.77%, respectively, in the UC group (adjusted difference 0.11%, 95% CI -0.10 to 0.33, P value for noninferiority = 0.01). HbA1c improved from baseline to 17 weeks by >0.5% (5.5 mmol/mol) in 12 (21%) in the TI group and in 3 (5%) in the UC group and worsened by >0.5% (5.5 mmol/mol) in 15 (26%) in the TI group and in 2 (3%) in the UC group. The most common TI side effect was a brief cough; eight participants discontinued TI due to side effects., Conclusions: In adults with type 1 diabetes, HbA1c after 17 weeks with a regimen of TI and degludec was noninferior to UC, which consisted predominately of either AID or MDI. TI should be considered an option for people with type 1 diabetes, particularly those who are motivated to further reduce postprandial hyperglycemia., (© 2024 by the American Diabetes Association.)

Objective: Secondary osteoporosis is a condition when the underlying disease or its treatment causes the bone mass to decrease and the bone structure to deteriorate, increasing the risk of fracture. The importance of diagnosis and treatment during childhood and adolescence is due to the long-term negative effects. In this study, our objectives were to determine the diagnostic findings, treatment efficacy, and follow-up characteristics of children with secondary osteoporosis., Methods: Patients diagnosed with secondary osteoporosis between January 2000 and January 2021 were included. The research was a cross-sectional and descriptive study. Study participants had to be under 18 years of age when the primary underlying disease was diagnosed and had received treatment for secondary osteoporosis. Patient data were collected from patient files. Statistical analysis was performed using Statistical Package for the Social Sciences, version 20.0 (IBM Corp, Armonk, NY, USA)., Results: Sixty-one patients (28 female; 45.9%) were evaluated. The most common underlying primary diseases were inflammatory diseases (57.7%), neuromuscular diseases (26.2%), immunodeficiency (13.1%), acute lymphoblastic leukemia (8.2%), metabolic diseases (8.2%), solid organ transplantation (8.2%), bone marrow transplantation (6.6%) and epilepsy (6.6%). The mean±standard deviation chronological age when secondary osteoporosis was diagnosed was 11.89±4.88 years. Patients were evaluated for osteoporosis at a mean of 6.39±5.13 years after the onset of the underlying primary chronic diseases. Most (78.7%) had a history of one or more chronic drug use, including systemic steroids (59%), chemotherapeutics (23%), immunomodulatory drugs (19.7%), antiepileptic drugs (8.2%), inhaled steroids (4.9%), intravenous immunoglobulin (1.6%), and antituberculosis drugs 1.6%.Bone pain was detected in 49.2%. All patients had vertebral fractures before treatment. Bisphosphonate treatment was given to 45 (73.8%). There was a significant increase in mean bone mineral density (BMD) and bone mineral content six months after treatment (both p<0.001). There was a significant increase in BMD Z-score values for chronological and height age (both p<0.001). Overall mean BMD values increased by 31.15% with treatment. Following bisphosphonate treatment, there was a significant reduction in both fracture number and bone pain (p<0.01). Similar benefits from bisphosphonate treatment were evident in those who did or did not receive steroid treatment., Conclusion: Secondary osteoporosis is a condition that is influenced by many factors, such as the primary disease causing osteoporosis and chronic medication use, especially steroids. If left untreated, osteoporosis may lead to clinically important morbidity (bone pain, fractures, immobilization) and reduced linear growth of bone. When used to treat childhood secondary osteoporosis, bisphosphonates significantly improve BMD and reduced fracture risk., Competing Interests: Conflict of interest: None declared., (©Copyright 2024 by Turkish Society for Pediatric Endocrinology and Diabetes / The Journal of Clinical Research in Pediatric Endocrinology published by Galenos Publishing House.)

The study highlights the need for quality control in evaluating medicinal plant products, especially CBD oils, before market release. Due to varying regulatory requirements, product labeling can sometimes be misleading, especially regarding cannabinoid concentrations such as CBD and THC. This research focused on developing a validated high-performance liquid chromatography (HPLC) method for accurately identifying and quantifying key cannabinoids in Commercial Veterinary CBD Oil. The main compounds identified included Cannabidivarin (CBDV), Cannabidiolic Acid (CBD-A), Cannabigerolic Acid (CBG-A), Cannabigerol (CBG), Cannabidiol (CBD), Tetrahydrocannabivarin (THCV), Cannabinol (CBN), ∆ 9 -Tetrahydrocannabinol (d9-THC) ∆8-Tetrahydrocannabinol (d8-THC), Cannabicyclol (CBL), Cannabichromene (CBC), and Tetrahydrocannabinolic Acid (THCA), determined in line with the International Conference on Harmonization's (ICH) guidelines. The method was validated for linearity, accuracy, precision, limit of detection (LOD), and limit of quantitation (LOQ). It was determined to be linear, with a correlation coefficient (R²) > 0.999. The LOD and LOQ values calculated from the calibration curve ranged from 0.05 to 0.13 and 0.50 to 0.61 µg/mL, respectively. The method also exhibited acceptable precision, with relative standard deviation values lower than or equal to 2%. The method's accuracy was assessed through recovery percentages and fell within an acceptable range of 98-102 if the RSD was 2%. This study's rigorous methodology and comprehensive findings significantly contribute to cannabinoid analysis. This validated protocol was used to analyze cannabinoids in 14 commercial veterinary CBD oil products from the Republic of North Macedonia. The performance parameters demonstrated that the method is reliable for quantitatively measuring cannabinoids in CBD oil. The analysis showed that the cannabinoid levels in the products were consistent with the manufacturers' declared specifications, with no significant discrepancies in labeling.

The aim of this study was to compare the levels of thyroid hormones in children with ADHD and ADHD-NOS and to assess the relationship between ADHD symptom severity, anxiety symptom severity and thyroid hormone levels. The study was planned as a cross-sectional, retrospective study. The records of patients who applied to the study center in between January 2012 and January 2013 were screened and 205 ADHD and ADHD-NOS cases' records were evaluated. Both groups were compared according to thyroid hormon levels. The diagnosis of 205 patients' records and their comorbid psychiatric disorders was made clinically. ADHD symptom severity was assessed by Turgay DSM-IV-Based Child and Adolescent Behavior Disorders Screening and Rating Scale (T-DSM-IV-S). Anxiety symptom severity was assessed by The Screen for Anxiety Related Emotional Disorders (SCARED). Groups were compared with parametric or non-parametric methods according to assumptions of normality. P was set at 0.05 (two-tailed). Among the whole sample, 99 (48.3 %) patients were ADHD, and 106 (51.7 %) patients were ADHD- NOS. The average age of the children in the ADHD group was 10.88 ± 3.02 years, and the average age of the children in the NOS-ADHD group 9.93 ± 2.49 years. Thyroid hormone levels were detected in 81 of 205 patients participating in the study. We found statistically significantly higher T4 levels in the ADHD group compared to the ADHD-NOS group (p=0.006). A statistically significant negative correlation between the total number of diagnoses and T4 level was noted (p=0.001). TSH levels correlated significantly with T-DSM-IV-S total score and symptom counts in the Hyperactivity subscale of this measure. Thyroid hormone levels may be affected in children with impairing ADHD symptoms and increased comorbidities. Our results should be supported with future studies.

Background: Abnormalities in mitochondrial energy homeostasis can lead to various disorders, including ocular motility aberrations. Previous studies have suggested the involvement of mitochondrial aberrations in strabismus etiology. We compared the blood-derived mitochondrial DNA (mtDNA) copy number from comitant strabismus patients with that from age-matched controls, and also compared expression of mitochondrial biogenesis genes in a separate set of extraocular muscle samples from strabismic and control subjects., Methods: Blood samples from 93 strabismic (39 esotropic, 54 exotropic) and 93 control subjects were analyzed for mtDNA copy number through quantitative polymerase chain reaction. We also examined the expression of 6 genes involved in mitochondrial biogenesis in cDNA obtained from extraocular muscles of a separate group of 26 strabismus patients and 4 healthy controls., Results: The mtDNA content was significantly higher in strabismus patients as compared to the control group, both overall (fold change, 1.39; Z = -2.43 [P = 0.01]) and in strabismus subgroups (esotropia: fold change,1.42; Z = 2.59 [P = 0.0096]; exotropia: fold change, 1.41, Z = 3.35 [P = 0.00078]). No significant difference was observed in the expression of the examined biogenesis genes between strabismus and control groups., Conclusions: Our results suggest an association between mtDNA copy number and strabismus; however, further studies are required to elucidate the significance of altered mtDNA in strabismus and its possible significance with regard to the etiology of strabismus., (Copyright © 2024 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.)

Purpose: To determine the relationship between gynecologic cancer awareness and health literacy among women of reproductive age., Methods: This study was conducted in a descriptive design and involved 510 women. Data collection utilized the "Personal Information Form", "Gynecologic Cancer Awareness Scale (GCAS)" and "Health Literacy Scale (HLS)", gathered. Pearson correlation and linear regression analyses, independent samples t-test, one-way analysis of variance and post hoc analyses were employed for data analysis. Effect sizes were calculated using eta-squared (η 2 ) coefficients., Results: The mean total score of women on the GCAS was 154.42 ± 18.27, while the mean total score on the HLS was 57.07 ± 7.86. Significant differences were observed in women's GCAS total scores concerning age, perceived income status, and history of gynecological examination, whereas significant differences were noted in HLS total scores concerning age, educational status, marital status, and perceived income status. A weak positive correlation was detected betwixt women's GCAS and HLS total scores. It was determined that 20.8% of the total variation in gynecologic cancer awareness level was explained by health literacy., Conclusion: Women exhibit an above-average level of awareness regarding gynecologic cancers. Health literacy level contributes to an increase in gynecologic cancer awareness., Competing Interests: Declarations. Conflict of interests: The authors have no relevant financial or non-financial interests to disclose. Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Lokman Hekim University (Decision No: 2023/15, Code No: 2023013) and institutional permission was access from the hospital where the research was conducted. Informed consent: Informed consent was obtained from all individual participants included in the study., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The ultimate goal of this study was to establish the groundwork for the development of high-mechanical pullulan based films for wound healing applications. For this purpose, pullulan (PUL) was successfully methacrylated with different methacrylic anhydride amounts and used for the fabrication of photocurable wound dressing films (PULMA). The mechanical properties of the films, evaluated by changing the methacrylation degree and polymer concentration for better mechanical performance, indicated the best results in terms of elastic modulus (2.55 ± 0.15 MPa), tensile strength (2.48 ± 0.12 MPa), and elongation at break (848 ± 111 %). Additionally, the incorporation of PRO into wound dressing films has demonstrated strong antibacterial activity against Escherichia coli and Staphylococcus aureus, and it has also improved the release profile. The obtained films have scavenging properties against 2,2-diphenyl-1-picrylhydrazyl (DPPH). The wound dressing films were not cytotoxic to NIH/3T3 cells, a fibroblast cell line, according to the cytotoxicity assay. The in vitro scratch test showed that PRO incorporated films induced cell migration, suggesting that they have the potential to close wounds and promote healing. According to the image analysis conducted following the in ovo chorioallantoic membrane (CAM) test, PRO inclusion boosted different angiogenesis parameters stemming from the films. Clear evidence has been found that PRO loaded into high mechanical performance PUL based films can be suitable for advanced wound dressing applications., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)