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This study explores the implications of per-tourist and total carbon emissions generated across diverse sectors within the hospitality & tourism industry on climate change, as well as their secondary impacts on the economy, society, and environment. Employing a nonlinear framework, we investigate proposed hypotheses using panel data spanning a decade across 16 countries, employing threshold regression and a mediating effect model for analysis. The results reveal distinct nonlinear effects of per-tourist and total carbon emissions from each hospitality & tourism sector on climate change, as well as on the broader domains of the economy, society, and environment. While the total carbon emissions from the transportation sector have the most significant overall impact on climate change, per-tourist carbon emissions originating from the accommodation sector emerge as a more prominent contributor to climate change on a per tourist basis, followed by attractions & others, food & beverage, and transportation sectors. Considering the diverse levels of per-tourist carbon emissions, it becomes evident that the influence of each hospitality & tourism sector on the economy, society, and environment displays notable disparity. These findings emphasize the importance of developing targeted and tailored strategies to address climate change within individual hospitality & tourism sectors, rather than employing a uniform approach across the entire industry. [ABSTRACT FROM AUTHOR]

Salep, a traditional Turkish beverage, derives its name from its primary component: salep powder (SP), which is sourced from the tubers of certain orchid species. This study investigated various physicochemical attributes (including dry matter, protein content, pH, titration acidity, water activity, color, serum separation, and zeta potential), as well as rheological and sensory characteristics of salep beverages. These drinks were prepared by substituting SP with chia (Salvia hispanica L.) seed mucilage powder (MP) with different ratios (10%, 20%, 30%, and 40%). The substitution of SP with MP did not influence the dry matter and protein contents or the pH and acidity values of the drinks significantly (p >.05). The inclusion of MP in the formulation of salep drinks resulted in a decrease in lightness (L*) and a* color values while increasing the b* color values. However, consumer perception, as indicated by color difference values (∆E*), showed no distinguishable difference between drinks containing MP and control drinks. Furthermore, higher ratios of MP led to increased apparent viscosity values in the drinks and effectively prevented or significantly reduced serum separation observed in control drinks (p <.05). Remarkably, sensory evaluations revealed that substituting up to 30% of SP with MP did not negatively impact the overall sensory properties of the drinks (p >.05), suggesting that MP could be recommended as a feasible alternative. This substitution has the potential to contribute to the conservation of orchid plants, the primary source of salep, while also offering cost‐saving benefits in the production of salep drinks. [ABSTRACT FROM AUTHOR]

In this article, the matrix algebra is well-known concept in mathematics, has been extended to sedenionic-coefficient matrices using sedenions, which have many applications in recent years. Subsequently, sedenionic-coefficient matrices have been obtained in their real, complex, quaternionic and octonionic forms. Based on these definitions, the arithmetic operations of addition, multiplication, conjugation, transpose and conjugate transpose for sedenionic matrices and their complex, quaternionic and octonionic variations have been established and their algebraic properties scrutinized. Lastly, vector space over real and complex numbers and module structure over quaternions of sedenionic matrices has been searched. [ABSTRACT FROM AUTHOR]

This study involved fortifying pumpkin slices with calcium and vitamin D3 using vacuum impregnation (VI) pre‐treatment and assessing the quality characteristics of the resulting desserts/jams. Slices were subjected to immersion or VI pre‐treatments for 30, 60, and 90 min in a solution containing calcium oxide and vitamin D3. Calcium ions contributed to the hardness of desserts, with VI reducing processing time. The highest impregnated calcium (58.17 mg/100 g fw) and vitamin D3 contents (6.02 mg/100 g dm) were determined in slices pre‐treated by VI for 90 min. VI was more effective than immersion in terms of calcium and vitamin D3 transition into pumpkin tissues. Scanning electron microscope (SEM) images indicated that calcium oxide particles were noticeable in slices pre‐treated by VI. Immersing fruit slices for 90 min produced desserts with a textural hardness of 11.04 N, while VI pre‐treatment for the same duration increased their hardness value to 18.92 N. Desserts produced with VI‐pre‐treated slices exhibited superior texture and sensory attributes, with no adverse taste resulting from calcium oxide. In conclusion, VI pre‐treatment shows significant potential for the industrial production of desserts/jams with enhanced structural integrity for fruits. [ABSTRACT FROM AUTHOR]

While the presence of the term “Artificial Intelligence (AI)” in a product description may be viewed as a sign of that product having advanced capabilities and features, it may also trigger fear and concern among consumers. Therefore, this study explores the impact of inclusion (vs. exclusion) of the “Artificial Intelligence” term in goods and service descriptions on consumers’ purchase intentions. It also examines the mediating role of emotional trust and the moderating role of perceived product risk in this relationship. We conducted six experiments to investigate these relationships. The data were analyzed using T-tests and Hayes Process Macro Models 4 and 7. The findings of the study indicated that the inclusion of the “Artificial Intelligence” term in descriptions of products and services decreases purchase intention, and that emotional trust mediates this relationship. Findings further suggested that the negative mediating effect of emotional trust on the impact of AI term on purchase intention was stronger for high-risk products, compared to low-risk products. These findings provide valuable insights for both academia and practitioners, leading them to develop more effective and appealing strategies in the applications of AI. [ABSTRACT FROM AUTHOR]

Myelodysplastic syndrome (MDS) is a heterogeneous spectrum of clonal hematopoietic disorders with varying degrees of cytopenia and morphologic dysplasia. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a prognostic marker in several types of malignant tumors. Prognostic value of HALP score remains unclear for MDS. To determine the prognostic value of baseline HALP score in MDS. We retrospectively analyzed data from 130 newly diagnosed MDS patients evaluated and classified under HALP score. By the receiver operating characteristic (ROC) analysis, the optimal cut-off value of HALP was > 67.5 in predicting mortality. Patients were divided into two groups: with low and high HALP scores, and the characteristics were compared between both groups. Patients' median age was 68 (19–84) years, and 79 (60.8%) were male. Higher HALP score was detected in MDS patients with intermediate-risk under IPSS score, and at high and very high risks under IPSS-R score, and those receiving azacitidine (AZA) treatment. The survival rates of those with a HALP score > 67.5 were significantly lower than those with low HALP score at 17.77 ± 3.98 (median ± SE) (p < 0.001). The 3-, 5- and 10-years survival rates of individuals with HALP scores > 67.5 were found as 25, 18, and 11%, respectively. Median overall survival (OS) was also determined as 33.10 (95% CI 16.34–49.88) months by the Kaplan–Meier method. HALP score has shown an ability to be a useful prognostic biomarker in various cancers, including MDS. The meaningful cut-off value of HALP is disease-specific and largely study-specific. High HALP score is associated with unfavorable clinicopathological characteristics. Also, it may be useful in predicting OS and mortality of MDS. [ABSTRACT FROM AUTHOR]

Objective: This study sought to discern the differential impacts of communicating individualized breast cancer risk versus disseminating generic breast cancer information on women's proclivity towards breast cancer screenings. Method: A structured experimental design was used, including 300 female volunteers aged between 40-69, who had not previously been diagnosed with breast cancer, in Erzincan. Data collection entailed a face-to-face administration of a 22-item questionnaire complemented by the ASSISTS scale. Participants were randomized into two conditions: one receiving a standardized briefing on breast cancer screening modalities, and the other being apprised of their lifetime risk of breast cancer development based on the modified Gail model. Results: Post-intervention, 55.8% (n=72) of the risk-informed cohort and 40.5% (n=41) of the generic information cohort expressed a willingness to undergo screening (p=0.022). Notably, the group informed of their personalized risk exhibited a more pronounced uptick in requests for breast self-examination, clinical breast examination, and mammography screening compared to their counterparts. Conclusions: The communication of personalized breast cancer risk proves to be a more efficacious and time-efficient strategy than generic information dissemination in bolstering screening participation rates. [ABSTRACT FROM AUTHOR]

Background: The indirect head of the rectus femoris (IHRF) tendon has been used as an autograft for segmental labral reconstruction. However, the biomechanical properties and anatomic characteristics of the IHRF, as they relate to surgical applications, have yet to be investigated. Purpose: To (1) quantitatively and qualitatively describe the anatomy of IHRF and its relationship with surrounding arthroscopically relevant landmarks; (2) detail radiographic findings pertinent to IHRF; (3) biomechanically assess segmental labral reconstruction with IHRF, including restoration of the suction seal and contact pressures in comparison with iliotibial band (ITB) reconstruction; and (4) assess potential donor-site morbidity caused by graft harvesting. Study Design: Descriptive laboratory study. Methods: A cadaveric study was performed using 8 fresh-frozen human cadaveric full pelvises and 7 hemipelvises. Three-dimensional anatomic measurements were collected using a 3-dimensional coordinate digitizer. Radiographic analysis was accomplished by securing radiopaque markers of different sizes to the evaluated anatomic structures of the assigned hip.Suction seal and contact pressure testing were performed over 3 trials on 6 pelvises under 4 different testing conditions for each specimen: intact, labral tear, segmental labral reconstruction with ITB, and segmental labral reconstruction with IHRF. After IHRF tendon harvest, each full pelvis had both the intact and contralateral hip tested under tension along its anatomic direction to assess potential site morbidity, such as tendon failure or bony avulsion. Results: The centroid and posterior apex of the indirect rectus femoris attachment are respectively located 10.3 ± 2.6 mm and 21.0 ± 6.5 mm posteriorly, 2.5 ± 7.8 mm and 0.7 ± 8.0 mm superiorly, and 5.0 ± 2.8 mm and 22.2 ± 4.4 mm laterally to the 12:30 labral position. Radiographically, the mean distance of the IHRF to the following landmarks was determined as follows: anterior inferior iliac spine (8.8 ± 2.5 mm), direct head of the rectus femoris (8.0 ± 3.9 mm), 12-o'clock labral position (14.1 ± 2.8 mm), and 3-o'clock labral position (36.5 ± 4.4 mm). During suction seal testing, both the ITB and the IHRF reconstruction groups had significantly lower peak loads and lower energy to peak loads compared with both intact and tear groups (P =.01 to.02 for all comparisons). There were no significant differences between the reconstruction groups for peak loads, energy, and displacement at peak load. In 60° of flexion, there were no differences in normalized contact pressure and contact area between ITB or IHRF reconstruction groups (P >.99). There were no significant differences between intact and harvested specimen groups in donor-site morbidity testing. Conclusion: The IHRF tendon is within close anatomic proximity to arthroscopic acetabular landmarks. In the cadaveric model, harvesting of the IHRF tendon as an autograft does not lead to significant donor-site morbidity in the remaining tendon. Segmental labral reconstruction performed with the IHRF tendon exhibits similar biomechanical outcomes compared with that performed with ITB. Clinical Relevance: This study demonstrates the viability of segmental labral reconstruction with an IHRF tendon and provides a detailed anatomic description of the tendon in the context of an arthroscopic labral reconstruction. Clinicians can use this information during the selection of a graft and as a guide during an arthroscopic graft harvest. [ABSTRACT FROM AUTHOR]

The effects of Gd content on the solidification path and microstructure of an AlSi7Mg0.3 alloy have been studied. Two different Gd levels, 0.1 and 0.5 mass%, respectively, have been investigated while the material has been solidified at low (0.2 °C s−1) and high (1.3 °C s−1) cooling rates. Computer-aided thermal analysis and metallographic techniques have been used to study the solidification and microstructural evolution of the alloy at different Gd contents and cooling rates. The results show how Gd has no effect on the grain refinement at both cooling rates. The eutectic structure is unaffected at Gd level of 0.1 mass%. A concentration of 0.5 mass% Gd promotes the precipitation of the gadolinium phosphide (GdP) phase instead of aluminium phosphide (AlP) compounds, thus suppressing the eutectic plateau during the solidification and serving as nucleant for the GdAl2Si2 phase. The eutectic Si crystals solidified at low cooling rate are refined at 0.5 mass% Gd content, while the morphology of Si crystals is only partially modified at high cooling rate. [ABSTRACT FROM AUTHOR]

In this study, we investigate the inhibitory potential of a series of hydrazide derivatives bearing different substituents with the pyridazine structure (5 a–i and 6 a–f) against acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) using a modified Ellman's method. The inhibitory profiles of the synthesized compounds were assessed by comparing their IC50 and Ki values. Our results demonstrate that all the compounds exhibit significant inhibitory activity against both AChE and BChE when compared to the reference compound, tacrine. Particularly, compound 6 a exhibited the highest activity against Electrophorus electricus AChE (EeAChE) with a Ki value of 3.26 nM, while compound 5 a displayed the most potent inhibition against equine BChE (eqBChE) with a Ki value of 0.94 nM. The compounds did not possess significant cytotoxicity action using the MTT assay on the cancer cell lines. The DPPH assays revealed that all the compounds have moderate antioxidant activities. Furthermore, molecular docking studies provided valuable insights into the interaction mechanisms of these compounds within the active sites of AChE and BChE crystal structures (PDB ID: 4EY7 and 4BDS, respectively). The above results indicated that the pyridazine‐based compounds were a promising functional agent for the treatment of Alzheimer's disease. [ABSTRACT FROM AUTHOR]

Introduction: In recent years, highly selective reversible CDK4/6 inhibitors have been combined with aromatase inhibitors for their efficacy and ease of application in the treatment of advanced stage of hormone-responsive breast cancers. Oral use of these drugs facilitates patient compliance. However, adverse drug reactions are reported due to these drugs, in the literature. Diverse adverse reactions such as skin reactions, liver toxicity, and vitiligo with ribociclib have been reported. Case report: In this study, we present of liver toxicity due to the use of ribociclib in a case of advanced breast cancer with metastases. It is noteworthy that the patient did not have any other concomitant disease and did not take any other medication. Management and outcome: After the 600 mg initial dose of ribociclib, neutropenia occurred at the beginning of the therapy, the dose was reduced to 400 mg, and liver enzymes started to rise in the second month of the therapy. In the fifth month of the intermittent treatment period, liver toxicity was grade 3. Discussion: Liver adverse reaction occurred due to ribociclib use in the patient who had no history of any other disease. The Naranjo algorithm score was evaluated as 9. Considering the excretion of ribociclib by sulfation, cysteine conjugation, and glucuronidation, which are phase II reactions, n-acetyl cysteine (NAC) treatment (600 mg/day) was started for the patient. NAC therapy is recommended to reduce elevated liver enzymes in the case. The patient's treatment has been continuing with palbociclib for 5 months. No increase in liver enzymes was observed. [ABSTRACT FROM AUTHOR]

Postbiotics offer better properties than probiotics. This study investigated the antimicrobial activity of Lactiplantibacillus plantarum EIR/IF-1 postbiotics against pH-adaptive bacteria, namely Prevotella denticola, Fusobacterium nucleatum, and Streptococcus sanguinis. Cell-free culture media of L. plantarum EIR/IF-1 were used as postbiotics in either crude (acidic) or neutralized form to also understand non-pH-dependent antimicrobial potential. Minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and viable cell counts were determined for crude and neutralized postbiotics. Culture media adjusted to different pH values were also compared to adjusted media with postbiotics to understand the strength of organic acids in postbiotics. Antibiofilm activity of postbiotics was determined against polymicrobial biofilm formation. Finally, the toxicity of crude postbiotics was tested on human periodontal ligament fibroblast cells (hPDLFCs). MIC values of crude postbiotics were 12.5 mg/mL for all strains. F. nucleatum and P. denticola strains were sensitive to neutralized postbiotics after 48 h of incubation. Moreover, 12.5 and 25 mg/mL postbiotics inhibited biofilm formation and 2.5 mg/mL and lower concentrations of crude postbiotics showed no cytotoxicity in hPDLFCs. This study showed that postbiotics have antimicrobial activity against pH-adaptive oral bacteria and no cytotoxic effect on hPDLFCs depending on the dose. The non-acidic antimicrobial components of postbiotics could also enable their safe use in the oral cavity. [ABSTRACT FROM AUTHOR]

k-Mersenne and k-Mersenne-Lucas sedenions are specialised extensions of sedenions, a sixteen-dimensional algebraic structure. These variations introduce specific algebraic rules and properties derived from their connection to Mersenne and Lucas numbers. k-Mersenne sedenions are defined by their relationship to k-Mersenne numbers, while k-Mersenne-Lucas sedenions are associated with k-Mersenne-Lucas numbers. In this article firstly k-Mersenne and k-Mersenne-Lucas sedenions are defined. Then the algebraic properties of these sedenions such as norm, conjugate and inner product are examined. The Mersenne and Mersenne-Lucas recurrence relations, Binet's formulas, generating functions and finite sum formulas for these sedenions are derived. These sedenions also reveal interesting connections with established number theory identities such as Catalan's, Cassini's, D'Ocagne's and Vajda's identities, providing further depth to their significance within the mathematical theory and their potential applications across various scientific domains. [ABSTRACT FROM AUTHOR]

AbstractThis study explores whether AI is perceived as a threat or an opportunity and examines whether the perception of AI varies according to demographic factors, religious commitment, trust in science, beliefs in conspiracy theories, and previous experiences with AI utilizing data collected from 1443 participants. While most respondents believe that AI will simplify life (63%), increase efficiency (62%), and therefore, the development of AI should be encouraged (51%), a significant portion of the respondents is concerned that AI will increase unemployment (52%) and lead to social inequalities (47%). Around 21% of the respondents believe that AI may destroy humanity eventually. Respondents’ age, gender, occupation, religious commitment, beliefs in conspiracy theories, and previous experiences with AI (familiarity) significantly influence respondents’ perception of AI both as an opportunity and threat. Findings suggest that AI is paradoxically seen as a double-edged sword, perceived both as an opportunity and a threat, which indicates a pronounced confusion about AI among respondents. [ABSTRACT FROM AUTHOR]

Kefir drinks with sugar (5%, w/v), strawberry flavor (0.15%, v/v), and propolis extract (PE) at different ratios (0.150%, 0.225%, and 0.300%, v/v) were produced and stored at 4°C, and their physicochemical, rheological, microbiological, and sensory properties were monitored during storage. The ratio of PE and storage time had an insignificant effect on the dry matter, protein, fat contents, Commission Internationale de l'Eclairage (CIE) L* and a* color values, apparent viscosity, consistency coefficient, flow behavior index, Lactobacillus spp., Lactococcus spp., and yeast counts of kefir drinks (p >.05). The CIE b* values of kefir drinks increased with an increase in PE ratio (p <.05). All kefir samples exhibited a pseudoplastic flow behavior. Initially, the total antioxidant capacity of kefir drinks was 2.19 μmol TE/100 mL, which increased to 2.51 μmol TE/100 mL for kefir drinks with 0.225% PE. The total phenolic content and antioxidant capacity of kefir drinks with PE decreased during storage. PE addition did not influence the sensory color and taste liking scores of kefir drinks adversely until the 8th day of storage. In terms of odor liking scores, kefir drinks with 0.225% and 0.300% PE had a similar score to control drinks. Additionally, kefir drinks with 0.150% and 0.225% PE received an overall liking score similar to control drinks. Results indicated that the incorporation of PE at a ratio of 0.225% was recommended for the production of strawberry‐flavored kefir drinks with acceptable sensory characteristics and increased functional properties, and this product could be stored for up to 8 days. [ABSTRACT FROM AUTHOR]

Managers’ communication, relationships with subordinates, and employees’ feelings of meaningful work are vital in engaging subordinates. However, their relationships lack a theoretical foundation. Drawing on self-concept theory (SCT), this study assesses the mediating role of psychological meaningfulness and employee – manager relationships (EMR) in the connection between three types of motivating language used by managers and job engagement. This study also tests the moderating role of EMR between psychological meaningfulness and job engagement. A convenience sampling method was used to collect 380 responses from employees working at four- and five-star hotels in Malaysia. Data were analyzed using the partial least squares method. Although three forms of motivating language positively relate to psychological meaningfulness, only empathetic language positively relates to EMR. Psychological meaningfulness mediates relationship between the three forms of motivating language and job engagement, while EMR only mediates the relationship between empathetic language and job engagement. EMR also significantly and negatively moderates the link between psychological meaningfulness and job engagement. These findings add value to the SCT and motivating language by assessing the relationships between motivating language, EMR, psychological meaningfulness, and job engagement. Managers can use motivating language to make jobs meaningful and build relationships with subordinates to improve employee outcomes. [ABSTRACT FROM AUTHOR]

The oxidative stress level of organisms is one of the best indicators of whether they are healthy or not. The increase in oxidative stress level in the cell can affect the longevity of the organism as well as cause some immune diseases. In this study, wing, tail, tarsus lengths, weights, muscle and fat scores, Total Antioxidant Capacity (TAC), Total Oxidant Capacity (TOC) and Oxidative Stress Index (OSI) levels of Blackbirds living in Sinop, Sarıkum Nature Protection Area were examined during all four seasons. A total of 55 Blackbirds were caught in autumn, winter, spring and summer. The highest weight was detected in females and males in autumn, and the lowest in summer. Although there was no statistical difference between the wing and tail lengths, they were slightly higher in the Spring. Total antioxidant levels were highest in both sexes in spring. TAC levels were statistically different only in males, and OSI levels in both sex. The season with the highest OSI levels for both sexes is autumn. This situation was closely related to seasonal conditions and whether they were in the breeding period or not. This study shows that total antioxdant levels and oxidative stress index can easily change in Blackbirds. [ABSTRACT FROM AUTHOR]

Body-mind-based holistic methods of relaxation and improved well-being, such as yoga and meditation, improve body awareness and have often been used to enhance quality of life and the ability to cope with pain. We aimed to compare tactile sensory acuity and body awareness in healthy sedentary individuals who practiced yoga regularly and in control participants who had not practiced yoga. Participants were 60 individuals, aged between 18 and 35 years who were divided into two groups according to whether they had previously practiced yoga. We used the two-point discrimination (TPD) test to determine participants' tactile acuity, as measured with a digital calliper at the C7, C5, C3, C1 and T1 spinal segments and with the Body Awareness Questionnaire (BAQ). The TPD measurements of individuals who practiced yoga and meditation had a lower discriminatory threshold compared to those who had not practiced yoga (p <.001), and the self-reported BAQ score of yoga practitioners was higher than that of the controls (p <.001). We found a positive correlation between the length of the prior duration of yoga experience and self-reported body awareness (r =.567, p <.001). There was a significant negative correlation (r = −.379, p =.015) between the C5 segment and the TPD measurements, but not for the other cervical spinal segments (p >.05). There was a negative correlation between the length of prior yoga practice and the TPD measurements in all cervical segments (p <.001). The most negative correlation was found at the C7 segment (r = −.844, p <.001) and the least negative correlation was found at the C3 segment (r = −.669, p <.001). These data suggest that yoga and meditation practices may improve well-being and diminish pain by increasing body awareness and tactile sensory acuity in the cervical region. [ABSTRACT FROM AUTHOR]

Since its launch, ChatGPT, an artificial intelligence chatbot developed by Open AI based on the premises of generative pre-trained transformer autoregressive language models, has gained widespread popularity and is making significant impact on society with its unique features, such as natural language processing and contextual awareness. ChatGPT is viewed as a major disruptive innovation that is likely to revolutionize the operations in many industries including the hospitality and tourism industry. The adoption of ChatGPT will result in substantial changes throughout the hospitality and tourism industry by disrupting how customer search for information, make decisions, and how businesses produce, create, and deliver customized services and experiences. This conceptual paper provides a comprehensive discussion on generative pre-trained transformers' (GPTs) benefits, and potential challenges and threats they pose to the hospitality and tourism industry. The feasibility of integrating GPT into different travel stages and decision-making processes is also discussed. The article concludes by proposing a potential future research agenda on using GPT in creating and delivering hospitality and tourism experiences, which can guide further advancements in the field. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to evaluate the clinical features of children with tracheostomy and the predictors of psychological status of their primary caregivers in order to determine the associations between the children's clinical course with their caregivers' psychological status. Background: The caregivers of children with tracheostomy are responsible for providing basic tracheostomy care at home. All these responsibilities may be associated with significant changes in family members' lifestyles, daily routines and family dynamics. Design: This study is a cross sectional study. Methods: Data of the family's socioeconomic status and clinical status of children with tracheostomy were noted in four paediatric pulmonology centers. The Beck Depression Inventory, Maslach Burnout Inventory, Zarit Caregiver Burden Scale, and Rosenberg Self‐esteem Scale were used for psychological measurements of the caregivers. The STROBE checklist was used for this study. Results: Eighty‐five children and their primary caregivers were enrolled in the study. The children's median age was 4.1 years. Thirty‐eight of them were dependent on home ventilators. Twenty‐one had bacterial colonisation. All children's primary caregivers were their mothers. Beck Depression Inventory scores of mothers of children with colonisation were higher. Number of hospitalizations in previous 6 months was related to mothers' emotional exhaustion and depersonalization scores. Duration of children's hospitalizations in previous 6 months was positively correlated to mothers' emotional exhaustion, depersonalization, and Beck Depression Inventory scores. Conclusions: Mothers of children with tracheostomy may experience psychological conditions, such as high levels of depression, burnout, burden and low levels of self‐esteem. Frequent and long‐term hospitalizations of children correlated with mother's depression and burnout. Therefore, primary caregivers should be evaluated and supported psychologically. Relevance to Clinical Practice: Preventing mothers of children with tracheostomy from experiencing psychological conditions such as depression, burnout, burden and low self‐esteem can also increase the quality of care for children. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) is a systemic infectious disease that is caused by Mycobacterium tuberculosis and which can affect many tissues and organs. Despite the development of curative and preventive therapies in recent years, TB continues to be a serious health problem, in the developing countries in particular. Case presentation: In this case report, an extraordinary case of miliary tuberculosis with unexplained fever, joint pain, weight loss, pancytopenia, lymphadenopathy and splenomegaly, who was clinically suspected of lymphoma and successfully treated with a multidisciplinary approach without any complications, was presented. This case has been reported not because it is a rare case, but to raise awareness. It is a case, where early diagnosis and initiation of treatment early, as well as an individualized and multidisciplinary treatment approach emerged as the most important factors resulting in an improvement prognosis. Conclusion: Extrapulmonary TB, if with lymph node involvement in particular, can easily mimic lymphoma. Imaging methods and clinical findings may be insufficient to distinguish these two conditions at the time of diagnosis. In such a case, it will be beneficial for the patient to proceed with an experienced team in the management of the patient. [ABSTRACT FROM AUTHOR]

Increased globalization of the hospitality industry brings with it a multitude of challenges. Chief among them is the expanding diversity of both the hospitality labor pool and the traveling public. Diversity not only affects internal workplace culture, but it also has a direct correlation to customer experience and satisfaction. As our society grapples with more diverse cultures and changing values around equity and inclusion, appropriate leadership principles are needed to facilitate change. This study specifically examines value-centered leadership principles as a means to spark innovative programming around diversity, equity and inclusion practices within the hospitality sector. Applications of value-centered leadership principles are presented through the lens of mission, service, people, and task orientations. Managerial implications are discussed through a lens on promoting a culture of respect and inclusivity by fostering and encouraging employees to learn about, measure, and understand different cultural perspectives while also addressing and preventing discrimination and harassment.酒店业日益全球化带来了诸多挑战. 其中最主要的是酒店业劳动力库和旅游公众的多样性不断扩大. 多样性不仅影响内部工作场所文化, 而且与客户体验和满意度直接相关. 随着我们的社会努力应对更多样化的文化和围绕公平和包容不断变化的价值观, 需要适当的领导原则来促进变革. 这项研究专门研究了以价值为中心的领导原则, 将其作为在酒店业围绕多样性、公平性和包容性实践激发创新计划的一种手段. 以价值为中心的领导原则的应用是通过任务、服务、人员和任务导向的视角来呈现的. 通过培养和鼓励员工学习、衡量和理解不同的文化观点, 同时解决和防止歧视和骚扰, 从促进尊重和包容文化的角度讨论管理影响. [ABSTRACT FROM AUTHOR]

Objective: Tumour regression is defined as continuity of changes leading to the elimination of a neoplastic population and is reflected as periductal fibrosis and intraductal tumour attenuation. The aim of this study was to describe the radiological and clinicopathological characteristics of high-grade breast ductal carcinoma in situ (DCIS) with regressive changes (RC). Materials and Methods: Thirty-two cases of high-grade DCIS with RC on biopsy specimens followed by excision were included. The mammographic, ultrasonographic (US), and magnetic resonance imaging (MRI) findings of cases were retrospectively reviewed according to the breast imaging reporting and data system (BI-RADS) lexicon. Clinical and histopathological findings [comedonecrosis, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) status and Ki-67 proliferation index] were recorded. The rate of upgrade to invasive cancer after surgical excision and lymph node involvement were evaluated. Results: The most common mammographic finding was microcalcifications alone (68.8%). The most frequently seen findings on US were microcalcifications only (21.9%), followed by microcalcifications and hypoechoic area (18.7%). On MRI, most lesions presented as clumped non-mass enhancement with segmental distribution. ER/PR negativity (53.1%, 65.6%), HER2 positivity (56.3%) and high Ki-67 (62.5%), which are known to be associated with more aggressive behavior, were found to be proportionally higher. The rate of upgrade to invasive cancer was 21.8%. Conclusion: DCIS with RC lesions present most often as microcalcifications alone on both mammography and US. MRI features are not distinguishable from those of other DCIS lesions. DCIS with RC lesions show biomarker status reflecting more aggressive behavior and high upgrade rate to invasive cancer. [ABSTRACT FROM AUTHOR]

We aimed to evaluate cutoff values of immunoreactive trypsinogen (IRT)/IRT and determine relationship between IRT values and clinical characteristics of children with cystic fibrosis (CF). This study is cross-sectional study. Data of children with positive newborn screening (NBS) between 2015 and 2021 were evaluated in three pediatric pulmonology centers. Age at admission, sex, gestational age, presence of history of meconium ileus, parental consanguinity, sibling with CF, and doll-like face appearance, first and second IRT values, sweat chloride test, fecal elastase, fecal fat, biochemistry results, and age at CF diagnosis were recorded. Sensitivity and specificity of IRT cutoff values were evaluated. Of 815 children with positive NBS, 58 (7.1%) children were diagnosed with CF. Median values of first and second IRT were 157.2 (103.7–247.6) and 113.0 (84.0–201.5) μg/L. IRT values used in current protocol, sensitivity was determined as 96.6%, specificity as 17.2% for first IRT, and 96.6% sensitivity, 20.5% specificity for second IRT. Positive predictive value (PPV) was determined as 7.1%. When cutoff value for first IRT was estimated as 116.7 μg/L, sensitivity was 69.0% and specificity was 69.6%, and when cutoff value was set to 88.7 μg/L for second IRT, sensitivity was 69.0% and specificity was 69.0%. Area under curve was 0.757 for first and 0.763 for second IRT (p < 0.001, p < 0.001, respectively). PPV was calculated as 4.3%. Conclusion: Although sensitivity of CF NBS is high in our country, its PPV is significantly lower than expected from CF NBS programs. False-positive NBS results could have been overcome by revising NBS strategy. What is Known: • Although immunoreactive trypsinogen elevation is a sensitive test used in cystic fibrosis newborn screening, its specificity is low. • In countries although different algorithms are used, all strategies begin with the measurement of immunoreactive trypsinogen in dried blood spots. What is New: • In our study, it was shown that use of the IRT/IRT protocol for cystic fibrosis newborn screening is not sufficient for the cut-off values determined by the high number of patients. • Newborn screening strategy should be reviewed to reduce false positive newborn screening results. [ABSTRACT FROM AUTHOR]

The pervasive influence of social media on our lives provides new opportunities to study residents' attitudes to tourism. Even though it is now common for residents to express their opinions and read about tourism development on social media, the consequences of this for their attitudes remain to be understood. This article uses the analytical perspectives of the information society and draws from the elaboration likelihood model, the influence of presumed influence model, and the social exchange theory to develop a causal-chain framework that considers the influence of social media on residents' attitudes to tourism. Twenty-five research propositions emanate from the conceptual framework. The framework examines the direct as well as indirect influence of social media tourism messages on residents' attitudes. It also recognizes users as the receivers and expressers of pro- as well as anti-tourism messages on social media. Our framework is theoretically inclusive, providing a reference to scholars and stimulating new ideas for future research on social media and residents' attitudes. To the best of our knowledge, this is the first study that provides the necessary theoretical foundations and a conceptual framework to study residents' attitudes to tourism in an information era intensified by the growth of social media. [ABSTRACT FROM AUTHOR]

The platelet-rich plasma (PRP) has become popular in the medical world due to its content of growth factors and numerous studies are experimental. In experimental studies, the preparation and application of PRP are problematic and allogenic PRP transfers have been preffered, because of the difficulties in preparation of autogenic PRP in animal experiments. Xenogenic transfers and their effects have not been studied in this topic. This study aimed to investigate the effect of autogenic and xenogenic use of PRP on composite graft viability. Methods: Two composite grafts are prepared for each ear of nine rabbits. Each ear was randomly divided into three groups. After the procedure, the wound edges and base were injected with 1 cc serum physiologic, autogenic PRP or 1 cc human-derived xenogenic PRP. At 3 weeks, samples were taken, photographic and histopathological evaluations were made. Results: The graft viability was better in autogenic and xenogenic group compared to the control group. In comprasion of autogenic and xenogenic groups, although the macroscopic evaluation revealed better graft viability and less necrosis in the group which had been treated with autogenic PRP, the difference was not statistically significant. The three groups did not significantly differ in terms of inflammation. Vascularization examined histopathologically. CD31 staining, which was used to evaluate angiogenesis, was significantly higher in the autogenic PRP group than the remaining two groups. Conclusion: Although autogenic PRP has better results histopathologically, the xenogenic use of PRP may be an alternative for studies, when macroscopic evaluation is necessary. [ABSTRACT FROM AUTHOR]

Objectives: To compare the survival of first- and second-generation tyrosine kinase inhibitors (TKIs) in patients with rare EGFR exon 18 and exon 20 mutation-positive non-small cell lung cancer (NSCLC). Materials and methods: We retrospectively evaluated survival characteristics of 125 patients with EGFR exon 18 and exon 20 mutated NSCLC who received erlotinib or afatinib as first line treatment between 2012 and 2021 from 34 oncology centres. Since exon 20 insertion is associated with TKI resistance, these 18 patients were excluded from the study. Results: EGFR exon 18 mutations were seen in 60%, exon 20 mutations in 16%, and complex mutations in 24% of the patients with NSCLC who were evaluated for the study. There were 75 patients in erlotinib treated arm and 50 patients in afatinib arm. Patients treated with erlotinib had progression-free survival time (PFS) of 8.0 months and PFS was 7.0 months in the afatinib arm (p = 0.869), while overall survival time (OS) was 20.0 vs 24.8 months, respectively (p = 0.190). PFS of exon 18 mutated arm was 7.0 months, exon 20 mutated arm was 4.3 months, and complex mutation positive group was 17.3 months, and this was statistically significant (p = 0.036). The longest OS was 32.5 months, seen in the complex mutations group, which was not statistically different than exon 18 and in exon 20 mutated groups (21.0 and 21.2 months, respectively) (p = 0.323). Conclusion: In this patient group, especially patients with complex mutations are as sensitive to EGFR TKI treatment similar to classical mutations, and in patients with rare exon 18 and exon 20 EGFR mutation both first- and second-generation EGFR-TKIs should be considered, especially as first- and second-line options. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the present study is to determine the clinical, radiological and pathological characteristics of testicular torsion patients, the intervention techniques applied according to time to hospital admission of the patient and testis-saving rates in the childhood age group. Material and Methods: This retrospective study included the patients aged between 0-18 years who applied to pediatric surgery clinic due to the complaint of abdominal pain or scrotal pain between January 2011 to January 2021 and were diagnosed with testicular torsion after evaluation. The patient age, hospital admission complaint, duration of the symptoms, month of hospital admission, lateralization of the affected testicle, preoperative diagnostic studies, type of the implemented intervention (orchiectomy/detorsion) and postoperative diagnosis were determined. Hematoxylin-Eosin-stained archive slides of the materials sent to pathology department for examination were reviewed by two pathologists. Results: In this period of 10 years; 28 patients aged between 0-18 years admitted to our hospital because of testicular torsion. Scrotal pain and tenderness were present in all the patients (100%). Of the patients; 4 (14.3%) were neonatal and 21 (75%) were between the ages 12-18 years. Testicular parenchyma could not be macroscopically selected in the examination of orchiectomy materials and the materials were hemorrhagic. Hemorrhagic infarction was detected by microscopic examination. Conclusion: Acute scrotum is a frequently seen surgical emergency in the childhood period. There are many entities that may cause acute scrotum; performing differential diagnosis accurately and timely can protect the patient from unnecessary surgery and testicular loss. [ABSTRACT FROM AUTHOR]

Background and Aims: Readability can be defined as the easiness or difficulty of texts to be understood by readers. In our study, it was aimed to evaluate the patient information leaflet and the summary of product characteristics in terms of readability in Turkish. Methods: Our study is a cross-sectional study. For our study, the best-selling drugs included in the "Turkish Pharmaceutical Market Monitoring Report-8, 2020 Market Status in Terms of Sales Volume and Value" prepared by the Turkish Medicines and Medical Devices Agency in 2021, were evaluated by using Turkish readability formulas (Ateşman and Bezirci-Yılmaz). Results: 138 patient information leaflet and summary of product characteristics of a total of 69 products were evaluated. It has been determined that an average of at least undergraduate education is required for the readability of the texts. The patient information leaflets are significantly shorter than the summary of product characteristics (p=0.000). However, in terms of readability, it was easier in Ateşman calculation and more difficult in Bezirci-Yılmaz calculation (p=0.007 and p=0.000, respectively). Conclusion: It has been seen that patient information leaflets are not easy to read texts prepared for patients. While preparing the texts to be read by the patients, the texts should be easily understandable and should be read and understood by people of all education levels. [ABSTRACT FROM AUTHOR]

Considering the global urgency to decrease carbon emissions and shift to sustainable energy sources, combining solar and other renewables with hydrogen generation appears to offer an appealing answer. The combination of solar and ocean energies with hydrogen production, therefore, offers a great potential to improve energy efficiency and create a feasible route towards zero-emission energy systems. A new hybrid photoelectrochemical (PEC)-conventional electrolysis system was designed and incorporated into the proposed multigeneration system. The hybridized reactor combines the benefits of PEC and conventional electrolysis by using a developed bipolar anode to produce hydrogen continuously, even when there is no solar radiation. The main aim of this research is to investigate the integrated power process that utilizes solar power for several uses, such as generating electricity, producing freshwater, and synthesizing hydrogen. The proposed research involves integrating several components, including a solar through collector system, a combination of power cycles (steam and organic Rankine cycles), a multi-effect desalination (MED) unit, a new hybrid electrolyzer system, a wave energy system, and a hydrogen storage and refuelling station. The main outputs include 2.05 kg/s freshwater production, 0.125 kg/s hydrogen production, 16,284.24 kW net work rate, and 95,068 kW solar heat input. The highest exergy destruction rates were found in the solar collector (56,194.8 kW) and turbines T1 and T2 (6019.9 and 4627.6 kW). The overall energy and exergy efficiencies of the proposed system are obtained to be 15.83 % and 16.61 %, respectively. • A novel system generates power, freshwater, and hydrogen using solar and ocean energy. • The system includes a hybridized hydrogen generator with a PEC and a conventional method. • The proposed design shows an exergy efficiency of 16.61 % and energy efficiency of 15.83 %. [ABSTRACT FROM AUTHOR]

The development of a new hybrid hydrogen generator, using both photoelectrochemical process and conventional electrolysis, integrated into a combination system for buildings is a major step forward in the quest for sustainable energy solutions in cities where it is specifically designed, implemented and evaluated for incorporation into sustainable community systems. A significant advantage of this hydrogen generator is the ability to produce hydrogen constantly, regardless of the absence of solar irradiation. Furthermore, both electrolyzers contribute to a rise in the amount of hydrogen produced. Furthermore, the utilization of PEC electrolysis for hydrogen generation results in a significant reduction in the overall power requirements of the system. This new study investigates an integrated power system that produces electricity from solar energy and tackles issues related to freshwater supply, hydrogen production, and heating/cooling demands. The purpose of this research is to integrate advanced system components, including a solar power tower system, a combined Brayton-Rankine cycle, a multi-effect desalination (MED) unit, a new hybridized hydrogen generator system, an absorption cooling cycle (ACS), and a hydrogen storage and refuelling station. The overall energy efficiency is determined to be 49%, while the exergy efficiency becomes 46.2%. [ABSTRACT FROM AUTHOR]

In this paper, we introduce an alternative construction of graphs on MV-algebras. We called them as MV-graphs whose vertices are the elements of MV-algebra and whose edges are the association of two vertices. We also define graphs of equivalence classes by constructing ▵ ¯ -connection operator and complement annihilator on MV-algebras. We prove some related results based on the algebraic properties of graphs. We handle formation of graph folding on MV-algebras. And, we prove the relation between graphs folding and equivalence classes graph of MV-algebras. Moreover, we associate all of these processes with algorithms to serve related areas that used effectively MV-algebras. [ABSTRACT FROM AUTHOR]

Aim: Prodromal findings of migraine may be overlooked when patients are not questioned well. The International Classification of Headache Disorders classifies the prodromal phase as the symptomatic phase, which may last from 2 to 48 h and manifests before the onset of pain in migraine without aura and before the aura in migraine with aura. This study aimed to evaluate the frequency and duration of prodromal symptoms and their relationship with the presence of aura in migraine patients. Methods: This observational study was designed as a survey where participants took an online questionnaire between July and November 2020. The questionnaire consisted of two parts; in the first part, the diagnostic criteria for migraine were questioned. After the participants completed the migraine diagnostic criteria, they moved on to the second part, in which headache characteristics, the presence and type of the aura, and prodromal symptoms were asked. Results: This study included 521 participants with migraine according to the International Classification of Headache Disorders. Two hundred seventy-one participants responded that they had auras; 169 of these experienced visual auras. Considering the frequency of prodromes, the three most common symptoms in participants with migraine with or without aura were sensitivity to light, sensitivity to sound, and mood changes. When the two groups were compared, the percentages for the prodromal symptoms except for neck pain were found to be higher in patients with migraine with aura (p<0.05 for each). Conclusion: Our study's findings suggest that migraine patients with or without aura do not recognize the symptoms in this phase well enough. Also, the most crucial finding was that prodromal symptoms were more common in migraine patients with aura. This could be evaluated as the patients with migraine aura might have interpreted prolonged prodromal symptoms as aura. To predict the onset of attacks in migraine patients and enhance their treatment compliance, knowing and recognizing prodromal symptoms is essential. [ABSTRACT FROM AUTHOR]

Myalgia, arthralgia, headache, chest pain, back pain, abdominal pain, sore-throat may be present in COVID-19. The purpose of this study is evaluating the frequency, intensity and the regional characteristics of pain related symptoms in hospitalized COVID-19 patients as long as neuropathic pain and its components. In this retrospective study, for the assessment of pain, myalgia, arthralgia, headache, sore-throat, chest pain, back pain and abdominal pain were questioned. Intensity of pain was evaluated by an 11-point Numerical Rating Scale. Neuropathic pain detection was performed by Identification Pain Questionnaire (ID-Pain). The frequency of pain in hospitalized patients was 68.5%. The frequency of COVID-19-related symptoms were 53.4% myalgia, 39.7% arthralgia, 41.1% headache, 21.2% sore-throat, 21.9% chest pain, 28.1% back pain and 15.8% abdominal pain. A statistically significant relationship was observed between headache and hyposmia development (odds ratio= 6.53; 95% CI: 3.14-13.60; P<0.001). In neuropathic pain assessment, ID-Pain scores of 6 (4.1%) of patients were found ≥ 2. For neuropathic pain components, it was observed that hot/burning type was accompanying to pain in 12 (8.2%) of patients while pins and needles type was accompanying in 8 (5.5%) of the patients. In hospitalized COVID-19 patients, myalgia, arthralgia and headache are most frequent pain types. Headache was found to be related with hyposmia. Neuropathic pain or mixed pain with a neuropathic component is not a rare conditi on in COVID-19 disease. Finally, we suggest routine assessment of neuropathic pain in patients with COVID-19. [ABSTRACT FROM AUTHOR]

Background: Previous dual task studies suggested that the difficulty of the concurrent cognitive and motor tasks may not be challenging to the same degree for each person. This study approaches this problem by setting individualized difficulty levels for tasks to examine the dual task interference.Research Question: Do the features of postural sway depend on increased individualized difficulty levels of concurrent cognitive and postural activities?Methods: 20 young healthy participants (10 male, 10 female) took part in the study. Before the experiments, cognitive task difficulty (No-, Medium-, High) has been set individually. Subjects performed postural tasks (quiet stance, voluntary sway) concurrently with or without a cognitive task which based on simple arithmetic calculations. Postural sway features were examined.Results: Postural sway features were affected by individualized difficulty level of concurrent cognitive and postural activities. In voluntary sway, as a more challenging postural task, higher reductions were observed for such sway features as COP velocity and range in AP direction.Significance: This study signaled task-specific changes in postural sway features. When the difficulty levels were set individually, the effect of motor and cognitive dual task was more apparent when the balance requirement of the primary motor task increased. [ABSTRACT FROM AUTHOR]

Scholars have speculated that the metaverse will alter the way in which the hospitality and tourism industry operates. Efforts to understand this new phenomenon in both academia and industry are at a crossroads. In this opinion piece, we first attempt to explain the concept of the metaverse in general and in the context of the hospitality and tourism industry. Next, we propose a conceptual framework for creating metaverse experiences, identifying research gaps, and proposing agenda items with the potential to significantly benefit hospitality and tourism industry players. Finally, we classify future research agendas into three broad categories: staging experiences in the metaverse, understanding possible changes in the consumer behavior, and marketing and operations strategies in the metaverse. 学者们推测，metaverse将改变酒店业和旅游业的运作方式. 学术界和工业界对这一新现象的理解正处于十字路口. 在这篇评论文章中，我们首先试图在酒店业和旅游业的背景下解释metaverse的概念. 接下来，我们提出了一个概念框架，用于创建metaverse体验、确定研究差距，并提出有可能使酒店业和旅游业参与者受益的议程项目. 最后，我们将未来的研究议程分为三大类在metaverse中展示体验、了解消费者行为的可能变化，以及metaverse中的营销和运营策略. [ABSTRACT FROM AUTHOR]

Aim: Bell's palsy is an acute peripheral facial nerve paralysis affecting one side of the face and can be associated with various causes, such as infectious and autoimmune conditions. In line with this, an increase has been observed in the incidence of peripheral facial paralysis during the coronavirus disease-2019 (COVID-19) infection pandemic. We aimed to investigate whether the incidence of Bell's palsy increased before and after the COVID-19 in the pre-vaccine period. Methods: All cases diagnosed with Bell's palsy in a tertiary hospital aged 18 and up in 2020 were analyzed, and to compare these numbers to pre-pandemic numbers, patients' data from 2019 was accessed. Excluding those who had recurrent facial palsy, those whose conditions were due to central causes, and those who were misdiagnosed, the frequency of the disease was calculated by proportioning it to the total number of patients presenting to Neurology, and Ear, Nose, and Throat Diseases Outpatient Clinics and the Green Zone of the Emergency Department at that time; and the Bell's palsy distribution within three-month periods and whether this distribution is correlated with the distribution of COVID-19 infection were examined. Results: Three hundred twenty five cases from 2019 and 291 cases from 2020 were included in the study. No significant difference was detected between those years in terms of age and sex. The frequency of Bell's palsy in 2019 was 0.059% while it was 0.071% in 2020, which suggested a significant difference between the years. The significant difference could be clearly observed in the second and fourth quarters when the cases of COVID-19 infection were at their peak. Conclusion: This study suggests that patients with complaints of peripheral facial paralysis should also be examined for COVID-19 infection. [ABSTRACT FROM AUTHOR]

Objective: We aimed to compare clinical features of children with congenital lung malformations (CLM) who were diagnosed in prenatal and postnatal period. Material and Methods: Children with CLM followed in our pediatric pulmonology department between 2007-2021 were evaluated in terms of sex, age, complaints at presentation, time of onset of symptoms, age at diagnosis, diagnostic methods, gestational ages, birth weights, parental consanguinity, presence of any operations, age and indications of operations and long-term complications. Children who were diagnosed in prenatal period and those in postnatal period were compared in terms of their clinical features. Results: The mean age of 37 children with CLM was 6.7±5.8 years, and seventeen (45.9%) of the children were girls. Children who were diagnosed during the prenatal period (n:18) had no complaints, whereas cough and recurrent pneumonia were the most common reasons at admission in others. Median age at diagnosis of children who were postnatally diagnosed (n:19) was 30 days (10-1080). Eighteen (48.6%) children were diagnosed by prenatal ultrasonography, 14 (37.8%) by computed tomography, and five (13.6%) by chest x-ray. During follow-up, malformations of two children regressed spontaneously. Twelve children were operated while others were followed up with their anomalies. Asymptomatic follow-up duration of children who were prenatally diagnosed was significantly different than the children who were diagnosed in the postnatal period (36.5±4.7 vs 24.0±12.7 months) (p:0.004). Conclusion: Children with CLM who were diagnosed in the prenatal period were found to remain asymptomatic for longer. Prenatal diagnosis enables them to live longer without symptoms with appropriate surgical timing. [ABSTRACT FROM AUTHOR]

Mycobacterium abscessus appears to be increasing cause of pulmonary infection in children with underlying risk factors including cystic fibrosis, chronic lung disease and immunodeficiency syndromes. We present a case of pulmonary M. abscessus infection in a pediatric patient with primary ciliary dyskinesia and he was successfully treated with parenteral amikacin, linezolid and oral clarithromycin combined with inhaled amikacin. Clinical improvement was observed after adding inhaled amikacin to the treatment. [ABSTRACT FROM AUTHOR]

Aripiprazole (ARI) is a recently developed antipsychotic medication that belongs to the second generation of antipsychotics. The literature has contradictory information regarding ARI, which has been classified as pregnant use category C by the FDA. 125 pathogen-free fertilized eggs were incubated for 28 h and divided into five groups of 25 eggs each (including the control group), and 18 eggs with intact integrity were selected from each group. After the experimental groups were divided, ARI was administered subblastodermally with a Hamilton micro-injector at 4 different doses (1 mg/kg, 5 mg/kg, 10 mg/kg, 20 mg/kg). At the 48th hour of incubation, all eggs were hatched and embryos were removed from the embryonic membranes. And then morphologic (position of the neural tube (open or closed), crown-rump length, number of somites, embryological development status), histopathologic (apoptosis (caspase 3), cell proliferation (PCNA), in situ recognition of DNA breaks (tunnel)), genetic (BRE gene expression) analyzes were performed. According to the results of the morphological analysis, when the frequency of neural tube patency was evaluated among the experimental groups, a statistically significant difference was determined between the control group and all groups (p < 0.001). In addition, the mean crown-rump length and somite number of the embryos decreased in a dose-dependent manner compared to the control group. It was determined that mRNA levels of the BRE gene decreased in embryos exposed to ARI compared to the control group (p < 0.001). Morphologically, histopathologically, and genetically, aripiprazole exposure delayed neurogenesis and development in early chick embryos. These findings suggest its use in pregnant women may be teratogenic. We note that these results are preliminary for pregnant women, but they should be expanded and studied with additional and other samples. • All aripiprazole doses impaired neurogenesis and embryonic development. • BRE gene reduction affected somites development in aripiprazole-treated groups. • Chick embryo neural and spinal development resembles human embryos. [ABSTRACT FROM AUTHOR]

In this study, a series of 1,2-disubstituted benzimidazoles, designed to mimic nucleotides and interact favorably with amino acids in protein active sites, were synthesized and characterized. These compounds were characterized using IR, NMR spectral data, and elemental analyses, leveraging the recognition of substituted benzimidazoles as pharmacophores in the literature due to their documented anticancer activities. The compounds involved chloro and substituted phenyl rings, known for their anticancer activities, as key pharmacophores. Cytotoxicity assessments using the MTT assay were performed against MCF7, MDA-MB-231, and normal mouse fibroblasts (L929) for all synthesized compounds (11–19). Among them, compound 13 exhibited the most significant activity, inducing cell cycle arrest at the G0/G1 phase in MCF7 cells, suggesting its potential as an antitumor agent through apoptosis. To understand the underlying mechanisms of apoptotic cell death induced by compound 13 , we investigated the involvement of apoptotic proteins such as Bax, Bcl-2, and p53. Our findings highlight Compound 13 as a promising scaffold for further optimization in the development of effective anticancer drugs. [ABSTRACT FROM AUTHOR]

Since the economic recovery heavily depends on the population attaining herd immunity against the virus through the vaccination programme, understanding the factors that improve people's intentions to get vaccinated against COVID-19 is critically important for the hospitality and tourism industry. This research investigates whether travel desire can moderate the relationship between attitude toward COVID-19 vaccines and COVID-19 vaccination intentions. The proposed model was tested utilizing two sets of data collected from a total of 1,341 adults. The results of the study show that subjective norms and perceived risk are strong predictors of attitude toward COVID-19 vaccines. The effects of subjective norms and perceived vaccination risk on COVID-19 vaccination intentions are partially mediated by attitude toward COVID-19 vaccines. The findings show that the higher the travel desire individuals have, the stronger the effects of their attitude toward COVID-19 vaccines on COVID-19 vaccination intentions are. [ABSTRACT FROM AUTHOR]

Background: Although the risk of tibial tunnel convergence in the setting of multiligamentous reconstruction has been reported in the literature, the risk of tunnel convergence in the setting of posterior cruciate ligament (PCL), anterior cruciate ligament (ACL) reconstruction and medial and lateral meniscus root repair has not been defined. Purpose: To examine the risk of tunnel convergence and to determine optimal tunnel placement for ACL and PCL reconstruction performed in conjunction with posterior medial and lateral meniscus root repairs on the anteromedial proximal tibia. Study Design: Descriptive laboratory study. Methods: Three-dimensional (3D) tibial models were created using computed tomography scans of 20 cadaveric specimens. After determining optimal tunnel entry and exit points for ACL and PCL reconstructions, and medial and lateral meniscus root reattachment to the anatomic footprints, we used image processing software to create root tunnels over the anteromedial tibia on the tibial models. ACL and PCL tunnels were kept constant. The meniscus root repair tunnels were then reoriented to match the angle of the ACL tunnel, making both tunnels parallel in the sagittal plane. Tunnel convergence risk was analyzed by identifying the shortest 3D distance between tunnel axes and subtracting the radius of each tunnel from this distance for single- and double-tunnel repair techniques in both case scenarios. Results: All specimens demonstrated convergence between the ACL and lateral meniscus root tunnels when the root tunnel's entry was created proximal to the ACL tunnel's entry for single- and double-tunnel techniques, but no convergence was seen between these tunnels using the parallel orientation in the sagittal plane. There were no cases of convergence between the ACL and medial meniscus root tunnels in any of the configurations. The greatest distance between the ACL and medial meniscus root tunnels was achieved using the single-tunnel technique in parallel orientation (12.1 ± 2.8 mm). There were no cases of convergence between the PCL and medial meniscus root tunnels in the original orientation; however, 2 of 20 specimens demonstrated convergence using the parallel orientation with the double-tunnel technique, and there were no cases of convergence using the single-tunnel technique. The PCL and lateral meniscus root tunnels did not demonstrate convergence in any configuration. Conclusion: There was a high risk of convergence between ACL and posterior meniscus root tunnels when all the tunnels were created on the anteromedial tibia. Reorienting meniscus root tunnels parallel to ACL tunnels may help reduce this risk. There is increased risk of tunnel convergence with root repairs in cases of bicruciate reconstructions, and therefore a double-tunnel root repair technique should be used with caution. Clinical Relevance: To avoid tibial tunnel convergence when performing ACL and PCL reconstruction with medial and lateral meniscus root repair, surgeons should reorient the meniscus root repair tunnels to be parallel on the sagittal plane to the ACL tunnel to decrease the risk of convergence. In cases of bicruciate ligament reconstruction, use of the double-tunnel technique requires caution to avoid convergence risk with the PCL tunnel. [ABSTRACT FROM AUTHOR]

Since the COVID-19 pandemic has significantly increased the use of personal vehicles in travel, adoption of self-driving autonomous vehicles can radically transform the travel industry. Thus, this study develops and tests a conceptual autonomous vehicle acceptance model that identifies hedonic motivation, trust in autonomous vehicles and social influence as critical determinants of performance expectancy, perceived risk and emotions, which determine travelers' intentions to use autonomous vehicles (AVs) utilizing the Cognitive Appraisal Theory and the Artificially Intelligent Device Use Acceptance model as conceptual frameworks. Findings indicate that trust is the most powerful determinant of performance expectancy and essential to decrease risk perceptions. Furthermore, performance expectancy and hedonic motivation are critical determinants of travelers' positive emotions, which in turn determines the acceptance of AVs. Contribution to theoretical knowledge and implications for practice are provided, and limitations and recommendations for future studies are discussed. [ABSTRACT FROM AUTHOR]

In this paper, we propose a new effective algorithm for the categorical syllogisms by using a calculus system Syllogistic Logic with Carroll Diagrams, which determines a formal approach to logical reasoning with diagrams, for representations of the fundamental Aristotelian categorical syllogisms. We show that this logical reasoning is closed under the syllogistic criterion of inference. Therefore, the calculus system is implemented to let the formalism which comprises synchronically bilateral and trilateral diagrammatical appearance and naive algorithmic nature. And also, there is no need specific knowledge or exclusive ability to understand this decision procedure as well as to use it in an algorithmic system. Consequently, the empirical contributions of this paper are to design a polynomial-time algorithm at the first time in the literature to conduce to researchers getting into the act in different areas of science used categorical syllogisms such as artificial intelligence, engineering, computer science and etc. [ABSTRACT FROM AUTHOR]

Introduction: No clear information exists about the factors affecting pleural thickening following parapneumonic effusion in children. We aimed to investigate factors that affect the resolving time of pleural thickening after parapneumonic effusion.Methods: Between the years of 2007-18, 91 patients, which were followed due to diagnosis of pleural thickening after parapneumonic effusion, were assessed. Ages, complaints, physical examination findings, laboratory results, chest x-ray and ultrasonography findings, treatments, duration of treatment and recovery time of the patients were examined terms in of pleural thickening resolving time.Results: The mean age of patients was 7.5 ± 5.0 years. Pleural thickening resolving time was 151 ± 6.8 days. The resolving time for pleural thickening was delayed with older ages, longer duration of complaints, fever before hospital admission and treatment, lower oxygen saturation at the time of admission, crackles in the physical examination, higher white blood cell count and pleural fluid density (p = 0.018, p = 0.001, p = 0.021, p = 0.020, p = 0.024, p = 0.025, p = 0.021, p = 0.019). In addition, the amount of effusion measured by thorax ultrasonography, fibrinolytic usage, and complications had a role in the delayed resolving time (p = 0.034, p = 0.001, p = 0.034). Pleural thickening resolved in 80% of the patients.Conclusion: In this report, 80% of pleural thickening, following parapneumonic effusion resolved within 5 months. Patients who do not have a complication during follow-up are not required to monitor with frequent chest x-ray. Patients with a higher amount of pleural effusion, complications and need for fibrinolytic treatment should be followed more carefully. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to determine the incidence of the absence of the (last) 12th ribs in a population in a setting of detailed 2nd-trimester sonography using three-dimensional (3D) ultrasound and to assess whether or not this may be related to chromosomal aneuploidies.Methods: Prospectively, we counted fetal ribs for the absence of the (last) 12th ribs in singleton pregnancies of women who presented to our clinic for detailed 2nd-trimester sonography. The assessment was carried out using 3D ultrasound. Volume data sets were acquired with the 3D skeleton mode using the maximum intensity with X-ray-weighted rendering. If the 3D skeleton mode was not sufficient, volume contrast imaging with the OmniView bone mode was used.Results: The fetal ribs could be visualized in 97.01% of the 1,943 fetuses examined between 20 and 23 weeks' gestation. Timing the examination at 21, 22, or 23 weeks was found to be more successful than conducting it at 20 weeks. Twelfth ribs were found to be absent in 33 fetuses; 16 fetuses had 11 ribs unilaterally and 17 had so bilaterally. None of them had chromosomal abnormalities. Associated anomalies were present in 6 fetuses (18.2%); 2 of the anomalies were major and 4 minor.Conclusion: The incidence of absent 12th ribs in this mixed population was 1.75%. In the absence of additional anomalies, the prognosis is favorable. [ABSTRACT FROM AUTHOR]

• The growing problem of antibiotic resistance is a major public health concern. • An antimicrobial stewardship study was conducted in intensive care units. • There was a significant increase in total quality-of-care scores. One of the most important public health concerns is the ever-growing problem of antibiotic resistance. Importantly, the rate of introduction of new molecules into clinical practice has slowed down considerably. Moreover, the rapid emergence of resistance shortens the effective 'lifespan' of these molecules. The quality of care before and after active intervention and feedback was evaluated in patients diagnosed with sepsis/septic shock or ventilator-associated pneumonia (VAP) in the ICUs of Hacettepe University Adult and Oncology Hospitals. There was a significant increase in total scores. Significant improvements were achieved in the management of these patients in terms of requests for necessary diagnostic tests, and the prolonged infusion of beta-lactam agents. Implementation of an ASP in centers where antimicrobial management of ICU patients is largely controlled by infectious diseases specialists remains a feasible strategy that leads to better patient care. [ABSTRACT FROM AUTHOR]

Introduction: Most patients with non-small-cell lung cancer tumors that have epidermal growth factor receptor (EGFR) mutations have deletion mutations in exon 19 or exon 21, or both.In recent years, targeted therapies in lung cancer have increased survival, but the development of resistance to these drugs poses a major problem. Thesubstitution of methionineforthreonine at position 790 (T790M) mutation,is primarily responsible for this resistance. However, after osimertinib used in T790M positivepatients treatment options are generally limited to chemotherapy. Case report: We reported the efficacy of erlotinib, which we reapplied due to the disappearance of the resistance mutation after osimertinib in a 68-year-old patient using osimertinib after erlotinib. Management and outcome: In the patient using erlotinib due to exon 19 deletion when progression was observed and T790M positivity was detected, osimertinib treatment was initiated. However, when T790M was found to be negative with rebiopsy in progression after osimertinib, a complete response was achieved by restarting erlotinib. Discussion: The strategy of restarting erlotinib treatment with negative T790M mutation detected in biopsies of patients with osimertinib resistance may be an acceptable treatment option. [ABSTRACT FROM AUTHOR]