Showing papers by "Başkent University published in 2012"

Concise Review: Adipose‐Derived Stem Cells as a Novel Tool for Future Regenerative Medicine

Abstract: The potential use of stem cell-based therapies for the repair and regeneration of various tissues and organs offers a paradigm shift that may provide alternative therapeutic solutions for a number of diseases. The use of either embryonic stem cells (ESCs) or induced pluripotent stem cells in clinical situations is limited due to cell regulations and to technical and ethical considerations involved in the genetic manipulation of human ESCs, even though these cells are, theoretically, highly beneficial. Mesenchymal stem cells seem to be an ideal population of stem cells for practical regenerative medicine, because they are not subjected to the same restrictions. In particular, large number of adipose-derived stem cells (ASCs) can be easily harvested from adipose tissue. Furthermore, recent basic research and preclinical studies have revealed that the use of ASCs in regenerative medicine is not limited to mesodermal tissue but extends to both ectodermal and endodermal tissues and organs, although ASCs originate from mesodermal lineages. Based on this background knowledge, the primary purpose of this concise review is to summarize and describe the underlying biology of ASCs and their proliferation and differentiation capacities, together with current preclinical and clinical data from a variety of medical fields regarding the use of ASCs in regenerative medicine. In addition, future directions for ASCs in terms of cell-based therapies and regenerative medicine are discussed. STEM CELLS 2012;30:804–810

The risk of tuberculosis in transplant candidates and recipients: a TBNET consensus statement

Abstract: Tuberculosis (TB) is a possible complication of solid organ and hematopoietic stem cell transplantation. The identification of candidates for preventive chemotherapy is an effective intervention to protect transplant recipients with latent infection with Mycobacterium tuberculosis from progressing to active disease. The best available proxy for diagnosing latent infection with M. tuberculosis is the identification of an adaptive immune response by the tuberculin skin test or an interferon-γ based ex vivo assay. Risk assessment in transplant recipients for the development of TB depends on, among other factors, the locally expected underlying prevalence of infection with M. tuberculosis in the target population. In areas of high prevalence, preventive chemotherapy for all transplant recipients may be justified without immunodiagnostic testing while in areas of medium and low prevalence, preventive chemotherapy should only be offered to candidates with positive M. tuberculosis-specific immune responses. The diagnosis of TB in transplant recipients can be challenging. Treatment of TB is often difficult due to substantial interactions between anti-TB drugs and immunosuppressive medications. This management guideline summarises current knowledge on the prevention, diagnosis and treatment of TB related to solid organ and hematopoietic stem cell transplantation and provides an expert consensus on questions where scientific evidence is still lacking.

Usefulness of admission red cell distribution width as a predictor of early mortality in patients with acute pulmonary embolism.

Abstract: Red cell distribution width (RDW) is strongly associated with prognosis in cardiopulmonary disorders such as coronary artery disease, acute myocardial infarction, acute and chronic heart failure, and pulmonary hypertension. However, its prognostic significance in acute pulmonary embolism (PE) is unknown. The aim of this study was to investigate the relation between admission RDW and early mortality in patients with acute PE. One hundred sixty-five patients with confirmed acute PE were included. Patients with previous treatment for anemia, malignancy, or chronic liver disease, those with dialysis treatment for chronic renal failure, and those who received erythrocyte suspension for any reason were excluded. A total of 136 consecutive patients with acute PE were evaluated prospectively. According to receiver-operating characteristic curve analysis, the optimal cut-off value of RDW to predict early mortality was >14.6%, with 95.2% sensitivity and 53% specificity. Patients were categorized prospectively as having unchanged (group 1) or increased (group 2) RDW on the basis of a cut-off value of 14.6%. The mean age of patients was 63 ± 15 years. The mean follow-up duration was 11 ± 7 days, and 21 patients died. Among these 21 patients, 1 (1.6%) was in group 1 and 20 (27%) were in group 2 (p 14.6% on admission, age, presence of shock, heart rate, oxygen saturation, and creatinine level were found to have prognostic significance in univariate Cox proportional-hazards analysis. Only increased RDW >14.6% on admission (hazard ratio 15.465, p = 0.012) and the presence of shock (hazard ratio 9.354, p <0.001) remained associated with increased risk for acute PE-related early mortality in a multivariate Cox proportional-hazards model. In conclusion, high RDW was associated with worse hemodynamic parameters, and RDW seems to aid in the risk stratification of patients with acute PE.

An experimental design approach using TOPSIS method for the selection of computer-integrated manufacturing technologies

Abstract: The selection of Computer-Integrated Manufacturing (CIM) technologies becomes more complex as the decision makers in the manufacturing organization have to assess a wide range of alternatives based on a set of attributes. Although, a lot of Multi-Attribute Decision-Making (MADM) methods are available to deal with selection applications, this paper aims to explore the applicability of an integrated TOPSIS and DoE method to solve different CIM selection problems in real-time industrial applications. Four CIM selection problems, which include selection of (a) an industrial robot, (b) a rapid prototyping process, (c) a CNC machine tool and (d) plant layout design, are considered in this paper. TOPSIS method and Design of Experiment (DoE) are used together to identify critical selection attributes and their interactions of all these cases by fitting a polynomial to the experimental data in a multiple linear regression analysis. This mathematical model development process involves TOPSIS experiments with the model. The regression meta-model greatly reduced the cost, time and amount of the calculation step in application the TOPSIS model. Application results were validated and shown that they provide good approximations to four decision making problem's results in the literature.

Hematologic Parameters and Angiographic Progression of Coronary Atherosclerosis

Abstract: Hematologic parameters have prognostic importance in cardiovascular disease. However, the relation between atherosclerosis progression and hematologic parameters is not well defined. A total of 394 patients requiring repeat coronary angiography were included in the study. According to angiography, patients were divided into 2 groups, progressive (n = 196) and nonprogressive (n = 198) diseases. Hematologic parameters including mean platelet volume (MPV) and neutrophil/lymphocyte (N/L) ratio were measured. Glucose, creatinine, and cholesterol were significantly higher in the progressive group. Mean platelet volume count was similar in both groups. The N/L ratio was significantly higher in the progressive group (5.0 ± 5.1 vs 3.2 ± 3; P = .001). In multivariate analysis, the N/L ratio was significantly related with progression (relative risk [RR]: 2.267, 95% CI: 1.068-4.815, P = .03). Progression rate was significantly high in patients with high N/L ratio (39% vs 56%). Our results suggest that the N/L ratio is a predictor of progression of atherosclerosis.

Adipose-derived stem cells enhance primary tendon repair: biomechanical and immunohistochemical evaluation.

Abstract: Summary Background Primary tendon repair aims at increased tensile strength at the time of mobilisation. Tendon repair and regeneration using mesenchymal stem cells have been described in different studies; however, adipose-derived stem cell (ASC) use for tendon regeneration and repair has recently been taken into consideration. In this study, we sought to determine whether ASCs would be beneficial in primary tendon healing. Materials and methods Both the Achilles tendons of rabbits ( n = 6) were incised and consequently repaired. To the left side was applied platelet-rich plasma (PRP) gel and to the right side autologous ASC-mixed PRP. The tensile strength was measured on the 4th week. The samples were taken for immunohistochemical evaluation of collagen type I, transforming growth factor beta (TGF-β) 1, 2, 3, fibroblast growth factor (FGF) and vascular endothelial growth factor (VEGF). Results The tensile strengths in control and experimental groups were found out to be 29.46 ± 3.66 and 43.06 ± 3.80 kgf. Collagen type I, FGF and VEGF levels were statistically higher, whereas TGF-β1, 2, 3 were lower in the experimental group. Conclusion ASCs enhance primary tendon healing; however, the complex interaction and the cascades by which ASCs could increase collagen type I, FGF and VEGF and decrease TGF-β levels should further be investigated.

Review: Hybrid expert systems: A survey of current approaches and applications

Abstract: This paper is a statistical analysis of hybrid expert system approaches and their applications but more specifically connectionist and neuro-fuzzy system oriented articles are considered. The current survey of hybrid expert systems is based on the classification of articles from 1988 to 2010. Present analysis includes 91 articles from related academic journals, conference proceedings and literature reviews. Our results show an increase in the number of recent publications which is an indication of gaining popularity on the part of hybrid expert systems. This increase in the articles is mainly in neuro-fuzzy and rough neural expert systems' areas. We also observe that many new industrial applications are developed using hybrid expert systems recently.

Organizational and supervisory support in relation to employee turnover intentions

Abstract: Purpose – The present paper aims to examine the relationship between perceived organizational support (POS), perceived supervisory support (PSS) and turnover intentions. The paper also aims to investigate whether employee's individual cultural values regarding collectivism and individualism moderate the relationship between POS and turnover intentions.Design/methodology/approach – Data were obtained utilizing survey from a sample of 304 full‐time employed adults working in insurance companies in Turkey. Employees completed regular survey that contained measures of the constructs of interest of this study.Findings – Results revealed that employees who perceive high levels of PSS but report low levels of POS will also report high levels of turnover intentions compared to employees who perceive low PSS and low POS.Practical implications – For increasing POS to be successful, managers must strive to find out the way to increase their social support, and then tailor support accordingly. Managers may benefit fr...

The location-routing problem with simultaneous pickup and delivery: Formulations and a heuristic approach

Abstract: In this paper, we consider a variant of the Location-Routing Problem (LRP), namely the LRP with simultaneous pickup and delivery (LRPSPD). The LRPSPD seeks to minimize total cost by simultaneously locating the depots and designing the vehicle routes that satisfy pickup and delivery demand of each customer at the same time. We propose two polynomial-size mixed integer linear programming formulations for the problem and a family of valid inequalities to strengthen the formulations. While the first formulation is a node-based formulation, the second one is a flow-based formulation. Furthermore, we propose a two-phase heuristic approach based on simulated annealing, tp_SA, to solve the large-size LRPSPD and two initialization heuristics to generate an initial solution for the tp_SA. We then empirically evaluate the strengths of the proposed formulations with respect to their ability to find optimal solutions or strong lower bounds, and investigate the performance of the proposed heuristic approach. Computational results show that the flow-based formulation performs better than the node-based formulation in terms of the solution quality and the computation time on small-size problems. However, the node-based formulation can yield competitive lower bounds in a reasonable amount of time on medium-size problems. Meantime, the proposed heuristic approach is computationally efficient in finding good quality solutions for the LRPSPD.

Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study

Abstract: The CIAO Study (“Complicated Intra-Abdominal infection Observational” Study) is a multicenter investigation performed in 68 medical institutions throughout Europe over the course of a 6-month observational period (January-June 2012). Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study. 2,152 patients with a mean age of 53.8 years (range: 4–98 years) were enrolled in the study. 46.3% of the patients were women and 53.7% were men. Intraperitoneal specimens were collected from 62.2% of the enrolled patients, and from these samples, a variety of microorganisms were collectively identified. The overall mortality rate was 7.5% (163/2.152). According to multivariate analysis of the compiled data, several criteria were found to be independent variables predictive of patient mortality, including patient age, the presence of an intestinal non-appendicular source of infection (colonic non-diverticular perforation, complicated diverticulitis, small bowel perforation), a delayed initial intervention (a delay exceeding 24 hours), sepsis and septic shock in the immediate post-operative period, and ICU admission. Given the sweeping geographical distribution of the participating medical centers, the CIAO Study gives an accurate description of the epidemiological, clinical, microbiological, and treatment profiles of complicated intra-abdominal infections (IAIs) throughout Europe.

Differentiated and undifferentiated adipose-derived stem cells improve function in rats with peripheral nerve gaps

Abstract: The effect of differentiated and undifferentiated adipose-derived stem cells on the repair of peripheral nerve gaps was studied. Adipose-derived stem cells were maintained in differentiation medium for 2 weeks. The expression of Schwann cell proteins S-100, nerve growth factor receptor (NGFR) p75 and integrin β4 was examined by immunofluorescence staining and real time-polymerase chain reaction (real time-PCR) at the end of the differentiation period. A 10-mm gap on the left sciatic nerves of 20 Fischer rats was created and bridged with silicone tube (group I), silicone tube filled with collagen gel (group II), nerve graft (group III), silicone tube filled with adipose-derived stem cells (group IV) and silicone tube filled with differentiated adipose-derived stem cells (group V). In vitro, the positivity of differentiated adipose-derived stem cells for S-100, NGFR p75 and integrin β4 by immunofluorescence staining was 31%, 27% and 12%, respectively. Fold changes by real time-PCR in comparison with undifferentiated cells were 48.4, 168.7 and 284.85, respectively. In vivo, a walking track analysis did not yield any statistically significant differences after 3 months postoperatively; however, after 6 months, group IV (sciatic function index (SFI) = -49.1 ± 13.1) and V (SFI = -52.6 ± 5.7) showed significant improvement compared to other groups (I: -73.3 ± 5.07, II: -79.6 ± 12.01, III: -74.8 ± 12.89) (p 0.05). Myelin fibre density and myelinated fibre/unmyelinated fibre ratio were significantly higher in the midnerve and the distal nerve in groups IV and V (p < 0.05). These results reveal the therapeutic potential of adipose-derived stem cells in nerve reconstruction.

A Risk Model for Secondary Cytoreductive Surgery in Recurrent Ovarian Cancer: An Evidence-Based Proposal for Patient Selection

Abstract: To develop a risk model for predicting complete secondary cytoreductive surgery (SCR) in patients with recurrent ovarian cancer. Individual data of 1075 patients with recurrent ovarian cancer undergoing SCR from 7 worldwide centers were pooled and analyzed. The risk model was developed based on the factors impacting on SCR surgical outcome. Additional data on 117 patients who were not included in the development of the model were used for external validation and to assess the discrimination of the model. Of the 1075 patients, 434 (40.4%) underwent complete resection. Complete secondary cytoreduction was associated with six variables: FIGO stage (odds ratio [OR] = 1.32, 95% confidence interval [95% CI]: 0.97–1.80), residual disease after primary cytoreduction (OR = 1.69, 95% CI: 1.26–2.27), progression-free interval (OR = 2.27, 95% CI: 1.71–3.01), Eastern Cooperative Oncology Group (ECOG) performance status (OR = 2.23, 95% CI: 1.45–3.44), CA125 (OR = 1.85, 95% CI: 1.41–2.44), and ascites at recurrence (OR = 2.79, 95% CI: 1.88–4.13). These variables were entered into the risk model and assigned scores ranging from 0 to 11.9. Patients with total scores of 0–4.7 were categorized as the low-risk group, in which the proportion of complete cytoreduction was 53.4% compared with 20.1% in the high-risk group (OR = 4.55, 95% CI: 3.43–6.04). In external validation, the sensitivity and specificity was 83.3% and 57.6%, respectively. Area under the curve of the receiver-operating characteristics for predicting complete SCR was 0.68 (95% CI: 0.60–0.79). This model and scoring system may well predict the outcome of SCR and could potentially be useful in future clinical trials to determine which patients with recurrent ovarian cancer should have SCR as part of their management.

Clinical evaluation of alopecias using a handheld dermatoscope

Abstract: Background There are numerous reports of the value of videodermatoscopy in the clinical evaluation of alopecia. Studies performed with a handheld dermatoscope are scarce and limited to a few disease entities. Objective The aim of this study was to evaluate the potential benefit of a handheld dermatoscope in the clinical diagnosis of alopecia. Methods In all, 144 patients with alopecia and 144 age- and sex-matched control subjects were enrolled in the study. Diagnoses were established clinically, and confirmed by scalp biopsy in doubtful cases. Dermatoscopic examination was performed by a polarized-light handheld dermatoscope with a 10-fold magnification. The images were obtained by a digital camera with a 3-fold optical zoom. Results The dermatoscopic patterns of circular hairs, dirty dots, epidermal scale, and pustules showed no statistically significant difference between patients and control subjects. The following features were significantly more common, or observed solely, in particular types of alopecia: hair diameter diversity, peripilar sign, and empty follicles in androgenetic alopecia; yellow dots, black dots, tapering hairs, and broken hairs in alopecia areata; absence of follicular openings, tufted hairs, white dots, follicular hyperkeratosis, pili torti, red dots, honeycomb pigment pattern, pink-white appearance, crusts, and pustules in primary cicatricial alopecias. Limitations Evaluation of all primary cicatricial alopecias in the same cluster. Conclusions We suggest that a polarized-light handheld dermatoscope attached to a digital camera provides a practical and useful aid for the clinical diagnosis of alopecias.

Management of neuropathic pain with methylprednisolone at the site of nerve injury.

Abstract: Objective. Peripheral nerve blocks with methylprednisolone may provide effective pain therapy by decreasing ectopic neuronal discharge and the release of local inflammatory mediators at the site of nerve injury. In this study, we aimed to compare the efficacy of lidocaine alone with a combination of depo-methylprednisolone plus lidocaine in the management of neuropathic pain due to peripheral nerve damage. Design. Randomized, double-blind comparator trial Setting. Group control (N = 44) received 0.5% lidocaine and group methylprednisolone (N = 44) received 80 mg depo-methylprednisolone + 0.5% lidocaine proximal to the site of nerve injury with a total amount of 10–20 mL solution according to the type of peripheral nerve block with nerve stimulator. Outcome Measures. Demographic data, preblock numerical rating scales (NRSs), the Leeds assessment of neuropathic symptoms and signs (LANSS0) score, accompanying symptoms, and analgesic requirements were recorded. Postblock NRS scores were noted following peripheral nerve block and after 3 months. LANSS1, accompanying symptoms, and analgesic requirements were also reevaluated 3 months after the injection. Results. Demographic data, preblock NRS (8 ± 1.5 and 8.1 ± 1.2, respectively), postblock NRS (2.1 ± 1.2 and 2.4 ± 1.4, respectively), LANSS0 (18.4 ± 2.2 and 18.2 ± 2.1, respectively), and accompanying symptoms were comparable between groups. Scores for the methylprednisolone group were significantly improved at 3-month postblock for NRS (2 ± 1.4 vs 5.2 ± 1.7) and LANSS1 scores (4.14 ± 2.7 vs 14.1 ± 2.8), accompanying symptoms, and analgesic requirements (P < 0.0001). Conclusions. Our results suggest that peripheral nerve block with 80 mg depo-methylprednisolone plus 0.5% lidocaine provides effective management in the treatment of neuropathic pain due to peripheral nerve damage.

Novel mutations consolidate KCTD7 as a progressive myoclonus epilepsy gene.

Abstract: Background The progressive myoclonus epilepsies (PMEs) comprise a group of clinically and genetically heterogeneous disorders characterised by myoclonus, epilepsy, and neurological deterioration. This study aimed to identify the underlying gene(s) in childhood onset PME patients with unknown molecular genetic background. Methods Homozygosity mapping was applied on genome-wide single nucleotide polymorphism data of 18 Turkish patients. The potassium channel tetramerisation domain-containing 7 ( KCTD7 ) gene, previously associated with PME in a single inbred family, was screened for mutations. The spatiotemporal expression of KCTD7 was assessed in cellular cultures and mouse brain tissue. Results Overlapping homozygosity in 8/18 patients defined a 1.5 Mb segment on 7q11.21 as the major candidate locus. Screening of the positional candidate gene KCTD7 revealed homozygous missense mutations in two of the eight cases. Screening of KCTD7 in a further 132 PME patients revealed four additional mutations (two missense, one in-frame deletion, and one frameshift-causing) in five families. Eight patients presented with myoclonus and epilepsy and one with ataxia, the mean age of onset being 19 months. Within 2 years after onset, progressive loss of mental and motor skills ensued leading to severe dementia and motor handicap. KCTD7 showed cytosolic localisation and predominant neuronal expression, with widespread expression throughout the brain. None of three polypeptides carrying patient missense mutations affected the subcellular distribution of KCTD7. Discussion These data confirm the causality of KCTD7 defects in PME, and imply that KCTD7 mutation screening should be considered in PME patients with onset around 2 years of age followed by rapid mental and motor deterioration.

The role of mean platelet volume in predicting thrombotic events.

Abstract: Studies on platelet function have accelerated and gained popularity since the advent of novel treatment modalities and techniques on atherosclerotic vascular disease, such as antiplatelet drugs and stents. Today it is widely known that platelets exert a fundamental role in inflammation in addition to their long known role in homeostasis and thrombotic events. Interaction with endothelial cells and leukocytes mediates inflammation, contributes to atherogenesis and modulates immune activity. Platelet activation which is a central factor in many arterial disorders may be triggered by multiple pathways. Platelet activation is shown as forming a larger shape, aggregation and releasing various active contents. Mean platelet volume is a marker of platelet size, function and activation. Increased mean platelet volume is shown by active and large platelets that release more thromboxane A2 than smaller ones. The aim of this review is to determine whether early detection of platelet activation via increased mean platelet volume would help to recognize the pro-inflammatory state and administer appropriate and effective treatment properly. An easily detectable marker by using a prompt and functional technique would help our approach to inflammation caused by platelets.

Design and Implementation of a 154-kV $\pm$ 50-Mvar Transmission STATCOM Based on 21-Level Cascaded Multilevel Converter

Abstract: In this research work, the design and implementation of a 154-kV ± 50-Mvar transmission static synchronous compensator (T-STATCOM) have been carried out primarily for the purposes of reactive power compensation and terminal voltage regulation and secondarily for power system stability. The implemented T-STATCOM consists of five 10.5-kV ±12-Mvar cascaded multilevel converter (CMC) modules operating in parallel. The power stage of each CMC is composed of five series-connected H-bridges (HBs) in each phase, thus resulting in 21-level line-to-line voltages. Due to modularity and flexibility of implemented HBs, each CMC module has reached a power density of 250 kvar/m3, thus making the mobility of the system implementable. DC-link capacitor voltages of HBs are perfectly balanced by means of the modified selective swapping algorithm proposed. The field tests carried out at full load in the 154-kV transformer substation where T-STATCOM is installed have shown that the steady-state and transient responses of the system are quite satisfactory.

The relationship between social support and the level of anxiety, depression, and quality of life of Turkish women with gynecologic cancer.

Abstract: BACKGROUND Anxiety and depression are among the most common psychosocial problems with gynecologic cancer patients. In this respect, "social support" has become a key tool in the patients' coping with the aforementioned risk factors as an important contributor to their well-being. OBJECTIVE The purpose of this study was to assess the relationship between social support and the level of anxiety, depression, and quality of life of Turkish women with gynecologic cancer. METHODS In a hospital in Turkey, 187 women with a diagnosis of gynecologic cancer comprised a convenience sample and completed 4 study instruments in a cross-sectional design. RESULTS Statistically significant correlations among type of perceived social support, quality of life, anxiety, and depression (P < .001) were found. While high social support was associated with increased quality of life, it was also associated with reduced anxiety and depression rates. CONCLUSION Our study showed that the type of perceived social support by the patients with cancer had significant effect on depression, anxiety, and quality of life. IMPLICATIONS FOR PRACTICE Social support is a powerful tool that can mediate the effects of difficult life stressors and decrease the incidence of mood disorders, and, therefore, greater importance should be attached to it in the realm of cancer treatment. Supported by the collaborative efforts of family members and healthcare professionals, cancer patients will more easily cope with the drawbacks of their state.

Midterm outcome after a microsurgical unilateral approach for bilateral decompression of lumbar degenerative spondylolisthesis.

Abstract: Object The aim of this study was to evaluate the results and effectiveness of bilateral decompression via a unilateral approach in the treatment of lumbar degenerative spondylolisthesis (DS) Methods Operations were performed in 84 selected patients (mean age 621 ± 10 years) with lumbar DS between the years 2001 and 2008 The selection criteria included lower back pain with or without sciatica, neurogenic claudication that had not improved after at least 6 months of conservative treatment, and a radiological diagnosis of Grade I DS and lumbar stenosis Decompression was performed at 3 levels in 155%, 2 levels in 548%, and 1 level in 297% of the patients with 1 level of spondylolisthesis All patients were followed up for at least 24 months For clinical evaluations, a visual analog scale, Oswestry Disability Index (ODI), and Neurogenic Claudication Outcome Score (NCOS) were used Spinal canal size and (neutral and dynamic) slip percentages were measured both pre- and postoperatively Results Neutral a

A wavelet and teager energy operator based method for automatic detection of K-Complex in sleep EEG

Abstract: In this study, an efficient algorithm is proposed for the automatic detection of K-complex from EEG recordings. First, the morphology of the K-complex had been examined and the detection features were determined according to visual recognition criterions of human scorer. These features were based on amplitude and duration properties of K-complex waveform. The algorithm is based on wavelet and teager energy operator and includes two main stages. Both results of stages were combined to make robust decision. The EEG recordings obtained from the Sleep Research Laboratory in Department of Psychiatry at Gulhane Military Medical Academy. All night sleep EEG data, total 1045 epochs and 690 of these are NREM 2 stage, from 25 years old healthy female subject were used. Three scorers inspected recording separately to score K-complexes. The detection algorithm was then tested on the same recording. The results show that the agreements between the scorers were fairly different. The results are evaluated with the ROC analysis which proves up to 91% success in detecting the K-complex.

Cutaneous id reactions: A comprehensive review of clinical manifestations, epidemiology, etiology, and management

Abstract: Id reactions are a type of secondary inflammatory reaction that develops from a remote localized immunological insult. To date, id reactions caused by various fungal, bacterial, viral, and parasitic infections have been reported. Superficial fungal infections, especially tinea pedis, are the most common cause of id reactions. Id reactions exhibit multiple clinical presentations, including localized or widespread vesicular lesions, maculopapular or scarlatiniform eruptions, erythema nodosum, erythema multiforme, erythema annulare centrifugum, Sweet's syndrome, guttate psoriasis, and autoimmune bullous disease. The mechanisms underlying id reactions vary depending on the type of clinical presentation. The most important aspect of therapy involves the identification and adequate treatment of the underlying infection or dermatitis. This review comprehensively discusses the current state of the field concerning cutaneous id reactions, including diagnostic criteria, clinical presentations, underlying infectious conditions, etiologic agents, immunologic characteristics, histopathologic findings, and management strategies.

BOX- BEHNKEN experimental design in factorial experiments: The importance of bread for nutrition and health

Abstract: BACKROUND: In this study, a BOX-BEHNKEN design (BBD) of response surface methodology was used to investigate the effects of the amount of bran, the amount of yeast and the fermentation time on the amount of phytic acid in bread. The goal of first order factorial experiment is to identify the optimum levels of independent variables for the dependent variable. In this study, the implementation of first order response surface model and interpretation of the results were based on a 3 k Box- Benhnken (BBD) experimental design with one replicate. RESULTS: The calculation of the data for the first-order response surface model revealed that R 2 was 99,5% and that the model described most of the variance in the dependent variable (phytic acid). CONCLUSION: According to the results of the Box-Behnken experimental design (BBD), it was found that the amount of bran and the fermentation time had highest effect on phytic acid and that the amount of yeast, either alone or in any interaction, had no effect on the amount of phytic acid. Thus, it was concluded that optimal use of the amount of bran and fermentation time in the production of high-quality bread could prevent several diseases in future.

Predictability of outcome of caustic ingestion by esophagogastroduodenoscopy in children.

Abstract: AIM: To assess the necessity of esophagogastroduodenoscopy (EGD) to predict the outcome of caustic ingestion in children. METHODS: The study included 206 children who underwent EGD because of ingestion of caustic substances between January 2005 and August 2010. Retrospective analysis of data of the patients was performed. RESULTS: The male/female ratio was 1.6 and mean age was 38.1 ± 28.8 mo. The caustic substances were acidic in 72 (34.9%) cases, alkaline in 56 (27.2%), liquid household bleach in 62 (30.1%), and unknown in 16 (7.8%). Fifty-seven (27.7%) patients were symptom-free. Significant clinical findings were observed in 149 (72.3%) patients. Upper gastrointestinal endoscopy findings of esophageal injury were grade 0 in 86 (41.7%) patients, grade 1 in 49 (23.8%), grade 2a in 42 (20.4%), grade 2b in 28 (13.6%), and grade 3a in 1 (0.5%) patient. 35 patients with grade 2a, 2b, and 3a injuries underwent esophageal dilation at second week of ingestion. Esophageal stricture, which necessitated a regular dilation program developed in 13 of the aforementioned 35 patients. There is no statistically significant difference in the rate of development of esophageal stricture between the patients who ingested acidic (15.3%) and alkaline (8.9%) substances (P = 0.32). Severe gastric injury was detected in 38 (18.5%) patients. The rate of development of gastric injury was significantly higher in the acidic group (14%) than in the alkaline group (2.9%) (P = 0.001). Out of 149 patients with clinical findings, 49 (32.9%) patients had no esophageal injury and 117 (78.5%) patients had no gastric lesion. Esophageal and severe gastric injuries were detected in 20 (35.1%) and 8 (14%) of patients with no clinical findings respectively. Pyloric stenosis developed in 6 patients. Pyloric obstruction improved with balloon dilation in 2 patients. Mean hospitalization time were 1.2 ± 0.5 d for grade 0 and 2.3 ± 5 d for grade 1 and 6.3 ± 6.2 d for grade 2a and 15.8 ± 18.6 d for grade 2b. It was significantly longer for patients with grade 2a and 2b injuries (P = 0.000). CONCLUSION: Endoscopy is an effective technique for determining the presence of esophageal and gastric damage and to avoid unnecessary treatment in patients with no or mild injury.

Consumer-based brand equity in banking industry: A comparison of local and global banks in Turkey

Abstract: Purpose – The purpose of this paper is to examine bank brand equity from consumer perspectives by comparing the consumer‐based brand equity (CBBE) dimensions of local and global banks in Turkey. The paper determines if and how CBBE differs across three types of banks (state, private, and foreign).Design/methodology/approach – Measurements of brand equity dimensions were drawn from the literature, which included brand awareness, perceived quality, brand image, brand association, organizational association, and brand loyalty. Data were collected from adult customers of three types of banks.Findings – It was found that the overall CBBE, perceived quality, brand image/association, and brand loyalty were significantly higher for private banks than for state and foreign banks. Organizational association was the highest for state banks, followed by private banks, and the lowest for foreign banks. Foreign banks scored the lowest in perceived quality, brand loyalty, and the overall CBBE.Originality/value – The res...

Majocchi's granuloma: a symptom complex caused by fungal pathogens

Abstract: Majocchi's granuloma (MG) is a well-recognized but uncommon infection of dermal and subcutaneous tissues that is caused by mold fungi. Although primarily caused by keratinophilic dermatophytes such as anthropophilic Trichophyton rubrum, species from the Aspergillus and Phoma genera have been occasionally detected as etiologic agents of MG. In both healthy individuals and immunocompromised hosts, MG often presents as nodules, plaques, and papules on areas that are prone to trauma. Although MG generally appears on the upper and lower extremities (forearms, hands, legs, or ankles), it occasionally appears on the scalp and face. The clinical, mycologic, and/or cytologic diagnosis should be confirmed by the demonstration of perifollicular granulomatous inflammation by histologic examination. This review focuses on the clinical presentation, pathogenesis, laboratory diagnostic methods (including the Tzanck smear test), etiologic agents, histopathologic characteristics, and therapeutic approaches to the treatment of MG.

The effect of oral and parenteral vitamin D supplementation in the elderly: a prospective, double-blinded, randomized, placebo-controlled study

Abstract: Hypovitaminosis D in the elderly causes falls and fractures as a result of impaired neuromuscular functions and also may be a reason for nonspecific musculosceletal pain. The aim of this study is to investigate the benefits of a single dose per os or parenterally administrated vitamin D on increasing the quality of life and functional mobility and decreasing the pain in the elderly. The community-dwelling elderly subjects over 65 years age were included in the study. The subjects were given 300.000 IU Vitamin D via per os and parenteral route and assessed after 4 weeks. The serum creatinine, calcium, phosphorous, ALT, ALP, 24-h urine calcium excretion, PTH, and vitamin D levels, as well as VAS (visual analog scale) for pain assessment, functional mobility with TUG (timed up and go test) and quality of life with SF-36 before and after the treatment were evaluated. The serum vitamin D levels were measured by the RIA method. The subjects were divided into four groups each consisting of 30 subjects. The 1st group took i.m. vitamin D, the 2nd group took i.m. placebo, the 3rd group took p.o. vitamin D, and the 4th group took p.o. placebo. The mean age of all the participants was 70.1 ± 4.3 years. There was no difference in the age and gender between the groups (P > 0.05). After treatment, the PTH level of first group was decreased (P = 0.0001) and the vitamin D level increased (P = 0.0001) significantly. In the third group, the PTH level of first group was decreased (P = 0.0001) and the vitamin D level increased (P = 0.004) and the 24-h calcium excretion in urine (P = 0.015) increased significantly. When the pain, the functional mobility, and the quality of life were evaluated, in the first group, the TUG (P = 0.0001) and the VAS (P = 0.0001) decreased significantly, whereas the SF-36 subtitles: physical functioning (P = 0.0001), role physical (0.006), bodily pain (P = 0.0001), general health (P = 0.007), social functioning (P = 0.05), and mental health (P = 0.048) increased significantly. In group two, the VAS (P = 0.001) decreased, the role physical (P = 0.009), and role emotional (P = 0.034) increased significantly; In group three, the TUG (P = 0.0001) and the VAS (P = 0.002) decreased, whereas the physical function (P = 0.0001) and role physical (0.001) increased significantly; In group four, the VAS (P = 0.007) decreased significantly. The megadose vitamin D administration increases quality of life, decreases pain, and improves functional mobility via po or im route in the elderly.

Impact of Satisfaction and Commitment on Teachers' Organizational Citizenship.

Abstract: This study examined the impact of job satisfaction and organizational commitment on teachers’ organizational citizenship behavior (OCB) in a structural equation model. The study was employed to a group of teachers and their supervisors. The results indicated that job satisfaction and commitment to the school had an impact on OCBs of the teachers and organizational commitment mediated the relation between job satisfaction and OCB.

Shear bond strength of brackets to demineralize enamel after different pretreatment methods

Abstract: Objective: To compare the influence of demineralized and variously pretreated demineralized enamel on the shear bond strength of orthodontic brackets. Materials and Methods: Sixty bovine enamel specimens were allocated to five groups (n = 12). Specimens of group 1 were not demineralized and were not pretreated, but served as controls. The other specimens were demineralized to form artificial carious lesions. Samples from group 2 were only demineralized and were kept untreated in artificial saliva. The other samples were pretreated with highly concentrated fluoride preparations (group 3: Elmex Gelee, 1.23% F; group 4: Clinpro White Varnish, 2.23% F) or with an infiltrating resin (group 5: Icon). After respective pretreatments, brackets were adhesively fixed on all specimens with an adhesive system after etching with 35% phosphoric acid and application of a primer and bracket resin cement (Transbond XT). Bracket shear bond strength was evaluated with a universal testing machine. Statistical analy...