Impact of titanium-prepared platelet-rich fibrin in type 1 fascia graft tympanoplasty on graft survival and hearing outcomes.

Background: Type 1 fascia graft tympanoplasty (T1FGT) is the mainstay surgical approach for the treatment of tympanic membrane perforations. The most widely used graft material is temporal muscle fascia, and graft take rates are reported differently. The methods to enhance graft take are still being investigated. Aim: The aim of our study was to investigate the effect of titanium-prepared platelet-rich fibrin (T-PRF) on graft take and hearing outcomes in T1FGT. Materials and Methods: Fifty-seven ears eligible for T1FGT were involved in the study and prospectively evaluated. T-PRF was applied with T1FGT in 27 ears. Thirty ears in the other group underwent only T1FGT. The patients underwent an otomicroscopic and audiometric examination in preoperative and postoperative 2nd week, 1st month, and 6th month. Both groups were evaluated in terms of hearing levels, infection, and graft take rates. Results: Two patients in the T1FGT + T-PRF group and seven patients in the T1FGT group had postoperative perforation (graft take rate: 92.6% versus 76.7%). The graft take rate was found to be increased in the T-PRF group although the difference was not statistically significant. In the T1FGT group, the percentage of infection was higher than in the T1FGT + T-PRF group. When the preoperative and postoperative 6th-month audiometry was compared, a statistically significant hearing gain was obtained for both groups. Conclusion: In the treatment of tympanic membrane perforations, T-PRF applied over the fascia graft was shown to increase graft take rates and decrease the probability of infection. Further studies with larger samples are needed to demonstrate the effects of PRF.

A founder nonsense variant in NUDT2 causes a recessive neurodevelopmental disorder in Saudi Arab children.

We identified the homozygous p.Arg12* variant in 5 patients with neurodevelopmental delay, but variation databases list many truncating heterozygous variants for this small 2-exon gene. As most of these affect the protein's C-terminus, loss-of-function mediated pathogenicity may be confined to bi-allelic truncating variants in exon 1 (nonsense-mediated decay!) or in the catalytically active Nudix box.

Expanding the clinical and genetic spectra of NKX6-2-related disorder.

Hypomyelinating leukodystrophies (HLDs) affect the white matter of the central nervous system and manifest as neurological disorders. They are genetically heterogeneous. Very recently, biallelic variants in NKX6-2 have been suggested to cause a novel form of autosomal recessive HLD. Using whole-exome or whole-genome sequencing, we identified the previously reported c.196delC and c.487C>G variants in NKX6-2 in 3 and 2 unrelated index cases, respectively; the novel c.608G>A variant was identified in a sixth patient. All variants were homozygous in affected family members only. Our patients share a primary diagnosis of psychomotor delay, and they show spastic quadriparesis, nystagmus and hypotonia. Seizures and dysmorphic features (observed in 2 families each) represent an addition to the phenotype, while developmental regression (observed in 3 families) appears to be a notable and previously underestimated clinical feature. Our findings extend the clinical and mutational spectra associated with this novel form of HLD. Comparative analysis of our 10 patients and the 15 reported previously did, however, not reveal clear evidence for a genotype-phenotype correlation.

Not just a sum of its parts: How tasks of the theory of mind scale relate to executive function across time.

There is a well-established relationship between theory of mind (ToM) and executive function (EF) during the preschool years. However, less is known about the concurrent and longitudinal relations between EF and specific tasks tapping different aspects of ToM. The current study investigated the ToM-EF relationship across 1 year in 3- to 5-year-old Turkish children using the ToM battery of Wellman and Liu (2004), which measures understanding of diverse desires (DD), diverse beliefs (DB), knowledge access (KA), contents false belief (CFB), explicit false belief (EFB), and hidden emotion (HE). This battery has not yet been used in its entirety to test the predictive relations between ToM and EF. We used peg-tapping and day-night tasks to measure EF. Our sample comprised 150 Turkish preschool children (69 girls) aged 36-60 months at Time 1 (T1) and 49-73 months at Time 2 (T2). Using the ToM composite with all six tasks, when child's age, receptive language, and T1 ability level (EF or ToM) were controlled, T1 EF significantly predicted T2 ToM, whereas T1 ToM did not predict T2 EF. Among DD, DB, KA, false belief understanding (FBU: the composite score of CFB and EFB), and HE, only KA and FBU were significantly associated with EF at T1 and T2. Further regression analyses showed that KA did not have a predictive relationship with EF. Instead, FBU drove the predictive EF-ToM relationship across time. Thus, in Turkish children, earlier EF predicts later ToM, but especially the FBU component, in this well-validated battery.

Predictors of obesity and overweight in preschoolers: The role of parenting styles and feeding practices.

Childhood obesity/overweight (OB/OW) displayed a rapid increase and high prevalence in the last few decades in preschool-aged children, which raised health concerns across the world and motivated researchers to investigate the factors that underlie childhood obesity. The current study examined parenting styles and child-feeding practices as potential predictors for OB/OW in preschool children, controlling for child's temperament, which has been shown to be linked with OB/OW. The sample included 61 normal weight (NW) and 61 obese/overweight (OB/OW) Turkish pre-schoolers (M age = 62.2 months; SD = 7.64, range = 45-80 months). Parenting styles (authoritarian, authoritative), child-feeding practices (restriction, pressure to eat, monitoring), and child's temperament (negative affectivity) were measured with mothers' reports. Results showed that authoritarian parenting and maternal pressure to eat were the two parenting variables that significantly predicted child's weight status; the odds of being OB/OW was 4.71 times higher in children whose mothers used higher authoritarian parenting style, and was 0.44 times lower when mothers pressured their child to eat. These findings suggest that understanding the unique role of different aspects of parenting in the risk of early OB/OW status of children would be important in developing more effective interventions from early years in life.

Feelings of burden among family caregivers of people with spinal cord injury in Turkey.

STUDY DESIGN: The study was designed as a cross-sectional survey. OBJECTIVES: The purpose of the study was to examine the level of feelings of burden in family caregivers of people with spinal cord injury (SCI) in Turkey, and to explore its predictors. SETTING: Turkey. METHODS: One hundred family caregivers of people with SCI completed measures of burden of caregiving, depression, social support and physical health. The SCI participants completed a measure of functional independence. Multivariate statistics and structural equation modeling (SEM) were conducted to identify significant predictors of caregiver burden. RESULTS: Caregiver burden was significantly related to caregivers' feelings of depression. SEM analysis showed that social support from family and from friends predicted caregiver burden via depression. Caregivers' age, sex, educational level, physical health and household income did not significantly predict their feelings of depression or burden. CONCLUSIONS: Our findings revealed that support received from both families and friends is an important source for alleviating the depressive feelings of caregivers and, in return, their burden in the caregiving. In Turkey, high support from family members is expected and is important for psychological well-being, yet the current study showed that the support received from friends also has unique contribution to the well-being of the caregivers of persons with SCI. Overall, our findings highlight the importance of supportive relationships between family as well as friends for the caregivers who may have to provide lifetime care for their family member with special needs.

Interventions aimed at reducing obesity in early childhood: a meta-analysis of programs that involve parents.

BACKGROUND: Obesity is a growing problem even in very young childhood, resulting in high costs for individuals and society. As a response, numerous obesity prevention and intervention programs have been developed. Previous research has shown that early intervention programs are more effective when parents are involved, but the effectiveness of specific aspects of programs with parental involvement has not been investigated. This meta-analysis aims to investigate the features related to the effectiveness of different types of obesity intervention programs involving parents and targeting young children (0-6-year-olds). METHODS: The Web of Science, PubMed, PsycInfo, CINAHL, and ERIC databases were searched for childhood obesity prevention and intervention programs involving parents. Data were analyzed using the Comprehensive Meta-analysis (CMA) software. RESULTS: Fifty studies with effect sizes measured at short-term follow-up (within 3 months from the end of the intervention) and 26 studies with effect sizes measured at long-term follow-up (all reported in a total of 49 publications) were identified. The combined effect size of interventions was small but significant at short-term follow-up (d = .08, p < .01). The results suggested the presence of a potential publication bias in studies providing results at long-term follow-up, with a nonsignificant adjusted effect size (d = .02), which indicated that obesity interventions were not effective at long-term follow-up. Multivariate meta-regression analyses showed that interventions were more effective when including either interactive sessions or educational materials as opposed to those including both interactive sessions and noninteractive educational materials. No other moderators regarding sample characteristics, study design, or methodological quality were significant. CONCLUSION: Interventions targeting young children that require parental involvement are effective at short-term follow-up, specifically when interventions include one mode of intervention rather than two. However, results were not retained in the long run.

Pre-exercise arginine supplementation increases time to exhaustion in elite male wrestlers.

Dietary supplements containing arginine are among the most popular ergogenics intended to enhance strength, power and muscle recovery associated with both anaerobic and aerobic exercise. The aim of the present study was to evaluate the possible effect of pre-exercise acute intake of arginine on performance and exercise metabolism during incremental exhaustive exercise in elite male wrestlers. Nine volunteer elite male wrestlers (24.7±3.8 years) participated in this study. The test-retest protocol was used on the same subjects. The study was conducted using a cross-over design. A single dose of arginine (1.5 g · 10 kg(-1) body weight) or placebo was given to the subjects after 12 hours fasting (during the night) for both test and retest. Subjects were allowed to drink water but not allowed to eat anything between arginine or placebo ingestion and the exercise protocol. An incremental exercise protocol was applied and oxygen consumption was measured during the exercise. Heart rate and plasma lactate levels were measured during the exercise and recovery. Results showed that in the same working loads there was no significant difference for the mean lactate levels and no difference in maximum oxygen consumption (arginine 52.47±4.01 mL · kg(-1) · min(-1), placebo 52.07±5.21 mL · kg(-1) · min(-1)) or in maximum heart rates (arginine 181.09±13.57 bpm, placebo 185.89±7.38 bpm) between arginine and placebo trials. Time to exhaustion was longer with arginine supplementation (1386.8±69.8 s) compared to placebo (1313±90.8 s) (p < 0.05). These results suggest that L-arginine supplementation can have beneficial effects on exercise performance in elite male wrestlers but cannot explain the metabolic pathways which are responsible from these effects.

Empathy, sympathy, and emotion regulation: A meta-analytic review.

Empathy, sympathy, and emotion regulation are core components of social-emotional development. Regulating vicariously induced negative emotions is thought to support feeling empathy and sympathy for others in need, but empirical evidence for such effects is mixed. Moreover, despite the longstanding conceptual distinction between empathy and sympathy, most researchers refer to and measure these constructs interchangeably. This meta-analysis examined associations between emotion regulation and empathy and/or sympathy in childhood and adolescence, as well as potential methodological, study, and sample moderators. Analyses were conducted on 58 studies (75 effect sizes; N = 25,831). There was a significant and positive overall association between emotion regulation and empathy/sympathy (r = .19, p < .001); however, most scales assessing empathy were conflated with other constructs. Accounting for conflation, emotion regulation was related to sympathy (r = .24, p < .001) but not empathy (r = .04, p = .38). Moreover, the association between emotion regulation and empathy/sympathy was not significant when baseline respiratory sinus arrhythmia (RSA) and RSA reactivity were examined as proxies of emotion regulation. Results were largely similar across sample characteristics (e.g., age group, sex, and culture). Conceptual implications for differentiating empathy and sympathy are discussed, as well as methodological considerations to maximize the quality and clarity of research on emotion regulation, empathy, and sympathy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Biological basis of temperament: Respiratory sinus arrhythmia and inhibitory control across childhood.

Temperamental inhibitory control is a foundational capacity for children's social, emotional, and behavioral development. Even though temperament is suggested to have a biological basis, the physiological indicators of inhibitory control remain unclear amid mixed empirical results. In this study, we leveraged a multicohort longitudinal design to examine resting respiratory sinus arrhythmia (RSA) as a physiological correlate of inhibitory control across the early and middle childhood years. Data were collected annually across four time points from cohorts of 4- (n = 150, Mage = 4.53; SD = 0.30; 49.7% female) and 8- (n = 150; Mage = 8.53; SD = 0.29; 49.7% female) year-old children and their caregivers. There were weak, albeit significant, associations between resting RSA and caregiver-reported inhibitory control in middle childhood but not in early childhood. A stronger association was found for older children when latent trait assessments of RSA and inhibitory control were derived from commonalities across the four annual assessments. We conclude that using repeated measures to extract latent trait scores increases power to detect potential physiological indicators of temperament. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Obstructive sleep apnea syndrome and its association with vitamin D deficiency.

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is a widespread disorder characterized by recurrent, partial or complete episodes of apnea due to upper airway tract obstruction during sleeping period. Deficiency of vitamin D has roles in development of many diseases. Association between presence and severity of OSAS and vitamin D has recently gained research interest. AIM: The aim of our study was to investigate the association between serum 25-hydroxy [25 (OH)] vitamin D levels and severity of disease in patients with OSAS. MATERIAL AND METHODS: One hundred and fifty OSAS patients (50 patients with mild, 50 with moderate, 50 with severe OSAS) who were diagnosed by polysomnography (PSG) and 32 non-OSAS controls who were referred to the Health Ministry Ankara Numune Training and Research Hospital, Endocrinology and Metabolism Department, from January 2010 to May 2011 were included in the study. Serum 25(OH)D, PTH, calcium and phosphorus levels were evaluated in all the patients who were recruited to the study. RESULTS: There was no statistically significant difference in serum 25(OH)D levels between OSAS and controls (p>0.05). However, in subgroup analysis of OSAS, we found that the patients with severe OSAS had significantly lower levels of 25(OH)D as compared with other groups (p=0.003). Also, the number of patients with serum 25(OH)D deficiency (<10 µg/dl) were higher in OSAS group than in controls (p<0.05). CONCLUSIONS: We found that when the severity of OSAS increases, 25(OH)D deficiency becomes more pronounced.

Parental warmth predicts more child pro-social behaviour in children with better emotion regulation.

Parental warmth and child emotion regulation have each been implicated in the development of child pro-social behaviours; however, their interactive benefits remain unclear. In this multi-method, multi-cohort longitudinal study, we examined the effect of parental warmth on child pro-social behaviours at different levels of child emotion regulation. We collected data from 6- and 10-year-olds in Canada (NT1  = 233; Mage  = 8.41; SD = 2.08) and their parents. Parental warmth, child emotion regulation, and child pro-social behaviours were assessed via parent report. Children's baseline respiratory sinus arrhythmia (RSA; an indicator of cardiac regulatory capacity) was assessed as a correlate of emotion regulation. Child pro-social behaviours were assessed concurrently and 1 year later. Results showed that higher parental warmth was related to higher concurrent prosocial behaviours and greater increases in prosocial behaviours over 1 year. These effects were strengthened for children with higher emotion regulation whether measured by parent report or RSA. We discuss implications for understanding pro-social development in middle childhood from a strengths-based perspective.

Assessing social-emotional development: Reliability and validity of the social-emotional responding task.

The Social-Emotional Responding Task (SERT) assesses children's anticipated emotions in the contexts of transgressions (Malti, The Social-Emotional Responding Task. Unpublished tool by T. Malti, 2017.). We present a systematic psychometric evaluation of the SERT using data from two different samples of 4-8-year-old children from Canada (N = 291, Mage = 6.55 years, SDs = 2.02, 50% boys in Sample 1 and N = 282, Mage = 6.57 years, SDs = 1.56, 49% boys in Sample 2). Children reported their anticipated emotions in six vignettes describing three domains of transgressions [aggressive acts (AA), prosocial omission (PO), and social exclusion (SE)]. Caregivers rated children's sympathy and prosocial and aggressive behaviors. Results supported a one-factor ("domain-general") model over a three-factor ("domain-specific") model, indicating convergence of anticipated emotions across vignettes and domains. Measurement invariance was established across gender and age groups, indicating the robustness of the assessment. Construct validity was supported by associations with sympathy and less robustly, with prosocial and aggressive behavior. We discuss the use of SERT as an assessment tool for children's social-emotional capacities in research and practice settings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Culturally shared and unique meanings and expressions of maternal control across four cultures.

Maternal control is a major dimension of parenting and has different meanings, practices, and potential consequences across cultures. The present study aimed to identify and compare mothers' conceptualizations of parenting control across four cultures to reveal a more nuanced understanding regarding the meaning and practices of control: European American, Chinese immigrant, Korean immigrant, and Turkish. Using a semistructured open-ended interview, 100 European American, 102 U.S. Chinese immigrant, 103 U.S. Korean immigrant, and 109 Turkish mothers of preschool-aged children reported the ratings of importance, specific reasons, and strategies for exerting control over their children in daily life. Results revealed both shared and unique conceptualizations of maternal control across four cultures. Specifically, all mothers reported that it is important to express maternal control over their children in order to set behavioral norms/standards, maintain child safety, support social relations and respect for others, provide guidance, and guide moral development. Moreover, mothers discussed utilizing nonphysical punishment, setting and maintaining rules, reasoning/negotiating, consistency, physical punishment and verbal control, showing parents' serious/stern attitude, correction, and psychological control forms of control. However, the levels at which mothers emphasize the different reasons and strategies varied across cultures, reflecting culturally emphasized values. The findings of the present study further enrich our understanding of the complexities of maternal control across cultures. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A review on the vascular features of the hyperimmunoglobulin E syndrome.

Autosomal recessive, autosomal dominant and the sporadic forms of hyperimmunoglobulin E syndrome (HIES) are multi-system disorders. Although HIES patients may present with cold abscesses, the vascular features of HIES are not well recognized. The objective of this review is to characterize the nature and spectrum of vascular abnormalities in HIES patients. Vascular abnormalities in HIES patients were reviewed with Medline and Google Scholar-based searches. In brief, the searches combined terms related to HIES with the terms related to vasculature. Furthermore, reference lists from the original studies and review papers identified were screened. There were vascular abnormalities in 25 patients with HIES. These abnormalities were identified as aneurysms (coronary, aortic, carotid and cerebral), pseudoaneurysms, congenital patent ductus venosus, superior vena cava syndrome, vasculitides, vascular ectasia, thrombosis and others. They may be congenital or acquired, in the veins and arteries, affecting both sexes. These abnormalities can be seen in all subtypes of HIES. They could be also fatal in children and adults. Limited pathological investigations revealed the presence of vasculitis. Three of the patients were found to have overlap diseases. In this review, the spectrum of vascular abnormalities in HIES are documented and discussed in detail for the first time. They highlight a previously under-recognized and potentially devastating complication of these disorders. These vascular abnormalities constitute one of the major clinical characteristics in HIES. The presence of hypereosinophilia, vasculitis and defective angiogenesis in HIES may contribute to the formation of vascular abnormalities in HIES.

Evaluation of surface water quality characteristics by using multivariate statistical techniques: a case study of the Euphrates river basin, Turkey.

The surface water quality of the Euphrates river basin in Turkey are evaluated by using the multivariate statistical techniques known as factor analysis (FA) and multidimensional scaling (MDS) analysis. When FA was applied to the water quality data obtained from the 15 different surface water quality monitoring stations, two factors were identified, which were responsible from the 86.02% of the total variance of the water quality in the Euphrates river basin. The first factor called the urban land use factor explained 44.20% of the total variance and the second factor called the agricultural use factor explained 41.81% of the total variance. MDS technique showed that electrical conductivity (EC), percent sodium (Na%) and total salt are the most important variables causing difference in the water quality analysis.

Retropharyngeal submucosal dissection due to nasotracheal intubation.

PROBLEM: Nasal intubation is used often by anaesthetists because it offers many advantages; however, rare complications do arise. A 67-year-old man was admitted to our otorhinolaryngology clinic for uvulopalatopharyngoplasty. Nasotracheal intubation was performed without difficulty. At the beginning of surgery, the surgeon noticed that the nasotracheal tube had penetrated the oropharyngeal mucosa through a channel in the retropharyngeal space. METHODOLOGY: The tube was left in place during surgery to prevent bleeding. After surgery, a vertical incision was made through the mucosa surrounding the tube from the inferior pouch up to the nasopharynx to prevent hematoma. RESULT: The patient was extubated without complication and discharged on the second day postoperative. The oropharyngeal mucosa was healed by the 15th day postoperative. CONCLUSION: Nasal intubation tubes should be lubricated and inserted without force; the oropharynx should be examined carefully after intubation to rule out complications.

Sutureless vascular anastomoses by N-butyl-2 cyanoacrylate adhesive: an experimental animal study.

BACKGROUND: The purpose of this animal study was to find out whether sutureless anastomoses using N-butyl-2-cyanoacrylate were effective in the suppression of neointimal hyperplasia or not. MATERIAL AND METHODS: Ten male adult mongrel dogs were used in this animal study. The animals were randomly divided into a control group (n = 5) and a study group (n = 5). The study group underwent sutureless anastomoses using N-buthyl-2-cyanoacrylate adhesive. Infrarenal aortoaortic graft was interposed using polytetrafluoroethylene. RESULTS: In the study group, the mean intimal thickness at the proximal anastomosis was 27.4 +/- 1.94 microm and 27.4 +/- 1.51 microm at the distal anastomosis. In the control group, the mean intimal thickness was 138.4 +/- 5.02 mum at the proximal anastomosis and 67.6 +/- 6.42 microm at the distal anastomosis. Intimal thickness at the proximal and distal anastomoses in the control group was significantly (p < 0.001) greater than in the study group. Also, perianastomotic inflammation was more obvious in the control group compared to the study group (p < 0.01). CONCLUSION: Sutureless anastomoses using with N-butyl-2-cyanoacrylate adhesive might be a good alternative to conventional suture technique.

Numbers of Brain Deaths and Deceased Donors in Hospitals in Istanbul Region That Have Transplantation Units: A Retrospective Analysis Between the Years 2005 and 2015.

BACKGROUND: Turkey is one of the countries facing a serious organ shortage problem, with thousands of patients with end-stage organ failure. The Social Security Institution started to increase the reimbursement for transplantation operations in 2007 to solve this problem, and this policy has continued since then. Although the number of transplantation centers and operations in Turkey increased in this term, according to organ donation and transplantation statistics from the Ministry of Health, the rate of organ retrieval from deceased organ donors has decreased. METHODS: This study was performed with the purpose of retrospectively analyzing (between the years 2005 and 2015) the number of brain deaths and donors after brain death in hospitals that are affiliated with the Istanbul Regional Coordination Office and have transplantation units. Data were collected via the website of the Ministry of Health. Hospitals were categorized as those directly affiliated with the Ministry of Health, university hospitals, and private hospitals. RESULTS: This study found that the number of transplantation centers has increased >3 times since 2005, and the number of private transplantation centers has increased 9 times for the same period. We also found that the number of brain deaths, donors after brain death in hospitals, and number of brain deaths and donors after brain death per hospital had varied throughout the study years. CONCLUSIONS: Although the number of transplantation centers has increased since 2005, the number of brain deaths and donors after brain death has not increased to the same extent for this period in these hospitals that have transplantation units.