Showing papers by "Başkent University published in 2018"
Richard A. Klein1, Michelangelo Vianello2, Fred Hasselman3, Byron G. Adams4 +187 more•Institutions (118)
TL;DR: This paper conducted preregistered replications of 28 classic and contemporary published findings, with protocols that were peer reviewed in advance, to examine variation in effect magnitudes across samples and settings, and found that very little heterogeneity was attributable to the order in which the tasks were performed or whether the task were administered in lab versus online.
Abstract: We conducted preregistered replications of 28 classic and contemporary published findings, with protocols that were peer reviewed in advance, to examine variation in effect magnitudes across samples and settings. Each protocol was administered to approximately half of 125 samples that comprised 15,305 participants from 36 countries and territories. Using the conventional criterion of statistical significance (p < .05), we found that 15 (54%) of the replications provided evidence of a statistically significant effect in the same direction as the original finding. With a strict significance criterion (p < .0001), 14 (50%) of the replications still provided such evidence, a reflection of the extremely high-powered design. Seven (25%) of the replications yielded effect sizes larger than the original ones, and 21 (75%) yielded effect sizes smaller than the original ones. The median comparable Cohen’s ds were 0.60 for the original findings and 0.15 for the replications. The effect sizes were small (< 0.20) in 16 of the replications (57%), and 9 effects (32%) were in the direction opposite the direction of the original effect. Across settings, the Q statistic indicated significant heterogeneity in 11 (39%) of the replication effects, and most of those were among the findings with the largest overall effect sizes; only 1 effect that was near zero in the aggregate showed significant heterogeneity according to this measure. Only 1 effect had a tau value greater than .20, an indication of moderate heterogeneity. Eight others had tau values near or slightly above .10, an indication of slight heterogeneity. Moderation tests indicated that very little heterogeneity was attributable to the order in which the tasks were performed or whether the tasks were administered in lab versus online. Exploratory comparisons revealed little heterogeneity between Western, educated, industrialized, rich, and democratic (WEIRD) cultures and less WEIRD cultures (i.e., cultures with relatively high and low WEIRDness scores, respectively). Cumulatively, variability in the observed effect sizes was attributable more to the effect being studied than to the sample or setting in which it was studied.
495 citations
Karolinska Institutet1, University of Tennessee Health Science Center2, Semmelweis University3, Obafemi Awolowo University4, Rio de Janeiro State University5, St George's Hospital6, Gdańsk Medical University7, University of Parma8, Claude Bernard University Lyon 19, University of Ulsan10, Vanderbilt University11, Veterans Health Administration12, Imperial College Healthcare13, University of California, Irvine14, Taylors University15, Federal Fluminense University16, University of Toronto17, Case Western Reserve University18, Sanjay Gandhi Post Graduate Institute of Medical Sciences19, Başkent University20, University of Lausanne21, VU University Amsterdam22, University of Hong Kong23
TL;DR: It is concluded that PEW is a common phenomenon across the spectrum of AKI and CKD, and the well-documented impact of PEW on patient outcomes justifies the need for increased medical attention.
202 citations
University of Brescia1, University Hospitals Birmingham NHS Foundation Trust2, Mansoura University3, Ahmadu Bello University4, Başkent University5, Mustafa Kemal University6, Sakarya University7, Medical University Plovdiv8, Hadassah Medical Center9, UCLA Medical Center10, Sapienza University of Rome11, University of California, San Diego12, Central University, India13, Qatar Airways14, State University of Campinas15, National and Kapodistrian University of Athens16, Karadeniz Technical University17, Government Medical College, Thiruvananthapuram18, Aristotle University of Thessaloniki19, Erzincan University20, Hospital of Lithuanian University of Health Sciences Kaunas Clinics21, University of Belgrade22, Turku University Hospital23, Jubilee Mission Medical College and Research Institute24, Jagiellonian University Medical College25, LAC+USC Medical Center26, Inje University27, Edendale Hospital28, Mahidol University29, University Hospital Centre Zagreb30, University of the West Indies31, AHEPA University Hospital32, University of Ilorin33, King Abdullah University Hospital34, University of Valle35, SIDI36, King George's Medical University37, Bharati Vidyapeeth University38, Russells Hall Hospital39, Tan Tock Seng Hospital40, Russian Railways41, Jagiellonian University42, Tbilisi State Medical University43, University of Pécs44, Kocaeli University45, Memorial Hospital of South Bend46, Nankai University47
TL;DR: The results of the present study confirm the clinical value of imaging techniques and prognostic scores and confirm that appendectomy remains the most effective treatment of acute appendicitis.
Abstract: Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments. This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016–September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study. A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%. The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low.
153 citations
TL;DR: Overall, a decrease in net endogenous acid production and increase in fibre may lead to a better control of metabolic acidosis and provide mechanistic pathways to explain the observed reduced renal function decline and improved survival in CKD patients adhering to an MD.
Abstract: Traditional dietary management of chronic kidney disease (CKD) focuses on the quantity within the diet of energy and protein, and the restriction of single micronutrients, with little mention of dietary quality. Dietary patterns that are more plant-based, lower in meat (including processed meat), sodium and refined sugar, and have a higher content of grains and fibres are now included in multiple clinical guidelines for chronic disease prevention. The Mediterranean diet (MD) has been associated with reduced cardiovascular disease incidence in both observational and interventional studies. A wealth of evidence linksMDwith other beneficial effects on chronic diseases such as diabetes, obesity or cognitive health. This review examines each constituent of the classical MD and evaluates their suitability for the management of patients with CKD. We also evaluate the potential hyperkalaemia risk of increasing fruit and vegetable intake. Overall, a decrease in net endogenous acid production and increase in fibre may lead to a better control of metabolic acidosis. This, together with other putative favourable effects ofMD on endothelial function, inflammation, lipid profile and blood pressure, provide mechanistic pathways to explain the observed reduced renal function decline and improved survival in CKD patients adhering to an MD.
107 citations
TL;DR: Evidence is found that kinect-based game system in addition to conventional therapy may have supplemental benefit for stroke patients, and for virtual reality game systems to enter the routine practice of stroke rehabilitation, randomized controlled clinical trials with longer follow-up periods and larger sample sizes are needed.
Abstract: Objective Virtual reality game system is one of novel approaches, which can improve hemiplegic extremity functions of stroke patients We aimed to evaluate the effect of the Microsoft Xbox 360 Kinect video game system on upper limb motor functions for subacute stroke patients Methods The study included 42 stroke patients of which 35 (19 Virtual reality group, 16 control group) completed the study All patients received 60 minutes of conventional therapy for upper extremity, 5 times per-week for 4 weeks Virtual reality group additionally received Xbox Kinect game system 30 minutes per-day Patients were evaluated prior to the rehabilitation and at the end of 4 weeks Box&Block Test, Functional independence measure self-care score, Brunnstorm stage and Fugl-Meyer upper extremity motor function scale were used as outcome measures Results The Brunnstrom stages and the scores on the Fugl-Meyer upper extremity, Box&Block Test and Functional independence measure improved significantly from baseline to post-treatment in both the experimental and the control groups The Brunnstrom stage-upper extremity and Box&Block Test gain for the experimental group were significantly higher compared to the control group, while the Brunnstrom stage-hand, the Functional independence measure gain and Fugl-Meyer gain were similar between the groups Conclusions We found evidence that kinect-based game system in addition to conventional therapy may have supplemental benefit for stroke patients However, for virtual reality game systems to enter the routine practice of stroke rehabilitation, randomized controlled clinical trials with longer follow-up periods and larger sample sizes are needed especially to determine an optimal duration and intensity of the treatment
83 citations
TL;DR: A large cohort of patients with congenital diarrheal disorders with mutations in DGAT1 that reduced expression of its product are identified; dermal fibroblasts and intestinal organoids derived from these patients had altered lipid metabolism and were susceptible to lipid-induced cell death and fat metabolism and lipotoxicity in the intestinal epithelium.
72 citations
TL;DR: A meiotic abnormality in mammals is uncovered and a mechanism for the genesis of androgenetic zygotes that is the extrusion of all maternal chromosomes and their spindles into the first polar body is uncovered.
Abstract: Androgenetic complete hydatidiform moles are human pregnancies with no embryos and affect 1 in every 1,400 pregnancies. They have mostly androgenetic monospermic genomes with all the chromosomes originating from a haploid sperm and no maternal chromosomes. Androgenetic complete hydatidiform moles were described in 1977, but how they occur has remained an open question. We identified bi-allelic deleterious mutations in MEI1, TOP6BL/C11orf80, and REC114, with roles in meiotic double-strand breaks formation in women with recurrent androgenetic complete hydatidiform moles. We investigated the occurrence of androgenesis in Mei1-deficient female mice and discovered that 8% of their oocytes lose all their chromosomes by extruding them with the spindles into the first polar body. We demonstrate that Mei1−/− oocytes are capable of fertilization and 5% produce androgenetic zygotes. Thus, we uncover a meiotic abnormality in mammals and a mechanism for the genesis of androgenetic zygotes that is the extrusion of all maternal chromosomes and their spindles into the first polar body.
60 citations
TL;DR: Automated cut-off-finding and combination-testing in a tissue-microarray comprising 174 samples demonstrated that detection of high BCL11B and/or GLG1 expression is sufficient to reach 96% specificity for Ewing sarcoma.
Abstract: Ewing sarcoma is an undifferentiated small-round-cell sarcoma. Although molecular detection of pathognomonic EWSR1-ETS fusions such as EWSR1-FLI1 enables definitive diagnosis, substantial confusion can arise if molecular diagnostics are unavailable. Diagnosis based on the conventional immunohistochemical marker CD99 is unreliable due to its abundant expression in morphological mimics. To identify novel diagnostic immunohistochemical markers for Ewing sarcoma, we performed comparative expression analyses in 768 tumors representing 21 entities including Ewing-like sarcomas, which confirmed that CIC-DUX4-, BCOR-CCNB3-, EWSR1-NFATc2-, and EWSR1-ETS-translocated sarcomas are distinct entities, and revealed that ATP1A1, BCL11B, and GLG1 constitute specific markers for Ewing sarcoma. Their high expression was validated by immunohistochemistry and proved to depend on EWSR1-FLI1-binding to highly active proximal super-enhancers. Automated cut-off-finding and combination-testing in a tissue-microarray comprising 174 samples demonstrated that detection of high BCL11B and/or GLG1 expression is sufficient to reach 96% specificity for Ewing sarcoma. While 88% of tested Ewing-like sarcomas displayed strong CD99-immunoreactivity, none displayed combined strong BCL11B- and GLG1-immunoreactivity. Collectively, we show that ATP1A1, BCL11B, and GLG1 are EWSR1-FLI1 targets, of which BCL11B and GLG1 offer a fast, simple, and cost-efficient way to diagnose Ewing sarcoma by immunohistochemistry. These markers may significantly reduce the number of misdiagnosed patients, and thus improve patient care.
56 citations
Qualcomm1, National University of Health Sciences2, University of California, Los Angeles3, University of California, Irvine4, Oregon Health & Science University5, New York University6, University of Ontario Institute of Technology7, University of Hawaii at Manoa8, Canadian Memorial Chiropractic College9, University of Toronto10, University of Geneva11, Université de Montréal12, University of Valencia13, University of Sydney14, Washington University in St. Louis15, University of Melbourne16, Complutense University of Madrid17, Veterans Health Administration18, Tehran University of Medical Sciences19, University of Cape Town20, National University of La Plata21, Palmer College of Chiropractic22, Nottingham University Hospitals NHS Trust23, University of Health Sciences Antigua24, Novo Nordisk25, University of Southern Denmark26, University of Kansas27, University of Ottawa28, Case Western Reserve University29, Moi University30, University of Yaoundé I31, Stanford University32, Başkent University33, University of Namibia34, Pontifícia Universidade Católica do Paraná35, AMRI Hospitals36, Stellenbosch University37, University of Texas Medical Branch38, Houston Methodist Hospital39, Sarawak General Hospital40, Yıldırım Beyazıt University41
TL;DR: The GSCI proposes an evidence-based, practical, sustainable, and scalable model of care representing eight core principles with a six-step implementation plan to help transform spine care globally, especially in low- and middle-income countries and underserved communities.
Abstract: Spine-related disorders are a leading cause of global disability and are a burden on society and to public health Currently, there is no comprehensive, evidence-based model of care for spine-related disorders, which includes back and neck pain, deformity, spine injury, neurological conditions, spinal diseases, and pathology, that could be applied in global health care settings The purposes of this paper are to propose: (1) principles to transform the delivery of spine care; (2) an evidence-based model that could be applied globally; and (3) implementation suggestions The Global Spine Care Initiative (GSCI) meetings and literature reviews were synthesized into a seed document and distributed to spine care experts After three rounds of a modified Delphi process, all participants reached consensus on the final model of care and implementation steps Sixty-six experts representing 24 countries participated The GSCI model of care has eight core principles: person-centered, people-centered, biopsychosocial, proactive, evidence-based, integrative, collaborative, and self-sustaining The model of care includes a classification system and care pathway, levels of care, and a focus on the patient’s journey The six steps for implementation are initiation and preparation; assessment of the current situation; planning and designing solutions; implementation; assessment and evaluation of program; and sustain program and scale up The GSCI proposes an evidence-based, practical, sustainable, and scalable model of care representing eight core principles with a six-step implementation plan The aim of this model is to help transform spine care globally, especially in low- and middle-income countries and underserved communities These slides can be retrieved under Electronic Supplementary Material
53 citations
50 citations
TL;DR: Increased phosphorylated anti‐apoptotic Bax promotes resistance of cancer cells to inherent and drug‐induced apoptosis, and analysis of the TCGA database reveals that 98% of cancer patients with increased BAX levels also have an upregulated Akt pathway.
Abstract: Akt is a pro-survival kinase frequently activated in human cancers and is associated with more aggressive tumors that resist therapy. Here, we connect Akt pathway activation to reduced sensitivity to chemotherapy via Akt phosphorylation of Bax at residue S184, one of the pro-apoptotic Bcl-2 family proteins required for cells to undergo apoptosis. We show that phosphorylation by Akt converts the pro-apoptotic protein Bax into an anti-apoptotic protein. Mechanistically, we show that phosphorylation (i) enables Bax binding to pro-apoptotic BH3 proteins in solution, and (ii) prevents Bax inserting into mitochondria. Together, these alterations promote resistance to apoptotic stimuli by sequestering pro-apoptotic activator BH3 proteins. Bax phosphorylation correlates with cellular resistance to BH3 mimetics in primary ovarian cancer cells. Further, analysis of the TCGA database reveals that 98% of cancer patients with increased BAX levels also have an upregulated Akt pathway, compared to 47% of patients with unchanged or decreased BAX levels. These results suggest that in patients, increased phosphorylated anti-apoptotic Bax promotes resistance of cancer cells to inherent and drug-induced apoptosis.
TL;DR: Although the lower extremities were reported to be the most common site of infection, facial involvement has been predominant in the past 5 years and the most preferred drug is terbinafine, because of its efficacy, side effects, and safety.
Abstract: Majocchi's granuloma (MG) is a rare fungal infection of the dermis that is mainly caused by dermatophytes (in ≥95% of cases); the most frequently identified cause is anthropophilic Trichophyton rubrum. In the rest of the cases, the causes are non-dermatophytic fungi such as Aspergillus species. This review aimed to provide information about the current perspectives on MG regarding its clinical characteristics, predisposing factors, laboratory diagnosis, and treatment strategies. Although the lower extremities were reported to be the most common site of infection, facial involvement has been predominant in the past 5 years. Our literature research showed that the most common predisposing factor (55%) is the use of topical steroid creams without potassium hydroxide examination during treatment of erythematous squamous dermatoses. A reliable diagnosis of MG is based on histopathological examination, including fungal culture and molecular analyses. MG should be treated not only with topical agents but also with systemic antifungal agents that are continued until the lesions are completely resolved. In systemic treatment, the most preferred drug is terbinafine, because of its efficacy, side effects, and safety.
13 Jun 2018
TL;DR: It is considered that this case experienced grief/funeral mania because there was contiguity between loss of her son and manic episode, the patient did not react this way to previous challenging life events and the patient was outside of the ordinary 5 stages of grief process.
Abstract: 10th International Congress on Psychopharmacology & 6th International Symposium on Child and Adolescent Psychopharmacology[Abstract:0103][Mood disorders]A forgotten diagnosis: funeral maniaABSTRACT...
TL;DR: The identified Polo-like kinase 1 (PLK1), a mitotic kinase, as a resistance mediator whose genomic as well as pharmacological inhibition restored drug sensitivity and provided promising pre-clinical evidence for potential testing of T-DM1/volasertib combination in T- DM1 refractory HER2-positive breast cancer patients.
Abstract: Trastuzumab-refractory, HER2 (human epidermal growth factor receptor 2)-positive breast cancer is commonly treated with trastuzumab emtansine (T-DM1), an antibody-drug conjugate of trastuzumab and the microtubule-targeting agent, DM1. However, drug response reduces greatly over time due to acquisition of resistance whose molecular mechanisms are mostly unknown. Here, we uncovered a novel mechanism of resistance against T-DM1 by combining whole transcriptome sequencing (RNA-Seq), proteomics and a targeted small interfering RNA (siRNA) sensitization screen for molecular level analysis of acquired and de novo T-DM1-resistant models of HER2-overexpressing breast cancer. We identified Polo-like kinase 1 (PLK1), a mitotic kinase, as a resistance mediator whose genomic as well as pharmacological inhibition restored drug sensitivity. Both acquired and de novo resistant models exhibited synergistic growth inhibition upon combination of T-DM1 with a selective PLK1 inhibitor, volasertib, at a wide concentration range of the two drugs. Mechanistically, T-DM1 sensitization upon PLK1 inhibition with volasertib was initiated by a spindle assembly checkpoint (SAC)-dependent mitotic arrest, leading to caspase activation, followed by DNA damage through CDK1-dependent phosphorylation and inactivation of Bcl-2/xL. Furthermore, we showed that Ser70 phosphorylation of Bcl-2 directly regulates apoptosis by disrupting the binding to and sequestration of the pro-apoptotic protein Bim. Importantly, T-DM1 resistance signature or PLK1 expression correlated with cell cycle progression and DNA repair, and predicted a lower sensitivity to taxane/trastuzumab combination in HER2-positive breast cancer patients. Finally, volasertib in combination with T-DM1 greatly synergized in models of T-DM1 resistance in terms of growth inhibition both in three dimensional (3D) cell culture and in vivo. Altogether, our results provide promising pre-clinical evidence for potential testing of T-DM1/volasertib combination in T-DM1 refractory HER2-positive breast cancer patients for whom there is currently no treatment available.
TL;DR: This paper reviewed the evolution of the Adalet ve Kalkinma Partisi (AKP)'s civilizational outlook vis-a-vis the West as a discursive instrument that justified its Muslim democracy practices as well as its nativist authoritarian practices.
Abstract: This paper reviews the evolution of the Adalet ve Kalkinma Partisi (AKP)’s civilizational outlook vis-a-vis the West as a discursive instrument that justified its Muslim democracy practices as well as its nativist authoritarian practices. The former practice entails that the AKP appear as a Muslim democratic political force, reconciling Islam and democracy, falsifying the Orientalist essentialism prevalent in the West and resolving the crisis in Turkey’s Western identity. After relieving the secular establishment of its guardianship roles in 2010/2011, the AKP’s nativist practices have aimed at redefining Turkey as a Muslim nation by using a civilizational discourse. As such, the AKP’s nativism was characterized by an attempt at resetting the legitimate parameters of Turkish politics to reject the validity of the universal norms of democracy and the legitimacy of their domestic and international proponents. This naturally entailed a populist anti-establishment stance in foreign as well as domestic...
TL;DR: This study revealed that PV/ TV ratio was not gender dependent and the strongest correlation was found between the age and PV/TV ratio measured on maxillary central incisors than other teeth.
Abstract: Objectives:After tooth eruption, the size of the pulp cavity decreases with age owing to deposition of secondary dentine. The aim of this study was to investigate the relation between the chronological age and the ratio of pulp volume (PV) to tooth volume (TV) measurements using CBCT images of single rooted teeth.Methods:Maxillary anterior, canine and mandibular canine/premolar CBCT scans of patients older than 15 years of age were collected from the archives between 2013 and 2015 years. Patients with CBCT scans of teeth were seen in detail and patients with known chronological age were included. Teeth with caries, filling or crown restorations, periapical pathologies or pulps that could not be identified were excluded. Consequently, 204 patients with 655 teeth were evaluated. The PV and the TV of each tooth was measured and then the PV/TV ratio was calculated. Simple linear regression analysis was performed in order to predict age estimation by using PV/TV.Results:The PV/TV of all teeth ranged between 0....
TL;DR: A novel framework, which primarily integrates the Taguchi Method to a deep autoencoder based system without considering to modify the overall structure of the network, is presented and the results are quite encouraging and verified the overall performance of the proposed framework.
Abstract: Deep autoencoder neural networks have been widely used in several image classification and recognition problems, including hand-writing recognition, medical imaging, and face recognition. The overall performance of deep autoencoder neural networks mainly depends on the number of parameters used, structure of neural networks, and the compatibility of the transfer functions. However, an inappropriate structure design can cause a reduction in the performance of deep autoencoder neural networks. A novel framework, which primarily integrates the Taguchi Method to a deep autoencoder based system without considering to modify the overall structure of the network, is presented. Several experiments are performed using various data sets from different fields, i.e., network security and medicine. The results show that the proposed method is more robust than some of the well-known methods in the literature as most of the time our method performed better. Therefore, the results are quite encouraging and verified the overall performance of the proposed framework.
TL;DR: By providing optimal LC, low toxicity and a promising PFS in CS patients, the current retrospective study illustrated that 68Ga PSMA PET-CT-guided RT may be an attractive treatment strategy in patients with oligometastatic prostate cancer.
Abstract: To investigate the efficacy and toxicity of 68Ga-PSMA-HBED-CC (68Ga-PSMA) PET-CT-guided RT in the treatment of
oligometastatic prostate cancer retrospectively. A total of 23 prostate cancer patients with biochemical relapse, of which 13 were castration sensitive (CS) and 10 castration resistant (CR), were treated with intensity-modulated and image-guided RT (IMRT-IGRT) on ≤3 metastases detected by 68Ga PSMA PET-CT. Androgen deprivation therapy was continued in CR patients. A total of 38 metastases were treated. The involved sites were pelvic bone (n = 16), pelvic lymph nodes (n = 11), paraaortic lymph nodes (n = 6), ribs (n = 3) and vertebral body (n = 2). The median PSA prior to RT was 1.1 ng/mL (range 0.1–29.0 ng/mL). A median dose of 43.5 Gy (range 30–64 Gy) was delivered by IMRT-IGRT in 12–27 fractions. At a median follow-up of 7 months (range 2–17 months), 19 patients (83%) were in remission. Four patients (17%) developed distant recurrences. The actuarial 1-year LC, PFS and OS rates were 100, 51 (95% CI 8–83%) and 100%. Univariate analysis demonstrated a statistically significantly better PFS in CS patients as compared to CR patients (1-year PFS 67 vs. 0%, p < 0.01). One patient experienced grade 2 acute gastrointestinal toxicity. Grade 3 or more toxicity events were not observed. By providing optimal LC, low toxicity and a promising PFS in CS patients, the current retrospective study illustrated that 68Ga PSMA PET-CT-guided RT may be an attractive treatment strategy in patients with oligometastatic prostate cancer. Validation by randomized trials is eagerly awaited.
TL;DR: The desirability function method using the Response Optimizer tool in MINITAB and goal programming methodology was used to obtain the values of the parameters that achieved minimum surface roughness and a minimum quantity of carbon emission.
Abstract: Modern manufacturing systems are faced with the challenge of reducing the carbon emission related to manufacturing technologies. Machining centres consume large amounts of energy and as a consequen...
TL;DR: A computational solution for effective monitoring of PD patients from gait analysis via multiple foot-worn sensors that is fed by ground reaction force signals acquired from these gait sensors and shows that the predictions are highly correlated with the clinical annotations.
TL;DR: Patients whose wounds were healed were significantly more likely to have higher hemoglobin and mean arterial pressure, better mobility, received oral nutrition, and discharged from the hospital than patients whose ulcers did not heal.
Abstract: Owing to the number and severity of concomitant factors, pressure ulcers remain a significant problem. A retrospective study of data from adult patients with a pressure ulcer was conducted to identify factors that may affect their healing. Data from patients who were hospitalized between January 1, 2011, and December 31, 2015, in a private Turkish university hospital who had a Stage 2, Stage 3, Stage 4, or unstageable pressure ulcer that was assessed using the Bates-Jensen Wound Assessment Tool (BWAT) were abstracted. The following variables were examined: demographic characteristics (gender, age, hospital unit, duration of hospitalization), health status and disease data (vital signs, mobility, nutrition, diagnosis, chronic diseases, medication), laboratory values (albumin, hemoglobin, blood glucose), and pressure ulcer characteristics (stage, location, healing status, duration) and pressure ulcer risk status as determined by patient Braden Scale score. Seventy-eight (78) patient records were identified. Patient mean age was 70.8 ± 13.47 years, and length of hospitalization was on average 32.52 ± 27.2 days. Most ulcers (62; 79.5%) were Stage 2 and located in the sacral area (59; 75.6%). Thirty-four (34) patients (43.6%) were discharged and 44 (56.4%) died. At the time of discharge or death, 65.4% of the ulcers had not healed. Patients whose wounds were healed were significantly more likely to have higher hemoglobin and mean arterial pressure, better mobility, received oral nutrition, and discharged from the hospital than patients whose ulcers did not heal. The results suggest that these variables, including Braden Scale and BWAT scores, might be considered when developing a treatment plan of care. Additional studies examining risk factors for nonhealing pressure ulcers, including studies with large samples to facilitate multivariate analyses, are needed.
University of California, Los Angeles1, University of California, Irvine2, Qualcomm3, National University of Health Sciences4, Oregon Health & Science University5, New York University6, University of Ontario Institute of Technology7, Geneva College8, University of Toronto9, Canadian Memorial Chiropractic College10, Université de Montréal11, University of Sydney12, Washington University in St. Louis13, University of Melbourne14, Complutense University of Madrid15, Veterans Health Administration16, Tehran University of Medical Sciences17, University of Cape Town18, Palmer College of Chiropractic19, University of Kansas20, Case Western Reserve University21, Moi University22, University of Yaoundé I23, Başkent University24, University of Ottawa25, Stellenbosch University26, University of Texas Medical Branch27, Houston Methodist Hospital28, Sarawak General Hospital29
TL;DR: A care pathway for the management of individuals presenting with spine-related concerns includes evidence-based recommendations to guide health care providers in the Management of common spinal disorders is described, which is person-centered and evidence- based.
Abstract: The purpose of this report is to describe the development of an evidence-based care pathway that can be implemented globally The Global Spine Care Initiative (GSCI) care pathway development team extracted interventions recommended for the management of spinal disorders from six GSCI articles that synthesized the available evidence from guidelines and relevant literature Sixty-eight international and interprofessional clinicians and scientists with expertise in spine-related conditions were invited to participate An iterative consensus process was used After three rounds of review, 46 experts from 16 countries reached consensus for the care pathway that includes five decision steps: awareness, initial triage, provider assessment, interventions (eg, non-invasive treatment; invasive treatment; psychological and social intervention; prevention and public health; specialty care and interprofessional management), and outcomes The care pathway can be used to guide the management of patients with any spine-related concern (eg, back and neck pain, deformity, spinal injury, neurological conditions, pathology, spinal diseases) The pathway is simple and can be incorporated into educational tools, decision-making trees, and electronic medical records A care pathway for the management of individuals presenting with spine-related concerns includes evidence-based recommendations to guide health care providers in the management of common spinal disorders The proposed pathway is person-centered and evidence-based The acceptability and utility of this care pathway will need to be evaluated in various communities, especially in low- and middle-income countries, with different cultural background and resources These slides can be retrieved under Electronic Supplementary Material
TL;DR: Liver SBRT is a conservative approach with excellent LC and limited toxicities, and is the first to evaluate the feasibility of S BRT to BCLM patients.
TL;DR: The data suggests SSII to be a simple, feasible and clinically applicable tool for rapid risk stratification in patients with STEMI complicated with cardiogenic shock treated with primary percutaneous coronary intervention and provide an independent prognostic marker of in-hospital outcomes.
Abstract: SYNTAX Score II (SSII) connects clinical variables with coronary anatomy. We investigated the prognostic value of SSII in patients with ST segment elevated myocardial infarction (STEMI) complicated with cardiogenic shock treated with primary percutaneous coronary intervention (PPCI). In this retrospective analysis, we evaluated the in-hospital prognostic impact of SSII on 492 patients with STEMI complicated with cardiogenic shock treated with PPCI. Patients were stratified by tertiles of SSII, in-hospital clinical outcomes were compared between those groups. In-hospital univariate analysis revealed higher rates of in-hospital death for patients with SSII in tertile 3, as compared to patients with SSII in tertile 1 (OR 17.4, 95% CI 10.0–30.2, p < 0.001). After adjustment for confounding baseline variables, SSII in tertile 3 was associated with 6.2-fold hazard of in-hospital death (OR 6.2, 95% CI 2.6–14.1, p < 0.001). SSII in patients with STEMI complicated with cardiogenic shock treated with PPCI provide an independent prognostic marker of in-hospital outcomes. Our data suggests SSII to be a simple, feasible and clinically applicable tool for rapid risk stratification in patients with STEMI complicated with cardiogenic shock treated with PPCI.
University of California, Los Angeles1, University of California, Irvine2, New York University3, Oregon Health & Science University4, University of Ontario Institute of Technology5, National University of Health Sciences6, Qualcomm7, Canadian Memorial Chiropractic College8, University of Toronto9, Université de Montréal10, University of Geneva11, University of Valencia12, University of Sydney13, Washington University in St. Louis14, University of Melbourne15, St. Michael's Hospital16, Carlos III Health Institute17, Complutense University of Madrid18, Veterans Health Administration19, Tehran University of Medical Sciences20, Groote Schuur Hospital21, University of Cape Town22, National University of La Plata23, Palmer College of Chiropractic24, Nottingham University Hospitals NHS Trust25, University of Health Sciences Antigua26, University of Southern Denmark27, Novo Nordisk28, University of Kansas29, University of Ottawa30, Case Western Reserve University31, Moi University32, University of Yaoundé I33, Stanford University34, Başkent University35, University of Namibia36, Pontifícia Universidade Católica do Paraná37, AMRI Hospitals38, Stellenbosch University39, University of Texas Medical Branch40, Houston Methodist Hospital41, Sarawak General Hospital42, Yıldırım Beyazıt University43
TL;DR: The GSCI proposes an evidence-based model that is consistent with recent calls for action to reduce the global burden of spinal disorders and requires testing to determine feasibility.
Abstract: Spinal disorders, including back and neck pain, are major causes of disability, economic hardship, and morbidity, especially in underserved communities and low- and middle-income countries. Currently, there is no model of care to address this issue. This paper provides an overview of the papers from the Global Spine Care Initiative (GSCI), which was convened to develop an evidence-based, practical, and sustainable, spinal healthcare model for communities around the world with various levels of resources. Leading spine clinicians and scientists around the world were invited to participate. The interprofessional, international team consisted of 68 members from 24 countries, representing most disciplines that study or care for patients with spinal symptoms, including family physicians, spine surgeons, rheumatologists, chiropractors, physical therapists, epidemiologists, research methodologists, and other stakeholders. Literature reviews on the burden of spinal disorders and six categories of evidence-based interventions for spinal disorders (assessment, public health, psychosocial, noninvasive, invasive, and the management of osteoporosis) were completed. In addition, participants developed a stratification system for surgical intervention, a classification system for spinal disorders, an evidence-based care pathway, and lists of resources and recommendations to implement the GSCI model of care. The GSCI proposes an evidence-based model that is consistent with recent calls for action to reduce the global burden of spinal disorders. The model requires testing to determine feasibility. If it proves to be implementable, this model holds great promise to reduce the tremendous global burden of spinal disorders. These slides can be retrieved under Electronic Supplementary Material.
TL;DR: Early atherosclerotic structural changes may be reversed or improved by sustained weight loss after LSG in asymptomatic obese patients.
Abstract: Background and aims Cardiovascular disease (CVD) is one of the leading causes of mortality in obese patients. We aimed to investigate the influence of significant weight loss following laparoscopic sleeve gastrectomy (LSG) on carotid intima media thickness (CIMT) and epicardial fat thickness (EFT) which are the independent predictors of subclinical atherosclerosis. Methods and results Patients were recruited for standard indications. A total of 105 patients (79 women and 26 men) with the mean age of 43.61 ± 12.42 were prospectively enrolled. On B-mode duplex ultrasound; the mean CIMT at the far wall of both left and right common carotid arteries were measured. EFT was measured on the free wall of the right ventricle at end-diastole from the parasternal long-axis view by standard transthorasic 2D echocardiography. Delta (Δ) values were obtained by subtracting sixth month values from the baseline values. Body mass index (BMI) was significantly reduced from 46.95 ± 7.54 to 33.54 ± 6.41 kg/m2 (p Conclusion Early atherosclerotic structural changes may be reversed or improved by sustained weight loss after LSG in asymptomatic obese patients.
Akdeniz University1, Istanbul Medeniyet University2, Başkent University3, Cumhuriyet University4, Çukurova University5, Harran University6, Erciyes University7, Adıyaman University8, Mustafa Kemal University9, İnönü University10, Mersin University11, Imam Muhammad ibn Saud Islamic University12, Ege University13, University of Gaziantep14, Dicle University15
TL;DR: Although CL has been endemic for many years in the southern regions of Turkey, an increasing incidence in nonendemic regions is being observed due to returning travelers and, more recently, due to Syrian refugees.
Abstract: Background Cutaneous leishmaniasis (CL) is a vector-born parasitic disease characterized by various skin lesions that cause disfiguration if healed spontaneously. Although CL has been endemic for many years in the southern regions of Turkey, an increasing incidence in nonendemic regions is being observed due to returning travelers and, more recently, due to Syrian refugees. Thus far, a limited number of national guidelines have been proposed, but no common Turkish consensus has emerged. Objectives The aim of this study was to develop diagnostic and therapeutic guidelines for the management of CL in Turkey. Methods This guideline is a consensus text prepared by 18 experienced CL specialists who have been working for many years in areas where the disease is endemic. The Delphi method was used to determine expert group consensus. Initially, a comprehensive list of items about CL was identified, and consensus was built from feedback provided by expert participants from the preceding rounds. Results Evidence-based and expert-based recommendations through diagnostic and therapeutic algorithms according to local availability and conditions are outlined. Conclusion Because CL can mimic many other skin diseases, early diagnosis and early treatment are very important to prevent complications and spread of the disease. The fastest and easiest diagnostic method is the leishmanial smear. The most common treatment is the use of local or systemic pentavalent antimony compounds.
TL;DR: Metformin decreased glucose concentrations, reduced metabolic syndrome, as well as insulin dose requirement more than insulin therapy alone, 1 year after treatment, independent of blood lipid improvement or weight loss, although on average weight remained decreased with metformin-insulin therapy, whereas the average weight increased with insulin Therapy alone.
Abstract: This retrospective study investigated the effect of adding metformin to pharmacologic insulin dosing in type 1 diabetics on insulin therapy 1 year after treatment compared with patients on insulin therapy alone. Twenty-nine adults with type 1 diabetes who had metformin added to their insulin therapy for 12 months were compared with 29 adults with type 1 diabetes who remained on insulin-alone therapy. Fifty-eight patients with C peptide negative-type 1 diabetics (26 females, mean age: 29.01 ± 7.03 years, BMI: 24.18 ± 3.16 kg/m2) were analyzed. Age, sex, body weight, insulin dose requirement, plasma glucose (PG), blood pressure (BP), and lipids did not differ between groups before treatment (p > 0.05). Metabolic syndrome (44.8 vs 41.4%, p > 0.05) did not differ between the metformin-insulin and insulin alone groups before treatment. Metabolic syndrome was more decreased in the metformin-insulin group than in the insulin alone group after treatment (−8.9 ± 1.3 vs. 2.5 ± 0.6%, p = 0.028). Insulin dose requirement was lower in the metformin-insulin group than in the insulin alone group (−0.03 vs. 0.11 IU/kg/d, p = 0.006). Fasting PG (−26.9 ± 54.2 vs. 0.7 ± 29.5 mg/dL, p = 0.022) and postprandial PG (−43.1 ± 61.8 mg/dL vs. −3.1 ± 40.1 mg/dL, p = 0.010) was more decreased in the metformin-insulin group than in the insulin alone group. Body weight, lipids, and HbA1c did not differ between the groups (p > 0.05). Metformin decreased glucose concentrations, reduced metabolic syndrome, as well as insulin dose requirement more than insulin therapy alone, 1 year after treatment. These results were independent of blood lipid improvement or weight loss, although on average weight remained decreased with metformin-insulin therapy, whereas the average weight increased with insulin therapy alone.
TL;DR: It is suggested that IMT may be an effective modality to enhance respiratory muscle strength, exercise capacity, quality of life, daily living activities, reduced perception of dyspnea, and fatigue in asthmatic patients.
Abstract: Purpose:The aim of this study was to investigate the effects of inspiratory muscle training (IMT) on respiratory muscle strength, exercise capacity, dyspnea, fatigue, quality of life, and daily living activities of asthmatic patients.Methods:Thirty-eight asthmatic patients, between 18 and 65 years o