Identification of IDH and TERTp mutations using dynamic susceptibility contrast MRI with deep learning in 162 gliomas.

PURPOSE: Isocitrate dehydrogenase (IDH) and telomerase reverse transcriptase gene promoter (TERTp) mutations play crucial roles in glioma biology. Such genetic information is typically obtained invasively from excised tumor tissue; however, these mutations need to be identified preoperatively for better treatment planning. The relative cerebral blood volume (rCBV) information derived from dynamic susceptibility contrast MRI (DSC-MRI) has been demonstrated to correlate with tumor vascularity, functionality, and biology, and might provide some information about the genetic alterations in gliomas before surgery. Therefore, this study aims to predict IDH and TERTp mutational subgroups in gliomas using deep learning applied to rCBV images. METHOD: After the generation of rCBV images from DSC-MRI data, classical machine learning algorithms were applied to the features obtained from the segmented tumor volumes to classify IDH and TERTp mutation subgroups. Furthermore, pre-trained convolutional neural networks (CNNs) and CNNs enhanced with attention gates were trained using rCBV images or a combination of rCBV and anatomical images to classify the mutational subgroups. RESULTS: The best accuracies obtained with classical machine learning algorithms were 83 %, 68 %, and 76 % for the identification of IDH mutational, TERTp mutational, and TERTp-only subgroups, respectively. On the other hand, the best-performing CNN model achieved 88 % accuracy (86 % sensitivity, 91 % specificity) for the IDH-mutational subgroups, 70 % accuracy (73 % sensitivity and 67 % specificity) for the TERTp-mutational subgroups, and 84 % accuracy (86 % sensitivity, 81 % specificity) for the TERTp-only subgroup using attention gates. CONCLUSIONS: DSC-MRI can be utilized to noninvasively classify IDH- and TERTp-based molecular subgroups of gliomas, facilitating preoperative identification of these genetic alterations.

Functional-Group Effect of Ligand Molecules on the Aggregation of Gold Nanoparticles: A Molecular Dynamics Simulation Study.

In this paper, atomistic molecular dynamics simulations are performed for the systems consisting of functionalized gold nanoparticles (NPs) in a toluene medium. Gold NPs are coated with ligand molecules that have different terminal groups, that is, polar carboxyl (COOH), hydroxyl (OH), amine (NH2), and nonpolar methyl (CH3). These functional groups are selected to understand the relation between the aggregation behavior of functionalized gold NPs in toluene and the polarity of terminal groups of ligand molecules. The center-of-mass distances between NP pairs, the radial distribution functions, the mean square displacements, the radius of gyration, and the number of hydrogen bonds (H-bond) between ligand molecules are computed. Our simulation results indicate that functionalized gold NPs exhibit different aggregation/dispersion behaviors depending upon the terminal group of ligands.

Evaluation of Relationship between fQRS and CD4/CD8 Ratio in Patients with HIV.

OBJECTIVES: Myocardial dysfunction is an important cause of morbidity in human immunodeficiency virus (HIV)-infected patients. Decline in CD4 T-cell level and reversal of CD4/CD8 ratio was associated with cardiovascular events. Fragmented QRS (fQRS) can show myocardial dysfunction and cardiovascular events. The aim of this study is to investigate the presence of fQRS in HIV-infected patients and the factors affecting it. METHODS: This case-control study included 153 outpatient HIV patients (97% male) and 141 healthy subjects (96% male). Patients with cardiac disease history, arrhythmia, diabetes, cancer disease, and thyroid dysfunction were excluded from the study. Electrocardiogram, echocardiography, and biochemistry tests were performed to all participants. CD4 and CD8 T cell count, and HIV RNA level were measured in HIV-infected patients. RESULTS: Both groups had similar basal characteristics. Mean CD4 T-cell level was 356 cell/cm3, HIV was under control in 48%, and the rate of antiretroviral treatment use was 64%. HIV-infected patients had lower left ventricular ejection fraction (LVEF), higher Tei index, and more fQRS. HIV-infected patients with fQRS had lower nadir CD4 T-cell levels, lower CD4/CD8 ratio, and higher Tie index. In multivariate analysis, CD4/CD8 ratio and LVEF were found to be independent predictors of fQRS in HIV-infected patients. CONCLUSION: Myocardial dysfunction can be seen in HIV-infected patients. Caution should be exercised in terms of myocardial dysfunction in HIV-infected patients with low CD4/CD8 ratio.

Evaluation of Tp-e interval and Tp-e: QT and Tp-e: QTc ratios in patients infected with HIV and using antiretroviral therapy.

OBJECTIVE: Sudden cardiac death (SCD) is one of the causes of death among patients infected with human immunodeficiency virus (HIV). The T peak to T end interval (Tp-e interval) is a parameter that is used in the prediction of SCD. The aim of this study was to investigate the difference in Tp-e interval and Tp: QT and Tp: corrected QT interval (QTc) ratios between patients infected with HIV and healthy individuals as well as in other factors affecting patients infected with HIV. METHODS: A total of 83 patients infected with HIV with negative HIV ribonucleic acid (RNA) levels who were receiving antiretroviral therapy (ART) and 83 healthy individuals were included in this study. All the participants underwent electrocardiography, their Tp-e and QT intervals were measured, and QTc intervals and Tp-e: QT and Tp-e: QTc ratios were calculated. In addition, in the patients infected with HIV, CD4 and CD8 T-cell count and HIV RNA levels were measured. RESULTS: The Tp-e interval was found to be longer and the Tp-e: QT and Tp-e: QTc ratios were found to be higher in patients infected with HIV. Nadir CD4 was observed to be an independent predictor of Tp-e interval (p=0.014, ß=‒0.28). Furthermore, correlation analysis revealed a negative correlation of the nadir CD4 level and CD4: CD8 ratio with Tp-e interval and Tp-e: QT ratio. CONCLUSION: Low nadir CD4 and a reversed CD4: CD8 ratio in patients infected with HIV receiving ART were found to be associated with a prolonged Tp-e interval and increased Tp-e: QT and Tp-e: QTc ratios. Thus, more attention should be taken in terms of SCD in patients infected with HIV, especially in those with low nadir CD4 and reversed CD4: CD8 ratio.

Evaluation of YouTube Video Content Related to the Management of Hypoglycemia.

Objective Hypoglycemia is a syndrome characterized by decreased blood glucose levels and can result in morbidity and mortality. Often, patients seek information about hypoglycemia from the Internet and especially YouTube. The objective of this study was to investigate the quality and reliability of the 50 most viewed videos related to hypoglycemia on YouTube. Methods The links of 50 videos that met the criteria were copied to spreadsheet software. Attributes of the uploaders, the content of the videos, their screening time, the date they were uploaded, the number of days since the upload date, the number of daily views, comments, likes, dislike, and video power indexes were recorded. The videos were assessed by two independent emergency specialists using DISCERN and global quality scales (GQS). Results Of the selection, 27 (54%) videos were uploaded by health channels, 11 (22%) by physicians, nine (18%) by hospital channels, and three (6%) by patients. Furthermore, 30 (60%) of these 50 videos were real-content videos and 20 (40%) were animations. The average DISCERN score given by the researchers to 50 videos was 3.72 ± 0.90 (min-max: 1-5) and the average GQS score was 3.65 ± 0.88. Mean video power index (VPI) value was determined as 92.64 ± 11. According to Pearson's analysis, there was a good agreement between the two observers. Conclusion Videos uploaded by physicians were useful. However, health videos should only be uploaded by physicians. Uploading videos with content that the patients and their relatives can clearly understand is of paramount importance.

Evaluation of Biological and Sociodemographic Factors Affecting Dysmenorrhea.

Objective Dysmenorrhea is the most important cause of chronic pelvic pain in women. Sometimes, dysmenorrhea can be severe enough, leading women to present to emergency departments. The aim of this study was to investigate factors affecting dysmenorrhea in female patients who presented to the emergency department of our hospital. Methods Female patients who presented to our emergency department with dysmenorrhea between January 2012 and January 2014 were included in the study. Patients' demographic and clinical data were filled in the Dysmenorrhea Data Form, which was designed by the researcher by screening the relevant literature. Patients' age, educational status, smoking status, age and regularity of menarche, sexual activity, and age of dysmenorrhea onset were recorded and analyzed. Results The mean age of the patients was 21.80 ± 3.75 years. There was a significant correlation between the type of dysmenorrhea and sexual activity (p=0.001). There was a statistically significant difference between age at menarche and age of dysmenorrhea onset (p<0.001). Absenteeism was less common in patients with an age of dysmenorrhea onset of <12 years compared with the other age groups (p<0.05). Conclusions There was a significant correlation between age at menarche and age of dysmenorrhea onset. Data obtained in this study could be used in developing educational programs on dysmenorrhea for adolescents at the age of menarche.

Assessment of Tp-e interval and Tp-e/QT ratio in patients with human immunodeficiency virus.

OBJECTIVE: Sudden cardiac death (SCD) plays an important part in all-cause mortality in patients infected with human immunodeficiency virus (HIV). The T-peak to T-end (Tp-e) interval, corrected Tp-e (Tp-ec) interval, and Tp-e/QT ratio on the ECG are parameters used to stratify risk for SCD. The objective of this study was to investigate the differences between HIV-infected patients and healthy individuals in terms of Tp-e interval, Tp-ec interval, and Tp-e/QT ratio, as well as other influencing factors. METHODS: Ninety-eight HIV-infected patients and 62 healthy controls were included in this prospective case-control study. Tp-e interval, Tp-ec interval, and Tp-e/QT ratio were measured in all participants. Echocardiographic examination and routine laboratory analysis were performed. In addition, CD4 T-cell count and HIV RNA levels were assessed in HIV-infected patients. RESULTS: All baseline characteristics were comparable in both groups. The median survival of those living with HIV was 20.63 months; 53% of them had controlled viral load, and 74% were receiving antiretroviral therapy. Mean baseline CD4 T-cell count was 409. In HIV-infected patients, the Tp-e interval and Tp-ec interval were prolonged, and the Tp-e/QT ratio was higher (p<0.001, p<0.001 and p=0.021, respectively). In bivariate and partial correlation analyses, there was a negative correlation between CD4 T-cell level and Tp-e interval, Tp-ec interval, and Tp-e/QT ratio. CONCLUSION: Tp-e interval, Tp-ec interval, and Tp-e/QT ratio were greater in HIV-infected patients compared with healthy individuals. HIV-infected patients, particularly those with low baseline CD4 T-cell counts, should be closely monitored due to risk of SCD.

A monolithic fluid-structure interaction framework applied to red blood cells.

A parallel fully coupled (monolithic) fluid-structure interaction (FSI) algorithm has been applied to the deformation of red blood cells (RBCs) in capillaries, where cell deformability has significant effects on blood rheology. In the present FSI algorithm, fluid domain is discretized using the side-centered unstructured finite volume method based on the Arbitrary Lagrangian-Eulerian (ALE) formulation; meanwhile, solid domain is discretized with the classical Galerkin finite element formulation for the Saint Venant-Kirchhoff material in a Lagrangian frame. In addition, the compatible kinematic boundary condition is enforced at the fluid-solid interface in order to conserve the mass of cytoplasmic fluid within the red cell at machine precision. In order to solve the resulting large-scale algebraic linear systems in a fully coupled manner, a new matrix factorization is introduced similar to that of the projection method, and the parallel algebraic multigrid solver BoomerAMG is used for the scaled discrete Laplacian provided by the HYPRE library, which we access through the PETSc library. Three important physical parameters for the blood flow are simulated and analyzed: (1) the effect of capillary diameter, (2) the effect of red cell membrane thickness, and (3) the effect of red cell spacing (hematocrit). The numerical calculations initially indicate a shape deformation in which biconcave discoid shape changes to a parachute-like shape. Furthermore, the parachute-like cell shape in small capillaries undergoes a cupcake-shaped buckling instability, which has not been observed in the literature. The instability forms thin riblike features, and the red cell deformation is not axisymmetric but three-dimensional.

Evaluation of Subtle Left Ventricular Systolic Dysfunction by Longitudinal Systolic Strain in Patients with Human Immunodeficiency Virus.

BACKGROUND: Although left ventricular systolic dysfunction (LVSD) is a major cause of morbidity in human immunodeficiency virus (HIV)-infected patients, there is limited data on cardiac functions of these patients. Compared to the conventional echocardiography, the global longitudinal strain (GLS) can detect subclinical myocardial dysfunction at an earlier stage. OBJECTIVES: In our study, we aimed to evaluate left ventricular systolic functions using the GLS in HIV-infected patients and to investigate the effect of cluster of differentiation 4 T-cell values on LVSD. METHODS: This prospective, case-control study included a total of 65 HIV-infected patients and 48 healthy volunteers. Conventional and strain echocardiography were performed on all participants. In HIV-infected patients, CD4 T-cell counts and HIV-ribonucleic acid (HIV-RNA) values were measured. RESULTS: The median CD4 T-cell count was 529.65 cells/mm3 in the HIV-infected patients and median duration of living with HIV was 16.25 (range: 2 to 120) months. Baseline characteristics and left ventricular ejection fraction values were similar in both groups. However, there was a significant difference in the low-density lipoprotein cholesterol, triglycerides, interventricular septum, left ventricular posterior wall, and GLS between the groups (p = 0.013, p = 0.005, 0.041, p = 0.013, and p = 0.003, respectively). There was a positive correlation between GLS and CD4 levels (r = 0.463, p < 0.001). CONCLUSIONS: Our study results suggest that reduced CD4 T-cell counts in HIV-infected patients may cause myocardial dysfunction and GLS can be useful to show subtle LVSD asymptomatic cases.

Endocan and albuminuria in type 2 diabetes mellitus.

BACKGROUND: Endocan is a newly identified proteoglycan released from endothelium, stimulating angiogenesis and when increased, indicates endothelial activation (inflammation). Our aim was to examine the association between serum endocan levels and urine albumin-creatinine ratio (UACR). METHOD: One hundred and thirty-seven patients with type 2 diabetes mellitus and normal serum creatinine who had no co-morbidities other than hypertension, diabetic nephropathy, retinopathy, or neuropathy were divided into normoalbuminuria (G1), microalbuminuria (G2), and macroalbuminuria (G3) groups and compared cross-sectionally regarding serum endocan levels. RESULT: There were 55, 47, and 35 patients in G1, G2, and G3, respectively. The groups were comparable in terms of gender, age, duration of diabetes, diabetic neuropathy/retinopathy, fasting glucose, HbA1c, serum creatinine level, and eGFR. Patients in G3 had significantly higher blood pressure but lower serum albumin and endocan levels. UACR showed a negative bivariate correlation with serum endocan levels (r = -.282, p = .001). There was bivariate positive correlation between endocan and systolic blood pressure (r=.185, p = .030). In linear regression analysis, UACR was negatively correlated with endocan while positively correlated with systolic blood pressure, duration of diabetes, and platelet distribution width. CONCLUSION: Patients with macroalbuminuria had lower endocan levels, and increasing UACR was associated with decreasing serum endocan levels. Despite the occurrence of angiogenesis and glomerular hypertrophy in the early phase of diabetic nephropathy, ensuing significant renal injury over time may reduce the expression of endocan. Serum endocan levels may represent a novel marker for nephropathy progression.

GAS6 intron 8 c.834 + 7G > A gene polymorphism in diabetic nephropathy.

UNLABELLED: BACKGROUND - AIM: In animal experiments, growth arrest-specific 6 (Gas6) protein plays a key role in the development of mesangial cell and glomerular hypertrophy in the early phase of diabetic nephropathy, and diabetic nephropathy is prevented by warfarin-induced inhibition of GAS6 protein. It was shown that GAS6 intron 8 c.834 + 7G > A polymorphism is protective against type 2 diabetes mellitus, and AA genotype is associated with higher blood levels of GAS6 protein. Our aim is to investigate whether this polymorphism is a risk factor for diabetic nephropathy in type 2 diabetes mellitus. METHOD: Eighty-seven patients with diabetic nephropathy were compared with 66 non-diabetic controls in terms of GAS6 intron 8 c.834 + 7G > A polymorphism. Patients with history of stroke, ischemic heart disease were excluded. Each patient was examined by the ophthalmologist to determine diabetic retinopathy. RESULTS: Frequency of GG, GA and AA genotypes are similar in diabetic nephropathy and control groups according to GAS6 intron 8 c.834 + 7G > A polymorphism (p = .837). Rate of diabetic retinopathy was 54.02%. In the subgroup analysis, GA genotype was significantly more frequent than GG genotype in patients with diabetic retinopathy when compared to without diabetic retinopathy (p = .010). CONCLUSION: In our study, GAS6 intron 8 c.834 + 7G > A polymorphism was not associated with diabetic nephropathy in type 2 diabetes mellitus. However, heterozygous state of this polymorphism may be a risk factor for diabetic retinopathy in patients with diabetic nephropathy.

Acute toxic effects of cadmium in larvae of the green toad, pseudepidalea variabilis (pallas, 1769) (amphibia: anura).

The environmental impact of cadmium use and its accumulation in nature have increased to alarming levels. This study aimed to morphologically and histologically investigate the acute toxic effects of cadmium on green toad, Pseudepidalea variabilis (Pallas, 1769) larvae. Embryos were obtained from specimens collected in amplexus from nature and kept under laboratory conditions until stage 26, when they were exposed to cadmium (0, 1, 5, 10, 25, and 50 Lig L⁻¹) for 96 h. The LC10 LC50, and LC90 values of cadmium were calculated to be 26.98, 35.35, and 46.31 Lig L⁻¹, respectively. Our results showed that cadmium had a negative effect on the body size of P. variabilis larvae (over 1 ng L⁻¹). Histological examination detected a fusion of gill lamellae, liver haemorrhage, oedema in the abdominal cavity, and deformations of pronephric tubules (over 10 ng L⁻¹). Our findings suggest that the green toad was sensitive to the cadmium treatment, with LC50 values lower than those reported by other studies. Thus, this species could be considered a reliable indicator species of environmental stress in aquatic ecosystem.

Lower Extremity Tissue Defect Caused by Mobile Phone Charger Explosion: A Case Report.

As the usage of cell phones is markedly increasing worldwide, accidental injuries and even lethal damages caused by cellular phone explosions have been reported lately. Although, cell phone charger explosion related scalding and tissue loss is extremely rare, they generally cause severe damage to tissues and cause severe complications, ending up in hospitalization. We are presenting a case of 9-year old female patient who was admitted to our emergency service due to a phone charger explosion that resulted in a lower extremity tissue defect.

The effect of feeding system on fattening performance, slaughter, and carcass characteristics of Norduz male kids.

The study was conducted to determine the effect of feeding systems on fattening performance, slaughter, and carcass characteristics of male Norduz kids. In the study, 20 male Norduz kids weaned at 2.5 months of age were divided into two groups after weaning. The first group was reared under semi-intensive conditions (SI) on a mixture of pasture and concentrate, and the second group was reared under extensive conditions (E) on pasture only. SI group had higher final weight (35.30 kg versus 32.81 kg), daily weight gain (153.10 g versus 132.14 g), and warm carcass yield (44.84% versus 46.55%) compared to the E group although there were no significant differences. Body organs, carcass parts, prime cuts, and chemical composition of the chop area did not also differ in two groups significantly. As a conclusion, this study showed that semi-intensive feeding systems improved kid fattening performance and carcass characteristics.

Selective extraction of chromium(VI) using a leaching procedure with sodium carbonate from some plant leaves, soil and sediment samples.

Speciation of chromium in some plant leaves, soil and sediment samples was carried out by selective leaching of Cr(VI) using a sodium carbonate leaching procedure. Total chromium from the samples was extracted using aqua regia and oxidative acid digestion, respectively. The concentrations of chromium species in the extracts were determined using by graphite furnace atomic absorption spectrometry (GFAAS). Uncoated graphite furnace tubes were used as an atomizer. Due to the presence of relatively high amounts of Na(2)CO(3) in the resulting samples, the possible influences of Na(2)CO(3) on the absorbance signals were checked. There is no interference of Na(2)CO(3) on the chromium absorbance up to 0.1 mol L(-1) Na(2)CO(3). A limit of detection (LOD) for determination of Cr(VI) in 0.1 Na(2)CO(3) solution by GFAAS was found to be 0.93 microg L(-1). The procedure was applied to environmental samples. The relative standard deviation, R.S.D. as precision for 10 replicate measurements of 20 microL(-1) Cr in processed soil sample was 4.2%.