Serum testosterone levels and oxidative stress in type 1 diabetes, type 2 diabetes, and obesity.

INTRODUCTION: Obesity, type 1 diabetes mellitus (T1DM), and type 2 diabetes mellitus (T2DM) are metabolic diseases that continue to be a global problem. Testosterone levels in men are affected by several factors, including obesity and DM. Although the relationship between diabetes and testosterone is not fully understood, oxidative stress is thought to play a major role. The aim of this study was to compare serum testosterone levels and oxidative stress markers [total antioxidant status (TAS), total oxidant capacity (TOS), oxidative stress index (OSI), and ischaemic modified albumin (IMA)] among the control group and experimentally induced obese, T1DM, and T2DM rats. MATERIAL AND METHODS: The study included 28 male Sprague-Dawley rats divided into 4 groups: the obesity group were fed a high-fat diet (HFD), the T2DM group received a HFD plus a single dose of streptozocin (STZ), the T1DM group received only STZ, and there was a control group. Serum testosterone, TAS, TOS, OSI, and IMA were analysed. RESULTS: Serum testosterone levels were lower in the T1DM and T2DM groups compared to the control and obesity groups. The TOS levels were highest in the T2DM group, followed by the T1DM group, the obesity group, and finally the control group. No significant difference was found between the obesity group and the control group in terms of TOS levels. Regarding TAS levels, the order observed was control group > obesity group > T2DM > T1DM. Testosterone was positively correlated with TAS and negatively correlated with TOS and OSI. CONCLUSIONS: Increased oxidative stress in diabetes may be an important factor that decreases serum testosterone levels.

Association between vitamin D receptor gene FokI polymorphism and mortality in patients with sepsis.

BACKGROUND: Sepsis is life-threatening organ dysfunction as a result of the host's dysregulated immune response to infection. The vitamin D receptor (VDR) gene FokI polymorphism influences immune cell behavior. In the present study, we aimed to investigate the association between VDR FokI polymorphism and mortality in sepsis and non-sepsis patients in the intensive care unit (ICU). METHODS AND RESULTS: This is a prospective observational study involving 96 sepsis and 96 non-sepsis patients admitted to the Ege University ICU. VDR FokI polymorphisms were investigated, as well as the relationship between the identified polymorphisms and mortality.  In-hospital mortality was 27.1% in the sepsis group and 8.33% in the non-sepsis group (p = 0.001). The frequencies of VDR FokI TT, TC, and CC genotypes were 8 (8.33%), 48 (50.0%), and 40 (41.7%) in the sepsis group, and 11 (11.5%), 42 (43.8%), and 43 (44.8%) in the non-sepsis group, respectively (p = 0.612). In the sepsis group, the frequencies of Fokl TT, TC, and CC genotypes did not differ significantly between survivors and non-survivors. However, homozygous C allele carriers had lower overall mortality (p = 0.047). CONCLUSION: The VDR FokI polymorphism, particularly the CC genotype, appears to be associated with lower mortality in ICU patients.

Increasing farm size is an effective way to decrease the carbon footprint in dairy cattle production.

The purpose of this study was to investigate the effects of the farm size on the carbon footprint of dairy cattle farms in Isparta province in Türkiye. For this purpose, face-to-face interviews were conducted with 159 farms which represent 1866 dairy cattle farms in Isparta province. The number of animals on the farm was converted into animal unit (AU) and the farms were divided into three groups. Accordingly, farms were classified as small, medium, and large farms. The carbon footprint produced per AU in the farm was the sum of feed, enteric fermentation, CH4 from manure, CO2 from manure, N2O from manure, and anthropogenic emissions. The milk produced in the farms was standardized according to 4% fat and 3.3% protein (FPCM) and the ratio of meat to milk was found by dividing the total live weight gain produced except for cows by FPCM. Accordingly, 65% of the greenhouse gas emissions of dairy farms were allocated to milk and 35% to meat. Of the total emissions, enteric fermentation and emission on feed contributed the highest proportion. Results showed that when using the IPCC (2021) global warming potential (GWP) values, the carbon footprint for 1 kg of FPCM milk was 1.26 kg CO2-eq on average, whereas the carbon footprint for 1 kg of meat was 11.78 kg CO2-eq on average. Results showed that as farm size increased carbon footprint for a kilogram of FPCM and meat decreased and this showed the effectiveness of farm size on decreasing carbon footprint per unit of product.

Hepatic insulin synthesis increases in rat models of diabetes mellitus type 1 and 2 differently.

Insulin-positive (+) cells (IPCs), detected in multiple organs, are of great interest as a probable alternative to ameliorate pancreatic beta-cells dysfunction and insulin deficiency in diabetes. Liver is a potential source of IPCs due to it common embryological origin with pancreas. We previously demonstrated the presence of IPCs in the liver of healthy and diabetic rats, but detailed description and analysis of the factors, which potentially can induced ectopic hepatic expression of insulin in type 1 (T1D) and type 2 diabetes (T2D), were not performed. In present study we evaluate mass of hepatic IPCs in the rat models of T1D and T2D and discuss factors, which may stimulate it generation: glycaemia, organ injury, involving of hepatic stem/progenitor cell compartment, expression of transcription factors and inflammation. Quantity of IPCs in the liver was up by 1.7-fold in rats with T1D and 10-fold in T2D compared to non-diabetic (ND) rats. We concluded that ectopic hepatic expression of insulin gene is activated by combined action of a number of factors, with inflammation playing a decision role.

Ultrasound guided versus blinded injection in trigger finger treatment: a prospective controlled study.

BACKGROUND: Trigger finger is a common disease with a lifetime prevalence of 2%. One of the frequently preferred non-surgical treatments is blinded injection around the A1 pulley. This study aims to compare the clinical results of ultrasound-guided and blinded corticosteroid injection in the trigger finger. METHODS: In this prospective clinical study, 66 patients who had persistent symptoms of a single trigger finger were included. Patients with similar baseline characteristics such as age, gender, triggering period, and comorbidities were randomized. 34 patients had ultrasound-guided (UG), and 32 had blinded injections (BG). QDASH, VAS, time to return to work, and complications were compared between the groups. RESULTS: The mean age was 52,66 (29-73) years. There were 18 male and 48 female patients. In the UG, the triggering resolved faster, returning to work was earlier, and the medication period was shorter (p < 0.05). A total of 17 patients who had diabetes mellitus received re-injections, 11 of which were in BG and 6 in UG (p < 0.05). Although statistically significantly lower scores were obtained in UG at the 1st and 4th weeks in the QDASH and VAS scores (p < 0.05), at the 12th and 24 weeks, there was no significant difference (p > 0.05). CONCLUSION: Using ultrasound guidance for corticosteroid injections is more effective for treating trigger fingers than the blinded method, leading to better results and a faster return to work in the early stages of treatment.

An Exploratory Study of the Effect of Tinnitus on Listening Effort Using EEG and Pupillometry.

OBJECTIVE: Previous behavioral studies on listening effort in tinnitus patients did not consider extended high-frequency hearing thresholds and had conflicting results. This inconsistency may be related that listening effort is not evaluated by the central nervous system (CNS) and autonomic nervous system (ANS), which are directly related to tinnitus pathophysiology. This study matches hearing thresholds at all frequencies, including the extended high-frequency and reduces hearing loss to objectively evaluate listening effort over the CNS and ANS simultaneously in tinnitus patients. STUDY DESIGN: Case-control study. SETTING: University hospital. METHODS: Sixteen chronic tinnitus patients and 23 matched healthy controls having normal pure-tone averages with symmetrical hearing thresholds were included. Subjects were evaluated with 0.125 to 20 kHz pure-tone audiometry, Montreal Cognitive Assessment Test (MoCA), Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS), electroencephalography (EEG), and pupillometry. RESULTS: Pupil dilation and EEG alpha band in the "coding" phase of the sentence presented in tinnitus patients was less than in the control group (p < .05). VAS score was higher in the tinnitus group (p < .01). Also, there was no statistically significant relationship between EEG and pupillometry components and THI or MoCA (p > .05). CONCLUSION: This study suggests that tinnitus patients may need to make an extra effort to listen. Also, pupillometry may not be sufficiently reliable to assess listening effort in ANS-related pathologies. Considering the possible listening difficulties in tinnitus patients, reducing the listening difficulties, especially in noisy environments, can be added to the goals of tinnitus therapy protocols.

Dynamic eye-tracking evaluation of responding joint attention abilities and face scanning patterns in children with attention deficit hyperactivity disorder.

There has been growing evidence that autistic traits are more represented in children with attention-deficit hyperactivity disorder (ADHD). The purpose of this study was to investigate autistic traits associated with responding joint attention (RJA) abilities and face scanning patterns using eye-tracking in children with ADHD, and to compare with typically developing peers (TDs). All child participants viewed a series of videos related to male and female children under congruent and incongruent conditions during eye-tracking evaluation. The object and face regions of the models within the videos were determined as areas of interest (AOIs). Children with ADHD had significantly elevated ratings of autistic traits than TDs. Time course analysis of the proportion of fixations (PoF) on object region determined that children with ADHD tended to show more interest in the objects and had higher PoF on face interest area, including eyes and mouth compared to TD children in the videos when the male/female model shifts his/her gaze to the corner. Higher SRS scores were associated with higher PoF on the Face AOI in both groups. Given these findings, social skill interventions directly targeting the core deficits of RJA and problems in facial scanning appears to be beneficial in children with ADHD.

Pupil Dilation Response to Prosody and Syntax During Auditory Sentence Processing.

Pupil dilation response has been shown to reflect different levels of sentence processing during prosodic and syntactic processing in language comprehension. Our pupillometry experiment aimed to investigate whether pupil diameter was sensitive to the auditory sentence processing involved in comprehending congruent and incongruent statements. Twenty-one participants were presented with 300 auditory stimuli consisting of syntactically and/or prosodically congruent and incongruent sentences in Turkish. The pupillary response results were significant only for syntactically incongruent sentences and for sentences that were both syntactically and prosodically incongruent. This indicates that prosody had no significant effect on its own. Based on the hypothesis that prosodic and syntactic processing require cognitive sensitivity for auditory sentence comprehension, we expected an increase in pupil diameter for both processes. However, our findings are consistent with the previous assumptions that pupil size increases during syntactic manipulation, but our findings showed that prosodic processing does not increase pupil size, contrary to previous studies.

Therapeutic Monoclonal Antibody Interference in Monoclonal Gammopathy Monitoring: a Denosumab Experience.

A 73-year-old woman was diagnosed with a lambda light chain myeloma. A follow-up immunofixation electrophoresis showed a monoclonal immunoglobulin (Ig)G kappa in addition to the regular lambda band. A monoclonal antibody therapy interference was suspected but her VRD (bortezomib, lenalidomide, dexamethasone) regimen did not include such a medication. Later it was learned that she was prescribed denosumab, a monoclonal human antibody agent to treat bone lesions. The IgG kappa band disappeared 7 months after the first and 4 months after the last dose of denosumab, confirming a case of interference. This case once again emphasizes the importance of delta check and close communication between clinicians to avoid a false result in electrophoresis. It also describes the migration pattern of denosumab. As therapeutic antibodies gain approval and enter into common clinical practice, drug interference will complicate electrophoresis testing in diagnosis and patient follow-up.

The cost and profitability analysis of different dairy farm sizes.

Dairy cattle production is a substantial industry in Türkiye's livestock sector, with a significant economic impact. Because of its proximity to Türkiye's major market zone, the Mediterranean and Aegean regions, the province of Isparta can develop its milk production capacity and make investments in dairy production. Therefore, the purpose of this study was to look into production costs and drivers of profitability for dairy farms of various sizes in Isparta, a major milk-producing region in Türkiye. The study included data from 159 dairy cattle farms operating in the production period 2020-2021 in the designated area. Dairy farms were separated into three groups based on size and analysed consequently. The findings revealed that total feed consumption was higher on small-scale farms, while milk production was lower. Feed costs were the highest portion of the total production cost among the cost items (72.86%), followed by permanent labour costs (7.12%). Furthermore, milk sales income (64.39%) was the largest contributor to the average income in terms of the gross product value. Aside from milk production, it was discovered that cattle value appreciation (24.12%) increased farm income. Consequently, as farm size increased, production costs per animal unit fell while net profit rose. Finally, feed is the most significant input that boosts milk production costs. Also, larger farms were found to be more profitable in the study area. Thus, it was concluded that policies that could have a favourable effect on an increase in the cattle population on the farm should be advanced in the study area.

Discordant Hemoglobin Values Determined by Blood Gas Analyzer and Hematology Analyzer Synchronously Is a Warning for Inappropriate Blood Sampling.

A patient may have two contemporary hemoglobin test results; one received from a hematology analyzer and the other from a blood gas analyzer. Such results may pose a dilemma if validated without investigation. A 27-year-old female patient presented to the emergency department because of worsening dyspnea and hemoptysis. Her hemogram revealed Hb 4.5 g/dL; Hct 16.1% while blood gas analysis showed Hb 8.1 g/dL; Hct 25.3%. The results were evaluated to be suspicious. All results were rejected and new requests were made. Hb 9.8 g/dL; Hct 31.9% were seen in repeated hemogram while blood gas analysis showed Hb 10.2 g/dL; Hct 31.5%. It was understood that the nurse used the vein with an intravenous fluid for sampling the first hemogram. A multitude of factors affect the accuracy of hemoglobin concentration measurements. Literature suggests that hemoglobin values of hematology analyzers and blood gas analyzers should be in harmony. Any discordance must be an alarm to stop and review the test results before validation.

Dynamic changes in the food-cue processing of obese adolescents: A controlled eye-tracking study from a dual-system perspective.

Adolescent obesity is a growing global health problem. Studies have demonstrated that exposure to food cues plays a role in both the development and the persistence of obesity. Understanding how visual attention changes dynamically in response to food cues may explain how they contribute to obesity. The primary aims were to evaluate attentional bias for food cues and conduct a time-course analysis of obese adolescents' food-cue processing. We also investigated the roles of inhibition, cognitive flexibility, and eating styles in their visual attention to food stimuli. A total of 60 age- and gender-matched 12-16-year-olds (n = 30, obese group; n = 30, control group; M = 13.9 years, SD = 1.26) were included in this study's sample. The participants viewed a series of high-calorie and low-calorie food images along with nonfood images in the free exploration paradigm during eye-tracking. Time-course analysis of the proportion of fixations on images of food and high-calorie foods determined that the attentional processing of the two groups differed, especially in later stages. The obese group had higher Stroop Interference and Trail Making Test-B scores than the control group, but these executive functions' scores did not affect their proportions of fixations on food and high-calorie food images over time. Higher Perceptual Reasoning Index scores led to a decrease in the proportions of fixations on high-calorie food images over time in the obese group, and this was particularly noticeable after about 4000 ms. This study found that time-course analysis of visual attention to food cues allows us to understand how it changes dynamically over larger time intervals. Future studies should provide knowledge about maintained attention for food cues and their relationship with top-down factors in obese adolescents.

Production of time reference in Turkish Broca's aphasia: The effect of morphological complexity.

In PWA (people with aphasia) difficulties with sentences that refer to the past compared to non-past time reference have been shown for many languages, including Turkish. However, the impact of morphological complexity on past time reference ability in production has not yet been reported for Turkish-speaking PWA. Turkish, where verb forms have complex inflectional paradigms and exhibit overt and non-overt morphology, facilitates the examination of the effects of morphological complexity. The current study has two objectives: 1) to investigate whether the morphological complexity of the verb form affects time reference production of Turkish-speaking PWA and 2) to provide analysis for the error patterns discovered. Seventeen Turkish individuals with Broca's aphasia who were matched in age with a control group of 17 neurologically intact Turkish individuals were tested with a picture sentence completion task. Test conditions were present progressive, simple past, past perfect, past progressive, and future tense. The task required the participants to complete each sentence frame with a verb. Our findings show that Turkish-speaking PWA were more successful in producing verb forms referring to non-past than verb forms referring to the past time reference. The current study supports previous findings that past is more difficult than non-past time reference for Turkish-speaking PWA. In terms of morphological complexity, we find that PWA were more impaired when producing morphologically complex verb forms rather than morphologically simple forms. We argue that these impairments lie in the realization of overt morphology.

Atypical cells parameter in Sysmex UN automated urine analyzer: feedback from the field.

BACKGROUND: "Atypical cells" parameter in automated urinalysis has recently been introduced. An instrument capable of measuring quantitative and qualitative features of nuclear and cytoplasmic properties of a cell has the potential to detect cellular atypia. Instruments using flow cytometry have been detecting atypical cells in blood for a long time; yet instruments using the same methodology very lately developed this parameter in urinalysis. MATERIALS AND METHODS: Samples with an atypical cells value higher than 1 atypical cell/µL were included in the study. Besides automated urinalysis, every sample was reflexed to modular unit for digital imaging. The remainder of each sample was stained with Sternheimer dye and examined manually under a light microscope. RESULTS: 50 samples with higher than1 atypical cell/µL result were included in the study. Patients were composed of 43 females (86 %) and 7 males (14 %). The mean age was 47.12 ± 19.45 years. The median atypical cells value was 1.8/µL (95 % range 1.5-2.4/µL). Manual microscopic evaluation of the 50 samples showed atypical cells in 1 sample. The patient had papillary lesions on cystoscopy and pathology report informed a high grade urothelial carcinoma. Other 49 samples were negative for atypical cells in manual microscopy. They were crowded samples with leucocytes and squamous epithelial cells. CONCLUSIONS: The positive case provided evidence for Sysmex UN's capability to detect atypical cells in urine. The negative cases presented clues that probable vulvovaginal contamination and crowded specimens could be deceptive for Sysmex UN in this particular parameter.

The effect of Subthalamic nucleus deep brain stimulation on verb and noun naming in Turkish-Speaking Parkinson's disease patients.

Parkinson's disease (PD) is associated with an action language deficit. Subthalamic nucleus deep brain stimulation (STN DBS) deteriorates verbal fluency, but may improve verb naming more than nouns in PD. We investigated effects of grammatical class (verb vs noun), action content (action vs non-action) of words and unilateral, bilateral or no stimulation on naming. Nouns were named more accurately and faster by controls and PD participants; however the noun-verb difference was higher for PD participants. Language, executive and visuospatial function deficits in PD accounted for this difference between PD group and controls. Noun-verb difference was accounted by differences in imageability, familiarity and complexity of the stimuli. Non-action words were named more accurately than action words in the overall sample. Stimulation conditions did not have an effect on naming. This study in Turkish-speaking participants show an action language deficit due to underlying cognitive deficits without an STN DBS effect in PD.

Effects of Complement Regulators and Chemokine Receptors in Type 2 Diabetes.

CD55 and CD59 are complement regulatory proteins suggested to be related with progression of diabetes and its complications. The stromal cell-derived factor 1 (SDF-1) and C-X-C chemokine receptor type 4 (CXCR-4) are chemokine proteins. We aimed to investigate the relation of CD55 and CD59 expression levels and polymorphisms of SDF-1 and CXCR-4 with type 2 diabetes mellitus (T2DM) and its complications. Seventy-five T2DM patients and 73 controls were enrolled. Expression levels of CD55 and CD59 were measured by FACS Calibur; qRT-PCR was used to determine SDF-1 and CXCR-4 gene polymorphisms. CD55 and CD59 expressions in patients with nephropathy, retinopathy and cardiovascular disease were significantly lower than controls. Frequency of CXCR-4 T allele carrying was high in patients and created 1.6 fold risk for the disease (p = .07). CXCR-4 a allele carriers had decreased nephropathy; although there was no statistical significance in carrying CXCR-4 T allele, presence of nephropathy was approximately 2 times higher (p = .254). The nephropathy risk increased 10-fold in CXCR-4 TT genotype carriers (p = .02). All SDF-1 CC genotype carriers had retinopathy, so, it was considered that the CC genotype was effective in retinopathy development (p = .031). For the presence of cardiovascular disease, significant difference was observed for SDF-1 genotypes. Increased cardiovascular risk of 5- and 1.9-fold in SDF-1 T (p = .007) and CXCR-4 T (p = .216) allele carriers, respectively, was observed. We suggest that CD55 and CD59 protein levels and SDF-1 and CXCR-4 have predictive importance in process, complications and tendency of T2DM.

Atypical cells parameter in an automated urine analyzer: Does it have a future?

Sysmex UN-Series automated urine analyzer has recently introduced "atypical cells" parameter. These cells are supposed to be epithelial cells with features of suspicion for a neoplastic proliferation. Atypical cells parameter in urinalysis should be considered to be as useful as the blast parameter in hematology. However, it has many disadvantages compared to its counterpart. I suggest it should be used as a caution flag rather than a quantitative value to appear in the patient result page. A decision limit must be defined; perhaps the color parameter should be matched to define patients with both hematuria and atypical cells.

The Comparison of the Morphological and Syntactic Awareness Skills of Deaf and Hard of Hearing Students Regarding Agreement and Tense Categories that Exist in Verbs in Reading Activities with those of Students Without Hearing Disabilities.

The difficulties in learning skills that deaf and hard of hearing students encounter stem from morphology and syntactic morphology (morpho-syntax) and it is clear that there are limited studies related to these. In this study, it is aimed at examining hearing and deaf and hard of hearing students' morpho-syntactic actions which are compatible with the Turkish Sign Language and the awareness skills of these actions in the time categories. In total 122 students; 57 deaf and hard of hearing students from secondary and high school and 65 hearing students have participated this study. The data is gathered through DMASTR and SuperLab 5 software programs where data is collected by a process with a "word reading method" and "an inclusion of agreement and tense categories in actions". In the outcome of the study it is identified that students hard of hearing had an underachievement in the agreement and tense categories compared to hearing students. At the agreement category, in terms of reading duration it is seen that deaf students' verbs with disagreement compared with verbs with agreement, they read faster. In the tense category, it is clear that deaf and hard of hearing students' accuracy rate of reading words have got similarities in the categories of past and future tenses whereas they have got inadequacies in the present tense, when the data is observed in terms of the speed of reaction and reading duration, it is seen that they are more successful in the past tense. In accordance with these findings, it is indicated that hard of hearing students have shared the same reading skills with their hearing peers whereas they had plenty of difficulties related to reading skills some of them which are from the fields of morphology and syntactic morphology, in the steps of formal education.

Regional distribution of genetic mutation in lung cancer in Turkey (REDIGMA).

INTRODUCTION: The results of standard chemotherapy in lung cancer are not very satisfactory, so it is important to identify genetic mutations that provide targeted therapies. Recent reports have suggested influences of racial difference on the frequency of mutation in lung cancer. We aimed to determine the frequency and regional distribution of genetic mutations of non-small cell lung cancer (NSCLC) in Turkey. MATERIALS AND METHODS: Regional distribution of genetic mutations in lung cancer in Turkey (REDIGMA) study was carried out as a prospective, cross-sectional, observational study in a large number of centers in which lung cancer patients were followed and could perform genetic mutation analysis on patients' biopsy materials. RESULT: The 703 patients (77.7% male, mean age 63.3 ± 12.5 years) who were diagnosed as NSCLC from 25 different centers were included in the study. Tumor samples from patients were reported as 87.1% adenocarcinoma, 6.4% squamous cell carcinoma and 6.5% other. Mutation tests were found to be positive in 18.9% of these patients. The mutations were 69.9% EGFR, 26.3% ALK, 1.6% ROS and 2.2% PDL. Mutations were higher in women and non-smokers (p<0.000, p<0.001). Again, the frequency of mutations in adenocarcinoma was higher in metastatic disease. There was no difference between the patient's age, area of residence, comorbidity and clinical stage and mutation frequency. CONCLUSIONS: Our study revealed that the EGFR mutation rate in Turkey with NSCLC was similar to East European, African-American and Caucasian patients, and was lower than in East Asia.