Psychological risk factors for upper extremity fractures in preschool children: A case-control study.

BACKGROUND: In school-age children, upper extremity fractures are associated with both parental and child-related factors and represent a multifactorial entity. This study aims to explore the psychological risk factors associated with upper extremity fractures in preschool children. METHODS: This single-center, hospital-based, age-matched case-control study involved 55 cases of upper extremity fractures and 55 controls experiencing growing pains. Parents of the children participated in face-to-face interviews. We examined the potential as-sociations between scores on the Mother-to-Infant Bonding Scale (MIBS), Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS), Autism-Spectrum Quotient (AQ), State-Trait Anxiety Inventory (STAI), and Strengths and Difficulties Questionnaire (SDQ), and the risk of upper extremity fractures. RESULTS: Advanced parental age and lower household income emerged as risk factors for upper extremity fractures, while longer maternal educational attainment was identified as a protective factor. In the univariate analyses, elevated scores on the Autism-Spec-trum Quotient Communication subscale (AQ-C), overall AQ score, Strengths and Difficulties Questionnaire Hyperactivity subscale (SDQ-H), and Strengths and Difficulties Questionnaire Emotional and Peer Problems subscale (SDQ-Int) were associated with an increased fracture risk (Odds Ratio [OR] (95% Confidence Interval [CI]): 1.15 (1.05-1.27), OR: 1.05 (1.01-1.09), OR: 1.25 (1.01-1.54), and OR: 1.19 (1.04-1.37), respectively). The AQ-C and SDQ-Int scales remained statistically significant as risk factors for upper ex-tremity fractures (OR: 1.15 (1.02-1.28) and OR: 1.21 (1.02-1.43), respectively) in the multivariate regression analyses. CONCLUSION: Our findings suggest that psychological factors affecting both parents and children could potentially increase the risk of upper extremity fractures in preschool children.

The role of the psychological attributes of parents and children, and fracture history in upper extremity fractures in school-age and adolescents: A case-control study.

OBJECTIVES: This study aims to investigate the influence of parents and children's psychological attributes and previous fracture history on upper extremity fractures in school-aged and adolescent children. PATIENTS AND METHODS: Between January 2022 and January 2023, a total of 194 participants consisting of 97 cases with upper extremity fractures (23 males, 74 females; median age: 10 years; range, 6 to 16 years) and 97 age-matched controls suffering from growing pains (47 males, 50 females; median age: 10 years; range, 6 to 16 years) were included in this case-control study. Both cases and controls were of school-age or over. The parents of the children were interviewed face-to-face using psychological scales including the Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS), the Autism-Spectrum Quotient (AQ), the Short Form of the Conners' Parent Rating Scale-Revised (CPRS-R:S), and the Developmental Coordination Disorder Questionnaire 2007 (DCDQ'07). The results derived from these scales and the demographics of the participants were evaluated in terms of their association with the risk of upper extremity fractures. RESULTS: A household income below the official minimum monthly wage (MMW) and a previous fracture history showed a higher risk for upper extremity fractures (odds ratio [OR]=2.38, 95% confidence interval [CI]: 1.07-5.26 and OR=24.93, 95% CI: 3.27-189.98, respectively). In the univariate analyses, elevated scores on the hyperactivity subscale of CPRS-R:S (CPRS-R:SHS) were associated with a higher fracture risk (OR=1.14, 95% CI: 1.05-1.24). Furthermore, both a household income below MMW, a previous fracture history, and higher CPRS-R:S-HS scores were found as independent risk factors for upper extremity fractures in the multivariate regression analysis (OR=2.78, 95% CI: 1.13-6.86, OR=21.79, 95% CI: 2.73-174.03), and OR=1.11, 95% CI: 1.02-1.22, respectively). CONCLUSION: Our study results highlight the importance of known risk factors for upper extremity fractures such as lower monthly wage and the presence of previous fractures. The psychological states of parents and children should be evaluated together.

Effect of pulmonary embolism location on electrocardiological parameters.

OBJECTIVE: Pulmonary thromboembolism is a disease with high morbidity and mortality. Various changes occur on the electrocardiogram secondary to pulmonary thromboembolism. The objective of this study was to investigate variations in QT dispersion, Tpeak-Tend duration, and Tpeak-Tend/QT ratio in relation to pulmonary thromboembolism localization and their impacts on 30-day mortality. METHODS: This study was carried out in a tertiary emergency medicine clinic between December 1, 2019 and November 30, 2020. We evaluated correlations between radiological outcomes of patients, QT dispersions, T-wave dispersions, Tpeak-Tend durations, and Tpeak-Tend/QT ratios. We sought statistically significant disparities between these values, considering the presence or localization of pulmonary thromboembolism. The 30-day mortality in pulmonary thromboembolism-diagnosed patients was reassessed. RESULTS: Electrocardiogramfindings revealed that T-wave dispersion (p<0.001), Tpeak-Tend duration (p=0.034), and Tpeak-Tend/corrected QT ratio (p=0.003) were lower in patients than controls. Conversely, QT dispersion (p=0.005) and corrected QT dispersion (p<0.001) were higher in patients. CONCLUSION: Electrocardiogram findings such as T-wave dispersion, QT duration, Tpeak-Tend time, and Tpeak-Tend/corrected QT ratio can detect pulmonary thromboembolism. More studies with larger cohorts are required to further understand the role of QT and corrected QT dispersion in pulmonary thromboembolism patient mortality.

A Comparison of the Effects of Dexamethasone and Methylprednisolone, Used on Level-3 Intensive Care COVID-19 Patients, on Mortality: A Multi-Center Retrospective Study.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is often a mild disease, usually manifesting with respiratory complaints, and is sometimes mortal due to multiple organ failure. Hyperinflammation is a known COVID-19 component and is associated with organ dysfunction, disease severity and mortality. Controlling hyperinflammatory response is crucial in determining treatment direction. An important agent in providing this control is corticosteroids. This study aimed to determine whether dexamethasone and methylprednisolone, doses, administration time and duration in COVID-19 treatment are associated with improved treatment outcomes. METHODS: This retrospective multicenter study was conducted with participation of 6 healthcare centers which collected data by retrospectively examining files of 1,340 patients admitted to intensive care unit due to COVID-19 between March 2020 and September 2021, diagnosed with polymerase chain reaction (+) and/or clinically and radiologically. RESULTS: Mortality in the pulse methylprednisolone group was statistically significantly higher than that in the other 3 groups. Mortality was higher in older patients with comorbidities such as hypertension, diabetes mellitus, chronic kidney failure, coronary artery disease, and dementia. Pulse and mini-pulse steroid doses were less effective than standard methylprednisolone and dexamethasone doses, pulse steroid doses being associated with high mortality. Standard-dose methylprednisolone and dexamethasone led to similar effects, but standard dose methylprednisolone was more effective in severe patients who required mechanical ventilation (MV). Infection development was related to steroid treatment duration, not cumulative steroid dose. CONCLUSION: Corticosteroids are shown to be beneficial in critical COVID-19, but the role of early corticosteroids in mild COVID-19 patients remains unclear. The anti-inflammatory effects of corticosteroids may have a positive effect by reducing mortality in severe COVID-19 patients. Although dexamethasone was first used for this purpose, methylprednisolone was found to be as effective at standard doses. Methylprednisolone administered at standard doses was associated with greater PaO2/FiO2 ratios than dexamethasone, especially in the severe group requiring MV. High dose pulse steroid doses are closely associated with mortality and standard methylprednisolone dose is recommended.

Fuel, cost, energy efficiency and CO2 emission performance of PCM integrated wood fiber composite phase change material at different climates.

Wood fiber is a great potential supportive material for creating a new composite the phase change materials (PCM) due to its beneficial qualities, including high sorption competency, low density, enviro -friendliness, economic effectiveness, and chemical inertness. The main objective of this paper is to study the effect of using the wood fiber/eutectic mixture of stearic and capric acid on the fuel, cost, and carbon emission-saving potentials for various PCM cases. Which experiences a phase transition within the thermally pleasant temperature range of buildings, used for the building's thermal energy storing purposes and consumption cost saving. The energy performance analysis was carried out for buildings incorporated with stearic and capric acid eutectic mixture of PCM with wood fiber-based insulation material (INS) in different climate regions. The results showed that the largest energy-saving capacity belongs to PCM5. The energy saving reaches 52.7% for PCM5 for a thickness of 0.1 m. The PCM1, PCM2, PCM3, PCM4 can provide energy saving rates of 23.5%, 34.3%, 44.7% and 50.5%, respectively. INS-PCM5 can provide about 1.74-, 1.5-, and 1.33 times larger cost savings than INS in 2nd, 3rd, and 4th regions for all fuels. The payback period varies between 0.37 and 5.81 years regarding the fuel and Region. Finally, the results indicate that the proposed composite provided a promising energy-saving potential in building applications by reducing.

Comparison of the healthcare-associated infections in intensive care units in Turkey before and during COVID-19.

Background: Secondary bacterial infections are an important cause of mortality in patients with coronavirus disease 2019 (COVID-19). All healthcare providers acted with utmost care with the reflex of protecting themselves during the COVID-19 period. We aimed to compare the rates of ventilator-associated pneumonia (VAP) and bloodstream infections (BSIs) in our intensive care units (ICUs) before and during the COVID-19 outbreak surges. Methods: This multicenter, retrospective, cross-sectional study was performed in six centers in Turkey. We collected the patient demographic characteristics, comorbidities, reasons for ICU admission, mortality and morbidity scores at ICU admission, and laboratory test data. Results: A total of 558 patients who required intensive care from six centers were included in the study. Four hundred twenty-two of these patients (males (62%), whose mean age was 70 [IQR, 58-79] years) were followed up in the COVID period, and 136 (males (57%), whose mean age was 73 [IQR, 61-82] years) were followed up in the pre-COVID period. BSI and VAP rates were 20.7 (19 events in 916 patient days) and 17 (74 events in 4361 patient days) with a -3.8 difference (P = 0.463), and 33.7 (31 events in 919 patient days) and 34.6 (93 events in 2685 patient days) with a 0.9 difference (P = 0.897), respectively. The mortality rates were 71 (52%) in pre-COVID and 291 (69%) in COVID periods. Conclusion: Protective measures that prioritize healthcare workers rather than patients and exceed standard measures made no difference in terms of reducing mortality.

Acetabular index and acetabular depth ratio in newborns and infants aged 6 months or less with the healthy development of hips: A retrospective cross-sectional study.

Radiographic assessment of the hip may render critical in the diagnosis of developmental dysplasia of the hip (DDH) in newborns and infants aged ≤6 months. There is no complete dataset on the acetabular index (AI) and acetabular depth ratio (ADR) values in this age group. The objective of this study was to assess the AI and ADR values in newborns and infants aged ≤6 months with healthy development. A retrospective analysis was performed on pelvic radiographs of newborns and infants (≤6 months) between August 2020 and September 2021. There were 3000 children with pelvic radiographic imaging. Normal sonographic findings and radiographs without any structural deformity of the hip were inclusion criteria. A total of 1132 newborns and infants (2264 hips) were analyzed. Measurements of AI and ADR (ischium and pubic bone as landmarks for acetabular depth ratio A [ADR-A] and acetabular depth ratio B [ADR-B]) were performed. Correlation and intraclass correlation coefficient (ICC) values were calculated. Left-sided AI values were significantly higher than the right-sided AI values, except in infants aged 4 to ≤5 months (P < .05). ADR-B values differed significantly between male and female newborns and infants both in terms of the side of the hip measured and age (P < .05). AI values were fairly correlated with age (r = -0.286 for left and r = -0.254 for right) in the negative direction and with ADR-A (r = 0.449 and r = 0.469 for left and right) and ADR-B (r = 0.545 and r = 0.592 for left and right) in the positive direction. Inter-observer ICC was 0.845 to 0.989 (excellent) for AI, 0.534 and 0.904 (moderate to excellent) for ADR-A, and -0.014 and 0.774 (slightly good to good) for ADR-B. Intra-observer ICC was 0.811 to 0.996 (excellent) for AI, 0.575 to 0.98 (moderate to excellent) for ADR-A, and 0.023 to 0.954 (slightly good to excellent) for ADR-B. This study features the first complete data set of AI and ADR measurements, which are essential for pelvic radiographic imaging of hip dysplasia, in newborns and infants aged ≤6 months.

Cleaner production of polyurethane (PU) foams through use of hydrodesulfurization (HDS) spent catalyst.

Due to the increased population in the urbanized areas, considerable attention is being paid on the development of energy-efficient buildings. In construction, the use of insulating foams has grabbed considerable attention in recent decades due to their porous structure that can reduce thermo-acoustic conductivity leading to higher energy efficiency. Nonetheless, the production of certain foams (e.g., polymer foams) is based on harmful chemical substances, such as isocyanate, as well as having difficulty being recycled. In this regard, this study adopted the use of hydrodesulfurization (HDS) spent catalyst, which is a byproduct of petroleum industry and is known to be a hazardous solid waste material, to produce a more environmentally friendly composite foam with lower thermal conductivity. In this sense, a series of material property tests, as well as thermal conductivity test, have been conducted. In addition, to further confirm the impact of HDS inclusion in the produced foams, energy cost savings and CO2 emission reduction based on their actual application in four different environments and four different fuel types for heating have been evaluated. The results are found to be highly promising and point to the great potential of utilizing HDS spent catalyst as a hazardous waste to enhance the efficiency of foams leading to CO2 emission and energy use reduction by up to 68.79 kg/m2 and 8.6 kWh/m2, respectively. Finally, this would reduce the heating cost, up to 0.69 $/m2 in an idealized building. In the end, suggestions for future studies in this area are also provided.

Comparison of Ventilator-Associated Pneumonia in Patients Admitted to Intensive Care for COVID-19 Versus Other Reasons: A Single-Centered Study.

OBJECTIVE: COVID-19 patients in intensive care usually need invasive mechanical ventilation due to advanced respiratory failure. Deep lym- phopenia, immunosuppressive agents, long-term mechanical ventilation, and sedation may lead to ventilator-associated pneumonia; an impor- tant cause of morbidity and mortality. This study evaluates the frequency, clinical features, causative pathogens, and outcomes of ventilator-asso ciated pneumonia in COVID-19 patients who require mechanical ventilation. METHODS: The files of patients hospitalized in our hospital's intensive care clinic between March 25, 2020, and January 15, 2021, in the first 2 peaks due to COVID-19 and other reasons were retrospectively reviewed. RESULTS: We found ventilator-associated pneumonia rate in COVID-19 patients as 52.2%, which was statistically significantly higher than in non-COVID patients (33.5%). Purulent sputum, leukocyte, and procalcitonin levels were found to be significantly higher in both groups develop- ing ventilator-associated pneumonia. However, fever levels were found to be significantly normal in both groups; 97.1% and 87%, respectively. High fever was observed in only 2.9% of COVID-19 patients who developed ventilator-associated pneumonia. We determined a mortality rate of 17 (100%) in the diabetes patients in the COVID-19 group, which was statistically significantly higher than in non-COVID-19 patients at 9 (64.3%). The mortality rate (86.1%) in those with COVID-19 was statistically significantly higher than in those without COVID-19 (64.9%). CONCLUSIONS: Ventilator-associated pneumonia is more common in COVID-19 patients treated with mechanical ventilation than in non- COVID patients. The predictive value of fever in the diagnosis is very low, and agent production together with increased purulent sputum will be more valuable in terms of diagnosis.

The effect of steroids used in the treatment of coronavirus disease 2019 on infections in intensive care.

Objective: Cytokine storm in coronavirus disease 2019 (COVID-19) patients causes lung damage and acute respiratory distress syndrome (ARDS). Immunomodulators such as steroids are widely used to control this situation. This study investigates the effectiveness of steroids used in COVID-19 patients, and their effects on secondary infections, morbidity, and mortality. Methods: Data were obtained by retrospectively scanning the files of patients in our hospital's intensive care unit clinic during the three peak periods. Results: Between the steroid and non-steroid groups, there was no statistically significant difference in reproductive rates. These rates were 49.7% and 43.2%, respectively. Reproductive rates among steroid types were determined as 25 (56.8%) in the Methylprednisolone group, 18 (69.2%) (Highest) in the Dexamethasone + Methylprednisolone group, and 54 (43.2%) (Lowest) in the Dexamethasone group. Steroid treatment duration was effective on reproduction. Steroids cause more infections, especially after invasive procedures (Tracheal intubation, central venous catheter, etc.). In the groups with and without tracheal aspirate steroids, the growth rates were 71 (76.3%) and 32 (54.2%) respectively. There was no difference in mortality between the groups. Conclusion: Cytokine storm causes lung damage and ARDS. Steroids can be useful in controlling this hyper-inflammatory situation. However, increased secondary infections, an important side effect of steroids, increase mortality. Steroids more often cause these infections, especially in patients undergoing invasive Strict adherence to infection control measures during steroid treatment will reduce this risk. In conclusion, while steroids reduce mortality by controlling the hyper-inflammatory picture, they also increase mortality with increased secondary infections. Preventing infections enables success with steroids.

A critical overview of upstream cultivation and downstream processing of algae-based biofuels: Opportunity, technological barriers and future perspective.

Fossil fuels are sharing a large portion of energy demand. Conventional energy sources emit a huge amount of greenhouse gas into the atmosphere, which creates energy and environmental challenges for the ecosystem. To fulfill the world energy demand and to support environmental as well as economic development in a sustainable way, with the utilization of technological advancement of renewable energy resources, algae are presently believed as most adaptable feedstock materials for bioenergy production. Algae has a high fixation rate of atmospheric carbon dioxide which supports to fast growth rate with high productivity per unit area in the form of renewable algal biomass. The present article aims to elaborate on the three generations of biofuels, sustainable microalgae biomass production, cultivation systems, and a wide range of growth parameters. The microalgae harvesting methods and their challenges are also discussed, with a special focus on lipid extraction methods and future r recommendations. The upstream and downstream processes of microalgae could help to harness the microalgae energy in an eco-friendly manner and will help in achieving overall sustainable development.

Utilization of Chlorella pyrenoidosa for Remediation of Common Effluent Treatment Plant Wastewater in Coupling with Co-relational Study: An Experimental Approach.

Earlier investigations on biological methods of wastewater treatment have revealed that algal based wastewater treatment could be a green, cost effective and efficient approach for the removal of heavy metals. So, this study aimed to assess the potential of microalga Chlorella pyrenoidosa for remediation of heavy metals (Cr, Cu, Pb, Zn, Cd, Mn, and Ni) from varying concentration (25%, 50%, 75 and 100%) of wastewater collected from Common Effluent Treatment Plant. Heavy metals such as Cr, Cu, Pb, Zn, Cd, Mn, and Ni have been removed significantly from the wastewater, with percentage removal ranging from 73%, 60%, 75%, 66%, 87%, 83%, and 74% with 50% test solution, 57%, 59%, 70%, 56%, 72%, 66%, and 62% with 75% test solution, and 47%, 55%, 56%, 71%, 61%, 77%, and 72% with 100% test solution respectively. Studies on biochemical assay (protein, carbohydrate, and pigment) of Chlorella pyrenoidosa were also an important part of the present investigation to understand the interaction of heavy metals with algal biochemical compounds using Pearson correlation co-efficient. Biomass grown in CETP wastewater can be used for synthesis of various fruitful value-added end products like bio-diesel, pharmaceutical products, cosmetic products, bio-adsorbent etc.

Cultivation of two Chlorella species in Open sewage contaminated channel wastewater for biomass and biochemical profiles: Comparative lab-scale approach.

Open sewage contaminated channel wastewater (OSCCW) has high pollutant loads, responsible for eutrophication, when mixed with various channels of urban communities. But, these pollutants can be converted and recovered into useful end products with the help of algal species. In this study, two species of Chlorella (C. vulgaris and C. pyrenoidosa) were selected and investigated for the production of algal biomass and nutrient removal efficiencies with 50% concentration of OSCCW, in a comparative way at lab-scale. Chlorella sp. cultivated in OSCCW have removed nitrate (76.9-78.8%) and phosphate (67.6-79.7%) whereas COD (72.4-76.2%) and BOD (62.3-72.4%) respectively. Correlation analysis was investigated between physico-chemical parameters and biochemical profile of both species to analyze the positive and negative correlation between two variables. The bio-chemical profile and biomass productivity of both species of Chlorella were observed well on the basis of productivity of biomass (60.1, 56.5 mg/l/d), carbohydrate (15.71, 8.82 mg/l/d), protein (11.21, 15.82 mg/l/d), lipid (20.8, 17.5 mg/l/d) and chlorophyll (0.78, 0.67 mg/l/d) in OSCCW. The maximum lipid content (34.6%) was obtained with C. pyrenoidosa as compared to C. vulgaris. Findings also support that OSCCW is well-off with nutrient resources, which can be suitable alternative for algal biomass production and remediated wastewater can be used for animal and fish farming type activities.

Characteristics and outcomes of 974 COVID-19 patients in intensive care units in Turkey.

BACKGROUND: In our previous report on Turkish COVID-19 patients requiring intensive care, the 24 patients in a single ICU were elderly and mortality was high. We extended our analysis to include patients admitted to ten ICUs. OBJECTIVES: Report the demographics, clinical features, imaging findings, comorbidities, and outcomes in COVID-19 patients. DESIGN: Retrospective. SETTING: Intensive care unit. PATIENTS AND METHODS: The study includes patients with clinical and radiological confirmed or laboratory-confirmed COVID-19 infection who were admitted to ten ICUs between 15 March and 30 June 2020. MAIN OUTCOME MEASURES: Clinical outcomes, therapies, and death during hospitalization SAMPLE SIZE: 974, including 571 males (58%). RESULTS: The median age (range) was 72 (21-101) years for patients who died (n=632, 64.9%) and 70 (16-99) years for patients who lived (n=432, 35.2%) (P<.001). APACHE scores, and SOFA scores were higher in patients who died than in those who survived (P<.001, both comparisons). Respiratory failure was the most common cause of hospitalization (82.5%), and respiratory failure on admission was associated with death (P=.013). Most (n=719, 73.8%) underwent invasive mechanical ventilation therapy. CONCLUSIONS: The majority of patients admitted to the ICU with a diagnosis of COVID-19 require respiratory support. LIMITATIONS: Although the Turkish Ministry of Health made recommendations for the treatment of COVID-19 patients, patient management may not have been identical in all ten units. CONFLICT OF INTEREST: None.

The promising effects of BMP2 transfected mesenchymal stem cells on human osteosarcoma.

Selective targeting of transfected mesenchymal stem cells (MSCs) carrying specific antioncogenes to the tumor was suggested as a treatment option. Bone morphogenetic protein-2 (BMP2) was shown to inhibit the proliferation and aggressiveness of osteosarcoma (OS) cells. Here, we aimed to assess the homing efficiency of intraperitoneally administered hMSCs transfected with BMP2 to the tumoral site and their effects on OS using an orthotopic xenograft murine model. Orthotopic xenograft murine model of OS in six-week-old female NOD/SCID mice using 143B cells was established. hMSCs transfected with BMP2 (BMP2+hMSC) were used. In vivo experiments performed on four groups of mice that received no treatment, or intraperitoneally administered BMP2, hMSCs, and BMP2+hMSCs. Histopathological and immunohistochemical studies were used to evaluate the pathological identification and to assess the dimensions and necrotic foci of the tumor, the features of lung metastases, and immunostaining against p27, Ki-67, and caspase-3 antibodies. The osteogenic differentiation markers BMP2, BMP4, COL1A1, OPN, OCN and PF4 evaluated using RT-PCR. The tumor dimensions in the hMSCs group were significantly higher than those of the remaining groups (p < 0.01). The number of metastatic foci in the BMP2+hMSCs group was significantly lower than those of the other groups (p < 0.01). The current results showed that the intraperitoneal route could be efficiently used for targeting hMSCs to the tumoral tissues for effective BMP2 delivery. In this study, the effects of BMP2 transfected hMSCs on human OS and metastasis were promising for achieving osteogenic differentiation and reduced metastatic process.

Difference in the results of repair made with single or double rows according to the shape and size of the tear in arthroscopic rotator cuff surgery.

ABSTRACT: The aim of this study was to evaluate the effect on the results of patients applied with arthroscopic full layer total layer rotator cuff repair made according to the shape and size of the tear.The study included a total of 120 patients applied with arthroscopic full layer rotator cuff repair as single or double row repair. The patients were separated into 3 groups of 40 according to the shape of the tear, as Group A (crescent type), Group B (U type), and Group C (L type).The mean age of the whole sample was 66.68 ±â€Š6.86 years (range, 50-81 years). A statistically significant difference was determined between the groups in respect of constant murley (CM), American shoulder and elbow surgeons score (ASES), and University of California Los Angeles score (UCLA) scores (P < .05). The scores of Group A of all the scales were found to be higher than those of Group C (P < .05). In single row and double row repair of small and medium-sized tears of all shapes, no significant difference was determined in respect of the CM and UCLA scores (P > .05).No significant difference was determined between single and double row repair of crescent type tears of all sizes. In large U-shaped tears, the CM, ASES, and UCLA scores were determined to be high in double row repair.

Novel approach for harvesting of microalgal biomass using electric geyser waste material deposit as flocculant in coupling with poultry excreta leachate.

The aim of this work was to study the flocculation efficiency of algal biomass (Chlorella pyrenoidosa) in coupling with waste materials i.e. poultry excreta leachate by using other waste material which was obtained from deposition of scaling in electric geyser. Utilization of electric geyser waste material deposit (EGWMD) for flocculation is a novel approach because of various elements which are replica of chemical flocculants responsible for flocculation mechanism in culture medium. Flocculation process was optimized by response surface methodology and 98.21% flocculation efficiency was achieved with designed process parameters as temperature 32.5 °C, flocculant dose 275 mgL-1, pH 5 and time 30 min. The reusability of spent medium was also analyzed at 70.2% and 32.5% flocculation efficiency with two successive steps. The cellular morphology of pre-harvested and post-harvested Chlorella pyrenoidosa was also observed. EGWMD is abundant and freely available that has no application till now and can alternate of chemical flocculants.

Evaluation of poly(ethylene diamine-trimesoyl chloride)-modified diatomite as efficient adsorbent for removal of rhodamine B from wastewater samples.

Diatomite (D) as a low-cost and eco-friendly clay was modified by ethylene diamine (EDA)-trimesoyl chloride (TMC) polymer to achieve a novel adsorbent for efficient removal of rhodamine B dye (RB) from wastewater samples. The EDA-TMC polymer was grafted to the surface of diatomite by in situ interfacial polymerization. The prepared p(EDA-TMC)/D adsorbent was characterized by XRD, FTIR, and SEM/EDX techniques. The effective experimental parameters on the adsorption performance were optimized with factorial design analysis. The equilibrium data were better correlated by non-linear Langmuir model compared to non-linear Freundlich model. The Langmuir monolayer adsorption capacity of the p(EDA-TMC)/D adsorbent was determined as 371.8 mg g-1. The key adsorption parameters were optimized by experimental design analysis. The kinetic findings showed the adsorption mechanism of RB onto p(EDA-TMC)/D adsorbent was well designated by the pseudo-second-order kinetic model. The thermodynamic results indicate that the RB adsorption had an exothermic character in thermal nature and was less favorable with increasing temperature from 20 to 60 °C. Furthermore, the adsorption/desorption yield of p(EDA-TMC)/D was still 80%/70% after 5th cycle and reduced to 60%/52% at the end of 8th cycle. Thus, the present study revealed that the developed p(EDA-TMC)/D composite had great adsorption potential for removal of RB from wastewater samples compared to that of different kinds of adsorbents reported in the literature.

The Effect of Acromioplasty or Bursectomy on the Results of Arthroscopic Repair of Full Thickness Rotator Cuff Tears: Does the Acromion Type Affect These Results?

Objectives: The aim of this study was to investigate the effect of subacromial decompression on the results of full thickness rotator cuff repair applied arthroscopically. Examination was also made of the effect of acromion type on the subacromial decompression procedure in patients applied with arthroscopic rotator cuff repair. Methods: The study included a total of 150 patients, comprising 102 (68%) females and 48 (32%) males with a full thickness rotator cuff tear repaired arthroscopically. The patients were separated into three groups of 50. Group A comprised those with acromioplasty and bursectomy applied additional to the repair. In Group B, only bursectomy was performed additional to the repair and in Group C, only rotator cuff repair was applied. Evaluation was made of the post-operative long-term pain and functional results. Results: The mean age of the cases was 65.63±9.22 years (range, 46-86 years). The affected side was right side in 95 (63.3%) cases and left side in 55 (36.7%). No statistically significant difference was determined between the groups according to the post-operative Constant Murley and ASES scores (p>0.05). In the paired comparisons, the post-operative VAS scores of Group C were higher than those of Groups A and B (p=0.018, p=0.029, p<0.05). No statistically significant difference was determined between Group A and Group B in respect of the post-operative VAS scores (p>0.05). Conclusion: In the arthroscopic repair of full thickness rotator cuff tears, neither acromioplasty, coracoacromial ligament loosening nor bursectomy were determined to have any positive effect on the results. Whatever the acromion type, there is no need for an additional subacromial decompression procedure after rotator cuff repair, in respect of pain and functional outcomes. Only acromial spurs should be gently removed paying attention to the coraco-acromial ligament.

Diagnostic efficacy of apparent diffusion coefficient measurements in differentiation of malignant intra-axial brain tumors

Background/aim: To evaluate diagnostic efficacy of the apparent diffusion coefficient measurements from tumor (ADCt) and tumor circumference hyperintensities (ADCtch) in different types of malignant intra-axial brain tumors. Materials and methods: Between April 2013 and June 2017, 125 patients (52 females (41.6%) and 73 males (58.4%); mean age: 53 years, age range: 14-81 years), who underwent diffusion-weighted imaging (DWI) with intracranial mass, were retrospectively evaluated. The mean ADCt and ADCtch values and ratios were measured. Results: Of the 125 patients, 22 (17.6%) had a low-grade glioma (LGG), 55 (44%) had a high-grade glioma (HGG), 32 (25.6%) had metastasis, and 16 (12.8%) had lymphoma diagnosis. There was a statistically significant difference in LGG and HGG in terms of mean ADCt and mean ADCtch values, and ratios. ADCtch values and ratios showed a statistically significant difference in the differentiation of HGG and metastasis and in the differentiation of HGG and lymphoma. According to ROC curve analysis, a cut-off value of 1.49 × 10−3 mm2/s for the mean ADCtch value generated the best combination of 70% sensitivity and 71% specificity for differentiation of HGGs and metastasis. The mean ADCtch value had the highest statistical predictive value for differentiation of HGGs and lymphoma with a sensitivity of 78% and a specificity of 76% for the optimal cut-off value of 0.82 × 10ˉ3 mm2/s. Conclusion: The mean ADCt ratio allowed reliable differentiation of LGG and high grade brain tumors, including HGGs, metastases, and lymphoma. The mean ADCtch might be a better imaging biomarker in the differentiation of HHG from metastasis and lymphoma.