Volume CXIV, Number 4, November 7, 1996

Objective: Turner syndrome (TS) is a chromosomal disorder caused by complete or partial X chromosome monosomy that manifests various clinical features depending on the karyotype and on the genetic background of affected girls. This study aimed to systematically investigate the key clinical features of TS in relationship to karyotype in a large pediatric Turkish patient population.Methods: Our retrospective study included 842 karyotype-proven TS patients aged 0-18 years who were evaluated in 35 different centers in Turkey in the years 2013-2014.Results: The most common karyotype was 45,X (50.7%), followed by 45,X/46,XX (10.8%), 46,X,i(Xq) (10.1%) and 45,X/46,X,i(Xq) (9.5%). Mean age at diagnosis was 10.2±4.4 years. The most common presenting complaints were short stature and delayed puberty. Among patients diagnosed before age one year, the ratio of karyotype 45,X was significantly higher than that of other karyotype groups. Cardiac defects (bicuspid aortic valve, coarctation of the aorta and aortic stenosis) were the most common congenital anomalies, occurring in 25% of the TS cases. This was followed by urinary system anomalies (horseshoe kidney, double collector duct system and renal rotation) detected in 16.3%. Hashimoto's thyroiditis was found in 11.1% of patients, gastrointestinal abnormalities in 8.9%, ear nose and throat problems in 22.6%, dermatologic problems in 21.8% and osteoporosis in 15.3%. Learning difficulties and/or psychosocial problems were encountered in 39.1%. Insulin resistance and impaired fasting glucose were detected in 3.4% and 2.2%, respectively. Dyslipidemia prevalence was 11.4%.Conclusion: This comprehensive study systematically evaluated the largest group of karyotype-proven TS girls to date. The karyotype distribution, congenital anomaly and comorbidity profile closely parallel that from other countries and support the need for close medical surveillance of these complex patients throughout their lifespa

GEMv2 : Multilingual NLG benchmarking in a single line of code

Evaluation in machine learning is usually informed by past choices, for example which datasets or metrics to use. This standardization enables the comparison on equal footing using leaderboards, but the evaluation choices become sub-optimal as better alternatives arise. This problem is especially pertinent in natural language generation which requires ever-improving suites of datasets, metrics, and human evaluation to make definitive claims. To make following best model evaluation practices easier, we introduce GEMv2. The new version of the Generation, Evaluation, and Metrics Benchmark introduces a modular infrastructure for dataset, model, and metric developers to benefit from each others work. GEMv2 supports 40 documented datasets in 51 languages. Models for all datasets can be evaluated online and our interactive data card creation and rendering tools make it easier to add new datasets to the living benchmark.Peer reviewe

GEMv2 : Multilingual NLG benchmarking in a single line of code

Evaluation in machine learning is usually informed by past choices, for example which datasets or metrics to use. This standardization enables the comparison on equal footing using leaderboards, but the evaluation choices become sub-optimal as better alternatives arise. This problem is especially pertinent in natural language generation which requires ever-improving suites of datasets, metrics, and human evaluation to make definitive claims. To make following best model evaluation practices easier, we introduce GEMv2. The new version of the Generation, Evaluation, and Metrics Benchmark introduces a modular infrastructure for dataset, model, and metric developers to benefit from each others work. GEMv2 supports 40 documented datasets in 51 languages. Models for all datasets can be evaluated online and our interactive data card creation and rendering tools make it easier to add new datasets to the living benchmark.Peer reviewe

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Vitamin D status of adults in Kayseri, Turkey: Summer time population based cross-sectional study

Aim: Research shows that deficiency and insufficiency of vitamin D is high in the world. There are limited studies in Turkey but it has been shown that deficiency and insufficiency are high in Turkey. The aim of this study is to determine the prevalence of vitamin D deficiency and insufficiency and related factors in an adult population. Material and Method: This study was conducted In urban area of Kayseri in Central Anatolian region of Turkey. in adults aged 18-65 years In the summer period The minimum sample size was calculated as 323 and the survey was completed with 381 people. A questionnaire about sociodemographic characteristics, and variables that may affect vitamin D level was administered. Blood samples were analyzed by LC-MS/MS. Results: The mean age of the participants was 36.21 +/- 12.10. The mean serum vitamin D level was 15.11 +/- 9.07 ng/ml. Vitamin D deficiency (30 ng/ml). Vitamin D deficiency was found in 68.8% of males and in 75.7% of females. People who have exposure to the sun for less than 1 hour in the summer have 1,7 fold higher vitamin D deficiency. Vitamin D deficiency was 1.8 fold higher in those >35 years old, 1.8 times higher in the unmarried, 2.4 fold higher in those using sunscreen and 2.6 fold higher in those who did not have a good economic condition. Discussion: Kayseri has a high prevalence of vitamin D deficiency and insufficiency. Factors that have the most effect on vitamin D levels were determined as gender, marital status, economic status, use of sun cream and exposure to sunlight in summer

The influence of Mn nanoparticles on superconducting properties and pinning mechanism of MgB2

A series of the nano-sized Mn polycrystalline-substituted MgB2 samples were synthesized by solid-state reaction method with the ratio of Mg1-xMnxB2 (x = 0.00, 0.01, 0.03 ,and 0.05). Mn substitution emerges shifting (002) peak position to higher angles on MgB2 samples. This shows that isovalent Mn2+ is substituted by Mg2+ ions. Randomly oriented grains were obtained in surface morphology. The presence of Mn nanoparticles was observed with energy-dispersive spectrometry analysis. The superconducting transition temperature was significantly suppressed by Mn ions, from 39.28 to 26.60 K. Spin-flip scattering and pair breaking effect arose from the magnetic nature of Mn. Increasing Mn content ratio in the samples caused narrower magnetization versus applied magnetic field loops, without magnetic flux jumping. Self-field critical current density decreased from 260 to 16 kA cm(-2) with rising Mn substitution ratio. Scaling behavior of the samples was examined between reduced force (f = F/F-max) and reduced applied field (h = H/H-max). Fitting lines showed that pure MgB2 was dominated by normal point pinning mechanism at both lower and higher magnetic fields. However, Mn-substituted MgB2 samples exhibited surface pinning mechanism due to grain refinement

Prevalence of Chronic Obstructive Pulmonary Disease in Individuals Over 40 in Central Kayseri

Objective: The present study aims to investigate the prevalence of COPD using spirometry and examine related risk factors, such as exposure to cigarette and biomass smoke, in individuals over the age of 40, in the provincial capital of Kayseri, Turkey

Evaluation of anterior and middle cranial fossa intraosseous arachnoid granulations with 3D T2-SPACE sequence

Objectives Arachnoid granulations (AG) can be located anywhere outside the dural sinuses. Their presence is thought to be associated with idiopathic intracranial hypertension (IIH) and cerebrospinal fluid (CSF) leaks. It was aimed to evaluate the intraosseous AGs located in the middle and anterior cranial fosses in detail with three-dimensional T2-SPACE (Sampling Perfection with Application optimized Contrasts using different flip angle Evolution-Siemens) imaging and to investigate their clinical significance. Materials and methods Sixty-five intraosseous AG of 46 patients were included in this retrospective study. The highest diameter, bone indentation degree (in the inner tabula, diploe distance, reaching and exceeding the outer tabula), content (CSF/+parenchyma) of each AG were evaluated by 2 experienced radiologists. In addition, the presence of other MRI findings supporting IIH was examined. Results Additional signs of IIH were detected in 25 patients, and they were statistically significantly more common in the middle cranial fossa. Parenchymal herniation (in four patients) was more common in the young population. Conclusions Intraosseous AGs can be evaluated in detail with T2-SPACE imaging. Determining intraosseous AG is very important both as an indicator of IIH and in terms of its content. T2-SPACE imaging is superior to CT and conventional sequences in this regard