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Objective To investigate the choroidal thickness and the microvascular network changes around the macula in thyroid eye disease (TED) patients at different stages and the relationship of those changes with risk factors, serum antibodies and the severity of TED Material and Methods A total of 85 participants were enrolled. All participants underwent ophthalmology and endocrinology examinations. Central choroidal thickness (CCT), superficial (s) and deep (d) foveal avascular zone (FAZ) area, mean (m) and central (c) macular vascular density (SVD, DVD) measurements of the enrolled cases were performed with Topcon Swept Source OCT / OCT-Angiography DRI OCT Triton (Topcon Co. Japan). Multiple linear regression analysis was used to explore the associations between CCT, FAZ area, SVD, DVD and the relevant factors of TED. Results It was found that those with active TED patients had higher c-DVD and m-DVD levels (p

Aim of the study We reported the association between interleukin 8 (IL-8) polymorphisms (-251T/A and +781C/T) and hepatocellular carcinoma (HCC) risk in a meta-analysis. Material and methods Scopus, PubMed, Web of Science, and Cochrane Library databases were searched until 21 November 2020. The analyses were performed by RevMan 5.3 software using odds ratios (ORs) and 95% confidence intervals (CIs). Also, the analysis of publication bias was performed by CMA 2.0 software. Results Searching databases/sources, five articles including ten studies were entered into the meta-analysis. The pooled ORs for -251T/A polymorphism were 1.07 (p = 0.55), 1.04 (p = 0.75), 1.31 (p = 0.24), 1.24 (p = 0.31), and 1.85 (p = 0.29) for allele, homozygote, heterozygote, recessive and dominant models, respectively. With regards to +781C/T polymorphism, the pooled ORs were 0.74 (p = 0.07), 0.53 (p = 0.03), 0.83 (p = 0.41), 0.75 (p = 0.19), and 0.57 (p = 0.02) for allele, homozygote, heterozygote, recessive, and dominant models, respectively. Conclusions The findings of the meta-analysis showed a lack of significant association between IL-8 (-251T/A) polymorphism and the HCC risk, whereas the TT genotype of IL-8 (+781C/T) polymorphism had a protective role in HCC.

Pediatric gastroenteritis is a potentially fatal disease that accounts for 10% of childhood deaths. The main risk is environmental factors and nutrition. Arsenic (As) is commonly found in the earth's crust. As is an essential element that can form many organic compounds. In children, it causes diarrhea, gums, tongue lesions, diabetes, conjunctivitis, ocular opacity, and impaired immune response. It also causes low growth, mental retardation, and neurological problems. It is also known as the cause of many cancers that originate at an early age. Regionally, there is an iron and steel industry for almost a century. According to the Rome IV criteria, the blood and stools of 50 children aged 6-18 years, male and female, living in our province with functional gastrointestinal disease (FGD), were screened for As, and compared with the Healthy group (control) of 30 children. The results were evaluated with the Mann-Whitney Rank Sum Test. When blood and stool As values in males were compared with control samples, a high level of significance (p = 0.001) was found between both blood and stool As values in sick males and the control group (p < 0.005). In females, blood and stool As median values were also highly significant when compared with the control group (p = 0.001). According to these data, when the sick children (children with male and female gender) are compared with the healthy ones, the difference is highly significant (p < 0.005). High blood As levels in children indicate environmental pollution. It can be said that blood As levels are high as a result of food, water, and inhaler exposure. The presence of a high level of significant difference in stool means that the amount of As is high in the foods consumed daily. High levels of As are in blood and stools; It was evaluated that FGD could be the cause of nausea, diarrhea, vomiting, and colic. The increase in blood and stool As values due to environmental pollution is an important reason for FGD. For diseases of uncertain cause (such as FGD) resulting from chronic As exposure, blood and especially stool As values are more significant than urinary As levels. In conclusion, As a diagnostic criterion, it was concluded that blood and stool As values are an important marker in children with functional abdominal pain with other metals., Karabuk University Scientific Research Projects Unit, We would like to thank Karabuk University Scientific Research Projects Unit for their support for our study.

Hunting search method–based optimum design algorithm is presented to investigate the weight optimization of steel frames with cellular beams. Unlike practical applications where rolled sections are assigned to both the beams and columns, built-up sections are used for beams. Design specifications including the design of steel frames and that of cellular beams are taken from Load and Resistance Factor Design–American Institute of Steel Construction. The algorithm presented selects optimal W-sections to be used for the members of the unbraced plane frame from the ready section pool of the same code. In addition, number of holes and hole diameter of the beams are selected for optimal frame by the algorithm for satisfying the design constraints and making the weight of the frame to be minimum. Besides, Levy Flight procedure is also adopted to the simple hunting search method for better designs. Optimized steel frames with cellular beams are then analyzed by ABAQUS three-dimensional finite element software. The results attained from nonlinear finite element analysis of the steel frames are then taken into account for comparison with optimization outcomes. Results reveal that designing the beam members as cellular beams reduces the weight of the frame.

Purpose. To compare the visual outcomes and complications of patients who underwent flanged transconjunctival sutureless intrascleral intraocular lens (SIS IOL) implantation after anterior and pars plana vitrectomy. Methods. All patients who underwent flanged transconjunctival SIS IOL fixation using a 27-gauge needle between September 2017 and November 2019 and were followed up for at least six months were evaluated. The cases in which anterior vitrectomy was performed were classified as Group 1, and those that underwent pars plana vitrectomy were classified as Group 2. The best-corrected visual acuity (BCVA), spherical equivalent values, corneal endothelial cell density, and intraocular pressures were compared between the two groups before and after the operation. Intraoperative and postoperative complications were assessed. Results. The study included 108 eyes of 108 patients who were included in the study. Group 1 consisted of 48 patients and Group 2 comprised of 60 patients. When the findings between Groups 1 and 2 were compared in the postoperative period, there was no statistically significant difference in terms of the mean intraocular pressure increase, endothelial cell density, BCVA, and spherical equivalent value ( P = 0.818 , 0.601, 0.368, and 0.675, respectively). When all the patients were considered as a single group, the mean spherical value at the sixth postoperative month was 0.3 ± 2.2 D (min-max, (−5.5)–(+6)), the mean cylindrical value was −1.7 ± 2.4 D (min-max, (−9.25)–(+4)), and the mean spherical equivalent value was −0.5 ± 2.3 D (min-max, (−6.5)–(+6)). Conclusion. The flanged transconjunctival SIS IOL fixation technique performed using a 27-gauge needle is safe and effective in the patient group with aphakia and lens/IOL dislocation or subluxation. However, in patients planned to undergo flanged transconjunctival SIS IOL implantation, pars plana vitrectomy seems to be a more suitable option than anterior vitrectomy to reduce complications.

Background: Transient tachypnea of the newborn (TTN) is a common but mild respiratory problem seen in late preterm and term newborns. However, it may sometimes cause severe morbidity. Objectives: Therefore, biomarkers that can predict TTN severity may aid the clinician in determining the need for intensive care. Our aim was to identify whether blood gases and complete blood count parameters could be utilized to predict the severity of TTN.s Methods: We retrospectively examined the medical records of newborns (> 37 weeks gestation, > 2000 grams) diagnosed with TTN who were hospitalized in the Neonatal Intensive Care Unit (NICU) of Karabuk University Faculty of Medicine, Training and Research Hospital, Karabük/Turkey between June 2019 and June 2020. Patients were grouped according to the length of stay in the NICU. Group 1 included patients that did not require NICU monitoring after 48 hours, and group 2 included patients who continued to require NICU monitoring after 48 hours. Blood gases and complete blood count parameters were compared between the two groups. Results: During the study period, 91 newborns were hospitalized in the NICU due to respiratory distress. Thirty-nine patients who did not meet the inclusion criteria were excluded. Gestational age and birth weight were significantly lower in group 2 (P < 0.05). There were no significant differences between the groups in terms of leukocyte count, hemoglobin level, mean platelet volume (MPV), and platelet count. Partial carbon dioxide pressure (PCO2) was significantly elevated, and base excess (BE) was significantly greater in group 2. Conclusions: We determined a relationship between a prolonged stay in NICU and the levels of PCO2 and BE among patients hospitalized with a diagnosis of TTN. Therefore, PCO2 and BE values may be valuable to determine the prognosis of TTN in the early period. Despite being one of the most common causes of intensive care admission in the newborn population, there is limited data on the diagnosis, treatment, and prognosis of TTN; thus, we believe that our results will shed light on this problem.

Analysis of foveal avascular zone (FAZ) width and vascular density (VD) changes before and after intravitreal dexamethasone implant (IDI) treatment in diabetic macular edema (DME) patients resistant to anti-VEGF treatment.In this retrospective study, patients who were regularly treated with at least 5 doses of intravitreal Anti-VEGF (bevacizumab, ranibizumab or aflibercept) for DME and whose DME continued were considered resistant to Anti-VEGF and were treated with IDI for the first time. Thirty-four eyes of 34 patients were included in the study. FAZ and VD values of optical coherence tomography angiography (OCT-A) scans at 0, 1 and 3 months were examined.In OCT-A measurements, the pre-IDI superficial plexus FAZ (SFAZ) area (0.350 ± 0.120 mmThe study showed that IDI caused a significant decrease in the FAZ area without any change in VD in patients with DME resistant to the anti-VEGF agents. IDI might be related to a decrease in the macular ischemia secondary to diabetic retinopathy.

The purpose of this chapter is the comparison of the optimum design of trapezoidal and sinusoidal types of steel corrugated web beams. The minimum weights of these two main types of beams are taken as the objective functions, while the design constraints are, respectively, implemented from EUROCODE, DIN and DAST-Ri. 015 code provisions. The formulation of the design problem considering the limitations of both corrugated web beams turns out to be a discrete programming problem. Firefly optimization method is used to compare the optimum design of mentioned corrugated web beams to analyse the performance of both beams. The design algorithms based on the technique select the optimum universal beam sections, dimensional properties of trapezoidal and sinusoidal webs along the beam as design variables.

Introduction: To investigate the blood lead levels (BLLs) and faecal lead levels (FLLs) in children with various functional gastrointestinal disorders (FGIDs) and compare them with controls. Patients and methods: One hundred and two children with FGIDs defined by the Rome IV criteria, aged 4–18 years, and one hundred and two sex matched healthy children were enrolled in the study. Children with FGIDs were divided into three subgroups as functional constipation (FC) (n = 36), functional abdominal pain (FAP) (n = 36) and functional nausea (FN) (n = 30). The lead levels were measured using atomic absorption spectrometer. Results: The median BLLs in the FGIDs group was significantly higher than in controls (5.12 and 1.77 µg/dL, respectively). The BLLs were above 5 µg/dL in 51,9% of children with FGIDs. There was statistically significant difference in BLLs between FC subgroup and the other subgroups (FAP and FN) (p = 0.003, p

The aim of this study was to investigate whether intraoperative 360° prophylactic endolaser photocoagulation is necessary for the treatment of uncomplicated retinal detachment. This prospective, randomized, comparative and interventional study includes 50 consecutive patients with primary rhegmatogenous retinal detachment (RRD) who were treated by pars plana vitrectomy. The patients were divided into two groups: in Group A endolaser applied to all existing breaks as well as a 360° laser retinopexy, while Group B received endolaser only to the retinal breaks. Primary anatomical success rate, a final best-corrected visual acuity (BCVA) and postoperative complications were analyzed and compared between the groups at 1 and 3 months. After the primary procedure, the retina was reattached in 96% (24 of 25) of patients in Group A and in 88% (22 of 25) of patients in Group B at 1 and 3 months. The mean final BCVA (logarithm of the minimum angle of resolution) improved from 1.26 to 0.52 in Group A with 17 cases (68%) macula-off and 1.19 to 0.77 in Group B with 18 cases (72%) macula-off at preoperative and final follow-up visit. Epiretinal membranes were seen in four cases in Group A and four cases in Group B at 3 months. No statistically significant difference in the anatomical, functional and complication outcomes between the two groups was recorded. Pars plana vitrectomy without the 360° peripheral endolaser can provide successful anatomic outcomes and functional improvement in uncomplicated primary RRDs.

Tumour Lysis Syndrome (TLS) is an important oncological emergency case which is often found together with haematological malignities and, much less often, with solid tumours. While TLS seen in solid tumour cases usually develops following a cytotoxic chemotherapy and its prognosis is poor. We present the case of a 60-year-old man with gastric adenocarcinoma with diffuse liver metastases (image shows diffuse liver metastatic lesions) and high serum LDH levels, who developed TLS after systemic chemotherapy. With urgent and proper supportive treatment (intravenous intensive hydration, sodium bicarbonate, diuretic, calcium gluconate, allopurinol and haemodialysis), an impressive recovery from TLS was achieved in the patient with an advanced stage gastric cancer. The purpose of this report is to emphasize that although the present case was a rare, high physician attention is required because significant morbidity or mortality may occur when the syndrome is not duly considered during the pre-cytotoxic evaluation of the patient, when preventive measures are not taken, or if the appropriate treatment is not applied immediately once the syndrome appears, especially in patients who have high tumour burden solid cancer.

To compare the efficacy and safety of postoperative topical loteprednol etabonate (LE) 0.5% with dexamethasone (DEX) 0.1% for the treatment of inflammation following pars plana vitrectomy (PPV).A total of 150 eyes of 150 patients who underwent transconjunctival PPV for various diagnoses were included in this prospective, randomized study. The patients were assigned into two groups as Group LE (n = 75) and Group DEX (n = 75). Intraocular inflammation, intraocular pressure (IOP), and the intensity of postoperative pain were compared between the groups.The mean IOP was higher in the patients treated with DEX (p 0.05). The need for anti-glaucoma medications was significantly lower in Group LE (5.3%) than in Group DEX (17.3%) (p = 0.020). Tyndall scores were less in Group DEX at postoperative Days 1 (p = 0.01) and 3 (p = 0.017). On Day 1, it was more likely for patients to have mild or moderate pain in Group LE (p 0.001). On Day 3, the number of the patients with no pain was higher in Group DEX (p = 0.005).Although DEX is more effective in the early postoperative days, LE appears to be as effective in controlling inflammatory response following PPV in the long-term. Topical LE is associated with less increase in the IOP and a lower need for anti-glaucoma medications.

Objective: The main treatment modality for esophageal cancer remains to be surgery. Over the last decades, surgical strategies have evolved remarkably. When neoadjuvant chemoradiotherapy became standard, discussions about the role, type, and timing of surgery began. In this study, we share results we obtained after operating our patients using various surgical techniques. Material and Methods: Reliable data from 51 esophageal cancer patients were evaluated retrospectively. Of the 51 cases, 31 were operable. These operable cases were further classified according to surgical method and neoadjuvant therapy status. Median survival time in months, complications, hospital mortality, length of hospital stay, and pathology results (total lymph nodes harvested and pathologic tumor node metastasis stage [p_TNM]) were documented for the different surgical approaches. Results: Open surgical methods were performed in 21 cases, while in 10 cases the Minimally Invasive Surgery (MIS) method was used. The MIS group received neoadjuvant therapy more frequently than the open surgical methods group (p=0.013). Although more complications were observed in the MIS group, the difference to the open esophagectomy methods group was not significant. Patients in the MIS group also had longer hospital stays, but again the difference was not significant. Although a pathologic complete response was seen in 8 of the 11 (72.7%) patients in our study who received chemoradiotherapy as neoadjuvant treatment, the surgical results of patients who received chemoradiotherapy were worse, although not to a statistically significant extent. Conclusion: Despite changing trends and treatment options in esophageal cancer surgery, we have yet to see the expected improved results.

The construction sector is one of the few high-risk businesses due to occupational accidents, their rate of frequencies, and related serious consequences, sometimes even resulting in the death of individuals. Therefore, it is a vital necessity and priority for employers and employees during the course of a project to comply with occupational safety rules under any circumstances. Nothing should deter or compromise the safety of any individual working in a potential risk environment. Within the scope of this study, the analysis addresses a scaffolding accident that occurred on a construction site. Once the information about how the accident possibly happened was received, the scaffolding in question identified at the construction was kept for an investigation to carry out the corrective and renovation works. In this paper the suspended scaffoldings are firstly categorized. Then how the accident happened was examined and theorized. The examination and analysis were supported by the results. This study is intended to prevent similar accidents and establish necessary precautions as a matter of procedure.

The possibility of construction disputes can be reduced, but they cannot be avoided due to the uncertain and risky nature of the building industry. Conflicts between construction parties often have very unfavourable effects, such as cost increases, poor construction quality and time extension in the schedule. Lots of studies have been carried out in order to try and avoid these disagreements. However, there are no common resolution tools or techniques due to the improving conditions and scope of contracted works. Advanced methods and dispute reasons should be fully monitored and updated for the applicable solutions. This paper discusses the current major constructional dispute reasons in Turkey. The questionnaire method was applied within the scope of this study. The questionnaire documents were randomly distributed to 80 contractors to analyse major dispute reasons in Turkey. Analysis of the questionnaire results indicates that the major current dispute causes are poor quality of performed works, delays in progress payments, inefficient site management, poorly written contracts and design mistakes.

The aim of this study was to calculate the corrected rate of reflux in children with gastroesophageal reflux (GER)-like complaints by 24-hour pH monitoring and esophagogastroduodenoscopy (EGD), and to determine the utility of mean platelet volume (MPV) and red cell distribution width (RDW) as diagnostic biomarkers of GER disease (GERD) in children. The subjects in this prospective study were 109 children, 6 to 18 years old. Of them, 74 subjects were with GER symptoms and 35 healthy controls. The subjects were divided into three groups: those who underwent 24-hour pH monitoring (Group 1), those who underwent EGD together with pH monitoring (Group 2), and the healthy controls (Group 3). The results of pH monitoring and EGD and hematological parameters with controls were compared between Groups 1 and 2. In Groups 1 and 2, the overall rate of reflux was 40%, of esophagitis was 27.8%, and of Helicobacter pylori infection was 31.2%. The MPV and RDW cut-offs in subjects with reflux were ≤ 8.97 (sensitivity 89%, specificity 89%) and ≤ 12.78 (sensitivity 80%, specificity 97%), with an area under the Receiver Operating Characteristic (ROC) curve ± standard error (AUC ± SE) = 0.917 ± 0.027 (P < 0.001) and AUC ± SE = 0.866 ± 0.036 (P < 0.001), respectively. The endoscopic procedures are not practical due to being invasive and expensive. However, hemogram is a simple test which can be performed in an outpatient clinic. MPV and RDW calculated in hemogram could be easy, cost-effective, and high sensitive new biomarkers that can be used in children with GERD.

Congenital chloride diarrhea is a rare cause of severe infantile diarrhea with excessive chloride excretion. Mutations in the SLC26A3 gene cause congenital chloride diarrhea. It generally becomes apparent in the neonatal period and is characterized by electrolyte imbalances, metabolic alkalosis, and failure to thrive. The diagnosis of congenital chloride diarrhea is based on detecting excessive chloride in the stool (90 mmol/L). We report a Turkish neonate with congenital chloride diarrhea whose sibling had the same disease. The newborn was born by cesarean delivery. Diarrhea, vomiting, and weight loss started soon after birth. She was diagnosed as having congenital chloride diarrhea based on its typical clinical signs and a high concentration of stool chloride and was confirmed by genetic analysis. She was treated by means of salt supplementations and lansoprazole. Family history may play an important role in the early diagnosis because the disease is inherited autosomal recessively.

To evaluate the balance skills and falling risk in children with a congenital bilateral profound sensorineural hearing loss (CBPSNHL).25 children with CBPSNHL and healthy 25 children with similar age and gender were included in the study. The flamingo balance test, the tandem stance test, and the one-leg standing test were performed to assess the patients' static balance skills. The pediatric balance scale (PBS) was used to evaluate the dynamic balance. Visual analog scale (VAS) was applied to the patients assess the frequency of falls.The flamingo balance test, the tandem stance test, and the one-leg standing test in the children with CBPSNHL were all significantly worse than the control group. Although the scores of PBS in patients with CBPSNHL were significantly lower than the control group (p 0.001), the results of both groups were consistent with a low risk of falls. There was no significant difference between the VAS scores indicating the frequency of falls among the groups (p = 0.552).Static and dynamic balance skills of the children with CBPSNHL are significantly impaired compared to their healthy peers. Children with CBPSNHL also have a lower risk of falling just like their healthy peers and there is no significant difference between their falling frequencies. Balance skills of children with CBPSNHL can be assessed quickly and effectively on a hard floor (eyes closed), with a tandem standing test or a one-leg standing test.

The presence of growth differentiation factor-15 (GDF-15), a protein implicated in the regulation of the inflammatory response, was investigated in the vitreous of patients with vitreoretinal disorders.Vitreous and plasma samples were collected from patients with idiopathic epiretinal membrane (IERM), macular hole (MH), rhegmatogenous retinal detachment (RRD), nucleus drop (ND), or proliferative diabetic retinopathy (PDR). GDF-15 concentrations were measured using ELISA.The vitreous levels of GDF-15 were higher in ND (5) and PDR (14) patients (1494 ± 243 and 904 ± 138 pg/mL, respectively) than RRD (3), MH (3), and IERM (8) patients (302 ± 160, 288 ± 24, and 254 ± 91 pg/mL, respectively). The vitreous levels of GDF-15 were significantly higher in patients with inflammatory vitreoretinal disorders (p 0.0001).This is the first report showing that GDF-15 appears to be expressed in the vitreous, and that its expression is significantly higher in the presence of a vitreoretinal disorder in which there is an inflammatory component.

Multi-Criteria Decision Making is one of the most important issues, especially when there are numerous competing criteria and alternatives to consider. There are a variety of approaches for dealing with such issues. The Analytic Hierarchy Process (AHP) is one of the most popular problem solvers for this type of problem, and it's especially useful for determining the weights of the criteria. Using decision-makers' evaluation tables, this method compares each of the criteria to each other. Furthermore, this method employs a consistency ratio to assess the consistency of decision-makers' choices. The decision maker's experience and knowledge are critical in this process. Selection of a construction vehicle (truck) alternative is discussed in this study. Four different vehicles are selected based on five criteria. The AHP approach is used to choose the best option. The results are interpreted at the end of the process.

Background and Objective Spinal bone metastases are common. They are mostly localized to the lumbar, thoracic, and cervical spine. The most common primaries to result in spinal metastases include lung, breast, and prostate carcinomas in adults as opposed to leukemia, Ewing sarcoma, rhabdomyosarcoma, and neuroblastoma in children. In patients diagnosed with cancer, bone metastases are found in 40% and spinal metastases in 10%. In this study, we reviewed 25 patients diagnosed with a spinal metastasis of unknown primary who presented with low back pain or acute-onset neurologic deficits and underwent operative treatment. Methods The retrospective study included 25 patients with a spinal metastasis of unknown primary who presented to our clinic with acute-onset vertebral fracture or neurologic deficit. Statistical descriptions were obtained for each patient. Survival analysis was performed using the Kaplan-Meier method. Results The 25 patients included 17 men (68%) and 8 women (32%), with a mean age of 55 years (range, 14–81 years). Eleven patients (44%) presented with varying degrees of motor deficits ranging from flaccid paralysis to paraplegia. Motor deficits were completely reversed in 4 patients postoperatively. The tumors were localized to the upper thoracic spine (T1-4) in 2 patients, in the midthoracic spine (T5-8) in 2 patients, in the lower thoracic spine (T9-12) in 8 patients, in the cervical 7 in 1 patient, and in the lumbar spine in 12 patients. In 10 patients, the tumor affected multiple spinal regions. Nonosseous tumors were not present in 10 patients. Ten patients had an extradural tumor. Costal involvement was detected in 2 patients. The tumors were pathologically identified as lung cancer (n = 3), lymphoma (n = 5), breast cancer (n = 3), gastric cancer (n = 2), liver cancer (n = 2), prostate cancer (n = 2), renal cell carcinoma (n = 2), malignant melanoma (n = 1), plasmacytoma (n = 1), bladder cancer (n = 1), paraganglioma (n = 1), Ewing sarcoma (n = 1), and yolk sac carcinoma (n = 1). Posterior instrumentation was performed in patients with instability. In addition, decompression was performed in patients with neurologic deficit. Conclusions Considering that 10% of patients with cancer are diagnosed by vertebral metastasis, presence of malignancy should be suspected and a detailed examination should be performed in patients presenting with vertebral fractures caused by no or minor trauma. Moreover, in patients presenting with neurologic deficit, soft tissue metastases leading to spinal cord compression should be kept in mind and further examinations should be promptly administered.

Background Baby-led weaning (BLW) is an approach to introducing solid foods to infants that gives control of the feeding process to the infant. Anecdotal evidence suggests that BLW is becoming popular with parents, but scientific research is limited to a few publications. This study assessed growth, hematological parameters and iron intake in 6-12-month-old infants fed by traditional or baby-led complementary feeding. Methods We recruited 280 healthy 5-6-month-old infants allocated to a control (traditional spoon feeding; TSF) group or an intervention (BLW) group in a randomized controlled trial. Infant growth, hematologic parameters and iron intake were evaluated at age 12 months. Results Infants in the TSF were significantly heavier than those in the BLW group. Mean weight in the BLW group was 10.4 ± 0.9 kg compared with 11.1 ± 0.5 kg in the TSF group. There was no statistically significant difference in the iron intake from complementary foods between the BLW (7.97 ± 1.37 mg/day) and TSF (7.90 ± 1.68 mg/day) participants who completed the diet records. Hematologic parameters were similar at 12 months. The incidence of choking reported in the weekly interviews was not different between the groups. Conclusions To the best of our knowledge, this is the first randomized -controlled study to have examined the impact of weaning method on iron intake, hematological parameters and growth in breast-fed infants. BLW can be an alternative complementary feeding type without increasing the risk of iron deficiency, choking or growth impairment.

This study presents a hunting search based optimum design algorithm for engineering optimization problems. Hunting search algorithm is an optimum design method inspired by group hunting of animals such as wolves, lions, and dolphins. Each of these hunters employs hunting in a different way. However, they are common in that all of them search for a prey in a group. Hunters encircle the prey and the ring of siege is tightened gradually until it is caught. Hunting search algorithm is employed for the automation of optimum design process, during which the design variables are selected for the minimum objective function value controlled by the design restrictions. Three different examples, namely welded beam, cellular beam and moment resisting steel frame are selected as numerical design problems and solved for the optimum solution. Each example differs in the following ways: Unlike welded beam design problem having continuous design variables, steel frame and cellular beam design problems include discrete design variables. Moreover, while the cellular beam is designed under the provisions of BS 5960, LRFD-AISC (Load and Resistant Factor Design-American Institute of Steel Construction) is considered for the formulation of moment resisting steel frame. Levy Flights is adapted to the simple hunting search algorithm for better search. For comparison, same design examples are also solved by using some other well-known search methods in the literature. Results reveal that hunting search shows good performance in finding optimum solutions for each design problem.

Introduction We investigated the impact of modern chemotherapy regimens and bevacizumab following pulmonary metastasectomy (PM) from metastatic colorectal cancer (CRC). Methods A total of 122 consecutive patients who were curatively resected for pulmonary metastases of CRC in twelve oncology centers were retrospectively analysed between January 2000 and April 2012. Results Of 122 patients, 14 did not receive any treatment following PM. The remaining 108 patients received fluoropyrimidine-based (n = 12), irinotecan-based (n = 56) and oxaliplatin-based (n = 40) chemotherapy combinations. Among these, 52 patients received bevacizumab (BEV) while 56 did not (NoBEV). Median recurrence-free survival (RFS) was 17 months and median overall survival (OS) has not been reached at a median follow-up of 25 months after PM. Three and five-year OS rates were 66% and 53%, respectively. RFS and OS were similar, irrespective of the chemotherapy regimen or BEV use. Positive pulmonary margin, KRAS mutation status, and previous liver metastasectomy were negative independent prognostic factors for RFS, while pathologically confirmed thoracic lymph node involvement was the only negative independent prognostic for OS in multivariate analysis. Conclusions No significant RFS or OS difference was observed in respect to chemotherapy regimens with or without BEV in patients with pulmonary metastases of CRC following curative resection.

WOS: 000335651700087, PubMed ID: 24761926, Background: Hepatocellular cancer (HCC) is one of the important health problems in Turkey, being very common and highly lethal. The aim of this study was to determine clinical, demographic features and risk factors. Materials and Methods: Nine hundred and sixth-three patients with HCC from 13 cities in Turkey were included in this study. Results: Only 205 (21%) of the 963 patients were women, with a male: female predominance of 4.8:1 and a median age of 61 years. The etiologic risk factors for HCC were hepatitis B in 555 patients (57.6%), 453 (81%) in men, and 102 (19%) in women, again with male predominance, hepatitis C in 159 (16.5%), (14.9% and 22.4%, with a higher incidence in women), and chronic alcohol abuse (more than ten years) in 137 (14.2%) (16.8% and 4.9%, higher in males). The Child-Pugh score paralleled with advanced disease stage amd also a high level of AFP. Conclusions: According to our findings the viral etiology (hepatitis B and hepatitis C infections) in the Turkish population was the most important factor in HCC development, with alcohol abuse as the third risk factor. The Child-Pugh classification and AFP levels were determined to be important prognostic factors in HCC patients.

In this paper, an improved version of particle swarm optimization based optimum design algorithm (IPSO) is presented for the steel grillage systems. The optimum design problem is formulated considering the provisions of American Institute of Steel Construction concerning Load and Resistance Factor Design. The optimum design algorithm selects the appropriate W-sections for the beams of the grillage system such that the design constraints are satisfied and the grillage weight is the minimum. When an improved version of the technique is extended to be implemented, the related results and convergence performance prove to be better than the simple particle swarm optimization algorithm and some other metaheuristic optimization techniques. The efficiency of different inertia weight parameters of the proposed algorithm is also numerically investigated considering a number of numerical grillage system examples.

Purpose: It is well known that trace elements and heavy metals play a significant role in human health and disease. These elements play an important role in different metabolic pathways of cells and tissues. Trace element deficiency or excess is implicated in the development or progression of some cancers. We present a study which investigates serum/ plasma levels of trace-heavy elements in metastatic colon cancer patients and healthy subjects. Methods: Blood samples were collected from 29 healthy subjects and 40 patients with metastatic colon cancer in Oncology Department of Medical School of Yuzuncu Yil University. In both groups, the serum levels of copper (Cu), magnesium (Mg), lead (Pb), chromium (Cr), zinc (Zn) selenium (Se), manganese (Mn), and cadmium (Cd) were determined. Results: Higher levels of Cu, Mg, Pb, Cr, Zn, Mn and Cd were seen in patients with metastatic colon cancer compared to healthy subjects and these findings were statistically significant (p < 0.05). Se levels were noted to be lower in patients with colon cancer in comparison to healthy subjects and this finding was also statistically significant (p < 0.05). Conclusions: According to our findings there was significant diffence in trace elements and heavy metals levels between healthy subjects and metastatic colon cancer patients. Therefore heavy metal and trace elements may have prognostic significance in complex disorders including colon cancer. However, further comprehensive studies are needed in order to advance our understanding of the relationship between heavy metal and trace elements and their role in cancers.

Dogada yer alan boceklerin problem cozmede izledigi basarili yol (besin kaynagina giden en kestirme yolu bulabilmeleri gibi) arastirmacilar tarafindan incelenmekte, suru icindeki davranislari taklit edilmeye calisilarak optimizasyon teknikleri olusturulmaktadir. Av arama, parcacik kume, karinca kolonisi, yapay ari kolonisi, yarasa algoritmasi, ates bocegi algoritmasi ve kandil bocegi algoritmasi bu tekniklerden bazilaridir. Bu calismada, bahsedilen yedi teknik ayri ayri incelenmis olup, bes adet en kucukleme ve bir adet buyuge yaklastirma olmak uzere toplam alti adet optimizasyon problemi bu yedi algoritma ile ayri ayri cozulmustur. Her bir problemin kendi icerisinde kisitlayicilari ve degiskenleri vardir. Her problem icin en az on bes bin iterasyon yapilmis, problemin tipine gore bu sayi yirmi bine kadar cikmistir. Optimizasyon teknikleri her problem icinde ayri ayri karsilastirilmistir. Ayrica bu alti problem kendi arasinda da kiyaslanmistir. Problemler icin optimizasyon tekniklerinin birbiri ile karsilastirilmis grafikleri cizilerek algoritmalarin yakinsamalar uzerinden performans kiyaslamalari da yapilmistir.

Background Diagnostic performance of Diffusion-Weighted magnetic resonance Imaging (DWI) and Multi-Detector Computed Tomography (MDCT) for TNM (Tumor, Lymph node, Metastasis) staging of gastric cancer was compared. Patients and methods We used axial T2-weighted images and DWI (b-0,400 and b-800 s/mm2) protocol on 51 pre-operative patients who had been diagnosed with gastric cancer. We also conducted MDCT examinations on them. We looked for a signal increase in the series of DWI images. The depth of tumor invasion in the stomach wall (tumor (T) staging), the involvement of lymph nodes (nodal (N) staging), and the presence or absence of metastases (metastatic staging) in DWI and CT images according to the TNM staging system were evaluated. In each diagnosis of the tumors, sensitivity, specificity, positive and negative accuracy rates of DWI and MDCT examinations were found through a comparison with the results of the surgical pathology, which is the gold standard method. In addition to the compatibilities of each examination with surgical pathology, kappa statistics were used. Results Sensitivity and specificity of DWI and MDCT in lymph node staging were as follows: N1: DWI: 75.0%, 84.6%; MDCT: 66.7%, 82%;N2: DWI: 79.3%, 77.3%; MDCT: 69.0%, 68.2%; N3: DWI: 60.0%, 97.6%; MDCT: 50.0%, 90.2%. The diagnostic tool DWI seemed more compatible with the gold standard method (surgical pathology), especially in the staging of lymph node, when compared to MDCT. On the other hand, in T staging, the results of DWI and MDCT were better than the gold standard when the T stage increased. However, DWI did not demonstrate superiority to MDCT. The sensitivity and specificity of both imaging techniques for detecting distant metastasis were 100%. Conclusions The diagnostic accuracy of DWI for TNM staging in gastric cancer before surgery is at a comparable level with MDCT and adding DWI to routine protocol of evaluating lymph nodes metastasis might increase diagnostic accuracy.

Kavramsal Hidrolojik Modellerin Farkli Optimizasyon Algoritmalari Ile Kalibrasyonu Mevcut calismada kavramsal hidrolojik modellerin optimizasyon metotlari yardimiyla kalibrasyonu ele alinmistir. Sezgiye dayali yenilikci optimizasyon algoritmalari dogada var olan olaylarin matematiksel olarak taklit edildigi cozum yontemleridir. Bu tip yontemler, optimum cozumu arastirirken rastgele ve olasiksal parametreler kullanirlar. Bu yontemlerden av arama, yapay ari kolonisi ve ates bocegi algoritmalari literaturde yer alan GR4J, GR2M kavramsal hidrolojik modellerinin kalibrasyonu icin kullanilmis, farkli gozlem istasyonlarindan alinan veriler degerlendirilerek yontemlerin optimizasyon problemi uzerindeki etkinlikleri arastirilmistir. Calibration of Conceptual Hydrological Model by Different Optimization Algorithms In this study, calibration of conceptual hydrological models is carried out by means of optimization methods. Meta-Heuristic inonative optimization algorithms are the methods in which the natural events have been imitated mathematically. These type of methods use random and probabilistic parameters to investigate optimal solutions. Hunting search, artificial bee colony and firefly algorithms are used for calibration of GR4J, GR2M conceptual hydrological models and the efficiency of the methods on the optimization problems is investigated by evaluating the data from the different gauging stations.