Potential diagnostic and prognostic biomarkers of pediatric Burkitt lymphoma identified through miRNA expression profiling.

BACKGROUND: Pediatric Burkitt lymphoma (pBL) is the most common non-Hodgkin lymphoma in children. These patients require prompt diagnosis and initiation of therapy due to rapid tumor growth. The roles of tumor tissue and circulating microRNAs (miRNAs) in the diagnosis or prognostication have not been fully elucidated in pBLs. METHODS: Differentially expressed (DE) miRNAs were identified with microRNA sequencing (miRNA-Seq) in tumor tissues and plasma of diagnostic pBLs. The diagnostic potential of total miRNA concentrations and overexpressed miRNAs were evaluated through receiver operating characteristic (ROC) analyses. Log-rank test was employed to evaluate survival differences associated with DE miRNAs. Selected miRNA expressions were cross-validated with quantitative reverse transcription PCR (qRT-PCR). RESULTS: Total circulating cell-free miRNAs were higher in pBL cases compared to controls. Cancer-associated pathways were enriched among miRNAs differentially expressed in pBL tumor tissues. Several upregulated miRNAs in pBL tumors demonstrated high diagnostic potential. Similarly, ROC analysis of overexpressed plasma miRNAs revealed circulating cell-free or exosomal miRNAs that can distinguish pBLs from control cases. Indeed, integrative analysis of overexpressed circulating exosomal miRNAs showed an enhanced diagnostic potential for certain triple combinations. Kaplan-Meier analyses of DE miRNAs in tumor tissues identified miRNAs predicting overall survival. CONCLUSIONS: Differentially expressed miRNAs in tumor tissue and plasma of pBL have the potential to improve diagnosis and prognosis. IMPACT: Differentially expressed miRNAs in treatment-naive pediatric Burkitt lymphoma cases have diagnostic or prognostic biomarker potential. This is the first study that applied miRNA-Seq on treatment-naive pediatric Burkitt lymphoma cases for identification of differentially expressed miRNAs both in tumor tissue and plasma samples with diagnostic potential. Through systematic analysis of differentially expressed miRNAs, tumor tissue miRNAs associated with the overall survival of pBLs have been discovered. The clinically significant, differentially expressed miRNAs identified in pediatric Burkitt lymphoma cases can potentially improve the current tissue-based or non-invasive clinical practice in terms of diagnosis or prognostication.

ChatGPT for generating multiple-choice questions: Evidence on the use of artificial intelligence in automatic item generation for a rational pharmacotherapy exam.

PURPOSE: Artificial intelligence, specifically large language models such as ChatGPT, offers valuable potential benefits in question (item) writing. This study aimed to determine the feasibility of generating case-based multiple-choice questions using ChatGPT in terms of item difficulty and discrimination levels. METHODS: This study involved 99 fourth-year medical students who participated in a rational pharmacotherapy clerkship carried out based-on the WHO 6-Step Model. In response to a prompt that we provided, ChatGPT generated ten case-based multiple-choice questions on hypertension. Following an expert panel, two of these multiple-choice questions were incorporated into a medical school exam without making any changes in the questions. Based on the administration of the test, we evaluated their psychometric properties, including item difficulty, item discrimination (point-biserial correlation), and functionality of the options. RESULTS: Both questions exhibited acceptable levels of point-biserial correlation, which is higher than the threshold of 0.30 (0.41 and 0.39). However, one question had three non-functional options (options chosen by fewer than 5% of the exam participants) while the other question had none. CONCLUSIONS: The findings showed that the questions can effectively differentiate between students who perform at high and low levels, which also point out the potential of ChatGPT as an artificial intelligence tool in test development. Future studies may use the prompt to generate items in order for enhancing the external validity of the results by gathering data from diverse institutions and settings.

Development of stigma scale for women with mental illness in perinatal period, validity and reliability study.

AIM: Although there are many scales that measure stigma, there is no scale with the necessary adequacy to measure stigma in the perinatal period. The study aims to develop the stigma scale for women with mental illness in the perinatal period and test its validity and reliability. MATERIALS AND METHODS: Participants were reached via patients, visitors, and hospital staff who applied to Sakarya Training and Research Hospital between 01/06/2022 and 01/12/2022. Two hundred people (female n = 134, male n = 66) aged 18-65 participated in the study and "Sociodemographic data form," "Perinatal Mental Illness Stigma Scale (PMISS)," "Social Distance Scale," and "Beliefs Towards Mental Illness Scale" were used to collect data. Data were analyzed using SPSS 22 and the AMOS 26 program. RESULTS: The Content Validity Index of the scale items was between 0.80-1. Cronbach's alpha coefficient score of the general scale was 0.94, the "Discrimination and Prejudice" sub-dimension was 0.93, and the "Labeling" sub-dimension was 0.88. It was determined that item-total score correlations varied between 0.410 and 0.799. P value calculated < 0.05 in Barlett's test and 0.94 in the Kaiser-Meyer Olkin test. These values show that factor analysis can be applied to the scale. According to the Exploratory Factor Analysis result, the scale has a 2-factor structure, explaining 60% of the total variance. The Guttman Split-Half coefficient of the scale was 0.882, and the Spearman-Brown coefficient was 0.883. The scale was reapplied to 30 participants with an interval of three weeks. The correlation coefficient between the two measurements was 0.91, indicating that the scale satisfies the invariance principle over time. CONCLUSION: The PMISS is a reliable measurement tool that can be used to investigate stigma towards mental illness during the perinatal period in the Turkish population.

ChatGPT prompts for generating multiple-choice questions in medical education and evidence on their validity: a literature review.

ChatGPT's role in creating multiple-choice questions (MCQs) is growing but the validity of these artificial-intelligence-generated questions is unclear. This literature review was conducted to address the urgent need for understanding the application of ChatGPT in generating MCQs for medical education. Following the database search and screening of 1920 studies, we found 23 relevant studies. We extracted the prompts for MCQ generation and assessed the validity evidence of MCQs. The findings showed that prompts varied, including referencing specific exam styles and adopting specific personas, which align with recommended prompt engineering tactics. The validity evidence covered various domains, showing mixed accuracy rates, with some studies indicating comparable quality to human-written questions, and others highlighting differences in difficulty and discrimination levels, alongside a significant reduction in question creation time. Despite its efficiency, we highlight the necessity of careful review and suggest a need for further research to optimize the use of ChatGPT in question generation. Main messages  Ensure high-quality outputs by utilizing well-designed prompts; medical educators should prioritize the use of detailed, clear ChatGPT prompts when generating MCQs. Avoid using ChatGPT-generated MCQs directly in examinations without thorough review to prevent inaccuracies and ensure relevance. Leverage ChatGPT's potential to streamline the test development process, enhancing efficiency without compromising quality.

Evaluation of sinonasal involvement in patients with asthma and chronic obstructive pulmonary disease.

Background: Asthma and chronic obstructive pulmonary disease (COPD) are the most common obstructive diseases. Based on the similarities, we aimed to evaluate sinonasal symptoms in patients with asthma or COPD, and compare the two diseases with regard to upper-airway involvement. Methods: Patients with asthma or with COPD who were followed up at Ankara University Immunology and Allergy or Chest Diseases Departments were included in the study. The participants went through pulmonary function tests, skin-prick tests, and disease severity assessment of either disease. Nasal endoscopic evaluations of all the patients were performed in the Department of Otorhinolaryngology. Lund-Mackay scoring was performed on the computed tomography of the paranasal sinus. Chronic rinosinusitis (CRS) diagnosis was made as recent guidelines. Results: A total of 112 subjects (number of women/men: n = 67/45; median age, 49 years [The range for IQR was 22 years]) were included in the study. Fifty-five patients had asthma, 33 had COPD, and 24 were healthy controls. Nasal symptoms were more frequent in the patients with asthma (patients with asthma, n = 52 [98%]; patients with COPD, n = 17 [52%]; controls, n = 9 [38%]) (p < 0.001). The median (IQR) 22-item Sino-Nasal Outcome Test (SNOT-22) questionnaire score was higher in the patients with asthma (33 [20-50]) than in the patients with COPD (8 [1.5-18.7]) and the control group (3.5 [0-18.7]) (p < 0.01). Patients with asthma had significantly higher prevalence rates of rhinosinusitis than did those in the COPD and the control groups (36%, 15.6%, 8.3%, respectively; p < 0.01). The SNOT-22 optimal cutoff score was calculated as ≥11 to detect the score limit for CRS prediction with the best sensitivity and specificity. Conclusion: As a result, patients with both asthma and COPD may have upper-airway symptoms. CRS, was primarily seen in the patients with asthma. Accordingly, SNOT-22 scores were higher in the patients with asthma than in those in the COPD and the control groups. A referral to the Ear Nose Throat department for further evaluation with nasal endoscopy and computed tomography of the paranasal may be required in a subgroup of patients.

Case-based MCQ generator: A custom ChatGPT based on published prompts in the literature for automatic item generation.

WHAT IS THE EDUCATIONAL CHALLENGE?: A fundamental challenge in medical education is creating high-quality, clinically relevant multiple-choice questions (MCQs). ChatGPT-based automatic item generation (AIG) methods need well-designed prompts. However, the use of these prompts is hindered by the time-consuming process of copying and pasting, a lack of know-how among medical teachers, and the generalist nature of standard ChatGPT, which often lacks the medical context. WHAT ARE THE PROPOSED SOLUTIONS?: The Case-based MCQ Generator, a custom GPT, addresses these challenges. It has been trained by using GPT Builder, which is a platform designed by OpenAI for customizing ChatGPT to meet specific needs, in order to allow users to generate case-based MCQs. By using this free tool for those who have ChatGPT Plus subscription, health professions educators can easily select a prompt, input a learning objective or item-specific test point, and generate clinically relevant questions. WHAT ARE THE POTENTIAL BENEFITS TO A WIDER GLOBAL AUDIENCE?: It enhances the efficiency of MCQ generation and ensures the generation of contextually relevant questions, surpassing the capabilities of standard ChatGPT. It streamlines the MCQ creation process by integrating prompts published in medical education literature, eliminating the need for manual prompt input. WHAT ARE THE NEXT STEPS?: Future development aims at sustainability and addressing ethical and accessibility issues. It requires regular updates, integration of new prompts from emerging health professions education literature, and a supportive digital ecosystem around the tool. Accessibility, especially for educators in low-resource countries, is vital, demanding alternative access models to overcome financial barriers.

ChatGPT to generate clinical vignettes for teaching and multiple-choice questions for assessment: A randomized controlled experiment.

AIM: This study aimed to evaluate the real-life performance of clinical vignettes and multiple-choice questions generated by using ChatGPT. METHODS: This was a randomized controlled study in an evidence-based medicine training program. We randomly assigned seventy-four medical students to two groups. The ChatGPT group received ill-defined cases generated by ChatGPT, while the control group received human-written cases. At the end of the training, they evaluated the cases by rating 10 statements using a Likert scale. They also answered 15 multiple-choice questions (MCQs) generated by ChatGPT. The case evaluations of the two groups were compared. Some psychometric characteristics (item difficulty and point-biserial correlations) of the test were also reported. RESULTS: None of the scores in 10 statements regarding the cases showed a significant difference between the ChatGPT group and the control group (p > .05). In the test, only six MCQs had acceptable levels (higher than 0.30) of point-biserial correlation, and five items could be considered acceptable in classroom settings. CONCLUSIONS: The results showed that the quality of the vignettes are comparable to those created by human authors, and some multiple-questions have acceptable psychometric characteristics. ChatGPT has potential in generating clinical vignettes for teaching and MCQs for assessment in medical education.

Automatic segmentation of the maxillary sinus on cone beam computed tomographic images with U-Net deep learning model.

BACKGROUND: Medical imaging segmentation is the use of image processing techniques to expand specific structures or areas in medical images. This technique is used to separate and display different textures or shapes in an image. The aim of this study is to develop a deep learning-based method to perform maxillary sinus segmentation using cone beam computed tomography (CBCT) images. The proposed segmentation method aims to provide better image guidance to surgeons and specialists by determining the boundaries of the maxillary sinus cavities. In this way, more accurate diagnoses can be made and surgical interventions can be performed more successfully. METHODS: In the study, axial CBCT images of 100 patients (200 maxillary sinuses) were used. These images were marked to identify the maxillary sinus walls. The marked regions are masked for use in the maxillary sinus segmentation model. U-Net, one of the deep learning methods, was used for segmentation. The training process was carried out for 10 epochs and 100 iterations per epoch. The epoch and iteration numbers in which the model showed maximum success were determined using the early stopping method. RESULTS: After the segmentation operations performed with the U-Net model trained using CBCT images, both visual and numerical results were obtained. In order to measure the performance of the U-Net model, IoU (Intersection over Union) and F1 Score metrics were used. As a result of the tests of the model, the IoU value was found to be 0.9275 and the F1 Score value was 0.9784. CONCLUSION: The U-Net model has shown high success in maxillary sinus segmentation. In this way, fast and highly accurate evaluations are possible, saving time by reducing the workload of clinicians and eliminating subjective errors.

Phytochemical analysis, evaluation of the antioxidant and anti alzheimer activities of Algerian Seseli Trotuosum.

HPLC analysis, phytochemical screening, thin layer chromatography, polyphenols and flavonoid contents were conducted to determine the bioactive contents of the Algerian Seseli tortuosum plant. Antioxidant activity was tested using DPPH and ABTS scavenging assays, reducing power, phenanthroline and silver nanoparticle (SNP) assays. BChE inhibitory assay was performed in vitro and in silico. Phytochemical analysis highlighted the richness of the extracts in terms of coumarins and terpenoids. The quantitative determination of total polyphenols and flavonoids showed that the highest amounts occurred in the dichloromethane (DCME) and methanolic (MeOH) extracts. The antioxidant activities indicated a moderate potential. Compared with galantamine, DCME had a significantly greater inhibitory effect on BChE (CI50 = 9.14±1.74 µg/ml and 34.75±1.99 µg/ml respectively). An in silico study of butyrylcholinesterase inhibition revealed a significant effect of quercetin (-30,13 KJ/mol). Conclusion: This study demonstrated the richness of the phytochemical components of seseli tortuosum, which are responsible for several biological properties, mainly their anti-Alzheimer potential.

Test-Only Learning via Virtual Patients to Improve Surgical Illness Scripts of Preclinical Medical Students as a Preparation for Clinical Clerkships: An Experimental Study.

OBJECTIVE: The aim was to determine whether preclinical medical students can develop their illness scripts to a level comparable to that of clerkship students through test-only learning using repeated formative online testlets. METHODS: In this experimental study, participants were 52 preclinical and 53 clinical medical students. The intervention group consisted of preclinical medical students, and the control group consisted of clinical medical students. The intervention group responded to online testlets containing feedback, an innovative formative assessment method called ContExtended Questions, on general surgery for 8 days by spending no more than 30 minutes each day. The control group completed the general surgery clerkship. The performances were assessed using 20 Key-Feature Question items. The intervention group was assessed twice: immediately after the intervention (the immediate test), and again 1 month later (the delayed test). The control group was assessed once, immediately after the clerkship. All performance tests were identical. RESULTS: The preclinical students had a significantly higher mean score on the immediate test (83.1 ± 9.6) compared to the clinical students (75.4 ± 8.9), P < .001. The effect size (Cohen's d) was .83. However, the mean score in the delayed test (76.9 ± 13.6) was not significantly different from clinical students' mean score (75.4 ± 8.9), P > .05. CONCLUSIONS: Test-only learning as a spaced repetition of online formative testlets is effective in preparing preclinical medical students to the clinical clerkship. Through using this approach in preclinical period, they can prepare themselves for the clinical environment to optimize the benefits derived from clerkships.

Anxiety management strategies on TikTok: a discourse analysis of collective coping mechanisms.

Background: This study investigates the discourse on anxiety management strategies within the TikTok platform, analyzing a substantial dataset of 45,639 comments collected over a year.Aims: The primary aim is to explore the various strategies users employ to manage anxiety, focusing on how these strategies are discussed and shared on TikTok.Methods: A mixed-method approach was utilized, combining Latent Dirichlet Allocation (LDA) for topic modeling with qualitative analysis. This methodology allowed for the identification of nine distinct topics, which were further grouped into three main categories: Self-Empowerment and Coping Strategies, Community Support and Social Connectivity, and Recognizing and Navigating Triggers.Results: The analysis revealed a diverse range of strategies users employ to manage anxiety, spanning personal coping mechanisms, social support networks, and the recognition and mitigation of triggers. These findings underscore TikTok's role as a dynamic space for sharing, exploring, and validating experiences related to anxiety management.Conclusions: TikTok offers unique opportunities for identity construction and community support amidst the challenges of anxiety. However, the study acknowledges limitations, such as potential biases in keyword-based data collection and the complexity of capturing multimodal discourse on the platform. The conclusion emphasizes the need for further refinement of digital mental health platforms, calling for sophisticated algorithmic solutions to enhance user support and content relevance.

Development of a mobile monitoring program for anxiety and depression in pregnancy and evaluation of 3-month results.

BACKGROUND: The aims of this study were to develop a mobile mental health application (app) to scan the symptoms of anxiety, depression, and related factors during pregnancy; examine the effect of the app on pregnant women; and determine the factors related to using such an app. METHODS: A software platform called Perinatal Anxiety Depression Monitoring Platform (PADIP) was developed. This study included 320 pregnant women: 160 in the PADIP group and 160 in the control group. The PADIP group was screened monthly for 3 months for depression, anxiety, and sleep quality, and instant feedback was provided on scale scores. RESULTS: During the follow-up period, there was a significant decrease in depression and anxiety scale scores in the PADIP group but no significant difference in scale scores in the control group. The interface used for the app was important for scale scores. It was preferred by pregnant women with a high education level, higher Perinatal Anxiety Screening Scale scores, and lower sleep quality scores. CONCLUSIONS: PADIP use was associated with a decrease in depression and anxiety scores of pregnant women. It was more useful for patients with higher education levels and a history of a psychiatric disorder, but further research is needed to develop a more comprehensive model.

Teaching rational prescribing in undergraduate medical education: a systematic search and review.

AIM: This study aimed to reveal the current status of the literature on rational prescribing training in undergraduate medical education. METHODS: This study followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. An online search using 50 keywords in four databases was performed to access the studies published between 2008 and 2020. Specific features of the training such as aims or objectives of teaching, methods or model, and evaluation of effectiveness were extracted. Kirkpatrick levels were used to evaluate the effectiveness of teaching. RESULTS: Of 74 studies included in the full review, 16 (21.6%) of them reported the use of WHO 6-Step Model for Rational Prescribing in their educational interventions. In terms of effectiveness, only two of the studies investigated changes in learner behavior in the context for which they are being trained, and only one study showed the effect of training on patient outcomes. CONCLUSION: The evidence on the effectiveness of rational prescribing training has been presented mostly by using student satisfaction surveys and test of knowledge and skills. A higher level of evidence such as patient outcomes of the training needs to be reported.

Increased Medial Femoral Condyle Angle and Narrow Intercondylar Notch Are Associated With Medial Meniscus Posterior Root Tear.

PURPOSE: To investigate the correlation between nontraumatic medial meniscus posterior root tear (MMPRT) and bone morphology of the knee with a particular emphasis on MMPR impingement. METHODS: Magnetic resonance imaging (MRI) findings were examined between January 2018 and December 2020. MRI findings of patients with traumatic MMPRT, Kellgren Lawrence stage 3-4 arthropathy on radiographs, single- or multiple-ligament injuries and/or those who underwent treatment for these diseases, and surgery in and around the knee were excluded from the study. MRI measurements included medial femoral condylar angle (MFCA), intercondylar distance (ICD), and intercondylar notch width (ICNW), distal/posterior medial femoral condylar offset ratio, notch shape, medial tibial slope (MTS) angle, and medial proximal tibial angle (MPTA) measurements and spur presence and were compared between groups. All measurements were performed by two board-certified orthopedic surgeons on a best agreement basis. RESULTS: MRI examinations of patients aged 40-60 were analyzed. MRI findings were divided into two groups: the study group of MRI findings of patients with MMPRT (n = 100) and the control group of MRI findings of patients without MMPRT (n = 100). MFCA was found to be significantly higher in the study group (mean: 46.5 ± 3.58) than in the control group (mean: 40.04 ± 4.61) (P < .001). In the study group, the ICD (study group mean: 76.26 ± 4.89; control group mean: 78.18 ± 6.1) was significantly narrower (P = .018), and the ICNW (study group mean: 17.19 ± 2.23; control group mean: 20.48 ± 2.13) was significantly shorter (P < .001). The ICNW/ICD ratio was significantly lower in patients in the study group (0.22 ± 0.02) than in the control group (0.25 ± 0.02) (P < .001). Bone spurs were present in 84% of the study group and only in 28% of those in the control group. In the study group, the most common notch type was A-type with 78%, while the least common was the U-type notch with 10%. However, in the control group, the most common notch type was A-type with 43%, and the least common was the W-type notch with 22%. The distal/posterior medial femoral condylar offset ratio was statistically lower in the study group (0.72 ± 0.07) than in the control group 0.78 ± 0.07) (P < .001). No significant intergroup differences were found in MTS (study group mean: 7.51 ±2.59; control group mean: 7.83 ± 2.57) (P = .390) and MPTA (study group mean: 86.92 ±2.15; control group mean: 87.48 ±1.8) measurements (P = .67). CONCLUSIONS: Increased medial femoral condylar angle, low distal/posterior femoral offset ratio, narrow intercondylar distance and intercondylar notch width, A-type notch shape, and spur presence are associated with MMPRT. LEVEL OF EVIDENCE: Level III, retrospective cohort study.

The effect of watching lecture videos at 2× speed on memory retention performance of medical students: An experimental study.

AIM: This study aimed to determine how watching lecture videos at 1× and 2× speeds affects memory retention in medical students. METHODS: A posttest-only experimental design was utilized. The participants were 60 Year-1 and Year-2 medical students. The participants were assigned to one of two groups through stratified randomization: Group 1 would watch the video at 1× speed, and Group 2 at 2× speed. Their performance was assessed using a test comprising 20 multiple-choice questions. The test has been applied immediately after watching the video (Immediate test), and, again after one week (Delayed test). Parametric and non-parametric statistical tests were performed. RESULTS: In the Immediate test, the mean score of the 1× speed group was 11.26 ± 4.06, while 2× speed group's mean score was 10.16 ± 2.46. The difference was not significant t(58) = 1.26, p > .05. In the Delayed test, the mean score of 1× speed group was 9.66 ± 3.94, while 2× speed group's mean score was 8.36 ± 2.80. The difference was not significant t(55) = 1.42, p > .05. CONCLUSIONS: Watching the video lecture at 2× speed did not impair memory retention in medical students. This may help students to save time in their dense curricula.[Box: see text].

Validation of IFMSA social accountability assessment tool: exploratory and confirmatory factor analysis.

BACKGROUND: IFMSA Social Accountability Assessment Tool has been developed for medical students by medical students to assess medical schools. However, its psychometric characteristics are unknown since it was developed without any analysis. We aimed to reveal its reliability and validity. METHODS: 1122 undergraduate medical students from various years in Gazi University Faculty of Medicine have participated in the study. They have answered the Turkish version of IFMSA Social Accountability Assessment Tool created through a translation process by experts. Exploratory and confirmatory factor analyses were carried out. RESULTS: Exploratory factor analysis showed that factor loadings were between 0.46 and 0.73 for Factor 1, 0.68 and 0.87 for Factor 2. The two-factor model, which consists of "Community Centeredness" and "Socio-Demographic Characteristics", was evaluated through confirmatory factor analysis. The goodness-of-fit statistics of the model showed well-fit: CMIN/df 4.46, GFI 0.96, CFI 0.95, RMSEA 0.05, SRMR 0.03. Standardized regression weights were between 0.43 and 0.77. CONCLUSION: The tool has acceptable psychometric characteristics, with good reliability and validity. It could be considered as a point of departure for the change in the way of being socially accountable since it enables medical students to explore the weak areas of their medical schools in terms of social accountability.

Effectiveness of using 2D atlas and 3D PDF as a teaching tool in anatomy lectures in initial learners: a randomized controlled trial in a medical school.

BACKGROUND: Anatomy is a crucial part of medical education, and there have been attempts to improve this field by utilizing various methods. With the advancement of technology, three-dimensional (3D) materials have gained popularity and become a matter of debate about their effectiveness compared to two-dimensional (2D) sources. This research aims to analyze the effectiveness of 3D PDFs compared to 2D atlases. METHODS: This study is a randomized controlled trial involving 87 Year-1 and Year-2 medical students at Gazi University Faculty of Medicine, Turkey. The study was conducted in two steps. In Step-1, students were randomized to watch lecture videos on liver anatomy and male genitalia anatomy supplemented with either a 3D PDF (intervention group) or 2D atlas (control group) images. Following the video lectures, a test (immediate test) was administered. In Step-2, the same test (delayed test) was administered 10 days after the immediate test. The test scores were compared between the intervention and control groups. In addition to the descriptive analyses, Chi-square and Mann-Whitney U tests were performed. RESULTS: In the immediate test, while there was no significant difference between the groups for the liver test (p > 0.05), 3D PDF group's scores (Median = 24.50) was significantly higher than the 2D atlas group's in the genitalia test (Median = 21.00), (p = 0.017). The effect size (Cohen's d) was 0.57. In the delayed test, there was no significant difference between the groups in the liver and genitalia tests (p > 0.05). However, the effect size in the immediate genitalia test was 0.40. Year-1 students' immediate test of genitalia performances were significantly higher in the 3D PDF group (Median = 24.00) than the 2D atlas group (Median = 19.00), (p = 0.016). The effect size was 0.76. Also, Year-1 students' 3D PDF group (Median = 20.50) presented with significantly higher performance than the 2D atlas group (Median = 12.00), (p = 0.044) in the delayed test of genitalia, with the 0.63 effect size. CONCLUSION: 3D PDF is more effective than 2D atlases in teaching anatomy, especially to initial learners. It is particularly useful for teaching complex anatomical structures, such as male genitalia, compared to the liver. Hence, it may be a valuable tool for medical teachers to utilize during lectures.

Beef Quality Classification with Reduced E-Nose Data Features According to Beef Cut Types.

Ensuring safe food supplies has recently become a serious problem all over the world. Controlling the quality, spoilage, and standing time for products with a short shelf life is a quite difficult problem. However, electronic noses can make all these controls possible. In this study, which aims to develop a different approach to the solution of this problem, electronic nose data obtained from 12 different beef cuts were classified. In the dataset, there are four classes (1: excellent, 2: good, 3: acceptable, and 4: spoiled) indicating beef quality. The classifications were performed separately for each cut and all cut shapes. The ANOVA method was used to determine the active features in the dataset with data for 12 features. The same classification processes were carried out by using the three active features selected by the ANOVA method. Three different machine learning methods, Artificial Neural Network, K Nearest Neighbor, and Logistic Regression, which are frequently used in the literature, were used in classifications. In the experimental studies, a classification accuracy of 100% was obtained as a result of the classification performed with ANN using the data obtained by combining all the tables in the dataset.

Comparison of perennial and preseasonal allergoid immunotherapy in grass pollen allergic patients.

BACKGROUND: The clinical and immunological efficacy of preseasonal allergoid immunotherapy has been previously investigated, however, studies comparing the effectiveness of the two protocols are limited in the literature. OBJECTIVE: The aim of this study is to compare the clinical and immunological efficacy of pre-seasonal and perennial allergoid immunotherapy. METHODS: This is a prospective cross sectional two-arm study. During the season; symptom and medication scores were filled. Before and at the end of the season; RQLQ was applied, Phl p sIgE, sIgG4 and IL-10 levels were measured. RESULTS: In preseasonal group patients had better symptom control for most of the weeks, particularly during the peak pollen period (April: w-2 & w-4, p = 0.04; May: w-2, p = 0.02; June: w-1, w-2, p = 0.02; w-3, w-5, p = 0.03; July: w-2, p = 0.01; w-3, p = 0.02; w-4, p = 0.04). In the perennial group, sIgG4 [1st time point: preseasonal 0.02 mgA/L vs perennial 0.13 mgA/L (p < 0.0001); 2nd time point: preseasonal 0.52 mgA/L vs perennial 0.33 mgA/L; 3rd time point: preseasonal 0.04 mgA/L vs perennial 0.12 mgA/L (p < 0.0001)] and IL-10 (1st time point: preseasonal 1.45 pg/ml vs perennial 2.03 pg/ml; 2nd time point: preseasonal 2.29 pg/ml vs perennial 2.19 pg/ml; 3rd time point: preseasonal 2.32 pg/ml vs perennial 2.16 pg/ml) levels were higher and more stable. CONCLUSIONS: Preseasonal immunotherapy provided better control of symptoms throughout the pollen season. However, the blocking antibody response was stronger and more permanent in the perennial immunotherapy group.

Does eating fish cause cancer? A case study metal(loid)s accumulation in mackerel and sardine tissues from Iskenderun Bay, Türkiye.

Due to the increasing harmful effects of metal(loid)s over time, it has become important in environmental studies carried out to increase environmental awareness. It is important to investigate the cumulative presence of metal(loid)s in nature, their interactions with each other and risks posed by fish consumption for human health. Total concentrations of As, Cd, Cu, Fe, Mn, Ni, Pb, and Zn were determined in muscle and gill tissues of horse mackerel (Trachurus trachurus) and sardine (Sardina pilchardus). Metal analyses were carried out using Inductively Coupled Plasma-Mass Spectroscopic (ICP-MS) methods. In both tissues, Fe and Zn concentrations were the highest and Cd, Cu and Pb concentrations were the lowest. The target hazard coefficient, estimated daily intake, target cancer risk, total target hazard coefficient, and hazard indices were calculated to assess the risks to an individual's health from consuming fish. Hazard index and total target hazard coefficient values calculated for each fish exceeded 1 but were very close to 1. Target cancer risk values of As and Ni were found to be 10-6 and 10-4 for Pb. These limit values indicate the need for regular monitoring of the region. In addition, the interactions between the metal(loid)s accumulated in the tissues were analyzed and a high correlation was found between As-Ni, which poses a risk to public health.