Deciphering the implications of MAFLD and MASLD definitions in the NAFLD population: Results from a single-center biopsy study

To the Editor: The nomenclature for steatotic liver disease has been a topic of debate since 2020. The conventional expression, non-alcoholic fatty liver disease (NAFLD), was introduced in 1980 to describe the occurrence of steatosis in the absence of other hepatic diseases. However, in recent years, there has been a growing movement to phase out and retire this term

The role of FibroScan in the era of metabolic (dysfunction)-associated fatty liver disease

Among chronic liver conditions, metabolic (dysfunction)-associated fatty liver disease (MAFLD) ranks as the most frequent. With a worldwide prevalence of 37%, the global burden of MAFLD is large and growing

A Review of the Epidemiology, Pathophysiology, and Efficacy of Anti-diabetic Drugs Used in the Treatment of Nonalcoholic Fatty Liver Disease

In recent years, epidemiological studies have consistently demonstrated that the coexistence of nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) is strongly associated with increased mortality and morbidity related to hepatic- and extrahepatic causes. Indeed, compared with the general population, patients with T2DM are more likely to be diagnosed with more severe forms of NAFLD (i.e., nonalcoholic steatohepatitis (NASH) with liver fibrosis). There is an ongoing debate whether NALFD is a consequence of diabetes or whether NAFLD is simply a component and manifestation of the metabolic syndrome, since liver fat (steatosis) and even more advanced stages of liver fibrosis can occur in the absence of diabetes. Nevertheless, insulin resistance is a key component of the mechanism of NAFLD development; furthermore, therapies that lower blood glucose concentrations also appear to be effective in the treatment of NAFLD. Here, we will discuss the pathophysiological and epidemiological associations between NAFLD and T2DM. We will also review currently available anti-diabetic agents with their regard to their efficacy of NAFLD/NASH treatment.Open Access funding enabled and organized by Projekt DEA

Advances in Cellulose-Based Packaging Films for Food Products

Cellulose and its derivatives can be used to manufacture packaging film materials with versatile properties as alternatives to petroleum-based films. This chapter covers the recent trends and advancements in cellulose-based films for food materials. The chapter starts with the introduction of traditional and novel cellulose structures relevant to film-making properties including cellulose fibers, filaments, nano-fibrils, crystalline cellulose, and other traditional cellulose derivatives. The relevant cross-linking methods, such as esterification, etherification, oxidation, and carboxylation will be described in the production of materials such as methylcellulose, cellulose acetate, rayon fabric, carboxymethyl cellulose, cellulose ether, etc. The chapter will relate the properties of the films (e.g., crystallinity, mechanical, optical, barrier, and solubility properties) to the chemical characteristics of the cellulose materials. The chapter will also cover the interactions of cellulose with polymeric composites such as protein, polysaccharides, and other nanoparticles ingredients with a focus on emerging technologies

Relationship between shoulder joint position sense and swimming performance in disabled swimmers

Amaç: Yüzme, kişisel veya takım hâlinde mücadele içeren vücut bölümlerinin birbirleriyle olan koordineli hareketleri ile karakterize kompleks bir spor dalıdır. Bu çalışmanın amacı, bedensel engelli yüzücülerin glenohumeral eklem pozisyon hissi ile yüzme performansının ilişkisini incelemektir. Gereç ve Yöntemler: Çalışmaya, 29 bedensel engelli yüzücü dâhil edildi ve paralimpik sınıflandırma sistemine göre S/SB 6-S/SB 10 sınıflandırıldı. Sınıflandırma süreci; fiziksel değerlendirme, teknik değerlendirme ve gözlemsel değerlendirme olmak üzere 3 aşamayı içerdi. Sporcuların glenohumeral eklem pozisyon hissi, akıllı telefon inklinometre uygulaması kullanılarak aktif açı tekrarlama testiyle ve yüzme performansları 50 m serbest stil yüzme performansıyla değerlendirildi. Bulgular: Çalışmaya dâhil edilen 29 sporcunun %13,8’i (n=4) S6, %6,9’u (n=2) S7, %20,7’si (n=6) S8, %34,5’i (n=10) S9 ve %24,1’i (n=7) S10 sınıfında idi. Sporcuların, baskın üst ekstremite glenohumeral ekleme ait iç ve dış rotasyon aktif eklem pozisyon hissi (mutlak yeniden pozisyonlama hata) sonuçları ile 50 m serbest yüzme performansı arasında bir ilişki bulunmadı (p>0,05). Sonuç: Çalışma sonucunda, bedensel engelli yüzücülerde glenohumeral eklem pozisyon hissi ile yüzme performansı arasında bir ilişki bulunmasa da meydana gelebilecek herhangi bir yaralanmaya karşı önlem almak açısından, antrenman ve rehabilitasyon programlarına proprioseptif duyu değerlendirmesi ve eğitiminin önemini vurgular özelliktedir.Objective: Swimming is a complex sport that is characterized by the coordinated movements of body parts. The aim of this study was to examine the relationship between glenohumeral joint position sense and physical performance of upper extremities in swimmers with physical disabilities. Material and Methods: 29 physically disabled swimmers were included in the study and classified as S/SB 6- S/SB 10 according to the paralympic classification system. Classification process has included tree stages: physical evaluation, technical evaluation and obsevational evaluation. Evaluation of the glenohumeral joint position sense of the athletes was evaluated by using the active angle repetition test with the assistance of smart phone inclinometer application, swimming performance of athletes was evaluated with 50 m free style swimming performance. Results: The 29 athletes included in the study, 13.8% (n=4) S6, 6.9% (n=2) S7, 20.7% (n=6) S8, 34.5% (n=10) S9 and 24.1% (n=7) are in S10 class. There wasn’t relationship between athletes' (absolute repositioning error) results of internal and external rotation active joint position sensation of the dominant upper extremity glenohumeral joint and 50 m free swimming performance (p>0.05). Conclusion: As a result, there wasn’t relationship between glenohumeral joint position sense and swimming performance in physically disabled swimmers but it emphasizes the importance of proprioceptive sensory assessment and training in training and rehabilitation programs in order to prevent any possible injury.No sponso

The effects of dietary flavonoid supplementation on the antioxidant status of laying hens

Department of Science Research Project at Artvin Coruh UniversityNinety-six 28-week-old Lohmann White laying hens were utilized to test the antioxidant effects of flavonoids (hesperidin, naringin, and quercetin at 0.5 g/kg diet) during an 8-wk experimental period. At the end of the experiment blood samples were collected to determine total protein, cholesterol, and malondialdehyde (MDA) serum levels as well as activities of glutathione reductase (GR), glutathione peroxidase (GSH-Px), glutathione-S-transferase (GST), and superoxide dismutase (SOD) and level of glutathione (GSH) in erythrocyte lysates. Data were analyzed using one-way ANOVA. Naringin supplementation did not alter serum cholesterol concentration, whereas hesperidin and quercetin supplementations decreased serum cholesterol concentration. Naringin and quercetin supplementations did not affect serum protein concentration. All flavonoids decreased MDA concentration as well as increased GSH-Px, GR, GST, and SOD activities and GSH level, being quercetion superior to hesperidin and naringin. In conclusion, flavonoids, especially quercetin, exert antioxidant activity, which may help improve wellbeing when laying hens are exposed to stressors

Assessment of early and late dysphagia using videofluoroscopy and quality of life questionnaires in patients with head and neck cancer treated with radiation therapy

BACKGORUND: The aim of this study was to evaluate dysphagia in patients with head and neck cancer (HNC) undergoing three-dimensional conformal radiation therapy using objective and subjective tools simultaneously and to associate the clinical correlates of dysphagia with dosimetric parameters. METHODS: Twenty patients were included in the study. The primary tumor and the involved lymph nodes (LN) were treated with 66-70 Gy, the uninvolved LN were treated with 46-50 Gy. Six swallowing structures were identified: the superior pharyngeal constrictor muscle (SPCM), the middle pharyngeal constrictor muscle (MPCM), the inferior pharyngeal constrictor muscle (IPCM), the base of tongue (BOT), the larynx and the proximal esophageal sphincter (PES). Dysphagia was evaluated using videofluoroscopy and European Organization for Research and Treatment of Cancer (EORTC) QoL questionnaire (QLQ-C30) and supplemental EORTC QoL module for HNC (QLQ-H&N35). The evaluations were performed before treatment, at 3 months and at 6 months following treatment. RESULTS: On objective evaluation, the D(max) for the larynx and the sub-structures of the PCM were correlated with impaired lingual movement, BOT weakness and proximal esophageal stricture at 3 months, whereas the V(65), the V(70)and the D(max) for the larynx was correlated with BOT weakness and the V(65), the V(70), the D(max) or the D(mean) for the sub-structures of the PCM were correlated with impaired lingual movement, BOT weakness, reduced laryngeal elevation, reduced epiglottic inversion and aspiration at 6 months following treatment. On subjective evaluation, the V(60), the D(max) and the D(mean) for SPCM were correlated with QoL scores for HNSO at 3 months, whereas the V(70) for SPCM were correlated with QoL scores for HNPA and the V(60), the V(65), the V(70), the D(max) and the D(mean) for SPCM were correlated with QoL scores for HNSO at 6 months following treatment. CONCLUSIONS: The use of multiple dysphagia-related endpoints to complement eachother rather than to overlap with one another, as well as the use of multiple evaluations over time to represent a scale of early to late findings might provide a better insight in terms of the association of the clinical correlates of dysphagia with the dose-volume data for the dysphagia-related anatomical structures

Changes in the etiology of chronic liver disease by referral to a FibroScan center: Increasing prevalence of the nonalcoholic fatty liver disease

Background and Aim: Chronic liver disease (CLD) is a leading cause of morbidity and mortality worldwide with a wide etiological spectrum. Fi-broScan (R) is used for follow-up of fibrosis and steatosis. This single -cen-ter study aims to review the distribution of indications by referral to Fi-broScan (R).Materials and Methods: Demographic characteristics, CLD etiolo-gies, and FibroScan (R) parameters of the patients who were referred to our tertiary care center between 2013 and 2021 were retrospectively evaluated.Results: Out of 9345 patients, 4946 (52.93%) were males, and the medi-an age was 48 [18-88] years. Nonalcoholic fatty liver disease (NAFLD) was the most common indication (N=4768, 51.02%), followed by hepa-titis B (N=3194, 34.18%) and hepatitis C (N=707, 7.57%). Adjusting for age, sex, and CLD etiology, the results revealed that patients with old-er age (Odds ratio (OR)=2.908; confidence interval (CI)=2.597-3.256; p<0.001) and patients with hepatitis C (OR=2.582; CI=2.168-3.075; p<0.001), alcoholic liver disease (OR=2.019; CI=1.524-2.674, p<0.001), and autoimmune hepatitis (OR=2.138; CI=1.360-3.660, p<0.001) had increased odds of advanced liver fibrosis compared to NAFLD.Conclusion: NAFLD was the most common indication for referral to FibroScan (R)

Investigation of the Relationship between Empathy and Burnout Levels of Nursing Students

Amaç: Bu araştırma, hemşirelik öğrencilerinin empati ve tükenmişlik düzeyleri arasındaki ilişkiyibelirlemek amacı ile planlandı.Yöntem: Tanımlayıcı ve kesitsel türde gerçekleştirilen araştırmanın evrenini bir Hemşirelik Fakültesi’nde2016-2017 eğitim-öğretim yılında öğrenim gören 1294 öğrenci; örneklemini ise; tabakalı rastgeleörnekleme yöntemi ile belirlenen 290 hemşirelik öğrencisi oluşturdu. Veriler, “Yapılandırılmış SoruFormu”, “Empatik Beceri Ölçeği B-Formu” ve “Maslach Tükenmişlik Envanteri-Öğrenci Formu” kullanılaraktoplandı. Araştırmanın yürütüleceği fakülteden yazılı izin ve Etik Kurul’dan etik onay sağlandı. Veri analizi,SPSS 21.00 programında, tanımlayıcı ve önemlilik analizi kullanılarak yapıldı.Bulgular: Öğrencilerin %84.1’i kız, yaş ortalaması 20.28±1.47 yıldır. Empatik Beceri Ölçeği B-Formu puanortalaması 143.86±23.93; Maslach Tükenmişlik Envanteri-Öğrenci Formu alt boyutları puan ortalamalarıise tükenmede 15.11±4,69, duyarsızlaşmada 9.34±3.62, yetkinlikte ise 12.78±2.67 olduğu saptandı.Öğrencilerin Empatik Beceri Ölçeği puanı ile Maslach Tükenmişlik Envanteri Duyarsızlaşma alt boyutupuanları arasında istatistiksel olarak anlamlı düzeyde negatif bir ilişki bulunmaktadır (p<0.05).Sonuç: Hemşirelik öğrencilerinin tükenmişlik ve empati becerilerinin orta düzeyde olduğu ve bazı sosyodemografiközelliklerin empati ve tükenmişlik düzeylerini etkilediği belirlendi.Aim: This research was designed to determine the relationship between empathy and burnout levels of nursing students. Method: The population of this descriptive and cross-sectional research consisted of 1294 students studying at a Nursing Faculty in the 2016-2017 academic year and the sampling consisted of 290 nursing students who were selected by the stratified random sampling method. Data were collected using the “Structured Question Form”, the “Empathic Skill Scale B-Form” and the “Maslach Burnout Inventory-Student Form”. Written permission and ethical approval were obtained from the faculty where the research would be conducted. Data analysis was performed using the descriptive and significance analysis in the SPSS 21.00 program. Results: 84.1% of the students were female, and the average age was 20.28±1.47. It was determined that the mean score of the Empathic Skill Scale B-Form was 143.86±23.93, and that the mean scores of the sub-dimensions of the Maslach Burnout Inventory-Student Form were 15.11±4,69 in burnout, 9.34±3.62 in depersonalization, and 12.78±2.67 in competency. There is a statistically significant relationship between the Empathic Skill Scale score of nursing students and the Depersonalization sub-dimension score of the Maslach Burnout Inventory (p<0.05). Conclusion: It was determined that the burnout and empathy skills of nursing students were at a moderate level and that some socio-demographic characteristics affected their empathy and burnout levels

Prognostic Factors in Operated Early Stage Lung Cancer Patients- Retrospective Single Center Data

Aim: Non-small cell lung cancer (NSCLC) accounts for 85% of all lung cancers. Although curative treatment is surgery in the early stages, disease relapse is common. In this study, we retrospectively evaluated the prognostic factors and outcomes of operated NSCLC cases.Materials and Methods: Retrospective analysis of data from 166 patients with early stage NSCLC who presented after surgery and treated and followed in our clinic between 2006-2018 was performed. Histopathologic features and clinical findings were investigated as prognostic factors.The findings were analyzed using SPSS.Results: At the time of diagnosis, median age was 61 (39-82) and 84% of the patients were male. Most common pathologic subtype was adenocarcinoma. Median disease free survival (DFS) and overall survival (OS) were 76 months (%95CI:32.1-110.0) and 87 months (95%CI:59.8-114.1). ). In multivariate analysis, presence of vascular invasion was found to be independent prognostic factors for both DFS and OS (HR:2.5 and 2.3, respectively). Adenocarcinoma solid pattern was only associated with worse disease-free survival (HR: 1.7).Conclusion: In our study, we showed that the presence of vascular invasion and solid-type adenocarcinoma is associated with poor survival