Evaluation of lamina cribrosa curvature index in different types of glaucoma.

OBJECTIVE: The aim of this study was to evaluate the lamina cribrosa curvature index in different types of glaucoma in comparison with clinical findings and conventional measurement methods. MATERIAL AND METHOD: Patients older than 18 years who were followed up in Glaucoma Unit of Department of Ophthalmology at Firat University Faculty of Medicine, whose disease had been under control at least for 1 year, who had at least three reliable visual fields, whose refractive error was between - 6 and + 5 diopter and who did not have any disease other than glaucoma that would affect the visual field, were included in the study. Clinical and demographic characteristics, visual field, optical coherence tomography and lamina cribrosa curvature index (LCCI) results were evaluated. The study patients were divided into six groups: early-stage primary open-angle glaucoma (POAG) as group 1 and intermediate-advanced stage POAG as group 2, pseudo-exfoliation glaucoma (PEXG) as group 3, normal tension glaucoma (NTG) as group 4, ocular hypertension patients whom subsequently developed POAG as group 5 and healthy control as group 6. RESULTS: A total of 189 eyes of 101 patients were included in our study. Forty-seven patients were male (46.5%) and 54 were female (53.5%). The mean age was 62.43 ± 1.49 years. LCCI, mean deviation (MD), visual field index (VFI), pattern standard deviation (PSD) and retinal nerve fiber layer thickness (RNFL) values were analyzed in all groups and Pearson correlation analysis showed statistically significant correlation between PSD and RNFL measurements with LCCI values in all groups. MD value was correlated with LCCI in groups 2, 3 and 4, while VFI value was correlated with LCCI in all groups except group 5. When the groups were compared with each other according to the Post-Hoc Tamhane test, LCCI measurement showed statistically significant results in accordance with MD, VFI, PSD and RNFL values. CONCLUSION: The LCCI assessment is mostly consistent with conventional tests. In this study, in which different types of glaucoma and healthy subjects were examined simultaneously, LCCI shows promise as a detailed and reliable assessment method.

Preoperative Magnetic Resonance Imaging Cannot Predict the Presence of a Rare Myoid Gonadal Stromal Testicular Tumor: A Case Report.

Testicular myoid gonadal stromal tumors (MGSTs) are rare neoplasms. While past research has detailed the pathological characteristics of these tumors, the radiological differences between MGST and other types of testicular tumors have not been elucidated. Our study aimed to reveal the possible distinctive features of MGST using magnetic resonance imaging (MRI). We report a 24-year-old patient presenting with a left scrotal mass. During the patient's preoperative MRI, we observed a testicular tumor measuring 2.5 cm that was consistent with the findings of a seminoma. The serum tumor markers were within the normal range. The T1-weighted MRI revealed a solid mass that was isointense-slightly hyperintense compared to the testicular parenchyma, while the mass appeared homogeneously hypointense on the T2-weighted imaging. The patient was planned to undergo left inguinal orchiectomy with the final pathological diagnosis of MGST. The MGST cannot be distinguished from other testicular tumors with certainty based on any MRI findings. The main tool for diagnosis should be based on the histomorphological characteristics and the immunohistochemical profile of the mass.

Retinal changes in generalized anxiety disorder patients.

OBJECTIVE: Optical coherence tomography (OCT) is a method that allows high-resolution cross-sectional imaging of biological tissues. It was suggested that changes in the cranial structure or functions would be reflected in the retina. OCT has been an important method in the diagnosis and follow-up of diseases via morphometric or quantitative retinal measurements. Free radicals, inflammatory processes, and neurotransmission disorders play a role in the etiology of generalized anxiety disorder (GAD). The study aimed to demonstrate the retinal changes in GAD patients due to neurodegeneration based on the comparison of the OCT data of the GAD patients and controls, and the differences between OCT findings of GAD patients and those of controls. METHODS: The study group included 21 GAD patients. The control group included 21 individuals without any known psychiatric or organic disease, including eye diseases. RESULTS: There was a statistically significant difference between the macular volumes (MV) of the GAD and control groups, the macular volume was lower in the GAD group. There were positive correlations between BDI scores and MV, GCLT, RNFLT-i, RNFLT-n, between BAE scores and (RNFLT-n), and between the CGI severity scale scores and MV, RNFLT-n, and RNFLT-t. CONCLUSION: OCT analysis of the GAD patients demonstrated that MV values were lower when compared to the control group. Patients with GAD should be screened for these retinal changes. OCT, a simple, non-invasive, and relatively inexpensive method could be employed as a supplementary method in the follow-up of GAD patients.

Effect of topical motesanib in experimental corneal neovascularization model.

PURPOSE: This study aimed to compare the efficacy of topical bevacizumab and motesanib in an experimental corneal neovascularization model, and find the most effective motesanib dose. MATERIALS AND METHODS: In experiments, 42 Wistar Albino rats were randomly divided into six groups (n = 7). Corneal cauterization was applied to all groups except the group 1. Group 1 did not receive any treatment. Topical dimethylsulfoxide was applied to sham group three times a day(tid). Topical bevacizumab drops (5 mg/ml) were applied to Group 3 tid. Topical motesanib drops with a dose of 2.5, 5, and 7.5 mg/ml were respectively applied in Groups 4, 5, and 6 tid. On the 8th day, corneal photographs of all rats were taken under general anesthesia, and the percentage of corneal neovascular area was calculated. VEGF-A mRNA, VEGFR-2 mRNA, miRNA-21, miRNA-27a, miRNA-31, miRNA-126, miRNA-184, and miRNA-204 were evaluated by the qRT-PCR method in corneas taken after decapitation. RESULTS: The percentage of corneal neovascularization areas and VEGF-A mRNA expression levels were decreased in all treatment groups compared to group 2 (p < 0.05). VEGFR-2 mRNA levels were found to be statistically significantly decreased in groups 4 and 6 compared to group 2 (p < 0.05). Statistically significant changes were detected in the expression levels of only miRNA-126 among all miRNAs. CONCLUSION: Motesanib with a dose of 7.5 mg/ml statistically significantly suppressed the VEGFR-2 mRNA level compared with other treatment doses and may be more effective than bevacizumab. Further, miRNA-126 can be used as a proangiogenic marker.

Investigation of effect of nintedanib in experimental uveitis model.

PURPOSE: This study aims to investigate the protective efficacy of nintedanib in experimental uveitis induced by endotoxins. MATERIALS AND METHODS: In this study, 24 Wistar albino rats were randomly divided into three groups: Group I was the healthy control with no uveitis that did not receive any treatment, Group II (sham) group did not receive treatment, and Group III (nintedanib) received oral nintedanib for 10 days. On the 10th day, endotoxin-induced uveitis (EIU) was induced by lipopolysaccharide (LPS) injection in Groups II and III. The clinical activity score was evaluated in all groups at the 24th hour, when uveitis formation was thought to be the most intense after LPS injection. All rats were then killed via anaesthesia. Tumour necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) levels were measured in their right eyes using the enzyme-linked immunosorbent assay (ELISA) method. Further, histopathological examinations were performed on their left eyes. RESULTS: For Groups I, II, and III, the IL-6 levels were 30.88 ± 1.79, 36.77 ± 1.21, and 30.93 ± 3.96 mg/pr, respectively, and TNF-α levels were 50.20 ± 3.24, 59.87 ± 2.98, and 50.23 ± 4.83 mg/pr, respectively. IL-6, TNF-α levels and clinical activity score were higher in the sham group compared to the other groups, and it decreased significantly in the treatment group (p < 0.05). Intense inflammatory cell infiltration of the ciliary body, edema and hyperaemia were evident in the sham group compared to the healthy control group (p < 0.05). These pathological findings were significantly decreased in the treatment group compared to the sham group (p < 0.05). CONCLUSION: Nintedanib may be preferable as a new agent for treating non-infectious uveitis. However, further studies are needed to evaluate its long-term effects, effects on other antiinflammatory pathways, side-effects, and ideal dose optimization.

Protective effect of filgotinib in rat endotoxin-induced uveitis model.

PURPOSE: To investigate the protective effect of filgotinib in endotoxin-induced uveitis model in rats. MATERIALS AND METHOD: This study used 24 Wistar Albino rats. Group I (control group) included the healthy controls; in Group II (sham group), only 300 µg/kg intraperitoneal (ip) lipopolysaccharide (LPS) was administered; and in Group III (treatment group), 3 mg/kg/day filgotinib was administered orally for 10 days followed by 300 µg/kg ip LPS. In all groups, clinical activity scores were evaluated after 24 h. Moreover, histopathological and immunological examinations were performed. RESULTS: In Groups I, II, and III, the mean clinical activity and histopathological examination scores were 0.00, 3.25 ± 0.70, and 1.89 ± 0.60 and 0.00, 2.88 ± 1.12, and 1.44 ± 0.52, respectively. The clinical activity and histopathological examination scores were significantly increased in the sham group compared to the control group (p < 0.05); these findings were significantly reduced in the treatment group (p < 0.05). The mean TNF-α and IL-6 ELISA levels in all groups were 50.20 ± 3.24, 59.87 ± 2.98, and 54.34 ± 4.62 and 30.88 ± 1.79, 36.77 ± 1.21, and 33.66 ± 1.86, respectively. The TNF-α and IL-6 ELISA levels were significantly decreased in the treatment group compared to the sham group (p < 0.05); there was no significant difference between the treatment group and the control group (p = 0.105, p = 0.067, respectively) CONCLUSION: Filgotinib may be an alternative treatment option in preventing the development of noninfectious uveitis.

Comparison of the effect of topical bevacizumab and sorafenib in experimental corneal neovascularization.

PURPOSE: The purpose of this study was to compare the neovascularization inhibiting the effect of topical bevacizumab and sorafenib and to determine the effective dose of sorafenib. MATERIAL AND METHODS: Forty-two healthy Wistar albino rats were randomly divided into six groups. The right corneas of all rats except group 1 were cauterised with silver nitrate. Group 2 received DMSO, group 3 received topical bevacizumab (5 mg/dL, 3 times a day) and group 4, 5 and 6 received topical sorafenib (2.5 mg/dl, 5 mg/dL, 7.5 mg/dL, 2 times a day respectively), between days 1 and 7. Corneal photographs were taken on day 8 and the corneal neovascular area percentage was calculated. Following decapitation, the corneas were removed to determine the levels of VEGF ELISA and corneal immune staining. The Mann-Whitney U-test was used for statistical analysis. RESULTS: The neovascular corneal area percentage was statistically significantly lower in the treatment groups than group 2 (p < 0.05). The intensity of VEGF immune staining was also lower in groups 3, 5 and 6 from the group 2. Group 3, 5 and 6 were no significant differences compared to group 1. The VEGF ELISA levels were statistically significantly lower in group 3, 5 and 6 compared to group 2 (p < 0.05). There was no statistically difference between VEGF ELISA levels of group 2 and 4 (p > 0.05). CONCLUSIONS: Sorafenib was as effective as bevacizumab in the regression of corneal neovascularization. The effect of sorafenib seems to be dose-dependent. The low doses and twice a day administration are important advantages of sorafenib.

Thiol/disulfide homeostasis in patients with ocular-active and ocular-inactive Behçet disease.

PURPOSE: To evaluate thiol/disulfide homeostasis in ocular-active (OA) and ocular-inactive (OI) Behçet disease (BD) patients and compare the data with healthy subjects. METHODS: Twenty OABD patients, 20 OIBD patients and 20 healthy control subjects were included into the study. The BD ocular attack score 24 (BOS24) scoring system was used to assess the activity of disease in ocular BD patients. Systemic activity was also evaluated using BD current activity form (BDCAF). The native thiol (NT), total thiol (TT) and disulfide levels and NT/TT, disulfide/NT and disulfide/TT ratios were measured via using an innovative and automated method. RESULTS: BOS24 and BDCAF scores were 13.25 ± 2.32 and 4.18 ± 2.06 in OABD patients and 0.31 ± 0.47 and 2.14 ± 1.98 in OIBD patients, respectively. The NT, TT levels and NT/TT ratio were significantly reduced; in contrast, the disulfide levels, disulfide/NT and disulfide/TT ratios were significantly increased in OABD and OIBD patients compared to the healthy control subjects (p < 0.05). Moreover, while the levels of NT and TT were significantly reduced, the disulfide levels as well as disulfide/NT and disulfide/TT ratios were significantly elevated between OABD and OIBD patients (p < 0.05). However, the ratio of NT/TT did not significantly differ between OABD and OIBD patients (p = 0.449). The multiple regression model including BOS24 and BDCAF score statistically significantly predicted NT level, TT level and disulfide level (p < 0.001 for all). CONCLUSION: Thiol oxidation in BD patients resulted in a change of the thiol/disulfide balance. Therefore, thiol/disulfide homeostasis in BD patients can be used an innovative oxidative stress marker.

Chemokine CXCR-4 and cyclooxygenase-2 in the pathogenesis of pterygium

Background/aim: This study aimed to investigate the expression of chemokine receptor 4 (CXCR-4) and cyclooxygenase-2 (COX-2) in the epithelium and stroma of pterygium tissue in comparison with healthy conjunctiva. Materials and methods: The expression of CXCR4 and COX-2 was investigated by immunohistochemistry in the epithelium and stroma of the pterygium tissue of 29 eyes and compared with healthy conjunctival tissues. The correlation between CXCR4 and COX-2 expression as well as the correlation of these markers with the area of pterygium were evaluated statistically. Results: COX-2 staining scores were 1.75 ± 0.63 in the epithelium and 1.20 ± 0.62 in the stroma of the pterygium tissue. Mean CXCR-4 staining in the epithelium was 0.069 ± 0.37, whereas it was 5.0 ± 2.84 cells in the stroma. There was almost no staining of COX-2 and CXCR4 in the control samples. There was a strong positive correlation between the expression of CXCR-4 and COX-2 in the stroma of the pterygium. Conclusion: CXCR-4 and COX-2 may play important roles in the pathogenesis of pterygium.

Solvent type influences bond strength to air or blot-dried dentin.

BACKGROUND: Air-drying of etched and rinsed dentin surface may force the exposed collagen fibrils to collapse. Blot-drying is an alternative method to wipe the excess water from the dentin surface without compromising the monomer penetration. Contemporary total etch adhesives contain ethanol/water or acetone as solvent in which resin monomers are dissolved. Solvent type of the adhesive system has an important role in bonding to dentin. An adhesive containing tertiary butanol as an alternative solvent has been in the market. Purpose of this study is to determine the shear bond strengths of three total-etch adhesives with different solvents (acetone, ethanol or tertiary butanol) applied to air or blot dried moist dentin. METHODS: Sixty extracted non-carious human third molars were divided into three main groups according to solvent content of the adhesives [acetone based - One Step (OS, Bisco, IL, USA); ethanol/water based - Optibond Solo Plus (OB, Kerr, CA, USA); and tertiary butanol based - XP Bond (XP, Caulk/Dentsply, DE, USA)]. Each main group was divided into two groups according to drying methods (blot or air) (n = 10). Shear bond strengths (SBS) were measured. Data were analyzed by Student's t test and Tukey HSD test (p < 0,05). RESULTS: XP showed highest SBS values in both drying methods applied (p < 0.05). Drying method did not influence the SBS in OS and OB (p > 0.05). XP-blot produced significantly higher SBS than XP-air (p < 0.05). CONCLUSIONS: Tertiary butanol based adhesive showed higher bond strength values than ethanol or acetone based adhesives. Blot drying of dentin improved the bond strength values of tertiary butanol based adhesive. Further research is necessary to determine in vivo and in vitro performance of tertiary butanol based adhesives.

Effects of protective resin coating on the surface roughness and color stability of resin-based restorative materials.

The aim of this study was to evaluate the effects of nanofilled protective resin coating (RC) on the surface roughness (Ra) and color stability (ΔE) of resin-based restorative materials (RM) (compomer (C), nanofilled composite (NF), and microhybrid composite (MH)) after being submitted to the ultraviolet aging (UV) method. Thirty-six specimens were prepared (n = 6 for each group). The Ra and (ΔE) values and SEM images were obtained before and after UV. Significant interactions were found among the RM-RC-UV procedures for Ra (P < 0.001). After the specimens were submitted to UV, the Ra values were significantly increased, regardless of the RC procedure (with RC; P < 0.01 for all, without RC; C (P < 0.01), NF (P < 0.001), and MH (P < 0.001)) for each RM. Significant interactions were found between the RM-RC (P < 0.001) procedures for the ΔE values. The ΔE values were increased in each group after applying the RC procedures (P < 0.001). Protective RC usage for RM could result in material-related differences in Ra and ΔE as with used UV method.

Effect of ultraviolet aging on translucency of resin-cemented ceramic veneers: an in vitro study.

PURPOSE: The aim of this in vitro study was to evaluate the translucency of ceramic veneers cemented with light- or dual-cured resin cements after accelerated aging. MATERIALS AND METHODS: A total of 392 specimens were made of shade A1 with 0.5- and 1.0-mm thickness. Light-cured RelyX Veneer and dual-cured Maxcem Elite and Variolink II resin cements were applied on the porcelain discs with a thickness of 0.1 mm. Translucency parameter (TP) values of the ceramic veneers after cementation and UV aging test were evaluated. Statistical analyses were done with ANOVA and Tukey's tests and paired sample t-test (p < 0.05). RESULTS: All the resin cements affected the TP values of 0.5-mm-thick ceramic, while RelyX Veneer Tr (TP = 11.15; p = 0.608), Variolink II Tr (TP = 10.98; p = 0.55), and Maxcem Clear (TP = 11.81; p = 0.702) did not affect the translucency of 1-mm-thick ceramics (TP = 11.38). The aging process affected TP values of both ceramics and cemented ceramics, as the TP values decreased after aging. Among the TP values of opaque shade resin cements, there were significant differences between the "ceramic," "ceramic + RelyX Veneer WO," "ceramic + Variolink II WO," and "ceramic + Maxcem WO" variables for both 0.5 and 1 mm thicknesses (p < 0.05). There were no significant differences between "ceramic," "ceramic + RelyX Veneer Tr," "ceramic + Variolink II Tr," and "ceramic + Maxcem Clear" variables at 0.5 mm thickness, and there were no significant differences between "ceramic," "ceramic + RelyX Veneer Tr," and "ceramic + Variolink II Tr" variables after aging (p > 0.05). CONCLUSIONS: The TP of the same color of resin cements varied related to the type or brand. Aging caused both the ceramics and cemented ceramics to become more opaque.

Machine learning prediction of Gleason grade group upgrade between in-bore biopsy and radical prostatectomy pathology.

This study aimed to enhance the accuracy of Gleason grade group (GG) upgrade prediction in prostate cancer (PCa) patients who underwent MRI-guided in-bore biopsy (MRGB) and radical prostatectomy (RP) through a combined analysis of prebiopsy and MRGB clinical data. A retrospective analysis of 95 patients with prostate cancer diagnosed by MRGB was conducted where all patients had undergone RP. Among the patients, 64.2% had consistent GG results between in-bore biopsies and RP, whereas 28.4% had upgraded and 7.4% had downgraded results. GG1 biopsy results, lower biopsy core count, and fewer positive cores were correlated with upgrades in the entire patient group. In patients with GG > 1 , larger tumor sizes and fewer biopsy cores were associated with upgrades. By integrating MRGB data with prebiopsy clinical data, machine learning (ML) models achieved 85.6% accuracy in predicting upgrades, surpassing the 64.2% baseline from MRGB alone. ML analysis also highlighted the value of the minimum apparent diffusion coefficient ( ADC min ) for GG > 1 patients. Incorporation of MRGB results with tumor size, ADC min value, number of biopsy cores, positive core count, and Gleason grade can be useful to predict GG upgrade at final pathology and guide patient selection for active surveillance.

A case of an aberrant internal carotid artery with a persistent stapedial artery: association of hypoplasia of the A1 segment of the anterior cerebral artery.

Congenital vascular variants involving the temporal bones are rare. Awareness of these variants is important as they may mimic glomus tumors or complicate middle ear surgery. We present a case of a persistent stapedial artery associated with an aberrant carotid artery in the left temporal bone, which is highlighted in computed tomography imaging findings. We further discuss a possible relationship between hypoplasia of the A1 segment of the anterior cerebral artery and this congenital variant.

A rare cause of acquired esotropia: Leprosy.

Leprosy is an infective chronic granulomatous disease involving the skin and peripheral nerves caused by Mycobacterium leprae. Complications such as lagophthalmos, corneal opacity and uveitis are common, but cranial nerve involvement is rarely seen. The fifth and seventh cranial nerves are most commonly involved. We report a case of acquired esotropia due to sixth nerve palsy following a rare cranial nerve involvement by leprosy.

The role of economic freedom and clean energy in environmental sustainability: implication for the G-20 economies.

With the increasing challenge of attaining sustainable balance in socioeconomic-ecosystem activities, the aspects of the global goals are continously being harnesed in order to ensure a sustainable interaction. As an alliance of the United Nations, the G-20 member countries have not only committed to attaining the Sustainable Development Goals 2030, the alliance body has further fostered frameworks that are targeted at advancing global economic and environmental sustainability. Within this context, the current study examined the environmental sustainability effects arising from the economic freedom prowess in the panel of the G-20 economies over the period 2000-2016. Among the sparse studies, the study employed the indices of economic freedom: freedom to trade internationally, regulation, sound money, legal framework, and property right and alongside the real income and renewable energy consumption as explanatory indicators. With the result of the difference- and two-step system GMM (generalized method of moments), the legal system and property right, sound money, freedom to international trade, and regulatory efficiency are detrimental to the panel countries' environmental quality. Although this is likely to be untrue for countries that have advanced their climate actions and especially the Sustainable Development Goals (SDGs) 2030, it suggests a dearth in the SDGs achievement among the developing and emerging economies. Moreover, it probably shows the depth of traditional or business-as-usual practices (such as the lack of sustainable economic and environmental practices) and the socioeconomic system that are obtainable in most of the developing and emerging economies. Thus, the study put forward tangible policies that are essential for governance and toward attaining desirable country-specific SDGs.

Retinal Changes in Panic Disorder Patients.

AIM: Optical coherence tomography (OCT) is a novel method that allows high resolution cross-sectional imaging of biological tissues. It was suggested that changes in the cranial structure or functions would be reflected in the retina. OCT has been an important method in the diagnosis and follow-up of diseases via morphometric or quantitative retinal measurements. Panic disorder (PD) is an anxiety disorder, where free radicals, inflammatory processes and neurotransmitter transmission disorders play a role in the etiology. The present study aimed to demonstrate neurodegeneration in PD by the comparison of PD patient and control OCT data. MATERIAL AND METHOD: The study group included 21 PD patients who met the study criteria. The control group included 21 healthy individuals without any known psychiatric or organic disease, including eye disease, and gender-matched to the patient group. All participants underwent detailed psychiatric and eye examinations. Central macular thickness (CMT), macular volume (MV), mean and retinal nerve fiber layer thickness (RNFL), ganglion cell layer thickness (GCLT), and central choroidal thickness (CCT) were measured in both eyes of all participants with OCT. A sociodemographic data form, Clinical Global Impression Scale (CGIS), and Panic Disorder Severity Scale (PDSS) were administered to the participants. RESULTS: In the study, it was determined that the CMT values of the PD patients were lower when compared to the controls in the OCT examination. There was a statistically significant difference between the CMT of the PD patient group and the control group; the CMT was lower in the patient group. There were no significant differences between the groups based on GCLT, RNFL superior, RNFL inferior, RNFL nasal, RNFL temporal, and CCT. There was no significant correlation between CGIS, PDSS scores and OCT measurements. CONCLUSION: This is the first study in the literature where patients with a PD diagnosis were analyzed based on the OCT method. OCT, which is a simple, noninvasive and relatively inexpensive method that the patient could easily adapt to during imaging, could be employed as a supplementary method in the diagnosis and follow-up of PD patients.

Preoperative Magnetic Resonance Imaging Abnormalities Predictive of Lumbar Herniation Recurrence After Surgical Repair.

OBJECTIVE: There are currently no standard criteria for evaluating the risk of recurrent disk herniation after surgical repair. This study investigated the predictive values of 5 presurgical imaging parameters: paraspinal muscle quality, annular tear size, Modic changes, modified Phirrmann disk degeneration grade, and presence of sacralization or fusion. METHODS: Between 2015 and 2018, 188 patients (89 female, 99 male, median age 50) receiving first corrective surgery for lumbar disk herniation were enrolled. Microdiskectomy was performed in 161 of these patients, and endoscopic translaminar diskectomy approach was performed in 27 patients. Clinical status was evaluated before surgery and 4, 12, and 24 months post surgery using a visual analog scale, Oswestry Disability Index, and Short Form 36. RESULTS: Recurrent disk herniation was observed in 21 of 188 patients. Seventeen of the recurrent disk herniations were seen in those who underwent microdiskectomy and 4 in those who underwent endoscopic translaminar diskectomy. There were significant differences in visual analog scale, Oswestry Disability Index, and Short Form 36 scores at 4, 12, and 24 months between patients with recurrence and the 167 no-recurrence patients. The median annular tear length was significantly greater in patients with recurrence than without recurrence. In addition, there were significant differences in recurrence rate according to Modic change type distribution, sacralization or fusion presence, Pfirmann disk; degeneration grade distribution, dichotomized annular tear size, dichotomized Modic change; and type and simplified 3-tier muscle degeneration classification distribution. CONCLUSIONS: Patients with poor clinical scores and recurrence exhibited additional radiologic abnormalities before surgery, such as poor paraspinal muscle quality, longer annular tears, higher Modic change type, higher modified Phirrmann disk degeneration grade, and sacralization or fusion. This risk evaluation protocol may prove valuable for patient selection, surgical planning, and choice of postoperative recovery regimen.

Automated Diabetic Retinopathy Detection Using Horizontal and Vertical Patch Division-Based Pre-Trained DenseNET with Digital Fundus Images.

Diabetic retinopathy (DR) is a common complication of diabetes that can lead to progressive vision loss. Regular surveillance with fundal photography, early diagnosis, and prompt intervention are paramount to reducing the incidence of DR-induced vision loss. However, manual interpretation of fundal photographs is subject to human error. In this study, a new method based on horizontal and vertical patch division was proposed for the automated classification of DR images on fundal photographs. The novel sides of this study are given as follows. We proposed a new non-fixed-size patch division model to obtain high classification results and collected a new fundus image dataset. Moreover, two datasets are used to test the model: a newly collected three-class (normal, non-proliferative DR, and proliferative DR) dataset comprising 2355 DR images and the established open-access five-class Asia Pacific Tele-Ophthalmology Society (APTOS) 2019 dataset comprising 3662 images. Two analysis scenarios, Case 1 and Case 2, with three (normal, non-proliferative DR, and proliferative DR) and five classes (normal, mild DR, moderate DR, severe DR, and proliferative DR), respectively, were derived from the APTOS 2019 dataset. These datasets and these cases have been used to demonstrate the general classification performance of our proposal. By applying transfer learning, the last fully connected and global average pooling layers of the DenseNet201 architecture were used to extract deep features from input DR images and each of the eight subdivided horizontal and vertical patches. The most discriminative features are then selected using neighborhood component analysis. These were fed as input to a standard shallow cubic support vector machine for classification. Our new DR dataset obtained 94.06% and 91.55% accuracy values for three-class classification with 80:20 hold-out validation and 10-fold cross-validation, respectively. As can be seen from steps of the proposed model, a new patch-based deep-feature engineering model has been proposed. The proposed deep-feature engineering model is a cognitive model, since it uses efficient methods in each phase. Similar excellent results were seen for three-class classification with the Case 1 dataset. In addition, the model attained 87.43% and 84.90% five-class classification accuracy rates using 80:20 hold-out validation and 10-fold cross-validation, respectively, on the Case 2 dataset, which outperformed prior DR classification studies based on the five-class APTOS 2019 dataset. Our model attained about >2% classification results compared to others. These findings demonstrate the accuracy and robustness of the proposed model for classification of DR images.

Escape from COVID-19 pandemic to safe haven.

Gold, which is accepted as a safe haven by households, is known as an investment tool that is preferred especially in times of crisis and uncertainty. Especially in recent days, the uncertainty caused by the COVID-19 pandemic and the visible increase in Turkey's 5-year CDS data has led investors in Turkey to grams of gold, which is considered a safe haven. In this context, this study aims to test the long-term relationship between daily case-related deaths and Turkey's 5-year CDS data with gram gold prices in Turkish lira during the COVID-19 pandemic. The long-term relationship between the variables was tested with the autoregressive distributed lag bound test (ARDL bound test) applied to the daily data for the period March 17, 2020-April 11, 2020. For the application of ARDL bound test, the stationarity of the variables was tested with unit root tests such as augmented Dickey-Fuller test (ADF) and Phillips-Perron (PP). According to the ARDL bound test findings, there is a statistically significant and positive relationship between the number of case-related deaths and the gram gold prices in Turkish lira in the long run. However, it has been found that Turkey's 5-year CDS data does not have a significant long-term relationship with gram gold prices in Turkish lira.