From Industrial Food Waste to Bioactive Ingredients: A Review on the Sustainable Management and Transformation of Plant-Derived Food Waste.

According to the United Nations, approximately one-third of the food produced for human consumption is wasted. The actual linear "Take-Make-Dispose" model is nowadays obsolete and uneconomical for societies and the environment, while circular thinking in production systems and its effective adoption offers new opportunities and benefits. Following the "Waste Framework Directive" (2008/98/CE), the European Green Deal, and the actual Circular Economy Action Plan, when prevention is not possible, recovering an unavoidable food waste as a by-product represents a most promising pathway. Using last year's by-products, which are rich in nutrients and bioactive compounds, such as dietary fiber, polyphenols, and peptides, offer a wake-up call to the nutraceutical and cosmetic industry to invest and develop value-added products generated from food waste ingredients.

Turkish pediatric residents' knowledge, perceptions, and practices of blood culture sampling.

INTRODUCTION: Pediatrics is one of the medical specialties in which blood cultures for bloodstream infections are performed very frequently. This study aimed to evaluate pediatric residents' knowledge and perceptions of blood culture sampling. MATERIAL AND METHODS: Between June 2019 and September 2019, a questionnaire comprising 20 questions about blood culture sampling was sent via email to participants who were pediatric residents at five different hospitals in Turkey. There were 11 true/false and nine multiple-choice questions that assessed three aspects of culture sampling: indications, sampling practice and knowledge, and contamination. The percentage of correct answers was used to calculate an overall score and subsection scores. RESULTS: A total of 132 pediatric residents [102 (77%) female] with a mean age of 28.3±2.8 years completed the questionnaire. Forty-five (35%) were in their 1st year of residency. Sixty (46%) participants reported that they had not performed blood culture sampling in the last week. There was a negative relationship between years in training and the number of cultures performed (Kendal's tau-b=-0.297, p<0.001). The overall median score was 65 (range, 35-90) and it seemed to increase with years of training. The lowest median score was in the contamination subscale and only one (0.76%) participant correctly answered all questions concerning contamination. CONCLUSION: Residents who obtained the majority of blood cultures had the lowest knowledge levels. Therefore, it is evident that the knowledge levels of pediatric residents must be increased in order to improve blood culture sampling practices in centers where they perform blood culture sampling.

A psychoeducation program for stress management and psychosocial problems in multiple sclerosis.

BACKGROUND: Multiple Sclerosis (MS) patients should cope effectively with problems of life and with problems originating from the disease. This is important because it affects the course of the disease, psychiatric morbidity, and quality of life. OBJECTIVE: This study was carried out as an intervention design with a control group to assess the effects of psychoeducation on MS patients' ways of coping with stress, psychiatric symptoms, and qualities of life. SUBJECTS AND METHODS: A total of 80 MS patients affiliated with the MS Association of Turkey were included and randomly assigned into intervention and control groups. An 8-week psychoeducation program was offered to the intervention group, whereas the control group was not given any treatment during the same period. Data were collected using a Descriptive Information Form, the Ways of Coping Inventory, the Brief Symptom Inventory, and the MS Quality of Life-54 scale. RESULTS: Based on the study, among the ways of coping with stress, problem-focused approach increased, whereas the emotional-focused approach decreased statistically significantly in the intervention group. Among the psychiatric symptoms, the levels of anxiety, depression, and somatization decreased. However, there was no significant change in the negative self-concept and hostility symptoms. The total quality-of-life scores increased significantly (P < 0.05). In the intervention group, these effects continued in the three-month-follow-up measurement. The control group showed no statistically significant change in the same parameters during the same periods. It is recommended that group psychoeducation programs should be carried out extensively in order for MS patients to cope with stress effectively and improve their mental health and quality of life.

Effect of psychosocial care model applied in an "elderly day care center" on loneliness, depression, quality of life, and elderly attitude.

BACKGROUND: The purpose of the study is to evaluate the effect of the model applied in order to meet psychosocial care needs of elderly people in an elderly day care center on loneliness, depression, quality of life, and elderly attitude. METHOD: An intervention program prepared for the psychosocial needs of elderly people was carried out in the study and it was evaluated as pretest-posttest. The data were collected with UCLA Loneliness Scale (UCLA, LS), Geriatric Depression Scale Short Form (GDS-SF), Turkish version of the WHO Quality of Life Instrument Older Adults Module (WHOQOL-OLD-TR) and Turkish version of the WHO - Atittudes of Aging Questionnaire (AAQ-TR) in the study. The psychosocial intervention program was conducted once in a week, nine sessions were held in total and each of them took 90-120 min. RESULTS: A statistically significant difference was found between the points that the elderly people obtained from the prior to and after UCLA Loneliness Scale and WHOQOL-OLD. TR instrument (P < 0.05). Besides, the difference between points gotten from the subdimensions "general," "psychosocial loss," and "psychosocial change" of AYTA-TR Scale was statistically significant. CONCLUSION: The intervention provided for the psychosocial needs of elderly people led to positive results in loneliness perception, quality of life, and elderly attitudes. Therefore, it is thought that this model is appropriate to be used commonly by nurses in psychosocial care of elderly people.

The influence of restorative material and glass fiber posts on fracture strength of endodontically treated premolars after extensive structure loss.

OBJECTIVE: The aim of this in vitro study was to investigate the fracture strength and cuspal deflection of endodontically treated premolars restored using different composite resins along with or without fiber post application. MATERIALS AND METHOD: Eighty intact premolars were randomly divided into eight groups (n = 10); CO group: intact teeth (control), OPR group: mesio-occlusal-distal-palatal (MODP) preparation (OPR) + endodontic treatment (ET), TC group: MODP preparation + ET + Tetric N-Ceram, TB group: MODP preparation + ET + Tetric EvoCeram Bulk Fill, SO group: MODP preparation + ET + SonicFill 2, TC-P group: MODP preparation + ET + Hahnenkratt glass fiber post + Tetric N-Ceram, TB-P group: MODP preparation + ET + Hahnenkratt glass fiber + Tetric EvoCeram Bulk Fill, and SO-P Group: MODP preparation + ET + Hahnenkratt glass fiber post + SonicFill 2. After thermocycling, specimens were subjected to a compressive load until fracture. Data were analyzed using analysis of variance and Tukey tests (P < 0.05). RESULTS: The mean fracture strength of groups which received post treatment showed similar fracture strength values [TC-P (931.6 ± 97.9), TB-P (882.0 ± 59.7), SO-P (862.0 ± 143.0) (P > 0.05)] and was significantly higher than OPR (530.6 ± 41.7), TC (841.2 ± 93.1), TB (774.5 ± 101.8), and SO (735.0 ± 178.01) groups (P < 0.05). No significant difference was detected among groups considering cuspal deflection (P > 0.05). The fiber post insertion resulted in more unfavorable fractures. CONCLUSION: Endodontically treated teeth restored with fiber post and bulk-fill or conventional composite resins demonstrated fracture strength values similar to intact teeth.

Long-term survival of different deep dentin caries treatments: A 5-year clinical study.

OBJECTIVE: The aim of this in-vivo study was to evaluate the long-term clinical survival of different deep dentin caries treatment options. MATERIALS AND METHODS: : In total, 391 patients with at least one permanent tooth with clinically diagnosed deep dentin caries were inspected. Two hundred and fourteen patients were examined at recall visits. Inclusion criteria were teeth with deep caries lesions with pulp vitality but absence of spontaneous pain and periapical alterations. The subjects received either stepwise removal (SWR), complete caries removal (CCR), or direct pulp capping (DPC). The radiological and clinical exams were performed after a mean observation time of 62 months. Success was defined as pulp sensitivity to vitality test and absence of periapical lesions as well as a clinical symptom. Data were statistically analyzed using Kaplan-Meier and log-rank (Mantel-Cox) tests (α = 0.05). RESULTS: Of the total 214 patients evaluated, 126 received SWR, 88 received CCR, and 67 received DPC treatment. One hundred and twenty-seven restorations were amalgam and 141 were composite. The mean observation period was 62 months. Survival rates were 85.7%, 90.9%, and 59.7% for SWR, CCR, and DPC, respectively (P = 0.001). Success rates of amalgam restorations (86.6%) were similar to composite restorations (83%), and both were found to be successful (P = 0.401). CONCLUSION: SWR treatment should be considered to preserve pulp vitality of deep dentin lesions instead of CCR or DPC. CLINICAL RELEVANCE: SWR method for deep dentin caries management had acceptable results over 5 years.

Investigation of SOSTDC1 gene in non-syndromic patients with supernumerary teeth.

BACKGROUND: The etiology of supernumerary teeth is still unclear however heredity is believed to be a major factor and this idea was supported by several case reports. Recently, a relationship between supernumerary tooth formation and deficiency of Uterine Sensitization Associated Gene-1 (Usag-1), a rat gene that is expressed in sensitized endometrium, was reported in mice. The human homolog gene for Usag-1, Sclerostin Domain Containing 1 (SOSTDC1), shows 85% identity with mouse Usag-1. The present study aimed to investigate SOSTDC1 coding regions in non-syndromic patients with one or more supernumerary teeth. MATERIAL AND METHODS: Twenty-five non-syndromic patients (21 male and 4 female) aged 5-15 years, with one or more supernumerary teeth were included in the study. Saliva samples were collected from patients and DNA samples were isolated and analyzed using PCR. RESULTS: Eight phenotypes of supernumerary tooth formation were observed in the study. From the DNA analysis, 2 novel and 3 previously identified sequence alterations were identified however, in investigating the Usag-1 homolog SOSTDC1 gene, the present study could not find any phenotype-genotype relationship. CONCLUSIONS: There are many SOSTDC1 homolog genes in the human genome and future studies should investigate these candidate genes. Also studies in larger case groups including family members may reveal the hereditary pattern.

Comparative Evaluation of Marginal Adaptation and Fracture Strength of Different Ceramic Inlays Produced by CEREC Omnicam and Heat-Pressed Technique.

OBJECTIVE: The aim of this in vitro study was to evaluate marginal adaptation and fracture strength of inlays produced by CEREC Omnicam using different types of blocs and heat-pressed technique. Methods: Seventy-five extracted human mandibular molars were divided randomly into 5 groups (n=15). 60 molars in four groups received MOD inlay preparations. Experimental groups were CO: Intact teeth, EC: IPS e.max CAD and CEREC, LU: Lava Ultimate and CEREC, EL: IPS Empress CAD and CEREC, EP: IPS Empress Esthetic ingots and heat-pressed technique. Marginal gap measurements were taken with a stereomicroscope. Restorations were cemented with Variolink N and stored in distilled water at 37°C for 24 hours. All samples were subjected to thermocycling. The fracture strength of specimens was determined at a 0.5 mm/min crosshead speed until fracture. Fracture modes were determined. Statistical analyses were performed using one-way analysis of variance for fracture strength data and Kruskal-Wallis for marginal gap data (p=0.05). RESULTS: The mean marginal gap size of EC, LU, EL, and EP were 33.54 µm, 33.77 µm, 34.23 µm, and 85.34 µm, respectively. EP had statistically higher values than other groups. The fracture strength values were significantly higher in the intact teeth group (3959,00 ± 1279,79 N) than those of restored groups EC (2408,00 ± 607,97 N), LU (2206,73 ± 675,16), EL (2573.27 ± 644,73) ve EP (2879,53 ± 897,30). CONCLUSION: Inlays fabricated using CEREC Omnicam demonstrated better marginal adaptation than inlays produced with heat-pressed technique, whereas fracture strength values of inlays fabricated with different type of blocks using CEREC Omnicam exhibited similarity to those fabricated with heat-pressed technique.

Turkish version of the SPAN questionnaire for highschool students: reproducibility and validity.

This study aimed to generate a Turkish version of the School Physical Activity and Nutrition (SPAN) (2009) questionnaire for high-school students and to test its validity and reproducibility. The questionnaire was translated and back translated and the language validity was assessed. It was tested and re-tested on 318 highschool students to evaluate its validity and reproducibility. Validity was determined by comparing the parts of the questionnaire about what was eaten in the previous day with that of 24-hour food consumption lists. Statistical analysis was performed by using Spearman correlation analysis, kappa statistics and percentage of agreement. The highest test-re-test results were on foods consumed the day before, with an agreement percentage range of 56%-96% and a kappa range of 0.43-0.95. The items related to physical activity had an agreement range of 38%-88% and a kappa range of 0.24-0.82. The reproducibility and validity of the Turkish version of SPAN questionnaire is acceptable and it is a rapid, easily used tool for the assessment of nutrition and physical activity in schoolchildren.

Turkish version of the SPAN questionnaire for high-school students: reproducibility and validity

This study aimed to generate a Turkish version of the School Physical Activity and Nutrition [SPAN] [2009] questionnaire for high-school students and to test its validity and reproducibility. The questionnaire was translated and back translated and the language validity was assessed. It was tested and re-tested on 318 high-school students to evaluate its validity and reproducibility. Validity was determined by comparing the parts of the questionnaire about what was eaten in the previous day with that of 24-hour food consumption lists. Statistical analysis was performed by using Spearman correlation analysis, kappa statistics and percentage of agreement. The highest test-re-test results were on foods consumed the day before, with an agreement percentage range of 56%-96% and a kappa range of 0.43-0.95. The items related to physical activity had an agreement range of 38%-88% and a kappa range of 0.24-0.82. The reproducibility and validity of the Turkish version of SPAN questionnaire is acceptable and it is a rapid, easily used tool for the assessment of nutrition and physical activity in schoolchildren

La présente étude avait pour objectif de générer une version turque du questionnaire SPAN [School Physical Activity and Nutrition] [activité physique et nutrition en milieu scolaire [2009] pour les élèves du secondaire et de tester sa validité et sa reproductibilité. Le questionnaire a été traduit puis a fait l'objet d'une rétro-traduction, et la validité de la langue a été évaluée. Il a été testé puis re-testé sur 318 élèves du secondaire afin d'évaluer sa validité et sa reproductibilité. La validité a été déterminée en comparant les parties du questionnaire sur les aliments consommés le jour d'avant avec celle comprenant des listes relatives à la consommation alimentaire sur une durée de 24h. L'analyse statistique a été réalisée à l'aide de l'analyse de corrélation de Spearman, du test du kappa et du pourcentage de concordance. Les résultats test-retest les plus élevés concernaient les aliments consommés le jour d'avant, avec un pourcentage de concordance compris entre 56% et 96% et un coefficient kappa allant de 0,43 à 0,95. Les items liés à l'activité physique avaient un pourcentage de concordance de 38 à 88% et un coefficient kappa de 0,24 à 0,82. La reproductibilité et la validité de la version turque du questionnaire SPAN est acceptable et constitue un outil rapide et simple d'utilisation pour évaluer la nutrition et l'activité physique chez les enfants scolarisés

Analysis of pulp chamber of primary maxillary second molars using 3D micro-CT system: an in vitro study.

AIM: The aim of this study was to determine the positional relationship between the crown contour and the pulp chamber as well as the morphological characteristics of the pulp chamber using micro-CT in order to plan, in restorations of deciduous maxillary second molars, reconstructions with a volumetric rendering programme. STUDY DESIGN: In total 16 deciduous maxillary second molar teeth (8 from boys, 8 from girls) were used. The positional relationship between crown contour and pulp chamber was three-dimensionally observed by micro-CT. Differences in sex, dentin thickness and pulp volumes were evaluated using chi-square and paired t-tests. Differences were considered significant when P < 0.05. RESULTS: Dentin thickness was found to be 2.8 mm ± 0.2, mesiobuccally 3.15 mm ± 0.2 distobuccally 3.8 ± 0.3, which was statistically significant (p ≤ 0.05). The pulp volume for boys was 77 mm³ ± 4, for girls 64 mm³ ± 5, with a statistical significance (p ≤ 0.05). CONCLUSIONS: General differences could play a role when planning a treatment for a child; however for both genders it should be noted that mesiobuccal pulp horn is most likely to get exposed during cavity preparation.

The relationship between T-wave peak-to end interval and ST segment recovery on intracoronary ECG during primary PCI.

OBJECTIVE: T-wave peak to end interval (TPE) is a measure of repolarization dispersion, which has been reported as a major arrhythmogenic factor post acute myocardial infarction. The aim of our study was to investigate the changes in TPE in this patient population with regard to peri-procedural intracoronary ECG findings. PATIENTS AND METHODS: Forty-four patients (34 male and mean age of 54.9 ± 10.9 years) with acute STEMI were included. Intracoronary ECG was performed during primary PCI. TPE indices were calculated before and after the procedure. Measurement of the intracoronary ST-segment was carried out before and just after coronary blood flow was established in the infarct related artery. Intracoronary ST-segment resolution (IC-STR) was defined as ≥ 1 mm compared to baseline. RESULTS: There was no difference with respect to baseline characteristics when patients with IC-STR were compared with patients without IC-STR. TPE values decreased significantly after primary PCI in patients with IC-STR (80.9 ± 22.8 ms vs. 65.8 ± 14.4 ms; p < 0.001) whereas they did not change significantly after PCI in patients without IC-STR (79.2 ± 20.9 ms vs. 68.5 ± 16.3 ms; p = 0.18). CONCLUSIONS: TPE measured from surface ECG recordings is significantly reduced in STEMI patients with successful reperfusion after primary PCI, as determined by IC-ECG recordings.

A decreased serum omentin-1 level may be an independent risk factor for peripheral arterial disease.

AIM: Recent evidence suggests that omentin-1, a visceral adipose-derived cytokine, may play a role in atherosclerosis The aim of this study was to evaluate whether serum omentin-1 levels are associated with peripheral artery disease (PAD) and its severity. METHODS: The present study was cross-sectional and observational. We enrolled 123 patients with PAD and 50 age-matched subjects without PAD. The cardiovascular risk factors, ankle-brachial index (ABI), and serum omentin-1 levels were assessed in all participants RESULTS: Patients with PAD had significantly lower omentin-1 levels than those without PAD (206. ±48.4 vs. 345. ±80 ng/mL, respectively; 0.001). A correlation analysis revealed positive correlations between the omentin-1 level and the ABI ( 0.52, P=0.008). After adjusting for cardiovascular risk factors, a decreased omentin-1 level was found to be an independent predictor of both PAD and its severity as measured by ABI in multivariate logistic regression analysis. CONCLUSION: The current study suggests a strong association between decreased serum omentin-1 levels and PAD and its severity. Thus, omentin-1 may be a novel biomarker for PAD.

Impaired coronary flow reserve in metastatic cancer patients treated with sunitinib.

PURPOSE: Hypertension is one of the major side effects of sunitinib, an angiogenesis inhibitor used in the treatment of metastatic renal cell carcinomas (mRCC) and gastrointestinal stromal tumors (GIST). Endothelial dysfunction, an early and reversible event in the pathogenesis of atherosclerosis, is suggested to be one of the possible underlying mechanisms of hypertension caused by angiogenesis inhibitors. Coronary flow reserve (CFR) measurement by trans-thoracic Doppler echocardiography (TTDE) reflects coronary microvascular and endothelial functions, as a cheaper and an easy screening test. We have used TTDE to evaluate endothelial function and coronary microvascular function in mRCC and GIST patients under sunitinib treatment. METHODS: Eighteen metastatic cancer patients (16 mRCC and 2 GIST) on sunitinib treatment and 27 healthy subjects were enrolled in this cross-sectional study. Thyroid stimulating hormone (TSH), lipid profile, creatinine, hemoglobin, glucose, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), anthropometric and physical parameters of patients were recorded. CFR recordings were performed by the Vivid 7 echocardiography device. RESULTS: CFR was significantly lower in patients when compared with controls (1.82±0.4 vs 2.71±0.8, respectively; p < 0.001). Impaired CFR was found in 13 (72%) patients whereas all controls had normal CFR values. CFR was inversely correlated with the duration of sunitinib treatment (r=-0.36, p =0.01), high sensitivite (hs) CRP (r = -0.574, p =0.01) and ESR (r = - 0.5, p = 0.02). CONCLUSION: Our findings indicate that CFR is significantly impaired in cancer patients on sunitinib treatment. There is an inverse correlation between CFR and duration of sunitinib treatment and inflammation markers.

Diagnostic value of liquid-based (Liqui-PREP) preparations and interobserver reproducibility in fine needle aspiration cytology of the nodular thyroid lesions.

The aim of this study is to define the diagnostic role of Liqui-Prep (LP) technique for the diagnosis of thyroid lesions and to assess interobserver variabilities. In all, 98 thyroid FNA (fine needle aspiration) cytology samples from 83 patients for preoperative evaluation of thyroid nodules, prepared by the LP, were examined. The LP slides were independently evaluated by three pathologists and they were classified into the five categories according to the Bethesda system. The histopathologic diagnoses were grouped as follows: benign, follicular neoplasm, and malignant. Agreements between LP and histopathologic diagnoses were investigated using kappa values. Marginal homogenity and kappa tests were used for statistical analysis for the evaluation of the agreement between the pathologists and the interobserver variability of the thyroid aspiration cytology results. The presence of nucleoli, nuclear grooving, overlapping, intranuclear inclusion, and nuclear irregularity were recorded and scored on each case based on LP slide review. Concurrences between LP and the histologic diagnoses for the three pathologists were almost perfect (k = 0.798; k = 0.826; k = 0.880). When the observers were paired there was no significant difference from the diagnostic point of view. Interobserver agreement among the three pathologists was moderate. Initially diagnostic difficulties may occur because of the inadequate experience of the pathologists concerning the evaluation of the cytologic changes associated with this new technique. Liqui-Prep technique is useful for the cytologic diagnosis of the thyroid nodules. The nuclear irregularity was the most essential feature for the differentiation of malignant lesions from follicular neoplasm by the LP method.

Home follow-up of early- and mid-stage Alzheimer's patients.

The study is carried out as an action research to investigate the effect of nursing interventions during home visits to early- and mid-stage Alzheimer's patients problems and the anxiety and depression levels. The study was realized as one initial visit, six weekly visits and another visit 1 month later in 40 early- and mid-stage Alzheimer's patients who met the study criterion and accepted to join the study presenting at a Turkish university hospital. The data were collected using the Alzheimer's Patient Data Collection Form, Cornell Scale for Depression in Dementia and Spielberg's State-Trait Anxiety Inventory. We found a statistically significant decrease in patient problems compared to the initial with nursing interventions administered during home visits during the study (P < 0.05). However, the follow-up visit 1 month after the weekly visits did not show persistence of this decrease in problems and some problems were found to have increased. There was a statistically significant decrease in the mean depression and situational and continuous anxiety scores of the patients at the end of the follow-up compared to the initial period with the nursing interventions administered during the follow-ups (P < 0.05). According to these results, it is recommended that continuous programmes for home care should be developed for Alzheimer's patients in Turkey.

Delayed onset bleomycin-induced pneumonitis.

We describe a 39-year-old male patient who developed bleomycin-induced pneumonitis 2 years after completion of chemotherapy for nonseminomatous testicular cancer. Bleomycin sometimes causes fatal pulmonary toxicity, including bleomycin-induced pneumonitis. The central event in the development of pneumonitis is endothelial damage of the lung vasculature due to bleomycin-induced cytokines and free radicals. Pulmonary toxicity usually begins at bleomycin administration. The development of bleomycin-induced pneumonitis up to 6 months after bleomycin therapy has also been reported. We report a patient who developed bleomycin-induced pneumonitis 2 years after the initiation of bleomycin-containing chemotherapy regimens.

Comparison of clinical and magnetic resonance imaging diagnoses in patients with TMD history.

The aim of this study was to evaluate the diagnostic accuracy of a well-defined clinical examination for diagnosing anterior disc displacement with and without reduction. A series of 40 patients with temporomandibular disorder (TMD) history were examined according to well-defined routine criteria. This examination included detailed history-taking, standardized clinical head and neck examination that included measurements of the range of motion, palpation of the temporomandibular joints and muscles of mastication for pain and auscultation of joint sounds. Magnetic resonance images of the joints were used as 'gold standard'. Diagnostic accuracy of the clinical examination was 83% for determining normal disc-condyle relationship, 72% for diagnosing anterior disc displacement with reduction, and 81% for diagnosing anterior disc displacement without reduction. Our results suggest that anterior displacement of the disc can be diagnosed with considerable accuracy using a well-defined clinical examination only. Therefore, we conclude that not all patients with TMD symptoms require magnetic resonance imaging examination before treatment.