Quantifying cognitive and affective impacts of Quizlet on learning outcomes: a systematic review and comprehensive meta-analysis.

Background: This study synthesizes research on the impact of Quizlet on learners' vocabulary learning achievement, retention, and attitude. Quizlet's implementation in language education is posited to enhance the learning experience by facilitating the efficient and engaging assimilation of new linguistic concepts. The study aims to determine the extent to which Quizlet influences vocabulary learning achievement, retention, and attitude. Methods: Employing a meta-analysis approach, this study investigates the primary research question: "Does Quizlet affect students' vocabulary learning achievement, learning retention, and attitude?" Data were collected from various databases, identifying 94 studies, of which 23 met the inclusion criteria. The coding reliability was established at 98%, indicating a high degree of agreement among experts. A combination of random and fixed effects models was used to analyze the effect size of Quizlet on each outcome variable. Results: Quizlet was found to have a statistically significant impact on learners' vocabulary learning achievement, retention, and attitude. Specifically, it showed moderate effects on vocabulary learning achievement (g = 0.62) and retention (g = 0.74), and a small effect on student attitude (g = 0.37). The adoption of the fixed effects model for attitude was due to homogeneous distribution, while the random effects model was used for achievement and retention because of heterogeneous distribution. Conclusion: Quizlet enhances vocabulary learning achievement, retention, and has small positive effect on learner attitude. Its integration into language education curricula is recommended to leverage these benefits. Further research is encouraged to explore the optimization of Quizlet and similar platforms for educational success.

Analysis of the Causes of Newborn Priapism: A Retrospective Clinical Study.

Priapism is a rare condition in the newborn. The aim of this study was to investigate the demographic, etiologic and clinical features of neonatal priapism. We retrospectively analysed the data of 11 patients diagnosed with neonatal priapism in the neonatal intensive care unit between 2000 and 2019. Priapism was defined as an erection in the neonatal period, lasting more than 4 hours. Etiological examinations revealed polycythemia in one (9.09%) patient, D-dimer elevation in three patients, and heterozygous methyltetrahydrofolate 667 gene mutations in one patient. Other patients were considered idiopathic. Detumescence was achieved in all 11 (100%) patients during the follow-up period. The median hospitalization duration was 6 (IQR [4, 8]; range, 2-9) days. The median follow-up duration was 38 (IQR [30, 42]; range, 13-94) months for patients followed-up in our hospital after discharge. Neonatal priapism is a rare condition. Successful treatment results can be achieved with conservative methods. Data acquired from our study showed that diseases with a tendency to hypercoagulation belong to the etiology by damaging penile microcirculation and make the response to conservative treatment more challenging.

The effect of single or multiple arteries in the donor kidney on renal transplant surgical outcomes.

BACKGROUND: As the number of end-stage renal disease (ESRD) patients is increasing, but there are not enough living donors, it is necessary to broaden the criteria for candidates who can undergo donor nephrectomy. Thanks to surgeons' increasing experience with laparoscopic donor nephrectomy (LND), multiple renal artery grafts, previously considered a relative contraindication to donor nephrectomy, have become candidates for LDN. We aimed to compare the outcomes of donors and recipients with single artery and with multiple arteries in LDN. METHODS: A total of 214 patients were included in the study. Patients were divided into two groups according to the number of donor arteries: donors with one artery (group 1) and donors with multiple arteries (group 2). The number of donor arteries, operative time, warm ischemia time (WIT), cold ischemia time (CIT), arterial anastomosis time, venous anastomosis time, the extent of bleeding, and preoperative complications were recorded to evaluate the preoperative data. RESULTS: The mean operation time in group 1 was 90.3 ± 11.8 min, while in group 2, it was 102.1 ± 5.5 min (p = 0.000). WIT group 1 was 90.9 ± 4.3 s and group 2 100.6 ± 2.1 s (p = 0.000). Arterial anastomosis time was 12.25 ± 3.8 in group 1 and 22.5 ± 4.5 in group 2 (p = 0.000). No statistically significant difference was found between the two groups in other parameters. CONLUSION: Increasing the number of donor arteries in renal transplantation (RT) operations prolonged the operation time on both the donor and recipient sides. Still, it had no negative impact on complications or graft function in the postoperative period.

Comparison of Incision Types Used for Kidney Extraction in Laparoscopic Donor Nephrectomy: A Retrospective Study.

PURPOSE: Laparoscopic donor nephrectomy (LDN) is the most commonly used method for kidney removal in kidney transplantation and, various incisions are used for kidney extraction. In this study, we aimed to compare the results of LDN operations using iliac fossa incision and Pfannenstiel incision. MATERIAL AND METHOD: LDN cases performed in our institute between June 2016 and February 2020 were retrospectively analyzed. Patients with previous abdominal surgery, bleeding coagulation disorders, ectopic kidneys, and patients who were converted to perioperative open surgery were excluded. Demographic data of the patients, operation times, warm ischemia times, complications were recorded and the patients were divided into two groups according to incision types. RESULTS: After the inclusion and exclusion criteria, 203 patients were included in the study. Iliac fossa incision was used in 65% of the patients and the Pfannenstiel incision was used in 35% of the patients to remove the donor's kidney. There were no difference in age, body mass index, gender, and Charlson Comorbidity Index (CCI) scores between the two groups. Operation time and warm ischemia time were significantly longer in the Pfannenstiel group (p = 0.001 and p = 0.016 respectively). There was no significant difference between the two groups in terms of bleeding amount, length of hospital stay, need for narcotic analgesic, visual analog scale scores, and postoperative complications. CONCLUSION: Both types of incisions can be used successfully and safely for the extraction of the kidney in LDN. Although WIT and operation time has been observed to be longer when a Pfannenstiel incision is made, complications and analgesic use are not different between Pfannenstiel incisions and iliac fossa incisions.

DSM-5 TÜRKÇE ÇEVIRIYE BIR KISMI ELESTIRI. / DSM-5 TÜRKÇE ÇEVIRIYE BIR KISMI ELESTIRI.

Sayin Editör, Bu yazida amaç Türkçe DSM-5 için daha akici ve anlasilabilir ortak bir dil olusturma çabasidir. Yöntem: DSM-5'in ya da DSM'nin 5. baskisinin Türkçe ve Ingilizce baskilari karsilastirilmistir. Bu yazida ana bölüm 2'ye kadar olan kisim incelenmistir. Kurum elestirisi: DSM-5 Türkçe çevirisinin elestirilebilecek noktalarinin olmasi özel bir yayincilik tarafindan çevrilmesinin etkisi olabilir. Bir kisinin özel çabasinin üzerinde bir organizasyon gerektirdigi düsünülmektedir. Çeviriyi Türkiye Psikiyatri Dernegi görev gruplari ve çalisma birimleri yapabilir veya en azindan çeviriye dahil edilebilirdi" seklinde yazmak daha uygun olabilir. Hâkim dil elestirisi: Çeviride hâkim olan Türkçenin tibbi Türkçe mi yoksa edebi Türkçe mi eski Türkçe veya Osmanlica Türkçesinin mi modern Türkçenin mi hâkim oldugu anlasilamamaktadir. Aslinda bu sorunun cevabi bellidir. DSM- 5 medikal model eksenli bir kitaptir (American Psychiatric Association 2013) ve çevirisinin de tibbi eksenli olmasi beklenir. DSM-5 Ingilizce ön sözünde biyolojik, psikodinamik, bilissel, davranissal, kisiler arasi gibi farkli alanlarda çalisan klinisyenler ve arastirmacilar için çesitlilik gösteren resmi bir dil kullanildigi ifade edilmektedir. Iste Türkçe çevirinin ortak resmi bir dil yerine kaynagi belirsiz tek bir görüsü temsil ettigi düsünülmektedir. DSM-5 TÜRKÇE ÇEVIRIYE BIR KISMI ELESTIRI Muhatap elestirisi: DSM-5 kitabinin muhataplari bellidir. DSM-5'in Ingilizce ön sözünde kitabin klinisyenler, egiticiler ve arastirmacilar için bu alanda bir basvuru kaynagi oldugu ifade edilmektedir. Türkiye için basta psikiyatri uzmanlari olmak üzere bu alanda çalisan diger meslek gruplaridir. Fakat DSM-5'in Türkçe çevirisinin kullanilan dil açisindan hangi meslek grubuna hitap ettigi net olarak anlasilamamaktadir. Profesyonel çalisanlardan ziyade edebiyata ya da eski Türkçeye merakli bir grubu hedef aldigi izlenimi olusmaktadir. Baslik elestirisi: Ruhsal Bozukluklarin Tanisal ve Sayimsal El Kitabi Amerikan Psikiyatri Birligi 2013. Burada istatistik kavrami sayimsal olarak çevrilmis. Dilde akicilik ve uyum göz önünde bulunduruldugunda güzel görünse de anlamin oturmadigi söylenebilir. Kitabin uzun halinin basligi da kisa hali gibi "DSM-5 Tani Ölçütleri Basvuru El Kitabi" olabilirdi. Ön söz elestirisi: Kitaba bir Türkçe çeviri ön sözü eklenebilirdi. Ön sözde öncelikle editörün DSM-5 hakkindaki genel görüsleri veya DSM-5 anlayisi degerlendirilebilirdi. Sonra Türkçe çeviri çalismalarindan bahsedilebilirdi. Nasil bir yöntem uygulandigi, anahtar veya tartismali kelimelerin yerine hangi Türkçe kelimelerin neden tercih edildigi anlatilabilirdi. Eksik yerler: Ingilizce baskida bulunan DSM-5 görev timinin (Task Force) baskan ve baskan yardimcisinin isimlerini tasiyan (Preface) Ön söz bölümü Türkçeye çevrilmemistir. Ayrica DSM-5'in hazirlanma süreçlerini anlatan (Introduction) Giris bölümü de Türkçe baskida bulunmamaktadir. Türkçe çeviri bu noktada eksik veya ihmal edilmis sekilde tanimlanabilir. Nitekim Giris bölümünde DSM-5 revizyon süreci, revizyonlar için öneriler, uzman görüsleri, organizasyon yapisi, tanilara boyutsal yaklasim, diger türlü siniflandirilan (other specified) ve siniflandirilamayan (unspecified) tanilar ve eksenler (eksen 1,2,3,4,5) yaklasimi gibi birçok önemli alt basliklar bulunmaktadir. Yine DSM-5'in adli durumlarda kullanimi 221 için uyarilar baslikli alan eksik yerler arasinda bulunmaktadir. Ayrica Bu elkitabinin Kulanimi bölümünün Giris'den bahseden ilk iki cümlesi Türkçe çeviride bulunmamaktadir. Ek olarak üçüncü paragraf 4. satirda yer alan "daha önce giriste belirtiledigi gibi" ifadesi de Türkçe çeviride yer almamaktadir. Bu örneklerden ana kitabin bazi kisimlarinin hem Türkçeye çevrilmedigi hem de çevrilmediginin belirtilmedigi görülmektedir. Burada çevirmenlerin inisiyatif aldigi anlasilmaktadir. Ama eger bir inisiyatif alinacaksa bunun ancak dili çevirmede, cümlelerin anlasilmasinda, daha uygun kelimelerin tercih edilmesinde kullanilabilecegi düsünülmektedir. Çeviri elestirisi: Türkçe çeviriden alinan yerler sayfa numarasi ve paragraf (x;y) seklinde belirtilerek italik yapilmistir. Incelenecek ifadeler alti çizilerek gösterilmistir. Acil serviste, özel bir bölümde yer alan en önde gelen belirtiler vurgulanabilir (örn. sanrilar, mâni, depresyon, madde esrikligi ya da nörobilissel belirtiler), dolayisiyla tam bir ayirici tani yapilana dek bu kapsamda 'tanimlanmamis' bozukluk tanisi konabilir (Ivi;1). Cümle ilk okundugunda "acil serviste" ifadesinden sonra "özel bir bölümde" ifadesi baska servisler (örnegin dahiliye) seklinde anlasilabilir. Halbuki "a particular chapter" (özel bir bölüm), DSM'de geçen "ilgili tani bölümü" anlaminda kullanilmaktadir. Türkçe çeviride "particular" sözlük anlaminda kullanildigi, cümledeki bütünlügün yakalanmadigi, gerek alaninda gerekse dil konusunda yetkin biri tarafindan çevrilmedigi izlenimi olusmaktadir. Asagidaki örnekler bu görüsü desteklemektedir. Ruhsal bozukluk, ruhsal islevselligin altinda yatan ruhsal, biyolojiyle ilgili ya da gelisimsel süreçlerde islevsellikte bir bozulma oldugunu gösteren, kisinin bilis, duygu düzenlemesi ve davranislarinda klinik açidan belirgin bir bozukluk olmasiyla belirli bir sendromdur (Ivi;3). Ayni kelime ardisik olarak üç kez tekrarlanmistir. Esas baskida "mental" sözcügü biri cümlenin basinda digeri sonunda olmak üzere iki kez kullanilmistir. DSM-5'te, herhangi tek bir bozuklukA için bugünkü tani ölçütlerinin, bütün bu dogrulayicilarlaB güvenli bir biçimde belirlenebilen türdesC bir hasta kümesini göstermesi gerekmedigini biliyoruz. Bugünkü kanitlar, bu dogrulayicilarin tanisal sinirlar arasinda çapraz varliginiD göstermekle birlikte, daha büyük bir siklikla DSM-5 bölümleri içinde ve bitisik bölümler arasinda toplanma egilimi içinde olduklarini göstermektedir. Özgül bozukluklar ya da bozukluk açilimlariniE tam dogrulayan, kesin nedensel ya da patofizyolojiyi ilgilendiren düzenekler belirlenmedigi sürece, DSM-5 bozukluk ölçütleri için en temel ölçü, bunlarin söz konusu tani ölçütleri altinda degerlendirilen kisilerin klinik gidisinin ve tedaviye alinan yanitin degerlendirilmesinde sagladigi klinik yararliktirF (Ivi;3). Bu uzun alintida ne anlatildigi tam olarak anlasilamamaktadir. Ingilizce baski okundugunda da özellikle bilimsel açidan anlasilmasinin zor bir yer oldugu görülmektedir. Aslinda buranin DSM-5'in temel felsefesinin anlatildigi can alici bir yer oldugu söylenebilir. Konunun uzmanlari tarafindan üzerinde çalisilmasi, tartisilmasi ve belki dipnot eklenmesi gereken alanin asagida daha ayrintili incelendigi üzere gereken özen gösterilmeden çevrildigi görünmektedir. A: Esas metinde "any single disorder" olarak geçen ifade Google translate ile benzer sekilde "herhangi tek bir bozukluk" seklinde çevrilmis. Halbuki Türkçede "herhangi bir bozukluk" seklinde kullanilmaktadir. Burada zaten "tek" anlami bulunmaktadir. Türkçede anlamca birbirini kapsayan kelimelerin bir arada kullanilmasi anlatim bozukluguna yol açar. B: "Validators" (dogrulayicilar) kelimesi ölçeklerde yapilan güvenilirlik (reliability) ve geçerlilik (validity) çalismalarini hatirlatmaktadir. Geçerlilik, bir ölçme aracinin amaçladigi özelligi dogru ölçebilme derecesidir (Ercan ve Kan 2004). Burada çevirinin sözlük anlami verilerek psikiyatriye yeni bir Türkçe kavram eklenmis. Halbuki çeviri yapilirken amaç dile yeni kelimeler kazandirmak degil; en yakin anlami bulmaya çalismaktir. Çeviri "dogru" yerine asina oldugumuz "geçerli" sözcügü üzerinden yapilabilirdi. Konu insandan bahsetmedigi için "geçerliler" yerine "geçerli seyler" yani "geçerli degiskenler" seklinde istatistiksel bir terim veya "dogrulayici" yerine daha çok bilinen "destekleyici" terimi kullanilabilirdi. Ingilizce metinden takip edildigi takdirde tani kriterlerini "destekleyen" bulgular-veriler anlaminin oturdugu hissedilecektir. Aslinda ayni paragraf içinde geçen "validating diagnostic criteria" (geçerli tani kriterleri), "fully validate specific disorders" (tam geçerli özgül bozukluklar) da oldugu gibi "geçerli" sözcügü uygun görünmektedir. C: Ingilizce baskida "homogeneous group of patients" ifadesinde geçen homogeneous sözlük anlami tercih edilerek "türdes" olarak çevrilmis. Halbuki "homojen hasta grubu" seklinde çevrilebilirdi. Homojen, "ayni özellikleri tasiyan" anlaminda bilim, tip ve istatistik dilinde kullanilan bir kelimedir. D: Cümle "these validators cross existing diagnostic boundaries" seklinde geçmektedir. "These validators" cümlenin öznesi, "cross" yüklemi ve "existing diagnostic boundaries" neyi sorusuna cevap veren cümlenin nesnesidir. "Bu destekleyiciler mevcut tani sinirlarini asmaktadir." Fakat çevirmen maalesef cümleyi ögelerine ayirmadigi için "cross existing diagnostic boundaries" ifadesini "tanisal sinirlar arasinda çapraz varligini" seklinde çevirmistir. Bu nedenle cümle anlasilmamaktadir. E: Ingilizce baskida "disorder spectra" olarak geçen ifade "bozukluk açilimlari" seklinde çevrilmis. Boyutsal 222 Gelis Tarihi: 02.04.2021, Kabul Tarihi: 24.05.2021, Çevrimiçi Tarihi: 19.04.2022 Doç., Serbest Psikiyatrist, Van. Dr. Osman Özdemir, e-posta: osmanozdemir56@gmail.com OÖ: https://orcid.org/0000-0003-4247-889X https://doi.org/10.5080/u26540 yaklasim ve spektrum kavrami DSM-5'in önemli degisikliklerinden biridir. Spektrum terimi psikiyatride birbirine benzeyen, ayni aileden gelen hastaliklar anlaminda kullanilagelmektedir (Özdemir 2012). DSM-5 çevirisinde spektrum teriminin tercih edilmemesi bir eksiklik ve "açilim" olarak degistirilmesi hatali olarak degerlendirilmektedir. F: Ingilizce baskida "will be clinicalutility" olarak geçen ifade "klinik yararliktir" seklinde çevrilmis. Çevirinin "klinik kullanimi olacaktir" seklinde olmasi gerektigi düsünülmektedir. Cümlenin yüklemi olan "will be" Türkçe'de "olacaktir" anlamina gelmektedir. Google translate tarandiginda "clinical utility" zaten terim seklinde "klinik kullanim" anlaminda bulunmaktadir. Diger yerlerde birçok sözcügün sözlük anlami kullanildigi halde burada daha uygun görünmesine ragmen kullanilmamistir. SONUÇ DSM-5 Türkçe çevirisinin, Ingilizce baskinin hazirlanma süreci ve asamalarinin takip edilmeden hizla yapildigi (Öztürk 2014) anlasilmaktadir. Türkçe çevirinin anlatim bozukluklari, yanlis çeviriler (Yildiz 2014) ve okuyucunun ilk kez karsilastigi tartismali kelimeleri içerdigi görülmektedir. Türkü dili veya yöresel agizlar hatta Türk Dil Kurumu (Köroglu 2014) bile degil; hâkim ve modern bilimsel psikiyatri dilinin kullanilmasi gerektigi düsünülmektedir. Tüm bunlarin sonucunda DSM-5 Türkçe çevirisinin Türk psikiyatrisinin ortak dilini temsil etmedigi söylenebilir. Türkiye Psikiyatri Dernegi'nden onayli bir revizyon önerilmektedir. Osman ÖZDEMIR.

Comparison of Open and Robot-Assisted Kidney Transplantation in terms of Perioperative and Postoperative Outcomes.

Background: The gold standard treatment method for end-stage renal disease (ESRD) is renal transplantation (RT). RT can be done with open or minimally invasive surgical methods. We aimed to compare the outcomes between patients who underwent robot-assisted renal transplantation (RART) and open renal transplantation (ORT). Methods: Data of the patients who underwent ORT or RART in two institutions between June 2015 and February 2020 were retrospectively reviewed. Patients who underwent live donor RT were included, and all donor nephrectomy procedures were performed by the laparoscopic technique. Demographic data, ischemia times, anastomosis times, operation times, and postoperative complications were recorded. Results: 98 patients were included in the ORT group, while 91 patients were included in the RART group. There was a significant difference between the two groups regarding mean patient age. While total ischemia time was 86.9 ± 7 minutes in the RART group, it was calculated as 71.2 ± 3.3 minutes in the ORT group, with a significant difference. The anastomosis time was significantly shorter in the ORT group than in the RART group. The incision length and duration of hospital stay were significantly shorter, visual analogue scores were significantly lower, and estimated blood loss was less in the RART group than in the ORT group. Conclusion: Both ORT and RART are effective and safe methods for treating ESRD. According to our study, RART is associated with relatively longer ischemia times but lower complication rates and higher patient comfort.

Factors affecting length of stay in Fournier's gangrene: a retrospective analysis of 10 years' data.

BACKGROUND: We aimed to investigate the parameters that have an effect on the length of stay and mortality rates of patients with Fournier's gangrene. MATERIAL AND METHODS: A retrospective review was performed on 80 patients who presented to the emergency department and underwent emergency debridement with the diagnosis of Fournier's gangrene between 2008 and 2017. The demographic and clinical characteristics, length of stay, Fournier's Gangrene Severity Index score, cystostomy and colostomy requirement, additional treatment for wound healing and the mortality rates of the patients were evaluated. RESULTS: Of the 80 patients included in the study, 65 (81.2 %) were male and 15 (18.7 %) female. The most common comorbidity was diabetes mellitus. The mean time between onset of complaints and admission to hospital was 4.6 ±â€Š2.5 days. As a result of the statistical analyses, it was found that Fournier's Gangrene Severity Index score, hyperbaric oxygen therapy, negative pressure wound therapy and the presence of sepsis and colostomy were significantly positively correlated with length of stay. Also it was found that the Fournier's Gangrene Severity Index score, administration of negative pressure wound therapy and the presence of sepsis were correlated with mortality. CONCLUSION: Fournier's gangrene is a mortal disease and an emergency condition. With the improvements in Fournier's gangrene disease management, mortality rates are decreasing, but long-term hospital stay has become a new problem. Knowing the values predicting length of stay and mortality rates can allow for patient-based treatment and may be useful in treatment choice.

Phosphorus tolerance levels of different chickpea genotypes.

Phosphorus (P) is a macronutrient required by the plants in large quantities. This study assessed P-tolerance levels of different chickpea genotypes under greenhouse conditions. Nine genotypes ('Damla', 'Diyar. 95', 'ER. 98', 'ILC.482', 'Izmir', 'Çagatay', 'Gökçe', 'Gülümser' and 'Yasa.05') were screened under seven P doses (i.e., 15, 30, 45, 75, 90, 100 and 120 mg P kg-1 soil). The P-deficiency symptoms were graded, subsequently root and shoot biomass and P accumulation were recorded after harvesting the plants 55 days after sowing. Principal component analysis (PCA) was executed to group genotypes. Genotypes and P levels significantly differed for growth and nutrient acquisition traits. The highest shoot biomass was recorded under 90, 100 and 120 mg P kg-1 soil, while plants grown under 15 mg kg-1P recorded the lowest biomass. Similarly, the highest root biomass was noted for 45 and 90 mg P kg-1 soil, while 15 and 30 mg P kg-1 soil had the lowest root biomass. The highest root:shoot ratio (RSR) was observed for 15, 30 and 45 mg P kg-1 soil, whereas 100 and 120 mg P kg-1 soil recorded the lowest RSR. The 'Gökçe' and 'Çagatay' genotypes produced the highest shoot biomass, while the lowest shoot biomass production was recorded for 'Diyar. 95' genotype. The highest and the lowest root biomass and RSR were recorded for genotypes 'Diyar 95' and 'Gökçe', respectively. The highest P was accumulated by genotypes 'Izmir' and 'ILC.482', while 'Diyar. 95' accumulated the lowest amount of P. The PCA grouped genotypes in two different groups based on root biomass, shoot biomass, RSR and P accumulation. Genotype 'Izmir' was in the first group. Similarly, 'Çagatay', 'ER 98' and 'ILC.482' had similar P accumulation. Thus, the results provide valuable insights for the use of these genotypes in the future for breeding purpose.

Is neutrophile to lymphocyte ratio a predictor of gleason score upgrading according to risk classifications in patients with prostate cancer / ¿Es la proporción de neutrófilos a linfocitos un predictor de la puntuación de Gleason?upgrading según clasificaciones de riesgo en pacientes conCancer de prostata

Objectives: We aimed to determine theparameters that predict Gleason Score (GS) upgradingin patients undergoing robot-assisted laparoscopic radical prostatectomy (RARP) and especially the ability ofneutrophile to lymphocyte ratio (NLR) in predicting theupgrading.Methods: Patients who underwent RARP for prostatecancer in our clinic between January 2013 and January2018 were retrospectively analyzed. Patients’ demographic data, preoperative and postoperative parameters were all recorded in the database. NLR was calculated by dividing the absolute neutrophil count (NC)by the absolute lymphocyte count (LC). Patients were classified as low, moderate and high risk according tothe National Comprehensive Cancer Network (NCNN)Guidelines. Any increase in GS between biopsy resultsand radical prostatectomy specimens were consideredas an GS upgrading.Results: After applying the inclusion and exclusion criteria, a total of 571 patients, 205 patients without GSupgrading (Group 1) and 366 patients with GS upgrading (Group 2), were included. The mean preoperativePSA values and prostate volumes were 10.8 ± 8 ng/dL and 45 ± 18.8 ml, respectively. Group 2 had asignificantly high NC and NLR, significantly low plateletcount (PC) and LC, (p=0.0001, 0.0001, 0.001 and0.002, respectively). Group 2 was found to have significantly higher positive surgical margin (PSM), extraprostatic extension (EPE) and seminal vesical invasion(SVI) (p<0.001). There was no significant correlation between the parameters of NLR and PSM, EPE, SVI, andlymph node invasion (LNI). Binomial logistic regressionshowed patients with increased NLR had 1.68 timeshigher odds to exhibit an upgrade in GS in the post-surgical histopathological analysis.Conclusions: NLR calculated preoperatively is aneasy diagnostic method that can predict GS upgradingin patients scheduled for radical prostatectomy for prostate cancer.(AU)

Objetivo: Determinamos los parámetros que predicen el grado de sobregradación deGleason en pacientes que recibieron prostatectomíaradical robótica asistida por laparoscopia (PRRL) yespecialmente la habilidad de la tasa de neutrófilos/linfocitos (NLR) a la hora de predecir la sobregradación.Métodos: Los pacientes que recibieron PRRL por cáncer de próstata en nuestra clínica entre enero 2013y enero de 2018 se analizaron retrospectivamente.Los datos demográficos, parámetros preoperatorios ypostoperatorios fueron reportados en la base de datos. NLR se calculo dividiendo el numero absoluto deneutrófilos (NC) por el numero absoluto de linfocitos(LC). Los pacientes se clasificaron como bajo, moderado y alto riesgo en la relación a las guías de NationalComprehensive Cancer Network (NCNN). Cualquieraumento en el grado de Gleason entre los resultadosde la biopsia y la prostatectomía radical fueron considerados como una sobregradación de grado deGleason.Resultados: Después de aplicar los criterios de inclusión y exclusión, un total de 571 pacientes, 205sin sobregradación de Gleason (Grupo 1) y 366 pacientes con sobregradación de Gleason (Grupo 2).La media de PSA preoperatorio y volúmenes prostáticos fueron de 10,8 ± 8 ng/dL y 45 ± 18,8 ml, respectivamente. El grupo 2 presentó un NC y NLR másalto, significativamente, bajos niveles de plaquetas yLC (p=0,0001, 0,0001, 0,001 y 0,002, respectivamente). El grupo 2 demostró tener niveles significativamente más altos de márgenes quirúrgicos (PSM),extensión extraprostatica (EPE) e invasión de vesículasseminales (SVI) (p<0,001). No se encontró una correlación significativa entre los parámetros de NLR yPSM, EPE, SVI, invasión ganglios linfáticos. El modelode regresión binomial logística demostró que los pacientes con un incremento de NLR tuvieron 1,68 másveces de tener una sobregradación de Gleason en elanálisis histopatológico postquirúrgico...(AU)

Machine learning algorithms can more efficiently predict biochemical recurrence after robot-assisted radical prostatectomy.

OBJECTIVES: To develop a model for predicting biochemical recurrence (BCR) in patients with long follow-up periods using clinical parameters and the machine learning (ML) methods. MATERIALS METHOD: Patients who underwent robot-assisted radical prostatectomy between January 2014 and December 2019 were retrospectively reviewed. Patients who did not have BCR were assigned to Group 1, while those diagnosed with BCR were assigned to Group 2. The patient's demographic data, preoperative and postoperative parameters were all recorded in the database. Three different ML algorithms were employed: random forest, K-nearest neighbour, and logistic regression. RESULTS: Three hundred and sixty-eight patients were included in this study. Among these patients, 295 (80.1%) did not have BCR (Group 1), while 73 (19.8%) had BCR (Group 2). The mean duration of follow-up and duration until the diagnosis of BCR was calculated as 35.2 ± 16.7 and 11.5 ± 11.3 months, respectively. The multivariate analysis revealed that NLR, PSAd, risk classification, PIRADS score, T stage, presence or absence of positive surgical margin, and seminal vesicle invasion were predictive for BCR. Classic Cox regression analysis had an area under the curve (AUC) of 0.915 with a sensitivity and specificity of 90.6% and 79.8%. The AUCs for receiver-operating characteristic curves for random forest, K nearest neighbour, and logistic regression were 0.95, 0.93, and 0.93, respectively. All ML models outperformed the conventional statistical regression model in the prediction of BCR after prostatectomy. CONCLUSION: The construction of more reliable and potent models will provide the clinicians and patients with advantages such as more accurate risk classification, prognosis estimation, early intervention, avoidance of unnecessary treatments, relatively lower morbidity and mortality. The ML methods are cheap, and their powers increase with increasing data input; we believe that their clinical use will increase over time.

Is neutrophile to lymphocyte ratio a predictor of Gleason score upgrading according to risk classifications in patients with prostate cancer.

OBJECTIVES: We aimed to determine the parameters that predict Gleason Score (GS) upgrading in patients undergoing robot-assisted laparoscopic radical prostatectomy (RARP) and especially the ability of neutrophile to lymphocyte ratio (NLR) in predicting the upgrading. METHODS: Patients who underwent RARP for prostate cancer in our clinic between January 2013 and January 2018 were retrospectively analyzed. Patients' demographic data, preoperative and postoperative parameters were all recorded in the database. NLR was calculated by dividing the absolute neutrophil count (NC) by the absolute lymphocyte count (LC). Patients were classified as low, moderate and high risk according to the National Comprehensive Cancer Network (NCNN) Guidelines. Any increase in GS between biopsy results and radical prostatectomy specimens were consideredas an GS upgrading. RESULTS: After applying the inclusion and exclusion criteria, a total of 571 patients, 205 patients without GS upgrading (Group 1) and 366 patients with GS upgrading (Group 2), were included. The mean preoperative PSA values and prostate volumes were 10.8 ± 8 ng/dL and 45 ± 18.8 ml, respectively. Group 2 had a significantly high NC and NLR, significantly low platelet count (PC) and LC, (p=0.0001, 0.0001, 0.001 and0.002, respectively). Group 2 was found to have significantly higher positive surgical margin (PSM), extraprostatic extension (EPE) and seminal vesical invasion (SVI) (p<0.001). There was no significant correlation between the parameters of NLR and PSM, EPE, SVI, and lymph node invasion (LNI). Binomial logistic regression showed patients with increased NLR had 1.68 times higher odds to exhibit an upgrade in GS in the post-surgical histopathological analysis. CONCLUSIONS: NLR calculated preoperatively is an easy diagnostic method that can predict GS upgrading in patients scheduled for radical prostatectomy for prostate cancer.

OBJETIVOS: Determinamos los parámetros que predicen el grado de sobregradación de Gleason en pacientes que recibieron prostatectomía radical robótica asistida por laparoscopia (PRRL) y especialmente la habilidad de la tasa de neutrófilos/linfocitos (NLR) a la hora de predecir la sobregradación.MÉTODOS: Los pacientes que recibieron PRRL por cáncer de próstata en nuestra clínica entre enero 2013 y enero de 2018 se analizaron retrospectivamente. Los datos demográficos, parámetros preoperatorios y postoperatorios fueron reportados en la base de datos. NLR se calculo dividiendo el numero absoluto de neutrófilos (NC) por el numero absoluto de linfocitos (LC). Los pacientes se clasificaron como bajo, moderado y alto riesgo en la relación a las guías de National Comprehensive Cancer Network (NCNN). Cualquier aumento en el grado de Gleason entre los resultados de la biopsia y la prostatectomía radical fueron considerados como una sobregradación de grado deGleason. RESULTADOS: Después de aplicar los criterios de inclusión y exclusión, un total de 571 pacientes, 205 sin sobregradación de Gleason (Grupo 1) y 366 pacientes con sobregradación de Gleason (Grupo 2). La media de PSA preoperatorio y volúmenes prostáticos fueron de 10,8 ± 8 ng/dL y 45 ± 18,8 ml, respectivamente. El grupo 2 presentó un NC y NLR más alto, significativamente, bajos niveles de plaquetas y LC (p=0,0001, 0,0001, 0,001 y 0,002, respectivamente). El grupo 2 demostró tener niveles significativamente más altos de márgenes quirúrgicos (PSM), extensión extraprostatica (EPE) e invasión de vesículas seminales (SVI) (p<0,001). No se econtró una correlación significativa entre los parámetros de NLR y PSM, EPE, SVI, invasión ganglios linfáticos. El modelo de regresión binomial logística demostró que los pacientes con un incremento de NLR tuvieron 1,68 más veces de tener una sobregradación de Gleason en el análisis histopatológico postquirúrgico. CONCLUSIONES: El cálculo de NLR preoperatorio es un método fácil de diagnóstico que puede predecir la sobregradación de Gleason en pacientes que van a recibir una prostatectomía radical por cáncer de próstata.

A nationwide survey on the impact of COVID-19 pandemic on minimal invasive surgery in urology practice.

OBJECTIVE: The beta-coronavirus (COVID-19) pandemic has changed the clinical approach of 93% of urologists worldwide, and this situation has affected the use of laparoscopic and robot-assisted laparoscopic methods, which are known as minimally invasive surgery (MIS). This study aimed to determine the effects of the COVID-19 pandemic on MIS in urology practice at national level. DESIGN, SETTING AND PARTICIPANTS: A total of 234 urologists in Turkey participated in an online survey between August 22 and September 23, 2020. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Descriptive statistical analyses were conducted to determine the participants' demographic characteristics and responses to multiple-choice questions. RESULTS: While 54% of urologists stated that they were concerned about the possibility that the patients planned to undergo MIS were carrying COVID-19 or false-negative for the virus, 51% considered that open surgery was safer than MIS in this regard. The pandemic led to a difference in the preferences of 40% of the urologists in relation to open or MIS methods, and during the pandemic, 39% of the urologists always directed their patients to open surgery. It was determined that during the pandemic, there was a statistical decrease in the intensity and weekly application of MIS methods among all surgical procedures compared to the pre-pandemic (P < .001 and P < .001, respectively). MIS was preferred for oncological operations by 97.3% of the urologists during the pandemic, with the most performed operation being radical nephrectomy (90.7%). Among oncological operations, radical prostatectomy was most frequently postponed. To prevent virus transmission during MIS, 44% of the urologists reported that they always used an additional evacuation system and 52% took additional precautions. There were a total of 27 healthcare workers who took part in MIS and tested positive for COVID-19 after the operation. CONCLUSIONS: Although the number of operations has decreased during the ongoing pandemic, MIS is a method that can be preferred due to its limited contamination and mortality in urology practice provided that safety measures are taken and guideline recommendations are followed.

Perineoscopic vesicourethral reconstruction: A novel surgical technique for anastomotic stricture following radical prostatectomy.

OBJECTIVE: Vesicourethral anastomotic stenosis (VUAS) is frequently seen after prostate surgery because of various operative and postoperative factors. In this study, we aimed to present our results of perineoscopic bladder neck reconstruction, which is a new technique of the perineal approach in the treatment of patients with VUAS after prostate cancer surgery. MATERIAL AND METHODS: Sixteen consecutive patients who underwent perineoscopic bladder neck reconstruction in our clinic between July 2017 and March 2019 were included in the study. Demographic characteristics, surgical history, postoperative continence status, and additional treatment requirements were recorded. Perineoscopic surgery is defined as the visualization of the surgical site with instruments used in laparoscopy and the surgeon performing the entire operative procedure through the screen. RESULTS: The mean number of preoperative endoscopic bladder neck resections of the patients was 7±5.1, with a history of suprapubic cystostomy in 7 (43.7%) and radiotherapy in 5 (31.2%) patients before surgery. The mean surgical time was 126.2±13.1 min. The mean follow-up period was 13.2±6.8 months, and the success rate was 81.25%. During follow-up, two (12.5%) patients received perineoscopic re-do reconstruction because of stricture recurrence, and one (6.2%) patient was included in a urethral dilatation program. CONCLUSION: Improving visualization and ergonomics with the perineoscopic approach can increase the success rate of bladder neck reconstruction in comparison with the standard approach. In addition, the lack of need for expanded dissection (corporal separation, inferior pubectomy) reduces postoperative complication rates.

Female Urethroplasty With Dorsal Onlay Labia Minora Graft: Technical Details and Initial Results.

OBJECTIVE: The objective of this study was to evaluate the functional results of dorsal onlay labia minora graft urethroplasty in the treatment of female urethral strictures. MATERIALS AND METHODS: Data were retrospectively examined for 13 patients who underwent augmentation urethroplasty through the dorsal approach using labia minora grafts between September 2017 and January 2019. Demographic, intraoperative, and postoperative data and follow-up conditions were recorded for all patients. RESULTS: The mean age of the patients was calculated as 48.2±7 years. The etiology of urethral strictures was found to be trauma in 2 patients, iatrogenic in 4 patients, and idiopathic causes in 7 patients. The mean urethral stricture length of the patients was 1.5±0.4 cm (range, 1-2.5 cm). The mean surgical duration was 95±11.4 minutes (range, 70-110 minutes). The mean postoperative American Urology Association symptom score, maximum urine flow rate, and postmictional residue values were statistically significantly different compared with preoperative data (P < 0.05). No peroperative and postoperative complications were detected in any patients. The mean follow-up duration of the patients was 19±5.3 months, and no recurrence of stricture was observed in any patients based on the cystourethroscopic examinations. All patients are being followed up in our clinic without any stricture recurrence or symptoms. CONCLUSIONS: The dorsal onlay labia minora graft urethroplasty technique in female urethral strictures is an efficient and applicable method with postoperative anatomic and functional results. Studies with longer follow-up periods and larger patient populations are required to present the success and reliability of this technique.

The thermally induced decarboxylation mechanism of a mixed-oxidation state carboxylate-based iron metal-organic framework.

Investigations into a thermally generated decarboxylation mechanism for metal site activation and the generation of mesopores in a carboxylate iron-based MOF, PCN-250, have been conducted. PCN-250 exhibits an interesting oxidation state change during thermal treatment under inert atmospheres or vacuum conditions, transitioning from an Fe(iii)3 cluster to a Fe(ii)Fe(iii)2 cluster. To probe this redox event and discern a mechanism of activation, a combination of thermogravimetric analysis, gas sorption, scanning electron microscopy, 57Fe Mössbauer spectroscopy, gas chromatography-mass spectrometry, and X-ray diffraction studies were conducted. The results suggest that the iron-site activation occurs due to ligand decarboxylation above 200 °C. This is also consistent with the generation of a missing cluster mesoporous defect in the framework. The resulting mesoporous PCN-250 maintains high thermal stability, preserving crystallinity after multiple consecutive high-temperature regeneration cycles. Additionally, the thermally reduced PCN-250 shows improvements in the total uptake capacity of methane and CO2.

Understanding the genital diseases of Ancient Anatolia in the light of the inscribed male genital offerings presented to gods.

In the ancient Greek and Roman world, many gods and goddesses were considered to possess healing powers, and there were their temples where they could heal those who prayed. For that reason, in the ancient times, people were going to healing temples of various gods and goddesses to recover from their illnesses or grievous injuries. Sick individuals at the temples were offering some written or unwritten votive reliefs indicating their illnesses, to the gods or goddesses to ask for healing or to express gratitude after finding a cure. Among these, votive stones containing written expressions and reliefs expressing the owner's health problem held an important position. In the research on this antiquity, four inscribed votives that had a male genital organ depicted on them and that were dedicated to Anatolian gods Theos Hypsistos and Sozon, and goddesses Phileis and Ollie, were found. In this article, we aimed to study the inscribed offerings that are still on display in museums and private collections discovered during the excavations in Anatolia hosting the ancient Greek and Roman civilizations simultaneously and their possible relations with the urogenital illnesses.

Relaxant effect of atorvastatin on isolated rat gastric fundus strips: implications for Ca2+-signalling mechanisms.

Statins are determined to have various pleiotropic effects apart from their lipid-lowering properties. Herein, we investigated the direct effects of atorvastatin on gastric smooth muscle tone. Atorvastatin effectively relaxed isolated rat gastric fundus strips precontracted with acetylcholine, potassium chloride, and serotonin. Incubation of the strips with nitric oxide synthase inhibitor, l-NOARG (10-4 M, 20 min), l-type voltage-operated Ca2+ channel (VOCC) blocker, nifedipine (10-6 M, 30 min), KATP channel blocker, glibenclamide (10-5 M, 30 min), or precursor of cholesterol, mevalonate (10-2 M, 45 min) did not change the relaxations to atorvastatin. However, pretreatment of fundus strips with atorvastatin (3×10-5-3×10-4 M, 30 min) inhibited the contractions to calcium chloride (10-4-10-1 M), acetylcholine (10-4 M), and caffeine (20 mM) in the calcium-free medium. Moreover, atorvastatin reduced the contractions induced by sarco-endoplasmic reticulum Ca2+-ATPase (SERCA) inhibitor, cyclopiazonic acid (10-7-3×10-5 M). The current study demonstrated that atorvastatin produces an acute relaxant effect on gastric fundus strips, which appears to be mediated by several Ca2+-signalling mechanisms such as the blockade of l-type VOCC-independent Ca2+ entry, decrease in smooth muscle Ca2+ sensitivity, inhibition of IP3- and ryanodine-sensitive intracellular stores to mediate Ca2+ release, as well as the activation of SERCA. This acute relaxing effect seems unlikely to be related with nitric oxide, KATP channels, and the mevalonate pathway.

Gossypiboma: A Dramatic Result of Human Error, Case Report and Literature Review.

Gossypiboma refers to a retained foreign object that was forgotten in the body cavity during an operation. It is a rare surgical complication that most commonly occurs after intraperitoneal abdominal emergency surgical procedures, but may also occur after virtually any type of operation. Gossypiboma can be confused with neoplastic lesions and abscess. Clinical examination and radiological findings may sometimes mislead the physician. We intend to present our cases, which is thought to be a kidney tumour and bladder cancer but resulted gossypiboma which is a condition that is caused by a forgotten sponge during the operation and it can mimic the cancer. During the operation, the team must work in coordination and be careful. Unnecessary operations in such situation can significantly increase the patient's morbidity.

Suspension Processing of Microporous Metal-Organic Frameworks: A Scalable Route to High-Quality Adsorbents.

Metal-Organic Frameworks (MOFs) have been intensively studied for applications such as gas storage, gas separation, catalysis, drug delivery, and more. Typically, the development of MOFs involves a post-synthetic solvent exchange process, which usually requires a significant investment of time, energy, labor, and resources. Herein, we propose a novel post-synthetic processing methodology for commercial and laboratory-scale MOFs called "Suspension Processing." Suspension processing is a non-destructive, agitation-based technique that provides efficient solvent exchange, pore cleaning, and surface defect removal in MOFs. Suspension processing has shown the capability to significantly improve the surface area and gas uptake properties of microporous MOFs, including PCN-250, UiO-66, and HKUST-1. Suspension processing displays improved time, energy, and labor efficiency, as well as considerably enhanced product quality. These findings confirm suspension processing as a straightforward methodology with applicability as a universal technique for the production of high-quality microporous materials.

Incorporating Heavy Alkanes in Metal-Organic Frameworks for Optimizing Adsorbed Natural Gas Capacity.

Metal-organic frameworks (MOFs) as methane adsorbents are highly promising materials for applications such as methane-powered vehicles, flare gas capture, and field natural gas separation. Pre- and post-synthetic modification of MOFs have been known to help improve both the overall methane uptake as well as the working capacity. Here, a post-synthetic modification strategy to non-covalently modify MOF adsorbents for the enhancement of the natural gas uptake for the MOF material is introduced. In this study, PCN-250 adsorbents were doped with C10 alkane and C14 fatty acid and their impact on the methane uptake capabilities was investigated. It was found that even trace amounts of heavy hydrocarbons could considerably enhance the raw methane uptake of the MOF while still being regenerable. The doped hydrocarbons are presumably located at the mesoporous defects of PCN-250, thus optimizing the framework-methane interactions. These findings reveal a general approach that can be used to modify the MOF absorbents, improving their ability to be sustainable and renewable natural gas adsorption platforms.