Scopus İndeksli Açık & Kapalı Erişimli Yayınlar

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Admission Tpe interval predicts reperfusion success in STEMI patients treated with fibrinolytic agents
(2020) Coner, Ali; Akinci, Sinan; Akkucuk, Mehmet Husamettin; Altin, Cihan; Muderrisoglu, Haldun; 0000-0002-9635-6313; 0000-0003-4569-1143; 0000-0001-5250-5404; 31974326; AAG-8233-2020; AAJ-2828-2021; AAD-5564-2021
Objective: Myocardial infarction is a leading cause of morbidity and mortality. Fibrinolytic administration is still a life-saving choice in ST-segment elevated myocardial infarction (STEMI), but the rate of successful reperfusion can be inconsistent. Failed reperfusion adds additional clinical risks to rescue percutaneous coronary intervention for STEMI patients. The interval between the peak of the T wave and the end of the T wave (Tpe) and the ratio of Tpe and a corrected measurement of the time from the start of the Q wave to the end of the T wave (Tpe/QTc ratio) are relatively new electrocardiogram (ECG) indices and have not yet been tested in STEMI patients treated with fibrinolytic agents. Methods: A total of 177 STEMI patients (mean age: 60.5 +/- 11.1 years; 138 men and 39 women) were enrolled in this retrospective study to evaluate ECG parameters. The Tpe interval and the Tpe/QTc ratio at baseline and at the 90th minute following the administration of fibrinolytic therapy were analyzed. The clinical and ECG findings of successful and failed reperfusion groups were compared. Results: Successful reperfusion was achieved in 119 patients (67.2%). The average Tpe interval on the admission ECG was shorter (91.7 vs. 100.9 milliseconds [ms]) (p<0.001) and shortened more in the successful reperfusion group (9.3 vs. 4.5 ms) (p<0.001). A cut-off value of 89.0 ms for the Tpe interval on the admission ECG was found to be related to reperfusion success with a sensitivity of 90.9%. Conclusion: The Tpe interval was a predictor for reperfusion success in STEMI patients treated with fibrinolytic agents.
Adrenergic receptor behaviors of mesenchymal stem cells obtained from different tissue sources and the effect of the receptor blockade on differentiation
(2021) Maytalman, Erkan; Alizadeh Yegani, Arash; Kozanoglu, Ilknur; Aksu, Fazilet; 0000-0002-5268-1210; 34323168; AAE-1241-2021
In this study, it was aimed to analyze behavioral changes of adrenergic receptors (ARs) in first three passages and osteogenic/adipogenic differentiation of mesenchymal stem cells (MSCs) derived from placenta fetal membrane (FM) and bone marrow (BM). It was also aimed to evaluate effects of receptor blockade on differentiation. We obtained first three passages of MSCs from placenta and BM samples. For cell identification, the cells were analyzed by flow cytometry using CD34, CD45 and CD3, CD105 antibodies in each passage. The effects of propranolol and phenoxybenzamine at incremental doses were analyzed by MTT. In addition, cell cultures were separately maintained with the blockers or without after second passage. After each passage and differentiation, alpha 1A, alpha 1B, alpha 2A, alpha 2B, beta 1, beta 2, beta 3 AR-mRNA expressions analyzed by RT-qPCR technique. BMP6 and PPARG mRNA expressions only after differentiation and passage 3 were analyzed. A microscopic examination was also performed. Our results showed that AR expression behaviors were different in MSCs obtained from different tissue sources. In particular, alpha(1A)-AR and alpha(2A)-AR were expressed with considerably high coefficients in differentiation under blocker effect in BM-derived MSCs. No such coefficients were observed in any group of placental MSCs. In addition, it was found that the blockers stimulated adipogenesis in BM-derived MSCs during osteogenic differentiation. MSCs exhibit protein expressions that vary according to source of tissue and differentiation. Given that MSCs from different sources are used for repair and modulation, our study makes implications of this variable expression intriguing in the clinical practice.
Age-And Sex-Related Changes In Selected Hematological Parameters, Lipid Peroxidation And Erythrocytes Osmotic Fragility Of Turkish Angora Cats
(2022) Kabakci, R.; Yigit, A. A.; Kara, E.; Cinar, M.; Ekici, H.; Aluc, Y.
This study was conducted to investigate the changes in selected hematological parameters, lipid peroxidation and osmotic fragility of erythrocytes in Angora cats depending on age and gender. For this purpose, the blood samples were collected from vena saphena medialis of 9 young and 14 adult cats which were also classified as male (n=12) and female (n=11). Following hematological analysis, samples were washed with PBS by centrifugation and 10% hematocrit suspension was prepared from the erythrocytes pellet for the osmotic fragility test. The concentration of malondialdehyde (MDA) was also measured from lysed erythrocytes to determine lipid peroxidation level. Red blood cells (RBCs), hemoglobin, and hematocrit were significantly (P<0.001) high in adults while the mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were significantly (P<0.05) high in young cats. Erythrocyte MDA level was also higher statistically (P<0.05) in adult cats than in young cats. There was no significance (P>0.05) in these parameters between male and female cats. Findings of fragility tests showed that erythrocytes of young and male cats were statistically more susceptible to hypotonic NaCl solutions than those of adult and female cats, respectively (P<0.01, P<0.05). It was concluded that erythrocytes related parameters in Angora cats changed depending on age rather than gender except for stability of RBCs.
Airfoil-slat arrangement model design for wind turbines in fuzzy environment
(2020) Atalay, Kumru Didem; Dengiz, Berna; Yavuz, Tahir; Koc, Emre; Ic, Yusuf Tansel
In this study, a multi-element wind turbine blade that consists of NACA 6411 and NACA 4412 leading-edge slat design is investigated computationally. Optimum design parameters of the slatted wind turbine blade leading to maximum value of C-L/C-D related to the turbine power are obtained. In the optimization process, a new fuzzy logic linear programming methodology integrating with fuzzy linear regression and 2D CFD analysis is proposed. The aerodynamic characteristics of the slatted blade are computed by using Incompressible Navier-Stokes equations and k-omega turbulence modeling. Results are compared with the results of linear programming method and direct search optimization method. The computational results reveal that the proposed methodology for performance optimization is more effective than other methods to obtain high-performance value of the C-L/C-D. The maximum value of the C-L/C-D is obtained as 25.1 leading the maximum efficiency of 0.52.
Alcohol- and Cigarette-Use-Related Behaviors Across Gender, Dysfunctional COVID-19 Anxiety, and the Presence of Probable ADHD During the Pandemic: A Cross-Sectional Study in a Sample of Turkish Young Adults
(2021) Evren, Cuneyt; Evren, Bilge; Dalbudak, Ercan; Topcu, Merve; Kutlu, Nilay
Objective: The objective of the study is to evaluate the alcohol-and cigarette-use-related behaviors among young adults during the COVID-19 pandemic restrictions in Turkey. The second objective was to evaluate whether the gender, dysfunctional COVID-19 anxiety, and presence of probable attention-deficit/hyperactivity disorder (ADHD) are associated with the increase in alcohol consumption and cigarette smoking while controlling the effects of current age and diagnosis of anxiety disorder before the COVID-19 pandemic. Method: The study was conducted with an online survey among volunteer participants of young adults. The Adult ADHD Self Report Scale (ASRS-v1.1) and the Coronavirus Anxiety Scale (CAS) were used to evaluate a group of university students. Results: A total of 1,042 respondents (mean age 26.9 +/- 10.9 years; 61.6% female) filled out the survey. Of these, 17.6% reported an increase and 7.7% reported reduced cigarette smoking, whereas 10.8% reported an increase and 8.5% reported reduced alcohol consumption during the pandemic. Both rates of increased cigarette smoking and alcohol consumption were higher among males and those with probable ADHD. In the logistic regression analyses, male gender, COVID-19 related dysfunctional anxiety, and presence of probable ADHD were related to the increase in alcohol consumption and cigarette smoking, while the current age and diagnosis of anxiety disorder before the COVID-19 pandemic were not. Conclusion: Findings of the current study may suggest that the pandemic period is related to both anv increase and a reduction of alcohol consumption and cigarette smoking. Males with probable ADHD and higher levels of COVID-19 related dysfunctional anxiety have a higher risk of increasing both alcohol consumption and cigarette smoking.
All the Dark Triad and some of the Big Five traits are visible in the face
(2021) Alper, Sinan; Bayrak, Fatih; Yilmaz, Onurcan; 0000-0001-6350-6234
Some of the recent studies suggested that people can make accurate inferences about the level of the Big Five and the Dark Triad personality traits in strangers by only looking at their faces. However, later findings provided only partial support and the evidence is mixed regarding which traits can be accurately inferred from faces. In the current research, to provide further evidence on whether the Big Five and the Dark Triad traits are visible in the face, we report three studies, two of which were preregistered, conducted on both WEIRD (the US American) and non-WEIRD (Turkish) samples (N = 880). The participants in both the US American and Turkish samples were successful in predicting all Dark Triad personality traits by looking at a stranger's face. However, there were mixed results regarding the Big Five traits. An aggregate analysis of the combined dataset demonstrated that extraversion (only female), agreeableness, and conscientiousness were accurately inferred by the participants in addition to the Dark Triad traits. Overall, the results suggest that inferring personality from faces without any concrete source of information might be an evolutionarily adaptive trait.
An Alternative Low-Cost Solution for Tracking Laboratory Animals
(2020) Kiziltan, Erhan; Aydin, Leyla; 0000-0001-6029-3835; AAD-6090-2021
Objectives: Monitoring animal behavior under various conditions can provide important information on their neuropsychological status, including learning, memory, and cognitive activity. Several commercial tracking systems are available, but they may be too expensive for low-budget projects. This study developed an alternative solution for automated animal tracking in behavioral experiments. Methods: The proposed system was designed to analyze a set of images sampled from a recorded video file in chronological order. The instantaneous location of the animal in each image frame was defined automatically, using a feature-extraction algorithm. Distances traveled were calculated using the coordinates of the successive instantaneous locations. The algorithm was tested using two arenas: the Morris water maze and open field test. The calculated measures were compared with those obtained manually. The internal consistency of the dataset was checked using Cronbach's alpha. The accuracy of the results was evaluated using the paired samples t-test and Pearson correlation, with the level of statistical significance set at p<0.01. Results: A statistical comparison of the distances traveled, which were derived from the coordinates of successive locations, did not differ significantly between the manual and automatic methods (r=0.954 and p=0.792 for the Morris water maze; r=0.996 and p=0.024 for the open field test). Conclusions: These results suggest that the algorithm is reliable and valid for estimating coordinates and may serve as a high-resolution tool for animal behavior experiments. We intend to make this software freely available to interested readers and to open feedback channels for further development.
Anaesthetic Management of a Patient with Brugada Syndrome in Total Knee Arthroplasty
(2021) Tuncali, Bahattin; Kokten, Gizem; Alun, Cihan; 0000-0002-7898-2943; 33718910; AAJ-7840-2021
We report the case of a 52-year-old female diagnosed with Brugada syndrome (BrS) scheduled to undergo right total knee arthroplasty. General anaesthesia was induced and maintained with thiopental intravenous sodium + remifentanil and sevoflurane + remifentanil infusion, respectively. Rocuronium bromide was used as the muscle relaxant. The defibrillator was ready for use with the electrodes on the patient. Sugammadex was used for muscle relaxant antagonization. Postoperative analgesia was provided by intermittent morphine HCL via an epidural catheter, intravenous patient-controlled analgesia (Meperidine), and intravenous tenoxicam. The patient was discharged on the 6th day without any problem. Anaesthetic management of patients with BrS is challenging for anaesthesiologists, because fatal cardiac arrhythmias can be triggered by many drugs commonly used in the perioperative period such as bupivacaine, lidocaine, neostigmine, propofol, succinylcholine, ketamine, and tramadol. In these cases, a detailed preoperative evaluation including family history, avoidance of drugs triggering arrhythmia, taking precautions against arrhythmia, and using the agents that are reported to be safe are essential for patient safety.
Analysis of 3-hydroxyisovaleric acid and 3-hydroxybutyric acid in plasma samples by LC-MS/MS
(2022) Recber, Tuba; Ozkan, Ece; Nemutlu, Emirhan; Beksac, Mehmet Sinan; Kir, Sedef
Down syndrome is a common genetic disorder that results from the presence of an extra chromosome in the 21st chromosome pair of humans. Metabolomics is an alternative method in discovery of new biomarkers for the screening and diagnosis of Down syndrome. In this study, quantitative analyzes of 3-hydroxybutyric acid and 3hydroxyisovaleric acid, selected as possible markers for prenatal diagnosis of Down syndrome were performed. LCMS/MS analyzes were performed on a Phenomenex Luna NH2(100 x 4.6 mm, 3 mu m) column using a mobile phase mixture of 0.1% formic acid and acetonitrile containing 0.1% formic acid at a flow rate of 0.35 mL/minute. The MRM transitions were 103.0 -> 59.0 for 3-hydroxybutyric acid and 117.1 -> 59.0 for 3-hydroxyisovaleric acid. Under these conditions, the retention times of 3-hydroxyisovaleric acid 3-hydroxybutyric acid were 2.7 and 3.1 minute, respectively. The method was found linear from 0.1 to 10.0 mu g/mL for both metabolites. The limit of detection (LOD) was 0.017 mu g/mL for 3-hydroxybutyric acid and 0.003 mu g/mL for 3-hydroxyisovaleric acid. The lower limit quantification (LLOQ) was 0.045 mu g/mL for 3-hydroxybutyric acid and 0.008 mu g/mL for 3-hydroxyisovaleric acid. The method has been proven to be selective, precise, accurate, sensitive, and robust based on the validation studies results. Finally, the method was applied to plasma samples of the pregnant women with healthy fetus (n = 30) and with Down syndrome fetus (n = 17). As a result of the analysis, a statistically significant increase (p <0.01) was observed in the 3-hydroxybutyric acid level of the group with Down syndrome compared to the healthy group. This result strengthens the use of 3-hydroxybutyric acid as an important biomarker in the prenatal screening/diagnosis of Down syndrome.
Analysis Of Gingival Display During Static And Dynamic Smiles In A Turkish Sample: A Clinical Study
(2022) Arifagaoglu, Ozge; Yilmaz, Umran; 35478707
Purpose The aim of this study is to determine the prevalence of smile types in spontaneous smiles among a Turkish population aged 18-23 and to compare it with the prevalence of static smiles. Materials and Methods This study was carried out with 150 undergraduate students at Baskent University Faculty of Dentistry (75 females, 75 males). For this purpose, photo recordings for static smiles and 20-second video recordings for dynamic smiles were taken 40 cm from the participant's nose. Measurements were made with an electronic ruler. Results High smile line was found to be the highest prevalence in both static and dynamic smiles (p<0.001). The average soft tissue display is higher in dynamic smiles (p<0.05). In both static and dynamic smiles, the average amount of gingival display was higher in females than in males (p<0.05). Conclusion When the smile line was evaluated on the photograph recordings while the patient was posing, it was found to be lower than the natural spontaneous smile line obtained from the video recordings. Since the gingival display increases when patients smile naturally instead of posing, clinical evaluations and restorative considerations should be planned according to the dynamic smile.
Analysis of Probiotic Bacteria Genomes: Comparison of CRISPR/Cas Systems and Spacer Acquisition Diversity
(2021) Ilikkan, Ozge Kahraman; 0000-0001-5843-6868; 35068602; Q-9641-2019
Clustered regularly interspaced short palindromic repeats (CRISPR) and CRISPR-associated (Cas) genes constitute an adaptive (acquired) defense system of bacteria and archaea. Here 72 probiotic bacteria genomes were investigated in terms of the presence of CRISPR/Cas systems and phage/plasmid invaders through spacer analysis. 49 CRISPR/Cas systems were detected within probiotic strains, namely,17 type II-A, 10 type I-C, 8 type I-E, 5 Type I-U (I-G), 4 type III-A, 2 type I-B, 1 type I-A, 1 type IV-B, and 1 type II-C. The predicted target of spacers was determined in 25 strains and consequently, three different spacer and target patterns were revealed. The diversity of CRISPR spacers provides insight and understanding to determine strain-specific invaders of probiotic bacteria as well as their relationships between strains. CRISPR systems were clarified in many studies for genomic characterization. However, recently, endogenous genome editing with CRISPR has provided an approach for various genome editing projects. Thus, in the future, producing strain-specific phage-resistant starter cultures or probiotics by endogenous genome editing methods according to phage/plasmid survey can be utilized for industrial and pharmaceutical applications. Therefore, this study intended a comprehensive investigation of CRISPR systems of probiotic bacteria.
Analysis of Quality of Life, Depression, and Sexual Function in Patients on the Liver Transplant List
(2021) Fidan, Cihan; Akdur, Aydincan; Kirnap, Mahir; Selcuk, Haldun; Yildirim, Sedat; Moray, Gokhan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-8726-3369; 34609310; AAJ-8097-2021; AAA-3068-2021
Background: I he only treatment in patients developing liver failure is liver transplantation. According to the Ministry of Health, the number of patients waiting for a liver transplantation is 2141, the average waiting period for liver transplantation is approximately 5 years, and 15-18% of these patients lose their life while waiting for transplantation. In these patients, limitations in daily activities and depression-anxiety are commonly found. The aim of this study was to analyze life quality, depression symptoms, and existence of sexual functional disorders of patients waiting for liver transplantation. Methods: A total of 74 patients, who were registered in Baskent University Hospital between 2015 and 2018, were included into the study. Short Form-36, Beck Depression Inventory, and Arizona Sexual Experiences Scale were applied to 56 patients who approved study. Results: Most of the patients were male (64.3%), and the mean age was 46 (18-64). Short Form-36 scores were low in all patients. The mean Beck Depression Inventory score of patients was found as 18.4 +/- 11.3, and they were suffering from moderate depressive symptoms. According to Arizona Sexual Experiences Scale, total mean scores of males was found as 16.3 +/- 5.5, and for females, it was 19.5 +/- 5.3 with a statistically significant difference (P < .05). It was found that sexual dysfunction mostly had moderate to mild. Conclusion: Depression and sexual dysfunction are common in patients with chronic liver diseases, and their life qualities deteriorate significantly. It is anticipated that evaluation of these patients in terms of psychological issues and sexual dysfunction will increase their quality of life during the organ waiting period and affect their well-being post-transplant.
Analysis of Risk Factors for Rectus Sheath Hematoma
(2021) Erkent, Murathan; Topcu, Ramazan; Ozkan, Murat Bulut; Yildirim, Murat Baki; Aslan, Orhan; Sezikli, Ismail; 0000-0002-3592-5092; 34102772; CAA-2756-2022
Analysis of the effect of the number of criteria and alternatives on the ranking results in applications of the multi criteria decision making approaches in machining center selection problems
(2020) Ic, Yusuf Tansel; Yurdakul, Mustafa
Multi criteria machining center selection models are widely used in the literature. In the applications of multi-criteria decision making models, machining center selection criteria are directly taken from catalogues. It is known that to have a ranking model sensitive to the weights of the selection criteria, it is especially important to limit the number of selection criteria to 7 +/- 2. A similar proposal can be put forward for the number of machining centers. In this study, whether or not reducing the number of criteria and alternative machining centers make the ranking results more sensitive to the changes in the criteria weights is studied using Spearman's rank correlation test. The study results show that the ranking results become more sensitive with a reduced number of criteria and alternative machining centers.
Analysis of the IR-Raman Modes and the Heat Capacity Near the alpha-Inc-beta Transitions in Quartz
(2021) Yurtseven, H.; Gunay, E.; Karacali, H.; Ates, S.
This study gives our analysis for the temperature dependence of the infrared frequency and the integrated intensity of the 695 cm(-1) mode near the alpha-beta transition at 847.5 K and the temperature dependence of the Raman scattering cross section of the 355 cm(-1) mode near the beta-INC (incommensurate) transition which occurs within a small temperature (similar to 1.3 K) interval in relation to the order parameter in quartz. Both analyses are performed according to a power-law formula for the order parameter Q with the critical index beta using the experimental data from the literature. We also analyze the temperature dependence of the heat capacity C p according to the renormalization-group expression including first-order corrections to scaling term close to the alpha-INC-beta transitions in quartz by using the literature data. From our analyses, values of the critical exponent beta for the frequency and the integrated intensity of the 695 cm(-1) infrared mode and for the Raman scattering cross section of the 355 cm(-1) mode as a measure of the order parameter, are extracted. From the analysis of C p , the values of the critical exponent alpha are also extracted. Additionally, by means of scaling relations the critical exponent gamma of the isothermal compressibility kappa T and the renormalized components ( beta R , alpha R and gamma R ) are predicted for the alpha-INC-beta transitions in quartz. Our analyses given here indicate that weakly first-order transition occurs from the alpha phase to the incommensurate (INC) phase, which changes to the nearly second-order transition to the beta phase with increasing temperature in quartz, as also observed experimentally.
Analysis of the manufacturing flexibility parameters with effective performance metrics: a new interactive approach based on modified TOPSIS-Taguchi method
(2022) Ic, Yusuf Tansel; Sasmaz, Turgut; Yurdakul, Mustafa; Dengiz, Berna; 0000-0001-9274-7467; AGE-3003-2022
Flexibility is one of the most important strategy parameters to achieve a long-term successful performance for a manufacturing company. Studies in the literature aim to operate a manufacturing system at optimum levels of flexibility parameters under its own manufacturing environment. This study aims to present an interactive analysis framework based on TOPSIS and Taguchi parameter design principles for investigating the effects of different levels of flexibility parameters on the performance of a flexible manufacturing cell (FMC). The main performance metric used in this study is manufacturing lead time. Other important metrics to evaluate quality control and inspection policies are also investigated in this study. To conclude, a combined model of an interactive approach based on TOPSIS and Taguchi methods are used to assess the effectiveness of the flexibility parameters for a FMC.
Analysis of The Performance of A Solar Air Heater With Different Configurations: Effect of Fins And Turbulators
(2022) Erol, Ozgur
Solar air heaters are simple tools used to harvest the energy of the sun. The main objective of the solar air heater design is to get the highest thermal energy from the sun. In order to do this different kinds of fins and turbulators are placed in the flow channel of the solar air heater, which also affects the flow characteristic of the working fluid. In this study, the performance of two different configurations, a turbulator placed at the bottom of the channel and a longitudinal rectangular fin placed on the absorber plate, are investigated using different performance parameters. These parameters are the thermal efficiency, rational exergy management method (REMM) efficiency, flow work, and the temperature distribution on the absorber plate. According to the results, both of the test cases have nearly the same performance, which is higher than the flat solar air except the flow work. When the heat gain per unit flow work is investigated, it can be said that turbulator configuration is the best choice among the configurations that are investigated.
Analysis of the relationship between tuberculosis-related mortality and nitrous oxide emission levels in the world with the environmental Kuznets curve method
(2022) Torun, Serife; Yilmaz, Kadir; Ozkaya, Sevket; Yosunkaya, Sebnem; Akcay, Sule; 36326361
Background/aim: It was aimed to analyze the relationship between tuberculosis-related mortality and nitrous oxide emission levels in the world with the Environmental Kuznets Curve (EKC) Method. Materials and methods: WHO ICD-10 mortality list data and the World Bank Country Data (WBCD) were used between 1997 and 2017 for 12 countries. Cubic regression analysis was used for EKC Analysis. Results: The difference between male and female deaths between 1996 and 1998 has increased sharply since 1999. Male deaths consistently occurred significantly more than female deaths. There was a significant and negative correlation between Nitrous oxide emissions (% change from 1990) and tuberculosis-related deaths, whereas there were significant and positive correlations between Nitrous oxide emissions in the energy sector (% of total) and tuberculosis-related deaths (p < 0.01). EKC analysis results showed that there is a U shaped between tuberculosis-related mortality and nitrous oxide emission levels in the world. Conclusion: Research results show that the relationship between nitrous oxide change and mortality is negative in the short term and positive in the long term. Therefore, although nitrous oxide gases cause respiratory diseases and mortality, it may be possible to transform a harmful environmental factor into a positive by developing devices or methods that will convert these gases into free radicals.
Analysis of the Robustness of the Operational Performance Using a Combined Model of the Design of Experiment and Goal Programming Approaches for a Flexible Manufacturing Cell
(2023) Ic, Yusuf Tansel; Yurdakul, Mustafa; Dengiz, Berna; Sasmaz, Turgut
A combined model of a 2(k) design of experiment (DOE) and goal programming (GP) approaches is presented to determine optimum levels of input variables and analyze their robustness for a multiobjective performance of a flexible manufacturing cell (FMC) in this study. Two main performance metrics, namely, manufacturing lead time (MLT) and surface roughness (SR), are considered performance outputs for the FMC. Machine sequence, robot speed, tool type, and material type are selected as the four input variables on the input side of the proposed model. The study shows that even with a limited number of experiments, one can determine optimum input levels for the multiobjective performance of the FMC and determine their robustness.
Analysis Of Therapy Monitoring In The International Congenital Adrenal Hyperplasia Registry
(2022) Guven, Ayla; 35781728
Objective Congenital adrenal hyperplasia (CAH) requires exogenous steroid replacement. Treatment is commonly monitored by measuring 17-OH progesterone (17OHP) and androstenedione (D4). Design Retrospective cohort study using real-world data to evaluate 17OHP and D4 in relation to hydrocortisone (HC) dose in CAH patients treated in 14 countries. Patients Pseudonymized data from children with 21-hydroxylase deficiency (21OHD) recorded in the International CAH Registry. Measurements Assessments between January 2000 and October 2020 in patients prescribed HC were reviewed to summarise biomarkers 17OHP and D4 and HC dose. Longitudinal assessment of measures was carried out using linear mixed-effects models (LMEM). Results Cohort of 345 patients, 52.2% female, median age 4.3 years (interquartile range: 3.1-9.2) were taking a median 11.3 mg/m(2)/day (8.6-14.4) of HC. Median 17OHP was 35.7 nmol/l (3.0-104.0). Median D4 under 12 years was 0 nmol/L (0-2.0) and above 12 years was 10.5 nmol/L (3.9-21.0). There were significant differences in biomarker values between centres (p < 0.05). Correlation between D4 and 17OHP was good in multiple regression with age (p < 0.001, R-2 = 0.29). In longitudinal assessment, 17OHP levels did not change with age, whereas D4 levels increased with age (p < 0.001, R-2 = 0.08). Neither biomarker varied directly with dose or weight (p > 0.05). Multivariate LMEM showed HC dose decreasing by 1.0 mg/m(2)/day for every 1 point increase in weight standard deviation score. Discussion Registry data show large variability in 17OHP and D4 between centres. 17OHP correlates with D4 well when accounting for age. Prescribed HC dose per body surface area decreased with weight gain.