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Purpose: Postoperative fever (POF)/urinary tract infection (UTI) is one of the most unpleasant and undesirable conditions for surgeons after retrograde intrarenal surgery (RIRS). RIRS is not recommended for any patient with a positive urine culture to avoid POF and UTI, but some patients may develop postoperative UTI even if the urine culture is sterile. This study investigated the predictive factors of fever and UTIs after RIRS. Methods: In total, 1240 patients who underwent RIRS for proximal ureteral stones and/or kidney stones were analyzed. After case-control matching, 168 patients were included in the study. Demographic data, preoperative/peroperative/postoperative data, and hematological parameters were compared. Patients with sterile urine cultures were included in the study. Postoperative fever was defined as fever ≥ 38 °C within 72 h after RIRS. Patients were divided into two groups: those with and without POF/UTI. Demographic data, preoperative and postoperative findings, and inflammatory parameters of the patients were compared retrospectively. Results: POF/UTI was observed in 61 (36.3%) of 168 patients who underwent RIRS. After case-control matching, increased body mass index (BMI) and longer operation time were found to be significant predictors of POF/UTI (p = 0.001 and 0.016 respectively). Preoperative systemic immune-inflammation index (SII) (PxN/L), high Platelet/Lymphocyte Ratio (PLR), and urine leukocyte positivity were found to be significant predictors of POF/UTI (p = 0.037, 0.025 and 0.038 respectively). Conclusion: Hematological parameters are simple and feasible to use to evaluate POF/UTI in patients undergoing RIRS. High SII and PLR may predict POF and early infection after RIRS. In addition, according to demographic data and per-operative status, high BMI and prolonged operation time are risk factors for infection. [ABSTRACT FROM AUTHOR]

Logistics centers are crucial for efficient and environmentally friendly transportation, storage, loading, unloading, maintenance, repair, and handling processes. Proper selection of a logistics center location is essential for efficient trade and economy. Unlike other studies, this study presents an ensemble decision-making approach for logistics center location selection, using four weighting methods—entropy, standard deviation, method based on the removal effects of criteria, and statistical variance; six ranking methods—evaluation based on distance from average solution, measurement of alternatives and ranking according to compromise solution, multi-attribute utility theory, range of value, Technique for Order Preference by Similarity to Ideal Solution, and weighted aggregated sum product assessment; Spearman's correlation coefficient; and Borda methods. One of the main reasons for proposing the approach is that relying on a single method in solving decision-making problems may lead to wrong decisions due to the procedures of the methods. Instead, group decision-making based on different methods, as in this study, may be more dependable. The proposed approach is applied to the real-life problem of Türkiye's logistics center location selection due to its strategic location on trade and transportation corridors, ranking 47th in the Logistics Performance Index, and plans to build 25 logistics centers. Considering the significance of the problem, it is essential to use a reliable model. The integrated results indicate that the total imports criterion is the most important meaning that total imports are the most determinant in the best location. The ensemble ranking results indicate that İstanbul, Ankara, İzmir, Kocaeli, and Konya are the best five alternatives. In general, the results show that different methods provide different rankings for the same problem, which proves the importance of the proposed approach in providing more reliable results and avoiding facing a new decision-making model in terms of choosing the right method. [ABSTRACT FROM AUTHOR]

This research evaluates the readability and quality of patient information material about female urinary incontinence (fUI) in ten popular artificial intelligence (AI) supported chatbots. We used the most recent versions of 10 widely-used chatbots, including OpenAI's GPT-4, Claude-3 Sonnet, Grok 1.5, Mistral Large 2, Google Palm 2, Meta's Llama 3, HuggingChat v0.8.4, Microsoft's Copilot, Gemini Advanced, and Perplexity. Prompts were created to generate texts about UI, stress type UI, urge type UI, and mix type UI. The modified Ensuring Quality Information for Patients (EQIP) technique and QUEST (Quality Evaluating Scoring Tool) were used to assess the quality, and the average of 8 well-known readability formulas, which is Average Reading Level Consensus (ARLC), were used to evaluate readability. When comparing the average scores, there were significant differences in the mean mQEIP and QUEST scores across ten chatbots (p = 0.049 and p = 0.018). Gemini received the greatest mean scores for mEQIP and QUEST, whereas Grok had the lowest values. The chatbots exhibited significant differences in mean ARLC, word count, and sentence count (p = 0.047, p = 0.001, and p = 0.001, respectively). For readability, Grok is the easiest to read, while Mistral is highly complex to understand. AI-supported chatbot technology needs to be improved in terms of readability and quality of patient information regarding female UI. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate and compare the clinical results of different single-use flexible ureteroscopes (su-fURS) used in retrograde intrarenal surgery (RIRS). Materials and methods: RIRS cases performed identically by an experienced surgeon between 2022 and 2023 in a single center were retrospectively analyzed. These surgeries were performed with three su-fURS (Redpine RP-U-C12, Hugemed HU30, and Pusen Uscope 3022 A). In the study, the age, gender, body mass index, and Charlson comorbidity index of the patients were compared, along with their clinical details, such as the stone size, volume, density, location, and history of hydronephrosis or a double J stent or SWL. Operation time, stone-free rates (SFR), perioperative and postoperative complications, and hospitalization times were also compared. Results: The study included 208 patients. Pusen had 63 cases, Hugemed had 62, and Redpine had 83. The comparison of the patient's demographic and clinical properties with stone-related variables was similar between the groups. The SFR was similar between the groups (p = 0.056). Perioperative, postoperative, and total complication rates and the need for a second intervention showed no significant differences among the three groups (p = 0.324, 0.088, 0.061, and 0.052, respectively). Conclusion: In the first study comparing the clinical results of cases in which different su-fURS were used, no difference was observed in surgical outcomes and complications, even though the technical features of these devices were different. Urologists should select su-fURS based on clinical requirements, financial constraints, and personal experiences. [ABSTRACT FROM AUTHOR]

A JJ stent placed before retrograde intrarenal surgery (RIRS) may ease the procedure. However, it is important to note that a prolonged duration of double J stent (DJS) placement before RIRS may increase the risk of postoperative urinary tract infection (UTI). Various publications have established this association, although the duration of the DJS before surgery is scarce. Our study investigates the relationship between the pre-stenting period and postoperative UTI and establishes a cut-off period to minimize this risk. We included a total of 500 cases with preoperative DJS prior to RIRS. The patients were divided into five groups according to their preoperative stenting duration (Group 1: 0–15 days; Group 2: 16–30 days; Group 3: 31–45 days; Group 4: 46–60 days; Group 5: >60 days). Demographic and clinical data of the patients, stone properties, operation data, perioperative and postoperative complications (including fever and UTI), hospitalization time, and stone-free rates (SFR) were compared. The groups contained 53, 124, 102, 63, and 158 patients. The demographics of the patients in each group were similar. There was no statistically significant difference between DJS duration, perioperative/postoperative complications, and SFR, except for the ureteral access sheath (UAS) insertion rate. (p = 0.001). The postoperative fever/UTI rate was the lowest in Group 1 (p = 0.046) compared to other durations. Stent duration does not impact SFR. Longer stents enhance UAS insertion success but increase postoperative infection risk. Our results suggest that RIRS should be performed within two weeks, ideally 20 days following stent insertion, to minimize postoperative infection risk. [ABSTRACT FROM AUTHOR]

The aim of the study is to evaluate and compare the quality and readability of responses generated by five different artificial intelligence (AI) chatbots—ChatGPT, Bard, Bing, Ernie, and Copilot—to the top searched queries of erectile dysfunction (ED). Google Trends was used to identify ED-related relevant phrases. Each AI chatbot received a specific sequence of 25 frequently searched terms as input. Responses were evaluated using DISCERN, Ensuring Quality Information for Patients (EQIP), and Flesch-Kincaid Grade Level (FKGL) and Reading Ease (FKRE) metrics. The top three most frequently searched phrases were "erectile dysfunction cause", "how to erectile dysfunction," and "erectile dysfunction treatment." Zimbabwe, Zambia, and Ghana exhibited the highest level of interest in ED. None of the AI chatbots achieved the necessary degree of readability. However, Bard exhibited significantly higher FKRE and FKGL ratings (p = 0.001), and Copilot achieved better EQIP and DISCERN ratings than the other chatbots (p = 0.001). Bard exhibited the simplest linguistic framework and posed the least challenge in terms of readability and comprehension, and Copilot's text quality on ED was superior to the other chatbots. As new chatbots are introduced, their understandability and text quality increase, providing better guidance to patients. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of preoperative single-dose methylprednisolone use on postoperative early pain after retrograde intrarenal surgery (RIRS). Methods: Patients who had 10–20 mm solitary kidney stones and underwent RIRS procedures were included in this prospective cohort study between February 2022 and May 2023. Patients who were administered methylprednisolone at a dose of 1 mg/kg preoperatively were included in group 1 (n: 31), and the other first 90 patients who met the inclusion criteria and did not receive methylprednisolone before surgery were included in group 2 (n: 90). Demographic data, features of stone, postoperative pain at 1, 6, 12, 18, and 24 hour, the need for analgesics, changes in serum glucose levels, and the prevalence of postoperative fever were compared. Results: Age, sex, stone laterality, localization, size, Hounsfield Unit, modified Satava scores, stone-free status, duration of the RIRS procedure, and duration of the ureteral access sheath were found to be similar between groups. Visual Analog Scale (VAS) scores at postoperative 1, 6, 12, 18, and 24 h were found to be statistically significantly lower in group 1 (p =.001, p =.001, p =.001, p =.001, and p =.001, respectively). Similarly, postoperative analgesic requirements were found to be significantly lower in group 1 (p =.048) with a similar postoperative fever rate and changes in serum glucose levels between groups. Conclusion: Giving a single dose of methylprednisolone at a dose of 1 mg/kg preoperatively for the RIRS procedure is safe and effective at preventing early pain and the need for analgesics after the RIRS procedure. [ABSTRACT FROM AUTHOR]

Material selection is influential in product design, manufacturing, and marketing. Appropriate material selection maximizes the performance of a product while minimizing its cost, whereas inappropriate material selection creates devastating results such as low performance, low quality, and high cost. Therefore, it is crucial how to choose the most suitable material. Unlike other studies, this study presents an ensemble multi-attribute decision-making approach for material selection. The approach involves four weighting methods—criteria importance through intercriteria correlation, Entropy, the method based on the removal effects of criteria, and statistical variance, five ranking methods—additive ratio assessment, combined compromise solution, multi-attributive border approximation area comparison, range of value, and the technique for order performance by similarity to the ideal solution, Spearman's correlation coefficients, and the Copeland method. Three different problems are considered to show the applicability of the proposed method and to reveal a comprehensive analysis. The results of each problem show valuable implications. The results of the ranking methods are sensitive to attribute weights. No ranking method alone can assure dependable selection for a given problem. Overall, the results reveal the importance of using multiple weighting and ranking methods and the superiority of the proposed integrated approach. [ABSTRACT FROM AUTHOR]

New treatment methods based on biologically produced metal catalysts and reagents are being developed for the removal of pollutants. Biogenic manganese oxide (BMO) is one of the biogenic metal oxide types that have attracted attention especially in recent years. BMO is a suitable material for the removal of pollutants due to its notable activity and structural diversity. However, the role of biogenic manganese oxides in persulfate activation is so far unclear. In the present study, the biogenic manganese oxide was used as a catalyst in persulfate (PS) activation for the atrazine removal from aqueous solution. BMO/PS system was effective for removing the atrazine. The removal efficiency of the atrazine by BMO/PS system decreased with increasing pH. The removal efficiency increased with the increasing PS amount. Increasing the temperature facilitated the decomposition of the atrazine. It was revealed that 99.9% of the atrazine was removed in 300 min at pH 3 and 50 °C (Co: 5 mg/L, BMO: 2 g/L, PS: 1.4 g/L). In this system, the efficiency and stability of the catalyst decreased over three cycles. Sulfate and hydroxyl radicals were both involved in the atrazine removal. Based on the detected decay by-products, two degradation pathways have been proposed. The BMO were characterized via SEM–EDX, XRD, FTIR, and TGA techniques. This system reduced the environmental toxicity of atrazine. As a result, it has been revealed that this innovative material, BMO, has persulfate activation potential as an effective solution to the problem of persistent organic pollutants present in aquatic environments. [ABSTRACT FROM AUTHOR]

Purpose: The flexible ureterorenoscopy (FURS) is expensive and fragile equipment which easily break down during the surgery. f-URS have yet some problems with their durability that affect survival. One of the most important ways to increase the survival of a device is to improve its use in the right indications. We aimed to investigate whether the durability of the f-URS will be affected due to the volume and location of the stone and some anatomical features of the including infundibulopelvic angle (IPA), and location anomalies. Materials and methods: The collected data from 705 patients' data including their age, sex, stone location, and stone volume, S-ReSC score, Hounsfield unit (HU) as stone density, IPA, BMI, and the usage time of f-URS using 10f-URS were included to study. Exp(B) values and confidence intervals (95% CIs) of parameters were calculated with COX regression and Roc curve analysis was also used to determine the cut-off value. Results: Renal malformation, DJstent use, previous ESL application, and UAS use did not affect contrary to expectations stone volume, HU, IPA, and S-ReSC score were among the factors statistically significant affecting the durability of the device. It was observed, Exp(B) values of the affecting factors to be 0.984, 0.268, 0.894, and 0.607, respectively. We found the most appropriate cutoff value for IPA as 41.25 degrees. Conclusion: The mean stone volume broken by each of the subsequent f-URS may increase, while the mean operative time may decrease as time progresses. This result shows us the importance of mastery of the device, such as the deflection maneuver, and the correct use distance of the laser, which improves with the increase in user experience, and makes us interpret that the operation time is shortened with this self-confidence. Factors including stone volume, HU, IPA, S-ReSC score affect the durability of the f-URS device and the as well as manufacturing features. [ABSTRACT FROM AUTHOR]

This study was conducted in Meram town of Konya province under unheated greenhouse conditions in 2019 autumn (September–November) and 2020 spring (February–April) growing periods. Davidole (Lactuva sativa L. var. longifolia) curly lettuce cultivar was used as the plant material of the present study. Experiments were conducted in randomized blocks design with three replications. Irrigation levels were arranged by applying certain percentage of 4‑day cumulative evaporations from Class‑A pan (60%, 80%, 100% and 120%) and effects of irrigation treatments on yield, yield components and water use efficiencies of lettuce plants were investigated. Crop water consumptions in S60, S80, S100 and S120 treatments were respectively measured as 136.2, 149.6, 163 and 168.4 mm in 2019 and as 110.6, 123.8, 136 and 146.2 mm in 2020. In terms of commercial head weights, in 2019, the lowest value (623 g) was obtained from S60 treatment and the greatest (1130.8 g) from S120 treatment; in 2020, the lowest (900.8 g) from S60 and the greatest (1177.8 g) from S100 treatments. Water use efficiency (WUE) values varied between 38.12–55.96 kg m−3 in 2019 and between 61.65–75.24 kg m−3 in 2020. Irrigation water use efficiency (IWUE) values varied between 43.19–56.19 kg m−3 in 2019 and between 60.82–81.85 kg m−3 in 2020. Lettuce yield-response factor (ky) was calculated as 2.26 for 2019 and 0.69 for 2020. For lettuce cultivation under unheated greenhouse conditions of Konya province, S100 treatment could be recommended for autumn (September–November) productions and S80 treatment for spring (February–April) productions. [ABSTRACT FROM AUTHOR]

The degree to which closely related species conserve or diverge in their niche characteristics may provide insight into evolutionary and diversification processes, as well as some understanding of broad-scale biogeographic patterns. In this study, we used an ensemble of 10 algorithms to predict the distributions of 12 Ablepharus species in geographical (G)-space for the recent time and the future (2081–2100) climate conditions. Niche overlap, equivalency, and similarity tests in environmental (E)-space were used to test niche divergence and conservatism. The consensus model showed that temperature seasonality (n = 6) and annual precipitation (n = 3) were the major factors predicting the distribution of 75% (9 out of 12) of the species. The ensemble models based on ssp585 predict that 83.33% of the species (n = 10) may have contracted their ranges, especially at lower altitudes along their southern margins. They may have also expanded northward during this period. However, in the ssp126, most species' distribution ranges may remain unchanged despite contractions and expansions. Based on multivariate niche analyses, the distributions of 28 and 11 paired comparisons explored in this study significantly diverged and conserved. We found that closely related species inhabit different habitats and respond to their climatic characteristics, indicating that ecology has a significant influence on speciation. [ABSTRACT FROM AUTHOR]

In the literature, only 11 Enterococcus gallinarum group meningitis has been reported so far. The Enterococcus gallinarum group was shown for the first time in a pediatric patient presenting with meningitis after bowel perforation, a complication of a ventriculoperitoneal shunt. A 30-month-old male patient presented with vomiting and fever, with the ventriculoperitoneal shunt distal catheter protruding from the anal orifice. The patient was diagnosed with intestinal perforation and meningitis. Enterococcus gallinarum group bacterial yield in cerebrospinal fluid culture. A total of 6 weeks of intravenous antibiotic treatment was given in the hospital. After the treatment, the patient was re-ventriculoperitoneal shunt and was discharged. Among the shunt complications, meningitis with intestinal perforation is rare. It should be kept in mind that meningitis in such patients may be caused by very rare microbiological factors such as Enterococcus gallinarum group. Antibiotherapy should be given according to the culture result. Then planning should be made for a permanent shunt. [ABSTRACT FROM AUTHOR]

Traumas are the most important cause of mortality in the pediatric population. Bleeding is an important complication, especially in traumatic brain injuries with coagulation problem addition. Low-velocity penetrating brain injuries may be caused by sewing needles, nails, and knives. There are few studies in the literature for this injury type. This study presented a surgical technique and treatment to increase hemostasis in a 2-year-old patient after a sewing needle injury. [ABSTRACT FROM AUTHOR]

Purpose: To assess the hearing function of patients with mild and moderate COVID-19. Methods: The hospital staffs recovered from COVID-19 were included. The candidates who had an ear disease or progressive hearing loss prior to COVID-19, or having been hospitalised because of severe and critical COVID-19 were excluded. The age, sex, symptoms during COVID-19, and medications received for the disease were noted. The hearing thresholds (HT) of the participants who had an audiogram before having COVID-19 disease were recorded. A pure tone audiometry was conducted to all. The participants were classified into two groups; Group 1: participants who had an audiogram previously, Group 2: participants who didn't have an audiogram previously. The changes of the HTs of the participants in Group 1 were analyzed. The HTs of the participants in Group 2 were documented without any comparison. The HTs of all participants were also analyzed by classifying them into subgroups according to their symptoms during, and medications received for COVID-19. Results: Fifty-four males and 47 females (18–59 years) were included. The participants' HTs in Group 1 (n = 31) did not change significantly at any of the frequencies after having COVID-19 (p > 0.05). The pure tone averages of the participants in Group 2 (n = 70) were below 25 dB and none of the participants reported worsening of their hearing permanently. The differences between the HTs of none of the subgroups were statistically significant (p > 0.05, p > 0.05). Conclusions: Mild and moderate COVID-19 and its treatments did not affect the hearing function permanently. [ABSTRACT FROM AUTHOR]

The location selection is a strategic decision that significantly influences revenue, level of competition, and success of companies and countries. This study aims to propose a hybrid approach for the location selection, to evaluate the potential location for the automotive manufacturing plant of Turkey, and to reveal a comprehensive analysis of weighting and multiple criteria decision-making (MCDM) methods. The proposed approach integrates different objective and subjective weighting, MCDM, and Copeland methods. Turkey has recently introduced its first automobile prototypes and has announced that the manufacturing plant will be located in Bursa. This decision is thoroughly examined via four objective weighting methods—entropy, criteria importance through inter-criteria correlation, standard deviation, and mean weight and a subjective method—analytic hierarchy process. Besides, the alternatives are evaluated based on six MCDM methods—technique for order preference by similarity to ideal solution, preference ranking organization method for enrichment evaluations, vise kriterijumska optimizacija i kompromisno resenje, organization, rangement et synthese de donnes relationnelles, elimination and choice translating reality, and the weighted sum method. The outcomes of the weighting methods and MCDM methods, the impact of the attribute weights provided by each method on rankings, the outcome of each method pair, and selection of the best location (Bursa) are thoroughly evaluated considering a real-world case with a potential outcome that makes evaluations more realistic and tangible unlike most of the other studies in the literature. In this regard, Spearman's rank correlation coefficients are considered. Also, sensitivity analysis is conducted to reveal the robustness of the methods and the impact of each weight on outcomes. Some considerable results, including the most robust method and optimal method pairs for the case, are presented. [ABSTRACT FROM AUTHOR]

Massive open online courses (MOOCs) provide a valuable learning platform for global learners. They are extensively utilized by an increasing number of people from all over the world due to their remarkable features, including unlimited enrollment, the lack of location requirements, free access to a high number of courses, and structural similarity to traditional lectures. However, high dropout rates negatively affect their educational effectiveness. In this regard, as a trending research topic in recent years, the prediction of dropout rates in MOOCs has become a critical issue in terms of planning for the future and taking precautions. This study proposes a practical prediction approach for the student dropout problem of MOOCs. In this regard, an adaptive neuro-fuzzy inference system (ANFIS) is utilized for the prediction of dropout rates in MOOCs for the first time in this study. The proposed approach uses the capabilities of both neural networks and fuzzy inference systems; thus, it provides highly accurate predictions. The performance of the proposed ANFIS approach is benchmarked against various models developed based on several machine learning methods, including the decision tree, logistic regression, support vector machine, ensemble learning, and K-nearest neighbor methods. The results reveal that the proposed approach provides higher statistical accuracy than its benchmarks, meaning that the proposed approach can be used effectively for MOOCs. [ABSTRACT FROM AUTHOR]

The genus Blanus Wagler, 1830 (Squamata, Amphisbaenia) contains seven fossorial species found in the East Mediterranean Basin. Recent molecular-based studies suggested that former B. strauchi (Turkish worm lizard) is divided into three species spread from Southern Anatolia to Levantine region: B. strauchi, B. aporus and B. alexandri. Although these species not only have highly similar morphological characters but also are genetically distinct, the ecological niche differentiations have not been studied yet. We aim to predict the suitable habitats for related Blanus species and to determine niche overlaps and niche differentiation by similarity and identity tests. The occurrence records were obtained from literature and our own field surveys. These occurrence locations were assessed in 30 arc-second resolution layer, compatible with bioclimatic parameters from World-Clim (www.worldclim.org). Suitable habitat prediction analyses were performed in MaxEnt and the pairwise niche overlap comparisons were made in ENMTools. Our results show that precipitation and temperature dynamics may have an influence on the vegetation types, which provide suitable habitats for these species. Even in the most conservative model, where B.strauchi was designated as the ancestral species, the predicted distribution area was larger than the actual one. The niche overlap analysis confirms that the ecological differentiations among these taxa are valid. This result is in agreement with a previous molecular-based study. We speculate that the Messinian Salinity Crisis had an effect on precipitation and temperature dynamics and niche differentiation among the worm lizards, potentially contributing to species formation. [ABSTRACT FROM AUTHOR]

In this study, a novel microporous activated carbon (AC) from low-cost biomasses (apricot and peach stones, and almond shell) mixture by FeSO4 activation and following pyrolysis was synthesized, characterized, and tested for etodolac (ETD) adsorption. The characteristics of AC were determined by BET surface area, total pore volume, average pore size, surface functional group analysis by Boehm's titration and FTIR, and SEM-EDX. A high-quality activated carbon with 958.57 m2/g surface area, 0.4796 cm3/g total pore volume, and 1.9963-nm average pore size could be successfully synthesized from the mixture activated by FeSO4 at impregnation ratio of (FeSO4/precursor (w/w)) 0.5. ETD adsorption ability of the prepared AC was investigated depending on the effects of AC dosage, contact time, pH, initial ETD concentration, and temperature. Also, the linear and nonlinear forms of Langmuir and Freundlich isotherms and pseudo-first-order and pseudo-second-order kinetic models were compared to get the best isotherm and kinetic model. The results showed that more than 95% ETD adsorption could be achieved at the presence of 5 g/L of AC, contact time of 150 min, and at a wide pH range. The adsorption data was found to be best fitted to the nonlinear pseudo-second-order kinetic model and nonlinear Freundlich isotherm. The adsorption of ETD onto the AC was found to be exothermic and spontaneous. [ABSTRACT FROM AUTHOR]

Offshoring has been commonly adopted by organizations in developed countries, which relocate their business activities to low-cost countries to achieve cost-saving, improved flexibility, and greater effectiveness. Manufacturing offshoring has been a crucial business decision impacting the performance and ultimate survival of companies. For this reason, the selection of offshore locations is a strategically important decision involving various conflicting factors, which makes it a typical multicriteria decision-making (MCDM) problem. In this study, twenty-five alternative countries are ranked according to thirty-two conflicting criteria. In this regard, the fuzzy analytic hierarchy process is used to obtain the weights of each criterion. The evaluations of three decision-makers are considered. A comparative analysis of evaluating offshore locations using five MCDM methods—preference-ranking organization method for enrichment evaluation, vise kriterijumska optimizacija i kompromisno resenje, weighted sum method, elimination and choice translating reality, and technique for order of preference by similarity to the ideal solution—is performed by using real data collected from various reliable sources. An illustrative case is implemented to validate the effectiveness of the proposed approach. The outcomes of the proposed models are compared to each other and the list of leading offshoring countries from the statistical institutions. A sensitivity analysis is performed to minimize subjectivity, as the outcome of the ranking methods heavily depends on the criteria weights. The results indicate that all the proposed methods can be utilized for the problem, and greater weight should be given to the accessibility and labor criteria groups. [ABSTRACT FROM AUTHOR]

Pharmaceutically active compounds are gradually increasing in different environments such as surface waters, groundwater, and soil. Paracetamol is a pharmaceutical used as a pain reliever and antipyretic. In this study, paracetamol removal was investigated using manganese oxide octahedral molecular sieves (OMS-2) and persulfate. In the first stage of the study, OMS-2 was produced in a laboratory, and then paracetamol removal was investigated in OMS-2 only, persulfate only, and a combination of OMS-2/PS. When using 5 mM persulfate and 0.1 g/L OMS-2, the paracetamol removal efficiency increased to 99.5%. The use of OMS-2 with persulfate resulted in faster and more effective removal of paracetamol compared with OMS-2 only and persulfate only. In another stage of the study, the effects of reaction temperature and pH were investigated. For this purpose, the pH was changed in the range of 2–8, while the temperature was examined at 20, 30, and 40 °C. A high rate of paracetamol removal occurred at all pH and temperature values tested. Paracetamol removal was investigated at different OMS-2 and persulfate concentrations, optimum OMS-2 amount was determined as 0.1 g/L, and optimum persulfate dosage was 20 mM. The reusability of the OMS-2 catalyst was investigated, showing a decrease in removal efficiency with each cycle. In the later stages of the study, free radical quenching studies, the effect of humic acid and inorganic anions and the characterization of the synthesized OMS-2 were performed. [ABSTRACT FROM AUTHOR]

In the present study, a 3D device-level numerical model is implemented via finite element method to assess the effects of design and operating parameters on the separation performance of a microscale acoustofluidic device. Elastodynamic equations together with electromechanical coupling at the piezoelectric actuators for the stress field within the solid parts, Helmholtz equation for the acoustic field within fluid, and Navier–Stokes equations for the fluid flow are coupled for the simulations. Once the zero-acoustic and flow fields are obtained, the trajectories of the particles are obtained by employing point–particle approach. The particle trajectories are simulated for many particles with different sizes released from random initial locations. Separation performances of the different cases are evaluated based on described metrics such as purity, yield, percentage of particle stuck in the channel, the force acting on the particles, residence time and separation parameter. [ABSTRACT FROM AUTHOR]

Intuitionistic trapezoidal fuzzy multi-numbers (ITFM-numbers) are a special intuitionistic fuzzy multiset on a real number set, which are very useful for decision makers to depict their intuitionistic fuzzy multi-preference information. In the ITFM-numbers, the occurrences are more than one with the possibility of the same or the different membership and non-membership functions. In this paper, we define ITFM-numbers based on multiple criteria decision-making problems in which the ratings of alternatives are expressed with ITFM-numbers. Firstly, some operational laws using t-norm and t-conorm are proposed. Then, some aggregation operators on ITFM-numbers are developed. Also, the ranking order of alternative is given according to the similarity of the alternative with respect to the positive ideal solution. Finally, a numerical example is given to verify the developed approach and to demonstrate its practicality and effectiveness. [ABSTRACT FROM AUTHOR]

Ankylosing Spondylitis (AS) is known to be associated with increased neutrophil activation and oxidative stress, however, the mechanism of neutrophil activation is still unclear. We have hypothesized that the antioxidant and anti-tumor necrosis factor properties of infliximab may affect intracellular Ca(2+) concentration in the neutrophils of AS patients. The objective of this study was to investigate the effects of infliximab on calcium signaling, oxidative stress, and apoptosis in neutrophils of AS patients. Neutrophils collected from ten patients with AS and ten healthy controls were used in the study. In a cell viability test, the ideal non-toxic dose and incubation time of infliximab were found as 100 μM and 1 h, respectively. In some experiments, the neutrophils were incubated with the voltage-gated calcium channel (VGCC) blockers verapamil + diltiazem (V + D) and the TRPM2 channel blocker 2-aminoethyl diphenylborinate (2-APB). Intracellular Ca(2+) concentration, lipid peroxidation, apoptosis, caspase 3, and caspase 9 values were high in neutrophils of AS patients and were reduced with infliximab treatment. Reduced glutathione level and glutathione peroxidase activity were low in the patients and increased with infliximab treatment. The intracellular Ca(2+) concentrations were low in 2-APB and V + D groups. In conclusion, the current study suggests that infliximab is useful against apoptotic cell death and oxidative stress in neutrophils of patients with AS, which seem to be dependent on increased levels of intracellular Ca(2+) through activation of TRPM2 and VGCC. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to examine the relationship between women leadership and teachers' emotional labor in Turkish high schools. 450 teachers from 11 high schools in İstanbul, Turkey participated in the study. The participants were asked to fill in the Leadership Function Scale and Emotional Labor Scale during the study. The data was analyzed with descriptive statistical techniques including arithmetical mean, standard deviation and Pearson correlation coefficient. To test whether the female principals' leadership behaviors are significant predictor of teachers' emotional labor simple regression was used. The results indicated that female principals display leadership functions in a high level. In addition to this, teachers display surface acting rarely and exhibit deep acting and genuine emotions in a high level. Pearson correlation and simple regression revealed that there is a negative correlation between leadership behaviors of female principals and surface acting. However, teachers display deep acting and genuine emotions more frequently when the female principals exhibit leadership function effectively. [ABSTRACT FROM AUTHOR]

In this paper, we define soft quotient G-module, soft G-module homomorphism and soft kernel. Related to these definitions, we give some examples, homomorphism theorem and isomorphism theorems on Soft G-modules. [ABSTRACT FROM AUTHOR]

In this paper, the concept of trapezoidal fuzzy multi-number (TFM-number) is proposed and some desired operational laws with properties are introduced. In the TFM-number, the occurrences are more than one with the possibility of the same or the different membership functions and the TFM-number is an extension of both fuzzy number set and fuzzy set, allowing the repeated occurrences of any element. Also, aim of this paper is to investigate a multiple criteria decision-making (MCDM) method under TFM-number environment. To construct this method, we first introduce some operational laws on TFM-number based on t-norm and s-norm. Then, TFM-number arithmetic and geometric operators are proposed. Finally, we develop an MCDM method and apply to an MCDM problem to verify the introduced decision-making methods. [ABSTRACT FROM AUTHOR]

In this paper, we introduced some similarity measures for bipolar neutrosophic sets such as; Dice similarity measure, weighted Dice similarity measure, Hybrid vector similarity measure and weighted Hybrid vector similarity measure. Also we examine the propositions of the similarity measures. Furthermore, a multi-criteria decision-making method for bipolar neutrosophic set is developed based on these given similarity measures. Then, a practical example is shown to verify the feasibility of the new method. Finally, we compare the proposed method with the existing methods in order to demonstrate the practicality and effectiveness of the developed method in this paper. [ABSTRACT FROM AUTHOR]

In this study, using the neutrosophic soft definitions, we define some new concept such as the neutrosophic soft lattice, neutrosophic soft sublattice, complete neutrosophic soft lattice, modular neutrosophic soft lattice, distributive neutrosophic soft lattice, neutrosophic soft chain then we study the relationship and observe some common properties. [ABSTRACT FROM AUTHOR]

In this study, we aimed to investigate the role of three trace elements, namely, zinc, copper, and lead, in tinnitus by analyzing the serum level of copper and lead and both the serum and tissue level of zinc. Eighty patients, who applied to outpatient otolaryngology clinic with the complaints of having tinnitus, and 28 healthy volunteers were included. High-frequency audiometry was performed, and participants who had hearing loss according to the pure tone average were excluded; tinnitus frequency and loudness were determined and tinnitus reaction questionnaire scores were obtained from the patients. Of all the participants, serum zinc, copper, and lead values were measured; moreover, zinc levels were examined in hair samples. The levels of trace elements were compared between tinnitus and control groups. The level of copper was found to be significantly lower in the tinnitus group ( p = 0.02), but there was no significant difference between the groups in terms of the levels of zinc, neither in serum nor in hair, and lead in serum ( p > 0.05). The lack of trace elements, especially that of 'zinc,' have been doubted for the etiopathogenesis of tinnitus in the literature; however, we only found copper levels to be low in patients having tinnitus. [ABSTRACT FROM AUTHOR]

Molodtsov introduced the concept of soft sets, which can be seen as a new mathematical tool for dealing with uncertainty. In this paper, we initiate the study of soft normed rings by soft set theory. The notions of soft normed rings, soft normed ideals, soft complete normed rings are introduced and also several related properties and examples are given. [ABSTRACT FROM AUTHOR]

Preparation and characterization of a novel activated carbon obtained from vine shoots by ZnCl activation and its rifampicine removal capacity were investigated in this study. The effects of activation temperature and impregnation ratio (precursor/ZnCl) on the activated carbon properties were investigated. The prepared activated carbon was characterized by BET surface area, surface functional group analysis by Boehm's titration and FT-IR analysis, pH, iodine number, SEM-EDX, and particle size distribution. The results showed that the surface area, pore size, and pore volume of the activated carbon increased with the increasing temperature and impregnation ratio and reached maxima at the impregnation ratio of 40/30 at 700 °C. Under the optimal conditions, it was determined that the BET surface area, total pore volume, iodine number, and pH of the activated carbon were 1689 m/g, 0.842 cm/g, 1276 mg/g, and 4.8, respectively, and it has mainly acidic functional groups (total 0.2516 meq/g) on its surface. The activated carbon obtained was evaluated for rifampicine removal efficiency depending on contact time, adsorbent dosage, and initial concentration of rifampicine. Maximum adsorption capacity of rifampicine by the activated carbon ( Q°) was determined according to Langmuir adsorption isotherm. The adsorption data was best fitted to the Langmuir isotherm with R of 0.983 and Q° was found to be 476.2 mg/g. [ABSTRACT FROM AUTHOR]

A predictive model for streamflow has practical implications for understanding the drought hydrology, environmental monitoring and agriculture, ecosystems and resource management. In this study, the state-or-art extreme learning machine (ELM) model was utilized to simulate the mean streamflow water level (Q WL) for three hydrological sites in eastern Queensland (Gowrie Creek, Albert, and Mary River). The performance of the ELM model was benchmarked with the artificial neural network (ANN) model. The ELM model was a fast computational method using single-layer feedforward neural networks and randomly determined hidden neurons that learns the historical patterns embedded in the input variables. A set of nine predictors with the month (to consider the seasonality of Q WL); rainfall; Southern Oscillation Index; Pacific Decadal Oscillation Index; ENSO Modoki Index; Indian Ocean Dipole Index; and Nino 3.0, Nino 3.4, and Nino 4.0 sea surface temperatures (SSTs) were utilized. A selection of variables was performed using cross correlation with Q WL, yielding the best inputs defined by (month; P; Nino 3.0 SST; Nino 4.0 SST; Southern Oscillation Index (SOI); ENSO Modoki Index (EMI)) for Gowrie Creek, (month; P; SOI; Pacific Decadal Oscillation (PDO); Indian Ocean Dipole (IOD); EMI) for Albert River, and by (month; P; Nino 3.4 SST; Nino 4.0 SST; SOI; EMI) for Mary River site. A three-layer neuronal structure trialed with activation equations defined by sigmoid, logarithmic, tangent sigmoid, sine, hardlim, triangular, and radial basis was utilized, resulting in optimum ELM model with hard-limit function and architecture 6-106-1 (Gowrie Creek), 6-74-1 (Albert River), and 6-146-1 (Mary River). The alternative ELM and ANN models with two inputs (month and rainfall) and the ELM model with all nine inputs were also developed. The performance was evaluated using the mean absolute error (MAE), coefficient of determination (r 2), Willmott’s Index (d), peak deviation (P dv), and Nash–Sutcliffe coefficient (E NS). The results verified that the ELM model as more accurate than the ANN model. Inputting the best input variables improved the performance of both models where optimum ELM yielded R 2 ≈ (0.964, 0.957, and 0.997), d ≈ (0.968, 0.982, and 0.986), and MAE ≈ (0.053, 0.023, and 0.079) for Gowrie Creek, Albert River, and Mary River, respectively, and optimum ANN model yielded smaller R 2 and d and larger simulation errors. When all inputs were utilized, simulations were consistently worse with R 2 (0.732, 0.859, and 0.932 (Gowrie Creek), d (0.802, 0.876, and 0.903 (Albert River), and MAE (0.144, 0.049, and 0.222 (Mary River) although they were relatively better than using the month and rainfall as inputs. Also, with the best input combinations, the frequency of simulation errors fell in the smallest error bracket. Therefore, it can be ascertained that the ELM model offered an efficient approach for the streamflow simulation and, therefore, can be explored for its practicality in hydrological modeling. [ABSTRACT FROM AUTHOR]

Behcet's disease (BD) is a chronic, inflammatory, and multisystemic condition although its pathogenesis is uncertain. Main component of St. John's wort ( Hypericum perforatum, HP) is hyperforin and induces antiinflammatory and antioxidant properties. We aimed to investigate effects of HP on oxidative stress, apoptosis, and cytosolic-free Ca [Ca] concentration in neutrophil of BD patients. Nine new-diagnosed active patients with BD and nine control subjects were included in the study. Disease activity was considered by clinical findings. Neutrophil samples were obtained from the patients and controls. The neutrophils from patients were divided into three subgroups and were incubated with HP, voltage-gated calcium channel (VGCC) blockers, (verapamil+dilitiazem) and non-specific TRPM2 channel blocker (2-aminoethyl diphenylborinate, 2-APB), respectively. The neutrophils were stimulated by fMLP as a Ca-concentration agonist and oxidative stress former. Caspase-3, caspase-9, apoptosis, lipid peroxidation, and [Ca] values were high in the patient groups, although cell viability, glutathione (GSH), and glutathione peroxidase (GSH-Px) values were low in patient group. However, the [Ca], caspase-3, and caspase-9 values decreased markedly in patient+HP group although GSH and GSH-Px values increased in the group. The [Ca] concentration was also decreased in the patient group by V+D, 2-APB, and HP incubations. In conclusion, we observed the importance of neutrophil Ca entry, apoptosis, and oxidative stress through gating VGCC and TRPM2 channels in the neutrophils in the pathogenesis and activation of the patients with BD. HP induced protective effects on oxidative stress by modulating Ca influx in BD patients. Graphical Abstract: [Figure not available: see fulltext.] [ABSTRACT FROM AUTHOR]

The aim of the study is to evaluate the effectiveness of ozone and betahistine treatments in the treatment of tinnitus. Sixty-eight patients were enrolled in this randomized, prospective controlled study. The ozone group consisted of 27, betahistine group consisted of 26 and control group consisted of 15 patients. The patients in ozone group received 10 sessions of ozone treatment via major autohemotherapy. Betahistine group received 48 mg/day betahistine tablets per oral for 3 months duration. The control group was followed up without any treatment given. The evaluation of tinnitus was made by tinnitus loudness and tinnitus handicap inventory (THI). The changes in findings from baseline to 3rd and 6th months were assessed, and the group results were compared. Comparison of the initial mean tinnitus loudness and 3 and 6 months after treatment in each of the three groups did not reveal a significant difference. The comparison between the groups in terms of the improvement of tinnitus loudness was not significant ( p = 0.821). Comparison of the initial mean THI and 3 and 6 months after treatment revealed a significant difference in ozone and betahistine groups but not in the control group. When the delta (Δ) THI (the change of mean THI between the initial and 6th month) was compared between the groups, there was no significant difference. This randomized controlled study investigating the effects of ozone in tinnitus tries to shed light to a new method of treatment in tinnitus. The findings of the study does not provide enough evidence to support ozone and betahistine as a treatment for tinnitus and further research on the subject is necessary. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to evaluate the epidemiology, clinical features, management and complications of subperiosteal orbital abscesses (SPOA)-a serious complication of rhinosinusitis. Retrospective data of 36 patients with SPOA secondary to acute rhinosinusitis from January 1998 to December 2011 were evaluated. Patients were analyzed in terms of age, gender, clinical features, CT findings, surgical procedures, microbiology, and complications. Twenty-three males and 13 females aged from 3 to 76 were evaluated. Nine patients-seven of which were under the age of 10-with small medial SPOA were treated only with medical management. Of the 13 with medial SPOA, transnasal endoscopic approach was performed for 10 and external approach for 3 to drain the abscess. As for the 12 patients with superior SPOA, 8 were treated via combined approach and 4 via external approach. The most common microorganisms were streptococci in children and anaerobes in adults. Total loss of vision developed in two adults with diabetes mellitus (DM). One patient with superior SPOA died due to frontal lobe abscess. Young children with small medial SPOA without significant ocular signs may successfully be managed medically. Surgical drainage is indicated for nonmedial abscesses, large medial abscesses with severe visual loss and with insufficient response to medical management. The risk of blindness from SPOA is higher in patients with DM. [ABSTRACT FROM AUTHOR]

This study introduces artificial neural networks (ANNs) for the estimation of land surface temperature (LST) using meteorological and geographical data in Turkey (26-45°E and 36-42°N). A generalized regression neural network (GRNN) was used in the network. In order to train the neural network, meteorological and geographical data for the period from January 2002 to December 2002 for 10 stations (Adana, Afyon, Ankara, Eskişehir, İstanbul, İzmir, Konya, Malatya, Rize, Sivas) spread over Turkey were used as training (six stations) and testing (four stations) data. Latitude, longitude, elevation and mean air temperature are used in the input layer of the network. Land surface temperature is the output. However, land surface temperature has been estimated as monthly mean by using NOAA-AVHRR satellite data in the thermal range over 10 stations in Turkey. The RMSE between the estimated and ground values for monthly mean with ANN temperature(LST) and Becker and Li temperature(LST) method values have been found as 0.077 K and 0.091 K (training stations), 0.045 K and 0.003 K (testing stations), respectively. [ABSTRACT FROM AUTHOR]

Precipitable water (PW) is an important atmospheric variable for climate system calculation. Local monthly mean PW values were measured by daily radiosonde observations for the time period from 1990 to 2006. Artificial neural network (ANN) method was applied for modeling and prediction of mean precipitable water data in Çukurova region, south of Turkey. We applied Levenberg-Marquardt (LM) learning algorithm and logistic sigmoid transfer function in the network. In order to train our neural network we used data of Adana station, which are assumed to give a general idea about the precipitable water of Çukurova region. Thus, meteorological and geographical data (altitude, temperature, pressure, and humidity) were used in the input layer of the network for Çukurova region. Precipitable water was the output. Correlation coefficient (R) between the predicted and measured values for monthly mean daily sum with LM method values was found to be 94.00% (training), 91.84% (testing), respectively. The findings revealed that the ANN-based prediction technique for estimating PW values is as effective as meteorological radiosonde observations. In addition, the results suggest that ANN method values be used so as to predict the precipitable water. [ABSTRACT FROM AUTHOR]

We investigated the effects of colchicine on oxidative stress and Ca²+ release in serum and polymorphonuclear leucocytes (PMNs) of Familial Mediterranean Fever (FMF) patients with attack, remission and unremission periods. Eighteen FMF patients and six age-matched healthy subjects in four groups were used. The first group was a control. The second group included patients with active FMF. The third and fourth groups were patients with remission and unremission, respectively. Colchicine (1.5 mg/day) was given to the third and fourth groups for 1 month. PMN cells, serum lipid peroxidation and intracellular Ca²+-release levels in the attack and unremission groups were higher than in those in controls, although they were lower in the remission group than in the attack group. Serum vitamin E and β-carotene concentrations were higher in the remission group than in the control and attack groups. However, PMN, serum lipid peroxidation and Ca²+-release levels were further increased in the unremission group compared to the attack group. Glutathione peroxidase, reduced glutathione and vitamin A values in the four groups did not change by FMF and colchicine. In conclusion, we observed that colchicine induced protective effects on oxidative stress by modulating vitamin E, β-carotene and Ca²+-release levels in FMF patients with a remission period. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is a systemic autoimmune disorder primarily involving the joints. Lung alterations in RA may be primary or secondary to pharmacological treatments and may involve the alveoli, interstitium, airways and/or pleura. Technetium-99m diethylenetriaminepentaacetic acid (Tc-99m DTPA) aerosol inhalation scintigraphy is a sensitive and noninvasive test commonly employed to assess pulmonary epithelial membrane permeability. The purpose of the this study was a) to investigate the changes of pulmonary alveolar epithelial permeability in patients with RA, b) to determine the relationship between the clearance rate of Tc-99m DTPA and pulmonary function test (PFT) results, and c) to determine the relationship between the clearance rete of Tc-99m DTPA and clinical parameters of disease. Twenty-five patients with RA but without lung alterations were included in the study. The patients were 22 females, and 3 males; mean age 53.6 +/- 8.7 years. Technetium-99m DTPA aerosol inhalation scintigraphy was performed on the study and healthy control groups. Clearance half times (T1/2) were calculated by placing a mono-exponential fit on the curves. Penetration index (PI) was calculated on the first-minute image. There were no significant differences in the mean T1/2 or mean PI values between the RA patients and control subjects. No correlation was found between the mean T1/2 values of Tc-99m DTPA clearance and activity of RA, clinical values, or the spirometric measurements except FEV1/FVC and functional status in RA patients (p = 0.02, p = 0.01, respectively). However, a weak correlation was found between duration of disease and T1/2 values of Tc-99m DTPA clearance (p = 0.006). PI values tended to correlate with FEF25-75, although, this was not statistically significant (p = 0.057). This study shows that no changes occur in alveolar-capillary permeability in RA patients without lung alterations. [ABSTRACT FROM AUTHOR]

The plasma levels of thrombomodulin in 54 patients with Behçet's disease (BD) and 20 healthy control subjects were studied. The mean thrombomodulin (TM) level was significantly higher in active BD patients than in inactive patients and healthy controls (P<0.001 and <0.01, respectively). Plasma TM levels did not show a significant relation with clinical manifestations. Increased plasma TM levels are associated with active disease and may reflect the presence of endothelial cell activation and/or injury. [ABSTRACT FROM AUTHOR]