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Asthma patients with obesity have a unique phenotype: a subanalysis of the Turkish adult asthma registry
No full textObjective: The obese-asthma phenotype has gradually increased in the last few years. We aimed to assess the differences between obese and non-obese patients with asthma. Methods: This research is a subanalysis of the Turkish Adult Asthma Registry (TAAR). Clinical presentation, disease control, severity, and demographics of obese and non-obese (normal-weight, overweight) patients were compared. Results: The obesity rate in TAAR was 32.2% (n = 619/1919; 18-83 years; 527 F/92 M). Patients with asthma and obesity had higher rates of childhood obesity, longer symptom duration, later onset of asthma, and more severe asthma. These patients were more likely to be female, older, less educated, and live in rural areas. Patients with obesity had more scheduled visits and emergency visits compared with non-obese patients, but similar asthma control, oral corticosteroid use, hospitalizations, intensive care unit admissions, and unscheduled visits. They also had a higher frequency of T2-high but lower frequency of possible T2-low phenotypes compared with normal-weight asthmatics. The risk of severe asthma in patients with obesity was 6.04 times higher for allergic than non-allergic patients and 3.58 times higher for the T2-high phenotype than for possible T2-low phenotypes. A one-unit increase in the asthma control test reduced the risk of severe asthma by 22%. Conclusions: A good definition of this phenotype is important to ensure that appropriate treatment strategies are implemented to achieve the control goal. We also believe that prevention of childhood obesity is an effective and pivotal strategy to achieve the goal of asthma control
Effect of hygrothermal aging and ply-stacking sequence on low-velocity impact properties of CFRP composite plates
No full textIt is essential to obtain preliminary design data of composite marine vehicles operated in harsh marine environments, such as those with hygrothermal and impact effects. The effects of hygrothermal aging and stacking sequence on the low-velocity impact (LVI) response of carbon fiber epoxy composite plates (CFRP) were investigated experimentally. CFRP plates in six orientations [0 degrees/90 degrees/45 degrees/-45 degrees]s, [90 degrees/45 degrees/-45 degrees/0 degrees]s, [0 degrees/90 degrees/0 degrees/90 degrees]s, [90 degrees/0 degrees/90 degrees/0 degrees]s, [-45 degrees/45 degrees/-45 degrees/45 degrees]s, and [45 degrees/-45 degrees/45 degrees/-45 degrees]s (quasi-isotropic, cross-ply, and angle-ply) were manufactured using a vacuum-assisted resin infusion method. LVI tests were performed by using the Ceast 9350 Fractovis Plus impact machine. Four aging conditions (atmospheric, 2, 4, and 6 weeks aged) were simulated using Ascott CC 1000ip programmable salt spray and cyclic corrosion test chamber cabin. The effect of the ply-stacking sequence plays an important role in the failure of the top or bottom surface of the plate samples and dent depth. When 0-degree fiber is used on the upper and lower surfaces of the plates, the dent depth is lowest, followed by 90, +45, and -45 degrees, respectively. Dent depth and top surface fiber cracking lengths generally decrease as the process begins with initial atmospheric conditions reaching 6 weeks
Successful Treatment Using Etanercept in a Patient with Enthesitis-Related Arthritis Who Had Late Allergic Reaction to Adalimumab
No full textBackground: Biological agents are considered important therapies and are increasingly used in the treatment of a range of rheumatological and inflammatory diseases. Nevertheless, the prevalent use of these treatments has been associated with increased incidence of drug-induced hypersensitivity reactions (HSR). Case Presentation: A 15-year-old patient with enthesitis-related arthritis developed late HSR after the use of adalimumab. Consequently, etanercept was used as an alternative treatment. Etanercept was administered subcutaneously through a single dose without any reaction upon examination using skin tests (skin prick test, intradermal test, and patch test) against likely cross-reactions given that both adalimumab and etanercept were anti-tumor necrosis factor (TNF) agents. Conclusions: Currently, TNF-α inhibitors find widespread use. Caution is required against HSR reactions, including systemic or local injection site reactions, although they are generally considered safe to use
Euler-Euler Numerical Model for Transport Phenomena Modeling in a Natural Circulation Loop Operated by Nanofluids
No full textThis paper explores a computational approach to model multiphase heat transfer and fluid flow in a natural circulation loop utilizing nanofluids. We propose and implement an Euler-Euler framework in a CFD environment, incorporating an innovative boundary condition to preserve mass conservation during thermophoretic particle flux. The model's accuracy is verified through a one-dimensional example, by comparing results against both an Euler-Lagrange model and an in-house finite volume solution. Experimental validation is conducted with aluminum oxide nanofluids at varying nanoparticle concentrations. We prepared the nanofluids and measured their thermophysical properties up to 60 degrees\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}\end{document}C. We assess the thermal performance of the nanofluid in natural circulation loop at different heating powers via experiment and numerical simulations. The findings reveal that the heat transfer enhancement offered by the nanofluid is modest, with minimal differences observed between the proposed Euler-Euler approach and a simpler single-phase model. The results underscore that while the Euler-Euler model offers detailed particle-fluid interactions, its practical thermal advantage is limited in this context
Liquid Biopsy in Progressing Prostate Cancer Patients Starting Docetaxel with or Without Enzalutamide: A Biomarker Study of the PRESIDE Phase 3b Trial
No full textBACKGROUND AND OBJECTIVE: The PRESIDE (NCT02288247) randomized trial demonstrated prolonged progression-free survival (PFS) with continuing enzalutamide beyond progression in metastatic castration-resistant prostate cancer (mCRPC) patients starting docetaxel. This study aims to test the associations of PFS and circulating tumor DNA (ctDNA) prior to and after one cycle (cycle 2 day 1 [C2D1]) of docetaxel and with a liquid biopsy resistance biomarker (LBRB; plasma androgen receptor [AR] gain and/or circulating tumor cells [CTCs] expressing AR splice variant 7 [CTC-AR-V7]) prior to continuation of enzalutamide/placebo. METHODS: Patients consenting to the biomarker substudy and donating blood before starting docetaxel with enzalutamide/placebo (N = 157) were included. Sequential plasma DNA samples were characterized with a prostate-cancer bespoke next-generation-sequencing capture panel (PCF_SELECT), and CTCs were assessed for AR-V7 (Epic Sciences, San Diego, CA, USA). Cox models, Kaplan-Meier, and restricted mean survival time (RMST) at 18 mo were calculated. KEY FINDINGS AND LIMITATIONS: There was a significant association of worse PFS with pre-docetaxel ctDNA detection (N = 86 (55%), 8.1 vs 10.8 mo hazard ratio [HR] = 1.78, p = 0.004) or persistence/rise of ctDNA at C2D1 (N = 35/134, 5.5 vs 10.9 mo, HR = 1.95, 95% confidence interval [CI] = 1.15-3.30, p = 0.019). LBRB-positive patients (N = 62) had no benefit from continuing enzalutamide with docetaxel (HR = 0.78, 95% CI = 0.41-1.48, p = 0.44; RMST: 7.9 vs 7.1 mo, p = 0.50). Conversely, resistance biomarker-negative patients (N = 87) had significantly prolonged PFS (HR = 0.49, 95% CI = 0.29-0.82, p = 0.006; RMST: 11.5 vs 8.9 mo, p = 0.005). Eight patients were unevaluable. An exploratory analysis identified increased copy-number gains (CDK6/CDK4) at progression on docetaxel. Limitations included relatively low detection of CTC-AR-V7. Validation of impact on overall survival is required. CONCLUSIONS AND CLINICAL IMPLICATIONS: Liquid biopsy gives an early indication of docetaxel futility, could guide patient selection for continuing enzalutamide, and identifies cell cycle gene alterations as a potential cause of docetaxel resistance in mCRPC. PATIENT SUMMARY: In the PRESIDE biomarker study, we found that detecting circulating tumor DNA in plasma after starting treatment with docetaxel (chemotherapy) for metastatic prostate cancer resistant to androgen deprivation therapy can predict early how long patients will take to respond to treatment. Patients negative for a liquid biopsy resistance biomarker (based on the status of androgen receptor (AR) gene and AR splice variant 7 in circulating tumor cells) benefit from continuing enzalutamide in combination with docetaxel, while patients positive for the resistance biomarker did not. Additionally, we identified alterations in the cell cycle genes CDK6 and CDK4 as a potential genetic cause of resistance to docetaxel, which may support testing of specific drugs targeting these alterations
Low apelin levels are associated with a marked increase in risk of gestational diabetes mellitus development
No full textDokuma Kumaş Takviyeli Diatomit İkameli Çimento ve Alçı Esaslı Kompozitlerin Mekanik Özelliklerinin İncelenmesi
No full textTez kapsamında keten ve poliester dokuma kumaş takviyeli, çimento ve α-hemihidrat alçı esaslı, diatomit ikameli çok katmanlı kompozitlerin mekanik performans parametreleri farklı yaşlarda incelenmiştir. Bu kapsamda, XRD analizleri, puzolanik aktivite deneyi, matris basınç dayanım tespiti, matris birim hacim ağırlık tayini, matris kuruma büzülmesi testi, tek eksenli iplik, kumaş ve kompozit çekme testleri ve mikroyapı incelemeleri kapsamında SEM-EDS analizleri yapılmıştır. Daha sonra kompozitlerin CO2 emisyon değerleri ve maliyet analizleri belirlenmiştir.Deneysel çalışmalarda; 0,28 ve 0,45 su/bağlayıcı oranına sahip matrislerin kıvamı, süper akışkanlaştırıcı katkı yardımıyla 235 mm yayılma çapında sabit tutulmuştur. Kompozitlerin gerilme-birim şekil değiştirme eğrileri; eksenel çekme cihazı ve LVDT’ler yardımıyla elde edilmiştir. Deney sonuçları dikkate alınarak, lif türü ve yaşlanmaya bağlı olarak kompozitlerin; çekme dayanımı, düktilitesi, tokluk gelişimi ve çoklu çatlak performansı elde edilip, yaşlanmanın mekanik özelliklere etkileri her lif türü için ayrı ayrı tartışılmıştır. Çimento esaslı matrise diatomit ikamesinin mekanik özellikleri geliştirdiği görülmüş, poliester dokuma kumaş takviyeli kompozitlerin keten dokuma kumaş takviyeli kompozitlere göre birçok mekanik özellik bakımından hem kısa vadede hem de uzun vadede üstün olduğu tespit edilmiştir.Yapılan çok katmanlı kompozit deneyleri sonucu dokuma kumaş katman artışı ile kalsine diatomit ikameli Portland çimentosu esaslı kompozitlerde, mekanik özellikler açısından optimum katman sayısı 3 olarak belirlenmiştir. Bu oranın α hemihidrat alçı esaslı kalsine diatomit ikameli kompozitlerde 4 katman olduğu görülmüştür. Bağlayıcı matrise kalsine diatomit ikamesi, Portland çimentolu serilerde puzolanik reaksiyon gelişimine bağlı kumaş-matris arayüz iyileşmesi sağlarken, alçılı serilerde reaksiyon gelişmemiş, zayıf kumaş-matris arayüzü oluşmuştur. Ancak kalsine diatomit alçılı kompozitlerde mikro boşluklu yapısı sayesinde hafifleme sağlamıştır. Bu durum mikroyapı incelemeleri ile karakterize edilmiştir. Diğer taraftan, lif/hacim oransal artışı ile α hemihidrat alçılı diatomit ikameli serilerde çoklu çatlama aşamasında kumaş liflerinin devreye girmesi ile çekme dayanımı ve tokluk parametrelerinde Portland çimentolu serilerin değerlerine ulaşabilmiş, hatta düktilite parametresinde de üstünlük sağlayabilmiştir. Çevreye uyumluluk açısından kritik bir gösterge olan karbon salım değerleri kıyaslandığında diatomit ikameli alçılı serilerin, Portland çimentolu serilere kıyasla CO2 salımında %50 mertebelerinde azalışa neden olduğu belirlenmiştir. Buna karşılık maliyetin ise 3.5 kata kadar attığı tespit edilmiştir. α hemihidrat alçılı diatomit ikameli poliester dokuma kumaş takviyeli kompozitlerin eğer lif/hacim oranı optimize edilirse hafif ve yeterli mukavemete sahip yapı elemanlarının üretimi için ideal olduğu ortaya konulmuştur. Alçıpan levha, cephe kaplaması, mimari restorasyon vb. alanlarda düşük karbon salım değerleriyle çevre dostu alternatif bir malzeme olarak ön plana çıkmaktadır.</p
The Mediating Role of Anxiety in the Relationship Between Humor Coping and Secondary Traumatic Stress
No full textBu çalışma, mizahla başa çıkma stratejilerinin ikincil travmatik stres üzerindeki etkisinde kaygının aracı rolünüincelemektedir. Araştırma, yordayıcı korelasyonel model kullanılarak yürütülmüştür. Çalışmaya 18-65 yaşaralığındaki 581 kişi katılmış olup, bunların 408’i kadın ve 173’ü erkektir. Veriler, İkincil Travmatik Stres Ölçeği,Mizahla Başa Çıkma Ölçeği ve Durumluk-Sürekli Kaygı Ölçeği kullanılarak toplanmıştır. Veri analizinde SPSSProcess Hayes Macro kullanılmıştır. Çalışmanın sonuçları, kadınların ikincil travmatik stres, durumluk kaygı vesürekli kaygı düzeylerinin erkeklere göre daha yüksek olduğunu, ancak mizahla başa çıkma düzeylerinde anlamlıbir cinsiyet farkı bulunmadığını göstermektedir. Araştırmanın aracılıkla ilgili bulguları, mizahla başa çıkmanınikincil travmatik stres üzerinde doğrudan anlamlı bir etkisi olmadığını, ancak durumluk ve sürekli kaygıdüzeylerini azaltarak ikincil travmatik stresi dolaylı olarak azalttığını ortaya koymaktadır. Ayrıca, süreklikaygının, durumluk kaygıya kıyasla daha güçlü bir aracı değişken olduğu bulunmuştur.This study examined the role of anxiety in mediating the relationship between humor coping and secondarytraumatic stress. A predictive correlational model was employed to conduct the research. The study included 581participants aged 18 to 65, comprising 408 females and 173 males. Data were collected using the SecondaryTraumatic Stress Scale, the Humor Coping Scale, and the State-Trait Anxiety Scale. The analyses were conductedusing SPSS Process Hayes Macro. The results indicated that female participants exhibited higher levels ofsecondary traumatic stress, state anxiety, and trait anxiety compared to male participants. However, their levels ofhumor coping did not differ significantly. The findings further revealed that humor coping did not have astatistically significant direct effect on secondary traumatic stress. Instead, it reduced state and trait anxiety levels,which in turn mitigated secondary traumatic stress. Additionally, trait anxiety emerged as a stronger mediatingfactor than state anxiety. These findings suggest that humor is an effective coping mechanism, with anxiety playinga crucial role in the process.</p