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Listeleniyor 1 - 20 / 2003

Tumor Necrosis Factor-Alpha and Interleukin 6 localization in the Umbilical Cord Tissue of Pregnant Women with Preeclampsia: Smokers and Non-smokers
(Univ Puerto Rico Medical Sciences Campus, 2024) Yediel-Aras, Suekran; Goktug, Berrin; Gezer, Arzu; Bakir, Buket; Karadag-Sari, Ebru
Objective: In this study, the localization of tumor necrosis factor alpha (TNF- alpha) and interleukin (IL)-6 in the umbilical cord tissue of pregnant women with preeclampsia who smoke and in those who do n'ot smoke was investigated using immunohistochemical methods. Methods: The sample groups consisted of a control group, cigarette smokers, preeclampsia, and cigarette smokers with preeclampsia. Histological and immunohistochemical methods were applied to the tissue samples. Results: It was determined that there were varying degrees of edematous change in the layers of arteries and veins in the preeclampsia and the cigarette smokers with preeclampsia groups, with a statistically significant level of difference in thickness compared to the other groups. In addition, different levels of TNF-alpha and IL-6 immunoreactivity were detected in the umbilical cord tissue across all the groups. In the preeclampsia group, TNF-alpha immunoreactivitywas found to increase in the arterial muscle layer. Moreover, IL-6 immunoreactivity was found to decrease in the arterial endothelium and muscle layers in the cigarette smokers, preeclampsia, and cigarette smokers with preeclampsia groups and increase in the venous endothelium and muscle layers. In addition, immunoreactivity increased in the amniotic epithelium in the cigarette smokers with preeclampsia group. Discussion: In conclusion, the differences in cytokine levels between the cigarette smokers, preeclampsia, and cigarette smokers with preeclampsia groups were thought to be caused by responses of the maternal immune system and histopathological changes in the umbilical cord tissue.
Trends and Outcomes of Laparoscopic Surgery in Low-Resource Settings: Lessons From Two African Healthcare Systems-A Narrative Review
(Wiley, 2024) Hamitoglu, Ali Emir; Fawaz, Violette; Elawad, Shaima Omer Mohamed; Assker, Mohamad Monif; Nader, Thea Maria; Wellington, Jack; Uwishema, Olivier
IntroductionLaparoscopic surgery (LS) has been a promising development in surgical practice globally ever since its introduction. LS has exhibited many an advantage, including bettering patient outcomes, lowering the risk of postoperative infection, and displaying economical affluence. However, its implementation in the African continent still faces various challenges. In this review, we investigated the status of laparoscopic surgery integration in Africa.ObjectivesIn this review, we aimed to investigate the challenges posed by the implementation of LS in low resource countries as well as critically evaluating initiatives and their impact within said domiciles. We also provide recommendations that may assist in LS prosperity in these settings by focusing efforts on improving training and financial incentives.MethodsA comprehensive literature review was conducted to garner up-to-date evidence concerning the fate of LS adoption in low- to middle-income countries. This comprised the analysis of different case studies from countries including Nigeria and Botswana, and investigated relevant recommendations and policies provided by other African countries.ResultsVarious challenges face the implementation of LS in countries with low resources comprising poor infrastructure, scarce training programs, and expert training personnel alongside financial boundaries. The adoption of LS in Africa has proved its benefits in improving patient outcomes and reducing hospital admissions. From a perspective of policy, it is crucial to sustain strong ties amongst institutions, stressing the importance of dynamic collaboration and locally tailored policies.ConclusionIt has been demonstrated that LS implementations in African nations lower infection rates and expedite recovery. A strong collaboration between governments, stakeholders, and healthcare providers is fundamental for successful integration of LS. Such extension in low-resource environments may be achieved by providing proper training programs, funding infrastructure and equipment, and fostering effective financial initiatives.
Rituximab in ankylosing spondylitis: a promising option when other treatments are not viable
(Clinical & Exper Rheumatology, 2025) Gokten, D. BuluT; Mercan, R.
[No abstract available]
Breath of relief: Transforming pediatric asthma care with telemedicine-guided exercises
(Wiley, 2025) Karaaslan, Betul Gemici; Ucgun, Hikmet; Kaya, Meltem; Cengiz, Gokce Nuran; Ozturk, Sueda; Barut, Ozge; Korkut, Zeynep
Background: Alternative non-pharmacological strategies such as breathing exercises can be used in combination with pharmacological treatments. Objective: The aim of this randomized, controlled, single-blind study was to investigate the effectiveness of breathing exercises in asthma patients on respiratory function, symptom control and quality of life. Methods: We enrolled pediatric asthma patients who were eligible and motivated for the study and randomly assigned them to either the exercise group (EG) or the control group (CG). The CG received a postural exercise program, while the EG received a breathing exercise program. At baseline and after 12 weeks, respiratory function (FEV1-FVC-FEV1/FVC-PEF), symptom control (using asthma control test, asthma control questionnaire, global initiative for asthma symptom control assessment), quality of life (using pediatric asthma quality of life questionnaire), breath-holding test (BHT) and sit-to-stand test (30sSTS) were assessed and compared. Results: One hundred twelve patients were randomized, and 99 (n = 51 EG, n = 48 CG) completed the 12-week study. Baseline data were also similar in both groups. After 12 weeks, FEV1, Peak expiratory flow (by spirometry and peak flow meter) and BHT were significantly better in EG than in CG (p = 0.01 and p = 0.007 and p = 0.005, respectively). Asthma Control Test and GINA symptom control tool values were also significantly better in both groups. Discussion:Our participants were children with mild to moderate asthma. We conclude that our results show that breathing exercises can be an effective intervention for children with partially controlled asthma with FEV1,PEF, and BHTs.
Amino Acid Metabolism and Immune Dysfunction in Urea Cycle Disorders: T and B Cell Perspectives
(Wiley, 2025) Karaaslan, Betul Gemici; Kiykim, Ayca; Burtecene, Nihan; Gokden, Meltem; Cansever, Mehmet Serif; Hopurcuoglu, Duhan; Cengiz, Gokce Nuran
Urea cycle disorders (UCDs) are a group of genetic metabolic conditions characterized by enzyme deficiencies responsible for detoxifying ammonia. Hyperammonemia, the accumulation of intermediate metabolites, and a deficiency of essential amino acids-due to a protein-restrictive diet and the use of ammonia scavengers-can increase the risk of infections, particularly during metabolic crises. While the underlying mechanisms of immune suppression are still being fully elucidated, hyperammonemia may impair the function of immune cells, particularly T cells and macrophages, inhibiting the proliferation of T cells and cytokine production. Arginine, which is essential for T-cell activation and function, may also be limited in these patients, and its depletion can increase their vulnerability to infections. Twenty-four UCD patients and 31 healthy donors were recruited for the study. Peripheral lymphocyte subset analysis, intracellular protein and cytokine staining, and proliferation assays were performed by flow cytometry. Amino acid levels were measured using the HPLC method. The UCD patients exhibited low lymphocyte-proliferation capacity in both proximal and distal defects in response to phytohaemagglutinin (PHA) and anti-CD2, anti-CD3, and anti-CD28 (CD-mix), which was lower than healthy controls. Proximal-UCD patients exhibited a significantly higher response for IFN-gamma compared to both distal-UCD patients and healthy controls. The different amino acids in the culture medium were changed significantly in the groups. This study highlights significant immune dysfunctions in UCD patients, particularly impaired T-cell proliferation and altered amino acid metabolism. Proximal UCD patients exhibited a higher IFN-gamma response, indicating a potential for hyperinflammation. Despite this, infection rates did not significantly differ between proximal UCD and distal UCD patients, although distal UCD patients had higher hospitalization rates. Amino acid analysis revealed distinct metabolic disruptions, emphasizing the complex interplay between metabolism and immune function. These findings suggest that UCDs cause profound immune alterations, necessitating further research to develop targeted therapeutic strategies.
The Importance of Body Mass Index on Prognostic Factors for Urinary Incontinence in Asymptomatic Nulliparous Women
(Wiley, 2025) Dizdarogullari, Gizem Elif; Cam, Cetin; Ayvaci, Habibe; Karateke, Ates
IntroductionMeasurements of levator hiatal area (LHA) by pelvic floor ultrasound examination were shown to be associated with symptoms and signs of prolapse and urinary incontinence. Body mass index (BMI) is a modifiable risk factor which has shown to be related with urinary incontinence. Our aim in this study was to observe and to understand the relation between BMI and weight with LH and other transperineal ultrasound parameters such as bladder neck mobility and bladder-urethra angles in asymptomatic nulliparous women.Materials and MethodsThis study was a cross-sectional study in a gynecology outpatient clinic of a tertiary center after receiving ethical approval. Nulliparous women presenting to the gynecology outpatient clinic without any uro-gynecological complaint were invited to participate.ResultsDuring study period, 167 women met the eligibility criteria. Our data showed that weight and BMI are correlated with hiatal dimensions, gamma angle and bladder neck descent even in asymptomatic nulliparous women.DiscussionThese findings may explain why weight loss is associated with improvements in stress incontinence symptoms and why we should encourage women in weight control which is the only modifiable factor in the etiology of incontinence.
Monkeypox Outbreak in the Democratic Republic of Congo: A Comprehensive Review of Clinical Outcomes, Public Health Implications, and Security Measures
(Wiley, 2024) Salomon, Izere; Hamitoglu, Ali Emir; Hertier, Unkwiye; Belise, Mugabekazi Albright; Sandrine, Uwase; Darius, Benimana; Abdoulkarim, Methode Yusufu
BackgroundThe Monkeypox virus (MPXV), a member of the Orthopoxvirus genus, is responsible for the zoonotic disease known as MPX. Primarily found in western and central Africa, emerging studies indicate a shift in transmission dynamics. Ongoing MPX outbreaks in the Democratic Republic of Congo (DRC) have escalated into significant public health concerns.ObjectivesThis review endeavors to provide a comprehensive analysis of the public health implications, clinical consequences, and preventive measures related to the current MPX outbreak in the DRC. It focuses on the epidemiology, clinical manifestations, and public health responses to this global health challenge.MethodologyThe research synthesizes data regarding MPX outbreaks in the DRC, drawing from academic journals, public health reports, and case studies through a narrative review approach.ResultsThe recent outbreak in the DRC has identified approximately 12,569 suspected MPX cases, resulting in 581 fatalities, which corresponds to a case fatality rate (CFR) of 4.6%. These cases have been documented across 156 health sectors in 22 out of 26 provinces, representing the highest case count recorded to date. The epidemic has also encroached upon previously unaffected regions. Hospitalization rates have varied between 4% and 10%, with a significant percentage of cases attributed to sexual transmission. Analysis of demographic and geographic data revealed distinct patterns in viral spread. Clinical outcomes have varied, with an average CFR close to 10%, influenced by factors such as timely diagnosis and access to healthcare services. Rural areas have accounted for over 70% of the cases, highlighting the necessity for targeted public health interventions. Control measures have focused on community awareness campaigns and immunization programs, reaching approximately 50% of the at-risk population; however, challenges related to resource limitations and political instability have impeded effective response strategies.ConclusionThe ongoing MPX outbreak in the DRC poses a substantial public health challenge. While progress has been made in managing the epidemic, it remains imperative to address resource deficiencies and enhance public health systems. Strengthening international collaboration, expanding healthcare access, and improving surveillance capabilities are critical to mitigating the risk of future outbreaks.
In Silico and In Vitro Verification of the Effects of Chemotherapeutic Doxorubicin and 5-Fluorouracil in Combination With Curcumin and Vitamin C on MCF-7 Cells
(Wiley, 2025) Akyuz, Asli; Sirin, Duygu Y. A. S. A. R.
Breast cancer ranks among the most prevalent cancers. Enhancing the effectiveness of chemotherapy and patient survival is the objective of many studies. In the literature, no study has investigated the combined effect of vitamin c and curcumin with chemotherapy drugs on cell viability in the MCF-7 cell line, nor the mechanism of inflammation induced by cancer drugs, both in vitro and in silico. Thus, the purpose of this study was to assess the synergistic effect of curcumin and vitamin c in combination with the chemotherapy drugs 5-fluorouracil and doxorubicin. The cytokine hub genes of the Toll-like receptor pathway for the administered drugs were identified using the Cytoscape program, and docking studies were conducted via the Cb Dock2 website. In silico analyses indicated that doxorubicin and curcumin displayed comparable characteristics, achieving the highest interaction scores (-10) with marker proteins, whereas 5-fluorouracil and vitamin c showed lower interaction scores. Cell viability was evaluated through MTT analysis and AO/PI staining, while the expression of inflammation-related markers IL-6, IL-10, and TNF-alpha proteins determined using the ELISA method. After 24 h, the cell viability of the chemotherapeutic drugs administered in combination with curcumin decreased by up to 28%. Subsequently, applications at 48 and 72 h were performed. These results indicate that the effect of curcumin on cell viability is significant when combined with chemotherapy drugs. In the ELISA test, a 52% expression of IL-6 was noted in MCF-7 cells treated with curcumin, whereas the IL-6 level decreased to 15% in the other experimental groups. An increase was observed in the TNF-alpha expression with 5-fluorouracil and doxorubicin compared to the control, while a notable decrease was recorded in the applications with vitamin c and curcumin (p < 0.05). This study demonstrates that vitamin c and curcumin exhibit a synergistic effect with chemotherapeutic agents in the inflammatory system.
Comparison of the overall fit of three-unit posterior fixed dental prostheses fabricated with laser sintering and conventional casting methods
(Springer Heidelberg, 2025) Pekkan, Gurel; Degirmenci, Kubra; Tuna, Suleyman Hakan; Hekimoglu, Canan; Saridag, Serkan
Objectives The aim of this study was to investigate the marginal, internal, and occlusal discrepancies of three-unit posterior cobalt-chromium (Co-Cr) fixed dental prostheses (FDPs) produced using five different fabrication techniques. Materials and methods Segmental maxillary models were prepared from polyamide material using a laser sintering method. The maxillary first premolar and first molar teeth were prepared to receive posterior FDPs. Direct metal laser sintering (DMLS) and selective laser melting (SLM) were used as two metal laser Co-Cr framework production systems. FDP specimen patterns were prepared by manual wax carving (Cast), 3D-printed polymer (3DP), and CAD/CAM wax and cast using the lost-wax technique as conventional methods. In total, 100 Co-Cr metal framework specimens were prepared for posterior FDPs (n = 20). The silicone replica technique was used to measure marginal, internal, and occlusal discrepancies of all frameworks. A stereomicroscope was employed to detect discrepancies at 100x magnification. The data were analyzed using two-way ANOVA (alpha = 0.05) and post hoc Bonferroni adjustment (alpha = 0.005) for pairwise comparisons. Results There were no significant differences between the occlusal discrepancy values of premolar abutments of FDPs when compared with different fabrication methods (P > 0.05). The highest marginal discrepancy value was detected as 116.22 mu m for molar abutment when the Cast method was used (P < 0.05). The highest occlusal discrepancy values were detected as 135.60 mu m and 141.49 mu m for molar abutments of posterior FDPs when the 3DP and Cast methods were used. The lowest marginal discrepancy value was detected as 38.94 mu m for molar abutments when the DMLS method was used (P < 0.05). Conclusions The DMLS method was more successful than other fabrication methods when fit values of abutment teeth for posterior frameworks were compared. Clinical relevance The morphology of the abutment teeth and the fabrication techniques of FDPs migth affect the discrepancy values of FDPs planned. It was seen that the discrepancy values were lowest with the DMLS and SLM methods. Considering the results of this in-vitro study, DMLS and SLM techniques may be more appropriate option than the 3DP method, which starts with digital design and ends conventionally casting technique for posterior three-unit FDPs.
Can we predict postoperative fever and urinary tract ınfection after retrograde ıntrarenal surgery? Results of a case control matching multicentric RIRSearch study group
(Springer, 2025) Akgul, Murat; Ozman, Oktay; Basatac, Cem; Cakir, Hakan; Cinar, Oender; Sahin, Mehmet Fatih; Simsekoglu, Fatih
PurposePostoperative fever (POF)/urinary tract infection (UTI) is one of the most unpleasant and undesirable conditions for surgeons after retrograde intrarenal surgery (RIRS). RIRS is not recommended for any patient with a positive urine culture to avoid POF and UTI, but some patients may develop postoperative UTI even if the urine culture is sterile. This study investigated the predictive factors of fever and UTIs after RIRS.MethodsIn total, 1240 patients who underwent RIRS for proximal ureteral stones and/or kidney stones were analyzed. After case-control matching, 168 patients were included in the study. Demographic data, preoperative/peroperative/postoperative data, and hematological parameters were compared. Patients with sterile urine cultures were included in the study. Postoperative fever was defined as fever >= 38 degrees C within 72 h after RIRS. Patients were divided into two groups: those with and without POF/UTI. Demographic data, preoperative and postoperative findings, and inflammatory parameters of the patients were compared retrospectively.ResultsPOF/UTI was observed in 61 (36.3%) of 168 patients who underwent RIRS. After case-control matching, increased body mass index (BMI) and longer operation time were found to be significant predictors of POF/UTI (p = 0.001 and 0.016 respectively). Preoperative systemic immune-inflammation index (SII) (PxN/L), high Platelet/Lymphocyte Ratio (PLR), and urine leukocyte positivity were found to be significant predictors of POF/UTI (p = 0.037, 0.025 and 0.038 respectively).ConclusionHematological parameters are simple and feasible to use to evaluate POF/UTI in patients undergoing RIRS. High SII and PLR may predict POF and early infection after RIRS. In addition, according to demographic data and per-operative status, high BMI and prolonged operation time are risk factors for infection.
Comparative Bladder Cancer Tissues Prediction Using Vision Transformer
(Springer, 2024) Sunnetci, Kubilay Muhammed; Oguz, Faruk Enes; Ekersular, Mahmut Nedim; Gulenc, Nadide Gulsah; Ozturk, Mahmut; Alkan, Ahmet
Bladder cancer, often asymptomatic in the early stages, is a type of cancer where early detection is crucial. Herein, endoscopic images are meticulously evaluated by experts, and sometimes even by different disciplines, to identify tissue types. It is believed that the time spent by experts can be utilized for patient treatment with the creation of a computer-aided decision support system. For this purpose, in this study, it is evaluated that the performances of three models proposed using the bladder tissue dataset. The first model is a convolutional neural network (CNN)-based deep learning (DL) network, and the second is a model named hybrid cnn-machine learning (ML) or DL + ML, which involves classifying deep features obtained from a CNN-based network with ML. The last one, and the one that achieved the best performance metrics, is a vision transformer (ViT) architecture. Furthermore, a graphical user interface (GUI) is provided for an accessible decision support system. As a result, accuracy and F1 score values for DL, DL + ML, and ViT models are 0.9086-0.8971-0.9257 and 0.8884-0.8496-0.8931, respectively.
Which current chatbot is more competent in urological theoretical knowledge? A comparative analysis by the European board of urology in-service assessment
(Springer, 2025) Sahin, Mehmet Fatih; Dogan, Cagri; Topkac, Erdem Can; Seramet, Serkan; Tuncer, Furkan Batuhan; Yazici, Cenk Murat
IntroductionThe European Board of Urology (EBU) In-Service Assessment (ISA) test evaluates urologists' knowledge and interpretation. Artificial Intelligence (AI) chatbots are being used widely by physicians for theoretical information. This research compares five existing chatbots' test performances and questions' knowledge and interpretation.Materials and methodsGPT-4o, Copilot Pro, Gemini Advanced, Claude 3.5, and Sonar Huge chatbots solved 596 questions in 6 exams between 2017 and 2022. The questions were divided into two categories: questions that measure knowledge and require data interpretation. The chatbots' exam performances were compared.ResultsOverall, all chatbots except Claude 3.5 passed the examinations with a percentage of 60% overall score. Copilot Pro scored best, and Claude 3.5's score difference was significant (71.6% vs. 56.2%, p = 0.001). When a total of 444 knowledge and 152 analysis questions were compared, Copilot Pro offered the greatest percentage of information, whereas Claude 3.5 provided the least (72.1% vs. 57.4%, p = 0.001). This was also true for analytical skills (70.4% vs. 52.6%, p = 0.019).ConclusionsFour out of five chatbots passed the exams, achieving scores exceeding 60%, while only one did not pass the EBU examination. Copilot Pro performed best in EBU ISA examinations, whereas Claude 3.5 performed worst. Chatbots scored worse on analysis than knowledge questions. Thus, although existing chatbots are successful in terms of theoretical knowledge, their competence in analyzing the questions is questionable.
Simplifying complexity: the novel degradation index for urban stream landscapes-case of Tekirdag
(Springer, 2024) Ozsahin, Emre; Ozdes, Mehmet
This study aims to examine the degradation process of urban stream landscapes in Tekirda & gbreve; by utilizing a newly developed degradation index (DI) that effectively defines degradation. The DI considers the vital factors that affect urban stream landscapes, making it possible to determine the level of degradation and resulting environmental quality. This index aims to provide valuable insight into the degradation of urban stream landscapes with a minimal amount of independent variables and training samples. The key enhancements of the DI include its clear computation of degradation value, ease of replication, and overall objectivity. The results indicate that the most substantial change has been observed on impermeable surfaces between 2000 and 2020, resulting in a 5.18% increase in impervious surfaces. Furthermore, there has been a decrease by 4.67% in agricultural lands, highlighting a pronounced shift towards impervious surfaces. The total percentage of areas categorized as high and very high degradation categories increased by 1.54% over the study period. Additionally, the area classified as high degradation expanded from 135.91 to 375.42 hectares between 2000 and 2020. Notably, there was no land classified as very high degradation in 2000, whereas in 2020, it reached 38.15 hectares. The DI has been proven to provide better representational information on how human activity affects ecosystems compared to both the Human Influence Index and the Human Footprint Index which has been used for this purpose. As a valuable tool for urban planning strategies, the DI can provide decision-makers with a more precise depiction of degradation, aiding in the preservation of sustainable urban stream landscapes, particularly in rapidly urbanizing areas.
How Useful are Current Chatbots Regarding Urology Patient Information? Comparison of the Ten Most Popular Chatbots' Responses About Female Urinary Incontinence
(Springer, 2024) Malak, Arzu; Sahin, Mehmet Fatih
This research evaluates the readability and quality of patient information material about female urinary incontinence (fUI) in ten popular artificial intelligence (AI) supported chatbots. We used the most recent versions of 10 widely-used chatbots, including OpenAI's GPT-4, Claude-3 Sonnet, Grok 1.5, Mistral Large 2, Google Palm 2, Meta's Llama 3, HuggingChat v0.8.4, Microsoft's Copilot, Gemini Advanced, and Perplexity. Prompts were created to generate texts about UI, stress type UI, urge type UI, and mix type UI. The modified Ensuring Quality Information for Patients (EQIP) technique and QUEST (Quality Evaluating Scoring Tool) were used to assess the quality, and the average of 8 well-known readability formulas, which is Average Reading Level Consensus (ARLC), were used to evaluate readability. When comparing the average scores, there were significant differences in the mean mQEIP and QUEST scores across ten chatbots (p = 0.049 and p = 0.018). Gemini received the greatest mean scores for mEQIP and QUEST, whereas Grok had the lowest values. The chatbots exhibited significant differences in mean ARLC, word count, and sentence count (p = 0.047, p = 0.001, and p = 0.001, respectively). For readability, Grok is the easiest to read, while Mistral is highly complex to understand. AI-supported chatbot technology needs to be improved in terms of readability and quality of patient information regarding female UI.
Navigating Uncertainty: Assessing Variants of Uncertain Significance in the CDKL5 Gene for Developmental and Epileptic Encephalopathy Using In Silico Prediction Tools and Computational Analysis
(Springernature, 2025) Capan, Ozlem Yalcin
Mutations in the CDKL5 gene are associated with developmental and epileptic encephalopathy (DEE), a severe disorder characterized by developmental delay and epileptic activity. In genetic analyses of DEEs, variants classified as pathogenic confirm the diagnosis of the disease while Variants of Uncertain Significance (VUS) remain in a gray area due to insufficient evidence. This study aimed to optimize the interpretation of VUS in the CDKL5 gene by evaluating the performance of 22 in silico prediction tools using 186 known pathogenic or benign missense variants from the ClinVar database. The best-performing tools were then applied to analyze CDKL5 VUS variants, complemented by the evaluation of evolutionary conservation, structural analyses, and molecular dynamics simulations to assess their impact on protein structure and function. The results identified SNPred as the most reliable tool, achieving 100% accuracy, sensitivity, and specificity. Other high-performing tools, including ESM-1v, AlphaMissense, EVE, and ClinPred, demonstrated over 98% accuracy. Among 44 CDKL5 VUS variants evaluated, 20 were initially classified as pathogenic by these tools. However, further evaluation using stringent criteria-incorporating conservation scores, structural disruptions identified by Missense3D and PyMol, and molecular dynamics simulation results-led to the reclassification of 8 VUS variants as potentially pathogenic and the remaining 12 as variants with conflicting data. This comprehensive approach provides a robust framework for the classification of VUS in the CDKL5 gene, offering critical insights for accurate diagnosis and treatment strategies in DEE. These findings will serve as a valuable resource for clinicians and geneticists in resolving the diagnostic ambiguity associated with VUS.
Could the Systemic Inflammatory Response Index be a Marker for the Non-Dipper Pattern in Newly Diagnosed Hypertensive Patients?
(Humana Press Inc, 2025) Kaplangoray, Mustafa; Toprak, Kenan; Caglayan, Cuneyt; Deveci, Edhem; Celik, Enes; Uyan, Umut; Aydin, Cihan
Systemic inflammatory response index (SIRI), is associated with prognosis in coronary artery disease (CAD), heart failure (HF), and acute myocardial infarction. This study investigated the relationship between SIRI and non-dipper hypertension. The study retrospectively included a total of 254 naive, newly diagnosed hypertensive individuals based on ambulatory blood pressure monitoring (ABPM), containing 166 dippers (DHT) and 88 non-dippers (NDHT). The SIRI value of all patients was calculated based on neutrophil, monocyte, and lymphocyte counts. The average age of study population was 50.7 +/- 9.4 years old, and the male ratio was 68.5%. Compared with DHT, patients in the NDHT group had higher SIRI, monocyte to HDL-C ratio (MHR), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), C-reactive protein (CRP), and neutrophil count, while high-density lipoprotein cholesterol (HDL-C) and lymphocyte count were lower (p < 0.05). The left ventricular mass index (LVMI) was higher in the NDHT group (p < 0.05). Multivariate logistic regression analysis showed that SIRI, LVMI, and HDL-C were independent predictor factors for NDHT. ROC curve analysis determined the optimal SIRI cut-off value for predicting NDHT diagnosis to be 2.41 (sensitivity 69.3%, specificity 64.5%, area under the receiver operating characteristic curve, 0.743; p < 0.001). The AUC values obtained for SIRI, MHR, NLR, PLR, HDL-C, and LVMI parameters in the ROC curve analysis were compared pairwise. The results demonstrated that SIRI's discriminative capacity in predicting NDHT was superior to all other indices. SIRI is an independent and significant predictor factor for NDHT and is superior in predicting NDHT diagnosis compared with HDL-C, MHR, LVMI, NLR, and PLR.
Optimization of bioactive compounds and sensory quality in thermosonicated black carrot juice: A study using response surface methodology, gradient boosting, and fuzzy logic
(Elsevier, 2025) Yikmis, Seydi; Turkol, Melikenur; Pacal, Ishak; Altan, Aylin Duman; Tokatli, Nazli; Abdi, Gholamreza; Demirok, Nazan Tokatli
This study investigates the optimization of bioactive components in thermosonicated black carrot juice using response surface methodology (RSM) and gradient boosting (GB) modeling techniques. Thermosonication, a combination of ultrasound and heat, was applied to enhance the nutritional quality of black carrot juice, which is rich in anthocyanins, phenolic compounds, and antioxidants. The study examined the effects of temperature, processing time, and ultrasonic amplitude on total carotenoid content (TCC), total anthocyanin content (TAC), ferric reducing antioxidant power (FRAP), and total phenolic content. RSM demonstrated higher prediction accuracy compared to GB, identifying optimal processing conditions at 48.68 degrees C, 11.15 minutes, and 82.62% amplitude. Thermosonication significantly increased total phenolic content to 414.28 mg GAE/L, surpassing traditional pasteurization. Sensory analysis, conducted via fuzzy logic, indicated improved sensory properties, including aroma, taste, and color, in thermosonicated samples. This study undercomes thermosonication as a promising method for improving both bioactive compounds and sensory quality in black carrot juice. Chemical compounds: Chlorogen & imath;c acid (PubChem CD:1794427); caffeic acid (PubChem CD: 689043); vanillin (PubChem CD: 1183); rutin (PubChem CD: 5280805); naringin (PubChem CD: 442428); rosmarinic acid (PubChem CD: 5281792); t-ferulic acid (PubChem CD: 445858); o- coumaric acid (PubChem CD: 637540); (PubChem CD: quercetin 5280459); 4-hyroxybenzoic acid (PubChem CD: 135).
Recent advances of structure, function, and engineering of carboxylesterases for the pharmaceutical industry: A minireview
(Elsevier, 2025) Surmeli, Yusuf; Vardar-Yel, Nurcan; Tutuncu, Havva Esra
Carboxylesterases have a wide range of applications due to their catalytic efficiency, robust structure, and broad substrate specificity. These enzymes, which can hydrolyze carboxylic acid esters, amides, and thioesters, stand out with their regio- and enantioselective properties. They play a crucial role in synthesizing pharmaceutical intermediates, including secondary and tertiary alcohols, alpha-hydroxy acids, and various bioactive compounds. However, in some cases, the enantioselectivity of carboxylesterases may be insufficient to achieve conversions with the purity required by the pharmaceutical industry. This review summarizes the crucial role of carboxylesterases, particularly in the pharmaceutical field, focusing on the classification, structure, and engineering approaches. After introducing the main families of carboxylesterases, the structural studies are presented to give a comprehensive insight into the active site architecture and related key determinants for enantioselectivity. The protein engineering studies to improve the enantioselectivity of carboxylesterases are discussed along with solvent engineering and immobilization applications.
Top cited articles about the stress urinary incontinence: A bibliometric analysis
(Elsevier, 2024) Aslan, Ilke Ozer; Dogan, Cagri
Objective: To produce a bibliographic source by compiling the most-cited articles about stress urinary incontinence to guide researchers for novel research topic ideas in urogynecology. Study design: We analyzed 200 most-cited articles (T200) between 1995-2022 by reviewing the Institution for Scientific Information (ISI)- Web of Science (WOS) and PubMed databases about the stress urinary incontinence. The time span-effect of publications was normalized by calculating average citations per item (ACI) index for each article. The publications were sub-classified by the publication year, journals, countries, surgical methods, and departments. Results: The median for total citation numbers and the ACI indices of T200 were 35 and 5 respectively. The top- cited articles were mostly published in USA with 91 articles (46.5 %) followed by Italy (22, 11 %), and United Kingdom (21, 10.5 %). Among T200, 149 were original research, 44 reviews, 4 meta-analyses, and 3 editorial articles. Further, 59 were about surgical procedures (of which 28 were about TOT-TVT comparison). M. Serati and L. Bruker were the most contributing authors to T200 with 19 articles. On the top of T200, the article of Pierre A. Clavien et al . (2009) sits with 6201 citations, published in the journal of Annals of Surgery. Conclusions: We suggest that the most-cited articles commonly conducted in the high-income countries, mostly published between 2014-2018. Best of our knowledge, this is the first study analyzing the most-cited 200 publications in urogynecology field under two different perspectives of two different disciplines, namely urology and obstetrics and gynecology.
Gelatins derived from aronia-supplemented fish diets: Structural effect and molecular simulation
(Elsevier, 2025) Kaynarca, Gulce Bedis; Yagcilar, Cretin; Kamer, Deniz Damla Altan; Gumus, Tuncay; Cretin, Ismail; Koc, Serim Tuna
Fish gelatin, a sustainable substitute for mammalian gelatin, frequently exhibits weaker gel strength and thermal stability, limiting its industrial uses. This study investigated an in vivo method to improve functional characteristics by supplementing Nile tilapia diets with Aronia extract. The control diet (A0) contained no Aronia extract, while the remaining four diets consisted of commercial pelleted feed enriched with 250 mg/kg (A250), 500 mg/kg (A500), 750 mg/kg (A750), and 1000 mg/kg (A1000) of Aronia extract. The gelatin samples revealed thermo-reversible behavior with increasing temperature. A250 exhibited the highest melting temperature of 29.65 degrees C, compared to 27.43 degrees C for A0. The gelation temperature for A250 was 17.56 degrees C, indicating a relatively stable gelatin structure. The elastic modulus (G') was the highest in A250, suggesting an improved gel network compared to the other samples. The gelation rate constant (kgel) was highest in A250 (540.67 Pa), followed by A750 (447.32 Pa), A500 (393.85 Pa), and A1000 (370.97 Pa), compared to 391.15 Pa for A0. The gel strength was improved, with A250 showing the highest value at 133.9 g, followed by A750, A1000, and A500, while A0 was 102.1 g. The glass transition temperatures (Tg) for A250, fish gelatin (FG), bovine gelatin (BG), and A0 were 76.72 degrees C, 74.31 degrees C, 70.71 degrees C, and 73.52 degrees C, respectively. Molecular docking studies revealed strong binding interactions between A250 and phenolic compounds, which contributed to the observed structural enhancements. These findings suggest that supplementing fish diets with Aronia extract can substantially enhance gelatin quality, offering a promising alternative to traditional gelatin sources.

Güncel Gönderiler