Correlation between Pulmonary Embolism and Sleep Apnea.

Introduction: It has been shown that there is a correlation between Obstructive Sleep Apnea Syndrome (OSAS) and pulmonary thromboembolism (PTE); OSAS is a risk factor for PTE. We aimed to evaluate the frequency of OSAS in PTE patients, the correlation of OSAS with the severity of PTE, and its effect on 1-month mortality in PTE patients. Methods: This single-center, prospective, comparative case control study contains 198 patients diagnosed with non-massive PTE in our hospital between the dates of 01/07/2018-04/01/2020 who were confirmed by imaging methods. Daytime sleepiness was assessed with Epworth questionnaires, and OSAS risk was assessed with Berlin, STOP, STOP-BANG sleep questionnaires. Alongside demographic and clinical data, comorbidities, Pulmonary Embolism Severity Index (PESI), simplified PESI (sPESI), WELLS scores, troponin, D-dimer values, echocardiyography (ECHO) findings were also examined. Epworth, Berlin, STOP, STOP-BANG sleep groups were compared in terms of PTE parameters. Results: A hundred and thirty-eight patients (69.6%) was assesed as high risk group according to Berlin, meanwhile STOP-BANG defined 174 patients (87.8%), furthermore STOP has considered 152 patients in the high risk group (76.7%) and Epworth questionnaire determined this number as 127 (64.1%). As a result of the logistic regression analysis, statistically significant correlation was found between Berlin score and heart failure, PESI, sPESI and troponin values; between Epworth score and WELLS score; between STOP-BANG score and PESI score (p<0.05). During the 1-month follow-up period, 9 of the patients were exitus and mortality was 4.5%. Conclusion: OSAS risk is more common in patients with PTE and it may be a risk factor for PTE. It has been shown that the risk of OSAS may aggravate PTE severity and prognosis.

From LUVs to GUVs─How to Cover Micrometer-Sized Pores with Membranes.

Pore-spanning membranes (PSMs) are a versatile tool to investigate membrane-confined processes in a bottom-up approach. Pore sizes in the micrometer range are most suited to visualize PSMs using fluorescence microscopy. However, the preparation of these PSMs relies on the spreading of giant unilamellar vesicles (GUVs). GUV production faces several limitations. Thus, alternative ways to generate PSMs starting from large or small unilamellar vesicles that are more reproducibly prepared are highly desirable. Here we describe a method to produce PSMs obtained from large unilamellar vesicles, making use of droplet-stabilized GUVs generated in a microfluidic device. We analyzed the lipid diffusion in the free-standing and supported parts of the PSMs using z-scan fluorescence correlation spectroscopy and fluorescence recovery after photobleaching experiments in combination with finite element simulations. Employing atomic force indentation experiments, we also investigated the mechanical properties of the PSMs. Both lipid diffusion constants and lateral membrane tension were compared to those obtained on PSMs derived from electroformed GUVs, which are known to be solvent- and detergent-free, under otherwise identical conditions. Our results demonstrate that the lipid diffusion, as well as the mechanical properties of the resulting PSMs, is almost unaffected by the GUV formation procedure but depends on the chosen substrate functionalization. With the new method in hand, we were able to reconstitute the syntaxin-1A transmembrane domain in microfluidic GUVs and PSMs, which was visualized by fluorescence microscopy.

Development and validation of the Turkish version of the Mobile App Rating Scale - MARS-TR.

BACKGROUND: The number of mobile health apps (MHAs) is growing rapidly. MHAs have great potential to improve health and health care. However, the quality of available MHAs remains unknown due to the lack of quality assessment regulations and standards for MHAs. The Mobile Application Rating Scale (MARS) is the most widely used instrument to assess the quality of MHAs, and available in English, Italian, Spanish, German, French, Arabic and Japanese. However, the scale is currently not available in the Turkish language. OBJECTIVE: This study aimed to cross-culturally adapt the MARS into Turkish and evaluate the validity and reliability of the scale. METHODS: The MARS was translated and adapted into Turkish according to the international guidelines. A total of 52 pregnancy tracking apps were evaluated by two independent raters. Internal consistency (Cronbach's alpha), inter-rater reliability (Intraclass Correlation Coefficient [ICC]), convergent validity and concurrent validity were explored. Regarding convergent validity, MARS-TR scores were compared with the ENLIGHT scale. RESULTS: The MARS-TR was highly aligned with the original MARS. The MARS-TR showed excellent internal consistency (Cronbach's alpha of 0.95 for both raters) and excellent inter-rater reliability (ICC = 0.94; SEM = 0.02), with a smallest detectable change (95 % confidence level) of 0.05 points for the total score. Cronbach's alphas for the subscales ranged from 0.76 to 0.94 for the two raters. Correlations between the MARS-TR and ENLIGHT demonstrated adequate convergent validity (P < 0.05). No ceiling or floor effects were observed. CONCLUSION: The results provide evidence that the Turkish version of MARS is a valid and reliable tool for researchers and experts to assess the quality of MHAs in Turkey.

The Relationship between Nutritional Parameters and Thrombosis Risk in Cancer Patients.

Venous thromboembolism which consists of pulmonary embolism and deep venous thrombosis is one of the most important problems in cancer patients. The mechanisms of cancer-associated thrombosis are multi-factorial and still unclear. Nutrition is an important factor in the treatment and prognosis of cancer. Assessment of the nutritional status of cancer patients is multifactorial and it should be performed at each visit. We aimed to assess the relationship between nutritional status and thrombosis risk in various cancer types. It was a cross-sectional and single-center study and 582 cancer patients were included. Patients nutritional status was evaluated with their height, weight, BMI, triceps skinfold thickness, waist circumference, and upper arm circumference. It was found that there was a statistically significant relationship between the thrombosis risk and nutritional parameters such as weight, BMI, and waist circumference which are important anthropometric measurements. As a result, thrombosis is an important cause of morbidity and mortality in cancer patients. Obesity and cachexia are both important conditions in cancer patients and should be well evaluated. It has been shown that increased weight, BMI, and waist circumference indicating obesity are important risk factors for thrombosis risk in cancer patients.

The self-confidence of dental students in oral surgery / La autoconfianza de los estudiantes de odontología en cirugía oral

ABSTRACT: The aim of this study is to evaluate the self-confidence of undergraduate students and thus to highlight the strengths and weaknesses of oral surgery education from the students' perspectives. A survey was conducted by preparing a questionnaire to assess the the self-confidence of students in performing oral surgery. Survey questions have been imported to Google Forms®. It was then electronically delivered to the students through the Turkish Dental Association. Regarding the data, besides the frequency and percentage distributions, the relationship between the variables was analyzed using the Chi-Square test. A total of 615 students, including 386 female and 229 male students, participated in this study. Of the students, 62.4% were 5th year and 37.56% were 4th year students. According to the survey, it was observed that male students and 5th year students were in general more confident in themselves. Students had low self-confidence in differentiating between odontogenic and non- odontogenic pain and recognizing malignant lesions or lesions with high malignant potential. In the oral surgery curriculum, subjects in which the students have issues should be identified and more emphasis should be placed on them. Oral pathology as well as head and neck anatomy courses should be emphasized further, priority should be given to case-based courses, and reminder presentations should be made at certain intervals. In addition, considering that practice is important for gaining self- confidence, students must practice more under the supervision of instructors in the areas in which they feel inadequate.

RESUMEN: El objetivo de este estudio es evaluar la autoconfianza de los estudiantes de pregrado y así resaltar las fortalezas y debilidades de la educación en cirugía oral desde la perspectiva de los estudiantes. Se realizó una encuesta mediante la elaboración de un cuestionario para evaluar la autoconfianza de los estudiantes en la realización de cirugía oral. Las preguntas de la encuesta se importaron a Google Forms®. Luego se les entregó electrónicamente a los estudiantes a través de la Asociación Dental Turca. En cuanto los datos, además de las distribuciones de frecuencia y porcentaje, se analizó tambien la relación entre las variables mediante la prueba Chi-Cuadrado. Se participaron 386 estudiantes femininas y 229 estudiantes masculinos en este estudio, un total de 615 personas. El 62,4% de los estudiantes eran del 5º año y el 37,56% eran estudiantes del 4º año. Según la encuesta, se observó que los estudiantes masculinos y los estudiantes del 5º año tenían en general más confianza en sí mismos. Los estudiantes tenían poca confianza en sí mismos para diferenciar entre dolor odontogénico y no odontogénico y reconocer lesiones malignas o lesiones malignas con alto potencial. En el plan de estudios de cirugía oral, se deben identificar las materias en las que los estudiantes tienen problemas y se debe poner más énfasis en ellas. Se debe enfatizar aún más los cursos de patología oral, así como de anatomía de cabeza y cuello. Se debe dar prioridad a los cursos basados en casos, y se deben hacer presentaciones recordatorias a ciertos intervalos. Además, considerando que la práctica es importante para aumentar la autoconfianza, los estudiantes deben practicar más bajo la supervisión de instructores en las áreas en las que se sienten inadecuados.

In vitro single vesicle fusion assays based on pore-spanning membranes: merits and drawbacks.

Neuronal fusion mediated by soluble N-ethylmaleimide-sensitive-factor attachment protein receptors (SNAREs) is a fundamental cellular process by which two initially distinct membranes merge resulting in one interconnected structure to release neurotransmitters into the presynaptic cleft. To get access to the different stages of the fusion process, several in vitro assays have been developed. In this review, we provide a short overview of the current in vitro single vesicle fusion assays. Among those assays, we developed a single vesicle assay based on pore-spanning membranes (PSMs) on micrometre-sized pores in silicon, which might overcome some of the drawbacks associated with the other membrane architectures used for investigating fusion processes. Prepared by spreading of giant unilamellar vesicles with reconstituted t-SNAREs, PSMs provide an alternative tool to supported lipid bilayers to measure single vesicle fusion events by means of fluorescence microscopy. Here, we discuss the diffusive behaviour of the reconstituted membrane components as well as that of the fusing synthetic vesicles with reconstituted synaptobrevin 2 (v-SNARE). We compare our results with those obtained if the synthetic vesicles are replaced by natural chromaffin granules under otherwise identical conditions. The fusion efficiency as well as the different fusion states observable in this assay by means of both lipid mixing and content release are illuminated.

Precipitation of Calcium Carbonate Inside Giant Unilamellar Vesicles Composed of Fluid-Phase Lipids.

Biomineralization of CaCO3 commonly involves the formation of amorphous CaCO3 precursor particles that are produced in a confined space surrounded by a lipid bilayer. While the influence of confinement itself has been investigated with different model systems, the impact of an enclosing continuous lipid bilayer on CaCO3 formation in a confined space is still poorly understood as appropriate model systems are rare. Here, we present a new versatile method based on droplet-based microfluidics to produce fluid-phase giant unilamellar vesicles (GUVs) in the presence of high CaCl2 concentrations. These GUVs can be readily investigated by means of confocal laser scanning microscopy in combination with bright-field microscopy, demonstrating that the formed CaCO3 particles are in conformal contact with the fluid-phase lipid bilayer and thus suggesting a strong interaction between the particle and the membrane. Atomic force microscopy adhesion studies with membrane-coated spheres on different CaCO3 crystals corroborated this notion of a strong interaction between the lipids and CaCO3.

Sleep problems, anxiety, depression and fatigue on family members of adult intensive care unit patients.

The purpose of this study was to determine the levels of sleep problems, anxiety, depression and fatigue in family members of intensive care patients in Turkey and factors affecting these complaints. This cross-sectional study was carried out with 350 first-degree relatives of intensive care patients at a university and state hospital. Data were collected between 5 January and 30 May 2014 using a personal information form, the Visual Analogue Scale for Fatigue, the Hospital Anxiety and Depression Scale and the modified Post Sleep Inventory. Of the 350 family members, 76% reported moderate or more serious problems. Anxiety was reported by 81.4% of the family members, and depression by 94.2%. Family members in the study had fatigue, with average scores of 79.42. There were significant correlations between the Visual Analogue Scale for Fatigue and anxiety, depression and scores on the Modified Post-Sleep Inventory (P < 0.05). Family members of intensive care patients experienced symptoms of fatigue, anxiety, depression and sleep problems. The prevalence of symptoms of sleep problems, anxiety and depression and complaints of fatigue was significantly higher in the family members of intensive care patients in Turkey than reported in the literature.