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Crimean-Congo hemorrhagic fever (CCHF) is an acute tick-borne viral zoonotic disease which is endemic in Turkey. Bradycardia has been reported among pediatric and adult patients with CCHF. But, it remains unclear, whether bradycardia is associated with ribavirin treatment or the severity of CCHF. In this study 26 hospitalized CCHF patients were reviewed in terms of age, gender, history of tick bite, duration of hospitalization, presence of bradycardia, laboratory features, ribavirin treatment, and blood products requirement. The demographic, clinical, laboratory and treatment characteristics of CCHF patients with or without bradycardia were compared. The mean age of the patients was 126.42 ± 48.21 months. There were 8 female and 18 male patients. Sinus bradycardia was noted in 15 patients (mean age was 120.20 ± 50.59 months, 5 female). Ribavirin had been administered 18 (69.2%) patients and 11 of them had bradycardia. There was not statistically significant relationships between bradycardia and ribavirin treatment ( p = 0.683). Furthermore the occurrence of bradycardia was not associated with disease severity according to Swanepoel severity criteria ( p = 0.683). We concluded that independent of the disease severity and the ribavirin treatment, transient sinus bradycardia might occur during the clinical course of CCHF in pediatric patients. For this reason clinicians should be aware of this finding and all CCHF patients should be monitored closely. [ABSTRACT FROM AUTHOR]

Summary Brucellosis is a zoonotic disease caused by Brucella spp. that is transmitted to humans by the ingestion of unpasteurized milk and other dairy products from infected animals or through close contact with secretions. Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease caused by a virus that is transmitted to humans by ixoid tick bites, contact with blood and tissue of infected animals or contact with infected humans. The symptoms of brucellosis are non-specific; it can mimic other diseases. In this paper, we present a case of brucellosis that was initially evaluated as CCHF. We emphasize that brucellosis should be considered in the differential diagnosis of CCHF, especially in endemic countries. [ABSTRACT FROM AUTHOR]

Abstract: Influence of sun exposure and physical activity on cognition has not been evaluated simultaneously. We aimed to evaluate predictors of clock drawing test (CDT) performance on n =125 patients attending an internal medicine outpatient clinic. Interview data was gathered on sociodemographic, health-related and lifestyle factors referring to the last year. Factors associated with obtaining a score >0 and a full score (10/10) were analyzed by univariate (UVA) and multivariate (MVA) logistic regression analyses. Mean age of the participants was 72±5, 58% were women and 17% were illiterate. Mean CDT score was 4.70±2.27, 61.6% scored >0 and 21.6% scored 10/10. Both duration of walking and summer sun exposure predicted a CDT score >0 in UVA. However only summer sun exposure was an independent predictor (odds ratio=OR=1.73, 95% confidence interval=CI=1.16–2.57). Other factors independently associated with obtaining a score >0 were education level (OR=2.70, 95%CI=1.77–4.12) and cerebrovascular disease (CVD) history (OR=0.08, 95%CI=0.008–0.78). Factors independently associated with obtaining a full score were weight (OR=1.05, 95%CI=1.00–1.10), education level (OR=2.04, 95%CI=1.38–3.00) and visiting the clinic alone (OR=3.92, 95%CI=1.354–11.39). Our study shows that CDT can be utilized to unravel the lifestyle factors associated with cognitive function. To our knowledge, this is the first study to suggest an association between sun exposure and cognition. [Copyright &y& Elsevier]

Low-grade chronic inflammation is a hallmark of ageing, associated with impaired tissue function and disease development. However, how cell-intrinsic and -extrinsic factors collectively establish this phenotype, termed inflammaging, remains poorly understood. We addressed this question in the mouse intestinal epithelium, using mouse organoid cultures to dissect stem cell-intrinsic and -extrinsic sources of inflammaging. At the single-cell level, we found that inflammaging is established differently along the crypt-villus axis, with aged intestinal stem cells (ISCs) strongly upregulating major histocompatibility complex class II (MHC-II) genes. Importantly, the inflammaging phenotype was stably propagated by aged ISCs in organoid cultures and associated with increased chromatin accessibility at inflammation-associated loci in vivo and ex vivo , indicating cell-intrinsic inflammatory memory. Mechanistically, we show that the expression of inflammatory genes is dependent on STAT1 signaling. Together, our data identify that intestinal inflammaging in mice is promoted by a cell-intrinsic mechanism, stably propagated by ISCs, and associated with a disbalance in immune homeostasis. [Display omitted] • Inflammaging establishes differently along the intestinal crypt-villus axis • Aged ISCs upregulate MHC-II for CD4+ T cell interaction via IFNγ-STAT1 signaling • In vivo -acquired changes in chromatin accessibility are maintained in organoids • Aged ISCs propagate cell-intrinsic sources of inflammaging to the epithelium Funk et al. identify at the single-cell level that intestinal inflammaging in mice develops differently along the crypt-villus axis. Moreover, epithelial cells acquire in vivo age-specific changes in chromatin accessibility that are maintained ex vivo in organoid cultures and associated with inflammation-associated loci, promoting stem cell-intrinsic sources of inflammaging. [ABSTRACT FROM AUTHOR]

Energy planning involves a perpetual process of reevaluating alternative energy strategies. Authorities responsible for energy planning and management have to adjust their strategies according to new and improved alternative solutions based on the sustainability criteria. In this study, we propose an integrated hybrid methodology for the analysis of Turkey’s energy sector using Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis, Analytic Network Process (ANP) process, and weighted fuzzy Technique for Order Performance by Similarity to Ideal Solution (TOPSIS) to formulate and holistically analyze the energy strategy alternatives and priorities. The methodology proposed in this study allowed identifying the relevant criteria and sub-criteria using a SWOT analysis. Then, ANP approach, which is one of the popular multi-criteria decision making (MCDM) methods, is employed to determine the weights of each SWOT factors and sub-factors. Finally, fuzzy TOPSIS methodology is conducted to prioritize alternative energy strategies. We discuss the obtained results for the development of long-range alternative energy strategies. The results showed that turning the country into an energy hub and an energy terminal by effectively using the geo-strategic position within the framework of the regional cooperation is the most important priority. On the other hand, using the nuclear energy technologies within the energy supply strategies found to be the least favored priority. [ABSTRACT FROM AUTHOR]

Local activation of the complement system has been associated with ischemia/reperfusion injury following kidney transplantation and tubular injury under proteinuric conditions. The soluble terminal complement complex sC5b-9 is a stable end-product of the complement cascade, and as such a promising urinary biomarker. In the early post-transplant period we found high urinary levels of sC5b-9, significantly correlating with the degree of proteinuria, suggesting activation of filtered complement components at the tubular epithelial surface of the kidney. However, when mimicking proteinuria in vitro by exposing serum (or blood) to urine (both negative for sC5b-9), we found extensive generation of sC5b-9 in urine. This process was inhibited by EDTA, confirming activation of the complement system. In conclusion, although sC5b-9 is an attractive urinary biomarker, one should be aware of the risk of extra-renal complement activation independent of a renal contribution. This may be of special interest when measuring urinary sC5b-9 following kidney transplantation in which procedure-related (microscopic) hematuria and proteinuria are common. [ABSTRACT FROM AUTHOR]