Comparison of endoscopic and microscopic methods in stapedotomy: a retrospective analysis.

PURPOSE: The goal of the present study was to compare the audiologic results, complications, and advantages/disadvantages of endoscopic and microscopic stapedotomy. METHODS: Patients who experienced stapedotomy surgery in the Ear Nose Throat Clinic (ENT) of Selcuk University Faculty of Medicine between September 2011 and January 2018 were included in the study. The data of all patients were analyzed and divided into two groups. Those who underwent endoscopic stapedotomy were included in group I, and patients who underwent microscopic stapedotomy formed group II. Surgical findings, complications, and operation times were compared for the two groups. Air and bone conduction thresholds were evaluated at the frequencies of 500, 1000, 2000, and 4000 Hz pre- and postoperatively at 1, 3, and 6 months, and the mean (± SD) air-bone gap value was recorded. RESULTS: While the mean pre- and postoperative air-bone gaps were 34.38 ± 7.47 dB (23-53 dB) and 9.69 ± 4.43 dB (0-19 dB), respectively, in group I, 34.32 ± 7.57 dB (23-6 dB) and 9.62 ± 4.25 dB (2-23 dB) were the respective means calculated in group II (p < 0.05). When the mean postoperative air-bone gap was compared, there was no statistically significant difference between the two groups (p = 0.774). The mean operative times for groups I and II were 57.22 ± 4.37 min and 63.70 ± 7.34 min, respectively (p < 0.001). The requirement for chorda tympani nerve manipulation and scutum curettage was significantly less in group I compared to group II (p = 0.003). Postoperative dysgeusia and postoperative pain were found to be higher in group II than group I, but they were not statistically significant (p > 0.05). CONCLUSION: Endoscopic stapedotomy displayed similar audiological results, shorter operation times, and similar complication rates, as well as being a less invasive surgery, compared to the microscopic approach.

Potential Use of High Pressure Homogenized Hazelnut Beverage for a Functional Yoghurt-Like Product.

Hazelnut beverage is a plant-based beverage produced from hazelnut cake as a by-product obtained after cold press extraction. It has high nutritional value and a significant percentage of consumers show interest in it due to its health benefits. In this study, hazelnut beverage manufactured from by-products of hazelnut oil industry was incorporated into functional yoghurt production. Five formulations (ratio of 1/0, 3/1, 2/1, 1/1, 0/1, v/v, cow milk/hazelnut beverage) of yoghurt-like products were prepared to indicate the storage period of the samples and the analysis performed. For yoghurt production, hazelnut beverage and cows' milk were standardized to 14.5 g 100 g-1 with skimmed milk powder. The use of hazelnut beverage in yoghurt production negatively affected L. bulgaricus counts. Water holding capacity and viscosity values were improved by using hazelnut beverage. Increasing hazelnut beverage concentration led to an increase in the total phenolic compounds and antioxidant activity, malic acid levels and also unsaturated fatty acids, especially oleic and linoleic acid. Using the ratio of 3/1 was found the best in view of appearance, flavor and overall acceptability. Based on the structural, rheological and sensorial properties, this study could guide the dairy industry to use hazelnut beverage obtained from hazelnut cake.

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.

Dosimetric evaluation of irregular surface compensator and intensity-modulated radiotherapy in breast radiotherapy.

BACKGROUND: This dosimetric study aims to evaluate the dosimetric advantage of the irregular surface compensator (ISC) compared with the intensity-modulated radiotherapy (IMRT). MATERIALS AND METHODS: Ten patients with whole breast irradiation were planned with the ISC and IMRT techniques. Six different beam directions were selected for IMRT and ISC plans. The treatment plans were evaluated with respect to planning target coverage, dose homogeneity index (DHI) and organs at risk (OARs) sparing. Monitor units (MUs) and the delivery time were analysed for treatment efficiency. RESULTS: The ISC technique provides a better coverage of the PTV and statistically significantly better homogeneity of the dose distribution. For the ipsilateral lung and heart, ISC and IMRT techniques deliver almost the same dose in all plans. However, MU counts and delivery time were significantly lower with the IMRT technique (p < 0.05). CONCLUSION: For breast radiotherapy, when the ISC method was compared to the IMRT method, ISC provided better dose distribution for the target.

Storage stability and sourdough acidification kinetic of freeze-dried Lactobacillus curvatus N19 under optimized cryoprotectant formulation.

In this study, the response surface methodology was used to optimize the cryoprotective agent (skimmed milk powder, lactose and sucrose) formulation for enhancing the viability of Lactobacillus curvatus N19 during freeze-drying and storage stability of cells freeze-dried by using optimum formulation was evaluated. Our results showed that the most significant cryoprotective agent influencing the viability of L. curvatus N19 to freezing and freeze-drying was sucrose and skim milk, respectively. The optimal formulation of cryoprotective agents was 20 g/100 mL skim milk, 3.57 g/100 mL lactose and 10 g/100 mL sucrose. Using the optimum formulation during freeze-drying, the cell survival was found more than 98%. Under the optimal conditions, although only storage of the cells at 4 °C for 6 month retained the maximum stability (8.85 log cfu/g), the employed protectant matrix showed promising results at 25 °C (7.89 log cfu/g). The storage stability of cells under optimized conditions was predicted by accelerated storage test, which was demonstrated that the inactivation rate constant of the freeze-dried L. curvatus N19 powder was 9.74 × 10-6 1/d for 4 °C and 2.08 × 10-3 1/d for 25 °C. The loss of specific acidification activity after the storage at 4 and 25 °C was determined.

The relationship between the findings of vestibular evoked myogenic potentials and severity of obstructive sleep apnea syndrome.

PURPOSE: Our study aimed to evaluate the effects of chronic hypoxic state in Obstructive Sleep Apnea Syndrome (OSAS) on brainstem pathways using Vestibular Evoked Myogenic Potential (VEMP) test and to investigate the presence of new markers likely to be correlated with the severity of the disease. METHODS: The study was planned as prospective and double blind. A total of 60 patients (120 ears) diagnosed with mild, moderate and severe OSAS were included in the study and the patients are grouped as 20 patients in each group. Twenty volunteer healthy individuals (40 ears) shown to be without OSAS were included in the study. VEMP measurements were made in 60 study group patients (120 ears) and in 20 healthy controls (40 ears). The groups were compared in terms of variables such as the acquisition rate of oVEMP and cVEMP waves, interval between the waves, latency and amplitude of the waves. p < 0.05 values were considered as significant. RESULTS: The results of cVEMP test showed that the rate of wave acquisition in the moderate and severe OSAS groups was significantly lower than the control group and mild OSAS groups (p = 0.008). There was no difference between the control group and the mild OSAS group in terms of the rate of obtaining the wave (p > 0.05). In the moderate and severe OSAS groups, P1N1 amplitude and N1P2 amplitude values were found to be significantly lower than the mild OSAS group (p = 0.007 and p = 0.017, respectively). In the oVEMP test, there was no significant difference between the mild OSAS group and the control group in terms of the wave yield (p > 0.05); however, it was found that the rate of wave acquisition in the moderate and severe OSAS groups was significantly lower than the mild OSAS group (p = 0.041). There was inverse correlation between the N1P2 interval and P1N1 amplitude value and AHI in simple regression analysis and multiple regression analysis (p = 0.012 and p = 0.021; p = 0.009 and p = 0.040, respectively). CONCLUSION: The negative effects of chronic intermittent hypoxia related with OSAS on the brainstem and vestibular system can be demonstrated by VEMP tests. Especially, the inability to obtain the wave is the most important finding showing this situation. Also, we think that N1P2 interval and P1N1 amplitude markers can be used to detect the subclinical negative effect of chronic hypoxia on vestibular nuclei in the brainstem.

Viral prevalence, clinical profiles and comparison of severity scores for predicting the mortality of adults with severe acute respiratory infections

Background/aim: The aim of this study was to determine the accuracy of severity scores for predicting the 28-day mortality among adults with severe acute respiratory infection (SARI) admitted to the emergency department. Materials and methods: This study included 159 consecutive adult patients with SARI admitted to the emergency department of a tertiary hospital. A standard form was filled out in order to record demographic information, clinical parameters, laboratory tests, and radiographic findings of the patients. CURB-65, PSI, SIRS, qSOFA, SOFA and APACHE II scores were compared between the survivor and nonsurvivor groups. Results: Of 159 patients included in the study, 38.4% were positive for respiratory viruses and 28.3% were positive for influenza viruses. 35.8% of the patients were admitted to an intensive care unit (ICU) and the mortality rate was 36.5%. The area under the receiver operating characteristic curve of CURB-65, PSI, SIRS criteria, qSOFA, SOFA and APACHE II scores were 0.717, 0.712, 0.607, 0.683, 0.755, and 0.748, respectively in predicting mortality and 0.759, 0.744, 0.583, 0.728, 0.741, and 0.731, respectively in predicting ICU admission. Conclusion: SOFA and APACHE II were more accurate than SIRS in predicting the 28-day mortality among adults with SARI. There was no significant difference among these scores in terms of other multivariate comparisons.

Influence of thermosonication (TS) process on the quality parameters of high pressure homogenized hazelnut milk from hazelnut oil by-products.

Hazelnut, an important source of nutrition, is reasonably expensive for hazelnut milk production. Hazelnut cake, a by-product from hazelnut oil production by cold press extraction technique, does not contain any chemical residue and can be used for hazelnut beverage production. This study investigates the effects of thermosonication process on the quality parameters of hazelnut milks and also compares the observed results with the conventional thermal process. Different thermosonication conditions at different amplitude levels (40 and 60% amplitudes for 5, 10, 15, 20 and 25 min and 80% amplitude for 3, 5, 10 and 15 min) were studied for physicochemical and rheological properties, as well as microbial inactivation and bioactive compounds of hazelnut milk produced from the cold pressed hazelnut cake as byproduct of oil production. In general, sonication process significantly improved the total phenolic compounds, antioxidant activity, appearance and structural properties like syneresis, sedimentation, viscosity and consistency of samples. The application of thermosonication at 60% amplitude for 25 min and 80% amplitude for 15 min achieved complete inactivation of microorganisms (total aerobic mesophilic bacteria and yeast-mould). Complete inactivation of microorganisms was also achieved by conventional pasteurization at 85 °C, but this treatment caused some undesirable changes such as loses of bioactive compounds and deterioration of structural properties. The findings of the present study indicate that thermosonication can be successfully utilized for commercial processing of hazelnut milk with improved quality. This technique allows the production of hazelnut milks in safety and quality standards with highly nutritious then the conventional product.

Effects of Anatolian Propolis and Hypertonic Saline Combination Nasal Spray on Allergic Rhinitis Symptoms: A Prospective, Multicenter Study.

Objectives: This study aimed to evaluate how Rhinapi nasal spray affects symptoms of allergic rhinitis. Methods: In this prospective, multicenter, observational study, 10,000 patients (comprising 5028 males and 4972 females) exhibiting symptoms of allergic rhinitis (namely, nasal discharge, sneezing, nasal itching, and nasal obstruction) from different centers in different regions of Turkey were enrolled in the study between March 2022 and March 2023. All the patients wanted to participate in the study and were administered Rhinapi one puff to each nostril three times a day, for a period of 3 weeks. Total symptom scores, quality of life (QoL) scores, and otolaryngological examination scores were evaluated before and 3 weeks after treatment. Results: The scores for discharge from the nose, sneezing, nasal pruritus, and blockage of the nose all indicated improvement when compared to pre-medication and post-medication. This difference achieved statistical significance (P < .001). The mean total symptom score fell following treatment (P < .001): whilst the score was 11.09 ± 3.41 before administering Rhinapi; after administration, the average score was 6.23 ± 2.41. The mean QoL scores also altered after medication (P < .001), improving from a mean value of 6.44 ± 1.55 to a mean of 7.31 ± 1.24. Significant improvement was also noted in the scores for conchal color and degree of edema after the treatment had been administered (P < .001). Conclusion: The study demonstrates that Rhinapi nasal spray decreases total symptom scores, and results in improved QoL and otolaryngological examination scores. Propolis spray may be recommended for patients with allergic rhinitis alongside other treatments.

Levels of organochlorine pesticide residues in butter samples collected from the Black Sea Region of Turkey.

The aim of the present study was to evaluate the levels of 9 organochlorine compounds (aldrin, hexachlorobenzene, 2,4-DDE, 4,4-DDE, 2,4-DDT, 4,4-DDT, and α-, ß-, and γ-HCH) in butter samples collected in the Eastern, Middle and Western Black Sea Regions of Turkey between October 2009 and June 2010. The liquid-liquid extraction method was used to extract the organochlorine compounds from the samples and the measurements were performed by using a gas chromatograph-electron capture detector system. DDT metabolites, aldrin, hexachlorobenzene (HCB), and α-, and γ-HCH were not detected in the samples but ß-HCH was detected in 3 of a total of 88 samples. In the first period, only one sample from the West Black Sea Region was ß-HCH positive (0.014 mg kg(-1)). The other ß-HCH positive samples collected in Middle and West Black Sea Regions in the second period had a concentration of 0.066 and 0.019 mg kg(-1), respectively. All concentrations of the detected compounds exceeded the legal limits of 0.003 mg kg(-1) for ß-HCH, as prescribed by the Turkish Food Codex, and therefore pose a potential health risk for consumers. The contamination detected is most likely due to the past usage of ß-HCH in agriculture and its long term persistence in the environment. These results strongly suggest that further research should be focused on the detection of pesticide residues in agricultural areas across the nation.

Modifications to structural, techno-functional and rheological properties of sesame protein isolate by high pressure homogenization.

In this study, we aimed to determine the effect of high pressure homogenization (HPH) at a pressure up to 150 MPa on microstructural, techno-functional and rheological properties of sesame protein isolate (SPI). HPH treatment caused a partial change in the secondary structure of SPI, however, the changes in surface hydrophobicity and free -SH groups, indicating HPH had significant effect on the tertiary structure. After the HPH treatment, the particles dispersed homogeneously with more rougher surface. Sesame proteins had the smallest particle size (0.79 µm) and highest zeta potential (38.83 mV) at 100 MPa pressure. The most developed water/oil holding capacity, emulsification and foaming properties were achieved at 100 MPa pressure. However, the maximum stable foam formation (83.33 %) was determined at 150 MPa pressure. When the shear rate is fixed as 50 1/s, an increase in the viscosity value of the samples treated with 100 and 150 MPa pressure was detected compared to the control sample, while the lowest viscosity was determined the ones treated at 50 MPa. In all samples except 50 MPa pressure-treated proteins, viscoelastic character became dominant with increasing frequency (G' > G″). Modification with HPH resulted in a decrease of about 15 °C in the gelation temperature of SPI.

Effect of oleaster (Elaeagnus angustifolia L.) flour addition combined with high-pressure homogenization on the acidification kinetics, physicochemical, functional, and rheological properties of kefir.

In this study, the effects of peeled oleaster flour (OF) addition (0.5% and 1%) with high-pressure homogenization (HPH) at 100 MPa on acidification kinetics, physicochemical, functional, and rheological properties of kefir made from bovine whole milk were investigated. The fermentation kinetic parameters such as Vmax and T f decreased by 23.63% and 20%, respectively, with 1% OF and application of HPH. The combined use of two treatments had a positive effect on Lactobacillus and Lactococcus counts, reaching a maximum of 9.63 and 9.31 log cfu/mL, respectively. Also, total phenolic contents and antioxidant activity reached maximum values of 85.31 mg GAE/g and 17.22%, respectively. The ΔE value was more limited with HPH. The maximum firmness and water-holding capacity values were determined in the sample produced with 1% OF and application of HPH. Rheological analysis revealed that all kefirs exhibited shear thinning behavior, and the Ostwald-de-Waele (R 2 > .99) model was suitable to describe the rheological behavior of all kefir samples. The highest viscosity (0.049 Pa.s, at 50/s shear rate) and consistency index (1.115 Pa.sn) were observed in kefir with 1% OF and application of HPH. Kefir samples were characterized as weak gel behavior because storage modulus (G') was much greater than loss modulus (G") and the power-law model was used to characterize the viscoelasticity. The overall quality assessment indicated that the improvement of the fermentation process and the enhancement of textural and functional properties of kefir samples could be achieved with the addition of 1% OF and application of HPH.

Effect of cold-pressed hazelnut cake incorporation on the quality characteristic of meat emulsion system and its potential application for frankfurter-type beef sausages.

This research was performed to investigate the effect of hazelnut cake (HC) as a cold press waste product on the physicochemical and textural properties of the frankfurter-type sausages during cold storage. According to the highest emulsion capacity (174.14 mL oil/g), emulsion stability (79.86%), and optimum rheological results obtained in emulsions, 1% HC concentration was selected for the utilization in the sausage formulation. HC added sausage was compared with the control sample at 4°C for 60 days of storage. HC addition increased the hardness and chewiness properties and decreased weight loss of sausages during storage. The incorporation of HC in formulation slowed down the increase in malondialdehyde and conjugated dienes concentrations after the 15th day of storage compared to the control sausages. The results demonstrated that HC presented a good opportunity for protecting the quality parameters of emulsified meat products during storage.

Structural Characterization, Technofunctional and Rheological Properties of Sesame Proteins Treated by High-Intensity Ultrasound.

Plant-derived proteins, such as those from sesame seeds, have the potential to be used as versatile food ingredients. End-use functionality can be further improved by high-intensity ultrasound treatments. The effects of high-intensity ultrasound on the properties of sesame protein isolates from cold-pressed sesame cake were evaluated. The SDS-PAGE demonstrated no significant changes in the molecular weight of proteins. Ultrasound treatments resulted in decreased particle size with a more uniform distribution, resulting in the exposure of hydrophobicity and free -SH groups and increased zeta potential. Although FTIR spectra of proteins were similar after ultrasonication, a partial increase in the intensity of the amide A band was observed. The ultrasound significantly (p < 0.05) affected the secondary structure of proteins. While optical micrographics revealed a dispersed structure with smaller particles after treatments, microstructural observations indicated more rough and irregular surfaces. Water solubility was improved to 80.73% in the sample subjected to 6 min of ultrasonication. Sesame protein solutions treated for 4 and 6 min exhibited viscoelastic structure (storage modulus (G') > loss modulus (G'')). In addition, the gelation temperature of proteins decreased to about 60-65 °C with increasing treatment time. Overall, ultrasound is a useful technique for the modification of sesame protein isolates.

Influence of pH and ionic strength on the bulk and interfacial rheology and technofunctional properties of hazelnut meal protein isolate.

The functional, bulk, and interfacial shear rheological properties of hazelnut protein isolate were studied at different pH values between 3.0 and 8.0 and ionic strength levels between 0.0 and 1.0 M. The results showed that pH significantly affected protein solubility, emulsion properties, water and oil holding capacities, foam stability, surface hydrophobicity, and free -SH groups. The highest surface hydrophobicity, free -SH groups, and better functional properties were observed at pH 8.0. Protein solubility also increased with increasing ionic strength up to 0.6 M. The emulsion and foam stability of hazelnut protein isolate showed similar changes with protein solubility. The flow behavior of hazelnut protein suspensions was found to be shear thinning with the highest consistency index at pH 3.0 and the lowest at pH 6.0, however, the ionic strength did not significantly affect the consistency coefficient but did cause a significant change in the flow behavior index, with the lowest value observed at 0.6 M. The best gel structure in hazelnut proteins was observed at pH 3.0 and 4.0. The addition of ions at 0.4 and 0.6 M concentrations resulted in an improved viscoelastic character. The hazelnut protein isolate was also found to form solid-like viscoelastic layers at both air-water and oil-water interfaces, with the interfacial adsorption behavior affected by both pH and ionic strength. Overall, these results suggest that pH and ionic strength have significant effects on the functional and rheological properties of hazelnut protein isolate, which may have the potential as an auxiliary substance in food systems.

A Wireless and Wearable Body-Pressure-Monitoring System for the Prevention of Pressure-Induced Skin Injuries.

This article presents a wireless and wearable body-pressure-monitoring system for the on-site, real-time prevention of pressure injuries for immobilized patients. For the prevention of pressure-induced skin injuries, a wearable pressure sensor system is designed to monitor the pressure at multiple sites on the skin and to alert the danger of prolonged application of pressure on the skin with a pressure-time integral (PTI) algorithm. The wearable sensor unit is developed using a pressure sensor based on a liquid metal microchannel and integrated with a flexible printed circuit board that includes a thermistor-type temperature sensor. The wearable sensor unit array is connected to the readout system board for the transmission of measured signals to a mobile device or PC via Bluetooth communication. We evaluate the pressure-sensing performances of the sensor unit and the feasibility of the wireless and wearable body-pressure-monitoring system through an indoor test and a preliminary clinical test at the hospital. It is shown that the presented pressure sensor has high-quality performance with excellent sensitivity to detect both high and low pressure. The proposed system measures the pressure at bony sites on the skin for about six hours continuously without any disconnection or failure, and the PTI-based alarming system operates successfully in the clinical setup. The system measures the pressure applied to the patient and provides meaningful information from the measured data for early diagnosis and prevention of bedsores to doctors, nurses, and healthcare workers.

Low-Power, Multi-Transduction Nanosensor Array for Accurate Sensing of Flammable and Toxic Gases.

Toxic and flammable gases pose a major safety risk in industrial settings; thus, their portable sensing is desired, which requires sensors with fast response, low-power consumption, and accurate detection. Herein, a low-power, multi-transduction array is presented for the accurate sensing of flammable and toxic gases. Specifically, four different sensors are integrated on a micro-electro-mechanical-systems platform consisting of bridge-type microheaters. To produce distinct fingerprints for enhanced selectivity, the four sensors operate based on two different transduction mechanisms: chemiresistive and calorimetric sensing. Local, in situ synthesis routes are used to integrate nanostructured materials (ZnO, CuO, and Pt Black) for the sensors on the microheaters. The transient responses of the four sensors are fed to a convolutional neural network for real-time classification and regression of five different gases (H2 , NO2 , C2 H6 O, CO, and NH3 ). An overall classification accuracy of 97.95%, an average regression error of 14%, and a power consumption of 7 mW per device are obtained. The combination of a versatile low-power platform, local integration of nanomaterials, different transduction mechanisms, and a real-time machine learning strategy presented herein helps advance the constant need to simultaneously achieve fast, low-power, and selective gas sensing of flammable and toxic gases.