Recent publications
This paper explores a computational approach to model multiphase heat transfer and fluid flow in a natural circulation loop utilizing nanofluids. We propose and implement an Euler–Euler framework in a CFD environment, incorporating an innovative boundary condition to preserve mass conservation during thermophoretic particle flux. The model’s accuracy is verified through a one-dimensional example, by comparing results against both an Euler–Lagrange model and an in-house finite volume solution. Experimental validation is conducted with aluminum oxide nanofluids at varying nanoparticle concentrations. We prepared the nanofluids and measured their thermophysical properties up to C. We assess the thermal performance of the nanofluid in natural circulation loop at different heating powers via experiment and numerical simulations. The findings reveal that the heat transfer enhancement offered by the nanofluid is modest, with minimal differences observed between the proposed Euler–Euler approach and a simpler single-phase model. The results underscore that while the Euler–Euler model offers detailed particle–fluid interactions, its practical thermal advantage is limited in this context.
Polymer matrix composites (PMCs) have emerged as critical materials in lightweight engineering applications due to their excellent mechanical properties and design versatility. However, their inherent limitations in electrical and thermal conductivity necessitate metallization, particularly for applications such as lightning strike protection (LSP) and electromagnetic interference (EMI) shielding. Cold spraying, a low-temperature metallization technique, addresses the shortcomings of conventional methods by enabling the deposition of dense, oxide-free, and highly conductive coatings with minimal damage to the composite substrate. This review provides a comprehensive overview of advancements in metallization techniques, with a focus on cold spraying, to enhance the electrical and thermal performance of PMCs for LSP and EMI shielding. The combination of PMCs with conductive materials presents an innovative approach to achieving lightweight, corrosion-resistant, and efficient LSP and EMI shielding solutions, offering significant advancements in surface functionalization. Future research directions include the exploration of hybrid metallization strategies and the integration of cold spraying with additive manufacturing, highlighting their potential to create multifunctional and high-performance PMC-based systems. Additionally, emerging trends such as novel or smart materials, optimization of cold spray processes through advanced modeling, and the translation of these innovations into industrial applications are discussed.
Background
Halitosis, or bad breath, significantly affects social and psychological well-being and is often caused by intraoral factors. Dentists play a key role in the diagnosis and treatment of halitosis, but inadequate education may lead to ineffective patient care. This study examines the levels of knowledge and awareness of halitosis among undergraduate dental students.
Methods
This study employed a cross-sectional design and used an online questionnaire that was developed via Google Forms. The questionnaire was distributed to a convenience sample of 250 undergraduate students from two different dentistry faculties who had completed their clinical internships. All the statistical analyses were performed using SPSS for Windows 11.5 (SPSS Inc., Chicago, IL, USA). Responses to the questionnaire were compared between groups using the Pearson chi-square test or Fisher’s exact test. The correct answer scores were compared between groups via the Mann‒Whitney U test.
Results
There was a significant difference in the degree of attention devoted to halitosis between X University and Y University (p < 0.05). When asked, “Have you ever treated patients with halitosis? “, 28.5% of fourth-year students and 60.5% of fifth-year students answered affirmatively, indicating a statistically significant difference (p < 0.001). There was no significant difference in the number of correct answers between fourth- and fifth-year students (U = 7714.00, p = 0.886). There was a significant difference in the number of correct answers between the universities (U = 5817.50, p = 0.001). The number of correct answers of X University students was slightly higher than that of Y University students.
Conclusions
These results support the importance of developing training programs to improve dentists’ self-confidence, social skills, and communication skills, thereby enhancing the diagnosis and treatment of halitosis. A manual for the diagnosis and treatment of halitosis could be helpful for improving dentists’ attitudes and behaviours and for promoting optimal oral health.
Background
The selection of an implant is a critical factor in the surgical treatment of patella fractures due to the risk of various complications, such as non-union, implant failure, and irritation. The present study evaluated and compared the biomechanical strength of headless cannulated screws about screw length using the tension band wiring technique.
Methods
Forty-eight sawbone patellas with transverse fractures were divided into three fixation groups based on the screw length used in tension band wiring. Overall, three different fixation groups were determined: Group 1 (recessed headless cannulated screw fixation), Group 2 (full-length headless cannulated screw fixation), and Group 3 (protruding headless cannulated screw fixation). A setup was used to simulate a knee with a flexion angle of 60 degrees. Specimens underwent biomechanical testing under axial traction (static test) and cyclic loading (dynamic test). Displacements at 300 Newtons (N), loads at 2 millimetres (mm) displacement, and failure loads were documented for each sample in the static test. In the dynamic test protocol, 10,000 repetitive cycles were performed under physiological load between 100 and 300 N, and final displacements were recorded.
Results
There were significant differences in the loads achieved at 2 mm displacement levels, and Group 3 demonstrated lower force values compared to other constructs in the static test (P = 0.003). All groups revealed similar displacements at 300 N and failure load values under axial traction. In the dynamic test, Group 3 had significantly higher fracture displacement under cyclic loading compared to the other specimens (P = 0.006).
Conclusions
This study found headless cannulated screws for transverse patella fracture fixation provide sufficient stability; however, protruding headless screws reduce the fixation strength. Recessed or full-length screws may improve stability and bony healing, potentially preventing complications in patella fractures.
Level of evidence
Biomechanical study N/A.
Objectives
To determine the association between hypomagnesemia and dynapenia in older women with different nutritional status.
Methods
This cross-sectional study included older women who attended one outpatient geriatric clinic. Undernutrition was defined according to the Mini Nutritional Assessment score (MNA) (< 23,5), and handgrip strength of < 16 kg on dynamometer was defined as dynapenia. The association between hypomagnesemia (serum magnesium < 1.7 mg/dL) and dynapenia was determined by logistic regression analysis.
Results
Among the 933 older women (mean age 81 ± 8), the prevalences of undernutrition and hypomagnesemia were 61% and 15%, respectively. The risk of hypomagnesemia increased with each step of decline in nutritional status, and undernutrition was associated with hypomagnesemia (OR 1.64, 95% CI 1.11–2.43, p = 0.013) In the entire cohort, hypomagnesemia was associated with dynapenia (OR 2.01, 95% CI 1.35-3.00, p = 0.001). In well-nourished patients, hypomagnesemia was not associated with dynapenia, even when unadjusted. However, in the undernourished group, hypomagnesemia was associated with dynapenia after adjusting for age, diabetes mellitus, hypertension, coronary heart disease, Barthel and Lawton scores, polypharmacy, glomerular filtration rate, serum albumin, hemoglobin, and MNA score (OR 2.95, 95% CI 1.04–8.32, p = 0.040). The coexistence of hypomagnesemia and undernutrition (versus neither of them) was significantly associated with dynapenia (OR 4.44, 95% CI 2.67–7.41, p < 0.001).
Conclusion
The prevalence of hypomagnesemia increases with worsening nutritional status. Hypomagnesemia is associated with dynapenia in older women who are undernourished, even after adjusting for nutritional status, but not in those who are well nourished. The coexistence of undernutrition and hypomagnesemia increase the risk of dynapenia substantially.
Working memory, which tends to be the most vulnerable cognitive domain to aging, is thought to depend on a functional brain network for efficient communication. The dynamic communication within this network is represented by segregation and integration. This study aimed to investigate healthy aging by examining age effect on outcomes of graph theory analysis during the visual short-term memory binding (VSTMB) task. VSTMB tasks rely on the integration of visual features and are less sensitive to semantic and verbal strategies. Effects of age on neuropsychological test scores, along with the EEG graph-theoretical integration, segregation and global organization metrics in frequencies from delta to gamma band were investigated. Neuropsychological assessment showed low sensitivity as a measure of age-related changes. EEG results indicated that network architecture changed more effectively during middle age, while this effectiveness appears to vanish or show compensatory mechanisms in the elderly. These differences were further found to be related to cognitive domain scores. This study is the first to demonstrate differences in working memory network architecture across a broad age range.
Purpose
Hip fractures are a common cause of mortality in elderly patients. This study aimed to determine the predictive factors affecting mortality among patients over the age of 80 who underwent surgical treatment for hip fractures.
Methods
We searched the Turkish Ministry of Health’s e-health database to identify patients over 80 years old who had undergone surgery for proximal femoral fractures from 2016 to 2022. This process yielded 53,495 patients. Demographic data as well as comorbidities, blood transfusions, postoperative 90 days medical complications, and mortality was investigated. Multivariate logistic regression analysis was performed to identify risk factors for one year mortality in patients undergoing surgical treatment for proximal hip fractures.
Results
The mortality rate was 37.2% in the first year. The mean Charlson comorbidity index(CCI) was 6.8 (range: 4–22). In the postoperative period, 68.6% of the patients received blood transfusions. Logistic regression analysis identified significant predictors of one-year mortality in surgical patients, including male gender, increased age, higher CCI scores, AKI, PE, pneumonia, electrolyte imbalance, gastrointestinal bleeding, blood transfusion, and increased mortality risks with hemiarthroplasty and internal fixation compared to total hip arthroplasty. ( p < 0.001 for all).
Conclusions
This large cohort study demonstrated that the mortality rate is high and that the type of surgery, male gender, older age, blood transfusion requirements, and high CCI score are associated with mortality in patients over 80 years of age who have undergone surgery for hip fractures. Preoperative optimization and postoperative care are critical for these vulnerable elderly patients.
This study uses machine learning (ML) to elucidate the contact relationship between the mandibular third molar (M3M) and the inferior alveolar canal (IAC), leading to three major contributions; (1) The first publicly accessible PR image dataset with semantic annotations for 1,478 IACs and M3Ms from 1,010 patients is introduced, which includes challenging cases, such as false positive contacts, with CBCT images as the gold standard, (2) Established radiological indicators for M3M-IAC contact were extracted as features using digital image processing, and these features were used as inputs for various ML methods. Eligibility was assessed through statistical analysis and radiologists evaluations. Clinical feedback from radiologists on these features provides insights for future improvements. (3) ANNs, two custom CNNs, seven established DL models, and their combinations were used for automatic M3M-IAC contact determination with extracted features, semantic annotations, and ROIs. The ANN configuration surpassed both radiologists and DL models in specificity (82%), F1 score (92%), and accuracy (85%), while maintaining a comparable sensitivity (86%) to the DL models. This indicates that ANNs can effectively predict M3M-IAC contact relations and are particularly effective at identifying cases with no contact relation between M3M and IAC compared to other ML methods. Future work should focus on developing automated segmentation algorithms for M3M and IAC on PRs, to identify relevant anatomical structures, thereby improving clinical usability. The dataset, feature extraction, and ML codes are available through the CONTACT grand challenge.
Background
Fibromyalgia Syndrome (FMS) predominantly affects middle-aged women, characterized by musculoskeletal pain, fatigue, and cognitive issues. Choline, an endogenous molecule, may influence FMS due to its analgesic and anti-inflammatory properties. This study compared choline, leptin, and interleukin-6 (IL-6) levels in FMS patients and controls and examining their association with pain severity.
Methods
Volunteers with FMS were clinically diagnosed at a Physical Medicine and Rehabilitation Department. The control group included pain-free volunteers. Pain severity was gauged using a numeric scale, dietary choline intake through a questionnaire. Serum choline, leptin and (interleukin)IL-6 levels were measured from fasting blood samples of volunteers with enzyme-linked immunosorbent assays (ELISA).
Results
All FMS patients (n = 38) and healthy volunteers (n = 38) were female. Pain score in patients with FMS was 7.6 ± 0.2. Dietary choline intake was lower in patients with FMS than the controls (p = 0.036). Serum choline and leptin levels were lower in the FMS group compared to control (p = 0.03). Serum IL-6 levels were higher in the FMS group than in the control (p < 0.001). There was weak positive correlation between IL-6 levels and pain scores and there were no correlation between leptin levels and pain scores in FMS.
Conclusions
This research highlights FMS's complex nature, involving neurochemical, immunological, and nutritional factors. It suggests the significance of choline's anti-inflammatory effect, leptin's metabolic function, and IL-6's role in FMS pathology. The results suggest that reduced dietary choline might influence serum choline, leptin, and IL-6 levels, potentially impacting FMS-related pain. This points to the potential of supplementary choline intake in FMS management.
Trial registration
Not applicable (Non-interventional study).
To overcome the difficulties in cancer treatments, scientists have been developing different and regenerative alternative treatment options for several years. One of the promising approaches is personalized targeted therapy. Small molecule inhibitors and monoclonal antibodies are used in targeted therapy investigations. Like everything else, considering the complex structure of cancer, small molecule inhibitors and monoclonal antibodies also have their own pros and cons. In order to develop a promising and effective small molecule inhibitor, understanding the changes in the pathways during carcinogenesis is vital.
Objective
This study investigated the use of oral rinse solutions formulated with boron-containing compounds, known for their antibacterial activity, as an alternative to chlorhexidine (CHX).
Material and method
Boron nitride (BN), boric acid (BA) and sodium borate (SB) were used in the study. BN was used in nanosuspension (BN-NS) due to its low solubility in water. BA and SB were also prepared and used in solution form (BA-S, SB-S). Antibacterial activity against cariogenic bacteria was evaluated using agar well diffusion and microdilution techniques, and antibiofilm activity was evaluated using the crystal violet method. Cytotoxicity in human gingival cell lines (HGF-1) was evaluated using MTT and LDH assays. Surface hardness was measured with Vicker’s Microhardness tester and surface roughness was measured with a profilometer. CHX was used as the control group.
Results
BN-NS, BA-S, and SB-S showed antibacterial and antibiofilm activity against all cariogenic bacteria. BN-NS and SB-S demonstrated much lower cytotoxicity compared to CHX, while BA-S exhibited similar cytotoxicity. SB-S caused an increase in enamel surface hardness (p = 0.017), whereas no significant changes were observed in surface roughness or hardness in the other groups (p > 0.05).
Conclusion
BN-NS and SB-S showed antibacterial effects and antibiofilm activity on all tested cariogenic bacteria. BN-NS and SB-S showed lower cytotoxicity than CHX, and their effects on enamel and composite resin surfaces were similar to the control group. Further studies are needed to support the use of BN-NS and SB-S as alternatives to CHX.
Clinical revelance
BN-NS and SB-S are promising alternatives to the antibacterial agent CHX, which is known to be cytotoxic.
Inotuzumab ozogamicin (InO) is approved for treatment of relapsed/refractory acute lymphoblastic leukemia (R/R ALL). Previous studies reported higher rates of post– hematopoietic stem cell transplant (HSCT) hepatic sinusoidal obstruction syndrome (SOS) in patients receiving InO versus chemotherapy prior to HSCT. It is unknown if a lower InO dose would reduce risk of post-HSCT SOS or if it would impact efficacy. This study evaluated efficacy and safety of the currently approved InO starting dose and a lower dose in adults with R/R ALL who were eligible for HSCT and were identified as being at higher risk of post- HSCT SOS. This open-label, phase 4 study (NCT03677596) had 2 phases: in the run-in phase patients received InO at 1.2 mg/m2/cycle (n=22); in the randomized phase patients received InO starting at dose levels of 1.8 mg/m2/cycle (n=38) or 1.2 mg/m2/cycle (n=42). Primary endpoints were rate of SOS and rate of hematologic remission. Overall, SOS was reported in 10 patients (9.8%); all were post-HSCT SOS. In patients who proceeded to HSCT, post-HSCT SOS rates were 20%, 28.6%, 25.8%, and 16.7% in 1.2 mg/m2/cycle (run-in), 1.2 mg/m2/cycle (randomized), 1.2 mg/m2/cycle (run-in and randomized), and 1.8 mg/m2/cycle (randomized), respectively. The CR/CRi rates were 50.0%, 83.3%, 71.9%, and 68.4% in the respective subgroups. The study found that a starting dose of 1.2mg/m2/cycle demonstrated consistent efficacy and safety to the recommended 1.8 mg/m2/cycle dose in adults with R/R ALL who were eligible for HSCT and had a higher risk of post-HSCT SOS.
Purpose of review
This review aims to evaluate the current evidence on blood-based biomarkers for frailty detection in older cancer patients. It explores the potential of various biomarkers, including inflammatory markers and microRNAs (miRNAs), to serve as indicators of frailty and examines the limitations of existing studies. The review also highlights the need for further research to validate these biomarkers and improve their clinical applicability.
Recent findings
Recent studies have examined blood biomarkers associated with frailty in older cancer patients. Findings suggest that elevated granulocyte levels and lower macrophage-derived stem cells and regulatory T cells are linked to frailty. Inflammatory biomarkers such as interleukin-6 and specific miRNAs, as well as higher neutrophil-to-lymphocyte ratios, have also been identified as potential indicators of frailty. While these biomarkers show promise, no single marker has proven sufficient, and combining them may improve frailty detection. Further research is needed to validate their clinical usefulness in this population.
Summary
Blood-based biomarkers show potential for detecting frailty in older patients with cancer, but further research is needed, particularly beyond an inflammatory focus and with more robust study designs.
Objective
Although the feeling of unrest in the legs is frequently reported as a sensory symptom by people with Neuromyelitis Optica Spectrum Disorder (NMOSD, pwNMOSD), there are limited studies to investigate the relationship between Restless Legs Syndrome (RLS) and NMOSD. The study's primary aim is to determine the frequency and severity of RLS in pwNMOSD. The other aim is to compare the sleep quality, daytime sleepiness level, quality of life, fatigue, magnetic resonance imaging results, and cognitive functions in RLS-positive and negative pwNMOSD.
Methods
The RLS diagnosis was performed with RLS-Diagnostic Index criteria. The patient-reported outcomes were RLS Severity Rating Score, The Preference-Based Multiple Sclerosis Index (PBMSI), the Modified Fatigue Impact Scale (MFIS), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). Cognitive function was assessed with The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery. The neurologist recorded the demographic and clinical characteristics of the participants.
Results
The RLS was detected in 17 (21.5%) of the 79 pwNMOSD participants. Fifty-six pwNMOSD were reached to assess cognitive functions and patient-reported outcomes. The rate of RLS was 60.71% in this group. The PBMSI, PSQI, MFIS, and ESS scores were significantly different in RLS-positive participants than in RLS-negative (p<0.05). Moreover, while participants' visuospatial and verbal learning was similar, the processing speed was slow in the RLS-positive group (p>0.05).
Conclusions
Our preliminary results have shown that the RLS frequency is high in pwNMOSD. This study suggests a connection between the presence of RLS and worse sleep quality, fatigue level, processing speed, and quality of life in the NMOSD population. However, our results should be considered with the fact that the study has a small sample size and needs future studies to confirm our results for solid evidence.
Background Sarcopenia is characterized by low muscle mass and strength, primarily affecting the elderly. It may also present in patients with type 2 diabetes mellitus (T2DM), especially those with poor glycemic control. This study aimed to evaluate the frequency of sarcopenia in nonelderly and overweight patients with T2DM and its association with glycemic control. Methods A total of 60 overweight patients with T2DM (mean duration 10 ± 1.3 years) were included to the study. Patients were classified into two groups according to their HbA1c levels. There were 30 patients (mean age 54 ± 5 years; 14 [46,6%] women) in poor glycemic control group (HbA1c > 7%) and 30 patients (mean age, 54 ± 6 years; 15[50%] women) in adequate glycemic control group (HbA1c ≤ 7). Hand grip strength (HGS) measurements using a dynamometer, skeletal muscle mass index (SMMI) measured by bioelectrical impedance analysis, 4-m walking test, and the Sarcopenia Quality of Life (SARQoL) and Pittsburgh Sleep Quality(PSQ) questionnaires were used to assess the presence of sarcopenia and QoL in all patients. Results Five patients (16.6%) in the poor glycemic control group were diagnosed with sarcopenia based on the assessment of muscle strength and mass. Among patients with adequate glycemic control, none met the criteria for sarcopenia. The median HGS and SMMI were significantly lower in patients with sarcopenia (15.4kg and 7.4kg/m ² ) than in patients with adequate glycemic control (29.8 kg and 10.6kg/m ² ; p = 0.021 and 0.006, respectively). There was a negative correlation between HbA1c and HGS in all patients (r = 0.424; p = 0.001). Multivariate linear regression analysis revealed that an increase in HbA1c leads to a decrease in SMMI (Beta: -0.293; 95% CI: -0.483 to -0.102; p = 0.003) and HGS (Beta: -2,016; 95% CI: -2,885 to -1,147; p = < 0.001). The SARQoL score was also significantly lower in patients with sarcopenia than the patients with adequate glycemic control (p = 0.022) while no significant difference was found in the PSQ score. Conclusion Sarcopenia may occur in nonelderly T2DM patients with poor glycemic control, leading to decreased QoL. Screening for sarcopenia should commence at a younger age if diabetes is uncontrolled and risk factors are present.
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İzmir, Turkey
Head of institution
Dokuz Eylül University, Faculty of architecture, Department of Architecture
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