Recently, alkali-activated slag (AAS) has attracted extensive attention in cemented paste backfill (CPB) due to its low cost/CO2 emissions and high strength benefits. However, a comprehensive analysis of the mechanical/rheological behavior and microstructure evolution of AAS-CPB using mineral admixtures is still lacking. In this study, metakaolin (MK), fly ash (FA), and silica fume (SF) were employed to replace ground granulated blast furnace slag (GGBS) at various levels to formulate an alkali-activated binder, and the corresponding mechanical, rheological, and microstructure properties of CPB were investigated. The results suggest that FA tends to reduce CPB’s rheological and strength evolution and this negative effect increases with the FA dosage. The replacement of MK or SF increases the rheological parameters and thus diminishes fluidity and has positive or negative effects on strength depending on the replacement level and curing age. This study’s findings will contribute to developing a new scheme for lucrative and environmentally responsive multi-solid waste-based AAS-CPB in the field.
This research problematizes the contested nature of the global norm diffusion by focusing on intra-group rivalries and fragmentations shaping local responses (often reactionary and resistant) to global norms. Such an examination is important primarily to account for what leads to shifts in the local reception of norms over time. This study empirically explores local fragmentation, rivalry and change in response nexus in the example of the reception of the global gender equality norms in Turkey by the conservative normative bloc. It reveals that the conservative bloc is not a monolithic normative order and that there are two main competing receptions of the gender equality norm within the group in Turkey. With a firm emphasis on Turkey’s first initiating and later withdrawal from the Istanbul Convention, the study elaborates how the institutionalized conservative response to gender equality has shifted from a compromising acceptance to a rejection over time.
This study consists of two parts. In first part; It is built on the definition of Intuitionistic Fuzzy Submodules of a Module. Many researchers have used the definition of Atanassov’s (Fuzzy Sets Syst 20:87–96, ) Intuitionistic fuzzy sets definition to move the definitions in classical algebra to intuitionistic fuzzy algebra. Davvaz et al. (Inf Sci 176:1447–1454, ) defined the Intuitionistic fuzzy submodules of a module. They used minimum and maximum operations to give that definition. In this study we replace minimum operation with triangular norms and maximum operation with triangular conorms for giving the definition of Intuitionistic (T, S)-fuzzy submodule of a module. By using this definition, we move some definition and theorems in classical algebra to Intuitionistic fuzzy algebra. In the second part It is built on the definition of intuitionistic L-fuzzy rings and ideals. Many researchers have used the definition of Atanassov’s (Fuzzy Sets Syst 20:87–96, ) intuitionistic fuzzy sets to move the definitions in classical algebra to intuitionistic fuzzy algebra (Davvaz et al. in Inf Sci 176:1447–1454, ; Çuvalcıoğlu et al. in Notes Intuitionistic Fuzzy Sets 20:9–16, ; Çuvalcıoğlu and Aykut in NIFS 20:57–61, ; Isaac and Pearly in Int J Math Sci Appl 1:1447–1454, ). When K. Atannassov gave the definition of intuitionistic fuzzy sets he used the closed interval [0, 1]. Then Meena and Thomas (Int Math Forum 6:2561–2572, ) replaced the closed interval [0, 1] with L-lattice. In that study they used ∧ ∧-infimum and ∨-supremum operations to give the intuitionistic L-fuzzy rings and intuitionistic L-fuzzy ideals. In this study we replace ∧-infimum with triangular norms and we replace ∨-supremum with triangular conorms and give the definition of intuitionistic (T,S)-L fuzzy rings and ideals. By using this definitions, we move some definition and theorems in classical algebra to intuitionistic fuzzy algebra.
Öğretmenlerin mesleki gelişimi, kariyerleri boyunca devam etmesi gereken ve hem kendi öğretim stratejilerini gözden geçirme imkânı buldukları hem de öğrencilerin ihtiyaçlarını nasıl karşılayabileceklerini öğrendikleri bir süreçtir. Başarılı bir kariyer gelişimi, öğretmenlerin kendilerini bu sürecin içerisinde nasıl konumlandırdıklarına bağlıdır. Çalışmada, öğretmenlik kariyer basamaklarına ve 19 Kasım 2022 tarihinde uygulanan yazılı sınavına ilişkin Türkçe öğretmenlerinin görüşlerine başvurulmuştur. Görüşler doğrultusunda sınavın tutarlılığı, niteliği, kapsayıcılığı, işlevselliği ve güvenilirliği ile Türkçe öğretmenlerinin uzmanlık ve başöğretmenlik kariyer basamaklarına ilişkin değerlendirmeler yapılmıştır. Temel nitel araştırma ile desenlenen bu araştırmanın çalışma grubunu, uzman öğretmenlik ve başöğretmenlik yazılı sınavına girmiş 71 Türkçe öğretmeni oluşturmaktadır. Görüşme aracılığıyla çalışma grubundan yazılı yolla veri toplanmış, toplanan veriler içerik analizine tabi tutularak tema ve alt temalar belirlenmiştir. Elde edilen bulgulardan hareketle öğretmenlerin kariyer basamaklarına yönelik yeterliklerini ölçmek için uygulanan sınava ilişkin görüşleri; uzman öğretmen ve başöğretmen olmanın yeterlikleri, sınavın kariyer basamaklarına yönelik beklentileri karşılayıp karşılamama durumu, uzman öğretmen ve başöğretmen ayrımı, sınavın kapsadığı konuların kariyer basamaklarını belirleme ve kılavuzda belirtilen konuları ölçme yeterliği olmak üzere beş ana tema etrafında analiz edilmiştir.
Background: In emergency settings, medication dosages are primarily determined based on the child's weight; however, the healthcare personnel sometimes may have to make the first intervention without knowing the patient's weight, which may result in an underdose or overdose of the medication. We aimed to find a reliable method to estimate children's bodyweight, including the obese and malnourished. Methods: We conducted the study with children between the ages of 3 and 17 years. We measured the children's bodyweight, right foot length, and mid-upper arm circumference in centimeters during their examination. We created a concise formula through regression analysis to estimate the patients' weight based on the right foot length and mid-upper arm circumference. Finally, we compared this formula to other conventional formulae. Results: The study included 741 patients whose average age was 8.4±3.9 (3-17) years. A high correlation was found between the patients' foot length, arm circumference, and bodyweight (R: 0.866, p<0.001 and R: 0.910, p<0.001, respectively). A single formula was created by regression analysis based on foot length and the mid-upper arm circumference without including sex and age in the calculation to make a more straightforward and faster calculation in emergency cases. Conclusion: The formula created may be advantageous for reliably and easily estimating the weight of children aged 3-17 of any sex and body habitus in emergency settings without special equipment. This newly developed formula may enable a low-cost optimal level of weight estimation without the need for special equipment.
An Al-12Si-0.1Sr alloy ingot was manufactured using a permanent mold casting technique. The microstructure and mechanical properties of this alloy were researched. Effects of different cutting conditions (cutting speed-V:200 m/min, 300 m/min, and 400 m/min and feed rate-f: 0.05 mm/rev, 0.1 mm/rev, and 0.15 mm/rev) on the cutting force (F) and surface roughness (Ra) during machining using uncoated and physical vapor deposition- titanium aluminum nitride coated carbide inserts were also revealed. Microstructure of the alloys consists of α phase, intermetallic δ and Al4Sr phases, thin spherical eutectic, and irregular coarse-shaped primary silicon particles. Cutting force and surface roughness decreased with the increased cutting speed during turning with uncoated, and titanium aluminum nitride coated inserts while they increased feed rate. A built-up edge and built-up layer were formed in both cutting inserts. The built-up edge and built-up layer decreased with increasing cutting speed and increased feed rate. The cutting force, surface roughness, built-up edge, and built-up layer were lower in uncoated inserts compared to the titanium aluminum nitride coated inserts.
Purpose To investigate the possible protective role of syringic acid on torsion/detorsion-induced testicular injury using biochemical and histopathological approaches for the first time. Methods A total of 24 rats were divided into 4 groups: sham control, torsion/detorsion, torsion/detorsion + syringic acid (50 mg/kg and 100 mg/kg). Tissue malondialdehyde, total oxidant status and total antioxidant status levels were determined using colorimetric methods. Tissue 8-hydroxy-2′-deoxyguanosine, superoxide dismutase, catalase, high mobility group box 1, nuclear factor kappa B protein 65, tumor necrosis factor-alpha, interleukin-6, myeloperoxidase, 78-kDa glucose-regulated protein, activating transcription factor-6, C/EBP homologous protein and caspase-3 levels were determined using commercial enzyme-linked immunosorbent assay kits. Johnsen’s testicle scoring system was used for histological evaluation. Results Compared with the control group, the levels of oxidative stress, inflammation, endoplasmic reticulum stress and apoptosis were significantly increased in the torsion/detorsion group (p < 0.05). Syringic acid administrations statistically significantly restored these damage in a dose dependent manner (p < 0.05). Moreover, it was found that the results of histological examinations supported the biochemical results to a statistically significant extent. Conclusion The overall results suggest that syringic acid emerges as a potential compound for the treatment of testicular torsion and may be subject to clinical trials.
Backgroud: Turkey is considered an important gene pool for the distribution of herbaceous Paeonia species. Twelve taxons were recorded in Turkey and all definitions are morphologically and/or anatomically performed. No studies have been conducted based on DNA barcode sequences. In this study, The matK and rbcL genes and ITS region were sequenced to determine phylogenetic relationships of 12 Turkish Paeonia taxa and chemical comparison was performed with root samples. Methods and results: The taxons were collected between May and June 2021 from nine different cities. Leaf materials were used for DNA isolation and ITS, matK and rbcL regions were amplified and sequenced. There was no difference among taxa in terms of rbcL sequences. But the ITS and matK regions distinguished 12 taxa. The genotypes were structured in two groups by ITS and matK data. ITS region distinguished P. peregrina, P. arietina, and P. tenuifolia from other taxa, while matK region distinguished P. arietina and P. witmanniana from other taxa. Both barcode sequences actually showed that the registration of P. mascula subsp. arasicola was faulty and it is 100% similar to P. arietina. Twelve taxa were each found to have characteristic polymorphisms in both the ITS and matK regions that could be used to distinguish the species from each other. The most polymorphism was determined in the ITS region (n=54), while the matK region showed less variability (n=9). We also detected the barcode sequences could successfully discriminate the hybrid polyploid Paoenia species from diploid P. tenuifolia. Except for P. tenuifolia, the other Paeonia species were seen to be hybrid. The methanolic root extracts were examined for total phenolic content, total flavonoid content, and antioxidant activities (by FRAP, ABTS, and DPPH). The results revealed significant variation in extracts, polyphenolic content, and antioxidant properties. In 100 g root, TPC ranged from 204.23 to 2343.89 mg, TFC ranged from 7.73 to 66.16 mg, and FRAP ranged from 523.81 to 4338.62 mg. SC50 values of ABTS ranged from 115.08 to 1115.52 μg/ml and DPPH ranged from 73.83 to 963.59 μg/ml. Conclusion: For the first time, genetic diversity and chemical comparison were performed among Paeonia species along Turkey. It was concluded that 11 of 12 taxa had differences in terms of ITS and matK sequences. It has been shown that barcode sequences must be used for the correct identification of Turkish Paeonia.
Surgical sutures are one of the most widely used medical devices for wound closure. In the meantime, the suture surface and area may be exposed to many microorganisms, and surgical site infections may develop in these environments. Today, giving antimicrobial properties to polymeric sutures has been one of the methods used to prevent these infections. In this study, the absorbable polymeric-based suture (Pegelak®) was homogeneously coated with nano-sized silver particles by the vacuum deposition at the cryogenic temperatures (< 300 K) instead of the commonly used vacuum deposition at high substrate temperatures, and its physical and antibacterial properties were investigated. It was determined from the morphological and tensile strength analysis that some deformations occurred in the Ag-coated suture at 300 K; however, the coating of the suture at 200 K did not significantly affect the morphological and mechanical properties of the suture. According to photocurrent measurement, the plasmon resonance effect of the Ag-nanoparticles-coated suture at 200 K was observed around 450–525 nm. The illumination of the Ag-coated suture at 200 K with light in the plasmon resonance wavelength region increased the Ag+ release from 3.67 × 10−3 ppm to 6.65 × 10−3 ppm. In the microbiological analysis, it was observed that Ag-coated sutures obtained at both 200 K and 300 K showed antibacterial activity against all tested bacteria.
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age. The aim of this study was to investigate the association of oxidized low-density lipoprotein receptor 1 ( OLR1) gene variations with the susceptibility of PCOS and to examine the relationship between the frequencies of OLR1 gene variations and atherosclerotic risk factors. Genomic DNA was extracted from blood samples collected from 49 patients with PCOS and 43 healthy controls. The variants in the OLR1 gene were identified using next-generation sequencing (NGS). Heterozygous rs11053646 (K167N), rs11611438, rs11611453, and rs35688880 genotype frequencies were significantly higher in the PCOS group than that of control group. Single nucleotide polymorphism (SNP) rs34163097 minor A allele increased the PCOS risk by ∼10-fold (p = 0.03). SNPs rs11053646, rs11611438, rs11611453, rs34163097, and rs35688880 were positively correlated with body mass index (BMI). The logistic regression model (area under the curve: 0.770, p = 0.000) further revealed a combination of 2-h plasma glucose (PG-2 h), dehydroepiandrosterone sulfate (DHEAS), and rs11053646 as predictors of PCOS phenotype. This is the first study reporting the NGS data of OLR1 gene variants which might be associated with the pathogenesis of PCOS and several atherosclerotic risk factors, particularly higher BMI and DHEAS. To fully understand the genetic basis of PCOS and the contribution of OLR1 gene variants to PCOS pathogenesis, additional large-scale studies are warranted.
Invertebrate iridescent virus 6 (IIV6) is a nucleocytoplasmic virus with a ∼212 kb linear dsDNA genome that encodes 215 putative open reading frames (ORFs). Proteomic analysis has revealed that the IIV6 virion consists of 54 virally encoded proteins. Interactions among the structural proteins were investigated using the yeast two-hybrid system, revealing that the protein of 415R ORF interacts reciprocally with the potential envelope protein 118L and the major capsid protein 274L. This result suggests that 415R might be a matrix protein that plays a role as a bridge between the capsid and the envelope proteins. To elucidate the function of 415R protein, we determined the localization of 415R in IIV6 structure and analyzed the properties of 415R-silenced IIV6. Specific antibodies produced against 415R protein were used to determine the location of the 415R protein in the virion structure. Both western blot hybridization and immunogold electron microscopy analyses showed that the 415R protein was found in virions treated with Triton X-100, which degrades the viral envelope. The 415R gene was silenced by the RNA interference (RNAi) technique. We used gene-specific dsRNA's to target 415R and showed that this treatment resulted in a significant drop in virus titer. Silencing 415R with dsRNA also reduced the transcription levels of other viral genes. These results provide important data on the role and location of IIV6 415R protein in the virion structure. Additionally, these results may also shed light on the identification of the homologs of 415R among the vertebrate iridoviruses.
Acrylamide, identified by the International Cancer Research Center as a possible carcinogenic compound to humans, is a contaminant formed as a result of the thermal process in many foods, such as coffee, French fries, biscuits and bread, which are frequently consumed by individuals in their daily lives. The biggest concern about acrylamide is that the health risks have not yet been fully elucidated. For this reason, many studies have been carried out on acrylamide in the food, nutrition and health equation. This study focused on epidemiological studies examining the associations between dietary acrylamide exposure and cancer risk. For this purpose, articles published in PubMed, Isı Web of Knowledge, Scopus and Science Direct databases between January 2002 and April 2022 were systematically examined using various keywords, and a total of 63 articles were included in the study. Although some studies on reproductive, urinary, gastrointestinal, respiratory and other systems and organs stated that there is a positive relationship between dietary acrylamide exposure and cancer risk, many publications did not disclose a relationship in this direction. Studies examining the relationship between dietary acrylamide exposure and cancer should be planned to include more people and foods in order to obtain more reliable results. Making research plans in this way is very important in terms of guiding health policies to be formed in the future.
Aluminum-doped zinc oxide (AZO) is one of the most popular transparent conducting oxide layers that can be employed in many optoelectronic applications in particular in photovoltaic devices due to being a low-cost and nontoxic material. In this study, we report on the effect of deposition pressure and substrate temperature on the properties of AZO films and solar cell performance by employing the optimized films. This study consists of two stages, the first of which concerns the optimization deposition pressure while the second is the substrate temperature of AZO films by evaluating the structural, optical, and electrical properties of the films. The deposited AZO thin film under 10 mTorr deposition pressure exhibited high optical transmission (89.9%), low electrical resistivity (9.1 × 10−2 Ω.cm), and high carrier concentration (3.74 × 1019 cm−3) among the others. The impact of substrate temperature was then investigated using this deposition pressure at room temperature, 150, 200, and 250 °C. The deposited AZO films at 150 °C temperature were found to possess the highest optical transmission (91.1%), lowest resistivity (9.9 × 10−4 Ω.cm), and highest carrier concentration (1.1 × 1020 cm−3) values. Hence, the 10 mTorr deposition pressure and 150 °C substrate temperature were selected as the optimum growth parameters to obtain AZO films, which were then employed in the cell structure. It was, thus, revealed that utilizing AZO films in silicon-based solar cell using such parameters led to the enhancement in the cell efficiency.
The purpose of this research is to analyze the performance of an air conditioner that uses natural refrigerant R290 both analytically and experimentally. The feasibility of R290 for R22 air conditioner is examined thoroughly. Since the alternatives used in R22 air conditioners possess high GWPs and they are controlled by the Kyoto Protocol. The Kyoto Protocol mainly indicates that the high GWP refrigerants used in refrigeration and air conditioning sectors are classified into one among the targeted greenhouse gases. Therefore, the present work focuses on ecofriendly-refrigerant R290 as a substitute to R22. In comparison to R22, R290 has no ODP and a very low GWP. An analytical study is conducted based on the actual VCR cycle. An experimental study was conducted on the R22 air conditioner with R290 at various outdoor conditions. Test results revealed that electrical energy consumption of air conditioner with R290 was 12.30% lower compared to R22 for the lower operating conditions and it was 11.40% lower compared to R22 for the higher operating conditions. Cooling capacity of R290 compared to R22 is lower in the range of 6.37–9.24% for the test conditions studied. For the operating circumstances studied, the energy efficiency ratio of R290 is higher than R22, ranging from 2.41 to 6.77%. Compressor discharge temperature of R290 is lower in the range of 8.67–15.32 °C for all the investigated conditions. When compared to R22, CO2 emissions from air conditioners operating with R290 are lower in the range from 13.10 to 14.18%. The study revealed that R290 is a viable option to replace R22 used in air conditioners in terms of performance and environmental aspects.
Objective: The nutritional status of frail elderly people receiving home health services should be evaluated. This study aimed to determine the nutritional status of patients aged ≥65 years registered in the Home Healthcare Services unit and investigate the factors that may be associated with malnutrition. Methods: This cross-sectional descriptive study was conducted during routine visits to patients and their caregivers. A total of 161 patients were asked to fill in surveys asking about sociodemographic characteristics, patient history, and clinical status. Anthropometric measurements were taken from all patients. The Mini Nutritional Assessment Short Form was applied to the patients for screening purposes. Patients who scored ≤11 on the Mini Nutritional Assessment Short Form were then asked to complete the full Mini Nutritional Assessment form. Results: According to the Mini Nutritional Assessment Short Form and Mini Nutritional Assessment tests, almost half of the elderly patients included in the study (49.7%, n=161) were malnourished or at risk of malnutrition. Analyses showed that those who had COVID-19 [odds ratio (OR): 9.423, 95%CI 2.448-36.273) and those diagnosed with dementia/depression (OR: 8.688, 95%CI 3.246-23.255) were more likely to be malnourished, whereas those with diabetes (OR: 0.235, 95%CI 0.084-0.657) were less likely to have malnutrition. Strikingly, those who were fed by caregivers (OR: 15.061, 95%CI 3.617-62.710) were also more likely to be malnourished than those with self-feeding ability. Conclusion: Malnutrition or the risk of malnutrition is common in elderly patients receiving home care services. Many factors can have an impact on malnutrition.
The genus Chondrostoma (Leuciscidae: Leuciscinae), composed of small to medium-sized fish with a scraper feeding characteristic, is distributed in the West and Middle East, Caucasus, Europe and Northern Mediterranean drainages. This genus spreads across Anatolia and Thrace, with the exception of Göksu and Eşen rivers in Turkey’s Mediterranean basin. It is also difficult to understand the systematics of Chondrostoma, which is complicated morphologically. Therefore, in this study, an identification key was made by evaluating external morphology, osteology (some jaw bones and 5th ceratobrachial) and molecular features together. A total of 13 valid species have been so far recorded from Turkish inland waters, among which are C. colchicum, C. beysehirense, C. ceyhanensis, C. cyri, C. holmwoodii, C. kinzelbachi, C. meandrense, C. nasus, C. regium, C. smyrnae, C. toros, C. turnai and C. vardarense. Our molecular data showed that C. angorense (Kızılırmak and Sakarya rivers) is a synonym of C. colchicum (Çoruh and Yeşilırmak rivers). In addition, C. angorense was morphologically similar to C. colchicum. Therefore, we explored the systematic position of C. vardarense (from Meriç River) and C. nasus (from Simav River) in this study.
Microplastics (MPs), which arise from the deterioration of larger plastics that are frequently used in daily life and are smaller than 5 mm in size, are found in many environments and can pose a serious threat to human health. Humans ingest these microplastics unintendedly through drinking water. Although plastic pollution has been extensively investigated in a variety of water sources, research on MP contamination in bottled waters is scarce. Hence, in this study, the presence and distribution of MPs were investigated in 150 samples of bottled natural and mineral water brands in Türkiye. Using FTIR stereoscopy and stereomicroscope analysis, MPs were detected in 43 out of the 50 (86%) of these brands. Among the four types of polymers detected, the most abundant type was polyethylene (33%), polypropylene (31%), polyethylene terephthalate (25%), and polyamid (11%). In comparison to natural waters, mineral waters had larger average-sized particles (63.98 ± 4.06 vs. 104.83 ± 14.28 µm) and higher MP concentrations (4.6 ± 0.5 vs. 12.6 ± 1.6 particles/L). Although the most dominant shape was found as fiber in natural waters, fragments were more prevalent in mineral waters. The estimated daily intakes (EDI) for adults and children were expected to be 0.019 and 0.42 MP/kg/bw/day, respectively, in natural waters while EDI were 0.009 and 0.04 MP/kg/bw/day, respectively, in mineral waters. The results of the study suggest that the EDI and annual intake (EAI) are negligible when compared to other studies. The baseline data on MP contamination of bottled water provided in the present study may be significant and useful for researchers to have a better understanding of microplastic contamination exposure.
Objective: Alzheimer's disease (AD) occurs in approximately 10% to 30% of individuals aged 65 or older worldwide. Novel therapeutic agents therefore need to be discovered in addition to traditional medications. Nimodipine appears to possess the potential to reverse cognitive impairment-induced dysfunction in learning and memory through its regulatory effect on the brain-derived neurotrophic factor (BDNF), acetylcholine (Ach), and acetylcholinesterase (AChE) pathway in the hippocampus and prefrontal cortex. Methods: Twenty-four male Sprague Dawley rats weighing 380 ± 10 g were used for behavioral and biochemical analyses. These were randomly and equally assigned into one of three groups. Group 1 received saline solution alone via the intraperitoneal (i.p) route, and Group 2 received 1 mg/kg/day i.p. scopolamine once a day for three weeks for induction of learning and memory impairments. In Group 3, 10 mg/kg/day nimodipine was prepared in tap water and administered orally every day for three weeks, followed after 30 min by 1 mg/kg/day scopolamine i.p. Behavior was evaluated using the Morris Water Maze test. BDNF, ACh, and AChE levels were determined using the ELISA test in line with the manufacturer's instructions. Results: Nimodipine treatment significantly increased the time spent in the target quadrant and the number of entries into the target quadrant compared to the scopolamine group alone. Additionally, BDNF and ACh levels in the hippocampus and prefrontal cortex decreased following 20-day scopolamine administration, while AChE activation increased. Conclusion: Nimodipine exhibited potentially beneficial effects by ameliorating cognitive decline following scopolamine administration in the hippocampus and prefrontal cortex.
Hemophilia is a rare inherited disease which causes bleeding due to Factor VIII or Factor IX deficiency. It is usually X‐linked recessive and typically affects males. Arthropathy occurs as a result of cartilage damage and chronic synovitis due to recurrent intra‐articular bleeding in hemophilic patients and is mostly seen in the knee, shoulder, hip and ankle joints. There are many other diseases that cause chronic synovitis ankylosing spondylitis (AS), which is a subtype of spondyloarthropathies that cause chronic low back pain, more common in men younger than 45 years of age. In addition to axial involvement, peripheral arthritis, uveitis, enthesitis and dactylitis can be seen. Although the etiology is not fully known, genetic and environmental factors are responsible for the pathogenesis. In this study, we aimed to present congenital hemophilia and AS coexistence in a 22‐year‐old male patient.
Chronic hepatitis B (CHB) infection is one of the most common causes of cirrhosis and liver cancer worldwide. Our aim was to assess clinical and patient‐reported outcome (PRO) profile of CHB patients from different regions of the world using the Global Liver Registry. The CHB patients seen in real‐world practices are being enrolled in the Global Liver Registry. Clinical and PRO (FACIT‐F, CLDQ, WPAI) data were collected and compared to baseline data from CHB controls from clinical trials. The study included 1818 HBV subjects (48±13 years, 58% male, 14% advanced fibrosis, 7% cirrhosis) from 15 countries in 6/7 Global Burden of Disease super‐regions. The rates of advanced fibrosis varied (3‐24%). The lowest PRO scores across multiple domains were in HBV subjects from the Middle East/North Africa (MENA), the highest – Southeast/East and South Asia. Subjects with advanced fibrosis had PRO impairment in 3 CLDQ domains, Activity of WPAI (p<0.05). HBV subjects with superimposed fatty liver had more PRO impairments. In multivariate analysis adjusted for location, predictors of PRO impairment in CHB included female sex, advanced fibrosis, and non‐hepatic comorbidities (p<0.05). In comparison to Global Liver Registry patients, 242 controls from clinical trials had better PRO scores (Abdominal, Emotional, and Systemic scores of CLDQ, all domains of WPAI) (p<0.05). In multivariate analysis with adjustment for location and clinicodemographic parameters, the associations of PROs with the enrollment setting (real‐life Global Liver Registry vs. clinical trials) were no longer significant (all p>0.10). The clinico‐demographic portrait of CHB patients varies across regions of the world and enrollment settings. Advanced fibrosis and non‐hepatic comorbidities are independently associated with PRO impairment in CHB patients.
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