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Netherton syndrome (NS) is a rare genodermatosis characterized by the triad of ichthyosiform erythroderma, hair shaft abnormality and an atopic diathesis. We report a case of a 20-year-old male patient presented with pruritus, decreased sweat secretion and generalized erythema on his body. Netherton syndrome is caused by mutations in the SPINK5 gene that is a crucial role for epidermal barrier function in the skin. Different clinical and phenotypical features can occur based on various LEKTI-domains mutations. Diagnosis is made by the atopic story, hair shaft abnormality, cutaneous lesions and identification of the SPINK5 gene mutation. In our patient, we detected a new splice site mutation in the SPINK5 gene and pili annulati as hair abnormality. Affected patients are usually misdiagnosed because of cutaneous lesions such as atopic dermatitis. Therefore, each clinical finding should be evaluated together. We aimed to present a case with a new SPINK5 gene mutation and different clinical features in NS.

Although micro companies overpower the small and medium enterprise (SME) segment, generalizations are often with medium size companies, and therefore, there are many unknowns, especially when it comes to its buying behavior. Conformist studies and industry practices assume SMEs to be “normative” or “conservative” buyers; however, this hypothesis is untested. This article aims to scrutinize the reality, and proposes a unified model that rejects pre-containerization in buying behavior typologies, as well as selectiveness in terms of audience type, whether it is corporate, SME, or consumer. While replacing researchers’ perceptions with the audience’s, the model yields actual knowledge that can lead to audience’s beliefs in lieu of the opposite, which is used to mislead stakeholders. The study shows that SMEs also buy like individuals and spend in a similar way to consumers’, including not only “normative” and “conservative” but also “negligent” and “impulse” zones. From the research-implications perspective, future studies by behaviorists can explore why SMEs purchase in this way. Marketers may benefit from the finding that SMEs buy like individuals. In addition, SMEs may want to be conscious of their purchasing habits, and—utilizing the newly introduced “risk score” frontier—policymakers should assess the consequences of these habits at the macro level.

Living donor liver transplantation has expanded in recent years, particularly in North America. As experience with this procedure has matured over the last 25 years, centers are increasingly faced with potential living donors who are more medically complex. As donors move through the evaluation process, completing the informed consent process continues to be challenged by a paucity of granular data demonstrating long-term outcomes and overall safety specifically in the otherwise "healthy" living liver donor population. Two recently published studies examined long-term outcomes post-living liver donation using Korean registry data and reported similar results, with excellent overall survival when compared to appropriately matched controls. However, the authors of these studies were presented differently, with one reporting an alarmist view based on one aspect of a suboptimal analysis approach using an inappropriate comparator group. Herein, the North American Living Liver Donor Innovation Group (NALLDIG) consortium discusses these two studies and their potential impact on living liver donation in North America, ultimately highlighting the importance of scientific integrity in data presentation and dissemination when using transplant registry data.

Background Adrenal masses are found in up to 5%-7% of adults. The 2016 European guidelines on the management of adrenal incidentalomas have standardised the workup of these patients, but evidence of their impact on clinical practice is lacking. Methods Retrospective review of clinical presentation, radiological characteristics, and final diagnosis of a large cohort of patients with adrenal masses referred to a tertiary care centre 1998-2022. Sub-analysis compares outcomes before and after implementing the 2016 guidelines. Results A total of 1397 patients (55.7% women; median age 60 years [interquartile range {IQR}, 49-70]) were included. Incidental discovery was the most frequent mode of presentation (63.7%) and 30.6% of patients had masses ≥ 4 cm (median 2.9 cm [IQR, 1.9-4.7]). Unenhanced computed tomography Hounsfield units (HU) were available for 763 patients; of these, 32.9% had heterogeneous masses or >20 HU. The most common diagnoses were adrenocortical adenoma (56.0%), phaeochromocytoma (12.7%), adrenocortical carcinoma (10.6%), and metastases (5.7%). At multivariable analysis, significant predictors of malignancy included >20 HU or heterogeneous density (odds ratio [OR] 28.40), androgen excess (OR 27.67), detection during cancer surveillance (OR 11.34), size ≥ 4 cm (OR 6.11), and male sex (OR 3.06). After implementing the 2016 guidelines, the number of adrenalectomies decreased (6.1% pre-2016 vs 4.5% post-2016) and the number of patients discharged increased (4.4% pre-2016 vs 25.3% post-2016) for benign non-functioning adrenal masses. Conclusion Implementing the 2016 guidelines positively impacted clinical practice, reducing unnecessary surgeries and increasing the discharge rate for benign adrenal masses, thereby preserving healthcare resources and patient burden. [ABSTRACT FROM AUTHOR]

SUBGROUPS is a free online program at the Bilbao Crystallographic Server (https://www.cryst.ehu.es/). It permits the exploration of all possible symmetries resulting from the distortion of a higher‐symmetry parent structure, provided that the relation between the lattices of the distorted and parent structures is known. The program calculates all the subgroups of the parent space group which comply with this relation. The required minimal input is the space‐group information of the parent structure and the relation of the unit cell of the distorted or pseudo‐symmetric structure with that of the parent structure. Alternatively, the wavevector(s) observed in the diffraction data characterizing the distortion can be introduced. Additional conditions can be added, including filters related to space‐group representations. The program provides very detailed information on all the subgroups, including group–subgroup hierarchy graphs. If a Crystallographic Information Framework (CIF) file of the parent high‐symmetry structure is uploaded, the program generates CIF files of the parent structure described under each of the chosen lower symmetries. These CIF files may then be used as starting points for the refinement of the distorted structure under these possible symmetries. They can also be used for density functional theory calculations or for any other type of analysis. The power and efficiency of the program are illustrated with a few examples. [ABSTRACT FROM AUTHOR]

Abstract Background In the past, cognitive disengagement syndrome (CDS) and attention deficit hyperactivity disorder (ADHD) were considered similar concepts. However, many differences have recently been identified between the two disorders, and they have been separated from each other. This study aims to investigate balance and vestibular function in individuals at high risk for ADHD and CDS. Materials and methods This study involved 60 college students. Participants were given the Adult ADHD Self-Report Scale and the Adult Concentration Inventory. Using the applied indices, participants with high and low risk for CDS and ADHD were identified. Every participant underwent static posturography, the video head impulse test (vHIT), and cervical vestibular myogenic-evoked potentials (cVEMP). Results People with low and high risk for CDS did not differ in terms of static posturography or cVEMP (p > 0.05). Similarly, no differences were found in ADHD (p > 0.05). While right ear lateral vHIT responses were worse in individuals with high-risk CDS (p > 0.05), bilateral posterior vHIT rates were worse in individuals with high-risk ADHD (p > 0.05). Conclusion The fact that individuals at high risk for CDS and ADHD show different vestibular involvement strengthens the fact that there are different clinical pictures.

Abstract We propose the addition of usability validation to the extended V3 framework, now “V3+”, and describe a pragmatic approach to ensuring that sensor-based digital health technologies can be used optimally at scale by diverse users. Alongside the original V3 components (verification; analytical validation; clinical validation), usability validation will ensure user-centricity of digital measurement tools, paving the way for more inclusive, reliable, and trustworthy digital measures within clinical research and clinical care.

This paper discusses the source and aspects of agony vexing Selim Işık the protagonist to a suicide at an early age in Oğuz Atay’s Tutunamayanlar. In this respect, Selim Işık’s Sartrianly defiant disposition is demonstrated by drawing upon specific quotations taken from the novel. In the paper, an intertextual method of comparison is occasionally employed by dint of references to another remarkable miserable protagonist in Turkish Literature – namely Doktor Hikmet in Yakup Kadri Karaosmanoğlu’s Bir Sürgün. Besides, throughout the article where available and applicable, references are made to some canonical works of Western Literature including Ibsen’s tragedies, Kafka’s Metamorphosis, and Shakespeare’s Hamlet in order to further substantiate and accentuate the arguments made.

Bu çalışmanın amacı, çekirge kullanarak protein oranı artırılmış bir unlu mamul üretmek, bu sayede önemli bir gıda kaynağı olan yenilebilir böceklerin tüketilmesine olan bakışı değiştirebilmek ve entomofaji konusunda farkındalık oluşturmaktır. Dünya’nın azalan kaynaklarına daha sürdürülebilir bir tüketim ürünü kazandırmak esas amaçtır. Çalışmada göçmen çekirge (locusta migratoria) kullanılmıştır. Bir kontrol örneği ile %1 ve %2 oranlarında çekirge tozu içeren tuzlu kurabiye üretilmiştir. Ürünlerin 10 kişilik eğitimli panelist grubu tarafından duyusal değerlendirilmesi yapılmıştır. Genel beğeni puanı en yüksek olan ürün, sonrasında 81 kişinin tüketici beğenisine sunulmuştur. Değerlendirmelerde, görünüş, renk, tat, koku, tekstür, ağızda bıraktığı his ve genel görünüm kriterleri üzerinden 5’li Likert ölçeği kullanılmıştır. Eğitimli panelistlere uygulanan duyusal değerlendirme sonrasında elde edilen verilere göre %1 oranında çekirge tozu ile hazırlanan çekirgeli tuzlu kurabiye 4,7/5 puan ile en çok beğenilen ürün olmuştur. 81 kişinin katıldığı tüketici beğenisi testi sonuçlarına göre 4,6/5 genel beğeni puanına ulaşılmıştır. Eğitimli panelist grubunda %70 ve tüketici beğeni testinde %85 oranında ürünü “satın alırım” cevabı verilmiştir. Ek olarak, Tübitak MAM laboratuvarlarında Protein Kjeldahl yöntemi (AOAC 960.52. Foss Tecator Manuel 2300 AB 2003 AN, Tüm gıdalar) ile ürünlerin protein analizleri gerçekleştirilmiştir. Analiz sonuçlarına göre; kontrol numunesinin protein oranı 11.4g/100g, hamur ağırlığının %1’i kadar çekirge eklenen numunenin protein oranı ise 11.69g/100g olarak tespit edilmiştir.

This study aimed to evaluate systemic inflammation, oxidative stress and lipid profile in cats that had either naturally gained excess weight or had developed obesity. The following groups were examined in the study: ten obese cats with a body condition score of (BCS) >8 (the obesity group), ten overweight cats with a BCS score of >6 (the overweight group) and ten ideal weight cats with a BCS score of 4-5 (the control group). In the cats that had either gained too much weight or had become obese, the serum AST (P < .001), albumin (P = .002) and total protein (TP) (P < .001) levels were found to be significantly higher than the values determined in the control group cats. Furthermore, blood serum high-density lipoprotein (HDL) (P = .009) and triglyceride (TG) (P < .001) levels in cats that had developed obesity were found to be significantly higher than the values defined in the control group cats. In the obese cats, serum procalcitonin (PCT), paraoxonase-1 (PON-1), total thiol, native thiol and MDA levels were found to be significantly higher than in overweight cats (P < .001). As a result, it was concluded that it would be useful for veterinarians to consider significant changes in parameters related to liver function and lipid metabolism, as well as to emphasize systemic inflammation and oxidative stress in their clinical evaluations in cats that had either naturally gained excess weight or had developed obesity.

Abstract This Letter proposes a new signature for confining dark sectors at the LHC. Under the assumption of a QCD-like hidden sector, hadronic jets containing stable dark bound states originating from hidden strong dynamics, known as semi-visible jets, could manifest in proton-proton collisions. In the proposed simplified model, a heavy $$Z'$$ Z ′ mediator coupling to SM quarks allows the resonant production of dark quarks, subsequently hadronizing in stable and unstable dark bound states. The unstable dark bound states can then decay back to SM quarks via the same $$Z'$$ Z ′ portal or photons via a lighter pseudo-scalar portal (such as an axion-like particle). This mechanism creates a new signature where semi-visible jets are enriched in non-isolated photons. We show that these exotic jets evade the phase space probed by current LHC searches exploiting jets or photons due to the expected high jet neutral electromagnetic fraction and photons candidates non-isolation, respectively. In the proposed analysis strategy to tackle such signature, we exploit jets as final state objects to represent the underlying QCD-like hidden sector. We show that, by removing any selection on the neutral electromagnetic fraction from the jet identification criteria, higher signal efficiency can be reached. To enhance the signal-to-background discrimination, we train a deep neural network as a jet tagger that exploits differences in the substructure of signal and background jets. We estimate that with the available triggers for Run 2 and this new strategy, a high mass search can claim a $$5 \sigma $$ 5 σ discovery (exclusion) of the $$Z'$$ Z ′ boson with a mass up to 5 TeV (5 TeV) with the full Run 2 data of the LHC when the fraction of unstable dark hadrons decaying to photons pairs is around $${30}{\%}$$ 30 % , and with a coupling of the $$Z'$$ Z ′ to SM quarks of 0.25.

Objective: This study aimed to investigate the epidemiological, clinical, laboratory, and radiological characteristics of children diagnosed with Hashimoto’s thyroiditis and to present the experiences of a referral center. Materials and Methods: This study included 200 pediatric patients diagnosed with Hashimoto’s thyroiditis between January 2020 and May 2024 at a single center. The data were extracted and compiled from the participants’ medical records, including clinical information, physical examination findings, laboratory test results, and radiological imaging. Results: Mean age of the study population was 11.3 ± 3.2 years at diagnosis, with a female predominance. At the time of clinical presentation, 8.5% of the study participants were 6 years of age or younger. The majority of patients, comprising 39.5% of the cohort, exhibited euthyroid thyroid function. Additionally, 33.5% of the patients were classified as having subclinical hypothyroidism, 22% demonstrated overt hypothyroidism, and 5% presented with hyperthyroidism. Approximately one-third of the study participants were referred for further evaluation due to the identification of abnormal thyroid function test results during routine screening examinations. 48% of the patients had a documented family history of thyroid disease. At diagnosis, 39.5% were prepubertal. The rate of overt hypothyroidism was higher in prepubertal patients compared to pubertal patients (41.8% vs. 9.1%, P < .005). Mean gland volume SDS was 2.61 ± 3.69, and 45.5% had goiter. Thyroid nodular lesions were identified in 5.5% of the study participants. Fine-needle aspiration biopsy was performed on five patients, revealing benign findings in three cases and atypia of undetermined significance in the remaining two cases. Conclusion: Patints with subclinical hypothyroidism who have a baseline TSH level exceeding 8.5 mIU/L at initial presentation and do not receive treatment are likely to progress to overt hypothyroidism during subsequent follow-up. Prepubertal cases were more frequently observed compared to previous reports, and the course of hypothyroidism was more severe in prepubertal patients. These findings suggest a potential shift towards earlier onset of autoimmunity in children. Further studies are warranted to substantiate this observation.

Abstract Background This study aims to examine the association for paternal care and father-child screen use with early childhood development and children’s temper tantrums. Method Study file included questions about paternal characteristics, child care, father-child screen habits, and utilized the UNICEF Early Childhood Development Index (ECDI). Factors influencing ECDI-on-track status and children’s responses when screen use was restricted were investigated with Chi-square test and multiple logistic regression. Results The study included 464 fathers having children aged 3–4 years. The findings showed that 89.7% of the children were on track in three out of the four ECDI subgroups. When screen use was restricted, 55.6% of the children engaged in another activity, while 44.4% reacted by crying. Multiple logistic regression analysis revealed that the father’s education level, the child’s age and gender, the starting age for screen usage, the child’s reaction to screen restriction, and having three or more books were associated with ECDI. Furthermore, the child’s reaction to screen restriction was related to the child’s and father’s screen time, the presence of three or more books, the adequacy of care, and being on track in the literacy-numeracy ECDI subgroup. Conclusion Screen usage habits significantly impact early childhood development and children’s reactions to screen restrictions. These findings underscore the importance of educating fathers about the effects of their own and their child’s media habits, the quality of fatherly caregiving, and the presence of books in fostering positive child development.

Objective: This study aims to investigate the influence of coronavirus (COVID-19) vaccination on hospital outcomes among patients with type 2 diabetes mellitus (T2DM). Methods: A total of 324 patients hospitalized for COVID-19 were evaluated retrospectively. Type 2 diabetes mellitus patients were matched 1:1 by the propensity score matching method to individuals without diabetes for age and gender. After matching, we analyzed 70 patients with T2DM and 70 without diabetes. Results: Individuals with T2DM exhibited a slightly higher vaccination rate than those without diabetes (67.1% vs. 54.3%, P=.119). Regardless of diabetes status, vaccinated participants experienced significantly lower rates of intensive care unit (ICU) admission (T2DM: 14.9% vs. 60.9%, P=.001; nondiabetics: 5.3% vs. 37.5%, P = .001) and fatality (T2DM: 2.1% vs. 60.9%, P=.001; non-diabetics: 0% vs. 46.9%, P=.001) compared to the unvaccinated group. The length of hospitalization and ICU admission rate were insignificantly higher in vaccinated individuals with T2DM than those without diabetes (9.0 days vs. 7.0 days, P=.154; 14.9% vs. 5.3%, P=.179). Multivariate logistic regression in T2DM patients revealed that CoronaVac vaccination significantly reduced ICU admission (OR: 0.089, 95% CI 0.022-0.360, P=.001), while male gender increased the risk (OR: 6.59, 95% CI 1.545-28.11, P=.011). Conclusion: In vaccinated individuals with T2DM, the risk of severe COVID-19 and fatality significantly decreased, similar to individuals without diabetes. This protection is not affected by vaccine type, vaccination count, or age.

Background: The devastating earthquakes that struck Turkey have left profound psychological impacts on those affected, with anxiety and trauma being particularly prevalent. Understanding the factors that can mitigate these effects is important for developing effective interventions. Objective: This study seeks to analyse the intermediary functions of perceived social support (PSS) and resilience within the correlations linking earthquake-induced anxiety and the occurrence of traumatic experiences after the seismic event in Turkey. Method: The study involved a sample of 504 young adults (61.31 % females) who survived the earthquake in Turkey on February 6, 2023. Participants aged 18 to 30 (M = 21.57, SD = 2.55) completed an online survey of self-reported measures of earthquake anxiety, traumatic experiences post-earthquake, PSS, and resilience. Results: The results indicated that earthquake anxiety significantly predicted levels of traumatic experiences, PSS, and resilience. Additionally, PSS and resilience emerged as significant predictors of traumatic experiences. Importantly, resilience and PSS served as mediators in the relationship between earthquake anxiety and traumatic experiences. Conclusions: These results highlight the importance of coordinating social and mental assets that focus on strengths in guidelines and interventions designed to enhance positive mental health among earthquake survivors coping with traumatic experiences.

ABSTRACT Purpose This study aimed to investigate the effects of the SARS‐CoV‐2 virus (COVID‐19) on tinnitus severity and quality of life in infected and non‐infected individuals who were re‐admitted to our clinic after the COVID‐19 outbreak. Methods The study involved both retrospective and prospective data analysis. The study included 30 individuals aged 20–65 years with normal hearing who had undergone psychoacoustic, tinnitus, and psychosomatic evaluations before the pandemic. Participants were divided into Group 1 (n = 15, COVID‐19 negative) and Group 2 (n = 15, COVID‐19 positive). Before the pandemic, tinnitus‐related evaluations of all participants (i.e., pure tone audiometry [PTA], tinnitus frequency, loudness, minimum masking level [MML], and residual inhibition [RI]) were conducted, and the Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS), and Short Form 36 (SF‐36) were administered to all participants. All assessments were repeated after the outbreak of the pandemic. Results There was no significant difference in the mean PTA thresholds of both groups before and after the pandemic (p > 0.05). There was a significant increase in tinnitus severity after COVID‐19 infection in Group 2 (p 0.05). Conclusion Although negative effects of the pandemic were observed in individuals with tinnitus who were not infected with COVID‐19, both the quality of life and tinnitus severity of individuals with tinnitus who were infected with COVID‐19 worsened.

BackgroundClinical data is instrumental to medical research, machine learning (ML) model development, and advancing surgical care, but access is often constrained by privacy regulations and missing data. Synthetic data offers a promising solution to preserve privacy while enabling broader data access. Recent advances in large language models (LLMs) provide an opportunity to generate synthetic data with reduced reliance on domain expertise, computational resources, and pre-training.ObjectiveThis study aims to assess the feasibility of generating realistic tabular clinical data with OpenAI’s GPT-4o using zero-shot prompting, and evaluate the fidelity of LLM-generated data by comparing its statistical properties to the Vital Signs DataBase (VitalDB), a real-world open-source perioperative dataset.MethodsIn Phase 1, GPT-4o was prompted to generate a dataset with qualitative descriptions of 13 clinical parameters. The resultant data was assessed for general errors, plausibility of outputs, and cross-verification of related parameters. In Phase 2, GPT-4o was prompted to generate a dataset using descriptive statistics of the VitalDB dataset. Fidelity was assessed using two-sample t-tests, two-sample proportion tests, and 95% confidence interval (CI) overlap.ResultsIn Phase 1, GPT-4o generated a complete and structured dataset comprising 6,166 case files. The dataset was plausible in range and correctly calculated body mass index for all case files based on respective heights and weights. Statistical comparison between the LLM-generated datasets and VitalDB revealed that Phase 2 data achieved significant fidelity. Phase 2 data demonstrated statistical similarity in 12/13 (92.31%) parameters, whereby no statistically significant differences were observed in 6/6 (100.0%) categorical/binary and 6/7 (85.71%) continuous parameters. Overlap of 95% CIs were observed in 6/7 (85.71%) continuous parameters.ConclusionZero-shot prompting with GPT-4o can generate realistic tabular synthetic datasets, which can replicate key statistical properties of real-world perioperative data. This study highlights the potential of LLMs as a novel and accessible modality for synthetic data generation, which may address critical barriers in clinical data access and eliminate the need for technical expertise, extensive computational resources, and pre-training. Further research is warranted to enhance fidelity and investigate the use of LLMs to amplify and augment datasets, preserve multivariate relationships, and train robust ML models.

Aim: It is a scientific fact that certain viral infections during pregnancy cause hearing loss in newborns. The aim of this study was to investigate whether such infections are the cause of congenital hearing loss. This study was based on an examination of the hearing screening of newborns born to pregnant women affected by the current pandemic caused by the SARS-CoV-2 virus, which is responsible for the disease designated Coronavirus Disease 2019 (COVID-19). Materials and Methods: In this retrospective case-control study, demographic data and ABR hearing test results of a total of 81 newborns were compared with those of 101 healthy controls. The newborns were born to mothers who tested positive for SARS-CoV-2 polymerase chain reaction (PCR) during pregnancy between March and September 2022. The mothers of the healthy controls had no problems during pregnancy. Results: The prevalence of SARS-CoV-2 PCR positivity during pregnancy was 3.5%. A higher cesarean delivery rate was observed in the group with positive SARS-CoV-2 infection (p=0.028). The failure rate of the initial screening test was higher in both groups (22/81 vs. 25/101; p=0.712). However, a subsequent analysis revealed that there was no statistically significant difference between the results of the secondary follow-up screening (p=0.926). Conclusion: The study data suggest that there is no indication that maternal SARS-CoV-2 infection during pregnancy results in neonatal hearing loss.

The integration of artificial intelligence (AI) into health communication systems has introduced a transformative approach to public health management, particularly during public health emergencies, capable of reaching billions through familiar digital channels. This paper explores the utility and implications of generalist conversational artificial intelligence (CAI) advanced AI systems trained on extensive datasets to handle a wide range of conversational tasks across various domains with human-like responsiveness. The specific focus is on the application of generalist CAI within messaging services, emphasizing its potential to enhance public health communication. We highlight the evolution and current applications of AI-driven messaging services, including their ability to provide personalized, scalable, and accessible health interventions. Specifically, we discuss the integration of large language models and generative AI in mainstream messaging platforms, which potentially outperform traditional information retrieval systems in public health contexts. We report a critical examination of the advantages of generalist CAI in delivering health information, with a case of its operationalization during the COVID-19 pandemic and propose the strategic deployment of these technologies in collaboration with public health agencies. In addition, we address significant challenges and ethical considerations, such as AI biases, misinformation, privacy concerns, and the required regulatory oversight. We envision a future with leverages generalist CAI in messaging apps, proposing a multiagent approach to enhance the reliability and specificity of health communications. We hope this commentary initiates the necessary conversations and research toward building evaluation approaches, adaptive strategies, and robust legal and technical frameworks to fully realize the benefits of AI-enhanced communications in public health, aiming to ensure equitable and effective health outcomes across diverse populations.

Objective Hematopoietic stem cell transplant is a life-saving procedure that treats patients with various conditions by transplanting hematopoietic stem cells from bone marrow. Mobile health apps could be useful in closing the digital divide and improving health equity among Spanish-speaking caregivers of children who undergo pediatric hematopoietic stem cell transplant. This study aims to transcreate the BMT4me adherence app originally designed for English-speaking caregivers for Spanish-speaking caregivers and evaluate the feasibility and usability. Methods This study consists of two phases. Phase 1 transcreates the existing BMT4me app for Spanish-speaking populations. App feedback is collected from three community advisory board focus groups ( n = 10; each meeting will include the same 10 community advisory board members). Groups consist of members connected to the local Spanish-speaking population and participating in the Community Engagement Program at The Ohio State University Center for Clinical and Translation Science. Phase 2 tests the feasibility and usability of the Spanish BMT4me app with child–caregiver dyads ( n = 30; 15 at site 1, n = 15 at site 2) whose primary language is Spanish. This phase is mixed methods and incorporates both a qualitative approach (caregiver interviews) and quantitative measures (system usability scale). It is expected that app users in phase 2 will report above average system usability scale scores (>68%). It is also expected that >75% of families approached in phase 2 will enroll and complete the surveys in our study. Conclusion This protocol paper details the transcreation process of the BMT4me app into a Spanish version. The findings of the study will demonstrate the level of acceptability of the Spanish BMT4me app with participants whose primary language is Spanish. As a digital health intervention for an underrepresented population that is increasingly online yet historically underserved, this app can overcome health barriers and disparities and improve overall health equity.

ABSTRACT Purpose Caregivers in pediatric oncology need accurate and understandable information about their child's condition, treatment, and side effects. This study assesses the performance of publicly accessible large language model (LLM)‐supported tools in providing valuable and reliable information to caregivers of children with cancer. Methods In this cross‐sectional study, we evaluated the performance of the four LLM‐supported tools—ChatGPT (GPT‐4), Google Bard (Gemini Pro), Microsoft Bing Chat, and Google SGE—against a set of frequently asked questions (FAQs) derived from the Children's Oncology Group Family Handbook and expert input (In total, 26 FAQs and 104 generated responses). Five pediatric oncology experts assessed the generated LLM responses using measures including accuracy, clarity, inclusivity, completeness, clinical utility, and overall rating. Additionally, the content quality was evaluated including readability, AI disclosure, source credibility, resource matching, and content originality. We used descriptive analysis and statistical tests including Shapiro–Wilk, Levene's, Kruskal–Wallis H‐tests, and Dunn's post hoc tests for pairwise comparisons. Results ChatGPT shows high overall performance when evaluated by the experts. Bard also performed well, especially in accuracy and clarity of the responses, whereas Bing Chat and Google SGE had lower overall scores. Regarding the disclosure of responses being generated by AI, it was observed less frequently in ChatGPT responses, which may have affected the clarity of responses, whereas Bard maintained a balance between AI disclosure and response clarity. Google SGE generated the most readable responses whereas ChatGPT answered with the most complexity. LLM tools varied significantly (p

Objective: The endothelial glycocalyx layer (EGL) is the interface between the blood and the endothelium that regulates permeability. This study compared the effects of liberal and restrictive fluid therapies on atrial natriuretic peptide (ANP) release and EGL products in radical cystectomy surgery. We hypothesized that a liberal regimen would damage the glycocalyx layer, resulting in a higher serum EGL product concentration than restrictive therapy. Materials and Methods: Patients were randomized into two groups for restrictive (group R) or liberal (group L) regimens. Group R received 2 mL/kg/h Ringer’s lactate and 2 mcg/kg/h norepinephrine infusion, whereas group L received only Ringer’s lactate infusion at 10 mL/kg/h rate during the surgery. Preoperative and postoperative blood samples were obtained to evaluate ANP levels and glycocalyx degradation products. The stroke volume index, cardiac index, stroke volume variation, and systemic vascular resistance index parameters were recorded at 30-min intervals throughout the surgery. The length of stay in the hospital and intensive care unit and postoperative complications were recorded. Results: The study was completed with 39 patients. Postoperative ANP levels were higher in group L in both between- and within group examination (p0.05). Postoperative complications and length of stay data were similar (p>0.05). Conclusion: ANP, hyaluronan, and syndecan-1 concentrations can be used as an indirect measurement method to show EGL damage and hypervolemia in major urologic surgeries. Advanced hemodynamic monitoring was ineffective for confirming hypervolemia.

Abstract Background Orthopedic surgeons face challenges regarding perioperative bleeding during the operations of pelvic and acetabular fracture cases. Although the recently popular tranexamic acid (TXA) has proven to be a useful tool, this study primarily aimed to conduct a retrospective comparative analysis of the results of the prophylactic administration of tranexamic acid during open fixation of pelvis and acetabulum fractures, especially regarding operative time and the amount of blood transfused; and in addition, share the results related to other findings including the management of the erythrocyte suspension use and overall cost as secondary aims and thus providing a comprehensive point of view. Methods The files of patients with pelvis or acetabulum fractures admitted to the Emergency Clinic of the Adana City Training and Research Hospital between January 1, 2020, and December 31, 2023, were analyzed retrospectively. The inclusion criteria were as follows: patients aged 18 years or older who had undergone open reduction for pelvis or acetabulum fractures. Results There were 78 files identified for analysis. Among the fractures, 27 were located at the pelvis (34.61%) and 51 at the acetabulum (65.38%). The pelvic fracture cases’ age and preoperative hemoglobulin levels were significantly lower (p = 0.019 and p = 0.006, respectively). When all cases were dichotomized into two groups, ones requiring ICU monitoring and the remaining, there were statistically significant differences in terms of the preoperative hemoglobin levels (p = 0.0446), intraoperative bleeding (p = 0.0134), units of erythrocyte suspension used (p = 0.0066), drain output (p = 0.0301), hospitalization duration (p = 0.0008), and the overall cost (p = 0.0002). The comparison regarding TXA use showed that the use of blood products was significantly higher in the pelvic fractures not treated with TXA (6.44 ± 4.42 units, p = 0.0029). The duration of surgery was shorter for pelvic fractures treated with TXA (98.33 ± 21.76 min, p = 0.047). Conclusion Among the variables, the amount of intraoperative bleeding emerged as the most correlated element, which strongly suggests that in managing open reduction internal fixation surgeries performed for pelvis and acetabulum fractures, intraoperative bleeding should be considered as the crucial factor. Therefore, the administration of TXA, by effectively reducing the amount of intraoperative bleeding, should be considered as an essential tool for orthopedic surgeons.

This article provides a model-based design method for heading control based autonomous trajectory tracking of a KVLCC2 ship. Kinematics, dynamics, and hydrodynamic force subsystems are used to represent the ship's motion equations. By contrasting the outcomes with experimental data received from the maneuvering modelling group, the accuracy of the model is confirmed. Heading angle of the ship is controlled by a linear cascade controller, and the settings of the controller are modified by using two separate heuristic optimization techniques: particle swarm optimization and genetic algorithm. The comparison of the findings demonstrates that the particle swarm optimization approach is computationally more effective than the genetic algorithm. Performance in the presence of disturbance has been investigated using the controller parameters discovered using particle swarm optimization. A suitable guidance algorithm is incorporated into the architecture of a trajectory tracking system to establish the necessary heading angle for travel between waypoints. We use a real-time simulator to visualize the ship motion on a graphical environment.

Abstract Background It is aimed to compare the block onset times and performance features of costoclavicular techniques (medial and lateral approach) versus lateral sagittal technique. Methods Patients were randomized into three groups. For costoclavicular techniques, ultrasound probe was placed parallel to clavicle obtaining nerve cords, axillary artery and axillary vein visual from lateral-to-medial, respectively. The block needle was advanced from lateral (Group CLB) or medial (Group CMB) to perform costoclavicular block. For lateral sagittal technique (Group LSB), ultrasound probe was placed sagittal and perpendicular below the coracoid process to obtain sagittal artery image with the cords around. Total 20 ml of 0.5% bupivacaine and 10 ml of 2% lidocaine were deposited for all groups. Sensory and motor block onset times, block performance properties, complications, and patient/surgeon satisfactions were investigated. Results Among 56 patients, the primary outcome, sensory block onset time was shorter in Group CLB than Group CMB and Group LSB (10 [5–15], 10 [10–20], and 15 [10–15] minutes, respectively, p