Assessment of Sepsis Risk at Admission to the Emergency Department: Clinical Interpretable Prediction Model.

This study aims to develop an interpretable prediction model based on explainable artificial intelligence to predict bacterial sepsis and discover important biomarkers. A total of 1572 adult patients, 560 of whom were sepsis positive and 1012 of whom were negative, who were admitted to the emergency department with suspicion of sepsis, were examined. We investigated the performance characteristics of sepsis biomarkers alone and in combination for confirmed sepsis diagnosis using Sepsis-3 criteria. Three different tree-based algorithms-Extreme Gradient Boosting (XGBoost), Light Gradient Boosting Machine (LightGBM), Adaptive Boosting (AdaBoost)-were used for sepsis prediction, and after examining comprehensive performance metrics, descriptions of the optimal model were obtained with the SHAP method. The XGBoost model achieved accuracy of 0.898 (0.868-0.929) and area under the ROC curve (AUC) of 0.940 (0.898-0.980) with a 95% confidence interval. The five biomarkers for predicting sepsis were age, respiratory rate, oxygen saturation, procalcitonin, and positive blood culture. SHAP results revealed that older age, higher respiratory rate, procalcitonin, neutrophil-lymphocyte count ratio, C-reactive protein, plaque, leukocyte particle concentration, as well as lower oxygen saturation, systolic blood pressure, and hemoglobin levels increased the risk of sepsis. As a result, the Explainable Artificial Intelligence (XAI)-based prediction model can guide clinicians in the early diagnosis and treatment of sepsis, providing more effective sepsis management and potentially reducing mortality rates and medical costs.

Determination of biomarker candidates for the placenta accreta spectrum by plasma proteomic analysis.

Placenta accreta spectrum (PAS) presents a significant obstetric challenge, associated with considerable maternal and fetal-neonatal morbidity and mortality. Nevertheless, it is imperative to acknowledge that a noteworthy subset of PAS cases remains undetected until the time of delivery, thereby contributing to an augmented incidence of morbidity among the affected individuals. The delayed identification of PAS not only hinders timely intervention but also exacerbates the associated health risks for both the maternal and fetal outcomes. This underscores the urgency to innovate strategies for early PAS diagnosis. In this study, we aimed to explore plasma proteins as potential diagnostic biomarkers for PAS. Integrated transcriptome and proteomic analyses were conducted to establish a novel diagnostic approach. A cohort of 15 pregnant women diagnosed with PAS and delivering at Inonu University Faculty of Medicine between 01/04/2021 and 01/01/2023, along with a matched control group of 15 pregnant women without PAS complications, were enrolled. Plasma protein identification utilized enzymatic digestion and liquid chromatography-tandem mass spectrometry techniques. Proteomic analysis identified 228 plasma proteins, of which 85 showed significant differences (P < 0.001) between PAS and control cases. We refined this to a set of 20 proteins for model construction, resulting in a highly accurate classification model (96.9% accuracy). Notable associations were observed for proteins encoded by P01859 (Immunoglobulin heavy constant gamma 2), P02538 (Keratin type II cytoskeletal 6A), P29622 [Kallistatin (also known as Serpin A4)], P17900 (Ganglioside GM2 activator Calmodulin-like protein 5), and P01619 (Immunoglobulin kappa variable 3-20), with fold changes indicating their relevance in distinguishing PAS from control groups. In conclusion, our study has identified novel plasma proteins that could serve as potential biomarkers for early diagnosis of PAS in pregnant women. Further research and validation in larger PAS cohorts are necessary to determine the clinical utility and reliability of these proteomic biomarkers for diagnosing PAS.

Explainable Artificial Intelligence Paves the Way in Precision Diagnostics and Biomarker Discovery for the Subclass of Diabetic Retinopathy in Type 2 Diabetics.

Diabetic retinopathy (DR), a common ocular microvascular complication of diabetes, contributes significantly to diabetes-related vision loss. This study addresses the imperative need for early diagnosis of DR and precise treatment strategies based on the explainable artificial intelligence (XAI) framework. The study integrated clinical, biochemical, and metabolomic biomarkers associated with the following classes: non-DR (NDR), non-proliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR) in type 2 diabetes (T2D) patients. To create machine learning (ML) models, 10% of the data was divided into validation sets and 90% into discovery sets. The validation dataset was used for hyperparameter optimization and feature selection stages, while the discovery dataset was used to measure the performance of the models. A 10-fold cross-validation technique was used to evaluate the performance of ML models. Biomarker discovery was performed using minimum redundancy maximum relevance (mRMR), Boruta, and explainable boosting machine (EBM). The predictive proposed framework compares the results of eXtreme Gradient Boosting (XGBoost), natural gradient boosting for probabilistic prediction (NGBoost), and EBM models in determining the DR subclass. The hyperparameters of the models were optimized using Bayesian optimization. Combining EBM feature selection with XGBoost, the optimal model achieved (91.25 ± 1.88) % accuracy, (89.33 ± 1.80) % precision, (91.24 ± 1.67) % recall, (89.37 ± 1.52) % F1-Score, and (97.00 ± 0.25) % the area under the ROC curve (AUROC). According to the EBM explanation, the six most important biomarkers in determining the course of DR were tryptophan (Trp), phosphatidylcholine diacyl C42:2 (PC.aa.C42.2), butyrylcarnitine (C4), tyrosine (Tyr), hexadecanoyl carnitine (C16) and total dimethylarginine (DMA). The identified biomarkers may provide a better understanding of the progression of DR, paving the way for more precise and cost-effective diagnostic and treatment strategies.

The role of different Doppler parameters in predicting adverse neonatal outcomes in fetuses with late-onset fetal growth restriction.

Objective: The aim of this study is to clarify the role of different Doppler parameters such as umbilicocerebral ratio (UCR), cerebroplacentouterine ratio (CPUR), aortic isthmus, renal artery, and umbilical vein flow Doppler in predicting adverse neonatal outcomes in fetuses with late -onset fetal growth restriction. Materials and Methods: The study included all patients diagnosed with fetal growth restriction at 32-39 weeks' gestation between 01/02/2020 and 01/02/2022 and treated at the Department of Obstetrics and Gynecology, Inonu University School of Medicine. Results: Patients included in the study had a median gestational week at delivery of 37 (minimum 33+0-maximum 39+0), median CPR of 1.42 (minimum-maximum 0.43-3.57), and median UCR of 0.7 (minimum-maximum 0.28-2.3). Receiver operating characteristic analysis was performed to determine the performance of the measured obstetric Doppler parameters in predicting the development of adverse neonatal outcomes. Umbilical venous blood flow showed the best performance in predicting adverse neonatal outcomes [area under the curve 0.952, 95% confidence interval (CI) 0.902-0.981, p<0.001]. Multivariate logistic regression analysis showed that fetuses with abnormal CPUR had a 4.5-fold (95% CI 0.084-0.583, p=0.02) increased risk of adverse neonatal outcome, whereas fetuses with abnormal umbilical venous flow had a 1.07-fold (95% CI 0.903-0.968, p<0.001) increased risk of adverse neonatal outcome. Conclusion: The results of this study demonstrate that the use of UCR, CPUR, umbilical venous flow, and aortic isthmus PI Doppler parameters along with umbilical artery PI and CPR are effective in predicting adverse neonatal outcomes in fetuses with late -onset fetal growth restriction.

Nerolidol attenuates dehydroepiandrosterone-induced polycystic ovary syndrome in rats by regulating oxidative stress and decreasing apoptosis.

AIMS: Although nerolidol (NRL) is a naturally occurring sesquiterpene alcohol with many pharmacological activities, its role in dehydroepiandrosterone DHEA-induced polycystic ovary syndrome PCOS is unknown. This study aims to explore the potential beneficial effects and underlying molecular mechanisms of nerolidol treatment on polycystic ovary syndrome. MAIN METHODS: Pre-pubertal female Sprague-Dawley rats were randomly assigned into four groups (n = 8/group); group I: control; group II: PCOS; group III: P + NRL; group IV: NRL. Biochemical parameters related to oxidative stress, inflammation, apoptosis, and hormones were estimated in the blood and ovarian tissues. Histopathological, ultrastructural, and immunohistochemical analyses were performed. Bax, P53, Cas-3, and Bcl-2 gene expression levels were detected with RT-PCR. The membrane array analysis detected chemokine, cytokine, and growth factor protein profiles. KEY FINDINGS: In light of the available data, it can deduce that nerolidol has a significant ameliorating effect on lipid peroxidation, oxidative stress, inflammation, histopathological damage, and apoptosis accompanying PCOS in female rats. SIGNIFICANCE: PCOS is not only a reproductive pathology but also a systemic condition and its etiopathogenesis is still not fully understood. Since changes in PCOS have important long-term effects on health, this study evaluated the efficacy of nerolidol, a phytotherapeutic for the control of biochemical, apoptotic, histopathological, and metabolic changes.

The effect of the severity of COVID-19 on the sequelae of the audiovestibular system.

Objectives: The neurotropic and neuroinvasive properties of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have been described. It remains unknown how SARS-CoV-2 affects the audiovestibular system when it causes mild or severe disease. In this study, the sequelae effect of SARS-CoV-2 on the audiovestibular systems of different patient groups was investigated using objective and subjective test batteries. Methods: In this present study, we evaluated vestibulocochlear functions of patients who previously had Coronavirus Disease-2019 (COVID-19) with pure tone audiometry, ocular vestibular-evoked myogenic potential (o-VEMP), and cervical vestibular-evoked myogenic potential (c-VEMP) tests to identify possible sequelae by comparing them with the control group. Results: We found that the amplitude of p13-n23 was lower in both groups of patients than in the control group (p < 0.001). In the results of the left ear c-VEMP, the amplitude of p13-n23 was statistically different between the outpatient, inpatient, and control groups. The amplitude of p13-n23 was lower in both groups of patients than in the control group (p < 0.001). In the evaluation of the o-VEMP in the left ear, we observed a statistically significant difference in the latency of n10 (p = 0.006) and the amplitude of n10-p15 (p < 0.001) between the groups. The n10 latency was prolonged in both groups of patients compared to the control group and there was no statistically significant difference between groups of patients. Furthermore, the amplitude of n10-p15 was lower in both groups of patients compared to the control group and there were no statistically demonstrable differences between the groups of patients. Conclusions: In conclusion, our results suggest that SARS-CoV-2 may affect the vestibulocochlear system. But we could not find a direct relationship according to the severity of the disease.

Evaluation of serum neopterin, periostin, Tenascin-C, tissue inhibitor of metalloproteinase-1 and matrix metalloproteinase-2 levels in obese pregnant women

Objective: To investigate the role of extracellular matrix proteins in the molecular mechanism of inflammatory response in obese pregnant women by comparing serum levels of neopterin, periostin, Tenascin-C, tissue inhibitor of metalloproteinase-1, and matrix metalloproteinase-2 between obese and normal weight pregnant women in the third trimester. Materials and Methods: A prospective cross-sectional study was conducted between April 2021 and December 2021. A total of 84 pregnant women were included and three groups were formed with 28 participants in each group. Results: Serum levels of neopterin, periostin, Tenascin-C and tissue inhibitor of metalloproteinase-1 were significantly higher in class II-III obese pregnant women than in class I obese and normal-weight women (p=0.002, p<0.001, p<0.001, and p<0.001, respectively). There was no significant difference in serum matrix metalloproteinase-2 levels between the groups (p=0.769). Receiver operating characteristic curve analysis showed that Tenascin-C and periostin were effective in predicting pre-eclampsia [area under the curve (AUC)=0.82, 95% confidence interval (CI), 0.72-0.90, p<0.001 and AUC=0.71, 95% CI, 0.60-0.80, p=0.007, respectively]. Conclusion: This study demonstrated that class II-III obese pregnant women had significantly higher serum levels of neopterin, periostin, Tenascin-C, and tissue inhibitor of metalloproteinase-1 in the third trimester. These higher serum levels may be associated with the adverse perinatal effects of obesity during pregnancy.

Molecular docking and in vitro anticancer studies of silver(I)-N-heterocyclic carbene complexes.

A series of symmetric and unsymmetrical benzimidazolium-based N-heterocyclic carbene (NHC) precursors (1a-i) and their silver complexes (2a-i) have been synthesized. The Ag(I)-NHC complexes were characterized by 1H, 13C{1H} NMR, FTIR, LC/MS-QTOF, and elemental analysis. Anticancer and cytotoxic activity of all Ag(I)-NHC complexes were tested against healthy fibroblast cell line (L929), breast cancer cell line (MCF-7), and neuroblastoma cell line (SH-SY5Y) by MTS [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4sulfophenyl)-2H-tetrazolium] assay. The 2b, 2c, 2e, 2g, 2h, and 2i complexes showed higher cytotoxicity than cisplatin against SH-SY5Y and MCF-7 and lower cytotoxic activity against L929 cell lines. Because of their high cytotoxic activity against cancer cells and low cytotoxicity against healthy fibroblast cell lines, the 2b, 2c, 2e, 2g, 2h, and 2i are expected to be new lead compounds. In addition, molecular docking studies were performed to explore the binding interactions of silver complexes with the enzyme to explore new anticancer compounds. Furthermore, ADME properties of all complexes were predicted to explore lead-like characteristics and may be a potential drug candidate for cancer treatment.

Evaluation of dyslipidemia in preeclamptic pregnant women and determination of the predictive value of the hemato-lipid profile: A prospective, cross-sectional, case-control study.

Objective: In this study, we examined the serum hematologic and lipid parameters of pregnant women with preeclampsia and an age- and gestational-age matched normotensive control group. We also compared the ratios of hemato-lipid parameters defined as systemic inflammatory markers and determined the predictive value of these values in preeclampsia. Materials and Methods: All patients diagnosed with late-onset preeclampsia or severe preeclampsia between 34 and 40 weeks of gestation at Inonu University Faculty of Medicine between March 2019 and October 2020 were included. Results: A total of 253 pregnant women were included in the study period. When the study groups were compared in terms of hematological and blood lipid profile; while serum lymphocyte, triglyceride, and total cholesterol levels were significantly higher in the preeclampsia group than in the control group (p<0.001, p<0.001, p=0.013, respectively); high-density lipoprotein (HDL)-cholesterol levels were found to be significantly lower (p=0.017). The cut-off value for the monocyte/HDL ratio in predicting severe preeclampsia was 16.65 with 59.0% sensitivity and 85.4% specificity [the area under the receiver operating characteristic 0.756, 95% confidence interval (CI) 0.681-0.821, p<0.001]. Multivariate analysis showed that the monocyte/HDL ratio was independently associated with both preeclampsia and severe preeclampsia [odds ratio (OR): 1.094; 95% CI 1.009-1.185 and OR: 1.731; 95% CI 1.218-2.459, respectively]. Conclusion: This study demonstrated that serum triglyceride and total cholesterol levels were significantly higher and serum HDL-cholesterol levels were significantly lower in pregnant women with late-onset preeclampsia compared to normotensive pregnant women. Additionally, this study revealed that the measurement of monocyte/HDL ratio in the pregnant population could be a useful clinical tool for predicting preeclampsia.

Does SARS-CoV-2 affect cochlear functions in children?

OBJECTIVES: To determine the influence of coronavirus disease-19 (COVID-19) on cochlear tasks of children who had COVID-19 previously, and the relevance among disease seriousness and cochlear involvement by otoacoustic emissions (OAEs). METHODS: The study included 24 hospitalized children after COVID-19 diagnosis, 23 pediatrics that received outpatient treatment, and 21 children who were without COVID-19 diagnosis as the control group between June 2021 and July 2021. Transient evoked otoacoustic emission (TEOAE), distortion product otoacoustic emission, and contrlateral suppression of otoacoustic emission measurements were carried out for each child. Symptoms of patients, the treatments they received, and the duration of hospitalization of the children in the hospitalized group were recorded. RESULTS: The comparison of TEOAE test results under masking showed a considerable difference between 3 groups at 1 kHz (p=0.033) and 4 kHz (p=0.021) frequencies (p<0.05). Distortion product otoacoustic emission test results of hospitalized outpatient and control group showed a statistically significant difference at 2 kHz among themselves (p=0.009). CONCLUSION: Our results suggest that severe acute respiratory syndrome coronavirus-2 may influence the medial olivocochlear system of children and have irreversible effects on the cochlear functions. Early detection of problems that may affect cochlear functions is a special critical task, especially in children, who are a particularly vulnerable group in terms of hearing and related speech problems.

Synthesis and investigation of antiproliferative activity of Ru-NHC complexes against C6 and HeLa cancer cells.

The 2-methylpyridine, 2-diethylaminoethyl, and isopentyl linked a series of symmetric and unsymmetric benzimidazolium salts 2a-e were prepared and used in the synthesis of silver-N-heterocyclic carbene (NHC) complexes (3a-e). The Ru(II)-NHC complexes (4a-h) were synthesized via transmetalation reaction from 3a-e. 4a-h complexes were converted to Ru(II)-NHC.HCl complexes (5ah) by HCl solution of diethyl ether and characterized by different spectroscopic techniques such as 1H and 13C NMR, LC/MS-Q-TOF, FT-IR, elemental analysis, and melting point detection. We examined the effect of the structural difference of complexes on anticancer activity via different arenes and metal centers. Antiproliferative activity of 5a-h and 3a was tested against human cervix adenocarcinoma (HeLa) and rat glioblastoma (C6) cell lines by ELISA assay. The IC50 value of 5b, 5c and 5e complexes exhibited good cytotoxic activity than cisplatin on C6 (14.2 ± 0.5 mM; 16.2 ± 0.4 mM; 24.2 ± 0.7 mM, respectively) and HeLa (11.1 ± 0.5 mM; 13.7 ± 0.3 mM; 22.8 ± 0.8 mM, respectively) cell lines.

Dose-dependent subacute cardiovascular effects of modafinil in rats.

Modafinil is used for the treatment of various sleep disorders; however, its usage among healthy individuals is also increasing. There are a limited number of cardiovascular side effects, including ischemic T-wave changes, dyspnea, hypertension, and tachycardia in the literature. Our research aimed to investigate the dose-dependent subacute cardiovascular effects of modafinil in rats. Thirty-two rats were randomly and equally assigned to a control group (vehicle-treated for 14 days), a subacute low-dose group (SALD, 10 mg/kg for 14 days), a subacute moderate-dose group (SAMD, 100 mg/kg for 14 days), and a subacute high-dose group (SHD, 600 mg/kg for 14 days). The cardiovascular effects of modafinil were evaluated using hemodynamic, biochemical, electrocardiographic, electrophysiologic, and histopathologic parameters. In terms of hemodynamic parameters, heart rate, and systolic/diastolic/mean blood pressure levels, electrophysiological parameters did not reach statistical significance among the groups (p > 0.05). The incidence of T-wave negativity in SAMD and SAHD groups was 25 and 37.5%, respectively. Moreover, one rat per group was affected by an atrioventricular blockage. Malondialdehyde, superoxide dismutase, catalase, and reduced glutathione levels in the heart and vascular tissues, serum troponin-I, and creatine kinase levels were similar between the modafinil-administered groups and the control group (p > 0.05); this indicates that modafinil activated neither oxidative stress nor antioxidant pathway. Also, there was no difference in histopathological parameters between groups (p > 0.05). Supratherapeutic doses of modafinil may have the potential to cause ischemic cardiac damage and atrioventricular blockage, despite inconsistency with literature findings; however, this does not pertain to hemodynamic changes.

Effects of the COVID-19 Pandemic on Pediatric Nasal Fractures.

OBJECTIVES: Nasal bone fracture is a frequent entity consulted to the otolaryngologists, approximately accounting for 39% of all facial bone fractures. The most frequent mechanisms of injury consist of assault, sport-related injuries, falls, and motor vehicle accidents. In this study, we examined the effects of the COVID-19 pandemic on pediatric nasal fractures. METHODS: Children with nasal fracture who applied to Malatya Training and Research Hospital during the year before the first case and the following year were included in this study. Data of 172 patients for the pre-pandemic period and 79 patients for pandemic were available and included in the study. Demographic information, clinical features, nasal fracture etiology, nasal fracture type, type and time of intervention, and other accompanying pathologies were recorded. RESULTS: While falls was the leading cause of fracture etiology before the pandemic (64 patients [37.21%]), assault seems to be the leading cause during the pandemic period (27 children [34.18%]). In the pre-pandemic period, the intervention for patients with nasal fractures was performed on an average of 5 days, while this period was calculated as an average of 6 days during the pandemic period. When the 2 groups are compared in terms of nasal fracture intervention time, it was seen that the intervention time was statistically significantly later in the pandemic period (P < .001). According to the results of the analysis, the most cases in the pandemic period were seen in the fourth month, which indicated a-month period between 11 June and 11 July. CONCLUSIONS: In conclusion, our number of nasal fracture cases was decreased during the pandemic period compared to the 1-year period before the pandemic. We observed the most common type IIA nasal fracture. We gave outpatient treatment to most of the patients. Our most common cause of fracture was assault. We intervened in our cases in an average of 6 days and preferred closed reduction most frequently. We could not find any study on the same subject in the literature, and we aimed to contribute to the literature with this study.

Neonatal Outcomes of Pregnant Women With Confirmed Coronavirus Disease 2019: One-Year Experience of a Tertiary Care Center.

The coronavirus disease 2019 (COVID-19) pandemic became an important public health problem affecting all age groups. The aim of this study was to evaluate clinical and laboratory findings of newborns born to mothers with COVID-19. Thirty pregnant women with COVID-19 were admitted to Turgut Ozal University Hospital for delivery. Fourteen pregnant women had at least one symptom associated with COVID-19. Positive polymerase chain reaction (PCR) results were seen in only 3 (9.7%) of 31 newborns. A statistically significant difference was observed between PCR-positive and PCR-negative newborns in terms of any adverse pregnancy outcomes. Neonatal lymphocyte count and partial arterial oxygen pressure were significantly lower in the PCR-positive group. Results were also compared according to the interval from the maternal diagnosis time to delivery. Hemoglobin and hematocrit levels in newborns born to mothers diagnosed more than 7 days before delivery were significantly lower. Neonates born to mothers with COVID-19 had mild clinical symptoms and favorable outcomes.

Evaluation of clinical characteristics and outcomes of postoperative infections in living liver donors.

AIM: To analyze developing infections after living donor hepatectomy (LDH) in living liver donors (LLDs). METHODS: Demographic and clinical characteristics of 1106 LLDs were retrospectively analyzed in terms of whether postoperative infection development. Therefore, LLDs were divided into two groups: with (n = 190) and without (n = 916) antimicrobial agent use. RESULTS: The median age was 29.5 (min-max: 18-55). A total of 257 (23.2%) infection attacks (min-max: 1-8) was developed in 190 (17.2%) LLDs. The patients with the infection that were longer intensive care unit (ICU) and hospital stays, higher hospital admissions, emergency transplantation, invasive procedures for ERCP, PTC biloma, and abscess drainage, and the presence of relaparatomies and transcystic catheters. Infection attacks are derived from a 58.3% hepatobiliary system, 13.2% urinary system, 6.6% surgical site, and 5.8% respiratory system. The most common onset symptoms were fever, abdominal pain, nausea, and vomiting. A total of 125 positive results was detected from 77 patients with culture positivity. The most detected microorganisms from the cultures taken are Extended-Spectrum ß-lactamases (ESBL) producing Klebsiella pneumonia (16.8%) and Escherichia coli (16%), Methicillin-Resistant Staphylococcus aureus [(MRSA) (9.6%)], Methicillin-susceptible S aureus [(MSSA) (9.6%)], and Pseudomonas aeruginosa (8.8%), respectively. The average number of ICU hospitalization days was 3 ± 2 (min 1-max 30, IQR:1) and hospitalization days was 14 ± 12 (min 3-max 138, IQR: 8). All infection attacks were successfully treated. No patients died because of infection or another surgical complication. CONCLUSION: Infections commonly observed infected biloma, cholangitis, and abscess arising from the biliary system and other nosocomial infections are the feared complications in LLDs. These infections should be managed multidisciplinary without delay and carefully.

Coblation cryptolysis method in treatment of tonsil caseum-induced halitosis.

PURPOSE: Halitosis, is a social problem affecting many patients seeking help from clinicians. Tonsil stones can cause halitosis and especially occur in crypts of palatine tonsils. Coblation cryptolysis is an alternative method for tonsil caseum treatment. The coblation technology includes passing a radiofrequency bipolar electrical current through a medium of normal saline which results in the production of a plasma field of sodium ions. In this study, our aim was to investigate the effectiveness of coblator cryptolysis treatment method in chronic caseous tonsillitis-induced halitosis. METHODS: We included in our study 28 patients who underwent coblator cryptolysis surgery for halitosis due to chronic caseous tonsillitis. The efficacy of treatment and the presence of caseoma were evaluated with the Finkelstein test, organoleptic test and VAS before the procedure and at the 6th month control after the treatment was completed. RESULTS: At the 6th month follow-up after the procedure (a single coblation cryptolysis) we found that 23 of the patients (82.1%) had no caseum. There was a statistically significant change in Finkelstein measurements before and after the procedure (p < 0.001). Organoleptic measurements demonstrated that 21 patients had no halitosis postoperatively and the mean organoleptic test score was calculated as 0.39 ± 0.79 after the procedure. The recovery was statistically significant (p < 0.001). The mean VAS score before coblation cryptolysis was 8.0 ± 1.33 (range 5-10). On the other hand 6 months after a single coblation cryptolysis session, the mean VAS score was 1.25 ± 1.78 (range: 0-6). This difference was statistically significant (p < 0.001). CONCLUSIONS: Our results suggest that coblation crptolysis is an effective, safe, minimally invasive and practical alternative method in treatment of halitosis due to tonsil caseums. We did not observe any complication after the procedure.

Comparison of preoperative serum neopterin, periostin, indoleamine 2,3-dioxygenase, YKL-40, and tenascin-C levels with current tumor markers for early-stage endometrial cancer.

OBJECTIVE: To compare the predictive value of serum levels of neopterin, periostin, YKL-40, tenascin-C (TNC), and indoleamine 2,3-dioxygenase (IDO) with current tumor markers for the primary diagnosis of early-stage endometrial cancer. METHODS: A prospective cross-sectional study was conducted between January 2020 and November 2020. A total of 59 patients (38 women newly diagnosed with early-stage endometrial cancer [study group] and 21 women with benign endometrial pathologies [control group]) were enrolled. Blood samples were collected prior to surgery and underwent immunoassay analysis. RESULTS: Carcinoembryonic antigen (CEA), periostin, and IDO levels were significantly higher in the study group than the control group (P = 0.008, P = 0.034, and P = 0.003, respectively). Receiver operating characteristic curve analysis revealed that IDO, periostin, and CEA were good predictors of early-stage endometrial cancer (AUC = 0.733, 95% CI, 0.602-0.840, P < 0.002; AUC = 0.668, 95% CI, 0.533-0.785, P = 0.018; and AUC = 0.709, 95% CI, 0.576-0.820, P = 0.002, respectively). Correlation analysis revealed no significant correlation of any biomarker with age or body mass index in either the control or study group. CONCLUSION: Serum CEA, periostin, and IDO levels were significantly higher in women with endometrial cancer than in those without cancer. These results may help identify new markers for diagnosing endometrial cancer.

Evaluation of cochlear functions in infants exposed to SARS-CoV-2 intrauterine.

PURPOSE: The novel coronavirus (SARS-CoV-2) caused an acute respiratory illness named COVID-19 and the disease spread all over the World. Fever, cough, fatigue, gastrointestinal infection symptoms form the main clinical symptoms. Pregnants and newborns form a vulnerable population and urgent measures must be addressed. Studies about the effect of COVID-19 on pregnant women, developing fetuses, and infants are limited. Various viral diseases can cause congenital or acquired, unilateral or bilateral hearing loss. METHODS: 37 infants whose mother was pregnant between March 2020 and December 2020 and were born after the diagnosis of COVID- 19 during pregnancy and 36 healthy infants were included in the study. Transient evoked otoacoustic emission (TEOAE), distortion product otoacoustic emission (DPOAE) and contralateral suppression of OAE (CLS OAE) tests were performed on all infants. RESULTS: According to the TEOAE results of patients and controls in the silent a statistically significant difference was observed between the two groups at 3 kHz and 4 kHz (p < 0.05). Contralateral suppression of OAE test results of patients and controls a statistically significant difference was found in all frequencies (p< 0.05). Suppression was much more effective at all frequencies in the normal group than patient group. This difference was found to be more significant at higher frequencies (2,3 and 4 kHz) (p < 0.001). CONCLUSIONS: Our results suggest an insufficiency in medial olivocochlear efferent system in infants exposed to SARS-CoV-2 intrauterine. Cochlear functions should be examined in infants whose mothers had COVID-19.

Artificial Intelligence-Based Prediction of Covid-19 Severity on the Results of Protein Profiling.

BACKGROUND: COVID-19 progresses slowly and negatively affects many people. However, mild to moderate symptoms develop in most infected people, who recover without hospitalization. Therefore, the development of early diagnosis and treatment strategies is essential. One of these methods is proteomic technology based on the blood protein profiling technique. This study aims to classify three COVID-19 positive patient groups (mild, severe, and critical) and a control group based on the blood protein profiling using deep learning (DL), random forest (RF), and gradient boosted trees (GBTs). METHODS: The dataset consists of 93 samples (60 COVID-19 patients, 33 control), and 370 variables obtained from an open-source website. The current dataset contains age, gender, and 368 protein, used to predict the relationship between disease severity and proteins using DL and machine learning approaches (RF, GBTs). An evolutionary algorithm tunes hyperparameters of the models and the predictions are assessed through accuracy, sensitivity, specificity, precision, F1 score, classification error, and kappa performance metrics. RESULTS: The accuracy of RF (96.21%) was higher as compared to DL (94.73%). However, the ensemble classifier GBTs produced the highest accuracy (96.98%). TGB1BP2 in the cardiovascular II panel and MILR1 in the inflammation panel were the two most important proteins associated with disease severity. CONCLUSIONS: The proposed model (GBTs) achieved the best prediction of disease severity based on the proteins compared to the other algorithms. The results point out that changes in blood proteins associated with the severity of COVID-19 may be used in monitoring and early diagnosis/treatment of the disease.