Severe skin and soft tissue infection in cohort patients admitted in a teaching hospital in Belgium: identification of risk factors for surgery.

BACKGROUND: Necrotizing soft tissue infections (NSTIs) are associated with significant mortality if not promptly diagnosed and surgically treated. AIM: This study aims to compare patients with severe skin and soft tissue infection treated with or without a surgical intervention and to identify risk factors that can predict the need for early surgery. METHODS: Demographics, clinical, laboratory, Risk Indicator for Necrotizing Fasciitis (LRINEC) and imaging results were retrospectively collected. RESULTS: There were 91 non-NSTI (group 1), 26 NSTI who were operated (group 2) and eight suspected NSTI who were not operated (group 3). In the multivariate analysis, skin necrosis, tachycardia, CRP value and hyperglycemia were predictive for surgery. A performance analysis revealed AUC of 0.65 (95%CI: 0.52-0.78) as to the LRINEC score for the use of surgery. The AUC for a predictive model associating four variables (heart rate, skin necrosis, CRP and glycemia at admission) was 0.71 (95%CI: 0.59-0.84). In terms of outcome, the median length of stay (LOS) was statistically higher in group 2 vs. group 1 (seven days (5-15) vs. 34 days (20-42), p < .001) and in group 2 vs. group 3 (34 days (20-42) vs. 14 days (11-19), p = .005). The overall in-hospital mortality at 30 days was 3.2% and did not statistically differ between the three groups. CONCLUSIONS: Although the LRINEC score performed well in predicting surgery, the AUC of a model combining four predictive variables (glycemia, skin necrosis, CRP and heart rate) was superior. Further research is needed to validate this model.

Trap-integrated fluorescence detection with silicon photomultipliers for sympathetic laser cooling in a cryogenic Penning trap.

We present a fluorescence-detection system for laser-cooled 9Be+ ions based on silicon photomultipliers (SiPMs) operated at 4 K and integrated into our cryogenic 1.9 T multi-Penning-trap system. Our approach enables fluorescence detection in a hermetically sealed cryogenic Penning-trap chamber with limited optical access, where state-of-the-art detection using a telescope and photomultipliers at room temperature would be extremely difficult. We characterize the properties of the SiPM in a cryocooler at 4 K, where we measure a dark count rate below 1 s-1 and a detection efficiency of 2.5(3)%. We further discuss the design of our cryogenic fluorescence-detection trap and analyze the performance of our detection system by fluorescence spectroscopy of 9Be+ ion clouds during several runs of our sympathetic laser-cooling experiment.

BASE-STEP: A transportable antiproton reservoir for fundamental interaction studies.

Currently, the world's only source of low-energy antiprotons is the AD/ELENA facility located at CERN. To date, all precision measurements on single antiprotons have been conducted at this facility and provide stringent tests of fundamental interactions and their symmetries. However, magnetic field fluctuations from the facility operation limit the precision of upcoming measurements. To overcome this limitation, we have designed the transportable antiproton trap system BASE-STEP to relocate antiprotons to laboratories with a calm magnetic environment. We anticipate that the transportable antiproton trap will facilitate enhanced tests of charge, parity, and time-reversal invariance with antiprotons and provide new experimental possibilities of using transported antiprotons and other accelerator-produced exotic ions. We present here the technical design of the transportable trap system. This includes the transportable superconducting magnet, the cryogenic inlay consisting of the trap stack and detection systems, and the differential pumping section to suppress the residual gas flow into the cryogenic trap chamber.

Ultra-thin polymer foil cryogenic window for antiproton deceleration and storage.

We present the design and characterization of a cryogenic window based on an ultra-thin aluminized biaxially oriented polyethylene terephthalate foil at T < 10 K, which can withstand a pressure difference larger than 1 bar at a leak rate <1×10-9 mbar l/s. Its thickness of ∼1.7 µm makes it transparent to various types of particles over a broad energy range. To optimize the transfer of 100 keV antiprotons through the window, we tested the degrading properties of different aluminum coated polymer foils of thicknesses between 900 and 2160 nm, concluding that 1760 nm foil decelerates antiprotons to an average energy of 5 keV. We have also explicitly studied the permeation as a function of coating thickness and temperature and have performed extensive thermal and mechanical endurance and stress tests. Our final design integrated into the experiment has an effective open surface consisting of seven holes with a diameter of 1 mm and will transmit up to 2.5% of the injected 100 keV antiproton beam delivered by the Antiproton Decelerator and Extra Low ENergy Antiproton ring facility of CERN.

Anthelmintic effects of peppermint (Mentha piperita), lemon (Citrus limon), and tea tree (Melaleuca alternifolia) essential oils against Monogenean parasite (Dactylogyrus sp.) on carp (Cyprinus carpio).

Dactylogyrus sp. (Monogenea) is one of the most dangerous pathogens causing parasitic infections in carp (Cyprinus carpio) and other freshwater fish. Due to the adverse effects of conventional chemical treatments on the environment and fish, the use of herbal products in aquaculture against various diseases has increased. In the present study, anthelmintic effects of peppermint (Mentha piperita), lemon (Citrus limon), and tea tree (Melaleuca alternifolia) essential oils against Dactylogyrus sp. found on the gills of carp were studied using in vitro and in vivo experiments. In in vitro experiments, 1, 2.5, 5, and 10 µl/ml concentrations of these essential oils were tested on the parasites and cumulative mortalities were observed to reach 100 % after treatment with peppermint, lemon, and tea tree essential oils of 1 µl/ml concentration in approximately 15, 10 and 2 min, respectively. The in vitro experiments demonstrated that the cumulative mortality of the parasites increased with essential oil concentration and exposure duration. As the concentration of essential oil used increased, the observed mean time to death of parasites decreased. In in vivo experiments, median effective concentrations (EC50) as assessed by in vitro tests for peppermint and lemon essential oils in 5 min exposure and EC50 concentration for tea tree essential oil in 2 min exposure was applied on fish as a single bath and there was a significant decrease in the mean parasite intensities (p<0.05). Antiparasitic efficacies of peppermint, lemon, and tea tree essential oils were determined as 28.23 %, 30.95 %, and 35.31 %, respectively. The tea tree oil was the most effective and peppermint oil was the least effective in both in vitro and in vivo experiments. All three herbal essential oils tested in this study have weak antiparasitic potential against monogenean infections in fish.

BASE-high-precision comparisons of the fundamental properties of protons and antiprotons.

Abstract: The BASE collaboration at the antiproton decelerator/ELENA facility of CERN compares the fundamental properties of protons and antiprotons with ultra-high precision. Using advanced Penning trap systems, we have measured the proton and antiproton magnetic moments with fractional uncertainties of 300 parts in a trillion (p.p.t.) and 1.5 parts in a billion (p.p.b.), respectively. The combined measurements improve the resolution of the previous best test in that sector by more than a factor of 3000. Very recently, we have compared the antiproton/proton charge-to-mass ratios with a fractional precision of 16 p.p.t., which improved the previous best measurement by a factor of 4.3. These results allowed us also to perform a differential matter/antimatter clock comparison test to limits better than 3%. Our measurements enable us to set limits on 22 coefficients of CPT- and Lorentz-violating standard model extensions (SME) and to search for potentially asymmetric interactions between antimatter and dark matter. In this article, we review some of the recent achievements and outline recent progress towards a planned improved measurement of the antiproton magnetic moment with an at least tenfold improved fractional accuracy.

Determining the aflatoxin M1 levels in breast milk.

OBJECTIVE: Mycotoxins are different toxic substances at relatively smaller molecular weight produced by some types of fungi. Aflatoxin is the most common type of mycotoxin easily reproducing in food stored for a long time in unsuitable conditions. This study determined the aflatoxin M1 (AFM1) levels in breast milk samples collected from mothers who gave birth in Kirsehir, Turkey. MATERIALS AND METHODS: A total of 82 breast milk samples to be analyzed to determine the AFM1 levels were collected from voluntary breastfeeding mothers who gave birth in the Kirsehir Training and Research Hospital and who were randomly selected. The AFM1 levels were determined using the competitive ELISA kit. RESULTS: The AFM1 levels in the breast milk samples of mothers who did not consume milk were lower than those of other mothers. The AFM1 levels in the breast milk samples of mothers consuming fabrication milk were lower than mothers consuming homemade milk (p<0.01). Additionally, the AFM1 levels in the breast milk samples of mothers consuming homemade or self-made bread were lower (p<0.05). CONCLUSIONS: This study found that the nutritional habits of breastfeeding mothers affected the AFM1 levels in breast milk.

Examining dietary acid load in individuals with type 2 diabetes: a case-control study.

OBJECTIVE: Diabetes is a chronic disease that can cause various complications and has a high prevalence. Evidence increasingly shows that acid-base homeostasis is critical to maintaining normal metabolic function. This case-control study aims to evaluate the relationship between dietary acid load and the risk of type 2 diabetes. PATIENTS AND METHODS: This study recruited 204 participants, 92 of whom had just been diagnosed with type 2 diabetes, and 102 healthy controls who were matched in age and gender as controls. Twenty-four dietary recall was used for dietary intake assessments. Dietary acid load was approximated using two different methods: potential renal acid load (PRAL) and net endogenous acid production (NEAP), both calculated from dietary recalls. RESULTS: In the case and control groups, the dietary acid load mean scores were 4.18±26.8, 20.84±29.54 mEq/day for PRAL, and 55.11±29.23, 68.43±32.23 mEq/day for NEAP, respectively. When it came to the multiple possible confounders, the participants in the highest tertile of PRAL (OR 4.43, 95% CI: 1.38-23.81, ptrend<0.001) and NEAP (OR: 3.15, 95% CI: 1.53-9.59, ptrend<0.001) had a significantly higher risk of developing type 2 diabetes compared to those in the lowest tertile. CONCLUSIONS: The findings of the present study suggest that a high acid load in the diet may increase the risk of type 2 diabetes. Therefore, it is possible that limiting dietary acid load could lower type 2 diabetes risk in vulnerable individuals.

Evaluation of cell morphology and adhesion capacity of human gingival fibroblasts on titanium discs with different roughened surfaces: an in vitro scanning electron microscope analysis and cell culture study.

BACKGROUND: Implantoplasty is an option in peri-implantitis treatment. What is known about the effects of implantoplasty on peri-implant soft tissue adhesion and cell behaviours is limited. This study aimed to evaluate the morphological features and adhesion capacity of human gingival fibroblast (HGF) cells onto sand-blasted, large-grit, acid-etched (SLA®) titanium (Ti) discs surfaces roughened with different implantoplasty protocols. MATERIALS AND METHODS: The study included a total of 48 Ti discs divided into four groups (n = 12 per group): Group I: machined, smooth surface discs; Group II: SLA® surface discs; Group III: SLA® surface discs roughened with diamond bur sequence (40 and 15-µm grit); Group IV: SLA® surface discs roughened with diamond bur sequence (125 and 40-µm grit). Following polishing procedure, the surface roughness value of discs was assessed by a profilometer and scanning electron microscope. HGFs were cultured on Ti discs and cell adhesion was examined after the 24th, 48th, and 72nd hours. Statistical significance was set at the p ≤ 0.05 level. RESULTS: Scanning electron microscope analyses of the discs revealed that fibroblasts exhibited well-dispersion and a firm attachment in all groups. The cells in group I and II had thin and long radial extensions from the areas where the nucleus was located to the periphery; however, attached cells in group III and IV showed more spindle-shaped morphology. The surface roughness parameters of the test groups were lower than those of the SLA®. The SLA® group showed the highest HGF adhesion (group II) (p ≤ 0.05). HGF adhesion in group IV was greater compared to group III, but less than group I. CONCLUSIONS: This study showed that the characteristics of the burs applied in the implantoplasty protocol are determinant for the surface roughness and fibroblast adhesion occurs on surfaces with decreased roughness following implantoplasty. Consequently, it should be kept in mind that the surface properties of the implant may affect the adherent cell morphology and adhesion.

Evaluation of different anthropometric indices for predicting metabolic syndrome.

OBJECTIVE: Metabolic syndrome is a condition characterized by metabolic abnormalities. Its overall prevalence increases with age, in turn resulting in a substantial burden of disease all around the world. The aim of this study is to evaluate the efficacy of several anthropometric indices for predicting metabolic syndrome among the elderly people. SUBJECTS AND METHODS: This study was conducted on 348 elderly people aged 65 and over, including those who were diagnosed with metabolic syndrome based on the National Cholesterol Education Program's Adult Treatment Panel III criteria and those who did not suffer from metabolic syndrome. A trained dietitian performed body weight, height, waist circumference, and hip circumference measurements. Furthermore, body mass index, waist-hip ratio, waist-height ratio, conicity index, abdominal volume index, body shape index, and body roundness index values were measured. The receiver operating characteristic (ROC) curve was applied to assess the capability of these indices to predict metabolic syndrome.  RESULTS: Of the 348 subjects recruited, 56.0% had metabolic syndrome. Body Roundness Index had the largest area under the curve for predicting metabolic syndrome in both males and females (0.678 and 0.645, respectively), followed by abdominal volume index (0.673 and 0.626, respectively) and waist circumference (0.672 and 0.626, respectively). CONCLUSIONS: Body roundness index was more effective compared to the other seven indices for predicting metabolic syndrome in the elderly population in Turkey.

MEASUREMENT OF THE CONCENTRATION OF 226RA, 232TH, 40K IN THE SOIL IN SETTLEMENTS ON THE COASTLINE OF LAKE VAN, TURKEY.

In this study, the natural radioactivity level and its effects on the environment of Lake Van, which is the largest lake in Turkey, were investigated extensively. Initially, 254 soil samples have been collected from the districts (Tusba, Edremit, Gevas, Tatvan, Ahlat, Adilcevaz, Ercis) located around the coastline of Lake Van in eastern Turkey. A Na(TI) detector was used to detect activity concentrations of radium (226Ra), thorium (232Th) and potassium (40K) in each collected soil sample. The obtained average results were compared with available data from Turkey and international data base. The average activity in soil samples was measured as 28.0 ± 3.7-43.6 ± 2.2 Bq/kg for 226Ra, 27.3 ± 4.1-55.4 ± 4.8 Bq/kg for 232Th and 377 ± 42- 706 ± 40 Bq/kg for 40K. It was observed that the average concentrations of 226Ra, 232Th, 40K (43.6 ± 2.2, 55.4 ± 4.8, 706 ± 40 Bq/kg, respectively) for Tatvan district and (37.0 ± 3.5, 51.4 ± 4.2, 479 ± 41 Bq/kg, respectively) for Ahlat district were higher than both national and international average value. In addition, radiological effect parameters originating from terrestrial natural radionuclides for the study area; gamma dose rate (Dout), annual effective dose equivalent (AEDE), and lifetime cancer development probability (LCR) were calculated. The Dout, AEDE, LCR (83.0 ± 3.9 nGy/h, 0.102 ± 0.005 mSv/y, 0.36 ± 0.02 x 10-3, respectively) parameters in Tatvan district were found to be above the international allowable value.

Use of ABO blood groups and co-morbidities as predictors of mortality in COVID-19 patients.

OBJECTIVE: This study aimed to investigate the mortality relationship between COVID-19 and ABO blood groups and comorbid diseases. The aim of this study was to determine whether ABO blood groups and comorbid diseases can be used as a prognostic factor for hospitalization. PATIENTS AND METHODS: This retrospective study included patients aged ≥ 18 years presenting to the adult emergency COVID-19 outpatient clinic. COVID-19 patients were divided into four stages according to their clinical status: mild, moderate, severe, and critical. Those with the comorbid disease were classified as Group I, and those without comorbid disease were classified as Group II. RESULTS: Of the 384 patients included in the study, 190 (49.5%) were male and 194 (50.5%) were female, with a mean age of 47.3 ± 18.4 years. The clinical data of the patients were scanned from the hospital automation system. Although the risk of transmission was higher, especially in people with A blood type, this rate was lower in the O blood group. The clinical course of the disease was more severe and the mortality rates were higher in the AB blood group (p < 0.001). In the hospital, 35 people who were treated for COVID-19 disease died. CONCLUSIONS: Certain ABO blood types and comorbid diseases were important risk factors for COVID-19 and were associated with mortality. We found that some ABO blood groups and comorbid diseases are associated with COVID-19 and may be important risk factors. While the risk of transmission of COVID-19 is high in blood group A, we think that the clinical course of COVID-19 may be more severe and the death rate higher in blood group AB.

Current status of urological training and differences between institutions.

OBJECTIVES: Appropriate training of urology residents is important to secure not only high-quality patient care, but also the bright future of our specialty. We aimed to investigate residency training from the perspective of qualification and standardization and to evaluate surgical education, publication output, working conditions, future plans, and overall satisfaction, in a comprehensive way. METHODS: We conducted a survey of urology chief residents/recent graduates in Turkey to identify differences between institutions and deficiencies in urology resident training. A total of 155 chief residents/recently graduated specialists were contacted by phone and a survey was completed. RESULTS: The survey response rate was 96.1%. Respondents had high proficiency in endourology (97.3%), similar to Canada and European countries. However, they reported a lack of proficiency in laparoscopy (28.9%) and functional urology (26.2%). Also, no one had completed a robotic procedure as first surgeon. A total of 75.2% respondents had no first author publication, and 10.1% had no first author abstract presentation. There was no significant difference between institution types with or without certification. There was a satisfaction rate of 87.2% among participants. CONCLUSIONS: It was observed that qualified and standardized training could has not been achieved and the positive effects of certification have not been seen yet. There is a lack of modernization in all aspects of education, and there is no standardized curriculum addressing academic research. Therefore, there is a risk that future urologists will have insufficient skills. We hope this study serves as a guide for modernization and standardization in urology training.

Misleading clinical presentation of carcinoid syndrome.

Rare cases of carcinoid syndromes can develop from either gastrointestinal neuroendocrine tumors (NETs) without liver metastasis or large retroperitoneal involvement. We report a case of a patient with isolated flushing highly suggestive of carcinoid syndrome caused by an ileal NET with adjacent lymph node metastases but with no liver metastases. The final diagnose was delayed for this patient due to a combination of misleading clinical presentation and negative usual screening tests (urinary 5-HIAA and serum chromogranine A). Given its high sensitivity and specificity, 68Ga-DOTATATE PET/CT confirmed the diagnosis of neuroendocrine tumor. Therefore, this case reminds clinicians that carcinoid syndrome may manifest as flushing only and highlights that imaging is a major aspect of the evaluation and diagnosis of patients with suspected gastrointestinal NETs.

Decline in Instrumental Activities of Daily Living over 4-Year: The Association with Hearing, Visual and Dual Sensory Impairments among Non-Institutionalized Women.

OBJECTIVE: Most older adults express the wish to live at home as long as possible, thus autonomy promoting measures are essential. Hearing and visual impairments are common among older people, and they have been consistently associated with functional disability. However, longitudinal data are scarce, notably regarding dual sensory impairments (both in hearing and vision). We aimed at assessing the relationship between hearing, visual, and dual sensory impairments, and subsequent decline in instrumental activities of daily living (IADL). DESIGN: Longitudinal. SETTING: the French E3N-elderly sub-cohort. PARTICIPANTS: 4,010 community-dwelling older women born between 1925 and 1930, and free of IADL limitations in 2006. MEASUREMENTS: Hearing and visual impairments were self-reported in 2006. IADLs were evaluated in 2006 and 2010. RESULTS: After 4 years of follow-up, 588 women became limited in their IADLs. In logistic regression models adjusted for potential confounders, odds ratios [95% confidence interval] for developing IADL limitations were 1.18 [0.98; 1.41], 1.98 [1.26; 3.11], and 2.61 [1.50; 4.54] for hearing, visual, or both sensory impairments respectively, compared with no sensory impairment at baseline. CONCLUSION: Results suggest that among autonomous older women, visual, and to a lesser extent, hearing impairment, have a short-term negative impact on their ability to perform daily activities, with some evidence of a multiplicative effect between sensory impairments. Appropriate evaluation and management of sensory impaired elderly, and more particularly those with dual impairments, may contribute to prevent disability in aging.