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Ebstein's anomaly represents 40% of congenital tricuspid valve abnormalities. Studies about paediatric Ebstein's anomaly patients are limited. To evaluate clinical characteristics, treatment (medical/arrhythmia ablation/surgical) results, and outcome of Ebstein's anomaly patients, and to determine factors affecting arrhythmia presence and mortality. Clinical data, echocardiography, treatment results, and outcomes of patients followed in our centre between 2000 and 2017 were retrospectively evaluated. A total of 79 patients (61 children, median diagnosis age: 1.5 years [1 day-24 years]) were included. Eight patients (10.1%) were deceased during the study period. Common associated anomalies were atrial septal defect/patent foramen ovale (56.9%), mitral regurgitation (25.3%), pulmonary stenosis/atresia (17.7%), and ventricular septal defect (16.5%). Genetic diseases/congenital anomalies were present in 5/3.8%. Tricuspid regurgitation was present in 75.9%, and severe in 50%. Arrhythmias were detected in 30.4%, and accessory pathway-mediated re-entrant tachycardia was the most common (67%). Wolff-Parkinson-White syndrome was present in 12.7%. Twenty-one ablation procedures (radiofrequency ablation [85.7%]/cryoablation [14.3%]) were performed in 16 patients (median age: 13.3 years [4.9-17]). Acute success/recurrence rates: 87.5/25%. Surgery was performed in 31.6% (median age: 6.5 years [4 days-29 years]), 7.6% were operated during the first month, and 12.6% during the first year. Second surgery was required in 28%. Perioperative mortality rate was 12%, and median mortality age was 25 days (1 day-17 years). Median follow-up period was 5.3 years (1 day-32 years). Older diagnosis age ( = 0.005) and mild-moderate mitral regurgitation ( = 0.036) were associated with arrhythmias. Younger age at diagnosis ( = 0.012), younger age at first surgery ( = 0.004), surgery before age three years ( = 0.037), and presence of pulmonary atresia ( = 0.000014) were associated with mortality. Gender, diagnosis age, congenital anomalies/genetic disorders, tricuspid regurgitation, arrhythmias, and surgery history did not have an independent effect on survival. In children and young adults presenting with Ebstein's anomaly, younger age at presentation and at surgery, surgery before age three years, pulmonary atresia were associated with death. Ablation procedures can be successfully performed but recurrence rate is still high.

Accessory pathways are commonly seen due to delamination of tricuspid valve leaflets. In addition to accessory pathways, an enlarged right atrium due to tricuspid regurgitation and incisional scars creates substrates for atrial re-entries and ectopic tachycardia. We sought to describe our experience with catheter ablation in children with Ebstein's anomaly. During the study period, of 89 patients diagnosed with Ebstein's anomaly, 26 (30.9%) of them who underwent 33 ablation procedures were included in the study. Accessory pathways were observed in the majority of procedures (n = 27), whereas atrial flutter was observed in five, atrioventricular nodal reentrant tachycardia in five, and atrial tachycardia in two procedures. Accessory pathways were commonly localised in the right posteroseptal (n = 10 patients), right posterolateral (n = 14 patients), septal (n = two patients), and left posteroseptal (n = one patient) areas. Multiple accessory pathways and coexistent arrhythmia were observed in six procedures. All ablation attempts related to the accessory pathways were successful, but recurrence was observed in five (19%) of the ablations. Ablation for atrial flutter was performed in five patients; two of them were ablated successfully. One of the atrial tachycardia cases was ablated successfully. Ablation in patients with Ebstein's anomaly is challenging, and due to nature of the disease, it is not a rare occasion in this group of patients. Ablation of accessory pathways has high success, but also relatively high recurrence rates, whereas ablation of atrial arrhythmias has lower success rates, especially in operated patients.

This study evaluated the nutritional status of Syrian refugees in the early adolescent period living in different vulnerable settings. Nutritional assessment of Syrian refugee adolescents is often neglected but essential for a healthy physical, pubertal and mental development. Growth parameters of Syrian refugee adolescents going to a public school in an urban area and in a temporary protection center (TPC) were recorded along with the Turkish adolescents. Stunting percentages were similar between the groups (p = 0.811). While the proportion of children with a BMI over 85th percentile were significantly higher among Syrian adolescents living in TPC, Turkish children have the highest percentage of underweight (p = 0.01). Both food insecurity and unhealthy weight gain continue to be major concerns for refugee adolescents after their resettlement to a host country. The findings suggest that nutritional assessment and intervention at early adolescence is critical for Syrian refugees depending on their living conditions.

Bacterial membrane vesicles (BMVs) are nanoscale, bilayered proteolipid structures secreted by both Gram-negative and Gram-positive bacteria. Initially considered cellular debris, BMVs are now recognized as evolutionarily conserved entities with critical roles in bacterial communication, immune modulation, virulence factor delivery, and horizontal gene transfer. Their structural and functional resemblance to eukaryotic extracellular vesicles has fueled growing interest in their use as versatile vaccine platforms. Licensed meningococcal OMV vaccines established proof-of-concept for their safety and immunogenicity, and ongoing studies are extending applications to enteric pathogens and viral infections. Recent advances in genetic engineering, glycoengineering, and modular antigen display systems have enabled the design of “plug-and-play” BMVs with reduced reactogenicity and enhanced protective efficacy. In parallel, innovations in bioprocessing and formulation technologies are improving scalability, stability, and delivery, including mucosal routes. This review highlights the immunological properties, translational potential, and key challenges of BMV-based vaccines, with an emphasis on strategies to optimize safety, antigen specificity, and manufacturing for next-generation vaccine development.

Football demands both aerobic and anaerobic capacities due to its dynamic movements, which include jumps, directional changes, ball control, and sprints. The Nordic hamstring exercise (NHE) enhances eccentric strength, which is crucial for high-intensity movements. However, the relationship between Nordic breaking point angle (NHEbpa), which is associated with eccentric hamstring peak torque during Nordic hamstring exercise, and sprint, countermovement jump (CMJ), and change of direction (COD) speed in soccer players has not been sufficiently investigated. This analysis examines the relationship between the Nordic breaking point angle and critical performance indicators-sprint speed, COD ability, and vertical jump-in football players. Fifty-eight male soccer players volunteered for the study. Assessments included anthropometric measurements, CMJ tests, 10-20-30 m sprint tests, and COD (zig-zag) tests. NHEbpa was measured using motion analysis software. Correlation analysis was used to determine the relationship between variables. A multiple linear regression analysis was conducted to evaluate the individual effects of the sprint, CMJ, and COD performances on NHEbpa, with data analyzed using JASP 0.18. Correlation analysis showed strong positive correlations between NHEbpa and sprint performances (r = 0.633 to 0.666), moderate negative correlation between NHEbpa and CMJ (r = -0.406), and moderate positive correlation between NHEbpa and COD (r = 0.580). Regression analysis results were used to analyze the independent coefficients of multiple variables more comprehensively, revealing significant predictors for performance: 20-m sprint (β = 24.166, = 0.030), 10-m sprint (β = 22.564, = 0.047), 30-m sprint (β = 10.677, = 0.027), and CMJ (β = 4.974, = 0.034). Conversely, COD performance (β = -0.154, = 0.470) did not demonstrate a significant effect. The study identified significant relationships between NHEbpa and sprint/CMJ performances ( < 0.05), while no meaningful effect was observed for COD speed ( > 0.05). These findings highlight the importance of eccentric strength in sprint performance, suggesting that other factors may play a more prominent role in COD. Incorporating eccentric-focused training, particularly through Nordic exercises, is recommended to enhance sprint performance and hamstring strength, which are essential for football players.

Neurodegenerative disorders, including Alzheimer’s disease (AD), Parkinson’s disease (PD), multiple sclerosis (MS), and amyotrophic lateral sclerosis (ALS), are characterized by the progressive and gradual degeneration of neurons. The prevalence and rates of these disorders rise significantly with age. As life spans continue to increase in many countries, the number of cases is expected to grow in the foreseeable future. Early and precise diagnosis, along with appropriate surveillance, continues to pose a challenge. The high heterogeneity of neurodegenerative diseases calls for more accurate and definitive biomarkers to improve clinical therapy. Cell-free DNA (cfDNA), including fragmented DNA released into bodily fluids via apoptosis, necrosis, or active secretion, has emerged as a promising non-invasive diagnostic tool for various disorders including neurodegenerative diseases. cfDNA can serve as an indicator of ongoing cellular damage and mortality, including neuronal loss, and may provide valuable insights into disease processes, progression, and therapeutic responses. This review will first cover the key aspects of cfDNA and then examine recent advances in its potential use as a biomarker for neurodegenerative disorders.

Background: This study aimed to determine the effect of the Nordic hamstring curl training (NHCT) program on athletic performance elements such as linear speed, change of direction (COD), jump performance (CMJ), and eccentric muscle strength (Nordic Hamstring Curl Breaking Point Angle—NHCBP) in young football players. Methods: The study group consisted of 40 male football players who were actively trained and had no previous eccentric training experience or reported any injuries. The participants were randomly divided into a training group (TG = 20) and a control group (CG = 20). The TG performed the NHCT program twice a week for eight weeks, in addition to their standard football training. The CG continued with standard football training. Results: The study findings revealed no statistically significant differences in the interaction between group and time in 10, 20, and 30 m sprint performance. However, statistically significant differences were found in CMJ performance in terms of group–time interaction (F = 19.99, p < 0.001, η2 = 0.52), COD (F = 11.10, p < 0.004, η2 = 0.38), and NHCBP (F = 6.14; p < 0.02; η2 = 0.25). After the eight-week NHCT program, the experimental group showed improvements of 18% in CMJ performance, 8% in COD performance, and 25% in NHCBP performance. Conclusions: The NHCT program significantly increased hamstring muscle strength in football players, and this increase positively affected players’ linear speed and change of direction performance. NHCT has the potential to enhance athletic performance in football.

Resistance to thyroid hormone beta (RTHβ) is a rare disorder characterized by a fairly heterogeneous clinical presentation due to varying degrees of tissue response to thyroid hormone. The present study aimed to evaluate the clinical and laboratory features and genotype-phenotype relationship of Turkish patients with RTHβ. Patients who underwent a THRβ gene analysis between September 2019 and September 2023 were retrospectively reviewed. Fifty patients with the clinical features of RTHβ syndrome or a family history of an index case were included. A total of eight different heterozygous pathogenic/likely pathogenic missense variants, three of which were novel, were detected in in 30 patients from 8 unrelated families. Although most patients with RTHβ were asymptomatic, seven patients exhibited various symptoms. Moreover, seven patients had received various treatments before diagnosis. Thyroid autoantibody was positive in 23% of all cases with a variant, and goitre was detected in 56% of children with a variant. While thyroid nodules were detected in seven adult patients, two adults had been diagnosed with papillary thyroid cancer. One child had attention-deficit disorder, learning disability, and type 1 diabetes mellitus. Of the 20 patients without a variant, TSHoma was detected in one. The present study provides an overview of clinical and genetic characteristics of patients with genetically confirmed RTHβ and expanded the gene variant database with three novel variants. Although most patients with RTHβ are asymptomatic, molecular genetic analysis of the gene and regular follow-up because of the apparent risk of concurrent autoimmune diseases or thyroid cancer is warranted.

Young soccer players need to enhance their athletic performance, including speed and endurance. Traditional training methods may not be effective enough to improve athletic performance in these young athletes. Velocity-based high-intensity interval training (vHIIT) workouts can increase the efficiency of energy systems and improve athletic performance. This study aimed to investigate the effects of four weeks of vHIIT on athletic performance in young soccer players. A total of 14 male soccer players participated in the study (mean age: 18.9 ± 1.0 years, body mass: 76.5 ± 5.3 kg, height: 1.81 ± 0.08 m). Participants were randomly assigned to either an experimental group ( = 7) or a control group ( = 7). While the control group continued their regular soccer training without additional vHIIT intervention, the experimental group underwent vHIIT training at 85-90% intensity twice a week for 4 weeks in addition to their regular training. Change of direction speed (COD), maximum sprint speed (MSS), maximum oxygen consumption (VO ), and the 30-15 intermittent fitness test (VIFT) were assessed twice, in the control and experimental groups, both at pre-test and post-test measurements. The findings indicated a significant decrease in COD time ( < 0.001, η p = 0.682) and 30-15 IFT ( < 0.001, η p = 0.735) in the experimental group. However, no statistically significant change was observed in these parameters between the pre-test and post-test in the control group. Additionally, group-time interaction effects were found to be significant in favor of the experimental group in all parameters. Four weeks of speed-based vHIIT training led to improvements in sprint performance, COD, and aerobic capacity in young soccer players. Incorporating vHIIT workouts into conditioning programs for youth soccer players may be an effective strategy for enhancing physical performance components, including speed, agility, and endurance, which are requirements of soccer.

Background: We aimed to compare the perinatal outcomes of dichorionic/diamniotic twin (DC/DA) pregnancies resulting from in vitro fertilization (IVF) with those resulting from spontaneous DC/DA pregnancies. Methods: The study group included 99 women with DC/DA pregnancies resulting from IVF, and the control group included 92 women with spontaneous DC/DA pregnancies. Maternal demographic characteristics (age, parity, and gravidity), pre-existing conditions (chronic hypertension and pregestational diabetes mellitus), and obstetric history were recorded. Pregnancy outcomes included gestational age at delivery, number of fetuses, and mode of delivery. The antepartum complications that we evaluated include first- and second-trimester bleeding, placenta previa, preterm birth, fetal growth restriction (FGR), oligohydramnios, and tocolytic use. The obstetric complications that we assessed include prematurity, twin-to-twin transfusion syndrome (TTTS), and hydrops fetalis. Additionally, neonatal data such as 1st minute and 5th minute Apgar scores, birth weight, neonatal intensive care unit (NICU) admission, presence of congenital anomalies, and neonatal death were recorded, and comparisons were made between the groups. Results: Women in the IVF group were older (34.7 ± 6.9 vs. 32.3 ± 6.1 years, p = 0.03) and more frequently primiparous (73.7% vs. 37.0%, p < 0.001). The mean gestational age at delivery was slightly lower in the IVF group, though this was not statistically significant (34.3 ± 3.5 vs. 35.1 ± 2.5 weeks, p = 0.101). Cesarean delivery was common in both groups, with comparable overall rates (90.9% vs. 94.6%, p = 0.411), but emergency cesarean section occurred more frequently in IVF pregnancies (81.8% vs. 55.8%, p = 0.001). No significant differences were found regarding chronic hypertension or pregestational diabetes. However, several differences were demonstrated in terms of obstetric complications. For example, preterm births and fetal growth restriction (FGR) were significantly more frequent in IVF pregnancies (59.8% vs. 30.4%, p < 0.001), and tocolytic use was also more frequent (56.6% vs. 29.7%, p < 0.001). No significant differences were observed in terms of placenta previa, oligohydramnios, TTTS, hydrops fetalis, and neonatal outcomes. The logistic regression analysis revealed that IVF pregnancies were associated with an increased risk of preterm birth: OR 3.45, 95% CI 1.85–6.78 (p < 0.001); the risk of FGR was also higher in IVF pregnancies: OR 2.11, 95% CI 1.02–4.37 (p = 0.015). However, tocolytic use was not significantly associated with IVF: OR 1.49, 95% CI 0.50–4.44 (p = 0.471). Conclusions: Although DC/DA pregnancies conceived through IVF have a higher risk of preterm birth, fetal growth restriction, and greater use of tocolytic agents than spontaneous DC/DA pregnancies, their neonatal outcomes are similar.