Marmara University

Biomaterials are materials intended to interact with biological systems for the purposes of treatment, enhancement, or replacement of biological functions defined as material used in medical devices. Biomaterials in tissue engineering have been studied many years, and their level of innovation has increased significantly recently. In the field of tissue engineering, a wide range of biomaterial has been shown to be effective in combination with naturally derived and synthetic polymers. All biomaterials shall satisfy several criteria, e.g. adequate strength, high corrosion resistance, bio-adhesion, biocompatibility, high durability, and lower friction coefficients. To analyse the properties of biomaterials, various characterization techniques are used. Characterizing biomaterials for tissue engineering is a multidisciplinary endeavour that relies on various tools and techniques, encompassing chemical, physical, mechanical, and biological aspects. This review outlines key characterization techniques available to researchers, considering the latest developments and challenges in tissue engineering. It aims to provide a comprehensive understanding for researchers in this field, facilitating the recognition of existing instruments and techniques for developing and discovering new materials, thereby expanding their applications in tissue engineering. The review also includes an examination of literature, presenting main results from the characterization of diverse biomaterials in tabular form.

Objective We aimed to evaluate the clinical usefulness of the systemic score in the prediction of life‐threatening evolution in Still disease. We also aimed to assess the clinical relevance of each component of the systemic score in predicting life‐threatening evolution and to derive patient subsets accordingly. Methods A multicenter, observational, prospective study was designed including patients included in the Gruppo Italiano Di Ricerca in Reumatologia Clinica e Sperimentale Adult‐Onset Still Disease Study Group and the Autoinflammatory Disease Alliance Network Still Disease Registry. Patients were assessed to see if the variables to derive the systemic score were available. The life‐threatening evolution was defined as mortality, whatever the clinical course, and/or macrophage activation syndrome, a secondary hemophagocytic lymphohistiocytosis associated with a poor prognosis. Results A total of 597 patients with Still disease were assessed (mean ± SD age 36.6 ± 17.3 years; male 44.4%). The systemic score, assessed as a continuous variable, significantly predicted the life‐threatening evolution (odds ratio [OR] 1.24; 95% confidence interval [CI] 1.07–1.42; P = 0.004). A systemic score ≥7 also significantly predicted the likelihood of a patient experiencing life‐threatening evolution (OR 3.36; 95% CI 1.81–6.25; P < 0.001). Assessing the clinical relevance of each component of the systemic score, liver involvement (OR 1.68; 95% CI 1.48–2.67; P = 0.031) and lung disease (OR 2.12; 95% CI 1.14–4.49; P = 0.042) both significantly predicted life‐threatening evolution. The clinical characteristics of patients with liver involvement and lung disease were derived, highlighting their relevance in multiorgan disease manifestations. Conclusion The clinical utility of the systemic score was shown in identifying Still disease at a higher risk of life‐threatening evolution in a large cohort. Furthermore, the clinical relevance of liver involvement and lung disease was highlighted. image

Perovskite solar cells (PSCs) are developed rapidly in efficiency and stability in recent years, which can compete with silicon solar cells. However, an important obstacle to the commercialization of PSCs is the toxicity of lead ions (Pb²⁺) from water‐soluble perovskites. The entry of free Pb²⁺ into organisms can cause severe harm to humans, such as blood lead poisoning, organ failure, etc. Therefore, this work reports a “lead isolation‐capture” dual detoxification strategy with calcium disodium edetate (EDTA Na‐Ca), which can inhibit lead leakage from PSCs under extreme conditions. More importantly, leaked lead exists in a nontoxic aggregation state chelated by EDTA. For the first time, in vivo experiments are conducted in mice to systematically prove that this material has a significant inhibitory effect on the toxicity of perovskites. In addition, this strategy can further enhance device performance, enabling the optimized devices to achieve an impressive power conversion efficiency (PCE) of 25.19%. This innovative strategy is a major breakthrough in the research on the prevention of lead toxicity in PSCs.

A series of hybrid compounds containing both the imidazole ring and the hydrazone moiety have been synthesized. Synthesized compounds were characterized by various spectral techniques, including FT‐IR, ¹H‐NMR, ¹³C‐NMR, and HRMS. The compounds were evaluated for their antiproliferative activities on colorectal cancer cells HCT‐116 and HT‐29 in a time‐dependent manner. Among them, some compounds exhibited remarkable anti‐cancer activity with a less cytotoxic effect on non‐cancerous cell lines, especially HRK‐2 with IC50 value of 1.35±0.18 μM in HCT‐116 cells and HRK‐5 with IC50 value of 2.67±0.61 μM in HT‐29 cells. Investigations of colon cancer cell death were performed, and the most active compounds were found to trigger cell death via nuclear localization and induce S phase arrest of the colon cancer cell. Moreover, molecular modeling studies for the synthesized compounds was performed to predict their binding affinities toward the active site of BCL‐2. The findings of the molecular modeling investigations were highly consistent with those of the cytotoxicity results.

Capecitabine is recommended as one of the first-line chemotherapy treatments for advanced or metastatic colorectal cancer. Researches have been conducted on capecitabine’s impact on the viability of human colon cancer cells and its potential to induce apoptosis. However, even in cases initially responsive to treatment, the development of acquired resistance significantly limits its efficacy. Challenges still exist in effectively treating patients with chemotherapy, and developing new cytotoxic drugs is hindered by drug resistance. Fisetin alters the cell cycle, inducing apoptosis, inhibiting cancer cell proliferation, and enhancing the therapeutic effectiveness of chemotherapy drugs. This work aims to create a plan for reversing capecitabine resistance. For this purpose, the role of capecitabine and/or fisetin combinations in cell proliferation and apoptosis has been determined in both wild-type and capecitabine-resistant HT29 cells (CR/HT29). We developed capecitabine-resistant cell line from wild-type HT29 cells. This study demonstrated the effects of capecitabine, fisetin, and their combinations on both resistant and wild-type cells through experiments including cell survival skills, cell proliferation, wound healing, colony formation, hoechst staining, and western blot analysis. We established capecitabine-resistant cell lines. P-gp expression increased in CR/HT29 cells. Capecitabine effects on a CR/HT29 cells less than wild-type HT29 cells. The combination of fisetin and capecitabine in cell proliferation caused greater reductions in wild-type HT29 cells than in capecitabine-resistant cells. Fisetin has also additive effects on the apoptotic pathway in CR/HT29 cells. This study provides new perspectives on the combination of capecitabine and/or flavonoid treatment in resistant cells. Graphical abstract

Skin is part of the integumentary and excretory system, which helps protect the body against infections. The skin should be properly treated when it gets injured, which requires a long healing process. In this study, 15% (w/v) polylactic acid (PLA) and 1 and 2% (w/v) polymethylsilsesquioxane (PMSQ) scaffolds were fabricated using 3D printing technology, and the surfaces of each scaffold were coated with 5% ethylcellulose (EC)/vitamin E microparticles using the electrospray method. The morphologies of the scaffolds were characterized using a scanning electron microscope (SEM), and results showed that the pore sizes of the scaffolds ranged from 136 to 265 μm. The vitamin E was completely released from the scaffolds within 5 h. MTT test was performed with fibroblast cells and results proved the biocompatibility of the scaffolds. These findings showed that the scaffolds may have good potential as a wound dressing material. The biodegradation test was performed in in vitro conditions and results showed that the surface coating with 5% EC/vitamin E microparticles on the 15% PLA/2% PMSQ scaffolds increased the degradation rate of the scaffolds.

Background This study assessed the consistency and accuracy of responses provided by two artificial intelligence (AI) applications, ChatGPT and Google Bard (Gemini), to questions related to dental trauma. Materials and Methods Based on the International Association of Dental Traumatology guidelines, 25 dichotomous (yes/no) questions were posed to ChatGPT and Google Bard over 10 days. The responses were recorded and compared with the correct answers. Statistical analyses, including Fleiss kappa, were conducted to determine the agreement and consistency of the responses. Results Analysis of 4500 responses revealed that both applications provided correct answers to 57.5% of the questions. Google Bard demonstrated a moderate level of agreement, with varying rates of incorrect answers and referrals to physicians. Conclusions Although ChatGPT and Google Bard are potential knowledge resources, their consistency and accuracy in responding to dental trauma queries remain limited. Further research involving specially trained AI models in endodontics is warranted to assess their suitability for clinical use.

This chapter examines the insurance industry’s role in mitigating the impacts of climate change by promoting clean energy transformation. First, based on theoretical frameworks and empirical evidence, it explores the implications of increased economic risks due to climate change on the industry. Then, using practices and case studies, it presents the tools and policies that insurance companies can use to facilitate the transition to clean energy. In conclusion, the chapter provides recommendations to industry stakeholders and policymakers on utilizing insurance to its fullest potential in the clean energy transition. Overall, this chapter argues that insurance can play an important role in adopting sustainable energy policies.

Aim The present study aimed to investigate the histomorphometric and immunohistochemical impacts of vitamin K2 on guided bone regeneration (GBR) in calvarial critical‐size defects (CSDs) in diabetic rats. Methods A total of 30 rats were used in this study, comprising 12 non‐diabetic (control) rats and 18 with streptozotocin‐nicotinamide‐induced experimental Diabetes mellitus (DM). In all rats, two calvarial CSDs were created: one defect was left empty (E), the other was treated with bovine‐derived bone graft and collagen‐based resorbable membrane (GM). Study groups were as follows: control rats administered saline ( n = 6, C‐E and C‐GM groups) or vitamin K2 ( n = 6, CK‐E and CK‐GM groups) and diabetic rats administered saline ( n = 6, DM‐E and DM‐GM groups) or vitamin K2 ( n = 6, DMK‐E and DMK‐GM groups). After 4 weeks of saline or vitamin K2 administration, the rats were euthanized. Bone defect healing and new bone formation were assessed histomorphometrically, and osteocalcin and osteopontin levels were examined immunohistochemically. Results Percentage of new bone formation was greater in CK‐GM vs. CK‐E and in DMK‐GM vs. DMK‐E [ d = 3.86 (95% CI = 16.38–28.61), d = 1.86, (95% CI = 10.74–38.58), respectively, p < .05]. Bone defect healing scores were higher in CK‐GM vs. CK‐E and in DMK‐GM vs. DMK‐E [ d = 2.69 (95% CI = ‐2.12 to −0.87), d = 3.28 (95% CI = 0.98–1.91), respectively, p < .05]. Osteocalcin expression levels were elevated in CK‐GM vs. CK‐E, in DMK‐GM vs. DMK‐E [ d = 1.19 (95% CI = 0.08–1.41), d = 1.10 (95% CI = 0.02–1.22), respectively p < .05]. Vitamin K2 enhanced osteocalcin expression levels in DMK‐E vs. DM‐E [ d = 2.78, (95% CI = 0.56–1.53), p < .05] and in DMK‐GM vs. DM‐GM [ d = 2.43, (95% CI = 0.65–2.10), p < .05]. Osteopontin expression was enhanced in defects treated with GM vs. E defects [C‐GM vs. C‐E, d = 1.56 (95% CI = 0.38–2.01); CK‐GM vs. CK‐E, d = 1.91 (95% CI = 0.49–1.72); DM‐GM vs. DM‐E, d = 2.34 (95% CI = ‐1.12 to −0.50); DMK‐GM vs. DMK‐E, d = 2.00 (95% CI = 0.58–1.91), p < .05]. Conclusion The research findings suggest that administering vitamin K2 in GBR for rats with DM favorably impacts bone healing in CSDs, presenting an adjunctive strategy for bone regeneration.

Background Despite the success of bariatric surgery in treating obesity, it can still lead to complications. The most serious and feared technical complications are bleeding and leakage from the gastric staple line. In this study, stapler line reinforcement was investigated to determine whether it affects postoperative leakage and bleeding rates and their management. Materials and Methods Overall, 510 patients who underwent sleeve gastrectomy were evaluated retrospectively. They were divided into 2 groups according to whether reinforcement of the staple line with running imbricating sutures was performed. Results In the reinforcement group, there were two leaks (0.7%), which were diagnosed seven and eight days after surgery. In the non-reinforcement group, there were nine leaks (4%). There was no difference between the two groups in staple line bleeding. Conclusions This study shows that reinforcement with continuous imbricating sutures is associated with less stapler line leakage and a lower reoperation rate at the cost of increased operative time.

The demand for sustainable and recyclable materials in industrial applications has led to a surge in interest in green composites, particularly those incorporating natural fillers derived from agro‐food industry waste. This study investigates the mechanical and thermal properties of polypropylene (PP) hybrid composites filled with hazelnut shell and wollastonite, along with the effect of styrene‐ethylene/butylene‐styrene (SEBS) and SEBS‐g‐maleic anhydride (SEBS‐g‐MA) compatibilizers. Various characterization techniques, including tensile, flexural, and impact tests, as well as differential scanning calorimetry (DSC), thermogravimetry (TGA), and scanning electron microscopy (SEM) analyses, were employed to evaluate the composites. Results demonstrate that the addition of wollastonite significantly improves mechanical properties, while hazelnut shell filler affects thermal behavior and stability. SEBS and SEBS‐g‐MA compatibilizers enhance impact resistance; however, they lead to a decrease in other mechanical properties. DSC and TGA analyses demonstrate changes in crystallization behavior and thermal stability due to filler and compatibilizer incorporation. SEM microstructure images show the distribution of SEBS and SEBS‐g‐MA within the composite structure, affecting mechanical and thermal properties. Overall, this study highlights the importance of filler selection, compatibilizer addition, and their distribution in attaining desired properties for industrial applications. Future research should focus on optimizing formulations for specific uses and assessing long‐term performance under real‐world conditions.

In this study, for the first time, non-isothermal oxidation behavior of the AM Ti-6Al-4V alloy was investigated through TGA-DTA to predict and determine the oxidation mechanism. TGA results were evaluated by both model-free kinetic models and model-fitting methods. The model-fitting kinetic method was applied to predict and determine the reaction mechanism. The obtained results indicate that the reaction is controlled by D2 and D3 models at heating rates of 5 and 10°C/min, respectively. F2 and F1 control the reaction mechanism at heating rates of 20 and 50°C/min, respectively. The results of this study indicate that oxidation kinetics vary with reaction time, allowing us to predict which materials are most favorable to use under certain conditions with respect to oxidation applications.

Background During pregnancy, the requirements of essential nutrients for the mother and foetus increase. The changes in pregnant women’s eating behaviours may vary according to their sociodemographic characteristics. It is important to meet these increased requirements and understand the factors influencing eating habits during pregnancy. Objectives This study aimed to determine the effects of changes in pregnant women’s eating attitudes and behaviours and their sociodemographic characteristics on their meeting status for nutrient recommendations. Methods Sociodemographic information, eating behaviours, and attitudes of 656 pregnant women were obtained in face-to-face interviews between February and June 2020. Food consumption records were taken with a 24-hour recall method and evaluated according to the estimated average requirement value. Results The average age of pregnant women was 29.0 ± 5.2 years, 28.0% were high school graduates, and 69.2% were non-working. The frequency of intakes below the estimated mean requirement value were iron, folic acid, vitamin B6, niacin, and calcium. It was demonstrated that there was a significant difference in snack consumption based on the working status and nutrition information obtained (P < .05). Getting nutrition information, age, education level, working status, and pre-pregnancy body mass index significantly increased food consumption (P < .05). Conclusion Inadequate nutrient intake is a common public health problem in pregnant women. It is necessary to identify the sociodemographic characteristics that negatively impact pregnant women’s nutritional status and to develop nutrition and health education programs based on these features.

Background The mitochondrial carrier homolog 2 (MTCH2) is a mitochondrial outer membrane protein regulating mitochondrial metabolism and functions in lipid homeostasis and apoptosis. Experimental data on the interaction of MTCH2 with viral proteins in virus-infected cells are very limited. Here, the interaction of MTCH2 with PA subunit of influenza A virus RdRp and its effects on viral replication was investigated. Methods The human MTCH2 protein was identified as the influenza A virus PA-related cellular factor with the Y2H assay. The interaction between GST.MTCH2 and PA protein co-expressed in transfected HEK293 cells was evaluated by GST-pull down. The effect of MTCH2 on virus replication was determined by quantification of viral transcript and/or viral proteins in the cells transfected with MTCH2-encoding plasmid or MTCH2-siRNA. An interaction model of MTCH2 and PA was predicted with protein modeling/docking algorithms. Results It was observed that PA and GST.MTCH2 proteins expressed in HEK293 cells were co-precipitated by glutathione-agarose beads. The influenza A virus replication was stimulated in HeLa cells whose MTCH2 expression was suppressed with specific siRNA, whereas the increase of MTCH2 in transiently transfected HEK293 cells inhibited viral RdRp activity. The results of a Y2H assay and protein-protein docking analysis suggested that the amino terminal part of the viral PA (nPA) can bind to the cytoplasmic domain comprising amino acid residues 253 to 282 of the MTCH2. Conclusion It is suggested that the host mitochondrial MTCH2 protein is probably involved in the interaction with the viral polymerase protein PA to cause negative regulatory effect on influenza A virus replication in infected cells.

Purpose: Immunodysregulation, Polyendocrinopathy, Enteropathy, and X-linked syndrome (IPEX), caused by FOXP3 mutations, is a rare autoimmune disorder with diverse clinical features, including early-onset diabetes, eczema, and enteropathy. Atypical cases show milder symptoms and unique signs, requiring different treatments. Therefore, there are ambiguities in the accurate diagnosis and management of IPEX. We sought to present clinical, genetic, and immunological assessments of 12 IPEX patients with long-term follow-up to facilitate the diagnosis and management of the disease. Methods: Clinical findings and treatment options of the patients were collected over time. Lymphocyte subpopulations, protein expressions, regulatory T (Treg) and circulating T follicular helper (cTFH) cells, and T-cell proliferation were analyzed. Results: Predominant presentations included chronic diarrhea (75%), failure to thrive (66.7%), and eczema (58.3%). There were four classical and eight atypical IPEX individuals. Strikingly, the classical triad of IPEX was observed only in one patient. Allergic manifestations were more common in atypical patients. Notably, infections and chronic diarrhea demonstrated heightened severity compared to other manifestations. Four patients (33.3%) demonstrated eosinophilia, and nine (75%) showed high serum IgE levels. Most patients showed normal percentages of Treg cells with reduced CD25, FOXP3, and CTLA-4 expressions. Compared to healthy controls, the TH2-like skewing accompanied by reduced TH17-like responses was observed in cTFH and Treg cells of patients. The impaired immune responses were corrected after hematopoietic stem cell transplantation (HSCT). Overall, nine patients (75%) received immunosuppressants (ISs), and six (50%) underwent HSCT, which was the only treatment revealing sustained control. Commonly used ISs included corticosteroids and sirolimus, but severe side effects led to therapy discontinuation in six patients. Conclusions: This comprehensive analysis of clinical features and treatment responses contributes valuable insights for the improved diagnosis and management of IPEX syndrome, particularly emphasizing the atypical presentations and the efficacy of HSCT in achieving sustained control.

Introduction Ionizing radiation is used daily during endourological procedures. Despite the dangers of both deterministic and stochastic effects of radiation, there is a lack of knowledge and awareness among urologists. This study reviewed the literature to identify the radiation exposure (RE) of urologists during endourological procedures. Methods A literature search of the Medline, Web of Science, and Google Scholar databases was conducted to collect articles related to the radiation dose to urologists during endourological procedures. A total of 1966 articles were screened. 21 publications met the inclusion criteria using the PRIMA standards. Results Twenty-one studies were included, of which 14 were prospective. There was a large variation in the mean RE to the urologist between studies. PCNL had the highest RE to the urologist, especially in the prone position. RE to the eyes and hands was highest in prone PCNL, compared to supine PCNL. Wearing a thyroid shield and lead apron resulted in a reduction of RE ranging between 94.1 and 100%. Educational courses about the possible dangers of radiation decreased RE and increased awareness among endourologists. Conclusions This is the first systematic review in the literature analyzing RE to urologists over a time period of more than four decades. Wearing protective garments such as lead glasses, a thyroid shield, and a lead apron are essential to protect the urologist from radiation. Educational courses on radiation should be encouraged to further reduce RE and increase awareness on the harmful effects of radiation, as the awareness of endourologists is currently very low.