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Upgrading the SuperKEKB electron-positron collider with polarized electron beams opens a new program of precision physics at a center-of-mass energy of 10.58 GeV. This white paper describes the physics potential of this `Chiral Belle' program. It includes projections for precision measurements of \\(\\sin^2\\theta_W\\) that can be obtained from independent left-right asymmetry measurements of \\(e^+e^-\\) transitions to pairs of electrons, muons, taus, charm and b-quarks. The \\(\\sin^2\\theta_W\\) precision obtainable at SuperKEKB will match that of the LEP/SLC world average, but at the centre-of-mass energy of 10.58 GeV. Measurements of the couplings for muons, charm, and \\(b\\)-quarks will be substantially improved and the existing \\(3\\sigma\\) discrepancy between the SLC \\(A_{LR}\\) and LEP \\(A_{FB}^b\\) measurements will be addressed. Precision measurements of neutral current universality will be more than an order of magnitude more precise than currently available. As the energy scale is well away from the \\(Z^0\\)-pole, the precision measurements will have sensitivity to the presence of a parity-violating dark sector gauge boson, \\(Z_{\\rm dark}\\). The program also enables the measurement of the anomalous magnetic moment \\(g-2\\) form factor of the \\(\\tau\\) to be made at an unprecedented level of precision. A precision of \\(10^{-5}\\) level is accessible with 40~ab\\(^{-1}\\) and with more data it would start to approach the \\(10^{-6}\\) level. This technique would provide the most precise information from the third generation about potential new physics explanations of the muon \\(g-2\\) \\(4\\sigma\\) anomaly. Additional \\(\\tau\\) and QCD physics programs enabled or enhanced with having polarized electron beams are also discussed in this White Paper. This paper includes a summary of the path forward in R&D and next steps required to implement this upgrade and access its exciting discovery potential.

Belle II is a Super \\(B\\) Factory experiment, expected to record 50 ab\\(^{-1}\\) of \\(e^+e^-\\) collisions at the SuperKEKB accelerator over the next decade. The large samples of \\(B\\) mesons, charm hadrons, and tau leptons produced in the clean experimental environment of \\(e^+e^-\\) collisions will provide the basis of a broad and unique flavor-physics program. Belle II will pursue physics beyond the Standard Model in many ways, for example: improving the precision of weak interaction parameters, particularly Cabibbo-Kobayashi-Maskawa (CKM) matrix elements and phases, and thus more rigorously test the CKM paradigm, measuring lepton-flavor-violating parameters, and performing unique searches for missing-mass dark matter events. Many key measurements will be made with world-leading precision.

Abstract ObjectivesIL-23p19/Ebi3 (IL-39) was described as a new IL-12 family member. The aim of this study is to evaluate the gingival crevicular fluid (GCF) IL-39 levels in periodontal diseases and health and to correlate them to GCF levels of IL-1β and periostin.Materials and methodsSixty-six adult patients were included in the study. The study design was comprised of three groups, each containing 22 individuals: the periodontally healthy (PH), gingivitis (G), and periodontitis (P) groups. The clinical periodontal parameters were recorded and GCF samples were collected from the participants. GCF interleukin (IL)-39, IL-1β, and periostin levels were examined using the enzyme-linked immunosorbent assay.ResultsGCF IL‑1β, periostin, and IL-39 levels were higher in the P and G groups than in the PH group (p < 0.001). Positive correlations were detected between all GCF biochemical parameters and clinical periodontal parameters (p < 0.05). In the multivariate generalized linear regression analysis, the P (β = 37.6, 95% CI = 22.9–52.4) and G (β = 28.4, 95% CI = 15.8–41) groups were associated with GCF IL-39 levels (p < 0.001).ConclusionIL-39 levels were elevated in the presence of periodontal disease paralleling the increase in IL‑1β and periostin levels. IL-39 may have a role in the periodontal inflammation process.Statement of clinical relevanceIL-39, a new cytokine from the IL-12 family, can be a possible predictor marker of periodontal diseases.

Wild Cicer species are considered to be more resistant for biotic and abiotic stresses than that of the cultivated chickpea ( Cicer arietinum L.). Alien genes conferring resistance for biotic and abiotic stresses can be transferred from wild Cicer species to the cultivated chickpea but success in interspecific hybridizations has already been achieved with only two wild Cicer species. The current study was undertaken to compare fruitful heterosis in F 2 and F 3 for yield and yield criteria and to identify transgressive segregation in F 2 and F 3 in reciprocal interspecific crosses between C. arietinum and C. reticulatum Ladiz. We define fruitful heterosis as a useful parameter that can be used instead of residual heterosis. Considerable fruitful heterosis in F 2 and F 3 was found for number of seeds, pods per plant, biological yield, and seed yield. Maximum values of most of the characteristics in F 2 and F 3 were higher than that of the best parent indicating that superior progeny could be selected for yield from transgressive segregation. Progeny selection should be based on number of seeds, pods per plant, and biological yield since these characteristics had the highest direct effect on seed yield. The narrow sense heritability was found to be the highest for 100-seed weight. It was suggested that the cultivated chickpea could be used as female parent in interspecific hybridization to increase yield and yield criteria since progeny in F 2 and F 3 had better performance when it was used as female. In conclusion, interspecific hybridization of wild and cultivated chickpea can be used to improve yield and yield components and resistance to biotic and abiotic stresses as well.

Background and Objectives: Despite developments in cervical cancer (CC) treatment, an advanced stage is a poor prognostic factor. Cervical cancer is an immunogenic tumor in which viruses, like HPV, play a role in carcinogenesis. Therefore, systemic inflammatory markers (SIMs) may have prognostic value. Most studies on SIMs focus on the early stage by evaluating pretreatment levels. This study aims to evaluate the prognostic and predictive values of both pretreatment and post-treatment parameters at the advanced stage, as well as treatment efficacy after progression with first-line treatment. Materials and Methods: A total of 133 advanced-stage CC patients with progression on first-line platin–paclitaxel and bevacizumab were evaluated retrospectively. Demographic and histopathological characteristics were recorded along with treatment details. Pre-treatment baseline blood parameters and post-treatment follow-up values were recorded to calculate SIMs as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI). Results: Median values for SIMs were accepted as cut-off values. Post-treatment values demonstrated stronger predictive power, with pre-treatment SIRI and NLR being significant only in univariate analysis, but not in multivariate analysis. High post-treatment SIRI (>2.1) was correlated with shorter overall survival (OS) and considered a poor prognostic factor. High post-treatment SIRI (>2.1), -SII (>746), and -PLR (>197) emerged as independent prognostic factors for progression-free survival (PFS). Their prognostic values were clearer in the whole population and the metachronous metastatic subgroup. Rechallenge of platinum-based chemotherapy was an option for those who had at least 6 months of PFS with first-line platinum-based chemotherapy. Bevacizumab addition to single-agent or combination regimens led to improved ORR as well. Conclusions: Post-treatment SIRI is a promising prognostic factor for OS, while post-treatment SIRI, SII, and PLR may serve as convenient SIMs for PFS. Platinum-based combination chemotherapy reinduction is a feasible second-line treatment strategy, especially with the addition of bevacizumab.

Krukenberg tumor (KT), mostly originates from gastric cancer, is the metastatic tumor of ovaries accounting for 1-2% of all ovarian cancer. Common presenting symptoms include abdominal pain, distension, and ascites. Rests of the patients have non-specific gastrointestinal symptoms including dyspepsia, weight loss, nausea and vomiting. Gynecologic symptoms such as virilization, menstrual bleeding or irregularity and amenorrhea are much less frequent in the literature cases. Here, we present an unusual case of KT presented with amenorrhea as the sole initial symptom.

The aim compares the blood gases, vital signs, mechanical ventilation requirement, and length of hospitalization in patients with hypertensive pulmonary edema treated with standard oxygen therapy (SOT) and high-flow oxygen therapy (HFOT).OBJECTIVEThe aim compares the blood gases, vital signs, mechanical ventilation requirement, and length of hospitalization in patients with hypertensive pulmonary edema treated with standard oxygen therapy (SOT) and high-flow oxygen therapy (HFOT).This prospective observational study was conducted in patients with tachypneic, hypoxemic, hypertensive pulmonary edema. The patients' 0th, 1st, and 2nd hour blood gas results; 0th, 1st, and 2nd hour vital signs; requirement of endotracheal intubation, length of hospitalization, and the prognosis were recorded on the study form.METHODSThis prospective observational study was conducted in patients with tachypneic, hypoxemic, hypertensive pulmonary edema. The patients' 0th, 1st, and 2nd hour blood gas results; 0th, 1st, and 2nd hour vital signs; requirement of endotracheal intubation, length of hospitalization, and the prognosis were recorded on the study form.A total of 112 patients were included in this study, of whom 50 underwent SOT and 62 received HFOT. The initial blood gas analysis revealed significantly lower levels of pH, PaO2, and SpO2 and significantly higher levels of PaCO2 in the HFOT group. Patients in the HFOT group had significantly higher respiratory rate and pulse rate and significantly lower SpO2 values. The recovery of vital signs was significantly better in the HFOT group (p<0.05). Similarly, follow-up results of arterial blood gas analysis were better in the HFOT group (p<0.05). Both length of stay in the emergency department (p<0.05) and length of intensive care unit hospitalization s significantly shorter in the HFOT group (p<0.05).RESULTSA total of 112 patients were included in this study, of whom 50 underwent SOT and 62 received HFOT. The initial blood gas analysis revealed significantly lower levels of pH, PaO2, and SpO2 and significantly higher levels of PaCO2 in the HFOT group. Patients in the HFOT group had significantly higher respiratory rate and pulse rate and significantly lower SpO2 values. The recovery of vital signs was significantly better in the HFOT group (p<0.05). Similarly, follow-up results of arterial blood gas analysis were better in the HFOT group (p<0.05). Both length of stay in the emergency department (p<0.05) and length of intensive care unit hospitalization s significantly shorter in the HFOT group (p<0.05).HFOT can be much more effective in patients with hypertensive pulmonary edema than SOT as it shortens the length of stay both in the emergency service and in the intensive care unit. HFOT also provides better results in terms of blood gas analysis, heart rate, and respiratory rate in the follow-up period.CONCLUSIONHFOT can be much more effective in patients with hypertensive pulmonary edema than SOT as it shortens the length of stay both in the emergency service and in the intensive care unit. HFOT also provides better results in terms of blood gas analysis, heart rate, and respiratory rate in the follow-up period.

Background/Aims: There are a limited number of studies including the impact of antiplatelet drugs use on hospital outcomes for nonvariceal upper gastrointestinal bleeding. The aim of this study was to determine the effect of anti-aggregant, anti-coagulant and non-steroidal anti-inflammatory drugs upon hospital outcomes in patients with peptic ulcer bleeding. Materials and Methods: The patients under treatment with antiaggregant, anticoagulant or non-steroidal anti-inflammatory drugs were categorized as exposed group (n = 118) and the patients who were not taking any of these drugs were categorized as non-exposed group (n = 81). We analyzed the data of drug intake, comorbid disease, blood transfusion, duration of hospital stay, Blatchford/total Rockall score and diagnosis of patients. Results: In total, 199 patients were included. Of these 59.3% (exposed group) were taking drugs. The patients in exposed group were significantly older than those in non-exposed group (62.9 ± 17.3 years; 55.5 ± 19.3 years, P = 0.005, respectively). Mean number of red blood cell units transfused (2.21 ± 1.51; 2.05 ± 1.87, P = 0.5), duration of hospital stay (3.46 ± 2.80 days; 3.20 ± 2.30 days, P = 0.532) and gastric ulcer rate (33% vs 23.4%, P = 0.172) were higher in exposed group than in non-exposed group but the differences were not statistically significant. Total Rockall and Blatchford scores of the patients were significantly higher in exposed group than in non-exposed group (3.46 ± 1.72 vs 2.94 ± 1.87, P = 0.045; 10.29 ± 3.15 vs 9.31 ± 3.40, P = 0.038). Conclusıon: Our study has shown that anticoagulants, antiaggregants and nonsteroidal anti-inflammatory drugs do not effect duration of hospital stay, red blood cell transfusion requirement and rebleeding for peptic ulcer bleeding.

Demonstrate of accidental intravascular injection during lumbar transforaminal anterior epidural steroid injection (TAESI) performed with three-dimensional imaging angiography (3DIA) and fluoroscopy. We assessed 20 (9 males and 11 females) patients (with a total of 40 levels) whose images were received with simultaneously 3DIA and fluoroscopy-guided TAESI between January 2016 and September 2016 as retrospective. Injections were carried out in the lumbar fourth intervertebral space bilaterally and performed in the same way all of the cases. The mean age and body mass index of the patients were 47.9±2.72 years and 26.95±1.21, respectively. There were 10 patients with disc herniation, seven patients with spinal stenosis, and three patients with failed back surgery syndrome. In 3D imaging, vascular escape was detected in the 7 levels (17.5%) which were thought to be no escape in the fluoroscopy imaging. In chronic lumbar radiculopathy patients, intravascular escapes may occur during the fluoroscopic TAESI procedure. To avoid intravascular injections during TAESI procedure, it may be appropriate to use different imaging methods that can give more detailed results such as 3D angiography.

Background There are reports that acrochordon (skin tag), the most common fibroepithelial tumor of the skin, may be associated with metabolic syndrome components, particularly insulin metabolism disorders. However, to the best of our knowledge, there is no study examining its association with insulin resistance and tissue levels of insulin-like growth factor 1 receptor (IGF-1R) and insulin-like growth factor 2 receptor (IGF-2R). Methods Thirty patients with at least one acrochordon in their body who had no known history of diabetes mellitus and a control group comprised 30 individuals who had no acrochordon or no known history of diabetes mellitus were included. The tissue expression of IGF-1R and IGF-2R were investigated via immunohistochemical assessment in both groups. Results In the group with acrochordon, IGF-1R and IGF-2R expression was found to be significantly higher compared to the control group (p < 0,01). Using logistic regression analysis, an increase in serum insulin, serum IGF-1 and HOMA-IR levels was found to be associated with the expression levels of IGF-1R and IGF-2R. Conclusion These findings support the view that insulin metabolism disorders should be evaluated in patients with acrochordon. Our study indicates that IGF receptors may have an effect on acrochordon pathogenesis and that acrochordon etiology and related conditions can be clarified by detection of parameters that influence receptor levels.