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The role of traction radiographs in the preoperative evaluation of intertrochanteric femur fractures remains controversial, with inconsistent evidence regarding their impact on fracture classification, stability assessment, and surgical decisionmaking. This nationwide simulation-based study aimed to investigate how orthopedic trauma surgeons use and interpret traction radiographs and to determine their influence on surgical planning across different levels of clinical experience. A nationwide, cross-sectional simulation-based study was conducted among actively practicing orthopedic and trauma surgeons between October 14 and November 15, 2025, using a structured questionnaire containing simulated cases. The questionnaire included demographic characteristics, clinical experience, perceptions of traction radiographs, and case-based assessments of 15 AO Foundation/Orthopaedic Trauma Association (AO/OTA)-classified intertrochanteric fractures (31-A1, 31-A2, 31-A3). A total of 133 surgeons participated, yielding 1,995 individual case evaluations. Changes in surgical decisions before and after traction radiographs were analyzed using McNemar tests, while independent predictors were identified using generalized estimating equations (GEE). Traction radiographs were requested in 59.5% of all assessments, with significantly higher request rates in unstable patterns (31-A2: 75%; 31-A3: 68.2%) compared with 31-A1 fractures (30%). Overall, traction imaging resulted in a 12.4% change in surgical planning, increasing to 21% among cases in which traction radiographs were obtained. Decision changes were most common in 31-A2.3 (14.9%) and 31-A3.3 (16.9%) patterns. The most frequent implant transition was from short to long proximal femoral nail (PFN) (40.8%), followed by conversion to arthroplasty (18.8%). GEE analysis demonstrated that both fracture type and requesting traction radiographs were independent predictors of surgical plan modification (odds ratio [OR]=1.55-2.40 for unstable fracture types; OR=1.60 for traction radiograph request; p<0.05 for all). Surgeon title, institutional setting, years of experience, and case volume were not associated with decision changes. Traction radiographs provide clearer visualization of fragment configuration and medial and lateral wall integrity, leading to improved recognition of fracture instability and a measurable shift toward more durable fixation strategies. Their impact on surgical planning is most pronounced in complex or borderline-unstable fracture patterns and remains consistent across experience levels. As a low-cost and readily accessible adjunct, traction radiography represents a valuable tool in the preoperative assessment of intertrochanteric fractures. Routine use is recommended, particularly when instability is suspected or when standard radiographs provide insufficient clarity. Traksiyon grafilerinin intertrokanterik femur kırıklarının preoperatif değerlendirilmesindeki yeri halen tartışmalıdır. Literatürde kırık sınıflandırması, stabilite değerlendirmesi ve cerrahi planlama üzerindeki etkisine ilişkin bulgular kesinleşmemiştir. Bu ulusal ölçekli çalışma, ortopedi ve travmatoloji uzmanlarının traksiyon grafisi kullanımına yönelik yaklaşımlarını ve bu görüntülemenin cerrahi karar verme sürecine etkisini, klinik deneyimden bağımsız olarak değerlendirmeyi amaçlamıştır. 14 Ekim–15 Kasım 2025 tarihleri arasında aktif olarak çalışan ortopedi ve travmatoloji hekimlerine çevrimiçi vaka temelli bir değerlendirme uygulanmıştır. Bu değerlendirme; demografik bilgiler, klinik deneyim, traksiyon grafisine yönelik algı ve 15 AO/OTA sınıflandırılmış intertrokanterik kırık vakasına (31-A1, A2, A3) ilişkin vaka temelli soruları içermiştir. Toplam 133 katılımcıdan 1995 gözlem elde edilmiştir. Cerrahi karar değişiklikleri McNemar testi ile analiz edilmiş, bağımsız belirleyiciler Genelleştirilmiş Tahmin Denklemleri (GEE) ile değerlendirilmiştir. Traksiyon grafisi istem oranı tüm değerlendirmelerin %59.5’ini oluşturmuş olup, bu oran instabil kırık tiplerinde anlamlı biçimde yükselmiştir (31-A2: %75; 31-A3: %68.2; 31-A1: %30). Traksiyon grafisi sonrası genel cerrahi plan değişikliği oranı %12.4, traksiyon grafisi istenen olgularda ise %21 olarak bulunmuştur. Karar değişikliği özellikle 31-A2.3 (%14.9) ve 31-A3.3 (%16.9) kırıklarında belirginleşmiştir. En sık implant geçişi kısa PFN’den uzun PFN’ye (%40.8), ardından artroplastiye geçiş (%18.8) şeklinde olmuştur. GEE analizinde kırık tipi ve traksiyon grafisi istemi cerrahi karar değişikliğinin bağımsız belirleyicileri olarak saptanmıştır (OR=1.55–2.40 ve OR=1.60; p<0.05). Katılımcının unvanı, kurum tipi, deneyim yılı ve vaka hacminin karar değişikliği üzerinde anlamlı etkisi bulunmamıştır. Traksiyon grafileri fragman konfigürasyonunun ve medial/lateral duvar bütünlüğünün daha net değerlendirilmesine olanak sağlayarak kırık instabilitesinin daha doğru tanınmasına ve daha dayanıklı implant tercihlerine yönelimde artışa neden olmaktadır. Bu etkinin özellikle kompleks veya sınırda instabil kırıklarda belirgin olduğu ve cerrah deneyiminden bağımsız olarak korunduğu gösterilmiştir. Traksiyon grafisinin düşük maliyetli, uygulanabilir ve klinik karar sürecine anlamlı katkı sağlayan bir yöntem olarak intertrokanterik kırıkların preoperatif değerlendirilmesinde rutin kullanımının, özellikle instabiliteden şüphelenilen durumlarda, faydalı olabileceği düşünülmektedir.
Understanding cellular metabolism often involves an accurate estimation of metabolic fluxes-the rates at which metabolites are converted in biochemical pathways. Flux Variability Analysis (FVA) is the gold standard for computing reaction flux intervals. However, its reliance on linear programming makes it computationally intensive, often requiring hours or days for large cohorts on complex genome-scale metabolic network models. To address this limitation, we propose mFLIP, a machine learning-based framework for predicting flux intervals across metabolic pathways. The models were trained using large-scale metabolomics datasets comprising over 22,000 samples obtained from Metabolomics Workbench and MetaboLights. Multiple machine learning and deep learning approaches, including Random Forest, XGBoost, CNN, GNN, VAE, and FT-Transformer, were evaluated. Model performance was independently validated across six independent cancer datasets (Breast, Colon, Pancreatic, Prostate, and two stages of Clear Cell Renal Carcinoma). The proposed approach significantly reduces computation time from minutes to under a second during inference. Among the evaluated models, Random Forest and XGBoost achieved the best overall performance, with the lowest regression errors and highest classification scores. Deep learning models, particularly CNN and FT-Transformer, also demonstrated competitive results. Overall, all proposed methods outperformed the state-of-the-art baseline in terms of both accuracy and computational efficiency. mFLIP provides a fast and accurate alternative to traditional FVA-based approaches for metabolic flux interval estimation. By leveraging supervised learning on FVA-derived data, it enables scalable analysis of large cohorts while maintaining high predictive performance, making it a practical tool for large-scale metabolic studies.
This paper presents a practical implementation of relative primary radiation thermometry (RPRT) together with MultiFixRadSoft, an open-source software package developed in accordance with the Mise-en-Pratique for the kelvin (MeP-K) for realization of the thermodynamic temperature scale and uncertainty evaluation under the new definition of the kelvin. The software enables realization of temperature scales using ITS-90 metal fixed points as well as metal-carbon and metal-carbide-carbon eutectic high-temperature fixed points (HTFPs) for both radiation thermometers and radiometers. It incorporates automated routines for melting plateau analysis, including determination of the point of inflection, liquidus point, and melting range, together with correction modules for size-of-source effect, detector nonlinearity, emissivity, and temperature drop. Validation is demonstrated through experimental realization using six fixed points (Cu, Fe-C, Co-C, Pd-C, Ru-C, and WC-C) and a linear radiation thermometer. The software also supports ITS-90 extrapolation procedures and flexible calibration schemes (n = 1 to n ≥ 3), with automated Sakuma-Hattori fitting and full uncertainty propagation compliant with MeP-K requirements. The results show excellent agreement with manual analyses and published data, confirming the correctness of the implemented algorithms. By integrating data processing, scale realization, and uncertainty analysis within a unified and transparent framework, MultiFixRadSoft provides a robust and accessible tool for traceable radiometric thermometry, supporting emerging NMIs and industrial laboratories while promoting the wider adoption of primary thermodynamic temperature realization methods.
Parkinson's Disease (PD) represents the second most prevalent neurodegenerative condition which leads to the progressive destruction of dopaminergic neurons in the substantia nigra through oxidative stress mechanisms. The research evaluated Gallic Acid (GA) as a natural polyphenol with proven antioxidant properties for its ability to protect cells from 1-methyl-4-phenylpyridinium (MPP⁺)-induced neurotoxicity in SH-SY5Y dopaminergic cell models. The research used SH-SY5Y cells which received 1 mM MPP⁺ treatment alongside different GA concentrations (25, 50 and 100 µM) for 24 and 48 h. The CCK-8 assay measured cell viability while flow cytometry evaluated apoptosis and SOD and MDA levels determined oxidative status through SOD and Catalase and NO measurements. The addition of MPP⁺ resulted in a 32.74% decrease in cell viability at 48 h while simultaneously decreasing SOD and Catalase and NO levels and increasing MDA levels. The addition of 25 µM GA protected cells from damage by increasing their viability to 86.53% at 48 h and decreasing apoptotic cell numbers. Our results revealed that co-treatment with 25-50 µM GA effectively mitigated oxidative damage by preventing the depletion of catalase and NO levels. Furthermore, GA successfully reduced lipid peroxidation; specifically, 25 µM GA decreased MDA levels from 21.18 to 9.64 nM/mg protein at 48 h, thereby restoring the cellular antioxidant defense system against MPP+-induced oxidative stress. In conclusion, the present study demonstrates that GA exerts a significant neuroprotective effect in an in vitro PD model by modulating the endogenous antioxidant network and alleviating lipid peroxidation. By effectively reversing the depletion of crucial enzymes and reducing apoptosis, GA shows potential therapeutic efficacy against oxidative stress-associated neurodegeneration. These findings suggest that GA is a promising phytochemical candidate warranting further in vivo evaluation to clarify its long-term bioavailability and translational value.
Biomarkers play a pivotal role in disease diagnosis and prognosis by offering molecular insights into biological states. The rapid growth of high-throughput omics technologies has enabled the generation of large-scale biomarker datasets, yet analyzing these complex, high-dimensional data remains a major challenge-particularly for researchers lacking advanced computational expertise. While numerous tools exist for omics data analysis, many fall short in providing an integrated, user-friendly environment tailored specifically for biomarker discovery and interpretation. To address this gap, we present BioMark, a web-based platform designed to streamline biomarker analysis across diverse omics types. BioMark integrates robust statistical methods with widely used machine learning algorithms to support key workflows including statistical analysis, dimensionality reduction, classification, and subsequent model explanation. The platform emphasizes accessibility, offering intuitive visualizations and automated reporting to facilitate interpretation and dissemination of results. Notably, BioMark also offers a feature-ranking strategy that consolidates outputs from multiple analytical methods, enhancing the robustness of biomarker identification. By lowering the barrier to advanced biomarker analytics, BioMark empowers a broader range of researchers to uncover clinically relevant molecular signatures and accelerate translational research. Biomark is available online at https://bioinf.itu.edu.tr/biomark .
Micro(nano)plastics (MNPs) are emerging environmental contaminants, yet pharmaceuticals and medical procedures represent a distinct, direct exposure pathway that bypasses primary physiological barriers. This access, via intravenous administration, implants, or injections, is hypothesized to alter toxicokinetic profiles compared to environmental ingestion, representing a unique but unquantified risk. This review synthesizes current knowledge on MNPs introduced via pharmaceutical and clinical routes through a systematic analysis of 27 core studies identified from Web of Science, PubMed, Scopus, and Google Scholar. Our analysis reveals a bifurcated research landscape: one domain focuses on the intentional engineering of particles for drug delivery systems, while the other investigates unintentional contamination from clinical applications. A critical finding is the disconnection between exposure confirmation and hazard characterization. While studies confirm significant iatrogenic exposure, ranging from thousands of particles in intravenous fluids to millions released from degrading sutures, regulatory-relevant toxicological data linking these exposures to adverse human health outcomes are largely lacking. Furthermore, we identify a lack of standardization in analytical processes; methods vary between direct characterization of engineered particles and inconsistent isolation protocols for detecting contaminants in clinical matrices. Consequently, current evidence establishes the presence of iatrogenic MNPs but remains insufficient for robust risk assessment, underscoring the need for standardized analytical methods and foundational toxicological research to bridge the gap between exposure detection and safety management in healthcare.
Obesity is common in rheumatoid arthritis (RA), but its prognostic value at first recorded advanced-therapy initiation is incompletely defined. We examined whether baseline body mass index (BMI) was associated with early DAS28-ESR remission and Health Assessment Questionnaire Disability Index (HAQ-DI)-based functional recovery after first recorded advanced therapy. Adults with clinician-diagnosed RA initiating first recorded advanced therapy between 2013 and 2020 were studied retrospectively. BMI was analyzed continuously and categorically. Outcomes were assessed at the eligible visit closest to 9 months within 6-12 months. Complete-case multivariable logistic regression was supplemented by robust Poisson and sensitivity analyses. Of 581 screened patients, 574 had baseline BMI data, including 235 (40.9%) with obesity. DAS28-ESR remission was evaluable in 258 patients and occurred in 125 (48.4%); remission was less frequent with obesity than with BMI < 25.0 or 25.0-29.9 kg/m² (38.7% vs. 55.8% and 54.7%). In the primary adjusted remission model (n = 208), BMI was not conventionally significant (OR 1.048 per 1 kg/m², 95% CI 0.999-1.100; P = 0.056). HAQ-DI response was evaluable in 228 patients; 226 entered the primary adjusted model. Higher BMI was associated with poor HAQ-DI response (OR 1.056, 95% CI 1.006-1.110; P = 0.029), attenuating after hypertension/diabetes adjustment. Higher BMI showed its most consistent adjusted association with less complete early HAQ-DI-based functional recovery, whereas the DAS28-ESR remission signal was weaker and model-sensitive. Findings are associative and prognostic rather than causal.
Psilocybin and MDMA produce rapid, enduring therapeutic effects in posttraumatic stress disorder (PTSD); however, the underlying cellular mechanisms remain incompletely understood. In this study, we investigated whether adult myelin plasticity contributes to the therapeutic actions of psilocybin and MDMA in a rat model of contextual fear conditioning. Adult male Wistar rats (N = 210) received repeated low doses of psilocybin (0.5 mg/kg, intraperitoneally [i.p.], for 4 days) or MDMA (0.1 mg/kg/day, i.p., for 4 days). Behavioral tests assessed anxiety-like behaviors and spatial memory. Following local and global manipulations of myelin integrity, we assessed the drugs' effects on myelination by quantifying myelin sheath thickness; oligodendrocyte-lineage cell densities; and transcriptomic, proteomic, and metabolomic profiles in the dentate gyrus. Both compounds reduced anxiety-like behaviors. These improvements coincided with oligodendroglial changes and multiomic signatures of myelin-related remodeling; however, mean g-ratio measures of myelin thickness did not differ significantly between intact fear-conditioned animals with or without psychedelic treatment. Myelin disruption abolished these anxiolytic effects, and integrative multiomics revealed convergent upregulation of myelin-related proteins following administration of psilocybin or MDMA. Psilocybin preferentially induced early oligodendroglial gene programs, while MDMA enhanced markers of mature myelin. Notably, 5-HT2A receptor blockade completely abolished the myelin and behavioral enhancements induced by both psilocybin and MDMA. Psilocybin and MDMA promote adult oligodendrocyte and myelin plasticity. Enhancing myelination may be a viable strategy to augment or sustain the therapeutic effects of psychedelic-assisted treatments for PTSD and related disorders.
To evaluate the applicability and clinical effectiveness of a modified clamp-rod internal fixation (M-CRIF) system compared with conventional locking plate osteosynthesis in the treatment of feline corpus ilium fractures. Prospective, controlled clinical study. Thirty-six client-owned cats with corpus ilium fractures. Cats were randomly assigned to two groups: Group I (M-CRIF, n = 18) and Group II (locking plate, n = 18). All fractures were stabilized with a lateral approach. Radiographic healing, sacral index (SI), and complications were assessed at postoperative days 21, 45, 60, and 120. Long-term outcomes were assessed using owner questionnaires addressing mobility and defecation. Fracture union was achieved in all cats. Healing scores increased over time in both groups (p < .05). At day 45, Group I showed higher healing scores than Group II (p = .002). Sacral index narrowing was lower in Group I (p = .005). Implant-related complications occurred in 22.2% (4/18) of cats in the plate group, including screw loosening and one revision surgery, whereas no screw loosening was observed in the M-CRIF group. Preoperative neurological deficits were present in 22.2% of cats, decreasing to 5.5% postoperatively. Owner questionnaires indicated satisfactory mobility, although some discrepancies with clinical and radiographic findings were observed. The M-CRIF system provided greater stability, fewer complications, and better preservation of the pelvic canal than locking plates. This study is the first clinical evaluation of the M-CRIF system in feline ilial fractures and demonstrates favorable outcomes, supporting its use as a reliable alternative to conventional plating.
Congested tournament schedules impose substantial physiological stress in team sports; however, the integrated endocrine and inflammatory responses to real competitive match load in female handball players remain insufficiently characterized. This study aimed to characterize the acute biochemical responses, including hormonal, inflammatory, muscle damage, and bone metabolism markers, elicited by competitive tournament load in female handball players and to provide practical insights for optimizing recovery strategies and load management during short-term competitive periods. In a pre-post study design, venous blood samples were collected from competitive female athletes (n = 8; age 20.83 ± 2.93 years) before the first match and after the fourth consecutive match of an official university qualification tournament. Biochemical analyses included cortisol, insulin, IL-6, creatine kinase (CK), IGF-1, irisin, lactate dehydrogenase (LDH), osteocalcin, and testosterone. Pre-to-post changes were assessed using paired t-tests and effect sizes. Tournament load induced substantial multisystem physiological perturbations. Significant increases were observed in cortisol (p < 0.001), insulin (p = 0.044), IL-6 (p < 0.001), CK (p < 0.001), and osteocalcin (p = 0.005), indicating activation of the hypothalamic-pituitary-adrenal axis, systemic inflammation, muscle membrane disruption, and enhanced bone turnover. Conversely, IGF-1 (p < 0.001) and testosterone (p = 0.004) significantly decreased, reflecting suppression of anabolic signaling and a shift toward a catabolic hormonal environment under cumulative match stress. LDH significantly decreased (p = 0.002), while irisin showed no significant change (p > 0.05). These findings demonstrate that congested tournament schedules provoke an integrated endocrine-inflammatory stress response in female handball players. Importantly, the observed anabolic-catabolic imbalance highlights the need for individualized recovery strategies, optimized load management, and adequate recovery periods to mitigate maladaptation and reduce injury risk during short-term competitive tournaments.
Alcohol-impaired driving is a well-established and preventable cause of road traffic deaths and injuries. This study examined national time trends in the relative burden of alcohol-related fatal-and-injury road traffic crashes in Türkiye between 2015 and 2024 and interpreted the findings within an ecological policy and enforcement context. We conducted a national ecological time-trend analysis using annual aggregate road traffic crash statistics from the Turkish Statistical Institute for 2015-2024. The outcome was the annual count of alcohol-related crashes resulting in death or injury. To estimate changes in the relative burden over time, the natural logarithm of the annual total number of fatal-and-injury crashes was included as an offset. Temporal trends were first assessed using Poisson regression; after overdispersion was identified, estimates were re-evaluated using negative binomial regression. Results are reported as incidence rate ratios (IRR) with 95% confidence intervals (CI). The proportion of alcohol-related fatal-and-injury crashes among all fatal-and-injury crashes declined from 2.13% in 2015 to 0.72% in 2024. In the Poisson model, calendar year was negatively associated with the relative burden (IRR 0.883; 95% CI 0.880-0.887; p < 0.001), although model fit indicated overdispersion. In the negative binomial model, the direction of the association remained negative but was not statistically significant (IRR 0.883; 95% CI 0.709-1.097; p = 0.260). Sensitivity analyses excluding 2020 alone and excluding both 2019 and 2020 yielded nearly identical estimates, indicating that the negative but non-significant trend was not materially driven by potentially atypical pandemic-period observations. Descriptive data showed a marked decline in the relative burden of alcohol-related fatal-and-injury road traffic crashes in Türkiye from 2015 to 2024. However, negative binomial regression did not confirm a statistically significant temporal trend, indicating that model-based evidence should be interpreted cautiously. Interpretation should consider the ecological nature of the data and the possibility of time-varying enforcement intensity, detection, and reporting practices.
Alzheimer's disease is characterized by progressive cognitive decline driven by oxidative stress, neuroinflammation, and synaptic dysfunction. This study investigated the neuroprotective effects of vitexin in a scopolamine (Sco)-induced rat model of cognitive impairment. Forty-two male Wistar rats were randomly assigned to six groups (n = 7 per group): saline, Sco (2 mg/kg/day, i.p.), Sco + vitexin (30 mg/kg/day, oral), Sco + donepezil (1.5 mg/kg/day, i.p.), vitexin alone, and donepezil alone. All treatments were administered for 14 consecutive days. Behavioral assessments using the morris water maze and elevated plus maze revealed that Sco significantly impaired spatial learning and memory while increasing anxiety-like behaviors. Vitexin treatment markedly improved these deficits, with efficacy comparable to donepezil. Biochemically, Sco elevated acetylcholinesterase activity, lipid peroxidation, and oxidative/nitrosative stress markers (TOS, OSI, MDA, Peroxynitrite, NO, and NOS) while decreasing total antioxidant status (TAS). Vitexin reversed these changes. Western blot and immunofluorescence analyses demonstrated that Sco reduced hippocampal BDNF, GDNF, PSD95, and synaptophysin levels and increased GFAP, IL-6, TNF-α, NF-κB p65, and COX-2 expression. Vitexin restored neurotrophic and synaptic proteins, suppressed astrocyte activation and inflammatory signaling, and activated the Nrf2/HO-1 pathway. These findings were further supported by qRT-PCR analysis of BDNF, GDNF, GPX4, and NF-κB. In conclusion, vitexin exerts significant neuroprotective and synaptoprotective effects against Sco-induced cognitive impairment by simultaneously restoring redox balance, suppressing neuroinflammation, and preserving synaptic integrity. These results position vitexin as a promising therapeutic candidate for neurodegenerative disorders, including Alzheimer's disease.
Cisplatin, a potent platinum-based chemotherapeutic, effectively treats various cancers. However, it is limited by cisplatin-induced peripheral neuropathy (CIPN), driven by oxidative stress and neuroinflammation.The present study investigates the neuroprotective potential of Taraxacum officinale L. leaf extract (TOE), rich in polyphenols such as luteolin and quercetin, known for their antioxidant and antiinflammatory properties.Molecular docking of 10 polyphenols against NF-κB1 revealed that luteolin and quercetin outperform synthetic inhibitors, forming strong interactions with key residues. These compounds exhibited favorable pharmacokinetics, including high gastrointestinal absorption and nontoxicity. The CIPN was induced in male Wistar albino mice (3 mg/kg cisplatin, i.p., weekly for 5 weeks), with TOE (500 mg/kg, intragastric, daily) or saline administered concurrently. A TOE-only group served as a control. Behavioral assessments (rotarod, hot plate, cold plate, tail flick) evaluated sensory and motor function, while biochemical assays measured antioxidant enzymes (CAT, GPx1, SOD2), oxidative stress markers (MDA, TOS, IMA), and proinflammatory cytokines (NF-κB, TNF-α, IL-6) in serum and sciatic nerve tissues.Cisplatin induced significant behavioral deficits, reduced antioxidant capacity, and elevated oxidative and inflammatory markers. The TOE significantly ameliorated these effects, restoring behavior, enhancing antioxidant status, and reducing inflammation, consistent with the in silico predictions of NF-κB1 inhibition.These findings highlight T. officinale as a promising, safe, complementary therapy for CIPN, warranting further clinical exploration.
Parental reports and experimental studies indicate that parents speak less to their children in the presence of background television. However, there is a lack of home observations examining the relations between infants' background TV exposure and maternal infant-directed speech. In the current study, 32 infants and their mothers were observed for 60 minutes in their homes at 8, 10, and 18 months of age. Results revealed that the number of words, the number of different words, and the number of questions in infant-directed speech were consistently lower in households with background TV. Furthermore, these aspects of maternal language input were negatively related to the duration of background TV, controlling for families' socioeconomic background. These findings suggest that television may have a negative impact on young children's language development via disrupted parent-child interactions in the presence of background TV in the home environment.
The aim of this study was to examine the short-term effects of early rehabilitation on physical and psychosocial functions in individuals undergoing breast cancer surgery. Sixty-three female patients with breast cancer who were scheduled for surgery were randomly divided into three groups using the closed envelope method. Participants in Group 1 (G1) received preoperative patient education, exercised under the supervision of a physiotherapist during postoperative hospitalization, received a patient information brochure, and were followed up for 3 months after surgery with telephone calls at 2-week intervals. Participants in Group 2 (G2) received preoperative patient information and a patient information brochure. Participants in Group 3 (G3) received only preoperative patient information. Upper extremity circumference measurements, tissue dielectric constant measurements, shoulder Function, quality of life, and fatigue level assessments were repeated preoperatively, at postoperative discharge, and 3 months after surgery. The limb volumes of all the groups increased over time (p < 0.05; except the volume of the unaffected limb in G2). The volume difference between the extremities increased over time only in G2 (p < 0.05). The subdermal fluid ratios of all the groups increased after surgery but decreased after 3 months. The modified Constant-Murley score, which reflects shoulder Function, decreased in all groups after surgery and was similar to the baseline value after 3 months, except G3, in which the score was significantly lower than the baseline value (p < 0.05). The results of this study revealed that the physical and psychosocial functions of individuals deteriorate after breast cancer surgery, but early physiotherapist follow-up is effective in maintaining these functions and preventing breast cancer-related lymphedema. NCT04979715 (27/07/2021).
This study aims to investigate the effects of a low-advanced glycation end products(AGEs) diet versus a standard AGE-containing weight-loss diet on metabolic and hormonal profiles of overweight phenotype-A polycystic ovary syndrome(PCOS) patients.A randomized controlled interventional study.A total of 44 Rotterdam phenotype-A PCOS patients aged 19-35 were enrolled between January 2022 and May 2023. They were randomly assigned to 12-weeks of an energy-restricted Standard-AGEs diet(S-AGEs) or an energy-restricted Low-AGEs diet(L-AGEs). At baseline and after 12-weeks of intervention, weight loss, oligo-amenorrhea, hormonal profiles, plasma lipid profiles, and inflammation markers were evaluated. During the intervention, 8 participants from the L-AGEs group and 6 from the S-AGEs group dropped out. Completers had similar baseline characteristics to dropouts. In the per-protocol analysis, similar weight loss was observed in the L-AGEs(n = 14) and S-AGEs(n = 16) groups compared to baseline weight [-8.4 [-10.3 to -5.8] vs. -5.2 [-8.8 to -4.6] kg, respectively, p = 0.183]. However, in the L-AGEs group, fasting glucose levels decreased significantly more compared to the S-AGEs group (-8.5 [-11.5 to -3.5] vs. -0.5 [-3.7 to 0.7] mmol/L, respectively, p = 0.027). Following the diet intervention in the L-AGEs group, the waist-to-hip circumference ratio, LDL-cholesterol, TNF-α, total testosterone (TT), free-androgen index (FAI), and anti-Müllerian hormone (AMH) levels significantly decreased compared to baseline levels, while sex hormone-binding globulin (SHBG) levels increased. In contrast, there was no statistically significant change in these parameters in the S-AGEs group.In addition to weight-loss, reducing dietary AGEs intake resulted in significantly greater improvements in metabolic and hormonal profiles among phenotype-A PCOS patients. Clinicaltrials.gov registration no. NCT05830487.
Biomass is a key element in biofuels which can be defined as a fuel produced through contemporary biological processes, and its increased use can support the EU's aims of reducing greenhouse gas emissions. Information on the nature and the quality of the biomass or biofuel is important in order to support the optimization of their combustion with respect to realizing higher efficiencies and lower emissions during energy production. Three reference materials were produced by a collaborative approach among national metrology institutes and designated institutes within the scope of the EMPIR project: BIOFMET. The project was aimed to establish advanced traceable measurement standards for the determination of the calorific value, impurities, and other parameters such as density, kinematic viscosity, moisture, and ash. This paper presents the sampling and processing methodology, homogeneity, stability, characterization campaign, the assignment of property values, and their associated uncertainties in compliance with ISO 17034 for biofuel reference materials: biodiesel, wood pellet powder, and wood pellet. Parameters of interest in biodiesel reference material-UME BIOFMET CRM 01 are gross calorific value (GCV), density, viscosity, and mass fractions of Ca, K, Mg, Na, P, and S elements. Parameters to be certified in wood pellet powder reference material-UME BIOFMET CRM 02 are GCV, moisture, ash, and mass fractions of Al, Cr, K, Mg, Mn, Ni, S, and Zn elements. Parameters to be certified in the wood pellet reference material-UME BIOFMET CRM 03 are GCV and moisture. The homogeneity and stability of the materials were assessed in accordance with ISO 33405. The materials were characterized by interlaboratory comparison studies among competent metrology institute and designated institute laboratories. Assigned values and uncertainties of the certified values were calculated in accordance with ISO 33405, and uncertainties include characterization, homogeneity, and stability components. The developed CRMs are intended to be used for the development and validation of measurement procedures for the determination and quality control/assurance purposes of the quality parameters for biofuels. It should be emphasized that the UME BIOFMET CRM 01-Biodiesel CRM is the first biodiesel reference material certified for calorific value. Among the developed wood CRMs, the pellet form, UME BIOFMET CRM 03, was found to be more stable than the powder one, UME BIOFMET CRM 02, for the moisture parameter. Sixfold lower relative uncertainty value for short-term stability at 45 °C and twofold lower relative uncertainty value for long-term stability at 22 °C were obtained for the moisture parameter of the CRM in pellet form compared to the CRM in powder form.
Hypoxia has been shown to cause disturbances in neurohormonal regulation in the brain and may play an important role in the pathophysiology of depression. Hence, this study aimed to evaluate the relationship between electroconvulsive therapy (ECT) and hypoxia-inducible factor-1 alpha (HIF-1α) activation and propose a perspective on the potential role of HIF-1α in the treatment of major depressive disorder (MDD). Twenty patients diagnosed with MDD who underwent ECT and 25 healthy controls who did not undergo any treatment were included in the study. Serum HIF-1α levels in peripheral blood samples taken from the patients both before ECT (pre-test) and after (post-test) were compared with those in the control group. The Hamilton Depression Rating Scale (HDRS), Clinical Global Impression-Severity (CGI-S) scale, and sociodemographic data form were administered to all the patients. The HIF-1α values in the patient group pre-test were significantly lower than in the control group (p = 0.008). The HIF-1α levels in the patient group post-test were significantly higher than pre-test (p < 0.001). There was no difference between the HIF-1α levels in the patient group post-test and the control group (p > 0.05). To our knowledge, this is the first research to investigate serum HIF-1α changes in MDD patients undergoing ECT. The study demonstrated that ECT treatment in MDD patients leads to an increase in HIF-1α levels and suggests that HIF-1α may contribute to the antidepressant mechanism of ECT.
There are increasing reports of failure of artemisinin-based combination therapy (ACT) in malaria patients returning from endemic areas. ACT has been used globally as first-line treatment for Plasmodium falciparum malaria. However, with the emergence of artemisinin-resistant strains of P.falciparum and their spread across Southeast Asia, there is a risk that these resistant strains could reach areas of high malaria incidence in Africa and elsewhere. In this case report, two cases of malaria imported from Africa, initially treated with six doses of artemether-lumefantrine (AL) were presented. Two middle-aged men returning from Gabon and Uganda developed symptoms of malaria in Türkiye and were hospitalized and diagnosed as P.falciparum malaria. Both patients were treated with AL. After being discharged from the hospital with marked improvement, they re-admitted to the hospital with high fever and chills and showed late signs of clinical failure. One patient was completely cleared of parasites with six doses of AL treatment and the other after non-ACT antimalarial (quinine and doxycycline) treatment and no recrudescence occurred. AL, an artemisinin-based combination, is a frequently preferred preparation for the treatment of malaria cases seen in Türkiye. It should be kept in mind that even if parasitemia is cleared in the peripheral blood smear after three days of appropriate AL treatment, treatment failure may be seen in patients and this treatment failure may also include cases of African P.falciparum malaria.