İstanbul University-Cerrahpaşa

This research uses parametric polynomial techniques to determine model-based control parameters of a dynamic fluid control system. The system identification process suitable for this purpose involves creating a mathematical model of a dynamic system using data measured in the time or frequency domain. The approach consists of fitting a polynomial function to the input–output data, with polynomial parameters representing the unknown parameters of the system. The aim is to estimate these parameters in order to control the system effectively. In this study, aortic, femoral, iliac, carotid and coronary artery signals were used in modeling and testing the flow system during parametric model studies, as the system forms the basis for hemodynamic research. Autoregressive model with external input, autoregressive moving average model with external input, Box–Jenkins, output-error and state space model parametric models were used in the modeling process. In the mathematical performance analysis, the transfer function of the most successful parametric model was calculated. AC motor and centrifugal pump were used as flow control devices. The transfer function with the most successful performance in the observer design was used as the Luenberger controller. An innovative closed-loop control system has been obtained using the Luenberger structure.

Turkey is abundant in natural mineral water sources, thanks to its location on the Alpine-Himalayan belt. Natural mineral water is drinking water characterized by its natural mineral, trace elements, and carbon dioxide content. Because of quite insufficient data, the boron content in bottled natural mineral waters in Turkey was analyzed by three different methods and compared: inductively coupled plasma mass spectrometry technique, carminic acid, and azomethine-H methods, in this study. The boron levels in mineral waters ranged from a minimum of 0.05 mg/L to a maximum of 8.61 mg/L. It was also safe by the upper limit level estimated by the World Health Organisation. As boron plays a beneficial role in human physiology, consuming natural mineral water may offer a positive contribution to public health by supporting boron intake in our country. The other outcome of our research was that the spectrophotometric carminic acid method can yield results similar to those obtained using the inductively coupled plasma mass spectrometry technique since the boron level of Turkish mineral water was within the limits level of the carminic acid method. However, the result of the azomethine-H method was found not to be suitable. Cross-sensitivity with other elements in mineral water might have caused this.

Purpose Cauliflower ear in wrestlers can lead to hearing impairment. This study primarily aims to assess the hearing of wrestlers with bilateral cauliflower ears and determine their external ear canal (EEC) resonance frequencies. Our second aim is to evaluate their hearing quality, speech, and spatial perception. Method This study included 28 male wrestlers aged 18–35 years with bilateral cauliflower ears, as well as 27 male participants in the control group with no wrestling history. The participants' hearing thresholds were determined across the frequency range of 125–16000 Hz for air-conduction and 500–4000 Hz for bone conduction. EEC resonance frequencies were measured. Additionally, all participants completed the Turkish version of the Speech, Spatial, and Qualities of Hearing Scale (SSQ) questionnaire. Results Wrestlers with cauliflower ears exhibited significantly higher hearing thresholds, particularly at frequencies above 4000 Hz ( p < .05). Analysis of EEC resonance showed a shift to higher frequencies in the second resonance peak of the right ear ( p < .001) and the first resonance peak of the left ear ( p = .045). SSQ scores revealed that wrestlers had higher spatial perception ( p = .046), hearing quality ( p = .004), and general scores ( p = .042) in comparison to the control group. Conclusions Blunt traumas in wrestlers, leading to cauliflower ear, can result in hearing loss. Moreover, deformities in the external ear affect the resonance frequencies of the EEC. Therefore, it is crucial to advocate for the use of ear protection equipment among wrestlers. When fitting hearing aids, attention should be given to changes in the EEC resonance frequency.

Glioblastoma tumors are the most aggressive primary brain tumors that develop resistance to temozolomide (TMZ). Eribulin (ERB) exhibits a unique mechanism of action by inhibiting microtubule dynamics during the G2/M cell cycle phase. We utilized the T98G human glioma cell line to investigate the effects of ERB and TMZ, both individually and in combination. The experimental groups were established as follows: control, E5 (5 nM ERB), T0.75 (0.75 mM TMZ), T1 (1.0 mM TMZ), and combination groups (E5+T0.75 and E5+T1). All groups showed a significant decrease in cell proliferation. Apoptotic markers revealed a time-dependent increase in annexin-V expression, across all treatment groups at the 48-hour time point. Caspase-3, exhibited an increase in the combination treatment groups at the 48-hour mark. Transmission electron microscopy (TEM) revealed normal ultrastructural features in the glioma cells of the control group. However, treatments induced ultrastructural changes within the spheroid glioblastoma model, particularly in the combination groups. These changes included a dose-dependent increase in autophagic vacuoles and apoptotic morphology of the cells. In conclusion, the similarity in the mechanism of action between ERB and TMZ suggests the potential for synergistic effects when combined. Our results highlight that this combination induced severe damage and autophagy in glioma spheroids after 48 hours. Keywords: Apoptosis; Eribulin; T98G; TEM; Temozolomide.

Introduction Therapeutic plasma exchange (TPE) may involve complications. We aimed to review the demographic data, indications, technical information, and complications. Methods Data for TPE procedures (TPEPs) performed between 2004 and 2018 were retrospectively. Results This study covered 2505 TPEPs performed on 338 patients; 55% of them were female ( n = 186), and the median age was 36 years (range, 11–93 years). Most TPEPs were administered for hematological (40.6%) indications. The incidence of complications on the first procedure was 3.2% ( n = 80); only 16 procedures (0.6%) were failed. The complication incidence was 19.8% ( n = 497), with 789 total complications. Most of the complications were patient‐related (90.4%), and the most of them were urticaria (29.1%), occlusion (3.2%), and faulty systems (1.01%), respectively. The use of only fresh frozen plasma as replacement fluid caused a higher complication rate (22.1%, p < 0.01). Conclusion The number of TPEPs is increasing every day. Hematologic indications for TPE and the use of fresh frozen plasma may increase the risk of complications.

The feline eosinophilic granuloma complex is a well‐known dermatological problem that affects domestic cats. It has three characteristic components: eosinophilic plaque, eosinophilic granuloma and indolent ulcer. In this case report, we report a 5‐year‐old, mixed‐breed cat with pruritic plaque formation, which was typical for eosinophilic plaque by dermatological examination. The diagnosis was established by histopathological and clinical findings. As previous literature showed, hair follicle epithelium mucinosis as a histopathological finding could potentially give us fundamental clues about the microscopic diagnosis of this complex. We discuss the presentation, histopathology and treatment response in detail. This case highlights how intricate feline eosinophilic granuloma complex can be, and underscores the significance of hair follicle epithelium mucinosis as a diagnostic tool in histopathology.

Borderline left ventricle cases present considerable difficulties in determining the most effective surgical approaches. The evolution of approaches in the field has shifted from classical systemic pulmonary shunts to orthodox univentricular palliation and has subsequently seen the emergence of biventricular repair concepts. The concept of biventricular repair for borderline left heart conditions has developed through studies that aim to establish predictive scoring systems for identifying appropriate candidates. Despite continuous efforts, a definitive scoring system for guiding this decision is still difficult to find. There is a growing trend to provide neonatal patients with borderline ventricles with options other than univentricular palliation. Several centers have developed personalized strategies, including hybrid and staged ventricular recruitment approaches. These strategies provide sufficient time for personalized decision-making, taking into account the individual circumstances of each patient. This article presents an overview of the changing approaches to borderline left ventricular cases. It discusses the use of predictive scoring systems and emphasizes the advancements in staged strategies that improve the likelihood of successful biventricular repairs.

Introduction Sleep disturbances are being increasingly recognized in association with autoimmune encephalitis (AIE). We investigated the prevalence of sleep-related symptoms and polysomnographic features of patients with AIE and the long-term outcomes in these patients in a multi-center, prospective study from Turkey. Methods We prospectively evaluated patients with definite AIE in a common database including demographics, AIE-related and sleep-related symptomatology. Maximum and latest modified Rankin scores (mRS) and Liverpool Outcome Score (LOS) were noted. Results Of 142 patients, 87 patients (61.3%) fulfilled the criteria for definite AIE (mean age, 46.8 + 18.8 years; 51.7% women; mean disease duration, 21.0 + 38.4 months). 78.9% of patients had at least one or more new onset or worsened sleep-related symptomatology: insomnia (55.3%), excessive daytime sleepiness (EDS, 28.0%), sleep apnea (18.7%), REM sleep behavior disorder (RBD, 17.3%), restless legs syndrome (10.7%) and oneiric stupor (9.3%). Sleep efficiency, N3 and REM sleep were decreased and N1 sleep was increased in patients with Ab[+] AIE. LOS points were highest in those with insomnia and sleep apnea, and lowest in those with EDS, RBD and oneiric stupor. RBD and sleep apnea were more common in anti-LG1 Ab[+] group than anti-NMDAR Ab[+] group. Index of periodic leg movements was highest in anti-LG1 Ab[+] group. Patients with EDS and oneiric stupor had more common memory problems. Maximum and latest mRS scores were positively correlated with EDS and oneiric stupor. EDS, RBD and oneiric stupor were negatively correlated with LOS points. Conclusion Our study emphasizes the presence and importance of early diagnosis of sleep disturbances in AIE in regard to their deteriorative influences on disease prognosis.

The aim of this study is to evaluate the relationship between serum TLR (Toll Like Receptor) 4, 9 and Resolvin E1 levels and primary sarcopenia in geriatric patients and to compare the diagnostic accuracy of these biomarkers with the SARC-F score. A total of 88 patients aged 65 years and older were evaluated in the study. Comorbidities and geriatric syndromes were identified and patients with secondary sarcopenia were excluded. EWGSOP2 criteria were used as diagnostic criteria for sarcopenia and SARC-F questionnaire was used to find individuals at risk for sarcopenia. Serum TLR 4, 9 and Resolvin E1 levels were analyzed by ELISA. There were no significant differences between the two groups in terms of age and gender (p = 0.654 and p = 1.000, respectively). SARC-F, serum TLR 9 and Resolvin E1 were significantly higher in the sarcopenia group compared to the non-sarcopenia group (p < 0.001, p < 0.001 and p = 0.040, respectively). Statistically significant parameters were evaluated by multiple regression analysis. TLR 9 and SARC-F score were both found to be associated with sarcopenia in multivariate logistic regression analysis [Odds ratio (OR) 3145, (95%) confidence interval (CI) 5.9–1,652,888.3, p = 0.012; OR 4.788, (95%) CI 2.148–10.672, p < 0.001, respectively]. ROC curve analysis showed that the area under the ROC curve (AUC) for TLR 9 and SARC-F was 0.896 (p < 0.001) and 0.943 (p < 0.001), respectively. Although this study supports the use of the SARC-F questionnaire in daily practice, serum TLR 9 levels may be an alternative to SARC-F in cases where SARC-F is not feasible.

Importance Inconsistent reporting of outcomes in clinical trials of rosacea is impeding and likely preventing accurate data pooling and meta-analyses. There is a need for standardization of outcomes assessed during intervention trials of rosacea. Objective To develop a rosacea core outcome set (COS) based on key domains that are globally relevant and applicable to all demographic groups to be used as a minimum list of outcomes for reporting by rosacea clinical trials, and when appropriate, in clinical practice. Evidence Review A systematic literature review of rosacea clinical trials was conducted. Discrete outcomes were extracted and augmented through discussions and focus groups with key stakeholders. The initial list of 192 outcomes was refined to identify 50 unique outcomes that were rated through the Delphi process Round 1 by 88 panelists (63 physicians from 17 countries and 25 patients with rosacea in the US) on 9-point Likert scale. Based on feedback, an additional 11 outcomes were added in Round 2. Outcomes deemed to be critical for inclusion (rated 7-9 by ≥70% of both groups) were discussed in consensus meetings. The outcomes deemed to be most important for inclusion by at least 85% of the participants were incorporated into the final core domain set. Findings The Delphi process and consensus-building meetings identified a final core set of 8 domains for rosacea clinical trials: ocular signs and symptoms; skin signs of disease; skin symptoms; overall severity; patient satisfaction; quality of life; degree of improvement; and presence and severity of treatment-related adverse events. Recommendations were also made for application in the clinical setting. Conclusions and Relevance This core domain set for rosacea research is now available; its adoption by researchers may improve the usefulness of future trials of rosacea therapies by enabling meta-analyses and other comparisons across studies. This core domain set may also be useful in clinical practice.

As a component of the biogeochemical cycle, litterfall contributes carbon and nutrients to forest ecosystems by transferring organic material to mineral soil. Litterfall therefore serves as an important indicator for soil fertility and ecosystem health. This study aimed to determine the impact of different levels of thinning (light, moderate, and heavy) on litterfall quantity (needles, branches, bark, cones, and miscellaneous parts) and on the amount of carbon and nutrients entering the ecosystem in black pine afforestation areas. Three levels of low thinning, namely light, moderate, and heavy thinning (15%, 25%, and 35% of breast height area, respectively), were applied as treatments. Additionally, a control plot was included in the experiment. Litterfall samples were collected four times per year (once per season) from 12 treatment plots for three years. In the laboratory, dry weight measurements and analyses of carbon and macro–micro nutrient elements (N, P, K, Ca, Mg, S, Na, Fe, Cu, Zn, and Mn) were performed on litterfall samples taken from the field. Differences between treatments in terms of litterfall and the amount of carbon and nutrient elements entering the ecosystem were evaluated through variance analysis and the Duncan test. According to the findings, the quantity of litterfall input into the forest floor was highest in the control treatment, at 6,543 kg ha⁻¹ year⁻¹ and lowest in the heavy treatment, at 4,378 kg ha⁻¹ year⁻¹, showing a significant variation in litterfall quantity. The input of C to the soil ranged between 2,233 kg ha⁻¹ year⁻¹ and 3,347 kg ha⁻¹ year⁻¹ depending on thinning treatment. Although thinning treatment reduced C input to the soil, there was no significant difference among treatments. This also applied to nutrient elements such as N, P, K, Mg, and S. Needles constituted the majority of litterfall components (60%) and had the highest C density among all components, at 51.2%. The weighted carbon ratio for litterfall was calculated at 50.8%. Considering carbon-focused planning, performing moderate thinning interventions in the study area or similar pine-afforested areas may be a suitable option for maintaining the sustainability and health of the forest.

Sleep is a basic, physiological requirement for living things to survive and is a process that covers one third of our lives. Melatonin is a hormone that plays an important role in the regulation of sleep. Sleep deprivation affect brain structures and functions. Sleep deprivation causes a decrease in brain activity, with particularly negative effects on the hippocampus and prefrontal cortex. Despite the essential role of protein and lipids vibrations, polysaccharides, fatty acid side chains functional groups, and ratios between amides in brain structures and functions, the brain chemical profile exposed to gentle handling sleep deprivation model versus Melatonin exposure remains unexplored. Therefore, the present study, aims to investigate a molecular profile of these regions using FTIR spectroscopy measurement’s analysis based on lipidomic approach with chemometrics and multivariate analysis to evaluate changes in lipid composition in the hippocampus, prefrontal regions of the brain. In this study, C57BL/6J mice were randomly assigned to either the control or sleep deprivation group, resulting in four experimental groups: Control (C) (n = 6), Control + Melatonin (C + M) (n = 6), Sleep Deprivation (S) (n = 6), and Sleep Deprivation + Melatonin (S + M) (n = 6). Interventions were administered each morning via intraperitoneal injections of melatonin (10 mg/kg) or vehicle solution (%1 ethanol + saline), while the S and S + M groups underwent 6 h of daily sleep deprivation from using the Gentle Handling method. All mice were individually housed in cages with ad libitum access to food and water within a 12-hour light–dark cycle. Results presented that the brain regions affected by insomnia. The structure of phospholipids, changed. Yet, not only changes in lipids but also in amides were noticed in hippocampus and prefrontal cortex tissues. Additionally, FTIR results showed that melatonin affected the lipids as well as the amides fraction in cortex and hippocampus collected from both control and sleep deprivation groups.

We aimed to evaluate the efficacy and safety of trastuzumab emtansine in patients with metastatic breast cancer previously treated with pertuzumab plus trastuzumab and taxane. We reviewed the medical records of patients who were diagnosed with Human Epidermal Growth Factor Receptor 2 (HER-2) positive metastatic breast cancer and received pertuzumab and then TDM-1 between January 2014 and January 2021 from twenty- five cancer centers. The Kaplan- Meier method estimated progression-free survival (PFS) and overall survival (OS). Additionally, objective response rate (ORR), clinical benefit rate (CBR), and safety were evaluated. One hundred fifty-three patients were included,79.1% of the patients received TDM-1 in the second line, 90.8% had visceral metastasis, and 30.7% had central nervous system involvement. The PFS and OS of TDM-1 were evaluated according to the number of previous lines (on the 2nd line or more than two lines) metastatic sites (visceral and non-visceral) and the presence of central nervous metastasis. In TDM-1 therapy, PFS in second line therapy was ten months (95% CI: 7.7 − 12.2); this was statistically higher than later-line PFS, which was six months (95% CI: 3.3 to 8.6) (p = 0.004). The median OS time was 25 months (95% CI: 21.0 to 28.9) in patients treated with TDM-1 in the second line and 19 months (95% CI: 12.3 to 25.6) in patients who received later than the second line(p = 0.175). There were no significant differences in PFS time of patients with and without visceral and central nervous metastases. Our study showed that TDM-1 was also effective in patients using pertuzumab, contributes significantly to PFS when used in the second line compared to its use in the later line, and does not make any difference in OS.

Radiofrequency Echographic Multi Spectrometry (REMS) is a radiation-free, portable technology, which can be used for the assessment and monitoring of osteoporosis at the lumbar spine and femoral neck and may facilitate wider access to axial BMD measurement compared with standard dual-energy x-ray absorptiometry (DXA). There is a growing literature demonstrating a strong correlation between DXA and REMS measures of BMD and further work supporting 5-year prediction of fracture using the REMS Fragility Score, which provides a measure of bone quality (in addition to the quantitative measure of BMD). The non-ionising radiation emitted by REMS allows it to be used in previously underserved populations including pregnant women and children and may facilitate more frequent measurement of BMD. The portability of the device means that it can be deployed to measure BMD for frail patients at the bedside (avoiding the complications in transfer and positioning which can occur with DXA), in primary care, the emergency department, low-resource settings and even at home. The current evidence base supports the technology as a useful tool in the management of osteoporosis as an alternative to DXA.

Background The composition and amount of breast milk is affected by factors such as the duration and frequency of breastfeeding, the time between two breastfeeding sessions, the effectiveness of breastfeeding, breastfeeding technique, genetic characteristics of the mother and diet. Breast milk macronutrients are provided by milk synthesized in lactocytes, mother's diet and maternal stores. Research Aim This study was conducted to investigate the relationship between the body composition of mothers and the anthropometric characteristics of the baby and the nutritional content of breast milk. Method The descriptive study was conducted between March and November 2023 in a hospital in a low socioeconomic neighbourhood in Turkey. The study sample consisted of 96 mothers and ibabies. Anthropometric measurements of mothers and babies and the nutrient content of breast milk were evaluated on the first postpartum day, Days 5 and 15. Breast milk macronutrient content was analyzed by Miris milk analyzer and body composition of mothers was analyzed by TANITA BC 730. Results From the weight and body composition of the mothers in the study group; a positive correlation was found between body fat, muscle and water ratio, and breast milk carnonhydrate and protein ( p < 0.05). There was no correlation between the gestational age of the baby and the content of breast milk ( p > 0.05). A positive correlation was found between the weight and height of the babies and the macronutrients of breast milk ( p < 0.05). Conclusion As the weight of mothers increases, breast milk protein and carbohydrate levels increase. As breast milk macronutrients increase, babies' weight and height increase.