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Purpose: This study aimed to develop the "Sudden Infant Death Syndrome Awareness Scale-Mother Form" (SIDSAS-MF) and assess its psychometric properties., Design and Methods: The methodological study involved mothers (n = 450) with infants aged 0-12 months. Data were collected using a socio-demographic information form and the draft of the SIDSAS-MF. Factor analysis and reliability analyses were conducted to assess the data., Results: Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) of the scale revealed a structure consisting of six items and two sub-dimensions. The factor loadings of the scale were found to be above 0.30. Fit indices following CFA were achieved at excellent levels. Both McDonald's omega and Cronbach's alpha values for each sub-dimension of the scale exceeded 0.6. Furthermore, the correlation values of the items with the total factor score ranged from 0.661 to 0.839., Conclusions: The study concluded that the six-item form of the SIDSAS-MF is a valid and reliable measurement tool for mothers with infants aged 0-12 months in the Turkish population., Practical Implications: Midwives and nurses can use this scale in their clinical training to determine the level of awareness mothers have towards SIDS. It is also recommended that the developed scale should be adapted to different cultures., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: World Health Organization defines palliative care as a multidisciplinary approach to enhancing patients physical, psychological, and emotional well-being. Our study investigated palliative care unit decannulation rates and factors affecting success. Methods: The data of patients hospitalized in the palliative care clinic between 2017 and 2019 were analyzed retrospectively. Demographic data, diagnoses, comorbidities, nutritional status, Norton and Braden Scale scores, day of hospitalization, and discharge direction of the patients were recorded. All patients were evaluated and treated by a multidisciplinary team. Results: One hundred two tracheostomy patients were monitored. Patients in the palliative care clinic had an average stay of 22.19 ± 13.67 days (median: 21, min: 4, max: 66). Forty-one patients were decannulated. Statistically significant age difference was observed between decannulated and non-cannulated groups, with the decannulated group having a significantly lower mean age (52.10 ± 20.54, median: 53) compared to the non-decannulated group (61.48 ± 18.07) ( z = -2.516, P = .012). The mean Braden scale score of the decannulated group (14.29 ± 2.50) was significantly higher than that of the non-decannulated group (12.20 ± 2.82) ( z = 3.823, P < .001), and the mean Norton scale score of the decannulated group (11.34 ± 2.50) was significantly higher than that of the non-decannulated group (9.46 ± 2.46) ( z = 3.472, P = .001). Conclusion: Patients with tracheostomy can be easily followed and decannulated in palliative care clinics. It is important that a multidisciplinary team is involved in palliative care units. Age, immobility, Norton and Braden scales, and level of consciousness are factors affecting the success of decannulation., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study investigates the effect of forest cover, development stage and aspect factors on surface temperature (LST) in Demirköy and Düzce Forest Enterprises (FE) using Landsat 8 OLI satellite imagery from July 2021. In Demirköy FE, the highest LST value was recorded in the district center with 47.4 °C, in Düzce FE, the highest LST value was recorded in the provincial center with 44.6 °C, while the lowest value was 14.3 °C in Demirköy FE and 13.02 °C in Düzce FE in densely forested areas. When the stands were evaluated, it was found that pure juvenile oak stands had the highest average LST value with 30.48 °C in Demirköy FE and 23.96 °C in Düzce FE, whereas lower LST values were observed in old oak stands due to more dense cover. In terms of aspect, higher temperatures were recorded in the southern and western aspects in both study areas. In Düzce FE, high LST values were also observed in juvenile stands in the northern direction, indicating the influence of local factors such as topography and solar radiation angle. The highest LST values were observed in open forest areas; 6-9 °C higher temperatures were found in Demirköy and 1-5 °C higher in Düzce compared to vegetated areas. Significant correlations were found between LST and vegetation indices, and the highest correlation was found between LST and Normalized Difference Structuring Index (NDBI) (R 2 , 0.54 in Demirköy and R 2 , 0.50 in Düzce). NDVI showed a negative relationship with LST (R 2 , 0.47 in Demirköy, R 2 , 0.43 in Düzce). These findings reveal the critical role of forest density, tree species, and forest management practices in regulating surface temperatures, especially in the context of urbanization and deforestation., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background and Aim: Chronic myeloid leukemia (CML) incidence has recently increased in younger individuals. With time, given the nature of the disease and available therapies, as well as the existing paucity and inconsistency of advice, worries about fertility have surfaced. With all these clear unknowns, we designed this study to raise awareness among both physicians and CML patients about whether male and female patients of childbearing age were using contraception at the time of diagnosis, and if so, which methods they were using. In this context, this study aimed to evaluate the contraception methods in patients with CML., Materials and Methods: Eighteen centres from Turkey participated in the study. Male and female patients of childbearing age diagnosed with chronic and accelerated phase CML between the years 2000 and 2024 were evaluated retrospectively., Results: Of the two hundred and thirty-two patients included, one hundred and twenty-five (53.9%) of these patients were female and 107 (46.1%) were male. At diagnosis, all female patients were in the childbearing age, and male patients were sexually active. The median age at diagnosis of the patients was 38 (range, 18-77) years. Eighty-six (68.8%) female patients were using any contraception method, while this was 53.2% (n = 57) among male patients., Conclusion: In conclusion, since CML patients are diagnosed at an earlier age and the desire of these patients to have children, adequate information and evaluation should be provided regarding fertility and contraception issues, especially in female patients, from the moment of diagnosis., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: Trying to juggle multiple roles and responsibilities as a student, nurse, and mother can be challenging due to pressures from overlapping time management. This study was conducted to explore the experiences of graduate students who work as nurses and are mothers., Methods: The qualitative phenomenological data for this study were gathered from nurses at a training and research hospital between August and November 2022, utilizing face-to-face interviews. The study cohort comprised twelve nurses aged 28 to 48, all actively engaged in postgraduate education. Data were collected using a descriptive information form and semi-structured interviews. Thematic analysis was executed through inductive coding, facilitated by the Max Qualitative Data Analysis (MAXQDA) Analytics Pro2022 software., Results: Four central themes were developed: "Experiences During the Breastfeeding Process," "Positive Effects," "Encountered Challenges," and "Expectations.", Conclusions: The findings underscored that nurses who are mothers and pursuing postgraduate education encounter difficulties throughout their academic pursuits, notably attributed to working conditions and professional cultural values., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: Palliative care patients experience problems in sleep quality due to stress, chronic diseases, and physical and psychosocial problems. Our aim is to determine the perceived stress and sleep quality levels of our palliative care patients and their related factors., Methods: This cross-sectional, descriptive research was conducted between November 2023 and February 2024 at a palliative clinic located in Ankara, Turkey, that is affiliated with a training and research hospital. In the research, a data form, the Perceived Stress Scale and the Pittsburgh Sleep Quality Index were used as data collection instruments. Kolmogorov-Smirnov and Shapiro-Wilk tests, and Mann-Whitney U and Kruskal-Wallis H tests were used for the analysis., Results: The total score on the Perceived Stress Scale was determined to be 35.81±7.45. The total score for Pittsburgh Sleep Quality Index was 13.20±3.20. Significant relationships were found between insufficient self-efficacy scores and habitual sleep efficiency, daytime dysfunction and total Pittsburgh Sleep Quality Index scores. Significant relationships were found between insufficient self-efficacy scores and sleep latency, habitual sleep efficiency, daytime dysfunction and total Pittsburgh Sleep Quality Index scores., Conclusions: This study determined that certain descriptive characteristics of palliative care patients affect their sleep quality and perceived stress level, as well as that some components of sleep quality and perceived stress level are related. Palliative care is holistic in nature, encompassing symptom management; therefore, the importance of patients' psychosocial integrity should not be overlooked. Consequently, identifying components that may hinder symptom management and addressing the patient comprehensively will be crucial., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Cytarabine (ARA-C) is an antimetabolite agent used especially in the treatment of hematologic malignancies. Infusion reactions have an important place among the side effects that may occur due to treatment. Clinical findings of infusion reactions resemble allergic reactions., Case Report: 47-year-old male patient with a diagnosis of B-cell Acute Lymphoblastic Leukaemia developed infusion reaction during ARA-C treatment., Management & Outcome: There was no alternative treatment option for his existing malignant disease, we decided ARA-C desensitization., Discussion: We would like to describe a successful desensitization protocol in an adult patient who experienced a reaction during ARA-C infusion., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Tracheostomy involves a challenging care process in which both patients and caregivers have difficulty communicating. Loss of speaking ability negatively affects caregivers as well as patients. The objective of this study was to examine the experiences of caregivers of patients with tracheostomy during care and after the first vocal exercise. This is a qualitative interview study using in-depth interviews. We used Colaizzi's method of data analysis. The interviews were carried out with 17 caregivers from March to July 2023. Two main themes were identified: the communication process and the first time hearing the patient's voice. In addition, communication techniques, difficulty in communication, providing motivation, and emotions were considered as subthemes. A better quality of care can be provided by understanding the experiences of caregivers of patients with tracheostomy, by sharing feelings and thoughts, and by using patient-specific communication methods., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 by The Hospice and Palliative Nurses Association. All rights reserved.)

Staphylococcus aureus, Escherichia coli and Mycoplasma bovis are the most commonly isolated mastitis pathogens. The aim of this study was to evaluate the efficacy of a new mixed vaccine against mastitis caused by  Staphylococcus aureus, Escherichia coli, and Mycoplasma bovis. For this purpose, a mixed inactivated vaccine was administered subcutaneously to 24 heifers as one dose (2 mL) on the 45th day before birth and the second dose 21 days later. In 9 heifers, 2 mL of PBS was administered as placebo instead of vaccine. Then, heifers were divided into 3 groups as 7 vaccinated and 3 unvaccinated animals. Staphylococcus aureus, Escherichia coli, and Mycoplasma bovis were administered to the groups through intramammary route. Three vaccinated heifers were considered the common control without bacteria in all groups. The parameters considered to assess the effect of vaccination were clinical findings, bacterial count in milk, somatic cell count, and antibody titers. Clinical signs were observed only in the unvaccinated placebo group. Bacteria count and somatic cell count in milk increased in vaccinated and unvaccinated heifers. However, this increase was less in vaccinated animals and gradually returned to the normal level. In the unvaccinated heifers, it was ever high. Serum antibody titers were measured before and after vaccination. Antibody titers were high in vaccinated heifers after vaccination and were negative in unvaccinated heifers. In conclusion, the mixed vaccine had beneficial effect against Staphylococcus aureus, Escherichia coli, and Mycoplasma bovis mastitis and stimulated the immune response of vaccinated heifers.

This research was conducted as a descriptive and cross-sectional study to determine the effects of nursing students' liking of children and attitudes toward clinical practice on their comfort and worry levels in the pediatric clinic. The research was carried out with 270 nursing students who had already taken or were taking the child health and diseases nursing course. Data were collected using a Nursing Student Information Form, the Barnett Liking of Children Scale, the Nursing Students' Attitudes toward Clinical Practices Scale, and the Pediatric Nursing Student Clinical Comfort and Worry Assessment Tool. Mean values, percentage calculations, and linear regression analysis were used for the analysis of the research data. Participants' mean scores were 52.30 ± 6.16 on the Barnett Liking of Children Scale, 103.72 ± 19.35 on the Nursing Students' Attitudes toward Clinical Practices Scale, 15.61 ± 3.74 on the comfort sub-dimension, and 11.63 ± 4.32 on the worry sub-dimension of the Pediatric Nursing Student Clinical Comfort and Worry Assessment Tool. It was determined that the liking of children and attitudes toward clinical practice explained 43.6% of the clinical comfort level of pediatric nursing students in Model 1 and 45.2% of their clinical worry level in Model 2. It was determined that the liking of children and attitudes toward clinical practice significantly affected the comfort and worry levels of nursing students in the pediatric clinic.

Various body fluids such as blood, semen, vaginal secretions, and saliva are frequently encountered at crime scene. In cases of sexual assault, semen stains are one of the most reliable evidence of biological origin. In this study, our objective was to develop a method for estimating the time since deposition of semen stains on five different fabric types using Attenuated Total Reflectance-Fourier Transform Infrared (ATR-FTIR) Spectroscopy, with a focus on a time frame of up to 8 weeks. Semen samples from six different volunteers were dripped onto five distinct fabric materials, and ATR-FTIR measurements were obtained at 17 different time points. Principal component analysis (PCA) and partial least squares (PLS) methods were employed to differentiate semen stains on various fabric samples and estimate the age of semen stains. Models constructed using PCA and PLSR achieved high R 2 values and low root-mean-square error (RMSE). While the performance varies depending on fabric types, it was observed that age estimation of semen stains can be made within following intervals: 0.39-0.76 days for 0-7 day range, 2.59-3.38 days for the 1-8 week range, and 3.98-8.1 days for the 0-56 day range. This study demonstrates the effectiveness of using ATR-FTIR spectroscopy in combination with chemometrics to estimate the age of human semen stains on various fabric types based on time-dependent spectral changes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Aim: The present study to determine the level of therapeutic communication skills among the students undertaking the pediatric nursing course and explore the associated influencing factors., Methods: This descriptive cross-sectional study was conducted with 140 nursing students who took the pediatric nursing course. Data were collected using a Nursing Student Information Form and the Therapeutic Communication Skills Scale for Nursing Students. The mean and percentage calculations, t-test, ANOVA test, and regression analysis were conducted to analyze the correlations between the participants' descriptive characteristics and their mean scores on the scales., Results: The participants' mean scores obtained on the total Therapeutic Communication Skills Scale for Nursing Students and all of its subdimensions were observed to have a statistically significant correlation with variables such as gender, grade point average, willingness to select the nursing department, satisfaction with the nursing department, difficulty in establishing communication, perceived ability to establish social relations, difficulty in communicating with a child, perception of childhood life, experience with child care, fondness for children, interest in playing therapeutic games with children, and perceived ability to communicate with children. In Model 1, certain descriptive characteristics (satisfaction with the nursing department, difficulty in communicating with a child, experience with child care, interest in playing therapeutic games with children, and perceived ability to communicate with children) explained 52.4% of the therapeutic communication skills scores of the pediatric nursing students and were statistically significantly., Conclusions: In this study, it was determined that some of the descriptive characteristics of the students who took the pediatric nursing course had a significant effect on their therapeutic communication skills., Implications for Practice: In order to develop the therapeutic communication skills of students undertaking a pediatric nursing course, it is necessary to support these students with a standard curriculum that includes student-centered, innovative, and interactive educational methods, such as role play, case analysis, and video-based learning. It is also recommended to conduct comparative studies on different educational approaches for nursing students undertaking pediatric nursing courses or meta-analyses to evaluate the effectiveness of such approaches., Competing Interests: Declaration of Competing Interest The authors have no funding or conflicts of interest to disclose. The authors have no conflicts of interest to disclose., (Copyright © 2023 Elsevier Inc. All rights reserved.)

This study describes the improvements of adsorption capacities for raw calcium oxide (CaO) particles subjected to ultrasonication, activation with nitric acid and thermal treatments. The influence of acids and bases on CaO particle surface was assessed with respect to several variables including treatment methods, adsorption contact times, particle size and specific surface area characteristics, concentration and temperature along with various thermodynamic parameters. Structural analyses and physical characteristics of CaO particles were evaluated using FT-IR and SEM methods. SEM micrographs of samples revealed uniform distributions of CaO particles of average diameter 0.5-2.0 µm. The CaO surfaces showed CH 3 COOH as having the greatest amounts of adsorbate and modeling of the experimental adsorption isotherm data agreed well with the Freundlich adsorption isotherm. Enhancements in adsorption performance of untreated CaO particles were noted with the ultrasonication, activation with HNO 3 and thermal treatment processes. The Langmuir-type adsorption demonstrated that single layer adsorption capacities of adsorbate CH 3 COOH at 25  o C on sonicated CaO (386.6 mg/g), with nitric acid and thermal activation (354.9 and 320.8 mg/g, respectively) were greater than that of the unsonicated CaO (296.3 mg/g) particles. Adsorption spontaneities of the processes were confirmed by the decreases in adsorption free energy values, ΔG ads 0 , changing from -16.1 to -17.1 kJ mol -1 with temperature range 283-338 K., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The synthesis of zinc oxide (ZnO) was accomplished from zinc borate (Zn 3 B 2 O 6 ) minerals to be used as electrodes in supercapacitor applications. The concentrations of obtained zinc (Zn) metal after treatment with hydrochloric acid (HCl) were determined by atomic absorption spectroscopy (AAS). Direct synthesis of ZnO on a nickel (Ni) foam surface was conducted by employing the hydrothermal technique using a solution with the highest Zn content. The results showed the successful synthesis of ZnO nanorods on the surface of Ni foam with an average wall size of approximately 358 nm. Cyclic voltammetry (CV) and galvanostatic charge-discharge (GCD) measurements revealed that the synthesized electrode exhibited battery-type charge storage characteristics, reaching a maximum specific capacitance of approximately 867 mF·cm - ² at a current density of 2 mA·cm - ². Additionally, the energy and power densities of the electrode at a current density of 2 mA·cm - ² were calculated as 19.3 mWh·cm - ² and 200 mW·cm - ², respectively. These results exhibited promising performance of the single-component electrode, outperforming the existing counterparts reported in the literature., Competing Interests: The authors declare no conflict of interest.

Purpose: The effects of Kangaroo mother care (KMC) on physiological parameters in preterm infants have been reported in the literature by experimental and quasi-experimental studies, and varying findings have been presented. The present study was conducted to determine the effects of KMC on the physiological parameters of premature newborns in the Neonatal Intensive Care Unit., Design and Method: The review was conducted according to the specified keywords by scanning the EBSCO-host, Cochrane Library, Medline, PubMed, ScienceDirect, Web of Science, and TR index databases using the keywords "kangaroo care AND preterm AND vital signs." The pool mean differences (MDs) were calculated, adopting a 95% confidence interval (CIs) using the Stata 16 software for the meta-analysis [PROSPERO: CRD42021283475]., Results: Eleven studies for systematic review and nine studies for meta-analysis, including 634 participants, were found eligible for inclusion. It was determined that the "temperature" (z = 3.21; p = 0.000) and "oxygen saturation" (z = 2.49; p = 0.000) values created a positive effect in general in the kangaroo care group; however, there was no sufficient evidence to state that it affected the "heart rate" (z = -0.60; p = 0.55) and "respiratory rate" (z = -1.45; p = 0.15) values. In the present study, the duration of KMC application had statistically different effects on temperature and oxygen saturation (SpO 2 ) (p < 0.05). One-hour or shorter applications of KMC had a higher effect on the temperature and oxygen saturation values (1.83; 1.62, respectively)., Conclusion: Our results provided references for clinical implications, and the "temperature" and "oxygen saturation (SpO 2 )" values created a positive effect in general in the KMC group. However, there was no sufficient evidence to state that it affected the "heart rate" and "respiratory rate" values. The duration of KMC application had statistically different effects on temperature and oxygen saturation. One-hour or shorter applications of KMC had a higher effect on the temperature and SpO 2 values. Longitudinal, randomized, controlled studies examining the effects of KMC on vital signs in premature newborns with vital parameters outside the normal reference range are recommended., Practice Implications: The goal of the NICU nurse is to improve the infant's well-being. The application of KMC is a unique care for the nurse in maintaining the newborn's well-being. The vital signs of newborns hospitalized in the NICU with critical problems may be out of normal limits. KMC is an essential developmental care practice that ensures that the neonate's vital signs are kept within normal limits by relaxing the neonate, reducing stress, increasing comfort, and supporting interventions and treatments. KMC application is unique for each mother‑neonate pair. Depending on the tolerance of the mother and infant in terms of duration, it is recommended to perform KMC in the NICU under the supervision of a nurse. Neonatal nurses should support mothers in giving KMC in the NICU since KMC has ameliorative effects on the vital signs of premature neonates., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)

This study describes the development of 2-hydrazinobenzothiazole modified-amide/imide co-polymers for the extraction/pre-concentration of trace As(III), from edible vegetable oils. Their characterization was realized by help of instrumental techniques. The method is based on pH-dependent complexation between As(III) and co-polymeric chelators in presence of 35-fold excess As(V), their selective extraction into the mixed micellar phase, and detected at pH 2.0 and 6.0 by UV-vis spectrophotometer. The variables affecting extraction efficiency were optimized. From pre-concentration of 20-mL sample, the good linear relationships were obtained in range of 1-40 and 3-75 µg/L with DLs of 0.32 and 1.00 µg/L. The accuracy was verified by analysis of a certified sample without and with spiking. The method was applied into the analysis of iAs levels of samples. The results show that the functional co-polymers are efficient chelators, and exhibit great potential for the selective extraction of As(III) from edible vegetable oils., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

The current investigation involved casting the Mg-2.2Gd-2.2Zn-0.2Ca (wt%) alloy (GZX220) through permanent mold casting, followed by homogenization at 400 °C for 24 h and extrusion at 250 °C, 300 °C, 350 °C, and 400 °C. Microstructure investigations revealed that α-Mg, Mg-Gd, and Mg-Gd-Zn intermetallic phases were present in the as-cast alloy. Following the homogenization treatment, a majority of these intermetallic particles underwent partial dissolution into the matrix phase. α-Mg grains exhibited a considerable refinement by extrusion due to dynamic recrystallization (DRX). At low extrusion temperatures, higher basal texture intensities were observed. The mechanical properties were remarkably enhanced after the extrusion process. However, a consistent decline in strength was observed with the rise in extrusion temperature. The corrosion performance of the as-cast GZX220 alloy was reduced by homogenization because of the lack of corrosion barrier effect of secondary phases. A significant enhancement of corrosion resistance was achieved by the extrusion process.

The primary purpose of this study was to produce an ore-based high-capacity supercapacitor electrode. For this, chalcopyrite ore was first leached with nitric acid, and then metal oxide synthesis was carried out immediately on nickel foam using a hydrothermal technique from the solution. Cauliflower-patterned CuFe 2 O 4 with a wall thickness of about 23 nm was synthesized on the Ni foam surface, characterized by XRD, FTIR, XPS, SEM, and TEM investigations. The produced electrode also displayed a feature of a battery-like charge storage mechanism with a specific capacity of 525 mF cm -2 at 2 mA cm -2 current density, energy of 8.9 mWh cm -2 , and a power density of 233 mW cm -2 . Additionally, even after 1350 cycles, this electrode still performed at 109% of its original capacity. The performance of this finding is 255% higher than that of the CuFe 2 O 4 in our earlier investigation; despite being pure, it performs far better than some of its equivalents in the literature. Obtaining such performance from an electrode made from ore indicates that the use of ore has a lot of potential for supercapacitor production and property improvement.

Purpose: Reducing the mean age of puberty onset in recent years has crucial public health, clinical, and social implications. This study aimed to evaluate the serum levels of appetite-related peptides (leptin, ghrelin, nesfatin-1, and orexin-A) and anthropometric data in girls with premature thelarche (PT)., Methods: We enrolled 44 girls aged 4-8 years diagnosed with PT and 33 age-matched healthy girls as controls. The demographic data of the girls were obtained using a questionnaire. Anthropometric data were measured and fasting blood samples were collected., Results: Body weight, height, body mass index (BMI), body fat mass, and basal metabolic rate (BMR) were higher in the PT group than in the control group (p < 0.05). Serum leptin (p < 0.001), nesfatin-1 (p = 0.001), and orxein-A (p < 0.001) levels were significantly higher in the PT group than in healthy controls. However, there were no significant differences in the serum ghrelin levels between the groups (p > 0.05). The results of multivariate logistic regression revealed that serum leptin level (OR (95% CI): 42.0 (10.91, 173.06), p < 0.001), orexin-A (OR (95% CI): 1.14 (1.04, 1.24), p = 0.006), and BMI for age z-score (OR (95% CI): 6.97 (1.47, 33.4), p = 0.014) elevated the risk of incidence of PT at 4-8 girls., Conclusion: These results suggest that in addition to serum leptin levels, serum orexin-A and nesaftin-1 can take part in the initiation of PT. Few studies have investigated the relationship between nesfatin-1 and orexin-A levels and age at onset of puberty; hence, it should be a subject for future studies., (© 2022. The Author(s), under exclusive licence to Italian Society of Endocrinology (SIE).)

Aim: This study was conducted to determine the fear of birth and coronavirus disease 2019 in pregnant women who applied to the high-risk pregnancy outpatient clinic during the pandemic and investigate whether there is a relationship between these fears., Method: This study is a descriptive cross-sectional study using questionnaires. The Fear of COVID-19 Scale and Fear of Birth Scale for Pregnant Women were validated in Turkish in outpatient women with high-risk pregnancies. The study was carried out with 238 pregnant women between February 15 - April 15, 2021., Results: The mean age of the pregnant women participating in the study was 30.22 ± 6.01, the mean week of gestation was 30.87 ± 5.56, the total mean of Fear of COVID-19 Scale score was found to be 18.23 ± 6.41, and Fear of Birth Scale for Pregnant Women total mean score was 62.30 ± 25.66. An increased prevalence of anxiety has been found in high-risk pregnant women during the coronavirus disease-2019 pandemic. It was observed that there was a significant, positive, and low-level relationship between Fear of COVID-19 Scale-19 and Fear of Birth Scale for Pregnant Women of high-risk pregnant women (r = .268; p = .000)., Conclusion: Prenatal anxiety was prevalent among high-risk pregnant women who required routine anxiety screening and psychosocial support during the coronavirus disease-2019 pandemic.

The aims of the researchers were to design the clothes to be worn by the mothers in kangaroo care (KC) and to determine the effect of the KC provided with these clothes on the comfort of the mother and infant. This study was experimentally carried out as a methodological, randomized controlled trial for the designing of clothes for KC. Data were collected using the "Parent and Newborn Information Form", "KC Comfort Scale" and "Newborn Comfort Behavior Scale (Comfort-Neo)". The body temperature, heart rate, oxygen saturation, respiration rate parameters of the newborns were evaluated. The data were transferred to the IBM SPSS Statistics 23 program and evaluated. Our results showed that the KC Comfort Scale total score was 71.1 ± 14.8 in the control group and 84.0 ± 1.5 in the intervention group and "Newborn Comfort Behavior Scale" total scores were found to be 12.47 ± 6.90 in the control group and 8.67 ± 3.46 in the intervention group. It was determined that the KC Comfort Scale ( z : -4.785 p: 0.000) in the intervention group were significantly higher compared to the control group ( p  < 0.05). Pain ( z : -4.439 p: 0.000) and distress ( z : -4.601 p: 0.000) levels of the control group were found to be significantly higher compared to the intervention group. Sarbebe is recommended to be used in KC practices since it was concluded that maternal comfort and satisfaction was high and the pain and distress scores of the newborn were low after KC provided with Sarbebe.

Healthcare workers (HCWs), as frontliners, are assumed to be among the highest risk groups for COVID-19 infection, especially HCWs directly involved in patient care. However, the data on the COVID-19 infection and seroprevalence rates are limited in HCWs. Therefore, we aimed to evaluate the seroprevalence rates in HCWs according to risk groups for COVID-19 contraction in a large cross-sectional study from a tertiary care hospital in Turkey. We enrolled 1974 HCWs before the vaccination programs. In two separate semi-quantitative ELISAs, either IgA or IgG antibodies against SARS-CoV-2 spike protein subunit 1 (S1) were measured. The proportion of positive test results for IgG, IgA, or both against SARS-CoV-2 of study subjects was 19% (375/1974). Frontline HCWs who had contact with patients (21.7%, RR 2.1 [1.51-2.92]) and HCWs in working in the COVID-19 units, intensive care units, or emergency department (19.7%, RR 1.61 [1.12-2.32]) had a notably higher Anti-SARS-CoV-2 IgG compared to the rest of HCWs who has no daily patient contacts ([11.1%]; p < 0.0001). HCWs who care for regular patients in the medium-risk group have also experienced a sustained higher risk of exposure to SARS-CoV-2. We should enhance the precaution against COVID-19 to protect HCW's safety through challenging times.

Aim: This study was conducted to determine the prevalence of contact lens (CL) use among university students, their awareness on CL, and CL users' practices for the cleaning and care of CLs., Methods: The data of this cross-sectional study were collected between April 2019 and July 2019. The sample consisted of university students who volunteered to participate in the study. The data obtained from the study were evaluated by Statistical Package for the Social Science (SPSS) 22.0 package program in computer environment., Results: 929 students participated in the study and the average age of them was 21.99±1.85 years (Min. 18 - Max. 24), and it was determined that 36.6% (n=340) of the participants were male, 10.2% (n=95) of the total were using CL, 91.6% (n=87) of them used CL due to visual impairment. When students' levels of knowledge about the hygiene and care in CL use were examined 85.4% (n=82) washed their hands before wearing/removing CL, 85.3% (n=81) cleaned the lens container and filled it with new solution when the solution in the container was reduced, 18.5% (n=17) continued wearing CL while sleeping, 6.5% (n=6) washed CL with tap water, and 28.3% (n=26) of them stated that they swam in the sea with CL. It was determined that the prevalence of CL use was higher (p= .045) among smoking students., Conclusion: Health professionals are important in the trainings to be given to increase the students' knowledge of hygiene and care regarding the use of CL. More studies are needed on the effect of smoking status on CL use., (© 2021 The College of Medicine and the Medical Association of Malawi.)

Background/aim: Increased length of stay (LOS) in the palliative care unit (PCU) is a serious burden to the patients and the health care system. The predictors of longer LOS in a PCU have not been reported so far from Turkey. Our aim in this study was to evaluate the factors associated with the LOS in the PCU of a tertiary hospital., Materials and Methods: This cross-sectional analysis of a retrospective cohort evaluated adult patients’ medical records admitted to the PCU between 2017 and 2019. The main inclusion criteria were 4 or more days of palliative unit stay and being discharged home during the study period. Data on demographics, chronic diseases, mobilization disability, route of feeding, tracheostomy, sleep disturbances, pressure ulcers, and antidepressant use were collected. Potential factors associated with prolonged LOS tertiles were examined by ordinal regression analysis., Results: A total of 287 discharges from the PCU to home were analyzed. Mean (SD) age was 70.5 (15.8) years, and there was a male predominance (55.7%). The majority of patients had malnutrition, mobility limitation, hypertension, malignant disease, and sleep disturbances. Median LOS was 15 days (4–79). Mean age, hypertension, infections, mobilization limitation, tube feeding, permanent tracheostomy, and pressure ulcers increased from the short stay tertile (4–12 days) to the medium stay tertile (13–20 days) and long stay tertile (>21 days) of LOS. Mobilization limitation [p = 0.013, OR: 2.34 (95% CI: 1.19–4.60)], tube feeding [p = 0.001, OR: 2.63 (95% CI: 1.49–4.66)], permanent tracheostomy [p = 0.007, OR: 4.10 (95% CI: 1.48–11.36)], and hypertension diagnosis [p = 0.023, OR: 1.80, (95% CI: 1.09–2.98)] on admission were associated with being in the medium stay or long stay tertiles of LOS compared to the lowest tertile., Conclusion: A longer length of PCU stay is associated with mobilization limitation, tube feeding, permanent tracheostomy, and hypertension. We found no evidence that age, infections or pressure ulcers on admission were associated with extra LOS in the PCU in patients discharged home., Competing Interests: The authors declare that there are no conflicts of interest., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

The effects of feeding and starvation have been studied with respect to oxidative stress and enzymatic antioxidant activities in the whole body of 4 cm rainbow trout fry Oncorhynchus mykiss (Walbaum 1792). The experiment was conducted for 28 days. The selected biomarkers for the study were determined, including non-enzymic scavengers glutathione (GSH), oxidized glutathione (GSSG) and malondialdehyde (MDA) contents and a number of enzymes are known to have major antioxidant activity, such as activities of süperoksit dismutaz (SOD), catalase (CAT), glutatyon peroksidaz (GSHpx), glutatyon Redüktaz (GR) and Glutatyon-S-Transferaz (GST). There is an endogenous cellular glutathione pool which consists of two forms of glutathione, i.e. the GSH and the GSSG. Oxidative damage was measured by the formation of MDA as an indication of lipid peroxidation. The activities of SOD in 14th and 28th day and the activity of CAT in 14th day were increased significantly during the 28 days of starvation. GSHpx and GR activities in starved fry decreased significantly in 28th day. GST activity in all starved fry showed the most significant increases the period of 28 days starving. The highest ΣSFA (Total Saturated Fatty Acid) content was obtained from 28 day starved fry. In starved fry, there was an apparent preference in utilization of C18:1n-9 than in the fed fry. In both starved and fed fry, C16:1n-7 was preferentially kept during the same period. Fry kept 28 days under starvation conditions exhausted C15:0, C17:0, C18:3n-6, C22:0, C24:0. They utilized less C20:5n-3 acid and conserved strongly C22:6n-3 acid. Concentrations of C20:5n-3, C22:5n-3, C22:6n-3 and total n-3 fatty acids significantly increased and C18:3n-3 significantly decreased in the whole body of starved fry during starvation period. A significant increase in the concentrations of C22:5n-3 and C22:6n-3 was determined in the fed fries in the last 2 weeks. Fat-soluble vitamins, cholesterol, stigmasterol and β-sitosterol levels were also determined in the same period of O. mykiss fry., (© 2021. The Author(s).)

Background: Metabolic syndrome (MetS) is associated with the risk of developing chronic kidney disease. Although the negative effects of high thyroid-stimulating hormone (TSH) values on glomerular filtration rate (GFR) levels have been known for years, the negative effects of increased TSH on GFR in euthyroid cases have been reported in recent years. This study was aimed at investigating the association between the effect of increased TSH values and estimated-GFR (eGFR) levels in euthyroid cases with MetS., Methods: For this hospital-based descriptive study, 191 MetS cases (123 females, 68 males) were evaluated. Those whose TSH was not within 0.5-4.5 uIU/mL, eGFR was <40 mL/min/1.73 m 2 , and/or reported any thyroid/kidney disease were excluded. Partial correlation coefficients were calculated to investigate the relationship between the eGFR values and several other numerical variables while controlling for age and BMI in addition to the adjusted gender effect. Thereafter, the multiple linear regression analysis with a stepwise variable selection approach was used to reveal the independent factors that could affect the logarithmically transformed eGFR., Results: The median age was 52 (19-65) years, the median eGFR was 94.3 (41.3-194) mL/min/1.73 m 2 , and the median TSH was 1.58 (0.50-4.50) uIU/mL in the whole group. Increased TSH even in the normal range was associated with eGFR after adjusting for age and body mass index (BMI), especially in females. The high age ( b  = -0.160, p =0.005), high BMI ( b  = -0.134, p =0.020), high TSH ( b  = -0.380, p < 0.01), and high uric acid ( b  = -0.348, p < 0.01) were found as significant predictors of the eGFR in MetS patients., Conclusion: Independent of age and BMI, elevated TSH even in the euthyroid range showed an association with the eGFR in female MetS cases who had normal kidney functions. This correlation was stronger than the correlations between the eGFR and the MetS diagnostic parameters. These findings need further studies on the issue.., Competing Interests: The authors declare no potential conflicts of interest., (Copyright © 2021 H. Keskin et al.)

Flavonoids are rich in seeds, citrus fruits, olive oil, tea and red wine. Citrus flavonoids constitute an important type of flavonoids. Naringin and naringenin belong to flavonoids with known antioxidant and were found to display antioxidant activities. Malathion is an organophosphorus pesticide that has been broadly used throughout the world to control weeds and pests. It has also been used in public health for mosquito control and fruit fly eradication programs. Malathion, naringin, and naringenin were added to be in 40, 80, and 160 mg doses in Saccharomyces cerevisiae cultures mainly used to determine the antioxidant capacity, it is known that they have shown similar results to man. At the end of the experiment, total protein, malondialdehyde (MDA), reduced glutathione (GSH), oxidized glutathione (GSSG), vitamin K, vitamin E, vitamin D, ergosterol, stigmasterol, β-Sitosterol, and fatty acids were analyzed by HPLC (high performance liquid chromatography) and GC (gas chromatography) devices in the tested S. cerevisiae samples. The contents of the yeast cell of octanoic acid (C8:0), lauric acid (C12:0), myristic acid (C14:0), palmitic acid (C16:0), palmitoleic acid (C16:1n-7), heptadecanoic acid (C17:0), stearic acid (C18:0), oleic acid (C18:1n-9), and linoleic acid (C18:2n-6) were identified. There were statistically significant changes in total protein, MDA, GSH, GSSG, vitamin K, vitamin E, vitamin D, phytosterol and fatty acid levels. It was determined that naringin and naringenin showed statistically significant decreases against malathion toxicity on these parameters. From this study it is found that, the mitigating effect of naringin against DPPH stable free radical was higher than that of naringenin. Citrus flavonoid, naringin showed promising antioxidant activity which can be used as effective protecting agents against oxidative stress., (Copyright © 2020. Published by Elsevier Inc.)

In this study, a novel functional nanocomposite was synthesized, characterized and selectively used in pH-controlled separation, pre-concentration and speciation analysis of Cu(I) and Cu(II) from sample matrices where extraction is assisted, facilitated and greatly enhanced by ultrasound energy. The hydrophilic composite material functionalized with tris(2-hydroxymethyl)aminomethane (Tris) and Fe 3 O 4 NPs was characterized in detail by ATR-FT-IR, 1 H NMR, XRD, EDX peaks and SEM images. After optimization of the main variables influencing extraction efficiency such as pH, volumes of buffer, modified copolymer in acetone, CTAB and Triton X-114 at fixed concentrations including sonication conditions, the Cu(I) and Cu(II) were monitored against a blank at 347 nm by micro-volume UV-vis spectrophotometer. A good linearity was obtained in the range of 2-140 and 5-150 μg L -1 for Cu(II) and Cu(I) with r 2  ≥ 0.993. The limits of detection (LODs) of 0.66 and 1.60 μg L -1 for each analyte, were obtained from a pre-concentration of 70-fold. After validation, the method was applied to speciation of Cu(I), Cu(II), and total Cu in the pre-treated and diluted beverage samples before and after pre-oxidation of Cu(I) to Cu(II) due to be more sensitive of extraction process to Cu(II) at pH 6.0. The results were also compared with those obtained by FAAS analysis to ensure the reliability of the results. It was observed that there was a statistically good agreement between the results of both methods., (Copyright © 2020. Published by Elsevier B.V.)

Aim: The aim of this study was to translate and validate the shortened version of the "EMpowerment of PArents in THe Intensive Care" (EMPATHIC-30) questionnaire into Turkish to measure parent satisfaction in the Neonatal Intensive Care Units (NICU). Method: The study used a cross-sectional design. The data of the study were collected from parents with infants staying in the NICU of a training and research hospital in Sakarya, Turkey, between July 2018-2019 after obtaining ethical approval. Totally, 238 parents (234 mothers, four fathers) agreed to participate in the study and completed the questionnaire. Of these, 35 mothers were recruited 1 month later for the test-retest reliability analysis. The questionnaire was translated using back and forward translation. Reliability and validity test were performed to measure the psychometric properties of the Turkish EMPATHIC-30. Results: The mean age of the parents was 28.27 (SD 5.93), and 48.3% of them were primary school graduates. The infants: 55.9% were male, the mean gestational age was 36.89 (SD 3.25) weeks, and mean length of hospital stay was 9.36 (SD 10.17) days. The mean scores of each item with a six-point scale of the EMPATHIC-30 questionnaire ranged between 4.01 and 4.87. The Cronbach's alpha of the total questionnaire was 0.95. Cronbach's alpha of the five domains (Information, Care and Treatment, Organization, Parent Participation, and Professional Attitude) ranged between 0.80 and 0.92. Pearson correlation coefficient between the domains and total questionnaire was r = 0.988. The Intraclass correlation coefficient was ICC = 0.998 in the test-retest evaluation. Confirmatory factor analysis was performed for construct validity and was moderate; Comparative Fit Index = 0.792, Tucker-Lewis Index = 0.770, Standardized Root Mean Square Residual = 0.0811, and Root Mean Square Error of Approximation = 0.107. Conclusion: The Turkish version of EMPHATIC-30 has adequate psychometric properties. The EMPATHIC-30-Turkish questionnaire is an easy and appropriate instrument which can be used to measure satisfaction of Turkish parents with infants staying in the NICU., (Copyright © 2020 Tiryaki, Zengin, Çınar, Umaroǧlu and Latour.)

Objective: This study was carried out to determine the factors affecting pregnant women's anxiety levels during delivery and the postpartum period., Study Design: A descriptive and analytical study., Place and Duration of Study: Department of Gynecology and Obstetrics, Polyclinic; and Antenetal Education Class, Sakarya University Education and Research Hospital, Sakarya,Turkey, from October 2018 to January 2019., Methodology: Five hundred pregnant women constituted the sample. The data were obtained by using the questionnaire form consisting 25 questions containing the introductory information of pregnant women, prepared by the researchers, and the fear of childbirth and postpartum period scale (FCPPS). Pregnant women's demographic and obstetrical factors and FCPS score were analysed., Results: A statistically significant difference was determined between pregnant women's employment status (p = 0.003), smoking status (p <0.001), trimester of pregnancy (p <0.001), number of living children (p = 0.015), chronic disease (p <0.001), status of receiving education during pregnancy (p <0.001), status of receiving support during/after delivery (p <0.001), and the FCPPS averages., Conclusion: It was determined that pregnant women's anxieties about delivery and babycare increased, especially in the last trimester.

In this study, a new method was developed for the pre-concentration of trace mercury from seafood samples prior to analysis by spectrophotometry. The method is based on the complexation between 2-hydrazinobenzothiazole (2-HBT)-modified copolymer(s) and Hg(II) in the presence of an ionic surfactant, cetyltrimethylammonium bromide (CTAB), as sensitivity enhancer at pH 4.5 and the extraction of the complex into the surfactant-rich phase of polyethylene glycol tert-octylphenyl ether (Triton X-114) as the extractant. The variables affecting extraction efficiency were evaluated and optimized. Due to the observation that the modified copolymers are 2.5-fold more sensitive and selective to the Hg 2+ ions than the CH 3 Hg + , the amounts of free Hg 2+ and total Hg were determined at 325 nm by spectrophotometric detection of free Hg 2+ and total Hg in the pre-treated and extracted fish samples using dilute acid mixture containing Triton X-114 and K 2 Cr 2 O 7 , before and after oxidation of CH 3 Hg + to Hg 2+ with mixture of KBr and KBrO 3 in the acidic media. The amount of CH 3 Hg + was calculated from the difference between total Hg and free Hg 2+ amounts. The accuracy was tested by analysis of two certified samples. The results were statistically in good agreement with the certified values, and the precision was lower than 6.4%. The limits of detection were 1.40 (1.58) and 1.91 (2.11) μg L -1 for Hg 2+ from the two calibration solutions spiked before the pre-treatment, respectively. It has been observed that there is no significant matrix effect by comparison of slopes of the calibration curves. The method was applied to seafood samples for speciation analysis of free Hg 2+ and CH 3 Hg + . In terms of speciation, while total Hg is detected in the range of 12.6-143.8 μg kg -1 , the distribution of mercury in seafood was in the range of 7.4-53.3 μg kg -1 for CH 3 Hg + and in 8.3-90.5 μg kg -1 for free Hg 2+ .

Objective: The aim of this study was to assess the efficacy and feasibility of an enhanced heart failure (HF) education with a 6-month telephone follow- up program in post-discharge ambulatory HF patients., Methods: The Hit-Point trial was a multicenter, randomized, controlled trial of enhanced HF education with a 6-month telephone follow-up program (EHFP) vs routine care (RC) in patients with HF and reduced ejection fraction. A total of 248 patients from 10 centers in various geographical areas were randomized: 125 to EHFP and 123 to RC. Education included information on adherence to treatment, symptom recognition, diet and fluid intake, weight monitoring, activity and exercise training. Patients were contacted by telephone after 1, 3, and 6 months. The primary study endpoint was cardiovascular death., Results: Although all-cause mortality didn't differ between the EHFP and RC groups (p=NS), the percentage of cardiovascular deaths in the EHFP group was significantly lower than in the RC group at the 6-month follow up (5.6% vs. 8.9%, p=0.04). The median number of emergency room visits was one and the median number of all cause hospitalizations and heart failure hospitalizations were zero. Twenty-tree percent of the EHFP group and 35% of the RC group had more than a median number of emergency room visits (p=0.05). There was no significant difference regarding the median number of all-cause or heart failure hospitalizations. At baseline, 60% of patients in EHFP and 61% in RC were in NYHA Class III or IV, while at the 6-month follow up only 12% in EHFP and 32% in RC were in NYHA Class III or IV (p=0.001)., Conclusion: These results demonstrate the potential clinical benefits of an enhanced HF education and follow up program led by a cardiologist in reducing cardiovascular deaths and number of emergency room visits with an improvement in functional capacity at 6 months in post-discharge ambulatory HF patients.

In this study, several sulfonamide derivatives, 4-(2-methylacetylamino)benzenesulfonamides were synthesized. Chemical structures of the derivatives were characterized by 1 H NMR, 13 C NMR, LC-MS-MS, UV-Vis, FTIR, photoluminescence and elemental analysis. Sulfanilamide was reacted with 2-bromopropionyl bromide, in the presence of pyridine, to form bromo-substituted sulfonamide key intermediates, which were subsequently treated with secondary amines to obtain novel sulfonamide derivatives. All the synthesized compounds were evaluated for in vitro antimicrobial activities and cytotoxicity. Increases in ring size, and rings bearing a nitrogen heteroatom led to improvements in antimicrobial activities. As the presence of CA IX and CA XII enzymes have been implicated in some cancerous tumors, the studies presented herein focuses on targeting these enzymes. It was found that the synthesized derivatives had in vitro anti-cancer properties, where compounds (3-6) were found to be active against all cancerous cells, and no cytotoxic effects on normal cells were observed., (Copyright © 2016 Elsevier Inc. All rights reserved.)

We conducted this study to determine demographic details, and clinical presentations in patients with peripartum cardiomyopathy (PPCMP) of Turkish origin. The study population consisted of 58 patients with PPCMP treated at 3 major hospitals in Turkey, retrospectively. In this study, demographic details and initial echocardiographic data were recorded and long-term clinical status was evaluated. The mean age for the patient cohort was 31.47 ± 6.31 years. Thirty-eight patients (73.1%) were multigravida and seven patients had multifetal pregnancy (13.7%). The mean follow-up left ventricular (LV) ejection fraction increased from 31 ± 7 to 38 ± 19. A minority of patients were defined as improvers according to our pre-specified criteria. The average survival period after diagnosis of PPCMP was 20.66 ± 14.44 months. Initial values for LV end-diastolic diameter and urea were higher in the deceased patients compared with the surviving patients, respectively. Twenty-eight (48%) patients with PPCMP showed improvement in the follow-up period. Of the 58 PPCMP patients, 9 (15%) died during a mean follow-up of 32 ± 22 months.

Background: The coronary slow flow phenomenon (CSFP) is defined as a delayed distal vessel contrast opacification in the absence of obstructive epicardial coronary artery disease during coronary angiography. There is conflicting data in medical literature regarding the effects of CSFP on the left ventricular functions assessed by conventional echocardiography or tissue Doppler imaging. Therefore, we aimed to evaluate whether there is any abnormality in the myocardial deformation parameters (strain, strain rate (SR), rotation, twist) of the left ventricle obtained by speckle tracking echocardiography (STE) in patients with CSFP., Methods: Twenty patients with CSFP were included prospectively in the study. Another 20 patients with similar demographics and cardiovascular risk factors as well as normal coronary angiography were used as the control group. Two-dimensional echocardiographic images of the left ventricle from the apical long-axis, two-chamber, four-chamber, and parasternal short-axis views were used for STE analysis., Results: The analysis of left ventricular circumferential deformation parameters showed that the averaged peak systolic strain, systolic SR, and early diastolic SR values were significantly lower in patients with CSFP (P = 0.009, P = 0.02, and P = 0.02, respectively). Among the left ventricular rotation and twist values, apical rotation was significantly lower in patients with CSFP (P = 0.02). Further, the mean thrombolysis in myocardial infarction frame count value was found to be negatively correlated with the averaged peak circumferential early diastolic SR (r = -0.35, P = 0.03). It was positively correlated with the averaged peak circumferential systolic strain (r = 0.47, P = 0.003) and circumferential systolic SR (r = 0.46, P = 0.005)., Conclusion: Coronary slow flow phenomenon leads to significant alterations in the myocardial deformation parameters of the left ventricle as assessed by STE. Specifically, circumferential deformation parameters are affected in CSFP patients., (© 2015, Wiley Periodicals, Inc.)

A novel Salen-type azo-azomethine ligand H2agen, 2,2'-{ethane-1,2-diylbis[nitrilomethylylidene]}bis{4-[ethylphenyldiazenyl]phenol}, formed by the 1:2M condensation of ethane-1,2-diamine with 5-[(4-ethylphenyl)diazenyl]-2-hydroxybenzaldehyde and its nickel(II), copper(II), and zinc(II) complexes were synthesized and characterized by the spectroscopic and analytical methods. The UV-vis spectra of the ligand were investigated in three organic solvents (DMSO, DMF and CHCl3). The ligand shows two absorption bands assigned to π-π(∗) and n-π(∗) transitions in the solvents used. Cu(II), and Ni(II) are tetra-coordinate binding to two phenolic oxygens and two imine nitrogens in approximate square planar geometry. Zn(II) also coordinates using the same sites like other metals but gave tetragonal configuration. Molecular structure of the Cu(II) complex [Cu(agen)] was determined by single crystal X-ray diffraction study. The X-ray data revealed that crystallographic imposed symmetry was absent for the complex molecule. In the structure, the Cu(II) ion is coordinated to two phenolate oxygen atoms and two imine nitrogen atoms of the azo-azomethine ligand with approximate square planar geometry. The ligand H2agen and its metal complexes exhibit strong blue emissions with irradiation. Fluorescence quantum yields and excited-state lifetimes for the ligand and its complexes were obtained. The H2agen ligand had a 35% quantum yield and a 3.27 ns excited-state lifetime. Complexation with metal ions caused reductions in intensities and quantum yields., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Objective: The underlying mechanism of coronary slow flow (CSF) has not yet been clarified, although many studies have been conducted to understand its pathophysiology. In this study, we investigated the role of a very potent vasoconstrictor, urotensin-II (UII), in the pathophysiology of CSF. This prospective and controlled investigation aimed to evaluate the association between CSF and serum levels of UII., Methods: Our study included 32 patients with slow flow in any coronary artery and 32 patients with normal coronary arteries. Coronary flow was calculated using the Thrombolysis in Myocardial Infarction (TIMI) frame count (TFC) method, and CSF was defined as TFC ≥39 for the left anterior descending artery, TFC ≥27 for the circumflex coronary artery, and TFC ≥24 for the right coronary artery. UII levels in blood samples obtained from both groups were measured by enzyme-linked immunosorbent assay (ELISA) method., Results: UII levels were significantly higher in the CSF group than in the control group [122 pg/mL (71-831), 95 pg/mL (21-635), respectively; p<0.001]. High-density lipoprotein (HDL) levels were lower in the CSF group, and leukocyte counts were significantly higher. A positive correlation between UII and mean TFC (r=0.524, p=0.002) was found in the CSF group. The multivariate logistic regression analysis determined that UII, HDL, and cigarette smoking were independent indicators in predicting CSF (OR=1.010, 95% confidence interval 1.002-1014, p=0.019; OR=0.927, 95% confidence interval 0.869-0.988, p=0.019; OR=5.755, 95% confidence interval 1.272-26.041, p=0.021, respectively)., Conclusion: Serum UII levels were found to be significantly higher in the CSF group, suggesting that UII may be one of the underlying factors in the pathogenesis of CSF.

Objective: The aim of this experimental study was to investigate whether hypertonic saline or sodium bicarbonate administration prevented the development of cardiotoxicity in rats that received toxic doses of amitriptyline., Method: Thirty-six Sprague Dawley rats were used in the study. The animals were divided into six groups. Group 1 received toxic doses of i.p. amitriptyline. Groups 2 and 3 toxic doses of i.p. amitriptyline, plus i.v. sodium bicarbonate and i.v. hypertonic saline, respectively. Group 4 received only i.v. sodium bicarbonate, group 5 received only i.v. hypertonic saline, and group 6 was the control. Electrocardiography was recorded in all rats for a maximum of 60 minutes. Blood samples were obtained to measure the serum levels of sodium and ionised calcium., Results: The survival time was shorter in group 1. In this group, the animals' heart rates also decreased over time, and their QRS and QTc intervals were significantly prolonged. Groups 2 and 3 showed less severe changes in their ECGs and the rats survived for a longer period. The effects of sodium bicarbonate or hypertonic saline treatments on reducing the development of cardiotoxicity were similar. The serum sodium levels decreased in all the amitriptyline-applied groups. Reduction of serum sodium level was most pronounced in group 1., Conclusion: Empirical treatment with sodium bicarbonate or hypertonic saline can reduce the development of cardiotoxicity during amitriptyline intoxication. As hypertonic saline has no adverse effects on drug elimination, it should be considered as an alternative to sodium bicarbonate therapy.

Objectives: Atrial fibrillation (AF) is one of the most common causes of preventable ischemic stroke and is related to increased cardiovascular morbidity and mortality. There is a lack of data in Turkey on the use of new oral anticoagulants (NOACs), and time in therapeutic INR range (TTR) in vitamin K antagonist users and AF management modality. In this multi-center trial, we aimed to analyze, follow and evaluate the epidemiological data in non-valvular AF patients., Study Design: Four thousand one hundred consecutive adult patients from 42 centers with at least one AF attack identified on electrocardiography will be included in the study. Patients with rheumatic mitral valve stenosis and prosthetic valve disease will be excluded from the study. At the end of one year, the patients will be evaluated in terms of major cardiac end points (death, transient ischemic attack, stroke, systemic thromboembolism, major bleeding and hospitalization)., Results: First results are expected in June 2015. Data about major cardiovascular end-points will be available in January 2016., Conclusion: The rates and kind of oral anticoagulant use, TTR in vitamin K antagonist users and main management modality applied in non-valvular AF patients will be determined by AFTER-2 study. In addition, the rate of major adverse events (MACEs) and the independent predictors of these MACEs will be detected (AFTER-2 Study ClinicalTrials.gov number, NCT02354456.).

The antibacterial activity and antioxidant effect of the compounds α-terpineol, linalool, eucalyptol and α-pinene obtained from essential oils (EOs), against pathogenic and spoilage forming bacteria were determined. The antibacterial activities of these compounds were observed in vitro on four Gram-negative and three Gram-positive strains. S. putrefaciens was the most resistant bacteria to all tested components, with MIC values of 2% or higher, whereas E. coli O157:H7 was the most sensitive strain among the tested bacteria. Eucalyptol extended the lag phase of S. Typhimurium, E. coli O157:H7 and S. aureus at the concentrations of 0.7%, 0.6% and 1%, respectively. In vitro cell growth experiments showed the tested compounds had toxic effects on all bacterial species with different level of potency. Synergistic and additive effects were observed at least one dose pair of combination against S. Typhimurium, E. coli O157:H7 and S. aureus, however antagonistic effects were not found in these combinations. The results of this first study are encouraging for further investigations on mechanisms of antimicrobial activity of these EO components.

Objective: The purpose of this study was to evaluate the patients with acute amitriptyline poisoning and investigate predictive factors for the development of life-threatening complications., Methods: Demographics, clinical, laboratory, and electrocardiographic (ECG) findings of 250 patients were evaluated retrospectively. Predictive parameters for the development of serious complications were studied., Results: Median age of patients was 14.6 years, of which, 70% of patients were female and 66% were in pediatric age group. The most common pathological clinical finding and laboratory abnormality were alteration of consciousness and hyponatremia. The rate of convulsive seizure, arrhythmia, and respiratory depression were 17 (6.8%), 16 (6.4%), and 11 (4.4%), respectively. These complications were more seen in pediatric patients than adults (15.8% and 1.2%). The incidence of hyponatremia was more in pediatric patients and severe poisoning groups (38.8 and 53.4%, respectively). The levels of amitriptyline and nortriptyline were significantly higher in the group with complications than the group without complications (p < 0.05). All adult patients were discharged with good prognosis. In pediatric age group, one patient was discharged with severe neurological sequelae and one patient died. QRS duration >100 ms, long corrected QT duration interval, and low Glasgow Coma Score (GCS) at admission were identified as independent risk factors for the development of life-threatening complications (odds ratio: 69.4, 1.9, and 1383, respectively; p < 0.05)., Conclusion: Amitriptyline poisoning may be associated with life-threatening complications, especially in pediatric age group and in patients with hyponatremia. Low GCS, presence of hyponatremia, high serum drug levels, and pathological ECG findings on admission may be helpful in predicting the development of complications and poor prognosis., (© The Author(s) 2014.)

The myocardial performance index (MPI) reflects both the systolic and diastolic function of the heart, and is easily applied in practice. In this study, we aimed to determine the relationship between MPI and invasive haemodynamic parameters in heart failure patients. A total of 126 patients with heart failure were selected, all of whom were referred for diagnostic cardiac catheterisation, and were divided into two groups. Group I consisted of 59 patients (32 men and 27 women, mean age 61 ± 10; functional capacity New York Heart Association (NYHA) Class I; and left ventricular end-diastolic pressure (LVEDP) <16 mmHg). Group II included 67 patients (34 men and 33 women, mean age 60 ± 9; NYHA Class ≥ II; LVEDP ≥ 16 mmHg). The following parameters were measured in all patients: ejection fraction with Simpson method, the peak mitral early (E) and late (A) diastolic velocities, E/A ratio, deceleration time (DT) and tissue Doppler from four different areas of the mitral annulus (septum, lateral, inferior and anterior). In order to measure MPI with two methods (standard Doppler and tissue Doppler), isovolumetric contraction time (IVCT), isovolumetric relaxation time (IVRT) and ejection time (ET) were measured from four areas and mean values of MPI were calculated. There was no difference between the two groups in E/A ratios, DT and IVRT (p > 0.05). Group II patients had longer IVCT and ET, when compared with group I patients (p < 0.05). MPI, measured by both standard pulsed wave Doppler and tissue Doppler methods, was significantly higher in group II patients, when compared with the values obtained from group I patients (Group I: 0.50 ± 0.2 and 0.50 ± 0.14; group II: 0.98 ± 0.3 and 1.2 ± 0.32; p < 0.001). According to receiver operating characteristics curve analysis, the cut-off value for MPI measured by tissue Doppler was 0.74. The sensitivity and specificity of this value were measured as 92.5 and 91.5%, respectively. MPI measured by standard Doppler method was 0.67, and its sensitivity and specificity were 85.1 and 83.1%, respectively. We found a strong relationship between MPI and LVEDP (r = 0.83, p < 0.001; r = 0.96, p < 0.001), especially when measured by tissue Doppler. In addition, we observed a significant relationship between the MPI values measured by tissue Doppler and those measured by standard traditional methods (r = 0.85, p < 0.001). We showed that MPI was reliable for the evaluation of global cardiac functions in patients with heart failure, as measured with both pulsed-wave Doppler and tissue Doppler. We assert that, in order to differentiate between those patients with symptomatic heart failure from the asymptomatic cases, MPI as measured with the tissue Doppler method is an improvement on MPI as measured using traditional methods.

The coronary slow flow phenomenon (CSFP) is the delayed opacification of coronary arteries in the absence of significant stenosis. The pathogenesis of CSFP has not been completely understood yet. There are several proposed mechanisms such as the structural and functional abnormalities in coronary microcirculation. Nail fold capillaroscopy is a simple, noninvasive examination of the microvasculature and suggested to be a useful technique for analysis in various inflammatory and autoimmune diseases. In this study; we hypothesized that; CSFP is a part of systemic vascular entity rather than a problem confined to coronary vasculature and our aim was to investigate the nail fold capillaries of the patients with CSFP and compare to those with normal coronary flow (NCF). The study was designed as a case-control study and total 25 patients (10 male, mean age 55 ± 9 years) with documented CSFP, and 24 patients (15 male, mean age 55 ± 11 years) with NCF were recruited. Nail fold capillaroscopy examinations were performed by video dermatoscopy in all patients and results were compared between two groups. The demographic and clinical characteristics were similar between patients of CSFP and NCF groups. Nail fold capillary abnormalities including dilatation, tortuosity and microhemorrhage were present in 15 (60%) patients in CSFP group and 5 (21%) patients in NCF group (p < 0.05 OR: 5.7 95% C.I 1.602-20.279). In this study, we found that the abnormalities in nail fold capillaries suggesting the presence of inflammation and anatomical changes were significantly higher in patients with CSFP.

Background: An early prediction of prognosis in pulmonary embolism (PE) is a crucial clinical entity. The aim of the study is to investigate whether growth differentiation factor-15 (GDF-15) or N-terminal pro-brain natriuretic peptide levels (NT-proBNP) can better predict the 30 day overall mortality in patients with normotensive acute PE., Methods: Patients with a high clinical probability of PE, or with low/intermediate probability and a positive D-dimer test, underwent contrast-enhanced computed tomography and ventilation/perfusion lung scan. Simplified pulmonary embolism severity index, the presence of echocardiographic right ventricular dysfunction, and ROC curve analysis by calculated cut-off value of serum GDF-15 and NT-proBNP levels were evaluated for each individual of study population., Results: The serum levels of GDF-15 and NT-proBNP were found to be significantly higher in patients with PE compared with controls (p < 0.0001). In this study, GDF-15 provided better results compared to NT-proBNP in predicting the short-term or 30 day mortality (p = 0.046 and p = 0.418, respectively). Serum GDF-15 with a cut-off value of > 2943 pg/mL yielded a 75% sensitivity, 68.7% specificity, 91.6% negative predictive value, and 90% accuracy for predicting 30 day overall mortality. The results of these tests were found as 62.5%, 40.6%, 81.2%, and 40% for NT-proBNP (with the cut-off value of > 1409 pg/mL), respectively., Conclusions: High serum GDF-15 levels may provide better information than NT-proBNP for early death in the subjects with normotensive PE and these patients should be closely followed up.

Purpose: This study compared patients who underwent cardiac resynchronization therapy (CRT) by high-amplitude left ventricular (LV) pacing with those who underwent CRT by standard LV pacing., Methods: We included 32 CRT patients with ejection fraction (EF) ≤35%, QRS time ≥120 ms, and New York Heart Association (NYHA) class III/IV symptoms of heart failure despite optimal medical treatment. These patients were evaluated clinically and echocardiographically before, three and six months after CRT. At the 3(rd) month, the LV pulse amplitude value was set high at 5 volt for 16 patients [high-amplitude Group (HAG)], while for the other 16 patients, it was reduced to at least twice the threshold value at ≤2.5 volt [low-amplitude group (LAG)]., Results: Clinical and echocardiographic response rates of HAG and LAG after CRT were similar in the 3(rd) and 6(th) month. In both groups, increase in LVEF and decrease in LV ESV in the 3(rd) and 6(th) month were statistically significant compared to those before CRT, and NYHA class and end-diastolic volume (EDV) was significantly reduced in the 6(th) month compared to those before CRT. However, NHYA class and EDV continued to reduce significantly in HAG from the 3(rd) to the 6(th) month (P<0.05), while the decrease in LAG was not significant (P>0.05). The rate of mitral regurgitation (MR) was reduced significantly in HAG in the 6(th) month compared to that before CRT, while the decrease in LAG was not significant (P<0.05; P>0.05 respectively)., Conclusions: CRT by high-amplitude LV pacing was more effective according to clinical and echocardiographic evaluations. It should be considered as an alternative in non-responsive patients.