Evaluation of skin barrier functions in patients with breast cancer-related lymphedema: Measurement of stratum corneum hydration, sebum level, and transepidermal water loss

Background and Design: Skin barrier function in patients with breast cancer-related lymphedema (BCRL) has rarely been evaluated. This study aimed to investigate transepidermal water loss (TEWL), stratum corneum hydration (SCH), and sebum level (SL) on the skin of the lymphedema arm in comparison to the skin of the healthy contralateral arm in BCRL patients. Materials and Methods: This cross-sectional study included 40 female patients with unilateral BCRL. TEWL, SCH, and SL were measured using Tewameter®, Corneometer®, and Sebumeter®, respectively. Measurements were taken in each patient's lymphedema arms and healthy contralateral arm. The volar/dorsal regions of the forearm and the dorsal region of the upper arm were determined as measurement sites. Results: In all three measurement areas, there was no significant difference in SCH or SL between the skin of the lymphedema arm and the skin of the healthy contralateral arm. TEWL was significantly higher on the skin of the lymphedema arm than on the healthy arm for the volar forearm regions (p=0.007). However, there was no significant difference in TEWL between the skin of the lymphedema arm and the skin of the healthy contralateral arm in the dorsal forearm or dorsal upper arm region. Conclusion: This study showed that there was no difference in skin barrier functions in the lymphedema arm compared with the healthy contralateral arm, except for higher TEWL in the skin of the volar forearm region of the lymphedema arm in BCRL patients. The detection of changes in skin barrier function in BCRL patients may help in the regulation of optimal skin care of these patients' lymphedema arms

Adaptive pairs trading strategy performance in Turkish derivatives exchange with the companies listed on Istanbul stock exchange

Due to copyright restrictions, the access to the full text of this article is only available via subscription.We implemented model-driven statistical arbitrage strategies in Turkish equities market. Trading signals are generated by optimized parameters of distance method. When the trade in signal is triggered by the model, market-neutral portfolio is created by long in the synthetic ETF, which is based on constrained least squares regression of selected Istanbul Stock Exchange stocks and short in Turkish Derivatives Exchange (Turkdex) index futures contract. We performed pairs trading strategy based on a comparative mean reversion of asset prices with daily data over the period February 2005 through July 2011 in Istanbul Stock Exchange (ISE) and Turkdex. We constructed a hypothetical ISE30 ETF Index on a daily basis in order to originate pairs trading strategy with Turkdex. Because of the leverage rule of (1–10) index futures contracts, we had to evaluate spot stock pairs formation with futures contracts pairs strategy. The results indicate that applied pairs strategy produced overall returns of 901 per cent during the investment period, whereas naive strategy (buy and hold ISE-30 index) return for the same period was 111 per cent. Similar outperformance was observed in the Sharpe and Sortino ratios

First-line treatment of patients with HER2-positive metastatic gastric and gastroesophageal junction cancer

Fluoropyrimidine+cisplatin/oxaliplatin+trastuzumab therapy is recommended for the first-line treatment of HER2-positive metastatic gastric adenocarcinoma. However, there is no comprehensive study on which platinum-based treatment should be preferred. This study aimed to compare the treatment response and survival characteristics of patients with HER2-positive metastatic gastric or gastroesophageal junction (GEJ) cancer who received fluorouracil, oxaliplatin, and leucovorin (mFOLFOX)+trastuzumab or cisplatin and fluorouracil (CF)+trastuzumab as first-line therapy. It was a multicenter, retrospective study of the Turkish Oncology Group, which included 243 patients from 21 oncology centers. There were 113 patients in the mFOLFOX+trastuzumab arm and 130 patients in the CF+trastuzumab arm. The median age was 62 years in the mFOLFOX+trastuzumab arm and 61 years in the CF+trastuzumab arm (P = 0.495). 81.4% of patients in the mFOLFOX+trastuzumab arm and 83.1% in the CF+trastuzumab arm had gastric tumor localization (P = 0.735). The median progression-free survival (PFS) was significantly higher in the mFOLFOX+trastuzumab arm (9.4 months vs. 7.3 months, P = 0.024). The median overall survival (OS) was similar in both groups (18.4 months vs. 15.1 months, P = 0.640). Maintenance trastuzumab was continued after chemotherapy in 101 patients. In this subgroup, the median OS was 23.3 months and the median PFS was 13.3 months. In conclusion, mFOLFOX+trastuzumab is similar to CF+trastuzumab in terms of the median OS, but it is more effective in terms of the median PFS in the first-line treatment of HER2-positive metastatic gastric and GEJ cancer. The choice of treatment should be made by considering the prominent toxicity findings of the chemotherapy regimens

The frequency of Duchenne muscular dystrophy/Becker muscular dystrophy and Pompe disease in children with isolated transaminase elevation: results from the observational VICTORIA study

IntroductionElevated transaminases and/or creatine phosphokinase can indicate underlying muscle disease. Therefore, this study aims to determine the frequency of Duchenne muscular dystrophy/Becker muscular dystrophy (DMD/BMD) in male children and Pompe disease (PD) in male and female children with isolated hypertransaminasemia.MethodsThis multi-center, prospective study enrolled patients aged 3–216 months with serum alanine transaminase (ALT) and/or aspartate transaminase (AST) levels >2× the upper limit of normal (ULN) for ≥3 months. Patients with a known history of liver or muscle disease or physical examination findings suggestive of liver disease were excluded. Patients were screened for creatinine phosphokinase (CPK) levels, and molecular genetic tests for DMD/BMD in male patients and enzyme analysis for PD in male and female patients with elevated CPK levels were performed. Genetic analyses confirmed PD. Demographic, clinical, and laboratory characteristics of the patients were analyzed.ResultsOverall, 589 patients [66.8% male, mean age of 63.4 months (standard deviation: 60.5)] were included. In total, 251 patients (188 male and 63 female) had CPK levels above the ULN. Of the patients assessed, 47% (85/182) of male patients were diagnosed with DMD/BMD and 1% (3/228) of male and female patients were diagnosed with PD. The median ALT, AST, and CPK levels were statistically significantly higher, and the questioned neurological symptoms and previously unnoticed examination findings were more common in DMD/BMD patients than those without DMD/BMD or PD (p < 0.001).DiscussionQuestioning neurological symptoms, conducting a complete physical examination, and testing for CPK levels in patients with isolated hypertransaminasemia will prevent costly and time-consuming investigations for liver diseases and will lead to the diagnosis of occult neuromuscular diseases. Trial RegistrationClinicaltrials.gov NCT04120168

Coğrafi faktörler ile savaşlar arasındaki ilişki : Çanakkale Savaşı örneği

İnsanın mekân üzerinde gerçekleştirdiği faaliyetler ve mekan ile olan etkileşimi coğrafyanın inceleme konusudur. Nasıl bir inşaat mühendisliğinin uygulama alanı şantiyeler ise, coğrafya biliminin uygulama alanlarından biri de savaş meydanlarıdır. Savaşların sahnesi, coğrafi mekândır. Coğrafi mekânın sahip olduğu özellikler yani “jeopolitik” yeryüzünde savaşların dağılışında önemli etkilere sahiptir. Diğer yandan savaşlar sonucunda mekân üzerinde hem fiziki hem beşeri bir takım değişiklikler meydana gelir. Bu çalışma coğrafi faktörlerin, savaşların yeryüzündeki mekânsal dağılışını, savaşlardaki engelleyici veya destekleyici rolünü, savaşlarda uygulanan taktikler üzerindeki yerini ve önemini, savaşın sonucu üzerindeki etkisi ile savaştan sonra mekân üzerinde meydana gelen değişimi ortaya koymayı amaçlamaktadır. Bu amaç doğrultusunda çeşitli alt problemler oluşturularak bunlara cevap aranmıştır.Araştırma doküman analizi yöntemi ile şekillendirilmiş, cevap aranan alt problemlerle ilgili olarak Çanakkale savaş alanına yapılan arazi çalışmasından elde edilen gözlemler ve sahadan çekilen fotoğraflar metin içerisinde kullanılmıştır. Çalışmanın temel kaynağını tarihi metinler, savaş kayıtları, savaşlardaki askerlerin anıları ve bilimsel tarihi metinler oluşturmaktadır. Doküman analizine dayalı bu araştırmada savaşlar ile ilgili çok sayıdaki bilimsel metin, istatistiki kayıt ve tarihi belge incelenmiş, elde edilen veriler görüşlerimizi, amaç ve alt problemlerle ilişkilendirilerek ispatlamak amacıyla kullanılmış ve konuyu destekleyecek haritalar çizilerek görselleştirilmiştir. Bilimsel metinlerden aktarılanlardan hareketle CBS programında haritalar oluşturulmuş veya bazı haritalar dijital olarak yenilenmiştir. Örnek alan olarak seçilen Çanakkale Savaşları'nın gerçekleştiği Gelibolu Yarımadası'nda yapılan arazi çalışmasında elde edilen görseller kullanılmıştır. Yeraltı ve yerüstü kaynaklarını ele geçirmek, dini yaymak ve özgürlük için yapılan savaşlar da dahil hemen hemen bütün savaşlar belirli bir mekanın hakimiyetini ele geçirmek için yapılmaktadır. Bunun yanında savaşın gerçekleşeceği alanın belirlenmesinde de coğrafi özellikler göz önünde bulundurulur. Arazinin engebeli veya sade olması, bozkır veya ormanlık alan olması, kırsal bir alan ya da yerleşim yeri olması buna örnek verilebilir. Yaptığımız araştırmalar sonucunda, dünya tarihinde pek çok dezavantaja rağmen coğrafi faktörlerden yarar sağlayacak şekilde taktik geliştiren komutanların zafer elde ettikleri görülmüştür. M.Ö. 500 yıllarında, Çin’de yaşamış ünlü komutan Sun Tzu, ‘Savaş Sanatı’ adlı eserinde, savaşlarda coğrafi özelliklerden nasıl avantaj elde edileceğini anlatmaktadır. Mustafa Kemal’in, Cevat Paşa’nın ve diğer Türk komutanların Çanakkale Savaşı’nda ve Kurtuluş Savaş’ında, coğrafi faktörlere bağlı olarak uyguladığı stratejiler bir ulusun kaderini değiştirmiştir. Özetle şu söylenebilir; coğrafi bilgi yeri geldiğinde bir ülkeyi kurtarabilir, bir ulusun kaderini ve tarihin seyrini değiştirebilir. Tarihte bazı komutan ve hükümdarların coğrafi faktörleri göz ardı etmenin bedelini ağır ödediği görülmektedir. Napolyon, Rusya’da; İmparator Cambyses Nubia’da; İmparator Darius, Scythia’da, İmparator Krezüs, Parthianla’da, karşılarına çıkan pek çok orduyu yendikten sonra coğrafi koşullara yenilmişlerdir.Fiziki ve beşeri coğrafya unsurlarının savaşın taraflarını engelleyici veya destekleyici rolleri vardır. Bunlar savaşın sonucuna tesir edebilir. Savaşlarda coğrafi faktörleri iyi analiz etmek ve tüm hazırlıkları bu faktörlere uygun şekilde yapmak, bir orduya avantaj sağlar. Şu bir gerçektir; insanların hayatlarının ve ülkelerin bağımsızlıklarının ve önemli çıkarlarının söz konusu olduğu savaşlarda coğrafyayı iyi analiz etmek, coğrafi faktörleri iyi bir şekilde değerlendirmek, bir ulusun kaderini değiştirebilir. Çalışmada bu durumlara tarihten örnekler verilmiştir. Çanakkale Savaşları’nda da coğrafi faktörler hem savaşın nedenini oluşturmuş hem tarafları zaman zaman engellemiş veya desteklemiş hem de her iki tarafta zaman zaman stratejilerini bu faktörlere göre belirlemiştir. Yapılan araştırmalar sonucunda coğrafi faktörlerin savaşların gidişatı, uygulanan taktikler ve sonucu üzerinde önemli etkilerinin olduğu görülmüştür.--------------------Human activities on location are the subject of study of geography. Just as the field of application of civil engineering is construction sites, the field of application of geography science is also on battlefields. Features of the geographical location, in shortly, "geopolitical" have important effects on the distribution of wars on earth. On the other hand, as a result of wars, both physical and human structures changes occur on the location. This study aims to reveal the geographic factors, the distribution of wars in the world, their role in preventing or supporting wars, their place and importance on the tactics applied in wars, their effect on the outcome of the war and the change that occurred on the location after the war. For this purpose, various sub problems were created and answers were sought.The research was shaped by the method of document analysis, and the observations obtained from the field study conducted on the Gallipoli battlefield and photographs taken from the field regarding the sub problems that were sought to be answered were used in the text. The main source of the study is historical texts, war records, memories of soldiers in wars and scientific historical texts. In this documents analysied ressearch, a large number of scientific texts, statistical records and historical documents about wars were examined, the data obtained were used to prove our views by associating them with the purpose and sub problems, and the maps were drawn to support the subject and visualized. Based on the transmitted scientific texts, maps were created in the GIS program or some maps were digitally renewed. As an example, the visuals obtained during the field study conducted in Gallipoli where the Battle of Gallipoli took place, were used. Virtually all wars are fought for domination of a particular location, including wars for underground and aboveground resources, propagation of religion, and wars for freedom. In the other hand Geographical features are also considered in determining the area where the war will take place. For example, if the land is rough or plain, it is a steppe or forest area, it is an entertaining area or a settlement.As a result of our research, it has been observed that the commanders who developed tactics to benefit from geographical factors, despite many disadvantages in world history, achieved victory. The famous commander Sun Tzu, who lived in China for B.C. 500 years, explains how to gain advantage from geographical features in wars in his book "Art of War". The strategies implemented by Mustafa Kemal, Cevat Pasha and other Turkish commanders in the Battle of Gallipoli and the War of Turkish National Independence depending on geographical factors changed the destiny of a nation. In summary can be said; Geographical information can save a country, change the destiny of a nation and change the course of history. It seems that some commanders and rulers in history paid the price of ignoring geographical factors. Napoleon in Russia; Emperor Cambyses in Nubia; Emperor Darius was defeated in Scythia, Emperor Croesus in Parthianla, after defeating "many armies", they were defeated by geographical conditions.As a result, physical and human geography elements have roles that prevent or support the parties of the war. These can affect the outcome of the war. Analyzing geographical factors well and making all preparations in accordance with these factors provides an advantage for an army. This is a fact; analyzing geography well and making good use of geographical factors can change the destiny of a nation in wars for the lives of people, the independence of countries and their important interests. In the study, historical examples are given to these cases. In the Battle of Gallipoli, geographical factors both constituted the cause of the war and prevented or supported opponents from time to time, and from time to time both sides determined their strategies according to these factors. As a result of the researches, it has been observed that geographical factors have important effects on the course of wars, the tactics applied and the result

INDUSTRIAL APPLICATIONS OF NON-THERMAL NOVEL FOOD PRESERVATION TECHNIQUES-1

Isıl ifllem uygulamaları ile gıdalarda meydana gelen çeflitli kayıplar ve tüketicilerin besin içerikleri veduyusal kalitesi daha yüksek gıdalara olan talebi yeni gıda muhafaza tekniklerine ihtiyaç duyulmasınaneden olmufltur. Isıl olmayan yeni tekniklerden yüksek basınç, ultraviyole ıflık ve ıflınlama, son yıllardagıda sanayinde bazı gıdalarda mikroorganizmaların inaktivasyonu amacıyla kullanılmaya bafllanmıfltır.Ultraviyole ıflık ve vurgulu ıflık gıda sanayinde iflletme ekipmanlarının ve ortamının mikrobiyel yükününazaltılması ve ambalaj malzemelerinin sterilizasyonu amacıyla da kullanılmaktadır. Isıl olmayan yenimuhafaza teknikleri ile ifllenen gıdalar besin içerikleri ve duyusal özellikleri bakımından ısıl ifllemlerealternatif olmakla birlikte ilk yatırım maliyetlerinin yüksekliği, her gıdaya uygulanamaması ve ifllemparametrelerinin tam olarak ortaya koyulmamıfl olması gibi nedenlerle dünya genelinde henüzyaygınlaflamamıfltır. Gelişen teknoloji ile birlikte önümüzdeki yıllarda bu yeni gıda muhafaza teknikleriningıda sanayinde kullanımının artacağı tahmin edilmektedir. Bu derlemede ısıl olmayan yeni gıda muhafazatekniklerinden yüksek basınç, ultraviyole ışık, vurgulu ışık ve ışınlamanın gıda sanayindeki endüstriyeluygulamaları incelenmiştirLosses in foods caused by thermal processing and high demand for nutritions and high quality foodsby consumers have brought about the need for novel food preservation techniques. High pressureprocessing, ultraviolet light, and irradiation are some of the non-thermal novel technologies whichhave been in use for inactivation of microorganisms for certain foods in the food industry in recent years.Ultraviolet light and pulsed light are also used for reduction of microbial load of environment, foodpocessing equipments, and packaging materials in the food industry. Although processing of foodswith these non-thermal novel preservation techniques is a viable alternative to thermal processing,they have been limitedly used in the food industry due to high investment cost and uncertainty onprocess parameters for specific foods. This review will address applications of novel non-thermal foodpreservation techniques such as high pressure processing, ultraviolet light, pulsed light, and irradiationin the food industr

INDUSTRIAL APPLICATIONS OF NON-THERMAL NOVEL FOOD PRESERVATION TECHNIQUES-2

Isıl işlemin gıdalarda neden olduğu çeşitli olumsuzluklar ve tüketicilerin sağlıklı, güvenilir ve yüksekkaliteli gıdalara olan talebi yeni gıda muhafaza tekniklerine ihtiyaç duyulmasına neden olmuştur. Isılolmayan yeni tekniklerden birisi olan vurgulu elektrik alan, gıdaların ve mikroorganizmaların hücrezarlarını parçalayabilmektedir. Vurgulu elektrik alanın bu özelliğinden yararlanılarak gıda sanayindeekstraksiyon ve kurutma gibi ifllemler kolaylaştırmakta ve mikroorganizmaların inaktivasyonusağlanmaktadır. Vurgulu elektrik alan ilk yatırım ve işletme maliyetlerinin yüksekliği, her gıdayauygulanamaması ve işlem parametrelerinin ortaya koyulmamış olması gibi nedenlerle dünya genelindehenüz yaygınlaşamamıştır. Bir diğer yeni teknik ultrasesin gıda sanayinde ekstraksiyon, emülsifikasyon,homojenizasyon, kristalizasyon, filtrasyon, ayırma, viskozite değiştirme, köpük önleme, sıvı gıdalardagaz alma, kesme ve temizlik gibi çok sayıda uygulaması vardır. Ozmotik kurutma ise genellikle asıl kurutmaöncesi bir ön işleme tekniği olarak kullanılmaktadır. Bu derlemede ısıl olmayan yeni gıda muhafazatekniklerinden vurgulu elektrik alan, ultrases ve ozmotik kurutmanın gıda sanayindeki uygulamalarıincelenmiştirDisadvantages in foods caused by thermal processing and demand for healthy, safe and high qualityfoods by consumers have paved the way for novel food preservation techniques. Pulsed electric field anon-thermal novel technique, can disintegrate the cell membrane of food and microorganisms. Usingthis feature of pulsed electric field facilitates operations such as extraction and drying and providesinactivation of microorganisms in the food industry. Pulsed electrical field has been limitedly used bythe food industry because of high investment and operating costs and uncertainty on process parametersfor specific foods. Ultrasound is another novel technique which has numerous applications in the foodindustry such as extraction, emulsification, homogenization, crystallization, filtration, separation, viscosityalteration, foam inhibition, degassing of liquid foods, cutting and cleaning. Osmotic dehydration isgenerally used as a pre-treatment technique before the main drying process. Current applications ofnon-thermal novel food preservation techniques such as pulsed electric field, ultrasound and osmoticdehydration in the food industry will be covered in this revie

Soft Drink and Cookie Industry Wastewater Treatment by Anaerobic Contact Sequencing Batch Reactors

Wastewaters resulting from soft drink, cookie, and other food processing industries can have high concentrations of chemical oxygen demand (COD), suspended solids (SS). fats, oil and grease (FOG), as well as low pH values. Treatment is often required before discharging these wastewaters to either a receiving environment or the sewer. These high strength wastewaters have been treated under anaerobic and aerobic biological conditions and/or chemically as reported in previous studies. In the research reported herein, a new reactor type, the anaerobic contact sequencing batch reactor (AnCSBR), which is a combination of the anaerobic sequencing batch reactor and anaerobic contact process was used to treat soft drink industry (SDIW) and cookie industry (CIW) wastewaters. Results obtained in this study showed that SDIW is highly biodegradable under anaerobic conditions. Laboratory scale AnCSBRs were able to achieve 98% SCOD and 74 to 97% TCOD removal under organic loading rates ranging from 0.36 to 8.6g COD/L.day for SDIW. Organic loading rates of CIW between 0.6 and 3.4 g COD/L.day resulted in TCOD and SCOD removals of 75 to 95% and 82 to 98%, respectively. The ability of the AnCSBR to achieve high FOG removal under relatively high loading rates is also described. 85 to 98% FOG removal was obtained for CIW which had influent FOG concentrations ranging between 850 to 3,800 mg/L with an average of 2,030 mg/L