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The aim of this study is to examine the relationship between childhood trauma and psychological resilience in the Turkish Cypriot community and to identify the predictors of psychological resilience. The research was conducted with 354 individuals in a web-based online environment in Northern Cyprus. Data were collected using a "Personal Information Form", the "Adverse Childhood Events Scale", and the "Resilience Scale for Adults". Percentage, mean, standard deviation, and Pearson's correlation analysis were used in the data analysis. In the study, 16.67 % of the participants were exposed to war or conflict when they were young and 10.17 % had a mental illness. In addition, it was determined that there were statistically significant and negative correlations between the Adverse Childhood Events Scale scores and the scores they got from the Adult Resilience Scale and the sub-dimensions of the scale. Female gender and education level predicted the scores on the Resilience Scale for Adults positively, and the presence of mental disease and the scores on the Adverse Childhood Events Scale negatively predicted the scores on the Resilience Scale for Adults. İn this study, gender, educational status, presence of mental illness, and the total score on the Adverse Childhood Events Scale were determined to be predictive variables affecting resilience. Considering the research findings, it is recommended that nurses plan studies for the protection of the mental health of children and adolescents and the groups exposed to trauma should be psychologically supported to raise individuals with high resilience. • Negative life events experienced in childhood affect resilience negatively. • Gender, education level, presence of mental illness are predictive variables affecting resilience. • Nurses should identify high-risk children, and provide holistic training by using their investigative and educational roles. [ABSTRACT FROM AUTHOR]

Locating the screw channel in a cement-retained implant-supported crown is challenging. This article describes a fully digital workflow for fabricating a 3D printed template which can accurately guide the dentist to find the screw channel. A definitive implant cast from the patient and an implant planning software program are used in the workflow. This technique provides precise guidance for finding the location and angulation of the abutment screw access hole. [ABSTRACT FROM AUTHOR]

• Telerehabilitation is an important option for healthcare professionals and patients during epidemics and natural disasters. Telerehabilitation is used for many conditions, including psychiatric conditions (such as anxiety and depression). • Evidence suggests that nursing students experience stress during their first clinical experience. • In this study, the positive effects of using telerehabilitation were observed in nursing students who switched to distance learning after the earthquake. To investigate the effect of telerehabilitation on stress levels experienced by nursing students during their first clinical experience. For nursing students, the first clinical experience can cause stress and anxiety. As a result, nursing students may lose motivation and desire to learn. Telerehabilitation is used for many conditions, including mental health conditions. Seventy-four nursing students, aged 18-24 years, who volunteered to participate in the study and who were having their first clinical experience, participated in the study. The participants were randomly divided into two groups, the exercise group (n=37) and the control group (n=37). The experimental group received a total of 16 sessions of progressive muscle relaxation exercises with telerehabilitation four times a week for four weeks. The control group received no treatment. There was no statistically significant difference in the mean Perceived Stress Scale for Nursing Students scores of the students in the experimental group after the tele-rehabilitation application, but there was a decrease in the mean score levels compared to the experimental group (p>0.05). At the end of the study, the Biopsychosocial Response Scale of Nursing Students mean scores of the exercise group decreased statistically significantly compared to the control group (p<0.05). It was observed that telerehabilitation practice may have a positive effect on clinical stress levels and stress responses of nursing students during their first clinical experience. [ABSTRACT FROM AUTHOR]

• There is no special program to improve the rational drug use level of nursing students in the nursing curriculum. • This study indicates, rational drug use program (RDUP) remarkably increased the level of RDU among nursing students. • This study demonstrates that web-based RDUP can be integrated into the nursing curriculum for increasing the RDU levels of nursing students. Rational drug use (RDU) is an issue that has global concerns for all health professionals. The aim of this study was to determine the effects of web-based rational drug use program (RDUP) for nursing students. A total of 224 nursing students were randomly assigned to the intervention (IG = 112) and control (CG = 112) groups. The IG received a 4-week web-based RDUP. Data were collected at baseline (T0), postintervention (in 1-week = T1), and postintervention (in 16-week = T2). The level of RDU was significantly higher in the IG than in the CG at T1 (F = 88.890; p<0.001; η2 = 0.287) and at T2 (F = 251.875; p<0.001; η2 = 0.533). Web-based RDUP was effective in level of rational drug use among nursing students. Therefore web-based RDUP should be included in the nursing curriculum. [ABSTRACT FROM AUTHOR]

Current breast cancer treatment trends advocate nipple-sparing mastectomy (NSM) as the preferred technique for selected patients. A considerable and ptotic breast is often considered a relative contraindication for NSM due to the increased risk of skin and nipple necrosis. A retrospective review was performed for patients who underwent immediate prepectoral breast reconstruction (PPBR) after NSM with Wise-pattern incision between February 2020 and February 2023 at our institution. This procedure was offered to patients with grade II or III ptosis or large breasts eligible for NSM for therapeutic or prophylactic purpose. Exclusion criteria comprised a preoperative nipple-sternal notch distance greater than 30 cm, previous radiotherapy, pinch test <1 cm, body mass index (BMI) greater than 34 and active smoke. We present our short-term results with this technique. During the study period, 62 patients (76 breasts) had NSM with Wise-pattern incision. Patients had immediate PPBR with implant or tissue expander, both entirely wrapped with ADM. The median age of the patients was 57.0 years [The Interquartile Range (IQR 50.0–68.6)] with a median BMI of 25.5 (IQR 23.3–28.4). The median mastectomy specimen weight was 472 g (341−578). Median implant volume was 465 g (IQR 370–515). Major complications occurred in 8 patients (10.5%). Three patients experienced total nipple-areolar complex (NAC) necrosis (3.9%), and partial NAC necrosis occurred in 2 patients (2.6%). Two patients developed implant infection (2.6%). Univariate analysis showed a statistically significant correlation between major complications and the mastectomy specimen weight (p = 0.003). If oncologically indicated, NSM with Wise-pattern incision and immediate PPBR can safely be performed in selected patients with large and ptotic breasts. [Display omitted] [ABSTRACT FROM AUTHOR]

Ganglioneuromas (GNs) are rare benign peripheral neuroblastic tumors (PNTs). We shared our institutional experience with childhood GNs. Records of the children with PNTs between January 1995 and December 2021 were reviewed, and cases with histopathological diagnoses of GN were identified. Clinical, laboratory, radiological, and histopathological findings, image-defined risk factors (IDRFs), procedures, and overall outcomes were recorded. Of 668 cases with PNTs, 70 (10.4%) had GNs. The median age was 7.4 years (range, 2.6–15.7 years) (girls/boys, 41/29). Common presenting complaints were abdominal pain and cough; 33/70 cases (47.1%) were diagnosed incidentally. Primary tumors were in the abdomen in 41/70, the thorax in 25/70, the neck in 3 cases, and the pelvis in one. The median tumor size was 6.5 cm (range, 1.4–17). Fifty cases (71.4%) were staged as INRG-L1; 20 cases with IDRFs (15 single, five >1) were staged as INRG-L2. Complete and partial tumor resections were performed in 58/70 and 6/70 cases, while 6 had no resection. The overall complication rate was 17.1% (11/64). At a median follow-up of 9 years, five were lost to follow-up; 65 were alive. One patient with gross residue underwent total resection due to progression 13 years after the surgery, and one in the unresected group was lost to follow-up. Ten other cases without a complete resection experienced no tumor progression. Ganglioneuromas are benign PNTs, and most are free of IDRFs. Even without complete resection, long-term outcomes are excellent. Guidelines should be devised considering the high surgical complication rates and benign course of GNs. Case series, IV. [ABSTRACT FROM AUTHOR]

Color matching and marginal integrity are major challenges when providing extraoral maxillofacial prostheses. Which of the color and marginal harmony features are more important for the extraoral prostheses to be inconspicuous is unclear. Studies on the perception of these prostheses with objective evaluation criteria are lacking. The purpose of this observational study was to investigate the significance of color mismatch and conspicuous marginal adaptation in the perception of extraoral maxillofacial prostheses using eye-tracking technology. The secondary aim was to evaluate the perception of extraoral maxillofacial prostheses with regard to the observers' sex. Twenty-seven face images, in 3 groups, representing well-fitting orbital prostheses with a color mismatch (IC), prostheses with a good color match but distinct marginal adaptation (IM), and symmetrical face images, were viewed for 5 seconds by 52 laypeople. Time to first fixation (TFF), fixation duration (FD), and fixation count (FC) at defined areas of interest were recorded and analyzed by an eye-tracking device. Because of the nested structure of data, a sex- and age-adjusted random intercept linear mixed effects model was used to assess the difference between IC, IM, and SI. Bonferroni corrected P values were used for pairwise comparisons. The difference between observers' sex was evaluated with random intercept mixed model by adjusting for age for each image. For repeated measurement analysis, the lm4, lmerTest, and emmeans libraries in R version 4.3.1 (R Foundation for Statistical Computing) were used (α=.05 for all tests). Significant differences were found between the symmetrical image group and other study groups at the facial prosthesis region in all parameters (each P <.001). Observers first focused on the facial prostheses in IC (0.72 seconds) and in IM (0.789 seconds). Longer fixation durations, 1.909, 1.989 seconds for IC and IM (P IC <.001 , P IM <.001) , respectively, and a higher fixation count for IC (5.28) (P <.001) and for IM (5.45) (P<. 001) were recorded on facial prostheses compared with other areas of interest. Women were more focused on the prosthesis than men in the IC and IM groups considering FD (P IC =.003, P IM <.001) and FC values (P IC =.016, P IM <.001, P SI <.001). Fixation duration for women and men was 2.097 seconds and 1.739 seconds in the IC group, 2.219 seconds and 1.78 seconds in the IM group, and 1.364 seconds and 1.222 seconds in the SI group, respectively. Since the color mismatch and distinct marginal adaptation of maxillofacial prostheses were recognized using eye-tracking technology, both features appeared to be equally significant to be considered in fabrication procedures. [ABSTRACT FROM AUTHOR]

• Nursing students experience fear and anxiety while transforming knowledge into skills. • Nursing educators should take initiative to reduce students' anxiety by creating an active and flexible learning environment during skill acquisition. • Music and white noise listening reduce anxiety and increase academic success. • Listening to favorite music can be a useful intervention for promoting skill achievements and development. This study explored the effects of environmental white noise and music on the physiological and psychological conditions of nursing students who were first-year (n = 50). Also, intramuscular injection skills were evaluated. The data of randomized controlled design were collected by using an information form, the intramuscular injection checklist, The State-Trait Anxiety Inventory, and the vital signs assessment form. After interventions, the mean state anxiety levels of the groups showed a statistically significant difference, and the score of students in the white noise group was higher than students in the music and control groups (p ≤.001). All groups showed a statistically significant difference between the first and second measurements for the state anxiety level (p <.05). While no statistically significant difference was determined in the means of heart rate and diastolic pressure among the groups after the intervention, the means of systolic pressure of the white noise group increased significantly when compared to the music group (p <.05). There were no significant differences between the groups in the skill test (p >.05). While music listening and a silent environment had positive effects on the state of anxiety of students, white noise had negative effects. No significant difference was determined between the groups in the skill test. [ABSTRACT FROM AUTHOR]

Blood sampling, which is frequently performed on children admitted to hospital, causes them pain, anxiety and fear. The study was carried out to determine the effects of dry heat and dry cold application before blood sampling on pain, anxiety and fear levels in school age children. The study was conducted between June and January 2021 with a parallel-group randomized controlled experimental design. It was carried out with 117 children who applied to the Pediatric Blood Collection Polyclinic of a training and research hospital. The children were assigned to dry heat application, dry cold application and control group by simple randomization. Data were collected using the Child-Family Introductory Information Form, Wong Baker Faces Pain Rating Scale (WBFPS), Child Fear Anxiety Scale (CFAS) and Medical Procedure Fear Scale (MPFS). In the data analysis, descriptive statistics, the Kruskal-Wallis H test, the Dunn test, Yates correction and the Pearson Chi-Square test were used. A level of p < 0.05 was considered statistically significant. It was found that children who were treated with dry heat and dry cold before blood sampling experienced less pain. The anxiety of the children in the dry heat treatment group was lower than the control group. According to the children's MPFS Operational Fear sub-dimension median scores, procedural fear was found to be lower in the dry heat application group. Pediatric nurses can safely use dry heat and dry cold application in the management of invasive procedure-related pain, and dry heat application in the management of anxiety. This trial is registered with the US National Institutes of Health (ClinicalTrials.gov) under the number NCT05974319. [ABSTRACT FROM AUTHOR]

• Tele-yoga sessions performed three days a week for 12 weeks improved heart rate parameters and inspiratory respiratory muscle strength of OSAS patients. • Tele-yoga sessions improved neurocognitive performance, sleep duration (min), sleep efficiency, sleep quality and decreased daytime sleepiness of OSAS patients. • This study supported that tele-yoga intervention, which is feasible, easily accessible, non-invasive, and allows group sessions, can be included in exercise training programs in addition to CPAP treatments of OSAS patients in the clinic. Obstructive sleep apnea syndrome (OSAS) causes a decrease in aerobic capacity, respiratory muscle strength, and cognitive function, negatively affecting health-related quality of life. This study aimed to compare aerobic capacity, respiratory muscle strength, cognitive performance, functional capacity, sleep quality and daytime sleepiness in OSAS patients practicing and not practicing tele-yoga (TY). 44 OSAS patients (40 M, 4F) were randomized into TY and control groups. TY group underwent live synchronous group-based TY sessions, 60 min/day, three days/week, for 12 weeks. Control group performed unsupervised thoracic expansion exercises at home 4 times daily for 12 weeks. The following were evaluated at baseline and at the end of the 6th and 12th weeks: inspiratory and expiratory respiratory muscle strength (MIP, MEP), cardiopulmonary exercise test, Corsi Block Tapping Test (CBTT) and Stroop TBAG test, six-minute walk test (6MWT), Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). TY significantly improved MIP, and exercise test parameters (VE, HR max ,%HR, heart rate recovery in the first minute and RQ max), CBTT (forward) and Stroop TBAG test scores (parts of 3,4,5) compared to the controls (p <0.05). There were no significant changes 6MWT in the TY group compared to the control group (p > 0.05). Sleep duration (min), sleep efficiency, sleep quality of PSQI and ESS score improved significantly in the TY group compared to the control group (p < 0.05). We suggest including TY intervention as a method of exercise in addition to CPAP treatments since it improves the health-related parameters of OSAS patients. [ABSTRACT FROM AUTHOR]

The study was conducted to investigate the effect of technology addiction training given to nursing students on their Internet and technology addiction perspectives and addiction levels. The data of the experimental research with a control group and a pretest-posttest design were collected online using the Personal Information Form and the Technology Addiction Scale. Sample size was 82. Technology addiction training was given for 10 weeks. Post-test data were collected after the training. The Mann Whitney- U test, t -test, Tukey HSD test, Kruskal Wallis test, and Bonferroni-Dunn test were used for statistical analysis. The Fisher's Exact Test and the Chi-Square test were used to analyze the categorical variables. The level of technology addiction of the students in the experimental group was 52.69 ± 17.218 in the pre-test and 51.31 ± 14.931 in the post-test. In the control group, the level of technology addiction was found to be 54.03 ± 18.955 in the pre-test and 53.39 ± 20.159 in the post-test. Thus, it can be stated that the students in both groups were moderately addicted to technology and no significant difference was observed between the pre-test and post-test mean scores of the groups after the training. The study revealed that the students were moderately addicted to technology and used technological devices at a high rate. In addition, the ineffectiveness of the training, and being aware of the harms of technology, but disregarding the importance of these harms were the interesting findings that showed the severity of the problem. NCT05277545. • Undergraduate students are moderately addicted to technology. • Although students are aware of their technology addiction level, they do not see this as a problem. • Although detailed trainings were provided, students' perspectives did not change. • There is a need for supportive practices as well as education on technology addiction. [ABSTRACT FROM AUTHOR]

An eco-friendly and cost-effective NiFe 2 O 4 nanoparticles and its derivatives NiFe 2 O 4 :salicylamide, NiFe 2 O 4 :salicylamide:Tb3+ and NiFe 2 O 4 :salicylamide:Tb3+: Olea europaea L. extracts have been successfully synthesized using a simple and refluxed-assisted chemical co-precipitation method and green route approach followed by thermal treatment steps. In this report, the structural, morphological, optical characteristics and biological activities of the nanoparticles were characterized by using XRD, SEM, FTIR, UV-Vis, PL, BET analysis, antibacterial assays and antioxidant activities. The results from XRD revealed that NiFe 2 O 4 has a crystalline structure and EDX elemental mapping confirmed the uniform distributed of all the elements in the matrix. The incorporation of salicylamide, Tb3+ and Olea europaea L. extracts into NiFe 2 O significantly enriched the luminescence intensities and changed the emission colour coordinates. Colour tunability was achieved with luminescence ranging from bright blue emission to reddish orange light, which makes nanoparticles important candidates for solid-state lighting technologies. Combining olive leaf extracts with NiFe 2 O 4 nanoparticles provided effective antioxidant and antibacterial activity by reducing and stabilizing of nanoparticles. Moreover, all experimental results reveal new ideas for the design and optimization of multifunctional nanomaterials with higher sensitivity and pave the way for the production of new functional nanomaterials. [Display omitted] • NiFe 2 O 4 NPs were produced by green synthesis approach, which is an environmentally friendly method, and discussed in detail. • RT luminescence properties of Tb3+ doped NiFe 2 O 4 NPs synthesized with plant extract via green synthesis were investigated. • This research paves the way for new research on a group of nickel ferrites with novel tunable color properties. [ABSTRACT FROM AUTHOR]

CIC -rearranged sarcoma (CRS) is a group of high-grade undifferentiated small round cell sarcomas examined as a separate entity in the current WHO classification; since it shows more aggressive clinical behavior and distinct morphological and molecular features compared to Ewing sarcoma (ES). As CCNE1 expression is associated with tumor growth in CIC::DUX4 sarcomas, we aimed to demonstrate the value of cyclin E1 expression in CRS. Cyclin E1 immunohistochemistry and break-apart FISH for EWSR1 and CIC gene rearrangements were performed on 3-mm tissue microarrays composed of 40 small round cell tumors. Five cases were classified as CRS, whereas 22 were ES and 13 were unclassified (EWSR1 -/ CIC -). Among all three diagnostic groups, we found cyclin E1 expression level to be higher in CRS (80 %) and unclassified groups (61.5 %) compared to ES (4.5 %, p < 0.001). In addition, high cyclin E1 expression levels were associated with higher mean age at diagnosis, presence of atypical histology and myxoid stroma, low CD99 expression, and presence of metastasis at diagnosis. The sensitivity and specificity of high cyclin E1 expression in detecting non-ES cases were 95.5 % and 66.7 %, respectively. However, the correlation between cyclin E1 expression level and survival was not statistically significant. This is the first study that shows cyclin E1 immunohistochemical expression in EWSR1 -negative undifferentiated small cell sarcomas, particularly CRS. • Differential Cyclin E1 expression is seen in EWSR1 -negative undifferentiated small cell sarcomas, particularly CIC-rearranged sarcomas compared to Ewing sarcomas. • Cyclin E1 expression level does not correlate with survival significantly. • Cyclin E1 can be a good candidate to be targeted in patients with CIC-rearranged sarcoma. [ABSTRACT FROM AUTHOR]

This paper explores how the increasing professionalization of the short-term rental market (previously dominated by individual hosts) fosters the implementation of formal quality standards in the sector. It is based on 36 in-depth interviews conducted with different stakeholders of the short-term rental industry in six European countries, namely, Croatia, Cyprus, Italy, Spain, Turkey, and the UK, and at EU level. The article maps different initiatives that outline some quality standards for short-term rentals. We found first, that to implement quality standardisation, it is important to distinguish between private and professional hosts; and, second, that consensus must be reached on: (1) whether quality would be standardised at national or EU level; (2) which governing body should be responsible for quality certifications (e.g., governments or private institutions as in the case of ISO standards); and (3) identification of practices that should be certified (e.g., property facilities/amenities, size, health & safety protection, etc.). • Initiatives to provide quality standards for short-term rentals emerged in Europe. • Transition from self-regulation towards quality accreditations of short-term rentals. • The professionalisation of the short-term rental market fosters quality standards. • Distinction between private and professional hosts needed to assure quality. [ABSTRACT FROM AUTHOR]

Background and Objective: The effects of acupressure on sleep quality and insomnia symptoms have been studied in various groups of haemodialysis patients, those undergoing surgery, and those living in elderly care homes. The aim of this study is to determine the effect of acupressure on sleep quality in elderly people.Methods: This study was conducted with a systematic review and meta-analysis. In this study, electronic databases of PubMed, Science Direct, National Thesis centre, Google Scholar, Web of Science, EBSCO were systematically scanned between December 2020 and February 2021 using the keywords "older, elderly, sleep quality, acupressure". The study included 11 articles published in English and Turkish languages without any year limitation. This systematic review and meta-analysis were done by following the PRISMA reporting system.Results: The total sample size of 11 randomized controlled trials included in this systematic review and meta-analysis was 722 (experiment: 363 and control: 359), and the mean duration of acupressure interventions applied was 19.65 ± 11.28 days. The sleep quality of the acupressure group in the elderly was significantly increased compared to the control group (MD: -1.71,%95 CI: -2.31 to -1.11, Z = 5.60, p< 0.00001, I2 = 91%). After the subjects received training for acupressure application and applied acupressure themselves, their sleep quality improved compared to the control group (MD: -0.86, 95% CI: -1.39 to -0.32, p <0.001).Conclusions: We have utilized meta-analysis to try to reveal statistical significance by pooling small studies with high quality. This meta-analysis provided a potentially effective intervention on the quality of sleep in elderly people. [ABSTRACT FROM AUTHOR]

• Alzheimer's and Parkinson's patients show volumetric changes in brain. • Alzheimer's patients showed more cortical volume changes than Parkinson's. • Volumetric changes were observed both in primary and secondary smell/taste areas. • Endocannabinoids were higher in Alzheimer's and Parkinson's patients than controls. • Endocannabinoids may have a possible role in olfactory and taste dysfunctions. The purpose of this study is to determine the volumes of primary brain regions associated with smell and taste in Alzheimer's and Parkinson's patients and healthy controls using MR imaging and examine volumetric changes in comparison to smell/taste questionnaire and test results and endocannabinoid (EC) levels. The study included 15 AD patients with mild cognitive dysfunction scored as 18 ≤ MMSE ≤ 23, 15 PD patients with scores of 18 < MoCA < 26 and 18 ≤ MMSE ≤ 23, and 15 healthy controls. A taste and smell questionnaire was given to the participants, and their taste and smell statuses were examined using the Sniffin' Sticks smell identification test and Burghart Taste Strips. EC levels were analyzed in the blood serum samples of the participants using the ELISA method. The volumes of the left olfactory bulb (p = 0.001), left amygdala (p = 0.004), left hippocampus (p = 0.008), and bilateral insula (left p = 0.000, right p = 0.000) were significantly smaller in the Alzheimer's patients than the healthy controls. The volumes of the left olfactory bulb (p = 0.001) and left hippocampus (p = 0.009) were significantly smaller in the Parkinson's patients than the healthy controls. A significant correlation was determined between volume reduction in the left Rolandic operculum cortical region and taste dysfunction. EC levels were significantly higher in both AD (p = 0.000) and PD (p = 0.006) in comparison to the controls. Our results showed that volumetric changes occur in the brain regions associated with smell and taste in Alzheimer's and Parkinson's patients. It was observed that ECs played a role in these volumetric changes and the olfactory and taste dysfunctions of the patients. [ABSTRACT FROM AUTHOR]

Breast cancer stands as the second most common solid tumors with a propensity for brain metastasis. Among metastatic breast cancer cases, the brain metastasis incidence ranges from 10 % to 30 %, with triple-negative breast cancer (TNBC) displaying a heightened risk and poorer prognosis. SRS has emerged as an effective local treatment modality for brain metastases; however, data on its outcomes specifically in pure triple-negative subtype remain scarce. We retrospectively reviewed the electronic medical records of all brain metastasis (BM) TNBC patients treated with SRS. Patient, tumour characteristics and treatment details data were collected. This retrospective cohort study aimed to evaluate local control (LC), distant brain metastasis free survival (DBMFS), and overall survival (OS) outcomes in TNBC patients undergoing SRS for brain metastases while identifying potential prognostic factors. Forty-three patients with TNBC and brain metastases treated with SRS between January 2017 and 2023 were included. The study found rates of LC (99 % at 1 year) and DBMFS (76 % at 1 year) after SRS, with brain metastasis count (p = 0,003) and systemic treatment modality (p = 0,001) being significant predictors of DBMFS. The median OS following SRS was 19.5 months, with neurological deficit (p = 0.003) and systemic treatment modality (p = 0.019) identified as significant predictors of OS. SRS demonstrates favourable outcomes in terms of local control and distant brain metastasis-free survival in TNBC. Neurological deficit and systemic treatment significantly influence overall survival, emphasizing the importance of personalized treatment approaches and (magnetic resonance imaging) MRI surveillance based on these factors. • SRS shows good local control & DBMFS in TNBC brain metastases. • Immunotherapy enhances DBMFS vs chemotherapy in TNBC. • Neurological deficit and immunotherapy significantly influence OS. [ABSTRACT FROM AUTHOR]

pH reduction (Low pH), microplastic (MP), and lanthanum (La) are substantial stressors due to their increasing trends in marine ecosystems and having adverse effects on marine species. This study investigates the single and combined effects of those stressors (Low pH: 7.45, polyethylene MP: 26 μg L−1, and La: 9 μg L−1) on the physiology and histology of sea urchin Arbacia lixula. Regarding physiological results, while the coelomocytes' quantity was slightly affected by stressors, their viability was significantly affected. The coelomocyte count and viability were suppressed most in Low pH-MP-La treatment. The stressors did not impact the respiration rate. According to the histological examination results, the crypt (villi-like structure) was shorter, and epithelial layers were thinner in single and dual stress treatments like MP, Low pH, Low pH-La, and MP-La. Overall, we suggest that the combination of variable types of those stressors causes negative effects on sea urchin's physiology and histology. [Display omitted] • Total coelomocyte of sea urchins was affected by Low pH-MP-La treatment. • Significant decreases were determined in the viabilities of coelomocyte subpopulations. • No change was determined in the respiration rate. • Histological changes were observed in the Low pH-La, MP, MP-La, and Low pH treatments. [ABSTRACT FROM AUTHOR]

• Survival in Ewing sarcoma is still low according to real-world data. • Metastatic disease at presentation and positive margins after surgery are of prognostic significance in Ewing sarcoma. • Lack of aggressive local treatment reduces survival in Ewing sarcoma. The present study evaluates the clinical outcomes of children, adolescents and adults with Ewing sarcoma and identifies the prognostic factors. Included in the study were 222 pediatric and adult patients diagnosed with Ewing sarcoma (EwS) who were followed up between 1992 and 2019, and whose data were analyzed retrospectively. The median age of 131 male and 91 female patients included in the study was 13 (1–64). The median follow-up duration of the survivors was 79 months (range, 11–182 months). The 3-year EFS rate of the 222 patients was 34 % (Confidence Interval (CI) (0.158–0.242 %) and the OS rate was 54 % (CI, 0.289–0.590 %). For the non-metastatic patients, the 3-year EFS rate was 47 % and the OS was 68 %, while for the metastatic patients the 3-year EFS rate was 13 % and the OS was 30 %. Of the patient sample, 81 (36, 5 %) survived, of whom 72 were continuously free of disease while the disease persisted in nine, and three developed a secondary neoplasm (2 of whom subsequently died while one survived disease-free). Of the 129 patients who relapsed with metastases and/or local recurrence, eight survived and are disease-free, nine are alive with uncontrolled disease; five were lost to follow-up and 107 died. The findings of the present study suggest metastatic disease at presentation and positive margins after surgery to be of prognostic significance in EwS. Disruptions in aggressive local treatments may reduce the chances of cure in EwS. [ABSTRACT FROM AUTHOR]

This research focuses on the identification of lactic acid bacteria (LAB) isolated from traditionally produced Shalgam juices collected from different locations in Türkiye and the characterization of their probiotic potential in vitro. LAB isolates were identified by 16 S rRNA gene sequencing. The most common strains belonged to Pediococcus acidilactici (54.2%), Lacticaseibacillus sp. (18.8%), L. paracasei (8.3%) and Enterococcus faecalis (6.3%). According to the test results, LAB isolates survived after exposure to low pH (2.0) except Levilactobacillus brevis TS9 and P. acidilactici TS10. All isolates showed tolerance to bile salts (69.78%–147.84%), pepsin (50.10%–159.43%), pancreatin (46.64%–120.12%) and phenol (58.19%–121.84%) at various levels. The isolates E. faecalis TS2 and Lacticaseibacillus sp. TS3 were more resistant to the target microorganisms. The isolates E. faecalis TS2, L. paracasei TS7, P. acidilactici TS41, and P. acidilactici TS43 were highly resistant to the antibiotics. The hydrophobicity of the isolates toward xylene ranged from 2.32% to 58.56% and P. acidilactici TS42 showed a high hydrophobicity of 58.56%. The ability of auto-aggregation and co-aggregation varied from 3.59% to 23.67% and 0.85–29.37%, respectively. The isolates showing the best probiotic properties (Lacticaseibacillus sp. TS3, Lacticaseibacillus sp. TS11, and L. paracasei TS33) were tested for their ability to produce short-chain fatty acids. The acetate, butyrate and propionate production of the isolates varied between 4040 and 8135, 1025–1255 and 14620-17225 μg/mL, respectively. Butyrate production of the isolates were higher than the control group. These results indicated that LAB originated from Shalgam juice could be proposed as probiotic candidates for use in fermented foods. [ABSTRACT FROM AUTHOR]

Our society faces a great diversity of opportunities for youth. The 10-year Growing Up Together in Society (GUTS) program has the long-term goal to understand which combination of measures best predict societal trajectories, such as school success, mental health, well-being, and developing a sense of belonging in society. Our leading hypothesis is that self-regulation is key to how adolescents successfully navigate the demands of contemporary society. We aim to test these questions using socio-economic, questionnaire (including experience sampling methods), behavioral, brain (fMRI, sMRI, EEG), hormonal, and genetic measures in four large cohorts including adolescents and young adults. Two cohorts are designed as test and replication cohorts to test the developmental trajectory of self-regulation, including adolescents of different socioeconomic status thereby bridging individual, family, and societal perspectives. The third cohort consists of an entire social network to examine how neural and self-regulatory development influences and is influenced by whom adolescents and young adults choose to interact with. The fourth cohort includes youth with early signs of antisocial and delinquent behavior to understand patterns of societal development in individuals at the extreme ends of self-regulation and societal participation, and examines pathways into and out of delinquency. We will complement the newly collected cohorts with data from existing large-scale population-based and case-control cohorts. The study is embedded in a transdisciplinary approach that engages stakeholders throughout the design stage, with a strong focus on citizen science and youth participation in study design, data collection, and interpretation of results, to ensure optimal translation to youth in society. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to examine the probability of de-novo fQRS in patients with mild COVID-19 disease, as an indicator of cardiac injury.Methods: Data of 256 patients with normal admission electrocardiography and no comorbidities between 1.12.2020-31.12.2021, were examined retrospectively 6-month after mild COVID-19 disease. Patients were divided into two groups: fQRS+ group (n = 102) and non-fQRS group (n = 154). Relation between fQRS and other electrocardiography, echocardiographic and laboratory findings were investigated.Results: No significant difference was found between the groups among age and gender. Troponin-I and creatine kinase myocardial band values (retrospectively 9.10 ± 1.76 vs 0.74 ± 1.43, 34.05 ± 82.20 vs. 14.68 ± 4.42), COVID-19 IgG levels (45.78 ± 14.82 vs. 36.49 ± 17.68), diastolic dysfunction (39.21% vs. 15.07%), EF value (58.02 ± 1.95 vs. 64.27 ± 3.07), dyspnea (41.17% vs. 6.84%), post-COVID-19 tachycardia syndrome (19.6% vs. 2.74) were more frequent in fQRS+ group compared to non-fQRS group. The EF value was lower in the presence of fQRS in the high lateral leads (57.12 ± 1.99, 58.47 ± 1.79, p:0.018). There was a positive correlation between IgG value and endsystolic diameter, septum thickness and left atrium diameter. In multivariate analysis de-novo fQRS, dyspnea, high troponin and IgG values, diastolic dysfunction, low EF value and left atrial diameter were determined as independent risk factors for post-COVID-19 tachycardia syndrome in follow-up.Conclusion: In COVID-19 disease de-novo fQRS, dyspnea, high IgG and troponin value, left atrial diameter, lower EF value, diastolic dysfunction were associated with post-COVID-19 tachycardia syndrome. The de-novo fQRS in SARS-COV-2 may be a predictor of future more important adverse cardiovascular outcomes and this should alert clinicians. [ABSTRACT FROM AUTHOR]

Background and Objective: Public speaking is a common challenge that university students have to face. This study aims to determine the effects of Breathing Therapy and Emotional Freedom Techniques (EFT) on public speaking anxiety in Turkish nursing students.Methods: This randomized controlled study included 76 nursing students. Data were collected using the Descriptive Characteristics Form, Subjective Units of Disturbance Scale, The State-Trait Anxiety Inventory, and the Speech Anxiety Scale.Results: Before the administration of Breathing Therapy and EFT, the students' median scores from the Subjective Units of Disturbance Scale, the State-Trait Anxiety Inventory, and the Speech Anxiety Scale were similar. However, the median scores of the Subjective Units of Disturbance Scale, the State-Trait Anxiety Inventory, and the Speech Anxiety Scale scores significantly decreased in both of the experimental groups after the interventions (p <0.001). EFT (d = 3.18) was more effective than Breathing Therapy (d = 1.46) in reducing Speech anxiety.Conclusion: It was found that Breathing Therapy and EFT are effective methods to reduce stress, anxiety, and speaking anxiety. [ABSTRACT FROM AUTHOR]

Background: In advanced heart failure (HF), levosimendan increases peak oxygen uptake (VO2). We investigated whether peak VO2 increase is linked to cardiovascular, respiratory, or muscular performance changes.Methods and Results: Twenty patients hospitalized for advanced HF underwent, before and shortly after levosimendan infusion, 2 different cardiopulmonary exercise tests: (a) a personalized ramp protocol with repeated arterial blood gas analysis and standard spirometry including alveolar-capillary gas diffusion measurements at rest and at peak exercise, and (b) a step incremental workload cardiopulmonary exercise testing with continuous near-infrared spectroscopy analysis and cardiac output assessment by bioelectrical impedance analysis.Levosimendan significantly decreased natriuretic peptides, improved peak VO2 (11.3 [interquartile range 10.1-12.8] to 12.6 [10.2-14.4] mL/kg/min, P < .01) and decreased minute ventilation to carbon dioxide production relationship slope (47.7 ± 10.7 to 43.4 ± 8.1, P < .01). In parallel, spirometry showed only a minor increase in forced expiratory volume, whereas the peak exercise dead space ventilation was unchanged. However, during exercise, a smaller edema formation was observed after levosimendan infusion, as inferable from the changes in diffusion components, that is, the membrane diffusion and capillary volume. The end-tidal pressure of CO2 during the isocapnic buffering period increased after levosimendan (from 28 ± 3 mm Hg to 31 ± 2 mm Hg, P < .01). During exercise, cardiac output increased in parallel with VO2. After levosimendan, the total and oxygenated tissue hemoglobin, but not deoxygenated hemoglobin, increased in all exercise phases.Conclusions: In advanced HF, levosimendan increases peak VO2, decreases the formation of exercise-induced lung edema, increases ventilation efficiency owing to a decrease of reflex hyperventilation, and increases cardiac output and muscular oxygen delivery and extraction. [ABSTRACT FROM AUTHOR]

• Health professionals, caregivers, family members, and patients themselves can apply this simple technique to improve their quality of life. • Animal assisted intervention has the potential to improve the quality of life in the elderly. • Animal assisted intervention is simple and easy to perform for healthcare professionals. This meta-analysis was conducted to determine the effect of animal-assistant therapy on the quality of life of older adults. This research systematically searched electronic databases (CINAHL, Cochrane Central, Medline/PubMed, Web of Science, Science Direct, and the National Thesis Centre and ULAKBİM of the Council of Higher Education) for studies published between April – June 2021. Seven studies with experimental design were used, three were quasi-experimental and four were randomly controlled studies. The total sample size in the meta-analysis was 375 (experimental group: 177 and control group: 198). The mean duration of animal-assistant therapy was 38.5 ± 12.4 min. Animal-assistant therapy had a significant effect on the quality of life of older adults (mean difference: -4.59 p: 0.03, Z:2.23). Therefore, animal assistant therapy is an effective method to improve older adults' quality of life. [ABSTRACT FROM AUTHOR]

Corona Virus Disease 2019 (COVID-19) in pregnant women has important impacts on perinatal and neonatal outcomes. However, there are a limited number of studies investigating the effect of the pandemic period on newborns. With this study, we aimed to determine the impact of the 2020 COVID-19 outbreak on prenatal care, obstetric outcomes, neonatal mortality and morbidity. The retrospective results of patients hospitalized to the Tertiary Neonatal Intensive Care Unit between 1 March and 30 May 2020, the first peak period of the pandemic in our country, were compared with the data of the same period of the previous year. A total of 307 cases were included in our study. The mean gestational weeks of the neonates hospitalized in the Neonatal Intensive Care Unit during the COVID-19 period were higher than those in the control group (p: 0.003). During the pandemic period, an increase was found in the frequency of pregnant women presenting to obstetric emergency services in emergencies requiring acute intervention (p: 0.01). Compared to the control group, there was an increase in the number of infants with small for gestational age (SGA) diagnosis, 5th-minute Apgar score of <7, and newborns with a diagnosis of hypoxic-ischemic encephalopathy who were treated with hypothermia in the study group (p < 0.05). No difference was found in terms of maternal and neonatal mortality (p > 0.05). During the COVID-19 pandemic, it was shown that pregnant women disrupted their regular antenatal care, and more pregnant women were admitted to the obstetric emergency department with emergencies requiring acute intervention. This led to an increase in the number of cases diagnosed with SGA and hypoxic-ischemic encephalopathy in newborns. Our results will be useful for better management of current and future pandemic periods. [ABSTRACT FROM AUTHOR]

This study aimed to adapt and assess the validity and reliability of the Spanish version of the Exercise in Eating Disorders Questionnaire (EED-Q) in order to diversify and offer a more comprehensive, effective, and standardized assessment of maladaptive exercise (ME) in ED. The EED-Q is a self-reported questionnaire that assesses eating disorders (ED) patients' attitudes towards exercise. Based on the four-factor model of the original version, the EED-Q was adapted through forward and back-translation and inconsistencies were addressed through a committee of experts. Then, the EED-Q Spanish version (S-EED-Q) was administered to 172 patients with eating disorders (age = 15.28 ± 1.64 years). An exploratory factor analysis was computed to assess the construct validity. Inter-item correlations, item-factor correlations, McDonald's Omega, and Cronbach's Alpha were estimated to test the internal consistency (reliability). In addition, convergent validity was tested by relating EED-Q and the Eating Disorders Inventory 2 (EDI-2) scores, discriminant validity was assessed comparing EED-Q item-factor correlations, and divergent validity was conducted by analyzing EED-Q factor correlations. The S-EED-Q revealed significant generalized correlations among the scale items and showed good reliability scores (McDonald's Omega and Cronbach's alpha >0.7) except for Factor 2 (McDonald's Omega = 0.63 and Cronbach's alpha = 0.58). After eliminating items 8 and 15 due to their low factor loadings, the EFA revealed a robust empirical factor structure, adequate to the theoretical model, with good levels of total explained variance (65%). Convergent, discriminant and divergent validity showed good performance: results showed expected correlations between EED-Q and EDI-2, all items achieved higher item-factor correlations in their theoretical factor than in the others, and all factor-factor correlations were as expected. This study is the first to adapt and validate the S-EED-Q. The psychometric properties of the S-EED-Q compared to the original version were supported with some limitations. Although the psychometric properties of the scale are adequate and the construct, convergent, discriminant and divergent validity are endorsed, some of the original items are questionable. Likewise, the items of the positive and healthy exercise factor require an in-depth revision. • Unhealthy exercise behavior is a key predictor of relapse in eating disorders (ED). • Positive exercise improves symptomatology and physical health in ED patients. • EED-Q instrument evaluates positive and negative relationships with activity in ED. • The Spanish version's properties are similar to the original but with limitations. • A Spanish version of EED-Q expands accessibility reaching more diverse patients. [ABSTRACT FROM AUTHOR]

This study aimed to explore and describe the impact on patients with oxaliplatin-induced cold sensitivity in the early stages. An inductive design was used for this qualitative study, which included open-ended, and in-depth interviews with 18 cancer patients. Throughout the study, the authors followed the COREQ checklist. The interviews were audiorecorded and listened to multiple times. Observation notes were also recorded following each interview. Thematic analysis developed six main themes and 13 subthemes. The first theme concerns changing habits, including changes in fluid intake and clothing choice, changes in bathing and eating habits, and changes in caregiver roles. The second theme includes changes in daily routine behaviors that are perceived as difficulties with changing routines. The third theme is avoiding triggers; the fourth theme is anxiety about self-care. The fifth theme includes a subtheme of difficulty in contact. The final theme includes adaptation to life, caring responsibilities, changes in sexual functions, the performance of religious activities, and social activities This study provides an overview of the lived experiences of oxaliplatin-induced cold sensitivity among cancer patients. Patients faced fewer adverse events by avoiding initiators from the first treatment. They changed their eating and drinking habits owing to difficulties. The findings of this study can be used to better understand oxaliplatin-induced cold sensitivity, identify patients needs based on their experience, and develop interventions to improve patient outcomes. [ABSTRACT FROM AUTHOR]

Background and Objective: Infectious disease outbreaks pose psychological challenges to the general population, and especially to healthcare workers. Nurses who work with COVID-19 patients are particularly vulnerable to emotions such as fear and anxiety, due to fatigue, discomfort, and helplessness related to their high intensity work. This study aims to investigate the efficacy of a brief online form of Emotional Freedom Techniques (EFT) in the prevention of stress, anxiety, and burnout in nurses involved in the treatment of COVID patients.Methods: The study is a randomized controlled trial. It complies with the guidelines prescribed by the Consolidated Standards of Reporting Trials (CONSORT) checklist. It was conducted in a COVID-19 department at a university hospital in Turkey. We recruited nurses who care for patients infected with COVID-19 and randomly allocated them into an intervention group (n = 35) and a no-treatment control group (n = 37). The intervention group received one guided online group EFT session.Results: Reductions in stress (p < .001), anxiety (p < .001), and burnout (p < .001) reached high levels of statistical significance for the intervention group. The control group showed no statistically significant changes on these measures (p > .05).Conclusions: A single online group EFT session reduced stress, anxiety, and burnout levels in nurses treating COVID-19. [ABSTRACT FROM AUTHOR]

The study was done experimentally to test the effect of diabetes on body mass index (BMI), low-density lipoprotein (LDL), high-density lipoprotein (HDL), systolic blood pressure, diastolic blood pressure, fasting blood glucose and postprandial blood glucose. In the randomization performed, with 80 percent power, 80 people with Type 2 diabetes were found to be suitable for sampling. Personal data forms were filled in by conducting a face-to-face interview with both the experimental and control groups for randomization purposes. In the study, monitoring of BMI, LDL, HDL, systolic blood pressure, diastolic blood pressure, fasting blood glucose and postprandial blood glucose were used as outcome measures. Parameters were monitored pre-trial and at the 3rd, 6th, 9th, and 12th months. Data from the experimental group were collected online while data belonging to the control group were collected by the researcher from patients⿿ medical records in the Endocrinology Outpatient Clinic. Repeated measures analysis of variance (rANOVA) was performed to analyze pre-trial, 3rd, 6th, 9th, and 12th-month data. BMI, LDL, HDL, systolic and diastolic blood pressure, fasting and postprandial blood glucose average of the experimental group at 12 months were proven to be ameliorated compared to the average values at the start of the study (month 0). The metabolic data of the experimental group, who had web-based diabetes education, significantly improved between the start of the study (month 0) and the 12th month. In this era of technology, the importance of web-based monitoring of diabetes patients was once again proven. [ABSTRACT FROM AUTHOR]

Dialysis are the treatment modalities that affect the quality of life. The objective of this qualitative study is to reveal how hemodialysis and peritoneal dialysis patients perceive depression and psychological problems which they experience. An interpretative phenomenological analysis approach, as espoused by Smith and Osborn provided the framework for this study. The study was performed in hemodialysis and peritoneal dialysis units of a university hospital. 10 adult hemodialysis patients and 10 adult peritoneal dialysis patients, selected. In-depth, semi-structured, face-to-face interviews were held with the patients. All interviews were digitally recorded and subjected to qualitative analysis after transcription. Analysis revealed themes suggesting that hemodialysis and peritoneal dialysis patients frequently experienced depression as well as psychological problems such as decreased social support, burnout, despair, and anxiety. It was concluded as a result of this study that the prolonged hemodialysis and peritoneal dialysis process negatively affected patients with chronic kidney disorders. [ABSTRACT FROM AUTHOR]

The advent of acellular dermal matrix (ADM) for lower pole coverage allows immediate reconstructions with improved aesthetic outcomes and faster recovery. This study describes for the first time, the use of a new acellular pericardium matrix (APM) in implant-based breast reconstruction and characterises its safety profile. Equity is a membrane with a natural cross-linked structure with many of the properties of ADMs, but improved resistance and reduced thickness. A retrospective data collection of all Equity APM reconstructions was conducted at two Italian hospital centres with substantial experience using biomaterials. Between May 2013 and October 2018, a total of 63 APM-assisted breast reconstructions were performed in 55 women. The reconstructed breasts were small to medium and the mean implant weight was 285 g, ranging from 145 g to 685 g. Two patients were previously irradiated while seven received post-operative radiation; five were active smokers and six were hypertensive. Complications included visibility in the upper pole (9.5%), seroma (1.6%), dehiscence, infection and necrosis (3.2% for each). Implant loss occurred in 3.2% of the cases. The patients were highly satisfied, reporting scores above 50 for each section of the Breast-Q questionnaire. With an acceptable complication rate, the use of the equine APM can be considered safe with satisfactory aesthetic results. Although the retrospective nature of this study limits its clinical impact, the use of Equity can be considered a viable alternative to thicker and expensive ADMs. [ABSTRACT FROM AUTHOR]

The Lokomat is a commercially available exoskeleton for gait training in persons with cerebral palsy (CP). Because active contributions and variability over movement repetitions are determinants of training effectiveness, we studied muscle activity in children with CP, and determined (i) differences between treadmill and Lokomat walking, and (ii) the effects of Lokomat training parameters, on the amplitude and the stride-to-stride variability. Ten children with CP (age 13.2 ± 2.9, GMFCS level II(n = 6)/III(n = 4)) walked on a treadmill (±1 km/h; 0% bodyweight support(BWS)), and in the Lokomat (50% and 100% guidance; ±1 km/h and ±2 km/h; 0% and 50% BWS). Activity was recorded from Gluteus Medius (GM), Vastus Lateralis (VL), Biceps Femoris (BF), Medial Gastrocnemius (MG) and Tibialis Anterior (TA) of the most affected side. The averaged amplitude per gait phase, and the second order coefficient of variation was used to determine the active contribution and stride-to-stride variability, respectively. Generally, the amplitude of activity was lower in the Lokomat than on the treadmill. During Lokomat walking, providing guidance and BWS resulted in slightly lower amplitudes whereas increased speed was associated with higher amplitudes. No significant differences in stride-to-stride variability were observed between Lokomat and treadmill walking, and in the Lokomat only speed (MG) and guidance (BF) affected variability. Lokomat walking reduces muscle activity in children with CP, whereas altering guidance or BWS generally does not affect amplitude. This urges additional measures to encourage active patient contributions, e.g. by increasing speed or through instruction. • Muscle activity in children with CP is reduced in the Lokomat. • In the Lokomat, guidance and BWS result in slightly lower muscular amplitudes. • Increasing speed results in higher amplitudes during Lokomat walking. • Stride-to-stride muscle variability was similar during treadmill and Lokomat walking. • Within the Lokomat only speed and guidance slightly affected muscular variability. [ABSTRACT FROM AUTHOR]

Unexpected cancellations of planned elective procedures are a global problem for hospitals, causing a waste of hospital resources and manpower, and reduces the efficiency of hospitals. In this study, we tried to identify the causes of cancellations of elective procedures, and to examine the relationship between the causes. A retrospective, descriptive single-center study. Nine thousand five hundred sixty-six elective procedures scheduled between January 2015 and December 2015 were retrospectively examined. Reasons for cancellation, the associated surgical clinic, and the day and season of the canceled procedures were recorded. Of the total 9,566 procedures, 496 (5.2%) were canceled. Of the cancellations, 31.3% were due to patient-related reasons, 29.2% because of inadequate anesthesia preparation, and 19% because of nonavailability of operating rooms. Cancellation of elective surgeries causes a waste of time and resources. Determining the reasons for cancellations to reduce cancellation rates is important for each hospital. [ABSTRACT FROM AUTHOR]

Accidents and unintentional injuries account for the greatest number of adolescent deaths, often involving use of alcohol and other substances. This article describes the iterative design and development of Interactive Narrative System for Patient-Individualized Reflective Exploration (INSPIRE), a narrative-centered behavior change environment for adolescents focused on reducing alcohol use. INSPIRE is designed to serve as an extension to clinical preventive care, engaging adolescents in a theoretically grounded intervention for health behavior change by leveraging 3D game engine and interactive narrative technologies. Adolescents were engaged in all aspects of the iterative, multiyear development process of INSPIRE through over 20 focus groups and iterative pilot testing involving more than 145 adolescents. Qualitative findings from focus groups are reported, as well as quantitative findings from small-scale pilot sessions investigating adolescent engagement with a prototype version of INSPIRE using a combination of questionnaire and interaction trace log data. Adolescents reported that they found INSPIRE to be engaging, believable, and relevant to their lives. The majority of participants indicated that the narrative's protagonist character was like them (84%) and that the narrative featured virtual characters that they could relate to (79%). In the interactive narrative, the goals most frequently chosen by adolescents were "stay in control" (60%) and "do not get in trouble" (55%). With a strong theoretical framework (social-cognitive behavior change theory) and technology advances (narrative-centered learning environments), the field is well positioned to design health behavior change systems that can realize significant impacts on behavior change for adolescent preventive health. [ABSTRACT FROM AUTHOR]

Premature skin-aging is a disorder in human skin tissue caused by the effects of environmental factors. It is important to prevent and treat this disorder using natural ingredients. One of them is the Molineria latifolia plant, which is reportedly anti-aging. This study aims to characterize the chemical content of M. latifolia extract and evaluate its biological activity as a skin anti-aging. The 70% ethanol extract of M. latifolia roots was fractionated by a chromatography column using a solvent based on a gradient. The fractions obtained were evaluated for antioxidant, anti-tyrosinase, and anti-elastase activities. The active fraction was purified, and its chemical structure was characterized. The compounds were assessed for anti-aging activity in silico using 2Y9X and 3HGN proteins and continued with in vitro evaluation. The isolation results obtained six secondary metabolite compounds, namely 2,6 dimethoxy-benzoic acid (1) , curculigoside-A (2) , curcapital (3) , syringic acid (4) , 2-hydroxy-4-methoxybenzyl-2,3-dihydroxy-5-methoxybenzoate or curlatifolia-SN (5) , and luteolin (6). Compound 5 is newly phenolic discovered and has not been reported in previous research. Compounds 3, 5, and 6 interact best with 2Y9X (tyrosinase) and 3HGN (elastase) proteins in silico based on the obtained binding affinity. In vitro activity shows that compounds 3, 5, and 6 have strong to very strong activity inhibiting 2,2-diphenyl-1-picrylhydrazyl (DPPH) radicals, tyrosinase, and elastase. Compounds 3, 5, and 6 inhibit tyrosinase through a mixed inhibition mechanism, while elastase inhibits competitively. Compounds 3, 5, and 6 are phenolic derivatives with the best anti-aging activity, which can be used as anti-aging skin agent for future development. • Premature skin aging is a problem receiving attention in various countries. • Compounds from natural ingredients are the main focus as safe and effective anti-aging. • Phenolic compounds from the Molineria latifolia plant are anti-aging candidates. • Curlatifolia-SN is a new phenolic compound that is active as an antiaging agent. [ABSTRACT FROM AUTHOR]

• The use of standardized pediatric patient increases nursing students' self-efficiacy and perceived learning levels. • Using children as standardized patients prepares nursing students for the pediatric clinical setting. • Simulation reduces students' anxiety and fears about the clinical environment. In this study, we examined the effect of using standardized pediatric patients on the ability of students to prepare children for a medical procedure. The study was conducted using a convergent parallel design, which is a mixed-method design. In total, 106 students were included in the study. The intervention group participated in the simulation, and qualitative data were collected during the debriefing session of the simulation. All students underwent clinical practice, and their ability to prepare a child for a medical procedure was evaluated. The students in the intervention group had significantly higher skill, self-efficacy, and perceived learning levels than those in the control group (p <.05), and their state and trait anxiety levels were significantly lower than those of the students in the control group (p <.05). The use of standardized pediatric patients increased cognitive, affective, and psychomotor learning among students. The use of standardized pediatric patients should be increased in pediatric nursing education. [ABSTRACT FROM AUTHOR]

• We aimed to investigate vessel densities retinal, choroidal, and optic disc vascular changes using OCTA in obese patients. • The whole, parafoveal, and perifoveal vascular density values of the SCP and those of the DCP were statistically significantly lower in the obese group. • Statistically significant negative correlations were found between BMI and the whole, parafoveal and perifoveal vascular densities of the SCP and DCP and the density values of the optic disc for all vessels and small vessels. To evaluate optic disc and retinal vascular densities in obese patients using optical coherence tomography angiography (OCTA). This study included 27 eyes from 27 obese patients with a body mass index (BMI) of ≥35 who were scheduled for bariatric surgery at the general surgery clinic and 26 eyes from 26 healthy individuals with a BMI of 18.5–24.9 kg/m2 who were of similar age and gender to the obese group. The macular vascular densities of the superficial and deep capillary plexuses (SCP and DCP, respectively), choriocapillaris flow area, optic disc peripapillary vascular density, and retinal thicknesses were evaluated using the OCTA device in obese patients and controls. The mean age of the obese patients was 35.89 ± 10.93 years, and that of the controls was 32.31 ± 7.88 years (p = 0.199). The mean BMI values of the obese and control groups were 45.04 ± 6.89 kg/m2 and 23.19 ± 1.66 kg/m2, respectively (p < 0.0001). The whole, parafoveal, and perifoveal vascular density values of the SCP and those of the DCP were statistically significantly lower in the obese group than in the control group (p = 0.004, p = 0.011, p = 0.006, p = 0.036, p = 0.029, and p = 0.024, respectively). There was no significant difference between the two groups in terms of optic disc vascular density. Full retinal perifoveal thickness, full retinal perifoveal volume, inner retinal perifoveal thickness, and inner retinal perifoveal volume were statistically significantly lower in obese patients compared to the controls (p = 0.043, p = 0.042, p = 0.027, and p = 0.024, respectively). In addition, statistically significant negative correlations were found between BMI and the whole, parafoveal, and perifoveal vascular densities of the SCP and DCP and the whole vascular density values of the optic disc for all vessels and small vessels ​​(p = 0.017, r = -0.327; p = 0.043, r = -0.280; p = 0.033, r = -0.293; p = 0.034, r = -0.291; p = 0.017, r = -0.327; p = 0.023, r = -0.311; p = 0.031, r = -0.296; and p = 0.047, r = -0.274, respectively). We consider that the decrease in retinal vascular density and retinal thickness in obese patients is responsible for obesity-induced oxidative stress, increased inflammatory cytokines, and microvascular damage. [ABSTRACT FROM AUTHOR]