Search

INTRODUCTION: The hypothalamic-pituitary-gonadal axis is active during minipuberty, the timing of which coincides with infantile colic. To the best of our knowledge, the relationship between these entities has not been previously investigated. METHODS: Saliva samples were collected from 15- to 60-day-old term infants (n=139) between 9 am and 5 pm. Group 1 included infants with infantile colic (n=68, 54.4% female) while the remaining healthy infants constituted Group 2 (n=71, 47.9% female). Salivary levels of estradiol (Esal) in females and testosterone (Tsal) in males were measured by ELISA in duplicate. RESULTS: The median (25th-75th centile) age and birth week for all infants were 33 (29-43) days and 39 (38.1-40) weeks, respectively. Levels of Tsal in males [Group 1, 73.35 (59.94-117.82) pg/mL vs Group 2, 77.66 (56.49-110.08) pg/mL, p=0.956] and Esal in females [Group 1, 3.91 (2.76-5.31) pg/mL vs Group 2, 4.03 (1.63-12.1) pg/mL, p=0.683] were similar. However, in subjects with infantile colic (Group 1), Esal and body mass index (BMI) standard deviation scores of females were slightly correlated (Group 1, rs= 0.393, p=0.016 vs. Group 2, rs= 0.308, p=0.076) and there was a significant correlation between the sampling time and Tsal in males (Group 1, rs= 0.469, p=0.009 vs. Group 2, rs= -0.005, p=0.976). DISCUSSION AND CONCLUSION: Random salivary sex steroid levels were similar in infants with and without infantile colic. However, in subjects with infantile colic, Esal levels in females were positively correlated with BMI and Tsal levels were higher later in the day among males. Thus, sex steroid production may be altered during minipuberty in subjects with infantile colic.

Alignment of each optical element at a synchrotron beamline takes days, even weeks, for each experiment costing valuable beam time. Evolutionary algorithms (EAs), efficient heuristic search methods based on Darwinian evolution, can be utilized for multi-objective optimization problems in different application areas. In this study, the flux and spot size of a synchrotron beam are optimized for two different experimental setups including optical elements such as lenses and mirrors. Calculations were carried out with the X-ray Tracer beamline simulator using swarm intelligence (SI) algorithms and for comparison the same setups were optimized with EAs. The EAs and SI algorithms used in this study for two different experimental setups are the Genetic Algorithm (GA), Non-dominated Sorting Genetic Algorithm II (NSGA-II), Particle Swarm Optimization (PSO) and Artificial Bee Colony (ABC). While one of the algorithms optimizes the lens position, the other focuses on optimizing the focal distances of Kirkpatrick–Baez mirrors. First, mono-objective evolutionary algorithms were used and the spot size or flux values checked separately. After comparison of mono-objective algorithms, the multi-objective evolutionary algorithm NSGA-II was run for both objectives – minimum spot size and maximum flux. Every algorithm configuration was run several times for Monte Carlo simulations since these processes generate random solutions and the simulator also produces solutions that are stochastic. The results show that the PSO algorithm gives the best values over all setups.

In this study, the applicability of the Sustainable Forest Management socio-economic functions criterion was investigated together with the forestry studies in Muğla, Isparta and Antalya Regional Directorates of Forestry in the West Mediterranean Region. The study group of the research consisted of 117 forest engineers working in the West Mediterranean Region. In the research, a survey form consisting of 9 sections was applied to determine the opinions of engineers. To analyze the data obtained, with the help of the Statistical Package 28.0 program for Social Sciences; frequency and percentage, mean, t test (independent samples t test) was used for pairwise group comparisons, and one-way analysis of variance (one way anova) was used for comparisons of more than two groups. If a significant difference was found between the groups as a result of one-way analysis of variance, Tukey HSD (multiple comparisons) tests were applied to determine which groups caused the differences. According to the study results, engineers find the criterion very important. Levels of knowledge and awareness about the measure are high, but the perceived difficulty of measurement is high. For these reasons, studies should be carried out to increase the measurability level of the Criterion, standards should be developed, especially in social content indicators, and monitoring studies should be continued.

This review examines Organic Rankine Cycle (ORC) technology, which generates electricity using organic fluids at low temperature ranges. To enhance the efficiency of basic ORC systems, they are often adapted into Regenerative Organic Rankine Cycle (R-ORC) systems. The review highlights the dimensions of economic, energy, and exergy efficiency, which are critical for practical application. Factors like the choice of working fluid, heat source temperature, and heat exchanger efficiency significantly affect economic feasibility; suboptimal choices can reduce returns and hinder project viability. Strategic decisions can improve economic outcomes and make ORC technology more appealing, as improved efficiency often leads to better economic performance through increased energy output and reduced operational costs. ORC and R-ORC systems promote sustainable energy production by enhancing energy efficiency in various applications, including geothermal power plants, industrial waste heat recovery, biomass energy production, and solar power plants. By enabling electricity generation even at low temperatures, these systems efficiently utilize existing energy sources, reduce dependence on fossil fuels, and minimize environmental impacts, thus providing both economic and ecological benefits. Additionally, when the studies conducted are examined, R-ORC exhibits higher performance than basic ORC. R-ORC is significantly superior to ORC in terms of both energy and exergy efficiency. Specifically, in terms of energy efficiency, R-ORC has been found to be 1.83 %–25.5 % more efficient. Regarding exergy efficiency, R-ORC demonstrates approximately 7.69 % better performance. Furthermore, due to these increases in efficiency, it has been determined that R-ORC also provides a more positive economic contribution compared to ORC. Thus, comparisons between ORC and R-ORC systems play a significant role in sustainable energy production and offer valuable guidance for future research. The limitations of ORC and R-ORC systems include limited efficiency due to low temperature differentials, the environmental impact of the organic fluids used, and high costs.

Certification studies in forestry consist of two separate parts: forest certification and forest products certificate. In particular, the prerequisite for obtaining a forest products certificate is the need to use products obtained from forests with a forest certificate. In this study, the forest certification process of Milas Forest Management Directorate and the preliminary and interim assessment data carried out by the Forest Stewardship Council were analysed and evaluated. A two-stage data collection process was followed in the research. The first is to collect the necessary resources and documents for the study through a literature review. Latter; field applications and observations. The document/text analysis method was used to analyze the data. As a result, it has been determined that the certification process provides positive contributions to Milas forests, forest management and the people living in the region in terms of ecological, economic, social and managerial aspects. In addition, it has been determined that preliminary evaluation studies provide significant advantages to the business before the main evaluation and contribute to the successful completion of the process. Accordingly, it can be said that a well-managed certification process allows the forest administration the opportunity to see its weaknesses, correct them and monitor the results in terms of sustainable forest management.

ObjectivesChest pain is a common chief complaint in pediatric emergency departments (EDs). Coronavirus disease-2019 (COVID-19) has been shown to increase the risk of cardiac disease. It remains unclear how COVID-19 changed how pediatric emergency clinicians approach patients presenting with chest pain. The goal of this study was to characterize the diagnostic testing for chest pain in a pediatric ED before and during the COVID-19 pandemic.MethodsThis was a retrospective study of children between the ages of 2–17 years presenting to a pediatric ED from 1/1/2018–2/29/2020 (Pre-COVID-19) and 3/1/2020–4/30/2022 (COVID-19) with chest pain. We excluded patients with a previous history of cardiac disease.ResultsOf the 10,721 encounters during the study period, 5,692 occurred before and 5,029 during COVID-19. Patient demographics showed minor differences by age, weight, race and ethnicity. ED encounters for chest pain consisted of an average of 18% more imaging studies during COVID-19, including 14% more EKGs and 11% more chest x-rays, with no difference in the number of echocardiograms. Compared to Pre-COVID-19, 100% more diagnostic tests were ordered during COVID-19, including cardiac markers Troponin I (p

INTRODUCTION: The aim was to evaluate the adverse events seen after Coronavirus disease-2019 (COVID-19) vaccination in pediatric patients with diagnosed endocrinological problems and to compare them with healthy controls. METHODS: In this cross-sectional study, patients aged 12-18 years who attended a single department between January and May 2022 and were followed up for at least six months due to endocrine diseases, and healthy subjects in the same age group, all of whom had received a COVID-19 vaccine [BNT162b2 mRNA or inactivated vaccine] were included. Adverse events experienced after the vaccination were evaluated by questionnaire. RESULTS: A total of 160 subjects (85 patients, 75 healthy controls) with a median (25-75p) age of 15.5 (14.1-16.9) years were included. The frequency of adverse events was higher in those vaccinated with the mRNA vaccine compared to the inactivated one after the first dose (p=0.015). The incidence of adverse events observed after the first and second doses of both COVID-19 vaccines was similar in the patient and control groups (p=0.879 and p=0.495, respectively), with local reactions being the most common. The frequency of adverse events was similar among the patients who did or did not receive any endocrinological treatment (p>0.05). The incidence and severity of systemic reactions were similar to those in healthy subjects for both vaccine doses, regardless of the underlying diagnosis, autoimmunity state, or treatment regimen used in patients with endocrine diseases. DISCUSSION AND CONCLUSION: The incidence and severity of adverse events associated with COVID-19 vaccinations in adolescents with endocrinological disorders were similar to healthy subjects, in the early post-vaccination period.

INTRODUCTION: Both body weight (BW)- and body surface area (BSA)-based dosing regimens have been recommended for growth hormone (rhGH) replacement. The aim was to compare the two regimens to determine if either resulted in inadequate treatment depending on anthropometric factors. METHODS: The retrospective study included children diagnosed with idiopathic isolated growth hormone deficiency. BW-based dosing in mcg/kg/day was converted to BSA in mg/m2/day to determine the equivalent amounts of the given rhGH. Those with a BW-to-BSA ratio of more than 1 were allocated to the “relatively over-dosed group”, while the remaining patients with a ratio of less than 1 were assigned to the “relatively under-dosed” group. Patients with a height gain greater than 0.5 standard deviation score (SDS) at the end of one year were classified as the height gain at goal (HAG), whereas those with a height gain of less than 0.5 SDS were assigned as the height gain not at goal (NHAG). RESULTS: The study included 60 patients (18 girls, 30%). Thirty-six (60%) patients were classified as HAG. The ratio of dosing based on BW-to-BSA was positively correlated both with the ages and body mass index (BMI) levels of the patients, leveling off at the age of 11 at a BMI of 18 kg/m2. The relative dose estimations (over- and under-dosed groups) differed significantly between the patients classified as HAG or NHAG. Fifty-six percent of NHAG compared to 44% of HAG patients received relatively higher doses, while 79% of HAG compared to 21% of NHAG received relatively lower doses (p=0.006). When the patients were subdivided according to their pubertal status, higher doses were administrated mostly to the pubertal patients in both the NHAG and HAG groups. In the pre-pubertal age group, 73% of NHAG compared to 27% of HAG received relatively higher doses, while 25% of NHAG compared to 75% of HAG received relatively lower doses (p=0.01). DISCUSSION AND CONCLUSION: Dosing based on BW may be preferable in both prepubertal and pubertal children who do not show adequate growth responses. In prepubertal children, relatively lower doses calculated based on BW rather than BSA provide similar efficacy at lower costs.

Purpose In waters and wastes, direct pathogen detection is difficult and time consuming. Therefore, coliforms are used as indicators to measure the presence of pathogens. Composts originated from extrements, sewage sludges and plant wastes those contact with manures may have potential health hazard to human. Therefore, the detection of coliforms both during composting and in the obtained composts is used to investigate the presence of pathogens for determination of the potential health risk. Methods In this study, the effect of six different aeration rates on elimination of total and faecal coliform bacteria was investigated during in-vessel aerobic composting of vegetableâfruit wastes. Total coliform and faecal coliform numbers in the samples were measured by the most probable number method. Results Coliforms significantly increased before the thermophilic stage except the faecal coliforms in the reactor which operated with the lowest aeration. The coliforms suddenly decreased after thermophilic stage in all reactors. Total coliforms reduced within the range of 78.2â99.9 % while faecal coliforms reduced within the range of 72.5â99.9 % after the thermophilic stage. At the end of the composting period (day 18), total coliforms and faecal coliforms reduced within the range of 99.9â100 %. Conclusions Although all the aeration rates used in the present study were effective for the elimination of coliforms, the lowest faecal coliform number was seen in the reactor that had the lowest aeration rate. At the end of the study, the faecal coliform numbers in all reactors confirmed some limits for the application activities of composts.

Amaç: Bu çalışmada, COVID-19 pandemi sürecinde tip 1 diyabetli çocuğu olan ebeveynlerin sürekli ve durumluk kaygısının aile işlevleri üzerine etkisinin incelenmesi amaçlanmıştır. Yöntem ve Gereçler: Tanımlayıcı, kesitsel ve ilişkisel tipteki bu çalışma rastgele örnekleme yöntemi ile karantina döneminde yapılmıştır. Çalışma, Türkiye’nin batısındaki bir hastanenin pediatrik endokrinoloji polikliniğine kayıtlı 134 tip 1 diyabetli çocuğun ebeveynleri ile tamamlanmıştır. Bulgular: Tip 1 diyabetli çocuğu olan ebeveynlerin aile işlevlerini sırasıyla en çok durumluk kaygı düzeyi ve sürekli kaygı düzeyi etkilediği saptanmıştır. Modelin genelinde aile işlevselliğini etkileyen faktörlerin %43’ünün ((F= 51.356, p

The chokeberry plant, which is native to North America and the south of Canada, is a deciduous, shrub-shaped, berry-like plant belonging to the Rosaceae family, which survives for many years. It is seen as a plant that adapts easily to almost every climatic condition and soil and has many beneficial properties for health. Within the scope of this study, methanol, 70% ethanol, ethanol, ethyl acetate, hexane and water extracts were prepared from the fruits collected from the Aronia melanocarpa (Michx.) Elliott plant, which is cultivated in the Kırklareli region. The chemical contents of the obtained extracts were clarified by high performance liquid chromatography. It was determined that phenolic compounds such as ferulic acid, caffeic acid, quercetin, quercetin-3-galactoside, p-coumaric acid were found in the extracts, and ethyl acetate extract was found to have the richest phenolic substance profile. Malvin anthocyanin compound was detected only in methanol extract.

Bu makalede öncelikle, tabiî hukuk akımı bağlamında ortaya konan, devlet tarafından vazedilen hukukun ötesinde ulaşılmak istenen hukukun var olduğu, bütün pozitif hukuk sistemlerine nazaran daha mükemmel ve daha yüksek bir hukuk olması sebebiyle bütün insanlar ve milletler için genel geçer kabul edildiği, geçerliliğini kendi cevherinde bulan birtakım yüksek kuralların toplamından oluştuğu, pozitif hukuk için tükenmez bir kaynak ve kontrol mekanizması olduğu, tabiî hukuk anlayışının, hukuk sahasındaki ilerlemelerin öncüsü olduğu şeklindeki temel düşünceler verilmiştir. Sonrasında Heraklit’ten başlamak üzere ahlâk, adalet ve erdeme dair yaklaşımlarıyla tabiî hukukun ilk savunucularından biri olan Sokrat, idari emirlerin ilahî emirleri aşacak kuvvette olmadığını belirten Sofokles, duyular dünyası ve ideler dünyası ayrımını hukuka aktararak tabiî hukuku savunan Eflatun, tabiî hukuku pozitif hukukun yorumlanmasında bir rehber olarak gören Aristo, tabiî hukukun bütün insanları kapsadığını, hukukun insan iradesinden değil insan ve eşyanın doğasından kaynaklandığını söyleyen Cicero, tabiî hukukun ilk temel ilkesinin ahde vefa olduğunu söyleyen Grotius, tabiî hukuk düşüncesinde tanrıya daha fazla yer vermiş olan Pufendorf ile on sekiz ve on dokuzuncu asır tabiî hukuk düşünürleri ele alınarak tabiî hukukun tarihi seyri aktarılmıştır. Bunun ardından tabiî hukuk yaklaşımında savunulan temel düşünceler İslam hukuku perspektifiyle beş başlık halinde analiz edilmiştir. Birinci başlıkta insan tabiatı (doğası), eşyanın tabiatı, ilahi irade ve insan aklı şeklindeki farklı yaklaşımlar ekseninde, içtihat faaliyetini insan ruhuna odaklama ve insan ruhundaki adalet idesini arayış olarak nitelendirmenin fıkıh usulünün özüne ilişkin muhalif bir tavır takınmak anlamına geldiği, aklın hukukun mutlak delili olmadığı, aklın faaliyetinin müstakil olarak hüküm koymak şeklinde değil nasslarda mündemiç manaları keşif ve izhar şeklinde olduğu, hukukun kaynağının ilahî akılla değil ilahî irade ile izah edileceği vurgulanarak hukukun kaynağı konusu ele alınmıştır. İkinci başlıkta bir hükümde ümmetin icmâsı söz konusu ise o hükmün ideal olduğu, o hususta daha ideal olanın arayışına girilmeyeceği, hiçbir içtihadî hükmün, İslam’ın mutlak, tartışmasız hükmü olarak kabul edilmediği belirtilerek olan hukuk-olması gereken hukuk ayrımı konu edinilmiştir. Üçüncü başlıkta hüsün-kubuh meselesinin ulemanın kadim ihtilaf alanlarından biri olduğu, aklın hasen olanı bilmesi ve bu hususta bağlayıcı bilgi üretmesinin, aklı müstakil hukuk kaynağı olarak nitelendirmeyi mümkün kılacağı, İslam hukukunda Eş’arî yaklaşım bakımından tabiî hukukta savunulan haliyle, geçerliliğini kendi cevherinde bulan bir hukuk kuralından söz etmenin mümkün olmayacağı, Maturîdi yaklaşım bakımından “geçerliliğini kendi cevherinde bulan” hukuk kurallarından değil, “geçerliliği kendi cevheriyle teyit edilen” hukuk kurallarından söz edilebileceği, iyi ve kötünün fiil ve eşyada öz olarak var olduğunu, aklın iyi ve kötüyü bileceğini ve bunun bağlayıcı bilgi olduğunu söyleyen Mutezile’nin yaklaşımıyla tabiî hukukta savunulan yaklaşımın örtüştüğü, Sünni teoloji ve İslam hukuku bakımından ilahî iradenin herhangi bir ilke veya kuralla sınırlandırılmasının mümkün olmadığı ifade edilerek geçerliliğini kendi cevherinde bulan yüksek hukuk kuralları değerlendirilmiştir. Dördüncü başlıkta gerek kuralların oluşturulması gerekse uygulanması sürecinde etkili bir kısım faktörlerin adaletle hukuk arasında kaçınılmaz farklılaşma alanları oluşturduğu, teorik düzlemde içtihatlardan birini diğerine üstün görmek mümkün olamadığı gibi bu içtihatlardan herhangi biriyle elde edilen adalet düzeyini diğeriyle elde edilenden daha ileride görmenin de mümkün olmadığı, bütün hukukîlik ölçütlerinin ilahî iradeye, dolayısıyla da Kitâb’a ve sünnete uygunluk ölçütüne tâbî olduğu, İlahî iradenin üstünde, onu denetleyen, sınırlayan bir adalet ölçütünden söz edilemeyeceği vurgulanarak hukuk-adalet ilişkisi üzerinde durulmuştur. Beşinci başlıkta ise İslam hukuku açısından içtihat anlayışı ve serbestisinin ilerlemenin öncüsü olduğu belirtilerek tabiî hukukun hukukî değer ölçütü ve ilerlemenin öncüsü olarak görülmesi tahlil edilmiştir. Ulaşılan sonuçların sunumuyla makale tamamlanmıştır.

Determination of the vaccination's effect on immune responses with the emergence of the Sars-Cov-2 pandemic become an important issue. This study aimed to evaluate the response of the anti-nucleocapsid IgG (anti-N IgG) index in naïve, vaccinated, or infected cases, in addition to suggesting ‘How to distinguish between vaccinated versus infected cases via anti-N IgG?'. Anti-N levels of the naïve [0.03 (0.02–0.06)], vaccinated [0.7 (0.2–1.96)], and infected [3.07 (1.44–5.2)] groups were statistically different (p [Med-Science 2022; 11(4.000): 1534-40]

Abstract Objectives Cellular interactions and cell adhesion underlie preeclampsia (PE). The aim of the current study is to investigate the role of cell adhesion molecules such as CD97, neural (N)-cadherin, epithelial (E) -cadherin and integrin beta-4 in PE. Methods This prospective study included 20 pregnant women with PE and a control group of 16 healthy pregnant women who were matched for age, gestational age, gravida and parity. Standard blood tests and placental cell adhesion molecule immunohistochemical staining were examined. Results The creatinine, uric acid and lactate dehydrogenase (LDH) levels from standard blood tests were found to be statistically higher in the PE group (p = 0.002, p = 0.000, p = 0.001; respectively). In the PE group, the CD97 maternal serum level was statistically significantly lower, as was its immunohistochemical expression in placental sections (p = 0.028, p = 0.000; respectively). The E-cadherin expression score was statistically higher in the PE group compared to the control group (3,65 ± 1,84 vs 2,06 ± 1,76 respectively; p = 0.003). The N-cadherin expression score was statistically lower in the PE group compared to the control group (1,50 ± 0,82 vs 2,43 ± 1,59 respectively; p = 0.049). Integrin beta-4 was not statistically different between groups. Conclusions Cellular interaction may be responsible for PE as in cancer. A balance in intercellular communication, as researched in cancer therapy, may offer the solution in PE.

Bu makalede Amerikan ve İskandinav hukuki realizminde görülen temel iddia ve yaklaşımlar sunularak İslam hukuku ile mukayese edilmiştir. Belirsizliğin esas alınması, hukukî realizmin özünü oluşturmakta olup; İslam hukuku bakımından hukuki realizmde görülen biçimde belirsizlik yaklaşımına imkan yoktur. İcma edilen hususlar, belirginleşmiş, sabiteye dönüşmüştür. İçtihadi meselelerde ise belirsizlik değil, farklı belirginleşme görünümleri söz konusudur. Realistlerin kök ve kaynak anlayışını reddetmelerine karşılık İslam hukuku Kitâb ve sünnet kaynaklığında belli kökten oluşan ve gelişen bir hukuk sistemidir. Realistlerin reddetmelerine karşılık, İslam hukukunda ahlak ve değerlerin merkezi bir yeri ve önemi vardır. Realistler adaleti hukuka bağlı ve hukukun yönlendirmesine tâbî olarak tanımlarken; İslam hukukçuları karşılıklı bağlılık yaklaşımını esas almışlardır. Realistler süreç içerisinde oluşan bütün hukuk kurallarını reddederlerken; İslam hukukçuları, hukuk kurallarını sistematize etmiş, bu kapsamda eserler telif etmişlerdir. Realistlerin hukukun hakimin kararıyla belirginleşip varlık bulacağı yönündeki yaklaşımlarına karşılık İslam hukukçuları, naslarla belirginleşenin yanında içtihatla varlık kazanan hukukun sistemini beyan etmişlerdir. Kök ve kaynak anlayışının reddine bağlı olarak realizmde görülen sınırsız plüralizmin aksine İslam hukukunda kaynak anlayışı çerçevesinde örfle anlamını bulan sınırlı çoğulculuk söz konusu olmuştur. Makalede bu hususlar tahlil edildikten sonra, elde edilen sonuçların sunumuyla çalışma tamamlanmıştır.

Exfoliative cheilitis is a hardly diagnosed disease by pediatricians. We have presented this report to draw the attention of clinicians because the child is the youngest patient with complete relief from using tacrolimus ointment in the literature. We present the three-year-old child with scaled, crusted, and sensitive upper and lower lips. He was admitted to different centers from the beginning of the complaints without any relief despite different treatments. The clinicians may encounter exfoliative cheilitis in different age groups. There are some approaches to management and therapy of the disease. But consensus has not yet occurred on definitive treatment, especially in childhood.

Heat treatment in wood materials and the use of water-based varnishes (WBV) in furniture made from heat-treated wood materials come to the fore in terms of supporting environmentally friendly production in the wood sector. In this study, the total color changes (ΔΕ*) and surface roughness (SR) were investigated after heat-treated tree species were exposed to natural and accelerated weathering with and without varnish. In this context, test samples were first divided into two groups. Surface treatment was applied to the samples in the first group by applying modified WBV (A1) and normal WBV (A2), and the second group was left unvarnished. Then, one group of the varnished samples was subjected to natural weathering (NAT) for 90 days and the other group was subjected to accelerated weathering (QUV) for 720 h with VAS samples, and then the ΔΕ* and SR values of the samples were calculated. The results revealed that ΔΕ* was the lowest in the QUV WBV group, and NAT was more effective than QUV in ΔΕ*. The highest SR values among all groups were measured in the VAS group, and among the varnished samples, there was no statistical difference between A1 and A2 in SR values, except for Rq.

Effects of cryogenic treatment on the chemical, physical, and mechanical properties of oriental spruce wood, which was heat-treated with the Thermowood® method, were investigated in this work. Cryogenic treatment, which is a secondary process applied to industrially heat-treated ferrous and non-ferrous metallic materials, was applied to Thermowood® Oriental spruce wood. For this purpose, Oriental spruce wood was first heat-treated at two different temperatures (190 and 212 °C), and then both Thermowood® and control samples were cryogenically treated at -80 °C. The effects on shrinkage and swelling pressure resistance parallel to fibers, and the elemental structure were examined. The findings revealed that the improvement in shrinkage and swelling continued with heat treatment, and there was an average increase of 18 and 14.5%, respectively, in the compressive strength parallel to fibers compared with control and heat-treated samples. The FT-IR analysis showed that the wood compound structure was mostly cellulosic. The difference between the carbon-oxygen ratio in the cryogenically-treated wood decreased compared to the percentage change in the three basic elements, and the amount of hydrogen increased proportionally.

INTRODUCTION: Early puberty is development of secondary sex characteristics earlier than the expected normal age range. We subjectively observed an increased frequency of early puberty during the Coronavirus disease-2019 (COVID-19) lockdown and aimed to show the clinical, demographic characteristics of the cases and the change in its incidence. METHODS: Female patients with central precocious puberty (CPP, n=28) and rapidly progressive early puberty (RPEP, n=61), presenting to our clinic before (January 2019-March 2020) and during the COVID-19 pandemic (April 2020-June 2021) were included. RESULTS: Among 28 CPP cases, six (21%) presented before the pandemic lockdown, whereas 22 (79%) were diagnosed during the COVID-19 pandemic lockdown. While RPEP was seen in 16 (26%) patients before the pandemic, 45 (74%) patients were diagnosed during the lockdown period. Presentation with menarche was seen in 15 RPEP patients; two (13%) were in the prepandemic period and 13 (87%) were in the lockdown period. Chronological age, bone age, bone age to chronological age ratio, height, weight, and body mass index standard deviation scores of patients with RPEP and CPP were similar between the prepandemic and pandemic period. DISCUSSION AND CONCLUSION: In this cohort, the frequency of CPP and RPP cases were significantly (p

Stone Pine (Pinus pinea L.) is currently the pine species with the highest commercial value with edible seeds. In this respect, this study introduces a new methodology for extracting Stone Pine trees from Digital Surface Models (DSMs) generated through an Unmanned Aerial Vehicle (UAV) mission. We developed a novel enhanced probability map of local maxima that facilitates the computation of the orientation symmetry by means of new probabilistic local minima information. Four test sites are used to evaluate our automated framework within one of the most important Stone Pine forest areas in Antalya, Turkey. A Hand-held Mobile Laser Scanner (HMLS) was utilized to collect the reference point cloud dataset. Our findings confirm that the proposed methodology, which uses a single DSM as an input, secures overall pixel-based and object-based F1-scores of 88.3% and 97.7%, respectively. The overall median Euclidean distance revealed between the automatically extracted stem locations and the manually extracted ones is computed to be 36 cm (less than 4 pixels), demonstrating the effectiveness and robustness of the proposed methodology. Finally, the comparison with the state-of-the-art reveals that the outcomes of the proposed methodology outperform the results of six previous studies in this context.

Along with technological innovations and developments experienced in the second half of the twentieth century, very important changes have occurred in healthcare. Many different, complex and economically expensive services are being tried to be carried out together. For this reason, it is finally crucial that the health services delivered by providers to scarce resources are delivered effectively and efficiently to people without sacrificing quality. Today, the most important problem of the production of healthcare services is the resource shortage as it is in other sectors. Efficiency, quality and competition are important criteria in the production and delivery of health services. Reducing costs in the production of health services is one of the main health policies for many world countries. These policies have made it necessary for international competitiveness, product and service sectors to continually improve their performance. The objective of this paper is to identify the efficiency of healthcare services using the healthcare data of OECD countries through the years 2000 - 2015. Also, this paper examines the fluctuations in total factor productivity, which is obtained by multiplying technical and technological changes in efficiency measurements by years. Using the Malmquist Total Productivity Analysis method, the most efficient healthcare systems are found in Chile, Denmark, Iceland, Israel, Japan, Korea, Mexico, Slovenia, Sweden, and Turkey both technical efficiency and scale efficiency all years.

INTRODUCTION: Objective: Since there is no gold standard laboratory variable for adjustment of treatment in congenital adrenal hyperplasia (CAH), the aim was to assess the use of a 4-hour profile of serum 17-hydroxyprogesterone (17-OHP) to determine the most appropriate sample time and level of 17-OHP in predicting the metabolic control and evaluate the role of sex hormone-binding globulin (SHBG) in hyperandrogenemia. METHODS: Methods: This study included children with salt-wasting CAH. Measurements for 17-OHP and cortisol were made from samples obtained before and 1, 2, and 4 hours after the morning dose of hydrocortisone. Patients were designated to have poor metabolic control when androstenedione levels according to age and sex-specific reference intervals were high and annual height standard deviation score (SDS) changes were ≥0.5. RESULTS: Results: The study cohort was 16 children (9 girls) with a median age of 7-years old. Premedication 17-OHP levels were strongly correlated with 17-OHP levels 1, 2, and 4 hours after the morning dose (rs=0.929, p

INTRODUCTION: Objective: C1q/tumor necrosis factor-related proteins (CTRPs) are recently described members of the adipokine family. CTRP-13, a new member of this family, has been shown to increase insulin sensitivity and had an anorexigenic effect on food intake in experimental studies. The aim was to investigate serum CTRP-13 levels in children with obesity, and its relationship with other adipokines, metabolic parameters, or binge eating disorder (BED). METHODS: Methods: A cross-sectional study was conducted with 105 pubertal children attending a single center. Clinical (metabolic syndrome, BED) and biochemical (glucose, insulin, lipids, leptin, adiponectin, CTRP-13 levels) parameters were assessed. RESULTS: Results: Sixty children with obesity [24 males (40%); median age 14.7 (13.0-16.4) years] and 45 healthy controls [15 males (33.3%); median age 15.2 (14.1-16.5) years] were included. Serum adiponectin and CTRP-13 levels were significantly lower in children with obesity than controls (7.1 vs 20.1 μg/mL, p

Purpose: The of this study is to explore the differences between leptin (LEPG2548A), which is considered efficacious in respect of adiposity and leptin receptor gene variants (LEPRQ223R, K109R, K656N). Furthermore, the relationship between these differences and the serum leptin level shall be scrutinized. Materials and Methods: A total of 300 volunteers (12-17 years of age) joined our study (150controls–150obese). Blood samples obtained from these individuals were used for DNA isolation. An examination was carried out in order to show polymorphisms of the leptin receptor gene increased by RealTime PCR previously. The variations of the leptin gene were ascertained by implementation of restriction fragment length polymorphism method. Results: Genotype dispersion calculations led to the understanding that the AA-genotype was lower in the K109R polymorphism control group than in the patient group, whereas AG-genotype was higher. The control group of Q223R polymorphism had higher AA-genotype values than the patient group, whereas it showed lower AG-genotype values. Moreover, anthropometric and metabolic results were found to be significantly higher (p in the patient group than in the control group.Conclusion: The patient group of LEPRQ223R polymorphism showed lower AA-genotype values, a higher AG-genotype dispersion and a higher allele-G value. Therefore, a relationship to adiposity has been assumed.

Objective:Crimean-Congo Hemorrhagic Fever (CCHF) is a disease of the viral hemorrhagic fever group and is endemic in certain regions in Turkey. Here, the demographic, clinical, and laboratory findings of patients diagnosed with CCHF during the Coronavirus disease-2019 (COVID-19) pandemic were examined, and differential diagnosis was stressed.Methods:This study comprised 12 patients over the age of 18 who were admitted to our clinic after the onset of the COVID-19 pandemic on March 11, 2020 and whose CCHF diagnosis was confirmed by reverse transcription-polymerase chain reaction with viral-RNA or enzyme-linked immunosorbent assay with immunoglobulin M antibodies. Epidemiological, clinical, and laboratory findings as well as treatment and prognosis of the patients were investigated.Results:Of the 12 cases, 10 (83.3%) were men and 2 (16.7%) were women. The median (interquartile range) age was 51 (27-64) years. Eleven (91.7%) patients lived in rural regions, and seven (58.3%) had a history of tick contact. Five patients were hospitalized in an external center with a preliminary diagnosis of COVID-19 and transferred to our center due to clinical and laboratory deterioration. Loss of appetite, headache, fever, weakness, and muscle-joint pain were the most common complaints of the patients. Following the suspicion of COVID-19, thoracic computed tomography (CT) was performed in six patients, five of whom were transferred to an external center. None of the patients had any pathological findings following thoracic CT.Conclusion:Although it is thought that the COVID-19 pandemic will end in the following months owing to vaccine applications, it can be predicted that sporadic cases will still occur for a long time. Therefore, clinicians should take CCHF into consideration in their differential diagnosis. Also, it should be remembered that co-infections can be observed in endemic areas.

Satellite communications (SatComs) recently, have admitted as a new technological advances that attracted and raised special investment and ventures. Space communication technology has found many application areas from costly, one-of-a-sort structures, to utilize again of technology on sequential tasks, to the progress of canonical protocols accepted by space agencies of lots of countries. Satellite communication has accepted as one of the important technologies for 5G backhauling, particularly on bandwidth request increased in 5G mobile broad band (eMBB) applications. This paper presents the efficiency of the satellite communication system using 16 QAM digital modulation technique for the X band. This digital modulation method presents high data rate in transmission without raising the bandwidth compared with other digital modulation methods. Applications are realized in Matlab environment and obtained conclusions are discussed such as power spectrum diagrams, constellation schemas and BER ratio for several bands such as 4, 8, 12, 16 GHz.

Objective:Monogenic diabetes is a heterogeneous disease that causes functional problems in pancreatic beta cells and hyperglycemia. The aim of this study was to determine the clinical and laboratory features, the admission characteristics and distribution of monogenic form of diabetes in childhood in Turkey.Methods:Patients aged 0-18 years, who were molecularly diagnosed with monogenic diabetes, and consented to participate, were included in the study.Results:Seventy-seven (45.6%) female and 92 male cases with a mean age of 8.18±5.05 years at diagnosis were included. 52.7% of the cases were diagnosed with monogenic diabetes by random blood glucose measurement. The reason for genetic analysis in 95 (56.2%) of cases was having a family member diagnosed with diabetes under the age of 25. At the time of diagnosis, ketone was detected in urine in 16.6% of the cases. Mean hemoglobin A1c on admission, fasting blood glucose, fasting insulin, and c-peptide values were 7.3±2.1%, 184.9±128.9 mg/dL, 9.4±22.9 IU/L, 1.36±1.1 and ng/L respectively. GCK-MODY was found in 100 (59.2%), HNF1A-MODY in 31 (18.3%), and variants in ABCC8 in 6 (3.6%), KCNJ11 in 5 (3%), HNF4A in 2 (1.2%), and HNF1B in 2 (1.2%).Conclusion:Recent studies have indicated HNF1A-MODY is the most frequent of all the MODY-monogenic diabetes cases in the literature (50%), while GCK-MODY is the second most frequent (32%). In contrast to these reports, in our study, the most common form was GCKMODY while less than 20% of cases were diagnosed with HNF1A-MODY.

Duchenne muscular dystrophy (DMD), caused by mutations in the X-linked dystrophin gene, is a lethal neuromuscular disease. Correction of DMD mutations in animal models has been achieved by CRISPR/Cas9 genome editing using Streptococcus pyogenes Cas9 (SpCas9) delivered by adeno-associated virus (AAV). However, due to the limited viral packaging capacity of AAV, two AAV vectors are required to deliver the SpCas9 nuclease and its single guide RNA (sgRNA), impeding its therapeutic application. We devised an efficient single-cut gene-editing method using a compact Staphylococcus aureus Cas9 (SaCas9) to restore the open reading frame of exon 51, the most commonly affected out-of-frame exon in DMD. Editing of exon 51 in cardiomyocytes derived from human induced pluripotent stem cells revealed a strong preference for exon reframing via a two-nucleotide deletion. We adapted this system to express SaCas9 and sgRNA from a single AAV9 vector. Systemic delivery of this All-In-One AAV9 system restored dystrophin expression and improved muscle contractility in a mouse model of DMD with exon 50 deletion. These findings demonstrate the effectiveness of CRISPR/SaCas9 delivered by a consolidated AAV delivery system in the correction of DMD in vivo, representing a promising therapeutic approach to correct the genetic causes of DMD.

Following injury, cells in regenerative tissues can regrow, but how they adapt to injury conditions to regenerate the tissue is unclear. Here the authors identify a stress-responsive and cardioprotective factor Nrf1 that is critical for neonatal heart regeneration.

In recent years, steerable needles have attracted significant interest in relation to minimally invasive surgery (MIS). Specifically, the flexible, programmable bevel-tip needle (PBN) concept was successfully demonstrated in vivo in an evaluation of the feasibility of convection-enhanced delivery (CED) for chemotherapeutics within the ovine model with a 2.5 mm PBN prototype. However, further size reductions are necessary for other diagnostic and therapeutic procedures and drug delivery operations involving deep-seated tissue structures. Since PBNs have a complex cross-section geometry, standard production methods, such as extrusion, fail, as the outer diameter is reduced further. This paper presents our first attempt to demonstrate a new manufacturing method for PBNs that employs thermal drawing technology. Experimental characterisation tests were performed for the 2.5 mm PBN and the new 1.3 mm thermally drawn (TD) PBN prototype described here. The results show that thermal drawing presents a significant advantage in miniaturising complex needle structures. However, the steering behaviour was affected due to the choice of material in this first attempt, a limitation which will be addressed in future work.

Abstract We consider two‐dimensional (2‐D) thin dielectric parabolic reflector, covered with graphene from both sides, illuminated symmetrically by an E‐polarized electromagnetic plane wave. Our aim is to estimate the focussing ability of such a composite reflector depending on the graphene parameters. We use a version of the two‐side generalized boundary condition, modified for a thin multilayer case. The scattering is formulated as an electromagnetic boundary‐value problem; it is cast to a set of two coupled singular integral equations that are further subjected to analytical regularisation based on the known Riemann–Hilbert problem solution. Thanks to this procedure, the numerical results are computed from a Fredholm second‐kind matrix equation that guarantees convergence and provides easily controlled accuracy. In the lower part of the THz range, high values of the focusing ability are observed even for a thin reflector; they are greater than for a purely dielectric reflector and a free standing graphene reflector. On the other hand, a regime of almost full transparency, intrinsic for the dielectric layer, can spoil focusing ability. Novel aspect is that the location in frequency of this effect can be controlled, in wide range, by changing the chemical potential of graphene.

Lhermitte-Duclos disease (LDD) is dysplastic gangliocytoma of the cerebellum, which is rare, tends to grow slowly, usually has good prognosis, and wherein the cerebellar cortex becomes thick and the central white matter is not observed. On MRI of the brain, it has hyperintense and hypointense presentations on T2- and T1-weighted scans, respectively. It has nonhomogenous contrasting pattern on T1-contrast scans. LDD can be seen unilaterally or bilaterally in the cerebellum. When the disease is located at the cerebellopontine angle, it can be mistaken for the tumors located in this region. Recurrence can occur postoperatively, which is rare. The present case is a rare one because the tumor was located at the cerebellopontine angle and radiologically mimicked cerebellopontine angle tumors.

Through a bibliometric analysis, this study aimed to uncover the connections between technology, digital and visual literacy, and education. By examining the Web of Science database, we were able to gain insight into the scope of the topic and interdisciplinary trends in the literature. Our analysis revealed that journals such as the "Nordic Journal of Digital Literacy," "Computers & Education," and "Education and Information Technologies" are important and frequently cited resources in this area. Notable researchers such as Buckingham, D., McGrew, S., and Coiro, J. were identified through our author analysis. Our trend analysis demonstrated the growing importance of digital literacy, technology, and education. Through cluster analysis, we were able to identify relationships and topics between keywords. Our findings suggest that digital literacy education should be prioritized, technology should be more widely utilized, and teachers should be trained to collaborate and share. This study provides helpful guidance for educators and researchers and can inform future studies. Our goal is to encourage the development of effective strategies for technology and digital literacy in education. Further research should focus on improving students' digital skills, increasing the impact of technology in education, and enhancing learning experiences.

Although considerable discussion has been devoted to the macro determinants of labor market variables across genders, comparatively little attention has been given to the contribution of the informal economy to this market. This study was aimed at empirically investigating the impact of the size of the shadow or informal economy (IE) on labor market variables across genders in 12 Middle Eastern countries. The study used quarterly time series data on each country under investigation, covering 1991 to 2015. Phillips-Perron unit root tests were carried out to verify the stationarity of the examined economic series. An autoregressive distributed lag approach was adopted to conduct cointegration tests and estimate long-run regression coefficients and error correction terms. The results indicated that the IE served men and women differently across countries. Whereas this economy had a long-run positive relationship with men's employment rates in Bahrain, Iran, Qatar, and Turkey, this relationship existed among women only in Israel. IE activities matter in the employment of men and women in Middle Eastern countries. The sizes of IEs in the labor market are a significant factor that favors men's employment rather than that of women.

Many studies have examined the effect of argumentation-based instruction methods on student achievement in the literature. However, there was no mixed-research synthesis study providing a holistic overview of quantitative and qualitative research findings of primary studies. To fill this gap in the literature, the study investigated the effects of argumentation-based instructional practices on student achievement. It also aimed to reveal the factors affecting these practices by combining the quantitative and qualitative research findings. Therefore, a mixed-research synthesis was employed to achieve this purpose. The study included 72 quantitative and 22 qualitative studies. The data obtained from the quantitative studies were combined using a meta-analysis method, and the qualitative data were combined using a thematic synthesis method. Several analytical themes were created regarding the factors affecting argumentation-based instruction, and various analytic themes (recommendations/hypotheses) were developed accordingly. According to the data from the thematic synthesis, 13 analytical themes emerged. The meta-analytic results indicated that the argumentation method had a large positive effect on student achievement (g = 0.927, 95% CI [0.789, 1.064]). Also, the moderator analysis revealed that argumentation-based instruction highly affected student achievement in Chemistry and Mathematics than others. Also, the time allocated to courses was influential in increasing student achievement. Lastly, attempts were made to explain the variance between studies included in the meta-analysis using the analytical themes developed in the thematic synthesis. The thematic synthesis results indicated that the learning outcomes and the environment should be taken into consideration in argumentation-based instruction and that some deficiencies should be resolved.

The world’s high-resolution images are supplied by a radar system named Synthetic Aperture Radar (SAR). Semantic SAR image segmentation proposes a computer-based solution to make segmentation tasks easier. When conducting scientific research, accessing freely available datasets and images with low noise levels is rare. However, SAR images can be accessed for free. We propose a novel process for labeling Sentinel-1 SAR radar images, which the European Space Agency (ESA) provides free of charge. This process involves denoising the images and using an automatically created dataset with pioneering deep neural networks to augment the results of the semantic segmentation task. In order to exhibit the power of our denoising process, we match the results of our newly created dataset with speckled noise and noise-free versions. Thus, we attained a mean intersection over union (mIoU) of 70.60% and overall pixel accuracy (PA) of 92.23 with the HRNet model. These deep learning segmentation methods were also assessed with the McNemar test. Our experiments on the newly created Sentinel-1 dataset establish that combining our pipeline with deep neural networks results in recognizable improvements in challenging semantic segmentation accuracy and mIoU values.

Hypoparathyroidism is a rare clinical condition characterized by parathyroid hormone insufficiency, decreased serum calcium, and increased serum phosphorus levels. Neck surgery is the most common cause of acquired hypoparathyroidism in adults. Post-surgical hypoparathyroidism is reported as one of the important complications in thyroid gland surgeries and if not diagnosed timely, may be associated with severe morbidity. The clinical manifestations of hypoparathyroidism are variable and may affect almost all organ systems. It is usually manifested by symptoms associated with hypocalcemia. The most common symptom is neuromuscular irritability, which includes paresthesias and muscle spasms in hands, feet, and around mouth. Rarely, some cases may present with inflammatory low back and neck pain, widespread pain, posture disorders, muscle weakness or, limited vertebral range of motion in the long term. Some patients may be misdiagnosed as spondyloarthropathy and may receive unnecessary treatments. In this case report, we present the clinical findings of a 55-year-old male patient with delayed post-surgical hypoparathyroidism who had been previously diagnosed ankylosing spondylitis and referred to our clinics for further treatment.

The development of technologies that can rival the devices used by other countries in the defense industry, and more importantly, can disable their devices is becoming more critical. Radar absorber materials (RAM) make the detection of the material on the radar difficult because of absorbing a part of the electromagnetic wave sent by the radar. Considering that radar is one of the most important technologies used in the defense industry, the production of non-radar materials is vital for all countries in the world. Covering a gun platform with radar absorber material reduces the radar-cross-sectional area (RCA) value representing the visibility of that platform on the radar. This review aims to present the electromagnetic principles and developed Radar Absorbent Materials (RAM) during decades from the 1960s. The frequency range 8-12 GHz in the electromagnetic spectrum is named the microwave region and used in airport radar applications. Revised basis of electromagnetic theory and defined by a variety of absorbent materials and some design classification types and techniques are described in this article.

Abstract Background Tuberculous meningitis (TBM) represents a diagnostic and management challenge to clinicians. The “Thwaites’ system” and “Lancet consensus scoring system” are utilized to differentiate TBM from bacterial meningitis but their utility in subacute and chronic meningitis where TBM is an important consideration is unknown. Methods A multicenter retrospective study of adults with subacute and chronic meningitis, defined by symptoms greater than 5 days and less than 30 days for subacute meningitis (SAM) and greater than 30 days for chronic meningitis (CM). The “Thwaites’ system” and “Lancet consensus scoring system” scores and the diagnostic accuracy by sensitivity, specificity, and area under the curve of receiver operating curve (AUC-ROC) were calculated. The “Thwaites’ system” and “Lancet consensus scoring system” suggest a high probability of TBM with scores ≤4, and with scores of ≥12, respectively. Results A total of 395 patients were identified; 313 (79.2%) had subacute and 82 (20.8%) with chronic meningitis. Patients with chronic meningitis were more likely caused by tuberculosis and had higher rates of HIV infection (P

Objective:Hypophosphatemic rickets (HR) is a rare renal phosphate-wasting disorder, which is usually X-linked and is commonly caused by PHEX mutations. The treatment and follow-up of HR is challenging due to imperfect treatment options.Methods:Here we present nationwide initial and follow-up data on HR.Results:From 24 centers, 166 patients were included in the study. Genetic analysis (n=75) showed PHEX mutation in 80% of patients. The mean follow-up period was 6.7±2.4 years. During the first 3-years of treatment (n=91), mild increase in phosphate, decrease in alkaline phosphatase and elevation in parathyroid hormone (PTH) levels were detected. The height standard deviation scores were -2.38, -2.77, -2.72, -2.47 at initial, 1st, 2nd and 3rd year of treatment, respectively (p>0.05). On follow-up 36% of the patients showed complete or significant improvement in leg deformities and these patients had similar phosphate levels at presentation with better levels in 1st and 2nd years of treatment; even the treatment doses of phosphate were similar. Furthermore, 27 patients developed nephrocalcinosis (NC), the patients showed no difference in biochemical differences at presentation and follow-up, but 3rd year PTH was higher. However, higher treatment doses of phosphate and calcitriol were found in the NC group.Conclusion:HR treatment and follow-up is challenging and our results showed higher treatment doses were associated with NC without any change in serum phosphate levels, suggesting that giving higher doses led to increased phosphaturia, probably through stimulation of fibroblast growth factor 23. However, higher calcitriol doses could improve bone deformities. Safer and more efficacious therapies are needed.

Objective:Studies examining changes in thyroid function in the course of chronic liver disease have mostly been conducted in adults. The aim of this study was to investigate thyroid dysfunction in children with chronic liver diseases.Methods:Between 2005 and 2018, patients aged up to 18 years of age, diagnosed with chronic liver disease and had thyroid function test results available were included. Anthropometric characteristics, liver and thyroid function results were collected and analyzed.Results:The study included 107 (53 female; 49.5%) patients aged between one month and 18 years-old. Of the 107 patients, 96 (89.7%) had normal thyroid function results, seven (6.5%) had subclinical hypothyroidism (SH) and four (3.7%) had euthyroid sick syndrome. Of the patients with SH, one (14.2%) had glycogen storage diasease, one (14.2%) had biliary atresia, one (14.2%) had undiagnosed cholestatic liver disease, one (14.2%) had Alagille syndrome, one (14.2%) had idiopatic hepatitis, one (14.2%) had progressive familial intra-hepatic cholestasis and one (14.2%) had congenital hepatic fibrosis. Spearman correlation analysis showed a negative correlation between free tri-iodothyronine and direct bilirubin (r=-0.329, p=0.027).Conclusion:In conclusion, euthyroid sick syndrome or SH may affect up to 10% of children with chronic liver diseases. It is suggested that thyroid function should be evaluated in cases of pediatric chronic liver disease at diagnosis and during follow-up. Moreover, this study is the first to show a negative correlation between free T3 levels and direct bilirubin, suggesting a possible association between liver disease severity and thyroid function.

Objectives: Chronic hepatitis C (CHC) is now a more curable disease with new direct acting antivirals (DAA). Although high sustained virologic response rates, failures still occur in DAA regimens. Our objective in this study was to characterize the real-life presence of clinically relevant resistance – associated substitutions (RASs) in the HCV NS5A gene in CHC patients whose DAA regimen has failed. Methods: The study enrolled 53 CHC patients who experienced failure with DAA regimen as the prospective longitudinal cohort between 2017–2019. Genotypic resistance testing was performed via the viral population sequencing method and The Geno2pheno HCV tool was used for RAS analysis. Results: The most frequent failure category was relapse (88%) followed by non-responder (12%). For a total of 36% of patients, RASs was detected in NS5A, Y93H was the most detected RAS in GT1b infected patients (89%). Conclusions: This study establishes an HCV failure registry for Turkey in which samples were combined with clinical, virologic and molecular data of adult patients whose DAA therapy failed. RASs can occur in CHC patients with DAA treatment failures. Evaluation of RAS after DAA failure is very important before re-treatment is initiated to prevent virologic failure.

Background: Because of their similar modes of transmission, the simultaneous infection of viral hepatitis and human immunodeficiency virus are increasingly seen as a big problem related to human health. Aims: To determine the drug mutations in hepatitis B virus and/or hepatitis C virus co-infected human immunodeficiency virus-1 patients in Turkey. Study Design: Retrospective cross-sectional study. Methods: The present study was conducted between 2010 and 2017. HBsAg, anti-hepatitis C virus, and anti-human immunodeficiency virus were tested with ELISA. All anti-human immunodeficiency virus positive results by ELISA were verified for anti-human immunodeficiency virus positivity by a Western blot test, and Anti-human immunodeficiency virus positive patients with HBsAg and/or anti-hepatitis C virus positivity were included in the study. Subtyping and genotypic resistance analyses were performed by population sequencing of the viral protease and reverse transcriptase regions of the human immunodeficiency virus-1 pol gene. Results: We detected 3896 human immunodeficiency virus-1 positive patients whose sera were sent from numerous hospitals across the country to our polymerase chain reaction unit for detection of drug resistance mutations and whose molecular laboratory tests were completed. Viral hepatitis co-infections were detected in 4.3% (n=170) of patients. Hepatitis B virus and hepatitis C virus co-infection were observed in 3.2% and 0.5% of all human immunodeficiency virus-1 infected patients, respectively. The major human immunodeficiency virus-1 subtype detected was group M, subtype B (62.9%). However, 13.5% of drug resistance mutation motifs were found in human immunodeficiency virus-1 genomes of patients included in the study. Conclusion: Due to similar transmission routes, HIV1 patients are at risk of hepatitis B and C virus co-infection. However, antiretroviral drug resistance mutation model is similar to patients with hepatitis negative.

In this study, we aimed to evaluate the microbiological, molecular and pathological findings of abortus cases detected in a sheep herd consist of 200 animals. Macroscopically, irregular necrotic foci were observed in the liver in aborted fetuses. Selective and non-selective media were used for the isolation of causative agent. Phenotypic and molecular tests were performed for identification. Campylobacter fetus subsp. fetus (Cff) was isolated from organs of four foetuses aborted. While the vaginal swap samples taken from sheep that did not abort, water, feed and litter samples produced negative results for Cff, 5 of the 20 faecal samples and 5 of the vaginal swaps taken from the sheep that had aborted, yielded Cff. Multilocus Sequence Typing (MLST) was used for genotyping and all isolates were detected as Sequence Type 2 (ST2). This is the first documented report of an ovine abortion caused by Cff ST2 in Turkey. It is considered that the development and use of vaccines, containing local Campylobacter species, would contribute to both prophylaxis and control of abortions caused by campylobacters including Campylobacter fetus subsp. fetus.