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Abstract In this study, the performance of a novel organic tea compost developed for the first time in the world from raw tea waste from tea processing factories and enriched with worms, beneficial microorganisms, and enzymes was tested in comparison to chemical fertilizers in tea plantations in Rize and Artvin provinces, where the most intensive tea cultivation is carried out in Turkey. In the field trials, the developed organic tea vermicompost was incorporated into the root zones of the plants in the tea plantations in amounts of 1000 (OVT1), 2000 (OVT2) and 4000 (OVT4) (kg ha-1). The experimental design included a control group without OVT applications and positive controls with chemical fertilizers (N: P: K 25:5:10, (CF) 1200 kg ha-1) commonly used by local growers. The evaluation included field trials over two years. The average yields obtained in two-year field trials in five different areas were: Control (6326), OVT1 (7082), OVT2 (7408), OVT4 (7910), and CF (8028) kg ha-1. Notably, there was no significant statistical difference in yields between the organic (at 4000 kg ha-1 ) and chemical fertilizers (at 1200 kg ha-1). The highest nutrient contents were obtained when CF and OVT4 were applied. According to the average values across all regions, the application of OVT4 increased the uptake of 63% N, 18% K, 75% P, 21% Mg, 19% Na, 29% Ca, 28% Zn, 11% Cu and 24% Mn compared to the control group. The application of chemical fertilizers increased the uptake of 75% N, 21% K, 75% P, 21% Mg, 28% Na, 27% Ca, 30% Zn, 18% Cu and 31% Mn compared to the control group. The organic fertilizer treatment had the lowest levels of antioxidants compared to the control groups and the chemical fertilizers. It was also found that the organic fertilizer increased the levels of amino acids, organic acids and chlorophyll in the tea plant. Its low antioxidant activity and proline content prepared them for or protected them from stress conditions. With these properties, the biotechnologically developed organic tea compost fertilizer has proven to be very promising for tea cultivation and organic plant production.

The present study aims to evaluate the relationship between smartphone addiction and depression in primary care. Three hundred fifty-two people who participated in our research, designed as a cross-sectional study, filled out the Short Version of the Smartphone Addiction scale and Beck’s Depression Inventory. Among the participants, 28.9% were found to have smartphone addiction and 52.3% were found to have depressive symptoms. The mean score of participants in the Smartphone Addiction Scale was 24.32 ± 11.24 points (n = 352). The mean score in Beck’s Depression Inventory was 10.80 ± 7.94 points. A positive significant relationship was found between depression frequency and social media usage duration (1–2 hours/ day) and length of social media usage (≥5 hours/day). A weak but positive and significant correlation was found between Smartphone Addiction Scale and Beck’s Depression Inventory (r = 0.147; p = .006). In the regression analysis, it was determined that having an income between 1000 and 1999 TL, having a computer at home, having other addictions other than smoking, and being addicted to a smartphone increase the risk of depression development. The relationship between smartphone addiction and depression should be given attention. The factors influencing smartphone addiction should be considered. Especially the social media and smartphone usage should be limited.

Chiari Malformation type 1 (CM-I) is a neurological disorder characterized by morphological defects including excessive cerebellar tonsillar ectopia and associated manifestations. We used 3D amplified MRI on a cohort of healthy and CM-I subjects to investigate the brain’s intrinsic motion, its association with the morphology and patient’s symptomatology, and surgical outcomes. We observed that the regional brain motion in CM-I was significantly higher than that of the healthy subjects, with anterior-posterior (AP) and superior-inferior (SI) displacements in cerebellar tonsils and medulla having the highest differences between the healthy and CM-I (∼45%–∼73% increased motion in the CM-I group). Interestingly, we found the ratio of neural tissue in the foramen magnum to be directly correlated with the SI tonsillar motion (r=0.58). Tonsillar herniation was directly correlated with the AP motion of the tonsils (r=0.61), and AP and medial-lateral (ML) motions of the medulla (r=0.66, and r=0.57). Subjects with higher tonsillar ML motion prior to surgery showed improved outcome (p=0.03, and AUC=0.95). Although we did not observe a significant correlation between the brains motion and morphometrics on the CM-I symptoms (perhaps due to our small sample size), illustrative cases increase our hope for the development of a future tool based on brain biomechanics.

Paroxysmal sympathetic hyperactivity (PSH) is a state of autonomic dysfunction characterized by symptoms such as tachypnea, tachycardia, hypertension, hyperthermia, sweating, and dystonia. It can occur after traumatic brain injury, hypoxic-ischemic encephalopathy, and diseases such as stroke. Hypoxia, extensive axonal damage, and young age are believed to predispose to the development of PSH. These patients may be diagnosed with pulmonary embolism, septicemia, or epileptic seizures. Delays in diagnosis prolong hospital stay. Here, we present an 81-year-old man who developed PSH after a recurrent stroke and our management.

Background: Columellar strut grafts (CSG) are effective in providing the unity of the nasal tip with a weak,short, medial, or middle crura. However, its effect on tip stabilization is minimal. The CSG may be fixated to an autoextension at the caudal septum to augment the stabilization capacity of the strut. Septal auto-extension may not be applicable in cases with a short/shortened caudal septum, which can be solved by designing an extension in the middle of the CSG, which can be called an “inverted T-shaped CSG.” Methods: Patients who underwent tip stabilization with an inverted T-shaped CSG between January 2019 and November 2021 were selected for this research. All patients underwent open structural rhinoplasty. The inverted T-shaped CSG was prepared similarly to the standard strut. However, spike-like extension was preserved in the middle of the strut, branching out at a right angle. The T-shaped CSG was settled between the medial crura. Then, the extension was fixated to the caudal septum. Medial crura were sutured over the inverted T-shaped CSG, and stability was established. Preoperative, peroperative, and postoperative images were analyzed. Results: This technique was used in 64 patients. The average age was 37 years (26-48 years). Thirty-five patients were female, and 29 were male. Forty-one patients had undergone primary rhinoplasty, and 23 had undergone secondary rhinoplasty. The mean patient follow-up was 14 months (8-22 months). Statistical analysis was used to compare tip projection ratios and nasolabial angle calculations. A statistically meaningful difference was observed between preoperative, immediate postoperative, and 1-year postoperative measurements of the projection ratio and nasolabial angle increase in all cases, and this projection was observed to be maintained at 1 year. The inverted T-shaped CSG provided satisfactory tip stabilization in all patients. Conclusion: The inverted T-shaped CSG is a good alternative for tip stabilization with graft economy, without columellar retraction, overortation, stiffness, in short/shortened septae.

Population balance models (PBMs) for milling processes are based on two fundamental concepts: specific breakage rate function and breakage distribution function, which vary with particle size as well as design–operation conditions. The solution of the inverse problem, i.e., the estimation of these two functions’ parameters, may cause falsified kinetics and breakage distribution mechanisms. This perspective article aims to expose and mitigate various aspects of potential falsification, thus enabling the development of a robust PBM. Through an in-depth analysis of historical approaches to the PBM inverse problem and experimental observations, as well as the author’s recent contributions to the inverse methodology within the context of back-calculation methods, six principles have been offered: (i) include the governing physical phenomena and reduce errors in model building; (ii) reduce the number of model parameters via size–operation-dependent functional forms, hybrid approaches for back-calculation, and combination with CFD–DEM and other mechanistic models; (iii) generate a dense particle size distribution data set obtained at various milling times and/or locations; (iv) ensure a grid-independent solution with a sufficient number of size classes; (v) use a global optimization-based back-calculation method for parameter estimation and provide standard errors of the estimates; and (vi) test the predictive capability of the PBM. This perspective article boosts awareness of various challenges involved in the solution of the inverse PBM problem as pertinent to milling processes and provides researchers with six principles to minimize falsified kinetics.

Introduction Diagnosing and treating lung cancer in early stages is essential for survival outcomes. The chest X-ray (CXR) remains the primary screening tool to identify lung cancers in the UK; however, there is a shortfall of radiologists, while demand continues to increase. Image analysis by machine-learning software has the potential to support radiology workflows with a focus on immediate triage of suspicious X-rays. The RADICAL study will evaluate Qure.ai’s ‘qXR’ software in reducing reporting time for suspicious X-rays in NHS Greater Glasgow & Clyde.Methods and analysis This is a stepped-wedge cluster-randomised study consisting of a retrospective technical evaluation and prospective clinical effectiveness study alongside the assessment of acceptability via qualitative work and evaluation of cost-effectiveness via a cost utility analysis. The primary objective is to assess the clinical effectiveness of qXR to prioritise patients suspected with lung cancer on CXR for follow-up CT. Secondary objectives will look at the utility, safety, technical performance, health economics and acceptability of the intervention. The study period is 24 months, consisting of an initial 12 month data collection period and a 12 month follow-up period. All the standard care CXRs from outpatient and primary care requests will be securely transmitted to Qure.ai software ‘qXR’ for interpretation. Images with features of cancer will be flagged as ‘Urgent Suspicion of Cancer’ and be prioritised for radiologist review within the existing reporting workflow.Ethics and dissemination The study will follow the principles of Good Clinical Practice. The protocol was granted REC approval in August 2023 from North West—Greater Manchester West Research Ethics Committee (REC 23/NW/0211). This study was registered on clinicaltrials.gov (NCT06044454). An interim report will be produced for use by the Scottish Government. The results from this study will be presented at artificial intelligence, radiology and respiratory meetings and published in peer-reviewed journals.Trial registration number NCT06044454.

Objective: The aim of this study was to biomechanically compare a new lateral-pinning technique, in which pins engage the medial and lateral columns of the distal humerus in a divergent configuration in both the axial and sagittal planes instead of the coronal plane, with the cross-pin, and with 2 and 3 coronally divergent lateral-pin techniques in a synthetic humerus model of supracondylar humerus fractures. Methods: Thirty-six identical synthetic models of the humerus simulating a standardized supracondylar humerus fracture were included in this study. They were divided into 4 groups based on the pin configuration of fixation: the new 3-lateral pin-fixation technique (group A), 2 crossed pins (group B), 3 divergent lateral pins (group C), and 2 divergent lateral pins (group D). Each model was subjected to combined axial and torsional loading, and then torsional stability and torsional stiffness (Nmm/°) were recorded. Results: Group A had greater rotational stability than groups C and D but had no statistically significant additional rotational stability compared with group B (P=.042, P=.008, P=.648, respectively), whereas group B had greater rotational stability than only group D (P=.020). Furthermore, group A demonstrated higher internal rotational stiffness compared with groups C and D (P=.038, P=.006, respectively). Group B had better internal rotational stiffness than group D (P=.015). There was no significant difference in internal rotational stiffness between groups A and B (P=. 542), groups B and C (P=.804), and groups D and C (P=.352). Although no statistically significant differences existed between groups A and B, the modified pin configuration exhibited the highest torsional stability and stiffness. Group D showed the lowest values in all biomechanical properties. Conclusion: This study has shown us that this new lateral-pinning technique may provide torsional resistance to internal rotational displacement as strong as the standard technique of crossed-pin configuration of fixation. Furthermore, with this new pin configuration, greater torsional resistance can be obtained than with either the standard 2- or the standard 3-lateral divergent pin configuration.

Background The relationship between collateral circulation and prognosis after endovascular treatment in anterior circulation strokes has been reported in many studies.

Purpose: The relationship between public expenditure and revenue that determines the budget balance in the explanation of budget deficits is very important. This study aimed to examine the association between public spending and income in Turkey. Methodology: This article applies the continuous wavelet transform method (CWT) to study the relationship between government revenues and expenditures in Turkey. The study, which covers the period 2006-2020, consists of monthly data. The following four CWT tools were used in the analysis: Wavelet Power Spectrum, Cross Wavelet Power, Wavelet Coherence, and Phase Difference. Results: The results of the study, controlling taxes rather than expenditures, play a key role in reducing fiscal deficits in Turkey in the short term. It is revealed that the dynamics of the budget balance in the medium term can be explained by the spend-tax hypothesis and that the tax burden can be alleviated by spending cuts. In the long term, results were obtained that support the spend-tax hypothesis. Conclusion: The paper reveals that taxes play an important role in controlling budget deficits in the short run. It turns out that the dynamics of the budget balance can be explained in the medium term by expenditure cuts and then the tax burden can be alleviated. In the long run, implementing fiscal policies based on public spending rather than taxation will be more effective against budget deficits.

This study examines the complex and time-varying relationship between residential energy demand (including electricity, geothermal, and solar energy) and climate change using wavelet analyses with monthly USA data from January 1990 to March 2023. The results show that residential energy demand and climate change indicators exhibit a time-varying interrelationship with cyclical and lag effects. Specifically, before 2021, a positive correlation between residential electricity demand and carbon dioxide (CO2) emissions in short-term frequencies was found, but the relationship reversed thereafter, with an increase in CO2 levels influencing and decreasing residential electricity demand. In the long run frequencies, the link between residential power consumption and CO2 emissions shifted over time, exhibiting inconsistent co-movement. The co-movements between residential geothermal and CO2 show predominantly positive correlations, with CO2 leading the relationship in the short run, while geothermal leads the co-movements in the long run. In both short and long-term frequencies, the dependency and co-movement between residential solar and CO2 are mixed, with residential solar leading to positive correlations and CO2 leading to negative correlations. Therefore, improved insulation, energy-efficient windows, and high-efficiency heating systems can all assist in reducing heat loss and the total energy demand for domestic heating and subsequently low CO2 emissions.