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The effect of demographic features and environmental risk factors on the clinical course in patients with multiple sclerosis
No full textObjectives: This study aimed to investigate demographic, clinical, and environmental risk factors in patients with multiple sclerosis (MS) and their relationship with the disease. Patients and methods: The medical records of 913 patients with MS followed for >= 6 months between January 1996 and December 2015 were retrospectively reviewed, and 221 patients (158 females, 63 males; mean age: 43.4 +/- 11.6 years; range, 18 to 73 years) with demographic, clinical, and laboratory data were included. Results: Relapsing-remitting MS was identified in 75.6% (n=167) of patients, and progressive MS was identified in 24.4% (n=54). The initial Expanded Disability Status Scale (EDSS) scores were lower in the relapsing-remitting MS group compared to the progressive MS group (2.3 +/- 1.0 vs. 2.6 +/- 1.4; p<0.05). Motor symptoms were the initial presenting symptoms in 33.0% of the patients, followed by sensory symptoms and optic neuritis. The transition to the progressive phase was observed to occur at a younger age in patients with an earlier onset age (p<0.001). Motor symptom onset correlated with later disease onset, progression, and higher final EDSS score (p<0.05). Vitamin D deficiency and insufficiency were observed in 18.1% and 73.5% of patients, respectively. Seropositivity for Epstein-Barr virus (EBV) antibodies was high. Vitamin D levels and EBV serology were similar between the groups. Conclusion: In our patient group, early disease onset correlated with earlier transition to progression phase. Onset with motor symptom correlated with progression and higher disability scores. Vitamin D deficiency and high EBV seropositivity were common but not directly linked to clinical course. These findings potentially reflect MS patient profiles, warranting further epidemiological studies
Microbiota in Breast Cancer: A Need for Further Knowledge
No full textThe human microbiome is a mysterious organ that plays an important role in many different aspects of health through its effects on metabolism, digestion, and immune systems. In addition, microbiota plays an active role in the development of many products that play an important role in the pathophysiology of various diseases, including cancer. Thanks to the Human Microbiome Project and the metagenomics and new-generation sequencing technologies that have developed along with it, remarkable advances have been made in understanding the relationship between breast cancer and the microbiome. But there are many issues that need to be researched on this subject. Whether microbiota dysbiosis is the beginning of the disease etiology or a consequence of the disease is one of the main questions that need to be answered as a result of a detailed examination. Because the microbiome is a unique and complex structure, important questions remain about the mechanisms of this vital microbial organ function. It is unclear whether a change in the microbiome/dysbiosis causes breast cancer or vice versa. The existence of specific microbial family associations with specific subtypes of breast cancer has been identified. A healthy microbiome’s composition should be determined as there are unknown details about this subject. Microbiota studies and probiotic supplements have the potential to create a promising treatment model for targeted prevention and treatment of breast cancer. We are witnessing the dawn of an entirely new age of patient-specific medicine. This review is an attempt to summarize the relationship between the human microbiome and breast cancer. © 2025 Elsevier B.V., All rights reserved
Evaluation of Acute Enteritis Cases in Adults Presenting to the Emergency Department: A Single Tertiary Care Hospital Experience
No full textIntroduction: Acute enteritis can occur due to numerous bacterial, viral, and parasitic infections. This clinical condition can have various spectra in vulnerable patient groups with immunodeficiency and inflammatory bowel disease. This study aimed to examine cases of acute enteritis in the emergency unit of a tertiary-care hospital. Material and Methods: This cohort study was conducted with consecutive patients between September 2022 and November 2023. The clinical, laboratory, and microbiological data of the 194 patients were retrospectively examined. Patients with immunocompromised (IC) or inflammatory bowel disease (IBD) were analyzed in a healthy population. Results: The mean age of patients was 47 ± 19 (19 - 91). One-third of the patients had IC, and in the stool analysis, leukocytes and blood were positive in one-third and one-twentieth of the patients, respectively. Only one-tenth of patients had positive stool culture results. IC patients presented with metabolic acidosis, increased creatinine levels, and acute-phase reactant levels. Despite the lower prevalence of leukocytes and blood in stool samples, culture positivity was higher in IC patients. Conclusion: Stool culture positivity was low for the diagnosis of acute enteritis. Culture examination is important in IC patients, even in the absence of direct microscopic findings. Because patients with IC are more susceptible to complications, clinical assessment is important
Comparison of sphenoid sinus variations and morphometric values in dolichocephalic and hyperbrachycephalic individuals
No full textBackground: The internal carotid artery, optic, maxillary, and vidian nerves are important anatomical structures adjacent to the sphenoid sinus. In some individuals, these structures may protrude into the sinus, and this condition is important in surgical procedures. Purpose: To investigate the morphometric variations and anatomical differences in the sphenoid sinus and surrounding structures between dolichocephalic and hyperbrachycephalic skull types using computed tomography (CT). Material and Methods: CT images of dolichocephalic (n = 50), hyperbrachycephalic (n = 64), and mesocephalic (n = 52) individuals were used in the study. Sphenoid sinus position, dimensions, septum types, and protrusion and dehiscence for the carotid canal and optic canal, maxillary, and vidian nerves were evaluated. For statistical evaluation, the Mann-Whitney U-test, Kruskal-Wallis test, Pearson chi-square, Fisher's exact test, and Spearman's rho correlation were used in the study. Results The difference between all skull types was found to be significant in the rates of protrusion and dehiscence in the carotid canal and the maxillary nerve and the difference between sphenoid sinus heights in two different skull types (dolichocephalic and hyperbrachycephalic) was also significant (P < 0.05). In septum typing, seven different septum types were detected. The most common sphenoid sinus position was postsellar in all skull types. Conclusion: Differences in the frequency of protrusion and dehiscence for the carotid canal and maxillary nerve in dolichocephalic, hyperbrachycephalic, and mesocephalic individuals reveal that the skull types of individuals are important in studies on the sphenoid sinus
Myotonic dystrophy type 1 and oxidative imbalance: evaluation of ischemia-modified albumin and oxidant stress
No full textObjectives: Oxidative stress occurs when free radicals accumulate at high levels in the body, affecting biological molecules. Some studies have focused on the multisystemic involvement, signs of premature aging, and the potential role of oxidative stress in the pathogenesis of myotonic dystrophy type 1 (DM1). We aimed to evaluate the levels of oxidative stress markers in patients diagnosed with DM1. Methods: In a cross-sectional study, 27 clinically and genetically confirmed DM1 patients and 34 healthy individuals matched for age and gender were included. Oxidative stress markers, including ischemia-modified albumin (IMA), total antioxidant status (TAS), total oxidant status (TOS) levels, ischemia-modified albumin to albumin ratio (IMAR), and oxidative stress index (OSI) were examined. Results: TOS (p=0.001), IMA levels (p=0.001), IMAR (p=0.004), and OSI (p<0.001) in the patient group were significantly higher than in the healthy group, while TAS (p<0.001) was lower in the patient group. Conclusions: The elevation of oxidative stress markers suggests the potential effect on the pathogenesis of DM1. Thus, antioxidant therapy approaches could be crucial to reducing oxidative stress in patients with DM1
Efficient Solution Algorithms for Resource Planning and Scheduling in Seasonal Reservation Systems
No full textPurpose: In this study, efficient solution algorithms are proposed for a problem which simultaneously optimizes capacity planning and scheduling decisions in reservation systems. The problem is especially important for systems involving appointments/reservations, such as hotel or seat reservations in tourism, operation and treatment reservations in healthcare systems, or port logistics operations. Methodology: The optimization problem studied involves concurrent decisions of scheduling and dynamic capacity determination, with an objective of maximizing the net return gained from the served appointments. A randomized constructive heuristic exploiting problem’s structural characteristics is proposed together with effective improvement procedures. Extensive computational experimentation is conducted in order to test algorithm performance. Findings: The developed approach performs excellently in both solution quality and time. With up to 200 reservations, the heuristic technique outperforms CPLEX in terms of solution time and quality. The algorithm's performance remains unchanged as the size of the problem increases. Originality: This study presents the first heuristic approach to solving this significant problem. Through optimization of resource utilization and scheduling, substantial positive social and economic impact on a number of business sectors can be obtained. The efficient problem-solving techniques developed will pave the way for future research
Evaluation of tear film function and ocular surface disease index in patients with unilateral pseudoexfoliation syndrome
No full textBackground: To evaluate tear film function and ocular surface symptoms in unilateral pseudoexfoliation syndrome (PEX) and explore associations between pseudoexfoliative material, tear instability, and ocular surface disease index (OSDI) scores. Methods: Sixty-seven unilateral PEX patients and 72 matched healthy controls were enrolled. Tear break-up time (TBUT), non-invasive TBUT (NIBUT), basal Schirmer test (BST), and OSDI questionnaire were assessed in PEX-affected eyes (Group 1), fellow eyes (Group 2), and controls (Group 3). Statistical comparisons were performed using paired and independent t-tests or their non-parametric equivalents, and Chi-square analysis for OSDI categories. Results: Mean TBUT was 7.93 ± 2.9 s (G1), 8.93 ± 2.8 s (G2), and 10.04 ± 2.05 s (G3), with G1 and G2 significantly lower than G3 (p 0.05). Severe OSDI symptoms occurred in 22.4% of PEX eyes vs. 7.5% of controls, with a significant overall difference in severity distribution (p = 0.049). Conclusions: Tear film stability and quantity are reduced in unilateral PEX, affecting even clinically unaffected eyes. The higher prevalence of severe ocular surface symptoms underscores the need for routine ocular surface assessment and early intervention in this population. © 2025 Elsevier B.V., All rights reserved
Levy flight-assisted hybrid Sine-Cosine Aquila optimizer for solving chemical equilibrium problems through the Gibbs free energy minimization technique
No full textThis research proposes a novel hybrid metaheuristic optimization framework that combines the Aquila Optimization algorithm with the Sine-Cosine Optimizer to find equilibrium points of reacting components under specified operational reaction conditions. The method aims to address the exploitative limitations of the standard Aquila algorithm by incorporating oscillatory sine-cosine movements into the hybrid optimizer, which is one of the significant drawbacks of the base Aquila algorithm that should be addressed. The effectiveness of the hybrid approach is thoroughly tested on a suite of 100 multidimensional unimodal and multimodal benchmark cases, with results compared to those from well-known literature optimizers. Additionally, twenty-eight 30-dimensional benchmark functions from the 2013 Congress on Evolutionary Computation competition are used to evaluate the prediction performance. Three multidimensional constrained engineering design problems are also solved, and their results are compared with those from other literature optimizers. The findings show that the hybrid algorithm produces the best estimates and ranks first among competing algorithms based on average ranking results. To further verify its robustness and accuracy, three more complex chemical equilibrium problems are solved using the Gibbs Free Energy minimization method. The predictions are benchmarked against recent metaheuristic algorithms for each case, demonstrating that the proposed hybrid effectively overcomes the challenges of highly nonlinear and non-convex free energy surfaces, achieving higher solution consistency while finding minimum objective function values across different chemical equilibrium scenarios. © 2025 Elsevier B.V., All rights reserved.Engineering and Physical Sciences Research Council, EPSR
Constraints on the Higgs boson self-coupling from the combination of single and double Higgs boson production in proton-proton collisions at ?s=13 TeV
No full textThe Higgs boson (H) trilinear self-coupling, lambda(3), is constrained via its measured properties and limits on the HH pair production using the proton-proton collision data collected by the CMS experiment at root s = 13 TeV. The combination of event categories enriched in single-H and HH events is used to measure k(lambda), defined as the value of lambda(3) normalized to its standard model prediction, while simultaneously constraining the Higgs boson couplings to fermions and vector bosons. Values of k(lambda) outside the interval -1.2 < k(lambda) < 7.5 are excluded at 2 sigma confidence level, which is compatible with the expected range of -2.0< k(lambda) < 7.7 under the assumption that all other Higgs boson couplings are equal to their standard model predicted values. Relaxing the assumption on the Higgs couplings to fermions and vector bosons the observed (expected) k(lambda) interval is constrained to be within -1.4 < k(lambda) < 7.8 (-2.3 < k(lambda) < 7.8) at 2 sigma confidence level.FWF; FNRS; FWO (Belgium) [30820817]; CNPq; CAPES; FAPERJ; FAPERGS; FAPESP (Brazil); BNSF (Bulgaria); MoST; NSFC (China); CSF (Croatia); RIF (Cyprus); SENESCYT (Ecuador); ERC PRG [MoER TK202]; Academy of Finland; MEC; CEA; CNRS/IN2P3 (France); SRNSF; BMBF; DFG; HGF (Germany); NKFIH (Hungary); DAE; DST; IPM; SFI (Ireland); INFN (Italy); NRF (Republic of Korea); MES (Latvia); MOE; UM (Malaysia); BUAP; CONACYT; UASLP-FAI (Mexico); PAEC (Pakistan); FCT (Portugal); MESTD (Serbia); PCTI (Spain); MOSTR (Sri Lanka); Swiss Funding Agencies (Switzerland); NSTDA; TUBITAK; DOE; NSF (USA); Marie-Curie program; European Research Council; Horizon 2020 Grant [675440, 724704, 752730, 758316, 765710, 824093, 101115353, 101002207]; COST Action [CA16108]; Leventis Foundation; Alfred P. Sloan Foundation; Alexander von Humboldt Foundation; Science Committee [22rl-037]; Belgian Federal Science Policy Office; Fonds pour la Formation a la Recherche dans l'Industrie et dans l'Agriculture (FRIABelgium); Agentschap voor Innovatie door Wetenschap en Technologie (IWT-Belgium); Beijing Municipal Science AMP; Technology Commission [Z191100007219010]; Fundamental Research Funds for the Central Universities (China); Ministry of Education, Youth and Sports (MEYS) of the Czech Republic; Shota Rustaveli National Science Foundation [FR22985]; Deutsche Forschungsgemeinschaft (DFG) [EXC 2121, 390833306, 400140256 - GRK2497]; Hellenic Foundation for Research and Innovation (HFRI) [2288]; Hungarian Academy of Sciences [K 131991, K 133046, K 138136, K 143460, K 143477, K 146913, K 146914, K 147048, 2020-2.2.1-ED-2021-00181, TKP2021-NKTA-64]; Council of Science and Industrial Research, India - NextGenerationEU program (Italy); Latvian Council of Science; Ministry of Education and Science [2022/WK/14]; National Science Center [Opus 2021/41/B/ST2/01369, 2021/43/B/ST2/01552]; Fundacao para a Ciencia e a Tecnologia [CEECIND/01334/2018]; National Priorities Research Program by Qatar National Research Fund; ERDF a way of making Europe [MDM-2017-0765]; Programa Severo Ochoa del Principado de Asturias (Spain); National Science, Research and Innovation Fund via the Program Management Unit for Human Resources AMP; Institutional Development, Research and Innovation [B37G660013]; Kavli Foundation; Nvidia Corporation; SuperMicro Corporation; Welch Foundation [C-1845]; Weston Havens Foundation (USA)We congratulate our colleagues in the CERN accelerator departments for the excellent performance of the LHC and thank the technical and administrative staffs at CERN and at other CMS institutes for their contributions to the success of the CMS effort. In addition, we gratefully acknowledge the computing centers and personnel of the Worldwide LHC Computing Grid and other centers for delivering so effectively the computing infrastructure essential to our analyses. Finally, we acknowledge the enduring support for the construction and operation of the LHC, the CMS detector, and the supporting computing infrastructure provided by the following funding agencies: SC (Armenia), BMBWF and FWF (Austria); FNRS and FWO (Belgium); CNPq, CAPES, FAPERJ, FAPERGS, and FAPESP (Brazil); MES and BNSF (Bulgaria); CERN; CAS, MoST, and NSFC (China); MINCIENCIAS (Colombia); MSES and CSF (Croatia); RIF (Cyprus); SENESCYT (Ecuador); ERC PRG, RVTT3 and MoER TK202 (Estonia); Academy of Finland, MEC, and HIP (Finland); CEA and CNRS/IN2P3 (France); SRNSF (Georgia); BMBF, DFG, and HGF (Germany); GSRI (Greece); NKFIH (Hungary); DAE and DST (India); IPM (Iran); SFI (Ireland); INFN (Italy); MSIP and NRF (Republic of Korea); MES (Latvia); LMTLT (Lithuania); MOE and UM (Malaysia); BUAP, CINVESTAV, CONACYT, LNS, SEP, and UASLP-FAI (Mexico); MOS (Montenegro); MBIE (New Zealand); PAEC (Pakistan); MES and NSC (Poland); FCT (Portugal); MESTD (Serbia); MCIN/AEI and PCTI (Spain); MOSTR (Sri Lanka); Swiss Funding Agencies (Switzerland); MST (Taipei); MHESI and NSTDA (Thailand); TUBITAK and TENMAK (Turkey); NASU (Ukraine); STFC (United Kingdom); DOE and NSF (USA). Individuals have received support from the Marie-Curie program and the European Research Council and Horizon 2020 Grant, contract Nos. 675440, 724704, 752730, 758316, 765710, 824093, 101115353, 101002207, and COST Action CA16108 (European Union); the Leventis Foundation; The Alfred P. Sloan Foundation; the Alexander von Humboldt Foundation; the Science Committee, project no. 22rl-037 (Armenia); the Belgian Federal Science Policy Office; the Fonds pour la Formation a la Recherche dans l'Industrie et dans l'Agriculture (FRIABelgium); the Agentschap voor Innovatie door Wetenschap en Technologie (IWT-Belgium); the F.R.S.-FNRS and FWO (Belgium) under the Excellence of Science --EOS'' --be.h project n. 30820817; the Beijing Municipal Science & Technology Commission, No. Z191100007219010 and Fundamental Research Funds for the Central Universities (China); The Ministry of Education, Youth and Sports (MEYS) of the Czech Republic; the Shota Rustaveli National Science Foundation, grant FR22985 (Georgia); the Deutsche Forschungsgemeinschaft (DFG), under Germany's Excellence Strategy - EXC 2121 Quantum Universe'' - 390833306, and under project number 400140256 - GRK2497; the Hellenic Foundation for Research and Innovation (HFRI), Project Number 2288 (Greece); the Hungarian Academy of Sciences, the New National Excellence Program - UNKP, the NKFIH research grants K 131991, K 133046, K 138136, K 143460, K 143477, K 146913, K 146914, K 147048, 2020-2.2.1-ED-2021-00181, and TKP2021-NKTA-64 (Hungary); the Council of Science and Industrial Research, India; ICSC - National Research Center for High Performance Computing, Big Data and Quantum Computing and FAIR - Future Artficial Intelligence Research, funded by the NextGenerationEU program (Italy); the Latvian Council of Science; the Ministry of Education and Science, project no. r 2022/WK/14, and the National Science Center, contracts Opus 2021/41/B/ST2/01369 and 2021/43/B/ST2/01552 (Poland); the Fundacao para a Ciencia e a Tecnologia, grant CEECIND/01334/2018 (Portugal); the National Priorities Research Program by Qatar National Research Fund; MCIN/AEI/10.13039/501100011033, ERDF a way of making Europe, and the Programa Estatal de Fomento de la Investigacion Cientfica y Tecnica de Excelencia Maria de Maeztu, grant MDM-2017-0765 and Programa Severo Ochoa del Principado de Asturias (Spain); the Chulalongkorn Academic into Its 2nd Century Project Advancement Project, and the National Science, Research and Innovation Fund via the Program Management Unit for Human Resources & Institutional Development, Research and Innovation, grant B37G660013 (Thailand); the Kavli Foundation; the Nvidia Corporation; the SuperMicro Corporation; the Welch Foundation, contract C-1845; and the Weston Havens Foundation (USA)
Evaluation of Asthma Knowledge Level of Patients Over 11 Years of Age with Asthma Diagnosis
No full textIntroduction: Asthma is the most common respiratory disorder in children. Knowledge about asthma helps in achieving asthma control. Self-management of the disease includes adherence to medication, avoidance of trigger factors, and appropriate response to symptoms Education about asthma is essential to improve the health and reduce the negative impact on daily life. Materials and Methods: In this study, 62 patients aged 14.04 +/- 2.25 years, who had been followed up for at least 6 months at Dokuz Eyl & uuml;l University Pediatric Allergy and Immunology outpatient clinic, were included. A modified Asthma Self-Management Knowledge Questionnaire with 25 true or false questions was administered. Results: The results of the study included the mean asthma control score of the patients to be 20.08 +/- 4.50. Minimum and maximum score patients achieved on the questionnaire were 9 and 23 points, respectively. The effect of general asthma knowledge, asthma medication knowledge, and environmental factors knowledge on asthma control were found to be statistically significant. On the other hand, asthma exacerbation knowledge was not statistically significant. The findings of this study reveal that knowledge of environmental factors is the most influential factor on asthma control, whereas, the second most effective variable was the asthma medication knowledge. Conclusion: Hence, asthma education programs must be tailored specifically to this age group, so that they can self-manage properly, avoid exposure to triggering factors appropriately, and hopefully live symptom free