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Aim: This study aimed to examine how dyspnea, cough, sleep disruption, anxiety, depression, and physiological factors affect the quality of life in newly diagnosed, untreated IPF patients., Methods: This study is a multicenter observational study. Patients not receiving antifibrotic treatment were included. To assess patients' quality of life, Leicester Cough Questionnaire (LCQ), St. George's Respiratory Questionnaire (SGRQ), Short Form-36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Borg Dyspnea Index (BDI), Modified Medical Research Council Dyspnea Scale (MMRC) score, Composite Physiological Index (CPI), Gender Age and physiology (GAP) score, and Pittsburgh Sleep Quality Index (PSQI) were administered., Results: Among 88 patients (mean age: 67.6±8.5 years), 81.9% were diagnosed with IPF through HRCT, 14.8% through surgery, and 3.4% via cryobiopsy. The average disease duration was 2.2±2.9 years. Over 50% experienced moderate to severe depression, and 40% had moderate to severe anxiety. In the IPF group, 13.6% had possible usual interstitial pneumonia (UIP), and 81.8% had definite UIP pattern. No significant differences were found between UIP groups in various scores. Anxiety and depression correlated negatively with respiratory function and positively with MMRC score and BDI. Sleep quality scores had similar correlations. Patients with good sleep quality had better respiratory parameters (p=0.013), lower MMRC (p=0.004), BDI (p=0.026), and CPI (p=0.047). -Conclusion: A notable number of IPF patients in follow-up show symptoms of anxiety and depression. Moreover, declining respiratory function not only diminishes sleep quality but also elevates dyspnea scores.

Bile leakage is a common complication following liver surgeries, particularly in the cases of liver hydatid cyst operations. Currently, there is no adequate method which could be utilized to prevent this complication effectively. Our study aimed to assess the efficacy of the biliary lipid test (BLT) in reducing biliary complications after hydatid cyst surgery. We retrospectively included patients who underwent open liver hydatid cyst surgery between January 2011 and January 2024. The study encompassed 122 patients, with 41 males and 81 females, ranging in age from 18 to 79 years. In the BLT group, a lipid solution was injected transcystically after cholecystectomy. The BLT was performed on 65 patients, while 57 patients did not undergo the test. Following the transcystic injection of the lipid solution, orifices at the site of lipid droplets that became visible were ligated with 5.0 prolene sutures. A total of 200 leak sites were sutured. Remarkably, none of the patients in the BLT group experienced postoperative bile leakage lasting longer than one week. Consequently, a shorter hospital stay was observed in this group. Transcystic injection of the lipid solution with distal clamping effectively demonstrated leak sites, and suturing these sites prevented postoperative bile leakage. Our study demonstrates the effectiveness of the LIpid test in LIver Hydatid Cyst Surgery (Lili-Hics) in reducing biliary complications following hydatid cyst surgery.

Background: In patients with extrathoracic malignancies (ETM), granulomatous lymph adenopathy called sarcoid-like reactions (SLR) can be seen in the regional or draining lymph nodes. We hypothesized that SLR may be a sign of imminent metastasis and investigated the clinical course and rate of recurrence in patients with ETM and granulomatous mediastinal lymphadenopathy (MLN)., Methods: In this retrospective observational study, we reviewed the medical files of patients with known ETM and who underwent EBUS-TBNA for initial staging or detection of recurrence from 2011 to 2023. Patients with granulomatous MLN were included., Results: Forty-one patients (29 female) enrolled in the study. Breast and colorectal carcinomas were the most common malignancies. A total of 81 lymph nodes were sampled. The final diagnosis of patients was five sarcoidosis, one tuberculosis, one second primary, one drug reaction, and 33 SLR. Among patients with SLR, in one patient lymph nodes progressed during the follow-up and were accepted as false-negative without confirmatory biopsy. The negative predictive value (NPV) of granulomatous MLN for metastasis was 97.05%., Conclusion: Granulomatous MLN may be due to tuberculosis, drug reaction, sarcoidosis, or SLR in patients with ETM. SLR has a high NPV in patients with ETM. Follow-up imaging rather than confirmatory biopsy is reasonable in these patients., (© 2024 The Authors. Diagnostic Cytopathology published by Wiley Periodicals LLC.)

This study aimed to evaluate whether the Pediatric Dysphagia Risk Screening Instrument (PDRSI) was a suitable test for children with cerebral palsy (CP) and assess the instrument's Turkish validity and reliability. One-hundred twenty-six children with CP participated in this study. "Cronbach's alpha (ɑ)," "Cronbach's ɑ when one item is deleted," "inter-item correlation," and "corrected item-to-total correlation" were used to assess internal consistency. In addition, inter-rater agreement tests (Cohen's kappa coefficient) were conducted for reliability. Construct validity was used to assess the validity. Moreover, flexible fiberoptic endoscopic evaluation of the swallowing method was used to describe the receiver operating characteristic curve analysis and calculate the sensitivity and specificity of T-PDRSI. It was found that the PDRSI had adequate validity and reliability. The PDRSI can be used in children with CP as a valid and reliable instrument with high sensitivity and specificity., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Thermosonication (TS), also known as ultrasonic-assisted heat treatment, is gaining attention in liquid product processing due to its ability to improve quality parameters and can serve as an alternative to thermal treatments. The parsley juice (TS-PJ) was subjected to thermosonication treatment (frequency: 26 kHz; power: 200 W; amplitude 60, 70, 80, 90, and 100%; temperature: 40, 45, 50, 55, and 60 °C; time: 4, 6, 8, 10, and 12 min) and was compared with untreated control parsley juice (C-PJ) and pasteurized treated (P-PJ) (85 °C/2 min) parsley juice samples. The objectives of the research work were to determine the effect of thermosonication on the quality attributes such as total chlorophyll and ascorbic acid of parsley juice using particle swarm algorithm (PSO), multiple linear regression (MLR), and response surface methodology (RSM). Thermosonication enhanced the bioactive compounds of parsley juice. The results showed that 15 phenolic compounds were detected in the samples. There was a significant ( p < 0.05) increase in gallic acid contents in ultrasound-treated TS-PJ. There was no significant difference in total chlorophyll and ascorbic acid content between C-PJ and TS-PJ samples. Na and K from macro minerals and Fe and Zn from micro minerals were high in PJ samples. While K contents were increased, P contents were lower in the TS-PJ sample. RSM modeling provided superior prediction compared to MLR. PSO, on the other hand, made good predictions intuitively. Thermosonication enriched parsley juice's bioactive components and had positive health effects., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Premature infants have a risk of neurodevelopmental deficits. Little is known, however, about how retinopathy of prematurity (ROP) affects visual motor integration (VMI), which is necessary for both fine motor skills and further school abilities. Due to the systemic escape of bevacizumab in the treatment of ROP, concerns regarding the long-term neurodevelopmental effect of the drug have arisen. The aim is to evaluate VMI and motor development long-term outcomes after intravitreal bevacizumab (IVB) injection and laser treatment for ROP. Two groups of premature children were included: Bevacizumab group - 16 premature children who received IVB treatment and laser group - 23 premature children who underwent laser photocoagulation treatment in this single center cross-sectional study. At 2-6 years of age, VMI (Beery-Buktenica Developmental Test), motor development (Peabody Developmental Motor Scales-2), visual acuity, and refractive status were assessed. The incidence of abnormal visual function was significantly higher in bevacizumab group than in laser group ( p = 0.022). The incidence of abnormal VMI skill was significantly higher in bevacizumab group than in laser group ( p = 0.024). Incidences of abnormal gross, fine, and total motor skills were significantly higher in bevacizumab group compared to laser group ( p < 0.05). Premature children who received bevacizumab for ROP demonstrated significantly lower VMI and motor development features than those with laser treatment at preschool age. Although our results suggest the relevance of bevacizumab injection in impaired VMI and motor development outcomes, general level of sickness rather than treatment might be the cause of delayed motor development.

Problem: This study aimed to determine the prevalence of depressive symptoms, pain (headache, abdominal pain, back pain) and analgesic use among Turkish adolescents. Additionally, it aimed to examine the association between depressive symptoms and pain and analgesic use in adolescents., Methods: This cross-sectional, correlational study was conducted in Izmir, Turkey with 954 adolescents aged 11-19 years. Data were collected with the "socio-demographic questionnaires" and the "Center for Epidemiologic Studies Depression Scale for Children". Analyzes were performed using descriptive statistics and multiple logistic regression analysis., Findings: Of the adolescents, 632 (66.2%) showed depressive symptoms. Of the adolescents, 424 (44.4%) experienced headache, 256 (26.8%) experienced abdominal pain, and 343 (36.0%) experienced back pain. A total of 309 (32.4%) adolescents used analgesics for headaches, 132 (13.8%) abdominal pain, and 47 (4.9%) for back pain. Female gender, high level maternal education, bad economic status, poor health perception, bad school success, pain and analgesic use were the correlated variables with adolescent depression., Conclusions: The depressive symptoms, headache and back pain, and use of analgesics especially for headaches were common among adolescents. The results showed depression in adolescent correlated with pain (headache, abdominal pain, and back pain) and analgesic use. Regular screening is needed to assure early intervention of depression among adolescents., (© 2024 Wiley Periodicals LLC.)

BACKGROUND Chronic anal fissure is a common condition that causes pain and discomfort and has a significant impact on quality of life. When conservative management fails, surgical sphincterotomy can be successful. This retrospective study from a single center in Turkey included 188 patients with chronic anal fissures and aimed to compare outcomes from open and closed sphincterotomy. MATERIAL AND METHODS This retrospective study included 188 patients treated with lateral internal sphincterotomy (LIS) for chronic anal fissure between January 2015 and December 2021 in our hospital. Open LIS procedure was performed in 91 patients and closed LIS was performed in 97 patients. Demographic characteristics, postoperative complications, and recurrence were compared for these 2 methods. RESULTS Of the 188 patients included in the study, 47.9% were women and 52.1% were men. The mean age was 42.9 (20-84) years. In the open LIS group, recurrence occurred in 2 patients (2.19%), and no incontinence was observed. In the closed LIS group, recurrence occurred in 3 patients (3%; P=0.703), and incontinence developed in 5 patients (5.15%; P=0.035). CONCLUSIONS Comparing the 2 methods used in chronic anal fissure surgery, and considering the recurrence and risk of incontinence, the most feared outcome by the patient and surgeon, open LIS stands out as a superior technique, especially in young male patients.

BACKGROUND Primary hyperparathyroidism is one of the most common endocrine disorders, for which the definitive treatment is surgical parathyroidectomy. Generally, surgical exploration is performed as open focused neck surgery. The vestibular route is a new approach to minimally invasive endoscopic parathyroidectomy. This retrospective study from a single center in Turkey aimed to compare surgical outcomes from the transoral endoscopic vestibular approach (TOEPVA) vs direct open parathyroidectomy in 57 patients. MATERIAL AND METHODS Our study included data from 57 patients. TOEPVA was performed in 20 of these patients who did not want a cervical scar, and focused surgery was performed in the remaining 37 patients. The variables we analyzed were size, volume, and localization of the adenoma, operative time, presence of bleeding, presence of the recurrent laryngeal nerve damage, preoperative, short-term, and long-term postoperative PTH levels, use of drain, presence of postoperative hypocalcemia, and short-term and long-term calcium levels. RESULTS No laryngeal nerve and mental nerve damage was observed in either group. The mean operative time in focused open surgery was 80.54±33.1 min, while the mean operative time in TOEPVA was 128.21±30.88 (p: 0.794) min. The mean hospitalization period of patients who underwent open surgery was 3.29±1.9 days, while the mean discharge days of patients who underwent endoscopic surgery was 2.40±1.2. (p>0.05). CONCLUSIONS TOEPVA is a safe method in patients who underwent parthyroid surgery to avoid cervical scarring.

Introduction: We aimed to evaluate the relationship between the hand fine motor skills of peritoneal dialysis (PD) practitioners and PD-related peritonitis., Methods: This multicenter prospective observational study was conducted with 120 incident PD patients. Patients were divided into two groups who had PD-related peritonitis within the first year as Group 1, and those who did not as Group 2. Hand fine motor skills were evaluated by Nine-Hole Peg Test (NHPT) and Nut Screwing Test (NST)., Results: Initial NHPT (28.5 ± 6.0 s vs. 25.8 ± 5.0 s, p = 0.011) and NST (82.3 (61.5-102.8) s versus 65.3 (52.3-88.5) s p = 0.023) scores were significantly higher in Group 1 than Group 2. In multivariate logistic regression analysis, NHPT, Body Mass Index, Mini-Mental Test, self PD practitioner, and catheter complications were found to be independent variables in predicting PD-related peritonitis., Conclusion: Decreased hand fine motor skills of PD patients is a risk factor for peritonitis., (© 2023 International Society for Apheresis and Japanese Society for Apheresis.)

Drug allergy (DA) remains a complex and unaddressed problem worldwide that often deprives patients of optimal medication choices and places them at risk for life-threatening reactions. Underdiagnosis and overdiagnosis are common and due to the lack of standardized definitions and biomarkers. The true burden of DA is unknown, and recent efforts in data gathering through electronic medical records are starting to provide emerging patterns around the world. Ten percent of the general population engaged in health care claim to have a DA, and the most common label is penicillin allergy. Up to 20% of emergency room visits for anaphylaxis are due to DA and 15%-20% of hospitalized patients report DA. It is estimated that DA will increase based on the availability and use of new and targeted antibiotics, vaccines, chemotherapies, biologicals, and small molecules, which are aimed at improving patient's options and quality of life. Global and regional variations in the prevalence of diseases such as human immunodeficiency virus and mycobacterial diseases, and the drugs used to treat these infections have an impact on DA. The aim of this review is to provide an update on the global impact of DA by presenting emerging data on drug epidemiology in adult and pediatric populations., (© 2023 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)

Plasma membrane accumulation of phosphorylated mixed lineage kinase domain-like (MLKL) is a hallmark of necroptosis, leading to membrane rupture and inflammatory cell death. Pro-death functions of MLKL are tightly controlled by several checkpoints, including phosphorylation. Endo- and exocytosis limit MLKL membrane accumulation and counteract necroptosis, but the exact mechanisms remain poorly understood. Here, we identify linear ubiquitin chain assembly complex (LUBAC)-mediated M1 poly-ubiquitination (poly-Ub) as novel checkpoint for necroptosis regulation downstream of activated MLKL in cells of human origin. Loss of LUBAC activity inhibits tumor necrosis factor α (TNFα)-mediated necroptosis, not by affecting necroptotic signaling, but by preventing membrane accumulation of activated MLKL. Finally, we confirm LUBAC-dependent activation of necroptosis in primary human pancreatic organoids. Our findings identify LUBAC as novel regulator of necroptosis which promotes MLKL membrane accumulation in human cells and pioneer primary human organoids to model necroptosis in near-physiological settings., (© 2024. The Author(s).)

Introduction: Sarcoidosis is a multi-system disease of unknown etiology characterized by non-caseating granulomatous inflammation. Determining the characteristics and prognosis of sarcoidosis cases and revealing the factors that may affect the prognosis are important for approach to patient. This study was planned to obtain prognosis data for our country and to determine the factors affecting the prognosis., Patients and Methods: 188 patients, followed regularly for three years or more, admitted to Ankara University Faculty of Medicine, Department of Chest Diseases between 2012-2017 were evaluated retrospectively. Increased radiological findings, functional impairment and any of the clinical conditions requiring initiation/modification of treatment were accepted as progression. Clinical status of the patients at the last follow-up was defined as remission with treatment, spontaneous remission, stable disease, progression, chronic case and recurrence. Spontaneous remission and remission with treatment, regression, stable disease, and recurrence that followed without treatment and didn't cause symptom or functional impairment were accepted in good prognosis group. Progression, chronic cases that couldn't be followed without treatment and recurrence requiring treatment were included in poor prognosis group., Results: 58% of patients was accepted in good prognosis and 42% had poor prognosis group. During follow-up, spontaneous remission rate was 20.2%, pulmonary hypertension development rate was 10.6% and mortality rate was 4.25%. Low radiological stage, high spirometry and diffusion capacity values, being asymptomatic and having no previous treatment were associated with spontaneous remission and good prognosis. Increase in serum angiotensin converting enzyme and C-reactive protein and decrease in spirometry parameters and diffusion capacity values were associated with progression.

Purpose: To compare the differences in anterior segment parameters between eyes with primary angle closure (PAC) with and without gonioscopically-visualized ciliary body processes (CBP)., Study Design: Prospective, observational, comparative clinical study., Methods: Detailed ocular examinations and gonioscopy were performed in 89 eyes of 89 patients with PAC to determine the visibility of the CBP. Anterior chamber depth (ACD), anterior chamber width, lens thickness (LT), lens vault (LV) and pupil diameter were determined using ultrasound biomicroscopy. The lens-axial length factor (LAF) and relative lens position (RLP) were calculated. All parameters were compared between eyes with and without gonioscopically visible CBP (PAC+CBP and PAC-CBP groups) after adjusting for age and gender. The association of the parameters with visible CBP was analyzed by univariate logistic regression analysis., Results: PAC+CBP group included 41 eyes and the PAC-CBP group, 48 eyes. The axial length and ACD were statistically significantly smaller (p = 0.009 and p = 0.005, respectively) and LT, LV and LAF were statistically significantly greater (p = 0.03, p = 0.008 and p = 0.004, respectively) in the PAC+CBP group. In the PAC eyes with glaucoma, the LT, LV and LAF were statistically significantly greater in the PAC+CBP group (p = 0.02, p = 0.001 and p = 0.02, respectively). The LAF had the strongest association with visible CBP in the regression analysis (Odds ratio = 141.70, p = 0.002)., Conclusion: Gonioscopical visualization of ciliary processes may suggest that anterior segment crowding, especially lens factor is the underlying mechanism in PAC. It may provide a practical gonioscopic examination method for predicting the predominant pathophysiology of PAC., (© 2023. Japanese Ophthalmological Society.)

Objectives: The objective of the study is to evaluate the agreement between Goldmann applanation tonometer (GAT) and Easyton transpalpebral tonometer, Tonopen, and Icare in patients with Keratoconus., Methods: This cross-sectional study included 46 eyes of 26 patients with keratoconus. Intraocular pressure (IOP) is measured using easyton, icare, tonopen, and GAT. Measurements were compared and the influences of corneal topographic variables on IOP measurement were evaluated. Bland-Altman plots were used for assessing agreement between different tonometers., Results: The mean age of the participants was 24.08±6.76 (range, 18-47) years (15 males and 11 females). The highest of the mean IOP values measured with different tonometers was obtained with Easyton (12.33±1.65), followed by Tonopen (11.59±2.17), GAT (10.67±1.52), and Icare (10.04±2.33). The mean IOP value measured with Easyton was significantly higher than that measured with GAT (p<0.001). There was no significant difference between GAT and either Tonopen (p=0.154) or Icare measurements (p=0.732). There was no significant difference between Tonopen and Easyton measurements (p=0.421). Icare measurements were correlated with central corneal thickness and keratometric values. GAT measurements were correlated with only Kmax. Thirty-eight (82.6%) of the differences were within the agreement limits (assumed clinically important deviation of up to ±2 mmHg) of GAT and Tonopen, 73.9% (n=34) were within the agreement limits of GAT and Icare, and 78.3% (n=36) were within the agreement limits of GAT and Easyton., Conclusion: Compared with GAT, the gold standard method, Easyton IOP readings were higher, while both Tonopen and Icare readings were similar to GAT. All three tonometers showed acceptable agreement with the GAT, however, Tonopen showed the greatest agreement., Competing Interests: Conflict of Interest: None declared., (Copyright: © 2023 by Beyoglu Eye Training and Research Hospital.)

This study proposes a new deep learning-based method that demonstrates high performance in detecting Covid-19 disease from cough, breath, and voice signals. This impressive method, named CovidCoughNet, consists of a deep feature extraction network (InceptionFireNet) and a prediction network (DeepConvNet). The InceptionFireNet architecture, based on Inception and Fire modules, was designed to extract important feature maps. The DeepConvNet architecture, which is made up of convolutional neural network blocks, was developed to predict the feature vectors obtained from the InceptionFireNet architecture. The COUGHVID dataset containing cough data and the Coswara dataset containing cough, breath, and voice signals were used as the data sets. The pitch-shifting technique was used to data augmentation the signal data, which significantly contributed to improving performance. Additionally, Chroma features (CF), Root mean square energy (RMSE), Spectral centroid (SC), Spectral bandwidth (SB), Spectral rolloff (SR), Zero crossing rate (ZCR), and Mel frequency cepstral coefficients (MFCC) feature extraction techniques were used to extract important features from voice signals. Experimental studies have shown that using the pitch-shifting technique improved performance by around 3% compared to raw signals. When the proposed model was used with the COUGHVID dataset (Healthy, Covid-19, and Symptomatic), a high performance of 99.19% accuracy, 0.99 precision, 0.98 recall, 0.98 F1-Score, 97.77% specificity, and 98.44% AUC was achieved. Similarly, when the voice data in the Coswara dataset was used, higher performance was achieved compared to the cough and breath studies, with 99.63% accuracy, 100% precision, 0.99 recall, 0.99 F1-Score, 99.24% specificity, and 99.24% AUC. Moreover, when compared with current studies in the literature, the proposed model was observed to exhibit highly successful performance. The codes and details of the experimental studies can be accessed from the relevant Github page: (https://github.com/GaffariCelik/CovidCoughNet)., 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 © 2023 Elsevier Ltd. All rights reserved.)

Deuterium (D 2 (g)) storage of Pd-coated Ti ultra-thin films at relatively low pressures is fine-tuned by systematically controlling the thicknesses of the catalytic Pd overlayer, underlying Ti ultra-thin film domain, D 2 (g) pressure ( P D2 (g) exposure, and the thin film temperature. Structural properties of the Ti/Pd nanofilms are investigated via XRD, XPS, AFM, SEM, and TPD to explore new structure-functionality relationships. Ti/Pd thin film systems are deuterated to obtain a D/Ti ratio of up to 1.53 forming crystallographically ordered titanium deuteride (TiD 2 (g) exposure, and the thin film temperature. Structural properties of the Ti/Pd nanofilms are investigated via XRD, XPS, AFM, SEM, and TPD to explore new structure-functionality relationships. Ti/Pd thin film systems are deuterated to obtain a D/Ti ratio of up to 1.53 forming crystallographically ordered titanium deuteride (TiD x ) phases with strong Ti x + -D y - (g). Electronic interaction between Pd and D is weak, yielding metallic (Pd 2 (g). Electronic interaction between Pd and D is weak, yielding metallic (Pd 0 phases) leading to the thermal desorption of primarily DOH(g) and D x O(g) at <265 °C. D-storage typically increases with increasing Ti film thickness, 2 O(g) at <265 °C. D-storage typically increases with increasing Ti film thickness, P D2 , T , and t, whereas D-storage is found to be sensitive to the thickness and the surface roughness of the catalytic Pd overlayer. Optimum Pd film thickness is determined to be 10 nm providing sufficient surface coverage for adequate wetting of the underlying Ti film while offering an appropriate number of surface defects (roughness) for D immobilization and a relatively short transport pathlength for efficient D diffusion from Pd to Ti. The currently used D-storage optimization strategy is also extended to a realistic tritium-based betavoltaic battery (BVB) device producing promising β - particle emission yields of 164 mCi/cm 2 , an open circuit potential ( V OC ) of 2.04 V, and a short circuit current ( I SC ) of 7.2 nA.

Single-cell oil (SCO) produced by oleaginous microorganisms is potentially a more land-efficient and sustainable alternative to vegetable oil. The cost of SCO production can be reduced by value-added co-products like squalene, a highly relevant compound for the food, cosmetic, and pharmaceutical industry. For the first time, squalene in the oleaginous yeast Cutaneotrichosporon oleaginosus was analyzed, reaching 172.95 ± 61.31 mg/100 g oil in a lab-scale bioreactor. Using the squalene monooxygenase inhibitor terbinafine, cellular squalene was significantly increased to 2169 ± 262 mg/100 g SCO, while the yeast remained highly oleaginous. Further, SCO from a 1000 L scale production was chemically refined. The squalene content in the deodorizer distillate (DD) was found to be higher than that in DD from typical vegetable oils. Overall, this study demonstrates squalene as a value-added compound in SCO from C. oleaginosus for application in food and cosmetics without the use of genetic modifications.

Purpose: The aim of this study is to evaluate the prevalence of anxiety disorders, its correlation with sociodemographic characteristics, its comorbidities with other psychiatric disorders and its predictors in school-aged children., Methods: This study is part of a representative, multi-centered national study that is planned by the Turkish Association of Child and Adolescent Mental Health to evaluate the prevalence of psychopathology among elementary school students in Turkey between the years 2014-2015. Children are screened via Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version. Impairment is assessed by a 3-point Likert type scale independently by the parent and the teacher. The final sample included 5842 children with the mean age of 8.7 years., Results: The prevalence of any anxiety disorder without considering impairment is 16.7% and considering impairment is 5.2% in children according to our study. We found significant differences for comorbid Attention Deficit Hyperactivity Disorder, Disruptive Behavior Disorder, Mood Disorders, Tic Disorders, Obsessive Compulsive Disorder, Enuresis Nocturna, Encopresis, and Intellectual Disability. Having a history of paternal physical disorder, living in the regions of Marmara, Mediterranean and Black Sea were found to be the main predictors of having childhood anxiety disorders according to the logistic regression analysis., Conclusion: Better understanding of childhood anxiety disorders, comorbid conditions and predictors will result in earlier diagnosis and more appropriate treatment., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

To identify whether gonioscopic ciliary body visibility and factors including anterior chamber depth (ACD), axial length (AL), acute attack history, and preoperative intraocular pressure (IOP) had any effect on IOP decrease in primary angle closure (PAC) and primary angle-closure glaucoma (PACG) after phacoemulsification (PE) and/or laser peripheral iridotomy (LPI). This retrospective-design study was conducted with 81 eyes with PAC and PACG; 33 eyes whose IOP was controlled with LPI and PE constituted group 1, and 48 eyes whose IOP was controlled using LPI alone comprised group 2. The effects on preoperative and last-visit IOP levels, ciliary body visibility, ACD, AL, and acute attacks were analyzed. Eyes within the groups were similar in AL, ACD, and preoperative IOP except for acute attack history, which was found to be higher in group 1. For group 1, none of the factors was found to have a differentiative effect on IOP decrease after PE, except eyes with preoperative IOP > 21 mm Hg, which had significantly more IOP reduction. For group 2, no difference was found in ciliary body visibility, and higher or lower ACD. However, eyes with AL ≥ 22 mm, positive acute attack history, and higher preoperative IOP were associated with significantly better IOP reduction. We found no relationship between ciliary body visibility and an IOP-reducing effect of PE and LPI. Although we found PE effective in IOP reduction in all eyes, we determined LPI to have a lesser IOP-reducing effect in eyes with IOP ≤ 21 mm Hg and AL < 22 mm., (© 2023. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

Background: An objective of the Severe Heterogeneous Asthma Registry, Patient-centered (SHARP) is to produce real-world evidence on a pan-European scale by linking nonstandardised, patient-level registry data. Mepolizumab has shown clinical efficacy in randomised controlled trials and prospective real-world studies and could therefore serve as a proof of principle for this novel approach. The aim of the present study was to harmonise data from 10 national severe asthma registries and characterise patients receiving mepolizumab, assess its effectiveness on annual exacerbations and maintenance oral glucocorticoid (OCS) use, and evaluate treatment patterns., Methods: In this observational cohort study, registry data (5871 patients) were extracted for harmonisation. Where harmonisation was possible, patients who initiated mepolizumab between 1 January 2016 and 31 December 2021 were examined. Changes of a 12-month (range 11-18 months) period in frequent (two or more) exacerbations, maintenance OCS use and dose were analysed in a privacy-preserving manner using meta-analysis of generalised estimating equation parameters. Periods before and during the coronavirus disease 2019 pandemic were analysed separately., Results: In 912 patients who fulfilled selection criteria, mepolizumab significantly reduced frequent exacerbations (OR 0.18, 95% CI 0.13-0.25), maintenance OCS use (OR 0.75, 95% CI 0.61-0.92) and dose (mean -3.93 mg·day -1 , 95% CI -5.24-2.62 mg·day -1 ) in the pre-pandemic group, with similar trends in the pandemic group. Marked heterogeneity was observed between registries in patient characteristics and mepolizumab treatment patterns., Conclusions: By harmonising patient-level registry data and applying federated analysis, SHARP demonstrated the real-world effectiveness of mepolizumab on asthma exacerbations and maintenance OCS use in severe asthma patients across Europe, consistent with previous evidence. This paves the way for future pan-European real-world severe asthma studies using patient-level data in a privacy-proof manner., Competing Interests: Conflict of interest: Z. Csoma reports lecture honoraria from AstraZenca, Sanofi, Teva and GSK outside the submitted work. A. ten Brinke reports grants and payment for expert testimony from GlaxoSmithKline, AstraZeneca, TEVA and Sanofi-Genzyme Regeneron outside the submitted work. B. Gemicioglu reports support for the present work from GSK; lecture honoraria from GSK, Novartis, Deva, Chiesi, Abdi İbrahim and Sandoz; travel support from GSK, AstraZeneca and Novartis; and leadership positions with SHARP (Turkey Coordinator), GARD (Turkey Coordinator) and Turkish Board of Pulmonology (Chair), outside the submitted work. C.C. Loureiro reports grants from GSK; consulting fees from AstraZeneca, GSK, Novartis and Sanofi; lecture honoraria from AstraZeneca, GSK, Novartis, Sanofi and Teva; and travel support from AstraZeneca, Novartis and Sanofi, outside the submitted work. D. Ramos-Barbón reports honoraria and institutional research funding from GSK, outside the submitted work. E.H. Bel reports grants from GlaxoSmithKline and TEVA; lecture honoraria from GlaxoSmithKline, TEVA, AstraZeneca, Sanofi-Genzyme, Regeneron, Chiesi and Sterna, outside the submitted work. J.A. Kroes reports grants from AstraZeneca, outside the submitted work. K. Samitas reports lecture honoraria from MSD, GSK, Chiesi, Novartis, AstraZeneca, ELPEN, Menarini, BMS, Specialty Therapeutics, Boehringer and Rontis; travel support from Boehringer; advisory board participation with AstraZeneca, GSK and Specialty Therapeutics; and a leadership position with the Hellenic Thoracic Society, outside the submitted work. L. Pérez de Llano reports support for the present work from AstraZeneca; grants from AstraZeneca, Faes, TEVA and Sanofi; lecture honoraria from AstraZeneca, TEVA, Sanofi, MSD, Leo Pharma, Gebro, GSK, Novartis, Chiesi, Techdow Pharma and Gilead; patents from AstraZeneca, Novartis, Faes, TEVA, GSK, Sanofi and Chiesi; and advisory board participation with AstraZeneca, outside the submitted work. R.W. Jakes reports support for the present work from GSK, as an employee and shareholder. S. Škrgat reports honoraria for lectures and educational events, supported by AstraZeneca, Sanofi, Chiesi, Pliva Teva and Medis; and participation on advisory boards of AstraZeneca, Chiesi and Sanofi, outside the submitted work. A. Bourdin reports support for the present work from GSK; grants from AstraZeneca, GSK and Boehringer Ingelheim; lecture honoraria, nonfinancial support and other support from AstraZeneca, GSK, Boehringer Ingelheim, Novartis, TEVA, Chiesi Farmaceuticals, Actelion, Gilead, Roche and Regeneron, outside the submitted work. B. Dahlén reports grants from Novartis and GSK; and consulting fees from AstraZeneca, Teva and Sanofi, outside the submitted work. E. Zervas reports advisory board fees from Astra, Chiesi, Elpen, GSK, Menarini, MSD and Novartis; honoraria and fees for lectures from Astra, Boehringer, Bristol-Myers, Chiesi, Elpen, GSK, Menarini, MSD and Novartis; travel accommodations and meeting expenses from Astra, Boehringer, Chiezi, Galenica, GSK, Elpen, MSD, Novartis and Roche; and holds a leadership role as Secretary General of Hellenic Thoracic Society, outside the submitted work. E. Heffler reports consulting fees and lecture honoraria from AstraZeneca, Sanofi, Regeneron, Novartis, GSK, Stallergenes-Greer and Circassia outside the submitted work. F. Schleich reports grants from GSK and AstraZeneca; and consulting fees and lecture honoraria from GSK, AstraZeneca and Chiesi, outside the submitted work. K. Eger reports that TEVA sponsored printing their PhD thesis, outside the submitted work. K. Bieksiene reports lecture honoraria from AstraZeneca and Berlin Chemie, outside the submitted work. M. Paula Rezelj reports lecture honoraria from AstraZeneca, Novartis, GSK and Stallergenes, outside the submitted work. M. Masoli reports an investigator-led nonpromotional grant from GlakoSmithKline and an advisory board fee from AstraZeneca outside the submitted work. N. Kwon reports support for the present work from GSK, as an employee and shareholder. P. Howarth reports support for the present work from GSK, as an employee and shareholder. P. Kopač reports lecture honoraria and advisory board participation from AstraZeneca, GSK and Berlin-Chemie outside the submitted work. R. Alfonso-Cristancho reports support for the present work from GSK, as an employee and shareholder. G. Celik reports consulting fees and lecture honoraria from Novartis and GSK outside the submitted work. J.K. Sont reports grants from AstraZeneca; outside the submitted work. All other authors have nothing to disclose., (Copyright ©The authors 2023.)

Ternary PANI@Bi 2 O 3 -BiOCl nanocomposites were successfully synthesized during the oxidative polymerization of aniline monomer in the presence of Bi 2 O 3 . PANI@Bi 2 O 3 -BiOCl nanocomposites were characterized by several analytical techniques, including X-ray diffraction (XRD), Fourier Transform Infrared spectroscopy (FTIR), N 2 physisorption, UV-Vis Diffuse reflectance spectroscopy (DRS), X-ray photoelectron spectroscopy (XPS), transmission electron microscopy (TEM), and scanning electron microscopy with energy dispersive spectroscopy (SEM-EDS). The effective PANI-semiconductor interaction promotes the fast separation and transfer of photogenerated electrons and holes, enhancing the photocatalytic efficiency of the materials towards methylene blue (MB) degradation under solar light irradiation. The best results were obtained by 0.5%PANI@Bi 2 O 3 -BiOCl, leading to 80% MB degradation in 2 h, four times higher than pristine Bi 2 O 3 -BiOCl. Moreover, 0.5%PANI@Bi 2 O 3 -BiOCl maintained stable photocatalytic performances for four cycles without significant activity loss. Various scavengers (isopropyl alcohol, formic acid, and benzoquinone) were used to identify the active species by trapping holes and radicals generated during the photocatalytic degradation process. Finally, a probable photocatalytic mechanism of PANI@Bi 2 O 3 -BiOCl photocatalyst was suggested.

Plastics are engineering marvels that have found widespread use in all aspects of modern life. However, poor waste management practices and inefficient recycling technologies, along with their extremely high durability, have caused one of the major environmental problems facing humankind: waste plastic pollution. The upcycling of waste plastics to chemical feedstock to produce virgin plastics has emerged as a viable option to mitigate the adverse effects of plastic pollution and close the gap in the circular economy of plastics. Pyrolysis is considered a chemical recycling technology to upcycle waste plastics. Yet, whether pyrolysis as a stand-alone technology can achieve true circularity or not requires further investigation. In this study, we analyzed and critically evaluated whether oil obtained from the non-catalytic pyrolysis of virgin polypropylene (PP) can be used as a feedstock for naphtha crackers to produce olefins, and subsequently polyolefins, without undermining the circular economy and resource efficiency. Two different pyrolysis oils were obtained from a pyrolysis plant and compared with light and heavy naphtha by a combination of physical and chromatographic methods, in accordance with established standards. The results demonstrate that pyrolysis oil consists of mostly cyclic olefins with a bromine number of 85 to 304, whereas light naphtha consists of mostly paraffinic hydrocarbons with a very low olefinic content and a bromine number around 1. Owing to the compositional differences, pyrolysis oil studied herein is completely different than naphtha in terms of hydrocarbon composition and cannot be used as a feedstock for commercial naphtha crackers to produce olefins. The findings are of particular importance to evaluating different chemical recycling opportunities with respect to true circularity and may serve as a benchmark to determine whether liquids obtained from different polyolefin recycling technologies are compatible with existing industrial steam crackers' feedstock.

Numerous vaccines have been generated to decrease the morbidity and mortality of COVID-19. This study aims to evaluate the immunogenicity of the heterologous boosts by BioNTech against homologous boosts by CoronaVac at three-month intervals in two health care worker (HCW) cohorts, with or without prior COVID-19, for one year post-vaccination. This is a prospective cohort study in which the humoral responses of 386 HCWs were followed-up longitudinally in six main groups according to their previous COVID-19 exposure and vaccination status. Anti-SARS-CoV-2 spike-RBD total antibody levels were measured and SARS-CoV-2 neutralization antibody (NAbs) responses against the ancestral Wuhan and the Omicron variant were evaluated comparatively using international standard serum for Wuhan and Omicron, as well as with the aid of a conversion tool. The anti-SARS-CoV-2 spike-RBD total Ab and Nab difference between with and without prior COVID-19, three months after two-dose primary vaccination with CoronaVac, was statistically significant ( p = 0.001). In the subsequent follow-ups, this difference was not observed between the groups. Those previously infected (PI) and non-previously infected (NPI) groups receiving BioNTech as the third dose had higher anti-SARS-CoV-2 spike total Ab levels (14.2-fold and 17.4-fold, respectively, p = 0.001) and Nab responses (against Wuhan and Omicron) than those receiving CoronaVac. Ab responses after booster vaccination decreased significantly in all groups at the ninth-month follow-up ( p < 0.05); however, Abs were still higher in all booster received groups than that in the primary vaccination. Abs were above the protective level at the twelfth-month measurement in the entire of the second BioNTech received group as the fourth dose of vaccination. In the one-year follow-up period, the increased incidence of COVID-19 in the groups vaccinated with two or three doses of CoronaVac compared with the groups vaccinated with BioNTech as a booster suggested that continuing the heterologous CoronaVac/BioNTech vaccination, revised according to current SARS-CoV-2 variants and with at least a six-month interval booster would be an effective and safe strategy for protection against COVID-19, particularly in health care workers.

Purpose: SOFT syndrome is an extremely rare inherited dwarfism syndrome. The syndrome has four major clinical manifestations: short stature, onychodysplasia, facial dysmorphism, and hypotrichosis. Herein, we report a unique case of a SOFT syndrome with findings of pigmentary retinopathy., Methods: Case report., Results: A 3-year boy was referred to our clinic for ophthalmologic examination from Genetic Diseases Diagnosis Center. In ophthalmic examination, anterior segment was normal bilaterally in biomicroscopy. Fundus examination revealed bilateral yellow-white punctate retinal pigment epithelium lesions located in the midperipheral retina. Macula optical coherence tomography was bilaterally normal. Whole exome sequencing (WES) analysis revealed a homozygous intronic splice site variant (c.103 + 1 G>T) in POC1A, hemizygous intronic splice site variant (c.459-5T>A) in TBX22, and a heterozygous missense variant (c.2254 C>T) in DDR2 genes., Conclusion: There is a limited number of reported cases with SOFT syndrome and, though retinal findings in SOFT syndrome have been reported in two cases previously, none were given in detail. According to our findings, perivascular and macula sparing midperipheral retina pigment epithelium changes could be observed in patients with SOFT syndrome.

Covid-19 has become a worldwide epidemic which has caused the death of millions in a very short time. This disease, which is transmitted rapidly, has mutated and different variations have emerged. Early diagnosis is important to prevent the spread of this disease. In this study, a new deep learning-based architecture is proposed for rapid detection of Covid-19 and other symptoms using CT and X-ray chest images. This method, called CovidDWNet, is based on a structure based on feature reuse residual block (FRB) and depthwise dilated convolutions (DDC) units. The FRB and DDC units efficiently acquired various features in the chest scan images and it was seen that the proposed architecture significantly improved its performance. In addition, the feature maps obtained with the CovidDWNet architecture were estimated with the Gradient boosting (GB) algorithm. With the CovidDWNet+GB architecture, which is a combination of CovidDWNet and GB, a performance increase of approximately 7% in CT images and between 3% and 4% in X-ray images has been achieved. The CovidDWNet+GB architecture achieved the highest success compared to other architectures, with 99.84% and 100% accuracy rates, respectively, on different datasets containing binary class (Covid-19 and Normal) CT images. Similarly, the proposed architecture showed the highest success with 96.81% accuracy in multi-class (Covid-19, Lung Opacity, Normal and Viral Pneumonia) X-ray images and 96.32% accuracy in the dataset containing X-ray and CT images. When the time to predict the disease in CT or X-ray images is examined, it is possible to say that it has a high speed because the CovidDWNet+GB method predicts thousands of images within seconds., Competing Interests: 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., (© 2022 Elsevier B.V. All rights reserved.)

Background: The Postnatal Growth and Retinopathy of Prematurity (G-ROP) Study showed that adding postnatal weight gain to birth weight and gestational age detected 100% of cases with type 1 retinopathy of prematurity (ROP) while reducing the ROP examinations by 30%. The purpose of this study was to investigate whether being small for gestational age (SGA) affects the sensitivity and specificity of the G-ROP model., Methods: We applied the G-ROP criteria for premature infants. The infants were classified as three subgroups: SGA, appropriate for gestational age (AGA), and large for gestational age (LGA). The performance of G-ROP criteria was assessed for each group for ROP., Results: There were 41 (10.5%) SGA, 312 (80%) AGA, and 37 (9.5%) LGA neonates. Twenty-six (6.7%) neonates were treated for ROP, and the G-ROP model identified all of them. The sensitivity of the model for treatment-requiring ROP (TR-ROP) was found to be 100% in the whole patient group and for each subgroup. The specificity for TR-ROP was 46.4% for the whole group, 50% for SGA, 44% for AGA, and 63.6% for LGA. By applying the G-ROP model, the number of ROP examinations could be reduced by 25% for the whole group, 27% for SGA, 24% for AGA, and 31% for LGA, without missing TR-ROP., Conclusions: The sensitivity and specificity of the G-ROP model for TR-ROP in SGA infants were similar to the whole group. The model did not miss any cases of TR-ROP., (Copyright © 2022 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.)

Purpose: To define late-stage fluorescein angiography (FA) findings in patients who received anti-vascular endothelial growth factor (VEGF) agents (intravitreal bevacizumab or aflibercept) as a treatment for stage 3 retinopathy of prematurity (ROP) in zone II. We also compared the findings of untreated eyes., Method: Infants with a history of ROP who underwent fluorescein angiography were evaluated retrospectively. The patients were divided into 2 groups: those who received anti-VEGF treatment and those who regressed spontaneously without treatment. Vascular abnormalities, such as vascular leakage, shunts at the vascular-avascular junction, periarteriolar areas with hypoperfusion, fine branching and blunt termination of the vessels and, were recorded., Results: Angiography evaluations revealed leakage in the eyes of 27.69% of the infants in the anti-VEGF-treated group and in 21.7% of the untreated group ( p  = .638). Among the abnormal vascular findings in the peripheral retina, the ratios of fine branching and blunt termination, numbers of shunts along the vascular-avascular junction, and sizes of periarteriolar areas of hypoperfusion were significantly larger in the untreated group than in the treated group ( p  < .05; p  < .01). The gestational ages and birth weights were significantly lower ( p  ≤ .05) in infants with vascular findings in both groups., Conclusion: Vascular abnormalities in the peripheral retina are likely due to the ROP itself. Although these abnormalities were detected by FA imaging in both treated and untreated infants with ROP, they were significantly less frequent in patients treated with anti-VEGF, indicating that anti-VEGF treatments have a partially positive effect on the retinal vascularization process.

Objective: To evaluate changes in retrobulbar ocular blood flow parameters by using Colour Doppler Imaging (CDI) and changes in foveal microvasculature by using Optical Coherence Tomography Angiography (OCTA) in pediatric obese patients and to compare them with a group of healthy children., Methods: Children diagnosed with obesity without hypertension and diabetes (39 subjects, obese group) and age-matched healthy controls (26 subjects, control group) underwent CDI and OCTA imaging. Peak systolic velocity, end-diastolic velocity and resistivity index from ophthalmic, central retinal and posterior ciliary arteries on CDI; superficial and deep capillary plexus vascular density and foveal avascular zone area on OCTA imaging were obtained in each group. Central foveal and subfoveal choroidal thicknesses were also measured. CDI and OCTA parameters were compared between two groups., Results: Peak systolic and end-diastolic velocities were found to be significantly lower in obese children than in controls in all three examined arteries (p < 0.05). Resistivity index values were similar between the groups. OCTA imaging did not reveal significant changes in superficial and deep capillary plexus vascular densities and foveal avascular zone area across analysed retinal regions between the groups. Subfoveal choroid was thicker in obese group than in control group (325.89 ± 52.77 µm vs. 304.52 ± 21.76 µm, p = 0.04)., Conclusion: An apparent decrease was present in retrobulbar hemodynamics in obese children. This arises the possibility of early ocular macrovascular compromise rather than retinal microvascular impairment in childhood obesity.

Purpose: To assess clinical characteristics of torpedo maculopathy (TM) lesions in an infant population with age ≤1.5 years and to investigate the role of NEXMIF mutation in the development of TM., Methods: Retrospective analysis of medical records of 17 consecutive infants with the diagnosis of TM between 2016 January and 2019 December were done. Fundus images and a hand-held spectral-domain optical coherence tomography (Envisu 2300, Bioptigen, Morrisville, NC, USA) were used to identify clinical characteristics of TM lesions. Additional molecular testing for mutation screening for NEXMIF gene was also carried out., Results: Totally 55334 infants were screened during the study period and 17 (0.03%) were identified as having TM. The mean age at the time of diagnosis was 3.94±5.08 months. All TM lesions showed variable degrees of hypopigmentation. Satellite lesion in one infant was nasally located to the main TM lesion. Absence, disruption, loss, degeneration and/or irregularity of the ellipsoid zone were common findings on OCT examination. No pathogenic or likely pathogenic variant of NEXMIF gene was detected., Conclusion: Fundoscopic appearance and OCT findings of lesions show similarities to those already reported previously. Contrary to popular belief, a nasally located satellite lesion was observed in one of our case., (© 2021. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Background: Anaphylaxis, which is rare, has been reported after COVID-19 vaccination, but its management is not standardized., Method: Members of the European Network for Drug Allergy and the European Academy of Allergy and Clinical Immunology interested in drug allergy participated in an online questionnaire on pre-vaccination screening and management of allergic reactions to COVID-19 vaccines, and literature was analysed., Results: No death due to anaphylaxis to COVID-19 vaccines has been confirmed in scientific literature. Potential allergens, polyethylene glycol (PEG), polysorbate and tromethamine are excipients. The authors propose allergy evaluation of persons with the following histories: 1-anaphylaxis to injectable drug or vaccine containing PEG or derivatives; 2-anaphylaxis to oral/topical PEG containing products; 3-recurrent anaphylaxis of unknown cause; 4-suspected or confirmed allergy to any mRNA vaccine; and 5-confirmed allergy to PEG or derivatives. We recommend a prick-to-prick skin test with the left-over solution in the suspected vaccine vial to avoid waste. Prick test panel should include PEG 4000 or 3500, PEG 2000 and polysorbate 80. The value of in vitro test is arguable., Conclusions: These recommendations will lead to a better knowledge of the management and mechanisms involved in anaphylaxis to COVID-19 vaccines and enable more people with history of allergy to be vaccinated., (© 2022 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.)

Objective: This study aimed to evaluate the effect of artificial accelerated aging (AAA) on color stability, surface roughness, and microhardness of three laminate veneer (LV) materials., Materials and Methods: Specimens of ceramic LV (CLV-IPS E.max Press), hand-layered composite LV (hand-layered laminate veneer [HLV]-Tetric N-Ceram), and prefabricated composite LV (prefabricated laminate veneer [PLV]-Componeer Coltene) were prepared as discs (n = 10). CIE L*, a*, and b* color coordinates, the Vickers microhardness, and surface roughness were measured 24 hours after preparation and reevaluated after aging for 300 hours in an ultraviolet (UV)-AAA system (Ci35 Weather-Ometer). Color difference (CIEDE2000 [ΔE 00 ]) was calculated. Data were statistically analyzed with the Shapiro-Wilk test and the Kruskall-Wallis test followed by the Mann-Whitney U tests (α = .05)., Results: All of the LV groups showed significant differences in ΔE 00 after AAA (P < .001). Comparing the color changes of the HLVs with the PLVs, no significant difference could be found (P = .705). There was a statistically significant difference in the means of changes in microhardness among the LVs materials (P < .001). The changes in surface roughness results showed a significant difference after AAA in all the LVs (P < .001)., Conclusions: Within the limitations of this in vitro study, the color stability, the microhardness, and surface roughness of tested LVs were influenced by AAA., Clinical Significance: The prefabricated composite LV system does not replace the individualized ceramic LV technique, but rather offers an alternative to hand-layered LVs, which is delicate and time-consuming technique., (© 2020 Wiley Periodicals, Inc.)

Objective: This study aimed to determine the prevalence and comorbidities of attention-deficit hyperactivity disorder (ADHD) by evaluating a large-scale nation-wide sample of children., Method: The inclusion criterion was being enrolled as a 2nd, 3rd, or 4th-grade student. A semi-structured diagnostic interview (K-SADS-PL), DSM-IV-Based Screening Scale for Disruptive Behavior Disorders, and assessment of impairment (by both parents and teachers) were applied to 5,842 participants., Results: The prevalence of ADHD was 19.5% without impairment and 12.4% with impairment. Both ADHD with and without impairment groups had similar psychiatric comorbidity rates except for oppositional defiant disorder (ODD) and conduct disorder (CD) diagnoses. Impairment in the ADHD group resulted in significantly higher ODD and CD diagnoses., Conclusion: Even when impairment is not described, other psychiatric disorders accompany the diagnosis of ADHD and may cause impairment in the future. Impairment in the diagnosis of ADHD significantly increases the likelihood of ODD and CD.

Background: The sudden and unexpected pandemic changed the daily routine of the children with cerebral palsy (CP) and their caregivers., Aims: This study aimed to investigate the impact of the novel coronavirus (COVID-19) pandemic on the utilization of health and rehabilitation services and the general health and physical status of children with CP. In addition, the second aim of the study was to examine the effects of the COVID-19 pandemic on caregivers' quality of life (QOL) and their fear of COVID-19., Methods: The utilization of children health and rehabilitation services during the pandemic, the general health and physical status of the children during the pandemic, and the children and caregivers' history of COVID-19 infections were questioned. Furthermore, the caregivers' level of fear of COVID-19 and their QOL were examined., Results: One hundred twenty caregivers were contacted by phone, and 94 (78.33%) caregivers agreed to participate in the study. Sixty-three of 94 children (67.1%) did not attend their routine control check-up during the pandemic. Twelve children (12.8%) discontinued their physical therapy sessions during the pandemic. Caregivers physical and mental QOL significantly decreased during the pandemic (p < 0.05). The median of caregivers' Fear of COVID-19 scale (FCV-19S) was 17.5 (7-35)., Conclusion: We think that more attention should be given to telerehabilitation and telemedicine services of the clinicians who deal with the children with CP, and their caregivers in order to prevent the negative effects of future pandemic periods., (© 2021. Royal Academy of Medicine in Ireland.)

The energy efficiency, mechanical durability, and environmental compatibility of all moving machine components rely heavily on advanced lubricants for smooth and safe operation. Herein an alternative family of high-quality liquid (HQL) lubricants was derived by the catalytic conversion of pre- and post-consumer polyolefin waste. The plastic-derived lubricants performed comparably to synthetic base oils such as polyalphaolefins (PAOs), both with a wear scar volume (WSV) of 7.5×10 -5  mm -3 . HQLs also performed superior to petroleum-based lubricants such as Group III mineral oil with a WSV of 1.7×10 -4  mm -3 , showcasing a 44 % reduction in wear. Furthermore, a synergistic reduction in friction and wear was observed when combining the upcycled plastic lubricant with synthetic oils. Life cycle and techno-economic analyses also showed this process to be energetically efficient and economically feasible. This novel technology offers a cost-effective opportunity to reduce the harmful environmental impact of plastic waste on our planet and to save energy through reduction of friction and wear-related degradations in transportation applications akin to synthetic oils., (© 2021 Wiley-VCH GmbH.)

This study aims to examine 167 adolescents who were referred by courts between 2008 and 2016 to prepare medical-legal reports on their suitability for marriage. Most were illiterate or graduates of primary/secondary school; only 17 (10.2%) were still at high school. A total of 95 girls (56.9%) had a religious marriage without a civil certificate, 63 girls (37.7%) were pregnant, and 15 (9%) had a child. According to medical reports, 91 of the girls were considered unsuitable for marriage; 76 girls who were pregnant and/or had a child were also considered unsuitable, so it was necessary to let the judge decide.

Purpose: Our aim is to compare foveal microvascular structure, foveal retinal thickness, and best-corrected visual acuity (BCVA) in children with a history of premature retinopathy (ROP) and healthy children. It is also evaluated whether microvascular structural changes in the course of ROP had resulted from treatment modalities of ROP or the disease itself., Methods: This is a cross-sectional observational comparative study. Seventy-one children were analyzed in four different groups: children treated with bevacizumab (18), or laser (19) for ROP; or spontaneously regressed disease (18) and non-premature healthy children (16). We analyzed foveal avascular zone (FAZ) and vessel densities (VDs) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) at foveal and parafoveal region with optical coherence tomography angiography (OCT-A). Foveal thickness was measured by cross-sectional OCT. Correlations between FAZ area, foveal VD, central foveal thickness (CFT), BCVA, gestational age (GA), and birth weight (BW) were evaluated., Results: After comparing of OCT-A parameters between all premature children (groups 1-3) and non-premature children (group 4), significant differences were found in VD-SCP (whole), VD-SCP (foveal), VD-SCP (parafoveal), CFT, and VD-DCP (foveal) (all p < 0.001). Significantly smaller FAZ area was also noted in ROP children. Higher foveal VD of SCP, DCP, and smaller FAZ area were significantly associated with lower GA and BW., Conclusion: By using OCT-A, significant foveal microvascular anomalies were identified in children with ROP irrespective of the treatment option or spontaneous regression. There has been a correlation between microvascular anomalies, CFT, and a lower BCVA.

Objective: To evaluate foveal thickness, foveal microvasculature, and refractive error in children with asymmetric involvement of retinopathy of prematurity who had laser treatment in one eye and spontaneously regressed retinopathy of prematurity in the fellow eye., Methods: Totally, 17 children (34 eyes) with a history of asymmetric course of acute Zone II retinopathy of prematurity were assessed. Data on best-corrected visual acuity, refractive status, axial length, anterior chamber depth, and optical coherence tomography angiography findings were analyzed between treated and non-treated fellow eyes., Results: Treated eyes were more myopic than non-treated eyes (mean, -0.09 ± 1.86 diopters vs mean, 0.07 ± 0.98 diopters, p  = 0.026). Compared to non-treated eyes, treated eyes had shallower anterior chamber depth (mean, 3.27 ± 0.24 mm vs mean, 3.55 ± 0.19 mm, p  = 0.02). No significant difference was observed regarding optical coherence tomography angiography parameters between two eyes of the children. The mean central foveal thickness was found to be higher in treated eyes than in non-treated eyes (297.46 ± 22.03 vs 275.55 ± 18.45, p  = 0.009). Higher number of laser spots were associated with decreased parafoveal superficial capillary plexus vessel density ( r  = -0.56, p  = 0.02) and increased central foveal thickness ( r  = 0.62, p  = 0.008)., Conclusion: Our results revealed no difference in optical coherence tomography angiography parameters between laser-treated and non-treated eyes in children with asymmetric involvement of Zone II retinopathy of prematurity except for a higher central foveal thickness in laser-treated eyes. Treated eyes were more myopic than the non-treated eyes. Number of laser applications during treatment had an impact on parafoveal superficial capillary plexus vessel density.

Aim: H. pylori is a bacterial pathogen in the human stomach which infects about 50% of the world population. Untreated infection can lead to various diseases leading to cancer. Some of the H. pylori strains are asymptomatic, but some of them cause more severe diseases. Standard treatment protocol used for the treatment of H. pylori infection is triple therapy, which includes omeprazole as a proton pump inhibitor (PPI) and two antibiotics usually consist of amoxicillin and clarithromycin or metronidazole. In the recent years, because of the increase in the rate of antibiotic resistance, the eradication rate has decreased., Materials and Methods: We evaluated 140 patients who applied to a university hospital gastroenterology department and underwent biopsy during endoscopy. In these patients, we analysed floroquinolone and clarithromycin resistance using the GenoType® HelicoDR (Hain Life Science, Germany). We also used the real-time method for clarithromycin resistance., Results: We found the number and rate of floroquinolone resistance as 20 (25.6%) and clarithromycine resistance as 31 (39.7%). With the real-time PCR method, we detected clarithromycine resistance in 26 (33.3%) patients. These results were not statistically significant. Discussion and Conclusion . Our results show similarity to the other studies held in our country. There should be more studies for the policy of eradication through our country., Competing Interests: There are no conflicts of interest regarding this article., (Copyright © 2020 Zehra Kipritci et al.)

Purpose: To compare central foveal thickness, retinal nerve fiber layer thickness, and subfoveal choroidal thickness using swept-source optical coherence tomography in premature children with a history of treated retinopathy of prematurity (either with intravitreal bevacizumab or laser photocoagulation) or spontaneously regressed retinopathy of prematurity versus age-matched healthy children at the age of 5 years., Methods: A total of 79 children were divided into four groups: group 1, children who received intravitreal bevacizumab treatment; group 2, children who received laser photocoagulation treatment; group 3, children who had spontaneously regressed retinopathy of prematurity; and group 4, age matched, full-term healthy children. At the age of 5 years, visual functions and refractive status were assessed. The optical coherence tomography analysis was performed using swept-source optical coherence tomography (DRI-OCT Triton; Topcon, USA)., Results: There were 12 (15.2%), 23 (29.1%), 30 (38%), and 14 (17.7%) children in groups 1, 2, 3, and 4, respectively. Sex distribution was similar between the groups (p=0.420). Best corrected visual acuity was significantly better in group 4 compared with groups 1, 2, and 3 (p=0.035, p=0.001, and p=0.001, respectively). Refractive error results were similar between the groups (p=0.119). Central foveal thickness was significantly higher in group 2 than in group 1 (p=0.023). There were no significant differences observed between the groups in retinal nerve fiber layer thickness and subfoveal choroidal thickness (p>0.05)., Conclusions: Visual functional outcomes were better in term-born healthy children compared with those noted in children with a history of treated retinopathy of prematurity and spontaneously regressed retinopathy of prematurity. Laser treatment exerted a signifi-cant effect on central foveal thickness in premature children at the age of 5 years, as revealed by swept-source optical coherence tomography.

Ulcerative colitis is an inflammatory bowel disease that affects a large number of people around the world. Galectin-1 is a β-galactoside-binding lectin with a broad range of biological activities. The effects of galectin-1 on dextran sulfate sodium (DSS)-induced ulcerative colitis in vivo is not clear. We investigated the effect of galectin-1 on colon morphology, cell proliferation, oxidative stress, antioxidant system, and proinflammatory/antiinflammatory cytokines in a DSS-induced mouse model of ulcerative colitis. Thirty-two C57BL/6 mice were randomly assigned to one of the four groups: control, acute colitis, galectin-1, and DSS+galectin-1. Controls were treated with phosphate-buffered saline (PBS) for seven days. Acute colitis was induced by 3% DSS in drinking water administered orally for five days. Mice in galectin-1 groups were treated with 1 mg/kg recombinant human galectin-1 in PBS for seven consecutive days. Oral DSS administration resulted in acute colitis by causing histopathological changes; an increase in disease activity index (DAI), lipid peroxidation (malondialdehyde [MDA]), myeloperoxidase (MPO), and tumor necrosis factor (TNF)-α levels; a decrease in body weight, colon length, cell proliferation index, catalase, glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) activities, and GSH and interleukin (IL)-10 levels. The treatment with galectin-1 attenuated DSS-induced acute colitis by reducing DAI, MDA, MPO, and TNF-α levels and by increasing body weight, colon length, cell proliferation, antioxidant enzyme activity, GSH, and IL-10 levels. These findings suggest that galectin-1 has proliferative, antioxidant, antiinflammatory, and cytoprotective effects against DSS-induced ulcerative colitis in mice. Due to its antiinflammatory and antioxidant activity galectin-1 may be effective in preventing and treating ulcerative colitis.

We compared copeptin levels in relapsing-remitting multiple sclerosis (RRMS) patients with controls and investigated how plasma copeptin levels were changed with the disease period. Thirty patients with RRMS without a prior attack in the last twelve months, and 19 RRMS patients with a clinical acute attack and 30 healthy individuals were included into the study. Copeptin levels were significantly higher in all RRMS patient groups than healthy controls. Plasma copeptin levels were higher in patients in remission period compared with relapse period of 19 RRMS patients with an acute attack. We consider copeptin can be used as a potential biomarker for RRMS., 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 © 2020 Elsevier Ltd. All rights reserved.)

A recent survey of the European Academy of Allergy and Clinical Immunology (EAACI) Drug Allergy Interest Group (DAIG) on how European allergy specialists deal with beta-lactam (BL) hypersensitivity demonstrated a significant heterogeneity in current practice, suggesting the need to review and update existing EAACI guidelines in order to make the diagnostic procedures as safe and accurate, but also as cost-effective, as possible. For this purpose, a bibliographic search on large studies regarding BL hypersensitivity diagnosis was performed by an EAACI task force, which reviewed and evaluated the literature data using the GRADE system for quality of evidence and strength of recommendation. The updated guidelines provide a risk stratification in BL hypersensitivity according to index reaction(s), as well as an algorithmic approach, based on cross-reactivity studies, in patients with a suspicion of BL hypersensitivity and an immediate need for antibiotic therapy, when referral to an allergist is not feasible. Furthermore, the update addresses availability and concentrations of skin test (ST) reagents, ST and drug provocation test (DPT) protocols, and diagnostic algorithms and administration of alternative BL in allergic subjects. Specifically, distinct diagnostic algorithms are suggested depending on risk stratification of the patient into high and low risk based on the morphology and chronology of the reaction, immediate (ie, occurring within 1-6 hours after the last administered dose) or nonimmediate (ie, occurring more than 1 hour after the initial drug administration), and the reaction severity. Regarding the allergy workup, the main novelty of this document is the fact that in some low-risk nonimmediate reactions ST are not mandatory, especially in children. For DPT, further studies are necessary to provide data supporting the standardization of protocols, especially of those regarding nonimmediate reactions, for which there is currently no consensus., (© 2019 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.)

Introduction: Antibiotic resistance is a current global issue. Investigation of the level of knowledge of the public about antibiotics and antibiotic resistance is necessary to combat the antibiotic resistance problem. The aim of the present study was to evaluate the level of knowledge of the citizens of the north-eastern part of Cyprus on antibiotics and antibiotic resistance problem., Methodology: Randomly selected 701 adults were included in the study. A modified version of World Health Organization's public awareness survey was used to assess the knowledge on antibiotics and the resistance. Logistic regression was used to find out the relationship between knowledge and education level. Spearman's correlation analysis was carried out to determine the association between the education level and the awareness of antibiotic resistance., Results: Overall, 47.9% (336/701) of the respondents had used antibiotics in the last 6 months. Approximately 70% of respondents were determined to have intermediate/high knowledge on antibiotic consumption. In total, 66% of the population heard about antibiotic resistance and of these, 64% had intermediate knowledge on the resistance concept. University graduates were more likely to hear the term antibiotic resistance than primary school graduates., Conclusions: In the north-eastern region of Cyprus, the public is moderately knowledgeable about antibiotics and resistance. The study is the first large scale study in the northern part of Cyprus and is thought to improve the national health policies related with antibiotic consumption in Cyprus and other developing countries., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2020 Mehmet Ilktac, Mohammed Tamim Tarabishi, Pembe Ozbirtan, Canan Gulcan, Gulden Celik.)

Galectin-1 is an important mediator that regulates the T-cell-mediated immune response. It has many other biological functions such as cell growth, immunomodulation, and wound healing. The aim of this study was to reveal the role of galectin-1 on liver morphology, cell proliferation, apoptosis, inflammatory and anti-inflammatory mediators, oxidative stress, and antioxidant system in colitis-mediated hepatotoxicity induced by dextran sulfate sodium (DSS). In the present study, adult mice were divided into four groups: The control group intraperitoneally injected with phosphate buffer saline (I), the group which was orally administered with DSS (II), the control group which was injected with galectin-1 (III), and the group which was given DSS and galectin-1 (IV). DSS administration caused degenerative changes and diffuse necrotic damage, an increase in caspase-3 and cyclooxygenase-2 expression, the levels of lipid peroxidation and tumor necrosis factor-alpha, lactate dehydrogenase, and myeloperoxidase activities, and a decrease in cell proliferation, interleukin-10 levels, and antioxidant system parameters in liver tissues. Treatment of DSS group with galectin-1 reversed these effects and prevented liver damage. This study showed that galectin-1 has proliferative, antiapoptotic, anti-inflammatory, and antioxidant effects against DSS-induced liver injury in mice. It is expected considering all results of this study that galectin-1 may be useful as a protective agent against liver toxicity.

Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder that is characterised by obsessions and compulsions. The recommended treatments for OCD are cognitive- behavioural therapy using exposure and response prevention and/or pharmacotherapy. On the other hand, some nutritional and herbal supplements may be effective in the treatment of OCD. Nutritional and herbal supplements in OCD treatment will be reviewed in this paper. PubMed (Medline), Cochrane Library and Google Scholar databases were reviewed for the topic. There are some supplements that have been researched in OCD treatment studies such as vitamin D, vitamin B 12 , folic acid, homocysteine, trace elements, N-acetyl cysteine, glycine, myoinositol, St John's wort, milk thistle, valerian root, curcumin and borage. The effectiveness of herbal and nutritional supplements in the treatment of OCD should be supported with more conclusive evidence., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Our civilization relies on synthetic polymers for all aspects of modern life; yet, inefficient recycling and extremely slow environmental degradation of plastics are causing increasing concern about their widespread use. After a single use, many of these materials are currently treated as waste, underutilizing their inherent chemical and energy value. In this study, energy-rich polyethylene (PE) macromolecules are catalytically transformed into value-added products by hydrogenolysis using well-dispersed Pt nanoparticles (NPs) supported on SrTiO 3 perovskite nanocuboids by atomic layer deposition. Pt/SrTiO 3 completely converts PE ( M n = 8000-158,000 Da) or a single-use plastic bag ( M n = 31,000 Da) into high-quality liquid products, such as lubricants and waxes, characterized by a narrow distribution of oligomeric chains, at 170 psi H 2 and 300 °C under solvent-free conditions for reaction durations up to 96 h. The binding of PE onto the catalyst surface contributes to the number averaged molecular weight ( M n ) and the narrow polydispersity ( Đ ) of the final liquid product. Solid-state nuclear magnetic resonance of 13 C-enriched PE adsorption studies and density functional theory computations suggest that PE adsorption is more favorable on Pt sites than that on the SrTiO 3 support. Smaller Pt NPs with higher concentrations of undercoordinated Pt sites over-hydrogenolyzed PE to undesired light hydrocarbons., Competing Interests: The authors declare the following competing financial interest(s): Two patent applications partially based on this work have been filed (US Patent Applications 62/796,482 and 62/892,347)., (Copyright © 2019 American Chemical Society.)

Background: Nondipping heart rate (NHR) is a condition reported to be associated with cardiovascular events and cardiovascular mortality recently. We aimed to search whether there is difference among hypertensive patients with and without chronic kidney disease (CKD) in terms of NHR pattern and the factors associated with NHR in patients with CKD., Methods: The study included 133 hypertensive patients with normal kidney functions, 97 hypertensive patients with predialysis CKD, and 31 hypertensive hemodialysis patients. Heart rate, blood pressure and pulse wave velocity (PWV) were measured by 24-h ambulatory blood pressure monitorization. NHR was defined as a decrease of less than 10% at night mean heart rate when compared with daytime values., Results: NHR pattern was established as 26.3% in non-CKD hypertensive group, 43.3% in predialysis group and 77.4% in dialysis group. Among patients with CKD, when NHR group was compared with dipper heart rate group, it was seen that they were at older age, there were higher prevalence of diabetes mellitus and more female sex, and while the value of urea, creatinine, phosphorus, intact parathyroid hormone, and PWV were significantly higher, the value of hemoglobin, albumin and calcium were significantly lower. By multivariate analysis, hemoglobin [odds ratio (OR) 0.661; 95% CI 0.541-0.806; p < 0.001] and PWV (OR 1.433; 95% CI 1.107-1.853; p = 0.006) were established as independent determinants of NHR pattern., Conclusions: NHR pattern is significantly more frequently seen in hypertensive CKD patients than in hypertensive patients with non-CKD. Anemia and increased arterial stiffness are seen independently associated with NHR in CKD patients.

Purpose: We aimed to assess ocular surface characteristics in children with Hashimoto's thyroiditis without thyroid-associated ophthalmopathy and compare the results with those of healthy children., Methods: Twenty-two children with Hashimoto's thyroiditis (Group 1) and 20 healthy children without any ocular and/or systemic disorder (Group 2) were enrolled in the study. Ocular Surface Disease Index questionnaire, tear film osmolarity measurement (TearLab Osmolarity System, San Diego, CA, USA), Schirmer and tear film breakup time tests, meibography, and conjunctival brush cytology were performed and compared the results between the groups., Results: The study group included 19 girls and 3 boys in Group 1 and 12 girls and 8 boys in Group 2 (p=0.081). Thyroid-associated ophthalmopathy was not identified in any of the patients. Mean tear film osmolarity was 310.23 ± 11.98 mOsm/l in Group 1 and 313.60 ± 15.03 mOsm/l in Group 2 (p=0.424). Mean Schirmer test score was lower in Group 1 (14.91 ± 6.27) compared with Group 2 (23.60 ± 5.63) (p=0.001). Mean tear film breakup time was lower in Group 1 (11.78 ± 4.07) compared with Group 2 (15.1 ± 1.6) (p=0.013). Moreover, mean meibomian gland area loss was 25.01% ± 10.04% in Group 1 and 16.54% ± 6.02% in Group 2 (p=0.002). Conjunctival cytologic analysis in Group 1 revealed grade 0 changes in 6 patients (27.3%), grade 1 changes in 14 patients (63.6%), and grade 2 changes in 2 patients (9.1%), whereas 18 patients (90%) had grade 0 changes and 2 patients (10%) had grade 1 changes (p=0.001) in Group 2., Conclusions: The study demonstrates several ocular surface changes in children with Hashimoto's thyroiditis. These findings may indicate a tendency for dry eye in pediatric Hashimoto's thyroiditis patients without clinical evidence of thyroid-associated ophthalmopathy.