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Aim of study: This paper provides an analysis of growth and survival of twenty–year–old Scots pine saplings in relation to canopy cover density (CCD) gradients, from dense (D–CCD), sparse (S–CCD), and gap (G–CCD) situations. Area of study: Aladag (Bolu) in northern Turkey. Material and methods: Sparse canopy cover density (S–CCD), dense canopy cover density (D–CCD) and gap canopy (G–CCD) were chosen within ten different strip sample plots (10 × 50 m) with sapling regeneration cores. Those regeneration cores were divided into two portions (individuals at the edge and middle of the regeneration cores) and from each portion three individuals was were obtained from a sample. The growth relationships of individual saplings were calculated with stem analyses. Honowski Light Factor (HLF) (ratio of Terminal sprout length (T) to Lateral sprout length (L)) was used to present growth potential measure of seedlings. Main results: The largest sapling regeneration cores were found in the G–CCD followed by S–CCD, and finally D–CCD, all tested for significance with Kruskal–Wallis Test. Compared with saplings in the middle of regeneration cores (crop saplings), those at the edge were always reduced in terms of mean height. Significant difference was only found between the ‘Main Crop’ and the ‘Edge 1’ of the regeneration cores for G–CCD suggesting that sapling regeneration cores are more typical under G–CCD conditions. HLF ratios were greater than 1 with high growth potentials for both CCD gradients (G–CCD and S–CCD) and there were no significant variations between G–CCD and S–CCD for main crop and edges. The thinning after 12–14 years increased sapling growth. However, under D–CCD, growth had virtually ceased. Research highlights: Naturally occurring Scots pine saplings are suppressed by a dense canopy. However, they are tolerant of shade to the extent that they can survive over relatively long time–periods (10–12 years) and can exploit subsequent opportunities should a canopy gap occur. Keywords: Gap regeneration; sapling growth; light regime; canopy cover density; irregular silviculture.

Purpose: To evaluate the ocular surface (OS) parameters in the pediatric migraine patients (PMPs). Methods: This prospective case–control study consisted of 51 PMPs (PMP group) and 55 healthy pediatric patients (HPP group). In all participants, tear function was evaluated subjectively using the Ocular Surface Disease Index (OSDI) questionnaire, objectively using Schirmer tear test (STT) and tear film disintegration time (TBUT), and with clinical and laboratory examinations (conjunctival impression cytology). The PMP group was subdivided into two groups according to their aura. Results: The mean age and gender distribution of the study groups were almost the same (P > 0.05 for both of them). In the PMP group, both the STT value and the TBUT value were significantly lower than those determined in the HPP group (P = 0.021 and P = 0.018, respectively). In the PMP group, the OSDI scores were higher than those in the HPP group (P = 0.032). In the PMP group, the goblet cell density values were lower than those in the HPP group (P = 0.01). With regard to the aura, the TBUT and STT values were nonsignificantly lower in the PMP aura-positive group than in the PMP aura-negative group (P > 0.05 for both of them). The OSDI assessment was similar in both the groups. With regard to the goblet cell count, it was observed to be less in the PMP aura-positive group than in the PMP aura-negative group (P = 0.01). Conclusion: Influence of OS in children with migraine was also demonstrated using the samples taken from the conjunctiva. These changes were also demonstrated by objective tests such as STT and TBUT. Both clinical objective evaluations and pathologic changes were more prominent in the migraine with aura group.

Background/Aims: Familial mediterranean fever (FMF) is a genetic autoinflammatory disease typically diagnosed in childhood. In this study, we aimed to investigate the demographic, clinical, and genetic characteristics of patients aged 18 years and older who were diagnosed with FMF. Materials and Methods: Patients diagnosed with FMF between 2014 and 2022 at Karadeniz Technical University Faculty of Medicine Hospital were included in the study. Patients were divided into 2 groups based on the age of disease onset. Group I included patients with adult-onset (ages 18-40), while group II comprised patients with late onset (ages 40 and above). Subsequently, the 2 groups were compared. Results: A total of 150 patients with a mean age of 32 (18-79) were included in the study. There were 116 patients in group I and 34 (22.7%) in group II. The most common presenting complaint was abdominal pain (91.3%), and the most prevalent complication was amyloidosis (4.7%). No significant differences were observed between age groups regarding clinical findings and symptoms. The most frequent homozygous mutations were M694V (9.3%) and R202Q (1.8%), while the heterozygous mutations were M694V (37.3%) and R202Q (35.5%), respectively. The rate of M694V gene positivity in the adult-onset group was significantly higher compared to the lateonset group (52.9% and 25%, respectively, P = .020). Conclusion: There does not appear to be a significant difference in clinical signs and symptoms between adult-onset and late-onset FMF patients. The higher rate of M694V gene positivity in the adult-onset group suggests that the M694V mutation may be responsible for the early expression of the disease.

Abstract Dravet syndrome and genetic epilepsy with febrile seizures plus (GEFS+) are both epilepsy syndromes that can be attributed to deleterious mutations occurring in SCN1A, the gene encoding the pore‐forming α‐subunit of the NaV1.1 voltage‐gated sodium channel predominantly expressed in the central nervous system. In this research endeavor, our goal is to expand our prior cohort of Turkish patients affected by SCN1A‐positive genetic epilepsy disorders. This will be accomplished by incorporating two recently discovered and infrequent index cases who possess a novel biallelic (homozygous) SCN1A missense variant, namely E158G, associated with Dravet syndrome. Furthermore, our intention is to use computational techniques to predict the molecular phenotypes of each distinct SCN1A variant that has been detected to date within our center. The correlation between genotype and phenotype in Dravet syndrome/GEFS+ is intricate and necessitates meticulous clinical investigation as well as advanced scientific exploration. Broadened mechanistic and structural insights into NaV1.1 dysfunction offer significant promise in facilitating the development of targeted and effective therapies, which will ultimately enhance clinical outcomes in the treatment of epilepsy.

Immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome is an early onset systemic autoimmune genetic disorder caused by mutation of the forkhead box protein 3 (FOXP3) gene. Enteropathy, endocrinopathy and skin manifestations are considered the classic triad of IPEX syndrome. However, patients with IPEX syndrome display a variety of phenotypes including life threatening multi-organ autoimmunity. Here, we present the case of two siblings with IPEX syndrome with the same hemizygous mutation, but with different types of symptomology at onset of the disease.

Background: Congenital diarrheal disorders (CDDs) are a rare group of enteropathies that typically present in the early few months of life and pose a diagnostic challenge. We aimed to analyze the clinical findings and outcome of infants with CDDs and share experience about genetic testing. Methods: Demographic, clinical and genetic findings, and outcome of the patients (n = 24) with CDDs were recorded from hospital files. Results: The onset of diarrhea was within the neonatal period in 45.8% of the patients. The most frequent causes of CDDs were defects in digestion, absorption and transport of nutrients and electrolytes (DATN) (n = 11, 45.8%) and defects in intestinal immune-related homeostasis (IIH) (n = 6, 25%). Fat malabsorption (n = 6) was the leading cause of defects in DATN. Extraintestinal manifestations including neurological involvement (25%) and renal involvement (20.8%) were common among the patients. Genetic analyses were performed for 16 patients (targeted gene analysis in 9, congenital diarrhea panel in 3, immune deficiency panel in 1 and whole-exome sequencing in 3 patients). Genetic diagnosis was achieved in 14 of 16 patients (87.5%) with therapeutic consequences in 8 of 16 patients (50%). During the follow-up, 6 patients (25%) died. Conclusion: The percentage of undefined etiology decreased, and treatment of the patients improved with the increased number of genetic testing in patients with CDDs.

INTRODUCTION[|]This study is an analysis of the subfoveal choroidal thickness (SFCT) and ganglion cell complex (GCC) in children who have type 1 diabetes mellitus (T1D) without diabetic retinopathy.[¤]METHODS[|]In all, 36 right eyes of 36 patients with T1D and 36 right eyes of sex- and age-matched healthy subjects were included in this prospective study. SFCT and GCC measurements were obtained using spectral domain optical coherence tomography (SD-OCT). Correlations between SCFT, GCC and duration of T1D, glycated hemoglobin, and age were also investigated.[¤]RESULTS[|]The mean SFCT was 342.1+-42.3 µm in the T1D group and 354+-70.8 µm in the control group (p>0.05). There was no significant difference between the groups in the GCC superior and inferior retina values. The average GCC was thinner in the T1D group (T1D group: 88.11+-14.93 µm, control group: 103.39+-15.65 µm; p=0.005). The mean central retinal thickness (CRT) was decreased in the T1D group (T1D group: 248.1+-16.5 µm, control group: 262.1+-18.3 µm; p=0.021).[¤]DISCUSSION AND CONCLUSION[|]The mean SFCT was not significantly different in diabetic children compared with healthy eyes. The CRT and average GCC thickness were lower in children with T1D. SD-OCT can reveal neurodegenerative changes that may occur before vascular changes in diabetic children.[¤]

Abstract We use the results of CMS and ATLAS searches for resonances that decay to $$\tau \nu $$ τ ν or tb and $$\tau ^+\tau ^-$$ τ + τ - or $$t{\bar{t}}$$ t t ¯ final states to constrain the parameters of non-universal $$W^\prime $$ W ′ and $$Z^\prime $$ Z ′ gauge bosons that couple preferentially to the third generation. For the former we consider production from $$c\bar{b}$$ c b ¯ annihilation and find very weak constraints on the strength of the interaction and only for the mass range between 800 and 1100 GeV from the $$pp \rightarrow \tau _h p_T^{\mathrm{miss}}$$ p p → τ h p T miss channel. The constraints on the latter are much stronger and arise from both $$t{\bar{t}}$$ t t ¯ and $$\tau ^+\tau ^-$$ τ + τ - production. Treated separately, we find that the weak constraints on the $$W^\prime $$ W ′ still permit an explanation of the $$R(D^{(\star )})$$ R ( D ( ⋆ ) ) anomalies with a light sterile neutrino whereas the stronger constraints on the $$Z^\prime $$ Z ′ exclude significant light sterile neutrino contributions to the $$K \rightarrow \pi \nu \bar{\nu }$$ K → π ν ν ¯ rates. Within specific models the masses of $$W^\prime $$ W ′ and $$Z^\prime $$ Z ′ are of course related and we briefly discuss the consequences.

Amaç: Bu çalışmanın amacı, bcr-abl negatif kronik miyeloproliferatif hastalık tanısı alan hastaların tanı anında JAK2 V617F, kalretikulin (CALR tip-1 ve tip-2) ve MPL-W515K / L mutasyonların sıklığını ve bu mutasyonların klinik önemini tartışmaktır.Gereç ve Yöntem: Bu çalışmada, Temmuz 2017-Mart 2019 tarihleri arasında BCR-ABL negatif kronik miyeloproliferatif hastalık tanısı alan hastaların demografik özellikleri, tanı alt tipi, risk durumu ve mutasyon analizi araştırılmıştır.Bulgular: JAK2-V617F mutasyonu 18‘i (% 85,7) polistemia vera (PV) ve geri kalanı (N = 9, %56,2) esansiyel trombositoz (ET) tanısı alan toplam 27 hastada saptandı. ET tanısı konmuş JAK2 V617F negatif 4 (% 57,1) hastada kalretikulin mutasyonu saptandı. Üç hastada CALR-tip 1 mutasyon ve 1 hastada CALR-tip 2 mutasyon tespit edildi. ET tanısı alan hastaların hiçbirinde MPL-W515K / L saptanmadı. Trombotik olay PV' li hastaların % 12,6'sı ve ET' li hastaların% 6,25'i olarak tespit edildi. Hastaların 14'ünde (% 37,8) splenomegali saptandı. Sonuç: Kronik myeloproliferatif hastalıkların patogenezi, sınıflandırılması ve risk grupları son yıllarda bazı genetik mutasyonların tanımlanması ile iyi karakterize edilmiştir. JAK2 V617F, CALR ve MPL kronik myeloproliferatif hastalıkların patogenezinde, hastalığın tanı, risk sınıflandırması, takipte önemli olan ve kişiselleştirilmiş tıpta önem kazanan aynı zamanda en sık tanımlanan somatik mutasyonlardır.

Purpose: The purpose of this study is to investigate the change of anterior chamber angle morphology after cataract surgery in patients with type 2 diabetes mellitus (DM2) using anterior segment optical coherence tomography (AS-OCT). Methods: In this prospective and comparative study, 57 eyes of the patients with cataract were investigated. The patients were divided into two groups. The DM2 group included cataractous type 2 diabetic patients without diabetic retinopathy ( n = 30) and the non-DM2 group included nondiabetic participants with cataract ( n = 27). The AS-OCT examinations were performed at baseline and 1 month after the cataract surgery. The corrected distance visual acuity (CDVA), intraocular pressure (IOP), angle-opening distance at 500 µm (AOD-500) and trabecular iris space area at 500 µm (TISA-500), and scleral spur angle (SSA) in temporal quadrant were analyzed. Results: The mean age, sex, and axial length values were similar in both groups ( p > 0.05 for all). The CDVA was significantly improved in both groups ( p 0.05 for all). Conclusion: Cataract surgery showed significant increases in mean anterior chamber angle parameters and reductions in IOP values in both diabetic and nondiabetic patients without intergroup significant differences. These results suggested the safety and effectiveness of cataract surgery, especially regarding anterior chamber angle parameters and so IOP changes.

We present a newborn diagnosed with Beckwith-Wiedemann syndrome and hypoglycemia, and developed pulmonary hypertension due to initiated diazoxide treatment because of these indications. Beckwith-Wiedemann syndrome was considered due to abdominal wall defect, macrosomia, macroglossia and hypoglycemia in a 34 week newborn with respiratory distress, hypoglycemia and syndromic appearance. Blood glucose level was measured as 1 mg/dL. Oral feeding, glucose infusion, prednisolone and then diazoxide treatment were started. At the first admission transthoracic echocardiographic examination, ventricular and atrial septal defects were detected. Control echocardiography performed under diazoxide treatment, showed development of enlarged right heart chambers, severe tricuspid regurgitation, and pulmonary hypertension. The development of pulmonary hypertension was thought to be related to diazoxide treatment. Diazoxide was discontinued after the patient became normoglycemic during follow--up period. Subsequently performed echocardiography revealed that the systolic pulmonary artery pressure regressed to 20 mmHg, and cardiac chambers returned to their physiologic balance. The patient without any problem during monitorization was discharged with the recommendation to attend further controls visits. In this case report, it was aimed to be reminded that pulmonary hypertension can develop due to diazoxide treatment, and it can regress with discontinuation of diazoxide. Besides, transthoracic ECHO should be performed to check for the development of pulmonary hypertension in newborns treated with diazoxide.

INTRODUCTION[|]This study aims to compare the efficacy of intravitreal injection of aflibercept (IVA), ranibizumab (IVR) and dexamethasone implant (DEX IMP) for the treatment of macular edema (ME) secondary to branch retinal vein occlusion (BRVO).[¤]METHODS[|]In this retrospective and comparative study, 57 eyes of 57 patients with ME after BRVO were studied. Patients were diveded into three groups according to treatment regimen as follows: 2 mg IVA (group 1, n=18), 0,5 mg IVR (group 2, n=20) and 0,7 mg Dex imp (group 3, n=19). Group 1 and group 2 were treated with three monthly anti-VEGF treatment followed by pro re nata (PRN) regimen, and group 3 was treated with 0,7 mg dexamethasone dose followed by another injection based on patients' data. Best-corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure (IOP) measurements were noted at baseline, 1, 2, 3 and 6 months.[¤]RESULTS[|]All groups were similar concerning age, gender, duration of symptoms, initial CMT and BCVA (p>0.05). Mean number of injections were 3,85+-0.74 in group 1, 3,85+-0,87 in group 2 and 1,75+-0,44 in group 3. All the groups decreased CMT and increased BCVA for six months. There was not a statistically significant difference between groups. Concerning side effects, one person in group 1 and 2, four people in group 3 increased IOP, but all of them controlled IOP with anti-glaucomatous drugs. One patient in group 1, two in group 2, four in group three patients had cataract progression.[¤]DISCUSSION AND CONCLUSION[|]All three drugs have similar results in patients with ME secondary to BRVO at a six-month follow-up. Compared to anti-VEGF drugs, dex imp has side effects as increased IOP and cataract progression, but it has higher BCVA at all months in the treatment of ME after BRVO.[¤]

Objective: The prevalence of non‐alcoholic fatty liver disease in children has risen significantly, owing to the worldwide childhood obesity epidemic in the last two decades. Non‐alcoholic fatty liver disease is closely linked to sedentary lifestyle, increased body mass index, and visceral adiposity. In addition, individual genetic variations also have a role in the development and progression of non‐alcoholic fatty liver disease. The aim of this study was to investigate the gene polymorphisms of MCP‐1 (‐2518 A/G) (rs1024611), CCR‐2 (190 G/A) (rs1799864), ABCA1 (883 G/A) (rs4149313), and IL‐17A (‐197 G/A) (rs2275913) in obese Turkish children with non‐alcoholic fatty liver disease. Methods: The study recruited 186 obese children aged 10-17 years, including 101 children with non‐alcoholic fatty liver disease and 85 children without non‐alcoholic fatty liver disease. Anthropometric measurements, insulin resistance, a liver panel, a lipid profile, liver ultrasound examination, and genotyping of the four variants were performed. Results: No difference was found between the groups in respect to age and gender, body mass index, waist/hip ratio, or body fat ratio. In addition to the elevated ALT levels, AST and GGT levels were found significantly higher in the non‐alcoholic fatty liver disease group compared to the non non‐alcoholic fatty liver disease group (p

Objective: The prevalence of non-alcoholic fatty liver disease in children has risen significantly, owing to the worldwide childhood obesity epidemic in the last two decades. Non-alcoholic fatty liver disease is closely linked to sedentary lifestyle, increased body mass index, and visceral adiposity. In addition, individual genetic variations also have a role in the development and progression of non-alcoholic fatty liver disease. The aim of this study was to investigate the gene polymorphisms of MCP-1 (-2518 A/G) (rs1024611), CCR-2 (190 G/A) (rs1799864), ABCA1 (883 G/A) (rs4149313), and IL-17A (-197 G/A) (rs2275913) in obese Turkish children with non-alcoholic fatty liver disease. Methods: The study recruited 186 obese children aged 10–17 years, including 101 children with non-alcoholic fatty liver disease and 85 children without non-alcoholic fatty liver disease. Anthropometric measurements, insulin resistance, a liver panel, a lipid profile, liver ultrasound examination, and genotyping of the four variants were performed. Results: No difference was found between the groups in respect to age and gender, body mass index, waist/hip ratio, or body fat ratio. In addition to the elevated ALT levels, AST and GGT levels were found significantly higher in the non-alcoholic fatty liver disease group compared to the non non-alcoholic fatty liver disease group (p

Purpose: The purpose of this study was to compare the retinal vascular caliber of COVID-19 patients with that of healthy subjects. Methods: This was a prospective case–control study. Forty-six patients who had COVID-19 were successfully treated, and 38 age- and gender-matched healthy subjects were enrolled in this study. Fundus photography was taken using fundus fluorescein angiography (FA; Visucam 500; Carl Zeiss Meditec, Jena, Germany). Retinal vascular caliber was analyzed with IVAN, a semi-automated retinal vascular analyzer (Nicole J. Ferrier, College of Engineering, Fundus Photography Reading Center, University of Wisconsin, Madison, WI, USA). Central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and artery–vein ratio (AVR) were compared between groups. Results: The mean age was 37.8 ± 9.5 years in the COVID-19 group ( n = 46) and 40 ± 8 years in the control group ( n = 38) ( p = 0.45). The mean CRAE was 181.56 ± 6.40 in the COVID-19 group and 171.29 ± 15.06 in the control group ( p = 0.006). The mean CRVE was 226.34 ± 23.83 in the COVID-19 group and 210.94 ± 22.22 in the control group ( p = 0.044). AVR was 0.81 ± 0.09 in the COVID-19 group and 0.82 ± 0.13 in the control group ( p = 0.712). Conclusion: Patients who had COVID-19 have vasodilation in the retinal vascular structure after recovery. As they may be at risk of retinal vascular disease, COVID-19 patients must be followed after recovery.

Purpose: To evaluate outcome of intravitreal dexamethasone implant (IDI) treatment on serous retinal detachment (SRD) in patients with ranibizumab-resistant diabetic macular edema (DME). Materials and methods: Forty-eight eyes of 48 patients with DME resistant to ranibizumab were enrolled in this retrospective and comparative study. Patients were divided into two groups according to presence of serous retinal detachment: (1) SRD or (2) non-SRD groups. All patients had at least three monthly ranibizumab injections, after which they were treated with IDI. The best-corrected visual acuity (BCVA), central retinal thickness (CRT), use of antiglaucomatous drugs, and presence of cataract progression were noted at 1, 3, and 6 months post-IDI treatment. Results: There was not any statistically significant difference in terms of baseline characteristics of the patients. The mean CRT was declined in both groups at 1, 3, and 6 months ( p

Objectives: To evaluate the corneal effects of the intravitreal dexamethasone implantation using corneal topography and specular microscopy. Material and methods: 27 eyes of the 27 patients who received a single intravitreal dexamethasone implantation dose for diabetic macular edema were enrolled in this study. Sirius topography and EM-3000 specular microscopic examinations were performed at the initial examination (baseline), and then on the first day, during the first week, and 1 month after IDI. Changes in corneal parameters were investigated. Results: The mean age was 58.66 ± 6.59 years. 15 patients were men, and 12 were women. The mean disease duration was 12.2 ± 2.4 months, and mean glycosylated hemoglobin (HbA1c) was 7.2 ± 1.1. After dexamethasone injection, the mean central corneal thickness, endothelial cell density, and coefficient variation of cell area presented a statistically significant decrease ( p 0.05). Conclusion: Intravitreal dexamethasone implantation affects corneal endothelial cell structure but does not appear to affect corneal topography parameters.

AIM: To compare three initial monthly intravitreal ranibizumab (IVR) injections followed by pro re nata (PRN) dosing with one initial monthly IVR injections followed by PRN dosing for macular edema (ME) secondary to branch retinal vein occlusion (BRVO). METHODS: Forty-two eyes of 42 patients who had IVR injections for BRVO were retrospectively studied. Eighteen eyes received 1 initial IVR injection (1+PRN group) and 24 eyes received 3 monthly IVR injections (3+PRN). At 1, 3, 6 and 12mo; spectral-domain optical coherence tomography (SD-OCT) was performed. Central macular thickness (CMT), the integrity of the external limiting membrane (ELM), the presence of subretinal fluid, cyst size, the presence of inner segment/outer segment (IS/OS) defect were determined. RESULTS: At baseline the mean CMT was 521.3±153.2 µm in the 3+PRN group while it was 438.1±162.4 µm in 1+PRN group. At the final visit, mean CMT was 278.3±87.8 µm in the 3+PRN group and 285.2±74.2 µm in the 1+PRN group (P=0.079). The changes in CMT over the entire study period were also comparable in both groups (243±160 µm in the 3+PRN group, and 152.9±175.3 µm in the 1+PRN group; P=0.090). At baseline, best-corrected visual acuity (BCVA) was 0.92±0.60 logarithm of the minimal angle of resolution (logMAR) in the 3+PRN group, while it was 0.72±0.46 logMAR in the 1+PRN group. Final BCVA was 0.42±0.55 logMAR in the 3+PRN group and 0.38±0.50 logMAR in the 1+PRN group (P=0.979). Additionally, the BCVA changes from baseline to final visit were not significantly different (-0.50±0.45 logMAR in the 3+PRN group, and -0.33±0.39 logMAR in the 1+PRN group; P=0.255). CONCLUSION: No significant differences in the anatomical or functional results are found between 3+PRN and 1+PRN regimens in the patients receiving ranibizumab for ME secondary to BRVO. Intact IS/OS and baseline BCVA are good predictor of the visual gain, while baseline CMT is a good predictor of the anatomical gain.

To investigate the effect of capsulotomy size on refraction and anterior chamber parameters following Nd:YAG laser treatment. Fifty-six eyes of 56 pseudophakic patients with posterior capsular opacification (PCO) were reviewed. Patients were divided into two groups according to the capsulotomy size. Changes in best corrected visual acuity (BCVA), spherical equivalent (SE), anterior chamber depth (ACD), anterior chamber volume (ACV) and anterior chamber angle (ACA) were compared between groups. A hyperopic shift was remarkable in the 1st week in both groups but SE declined about to preoperative levels at 1 month after laser capsulotomy in both groups (p=0,056). In both groups, ACD decreased 1 week after laser capsulotomy (p [Med-Science 2018; 7(3.000): 571-4]

In this study, we address a production scheduling problem. The scheduling problem is encountered in a job-shop production type. The production system is discrete and dynamic system in which jobs arrive continually. We introduce a simulation model (SM) to identify several situations such as machine failures, changing due dates in which scheduling rules (SRs) should be selected independently. Three SRs, i.e. the earliest due date rule (EDD), the shortest processing time first rule (SPT) and the first in first out rule (FIFO), are incorporated in a SM. A simulated annealing heuristic (SA) based simulation-optimisation approach is proposed to identify the unknown schedules in the dynamical system. In the numerical analysis, the performance of SRs and SA are compared using the simulation experiments. The objective functions minimising the mean flowtime and the mean tardiness are examined with varying levels of shop utilization and due date tightness. As an overall result, we observe that the proposed SA heuristic outperforms EDD and FIFO, the well-known SPT rule provides the best results. However, SA heuristic achieves very close results to the SPT and offers a reasonable computational burden in time-critical applications.

The Teaching-Learning Based Optimization (TLBO) algorithm is a population-based optimization technique that has been shown to be competitive against other population-based algorithms. The main purpose of this paper is to solve the balancing problem of mixed-model two-sided assembly lines by using TLBO algorithm first time in the literature. Most recently, hybrid teaching-learning-based optimization (HTLBO) algorithm is proposed by [1] for solving the balancing of stochastic simple two-sided assembly line problem. The HTBLO algorithm is compared with the well-known 10 different meta-heuristic algorithms in the literature in [1]. The tests performed underlined that HTLBO algorithm presented more outstanding performance when compared to other algorithms. In this paper, HTLBO algorithm is also adapted for solving the problem of balancing mixed-model two-sided assembly line and its performance is analysed. The objective function of this study is to minimize the number of mated-stations and total number of stations for a predefined cycle time. A comprehensive computational study is conducted on a set of test problems that are taken from the literature and the performance of the algorithms are compared with existing approaches. Experimental results show that TLBO algorithm has a noticeable potential against to the best-known heuristic algorithms and HTLBO algorithm results show that it performs well as far as the best-known heuristic algorithms for the problem in the literature.

Bu çalışmada, bir üretim çizelgeleme problem ele alınmaktadır. Bu çizelgeleme problemine atölye tipi bir üretim tipinde karşılaşılmaktadır. Üretim sistemi sürekli iş gelişlerinin söz konusu olduğu kesikli dinamik sistemdir. Çizelgeleme kurallarının birbirinden bağımsız şekilde kullanılmasının gerektiği makine bozulmaları ve değişen teslim süreleri gibi bazı durumların değerlendirilmesi için bir simülasyon modeli sunulmaktadır. En erken teslim süresi, en kısa işlem süresi ve ilk giren ilk çıkar kuralı olmak üzere üç çizelgeleme kuralı bu simülasyon modeline dahil edilmiştir. Dinamik sistemdeki belirsiz çizelgeleri ortaya koymak için tavlama benzetimi sezgiseli tabanlı bir simülasyon optimizasyonu yöntemi önerilmektedir. Sayısal analizlerde çizelgeleme kurallarının ve önerilen tavlama benzetimi sezgiselinin performansları simülasyon deneyleri kullanılarak kıyaslanmıştır. Ortalama akış süresini ve ortalama gecikme süresini en küçükleyen amaç fonksiyonları farklı seviyelerdeki atölye kullanım oranı ve teslim süresi durumlarında incelenmiştir. Genel bir sonuç olarak, önerilen tavlama benzetimi sezgiselinin en erken teslim zamanı ve ilk giren ilk çıkar kurallarından daha iyi sonuç verdiği, en kısa işlem süresi kuralının en iyi sonuçları sağladığı gözlenmiştir. Fakat tavlama benzetimi sezgiseli en kısa işlem süresi kuralına çok yakın sonuçlara erişmektedir ve çözüm zamanının kritik olduğu uygulamalarda kabul edilebilir bir hesaplama yükü getirmektedir.

Bu çalışmada, bir üretim çizelgeleme problem ele alınmaktadır. Bu çizelgeleme problemine atölye tipi bir üretim tipinde karşılaşılmaktadır. Üretim sistemi sürekli iş gelişlerinin söz konusu olduğu kesikli dinamik sistemdir. Çizelgeleme kurallarının birbirinden bağımsız şekilde kullanılmasının gerektiği makine bozulmaları ve değişen teslim süreleri gibi bazı durumların değerlendirilmesi için bir simülasyon modeli sunulmaktadır. En erken teslim süresi, en kısa işlem süresi ve ilk giren ilk çıkar kuralı olmak üzere üç çizelgeleme kuralı bu simülasyon modeline dahil edilmiştir. Dinamik sistemdeki belirsiz çizelgeleri ortaya koymak için tavlama benzetimi sezgiseli tabanlı bir simülasyon optimizasyonu yöntemi önerilmektedir. Sayısal analizlerde çizelgeleme kurallarının ve önerilen tavlama benzetimi sezgiselinin performansları simülasyon deneyleri kullanılarak kıyaslanmıştır. Ortalama akış süresini ve ortalama gecikme süresini en küçükleyen amaç fonksiyonları farklı seviyelerdeki atölye kullanım oranı ve teslim süresi durumlarında incelenmiştir. Genel bir sonuç olarak, önerilen tavlama benzetimi sezgiselinin en erken teslim zamanı ve ilk giren ilk çıkar kurallarından daha iyi sonuç verdiği, en kısa işlem süresi kuralının en iyi sonuçları sağladığı gözlenmiştir. Fakat tavlama benzetimi sezgiseli en kısa işlem süresi kuralına çok yakın sonuçlara erişmektedir ve çözüm zamanının kritik olduğu uygulamalarda kabul edilebilir bir hesaplama yükü getirmektedir.

Öğretme-Öğrenme-Tabanlı Eniyileme (ÖÖTE) algoritması, diğer popülasyon-tabanlı algoritmalar kadar etkin olduğu ortaya konmuş, popülasyon-tabanlı bir eniyileme algoritmasıdır. Bu makalenin temel amacı, ÖÖTE algoritmasını kullanarak iki yönlü karışık modelli montaj hattı dengeleme problemini ilk defa çözmektir. Yakın zamanda, stokastik iki yönlü tek modelli montaj hattı dengeleme problemini çözmek için [1]’de melez öğretme-öğrenme-tabanlı eniyileme (MÖÖTE) algoritması önerilmiştir. [1]’de MÖÖTE algoritması en iyi bilinen 10 farklı meta-sezgisel algoritma ile karşılaştırılmıştır. Yapılan testler MÖÖTE algoritmasının diğer algoritmalara göre daha üstün bir performans sergilediğini ortaya koymuştur. Bu makalede ayrıca, MÖÖTE algoritması iki yönlü karışık modelli montaj hattı dengeleme problemini çözmek için adapte edilmiş ve algoritmanın performansı test edilmiştir. Bu çalışmanın amacı önceden tanımlanmış çevrim süresinde karşılıklı eşleşen istasyon sayısını ve toplam istasyon sayısını en aza indirmektir. Literatürden alınan test problem grupları üzerinden kapsamlı bir deneysel çalışma gerçekleştirilmiştir ve algoritmaların performansları var olan yaklaşımlarla karşılaştırılmıştır. Deneysel çalışmalar ÖÖTE algoritmasının karşılaştırılan diğer en iyi bilinen sezgisel algoritmalara karşı göze çarpan bir potansiyele sahip olduğunu ve problemin çözümünde MÖÖTE algoritmasının bilinen en iyi sezgisel algoritmalar kadar iyi performans sergilediğini ortaya koymuştur.

Öğretme-Öğrenme-Tabanlı Eniyileme (ÖÖTE) algoritması, diğer popülasyon-tabanlı algoritmalar kadar etkin olduğu ortaya konmuş, popülasyon-tabanlı bir eniyileme algoritmasıdır. Bu makalenin temel amacı, ÖÖTE algoritmasını kullanarak iki yönlü karışık modelli montaj hattı dengeleme problemini ilk defa çözmektir. Yakın zamanda, stokastik iki yönlü tek modelli montaj hattı dengeleme problemini çözmek için [1]’de melez öğretme-öğrenme-tabanlı eniyileme (MÖÖTE) algoritması önerilmiştir. [1]’de MÖÖTE algoritması en iyi bilinen 10 farklı meta-sezgisel algoritma ile karşılaştırılmıştır. Yapılan testler MÖÖTE algoritmasının diğer algoritmalara göre daha üstün bir performans sergilediğini ortaya koymuştur. Bu makalede ayrıca, MÖÖTE algoritması iki yönlü karışık modelli montaj hattı dengeleme problemini çözmek için adapte edilmiş ve algoritmanın performansı test edilmiştir. Bu çalışmanın amacı önceden tanımlanmış çevrim süresinde karşılıklı eşleşen istasyon sayısını ve toplam istasyon sayısını en aza indirmektir. Literatürden alınan test problem grupları üzerinden kapsamlı bir deneysel çalışma gerçekleştirilmiştir ve algoritmaların performansları var olan yaklaşımlarla karşılaştırılmıştır. Deneysel çalışmalar ÖÖTE algoritmasının karşılaştırılan diğer en iyi bilinen sezgisel algoritmalara karşı göze çarpan bir potansiyele sahip olduğunu ve problemin çözümünde MÖÖTE algoritmasının bilinen en iyi sezgisel algoritmalar kadar iyi performans sergilediğini ortaya koymuştur.

Bu çalışmada, bir üretim çizelgeleme problem ele alınmaktadır. Bu çizelgeleme problemine atölye tipi bir üretim tipinde karşılaşılmaktadır. Üretim sistemi sürekli iş gelişlerinin söz konusu olduğu kesikli dinamik sistemdir. Çizelgeleme kurallarının birbirinden bağımsız şekilde kullanılmasının gerektiği makine bozulmaları ve değişen teslim süreleri gibi bazı durumların değerlendirilmesi için bir simülasyon modeli sunulmaktadır. En erken teslim süresi, en kısa işlem süresi ve ilk giren ilk çıkar kuralı olmak üzere üç çizelgeleme kuralı bu simülasyon modeline dahil edilmiştir. Dinamik sistemdeki belirsiz çizelgeleri ortaya koymak için tavlama benzetimi sezgiseli tabanlı bir simülasyon optimizasyonu yöntemi önerilmektedir. Sayısal analizlerde çizelgeleme kurallarının ve önerilen tavlama benzetimi sezgiselinin performansları simülasyon deneyleri kullanılarak kıyaslanmıştır. Ortalama akış süresini ve ortalama gecikme süresini en küçükleyen amaç fonksiyonları farklı seviyelerdeki atölye kullanım oranı ve teslim süresi durumlarında incelenmiştir. Genel bir sonuç olarak, önerilen tavlama benzetimi sezgiselinin en erken teslim zamanı ve ilk giren ilk çıkar kurallarından daha iyi sonuç verdiği, en kısa işlem süresi kuralının en iyi sonuçları sağladığı gözlenmiştir. Fakat tavlama benzetimi sezgiseli en kısa işlem süresi kuralına çok yakın sonuçlara erişmektedir ve çözüm zamanının kritik olduğu uygulamalarda kabul edilebilir bir hesaplama yükü getirmektedir.

Öğretme-Öğrenme-Tabanlı Eniyileme (ÖÖTE) algoritması, diğer popülasyon-tabanlı algoritmalar kadar etkin olduğu ortaya konmuş, popülasyon-tabanlı bir eniyileme algoritmasıdır. Bu makalenin temel amacı, ÖÖTE algoritmasını kullanarak iki yönlü karışık modelli montaj hattı dengeleme problemini ilk defa çözmektir. Yakın zamanda, stokastik iki yönlü tek modelli montaj hattı dengeleme problemini çözmek için [1]’de melez öğretme-öğrenme-tabanlı eniyileme (MÖÖTE) algoritması önerilmiştir. [1]’de MÖÖTE algoritması en iyi bilinen 10 farklı meta-sezgisel algoritma ile karşılaştırılmıştır. Yapılan testler MÖÖTE algoritmasının diğer algoritmalara göre daha üstün bir performans sergilediğini ortaya koymuştur. Bu makalede ayrıca, MÖÖTE algoritması iki yönlü karışık modelli montaj hattı dengeleme problemini çözmek için adapte edilmiş ve algoritmanın performansı test edilmiştir. Bu çalışmanın amacı önceden tanımlanmış çevrim süresinde karşılıklı eşleşen istasyon sayısını ve toplam istasyon sayısını en aza indirmektir. Literatürden alınan test problem grupları üzerinden kapsamlı bir deneysel çalışma gerçekleştirilmiştir ve algoritmaların performansları var olan yaklaşımlarla karşılaştırılmıştır. Deneysel çalışmalar ÖÖTE algoritmasının karşılaştırılan diğer en iyi bilinen sezgisel algoritmalara karşı göze çarpan bir potansiyele sahip olduğunu ve problemin çözümünde MÖÖTE algoritmasının bilinen en iyi sezgisel algoritmalar kadar iyi performans sergilediğini ortaya koymuştur.

Cerebrotendinous xanthomatosis is a rare autosomal recessive disorder. It occurs as a mutation in the CYP27A1 gene with nine exons in the Long arm of chromosome 2. The patient was diagnosed with epilepsy in our clinic for seven years and was diagnosed with cerebrotendinous xanthomatosis with a weakness in the lower extremities that appeared a few years ago. We think that especially it is worth mentioning that it is a rare disease in childhood and it is diagnosed early.

Objective: We re-examined children who had previously been declared eligible to participate in competitive sports activities for cardiac disorders, using cardiac investigation protocol. Methods: Total of 250 children (224 males [89.6%], and 26 females [10.4%]) between the ages of 8 and 17 years who had just started or were already engaged in sports activities were included in the study. Participants had detailed physical examination evaluated by a pediatric cardiologist. Those with findings suggesting cardiac disorder in their history and/or physical examinations, and/or 12-channel electrocardiography (ECG) were examined with echocardiography (ECHO), 24-hour Holter monitoring, and exercise test. Results: Mean duration of participation in sports activities was 13 months. Among all, 10.4% of the children had abnormalities on ECG. ECHO demonstrated cardiomyopathy in 1, mitral valve prolapse in 2, tricuspid insufficiency in 2, and mitral insufficiency in 1 participant. Holter monitoring revealed non-sustained ventricular tachycardia attacks in 1, and supraventricular tachycardia in another child. Three were ultimately disqualified from partaking in competitive sports. Conclusion: Sports and medical communities must work together to establish study protocols to prevent sudden death related to sports and to make these activities safer for athletes. Pediatric cardiology consultation for young athletes before they start sports activities is needed.

To determine the time of anatomical and visual responses of intravitreal aflibercept (IVA) injections in patients with naive macular edema (ME) due to branch retinal vein occlusion (BRVO). 54 eyes of 54 patients who had three IVA injections after BRVO were retrospectively studied. All of the patients had three monthly IVA injections. SD-OCT was performed at the initial visit and one month after every injection. Changes in central macular thickness (CMT), best corrected visual acuity (BCVA) were determined. Results: 28 of 54 patients were women and 26 of 54 patients were man. Mean age was 62.56±2.35 years. Mean BCVA of the patients was logMAR 1.00±0.13 and the mean CMT was 476±35 µm. After first injections; mean BCVA and CMT were improved to logMAR 0.73±0.19, 279±15 µm respectively. These improvements were statically significant (p=0.047 and p=0.000 respectively). After second injections there was not any improvement in BCVA or CMT. The mean BCVA logMAR 0.75±0.18 and mean CMT 279±10 µm (p=0.725 and p=0.991). After third injections mean CMT was 267±6 µm and mean BCVA was logMAR 0.58±0.15. Although after third injections, CMT did not change but BCVA was statically significant improved (p=0.77 and p=0.036 respectively). Visual recovery comes after anatomical recovery after intravitreal aflibercept injections in patients with naive ME due to BRVO. [Med-Science 2018; 7(4.000): 810-2]

To evaluate the restoration of outer segment ellipsoid zone (EZ) layer and its prognostic value in visual gain following resolution of macular edema (ME) due to branch retinal vein occlusion (BRVO). In this retrospective study,33 eyes of 33 patients with ME due to BRVO who underwent intravitreal ranibizumab (IVR) injections were studied. All of the patients had the resolution of macular edema after IVR therapy. At baseline and final visit, SD-OCT scans were obtained. Best-corrected visual acuity (BCVA), central macular thickness (CMT) and integrity of outer segment ellipsoid zone (EZ) defects were determined. We divided the eyes with initial EZ defects into two groups. Group-1 had restoration of EZ and group-2 had EZ defects before and after treatment. 14 of 33 eyes (42.4%) did not have EZ defects and 19 of 33 eyes had EZ defects before treatment. 9 eyes (27.3%) had restoration of EZ defects and 2 patients (6.1%) had EZ defects after treatment while they did not have at initial visit. According to EZ change status (group-1 and group-2) the groups were similar in terms of initial BCVA and CMT. Group-1 had better final BCVA (p=0.005). There was a statically significant difference in BCVA improvement between groups (p=0.001). Disorganization of photoreceptors can have recovery after resolution of ME with ranibizumab treatment and to have better BCVA after resolution of ME, restoration of the structure of the photoreceptors is required. [Med-Science 2018; 7(3.000): 491-3]

Cor triatriatum dexter (CTD) is a rare congenital heart disorder that is result of persistence of the right valve of the embryonic sinus venosus. Clinical significance of CTD is related to degree of obstruction. Asymptomatic patients may be diagnosed during echocardiographic examination performed for unrelated reasons. Presently described is case of a 12-year-old girl with initial diagnosis of acute rheumatic fever whose echocardiogram revealed presence of CTD. Aim of this report was to emphasize that diagnosis of CTD can be difficult and requires careful evaluation of the right atrium by echocardiogram.

Purpose. To evaluate choroidal thickness in patients with coeliac disease (CD) using spectral domain optical coherence tomography (SD-OCT) and to compare the results to normal eyes. Methods. Seventy patients with CD and 70 healthy controls were included in this prospective, comparative study. All participants underwent a complete ophthalmologic evaluation and SD-OCT. Subfoveal, nasal (nasal distance to fovea 500 μm, 1000 μm, and 1500 μm), and temporal (temporal distance to fovea 500 μm, 1000 μm, and 1500 μm) choroidal thickness measurements were performed using SD-OCT. Results. There were no significant differences in sex, ages, and axial lengths between the groups (p=1.0, p=0.601, p=0.314, respectively). The mean choroidal thickness measurements at all predefined measurement point areas were higher in the coeliac group than in the healthy controls (p

The CMS Collaboration has reported a possible lepton flavor violating (LFV) signal h→μτ. Whereas this does not happen in the standard model (SM), we point out that new physics responsible for this type of decay would, in general, also produce charge-parity (CP) violation in h→ττ. We estimate the size of this effect in a model independent manner and find that a large asymmetry, of order 25%, is allowed by current constraints.

Objectives: In this study, we evaluated the correlation between severity of deformity and cardiopulmonary function with regards to echocardiographic and spirometric findings. Study design: Twenty-five children, mean age 13.6 years, presenting with pectus excavatum between August 2012 and May 2013, were included. Haller index (HI) was calculated for each patient. Patients with an index of 3.6 as Group 3. Left ventricle dimension, ejection fraction, and shortening fraction were evaluated with echocardiography. Using spirometry, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and FEV1/FVC ratio were calculated. Groups were compared using these parameters. Results: There were 18 males and 7 females. The mean index was 3.48+-0.78. Though there was no significant difference in the index with regards to sex, the index increased with age. Eight percent of patients were in Group 1, 52% in Group 2 and 40% in Group 3. A significant decrease in ejection and shortening fractions was evident as the index increased. A statistically significant relation between HI and cardiac dysfunction was evident (p

We report a baby with intralobar pulmonary sequestration who was successfully treated with a new embolization agent, Onyx. A 1.5-month-old female infant was admitted to our hospital with sweating and fatigue. Telecardiography showed cardiomegaly, dextrocardia, and increased pulmonary vascular markings. In thoracic computerized tomography, pulmonary sequestration, right pulmonary hypoplasia, and large collateral arteries were seen. The collateral arteries were originating from the celiac trunk and aorta. Echocardiography revealed enlargement of the left atrium and ventricle and left ventricle systolic dysfunction. Angiography revealed a large feeding artery and three branches originating from the aorta and another feeding artery originating from the celiac trunk. We performed embolization of the feeding arteries and their branches, with coils and Onyx. The procedure was performed without complications, and all feeding arteries were completely occluded. The infant started to gain weight. One year later, the infant's body weight had increased and she had no respiratory problems or signs of congestive heart failure. In this case report, we suggest that embolization with Onyx is a reliable alternative method to surgery for infants with pulmonary sequestration. With future studies, pulmonary sequestration embolization with Onyx may become an acceptable and easy treatment option in pediatric patients.

Approximately half of the individuals with Down syndrome have congenital heart disease requiring surgical repair. A holistic approach to treatment of these individuals should be focused on the management of physiological and cognitive functions. Cases requiring surgical treatment is realized that adequate level of physiological functions is not expected without surgical treatment. Inadequate physiological functions may cause in physical and cognitive function which can not get the desired efficiency. Early diagnosis and surgical treatment is crucially important for these individuals. Individuals with Down Syndrome, if not treated surgically because of high operative mortality, the decrease in functional capacity and quality of life is unavoidable. In both of our cases,surgical treatment was delayed by their families. Families should be informed about the success of the surgery done to cardiac problems in Down syndrome. [Med-Science 2017; 6(2.000): 365-6]

Comment and Response

Abstract Hexose and pentose cofermentation is regarded as one of the chief obstacles impeding economical conversion of lignocellulosic biomass to biofuels. Over time, successful application of traditional metabolic engineering strategy has produced yeast strains capable of utilizing the pentose sugars (especially xylose and arabinose) as sole carbon sources, yet major difficulties still remain for engineering simultaneous, exogenous sugar metabolism. Beyond catabolic pathways, the focus must shift towards non-traditional aspects of cellular engineering such as host molecular transport capability, catabolite sensing and stress response mechanisms. This review highlights the need for an approach termed 'panmetabolic engineering', a new paradigm for integrating new carbon sources into host metabolic pathways. This approach will concurrently optimize the interdependent processes of transport and metabolism using novel combinatorial techniques and global cellular engineering. As a result, panmetabolic engineering is a whole pathway approach emphasizing better pathways, reduced glucose-induced repression and increased product tolerance. In this paper, recent publications are reviewed in light of this approach and their potential to expand metabolic engineering tools. Collectively, traditional approaches and panmetabolic engineering enable the reprogramming of extant biological complexity and incorporation of exogenous carbon catabolism.