Diaper need in the United States: A nationally representative study during the COVID-19 pandemic.

Background: Diapers represent a unique financial burden for those with young children. Pre-pandemic, approximately one in three U.S. households with young children reported diaper need or an insufficient supply of diapers. To support this population, policymakers, clinicians, and service providers need a better understanding of the groups most commonly affected and the ways that families cope with deprivation. Methods: An online survey was administered between February and July 2021 to a national sample of U.S. caregivers of at least one child aged 0-4 years in diapers (n = 881), investigating diaper need, diaper access, and how household expenses are balanced and prioritized vis-à-vis diapers. We use bivariate and multivariable models to assess factors associated with diaper need, and examine coping strategies, tradeoffs made to purchase diapers, and how caregivers would reallocate their money if diapers were accounted for. Findings: The prevalence of diaper need (46 %) exceeded pre-pandemic estimates. Diaper need was more prevalent among Hispanic respondents, lower income respondents, cloth diaper users, those with more than one child in diapers, caretakers with depression, and those with a negative financial change in the past year. Caretakers with diaper need were more likely to utilize a range of resources to access diapers and to use diapers for longer than desired to extend their supply. Those with diaper need also made more economic tradeoffs to afford diapers and indicated that they would reallocate resources to cover other unmet basic needs if they did not have to buy diapers. Interpretation: Our results indicate elevated levels of diaper need even after the U.S. economy had largely rebounded and raise concerns that inequities in diaper access may impact families' abilities to meet other basic needs. Diapers may be an important target for policies and interventions aimed at improving the well-being of families with young children.

Birth outcomes following in utero co-exposure to tobacco and marijuana.

BACKGROUND: With recent changes in tobacco and marijuana use patterns, it becomes crucial to understand how the prenatal co-use of these substances impacts birth outcomes. The goal of this study was to examine the risk of adverse birth outcomes among infants born to women who used tobacco and marijuana concurrently throughout pregnancy compared to infants of women who used tobacco alone. METHODS: This study involved a retrospective chart review of pregnant women identified via self-report or biochemical testing who used tobacco products alone (N = 71) or tobacco and marijuana simultaneously (N = 127) at any point throughout pregnancy. Differences in birth outcomes between these groups, including APGAR (appearance, pulse, grimace, activity, and respiration) scores, respiratory distress, neonatal intensive care unit admission, intrauterine growth restriction, birth weight, birth length, head circumference, gestational age, and length of hospital stay, were analyzed using linear regression and odds ratio analysis. RESULTS: There were no significant differences in outcomes for infants of women who used tobacco and marijuana compared to infants of women who used tobacco alone during pregnancy. Rates of adverse birth outcomes were high among women who used tobacco compared to what would be expected in unexposed pregnancies. CONCLUSIONS: Tobacco and marijuana co-use during pregnancy was not associated with an additional risk of adverse birth outcomes compared to tobacco use alone. Women should be educated on potential risks of marijuana, and especially, tobacco use during pregnancy. These results will inform clinical recommendations for pregnant women using tobacco and marijuana, aiming to decrease preventable adverse outcomes for patients and infants.

Does in-brace correction affect coronal spinal and thoracic cage parameters in individuals with idiopathic scoliosis? A retrospective cohort study.

The aim of the study is to identify the effects of in-brace correction on coronal spinal and thoracic cage parameters in individuals with idiopathic scoliosis (IS). The coronal spinal parameters [Cobb angle, apical vertebral rotation (AVR), lateral trunk shift, coronal alignment, biacromial slope and pelvic asymmetry] and the thoracic cage parameters [T1- 12 height, T1-S1 height, thoracic transverse diameter, and apical vertebral body-rib ratio (AVB-R)] of 89 child and adolescent patients were measured on posterior-anterior full-spine radiographs at pre-brace and in-brace conditions using Surgimap software. The initial in-brace correction (IBC) was calculated as a percentage decrease in the Cobb angle on the in-brace radiographs. The mean IBC rate for the primary curve was 37% (range = 10-100%). In the in- brace condition, the Cobb angle (p<0.001), AVR (p<0.001) and lateral trunk shift (p<0.001) decreased significantly; no statistically significant difference was found in the biacromial slope (p=0.713) and the coronal alignment (p=0.074). The T1-12 height and the T1-S1 height increased significantly (p<0.001) whereas the thoracic transverse diameter and the AVB-R decreased significantly (p<0.001). Unlike IBC rate was below 30% as IBC rate was above 30%, the T1-12 height (p<0.001) increased and the AVB-R decreased (p<0.001). The bracing improved the lateral trunk shift, the AVB-R, the thoracic and spine heights, but decreased the thoracic transverse diameter. The thoracic cage parameters may be better when the IBC rate is above 30%.

In utero effects of opioids on fetal growth.

BACKGROUND: Studies indicate antenatal opioid use is associated with birth size deficits, as evidenced by reductions in birth weight and head circumference. However, there remains a limited understanding of how early this growth restriction occurs, and what specific parameters are affected. This novel study evaluated global and specific growth deficits associated with prenatal opioid exposure between 18-22 weeks' gestation as assessed during anatomy ultrasounds. METHODS: Pregnant women who completed an anatomy ultrasound were identified via electronic medical records from a large academic obstetric practice. The study group used opioids, with tobacco and/or marijuana use permitted (n = 41). The control group could have used tobacco and/or marijuana, but not opioids (n = 308). Neither group had alcohol or other drug exposure. Records were reviewed for medical history and ultrasound size parameters, coded as percentiles for gestational age. RESULTS: Demographics and medical histories were compared with several significant differences noted. After controlling for these differences, significant (p < 0.05) growth deficits were identified in opioid-exposed fetuses. Specifically, reductions >10 percentile points were observed in head circumference, biparietal diameter, and humerus length for opioid-exposed fetuses compared to controls. Additionally, intrauterine growth restriction (IUGR) was diagnosed five times more often. Femur length was significantly reduced in opioid-exposed fetuses prior to adjustment for confounding (p = .016), but this reduction was not significant (p = .072) after controlling for background differences. Estimated fetal weight (p = .274) and abdominal circumference (p = .633) were not significantly different between exposure groups. CONCLUSION: Fetal opioid exposure predicted various bone growth deficits during routine anatomy ultrasound, indicating the effects of opioid exposure on size deficits may be evident as early as 18-22 weeks' gestation. These findings may also suggest that in utero opioid exposure negatively impacts bone growth specifically rather than weight or fat/muscle mass. Additional studies with larger sample sizes may also reveal significantly reduced femur length, further supporting a negative impact on bone growth. Future studies evaluating bone health and immune function in children after antenatal opioid exposure may help clarify this specific effect of opioids on bone development.

A new index for predicting malignant causes in patients with extrahepatic biliary obstruction: the hemoglobin, albumin, lymphocyte, and platelet (HALP) score.

OBJECTIVE: The study aimed to investigate whether the pre-procedural hemoglobin, albumin, lymphocyte, and platelet (HALP) scores can distinguish between benign and malignant causes of obstruction in patients who undergo endoscopic retrograde cholangiopancreatography (ERCP) for extrahepatic biliary obstruction (EBO). PATIENTS AND METHODS: The HALP scores of the patients were calculated according to the values before ERCP. The patients were divided into two groups as malignant and benign according to their diagnosis after ERCP. The HALP scores, demographic characteristics, and some laboratory data of the groups were compared. The cut-off values of the HALP scores were found to detect malignant obstructive causes using the receiver operating characteristic (ROC) curve analysis. RESULTS: A total of 295 patients had benign and 50 had malignant causes of obstruction among the total of 345 patients. The HALP score was found to be lower in the patient group with malignant biliary obstruction (p = 0.013). The ROC curve analysis was used to determine the diagnostic efficiency, and an area under the curve (AUC) of 0.610 was obtained (0.526-0.693, 95% CI) (p = 0.013). For the HALP score, the sensitivity was found to be 82.4% and the specificity was 30% when a cut-off value of <12.54 was used, and the sensitivity was 61.4% and specificity was 52% when the cut-off value was <21.25. CONCLUSIONS: The study showed that a low HALP score can distinguish malignant causes in patients with EBO. We think that the HALP score, which is a low-cost index that can be easily calculated with simple tests, can be used in this patient population because it may allow early diagnosis of malignant causes in patients with EBO.

Anhedonia in Relation to Reward and Effort Learning in Young People with Depression Symptoms.

Anhedonia, a central depression symptom, is associated with impairments in reward processing. However, it is not well understood which sub-components of reward processing (anticipation, motivation, consummation, and learning) are impaired in association with anhedonia in depression. In particular, it is unclear how learning about different rewards and the effort needed to obtain them might be associated with anhedonia and depression symptoms. Therefore, we examined learning in young people (N = 132, mean age 20, range 17-25 yrs.) with a range of depression and anhedonia symptoms using a probabilistic instrumental learning task. The task required participants to learn which options to choose to maximize their reward outcomes across three conditions (chocolate taste, puppy images, or money) and to minimize the physical effort required to obtain the rewards. Additionally, we collected questionnaire measures of anticipatory and consummatory anhedonia, as well as subjective reports of "liking", "wanting" and "willingness to exert effort" for the rewards used in the task. We found that as anticipatory anhedonia increased, subjective liking and wanting of rewards decreased. Moreover, higher anticipatory anhedonia was significantly associated with lower reward learning accuracy, and participants demonstrated significantly higher reward learning than effort learning accuracy. To our knowledge, this is the first study observing an association of anhedonia with reward liking, wanting, and learning when reward and effort learning are measured simultaneously. Our findings suggest an impaired ability to learn from rewarding outcomes could contribute to anhedonia in young people. Future longitudinal research is needed to confirm this and reveal the specific aspects of reward learning that predict anhedonia. These aspects could then be targeted by novel anhedonia interventions.

PITUITARY FUNCTIONS AFTER RECOVERY FROM COVID-19.

Context: Injury and functional disorders in pituitary gland after COVID-19 still need elucidation. Objective: To investigate pituitary functions, particularly hypothalamic pituitary adrenal (HPA) axis after COVID-19 infection. Methods: This study was conducted at a university hospital between May and October 2021. Patients who had COVID-19, were enrolled as study group, three months after recovery. Participants who do not have COVID-19 diagnosis, with similar characteristics were included as control group. Blood samples were taken on the morning at 08 AM. Adrenal stimulation test was performed with 1 µg of ACTH (Synacthen). Results: The study group included 50 patients and control group was 49 cases. One (2%) out of the 50 patients with 8 a.m. serum cortisol below 5 µg/dL. Low serum ACTH levels were detected in 7 (14%) participants in patient group. Stimulation with 1 µg of ACTH (Synacthen) test was performed for 2 (4%) of 50 patients with serum cortisol below 10 µg/dL. Both patients achieved a peak cortisol of over 12.5 µg/dL after stimulation. Standard deviation (SD) score for insulin like growh factor-1 (IGF-1) was lower than -2 SD for age and gender in 7 (14%) patients. TSH levels was mildly increased in five (10%) patients. There was no significant difference in baseline pituitary hormone levels in study and control groups. Conclusion: Basal pituitary hormone levels and HPA axes were found to be preserved and competently functioning in patients who experienced mild/moderate COVID-19. However, symptoms observed after COVID-19 episode were evident in substantial amount of patients in this study and these symptoms were not associated with changes in pituitary gland function.

The Use of Dynamic Cognitive Behavioural Therapy (DCBT) in Social Anxiety Disorder (SAD): A Theoretical Integration Initiative.

Psychotherapy theorists can often become fervent advocates of the schools they follow and place the doctrines of the theories they adopt above all else. This situation can sometimes turn into a war of theories between researchers as well. However, therapists should not aim to shape therapy sessions according to their methods but to use them in line with clients' needs. Although it is emphasised that the integration of both psychoanalytic and cognitive behavioural therapy techniques, which is going to be named dynamic cognitive behavioural therapy (DCBT) in this case report, will provide more effective and permanent treatment, a discernible gap exists regarding the integration of these theories and their use in psychotherapy. Taking into account this gap, it is considered important to use this approach with a client who has a social anxiety disorder (SAD). Therefore, this study aims to describe the almost forgotten DCBT approach step by step through a case report and reveal the effectiveness of this approach. As a result, DCBT seems to be effective in the treatment of SAD.

The effect of the COVID-19 pandemic lockdown on symptom severity in school children with house dust mite-sensitized allergic rhinitis.

Study objective: The lockdown imposed on children due to the COVID-19 pandemic and their inability to attend school increased their exposure to indoor allergens by causing them to spend more time indoors. In this study, the aim was to reveal the effect of the pandemic and increased exposure to indoor aeroallergens on the symptom severity of school-age children with house dust mite-sensitized allergic rhinitis (AR). Patients and methods: Patients between the ages of 6-18-years old, who were followed-up with the diagnosis of perennial AR sensitized to only mites were questioned about their sinonasal symptoms. The Total Nasal Symptom Score (TNSS) questionnaire was performed. The clinical findings, drug usage, frequency of infections and attacks were evaluated and compared during COVID-19 lockdown and the same time frame in 2019. Results: Sixty-five patients had AR, and 33 patients (50.8%) had AR with asthma. TNSS of the patients improved during the pandemic (P < 0.001) and their medication scores decreased significantly (P < 0.001). The frequency of respiratory tract infections and asthma attacks decreased significantly (P < 0.001). In multivariate analysis, risk factors were evaluated for the 'group with worsening TNSS' and coal/wood burning was detected to be an independent risk factor (P = 0.006; OR = 10.09 (95% CI: 1.97-51.87)). Conclusion: Although the increased stay at home, it is surprising that nasal symptoms improved in our patients. This result suggests that whereas allergen sensitivity is responsible for the pathogenesis of AR, exposure to pollution and viral infections which are reduced by masking and social distance may also play an important role in the pathogenesis.

Introduction: Le confinement imposé aux enfants en raison de la pandémie de COVID-19, l'impossibilité pour les enfants d'aller à l'école; ont augmenté leur exposition aux allergènes intérieurs en les obligeant à passer plus de temps à l'intérieur. Dans cette étude, il visait à révéler l'effet de la période pandémique et de l'exposition accrue aux aéroallergènes intérieurs sur la sévérité des symptômes des enfants d'âge scolaire atteints de rhinite allergique (RA) sensibilisée aux acariens. Méthode: Patients âgés de 6 à 18 ans, qui ont été suivis avec le diagnostic de RA perannuelle avec seulement des acariens sensibilisés; ont été interrogés sur leurs symptômes naso-sinusiens. Le questionnaire Total Nasal Symptom Score (TNSS) a été réalisé. Leurs résultats cliniques, l'utilisation de médicaments, la fréquence des infections et des attaques ont été évalués et comparés pendant le verrouillage de COVID-19 et la même période de 2019. Résultats: Soixante-cinq patients avaient une RA et 33 patients (50,8 %) avaient une RA avec asthme. Le TNSS des patients pendant la période pandémique s'est amélioré (p < 0,001) et leurs scores de médication ont diminué de manière significative (p < 0,001). La fréquence des infections des voies respiratoires et des crises d'asthme a diminué significativement (p < 0,001). En analyse multivariée, les facteurs de risque ont été évalués pour le « groupe d'aggravation du TNSS ¼, la combustion de charbon/bois a été détectée comme étant un facteur de risque indépendant (p = 0,006 ; OR = 10,09 (IC95 % : 1,97­51,87)). Conclusion: Malgré l'augmentation du séjour à domicile, il est surprenant que les symptômes nasaux de nos patients se soient améliorés. Ce résultat suggère que si la sensibilité aux allergènes est responsable de la pathogenèse de la RA, l'exposition à la pollution et aux infections virales qui sont réduites par le masque et la distance sociale peuvent également jouer un rôle important dans la pathogenèse.

Effects of COVID-19 on Adolescent Mental Health and Internet Use by Ethnicity and Gender: A Mixed-Method Study.

Evidence suggests that mental health problems in young people have been exacerbated by COVID-19, possibly related to a lack of social connection. Young people report using the internet for connecting with their peers and mental health support. However, how they may have used the internet for support during COVID-19 is not clear. We wanted to know how mood and internet use may have changed in young people during COVID-19 and if this was different for those with and without depression symptoms. 108 adolescents were recruited. Participants with high and low levels of depressive symptomatology answered questions about their mood, internet use, loneliness and life satisfaction during July and August 2020. We found that the high depression group reported significantly more loneliness and less life satisfaction than the low depression group. We found that most young people used the internet for mental health information during COVID-19 but that the high depression group used the internet more for mental health information than the low depression group. The high depression group also had a worsening of mood compared to the low depression group during COVID-19. We found that Black, Asian and Minority Ethnic participants reported increased use of the internet compared to White participants during COVID-19 and that the role of the family facilitated coping during COVID-19 for some adolescents, but for others, it made the lockdown more difficult. Finally, we found that adolescents perceived school anxiety as stressful as COVID-19. To conclude this study supports the use of the internet as a way to help young people with mental health challenges. It also suggests that the internet is a way to help young people from ethnic minorities, who otherwise might be hard to reach, during challenging times. This study also shows that supportive family units can be important during times of stress for young people and that school anxiety is a major issue for young people in today's society even outside of the pandemic.

Role and limitations of high-flow nasal oxygen therapy in COVID-19 patients: An observational study.

Background: The management of acute respiratory failure in COVID-19 patients and the role and limitations of high-flow nasal oxygen therapy (HFNOT) remain unclear. Aim: This study aimed to investigate the effect of HFNOT, identify the characteristics of patients who will benefit from therapy, and determine monitoring strategies to decide on endotracheal intubation for patients with COVID-19. Patients and Methods: We conducted a prospective observational study of COVID-19 patients who were admitted to the intensive care unit (ICU) and required HFNOT for at least 2 days between 20 March 2020 and 20 June 2020. The exclusion criteria were a severe respiratory failure, reduced levels of consciousness, combination with other noninvasive ventilation strategies, and exhaustion. The patients were followed up until ICU discharge. The primary outcome was the proportion of patients with COVID-19 who were successfully weaned from HFNOT, whereas failure comprised intubation or death on HFNOT. Results: Thirty-five subjects (24 males, mean-age: 61.62, standard deviation: 14.9 yr.) were included in the study. A total of 20/35 (57.1%) subjects survived to discharge. C-reactive-protein (CRP) and interleukin-6 (IL-6) levels were significantly increased in the treatment failure group (CRP; effect size (r):0.35, P: 0.037, IL-6; r: 0.37, P: 0.03). Although there was a difference between repeated measures of partial-pressure-of-oxygen/fraction-of-inspired-oxygen (PaO2/FiO2:P/F) rates (partial-eta-squared (ηp2):0.79, P < 0.001), no difference was found between carbon dioxide levels (ηp2:0.29, p: 0.44). There was also no difference between ROX (ratio-of-oxygen-saturation/FiO2 to respiratory-rate) rates (Kendall's W: 0.33 P = 0.310). Conclusion: In COVID-19 patients with mild-to-moderate dyspnea and hypoxemia who are nonresponsive to conventional-oxygen-therapies, the initial approach may involve the use of HFNOT. In this study, patient monitoring could be performed with ROX and P/F ratios, and the effectiveness of the treatment could be decided by looking at these rates in the second hour. Prolongation of the period and awake prone positioning did not improve the outcome.

The relationship of psychological status and sociodemographic factors with bruxism among undergraduate dental students: A national survey.

Background: Although its etiology is not fully known, the accepted view is that bruxism is a multifactorial disorder. Aims: This study aims to evaluate the prevalance of self-reported bruxism and to investigate its relationship with psychological and sociodemographical factors amongst undergraduate dental students in Zonguldak, Turkey. Subjects and Methods: 250 dental students were asked to fill the bruxism questionnaire - to detect the prevelance of bruxism; personal information form - to determine sociodemographic variables; and symptom checklist-90-R (SCL-90-R) - to asses psychological state. Data were analyzed statistically by Kolmogorov Smirnov, Shapiro Wilk, Mann Whitney U, and Kruskal Wallis tests through Statistical Package for the Social Sciences (SPSS) program. Results: The prevalance of self-reported bruxism was 40%. 46% of the students showed higher levels of psychological symptoms. SCL-90-R subscales showed statistically significant differences in students with bruxism compared to those without bruxism (P < 0.05). It was observed that bruxism was associated with gender (P < 0.05) and both bruxism and psychological symptom levels were statistically higher in females (P < 0.05). Conclusions: The findings revealed that, although bruxism was common among dental students, gender and psychosocial factors are also mostly associated with the etiology of bruxism. In this context, during the challenging dentistry education period, it is important to direct students who are found to have high levels of psychological symptoms to psychological counseling and guidance services.

Hip dislocation based on Developmental Dysplasia of the Hip (DDH) in a patient with Giant Congenital Melanocytic Nevus (GCMN): A rare coexistence.

Giant congenital melanocytic nevus (GCMN) is a rare congenital benign neoplasm with the potential to become malignant. Various extracutaneous malformations may accompany GCMN. Acetabular dysplasia accompanying GCMN was described in previous studies. To the best of our knowledge, this case report of ours is the first reported case of GCMN diagnosed and treated with hip dislocation based on developmental dysplasia of the hip (DDH). The rare coexistence prompted us to report this case.

Current clinical practice for thromboprophylaxis management in patients with Cushing's syndrome across reference centers of the European Reference Network on Rare Endocrine Conditions (Endo-ERN).

BACKGROUND: Cushing's syndrome (CS) is associated with an hypercoagulable state and an increased risk of venous thromboembolism (VTE). Evidence-based guidelines on thromboprophylaxis strategies in patients with CS are currently lacking. We aimed to map the current clinical practice for thromboprophylaxis management in patients with CS across reference centers (RCs) of the European Reference Network on Rare Endocrine Conditions (Endo-ERN), which are endorsed specifically for the diagnosis and treatment of CS. Using the EU survey tool, a primary screening survey, and subsequently a secondary, more in-depth survey were developed. RESULTS: The majority of the RCs provided thromboprophylaxis to patients with CS (n = 23/25), although only one center had a standardized thromboprophylaxis protocol (n = 1/23). RCs most frequently started thromboprophylaxis from CS diagnosis onwards (n = 11/23), and the majority stopped thromboprophylaxis based on individual patient characteristics, rather than standardized treatment duration (n = 15/23). Factors influencing the initiation of thromboprophylaxis were 'medical history of VTE' (n = 15/23) and 'severity of hypercortisolism' (n = 15/23). Low-Molecular-Weight-Heparin was selected as the first-choice anticoagulant drug for thromboprophylaxis by all RCs (n = 23/23). Postoperatively, the majority of RCs reported 'severe immobilization' as an indication to start thromboprophylaxis in patients with CS (n = 15/25). Most RCs (n = 19/25) did not provide standardized testing for variables of hemostasis in the postoperative care of CS. Furthermore, the majority of the RCs provided preoperative medical treatment to patients with CS (n = 23/25). About half of these RCs (n = 12/23) took a previous VTE into account when starting preoperative medical treatment, and about two-thirds (n = 15/23) included 'reduction of VTE risk' as a goal of treatment. CONCLUSIONS: There is a large practice variation regarding thromboprophylaxis management and perioperative medical treatment in patients with CS, even in Endo-ERN RCs. Randomized controlled trials are needed to establish the optimal prophylactic anticoagulant regimen, carefully balancing the increased risk of (perioperative) bleeding, and the presence of additional risk factors for thrombosis.

Bone dehiscences of medial orbital wall on computed tomography and assessment of terminological errors in literature.

BACKGROUND: The objective of this study is to investigate the position and frequency of dehiscences in the medial orbital wall and to reveal that dehiscences and orbital adipose tissue hernias are distinct entities. MATERIALS AND METHODS: Two hundred-thirty medial orbital walls of 115 patients with a preliminary diagnosis of headache and sinusitis but without active ethmoidal sinusitis were examined by computer tomography in the axial plane. Two separate radiologists assessed continuity of the medial orbital wall and orbital fat tissue herniation in ethmoid cells. The medial orbital wall was divided into four quadrants and the dehiscence distribution was evaluated. RESULTS: Bone defects were detected in 71 (30.9%) patients in 230 orbital medial wall reviews of 115 patients (59 males, 56 females). Eight (3.5%) of these cases (4 male, 4 female) had herniation of the orbital adipose tissue into the ethmoid sinus. Of the 108 dehiscences, 47 were localised in the posterior upper quadrant. A statistically significant difference was found in the dehiscence distribution according to the quadrants. No significant relationship was found among age, gender, side of dehiscence and frequency of dehiscence. CONCLUSIONS: Dehiscences in the posterior upper quadrant are more common in the medial orbital wall. Although bone dehiscences in the medial orbital wall and the herniation of the orbital fat tissue are two different entities, they are used interchangeably in most of the literature and in radiological reporting.

Effects of barrier perch access and early dietary protein and energy dilution on some welfare parameters, tibiotarsus measurements, fear and mobility level in broiler chickens.

1. This experiment determined the effect of increasing mobility in broiler chickens by placing barrier perches between feeders and drinkers. In addition, the limitation of early weight gain by dietary energy and protein dilution on some welfare parameters, tibiotarsus measurements, fear and mobility level was examined.2. A total of 504 male, one-day-old broiler chickens (Ross 308) were randomly allocated to four treatments with three replicate pens per treatment and 42 broiler chickens per pen as a 2 × 2 factorial arrangement. Treatments included feeding the basal control diet between 0-42 days or a diet diluted by 10% energy and 20% crude protein fed between 0-21 d, with the control diet fed between 22-42 d. The second factor was the presence or absence of barrier perches. All treatments were allocated as a completely randomised design. Welfare parameters (foot pad dermatitis, hock burn, gait score, feather score, breast blister), tibiotarsus measurements (bone mineral content, bone mineral density, fluctuating asymmetry and relative fluctuating asymmetry), tonic immobility and mobility level were recorded.3. Results showed that access to a barrier perch and the diluted diet increased the mobility in broiler chickens. However, access to a barrier perch had no significant effect on tibiotarsus and welfare parameters. Broiler chickens had better gait scores (P < 0.05) and lower foot pad dermatitis incidence (P < 0.01) in groups fed the diluted diet. The diluted diet had no significant effect on bone mineral density but reduced the tibiotarsus bone mineral content (P < 0.05).4. In conclusion, the diluted diet provided positive effects in terms of leg health due to weight gain limitations in the early period, thus improving broiler chicken welfare.

A retrospective analysis of intensive care unit patients during the pandemic period.

aimed to evaluate the laboratory parameters, risk factors, and success in predicting mortality in COVID-19 patients admitted to our hospital's intensive care units (ICUs). METHODS: Levels of procalcitonin, ferritin, D-dimer, CRP and albumin measured on days 1 and 7 were recorded. Patients were divided into two groups as non-survivors and patients, who were discharged from ICUs. The predictive values of laboratory parameters in predicting COVID-19 mortality were investigated. RESULTS: A statistically significant difference was detected between the two groups in the mean values of all laboratory parameters tested on days 1 and 7, including D-dimer, procalcitonin, CRP, WBC, ferritin (excluding only D-dimer levels and WBC counts on day 1; p=0.061 and p=0.243, respectively) (p<0.001, p<0.001, p<0.001, p=0.013, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001; respectively). CONCLUSION: . It can be argued that procalcitonin, ferritin, and D-dimer can be guiding parameters in predicting mortality in COVID-19 because their levels were found to be significantly higher in non-survivors. D-dimer, procalcitonin, and ferritin showed an almost high level of sensitivity and specificity in predicting mortality (Tab. 5, Fig. 3, Ref. 19).

Potential therapeutic road for targeting the SARS-CoV-2 at throat.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) has become a serious public health problem for    183 out of 197 countries in the world. Understanding the routes and pathogenesis of the coronavirus is important and it is considered that the studies on host cell receptor Angiotensin Converting Enzyme 2 (ACE2) may be valuable for the treatment and prevention of the disease. AIM: To evaluate the possibility of inhibition of SARS-CoV-2 at throat. METHODS: A comprehensive literature search was conducted. CONCLUSION: In view of the fact that the mouth and nose have higher number of ACE2 expressed cells, they serve as a gateway for the virus to enter. Thus, blocking the gate could be a good choice to reduce or even prevent the transmission. Small interfering RNAs (siRNAs) are double-stranded RNA molecules and could be designed easily and directed against many strains of a virus. Due to their features, siRNAs can provide a potential strategy to interfere with the replication of viral diseases. We think that since oral and nasal epithelial cells are relatively easily accessible it may allow to develop siRNA molecules to inhibit SARS-CoV-2 already at the entry where it continues to replicate for a period (Fig. 1, Ref. 50).

Anaerobic co-digestion of oil-extracted spent coffee grounds with various wastes: Experimental and kinetic modeling studies.

The effect of oil extraction from spent coffee grounds as a pre-treatment strategy prior to anaerobic digestion besides assessing the feasibility of defatted spent coffee grounds co-digestion with spent tea waste, glycerin, and macroalgae were examined. Mesophilic BMP tests were performed using defatted spent coffee grounds alongside four co-substrates in the ratio of 25, 50, and 75%, respectively. The highest methane yield was obtained with the mono-digestion of defatted spent coffee grounds with 336 ± 7 mL CH4/g VS and the yield increased with the increase in the mass ratio of defatted spent coffee grounds during co-digestion. Moreover, defatted spent coffee grounds showed the highest VS and TS removal at 35.5% and 32.1%, respectively and decreased thereafter. Finally, a linear regression model for the interaction effects between substrates was demonstrated and showed that distinctly mixing defatted spent coffee grounds, spent coffee grounds, and spent tea waste outperforms other triple mixed substrates.

Sonoelastographic evaluation of the masseter muscle before and after mandibular setback surgery.

AIMS: The purpose of this study is to compare the thickness and elasticity of the masseter muscle before and after orthognathic surgery in patients with class III skeletal deformity and to investigate the relationship between the sonographic changes in the masseter muscle and the amount of mandibular setback. SUBJECTS AND METHODS: The study group consisted of 14 patients with skeletal class III malocclusions who had orthognathic surgery. The control group consisted of 14 patients who had dental and skeletal class I occlusion. Muscle thickness measurements were performed with B-mode and high-frequency linear scanning probe of the ultrasound device. Elastography feature and muscle hardness ratio were obtained by applying compression and decompression on muscles at rest and during maximum contraction in the transverse plane. Patients were categorized into two groups according to the mandibular setback as <5 mm and ≥5 mm. RESULTS: The masseter muscle thickness after surgery was found statistically increased bilaterally in both at rest and during contraction for the study group (P < 0.05). No difference was found between preoperative orthognathic measurements and postoperative measurements for elasticity index ratio measurements (P > 0.05). CONCLUSION: We believe that in the present study important findings have been emphasized for further research aiming to investigate the possible relationship between masticatory alterations and surgical outcomes after orthognathic surgery.