Pain pressure thresholds in children and adolescents with idiopathic chest pain.

OBJECTIVES: The pathophysiology of idiopathic chest pain remains unclear. Studies evaluating pain pressure thresholds in other idiopathic pain syndromes have revealed pain sensitivity in both affected and unaffected areas. The present study aimed to evaluate thoracic and extrathoracic pain pressure thresholds and their correlation with patients' pain characteristics and quality of life. METHODS: This cross-sectional, single-blind, controlled study included children and adolescents with idiopathic chest pain. The patients' pain characteristics, including their symptom duration, type of pain, mean pain intensity, mean duration of painful periods, pain frequency, and Pediatric Quality of Life Inventory Child Version scores, were assessed by a paediatric cardiologist via a face-to-face interview. Pain pressure thresholds were measured using an algometer by an algologist who was blinded to the study groups. RESULTS: There was a statistically significant difference in pain pressure thresholds in the trapezius; supraspinatus; thoracic 2, 4, and 10 areas; deltoid; and tibia between the patient and healthy control groups. In the patient group, while there was a positive correlation between the mean all-region pain pressure thresholds and age (p = 0.047, r = 0.235), there was no correlation between pain pressure thresholds and symptom duration, pain intensity, and quality of life. CONCLUSION: The present study is the first step towards investigating probable pain sensitivity mechanisms in children and adolescents with idiopathic chest pain. We noted lower thoracic and extrathoracic pain pressure thresholds in children and adolescents with idiopathic chest pain than in healthy controls.

Development and Evaluation of Combined Effect Buccal Films for Treatment of Oral Candidiasis.

Buccal film formulations, including antifungal nystatin, anti-inflammatory agent hydrocortisone acetate, and local anesthetic lidocaine hydrochloride for pain relief, were developed. Bioadhesive films were fabricated with hydrophilic polymers, hydroxyethyl cellulose (HEC), and xanthan gum (XG) and dried in the incubator. Textural, swelling, and bioadhesive properties, physicochemical and in vitro release characteristics, and antifungal activities of bioadhesive films were evaluated.Bioadhesive films significantly extended nystatin release by prolonging retention time of the target area formulation while rapidly releasing hydrocortisone acetate and lidocaine HCl, reducing drug administration. The polymer type affected bioadhesion strength and erosion ratio, and XG formulations had more polymer suitability. Consequently, XT-O2 formulation that was prepared with xanthan gum and tween 80, was best for its highest antifungal film activity (20.00 ± 0.07 mm), released nystatin (44.296% ± 1.695), and lowest erosion matrix (36.719% ± 0.249). The selected formulation can be used for compatibility, stability and in vivo studies targeted oral candidiasis infections.

Evaluation of Plasma Asymmetric Dimethylarginine Levels and Abdominal Aortic Intima-Media Thickness in Infants of Smoker Mothers.

OBJECTIVE: Smoking during pregnancy has harmful effects on the fetus and infant. Although some studies suggest that exposure to fetal-maternal smoking adversely affects both fetal growth and cardiovascular development, the mechanisms and biochemical consequences of smoking in pregnancy and newborns are not yet fully understood. We aimed to investigate whether maternal smoking during pregnancy causes fetal cardiovascular effect by measuring serum asymmetric dimethylarginine (ADMA) level and abdominal aortic intima-media thickness (aIMT). STUDY DESIGN: This prospective study was conducted in newborns of smoking mothers and never-smoker control mothers during their pregnancies. The babies were evaluated echocardiographically on the first day following birth. In two-dimensional mode, abdominal aIMT measurements were performed. ADMA was measured in umbilical cord blood at birth. RESULTS: There were 25 mothers in the study group and 25 mothers in the control group. Serum ADMA levels were 0.459 ± 0.119 µmol/L in the study group and 0.374 ± 0.1127 µmol/L in the control group (p = 0.034). The aIMT value in the study group was 0.84 ± 0.026 mm and the aIMT value in the control group was 0.63 ± 0.011 mm (p = 0.005). CONCLUSION: We found that both the serum ADMA and the aIMT significantly increased in the group with newborns of smoker mothers compared with the group of the newborns of never-smoker mothers. It may also be suggested that exposure to fetal-maternal smoking adversely affects cardiovascular development. KEY POINTS: · It is a known fact that smoking during pregnancy has harmful effects on the development of the fetus and infant.. · We found that both the serum ADMA and aIMT were significantly higher in the group of infants of smoker mothers..

Evaluating the readability, understandability, and quality of online materials about chest pain in children.

An increasing number of individuals use the Internet to obtain health information. However, online health information is unregulated and highly variable. We aimed to assess the readability, understandability, and quality of online information available for "chest pain in children." This analysis was performed in January 2020, by inputting the search term "chest pain in children" into Google. The 180 search results were evaluated/categorized. The readability was assessed using the Flesch reading ease score, the Gunning FOG readability score, the Flesch-Kincaid grade level, the Coleman-Liau score, the Simple Measure of Gobbledygook readability score, the Fry readability score, and the automated readability index (ARI). The quality was assessed through the Journal of the American Medical Association (JAMA) benchmark criteria. The understandability was evaluated by the Patient Education Materials Assessment Tool (PEMAT) for this study. Sixty-five websites were analyzed (academic and hospital websites (n = 30), physicians and health information websites (n = 35)). Among all websites, the average reading grade level was 9.99. There was no statistical difference between the two groups for the average readability level (p: 0.645). The mean PEMAT score for all websites was 65.09%. There was no statistical difference between the two groups for the average PEMAT score (p: 0.945). For both groups, the understandability score was below 70%. The average JAMA benchmark score was 2.43 ± 1.06, with a statistically significant difference between the academic and hospital websites (2.07 ± 0.91) and physician and health information websites (2.74 ± 1.09, p: 0.009).Conclusion: The readability of online materials available for patients regarding "chest pain in children" was significantly higher than the grade 6 recommended by the National Institutes of Health. The current online health information related to pediatric chest pain may be too difficult for the average reader to read. The quality and understandability were not good for both groups. Improving the readability, understandability, and quality of pediatric health-related online materials has the potential to reduce parental anxiety, improve baseline medical knowledge, and even enhance the physician-parent alliance.

The quality, understandability, readability, and popularity of online educational materials for heart murmur.

OBJECTIVE: Murmurs are abnormal audible heart sounds produced by turbulent blood flow. Therefore, murmurs in a child may be a source of anxiety for family members. Families often use online materials to explore possible reasons for these murmurs, given the accessibility of information on the Internet. In this study, we evaluated the quality, understandability, readability, and popularity of online materials about heart murmur. METHODS: An Internet search was performed for "heart murmur" using the Google search engine. The global quality score (on a scale of 1 to 5, corresponding to poor to excellent quality) and Health on the Net code were used to measure the quality of information presented. The understandability of the web pages identified was measured using the Patient Education Materials Assessment Tool (score range from 0 to 100%, scores below 70% reflect poor performance). The readability of each web pages was assessed using four validated indices: the Flesch Reading Ease Score, the Flesch-Kincaid Grade Level, the Gunning Frequency of Gobbledygook, and the Simple Measure of Gobbledygook. The ALEXA traffic tool was used to reference domains' popularity and visibility. RESULTS: We identified 230 English-language patient educational materials that discussed heart murmur. After exclusion, a total of 86 web pages were evaluated for this study. The average global quality score was 4.34 (SD = 0.71; range from 3 to 5) indicating that the quality of information of most websites was good. Only 14 (16.3%) websites had Health on the Net certification. The mean understandability score for all Internet-based patient educational materials was 74.6% (SD = 12.8%; range from 31.2 to 93.7%). A score suggesting these Internet-based patient educational materials were "easy to understand". The mean readability levels of all patient educational materials were higher than the recommended sixth-grade reading level, according to all indices applied. This means that the level of readability is difficult. The average grade level for all web pages was 10.4 ± 1.65 (range from 7.53 to 14.13). The Flesch-Kincaid Grade level was 10 ± 1.81, the Gunning Frequency of Gobbledygook level was 12.1 ± 1.85, and the Simple Measure of Gobbledygook level was 9.1 ± 1.38. The average Flesch Reading Ease Score was 55 ± 9.1 (range from 32.4 to 72.9). CONCLUSION: We demonstrated that web pages describing heart murmurs were understandable and high quality. However, the readability level of the websites was above the recommended sixth-grade reading level. Readability of written materials from online sources need to be improved. However, care must be taken to ensure that the information of web pages is of a high quality and understandable.

Investigation of Wheat Germ and Oil Characteristics with Regard to Different Stabilization Techniques.

RESEARCH BACKGROUND: Utilization of wheat germ and wheat germ oil is limited due to high enzymatic activity and the presence of unsaturated fatty acids, which require stabilization techniques to overcome this problem. EXPERIMENTAL APPROACH: In this study, the effects of stabilization methods (dry convective oven heating at 90 and 160 °C, microwave radiation at 180 and 360 W, and autoclave steaming) on both wheat germ and its oil were evaluated. RESULTS AND CONCLUSIONS: Steaming caused the most dramatic changes in lipoxygenase activity, free fatty acid content, DPPH radical scavenging activity, and mass fractions of tocopherols and tocotrienols. Lower peroxide values were measured in the oil samples treated with convectional heating (160 °C) and steaming at temperatures above 100 °C. However, p-anisidine values of samples treated at higher temperatures were considerably greater than those of samples stabilized at lower temperatures. Oven heating at 160 °C was also one of the most effective treatments, after steaming, for the inactivation of lipoxygenase. Steaming significantly reduced mass fraction of total tocopherols, which was directly associated with the greater loss of ß-tocopherol content. On the contrary, γ- and δ-tocopherol and tocotrienol homologues were abundant with higher amounts in steamed samples. α-Tocopherol and γ-tocotrienol were the most resistant isomers to stabilization processes. NOVELTY AND SCIENTIFIC CONTRIBUTION: This study shows that the high temperature oven heating method, which is widely used in the industry for thermal stabilization of wheat germ, does not provide an advantage in oxidative stability compared to steaming and microwave applications. Steaming delayed oxidation in the germ, while further inhibiting lipoxygenase activity. Moreover, tocotrienols were more conservable. In industrial application, low-power microwave (180 instead of 360 W) and oven heating at lower temperature (90 instead of 160 °C) would be preferable.

Growth-differentiation Factor-15 and Tissue Doppler Imaging in Detection of Anthracycline-induced Cardiomyopathy During Therapy of Childhood Cancers.

OBJECTIVES: The aim of this study was to evaluate the importance of growth-differentiation factor-15 (GDF-15) levels and tissue Doppler imaging (TDI) in the early detection of anthracycline-induced cardiomyopathy during the treatment of childhood cancers. PATIENTS AND METHODS: Twenty patients (13 males and 7 females) newly diagnosed with childhood cancer whose treatment protocol included anthracycline were included in the study. Echocardiography, including M-mode, pulse Doppler, and TDI, was performed after the first anthracycline treatment at cumulative doses of 100, 200, and 300 mg/m and at least 6 months after the last treatment. GDF-15 and troponin-I were also measured at these time points. RESULTS: The median age of the patients was 14 years (range, 3 to 18 y). The median cumulative anthracycline dose was 220 mg/m (range, 60 to 400 mg/m). Conventional pulse wave and pulse wave tissue Doppler methods revealed significant differences in the right ventricular myocardial performance indices of the patients who received cumulative anthracycline doses of 300 mg/m compared with their indices at least 6 months after the last treatment. The serum GDF-15 levels after the cumulative anthracycline dose of 200 mg/m were also higher than the patients' pretreatment levels. CONCLUSIONS: Doppler/TDI and GDF-15 levels may be used in the early determination of anthracycline-induced cardiomyopathy during the treatment of childhood cancers.

Translocation of bacteria from the gut to the eggs triggers maternal transgenerational immune priming in Tribolium castaneum.

Invertebrates can be primed to enhance their protection against pathogens they have encountered before. This enhanced immunity can be passed maternally or paternally to the offspring and is known as transgenerational immune priming. We challenged larvae of the red flour beetle Tribolium castaneum by feeding them on diets supplemented with Escherichia coli, Micrococcus luteus or Pseudomonas entomophila, thus mimicking natural exposure to pathogens. The oral uptake of bacteria induced immunity-related genes in the offspring, but did not affect the methylation status of the egg DNA. However, we observed the translocation of bacteria or bacterial fragments from the gut to the developing eggs via the female reproductive system. Such translocating microbial elicitors are postulated to trigger bacterial strain-specific immune responses in the offspring and provide an alternative mechanistic explanation for maternal transgenerational immune priming in coleopteran insects.

Prolonged QT dispersion in the infants of diabetic mothers.

Myocardial hypertrophy and cardiac dysfunction frequently occur in newborns of diabetic mothers. The authors hypothesized that wall hypertrophy or disproportionate left ventricular wall thickness in newborns of diabetic mothers may affect both QT and QTc dispersion. This study aimed to assess whether left ventricular hypertrophy affects the QT variables of infants born to diabetic mothers. This prospective cross-sectional study was conducted with 47 consecutively selected neonates of gestational diabetic mothers and 30 healthy neonates born to healthy mothers. All the subjects were evaluated during the neonatal period. Electrocardiography with echocardiography was performed for the patients and the control subjects. The newborns of the diabetic mothers were classified according to septal thickness as group 1 (16 newborns with septal hypertrophy) or group 2 (31 newborns without septal hypertrophy). The study group consisted of three cohorts: groups 1, 2, and 3 (control group). Both QT and QTc dispersion were computed from a randomly selected beat as well as from an average beat derived from 12 beats included in a 10-s electrocardiography. A total of 16 infants (34%) had a septal thickness of 6 mm or greater. The left ventricular end-systolic diameter in group 1 was smaller (p = 0.0029) than in groups 2 and 3 (p = 0.003). The interventricular septal thickness at end diastole (IVSTd) and the left ventricular posterior wall thickness at end diastole in group 1 were higher than in of groups 2 and 3. The QT and QTc dispersion intervals were longer in group 1 than in groups 2 and 3 (p < 0.001), and a highly significant positive correlation was detected between IVSTd and QT dispersion (r = 0.514, p = 0.042). Elevated QT and QTc dispersions may be risk factors for the development of arrhythmias in newborns of diabetic mothers. These patients may critically need systematic cardiac screening.

Assessment of P-wave dispersion in children with atrial septal aneurysm.

BACKGROUND: This was a prospective controlled study to determine the P-wave duration and P-wave dispersion in patients with atrial septal aneurysm. METHODS: A total of 41 children with atrial septal aneurysm, including 21 boys and 20 girls (mean age 11.85 ± 3.8 years), and 32 controls, including 17 boys and 15 girls (mean age 12.3 ± 2.9 years), were included. P-wave dispersion was calculated from the 12-lead electrocardiogram. Cardiac functions, morphology of the aneurysm, and left atrial diameter were measured using conventional echocardiography. The diagnosis of atrial septal aneurysm was made when the base of the aneurysms with an excursion ratio ≥25% was found on echocardiography. RESULTS: There was no significant difference between the patient and control groups in demographic, clinical findings, and M-mode echocardiographic parameters. The P-wave dispersion in patients with atrial septal aneurysm was significantly longer compared with the control group (64.4 ± 13.4 ms; p < 0.0001). Similarly, the the maximum duration of the P wave in the patient group was significantly longer compared with the control group (106.1 ± 13.3 ms; p < 0.001). The P-wave duration and dispersion were not correlated with age, gender, systolic and diastolic blood pressure, or m-mode echocardiographic parameters. CONCLUSIONS: This study shows that P-wave dispersion is delayed in atrial septal aneurysm patients. Prolonged P-wave dispersion was determined to indicate electrical disturbance, and therefore it has an increased electrocardiographic risk of atrial arrhythmia in children with atrial septal aneurysm.

Platelet distribution width and mean platelet volume in children with pulmonary arterial hypertension secondary to congenital heart disease with left-to-right shunt: new indices of severity?

The majority of patients with congenital heart disease (CHD), particularly those with relevant systemic-to-pulmonary shunts, if left untreated, will experience the development of pulmonary arterial hypertension (PAH). Previous studies have shown that platelet activation occurs in patients with PAH. In response, this study aimed to investigate the platelet indices, including platelet distribution width (PDW) and mean platelet volume (MPV), in patients with PAH. The study was conducted in the pediatrics cardiology unit of Selcuk University Medical Faculty between July 2010 and January 2012. The patients' clinical and laboratory data were obtained retrospectively from hospital recordings. The study enrolled 57 children with CHD (all with left-to-right shunting). The patients who had undergone diagnostic cardiac catheterization were analyzed according to the presence or absence of PAH. Group 1 had CHD with PAH, and group 2 had CHD without PAH. Compared with the group 2 patients, a significant decrease in PDW (p < 0.0001) was noted in the group 1 patients (with PAH). Likewise, a significant difference was found in the MPV of group 1 (p < 0.0001). Statistically, groups 1 and 2 did not differ in terms of platelet count (p = 0.3). Patients who had pulmonary hypertension secondary to CHD with left-to-right shunting exhibited a lower PDW and MPV.

P-wave duration and dispersion in children with uncomplicated familial Mediterranean fever.

OBJECTIVES: This was a prospective controlled study to determine the P-wave duration (Pdu) and P-wave dispersion (Pd) in patients with familial Mediterranean fever (FMF). METHODS: The study group consisted of 26 children with uncomplicated FMF and 25 age- and sex-matched healthy controls. We performed electrocardiography (ECG) with Doppler echocardiography on patients and controls. All participants underwent 12-lead electrocardiography under strict standards. Pdu and Pd were computed from a randomly selected beat and from an averaged beat constructed from 12 beats, included in a 10-s ECG. RESULTS: The left ventricle (LV) dimensions, LV ejection fraction (LVEF), and LV fractional shortening (LVFS) values, left atrium dimension, and aortic dimension were in normal range in both groups. There were significant differences between the groups regarding LV-isovolumic relaxation time (IRT), LV-isovolumic contraction time (ICT), right ventricle (RV)-ICT, RV-IRT, and Pd (all p < 0.0001). However, highly significant positive correlation was detected between LV-ICT, LV-IRT, RV-ICT, RV-IVT, C-reactive protein (CRP), and Pd (r = 0.505, p < 0.0001; r = 0.483, p < 0.0001; r = 0.433, p = 0.001; r = 0.421, p = 0.001; r = 0.452, p = 0.001; r = 0.478, p < 0.0001, respectively). CONCLUSIONS: Uncomplicated FMF children who are continuously treated with colchicine and do not develop amyloidosis have abnormal atrial dispersion and therefore seemingly have an increased electrocardiographic risk of atrial fibrillation.

Does oxybutynin hydrochloride cause arrhythmia in children with bladder dysfunction?

AIM: Pediatric surgeons frequently encounter children presenting with voiding dysfunction symptoms, including urgency, frequency, and incontinence. Antimuscarinic agents Oxybutynin) are the main drugs used to treat patients with overactive bladder (OAB) syndrome, defined as urgency, with or without urgency incontinence, usually with increased daytime frequency and nocturia. Increased QT dispersion is known to be the cause of ventricular arrhythmia in various systemic diseases and leads to increased mortality and morbidity. METHOD: This study represents a subset of a complete data set, considering only those children aged admitted to the Pediatric Surgery and Pediatric Nephrology Clinics during the period January 2011 to July 2012. RESULT: In this study, we have determined that the QT interval changes significantly depending on the use of oxybutynin. The QT changes increased cardiac arrhythmia in children. CONCLUSION: For this reason, children using such drugs should be closely monitored for cardiac arrhythmia.

P-wave dispersion in children with acute rheumatic fever.

As a new and simple electrocardiographic marker, P-wave dispersion is reported to be associated with inhomogeneous and discontinuous propagation of sinus impulses. The current study aimed to investigate P-wave dispersion in children with acute rheumatic fever. The study population consisted of 47 children with acute rheumatic fever (29 patients with carditis and 18 patients without carditis) and 31 healthy control subjects. Maximum and minimum P-wave durations were measured from the 12-lead surface electrocardiogram. The P-wave dispersion was calculated as the difference between maximum and minimum P-wave durations. The maximum P-wave duration and the P-wave dispersion of the patients with and without carditis were significantly greater than those of the control subjects. The P-wave dispersion of the patients with carditis was significantly greater than that of the patients without carditis. In conclusion, the P-wave dispersion was higher in the children with acute rheumatic fever than in the healthy control subjects.

Biochemical compositional and technological characterizations of black and white myrtle ( Myrtus communis L.) fruits.

Biochemical and technological properties were determined in developing Myrtus communis L. fruits (myrtle) from Mersin to investigate potential uses. Completely ripe black and white fruits contained ash, crude protein, crude oil, water- and alcohol soluble extracts, tartaric, malic and citric acids, and minerals including Ca, K, P, Mg and Na. Proximate compounds (%) for black and white fruits were: 7.47 and 6.36 protein, 3.487 and 3.453 oil, 3.02 and 2.30 ash, 24.28 and 26.09 dry matter, respectively. Fruits were found to be rich in some minerals such as Ca (6719.88 mg/kg and 4676.14 mg/kg), K (22647.78 mg/kg and 18339.84 mg/kg), Mg (2145.19 mg/kg and 1408.88 mg/kg), Na (3336.16 mg/kg and 2976.59 mg/kg) and P (4336.07 mg/kg and 3927.4 mg/kg). Also, physical properties such as length (14.94 mm and 13.64 mm), mass (0.94 g and 0.94 g), geometric mean diameter (12.73 mm and 12.31 mm), sphericity (0.85 and 0.90), diameter (11.76 and 11.70), projected area (1.48 cm(2) and 1.65 cm(2)), kernel density (757.47 kg/m(3)and 752.09 kg/m(3)), porosity (41.41% and 39.05%), bulk density (426.50 kg/m(3) and 431.05 kg/m(3)), terminal velocity (8.42 m/s and 8.49 m/s), volume (1.32 mm(3) and 1.35 mm(3)), repture strenth (1.77 N and 2.06 N), static (0.26-0.33 and 0.20-0.28) and dynamic coefficient (0.22-0.29 and 0.17-0.24) of friction of black myrtle and white myrtle fruits species were measured at 75.72% and 73.91% moisture content levels, respectively. These results show that both myrtle fruits may be useful for the evaluation of dietary information in important food crops.

Can "YouTube" help healthcare workers for learning accurate donning and doffing of personal protective equipments?

INTRODUCTION: Healthcare workers have a high risk of cross-infection during the care of Covid-19 cases. Personal protective equipment can reduce the risk. However, healthcare workers must be trained for the proper use of personal protective equipment to decrease exposure risk. This study aimed to investigate whether videos available on YouTube, presenting procedures of donning and doffing personal protective equipment, can be a useful learning resource for healthcare workers. METHODS: A search of YouTube was conducted using the keywords "Covid-19, personal protective equipment, donning, doffing". Two investigators reviewed each video and collected the basic video information. Total videos were assessed independently as educationally useful and non-useful categories using a valid tool. The relationship of each video's usefulness with viewers' preferences and the upload source were analyzed. RESULTS: A total of 300 videos were assessed; 66 (22%) fulfilled the inclusion criteria. Total video scores of educationally useful videos were higher than non-useful ones; the differences were significant. Healthcare/government agencies and hospitals mostly created educationally useful videos, e-learning platforms, and individuals mainly created non-useful videos. Significant correlations were observed between the video's usefulness and the total view and views per day. CONCLUSIONS: During a pandemic, YouTube might be a resource for learning donning and doffing of personal protective equipment for healthcare workers if an appropriate selection process applied for determining educationally useful videos.

Influence of Eriophyid mites (Aculus olearius Castagnoli and Aceria oleae (Nalepa) (Acarina: Eriophyidae)) on some physical and chemical characteristics of Ayvalik variety olive fruit.

BACKGROUND: Aculus olearius Castagnoli is a recently recorded species that damages olive fruits in the Mediterranean basin of Turkey. Thus, the effects of Eriophyid mites (Aculus olearius Castagnoli and Aceria oleae (Nalepa) (Acarina: Eriophyidae) on the olive fruits from Ayvalik variety in southern Turkey were studied for the first time in terms of some physical parameters and chemical constituents including some individual phenolics. RESULTS: The Eriophyid damaged fruits had higher L* values (lighter colour) and tyrosol level (37.53 mg kg(-1) ) than the undamaged fruits (28.51 mg kg(-1) ) in August. In contrast, Eriophyid damaged fruits were darker in colour and had lower levels (25.77 mg kg(-1) ) of tyrosol than those of undamaged fruits (79.14 mg kg(-1) ) in October. Eriophyid damaged samples had higher values of vanillic acid than the undamaged samples. An increase in the average concentrations of hydroxytyrosol and p-coumaric acid was observed in the fruits harvested in August, whilst the oleuropein content decreased. CONCLUSION: The harvest in October can be recommended regarding the higher dimensional values, total oil, dry matter and oleuropein contents. But the interaction between harvest time and Eriophyid damage was found effective in terms of tyrosol content and skin colour; as tyrosol values were lower in the fruits harvested in October and the fruits were darker. The resistance of undamaged fruits against Eriophyid damage can be linked to high tyrosol content of these fruits.

Application of fuzzy expert system approach on prediction of some quality characteristics of grape juice concentrate (Pekmez) after different heat treatments.

Effects of heat treatment on physicochemical characteristics and sensory properties of different fruit juice concentrates (pekmez) were studied. Apricot pekmez had the highest viscosity followed by mulberry and date pekmez. Apricot and date pekmez had higher scores for odour, taste and consistency than others. Hydroxymethyl furfural concentration of all pekmez samples increased after heat treatments. Samples heated at 75°C showed highest L* values while at 65°C the lowest mean L* values. L* values of all pekmez samples were similar while carob Pekmez had higher L* values. Also a development of the Fuzzy Expert System (FES) was made for prediction. Using the experimental values, FES model of the system was designed. Accordance was found with experimental and FES results when compared statistically. This study provides advantage for prediction possibility of unknown sub-values', which were not experimentally studied.

The Value of Neutrophil:Lymphocyte Ratio and Platelet:Lymphocyte Ratio in Predicting Clinical Severity in Children with Carbon Monoxide Poisoning.

OBJECTIVE: To compare the values of neutrophil:lymphocyte ratio (NLR), platelet:lymphocyte ratio (PLR), and mean platelet volume (MPV) with carboxyhemoglobin (COHb) and lactate levels in children with acute CO intoxication. METHODS: In this retrospective study, the patients were divided into two groups: mild-to-moderate carbon monoxide poisoning (COP) (COHb 10%-20%) and severe COP (COHb > 20%) according to the COHb levels in the application. All patients were compared in terms of NLR, PLR, and MPV parameters according to the severity of poisoning and the high lactate levels (≥ 2.2 mmol/L). RESULTS: A total of 261 children with COP were included in the study. The number of patients with mild-to-moderate COP was 183 (70.1%), and the number of patients with severe COP was 78 (29.9%). NLR [2.57 (3.27), 1.65 (1.93), (p = 0.001)] and PLR [123.0 (88.24), 92.8 (54.1), (p = 0.001)] values of mild-to-moderate COP were statistically significantly lower than the severe COP group. In the group with high lactate level, PLR values were significantly lower [120.1 (71.9), 100.2 (85.4), (p = 0.017)]. NLR and PLR values were found to be predictive of severe COP. CONCLUSION: NLR and PLR can be used for detection of clinical severity in patients with COP. PLR can be used in conjunction with lactate levels to detect tissue-level exposure in patients with COP.

Readability, understandability, and quality of retinopathy of prematurity information on the web.

BACKGROUND: The purpose of this study is to assess the readability, understandability, and quality of information on retinopathy of prematurity presented at websites frequently visited by parents. METHODS: A total of 220 websites were assessed, which were recruited by searching for "retinopathy of prematurity" at the Google search engine. The readability of each web page was assessed by Flesch Reading Ease Score, Gobbledygook's Gunning Frequency, Flesch Kincaid Grade Level, Coleman Liau score, The Simple Measure of Gobbledygook, Fry Graph Readability Formula, and Automated readability score. The understandability of the web pages included in the study was measured by using the Patient Education Materials Assessment Tool. Quality was evaluated using Health in Net code and JAMA. The ALEXA traffic tool was used to reference the domains' popularity and visibility. RESULTS: Sixty-four websites were included to the study. The average Flesch Reading Ease Score was 50.1 ± 11.4, Gunning Frequency of Gobbledygook level was 13.4 ± 2.5, The Flesch-Kincaid Grade level was 10.7 ± 2.2, Coleman Liau level was 10.8 ± 1.7, Simple Measure of Gobbledygook level was 10.0 ± 1.9, and Fry Graph Readability Formula 11.9 ± 2.7, Automated readability score 10.4 ± 2.5. The average understandability score for all website-based patient education materials was 76.9 ± 15.2. Total JAMA Benchmark score is 2.27 ± 1.14 (range from 1 to 4). The quality of information at most websites were determined by our chosen assessments to not to be good. CONCLUSION: Websites addressed to parents for retinopathy of prematurity had found to have high understandability. It was concluded based on this study that readability and quality of presented written materials at online sources need to be improved.