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This research aims to minimize the environmental impact and promote the sustainability of aquaculture by optimizing nutrient dynamics, improving water quality and enhancing species growth performance through a land-based Integrated Multi-Trophic Aquaculture (IMTA) system. The study focused on Black Sea trout (Salmo labrax), Mediterranean mussel (Mytilus galloprovincialis), and sea lettuce (Ulva lactuca), reared in interconnected tanks using Black Sea water over 90 days. The Black Sea trout more than doubled in size to 333.92 ± 6.60 g and significant improvements were observed in the specific growth rate (SGR) at 0.85% and the feed conversion ratio (FCR) at 1.38. The fish's proximate composition included 19.19% protein, 2.31% lipid, 70.35% moisture, and 1.34% ash, with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) levels at 6.06% and 13.50%, respectively. The macroalgae showed substantial growth, with a SGR of 0.34% and a weight gain of 310 ± 3.50 g. Additionally, it increased protein content by 13.41% and demonstrated significant nutrient removal efficiencies: 41.4% for nitrate, 66.7% for nitrite, and 90.8% for ammonia. EPA and DHA levels increased by 45% and 70%, reaching 4.66% and 2.19%, respectively. In contrast, the mussels experienced a weight loss, with a weight gain of -1.20 ± 0.00 g and an SGR of -0.20%. Initially, wild mussels had a composition of 77.56% moisture, 13.79% protein, 1.54% lipid, and 1.77% ash. The presence of mussels and macroalgae significantly improved water quality, notably reducing ammonia by 92.2%, nitrate by 44.6% and nitrite by 75%, benefiting the overall ecosystem. This study concludes that a land-based IMTA system enhances sustainable aquaculture by improving product quality and bioremediation, with macroalgae playing a crucial role in nutrient absorption and growth within the system., 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 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Determining the climate change anxiety and awareness of student nurses, who will provide health services in various parts of the world after the borders are removed, is important in combating climate change., Objectives: The study aims to assess whether nursing students' climate change awareness is a predictor of climate change anxiety., Design: This research adopts a descriptive cross-sectional study design., Participants: The population of the study consisted of a total of 562 students studying in the nursing department of a state university. 419 students were included in study., Methods: Data were gathered from 419 students enrolled in the nursing department of a university during the fall semester of 2022-2023, employing online questionnaires via Google Forms from January to March 2023. The research instrument comprised three parts: a Descriptive Information Form developed in line with the literature, the Global Climate Change Awareness Scale, and the Climate Change Anxiety Scale. SPSS 20.0 software was used for data analysis. The study obtained ethical committee approval, institutional permissions, and participant consent., Results: Findings indicated that nursing students' mean Global Climate Change Awareness Scale total score was 59.06 ± 15.78, Climate Change Anxiety Scale total score was determined to be 21.27 ± 8.75. A moderate positive relationship was identified between global climate change awareness and climate change anxiety levels among nursing students (r = 0.304, p < 0.05). Furthermore, the study revealed that the participants' awareness of global climate change served as a predictor for their anxiety levels., Conclusion: The climate change awareness of nursing students significantly influences their levels of anxiety related to climate change. Integrating climate change awareness into nursing education is quite important and necessary. This can empower future nurses to be more prepared and effective in a changing world., Competing Interests: Declaration of competing interest All authors declare that they have no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Assessment of medication adherence of patients with severe mental disorders is an important aspect of long-term treatment. There is a need for a brief and practical tool to assess medication adherence. This study investigates the clinical, functional, and validational correlations of a short and easy-to-use tool., Methods: Global Assessment of Medication Adherence (GAMA) was prepared as a single item with 5 severity degrees, from complete adherence (1 point) to complete nonadherence (5 points). The scale was applied to patients with severe mental illnesses receiving outpatient and inpatient treatment. The GAMA scores were compared with psychopathology, clinical severity, insight, and functionality scale scores. While the validity analyses were tested with face, convergent, and criterion validity, interrater reliability was used for the reliability analysis., Results: Data from 70 outpatients and 14 inpatients were examined. In the analyses performed for convergent validity, a positive correlation was found between GAMA scores and psychopathology (r=0.646, P < .001), and clinical severity (r = 0.692, P < .001), and a significant negative correlation was found between GAMA scores and insight (r = -0.793, P < .001), and functionality (r = -0.740, P < .001). There was a significant difference in the GAMA scores of 14 patients assessed during hospitalization and discharge. A high positive correlation was found between the GAMA measurements of the psychiatrist and the nurse at admission and discharge., Conclusion: This study shows that the GAMA has sufficient psychometric properties for assessing medication adherence. Due to its brevity, simplicity, and validity, the scale is appropriate for use in routine clinical practice and research.

BACKGROUND Sarcopenia, characterized by loss of skeletal muscle mass and function, is linked to poor outcomes in cancer patients. In breast cancer, sarcopenia has been associated with reduced treatment tolerance and survival. However, its impact on patients with locally advanced breast cancer receiving neoadjuvant chemotherapy is understudied. This study aimed to assess sarcopenia's impact on outcomes in 226 women with advanced breast cancer, pre- and post-chemotherapy. MATERIAL AND METHODS This retrospective cohort study included 226 patients with stage II-III breast cancer who received neoadjuvant chemotherapy (NAC) between 2015 and 2021. Sarcopenia was assessed using psoas muscle area (PMA) from pre- and post-NAC computed tomography scans, with a 25th percentile cut-off (415.4 mm²). Pathological response was evaluated using the Miller-Payne grading system, and survival outcomes were analyzed using Kaplan-Meier curves. Statistical significance was set at P<0.05. RESULTS The mean PMA decreased significantly after NAC (502.8 mm2 to 454.3 mm², P<0.001). Pre-NAC, sarcopenia was present in 24.8% of patients. This increased to 40.7% after NAC. Sarcopenia was more prevalent in obese patients (P<0.001), but no significant association was found between sarcopenia and pathological complete response (pCR) or survival outcomes. Although pre- and post-NAC sarcopenia did not affect recurrence or mortality, non-sarcopenic patients were more likely to achieve pCR (P=0.012). Hematologic toxicity was higher in sarcopenic patients with comorbidities (P<0.05). CONCLUSIONS Sarcopenia significantly increases after NAC but does not independently impact pathological response, recurrence, or survival in locally advanced breast cancer. Obesity and comorbid conditions are key factors influencing sarcopenia, highlighting the need for comprehensive management to mitigate treatment-related sarcopenia.

Objectives: Although Behçet's disease (BD) typically manifests in the second or third decade of life, initial symptoms may appear at a younger age. It may also take a longer time for the full disease phenotype to develop after the first symptom onset in pediatric patients. In this study we aimed to assess the clinical course of pediatric-onset BD in adulthood period., Methods: The files of 112 patients diagnosed with BD before the age of 18, selected from five tertiary clinics, were retrospectively examined. Patients with a follow-up of less than six months were excluded., Results: The study comprised 93 patients with pediatric-onset BD, of whom 64.5% (n = 60) were male. The median age of diagnosis was 15 years (13-17). Major organ involvement was present in 49 (52.5%) patients. The most commonly affected organ was the eye (29%).Sixty-eight (73.1%) patients had follow-up data in adulthood. Fourty patients had only mucocutaneous manifestations in the pediatric period. During follow-up in adulthood, 15 (53.3% were male) had new major organ involvement with a mean of 10.1 (SD: 7.9) years after diagnosis. Twenty-eight patients (41.1%) experienced major organ involvement during the pediatric period. In adulthood follow-up, 12 (42.8%) developed new major organ involvement and/or relapse of the same organ. Eighteen (26.5%) of 68 pediatric-onset BD patients had new major organ involvement, and 9 (13.2%) had a relapse during adulthood follow-up., Conclusion: Our results showed that nearly one-third of pediatric BD patients have a new major organ involvement or a relapse in adulthood. Regular follow-up of pediatric BD patients in adulthood is essential to prevent long-term damage in this disease subset., (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background and Objective: Intramedullary mature teratomas in adults are rare tumors that pose significant diagnostic and therapeutic challenges due to their diverse tissue composition and intramedullary location. This review, which includes an illustrative case, aims to provide a comprehensive overview of the clinical presentation, diagnosis, treatment, and outcomes of adult intramedullary mature teratomas through a systematic review of 89 cases., Methods: A systematic review was conducted following PRISMA guidelines, using keyword combinations in PubMed, MEDLINE, and Web of Science databases until June 2024. Inclusion criteria were adult patients (> 18 years) with histopathologically confirmed intramedullary mature teratomas. Statistical analyses examined relationships between the extent of resection (EoR), tumor location, and patient outcomes., Results: Among the 89 cases, the mean age was 39.94 ± 13.52 years, with a male-to-female ratio of 1.39:1. Tumors were most commonly located in the conus region (51.2%). Surgical resection was the primary treatment, with 43 cases undergoing partial resection and 33 gross total resection. No statistically significant differences in outcomes were found between EoR, sex, associated anomalies, or specific outcomes. However, younger patients showed improved outcomes for lower limb weakness and sphincter dysfunction. Recurrence was noted in three cases, all located in the conus., Conclusion: Intramedullary mature teratomas require a nuanced approach that balances complete resection and neurological preservation. Early diagnosis and individualized surgical planning are crucial for optimizing outcomes. Despite the challenges, effective management is achievable, and ongoing research is essential to refining treatment strategies for this rare tumor., (© 2024. The Author(s) under exclusive licence to Belgian Neurological Society.)

Purpose: Individuals below the age of 40 make up only 3%-11% of colorectal cancer (CRC) cases. In this study, we aimed to review clinicopathological characteristics of rectal cancer in young adults. Methods: Rectal adenocancer patients aged ≤40 were included in this study from Antalya Training and Research Hospital. A single-arm descriptive study was designed. Results: There were 85 patients in the final analyses ( n = 85). The median age was 37 (19-40). Mucinous adenocarcinoma and signet-cell carcinoma rates were 11.8% for each. Twenty patients (24.4%) had high-grade cancer. Fourteen patients (16.5%) had CRC history in a first-degree relative. None of the patients were diagnosed through a screening test. Of the 85 patients, 41 (48.2%) were stage 3 and 23 (27.1%) were stage 4 at the time of diagnosis. Thirty-four (54.8%) of the 62 nonmetastatic patients had neoadjuvant and 27 (43.5%) had adjuvant treatment because of having an upfront surgery before presentation. In the nonmetastatic population, the 5-year disease-free survival rate was 69.7 ± 6.5%. De-novo metastatic underwent chemotherapy, and biological agents were administered when feasible. KRAS mutation rate was 56.5% among metastatic patients. The median progression-free survival for the first-line treatment was 11.2 months (5.7-16.6), and the median overall survival was 22.3 months (15.4-29.1). Conclusion: We demonstrated that rectal cancer is usually diagnosed at late stages in young individuals which is compatible with the previous reports. Low cancer awareness in young patients and their caregivers and adverse histological features were advocated as the reason for the diagnostic delay. However, future studies may elucidate the reason behind the common diagnosis at advanced stages.

Gonadoblastoma is a rare ovarian tumor composed of sex cord cells and primitive germ cells. While the majority of gonadoblastomas are found in individuals with 46,XY gonadal dysgenesis, they are also rarely seen in patients with a 46,XX karyotype. We report a case of a fourteen-year-and-six-month-old girl presenting with an uncommon cause of virilization due to a virilizing ovarian tumor. The patient underwent bilateral salpingo-oophorectomy. Upon histopathological examination, the excised tumor was confirmed to be bilateral gonadoblastoma, with dysgerminoma on the left side. Malignant gonadal tumors should be considered in cases of primary gonadal insufficiency with a 46,XX karyotype and progressive virilization. Even when laboratory and imaging tests show no abnormalities, a gonadal biopsy should be considered.

Introduction: Proportional short stature is one of the most important features of Noonan Syndrome, and adult height often remains below the 3rd percentile. Although the pathophysiology of short stature in NS patients is not fully understood, it has been shown that GH treatment is beneficial in NS, and it significantly improves the height in respect to the results of short and long-term GH treatment., Methods: In this study, the efficacy of GH therapy was evaluated in children and adolescents with Noonan syndrome who attained final height. In this national cohort study, 67 cases with NS who reached final height from 14 centers were evaluated., Results: A total of 53 cases (mean follow-up time 5.6 years) received GH treatment. Height SDS of the subjects who were started on GH tended to be shorter than those who did not receive GH (-3.26± 1.07 vs. -2.53 ±1.23) at initial presentation. The mean final height and final height SDS in girls using GH vs those not using GH were 150.1 cm and -2.17 SD vs 47.4 cm and-2.8 SD, respectively. The mean final height and final height SDS in boys using GH vs. not using GH were 162.48 ± 6.19 cm and -1.81 SD vs 157.46 ± 10.16 cm and -2.68 ± 1.42 SD, respectively. The Δheight SDS value of the cases was significantly higher in the group receiving GH than in those not receiving GH (1.36 ± 1.12 SD vs. -0.2 ± 1.24, p<0.001). Cardiac findings remained stable in two patients with hypertrophic cardiomyopathy who received GH treatment. No significant side effects were observed in the cases during follow-up., Conclusion: In patients with Noonan syndrome who reach their final height, a significant increase in height is observed with GH treatment, and an increase of approximately +1.4 SDS can be achieved. It has been concluded that GH treatment is safe and effective.

Objective: This study was conducted to determine the effect of environmental awareness-based education given to nursing students on their environmental attitudes., Method: This study was designed in a parallel-group 1:1 single-blind randomized controlled experimental design. The study was conducted with 110 nursing students studying at a state university in Turkey between November 1, 2023, and March 15, 2024. Data were collected using a personal information form and the Environmental Attitude Scale. Data were analyzed using SPSS 25.0 and G Power 3.1.9.7 software., Results: After the training program was applied to the students, it was found that the mean score of the environmental attitude scale of the experimental group was significantly higher than the control group (p < 0.05). It was found that the posttest mean score of the experimental group's environmental attitude scale was higher than the pretest (p < 0.05)., Conclusion: It was observed that the environmental awareness-based education program given to nursing students had a positive effect on environmental attitude. Longitudinal studies on environmental attitude are recommended., Trial Registration: ClinicalTrials.gov identifier: NCT06169189., (© 2024 Wiley Periodicals LLC.)

Introduction: Hemodialysis (HD) patients have become a serious public health problem, the number of which is increasing every year worldwide. This study aimed to determine the relationship between satisfaction with life, dietary attitude, and comfort level in patients receiving HD treatment., Methods: This research was conducted in a relational cross-sectional descriptive design. The research was conducted with 174 patients (85% of the population) receiving HD treatment between March 20 and September 30, 2023. In the study, hierarchical regression analysis was performed with SPSS 25.0. Machine learning analysis and prediction were performed using R programming language, version 4.1.3., Results: The model used to determine the factors affecting satisfaction with life was significant and usable (F(2,171) = 25.855, p = 0.001). Attitudes of HD patients toward dietary therapy and their HD comfort levels together explained 22.3% of the total variance of satisfaction with life. In the regression model, according to the results of the t-test regarding the significance of the regression coefficient, the increase in the HD comfort levels of the participants (t = 2.668, p = 0.008) and the increase in the attitude of the HD patients toward dietary therapy (t = 5.897, p = 0.001) caused a statistical increase in "satisfaction with life." According to Shapley values, the most important variable in the prediction of satisfaction with life variable is attitude for the dietary attitude., Conclusion: It was determined that the increase in the comfort levels of HD patients and their positive dietary attitudes increased satisfaction with life. It is recommended to provide education to increase patients' diet attitudes and comfort levels., (© 2024 International Society for Apheresis and Japanese Society for Apheresis.)

Background: This study aimed to evaluate the long-term outcomes of double kissing crush stenting (DKC) and mini-culotte technique (MCT) in patients with complex bifurcation lesions., Methods: This retrospective study enrolled 236 patients who underwent percutaneous coronary intervention (PCI) for complex coronary bifurcation disease between January 2014 and November 2022. The primary endpoint was target lesion failure (TLF), defined as the combination of cardiac death, myocardial infarction (MI), or clinically driven target lesion revascularization (TLR). The secondary endpoint was major cardiovascular and cerebral events (MACCE) including all-cause death, MI, TLR, stroke, or stent thrombosis. The regression models were adjusted by applying the inverse probability weighted (IPW) approach to reduce treatment selection bias., Results: The initial management strategy was DKC in 154 (65.3%) patients and MCT in 82 (34.7%) patients (male: 194 [82.2%], mean age: 60.85 ± 10.86 years). The SYNTAX scores were similar in both groups. The rates of long-term TLF and MACCE rates were 17.4% and 20%, respectively. The rate of TLF (26.8% vs. 12.3%, p = 0.005) was higher in patients treated with MCT than those treated with the DKC technique, mainly driven by more frequent TLR (15.9% vs. 7.1%, p = 0.035). The long-term TLF and MACCE rates were notably lower in the DKC group compared to the others: adjusted hazard ratio (HR; IPW): 0.407, p = 0.009 for TLF, and adjusted HR(IPW): 0.391 [95% CI: 0.209-0.730], p = 0.003 for MACCE., Conclusion: At long-term follow-up, the rates of TLF and MACCE were 17.4% and 20%, respectively. However, long-term TLF was significantly higher in patients treated with MCT than those treated with the DKC technique, primarily due to a more frequent occurrence of clinically driven TLR., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Objective: This study aimed to investigate the relationship between procalcitonin (PCT) kinetic and estimated glomerular filtration rates (eGFR) in critically ill patients who had Gram-negative primary bloodstream infection (GN-BSI) and responded to the antimicrobial therapy., Materials and Methods: This single-centered study was retrospective and observational. Critically ill GN-BSI patients over 18 years old who had clinical and microbiological responses to antibiotic treatment were included in the study. Patients were divided into two groups according to eGFR (eGFR <30 mL/min/1.73m 2 and ≥30 mL/min/1.73m 2 ) and compared for PCT kinetic at seven different measurement points as initial, first, third, fifth, seventh, tenth, and fourteenth days., Results: The study included 138 patients. Initial PCT levels were higher in patients with eGFR <30 mL/min/1.73m 2 (4.58 [1.36-39.4] ng/mL) than in eGFR ≥30 mL/min/1.73m 2 (0.91 [0.32-10.2]) ( p <0.001). This elevation was present at all measurement points ( p <0.05). The decrease in PCT values by ≥30% (26.0% vs 47.9%; p =0.024) on the third day and ≥50% (69.2% vs 76.6%; p =0.411) on the fifth day was less in the low eGFR (<30 mL/min/1.73m 2 ) group. The effect of low GFR on serum PCT kinetic was present in both fermenter and non-fermenter GN-BSIs but was more prominent in the fermenter group., Conclusion: Serum PCT levels during therapy were higher in patients with low eGFR. Early PCT (<5 days) response was not obtained in non-fermenter GN-BSI patients with low eGFR. Antibiotic revision decisions should be made more carefully in patients with low eGFR due to high initial PCT levels and slow PCT kinetic., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Infectious Diseases and Clinical Microbiology.)

Objective: This study was conducted to investigate individuals' perceptions of media messages about the COVID-19 pandemic and the effect of these messages on their fear and uncertainty., Methods: Data for this descriptive correlational study were collected between October and November 2020. A total of 653 individuals living in Turkey provided online survey data by completing a Personal Information Form, the Pandemic Uncertainty Scale, and the COVID-19 Pandemic Fear Scale., Results: The mean age of the participants was 52.1 ± 12.6, and 79.9% were female. It was found that 27.9% of participants "always" followed COVID-19 news in the media, and 41.3% "often" followed COVID-19-related news. Participants' COVID-19 fear (24.46 ± 8.07) and uncertainty (55.35 ± 8.63) scores were moderate and correlated., Conclusions: Level of trust in mass media was found to affect uncertainty about the pandemic. As level of trust in mass media increased, uncertainty about the pandemic decreased. Appropriate measures must be identified and adopted for effective and safe media use in situations posing massive and significant health threats such as COVID-19.

Objective: It is of critical importance to determine the factors that contribute to nurses' disaster preparedness. This study aimed to examine nurses' perceptions of disaster preparedness and the factors affecting it., Methods: This descriptive study was conducted with 464 nurses working in the East Marmara region of Türkiye. The data were collected online using the "Personal Information Form," "The Scale of Perception of Disaster Preparedness on Nurses," and the "Adult Motivation Scale." Linear regression analysis was used to analyze the influencing factors., Results: It was found that nurses possessed a high level of perceived disaster preparedness, influenced by individual disaster preparedness, status of receiving disaster-related training, willingness to respond in the case of a disaster, disaster plan awareness, experience with caring for disaster victims, extrinsic motivation, and general motivation., Conclusions: The results of the study offer evidence that can be implemented by managers and educators to better prepare nurses for disasters. Hospital administrators and policy makers should consider the factors affecting nurses' perception of disaster preparedness to develop solutions for such disasters.

Transitional care is essential to maintain the continuity of care in younger patients with rheumatic diseases. In this study, we aimed to assess the transition readiness of rheumatology patients who had already transferred from pediatric to adult care using a questionnaire. We included young adult rheumatology patients who had already transferred to adult rheumatology care. The Transition Readiness Assessment Questionnaire (TRAQ) was used in the adult rheumatology clinic to assess the patients' readiness; a retrospective chart review was conducted to include diagnosis, age at diagnosis, age at transfer, and current age. Three hundred and ten patients (184 female and 126 male) participated in this study. The mean age at diagnosis, the mean age at transfer, and the mean age at the time of the study were 10.7 ± 4.29, 21.1 ± 1.69, and 24.0 ± 2.26 years, respectively. Most of the patients had familial Mediterranean fever, followed by arthritis, connective tissue disorders, and other diseases. Tracking health issues was the lowest-scored domain. Females scored significantly higher than males in the tracking health issue domain (P = .006) and managing health issue domain (P = .028) but not in the overall TRAQ score (P = .053). Patients in different diagnosis and transfer age groups scored similarly across the domains. In this study, females performed better than males in 2 domains of the TRAQ questionnaire. Diagnoses or transfer age groups were not associated with TRAQ outcomes.

Purpose: To evaluate the conjunctival/episcleral thickness (CET) and anterior scleral thickness (AST) in patients with keratoconus with an extended duration of mini-scleral contact lens wear by utilizing anterior segment optical coherence tomography (ASOCT)., Methods: This study included 17 eyes of 17 patients with keratoconus with mini-scleral contact lens wear (Group 1), 20 eyes of 20 patients with keratoconus without any contact lens wear (Group 2), and 20 eyes of 20 healthy controls (Group 3). CET and AST were measured using AS-OCT (Triton, Topcon, Japan) at 1, 2, and 3 mm posterior to the scleral spur in the nasal, temporal, superior, and inferior quadrants., Results: The median age of the mini-scleral contact lens group was 26, and the number of male patients was 14 (82.4 %). The superior CET values at 1 mm, 2 mm, and 3 mm statistically differed between the groups, with Group 1 having significantly lower values than Group 3 and Group 2 having statistically similar values to the remaining two groups. The inferior CET at 2 mm was lower in Groups 1 and 2 than in Group 3. The inferior CET at 3 mm was lower in Group 1 compared to Groups 2 and 3. AST was similar between the groups at all measured quadrants and distances. The duration of lens wear had a strong, statistically significant, negative correlation with the superior CET at 2 mm (rho: -0.847, p < 0.001) and a moderate, statistically significant, negative correlation with the superior CET at 3 mm (rho: -0.506, p < 0.038)., Conclusions: In this study, it was found that mini-scleral contact lens usage causes thinning in the conjunctival-episcleral layer, especially in the superior and inferior quadrants, but does not affect scleral thickness. AS-OCT is a non-invasive and clinically applicable technique for assessing the impact of contact lens use on the conjunctiva/episclera and sclera., 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 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.)

Background: Double kissing crush (DKC) and nano-crush (NC) techniques are frequently used, but the comparison for both techniques is still lacking. The goal of this multicenter study was to retrospectively assess the midterm clinical results of DKC and NC stenting in patients with complex bifurcation lesions (CBLs)., Methods: A total of 324 consecutive patients [male: 245 (75.6%), mean age: 60.73 ± 10.21 years] who underwent bifurcation percutaneous coronary intervention between January 2019 and May 2023 were included. The primary endpoint defined as the major cardiovascular events (MACE) included cardiac death, target vessel myocardial infarction (TVMI), or clinically driven target lesion revascularization (TLR). Inverse probability weighting (IPW) was performed to reduce treatment selection bias. This is the first report comparing the clinical outcomes of DKC and NC stenting in patients with CBL., Results: The initial revascularization strategy was DKC in 216 (66.7%) cases and NC in 108 (33.3%) patients. SYNTAX scores [25.5 ± 6.73 vs. 23.32 ± 6.22, p = 0.005] were notably higher in the NC group than the DKC group. The procedure time (76.98 ± 25.1 vs. 57.5 ± 22.99 min, p = 0.001) was notably higher in the DKC group. The incidence of MACE (18.5 vs. 9.7%, p = 0.025), clinically driven TLR (14.8 vs. 6%, p = 0.009), and TVMI (10.2 vs. 4.2%, p = 0.048) were notably higher in the NC group than in the DKC group. The midterm MACE rate in the overall population notably differed between the NC group and the DKC group (adjusted HR (IPW): 2.712, [95% CI: 1.407-5.228], p = 0.003)., Conclusion: In patients with CBLs, applying the DKC technique for bifurcation treatment had better ischemia-driven outcomes than the NC technique., (© 2024 Wiley Periodicals LLC.)

Background: Post-ischemia reperfusion can lead to oxidative stress and an increase in oxidative markers. Employing preventive strategies and antioxidant agents may help mitigate ischemia-reperfusion injury (IRI). The use of a tourniquet in extremity surgery has been associated with IRI. This study aims to investigate the impact of three different approaches- brachial plexus block, total intravenous anesthesia (TIVA), and inhalation anesthesia-on IRI during upper extremity surgery using a tourniquet., Methods: Patients aged 18 to 45 with American Society of Anesthesiologists (ASA) I-II scores were randomly assigned to one of three groups: Group A received an axillary block with bupivacaine; Group I underwent inhalation anesthesia with sevoflurane; and Group T received TIVA with propofol and remifentanil infusion. Blood samples were collected to measure glucose, lactate, total anti-oxidant status (TAS), total oxidant status (TOS), and ischemia-modified albumin (IMA) levels at various time points: before anesthesia (t1), 1 minute before tourniquet release (t2), 20 minutes after tourniquet release (t3), and 4 hours after tourniquet release (t4)., Results: In Group I, lactate levels at t3, and glucose levels at t2 and t3, were higher compared to the other groups. Group A exhibited lower IMA levels at t2, t3, and t4 than the other groups. Additionally, Group I had lower IMA levels at t2, t3, and t4 compared to Group T. TAS levels were higher in Group I at t2, t3, and t4 compared to the other groups. TOS levels at t2 and t3 were lower in Group A than in Group I., Conclusion: Axillary anesthesia results in a sympathetic block, promoting better perfusion of the upper extremity. This study demonstrated lower levels of oxidative stress markers with axillary plexus block. Therefore, these results suggest that the axillary block has the potential to mitigate IRI.

Background: The rising gamification in educational contexts has been driven by its potential to increase student motivation, engagement, interest and learning outcomes. Thanks to these effects, gamification has gained popularity in health education. Due to the increase in studies on gamification in health education in recent years, this study has been carried out to present the studies in the relevant literature to researchers., Aim: This study presents a quantitative mapping of gamification in health education through a bibliometric analysis of its publications., Methods: In this study, a total of 475 articles were analyzed by searching "health education*" and "gamif*" and similar terms from Web of Science and Scopus databases. R bibliometric package program was used for the analysis. 1971 authors contributed to the studies, which were spread between 2012 and 2024. The number of studies on gamification in the field of health education has grown in recent years. In particular, it was seen that 2018 can be seen as the breaking point and the highest number of publications was in 2023, with 101 publications., Results: The descriptive results showed that Zhang, X. was the most productive author, Nurse Education Today and BMC Medical Education were the most productive journals and the United States was the most productive country. It is concluded that terms such as gamification, medical education, game-based learning, education, serious games, simulation and e-learning are the most frequently used words in gamification studies in the field of health education. It has been observed that the concept of gamification is trending, especially in 2018-2023, with a frequency of 150 uses., Conclusions: This study is expected to guide researchers in terms of key points for future research on gamification in health education contexts. It is expected that the knowledge provided by this study will enable researchers to be involved in this field and/or focus their research more effectively., Competing Interests: Declaration of Competing Interest The author(s) declared no potential conficts of interest concerning the research, authorship, and/or publication of this article., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Fusarium species are agriculturally important fungi with a broad host range and can be found as endophytic, pathogenic, or opportunistic parasites in many crop plants. This study aimed to identify Fusarium species in bare-rooted, dormant plants in Turkish grapevine nurseries using molecular identification methods and assess their pathogenicity. Asymptomatic dormant plants were sampled from grapevine nurseries (43) in different regions of the country, and fungi were isolated from plant roots and internal basal tissues. The Fusarium strains were identified by performing gene sequencing ( TEF1-α , RPB2 ) and phylogenetic analyses. Pathogenicity tests were carried out by inoculating mycelial agar pieces of strains onto the stem or conidial suspensions into the rhizosphere of vines (1103 Paulsen rootstock). Laboratory tests revealed that Fusarium species were highly prevalent in Turkish grapevine nurseries (41 out of 43). Gene sequencing and phylogenetic analyses unraveled that 12 Fusarium species ( F. annulatum, F. brachygibbosum, F. clavum, F. curvatum, F. falciforme, F. fredkrugeri, F. glycines, F. nanum, F. nematophilum, F. nirenbergiae, F. solani, and Fusarium spp.) existed in the ready-to-sale plants. Some of these species ( F. annulatum, F. curvatum and F. nirenbergiae ) consistently caused wood necrosis of seedling stems, rotting of the basal zone and roots, and reduced root biomass. Although the other nine species also caused some root rot and root reduction, their virulence was not as severe as the pathogenic ones, and they were considered opportunistic parasites or endophytic species. This study suggests that Fusarium species might play an important role in root-basal rot, wood canker symptoms, and young vine decline in Turkish grapevine nurseries and that these species need to be considered for healthy seedling production.

The evaluation of in vitro biological activity of several previously reported quinolinequinones ( AQQ1-5 ) against 60 human cancer cell lines (NCI-60) used by the National Cancer Institute's Developmental Therapeutics Program (DTP) contributed to our earlier research on possible anticancer and/or antibacterial agents. Of interest, NCI-60 screening revealed that two quinolinequinones ( AQQ1 and AQQ2 ) significantly reduced the proliferation of several cancer genotypes. Following the administration of a single dose and five additional doses, all quinolinequinones demonstrated a significant inhibitory effect on the growth of leukemia and other cancer cell lines. Hence, a series of subsequent in vitro biological assessments were performed to further understand the mechanistic impact of the compounds. In MTT assays, it was found that AQQ1 and AQQ2 exhibited higher efficacy against DU-145 cells (IC 50 4.18 µM and 4.17 µM, respectively) compared to MDA-MB-231 (IC 50 8.27 and 13.33 µM, respectively) and HCT-116 cells (IC 50 5.83 and 9.18 µM, respectively). Additionally, AQQ1 demonstrated greater activity in this context. Further investigations revealed that AQQ1 inhibited DU-145 cell growth and migration dose-dependently. Remarkably, arrest of the DU-145 cell cycle at G0/G1 phase and ROS elevation were observed. Pharmacokinetic (PK) studies revealed that AQQ1 has better PK parameters than AQQ2 with %F of 9.83 in rat. Considering the data obtained with human liver microsomal stability studies, AQQ1 should have a better PK profile in human subjects. In silico studies (molecular dynamics) with three kinases (CDK2, CDK4, and MAPK) leading to cell cycle arrest at G 0 /G 1 identified MAPK as a probable target for AQQ1 . Taken together, our results showed that AQQ1 could be a potential chemotherapeutic lead molecule for prostate cancer.

This study includes the evaluation of multiplex real-time PCR (rPCR) kit, which was developed to provide rapid diagnosis of mastitis infections, by working with milk samples of 2 different sources of mastitis and comparing the results with the classical bacteriological culture method (BC). A total of 273 bacteria were isolated in 226 samples (47.88%) out of 472 samples by BC. These were 139 (50.91%) Staphylococcus spp., 61 (22.34%) Streptococcus spp., 15 (5.49%) E. coli, 8 (2.93%) Enterococcus spp., 50 (18.31%) other bacteria. When we look at the multiplex rPCR results; 1052 positive were obtained for the gene regions of 14 different bacteria, 1 yeast, and 1 β-lactamase gene examined in 472 samples. While no searched gene region was found by rPCR in 78 (16.5%) of the 472 samples studied, at least 1 gene was detected in 394 (83.5%) samples. These 1052 positive samples by rPCR were; 263 (28.43%) Staphylococcus spp., 51 (5.51%) S. aureus, 57 (6.16%) Enterococcus spp., 49 (5.29%) C. bovis, 16 (1.73%) S. dysgalactiae, 84 (9.08%) S. agalactiae, 71 (7.67%) S. uberis, 73 (7.89%) E. coli, 14 (1.51%) Prototheca spp., 39 (4.21%) T. pyogenes/P. indolicus, 5 (0.54%) S. marcescens, 15 (1.62%) K. oxytoca/pneumonia, 117 (12.64%) Mycoplasma spp., 31 (3.35%) M. bovis, 40 (4.32%) yeast, and 127 samples (26.90%) were β-lactamase positive. When the antibiotic resistance of the isolates was evaluated, 78 (31.96%) tetracycline, 72 (29.5%) penicillin, and 60 (24.59%) clindamycin resistance were observed predominantly in Gram-positive isolates, while 6 (23.07%) tigecycline, 6 (23.07%) netilmicin, 6 (23.07%) pipercillin resistance was found in gram-negative isolates. While a bacteria and/or yeast gene was found by rPCR in 187 of 246 (76.01%) samples with no bacterial growth, a bacterium was isolated with BC in only 20 (8.84%) samples whose gene region was not found by rPCR. As a result, the multiplex rPCR system used in the diagnosis of mastitis has been found to be quite reliable as it can detect a large number of bacteria in a very short time compared to classical methods. Therefore, we advise the use of rPCR and/or culture for confirmation of clinical signs in mastitis and at routine mastitis surveillance., 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 Ltd. All rights reserved.)

Early detection of cardiac involvement in Juvenile Dermatomyositis (JDM) is difficult due to the absence of clinical signs and symptoms, with systolic dysfunction often emerging in late stages and associated with a poor prognosis. This study aimed to employ two-dimensional speckle-tracking echocardiography (STE) for subclinical assessment of left ventricular (LV) systolic failure in JDM and explore potential associations between impaired LV systolic function (LV-GLS) and disease activity. A prospective study enrolled 20 healthy volunteers and 26 JDM patients (< 18 years old) without cardiac symptoms. Clinical data were collected from medical records, and echocardiograms were conducted by a pediatric cardiologist. Our study cohort demonstrated similar age to controls (13.5 ± .6 vs. 13.8 ± 4.7; p = 0.465). Median illness duration at echocardiography was 5 (1.5-17.5) years, and conventional echocardiography indicated normal LV ejection fraction (> 55%) in all participants. However, STE revealed lowered LV GLS in JDM patients (- 22.2 ± 4.1% vs. - 26.5 ± 5.3% p = 0.022). Pulse steroid users displayed lower GLS average values compared to non-users (β = 4.99, 95% CI 1.34-8.64, p = 0.009). Negative correlations existed between LV-GLS and age at diagnosis (r = - 0.499; p = 0.011), diastolic parameters (E/E' ratio) and age at diagnosis (r = - 0.469; p = 0.018), as well as RV global strain and age at diagnosis (r = - 0.443; p = 0.024). Employing STE in JDM patients facilitated the identification of preclinical cardiac dysfunction. Given JDM patients' younger age, early myocardial damage detection through STE may impact treatment decisions and long-term cardiovascular prognosis., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Aim: This study compared the effects of web-based and face-to-face education given to office workers on health beliefs and physical activity levels towards obesity., Methods: The research was conducted as a randomized controlled experimental study. The study population consisted of 768 office workers between February 2020 and April 2021, and the sample of the research consisted of 90 individuals selected from the population using the nonprobability sampling method. Clinical trial number of the study is NCT05591846., Results: A total of 90 people, including 30 people in each group, were included in the study. According to the obesity health belief model, a positive change was achieved in the beliefs of individuals about obesity; it was determined that there was a significant increase in the subdimensions of the importance of health, sensitivity, seriousness and perception of benefit and a decrease in the perception of obstacles (p < 0.05). After both education methods were given according to the health belief model, a positive change was achieved in the physical activity level of the individuals; it was determined that the physical activity level score increased significantly (p < 0.05)., Conclusion: It was determined that web-based and face-to-face education given to individuals had a positive effect on the obesity health belief model components and the levels of physical activity level., (© 2023 John Wiley & Sons Australia, Ltd.)

Chronic subdural hematomas (CSDH) with isolated psychiatric presentation are rare. In this paper, we report a case of 77-year-old-female patient who had psychotic depression after repetitive head trauma without any neurological symptoms. The brain magnetic resonance imaging revealed an 20 mm subdural hematoma in the right frontoparietal region and a 7 mm subdural hematoma in the left frontal region. The psychiatric symptoms improved within the first week after evacuation but relapsed with the occurrence of right sided pneumocephalus. In the follow up, with the disappearance of the pneumocephalus, the psychiatric symptoms improved. It should be kept in mind that isolated psychiatric symptoms can be seen due to subdural hematoma and evacuation of the hematoma has an important role in improving the psychiatric symptoms., Competing Interests: Conflict of Interest: The authors declared that there is no conflict of interest., (Copyright: © 2024 Turkish Neuropsychiatric Society.)

Background: Given the strong genetic background of familial Mediterranean fever (FMF), the frequently reported co-existing diseases in children with FMF should also be investigated in other family members. Therefore, we aimed to examine the medical conditions of first-degree relatives (FDRs) of our pediatric patients with FMF in the present study., Methods: Chronic diseases of FDRs of pediatric 449 FMF, 147 juvenile idiopathic arthritis (JIA) patients and 93 healthy controls (HC) were questioned during their routine clinical visits for 9 consecutive months., Results: A total of 1975 FDRs of 449 FMF, 690 FDRs of 147 JIA patients, and 406 FDRs of 93 HC were included into the study. The most common medical conditions were non-atopic asthma (n=71, 3.6%), type 2 DM (n=14, 2%), and tonsillectomy history (n=12, 2.95%) in the FMF, JIA, and HC groups, respectively. Atopic diseases (FMF vs. JIA: p=0.013; FMF vs. HC: p=0.014), rheumatic diseases (FMF vs. JIA: p=0.030; FMF vs. HC: p=0.017), and surgical histories (FMF vs. JIA: p<0.01; FMF vs. HC: p=0.026), including adenoidectomy, tonsillectomy, and appendectomy, were significantly more common in the FMF group than in other groups., Conclusions: Our novel findings may contribute to understanding the hereditary burden of co-existing diseases in children with FMF and encourage further studies involving genetic screenings., Competing Interests: The authors declare that there is no conflict of interest.

Aim: This study was conducted to determine the segmentation, classification, object detection, and accuracy of skin burn images using artificial intelligence and a mobile application. With this study, individuals were able to determine the degree of burns and see how to intervene through the mobile application., Methods: This research was conducted between 26.10.2021-01.09.2023. In this study, the dataset was handled in two stages. In the first stage, the open-access dataset was taken from https://universe.roboflow.com/, and the burn images dataset was created. In the second stage, in order to determine the accuracy of the developed system and artificial intelligence model, the patients admitted to the hospital were identified with our own design Burn Wound Detection Android application., Results: In our study, YOLO V7 architecture was used for segmentation, classification, and object detection. There are 21018 data in this study, and 80% of them are used as training data, and 20% of them are used as test data. The YOLO V7 model achieved a success rate of 75.12% on the test data. The Burn Wound Detection Android mobile application that we developed in the study was used to accurately detect images of individuals., Conclusion: In this study, skin burn images were segmented, classified, object detected, and a mobile application was developed using artificial intelligence. First aid is crucial in burn cases, and it is an important development for public health that people living in the periphery can quickly determine the degree of burn through the mobile application and provide first aid according to the instructions of the mobile application., Competing Interests: Declaration of Competing Interest The author(s) declared no potential conflicts of interest concerning the research, authorship, and/or publication of this article., (Copyright © 2024 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.)

Lanthanides are largely used in optoelectronics as dopants to enhance the physical and optical properties of semiconducting devices. In this study, lanthanum(III)hydroxide nanoparticles (La(OH) 3 NPs) are used as a dopant of polyethylenimine (PEI)-functionalized nitrogen (N)-doped graphene quantum dots ( PEI-N GQDs ). The La(OH) 3 NPs-doped PEI-N GQDs nanocomposites are prepared from La(NO) 3 in a single step by a green novel method and are characterized by Fourier-transform infrared spectroscopy (FT-IR), ultraviolet-visible spectroscopy (UV-vis), X-ray photoelectron spectroscopy (XPS), and transmission electron microscopy (TEM). Deposited over an n-type Si wafer, the La(OH) 3 NPs-doped PEI-N GQDs nanocomposites form Schottky diodes. The I - V characteristics and the photoresponse of the diodes are investigated as a function of the illumination intensity in the range 0-110 mW cm -2 and at room temperature. It is found that the rectification ratio and ideality factor of the diode decrease, while the Schottky barrier and series resistance increase with the enhancing illuminations. As a photodetector, the La(OH) 3 NPs-doped PEI-N GQDs/n-Si heterojunction exhibits an appreciable responsivity of 3.9 × 10 -3 AW -1 under 22 mW cm -2 at -0.3 V bias and a maximum detectivity of 8.7 × 10 8 Jones under 22 mW cm -2 at -0.5 V. This study introduces the green synthesis and presents the structural, electrical, and optoelectronic properties of La(OH) 3 NPs-doped PEI-N GQDs , demonstrating that these nanocomposites can be promising for optoelectronic applications.

Aim: The purpose of this systematic review is to examine evidence-based psychosocial intervention research aimed at family members caring for patients with cancer in the palliative period., Method: In this systematic review, randomized controlled psychosocial intervention studies for the family member caring for patients with cancer published between January 1, 2016 and July 30, 2021 were reviewed. PubMed (including MEDLINE), Cochrane, APA PsycNet, ProQuest, Science Direct, TR Index, and Wiley Online Library databases were scanned. Eight publications were identified following a database review for English language articles published from 2016 to 2021. Sample, methods, content, and outcomes of included interventions are summarized., Results: Only eight of the 4652 articles examined met the inclusion criteria. Psychosocial interventions such as mindfulness exercises, stress management, acceptance and commitment therapy, cognitive behavioral intervention, and meaning-centered psychotherapy for cancer caregivers were applied for relatives caring for patients with cancer in the palliative period., Conclusion: Psychosocial interventions applied to family members caring for patients with cancer during the palliative period lead to improvements in depressive symptoms, stress levels, the caregiver burden, quality of life, self-efficacy, coping skills, and awareness levels., (© 2023 NANDA International, Inc.)

Introduction: The aim of this study is to examine the effects of Ramadan fasting on melatonin, cortisol, and serotonin levels., Methods: In this study, the blood of 19 healthy male individuals between the ages of 26 and 51, registered in Agri (Turkey) Family Health Center and fasting during Ramadan, was studied. The study was carried out in 2021-2022. The SPSS-22 package program was used in the analysis of the data. Wilcoxon analysis was used in the study., Results: It was determined that the pre-test-post-test melatonin and cortisol levels of the individuals were not statistically significant (p>0.05). It was determined that the pre-test-post-test serotonin difference of the individuals was statistically significant (p<0.05)., Conclusion: It has been determined that Ramadan fasting increases the serotonin level of individuals but does not change the levels of melatonin and cortisol. It was determined that the level of happiness of individuals increased after Ramadan fasting. Longitudinal studies on the effects of Ramadan fasting are recommended., (© 2023. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)

In this era of rapidly advancing technology, artificial intelligence (AI) has emerged as a transformative force, even being called the Fourth Industrial Revolution, along with gene editing and robotics. While it has undoubtedly become an increasingly important part of our daily lives, it must be recognized that it is not an additional tool, but rather a complex concept that poses a variety of challenges. AI, with considerable potential, has found its place in both medical care and clinical research. Within the vast field of pediatrics, it stands out as a particularly promising advancement. As pediatricians, we are indeed witnessing the impactful integration of AI-based applications into our daily clinical practice and research efforts. These tools are being used for simple to more complex tasks such as diagnosing clinically challenging conditions, predicting disease outcomes, creating treatment plans, educating both patients and healthcare professionals, and generating accurate medical records or scientific papers. In conclusion, the multifaceted applications of AI in pediatrics will increase efficiency and improve the quality of healthcare and research. However, there are certain risks and threats accompanying this advancement including the biases that may contribute to health disparities and, inaccuracies. Therefore, it is crucial to recognize and address the technical, ethical, and legal challenges as well as explore the benefits in both clinical and research fields.

Objectives This study aims to investigate the negative prognostic indicators of pediatric and adult trigger finger surgery patients concerning complications, recurrence, and satisfaction. Methods A retrospective study was conducted on 61 patients with a total of 91 trigger fingers, including 31 in children and 30 in adult patients, all of whom were treated using a standardized surgical technique. The study considered several demographic and clinical factors, including age, gender, dominant hand, body mass index, occupation, history of trauma, single or multiple finger involvement, staging according to Green classification, diabetes mellitus, comorbidities, recurrence, revision surgery, utilization of non-surgical treatment methods, need for rehabilitation after surgery, time to return to work, the time interval from clinic initiation to the surgery, satisfaction and the duration of the follow-up period. In addition, the quick version of the disabilities of the arm, shoulder, and hand (QDASH); and the visual analog scale (VAS) were used to assess patients' data. Results In adult patients, a statistically significant relationship was observed between the increasing grade of the Green stage and complication rate (p<0.001), recurrence (p<0.001), and lower satisfaction (p<0.001). No statistically significant relationship was identified between Green's classification and complications (p=0.129), recurrence (p=0.854), or satisfaction (p=0.143) in pediatric patients. While a statistically significant relationship existed between the time interval from clinic initiation to surgery and complications (p=0.033) in adult patients, no significant relationships were observed for recurrence or satisfaction. Conversely, there was no statistically significant relationship between the time interval from clinic initiation to surgery and complications, recurrence, or satisfaction in pediatric patients. Conclusion This study demonstrates that increasing the grade of the Green stage and duration of symptoms before surgery were the substantial factors contributing to prognosis in adult patients but not in pediatric patients. These findings can assist physicians during patients' treatment management. We suggest that physicians consider these factors for patients' satisfaction., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Köroğlu et al.)

Objective: The level of intercultural sensitivity is important for nurses to approach the individual's culture in care and treatment without prejudice. In this study, it was aimed to determine the effect of nurses' intercultural sensitivity level on xenophobic attitude., Methods: This quantitative cross-sectional study was conducted at Van Training and Research Hospital between January and June 2022. The Introductory Information Form, the Xenophobia Scale, and the Intercultural Sensitivity Scale were used to collect the research data. SPSS-25 package program and R programming language 4.1.3 are used., Results: This study was conducted with 235 nurses. According to the findings obtained in our study, the regression model determine the effect of intercultural sensitivity on xenophobia level was found to be F(1,233) = 69.857, p = 0.001, and 23.1 % (R 2  = 0.231) of the variance in the dependent variable was explained by the independent variable. Intercultural sensitivity has a negative and significant effect on the level of xenophobia (β = -0.480; t (233) = -8.358, p = 0.001). When comparing the performance of all variables with machine learning algorithms for the prediction model, the best performing algorithm was found to be Random Forest (RF). The contributions of these variables to the model were calculated with Shapley Additive Explanations (SHAP) values. The most important variables that should be included in the model to predict the xenophobia variable are the respect for cultural differences sub-dimension and intercultural sensitivity variables., Conclusion: It was determined that as the level of intercultural sensitivity of the nurses increased, their xenophobic attitudes decreased. Longitudinal studies on xenophobic attitude in nurses are recommended. It is recommended to make predictions with different machine learning models., Competing Interests: Declaration of competing interest The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: Mercury poisoning is a condition with multiple-organ dysfunction that has effects on the central nervous system, gastrointestinal system, cardiovascular system, skin, lungs, and kidneys. It can be fatal or may result in sequelae such as neurological disturbances, if treated late or left untreated. The endocrinological effects of mercury exposure are not well-known. We aimed to evaluate patients with mercury poisoning., Materials and Methods: A total of 6 cases of mercury poisoning from 3 families were included in the study. Clinical, laboratory, and follow-up data were recorded., Results: Thyroid dysfunction was presented as high thyroid hormones and normal thyrotropin level (unsuppressed) in 5 cases (83.3%). On the other hand, pheochromocytoma-like syndrome was detected in 5 cases (83.3%) with hypertension. The 4 cases were the first to use methimazole for mercury poisoning due to tachycardia and hypertension despite antihypertensive treatment due to catecholamine excess and thyroid dysfunction. Hyponatremia was detected in 3 cases (50%)., Conclusion: Mercury poisoning is difficult to diagnose because it is rare and presents with nonspecific physical and laboratory findings. Early diagnosis and providing appropriate treatment are essential in order to prevent sequelae. Mercury poisoning should be considered in patients with unexplained hypertension and tachycardia suggesting the involvement of thyroid hormones and catecholamines.

Background: The optimal treatment of symptomatic paravalvular leak (PVL) remains controversial between transcatheter closure (TC) and surgery. This large-scale study aimed to retrospectively evaluate the long-term outcomes of the patients who underwent reoperation or TC of PVLs., Methods and Results: A total of 335 (men, 209 [62.4%]; mean age, 58.15±12.77 years) patients who underwent treatment of PVL at 3 tertiary centers between January 2002 and December 2021 were included. Echocardiographic features, procedure details, and in-hospital or long-term outcomes were assessed. The primary end point was defined as the all-cause death during follow-up. The regression models were adjusted by applying the inverse probability weighted approach to reduce treatment selection bias. The initial management strategy was TC in 171 (51%) patients and surgery in 164 (49%) cases. Three hundred cases (89.6%) had mitral PVL, and 35 (10.4%) had aortic PVL. The mean left ventricular ejection fraction was 52.03±10.79%. Technical (78.9 versus 76.2%; P =0.549) and procedural success (73.7 versus 65.2%; P =0.093) were similar between both groups. In both univariate and multivariable logistic regression analysis, the in-hospital mortality rate in the overall population was significantly higher (15.9 versus 4.7%) in the surgery group compared with the TC group (unadjusted odds ratio, 3.13 [95% CI, 1.75-5.88]; P =0.001; and adjusted odds ratio (inverse probability-weighted), 4.55 [95% CI, 2.27-10.0]; P <0.001). However, the long-term mortality rate in the overall population did not differ between the surgery group and the TC group (unadjusted hazard ratio [HR], 0.86 [95% CI, 0.59-1.25]; P =0.435; and adjusted HR (inverse probability-weighted), 1.11 [95% CI, 0.67-1.81]; P =0.679)., Conclusions: The current data suggest that percutaneous closure of PVL was associated with lower early and comparable long-term mortality rates compared with surgery.

Objectives: Biological drugs are one of the most effective treatment methods for systemic juvenile idiopathic arthritis (SJIA) and can significantly prevent morbidity and mortality. This study aimed to evaluate the efficacy and safety of biologics in patients with SJIA and provide real-life data that might help improve the outcomes., Methods: TURSIS was a retrospective multicentre study carried out in patients with SJIA for whom a biological treatment had been initiated between 1st March 2013 and 30th December 2018. Data include patients' characteristics, laboratory-clinical results, outcomes, and safety-related variables. The 24-month follow-up data of the patients and the efficacy and safety of biological drugs were evaluated., Results: 147 patients were enrolled. The clinical course of the disease was as follows; it was monocyclic in 38.1%, polycyclic in 49%, and persistent in 12.9% of patients. First-choice biologics were interleukin (IL)-1 blockers in the majority of patients (56.5%), followed by the anti-IL-6 (25.2%) and anti-TNF-alpha drugs (18.4%). Anakinra was the most preferred biologic agent in patients with macrophage activation syndrome (MAS), and tocilizumab was used more frequently in patients with persistent type (p=0.000 and p=0.003). The most frequent switch rate was seen in patients receiving anakinra (n=40/68, 58.8%), and it was most frequently switched to canakinumab (n=32/40, 80%). Better physician's global assessment scores were achieved in patients treated with anakinra in Month 3, compared to other treatments (p=0.04)., Conclusions: The results of our study support the efficacy of biological drugs in particular anti-IL-1 and anti-IL-6 drugs, in the treatment of SJIA. These treatments resulted in improvement in activity of disease and provide a considerable decrease in the frequency of MAS.

Cancer is a global public health problem that affects millions each year. Novel anticancer drug candidates are in need to treat various cancers and to overcome the resistance that exists against drugs in use. Benzimidazole derivatives have been reported as anticancer agents. These lead us to synthesize similar benzimidazole derivatives and investigate their anticancer activity. In this study, six new 1,3-dihydro-2 H -benzimidazol-2-one-based molecules ( 2a-f ) were synthesized. The structures of these molecules were verified by spectroscopic methods. The antiproliferative activities of molecules 2a-f were screened against a panel of human cancer cell lines, including the liver, colon, lung, and breast. The molecules were also tested towards normal human lung cell line to determine their selectivity. The results demonstrated that compound 2d had the highest cytotoxic effect compared to compounds 2a-c , 2e , and 2f against DLD-1 and MDA-MB-231 cell lines. The binding potential of the relatively active compound, 2d , with three targets was investigated through molecular docking. The stability of target-compound complexes procured from the docking was explored through molecular dynamics (MD) simulation. The docking and MD simulation studies revealed that compound 2d had the highest potential to bind to GALR3 among the targets. Furthermore, the computational pharmacokinetic study demonstrated that the synthesized compounds had drug-like properties.Communicated by Ramaswamy H. Sarma.

Objective: Since Cushing's disease (CD) is less common in the paediatric age group than in adults, data on this subject are relatively limited in children. Herein, we aim to share the clinical, diagnostic and therapeutic features of paediatric CD cases., Design: National, multicenter and retrospective study., Patients: All centres were asked to complete a form including questions regarding initial complaints, physical examination findings, diagnostic tests, treatment modalities and follow-up data of the children with CD between December 2015 and March 2017., Measurements: Diagnostic tests of CD and tumour size., Results: Thirty-four patients (M:F = 16:18) from 15 tertiary centres were enroled. The most frequent complaint and physical examination finding were rapid weight gain, and round face with plethora, respectively. Late-night serum cortisol level was the most sensitive test for the diagnosis of hypercortisolism and morning adrenocorticotropic hormone (ACTH) level to demonstrate the pituitary origin (100% and 96.8%, respectively). Adenoma was detected on magnetic resonance imaging (MRI) in 70.5% of the patients. Transsphenoidal adenomectomy (TSA) was the most preferred treatment (78.1%). At follow-up, 6 (24%) of the patients who underwent TSA were reoperated due to recurrence or surgical failure., Conclusions: Herein, national data of the clinical experience on paediatric CD have been presented. Our findings highlight that presenting complaints may be subtle in children, the sensitivities of the diagnostic tests are very variable and require a careful interpretation, and MRI fails to detect adenoma in approximately one-third of cases. Finally, clinicians should be aware of the recurrence of the disease during the follow-up after surgery., (© 2023 John Wiley & Sons Ltd.)