Pamukkale University

Plastic particles smaller than 5 mm are microplastics. They are among the significant pollutants that recently attracted attention. Great quantities of microplastics enter the sewage system daily and reach wastewater treatment plants (WWTPs). As a result, WWTPs are potential microplastic sources. Hence, they create a pathway for microplastics to reach aquatic environments with treated wastewater discharge. Studies on microplastic characterization in WWTPs have gained momentum in academia. This study investigates the abundance, size, shape, color, polymer type, and removal efficiencies of microplastics in a municipal wastewater treatment plant (WWTP) in Denizli/Turkey. The results showed that the dominant microplastic shape in wastewater samples was fibers (41.78%–60.77%) in the 100–500 µm (58.57%–80.07%) size range. Most of the microplastics were transparent-white (32.86%–58.93%). The dominant polymer types were polyethylene (54.05%) and polyethylene vinyl acetate (37.84%) in raw wastewater. Furthermore, the microplastic removal efficiencies of the Denizli Central WWTP as a whole and for individual treatment units were evaluated. Although the microplastic pollution removal efficiency of the Denizli Central WWTP was over 95%, the microplastic concentration discharged daily into the receiving environment was considerably high (1.28 × 1010 MP/d). Thus, Denizli Central WWTP effluents result in a high volume of emissions in terms of microplastic pollution with a significant daily discharge to the Çürüksu Stream.

In this paper, we give the definition of local variable Morrey–Lorentz spaces which are a new class of functions. Also, we prove the boundedness of the Hardy–Littlewood maximal operator and Calderón–Zygmund operators on these spaces. Finally, we apply these results to the Bochner–Riesz operator, identity approximation and the Marcinkiewicz operator on the spaces.

In recent years, one of the main challenges is to improve the mechanical performance of bio-composites to be used as structural parts for the construction, automotive, and aviation sector. This paper may contribute to developing durable structural bio-composite parts with starch addition. The mechanical properties of bio-composites reinforced by eucalyptus or pine fibers (48 wt %) compound with Cationic Starch (48 wt %) and Carboxymethyl cellulose (CMC) (4 wt %) were determined. The production method was a combination of molded pulp, extrusion, and compression molding production techniques. To see the effect of adding starch to bio-composites and different production methods, the mechanical performance of these natural fibers produced by the conventional molded pulp production method (without any additives) was also found and compared with the composite samples. Composite samples indicate significantly better tensile, flexural, and compressive values, at least four times, compared with the molded pulp samples. On the other hand, the molded pulp samples had more than 2 times better impact characteristics against composites. Using molded pulp technic in composite production (investigated in the study) is a new idea and may give some opportunities with its serial production compatibility and geometry freeness, to the industry.

Background In the study, we tried to analyze the effects of foreign players on Turkish Super League matches. For this purpose, in this long-term study, 1836 competition data played in 6 seasons between 2014 and 2020 was obtained from www.mackolik.com each year. Method Pearson's correlation coefficient applied between 18 different variables (goal, shoot, pass, cross, corner, offside, foul, yellow card, red card, accurate shot, percentage of the precise pass, rate of accurate access on opponent's field, the difference of ball possession percentage, shot difference, pass difference, big team superiority, home team superiority) and the number of foreign players (NoFP, active foreign players in 90 min.). Result In the Turkish Super League, within six seasons (2014–20), the NoFP in a match increased from 10.43 (38.06%) to 17.99 (64.26%). The increment was partially linear and statistically significant (F = 594.85) in all seasons. A positive association was found between NoFP several of passes (r = 0.219), percentage of accurate passes (r = 0.133), percentage of precise passes on the opponent's field (r = 0.139), exact pass difference between opponents (r = 0.114), and ball possession difference between opponents (r = 0.113). Fouls committed decreased with the increase of NoFP (r = -0.250). Although the win probability of the teams named The Big Three (Fenerbahçe, Galatasaray, and Beşiktaş) decreased from 67% (2014 season rate) to 50% in the last two seasons, no association was identified between the NoFP and big team superiority. Conclusions Consequently, NoFP increment may improve the game quality by increasing accurate passes and passes in the opponent's field. The number of passes and the ball possession percentage difference between opponent teams may indicate that one team has control of the game by keeping possession or the other is tactically giving possession. These findings may suggest that the game evolved into half-field, tactical, set-play, possessioning competition. Analyzing variables such as game speed, intensity, the duration of the ball in play, running distance, energy consumption, and fatigue markers may light future studies.

Human mpox (formerly monkeypox) disease has recently been reported in a number of European countries among individuals with no history of international travel or animal contact, causing global epidemic concerns. We describe the demographic, clinical characteristics, and laboratory data of four male patients with mpox disease, three of whom were human immunodeficiency virus (HIV)-positive, and one who was HIV-negative but had type 1 diabetes mellitus and a recent history of urological surgery. The HIV-negative patient attracted interest because he had no history of suspected sexual contact; however, he used shared bathrooms and towels at work, which could explain the potential transmission route. The remaining three male patients engaged in sexual activity with men recently. All four patients had prodromal symptoms such as short-term fever, myalgia, or fatigue, followed by a vesicular-pustular rash that began in the genital area, and two also had lesions on other parts of their bodies. Mpox is not generally considered in the differential diagnosis intitally because it is rare in Turkey; however, the diagnosis should be considered in patients with pustular umbilicated lesions and a history of risky sexual behavior. Keywords: mpox, outbreak, lesion, rash, HIV, infection

The relatively small panel cointegration literature on the dynamics between FDI and income inequality predominantly finds that FDI will reduce income inequality in the long-run in developed countries. However, we point out an important technical oversight in the literature. Not accounting for cross-section dependence in panel data methodologies may yield unreliable results. Expanding on the work of Herzer and Nunnenkamp [(2013). Inward and outward FDI and income inequality: Evidence from Europe. Review of World Economics, 149(2), 395–422. https://doi.org/10.1007/s10290-013-0148-3], who pioneered the use of panel cointegration in the European context, we obtain different results when we account for cross-section dependence and employ economic procedures robust to it. Using a panel containing 16 OECD countries (1979–2017), 2 income inequality measures, and 4 FDI measures, we begin by showing strong evidence for the existence of cross-section dependence. Then, using second-generation econometric procedures, we do not find any evidence for a cointegrating relationship between inward FDI and income inequality. We do find evidence that outward FDI is cointegrated with income inequality; however, contrary to the main results of the literature, we find that it widens the income gap in the long-run. Additionally, our results support the view that fiscal policy is an important tool to reduce income inequality.

The extended Kawahara (Gardner Kawahara) equation is the improved form of the KdV equation which is one of the important nonlinear evolution equations in mathematical physics. In that research, the analytical solutions of the conformable fractional extended Kawahara equation are obtained by utilizing the Jacobi elliptic function expansion method. This expansion method has been applied to the different fractional forms of the extended Kawahara equation such as the fractionality occurs in time, space or both time and space by using the suitable change of variables. Besides, various types of fractional problems are exhibited to expose the realistic application of the given method and some of the obtained solutions have been illustrated by two- or three-dimensional graphics as the proof of the visualisation.

I read with great interest the well-written and informative article, titled “ChatGPT and the Future of Medical Writ-ing,” by Dr Biswas (1) in the February issue of Radiol-ogy. The author provided a comprehensive review of the potential role of large language models (LLMs) such as ChatGPT in the future of medical writing (1). I wish to make a few comments on future medical journalism and potential implications of LLMs.Whereas important limitations of LLMs are presented (1), another limitation is that LLMs cannot explain their reasoning or decision-making process, making it difficult to understand how they arrived at a particular output or identify potential errors. This can be a problem in fields such as health care or finance, where transparency and ac-countability are crucial. Explainable AI techniques are be-ing studied to overcome these limitations (2,3).Radiology report generation is a potential application of LLMs; it can generate radiology reports by creating a narrative of the findings. Although LLMs may assist radi-ologists in their workflow, it is essential for the radiologist to check and verify the generated report.Detecting a publication fabricated with a language model like ChatGPT would likely be challenging. Although peer review, data validation, randomized con-trolled trial registration, and plagiarism detection are es-sential, the importance of so-called open data and open science publishing is increasing with the development of LLMs. The open data publication model is important in detecting fabricated articles because it promotes transpar-ency and reproducibility in scientific research. When re-search data and results are openly available, others can eas-ily verify the validity and reliability of the findings (4,5).Finally, LLMs like ChatGPT can be used to review manuscripts for grammar, spelling, and punctuation er-rors, but cannot effectively review the scientific content or method, or make ethical and/or moral judgments (5). Currently, it is best used to assist human reviewers but fu-ture advancements such as human-in-the-loop training or combining multiple models may improve its capabilities.

As an emerging economy, Turkey has experienced a significant structural transformation in the last twenty years. Within this period, Turkey has increased to the eleventh rank for international tourist arrivals in the world (UNWTO Citation2023). However, in recent years, there has been a rapid depreciation of the national currency, raising the question of how this affects the tourism trade. Using bilateral data and considering non-linearities, we investigate the exchange rate-tourism balance nexus for Turkey and its most tourist sender partners by applying ARDL and NARDL modelling. We find that (i) when the Turkish Lira (TL) appreciates, the tourism balance is positively affected in the German and UK models in the short-run and in the Russian and Netherlands models in the long-run; (ii) the depreciation of the TL, on the other hand, has a positive effect on the tourism balances for France and the UK in the short-run. Therefore, either the increase or decrease in the exchange rate (except for Russia in the short-run) affects the tourism balance insignificantly or positively. These findings imply that policymakers should focus more on country-specific tourism policies to attract more tourists to the country rather than on exchange rate policies to manage the tourism balance.

Sweet cherry (Prunus avium L.) fruits are prone to quality and quantity loss in shelf-life conditions and cold storage due to their short post-harvest life. Until now efforts have been made to extend the shelf life of the sweet cherry. However, an efficient and commercially scalable process remains elusive. To contribute to this challenge, here in this study, biobased composite coatings consisting of chitosan, mucilage, and levan, were applied on sweet cherry fruits and tested for postharvest parameters in both market and cold storage conditions. Results demonstrated that the shelf life of sweet cherries can be extended until the 30th day while retaining important post-harvest properties like decreased weight loss, fungal deterioration, increased stem removal force, total flavonoid, L-ascorbic acid, and oxalic acid. Given the cost-effectiveness of the polymers used, the findings of this study indicate the feasibility of extending the shelf-life of sweet cherries on a larger scale.

Background Duchenne muscular dystrophy (DMD) is an X-linked muscular disease which is caused by the absence of dystrophin. Troponin elevation with acute chest pain may indicate acute myocardial injury in these patients. We report a case of DMD that presented with ACP and troponin elevation, who was diagnosed with acute myocardial injury, and successfully treated with corticosteroids. Case presentation A 9-year-old with DMD was admitted to the emergency department with the complaint of acute chest pain. His electrocardiogram (ECG) revealed inferior ST elevation and serum troponin T was elevated. The transthoracic echocardiography (TTE) demonstrated inferolateral and anterolateral hypokinesia with depressed left ventricular function. An ECG-gated coronary computed tomography angiography ruled out acute coronary syndrome. Cardiac magnetic resonance imaging revealed mid-wall to sub-epicardial late gadolinium enhancement at the basal to the mid inferior lateral wall of the left ventricle and corresponding hyperintensity on T2-weighted imaging, consistent with acute myocarditis. A diagnosis of acute myocardial injury associated with DMD was made. He was treated with anticongestive therapy and 2 mg/kg/day of oral methylprednisolone. Chest pain resolved the next day, and ST-segment elevation returned to normal on the third day. Troponin T decreased in the sixth hour of oral methylprednisolone treatment. TTE on the fifth day revealed improved left ventricular function. Conclusion Despite advances in contemporary cardiopulmonary therapies, cardiomyopathy remains the leading cause of death in patients with DMD. Acute chest pain attacks with elevated troponin in patients with DMD without coronary artery disease may indicate acute myocardial injury. Recognition and appropriate treatment of acute myocardial injury episodes in DMD patients may delay the development of cardiomyopathy.

Pulmonary alveolar microlithiasis is an autosomal recessive lung disease caused by a deficiency in the pulmonary epithelial Npt2b sodium-phosphate co-transporter that results in accumulation of phosphate and formation of hydroxyapatite microliths in the alveolar space. The single cell transcriptomic analysis of a pulmonary alveolar microlithiasis lung explant showing a robust osteoclast gene signature in alveolar monocytes and the finding that calcium phosphate microliths contain a rich protein and lipid matrix that includes bone resorbing osteoclast enzymes and other proteins suggested a role for osteoclast-like cells in the host response to microliths. While investigating the mechanisms of microlith clearance, we found that Npt2b modulates pulmonary phosphate homeostasis through effects on alternative phosphate transporter activity and alveolar osteoprotegerin, and that microliths induce osteoclast formation and activation in a receptor activator of nuclear factor-κB ligand and dietary phosphate dependent manner. This work reveals that Npt2b and pulmonary osteoclast-like cells play key roles in pulmonary homeostasis and suggest potential new therapeutic targets for the treatment of lung disease.

The most common cause in the etiology of sudden cardiac death (SCD) is ischemic heart disease due to atherosclerosis. Postmortem diagnosis can be made by histopathological examinations, but routine histopathological examinations are limited, especially in the early period of postmortem ischemia. For this reason, many methods are being investigated for the postmortem diagnosis of ischemia, and postmortem biochemical studies are promising. In our study, we evaluated the biochemical markers; hs-cTnT, NT-proBNP, H-FABP, pentraxin-3, copeptin, ischemic modified albumin (IMA), and PAPP-A in postmortem serums. In forensic pathology practice, it was investigated whether it would be useful to go to the diagnosis by measuring more than one marker in a single biological fluid in SCD cases. The study included 35 sudden cardiac death cases and 24 control cases and as a result of our study, hs-cTnT, NT-proBNP, and H-FABP values were found to be significantly higher in the SCD group than in the control group. Within the scope of the multi-marker strategy, models were tried to be developed in which the markers were used together, and it was concluded that the model consisting of the myocardial ischemia marker hs-cTnT, the myocardial stress marker NT-proBNP, and the inflammation marker pentraxin 3 was the most accurate combination by correctly classifying the cases at a rate of 94.9%. As a result, it was thought that it would be appropriate to use the multi-marker strategy which is widely used in clinical applications, also in forensic medicine applications.

A 43-year-old male presented with acute right upper quadrant pain, nausea, and itchy skin rash for two hours. Physical examination revealed abdominal tenderness and itchy abdominal skin lesions that are compatible with urticaria. The patient’s blood pressure was 95/55 mmHg, pulse rate was 122 beats/minute, body temperature was 37.1 C degrees, and partial oxygen saturation was 96% in the room air. He had no history of recent trauma or chronic disease. Laboratory test results were within normal limits except for increased white blood cell count (14.79 K/uL, reference range; 4-10 K/uL). Abdominal ultrasound (US) was performed, and the US revealed abdominal free fluid and a thin-walled lobulated cystic lesion in the liver dome. For further evaluation, contrastenhanced abdominal computed tomography (CT) was obtained. CT showed a thin-walled cystic lesion with lobulated contours in the liver, pericystic fat stranding, perihepatic free fluid, and right pleural effusion (Figure 1).

A 58-year-old man presented to the cardiology clinic with intermittent chest pain and a 5-day history of palpitations that were not associated with exercise. His medical history revealed that a cardiac mass was detected at echocardiography performed 3 years ago and for similar symptoms. However, he was lost to follow-up before his examinations were concluded. Apart from that, his medical history was unremarkable, and he had not experienced any cardiac symptoms in the intervening 3 years. He had a family history of sudden cardiac death, and his father died of a heart attack when he was 57 years old. Physical examination findings were unremarkable except for increased blood pressure (150/105 mmHg). Laboratory findings, including a complete blood count and creatinine, C-reactive protein, electrolyte, serum calcium, and troponin T levels, were within normal limits. Electrocardiography (ECG) was performed and revealed sinus rhythm and ST depression in the left precordial leads. Transthoracic two-dimensional echocardiography revealed an irregular left ventricle mass. The patient subsequently underwent contrast-enhanced ECG-gated cardiac CT followed by cardiac MRI to evaluate the left ventricle mass (Figs 1-5).

Introduction: With recent advances in genome sequencing technology, a large body of evidence has accumulated over the last few years linking alterations in microbiota with cardiovascular disease. In this study, we aimed to compare gut microbial composition using 16S ribosomal DNA (rDNA) sequencing techniques in patients with coronary artery disease (CAD) and stable heart failure (HF) with reduced ejection fraction and patients with CAD but with normal ejection fraction. We also studied the relationship between systemic inflammatory markers and microbial richness and diversity. Methods: A total of 40 patients (19 with HF and CAD, 21 with CAD but without HF) were included in the study. HF was defined as left ventricular ejection fraction <40%. Only stable ambulatory patients were included in the study. Gut microbiota were assessed from the participants' fecal samples. The diversity and richness of microbial populations in each sample were assessed by the Chao1-estimated OTU number and the Shannon index. Results: The Chao1-estimated OTU number and Shannon index were similar between HF and control groups. There was no statistically significant relationship between inflammatory marker levels (tumor necrosis factor-alpha, interleukin 1-beta, endotoxin, C-reactive protein, galectin-3, interleukin 6, and lipopolysaccharide-binding protein) and microbial richness and diversity when analyzed at the phylum level. Conclusion: In the current study, compared to patients with CAD but without HF, stable HF patients with CAD did not show changes in gut microbial richness and diversity. At the genus level Enterococcus sp. was more commonly identified in HF patients, in addition to certain changes in species levels, including increased Lactobacillus letivazi.

Zinner syndrome is a rare disorder, and it is associated with unilateral renal agenesis, ipsilateral ejaculatory duct atresia (obstruction), and cystic dilatation of the ipsilateral seminal vesicle. Here, we present an eighteen-year-old male with Zinner syndrome who presented to a urology clinic with perineal/pelvic pain and dysuria. We also emphasize the computed tomography and magnetic resonance imaging findings of Zinner syndrome.

Article Type: Review Hypertension becomes the main reason behind various deaths. About 20% of the American population is suffering from hypertension and 33% of these Americans are unaware that they are hypertensive. Consequently, hypertension is sometimes known as a silent killer as well. Hypertension is mostly without any symptoms till the destructive consequences of high blood pressure like myocardial infarction, stroke, renal disorders and visual issues are detected. It's a major risk factor that describes heart attacks and coronary artery disease which sometimes needs coronary artery bypass surgery. High blood pressure is defined as constantly high blood pressure increasing from 140/90 mm HG or even more than this, nowadays it's a very common problem faced by almost everyone and almost billions of dollars are consumed every year to investigate cardiovascular ailments and may dollars are utilized for their medication as well Because high blood pressure majorly causes cardiovascular and cerebrovascular ailments. Recently, traditional medicine has managed little to decrease the patient ratio with this dangerous ailment. Natural remedies provide very useful ways to reduce the increasing patient ratio with hypertension. Taking supplements such as magnesium, omega-3 fatty acids, CoQ10, potassium, amino acids, taurine, and vitamins C and E have been efficiently utilized in dealing with cardiovascular ailments involving hypertension. The mentioned medicinal plants were effective against blood pressure and other cardiovascular diseases. This review highlights the herbs proven scientifically for the treatment of hypertension.

Background: We aimed to evaluate patients with nasopharyngeal carcinoma (NPC) in a nonendemic population. Methods: In a national, retrospective, multicenteric study, 563 patients treated with intensity modulated radiotherapy at 22 centers between 2015 and 2020 were analyzed. Results: Median age was 48 (9-83), age distribution was bimodal, 74.1% were male, and 78.7% were stage III-IVA. Keratinizing and undifferentiated carcinoma rates were 3.9% and 81.2%. Patients were treated with concomitant chemoradiotherapy (48.9%), or radiotherapy combined with induction chemotherapy (25%) or adjuvant chemotherapy (19.5%). After 34 (6-78) months follow-up, 8.2% locoregional and 8% distant relapse were observed. Three-year overall survival was 89.5% and was lower in patients with age ≥50, male sex, keratinizing histology, T4, N3 and advanced stage (III-IVA). Conclusions: Patients with NPC in Turkey have mixed clinical features of both east and west. Survival outcomes are comparable to other reported series; however, the rate of distant metastases seems to be lower.