Prediction of Intraperitoneal Adhesions in Repeated Cesarean Deliveries with Stria Gravidarum Scoring System: A Cross-sectional Study.

BACKGROUND: The preoperative prediction of intraperitoneal adhesion (IPA) before repeated cesarean deliveries (CD), which are becoming more prevalent, is crucial for maternal health. AIM: The aim of the study was to preoperatively predict IPA in repeated CD with the stria gravidarum (SG) scoring system. METHODS: A total of 167 patients with at least one previous CD at or beyond 37 weeks of gestation were analyzed. Preoperative SG was calculated according to the Davey scoring system: 0-2 score were defined as mild SG (Group 1; n: 94, 56.2%), and 3-8 score were defined as severe SG (Group 2; n = 73, 43.8%). Preoperative previous cesarean incision features were evaluated according to the Vancouver scar scale. IPA was evaluated according to the Nair's and modified Nair's scoring systems. RESULTS: Parity, younger age at first pregnancy, higher body mass index, number of previous CDs, rate of scar symptoms, Nair's and the modified Nair's scores were statistically significant in Group 2 (P = 0.01; P = 0.04; P = 0.007; P = 0.004; P < 0.001; P = 0.007; P = 0.02, respectively). Davey score ≥3 and Vancouver score ≥4.5 were determined as the cut-off value to predict IPA (P = 0.1 and 0.07, respectively). According to multivariate analysis, both Davey and Vancouver scores are independent factors in predicting IPA (P = 0.02 and 0.04, respectively). CONCLUSION: Evaluating the SG score through the Davey score in women with a history of previous CD may assist in predicting IPA status before the planning of a subsequent surgery.

Virulence properties of Listeria monocytogenes isolated from meat and meat contact surfaces in a slaughterhouse.

Listeria monocytogenes is a ubiquitous microorganism that is isolated from a variety of sources such as soil, water, decaying vegetation, sewage, animal feeds, silage, farm environments and food-processing environments. This study aimed to determine the prevalence, serogroups, biofilm formation, virulence factor genes, and genetic relationships of L. monocytogenes strains isolated from beef meat and meat contact surfaces obtained from a slaughterhouse in Burdur, Turkey. In this study, a total of 179 beef meat and meat contact surface samples were analyzed for the presence of L. monocytogenes by polymerase chain reaction (PCR). Out of a total of 179 beef meat and meat contact surface samples, 83 (46.37%) were found to be contaminated with L. monocytogenes, with the highest incidence (53.01%) occurring in beef meat. In the present study, most of the isolated strains belonged to serogroups IIB and IVB (lineage I). The L. monocytogenes strain also contained monoA-B, prfA, plcA, plcB, mpl, hlyA, actA, gtcA, dltA, Fri, flaA, InlA, InlC, InlJ, and iap genes. Biofilm formation was not determined in the tested samples at pH 5.5 and different temperatures (4°C, 10°C, 25°C, and 37°C). However, strong biofilm formation was observed in 6.45% (2/31) of the strains at pH 7.0 after 48 h incubation at 37°C, and in 3.22% (1/31) of the strains at pH 7.0 after 48 h incubation at 4°C and 10°C. Pulsed-field gel electrophoresis (PFGE) results showed that L. monocytogenes isolates were clonally related, and cross-contamination was present. In addition, PFGE results also revealed that AscI had more distinguishing power than the ApaI restriction enzyme. These results indicate that L. monocytogenes detected from meat and meat contact surfaces in the slaughterhouse pose a potential risk to public health.

Can pelvic floor muscle training positions be selected according to the functional status of pelvic floor muscles?

Background: Pelvic floor muscle (PFM) training varies according to the functional status of PFM. It is used to strengthen underactive PFM and relax overactive PFM. Aim: This study aimed to determine the appropriate PFM training positions according to the functional status of the PFM in women with pelvic floor dysfunction. Materials and Methods: Seventy-six women diagnosed with pelvic floor dysfunction were included. After the digital palpation, participants were divided into four groups according to the functional status of PFM: normal, overactive, underactive, and nonfunctional. Participants' PFM and abdominal muscle functions were assessed with superficial electromyography in three positions (modified butterfly pose-P1, modified child pose-P2, and modified deep squat with block pose-P3). Friedman's analysis of variance and the Kruskal-Wallis test were used to assess whether the function of the muscles differed according to the functional status of the PFM and training positions. Results: Normal PFM maximally contracted and relaxed in P1, whereas nonfunctional PFM was in P3 (P > 0.05). Overactive and underactive PFM was most contracted in P2 (P > 0.05) and relaxed in P1 (P < 0.001). In each functional state of the PFM, all abdominal muscles were most relaxed in P1, while their most contracted positions varied (P < 0.05). Conclusion: This study showed that the positions in which the PFM relaxes and contracts the most may vary according to the functional status of the PFM. Therefore, different PFM training positions may be preferred according to the functional status of the PFM in women with pelvic floor dysfunction. However, more study needs to be done in this subject.

First report of tethered cord syndrome in a patient with Verheij syndrome.

BACKGROUND: Verheij syndrome (VRJS) is a rare microdeletion syndrome of chromosome 8q24.3 that is characterized by severe growth retardation, microcephaly, vertebral anomalies, joint laxity/dislocation, psychomotor retardation, cardiac and renal defects, and dysmorphic facial features. Pathogenic variants of PUF60 (Poly-U Binding Splicing Factor 60 kDa) have been found to cause VRJS. Here we present a Turkish patient with Verheij syndrome who has typical facial dysmorphic features and renal and cardiac abnormalities, scoliosis, tethered cord, and mild intellectual disability. METHODS: This is a case report of a 11-year-old female child who presented with Verheij syndrome. Blood samples were collected from the patient and the family. We performed whole exome sequencing was used to identify potential genetic mutations. We also used 3-dimensional protein structure analysis to identify the effect of the mutation. RESULTS: A de-novo in-frame variant (c.449_457delCAAAGGGGG; p.Ala150_Phe152del) of the PUF60 gene was identified by whole exome sequencing. According to ACMG guidelines in 2015, the mutation is classified as pathogenic and it has been reported in the clinvar database. Results of in-silico prediction software tools predicted the mutation was pathogenic. Protein structure analysis showed that the three residues affected by the in-frame deletion form could lead to impaired stability and function of the PUF60 protein. CONCLUSIONS: To date, 25 patients have been reported with PUF60 mutations in the medical literature. In this article, we report a patient with VRJS who had the unusual findings of tethered cord syndrome and renal abnormalities. As far as we know, this is the first patient from Turkey who has been diagnosed with Verheij syndrome.

Relationship between the types of urinary incontinence, handgrip strength, and pelvic floor muscle strength in adult women.

AIM: To investigate the relationship between handgrip strength with types of urinary incontinence (UI) and pelvic floor muscle strength (PFMS) in women. METHODS: Ninety-two women, who presented to the geriatric and urology outpatient clinics complaining of UI between July 2019 and February 2020 and had indicated to undergo urodynamic assessment after basic neurourological evaluation, were included in this cross-sectional study. The presence and types of UI were identified by clinical examination and urodynamic studies. Demographic parameters, anthropometric data, comorbidities and medications were recorded. The International Consultation on Incontinence Questionnaire-Short Form was applied. Handgrip strength (HGS) was measured by a hand dynamometer. The PFMS was subjectively assessed via vaginal digital palpation and measured quantitatively by the vaginal probe of the perineometer. RESULTS: Thirty-eight urodynamic stress, 28 detrusor overactivity, 26 urodynamic mixed UI patients were reported. Perineometer measurements were significantly lower in the urodynamic stress UI group compared to the other two groups (p = 0.020). There was no relationship between the types of urinary incontinence and HGS. However, a positive correlation was found between PFMS and HGS (p = 0.045, r = 0.298). CONCLUSION: The positive correlation between HGS and PFMS indicates that low HGS may be a marker for PFMS weakness. Furthermore, the association between sarcopenia and UI may be explained by this condition.

Evaluation of Oxidative Stress Parameters and Antioxidant Status in Plasma and Erythrocytes of Elderly Diabetic Patients with Sarcopenia.

OBJECTIVES: Oxidative stress may play a role in the pathogenesis of both sarcopenia and diabetes. Although the risk of sarcopenia is increased in people with type 2 diabetes, the relationship between sarcopenia oxidative stress and antioxidant status among the older diabetes population is not well studied. The aim of this present study was to evaluate the relationship between oxidative stress and antioxidant status and sarcopenia in elderly diabetic patients. DESIGN: This was a cross-sectional designed study with a control group. A total of 60 type 2 diabetic elderly patients were enrolled in the study (30 sarcopenic and 30 controls). MEASUREMENTS: Comprehensive geriatric assessments and anthropometric measurements were performed. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People. Skeletal muscle mass was measured using bioelectrical impedance analysis. A handheld dynamometer was used for skeletal muscle strength measurements. Gait speed was measured using a 4 meter walking test. Plasma malondialdehyde (MDA), glutathione peroxidase (GSH-Px) and erythrocyte MDA, GSH-Px, superoxide dismutase (SOD), catalase and xanthine oxidase (XO) measurements were performed. RESULTS: While plasma XO was significantly higher in sarcopenic individuals (0.406(0.225-0.775)) compared to controls (0.312(0.112-0.712)) (p=0.006), plasma GSH-Px was significantly lower in sarcopenic individuals (0.154(0.101-0.274)) compared to controls (0.204(0.12-.0312)) (p=0.003). Plasma XO (OR: 2.69 (CI 95% 0.13-52.76, p=0.041) and BMI (OR: 0.6 (CI 95% 0.41-0.89, p=0.009) were independently associated with sarcopenia of diabetes in multivariate analysis. CONCLUSIONS: Only plasma XO was found to be independently associated with sarcopenia. XO can be important in the pathogenesis of sarcopenia in diabetes. Oxidative stress and antioxidant status might be associated with sarcopenia in diabetic older individuals but this association seems to be mediated by other factors. Further studies are needed on this subject.

Rolling circle amplification shows a sinusoidal template length-dependent amplification bias.

Biophysical properties of DNA such as its longitudinal and torsional persistence length govern many processes and phenomena in biology, DNA nanotechnology and biotechnology. It has, for example, long been known that the circularization efficiency of short DNA fragments shows a periodic pattern where fragments with integer helical turns circularize much more efficiently than those with odd helical half turns due to stronger stacking of duplex ends. Small DNA circles can serve as templates for rolling circle amplification (RCA), which is a common and extremely robust amplification mechanism for nucleic acids. We discovered a strong template length-dependent amplification efficiency bias of RCA with the same periodicity as B-DNA. However, stacking cannot explain the mechanism behind this bias as the presence of the polymerase in the bifurcation fork inhibits base stacking of ends. Instead, coarse-grained molecular dynamics simulations imply that different amplification efficiencies come from a varying fraying probability of the last two downstream base pairs. We conclude that an increased strain-promoted fraying probability can increase the polymerization rate compared to a relaxed template.

Immunohistochemical and immunocytochemical findings associated with Marek's disease virus in naturally infected laying hens.

We compared immunohistochemical (IHC) staining of tissue sections of liver, kidney, spleen, lung, proventriculus, sciatic nerve, bursa of Fabricius, brain, heart, intestine and skin; immunocytochemical (ICC) staining of peripheral blood samples and touch preparations of liver, spleen and kidney of laying hens naturally infected with Marek's disease (MD) virus. We used one hundred and fifty 5-17-week-old commercial hens. IHC and ICC staining were performed using polymer-based techniques. IHC staining exhibited mostly free immunopositive reactions in tumor cells and in the cytoplasm of the parenchymal cells of liver, kidney, spleen and bursa of Fabricius. In the sciatic nerve, severe reactions were observed in the cytoplasm of plasma and MD cells in the lymphoproliferative areas. Pronounced staining was found in the lymphoid cells in the medulla of intrafollicular regions in the bursa of Fabricius. Although immunostaining was observed in the liver and spleen touch preparations, there was no staining in the kidneys and peripheral blood cell samples. The presence of virus in the tissue and peripheral blood samples and in touch preparations was compared immunohistochemically and immunocytochemically. IHC and ICC techniques were helpful for diagnosis of MD. Peripheral blood samples are inappropriate for field conditions and natural infections.

Femtosecond laser written waveguides deep inside silicon.

Photonic devices that can guide, transfer, or modulate light are highly desired in electronics and integrated silicon (Si) photonics. Here, we demonstrate for the first time, to the best of our knowledge, the creation of optical waveguides deep inside Si using femtosecond pulses at a central wavelength of 1.5 µm. To this end, we use 350 fs long, 2 µJ pulses with a repetition rate of 250 kHz from an Er-doped fiber laser, which we focused inside Si to create permanent modifications of the crystal. The position of the beam is accurately controlled with pump-probe imaging during fabrication. Waveguides that were 5.5 mm in length and 20 µm in diameter were created by scanning the focal position along the beam propagation axis. The fabricated waveguides were characterized with a continuous-wave laser operating at 1.5 µm. The refractive index change inside the waveguide was measured with optical shadowgraphy, yielding a value of 6×10-4, and by direct light coupling and far-field imaging, yielding a value of 3.5×10-4. The formation mechanism of the modification is discussed.

Scalable amplification of strand subsets from chip-synthesized oligonucleotide libraries.

Synthetic oligonucleotides are the main cost factor for studies in DNA nanotechnology, genetics and synthetic biology, which all require thousands of these at high quality. Inexpensive chip-synthesized oligonucleotide libraries can contain hundreds of thousands of distinct sequences, however only at sub-femtomole quantities per strand. Here we present a selective oligonucleotide amplification method, based on three rounds of rolling-circle amplification, that produces nanomole amounts of single-stranded oligonucleotides per millilitre reaction. In a multistep one-pot procedure, subsets of hundreds or thousands of single-stranded DNAs with different lengths can selectively be amplified and purified together. These oligonucleotides are used to fold several DNA nanostructures and as primary fluorescence in situ hybridization probes. The amplification cost is lower than other reported methods (typically around US$ 20 per nanomole total oligonucleotides produced) and is dominated by the use of commercial enzymes.

Histopathological changes in rat pancreas and skeletal muscle associated with high fat diet induced insulin resistance.

The effects of a high fat diet on the development of diabetes mellitus, insulin resistance and secretion have been widely investigated. We investigated the effects of a high fat diet on the pancreas and skeletal muscle of normal rats to explore diet-induced insulin resistance mechanisms. Forty-four male Wistar rats were divided into six groups: a control group fed standard chow, a group fed a 45% fat diet and a group fed a 60% fat diet for 3 weeks to measure acute effects; an additional three groups were fed the same diet regimens for 8 weeks to measure chronic effects. The morphological effects of the two high fat diets were examined by light microscopy. Insulin in pancreatic islets was detected using immunohistochemistry. The homeostasis model assessment of insulin resistance index and insulin staining intensity in islets increased significantly with acute administration of high fat diets, whereas staining intensity decreased with chronic administration of the 45% fat diet. Islet areas increased significantly with chronic administration. High fat diet administration led to islet degeneration, interlobular adipocyte accumulation and vacuolization in the pancreatic tissue, as well as degeneration and lipid droplet accumulation in the skeletal muscle tissue. Vacuolization in the pancreas and lipid droplets in skeletal muscle tissue increased significantly with chronic high fat diet administration. We suggest that the glucolipotoxic effects of high fat diet administration depend on the ratio of saturated to unsaturated fatty acid content in the diet and to the total fat content of the diet.

Value of anatomic landmarks in carpal tunnel surgery.

This study investigated which anatomic landmarks were most useful for correct and safe incision placement in carpal tunnel surgery. Kirschner wires were attached to the hands to mark previously defined landmarks. The bony attachments of the transverse carpal ligament, which were identified previously, were drawn on an anteroposterior digital x-ray of the hand, with the thumb in full abduction. The relationship between anatomic landmarks and these bony attachments were examined. In all hands, either the line along the third web space or the crease between the thenar and the hypothenar regions, or both, were on the ulnar half of the transverse carpal ligament. During incision placement, we recommend selecting the most ulnar choice between the line drawn along the third web space and the crease between the thenar and hypothenar regions in order to be at safe distance from the recurrent motor branch of the median nerve.

Analysis and classification of compressed EMG signals by wavelet transform via alternative neural networks algorithms.

We propose intelligent methods for classifying three different muscle types, i.e. biceps, frontallis and abductor pollicis brevis muscles, with low computational complexity. For this aim, electromyogram (EMG) signals are recorded and modelled by using an auto-regressive (AR) model. As the size of the EMG signals is usually large, the computational complexity of artificial neural network (ANN) systems drastically increases. Therefore, in the proposed scheme EMG signals are pre-processed by using a wavelet transform and then they are modelled by employing an AR approach. The AR coefficients are used to train and test the ANNs. Experimental results show that the highest achieved classification accuracy is more than 95% in the case of EMG signals pre-processed by wavelet transform. The wavelet transform-based pre-processing significantly increases the performance rates compared to standard multilayer perceptron and general regression neural networks algorithms.

Comparison of serum CA 19.9, CA 125 and CEA levels with severity of chronic obstructive pulmonary disease.

OBJECTIVE: To investigate serum levels of CA 19.9, CA 125 and carcinoembryonic antigen (CEA) in patients with different stages of chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS: Fifty-three consecutive patients (50 males, 3 females, mean age 67.6 +/- 10.1 years) with COPD were included in this study. Serum levels of CA 19.9, CA 25 and CEA were determined by the chemiluminescent immunometric method. Based on values obtained from pulmonary function tests, the patients were divided into 3 groups: moderate (21), severe (18) and very severe (14). Data were analyzed with a Kruskal-Wallis one-way analysis of variance test and Mann-Whitney U test. RESULTS: The mean serum levels of CA 125 and CA 19.9 were significantly higher in patients with very severe COPD (p = 0.013 and p = 0.017, respectively) than in patients with severe and moderate COPD (p < 0.05). Patients with cor pulmonale had significantly high mean serum levels of CEA, CA 19.9 and CA 125 (p < 0.05). Patients using a long-acting beta-agonist and theophylline showed significantly higher mean serum levels of CA 125 than patients who were not (p < 0.05). CONCLUSION: Data showed that the increased serum tumor markers in patients with COPD might be due to the severity of COPD, medication and cor pulmonale.

Challenges of electrochemical impedance spectroscopy in protein biosensing.

Electrochemical impedance spectroscopy (EIS) measurement, performed in the presence of a redox agent, is a convenient method to measure molecular interactions of electrochemically inactive compounds taking place on the electrode surface. High sensitivity of the method, being highly advantageous, can be also associated with nonspecific impedance changes that could be easily mistaken for specific interactions. Therefore, it is necessary to be aware of all possible causes and perform parallel control experiments to rule them out. We present the results obtained during the early stages of aptamer-based sensor development, utilizing a model system of human alpha thrombin interacting with a thiolated DNA aptamer, immobilized on gold electrodes. EIS measurements took place in the presence of iron ferrocyanides. In addition to known method limitations, that is, inability to discriminate between specific and nonspecific binding (both causing impedance increase), we have found other factors leading to nonspecific impedance changes, such as: (i) initial electrode contamination; (ii) repetitive measurements; (iii) additional cyclic voltammetry (CV) or differential pulse voltammetry (DPV) measurements; and (iv) additional incubations in the buffer between measurements, which have never been discussed before. We suggest ways to overcome the method limitations.

Correlation of femoral head coverage and Graf alpha angle in infants being screened for developmental dysplasia of the hip.

Ultrasonography has become accepted as a useful imaging modality in the early detection of developmental dysplasia of the hip (DDH). The purpose of this study was to investigate the extent to which ultrasonographic measurements of femoral head coverage correspond to the categories of hip maturity defined by Graf's angle alpha. The infants in this study (1,037 infants, 2,034 hips) were examined as part of an ultrasound screening program for detecting DDH. We found that femoral head coverage is positively correlated with alpha angle, and we also found upper and lower threshold values of femoral head coverage (51% and 39%), such that all hips having these values or beyond had mature or pathological development, respectively. For the detection of hips having mature development, this provided a specificity of 100% (by definition) and a sensitivity of 82.6%. For hips having pathological development, specificity was 100% and sensitivity was 79.2%.

Biomaterial-based infrared detection.

This effort is focused on the use of crustacyanin protein extracted from the lobster shell in IR detection and imaging applications. In addition to the protein's excellent reversible thermo-active response in the IR region of interest, electrical characteristics versus temperature showed that the protein can be used as an electro-optic thermal sensing device as well. The high sensitivity and fast response of the protein layer were further enhanced by the deposition process we used. The thin coatings were prepared by Langmuir-Blodgett and self-assembly techniques. Furthermore, the protein exhibited temperature variation under Ti:sapphire laser excitation at different wavelengths in ambient environment. We have also shown that the protein exhibits fluorescence properties after exposure to IR heat. Stability of the protein, which is important in this type of application, was also demonstrated using the different characterization techniques after repeated heating/cooling cycles. We can conclude that this protein represents a formidable candidate for the fabrication of IR sensors and microbolometers for uncooled IR imaging applications.

Clinical examination versus ultrasonography in detecting developmental dysplasia of the hip.

Although hip ultrasonography is gaining acceptance as the most effective method for the early diagnosis of developmental dysplasia of the hip, there is still some controversy regarding the use of ultrasonography as a screening method. The purpose of this study was to investigate prospectively the capacity of clinical examination findings and associated risk factors to detect developmental dysplasia of the hip defined ultrasonographically in infants. A total of 3,541 infants underwent clinical examination and hip ultrasonography. Measured against ultrasonography as a standard, the sensitivity and specificity of clinical examination were 97% and 13.68%, respectively. Graf type IIb or more severe developmental dysplasia was found in 167 infants (208 hips), at an overall frequency of 4.71%. Graf type IIa physiological immaturity was encountered in 838 hips, and of these, 15 hips (1.78%) developed Graf type IIb dysplasia and underwent treatment. Patient characteristics that were found to be significant risk factors were swaddling use, female gender, breech delivery and positive family history. Given its low specificity, our findings suggest that clinical examination does not reliably detect ultrasonographically defined developmental dysplasia of the hip in infants being screened for this disease.

Indicators of successful use of the Pavlik harness in infants with developmental dysplasia of the hip.

This study examined the outcomes of ultrasound-monitored Pavlik harness treatment in 25 infants (2 boys and 23 girls) representing a total of 31 cases of developmental dysplasia of the hip of Graf type IIc or more severe. For all infants, Pavlik harness treatment started after ultrasonographic diagnosis in our clinic. If there was no improvement by the third week of follow-up, the harness treatment was discontinued. Of the 25 patients (31 hips), 16 patients (18 hips) were successfully treated with the Pavlik harness. The effects of age at start of treatment, gender, side of pathology, first clinical evaluation findings, bilaterality, and Graf type on Pavlik harness treatment success were analysed. We found that the outcome of treatment with the Pavlik harness was related to Graf type, age at start of treatment, and bilaterality.