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Purpose: To examine brain diffusion characteristics in pediatric patients with attention deficit hyperactivity disorder (ADHD) using diffusion tensor imaging (DTI) and an atlas-based anatomical analysis of the whole brain and to investigate whether these images have unique characteristics that can support functional diagnoses. Materials and Methods: Seventeen children with ADHD and ten control subjects (all age-matched) underwent MRI scans. The Institutional Ethics Board approved this study. Morphometric analysis was performed using MriStudio software. The diffusion images were normalized using a linear transformation, followed by large deformation diffeomorphic metric mapping (LDDMM). For 189 parcellated brain regions, the volume, fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were measured. Results: Children with ADHD were found to have increase in the body of lateral ventricle volumes compared to the control. Increased MD was found in the deep gray matter, amygdala, thalamus, substantia nigra, and also the cerebellum left and right side. Increased RD was found in the deep gray matter, caudate, thalamus, substantia nigra and hippocampus left and right side compared to the control. Significant elevated FA was found in the bilateral splenium of the corpus callosum in ADHD patients. Conclusion: Children with ADHD display abnormal diffusion characteristics and anatomical features compared to healthy controls. DTI can provide sensitive information on integrity of white matter (WM) and intra-WM structures in ADHD.

Bumblebees are crucial pollinators, providing essential ecosystem services and global food production. The success of pollination services relies on the interaction between sensory organs and the environment. The antenna functions as a versatile multi-sensory organ, pivotal in mediating chemosensory/olfactory information, and governs adaptive responses to environmental changes. Despite an increasing number of RNA-sequencing studies on insect antenna, comprehensive antennal transcriptome studies at the different life stages were not elucidated systematically. Here, we quantified the expression profile and dynamics of coding/microRNA genes of larval head and antennal tissues from early- and late-stage pupa to the adult of Bombus terrestris as suitable model organism among pollinators. We further performed Pearson correlation analyses on the gene expression profiles of the antennal transcriptome from larval head tissue to adult stages, exploring both positive and negative expression trends. The positively correlated coding genes were primarily enriched in sensory perception of chemical stimuli, ion transport, transmembrane transport processes and olfactory receptor activity. Negatively correlated genes were mainly enriched in organic substance biosynthesis and regulatory mechanisms underlying larval body patterning and the formation of juvenile antennal structures. As post-transcriptional regulators, miR-1000-5p, miR-13b-3p, miR-263-5p and miR-252-5p showed positive correlations, whereas miR-315-5p, miR-92b-3p, miR-137-3p, miR-11-3p and miR-10-3p exhibited negative correlations in antennal tissue. Notably, based on the inverse expression relationship, positively and negatively correlated microRNA (miRNA)-mRNA target pairs revealed that differentially expressed miRNAs predictively targeted genes involved in antennal development, shaping antennal structures and regulating antenna-specific functions. Our data serve as a foundation for understanding stage-specific antennal transcriptomes and large-scale comparative analysis of transcriptomes in different insects., (© 2024 The Authors. Insect Molecular Biology published by John Wiley & Sons Ltd on behalf of Royal Entomological Society.)

Background: Peritoneal fibrosis (PF) is a major, persistent complication of prolonged peritoneal dialysis that eventually leads to peritoneal ultrafiltration failure and termination of peritoneal dialysis. Prolonged exposure to high glucose concentrations, degradation products, uremic toxins, and episodes of peritonitis can cause some changes in the peritoneal membrane, resulting in intraperitoneal inflammation and PF, leading to failure of ultrafiltration and dialysis. CA-125 can be used as a biomarker of peritoneal mesothelial cell count in the peritoneal dialysate and for monitoring cell count in PD patients. Hypoxia-inducible factor 1-alpha (HIF-1α) has been reported to cause PF, but has not been reported to be associated with changes in peritoneal structure. We hypothesized that peritoneal adequacy can be followed using HIF-1α and CA-125 values. In the present study, therefore, we investigated the relationship between HIF-1α and CA-125 levels and parietal membrane permeability changes in PD patients., Methods: Forty-five patients were included in the study. Peritoneal permeability was constant in 20 of these, while peritoneal permeability increased in 11 and decreased in 14. The HIF-1α value from the blood samples of the patients and the CA-125 measurement from the peritoneal fluids were measured. The relationship between peritoneal variability and CA-125 and HIF levels after follow-up was investigated., Results: We compared serum HIF-1α and peritoneal fluid CA-125 levels in the three groups receiving peritoneal dialysis treatment. HIF-1α levels increased with peritoneal permeability changes, while CA-125 levels decreased. In patients with high to low permeability changes, HIF-1α levels were higher compared to those with stable or low to high changes, which was statistically significant. Conversely, CA-125 levels significantly decreased in patients whose peritoneal permeability changed from high to low, compared to the other two groups., Conclusion: Changes in peritoneal structure can be followed with biomarkers. It has been shown that CA-125 and HIF-1α levels can guide the changes in the peritoneal membrane. This can be useful in the monitoring of peritoneal dialysis., (© 2024 International Society for Apheresis and Japanese Society for Apheresis.)

This study investigated the intricate interplay between Crimean-Congo hemorrhagic fever virus (CCHFV) infection and alterations in amino acid metabolism. Our primary aim is to elucidate the impact of Crimean-Congo hemorrhagic fever (CCHF) on specific amino acid concentrations and identify potential metabolic markers associated with viral infection. One hundred ninety individuals participated in this study, comprising 115 CCHF patients, 30 CCHF negative patients, and 45 healthy controls. Liquid chromatography-tandem mass spectrometry techniques were employed to quantify amino acid concentrations. The amino acid metabolic profiles in CCHF patients exhibit substantial distinctions from those in the control group. Patients highlight distinct metabolic reprogramming, notably characterized by arginine, histidine, taurine, glutamic acid, and glutamine metabolism shifts. These changes have been associated with the underlying molecular mechanisms of the disease. Exploring novel therapeutic and diagnostic strategies addressing specific amino acids may offer potential means to mitigate the severity of the disease., (© 2024 Wiley Periodicals LLC.)

Crimean-Congo Hemorrhagic Fever (CCHF) is a formidable global health concern, characterized by its rapid onset and high fatality rate. Distinguishing between patients at different stages remains challenging because of overlapping clinical features. This study aimed to evaluate the diagnostic efficacy of 14 hepatic fibrosis indices for distinguishing fatal cases and intensive care unit requirement (ICU) in CCHF. This study enrolled 194 patients with confirmed CCHF. Laboratory measurements were performed using auto analyzers. Indirect indicators of fibrosis were calculated for each patient based on previously described formulas. Time-dependent receiver operating characteristic (tdROC) curve analyses were employed to evaluate the predictive effects of hepatic fibrosis indices on both intensive care unit requirement and overall survival among patients. Regarding the tdROC analyses results, the highest area under the curve statistics were obtained for the baseline S-INDEX, KING, and GPRI scores (0.920, 0.913, and 0.909 respectively) in the estimation of ten-day survival, and the baseline KING, Goteborg University cirrhosis index (GUCI), and gamma-glutamyl transferase to platelet ratio index (GPRI) scores (0.783, 0.773, and 0.769 respectively) in the estimation of intensive care requirements for up to ten days. S-index and KING index emerged as early predictors of ten-day survival, while KING, GUCI, and GPRI indices demonstrated predictive capabilities for ICU admission on the first day. The identified indices have the potential to assist healthcare providers in making timely and informed decisions regarding patient management and treatment strategies. Further research and validation are warranted to solidify the role of these hepatic fibrosis indices in the clinical setting and enhance their broader applicability in the management of CCHF., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Introduction: Cardiovascular diseases constitute a significant cause of morbidity and mortality in individuals with autosomal dominant polycystic kidney disease (ADPKD). This study aimed to assess the long-term effects of tolvaptan on the kidneys and heart in rapidly progressing ADPKD., Methods: Among 354 patients diagnosed with ADPKD, 58 meeting the eligibility criteria for tolvaptan were included in the study. The study comprised two groups with similar demographic and clinical characteristics: 29 patients receiving tolvaptan treatment and 29 in the control group. Several included genetic analysis, magnetic resonance imaging, and echocardiography. Clinical and cardiac changes were recorded in both groups after a 3-year follow-up., Results: Tolvaptan treatment demonstrated a significant reduction in the rate of eGFR decline compared to the control group. Furthermore, it was observed that tolvaptan could prevent the development of cardiac arrhythmias by inhibiting an increase in QTc interval and heart rate., Conclusion: These findings suggest that, in addition to slowing kidney progression in ADPKD management, tolvaptan may potentially benefit in preventing cardiac complications., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

The aim of this study was to evaluate whether there were significant sex x time interactions in lipoprotein(a) (Lp(a)) and low-density lipoprotein cholesterol (LDL-C) response to treatment with the Proprotein Convertase Subtilisin/Kexin type 9 inhibitor (PCSK9i) Evolocumab, in a real-life clinical setting. For this purpose, we pooled data from 176 outpatients (Men: 93; Women: 83) clinically evaluated at baseline and every six months after starting Evolocumab. Individuals who had been on PCSK9i for less than 30 months and nonadherent patients were excluded from the analysis. Over time, absolute values of Lp(a) plasma concentrations significantly decreased in the entire cohort ( p -value < 0.001) and by sex ( p -value < 0.001 in men and p -value = 0.002 in and women). However, there were no sex-related significant differences. Absolute plasma concentrations of LDL-C significantly decreased over time in the entire cohort and by sex ( p -value < 0.001 always), with greater improvements in men compared to women. The sex x time interaction was statistically significant in LDL-C (all p -values < 0.05), while absolute changes in Lp(a) were not influenced by either sex or time (all p -value > 0.05). Our data partially reinforce the presence of differences in response to treatment to PCSK9i between men and women and are essential to gain a better understanding of the relationship between LDL-C and Lp(a) lowering in response to PCSK9i. Further research will clarify whether these sex-related significant differences translate into a meaningful difference in the long-term risk of ASCVD.

Background: Pediatric dentists should have information regarding whether mouth opening is limited. In clinical practice, these professionals should collect and record oral area measurements at the pediatric patient's first medical examination., Objectives: The study's aim developed the standard mouth opening measurement in children by using ordinary least squares regression to develop a clinical prediction model in children with Temporomandibular Joint Ankylosis before preoperative surgery., Methods: All participants completed their age, gender, and calculated height, weight, body mass index, and birth weight. Pediatric dentist performed all mouth-opening measurements. The oral-maxillofacial surgeon marked subnasal and pogonion points for the lower facial length of soft tissue. It was measured using the distance between the subnasal and pogonion with a digital vernier caliper. The widths of the three fingers (index, middle, and ring fingers) and four fingers (index, middle, ring, and little fingers) were also measured using a digital vernier caliper., Results: Maximum mouth opening showed that three-finger width (R2 = 0.566, F = 185.479) and four-finger width (R2 = 0.462, F = 122.209) had a significant influence on the Maximum mouth opening (MMO) (p < 0.001)., Conclusion: Pediatric dentists should collaborate with the treating maxillofacial surgeon to manage long-term treatment needs for individuals with Temporomandibular Joint Ankylosis., (© 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

European anchovy is a multiple-spawning and highly fecundate pelagic fish with high economic and ecological significance. Although fecundity is influenced by nutrition, temperature and weight of spawners, high reproductive capacity is related to molecular processes in the ovary. The ovary is an essential and complex reproductive organ composed of various somatic and germ cells, which interact to facilitate the development of the ovary and functional oocytes. Revealing the ovarian transcriptome profile of highly fecundate fishes provides insights into oocyte production in teleosts. Here we use a comprehensive tissue-specific RNA sequencing which yielded 102.3 billion clean bases to analyze the transcriptional profiles of the ovary compared with other organs (liver, kidney, ovary, testis, fin, cauda and gill) and juvenile tissues of European anchovy. We conducted a comparative transcriptome and positive selection analysis of seven teleost species with varying fecundity rates to identify genes potentially involved in oogenesis and oocyte development. Of the 2,272 single copies of orthologous genes found, up to 535 genes were under positive selection in European anchovy and these genes are associated with a wide spectrum of cellular and molecular functions, with enrichments such as RNA methylation and modification, ribosome biogenesis, DNA repair, cell cycle processing and peptide/amide biosynthesis. Of the 535 positively selected genes, 55 were upregulated, and 45 were downregulated in the ovary, most of which were related to RNA and DNA transferase, developmental transcription factors, protein kinases and replication factors. Overall, our analysis of the transcriptome level in the ovarian tissue of a teleost will provide further insights into molecular processes and deepen our genetic understanding of egg production in highly fecund fish., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Eldem et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Low-density lipoprotein cholesterol (LDL-C) is a well-established biomarker in the management of dyslipidemia. Therefore, we aimed to evaluate the concordance of LDL-C-estimating equations with direct enzymatic measurement in diabetic and prediabetic populations. The data of 31,031 subjects included in the study were divided into prediabetic, diabetic, and control groups according to HbA1c values. LDL-C was measured by direct homogenous enzymatic assay and calculated by Martin-Hopkins, Martin-Hopkins extended, Friedewald, and Sampson equations. The concordance statistics between the direct measurements and estimations obtained by the equations were evaluated. All equations evaluated in the study had lower concordance with direct enzymatic measurement in diabetic and prediabetic groups compared to the non-diabetic group. Even so, the Martin-Hopkins extended approach demonstrated the highest concordance statistic in diabetic and prediabetic patients. Further, Martin-Hopkins extended was found to have the highest correlation with direct measurement compared with other equations. Over the 190 mg/dL LDL-C concentrations, the equation with the highest concordance was again Martin-Hopkins extended. In most scenarios, the Martin-Hopkins extended performed best in prediabetic and diabetic groups. Additionally, direct assay methods can be used at low values of the non-HDL-C/TG ratio (<2.4), as the performance of the equations in LDL-C estimation decreases as non-HDL-C/TG decreases.

As the most readily adopted molecular screening test, low-pass WGS of maternal plasma cell-free DNA for aneuploidy detection generates a vast amount of genomic data. This large-scale method also allows for high-throughput virome screening. NIPT sequencing data, yielding 6.57 terabases of data from 187.8 billion reads, from 12,951 pregnant Turkish women was used to investigate the prevalence and abundance of viral DNA in plasma. Among the 22 virus sequences identified in 12% of participants were human papillomavirus, herpesvirus, betaherpesvirus and anellovirus. We observed a unique pattern of circulating viral DNA with a high prevalence of papillomaviruses. The prevalence of herpesviruses/anellovirus was similar among Turkish, European and Dutch populations. Hepatitis B prevalence was remarkably low in Dutch, European and Turkish populations, but higher in China. WGS data revealed that herpesvirus/anelloviruses are naturally found in European populations. This represents the first comprehensive research on the plasma virome of pregnant Turkish women., Competing Interests: Declaration of Competing Interest The authors declare no competing interests., (Copyright © 2022. Published by Elsevier Inc.)

Several studies have shown a high prevalence of dyslipidemia in children. Since childhood lipid concentrations continue into adulthood, recognition of lipid abnormalities in the early period is crucial to prevent the development of future coronary heart disease (CHD). Low density lipoprotein cholesterol (LDL-C) is one of the most used parameters in the initiation and follow-up of treatment in patients with dyslipidemia. It is a well known fact that LDL-C lowering therapy reduces the risk of future CHD. Therefore, accurate determination of the LDL-C levels is so important for the management of lipid abnormalities. This study aimed to validate different LDL-C estimating equations in the Turkish population, composed of children and adolescents. A total of 3,908 children below 18 years old at Sivas Cumhuriyet University Hospital (Sivas, Turkey) were included in this study. LDL-C was directly measured by direct homogeneous assays, i.e. , Roche, Beckman, Siemens and estimated by Friedewald's, Martin/Hopkins', extended Martin-Hopkins' and Sampson's formulas. The concordances between the estimations obtained by the formulas and the direct measurements were evaluated both overall and separately for the LDL-C, triglycerides (TG) and non-high-density lipoprotein cholesterol (non-HDL-C) sublevels. Linear regression analysis was performed and residual error plots were generated between each estimation and direct measurement method. Coefficient of determination ( R 2 ) and mean absolute deviations were also evaluated. The overall concordance of Friedewald, Sampson, Martin-Hopkins and the extended Martin-Hopkins formula were 64.6%, 69.9%, 69.4%, and 84.3% for the Roche direct assay, 69.8%, 71.6%, 73.6% and 80.4% for the Siemens direct assay, 66.5%, 68.8%, 68.9% and 82.1% for the Beckman direct assay, respectively. The extended Martin-Hopkins formula had the highest concordance coefficient in both overall and all sublevels of LDL-C, non-HDL-C, and TG. When estimating the LDL-C categories, the highest underestimation degrees were obtained with the Friedewald formula. Our analysis, conducted in a large pediatric population, showed that the extended Martin-Hopkins equation gives more reliable results in estimation of LDL-C compared to other equations., Competing Interests: The authors declare there are no competing interests., (©2023 Ertürk Zararsız et al.)

This is a single-center prospective, open-label, single arm interventional study to test the safety and efficacy of recently described ChipEXO™ for severe COVID-19 pneumonia. The ChipEXO™ is a natural product derived from convalescent human immune plasma of patients recovered from moderate COVID-19 infection. In September 2021, 13 patients with pending respiratory failure were treated with ChipEXO™ adapted for aerosolized formulation delivered via jet nebulizer. Patients received 1-5x10 10 nano vesicle/5 mL in distilled water twice daily for five days as an add-on to ongoing conventional COVID-19 treatment. The primary endpoint was patient safety and survival over a 28-day follow-up. The secondary endpoint was longitudinal assessment of clinical parameters following ChipEXO™ to evaluate treatment response and gain insights into the pharmacodynamics. ChipEXO™ was tolerated well without any allergic reaction or acute toxicity. The survival rate was 84.6% and 11 out of 13 recovered without any sequel to lungs or other organs. ChipEXO™ treatment was effective immediately as shown in arterial blood gas analyses before and two hours after exosome inhalation. During the 5 days of treatment, there was a sustainable and gradual improvement on oxygenation parameters: i.e. respiratory rate (RR) [20.8% (P < 0.05)], oxygen saturation (SpO 2 ) [6,7% (P < 0.05)] and partial pressure of oxygen to the fraction of inspired oxygen (PaO 2 /FiO 2 ) [127.9% (P < 0.05)] that correlated with steep decrease in the disease activity scores and inflammatory markers, i.e. the sequential organ failure assessment (SOFA) score (75%, p < 0.05), C-reactive protein (46% p < 0.05), ferritin (58% p = 0.53), D-dimer (28% p=0.46). In conclusion, aerosolized ChipEXO™ showed promising safety and efficacy for life-threatening COVID-19 pneumonia. Further studies on larger patient populations are required to confirm our findings and understand the pathophysiology of improvement toward a new therapeutic agent for the treatment of severe COVID-19 pneumonia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Gül, Gonen, Jones, Taşlı, Zararsız, Ünal, Özdarendeli, Şahin, Eken, Yılmaz, Karakukçu, Kırbaş, Gökdemir, Bozkurt, Özkul, Oktay, Uygut, Cinel and Çetin.)

Practices for the evaluation and treatment for people with aphasia (PWA) is dominated by an impairment-based view of aphasia. The number of aphasia evaluation tools adapted or developed to reflect PWA's perspective in Turkish is limited. Aphasia Impact Questionnaire-21 (AIQ-21), a tool developed based on the social model of disability, measures the individuals' quality of life from their own perspective. This study sought to adapt and establish the validity and reliability of AIQ-21 in Turkish (AIQ-21-TR) to meet this need. Data from 43 PWA and 61 healthy participants were analysed to determine AIQ-21-TR's construct, criterion, face validity and content validity. Reliability of the scale was assessed using Cronbach's Alpha reliability coefficients and the inter-item and item-total score correlations coefficients. Correlation between AIQ-21-TR and Stroke and Aphasia Quality of Life Scale-39 Turkish (SAQOL-39-TR) was also calculated. The validity analysis indicated that the Turkish adaptation of AIQ-21 has a high level of construct, content, face, and criterion validity. Similarly, the reliability analysis showed that the adapted questionnaire has an excellent reliability coefficient ( α  = 0.91). Our findings suggested that AIQ-21-TR may be used as a reliable and valid tool with PWA in clinical and research settings.

Background: Neonatal cholestasis is caused by a group of diseases that cause jaundice, which can be encountered in the neonatal period. Biliary atresia (BA) and idiopathic neonatal hepatitis (INH) are among neonatal cholestasis diseases., Aims: The aim of this study was to perform histopathological and ultra-structural examinations of liver biopsy tissue samples from BA and INH patients with liver biopsies taken during laparotomy to confirm the diagnosis of biliary atresia., Settings and Design: A total of patients undergoing Kasai surgery before the age of 60 days were included in an "early" group (n = 7), whereas patients undergoing surgery after the age of 60 days were included in a "late" group (n = 11). The control group (n = 11) included INH patients., Materials and Methods: For histopathological examinations, liver tissue samples obtained intra-operatively were subjected to routine histopathological procedures after being stained with caspase-3 and cytokeratin-7 antibodies. Ultra-structural evaluations were also performed. Statistical analysis used: For comparisons between the groups, a one-way analysis of variance (ANOVA) test and the Mann-Whitney U test were used for continuous variables., Results: Histopathological findings reflected the specific liver pathologic findings seen in biliary atresia. Although there was no significant difference between the BA groups, these parameters were not detected in the control group. The histopathological evaluations revealed no significant differences in the findings of liver parenchyma damage between the early, late, and control groups. Electron microscopic examinations showed that the patients in the late group had more severe signs of intra-cellular damage to the liver., Conclusions: Although the histopathological examination revealed no significant differences in liver damage between the three groups, in ultra-structural evaluation, intra-cellular damage was found to be less in groups with better prognosis. Electron microscopy evaluations of intra-cellular damage may be more useful in this respect., Competing Interests: None

Background: Low-density lipoprotein cholesterol (LDL-C) is an important biomarker for determining cardiovascular risk and regulating lipid lowering therapy. Therefore, the accurate estimation of LDL-C concentration is essential in cardiovascular disease diagnosis and prognosis. Sampson recently proposed a new formula for the estimation of LDL-C. However, little is known regarding the validation of this formula., Objectives: This study aimed to validate this new formula with other well-known formulas in Turkish population, composed of adults., Methods: A total of 88,943 participants above 18 years old at Sivas Cumhuriyet University Hospital (Sivas, Turkey) were included to this study. LDL-C was directly measured by homogeneous assays, i.e., Roche, Beckman and Siemens and estimated by Friedewald's, Martin-Hopkins', extended Martin-Hopkins' and Sampson's formulas. The concordances between the estimations obtained by the formulas and the direct measurements were evaluated both in general and separately for the LDL-C, TG and non-HDL-C sublevels. Linear regression analysis was applied and residual error plots were generated between each estimation and direct measurement method. Coefficient of determination (R2) and mean absolute deviations were also calculated., Results: The results showed that the extended Martin-Hopkins approach provided the most concordant results with the direct assays for LDL-C estimation. The results also showed that the highest concordances were obtained between the direct assays with the extended Martin-Hopkins formula calculated with the median statistics obtained from our own population. On the other hand, it was observed that the results of the methods may differ in different assays. The extended Martin-Hopkins approach, calculated from the median statistics of our population, gave the most concordant results in patients with "low LDL-C level (LDL-C levels < 70 mg/dL) or hypertriglyceridemia (TG levels ≥ 400 mg/dL)"., Conclusions: Although the results of the formulas in different assays may vary, the extended Martin-Hopkins approach was the best one with the highest overall concordances. The validity of the Martin Hopkins' and Sampson's formulas has to be further investigated in different populations., Competing Interests: The authors have declared that no competing interests exist.

Background and Objectives: This study aims to evaluate the capacity of wideband tympanometry (WBT) in predicting the prognosis of otitis media with effusion (OME)., Subjects and Methods: Sixty-one ears with effusion and 30 healthy ears of children were enrolled. The patients were followed up monthly using WBT. After the completion of measurements, the ears were separated into four groups according to the duration of recovery; Group 1: Good prognosis (≤1-month, n=18), Group 2: Worse prognosis (>1-month, n=29), Group 3: Surgical (no recovery, n=14), and Group 4: Control (healthy ears, n=30). Tympanometric peak pressure (TPP), resonance frequency (RF), and absorbance levels were compared within and between the groups., Results: The TPP and RF values of the study group were lower than those of the controls (p<0.001). The ears with OME had lower absorbance measures than the controls at all frequencies; the differences were significant at 250, 500, and 1,000 Hz (p<0.001). However, at 2,000 Hz, the absorbance levels of the ears with OME were similar with those of the control group only in the good prognosis group (p>0.05). The receiver-operating characteristic analysis revealed that absorbance measures over 0.237 and 0.311 at 1,000 Hz and 2,000 Hz, respectively, have sensitivities and specificities over 70% for prediction of good prognosis, and the calculated odd ratio for these measures were 6 (p<0.05)., Conclusions: WBT measurement is promising in predicting the recovery of OME in children.

Background: Several factors play a role in the pathogenesis of pruritus in uremic patients. The pathophysiology is complex and many factors have been identified in these patients. The aim of this study was to investigate the presence, severity, and possible causes of pruritus in patients with peritoneal dialysis (PD) ., Methods: Eighty patients, who received continuous ambulatory peritoneal dialysis (CAPD) treatment, were included in this study. Biochemical measurements, parathormone, C-reactive protein (CRP), and vitamin B12 levels of all the patients were recorded. Furthermore, substance P (SP) levels were measured by ELISA methods. Patients were examined by a dermatologist and pruritus degrees were queried using the visual analog score (VAS) with skin dryness., Results: In generalized linear model analysis, total urea clearance and SP independently predicted VAS scores. SP was significantly predictive in ROC analysis in identifying the VAS score in patients with peritoneal dialysis. The sensitivity and specificity of SP were 80% and 67% (cut-off > 364), respectively, with an area under the ROC curve of 0.757 (95% CI 0.650-0.865, p < 0.001). SP also was significantly predictive in ROC analysis in identifying xerosis in PD patients., Conclusion: Pruritus was proportional to the amount of substance P and total urea clearance was another reason affecting pruritus in peritoneal dialysis patients., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: TPSORTAKSIS is a psoriasis registry, which is used for follow-up of patients in Kayseri City Education and Research Hospital, Dermatology Clinic since 2016 in Turkey. PSORTAKSIS includes demographic data, follow-up clinical findings, laboratory output, and treatment information of patients. Here, drug survivals of biologic therapeutics (BT) according to three-year data of PSORTAKSIS will be presented., Methods: Drug survival of BT in PSORTAKSIS was analyzed from 2016 to March 2019., Results: 158 patients (111 of them BT-naive) with psoriasis under BT were enrolled in the current study. Drug survival analysis of patients with ongoing BT (158 treatment periods) revealed mean survival time as 15.49 months for ustekinumab, 15.37 months for adalimumab, 14.00 months for etanercept, 5 months for infliximab, and 4.59 months for secukinumab. The differences between drug survivals of BT were statistically significant (log-rank test, χ2 = 79.915, p < 0.0001).

Oropharyngeal dysphagia has features of geriatric syndromes and is strongly associated with sarcopenia. In this cross-sectional study, we aimed to evaluate the association between dysphagia and sarcopenia, in a practical way, accompanied by comprehensive geriatric assessment. Dysphagia and sarcopenia were defined by the EAT-10 and SARC-F questionnaires, respectively. Cognition and mood, was evaluated by the Mini-mental State Examination (MMSE) and Geriatric Depression Scale (GDS), respectively. Physical performance was assessed by the Timed up and Go Test (TUG) and muscle strength was determined by Hand Grip Strength (HGS). Functionality was stated by Katz and Lawton Indexes. Serum levels of hemoglobin, triglyceride, albumin, and total cholesterol were recorded. A total of 512 (151 male/361 female) patients age 60 and older were included in the study. Prevalences of dysphagia and sarcopenia were 23% and 40.6%, respectively. In multivariate analysis sarcopenia (OR:2.596, p = 0.008), depressive symptoms (OR:1.115, p < 0.001), and lower KATZ scores (OR:0.810, p = 0.036) were independently related with dysphagia. Dysphagic patients with sarcopenia had lower scores on the Katz and Lawton scales (p < 0.001, r pb  = 0.380 and p < 0.001, r pb  = 0.447 respectively) and TUG performances were worse (p = 0.009, r pb  = - 0.254). Serum hemoglobin and albumin levels were significantly low in dysphagic patients with sarcopenia (p < 0.001, r pb  = 0.345, p = 0.008, r pb  = 0.243). Dysphagia is independently associated with sarcopenia, depressive symptoms, and functionality. Dysphagia coexist with sarcopenia is associated with worse clinical consequences than without sarcopenia.

Purpose: Because of the increase in globalization, clinicians all over the world are confronted the questions about safety of Ramadan fasting. However, there is no clear information about whether there is an obstacle for fasting patients with chronic disease. Hence, in the present study, we aimed to investigate the effects of Ramadan fasting on kidney and the factors affecting this relationship in patients with chronic kidney disease., Methods: This study involving 117 patients [36 females, 81 males; mean age, 60 (46.0-70.0) years] with stage 2-3 chronic kidney and fasting. Patients were evaluated every 10 days for acute kidney injury (AKI) in Ramadan month. And, patients with acute kidney injury and patients without AKI were grouped., Results: When the patients were evaluated for AKI, we observed that in 27 patients had acute kidney injury. While patients without AKI fasted for more days (p < 0.001), urea levels and frequency of hypertension were higher in the group with AKI (p = 0.019; p = 0.025 respectively). We also performed univariate and multiple binary logistic regression analysis to identify the risk factors of AKI. Hypertension and number of fasting day were found to be predictive of AKI (p = 0.02; p < 0.001 respectively)., Conclusions: We found a significant relationship between hypertension, the number of fasting days and acute kidney injury. Patients with chronic kidney damage and hypertension should be evaluated more carefully, informed about the importance of hydration after fasting and should be followed frequently for AKI.

Background/aims: mbitasvir/paritaprevir/ritonavir (OMV/PTV/r) ± dasabuvir (DSV) ± ribavirin (RBV) combination has demonstrated excellent rates of sustained virologic response (SVR) and a very good safety profile in patients with the chronic hepatitis C virus (HCV) genotype 1 or 4 infections. We aimed to investigate the effectiveness and safety of OMV/PTV/r ± DSV ± RBV combination regimen in a real-world clinical practice., Materials and Methods: Data from HCV genotype 1 and 4 patients treated with OMV/PTV/r ± DSV ± RBV (n=862) in 34 centers across Turkey between April 1, 2017 and August 31, 2018 were recorded in a large national database. Demographic, clinical, and virologic data were analyzed., Results: The mean age of the patients was 55.63, and 430 patients (49.9%) were male. The majority had HCV genotype 1b infection (77.3%), and 66.2% were treatment-naïve. Non-cirrhosis was present at baseline in 789 patients (91.5%). SVR12 rate was 99.1% in all patients. Seven patients had virologic failure. No significant differences were observed in SVR12 according to HCV genotypes. HCV RNA was undetectable at treatment week 4 in 90.9%, at treatment week 8 in 98.5%, and at the end of treatment (EOT) in 98.9%. SVR12 ratio was significantly higher in the non-cirrhotic patients compared to that in the compensated cirrhotic patients. Rates of adverse events (AEs) in the patients was 59.7%., Conclusion: The present real-life data of Turkey for the OBV/PTV/r ± DSV ± RBV treatment of patients with HCV genotype 1b, 1a, or 4 infection from 862 patients demonstrated high efficacy and a safety profile.

Purpose: To find out which single measurement and/or linear regression model correlates well with splenic volume using the orthogonal measurements approach., Methods: The study relied on retrospective analysis of 205 contrast-enhanced abdominal CT examinations carried out in adult patients using a 320-detector CT system. CT volumetry was conducted by a semi-automated, model and threshold based segmentation algorithm that enables voxel-based volume calculation of abdominal organs. The orthogonal measurements were carried out in axial sections by measuring the maximum diameters of spleen projected in sagittal, coronal and transverse planes. In addition, we calculated the diagonal diameter of spleen, which is a derivative of orthogonal measurements. Statistical analysis included calculation of interobserver agreement on orthogonal measurements, followed by model building using linear regression analysis of the measurements., Results: The interobserver agreement between two radiologists was very strong for all orthogonal measurements (r ≥ 0.971). The highest model performance was detected with the diagonal diameter (r2 = 0.956), followed by the superoinferior diameter (r2 = 0.857). Agreement statistics revealed that the regression formula derived from the diagonal diameter outperformed that of superoinferior diameter., Conclusion: The diagonal diameter appears to be the best parameter which correlates with splenic volume, whereas the superoinferior diameter can be an alternative in daily CT reporting practice. The orthogonal measurements approach not only provides a high interobserver agreement, but also the diagonal diameter can be translated into ultrasound studies.

Objectives: To evaluate the accuracy of US in calculating renal volumes and renal resistive index (RRI) that was obtained using a new method in patients with autosomal dominant polycystic kidney disease (ADPKD)., Methods: In this prospective study, US and MRI were performed in 57 patients with ADPKD (31 female and 26 male; age range, 19-79 years) between August 2017 and May 2018. The volumes determined using US and MRI were compared. The ellipsoid formula was re-evaluated using different multipliers. RRI was obtained 1.5-2 cm distal to the outlet of main renal arteries. The relationship between mean RRI, renal function tests, and kidney volumes and difference between mean RRI of ADPKD patients with and without renal failure were investigated using a two-sided independent samples t test and Pearson correlation test. Interobserver agreements for volume assessments and RRI measurements were determined., Results: By changing the ellipsoid formula, a very good agreement was found (ICC 0.970 for the right kidney and ICC 0.973 for the left kidney). The mean RRI in the right renal artery was 0.61 ± 0.07 and in the left renal artery 0.63 ± 0.06. The mean RRI of ADPKD patients with renal failure was significantly higher than that of patients without renal failure (p = 0.005). There was a significant correlation between mean RRI and renal function tests., Conclusion: The accuracy of the US in calculating renal volumes increases by adapting the ellipsoid formula. RRI may be used for the management of ADPKD independently of volumes., Key Points: •The accuracy of ultrasonography for renal volume measurement increases by changing the classical ellipsoid formula. •Renal resistive index measured by color Doppler ultrasonography is helpful for the management of autosomal dominant polycystic kidney disease. •The role of Doppler US in autosomal dominant polycystic kidney disease should increase as a result of our findings.

Introduction: Mucociliary clearance (MC) is a critical defense mechanism for the protection of the entire respiratory system. Nasal colonization of some pathogens and chronical nasal infections are important risk factors for peritonitis. Any disturbance in the MC causes stasis of secretions and secondary infections., Objective: The aim of the study was to evaluate the patients with chronic kidney disease (CKD) receiving continuous ambulatory peritoneal dialysis (CAPD) in terms of nasal MC. More specifically, the goal is to investigate the possible correlation between the nasal MC and peritonitis., Methods: Forty CAPD patients and 39 healthy volunteers were involved in the study. The nasal MC was evaluated with the saccharin test, in which a 1mm diameter saccharin particle was carefully placed on the antero-medial surface of inferior nasal concha. The time taken by the subjects from the placement of particle to the perception of the sweet taste was taken as mucociliary clearance time (MCT). The groups were compared in terms of MCT. The patient group was evaluated in terms of a peritonitis history, and the correlations with MC were analyzed., Results: Patient group with CKD consisted of 16 females and 24 males with a mean age of 32.4 years; healthy individuals in the control group consisted of 17 women and 22 men with a mean age of 33.3 years. There was not a significant difference in terms of mean MC time in patients with CKD when compared with the individuals in the control group. The comparison between the mean MCT in the patients who had a history of peritonitis and patients without peritonitis was statistically significant (p<0.05)., Conclusions: Unique for being conducted with patients in continuous ambulatory peritoneal dialysis, the current study shows that although the MC of CKD patients and healthy individuals is similar, patients with low rates of MC appear to present an increased incidence of peritoneal infection. Considering the small sample investigated, an invitation to future confirmatory studies would be appropriate., (Copyright © 2019 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Flow cytometric analysis of the lymphocyte subsets has become one of the most commonly used techniques in the routine clinical laboratory. It is frequently used in monitoring lymphocyte recovery after hematopoietic stem cell transplantation (HSCT), as well as diagnosis and treatment of acquired immunodeficiency syndrome (AIDS). Reliable biological variation (BV) data is needed for safe clinical application of these tests. In this study, similar preanalytical and analytical protocols to the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) checklist were followed and a stringent statistical approach was applied to define BV of T-lymphocytes., Methods: During the 10 weeks study period, weekly blood samples were obtained from 30 healthy individuals (20 females, 10 males) and analyzed with Facs Canto (BD Biosciences, San Jose, CA, USA) analyzer using 4-colour BD Multitest CD3/CD8/CD45/CD4 reagents. Data were assessed in terms of normality, tendencies, outliers and variance homogeneity prior to applying coefficient of variance (CV)- analysis of variance (ANOVA) test. Sex-stratified within-individual (CV I ) and between-individual (CV G ) BV estimates of CD3+, CD3 + CD4+, CD3 + CD8+, and CD3 + CD4 + CD8+ T lymphocytes were calculated., Results: No difference was found between males and females. Except for the CD3 + CD4 + CD8+ subset, stable BV was found for CD3+, CD3 + CD4+, and CD3 + CD8+ subsets., Conclussion: Instead of using the conventional reference ranges of CD3+, CD3 + CD4+ and CD3 + CD8+ counts for monitoring HIV positive or post-HSCT patients, RCV should be used. Because individualityis characteristic of lymphocytes subsets RCVs should be used instead of RIs for patient monitoring., (Published by Elsevier B.V.)

Background/objectives: The aim of this study was to determine a cut-off value for the SNAQ according to both the MNA long and MNA short forms and to assess whether the SNAQ can predict malnutrition or risk of malnutrition in the elderly., Subjects/methods: Nutritional status was assessed both by the Mini Nutritional Assessment (MNA) long and short forms. All demographic characteristics, mental status, depressive mood, functional status, and frailty were determined. Receiver operating characteristic (ROC) curves were used to calculate the cut-off of the SNAQ according to both the MNA long and short forms for malnutrition or risk of malnutrition. Reliability and validation of the SNAQ was analysed., Results: We included 905 community-dwelling elderly, but those with middle-stage dementia (MMSE score <18, n = 30) were excluded. The mean age ± standard deviation (SD) was 71.4 ± 5.5 years (49.3% female and 50.7% male). The prevalence of well-nourished, risk of malnutrition or malnutrition were 55.2%, 44.8%, respectively according to the MNA-long form. The prevalence of elderly at risk of future weight loss (SNAQ score of ≤14) was 31.0% (n = 268; 66.0% female, 34.0% male). The area under the curve (AUC) for SNAQ was 0.725 (95% CI 0.690-0.760). The cut-off value of the SNAQ, according to both the MNA long and short forms, was 14 (sensitivity; 50%, 50% and specificity; 84%, 82%, respectively). The Cronbach's alpha reliability coefficient of SNAQ for internal consistency was 0.639., Conclusion: The SNAQ was reliable and valid as an appetite screening tool in community-dwelling Turkish elderly., (Copyright © 2019. Published by Elsevier B.V.)

Objective: Treatments for enthesitis-related arthritis (ERA) consist of a mono- or combination therapy with non-steroidal anti-inflammatory drugs, disease-modifying anti-rheumatic drugs (DMARDs), and biological agents, and they are primarily based on adult studies and studies on other forms of juvenile idiopathic arthritis, depending on whether there is axial or peripheral involvement. We use DMARDs frequently in our daily practice, even in patients with axial involvement. The main reason for this is that the health insurance system in Turkey does not allow the use of Tumor Negrosis Factor (TNF) blockers as the first line of treatment. The aim of this study is to evaluate the factors affecting the duration of DMARDs application in patients with ERA., Methods: Fifty-two patients with ERA were accepted in this retrospective cohort study. These patients did not have an inflammatory bowel disease, reactive arthritis or undifferentiated arthritis, psoriasis, and familial Mediterranean fever. Demographic characteristics, medical history, the initial and follow-up physical examination, initial Juvenile Spondyloarthritis Disease Activity Index (JSpADA), initial laboratory tests, radiographic tests, Juvenile Arthritis Damage Index-articulary (JADI-A) and extra-articulary (JADI-E) on the last admission, and data on medical treatments were recorded from the registered data. The univariate Cox proportional hazards regression analyses was used to determine factors affecting the non-response time of ERA patients to DMARDs before the biological treatment was started., Results: Twenty-seven patients (52%) achieved remission with DMARDs, while 25 (48%) patients did not. The age at diagnosis (HR=1.12; p=0.247); gender (HR=2.53; p=0.210); family history of ankylosing spondylitis (HR=1.17; p=0.730); inflammatory back pain (HR=0.57; p=0.175); the shoulder (HR=0.75 p=0.706), hip (HR=0.45; p=0.129), and small-joint involvement (HR=1.53; p=0.439); sacroiliitis with physical examination (HR=0.90; p=0.814) and magnetic resonance imaging (MRI) (HR=2.84; p=0.110); enthesitis (HR=0.83; p=0.670); presence of uveitis (HR=2.04; p=0.342); presence of HLA-B27 (HR=1.39; p=0.524); initial high acute phase reactants levels(HR=1.89; p=0.183); initial JSpADA score (HR=0.98; p=0.944); and last JADI-A (HR=1.41; p=0.060) score did not affect the duration of DMARDs treatment before switching to biological treatments., Conclusion: In our study, the absence of factors affecting the duration of DMARDs application in patients with ERA showed that DMARDs may still be applied as the first line of treatment.

Background and Objectives: Cyst pressure induces renin-angiotensin-aldosterone system activation and kidney hypoxia in autosomal dominant polycystic kidney disease (ADPKD). Lipopolysaccharide-induced Toll-like receptor activation causes metabolic disturbances that are triggered by increased succinate levels and hypoxia inducible factors, which results in inflammation via IL-1β activation. Since we aimed to investigate the role of both inflammation and hypoxia in the clinical course of ADPKD, via succinate levels from sera samples, HIF-1α gene expression from whole blood and urine samples and IL-1βgene expression from whole blood were measured., Methods: One hundred ADPKD patients and 100 matched healthy controls were enrolled to this cross-sectional study. Twenty-four-hour ambulatory blood pressure monitoring was conducted in all participants. Blood, serum, and urine samples were taken after 12-h fasting for the measurement of biochemical parameters and succinate levels. Whole blood and urine samples were used for HIF-1α and IL-1β geneexpression by using quantitative real-time PCR., Results: There were significant differences in whole blood HIF-1α, IL-1β geneexpression, and serumsuccinate levels between the ADPKD patients and the control subjects. Whole blood HIF-1αgene expression, IL-1β geneexpression, and serumsuccinate levels were also significantly different in ADPKD patients with hypertension in comparison with normotensive ones (p < 0.05). Serum succinate levels and blood IL-1β geneexpression were increased in ADPKD patients with high levels of HIF-1α geneexpression (p = 0.018 and p = 0.029, respectively)., Conclusions: Increased age,low eGFR, and HIF-1α and IL-1β geneexpressions were also independently associated with hypertension in ADPKD patients. Inflammation and hypoxia are both relevant factors that might be associated with hypertension in ADPKD., (© 2019 S. Karger AG, Basel.)

Age-associated deterioration of cellular physiology leads to pathological conditions. The ability to detect premature aging could provide a window for preventive therapies against age-related diseases. However, the techniques for determining cellular age are limited, as they rely on a limited set of histological markers and lack predictive power. Here, we implement GERAS (GEnetic Reference for Age of Single-cell), a machine learning based framework capable of assigning individual cells to chronological stages based on their transcriptomes. GERAS displays greater than 90% accuracy in classifying the chronological stage of zebrafish and human pancreatic cells. The framework demonstrates robustness against biological and technical noise, as evaluated by its performance on independent samplings of single-cells. Additionally, GERAS determines the impact of differences in calorie intake and BMI on the aging of zebrafish and human pancreatic cells, respectively. We further harness the classification ability of GERAS to identify molecular factors that are potentially associated with the aging of beta-cells. We show that one of these factors, junba, is necessary to maintain the proliferative state of juvenile beta-cells. Our results showcase the applicability of a machine learning framework to classify the chronological stage of heterogeneous cell populations, while enabling detection of candidate genes associated with aging.

Objective: As in adults, hypertension is also an important risk factor for cardiovascular disease in children. We aimed to evaluate the effect of sleep duration on blood pressure in normal weight Turkish children aged between 11-17 years., Methods: This cross-sectional study was conducted in the primary and secondary schools of the two central and ten outlying districts of Kayseri, Turkey. Subjects were 2860 children and adolescents (1385 boys, 1475 girls). Systolic and diastolic blood pressures were measured according to the recommendations of the Fourth Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. Sleep duration was classified as follows: ≤8 hours, 8.1-8.9 hours, 9.0-9.9 hours or ≥10 hours., Results: For short sleeper boys and girls (participants with a sleep duration ≤8 h) the prevalence of prehypertension and hypertension was 35.0% and 30.8%, respectively. In univariate binary logistic regression analyses (age-adjusted), each unit increment in sleep duration (hours) in boys and girls, decreased the prehypertension and hypertension risk by 0.89 [odds ratio (OR)] [confidance interval (CI); 0.82-0.98] and 0.88 (OR) (CI; 0.81-0.97), respectively (p<0.05). In multiple binary logistic regression analyses [age- and body mass index (BMI)-adjusted] the location of the school and sleep duration categories were shown to be the most important factors for prehypertension and hypertension in both genders, while household income was the most important factor, only in boys., Conclusions: A sleep duration ≤8 h is an independent risk factor for prehypertension and hypertension in Turkish children aged 11-17 years.

Objective: The aim of the current study was to provide wrist circumference (WrC) and body frame size (height/WrC) percentile values in Turkish children and adolescents aged 6-17 years., Methods: In this cross-sectional study, the data of "Determination of Anthropometric Measures of Turkish Children and Adolescents" (DAMTCA II) study in Kayseri/Turkey were used. A total of 4330 observations were recorded (1931 boys, 2399 girls). The WrC and frame size reference values were produced with generalized additive models for location, scale and shape., Results: The WrC percentiles (3rd-97th) were calculated. The frame size (height/WrC) was estimated as small, medium, and large (<15 th , 15-85 th , and ≥85 th percentiles, respectively). For both genders, WrC linearly increased with age (13.0-16.8 cm for boys and 12.5-15.5 cm for girls). In boys and girls, the mean ± standard deviation of WrC is 13.00±0.89 cm and 12.48±0.93 cm (6 years) and increases to 16.83±1.16 and 15.58±0.86 cm (17 years), respectively. The WrC values in all age groups were higher in boys compared with girls. The increment in frame size from 6 to 17 years were 1.25 cm in boys and 0.85 cm in girls., Conclusion: WrC is a simple, easy-to-detect anthropometric index which is not subject to measurement errors. Additionally, WrC can be used both to decide about frame size and to determine metabolic risks related to obesity. We consider that this easy-to-get anthropometric index can be used both in screening procedures and clinical assessment procedure for obesity-related metabolic consequences.

This study was carried out to measure the volume of the palatine tonsil in otorhinolaryngology outpatients with complaints of adenotonsillar hypertrophy and chronic tonsillitis who had undergone tonsillectomy. To date, no study has investigated palatine tonsil volume using different methods and compared with subjective tonsil size in the literature. For this purpose, we used three different methods to measure palatine tonsil volume. The correlation of each parameter with tonsil size was assessed. After tonsillectomy, palatine tonsil volume was measured by Archimedes, Cavalieri and Ellipsoid methods. Mean right-left palatine tonsil volumes were calculated as 2.63 ± 1.34 cm 3 and 2.72 ± 1.51 cm 3 by the Archimedes method, 3.51 ± 1.48 cm 3 and 3.37 ± 1.36 cm 3 by the Cavalieri method, and 2.22 ± 1.22 cm 3 and 2.29 ± 1.42 cm 3 by the Ellipsoid method, respectively. Excellent agreement was found among the three methods of measuring volumetric techniques according to Bland-Altman plots. In addition, tonsil grade was correlated significantly with tonsil volume.

RNA sequencing (RNA-Seq) is a powerful technique for the gene-expression profiling of organisms that uses the capabilities of next-generation sequencing technologies. Developing gene-expression-based classification algorithms is an emerging powerful method for diagnosis, disease classification and monitoring at molecular level, as well as providing potential markers of diseases. Most of the statistical methods proposed for the classification of gene-expression data are either based on a continuous scale (eg. microarray data) or require a normal distribution assumption. Hence, these methods cannot be directly applied to RNA-Seq data since they violate both data structure and distributional assumptions. However, it is possible to apply these algorithms with appropriate modifications to RNA-Seq data. One way is to develop count-based classifiers, such as Poisson linear discriminant analysis and negative binomial linear discriminant analysis. Another way is to bring the data closer to microarrays and apply microarray-based classifiers. In this study, we compared several classifiers including PLDA with and without power transformation, NBLDA, single SVM, bagging SVM (bagSVM), classification and regression trees (CART), and random forests (RF). We also examined the effect of several parameters such as overdispersion, sample size, number of genes, number of classes, differential-expression rate, and the transformation method on model performances. A comprehensive simulation study is conducted and the results are compared with the results of two miRNA and two mRNA experimental datasets. The results revealed that increasing the sample size, differential-expression rate and decreasing the dispersion parameter and number of groups lead to an increase in classification accuracy. Similar with differential-expression studies, the classification of RNA-Seq data requires careful attention when handling data overdispersion. We conclude that, as a count-based classifier, the power transformed PLDA and, as a microarray-based classifier, vst or rlog transformed RF and SVM classifiers may be a good choice for classification. An R/BIOCONDUCTOR package, MLSeq, is freely available at https://www.bioconductor.org/packages/release/bioc/html/MLSeq.html.

Purpose: To evaluate the safety and efficacy of accelerated corneal crosslinking (CXL) in patients with progressive keratoconus aged 18 years or less., Methods: A total of 28 eyes from 19 patients with progressive keratoconus aged 18 years or less were enrolled. We divided participants into 2 groups according to corneal thickness (CT). Group 1 included 13 eyes of 8 patients with CT ≥450 µm; group 2 included 15 eyes of 11 patients with CT <450 µm. Each participant underwent accelerated CXL using 10-minute ultraviolet A irradiance at 9 mW/cm2 for a total energy dose of 5.4 J/cm2. The efficacy and safety of the procedure were assessed postoperatively at 1, 3, 6, and 12 months with Pentacam and visual acuity., Results: In uncorrected visual acuity, group 1 showed a statistically significant +0.12 logMAR improvement at 3 months postoperatively (p = 0.003), and in group 2, there was a statistically significant +0.3 logMAR improvement at 1 month postoperatively (p = 0.005). In best-corrected visual acuity, there was a +0.15 logMAR (p<0.001) and +0.22 logMAR (p = 0.005) improvement in group 1 and group 2, respectively, at 12 months postoperatively. All mean keratometric values including K1 and K2 dropped by at least 1 D or remained stable (< ± 1 D) in both groups after accelerated CXL treatment., Conclusions: The findings showed that accelerated CXL treatment seems to be effective in slowing or halting the progression of keratoconus and that no permanent apparent complications are noted 6 months after accelerated CXL.

Introduction: The use of αβ+ T-cell-depleted grafts is a novel approach to prevent graft failure, graft-versus-host disease (GVHD), and non-relapse mortality (NRM) in patients undergoing haploidentical hematopoietic stem cell transplantation., Patient and Method: Thirty-four patients with acute leukemia and lacking a match donor were treated with αβ T-cell-depleted allografts from haploidentical family donors. A total of 24 patients had acute myeloid leukemia (AML) and 10 had acute lymphoblastic leukemia. 84.4% of patients were in the high-risk group, and 55.9% were not in remission. The preparative regimen included thiotepa, melphalan, fludarabine, and anti-thymocyte globulin-Fresenius. Grafts were peripheral blood stem cells engineered by TcR-alpha/beta depletion., Results: Neutrophil and platelet engraftment was achieved on days +12 (range, 10.5-15) and +11 (range, 10-12). All but three patients were engrafted with full donor chimerism. Grade III-IV acute GVHD occurred in two (5.9%) patients and chronic GVHD in two (6.1%). Disease-free survival and overall survival were 42 and 54% at 1 year, respectively. AML as disease type (HR: 4.87, 95% CI: 1.50-15.87) and mother as donor (HR: 1.05, 95% CI: 1.00-1.11) were found to be independent risk factors on patient survival. Mortality and NRM in the first 100 days were 5 of 34 (14.7%) and 4 of 34 (11.7%). Relapse was the main cause of death (56.3%). T-cell reconstitution appears to be faster than that reported in published data with CD3/CD19-depleted grafts., Conclusion: αβ T-cell-depleted haploidentical transplantation may be a good alternative for high-risk patients if there are no human leukocyte antigen matched donors.

Objective: To compare updated weight and height percentiles of 6-17-year-old children from all socio-economic levels in Kayseri with previous local references and other national/international data., Methods: The second study "Determination of Anthropometric Measurements of Turkish Children and Adolescents study (DAMTCA II)" was conducted in Kayseri, between October 2007 and April 2008. Weight and height measurements from 4321 (1926 boys, 2395 girls) school children aged between 6 to 17 years were included in this cross-sectional study. Using these data, weight and height percentile curves were produced with generalized additive models for location, scale and shape (GAMLSS) and compared with the most recent references., Results: Smoothed percentile curves including the 3 rd , 5 th , 10 th , 15 th , 25 th , 50 th , 75 th , 85 th , 90 th , 95 th , and 97 th percentiles were obtained for boys and girls. These results were compared with DAMTCA I study and with two national (İstanbul and Ankara) and international data from Asia and from Europe., Conclusion: This study provides updated weight and height references for Turkish school children aged between 6 and 17 years residing in Kayseri.

Purpose: To investigate thickness of the retinal nerve fiber layer (RNFL) and choroid thickness in patients with pseudoexfoliation syndrome (PEX) and pseudoexfoliation glaucoma (PXG) compared to healthy volunteers., Methods: This cross-sectional, prospective study included 43 patients with PXG, 45 patients with PEX syndrome, and 48 healthy volunteers. The RNFL and macular thickness were analyzed with standard OCT protocol while choroidal thickness was analyzed with EDI protocol in all subjects., Results: The RNFL thickness was higher in the PEX and control groups compared to the PXG group (p<0.001). The choroid thickness was significantly higher in the control group compared to the PXG and PEX groups (p<0.05). No significant difference was detected between the both groups., Conclusions: PEX might weaken choroid circulation by accumulating in choroid vessels. The thinner choroid in the PXG group suggests that ischemia affects the duration of PEX and has a role in the development of glaucoma.

Purpose: We aimed to evaluate the differences in the corneas of eyes with isolated iris coloboma., Methods: This study was designed as a prospective study. Among patients who applied to our hospital within the last 3-year period, those with isolated iris coloboma in one eye and a completely normal contralateral eye were included in the study. In addition to a complete ophthalmologic examination, all patients were scanned by Pentacam Scheimpflug camera in the dark, and a corneal endothelium cell count was taken using a Topcon Specular Microscope. Data entered using SPSS software were then evaluated by paired t-test; p < 0.05 value was considered statistically significant., Results: Nine patients, seven men and two women, with a mean age of 35.77 ± 22.50 (range 8-60) years, were included in the study. In comparison to normal eyes, the colobomatous eyes were statistically found to have lower keratometry values in diopters (43.82 ± 2.17, 44.46 ± 1.86; p = 0.040), a greater negative asphericity (Q value) (-0.38 ± 0.07, -0.22 ± 0.20; p = 0.042), increased corneal thickness (569.78 ± 25.42, 537.33 ± 27.36; p < 0.001), decreased anterior chamber depth (2.50 ± 0.32, 2.81 ± 0.50; p = 0.005), a shallower angle (30.51 ± 10.68, 35.29 ± 9.99; p = 0.057), higher best-fit sphere (BFS) values of the anterior and posterior corneal surfaces (7.88 ± 0.39, 7.67 ± 0.37; p = 0.001; 6.40 ± 0.26, 6.23 ± 0.19; p = 0.006), larger pupil diameter (3.48 ± 0.49, 2.80 ± 0.34; p = 0.001), smaller horizontal corneal diameter (HCD) (11.06 ± 0.42; 11.26 ± 0.45; p = 0.009), and higher value of endothelial cell density (ECD) (3161 ± 431; 2923 ± 590; p = 0.031)., Conclusion: We have determined that a number of factors such as keratometry values, particularly of the corneal endothelium, are different from those of normal eyes. These differences should be taken into account in the follow-up and treatment of eyes with iris coloboma.

Measuring of brain and its compartments' sizes from magnetic resonance (MR) images is an effective way to assess disease progression in neurodegenerative disorders, particularly Alzheimer's disease (AD). The objective of this study was to compare total intracranial volume (TIV) and lateral ventricle volume (LVV) in patients with Alzheimer's disease with those in elderly control subjects, and to compare an automated method (automatic lateral ventricle delineation [ALVIN]) and a manual method (ImageJ). MRI of the brain was performed on 20 patients with Alzheimer's disease and 18 control subjects. The TIV was calculated by a manual method and the LVV was calculated by using two methods: an automated and manual method. We found a significant increase in LVVs in Alzheimer's disease patients compared to control subjects, but no difference in TIV between the two groups. A perfect agreement, with 0.989 (0.973-0.996) intraclass correlation coefficient (ICC) and 0.978 (0.946-0.991) concordance correlation coefficient (CCC), was observed between the manual and automatic lateral ventricle measurements in Alzheimer patients. The results revealed that LVV measure has predictive performance in AD. We demonstrated that ALVIN and ImageJ are both effective in determining lateral ventricular volume, providing an objective tool for quantitative assessment of AD., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Objectives: To determine the role of hemogram parameters such as platelet count (PLT), mean platelet volume (MPV), and the MPV/PLT ratio in predicting the risk of postoperative vomiting (POV) in children after tooth extraction under deep sedation., Methods: A total of 100 American Society of Anesthesiology Classification I and II pediatric patients who underwent tooth extraction procedures under a standard anesthetic method were included in the study between 2012 and 2014. The study took place at the Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Erciyes University, Erciyes, Turkey Fifty patients without POV (group 1) and 50 patients with POV (group 2) were retrospectively selected randomly from the records of 885 consecutive patients. Age, gender, duration of the operation, and preoperative hemogram findings were recorded., Results: There was a statistically significant difference between the 2 groups in terms of MPV (p less than 0.001), PLT (p=0.006), and MPV/PLT (p less than 0.001) ratio. Mean platelet volume and MPV/PLT ratio were higher in group 2, whereas PLT was higher in group 1., Conclusion: The PLT count, MPV, and MPV/PLT ratio may be used to predict POV in children.

Purpose: To investigate the retina and macular thickness in patients with schizophrenia and to compare the results with those of healthy controls., Methods: Sixty-eight eyes of 34 patients with schizophrenia and 60 eyes of 30 randomly selected healthy volunteers were involved in the study. Measurements of peripapillary retinal nerve fiber layer (RNFL) thickness, macula thickness, and macula volume were taken in both eyes using spectral-domain optical coherence tomography (OCT). Statistical analysis was performed using Statistical Package for the Social Sciences version 20.0., Results: Average and nasal RNFL thicknesses were found to be significantly lower in the patient group than the control group (p = 0.030, p = 0.04, respectively). Macular thicknesses of nasal outer and inferior outer quadrants in the patient group were significantly lower than in the control group (p = 0.009, p = 0.027, respectively). Average macular thickness and macular thicknesses in the superior outer, superior inner, temporal outer, temporal inner, nasal inner, and inferior inner areas were lower in the patient group compared to the control group, but not significantly (p = 1.000, p = 1.000, p = 0.837, p = 1.000, p = 0.279, p = 1.000, p = 0.180, respectively)., Conclusions: We detected RNFL and macular thinning in patients with schizophrenia. Based on these findings and results of other studies evaluating retina using OCT and brain magnetic resonance imaging studies in patients with schizophrenia, a neurodegenerative process may be an underlying pathologic mechanism in this disease.

European anchovy has considerable economic and ecological importance due to its high reproduction capacity and growth rate. As one of the largest source of wild marine protein, an increasing muscle mass strength has a major contribution to this growth rate during transition from subadult to adult stage. In the present study, using Illumina sequencing technology (HiSeq2000) accompanied with appropriate bioinformatics softwares; we have sequenced, assembled and annotated the transcriptome of wild subadult and adult anchovy muscles. A total of 131,081,776 high-quality reads were assembled into 125,506 contigs with an average length of 709.35 bp and N50 length of 1159 bp. Functional annotations of assembled contigs have been summarized according to 3325 GO terms, 3370 PFAM domains and 378 predicted KEGG metabolic pathways. About 11% of all contigs had at least one type of SSR motif in their sequences. According to the sequence homology analysis by BlasTN it was concluded that the assembled contigs include 16 skeletal muscle-expressed miRNAs, 14 ncRNAs and most of sarcomeric/myofibrillar genes. We hope that the sequence information regarding the muscle transcriptome of anchovy can provide some insight into the understanding of genome-wide transcriptome profile of teleost muscle tissue and give useful information in fish muscle development., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Background: Host genetic factors can affect the progress of hepatitis-C virus (HCV) infection. Interleukin-28B (IL28B) single nucleotide polymorphisms may play an important role in the clearance of HCV spontaneously or with treatment., Aims: The aim of our study was to evaluate the rate of IL28B genotypes in patients with Chronic Hepatitis-C (CHC) and healthy control subjects and to examine the characteristics of patients in each IL28B subgroup., Study Design: Case-control study., Methods: IL28B polymorphisms were genotyped by Polymerase Chain Reaction and Restriction Fragment Length Polymorphism (PCR-RFLP) in all subjects., Results: The mean age was 52.3±10.9 years (33% female) in the CHC patients and 52.5±11.5 years (39.1% female) in the healthy controls. The percentage of patients with a high baseline viral load (≥400,000 IU/mL) was higher in the CT group (69.8%) compared to the C/C (44.4%) and T/T (50%) groups (p=0.021). There was no significant difference in liver fibrosis and liver necroinflammation distribution among the CC, CT and TT genotypes with mild, moderate and severe groups (p=0.058 and p=0.791, respectively). Mean age, gender ratio, body mass index, viral load at baseline, rate of HCV genotypes, baseline ALT levels were not significantly different among the three IL28B subgroups (p>0.05). A significant increase was observed in the frequencies of IL28B rs12979860 TT genotypes in the CHC patients (20.6%) compared to the healthy control group (8.7%) (p=0.033)., Conclusion: In the patients with chronic HCV-genotype 1b and 4 infections, the IL28B rs12979860 (C>T) gene polymorphism frequency of the TT genotype and T allele was higher than in healthy control subjects. This result indicates that the TT genotype may be more effective in the progression of HCV infection than other genotypes.

Purpose. To investigate the thickness of the retinal nerve fiber layer (RNFL) and choroid in patients who have migraines in comparison to healthy controls. Methods. This study included 76 eyes and patients in the migraine group, 36 with aura (MWA group) and 40 without (MWoA group), and 38 eyes as control subjects. The RNFL and macular thicknesses were analysed with standard OCT protocol while choroidal thickness was analysed with EDI protocol in all subjects. Choroidal thickness was measured at the fovea, 1500 µm nasal and 1500 µm temporal to the fovea in a horizontal section. Results. The mean RNFL thickness for nasal and nasal inferior sectors was significantly thinner (P ≤ 0.018) in the migraineurs' eyes than in those of the controls, as was the mean choroid thickness at the fovea and measured points (P < 0.0001). However, the mean macular thickness was not significantly different between the groups. Conclusions. This study suggests that migraine leads to a reduction in the peripapillary RNFL thickness and to thinning in choroidal structures. These findings can be explained by a chronic ischemic insult related to migraine pathogenic mechanisms and these findings are considered supportive of the relationship between glaucoma and migraine.

Purpose: To compare the anterior segment parameters during pregnancy and post-pregnancy., Materials and Methods: Fifty-four healthy pregnant women in their third trimester with ages ranging from 18 to 38 years were included in the study. All of the patients underwent comprehensive ophthalmologic examinations, including refraction, anterior segment, and fundus examinations, intraocular pressure, and axial length measurements. In addition, anterior chamber angle, anterior chamber depth, anterior chamber volume, corneal volume, central corneal thickness, and keratometry values were measured by Pentacam Scheimpflug camera. All measurements were measured again 3 months after delivery., Results: The mean intraocular pressure, anterior chamber angle, anterior chamber depth, anterior chamber volume, corneal volume, central corneal thickness, and keratometry measurements were significantly different during pregnancy and post-pregnancy (p<0.05 for all); however, the mean spherical refraction, cylindrical refraction, and axial length were not statistically significantly different during pregnancy and post-pregnancy (p>0.05 for all)., Conclusions: We found that there is an increase in the anterior chamber parameters, corneal volume, corneal thickness, and corneal curvature and a decrease in intraocular pressure in the third trimester., (Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.)