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Objective:Survivors of patients with artery of Percheron infarction (API) often have a prolonged and disabling form of cognitive impairment that remains insufficiently characterized. We aimed to examine the clinical and cognitive features of API in the short and long term after stroke.Methods:We reviewed 6400 patients with a first-ever stroke included in the Stroke Registry between 2011 and 2021. The diagnosis of API was based on clinical diagnosis and imaging confirmation. All patients underwent neuropsychological assessment at hospital stay and 1 year after stroke. A z-score of each patients’ cognitive test point was calculated, and a z-score inferior to 2 was considered as pathological.Results:Of the 10 patients enrolled, all had cognitive impairment, consciousness, and behavioral disorders at stroke onset. Six patients had pure bilateral thalamic involvement while four had bilateral thalamic and rostral midbrain involvement. At 12 months, 50% of patients had global mental state scores 2 SD below the population mean (z-score mean ± SD, −2.17 ± 0.4). Most of the prefrontal cortex cognitive processes including executive functions such as planning and cognitive control (z-score mean ± SD, −3.92 ± 0.3), processing speed (−4.42 ± 0.5), working memory (−3.97 ± 0.3) were severely impaired at stroke onset. Especially in patients with thalamic and rostral midbrain involvement, deficiencies in executive function (z-score mean ± SD, −2.60 ± 0.4), processing speed (−2.22 ± 0.5), working (−3.76 ± 0.4), and episodic memory (−2.23 ± 0.3) continued 12 months after stroke.Conclusions:The occlusion of the artery of Percheron results in severe behavioral and cognitive disorders in the short and long term after stroke.

The superior parietal lobule (SPL) plays a strategic role in somatosensory and visuomotor integration. This study aims to evaluate the clinical, neurocognitive, and behavioral characteristics of isolated SPL stroke. We assessed neuropsychological and behavioral findings in 14 patients with isolated SPL stroke among 4200 patients with ischemic stroke. All patients underwent neuroimaging, clinical and neuropsychological assessment after stroke. Of the 14 patients enrolled, the first complaints were tactile and visuospatial disorders at stroke onset. Except for 6 patients with only 1 cognitive impairment, the majority of patients (57%) experienced more than 1 cognitive impairment category. Functional hemispheric asymmetries have been found in different cognitive processes, such as between visuospatial and body image functions and language process. Among visuospatial abilities disorders, spatial disorientation, visuospatial neglect, and visual extinction were found in two-thirds (63%) of patients with right SPL lesion. Body schema and image disorders were observed in all patients with right-sided lesions, such as alien hand, autotopagnosia for body parts (36%), autotopagnosia for sensory sensations (36%), and fading limb (21%). Two-thirds (57%) of patients with left SPL had impairment in language abilities. Our findings after stroke suggest that SPL plays a pivotal role in the regulation of visuospatial abilities, body schema and body image processing, and language skills through bilateral frontoparietal networks and interhemispheric parietal networks.

BackgroundWe aimed to determine the incidence of multisystem inflammatory syndrome in children (MIS-C) in pediatric coronavirus disease 2019 (COVID-19) cases and to define the relationships between the need for hospitalization, the development of MIS-C, and the Charlson Comorbidity Index (CCI) and Pediatric Comorbidity Index (PCI) scores.MethodsAll pediatric COVID-19 cases between March 25, 2020, and December 28, 2020, in the Marmara University Pendik Training and Research Hospital were enrolled. Patients who needed hospitalization were determined. Hospital records were re-examined to identify those diagnosed as having MIS-C. The CCI and PCI were used to validate the comorbidity status.ResultsAmong 2,055 pediatric COVID-19 cases, 1,340 were included in the study, and 213 patients (15.9%) had at least one comorbidity. All the patients or their parents were interviewed about the need for hospitalization, except for the acute period. Six patients had MIS-C, which corresponds to a MIS-C incidence of 0.4%. The need for hospitalization increased in the patients with comorbidities (P < 0.05). No correlation was found between the comorbidity scores and the development of MIS-C. The need for hospitalization increased in the patients with CCI scores of ≥2 and PCI scores of ≥4 (P < 0.05).ConclusionsOur study is the first to examine the incidence of MIS-C, which was 0.4%, by long-term follow up of pediatric COVID-19 cases and to demonstrate that the CCI and PCI can be used to predict the need for hospitalization and prognosis of pediatric patients with COVID-19.

This study aims to analyze and generalize the factors influencing credit decision-making in Turkey’s service sector, which has seen substantial growth and increased dynamism post-2000, coinciding with accelerated economic development. The evolving competitive landscape and shifting consumer purchasing perceptions have led companies within this sector to seek differentiation strategies to attain a competitive edge. In this context, access to credit emerges as a crucial enabler for companies to expand and capture market share. The research focuses on the financial and non-financial characteristics of medium-sized service sector firms seeking credit, recognizing that both sets of variables play a pivotal role in the credit allocation process conducted by banks. The core of this study involves applying established assumption tests from extant literature, followed by an extensive regression analysis. The primary objective of this analysis is to identify and underscore the key financial and non-financial factors that significantly impact credit decisions in the service sector. By examining these variables, the study seeks to contribute valuable insights into the credit decision-making process, addressing the nuanced and varied nature of the service sector. This approach not only provides a deeper understanding of the sector’s credit dynamics but also assists in formulating more informed strategies for businesses seeking financial support within this evolving economic landscape. The primary conclusion reached by the study is that non-financial variables exert a greater influence on credit decision-making in the service sector compared to financial variables.

Calibration estimation sets the original weights to include the known population characteristics of auxiliary variables using constraints. In this article, we have proposed a new calibration estimator of the population mean in stratified extreme ranked set sampling design, which is more efficient and costeffective design against other sampling designs in the literature. A detailed simulation study is carried out to observe the performance of proposed estimators. We have used the information of auxiliary variable to avoid ranking errors in our simulations. We have created samples from a bi-variate normal distribution with different values of ρxy . While one of these variables is taken as the variable of interest, the other is accepted as an auxiliary variable and used in ranking the sample units in each set. As a result of the simulation study using both synthetic and real data sets, we have found that our proposed estimators are more efficient than Sinha et al. [19] calibration estimator and classical stratified estimator.

Background Lenz-Majewski Syndrome (LMS) is a rare multisystem genetic disorder characterized by intellectual disability, cutis laxa, craniofacial abnormalities, and distinct dental features. It is caused by gain-of-function mutations in the Phosphatidylserine Synthase 1 ( PTDSS1 ) gene, which plays a key role in phospholipid biosynthesis. Among the craniofacial and dental manifestations, a progeroid facial appearance with prognathism, midface hypoplasia, large auricles, enamel dysplasia, delayed tooth eruption, and malocclusion are commonly observed. Due to the rarity and phenotypic variability of LMS, individual case reports remain essential for expanding the clinical and molecular understanding of the syndrome. Case presentation We report a 13-year-old male diagnosed with Lenz-Majewski Syndrome (LMS) through whole exome sequencing, which identified a heterozygous de novo PTDSS1 variant (c.284G > A; p.R95Q), not previously documented in LMS cases. Clinical evaluation revealed moderate intellectual disability, cutis laxa, a progeroid facial appearance, and pronounced prognathism. Intraoral and radiographic examinations demonstrated enamel hypoplasia, taurodontism, delayed eruption of permanent teeth, a horizontally positioned upper lateral incisor, and a large follicular cyst in the maxilla. Orthodontic intervention using Hawley appliances was employed to stimulate the oral mucosa and support the eruption of delayed permanent teeth. Conclusion This case expands the phenotypic and genotypic understanding of LMS and documents novel dental findings—particularly taurodontism—in association with a previously unreported PTDSS1 variant. It underscores the importance of early dental assessment and multidisciplinary care in managing LMS. Recognizing oral manifestations can facilitate timely diagnosis and personalized treatment strategies, contributing to improved quality of life in affected individuals.

To the Editor, We read the article by Dr Izhar et al. (1), entitled “Anti-phospholipid antibodies in women presenting with preterm delivery because of preeclampsia or placental insufficiency”, in the last issue of your journal with great interest. The authors observed a high prevalence of anti-phospholipid antibodies (APLA) in women who have preterm delivery due to preeclampsia or placental insufficiency (PREPI), corroborating the results of previous reports. Their findings are of great interest and finally shed some more light on this interesting topic. Therefore, we would like to commend the authors for addressing this issue. However, several points caught our attention while reading this paper and we would like to highlight these to the reader.

Prevalence of Salmonella in slaughter sheep and cattle was determined by International Organization for Standardization Method 6579 (ISO) and Vitek Immunodiagnostic Assay System UP Salmonella Phage Technology (VIDAS UP Salmonella SPT—VIDAS UP). A total of 400 healthy slaughter sheep (n = 200) and cattle (n = 200) carcass (C), fecal content (FC), mesenteric lymph node (MLN), liver (L), kidney (K), spleen (S) and gall bladder (GB) were randomly sampled and analysed. ISO and VIDAS UP results indicated 13 (3.25%) and 17 (4.25%) of 400 animals carried Salmonella, respectively, regardless of sample type. There was no isolation from L, S, GB, while 2 C (0.5%), 6 FC (1.5%), 7 MLN (1.75%), 3 K (0.75%) were contaminated with Salmonella. S. Typhimurium (27.8%), S. Enteritidis (22.2%), S. Newport (22.2%) were the three dominant serovars, followed by S. Kentucky (11.1%), S. Umbilo (5.6%), S. Corvallis (5.6%), and S. Albany (5.6%). Overall prevalence in 2800 samples was 0.46% by ISO and 0.61% by VIDAS UP. High relative trueness (RT: 99.79%) of VIDAS UP with a substantial agreement to ISO (κ value: 0.80) indicated its efficiency to accompany ISO to monitor Salmonella in slaughter animals. As the first report to evaluate ISO and VIDAS UP in detecting Salmonella from slaughter sheep and cattle, this current prevalence signifies a risk for public health in red-meat and related products in Turkey.

This study examined the attitudes of police officers and judiciary members toward wife abuse in Turkey and the relation between these attitudes and profession, ambivalent sexism (hostile/benevolent sexism), gender, and gender roles. The following instruments were used for the analyses: The Attitudes Toward Wife Abuse Scale (AWAS), the Ambivalent Sexism Inventory (ASI), and the Bem Sex Role Inventory. The participants were 300 police officers and 150 judiciary members selected from different regions of Turkey. Results showed that compared to judiciary members, police officers are more tolerant of physical and verbal abuse of women in marriage, but less tolerant of the idea of the victim leaving an abusive marriage partner. Similarly, men were more tolerant than women of those husbands who physically and verbally abuse their wives, but less supportive of the wife leaving the abusive partner. Profession and ambivalent sexism (hostile/benevolent sexism) were found to be the strongest predictors of attitudes toward wife abuse.

Post-stroke depression (PSD) is a significant sequela of cerebrovascular accidents, affecting a substantial proportion of stroke survivors. However, it is still unclear whether the existence of depression after stroke is an independent risk factor for stroke recurrence and if the increased risk of cognitive impairment in PSD is related to the location of stroke. We aimed to compare the role of cortical, subcortical and cortico-subcortical infarcts in the development of PSD and cognitive impairment, as well as the role of the existence of depression in stroke recurrence. In this study, a 52-week, randomised, double-blind study consisted of 1059 stroke patients (866 non-depressive and 193 untreated depressive persons) who were matched in terms of demographic and clinical parameters. The Mini Mental State Examination Test (MMSE), Executive function (Trail Making Test Part A), processing speed (colour naming condition of the Stroop test), episodic memory (Rey Auditory Verbal Learning Test [RAVLT], including delayed free recall), semantic memory (verbal fluency test [animal naming]), language processing (Boston Naming Test [(number correct]), visuospatial perception (the bells test) was assessed at the baseline. The lesion sites are subdivided as cortical, subcortical, and cortico-subcortical territory infarcts on MRI. The stroke recurrence ratio was also recorded after a year. In results, we observed a higher rate of depression associated with lesions affecting the cortico-subcortical structures in patients with PSD compared to non-depressive patients (p < 0.05). Our results further indicated impaired cognitive scores in patients with PSD compared to those with non-depressive individuals (p < 0.05). Regarding the risk of stroke recurrence, we also found an increased rate of stroke recurrence in PSD after 12 months (p < 0.05). In detail, binomial logistic regression analyses using the backward Wald method determined that patients with depression (p = 007; odds ratio (OR) = 1.64; CI 1.14–2.35), hypertension (p = 0.004; OR = 1.74; CI 1.19–2.55), atrial fibrillation (p = 0.007; OR = 1.61; CI 1.14–2.28) and older age (p = 0.019; OR = 1.02; CI 1.003–1.03) were significantly predictors for stroke recurrency. Our regression analysis further revealed that PSD was a predictive factor for disabling cognitive test scores (impaired executive function [p < 0.001; OR = 4.51; CI 3.24–6.27], reduced processing speed [p < 0.001; OR = 4.29; CI 3.12–5.91], episodic memory [p < 0.001; OR = 4.65; CI 3.37–6.42), semantic memory [p < 0.001; OR = 4.79; 3.47–6.61], visuospatial [p < 0.001; OR = 6.10; CI 4.36–8.55], and language function [p < 0.001; OR = 5.086; CI 3.67–7.05]) after adjusting for age and education. In conclusion, the present study provides strong evidence confirming the importance of depression in predicting cognitive impairment and recurrence in stroke patients. Despite these positive findings, our findings warrant the performance of further research to demonstrate the efficacy of treatment on stroke recurrence, together with other vascular risk factors and cognitive disorders.