Clinical course of psoriasis patients that discontinued biologics during the COVID-19 pandemic

Background: Since psoriasis is a chronic disease, it is not recommended to discontinue the treatment agents used. However, in real life, the treatment of psoriasis patients may be interrupted for various reasons. During the pandemic period, the treatment of many patients was also interrupted. Objectives: To evaluate relapse and clinical worsening in psoriasis patients whose biological therapy was interrupted during the pandemic and reveal associated factors. Methods: The study included patients aged ≥18 years, who were followed up with moderate and severe chronic psoriasis controlled by the last biological agent [Psoriasis Area Severity Index (PASI) 75 response achieved] but had to discontinue their treatment during the pandemic. The patients' demographic and clinical characteristics, clinical course after the discontinuation of these agents, presence of clinical worsening, and relapse were evaluated. Risk factors were analyzed with the logistic regression analysis. Results: The study included 169 patients, with a mean age of 47.3 ± 14.5 (18–87) years. The mean biologics-free time was 18.2 ± 12.3 (2–56) weeks. Clinical worsening was detected in 41.4% and relapse in 48.5% of the patients. The significant risk factors for clinical worsening and relapse in both univariate and multivariate analyses were alcohol use during the biologics-free period, total time off biologics, and the presence of an additional triggering factor. The use of secukinumab and ustekinumab was found to be a protective factor against clinical worsening in multivariate analyses. Conclusion: As the biologics-free period is prolonged, the likelihood of clinical worsening and relapse increases, therefore, we do not recommend discontinuing biological agents. © 2023 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC

Physiological and gene expression responses of the mussel Mytilus galloprovincialis to low pH and low dissolved oxygen

The prevalence and frequency of hypoxia events have increased worldwide over the past decade as a consequence of global climate change and coastal biological oxygen depletions. On the other hand, anthropogenic emissions of CO2 and consequent accumulation in the sea surface result in a perturbation of the seawater carbonate system, including a decrease in pH, known as ocean acidification. While the effect of decreases in pH and dissolved oxygen (DO) concentration is better understood, their combined effects are still poorly resolved. Here, we exposed adult mussels (Mytilus galloprovincialis) to two pHs (8.27 and 7.63) and DO concentrations (7.65 and 2.75 mg L−1) over 17 days in a full-factorial design. These levels correspond to extremes of the present natural variability and are relevant in the context of ocean acidification and hypoxia. No mortality was observed during the experiment. However, sublethal effects were observed for clearance and oxygen consumption rates, as well as total haemocytes count and haemocytes viability and gene expression in mussels exposed to the combination of low pH and low DO. Respiration and excretion rates were not significantly impacted by low pH and DO, alone or in combination. Overall, low pH alone led to a decrease in all tested physiological parameters while low DO alone led to a decline in clearance rate, haemocyte parameters and an increase in carbohydrate content. Both parameters led to up- or down-regulation of most of the selected genes. Not surprisingly, the combined effect of low pH and low DO could not be predicted by a simple arithmetic additive response at the effect level, highlighting more complex and non-linear effects. © 2023 Elsevier Lt

The mechanical testing and performance analysis of three-dimensionally produced lingual retainers

Background: Introducing three-dimensional (3D) printing has opened new visions in the orthodontic field. This research evaluates three-dimensionally produced orthodontic retainers and their future possible uses. For this purpose, in vitro tests were performed for these groups, including bond strength, failure analysis, discoloration, and biodegradation. Methods: A total of 30 specimens (n = 30), lower incisor human teeth, were randomly divided into three groups for a bond strength failure analysis (for each group n = 10). In the experimental groups, lingual retainers were fabricated using 3D systems (group 1 with 3D dental pen and group 2 with 3D-printed). In the control group (group 3), the retainer system was a combination of a wire and composite, which is being used worldwide. A total of 30 specimens (n = 30) from the 3D dental pen and 3D-printed for discoloration and biodegradation tests were divided into three groups (water, tea, and coffee). Data were analyzed using the Mann-Whitney U test, ANOVA, and chi-square test. Results: For all parameters tested, significant differences were determined among groups. The 3D pen group had the highest score for bond strength, whereas discoloration differed significantly. Conclusions: According to the limitations of this research, 3D-printed retainers have the potential for clinical use in the near future. © 2023 World Federation of Orthodontist

Emotional labour behavior of nursing students: A qualitative study

Aim: This study aimed to determine the opinions of nursing students on emotional labor behavior. Background: It is of importance to teach emotional labor behavior to nursing students, the nurses of the future. Design: The research has a phenomenological qualitative design. Method: Participants consisted of 20 nursing students who were in face-to-face communication with patients in clinical practice. The Standards for Reporting Qualitative Research (COREQ) was used to report this research. Results: Considering the theoretical structure of the subject, emotional labor behavior was examined under three main themes: surface acting, deep acting, and genuine acting. Conclusions: Emotional labor behavior affects students’ approach to patients and performance in clinical practice. Education has a supportive effect on the management of emotions and the guidance of the clinical environment and clinical services. © 2022 Elsevier Lt

The effect of politics on the formation of urban aesthetics, the case of Iran

Urban aesthetics is a complicated issue that needs further evaluation of its physical specifications in a city. This article examines urban aesthetics through the historical political patterns and urban planning and development process. The aim is to reveal the relationship between the formation of urban aesthetics, the urban planning process, and the political impact. Iran as the case of a developing country with a different socio-political context and national system is selected for this aim. Path-dependency analysis has been used as a methodology to provide a framework to understand urban aesthetics followed by different socio-political periods and planning processes. Three political periods have been selected for analysis in which the country gained most of its unprecedented changes in political, and social aspects. Analysis results demonstrated that urban aesthetics is more dependent on the political path dependency than the planning process while still the same planning approaches have been carried out in the country. © 2022 Elsevier Lt

Efficacy of keratometric values obtained from Sirius topographer® in nidek axial length-scan® for intraocular lens calculation after penetrating keratoplasty

Background: To evaluate the accuracy of keratometric values obtained from Scheimpflug (Sirius) topography using Nidek AL-Scan optical biometry (OB) for intraocular lens (IOL) power calculating after penetrating keratoplasty (PK). Methods: Thirty eyes of 26 patients were included in this study. The demographic information, complete ophthalmic examination, IOL calculation technique, and its effect on final refractive results were evaluated. Results: The mean age of the patients was 52.76 ± 16.20 years. The mean K readings using Nidek AL-Scan OB, mean simulated K (SimK) (3mm), and mean pupillary power (MPP) (4.5mm) K readings using Sirius were 41.92 ± 5.05 D, 42.99 ± 5.78 D, and 43.30±6.23 D (p= 0.515). Conclusions: Both devices correctly calculated IOL power after PK; however, Sirius SimK (3mm) gave the lowest mean absolute error (MAE) results and can be safely used for IOL power calculation. © 2022 Elsevier B.V

Weber's gland immune/histopathology in pediatric recurrent tonsillitis and obstructive tonsillar hypertrophy cases

OBJECTIVE: Recurrent tonsillitis and obstructive tonsillar hypertrophy are very common in childhood and constitute the two major causes of tonsillectomy in this age group. There is no study in the literature on the immune/histopathological changes in the recurrent and obstructive tonsillar hypertrophy of Weber's glands. In this study, we aimed to histopathologically and immunohistochemically examine the Weber's glands of pediatric patients with recurrent. PATIENTS AND METHODS: A total of 63 patients, with 31 patients aged 6-9 who had surgery for recurrent tonsillitis, and 32 patients aged 6-11 years who had surgery for obstructive tonsillar hypertrophy, were included in the study. The removed Weber's glands were included in the obstructive tonsillar hypertrophy or recurrent tonsillitis group according to the patient's clinical diagnosis. All specimens were coded with a numbering method, where only the surgeon knew which patient was in which group. All specimens were evaluated in the same histology center and by the same histologist, unaware of the clinical diagnosis of the patients (blind). RESULTS: The comparison of Weber's gland immunohistochemical parameter scores of the groups revealed that the scores of the RT group were significantly higher for all three parameters (VEGF: t=6.777; p<0.001), (EGFR: t=4.386; p<0.001), (IL-6: t=5.072; p<0.001). The comparison of the groups in terms of inflammation, basement membrane thickening, myoepithelial cell and glycoprotein accumulation revealed significantly higher Weber's gland evaluation scores in the RT group for all four parameters. (inflammation: t=7.794; p<0.001), (basement membrane thickening: t=6.582; p<0.001), [myoepithelial cell: t=3.693; p<0.001), (glycoprotein accumulation: t=5.287; p<0.001)]. CONCLUSIONS: Histopathological and immunohistochemical examination of Weber's gland in pediatric recurrent tonsillitis and obstructive tonsillar hypertrophy cases revealed inflammatory changes in both disease groups. As expected, inflammatory manifestations were more common in the recurrent tonsillitis group. Besides, inflammatory changes detected in Weber's glands of obstructive tonsillar hypertrophy cases without a history of tonsillitis may contribute to the Weber's gland hypothesis, which attempts to explain the etiology of peritonsillar abscess

Evaluation of the Utility of Indocyanine Green Video Angiography in Cerebral Arteriovenous Malformation Surgery

Objective: To assess the utility of intraoperative indocyanine green video angiography (ICG-VA) during microsurgical resection of arteriovenous malformations (AVMs). Methods: Data of the 24 patients, who were surgically treated for AVM using intraoperative ICG-VA, were reviewed retrospectively. Postoperative digital subtraction angiography (DSA) was performed in all patients before they regained consciousness and became fully awake, and the results were compared with those obtained with intraoperative ICG-VA. A scheduled DSA was performed in all patients in the third, sixth, and 12th postoperative months as well. Results: Authors retrospectively analyzed the records of intraoperative ICG-VA application of all 24 patients. Though the exposures were limited and the image qualities were poor at higher magnification on the surgical microscope within deep surgical fields, the AVM niduses, feeding arteries, draining veins, and their relations to normal vasculature were observed precisely with ICG-VA in all the procedures. Furthermore, the visualization was not qualified enough to identify these pathological vascular structures accurately before evacuating and irrigating the layer of blood clots that obscure the view in patients who presented with hemorrhage. In a patient in our series, a residual nidus in the tail of the caudate nucleus was detected with immediate postoperative DSA which was not revealed by terminal assessment with final intraoperative ICG-VA. Conclusions: Intraoperative ICG-VA is particularly effective in the identification of the feeder, nidus, and drainer and in the assessment of the flow dynamics of the nidus in cerebral AVM surgery. It may be a quick and safe technique for intraoperative imaging of the angioarchitecture of superficial AVMs, but it may be less helpful for deep-seated lesions. Furthermore, this method alone may not be useful in the identification of residual disease or improvement of the clinical outcomes. DSA has remained the gold standard for confirming AVM obliteration. Despite the technical limitations associated with ICG-VA, a combination of intraoperative ICG-VA and immediate postoperative DSA may advance the safety and efficacy of AVM surgery. © 2022 Elsevier Inc

An Analysis of the Failure of the Peace Process (2013-2015) with PKK through the Ripeness Theory

Turkey has experienced a protracted conflict with the PKK since 1984. Over the history of almost 30 years of the violent conflict, the first comprehensive and overt peace attempt was launched by Turkish government in 2013. It had lasted for two years with great optimism and high expectations on reaching a political settlement before it failed in July 2015. This article aims to explore the reasons of the failure of 2013-2015 negotiations and examines whether conditions were suitable for launching a ‘peace process’ in 2013 to resolve Turkey’s conflict with the PKK. It draws on three main elements of Zartman’s Ripeness theory: mutually hurting stalemate (MHS), a formula for a way out and valid spokespersons. It is argued in the article that the conflict in Turkey was not in fact ripe enough for negotiations which were initiated and conducted hastily without any formula for way out and with problematic spokespersons

A SWARA-VAHP and FCM Based Model Proposal for MCIC (extended abstract)

ABC analysis is an efficient and easy-to-use methodology to classify inventory based on a single or multi-criteria basis that may consist of thousands of items. The evolution of the subject is now focused on multiple criteria instead of a single criteria. The proposed approach to the multi-criteria inventory classification (MCIC) problem integrates improved version of Stepwise Weight Assessment Ratio Analysis and Voting Analytic Hierarch Process (SWARA-VAHP) and Fuzzy-C-Means. This new approach is called AHP-SWARA-FCM-RVeto and proposed in this study for the first time. The proposed model integrates SWARA-VAHP which is an improved version of AHP. By using SWARA-VAHP, minimum information from experts will be sufficient. Also incorporating FCM will allow users to make clustering based on figures but also gives the flexibility to assign members between different clusters by using membership values. A real life example is used to show the application of the proposed model. In the real-life example, the main advantage of compliance with the Pareto principle of the proposed method is shown