A Novel Physical Examination Test for Ischiofemoral Impingement: Validation With Magnetic Resonance Imaging Correlation.

OBJECTIVE: The purpose of this study was to propose and validate a novel physical examination test for ischiofemoral impingement with magnetic resonance imaging (MRI) correlation. METHODS: We prospectively studied 24 women with buttock (deep gluteal) pain and 27 asymptomatic women. Each group underwent a 2-stage physical examination test that featured hip adduction-external rotation-extension and knee flexion. Visual analog scale pain scores were noted just before and during test stages on both sides. The MRI findings of the ischiofemoral impingement were evaluated quantitatively and qualitatively. RESULTS: Mean ages were 56.0 and 55.2 years (P = 0.797), and mean body mass indexes were 29.1 and 28.8 kg/m2 (P = 0.817) in symptomatic and asymptomatic groups, respectively. Ischiofemoral spaces were significantly narrower (P < 0.001), ischial angles were wider (P < 0.001, right; P = 0.002, left), and soft tissue edema at the ischiofemoral space was more common (P < 0.001) in the symptomatic group, which also had higher pretest visual analog scale scores (P < 0.001) that increased significantly during both upright standing (P = 0.003, right; P < 0.001, left) and recumbent (P < 0.001 for both sides) stages of the physical examination test. CONCLUSIONS: A novel physical examination test significantly increases symptoms of ischiofemoral impingement with positive MRI correlation.

Conjunctival impression cytology and tear-film changes in cases with vitamin D deficiency.

PURPOSE: To evaluate conjunctival surface cells and tear-film functions in cases with vitamin D deficiency. METHODS: Thirty-six patients with serum vitamin D deficiency and 27 control subjects with normal serum vitamin D levels were included in this prospective study. The tear break-up time (TBUT), Schirmer II test, and conjunctival impression cytology tests were performed to all participants. RESULTS: The mean serum vitamin D levels were 10.5 ± 5.0 µl in the study group and 33.9 ± 11.7 µl in the control group (p < 0.001). The median TBUT scores were 11 s and 17 s and the median Schirmer II values were 7.5 mm and 12 mm in the study and the control groups, respectively (p = 0.003, p = 0.049). According to the Nelson staging system, 69.4% of the patients in the study group had grade 2 or 3 impression cytology, whereas 18.5% of the participants in the control group had grade 2 or 3 impression cytology (p < 0.001). CONCLUSION: Our study results showed that vitamin D deficiency may lead to dry eye causing conjunctival squamous metaplasia and loss of goblet cells on the ocular surface.

Lipocalin 2 as a clinical significance in rheumatoid arthritis.

AIM OF THE STUDY: In this study, serum lipokalin 2 (LCN-2) levels and its clinical and radiological significance in patients with rheumatoid arthritis was evaluated. MATERIAL AND METHODS: The study enrolled 37 patients with RA and 34 healthy controls. Serum LCN-2 level was measured using ELISA method. Patients with DAS 28 scores ≤ 3.2, and > 3.2 were allocated into lower and high/moderate disease activity groups, respectively. Additionally patients were divided into 2 groups as early RA (disease duration ≤ 2 years) and established RA (duration of the disease ≥ 2 years). Functional disability was evaluated using Health Assessment Questionnaire (HAQ). Radiographs were scored using the modified Larsen score. RESULTS: Serum LCN-2 (p = 0.029) levels were significantly higher in patients with RA than in the controls. Serum LCN-2 level did not correlate with laboratory and clinical parameters of disease activity like erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), DAS 28, Health Assessment Questionnaire Score (HAQ) and Nottingham Health Profile (NHP). Similarly, any correlation could not be found between structural joint damage and serum LCN2 levels. CONCLUSIONS: These results indicate that serum LCN-2 levels may be used as an indicator for structural damage like erosions in the early stage of the disease but do not able to be used to monitor disease activity.

Affective temperament profile in ankylosing spondylitis patients using TEMPS-A.

[Purpose] This study aimed to compare the most common dominant affective temperaments in Ankylosing Spondylitis patients and investigate the relationship between the dominant affective temperaments and pain levels, disease activity, quality of life, current depression, and anxiety level in Ankylosing Spondylitis patients. [Subjects and Methods] Fifty-one patients diagnosed with axial spondiloartropathy and forty-two age- and gender-matched control subjects were included in this study. Disease duration, erythrocyte sedimentation rate, serum C-reactive protein, pain by the Visual Analog Scale, disease activity by the Bath Ankylosing Spondylitis Disease Activity Index, functional status by the Bath Ankylosing Spondylitis Functional Index; psychological status by the Beck Depression Inventory, Beck Anxiety Inventory and overall health assessment by the Ankylosing Spondylitis Quality of Life Scale were assessed in patients. The Turkish version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto Questionnaire was used to determine the dominant affective temperament. [Results] There was no statistical difference in the distribution of temperament subtypes between patients with Ankylosing Spondylitis and the controls. Depressive, anxious, and cyclothymic temperament scores were higher in patients with high values on the Bath Ankylosing Spondylitis Functional Index and Visual Analog Scale. There was a correlation between anxious subtypes of affective temperament scores and the value of Ankylosing Spondylitis Quality of Life Scale. Correlation analysis also found depressive, cyclothymic, irritable, and anxious temperament and psychiatric symptoms to be significantly related. [Conclusion] Affective temperament may contribute to symptoms of depression and anxiety in patients with Ankylosing Spondylitis and may increase disease activity and may reduce their quality of life.

The association of vitamin D with inflammatory cytokines in diabetic peripheral neuropathy.

[Purpose] The effects of vitamin D on the circulating levels of IL-17 and IL-13 were investigated in patients with diabetic peripheral neuropathy, patients with diabetes mellitus type 2 without neuropathy, and healthy controls. [Subjects and Methods] A single-blind controlled clinical study was performed, including70 type 2 diabetic patients with or without diabetic peripheral neuropathy and 33 healthy volunteer controls. The 25(OH)D levels were evaluated using ultra-performance liquid chromatography, and IL-17 and IL-13 levels were assessed using enzyme-linked immunosorbent assays. [Results] The 25(OH) vitamin D concentration was lower in diabetic peripheral neuropathy patients than in diabetes mellitus patients without neuropathy and healthy controls. Similarly, 25(OH)D levels were lower in diabetes mellitus patients than healthy controls. IL-17 and IL-13 levels were higher in diabetes mellitus patients than in controls. Additionally, IL-13 levels were higher in diabetic peripheral neuropathy patients than in diabetes mellitus patients without neuropathy. These differences were statistically significant. There was a significant positive correlation between 25(OH)D and IL-13,and a negative correlation between 25(OH)D andIL-17 in the diabetic and diabetic neuropathy groups. [Conclusion] Vitamin D is a potential modifiable risk factor for diabetic peripheral neuropathy and may regulate inflammatory mediators, e.g., IL-17 and IL-13.

A comparative analysis of multi-biometrics performance in human and action recognition using silhouette thermal-face and skeletal data.

Biometrics is a field that has been given importance in recent years and has been extensively studied. Biometrics can use physical and behavioural differences that are unique to individuals to recognize and identify them. Today, biometric information is used in many areas such as computer vision systems, entrance systems, security and recognition. In this study, a new biometrics database containing silhouette, thermal face and skeletal data based on the distance between the joints was created to be used in behavioural and physical biometrics studies. The fact that many cameras were used in previous studies increases both the processing intensity and the material cost. This study aimed to both increase the recognition performance and reduce material costs by adding thermal face data in addition to soft and behavioural biometrics with the optimum camera. The presented data set was created in accordance with both motion recognition and person identification. Various data loss scenarios and multi-biometrics approaches based on data fusion have been tried on the created data sets and the results have been given comparatively. In addition, the correlation coefficient of the motion frames method to obtain energy images from silhouette data was tested on this dataset and yielded high-accuracy results for both motion and person recognition.

A hybrid approach based on multiple Eigenvalues selection (MES) for the automated grading of a brain tumor using MRI.

BACKGROUND AND OBJECTIVE: The manual segmentation, identification, and classification of brain tumor using magnetic resonance (MR) images are essential for making a correct diagnosis. It is, however, an exhausting and time consuming task performed by clinical experts and the accuracy of the results is subject to their point of view. Computer aided technology has therefore been developed to computerize these procedures. METHODS: In order to improve the outcomes and decrease the complications involved in the process of analysing medical images, this study has investigated several methods. These include: a Local Difference in Intensity - Means (LDI-Means) based brain tumor segmentation, Mutual Information (MI) based feature selection, Singular Value Decomposition (SVD) based dimensionality reduction, and both Support Vector Machine (SVM) and Multi-Layer Perceptron (MLP) based brain tumor classification. Also, this study has presented a new method named Multiple Eigenvalues Selection (MES) to choose the most meaningful features as inputs to the classifiers. This combination between unsupervised and supervised techniques formed an effective system for the grading of brain glioma. RESULTS: The experimental results of the proposed method showed an excellent performance in terms of accuracy, recall, specificity, precision, and error rate. They are 91.02%,86.52%, 94.26%, 87.07%, and 0.0897 respectively. CONCLUSION: The obtained results prove the significance and effectiveness of the proposed method in comparison to other state-of-the-art techniques and it can have in the contribution to an early diagnosis of brain glioma.

The relationship between internalized stigma and loneliness in patients with schizophrenia.

PURPOSE: The study was conducted for the purpose of determining the relationship between internalized stigma and loneliness in patients with schizophrenia. DESIGN AND METHODS: The population of this correlational-descriptive study consisted of a total of 200 in patients with schizophrenia. The data were collected using "Form of Descriptive Characteristics", "Internalized Stigma of Mental Illness Inventory (ISMI)", and "UCLA Loneliness Scale". FINDINGS: It was determined that the loneliness level of the patients who participated in the study was 57.20 ± 10.38 and level of of internalized stigma was 79.65 ± 13.48. There was a statistically positive and strong correlation between loneliness and internalized stigma total mean scores of the patients (P = 0.001, r = 0.854). PRACTISE IMPLICATIONS: It was found that the schizophrenic patients had high levels of internalized stigma and loneliness.

The effect of negative automatic thoughts on hope in patients with schizophrenia.

PURPOSE: The purpose of this study is to determine the effect of negative automatic thoughts on hope in patients with schizophrenia. DESIGN AND METHODS: The sample size of the study was calculated to be 94 patients through the power analysis. The study was completed with 115 patients who met the inclusion criteria. "descriptive characteristics form," "automatic thoughts questionnaire-negative," and "dispositional hope scale" were used to collect the data. FINDINGS: In the study, it was found that there was a negative strong correlation between negative automatic thoughts and hope levels. In addition, the negative automatic thoughts of the patients had a statistical significance in accounting for hope (p < .05) and the negative automatic thoughts predicted the hope by 66%. PRACTICE IMPLICATIONS: In the study, it was found that the patients had high negative automatic thoughts and moderate level of hopes. As negative automatic thoughts increased, hope decreased.

Prediction of force measurements of a microbend sensor based on an artificial neural network.

Artificial neural network (ANN) based prediction of the response of a microbend fiber optic sensor is presented. To the best of our knowledge no similar work has been previously reported in the literature. Parallel corrugated plates with three deformation cycles, 6 mm thickness of the spacer material and 16 mm mechanical periodicity between deformations were used in the microbend sensor. Multilayer Perceptron (MLP) with different training algorithms, Radial Basis Function (RBF) network and General Regression Neural Network (GRNN) are used as ANN models in this work. All of these models can predict the sensor responses with considerable errors. RBF has the best performance with the smallest mean square error (MSE) values of training and test results. Among the MLP algorithms and GRNN the Levenberg-Marquardt algorithm has good results. These models successfully predict the sensor responses, hence ANNs can be used as useful tool in the design of more robust fiber optic sensors.

Cerebral Blood Flow Volume Using Color Duplex Sonography in Patients With Fibromyalgia Syndrome.

OBJECTIVES: This study aims to evaluate cerebral blood flow using color duplex Doppler ultrasonography in patients with fibromyalgia syndrome (FMS). PATIENTS AND METHODS: The study included 30 female patients with FMS (mean age 42.3 years; range 22 to 59 years) and 30 female healthy controls (mean age 39.6 years; range 22 to 56 years). Color duplex Doppler ultrasonography imaging was performed with an EPIQ 5 unit equipped with a multi-frequency linear probe (3-12 MHz) in the supine position. Severity of pain, fatigue, and the patient's and physician's global assessments of disease were evaluated on a visual analog scale. The Symptom Severity Scale, Hamilton Anxiety Rating Scale, Hamilton Depression Evaluation Scale, and Fibromyalgia Impact Questionnaire were also implemented to assess disease severity. RESULTS: Cerebral blood flow volume and bilateral internal carotid artery (ICA) and vertebral artery (VA) volumes were not significantly higher in FMS patients compared to controls. Bilateral ICA and VA diameters were similar between FMS patients and controls. Bilateral mean peak systolic velocities and end diastolic velocities in the common carotid arteries, ICAs and VAs were similar in both groups. A significant correlation between symptom severity parameter and the cerebral blood flow volume was noted in FMS patients. CONCLUSION: Cerebral blood flow volume, ICA flow, and VA flow do not appear to increase, and are correlated with only Symptom Severity Scale among other clinical parameters reflecting disease severity in patients with FMS.

The influence of vitamin D deficiency on eradication rates of Helicobacter pylori.

BACKGROUND: Helicobacter pylori eradication therapy improves the healing of various gastro-duodenal diseases such as chronic gastritis and peptic ulcer, and also reduces gastric cancer incidence. Several studies have reported on risk factors other than antibiotic resistance related to Helicobacter pylori eradication failure. OBJECTIVES: In this study, we aimed to investigate whether or not the serum levels of 25-hydroxy-vitamin D (25(OH)D) influence eradication rates of H.pylori. MATERIAL AND METHODS: 220 patients diagnosed with H.pylori gastritis using endoscopic biopsy had their 25-OH vitamin D levels measured via the electrochemiluminescence method before beginning eradication therapy of H.pylori. Gastric biopsies obtained at endoscopy were examined for H.pylori strains and histopathologic findings. All patients were treated with bismuth-containing quadruple therapy for 14 days. H.pylori eradication was determined via the 14C-urea breath test performed 4 weeks after the end of therapy. Based on the 25-OH vitamin D levels, the patients were divided into 2 groups: group 1 (deficient) had a vitamin D level of <10 ng/mL, while group 2 (sufficient) had a vitamin D level of ≥10 ng/ mL. RESULTS: Eradication was successful in 170 (77.2%) patients and failed in 50 (22.7%) patients. The prevalence of 25(OH)D deficiency was 30.5%. Mean 25(OH)D levels were significantly lower in the eradication failure group compared to the successful treatment group (9.13 ±4.7 vs 19.03 ±8.13; p = 0.001). There were significantly more patients with deficient 25(OH)D levels in the failed treatment group compared to the successful treatment group (p = 0.001). CONCLUSIONS: Our findings suggest that 25-OH vitamin D deficiency may be considered a risk factor related to eradication failure of H.pylori, which may lead to a need for supplementation of vitamin D before eradication of H.pylori.

Performance characteristics of the simplified version of ankylosing spondylitis disease activity score (SASDAS).

Various types of disease activity measures are available for axial spondyloarthritis (axSpA), and there is no gold standard for all individual patients. The ankylosing spondylitis disease activity score (ASDAS) is highly discriminatory, sensitive to change, and associated with structural progression. A simplified version of the ASDAS (SASDAS) was proposed and found to be a simple and practical tool to assess disease activity. Our aim was to test the performance characteristics of the SASDAS and compare it with validated tools. In total, 97 consecutive ankylosing spondylitis (AS) patients were included in the study. Disease activity was assessed by the ASDAS-erythrocyte sedimentation rate (ESR), ASDAS-C-reactive protein (CRP), bath ankylosing spondylitis disease activity index (BASDAI), and SASDAS. The relationship among these activity indices and the level of agreement of various activity categories were tested. There was a strong correlation between the SASDAS and other activity indices, including the BASDAI (r = 0.916, p < 0.001), ASDAS-CRP (r = 0.847, p < 0.001), and ASDAS-ESR (r = 0.942, p < 0.001). Although the agreement between the ASDAS-ESR and SASDAS was good (weighted kappa of 0.744 and total agreement of 77 %), there was moderate agreement between the ASDAS-CRP and SASDAS (weighted kappa of 0.579 and total agreement of 66 %). The disagreement was particularly striking in "moderate" and "high disease activity" states. Approximately 40 % of patients classified as moderate activity according to the ASDAS-ESR and 45 % according to the ASDAS-CRP were differentially categorized by the SASDAS. The results of the present analysis suggest that the simplified version of the ASDAS-ESR should be further validated in various settings and populations due to a questionable level of agreement between the ASDAS-CRP and SASDAS.

Is 4-Hydroxynonenal a Predictive Parameter for the Development of Joint Erosion in Patients With Rheumatoid Arthritis?

OBJECTIVES: This study aims to evaluate serum 4-hydroxynonenal (4-HNE) levels and its clinical and radiological significance in patients with rheumatoid arthritis (RA). PATIENTS AND METHODS: The study included 40 patients (8 males, 32 females; mean age 51.4±11.2 years; range 24 to 72 years) with RA and 30 healthy controls (8 males, 32 females; mean age 53.0±11.7 years; range 24 to 72 years. Serum 4-HNE levels were measured using sandwich enzyme-linked immunosorbent assay method. Patients with disease activity score 28 ≤3.2 and >3.2 were allocated into low and high/moderate disease activity groups, respectively. Additionally, patients were divided into two groups as early RA (disease duration ≤2 years) and established RA (disease duration ≥2 years). Functional disability was evaluated using health assessment questionnaire. Radiographs were scored using the modified Larsen scoring. RESULTS: Serum 4-HNE levels in patients with RA were significantly higher than controls (p=0.001). Serum 4-HNE levels did not correlate with laboratory or clinical parameters of disease activity including erythrocyte sedimentation rate, C-reactive protein, disease activity score 28, and health assessment questionnaire. Serum 4-HNE levels were higher in patients with established RA than patients with early RA (r=0.487, p=0.001). Besides, modified Larsen score which indicates structural damage correlated significantly with serum 4-HNE levels (p=0.001). CONCLUSION: These results indicate that serum 4-HNE levels may be used as an indicator for structural damage such as erosions in the early stage of RA; however, they are not efficient to monitor disease activity.

Conic section function neural network circuitry for offline signature recognition.

In this brief, conic section function neural network (CSFNN) circuitry was designed for offline signature recognition. CSFNN is a unified framework for multilayer perceptron (MLP) and radial basis function (RBF) networks to make simultaneous use of advantages of both. The CSFNN circuitry architecture was developed using a mixed mode circuit implementation. The designed circuit system is problem independent. Hence, the general purpose neural network circuit system could be applied to various pattern recognition problems with different network sizes on condition with the maximum network size of 16-16-8. In this brief, CSFNN circuitry system has been applied to two different signature recognition problems. CSFNN circuitry was trained with chip-in-the-loop learning technique in order to compensate typical analog process variations. CSFNN hardware achieved highly comparable computational performances with CSFNN software for nonlinear signature recognition problems.