Prevalence, comorbidities and mediators of childhood anxiety disorders in urban Turkey: a national representative epidemiological study.

PURPOSE: The aim of this study is to evaluate the prevalence of anxiety disorders, its correlation with sociodemographic characteristics, its comorbidities with other psychiatric disorders and its predictors in school-aged children. METHODS: This study is part of a representative, multi-centered national study that is planned by the Turkish Association of Child and Adolescent Mental Health to evaluate the prevalence of psychopathology among elementary school students in Turkey between the years 2014-2015. Children are screened via Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version. Impairment is assessed by a 3-point Likert type scale independently by the parent and the teacher. The final sample included 5842 children with the mean age of 8.7 years. RESULTS: The prevalence of any anxiety disorder without considering impairment is 16.7% and considering impairment is 5.2% in children according to our study. We found significant differences for comorbid Attention Deficit Hyperactivity Disorder, Disruptive Behavior Disorder, Mood Disorders, Tic Disorders, Obsessive Compulsive Disorder, Enuresis Nocturna, Encopresis, and Intellectual Disability. Having a history of paternal physical disorder, living in the regions of Marmara, Mediterranean and Black Sea were found to be the main predictors of having childhood anxiety disorders according to the logistic regression analysis. CONCLUSION: Better understanding of childhood anxiety disorders, comorbid conditions and predictors will result in earlier diagnosis and more appropriate treatment.

Topological Euler Class as a Dynamical Observable in Optical Lattices.

The last years have witnessed rapid progress in the topological characterization of out-of-equilibrium systems. We report on robust signatures of a new type of topology-the Euler class-in such a dynamical setting. The enigmatic invariant (ξ) falls outside conventional symmetry-eigenvalue indicated phases and, in simplest incarnation, is described by triples of bands that comprise a gapless pair featuring 2ξ stable band nodes, and a gapped band. These nodes host non-Abelian charges and can be further undone by converting their charge upon intricate braiding mechanisms, revealing that Euler class is a fragile topology. We theoretically demonstrate that quenching with nontrivial Euler Hamiltonian results in stable monopole-antimonopole pairs, which in turn induce a linking of momentum-time trajectories under the first Hopf map, making the invariant experimentally observable. Detailing explicit tomography protocols in a variety of cold-atom setups, our results provide a basis for exploring new topologies and their interplay with crystalline symmetries in optical lattices beyond paradigmatic Chern insulators.

How to Directly Measure Floquet Topological Invariants in Optical Lattices.

The classification of topological Floquet systems with time-periodic Hamiltonians transcends that of static systems. For example, spinless fermions in periodically driven two-dimensional lattices are not completely characterized by the Chern numbers of the quasienergy bands, but rather by a set of winding numbers associated with the gaps. We propose a feasible scheme for measuring these winding numbers in a periodically driven optical lattice efficiently and directly. It is based on the construction of a one-parameter family of drives, continuously connecting the Floquet system of interest to a trivial reference system. The winding numbers are then determined by the identification and the tomography of the band-touching singularities occurring on the way. As a by-product, we also propose a method for probing spectral properties of time evolution operators via a time analog of crystallography.

Floquet Engineering of Optical Solenoids and Quantized Charge Pumping along Tailored Paths in Two-Dimensional Chern Insulators.

The insertion of a local magnetic flux, as the one created by a thin solenoid, plays an important role in gedanken experiments of quantum Hall physics. By combining Floquet engineering of artificial magnetic fields with the ability of single-site addressing in quantum gas microscopes, we propose a scheme for the realization of such local solenoid-type magnetic fields in optical lattices. We show that it can be employed to manipulate and probe elementary excitations of a topological Chern insulator. This includes quantized adiabatic charge pumping along tailored paths inside the bulk, as well as the controlled population of edge modes.

Pairing of Fermions with Unequal Effective Charges in an Artificial Magnetic Field.

Artificial magnetic fields (AMFs) created for ultracold systems depend sensitively on the internal structure of the atoms. In a mixture, each component experiences a different AMF depending on its internal state. This enables the study of Bardeen-Cooper-Schrieffer pairing of fermions with unequal effective charges. In this Letter, we investigate the superconducting (SC) transition of a system formed by such pairs as a function of field strength. We consider a homogeneous two-component Fermi gas of unequal effective charges but equal densities with attractive interactions. We find that the phase diagram is altered drastically compared to the usual balanced charge case. First, for some AMFs there is no SC transition and isolated SC phases are formed, reflecting the discrete Landau level (LL) structure. SC phases become reentrant both in AMF and temperature. For extremely high fields where both components are confined to their lowest LLs, the effect of the charge imbalance is suppressed. Charge asymmetry reduces the critical temperature even in the low-field semiclassical regime. We discuss a pair breaking mechanism due to the unequal Lorentz forces acting on the components of the Cooper pairs to identify the underlying physics.

The role of N-Acetylcysteine in preventing cyclophosphamide-induced gonadotoxicity: An experimental study in rats.

This study assessed whether NAC could prevent cyclophosphamide (CY)-induced damage, by measuring the anti-Müllerian hormone (AMH) levels. Forty-eight Sprague-Dawley female rats were divided into four groups: CY + NAC, CY, NAC and control, each including 12 rats. There was no significant difference among the 24-h AMH values of the groups (p = 0.452), whereas a significant difference was found in terms of 72-h values (p = 0.003). Paired comparisons revealed no significant difference between CY and CY + NAC (p>0.699) and NAC (p = 0.065) groups regarding 72-h AMH values. However, AMH concentrations of the CY group at 72 hours were significantly lower than those of the control group (p = 0.015). AMH concentrations of the CY + NAC group at 72 hours were also significantly lower than those of the NAC group (p = 0.002) and the control group (p = 0.002). The AMH levels of CY and CY + NAC groups at 72 hours were significantly lower than those at 24 hours. The 24-h and 72-h AMH levels in the NAC and control groups were similar. In the present study, a single dose of NAC failed to prevent the cytotoxic effects of CY.

Non-Abelian Floquet braiding and anomalous Dirac string phase in periodically driven systems.

While a significant fraction of topological materials has been characterized using symmetry requirements1-4, the past two years have witnessed the rise of novel multi-gap dependent topological states5-9, the properties of which go beyond these approaches and are yet to be fully explored. Although already of active interest at equilibrium10-15, we show that the combination of out-of-equilibrium processes and multi-gap topological insights galvanize a new direction within topological phases of matter. We show that periodic driving can induce anomalous multi-gap topological properties that have no static counterpart. In particular, we identify Floquet-induced non-Abelian braiding, which in turn leads to a phase characterized by an anomalous Euler class, being the prime example of a multi-gap topological invariant. Most strikingly, we also retrieve the first example of an 'anomalous Dirac string phase'. This gapped out-of-equilibrium phase features an unconventional Dirac string configuration that physically manifests itself via anomalous edge states on the boundary. Our results not only provide a stepping stone for the exploration of intrinsically dynamical and experimentally viable multi-gap topological phases, but also demonstrate periodic driving as a powerful way to observe these non-Abelian braiding processes notably in quantum simulators.

First Report of Leaf Blotch on Sorghum Caused by Bipolaris spicifera in Turkey.

In July 2009, a leaf blotch disease was observed on sorghum in Sakarya Province, Turkey. Disease incidence and severity were rated at 45% and 25 to 75%, respectively. Typical symptoms included elliptical, straw-colored, necrotic lesions with darker margins. The lesions eventually coalesced, resulting in drying of leaves. A fungus was isolated from the lesions on potato dextrose agar (PDA) incubated under near ultraviolet light for 12 h daily at 22°C for 2 weeks. Flexuous conidiophores of the fungus were solitary or produced in small groups. They were geniculate with numerous well-defined scars, medium to dark brown, ≥300 µm long, and 4 to 9 µm thick. Five to eight or more conidia were produced on the apices of the conidiophores. The conidia were straight, oblong or cylindrical, rounded at the ends, golden brown at maturity except for a small area just above the dark scar, pseudoseptate, and 20 to 31 × 7.5 to 12.5 µm (1). The causal fungus was identified as Bipolaris spicifera (Bain) Subram. (teleomorph Cochliobolus spicifer Nelson). The identification was confirmed with specific PCR primers (Bipol-1 F: 5'-CAGTTGCAATCAGCGTCAGT-3', R: 5'-AAGACAAAAACGCCCAACAC-3', Bipol-2 F: 5'-GTGTTGGGCGTTTTTGTCTT-3', R: 5'-CCTACCTGATCCGAGGTCAA-3', Bipol-3 F: 5'-GATGAAGAACGCAGCGAAAT-3', R: 5'-AAGACAAAAACGCCCAACAC-3'). These primers were designed by the authors using Primer3 primer design software and sequences of B. spicifera found in GenBank. PCR products were amplified from nuclear DNA of the cultured fungus and were sequenced after cleaning with a Beckman 8000 CEQ DNA sequencer. Sequences amplified using Bipol-1 and Bipol-2 showed 99 to 100% similarity with B. spicifera sequences from GenBank. The DNA sequence amplified using Bipol-2 was deposited in GenBank (Accession No. HQ538774). B. spicifera has been reported previously as pathogenic in Africa, North and South America, Asia, Australia, Oceania, and the West Indies on Agrostis, Avena, Cymbopogon, Cynodon, Dactylis, Desmostachya, Eleusine, Holcus, Hordeum, Oryza, Panicum, Pennisetum, Phleum, Poa, Saccharum, Sorghum, Triticum, and Zea spp. (3). Pathogenicity tests were conducted on sorghum (Sorghum bicolor (L.) Moench) and Sorghum × sudangrass hybrid cultivars. From PDA cultures, conidia were collected in sterile distilled water with a concentration of 3% Tween 20. Twenty-five plants (five per pot) were inoculated by spraying the conidia (105 ml-1) onto 21-day-old plants, which were then maintained at 25 ± 2°C in a greenhouse following 48 h in a humid chamber. The test was repeated once. Control plants were sprayed with sterile distilled water. Typical symptoms (2) were obtained from all inoculated plants 7 days after inoculation. No symptoms developed on the control plants. The pathogen was reisolated from inoculated leaves to fulfill Koch's postulates. To our knowledge, this is the first report of B. spicifera on sorghum in Turkey. References: (1) M. B. Ellis. Dematiaceous Hyphomycetes. Commonwealth Mycological Institute, Kew, Surrey, England, 1971. (2) H. Koo et al. Plant Pathol. J. 19:133, 2003. (3) A. Sivanesan. Mycologia Papers 158:1, 1987.

Measuring topology from dynamics by obtaining the Chern number from a linking number.

Integer-valued topological indices, characterizing nonlocal properties of quantum states of matter, are known to directly predict robust physical properties of equilibrium systems. The Chern number, e.g., determines the quantized Hall conductivity of an insulator. Using non-interacting fermionic atoms in a periodically driven optical lattice, here we demonstrate experimentally that the Chern number determines also the far-from-equilibrium dynamics of a quantum system. Extending a respective proposal to Floquet systems, we measure the linking number that characterizes the trajectories of momentum-space vortices emerging after a strong quench. We observe that it directly corresponds to the ground-state Chern number. This one-to-one relation between a dynamical and a static topological index allows us to experimentally map out the phase diagram of our system. Furthermore, we measure the instantaneous Chern number and show that it remains zero under the unitary dynamics.

Genotoxic action of fungicide Conan 5FL (hexaconazole) on mammalian cells in vivo and in vitro.

The genotoxic effects of fungicide Conan 5FL (containing 50 g/L hexaconazole) in mouse bone-marrow cells and human lymphocytes have been evaluated. Three different concentrations of Conan 5FL (17.50, 35.00 and 70.00 microg/mL for human lymphocytes and 17.50, 35.00 and 70.00 mg/kg for mouse bone marrow cells) were studied. Conan 5FL induced significant increases (except 17.50 mg/kg for mouse bone marrow) in the frequency of chromosomal aberrations (CAs) in both test systems. This fungicide caused structural and numerical abnormalities in both mammalian cells. These are sister chromatid union, chromatid and chromosome breaks, fragments, dicentric and ring chromosomes, and polyploidy. Significant increase was found in induction and in minimum-maximum numbers of sister chromatid exchanges (SCEs) at all treatments compared with the negative control. Conan 5FL did not affect the replication index (RI) in human lymphocyte cultures, however, it significantly decreased the mitotic index (MI) in all treatment concentrations in both test systems. Using of Conan 5FL should be reconsidered due to its possible cytotoxic, clastogenic and mutagenic effects.

Induction of sister chromatid exchanges and cell division delays by clomiphene citrate in human lymphocytes.

OBJECTIVE: Clomiphene citrate (CC) is a selective estrogen receptor modulator and is used for the treatment of in vitro fertilization, intracytoplasmic sperm injection, intrauterine insemination, and so on. In this study, sister chromatid exchanges (SCEs) and cell cycle delays were analyzed to investigate genotoxicity and cytotoxicity of CC in peripheral blood lymphocytes of healthy women. METHODS: Human peripheral blood lymphocytes obtained from two donors were used to detect genotoxicity and cytotoxicity of CC. Lymphocytes were treated with various concentrations (0.40, 0.80, 1.60, and 3.20 µg/ml) of CC. A negative (distilled water) and a positive control (mitomycin-C = 0.20 µg/ml) were also used simultaneously with test substance-treated cultures. SCEs and cell division delays were measured from 25 cells and 100 cells perdonor, respectively. RESULTS: CC significantly increased the mean SCE value at all concentrations compared with the negative control. This increase was found to be dose dependent (r = 0.83) and at the highest concentration, nearly two times higher increase was observed than the negative control. However, replication index was not affected by the CC treatment. CONCLUSION: The present study shows that CC is genotoxic for human lymphocytes in vitro. Further investigations, especially in vivo are now needed in different test organisms to clarify the genotoxic activity of CC, which should also help to better understand genotoxic mechanism of this ovulation-stimulating drug.

Terminal syringomyelia in association with the tethered cord syndrome.

OBJECTIVE: With the increasing use of magnetic resonance imaging, terminal syringomyelia (segmental cystic dilation of the caudal one-third of the spinal cord) in association with the tethered cord syndrome has become an appreciable finding. This study attempted to define the clinical significance of this associated pathological condition by describing its clinical and radiological characteristics and its contribution to the clinical status of patients with tethered spinal cords. METHODS: Of 132 consecutive patients with tethered cord syndrome who presented to our department between 1990 and 1997, 32 patients with terminal syringomyelia were enrolled in this study. Clinical findings were correlated with syrinx morphological features, as defined using magnetic resonance imaging. Surgical treatment used two basic approaches, i.e., simple untethering or untethering with concurrent syrinx drainage. RESULTS: Analysis of the neurological deficits established a contribution of segmental symptoms, which were correlated with the extension and dilation of the syrinx cavity. Magnetic resonance imaging scans revealed the frequency of sacral tethering (40.6%), the intramedullary paracentral position of the syrinx (75%), and disturbances in regional cerebrospinal fluid flow (42%). The clinical outcomes seemed to be correlated with syrinx shrinkage; all patients who experienced collapse of the cavity achieved better symptom resolution. CONCLUSION: Radiologically significant terminal syringomyelia affects the clinical presentation of tethered cord syndrome, by increasing or inducing neurological deficits. Better clinical outcomes after syrinx decompression emphasize the importance of the recognition and treatment of this pathological condition.

Skull base amyloidoma. Case report.

A mass lesion of amyloid involving the central nervous system is a rare finding. A 64-year-old woman presented with a large amyloidoma at the skull base causing neural tissue compression. The only accompanying disease was an asymptomatic renal cyst. The mass had caused destruction of the bone elements and pathological calcification as seen on x-ray films, computerized tomography (CT) scans, and magnetic resonance (MR) images, and was enhanced after injection of contrast medium on both CT scans and MR imaging.

Effect of the herbicide 4-CPA on human erythrocyte antioxidant enzymes in vitro.

To investigate the possible role of oxygen free radicals and oxidant stress in the toxic effects of phenoxyherbicides, we studied the in vitro effect of 4-chlorophenoxyacetic acid (4-CPA) on various human erythrocyte antioxidant enzymes, namely glucose-6-phosphate dehydrogenase, catalase, selenium-dependent glutathione peroxidase, glutathione reductase and Cu/Zn-superoxide dismutase. 4-CPA added in a dose of 1 ppm to human erythrocytes for 1 h caused a significant reduction in glucose-6-phosphate dehydrogenase (P <0.001) and catalase (P <0.001) activities, but did not significantly affect the activities of other enzymes. Such selective inactivation of specific erythrocyte antioxidant enzymes may play a role in the toxic effects of phenoxyherbicides.

Immune status and autoantibody formation in children with chronic hepatitis B infection.

BACKGROUND: The hepatitis B virus (HBV) causes a wide spectrum of disease which ranges from acute hepatitis to liver cirrhosis. Patients who fail to mount a vigorous immune response in acute HBV develop chronic infection. Therefore, the aim of the study was to determine the cellular and humoral immune parameters of the patients with chronic HBV and to evaluate the prevalence of autoantibodies before the beginning of immunomodulator and antiviral therapy. METHODS: In this comparative study, serum immunoglobulins, IgG subclasses, secretory IgA, serum complement components, lymphocyte subsets and CD11a, CD18, CD54 molecules on lymphocytes were determined in 44 hospitalized patients of chronic HBV infection and 20 cases of healthy control subjects. RESULTS: Significant increase in IgG and significant decrease in the complement C4 were observed. The mean percentage of CD3+ lymphocytes, reflecting the percentage of total T cells was significantly higher in the patient group due to the increase of CD8+ lymphocytes. The mean percentage of CD19+ B lymphocytes was lower in the patient group secondary to the increase of their total T cells. No significant difference was found in cell surface adhesion molecules between patient and control groups. The percentage of antinuclear antibody positivity was 18.2%. CONCLUSIONS: Our data show that ANA formation is part of the natural course of chronic HBV infection and this value may reflect the tendency to autoimmune diseases and the importance of clinical follow-up. The abnormalities observed in immunological parameters may reflect the role of the cellular and humoral immune system in pathogenesis.

Bromocriptine-induced cerebrospinal fluid fistula in patients with macroprolactinomas: report of three cases and a review of the literature.

Bromocriptine therapy for macroprolactinoma induced cerebrospinal fluid (CSF) rhinorrhea in three patients. The tumor had extended well beyond the sella turcica and caused bony erosion in all the cases. All three patients responded to bromocriptine therapy rapidly. CSF fistula occurred concomitantly with the reduction of tumor size and caused meningitis in two of the patients. Withdrawal of bromocriptine resulted in cessation of the leakage. One of the patients underwent transsphenoidal repair. Two patients refused surgery. This potentially lethal complication encountered in these three cases demonstrates the need for close supervision of macroprolactinoma patients with skull base erosion placed under bromocriptine therapy.

Real-time sonography for screening of gallbladder dysfunction in children with type 1 diabetes mellitus.

The aim of this study was to evaluate the occurrence of gallbladder dysfunction in children with type 1 diabetes mellitus using real-time ultrasonography. The study population consisted of 20 diabetic children (11 male, 9 female; age 11.7+/-2.8 years; diabetes duration 0.5-7 years) with clinically negative neuropathy findings and 15 healthy controls (11 male, 4 female; age 10.5+/-3.7 years). Three-dimensional measurements of the gallbladder were made before and 15, 30, 45, 60 min after intake of diet chocolate. Gallbladder volumes were calculated by the ellipsoid formula. Fasting gallbladder volume of diabetic children (16.9+/-9.5 ml) was significantly greater than that of the controls (10.6+/-5.3 ml; p=0.017). Ejection fraction and maximal contraction showed no significant difference between the two groups. Diabetic patients with multiple microvascular complications had diminished gallbladder motility. There was a negative correlation between BMI and maximal contraction (p<0.05). Nerve conduction velocity was diminished in 45% of the diabetic patients. In conclusion, gallbladder function is preserved in pediatric type 1 diabetic patients with a disease duration less then 10 years, but dilated gallbladder at rest may be an early sign of gastrointestinal autonomic neuropathy and a risk factor for gallstone formation.

Treatment of terminal syringomyelia in association with tethered cord syndrome: clinical outcomes with and without syrinx drainage.

OBJECT: Current use of magnetic resonance (MR) imaging has led to increased awareness of the frequency of terminal syringomyelia in patients with tethered cord syndrome. However, that the surgical treatment of terminal syringomyelia is necessary remains unclear. In this study the authors attempted to assess the clinical impact, if any, brought after syrinx decompression on the clinical outcome of tethered cord syndrome. METHODS: They randomly assigned 30 cases of pediatric tethered cord into two treatment groups: those in whom an untethering procedure was performed (Group I) and those in whom this procedure was combined with syrinx decompression (Group II). The 1-year follow-up clinical results obtained in the two groups, in correlation with MR imaging findings, were compared to evaluate the benefit of added syrinx drainage. Clinical follow-up evaluation revealed that surgical drainage of the syrinx, when combined with spinal cord untethering, resulted in better outcomes in terms of resolution of sensory deficits (p = 0.036) and bladder dysfunction (p = 0.05). The improvement in clinical outcome correlated with the radiologically documented resolution of the syrinx cavity; however, response rates of symptoms differed for each tethering subgroup. CONCLUSIONS: Preliminary results of this study indicated that terminal syringomyelia should be considered as a comorbidity that contributes to the clinical outcome of patients with tethered cord syndrome. A better clinical outcome is achieved following successful decompression of the syrinx in addition to untethering the spinal cord. These findings emphasize the importance of recognizing, evaluating, and treating this pathological entity.

The clinical outcome of childhood masturbation.

This study was performed to investigate the clinical outcome of childhood masturbation. For this purpose 50 children (mean age = 48.7 +/- 24.5 months, 34 girls females and 16 boys males) with masturbation symptoms were examined at first visit to the Department of Child Psychiatry and two years thereafter with psychiatric interviews. The mean masturbation frequency at the initial interview was significantly decreased after two years. It was noted that 39 children (78%) were completely recovered and 11 children (22%) continued to masturbate after two years. Children who did not recover were significantly younger, began to masturbate earlier and masturbated more frequently than others at the time of initial evaluation. It was concluded that the findings about the beneficial effect of sedative drugs in combination with parental guidance, education and means for behavior modification were promising.

Conversion disorder in children and adolescents: clinical features and comorbidity with depressive and anxiety disorders.

The aim of this study was to determine some of the demographical and clinical characteristics of conversion disorder in children and adolescents and to ascertain comorbidity with depressive and anxiety disorders. For this purpose 51 children and adolescents (mean age: 13.2 +/- 1.9, range: 9-16 years) who met DSM-IV criteria for conversion disorder were compared with a control group. The subjects of this study were mostly postpubertal girls, and pseudoseizure was the most frequent presentation. Misdiagnoses were frequent among these patients. Eight (15.7%) patients received a comorbid diagnosis of major depression and 19 (37.2%) patients had comorbid anxiety disorders according to DSM-IV diagnostic criteria. Significant differences between the two groups on depression and anxiety scales supported the clinical findings. It was concluded that clinicians should screen every patient with conversion disorder for major depression and anxiety disorders for a better outcome.