Effect of Ursodeoxycholic Acid Alone and Ursodeoxycholic Acid Plus Domperidone on Radiolucent Gallstones and Gallbladder Contractility in Humans

Background/Aims. The aim of this study was to compare the effects of ursodeoxycholic acid (UDCA) alone and UDCA plus domperidone on dissolution of solitary or multiple gallstones. Methods. Fifty-three patients with cholesterol gallstones were randomized into three treatment groups: group I (n = 22) was given UDCA (15 mg/kg/day) alone and group II (n = 18) was treated with domperidone (30 mg/day) in addition to UDCA. The control group (n = 13) was followed without a medical treatment. Gallbladder volumes and ejection fractions were measured sonographically in all patients before and after treatment. Results. After 12 months of treatment, stone dissolution was found in 9 (40.9%) of the patients in group I and 7 (38.8%) of the patients in group II. The difference was statistically significant compared to controls in both treatment groups (P < 0.05) but the two groups did not show a difference between each other (P > 0.05). All the patients that achieved dissolution had multiple gallstones except for one patient with a solitary stone in group I. Neither monotherapy of UDCA nor the combination with domperidone affected the ejection fraction of gallbladder. Conclusions. Combination with domperidone did not potentiate the efficacy of UDCA. It has been observed that both UDCA alone and UDCA plus domperidone treatment did not affect ejection fraction of gallbladder

The harder firms practice strategic management, the better they are

The integrated practice of strategic management, that is the use of the three components of the strategic management process (formulation, implementation, and evaluation) does matter. Firms should plan intensively and pay attention to choosing strategic planning tools that best fit their needs. No matter how sound the formulated plans are, firms will not benefit if these plans are neither implemented nor evaluated correctly. The harder firms practice strategic management, the better their performance and competitiveness will be.Open Access funding provided by the Qatar National Librar

Do Leadership Styles Influence Organizational Health? A Study in Educational Organizations

This research aims to investigate the effect of leadership styles of school principals on organizational health. Causal-comparative research model was used to analyze the relationships between leadership types and organizational health. For data collection, a Likert type Multifactor Leadership scale questionnaire and Organizational Health scale were administered to 151 teachers working primary and secondary schools in Osmaniye city. Data were analyzed by using multiple regression analysis method. Findings of this study indicated significant relationships between school principals&#39; leadership styles and health of schools, that leadership style of school leaders influence organizational health level of a school. Transformational leadership style was also found out to be closely related to a healthy school environment while transactional leadership style is negatively correlated with organizational health. Individual consideration, inspirational motivation, idealized influence, and intellectual stimulation sub-dimensions are found to effective in the formation of organizational health. In the light of the findings, some recommendations were also presented

Altitudinal Effects on Innate Immune Response of a Subterranean Rodent.

Solak HM, Yanchukov A, Colak F, et al. Altitudinal Effects on Innate Immune Response of a Subterranean Rodent. Zoological science. 2020;37(1):31-41.Immune defense is costly to maintain and deploy, and the optimal investment into immune defense depends on risk of infection. Altitude is a natural environmental factor that is predicted to affect parasite abundance, with lower parasite abundance predicted at higher altitudes due to stronger environmental stressors, which reduce parasite transmission. Using high and low altitude populations of the Turkish blind mole-rat (TBMR) Nannospalax xanthodon, we tested for effects of altitude on constitutive innate immune defense. Field studies were performed with 32 wild animals in 2017 and 2018 from two low- and one high-altitude localities in the Central Taurus Mountains, at respective altitudes of 1010 m, 1115 m, and 2900 m above sea level. We first compared innate standing immune defense as measured by the bacteria-killing ability of blood serum. We then measured corticosterone stress hormone levels, as stressful conditions may affect immune response. Finally, we compared prevalence and intensity of gastrointestinal parasites of field-captured TBMR. We found that the bacteria-killing ability of serum is greater in the mole-rat samples from high altitude. There was no significant difference in stress (corticosterone) levels between altitude categories. Coccidian prevalence and abundance were significantly higher in 2017 than 2018 samples, but there was no significant difference in prevalence, abundance, or intensity between altitudes, or between sexes. Small sample sizes may have reduced power to detect true differences; nevertheless, this study provides support that greater standing innate immunity in high altitude animals may reflect greater investment into constitutive defense

Heart-Type Fatty Acid Binding Protein (H-FABP): Relationship with arterial ıntima-media thickness and role as diagnostic marker for atherosclerosis in patients with ımpaired glucose metabolism

<p>Abstract</p> <p>Background</p> <p>Heart type fatty acid binding protein (H-FABP) has been closely associated with acute coronary syndrome, cardiac abnormalities, stroke, and obstructive sleep disorder in previous studies. The aim of this study was to evaluate and compare the serum H-FABP levels and carotid artery intima-media thickness (CIMT) between patients with prediabetes and control subjects.</p> <p>Research design and methods</p> <p>We measured serum H-FABP levels in 58 prediabetic patients, 29 with impaired fasting glucose (IFG) and 29 with impaired glucose tolerance (IGT) and 28 age-, sex- and body mass index-matched control subjects using a sandwich enzyme-linked immunosorbent assay (ELISA), and in order to measure CIMT, all participants underwent high-resolution B-mode ultrasonography.</p> <p>Results</p> <p>Serum H-FABP levels were significantly elevated in pre-diabetic patients when compared with that of control subjects (IFG: 32.5 ± 34.2 ng/dL, IGT: 45.4 ± 45.8 ng/dL, control: 16.8 ± 14.9 ng/dL; p = 0.011). The difference in means of H-FABP levels between patients with IGT or IFG and control subjects was significant (p = 0.010 and p = 0.009, respectively). CIMT was higher in the pre-diabetic groups compared with the control group (IFG: 0.6 ± 0.1, IGT: 0.6 ± 0.1, control: 0.5 ± 0.1; p < 0.001), and H-FABP level was positively correlated with CIMT (p < 0.001, rho = 0.626).</p> <p>Conclusion</p> <p>Our results indicate that patients with pre-diabetes are at increased risk for cardiovascular disease. In addition, serum H-FABP levels could represent a useful marker for myocardial performance in patients with IFG and IGT.</p

Evaluation of renal near-infrared spectroscopy for predicting extubation outcomes in the pediatric intensive care setting

BackgroundIn pediatric intensive care units, extubation failure following invasive mechanical ventilation poses significant health risks. Determining readiness for extubation in children can minimize associated morbidity and mortality. This study investigates the potential role of renal near-infrared spectroscopy (RrSO2) in predicting extubation failure in pediatric patients.MethodsA total of 84 patients aged between 1 month and 18 years, mechanically ventilated for at least 24 h, were included in this prospective study. RrSO2 levels were measured using near-infrared spectroscopy before and during an extubation readiness test (ERT). The primary outcome measure was extubation failure, defined as a need for reintubation within 48 h.ResultsOf the 84 patients, 71 (84.6%) were successfully extubated, while 13 (15.4%) failed extubation. RrSO2 was found to be lower in the failed extubation group, also decrease in RrSO2 values during ERT was significantly greater in patients with extubation failure. ROC analysis indicated a decrease in ΔRrSO2 of more than 6.15% from baseline as a significant predictor of extubation failure, with a sensitivity of 0.984 and a specificity of 0.889.ConclusionMonitoring changes in RrSO2 values may serve as a helpful tool to predict extubation failure in pediatric patients. Further multi-center research is warranted to improve the generalizability and reliability of these findings

Serum neudesin levels in patients with polycystic ovary syndrome

Objectives: We aimed to investigate serum neudesin levels that has neural, metabolic functions in patients with polycystic ovary syndrome (PCOS). Material and methods: The study included 180 women (age range, 18–44 years) with a diagnosis of PCOS and a control group that included 100 healthy females (age range, 18–46 years). Body mass index (BMI), waist circumference, Ferriman-Gallwey score, was evaluated and plasma glucose, lipid profile, estradiol, progesterone, total testosterone, prolactin, insulin, dehydroepiandrosterone sulfate (DHEA-S), FSH, LH, free T3, free T4, thyroid stymulating hormone (TSH), anti-thyroperoxidase (anti-TPO) antibody and neudesin levels were evaluated in all participants. Results: BMI and waist circumference were similar between two groups. Ferriman-Gallwey score was significantly higher in the patient group. Fasting blood glucose, HbA1C, lipid parameters except triglyceride levels, free T3, free T4, TSH, anti-TPO were similar between the two groups. Triglyceride, insulin and HOMA values were significantly higher in PCOS patients. While follicle-stimulating hormone (FSH), estradiol, progesterone, prolactin and DHEAS levels were similar, LH was significantly higher in patients with PCOS. Serum neudesin level was significantly lower in PCOS patients with respect to controls (p = 0.015). Neudesin was positively correlated with insulin (r = 0.224, p = 0.037), and progesterone (r = 0.716, p = 0.001). Multiple regression analysis revealed that neudesin correlated with only progesterone (beta = 0.308, p = 0.001). Conclusions: Due to the association of decreased levels of neudesin with PCOS and correlation of neudesin with progesterone, neudesin may be related with one of patophysiologic pathways of PCOS. Still, it is not certain that decreased neudesin is involved in the pathogenesis of PCOS or is the result of the disorder

THE EFFECT OF COVID-19 OUTBREAK ON THE MENTAL STATUS OF HEALTH CARE PROFESSIONALS IN THE PEDIATRIC INTENSIVE CARE UNIT

Background: Coronavirus disease 2019 (COVID-19) may affect the mental status of health care professionals. The purpose of our study is to evaluate the mental health effects of the COVID-19 epidemic on health care professionals in the pediatric intensive care units (PICUs). Subjects and methods: Our study was conducted prospectively between 01.04.20 and 10.04.20. The created questionnaire was applied to health care professionals through online platforms. Thus it was involved in 5 different institutions that participated from different regions of Turkey. With the questionnaire, we applied; the participants\u27 age, gender, the general status of contamination and the level of COVID-19 knowledge were questioned. Besides; Beck Anxiety Scale, Acute Stress Scale (PCL-5), STAI-1 and STAI-2 (State and Trait Anxiety Inventory 1-2) scales were used to determine the anxiety levels. Results: A survey of 210 participants, 86 (41%) doctors, 124 (59%) nurses, were included in our study. When we evaluate the Beck anxiety levels, the majority of the participants (44%) were normal, while about one third had mild anxiety. When we evaluated the acute stress scale, all participants had a certain amount of stress levels. The majority (80 people each (38%)) experienced mild and moderate acute stress. Being female and having chronic disease poses a high risk for anxiety (OR, 0.330; 95% CI, 0.087-1.250, p <0.05 and OR, 0.246; 95% CI, 0.068-1.116, p<0.05), preoccupation (OR, 0.603; 95% CI 0.261-1.395, p<0.05 and OR, 0.433; 95% CI, 0.122-1.538, p<0.05) and acute stress (OR, 0.294; 95% CI, 0.033-2.649, p<0.05 and OR, 0.317; 95 % CI 0.060-1.679, p<0.05). Professional definition, marital status and having a child do not pose any risk factors. Conclusion: Our study has shown that the COVID-19 outbreak affects the mental status of health care professionals working at PICU at various levels

THE EFFECT OF COVID-19 OUTBREAK ON THE MENTAL STATUS OF HEALTH CARE PROFESSIONALS IN THE PEDIATRIC INTENSIVE CARE UNIT

Background: Coronavirus disease 2019 (COVID-19) may affect the mental status of health care professionals. The purpose of our study is to evaluate the mental health effects of the COVID-19 epidemic on health care professionals in the pediatric intensive care units (PICUs). Subjects and methods: Our study was conducted prospectively between 01.04.20 and 10.04.20. The created questionnaire was applied to health care professionals through online platforms. Thus it was involved in 5 different institutions that participated from different regions of Turkey. With the questionnaire, we applied; the participants\u27 age, gender, the general status of contamination and the level of COVID-19 knowledge were questioned. Besides; Beck Anxiety Scale, Acute Stress Scale (PCL-5), STAI-1 and STAI-2 (State and Trait Anxiety Inventory 1-2) scales were used to determine the anxiety levels. Results: A survey of 210 participants, 86 (41%) doctors, 124 (59%) nurses, were included in our study. When we evaluate the Beck anxiety levels, the majority of the participants (44%) were normal, while about one third had mild anxiety. When we evaluated the acute stress scale, all participants had a certain amount of stress levels. The majority (80 people each (38%)) experienced mild and moderate acute stress. Being female and having chronic disease poses a high risk for anxiety (OR, 0.330; 95% CI, 0.087-1.250, p <0.05 and OR, 0.246; 95% CI, 0.068-1.116, p<0.05), preoccupation (OR, 0.603; 95% CI 0.261-1.395, p<0.05 and OR, 0.433; 95% CI, 0.122-1.538, p<0.05) and acute stress (OR, 0.294; 95% CI, 0.033-2.649, p<0.05 and OR, 0.317; 95 % CI 0.060-1.679, p<0.05). Professional definition, marital status and having a child do not pose any risk factors. Conclusion: Our study has shown that the COVID-19 outbreak affects the mental status of health care professionals working at PICU at various levels

Key challenges, drivers and solutions for mobility management in 5G networks: a survey

Ensuring a seamless connection during the mobility of various User Equipments (UEs) will be one of the major challenges facing the practical implementation of the Fifth Generation (5G) networks and beyond. Several key determinants will significantly contribute to numerous mobility challenges. One of the most important determinants is the use of millimeter waves (mm-waves) as it is characterized by high path loss. The inclusion of various types of small coverage Base Stations (BSs), such as Picocell, Femtocell and drone-based BSs is another challenge. Other issues include the use of Dual Connectivity (DC), Carrier Aggregation (CA), the massive growth of mobiles connections, network diversity, the emergence of connected drones (as BS or UE), ultra-dense network, inefficient optimization processes, central optimization operations, partial optimization, complex relation in optimization operations, and the use of inefficient handover decision algorithms. The relationship between these processes and diverse wireless technologies can cause growing concerns in relation to handover associated with mobility. The risk becomes critical with high mobility speed scenarios. Therefore, mobility issues and their determinants must be efficiently addressed. This paper aims to provide an overview of mobility management in 5G networks. The work examines key factors that will significantly contribute to the increase of mobility issues. Furthermore, the innovative, advanced, efficient, and smart handover techniques that have been introduced in 5G networks are discussed. The study also highlights the main challenges facing UEs' mobility as well as future research directions on mobility management in 5G networks and beyond