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Abstract Breaking bad news is a difficult but unavoidable responsibility of physicians. It constitutes a set of stressfull duties, which become more critical during uncertain medical situations such as the COVID-19 pandemic. The purpose of the current study; To determine the factors that affect physicians’ attitudes and approaches in giving bad news about, life-threatening medical conditions. All staff working in the COVID-19 wards as physicians were invited to complete a standardized questionnaire evaluating the descriptive properties and attitude and approach to breaking bad news in this cross-sectional study. A total of 120 physicians were included in the study. An approximately equal number of physicians working in internal medicine and surgical branches were included in the study (p = 0.540). Internal medicine specialists encountered breaking bad news more commonly than surgeons (p = 0.002). Only 14.2% of them stated that they “always” felt competent. Approximately, 68.3% (n = 82) of the physicians did not receive any kind of training on breaking bad news. More than half of the physicians stated feeling anxious about breaking bad news, particularly when announcing death. Announcement of death due to COVID-19 (5.8%) followed announcing fatal diseases (13.3%) and limb loss with function loss (8.3%). The COVID-19 pandemic revealed the physicians’ need for education on “breaking bad news.” Physicians with a shorter work experience had a higher rate of receiving undergraduate education about breaking bad news than those with more work experience. As the length of service increased, there was a significant increase in the rate of receiving education regarding breaking bad news after graduation (p = 0.037). Additionally, it helped to convey the optimal approach in extraordinary and uncertain medical situations. Our study findings support this statement.The most common reason for breaking bad news is the announcement of death, which should be conveyed to the patient’s relatives in accordance with communication principles, taking into account their current situation. This approach can effectively reduce the anxiety experienced by the physician breaking the news and mitigate reactions from the patient’s relatives such as refusal and incomprehension in the face of the patient’s loss.

The aim of this study was to analyze the pregnancy process, especially the Familial Mediterranean fever (FMF) disease course and attack types during pregnancy, and to examine the relationship between disease-related factors and female infertility in FMF patients. The study, which was planned in a multicenter national network, included 643 female patients. 435 female patients who had regular sexual intercourse were questioned in terms of infertility. Pregnancy and delivery history, FMF disease severity and course during pregnancy were evaluated. The relationship between demographic and clinical findings, disease severity, genetic analysis results and infertility was investigated. 401 patients had at least 1 pregnancy and 34 patients were diagnosed with infertility. 154 patients had an attack during pregnancy. 61.6% of them reported that attacks during pregnancy were similar to those when they were not pregnant. The most common attack symptoms were fever, fatigue and abdominal pain-peritonitis (96%, 87%, and 83%, respectively) in the pregnancy period. The disease-onset age, disease activity score, gene mutation analyses, and regular colchicine use (> 90%) were similar between the fertile and infertile groups, while the frequency of previous appendectomy and alcohol consumption rates were higher in individuals with infertility. Our results indicated no significant change in the frequency and severity of attacks during pregnancy. The low rate of infertility (7.8%) in our patients was noted. It has been suggested that the risk of FMF-related infertility may not be as high as thought in patients who are followed up regularly and received colchicine. [ABSTRACT FROM AUTHOR]

The present study aimed to examine the effect of a dialogic book reading program on preschool children's perspective taking skills. In line with this aim, a dialogic book reading program was designed, and its effects were tested in a quasi-experimental study involving both pre/post and follow-up tests. The study group consisted of 42 five-year old children (21 children in the intervention group, 21 children in the control group) who were attending a preschool education institution in Antalya, Turkey. In the study, the Perspective Taking Test for Children (PTC) was used in order to assess the children's perspective taking skills. In the program implementation, the PTC was administered to both the intervention and control group as a pre-test. Subsequently, the dialogic reading program was applied to the intervention group for six weeks. After the implementation of the program, PTC was administered to both groups as a post-test, and a follow-up test was administered to the intervention group one month later. As a result, statistically significant differences were found between the pre-test and post-test scores of all sub-dimensions and the total scores for perspective taking of the children in the intervention group (p < 0.01). In other words, an increase was seen in the perspective taking skills in the intervention group after the implementation of the dialogic book reading program. This effect was found to be sustained in the follow-up test one month after the implementation of the program. According to the results obtained, it is thought that dialogic reading, which facilitates the active participation of children in the reading process, can support children's perspective-taking skills by enabling them to focus on the emotional and mental states of the characters in the story, and thus, to acquire indirect social experiences. The results are discussed in line with the literature findings and suggestions are made for further studies. The findings of the present study reveal the necessity to use this method more widely in preschool education. [ABSTRACT FROM AUTHOR]

Leafy plants are commonly consumed as vegetables in India due to their high nutrient and vitamin content. This study, conducted in Ambagarh Chowki (India), investigated the accumulation potential of 52 elements (including Al, As, Ba, Be, Bi, Ca, Cd, Ce, Co, Cr, Cu, Dy, Er, Eu, Fe, Ga, Gd, Ge, Ho, K, La, Li, Lu, Mg, Mn, Mo, Na, Nb, Nd, Ni, P, Pb, Pr, Rb, Sb, Sc, Se, Sm, Sn, Sr, Tb, Te, Th, Ti, Tl, Tm, U, V, W, Y, Yb, and Zn) in seven leafy vegetable species, namely Amaranthus tricolor L., Corchorus olitorius L., Cordia myxa L., Hibiscus sabdariffa L., Ipomoea batatas (L.) Lam., Moringa oleifera Lam., and Spinacia oleracea L. Technique: Inductively coupled plasma mass spectrometry (ICP-MS) was employed for analysis. The maximum concentrations of elements such as Al, Ba, Be, Bi, Cd, Co, Cr, Fe, Ga, Ge, Li, Mn, Ni, Pb, Sb, Th, Tl, U, V, W, and REEs were observed in S. oleracea leaves, indicating their highest accumulation potential. In contrast, the maximum concentrations of As were found in H. sabdariffa leaves; Ca and Si in M. oleifera leaves; Mg, Sr, and Mo in A. tricolor leaves; and P, K, Cu, and Zn in C. myxa leaves, respectively. Twenty-one elements (Cr, Cd, Pb, Ni, Co, V, Cu, Zn, Fe, Mn, Th, Sb, Ba, Be, Li, Sr, Tl, U, Se, Sn, and REEs) exceeded permissible limits set by the WHO. The elevated hazard index values indicated significant non-carcinogenic effects. The sources of these elements could be attributed to a combination of geological factors and agricultural practices. This study highlights the need for further investigation into the potential health implications of consuming these vegetables in the aforementioned region. [ABSTRACT FROM AUTHOR]

Background: Auditory temporal processing skills to perceive rapid changes in intensity, duration, and frequency of sounds over time are essential for early spoken language acquisition and speech perception. This study aimed to assess auditory temporal order and speech perception in late talkers. Methods: Fifty children (25 with late-talking and 25 with typical development) aged 7 to 9 years were included in the study. All subjects had typical audiometric thresholds between 125 Hz and 8 kHz (≤ 20 dB HL) and no middle ear pathology. The frequency pattern test, duration pattern test, and speech intelligibility tests in quiet and noise conditions were used to assess auditory temporal order and speech perception. Results: Late talkers performed lower than typically developing children on tests of frequency pattern, duration pattern, and speech intelligibility in noise (p < 0.05). When the correlations between the tests used were calculated, there were correlations between the tests for both groups. Conclusions: The results indicate that children who talk later than their typically developing peers in the early years of life may have difficulties with some auditory processing skills, even if they catch up with their typically developing peers in speech and language skills in middle childhood. Thus, it is very crucial to monitor auditory processing skills as well as speech and language skills in late talkers. [ABSTRACT FROM AUTHOR]

The aim of this study was to develop the Multidimensional Medical Neglect of Children Scale (MMNCS) and assess its validity and reliability. The scale consists of three separate forms, intended for parents with children in the age groups of 3–6, 7–11, and 12–18. In Study 1, a total of 1101 Turkish parents (339 for the 3–6 years old form, 452 for the 7–11 years old form, and 310 for the 12–18 years old form) were included. Principal factor analysis indicated that all three scales had a three-factor structure. In Study 2, 894 Turkish parents (265 for the 3–6 years old form, 311 for the 7–11 years old form, and 318 for the 12–18 years old form) were included. Confirmatory factor analysis confirmed the three-factor structure for all three forms. Criterion-related validity analyses showed significant and positive correlations between the sub-dimensions and total scores of the MMNCS and the Parental Acceptance-Rejection Questionnaire for all three forms. Reliability analyses, using Cronbach's alpha and McDonald's omega coefficients, demonstrated that the internal consistency coefficients of the total scores for all three forms exceeded 0.70. In conclusion, the findings of this study indicate that the MMNCS can be regarded as a valid and reliable instrument for assessing the medical neglect of parents towards their children in a Turkish sample. [ABSTRACT FROM AUTHOR]

Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that primarily involves the axial skeleton but may also present with peripheral joint involvement and extra-articular involvement. The present study aims to quantitatively analyze posture, balance, and gait parameters in patients with axSpA and and assess associated factors. This cross-sectional case-control study included 51 axSpA patients (30 males, 21 females; mean age 40.94 ± 10.48 years) and 51 age- and sex-matched healthy controls. In patients with axSpA, the Ankylosing Spondylitis Disease Activity Score CRP, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Metrology Index (BASMI), the Maastrich Ankylosing Spondylitis Enthesitis Score (MASES), and the Ankylosing Spondylitis Quality of Life (ASQoL) scale were used. For postural analysis, DIERS formetric (Diers GmbH, Schlangenbad, Germany) videoraster- stereography device was utilized. HUR SmartBalance BTG4 (HUR-labs Oy, Kokkola, Finland) balance platform was used for postural balance and limit of stability (LOS) measurement. Participants were evaluated using Berg Balance Scale (BBS), Functional Reach Test (FRT) and Timed Up and Go Test (TUG). The Zebris FDM type 3 (Zebris Medical GmbH, Germany) walking platform was used to measure the spatiotemporal parameters of the participants. Comparison of postural parameters showed that sagittal imbalance and cervical depth distance were increased in the axSpA group than in the healthy participants (p < 0.004). Comparison of functional balance parameters showed that BBS and FRT scores were significantly lower (p < 0.001) in the axSpA group than in the control group, while TUG scores were significantly higher (p < 0.001). The LOS values, which evaluate dynamic balance were significantly lower, indicating impairment, in the axSpA group. In the measurement of postural sway, which indicates static balance, all 23 subparameters were found to be similar. When analyzing the spatiotemporal gait parameters, in the axSpA group compared with those in the control group; Foot angles (p= 0.028) and stride width (p = 0.004) were increased, whereas step lengths (p = 0.004) and stride lengths (P = 0.004) were decreased. In the axSpA group the gait speed was decreased (p = 0.004). When axSpA was analyzed separately as radiographic and nonradiographic axSpA, similar findings were observed in posture, balance, and gait parameters. No significant difference was observed. We found that the clinical assessments most closely associated with posture, balance, and gait analyses were BBS, FRT, TUG, and BASFI. [ABSTRACT FROM AUTHOR]

Aluminum parts are used in the aviation industry because of the need for light. However, in addition to lightness, critical parts that must have high strength properties have also been developed. The corrosion resistance, resistance to high temperatures, and workability were investigated in this case. It becomes difficult to choose among many aluminum materials that can be alternatives to each other when these features are included. The developed approach, which considers many of the features listed above and ultimately recommends to the user the most suitable aluminum material for the relevant critical part, will be used in overcoming the difficulties in this process. A material selection model is proposed in this paper for this purpose, and the decision-making model is demonstrated with examples from the aviation industry. Therefore, the developed model, which will enable the selection of the most suitable materials among alternative materials, especially for critical parts in the aviation industry, will guide professionals working in this field. For this purpose, the fuzzy TOPSIS method is used in the study, and suitable alternatives are determined. Finally, a robustness analysis is proposed to determine the most suitable aluminum material for highly uncertain situations. We apply a stability evaluation study based on process control theory in the robustness analysis. [ABSTRACT FROM AUTHOR]

Almond (Prunus dulcis) is a nutritious food with a rich content. In addition to consuming as food, it is also used for various purposes in sectors such as medicine, cosmetics and bioenergy. With all these usages, almond has become a globally demanded product. Accurately determining almond variety is crucial for quality assessment and market value. Convolutional Neural Network (CNN) has a great performance in image classification. In this study, a public dataset containing images of four different almond varieties was created. Five well-known and light-weight CNN models (DenseNet121, EfficientNetB0, MobileNet, MobileNet V2, NASNetMobile) were used to classify almond images. Additionally, a model called 'Genetic CNN', which has its hyperparameters determined by Genetic Algorithm, was proposed. Among the well-known and light-weight CNN models, NASNetMobile achieved the most successful result with an accuracy rate of 99.20%, precision of 99.21%, recall of 99.20% and f1-score of 99.19%. Genetic CNN outperformed well-known models with an accuracy rate of 99.55%, precision of 99.56%, recall of 99.55% and f1-score of 99.55%. Furthermore, the Genetic CNN model has a relatively small size and low test time in comparison to other models, with a parameter count of only 1.1 million. Genetic CNN is suitable for embedded and mobile systems and can be used in real-life solutions. [ABSTRACT FROM AUTHOR]

Purpose: To present a clinically based approach to the differentiation of optic disc edema (DE) cases, commonly seen in neuro-ophthalmology. Methods: Consecutive patients who were considered to have unilateral or bilateral DE during examinations in the outpatient clinic and were referred to the neuro-ophthalmology department were included in this prospective study. The examination findings and differential diagnosis based on clinical signs and symptoms, and neuro-ophthalmological approach were evaluated in cases of DE. Results: Of the 119 cases with DE, 69 (58%) were women and 50 (42%) were men, where 89 (75%) had true optic DE (ODE) and 30 (25%) had pseudo optic DE (PODE). Non-arteritic anterior ischemic optic neuropathy (n = 40), increased intracranial pressure (n = 32), and anterior optic neuritis (n = 17) were determined as the causes of true ODE, whereas small and crowded optic disc (n = 12), tilted optic disc (n = 8), myelinated nerve fibers (n = 5) and optic disc drusen (n = 5) as the causes of PODE. Patients with optic neuritis were the youngest (28.41 years) group of ODE cases while those with non-arteritic anterior ischemic optic neuropathy were the oldest (59.98 years). The first symptoms were sudden and painless loss of vision and/or visual field in cases with non-arteritic anterior ischemic optic neuropathy, pain increasing with eye movements and loss of vision and/or visual field in cases with optic neuritis, headache, and from time to time blurred vision in cases with increased intracranial pressure. Patients having vision loss due to amblyopia constituted (30%) of PODE cases while 70% were determined incidentally and they had the best visual acuity. The accuracy of the preliminary diagnosis based on neuro-ophthalmologic examination findings was 79% in all cases. Conclusion: Detailed history taking and neuro-ophthalmological examination are essential in the differential diagnosis of ODE and PODE. [ABSTRACT FROM AUTHOR]

ADHD negatively affects the functionality of families and parents; however, no studies have examined the experiences of Turkish families with children diagnosed with ADHD. In this context, the present study aimed to explore the life experiences of Turkish parents with children diagnosed with ADHD. For this purpose, a descriptive phenomenological research design was used. Data were collected using a personal information and semi-structured interviews, while analysis was conducted using Giorgi's phenomenological method. As a result of the content analysis, five main themes were identified, namely experiences regarding the diagnosis process, emotional reactions related to the diagnosis, experiences with social relations, influences of ADHD diagnosis on the family, and academic difficulties. In line with the results, it is suggested that mental health professionals and other related specialists should include the findings of parents' life experiences in the treatment planning of children with ADHD and intervention programs should be developed for parents. [ABSTRACT FROM AUTHOR]

Breaking bad news is a difficult but unavoidable responsibility of physicians. It constitutes a set of stressfull duties, which become more critical during uncertain medical situations such as the COVID-19 pandemic. The purpose of the current study; To determine the factors that affect physicians' attitudes and approaches in giving bad news about, life-threatening medical conditions. All staff working in the COVID-19 wards as physicians were invited to complete a standardized questionnaire evaluating the descriptive properties and attitude and approach to breaking bad news in this cross-sectional study. A total of 120 physicians were included in the study. An approximately equal number of physicians working in internal medicine and surgical branches were included in the study (p = 0.540). Internal medicine specialists encountered breaking bad news more commonly than surgeons (p = 0.002). Only 14.2% of them stated that they "always" felt competent. Approximately, 68.3% (n = 82) of the physicians did not receive any kind of training on breaking bad news. More than half of the physicians stated feeling anxious about breaking bad news, particularly when announcing death. Announcement of death due to COVID-19 (5.8%) followed announcing fatal diseases (13.3%) and limb loss with function loss (8.3%). The COVID-19 pandemic revealed the physicians' need for education on "breaking bad news." Physicians with a shorter work experience had a higher rate of receiving undergraduate education about breaking bad news than those with more work experience. As the length of service increased, there was a significant increase in the rate of receiving education regarding breaking bad news after graduation (p = 0.037). Additionally, it helped to convey the optimal approach in extraordinary and uncertain medical situations. Our study findings support this statement.The most common reason for breaking bad news is the announcement of death, which should be conveyed to the patient's relatives in accordance with communication principles, taking into account their current situation. This approach can effectively reduce the anxiety experienced by the physician breaking the news and mitigate reactions from the patient's relatives such as refusal and incomprehension in the face of the patient's loss. [ABSTRACT FROM AUTHOR]

Internet use among children is increasing. This requires parents to develop digital parenting competencies as they are responsible for their children's well-being. In the current study the digital parenting self-efficacy perceptions of Turkish parents are examined with regard to the parental role, educational status, age, number of children, and Internet use experiences. Data were collected from a stratified sample of 7150 Turkish parents (i.e., only the mother or father in each family) from twenty-six provinces through the Digital Parenting Self-Efficacy Perception Scale. Descriptive statistics, comparison tests, and cluster analysis were used to analyze the data. The findings reveal that the participants' perceived digital parenting efficacy is high, and that perceptions change in terms of the parental role, educational status, age, number of children, and the Internet use experience. [ABSTRACT FROM AUTHOR]

The association between spondyloarthritis and cardiovascular (CV) diseases is complex with variable outcomes. This study aimed to assess the prevalence rates of CV diseases and to analyze the impact of CV risk factors on CV disease in patients with spondyloarthritis. A multi-center cross-sectional study using the BioSTAR (Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Registry) database was performed on patients with spondyloarthritis. Socio-demographic, laboratory, and clinical data were collected. Patients with and without major adverse cardiovascular events (MACE) were grouped as Group 1 and Group 2. The primary outcome was the overall group's prevalence rates of CV disease and CV risk factors. The secondary outcome was the difference in socio-demographic and clinical characteristics between the groups and predictive risk factors for CV disease. There were 1457 patients with a mean age of 45.7 ± 10.9 years. The prevalence rate for CV disease was 3% (n = 44). The distribution of these diseases was coronary artery disease (n = 42), congestive heart failure (n = 4), peripheral vascular disorders (n = 6), and cerebrovascular events (n = 4). Patients in Group 1 were significantly male (p = 0.014) and older than those in Group 2 (p < 0.001). There were significantly more patients with hypertension, diabetes mellitus, chronic renal failure, dyslipidemia, and malignancy in Group 1 than in Group 2 (p < 0.05). Smoking (36.7%), obesity (24.4%), and hypertension (13.8%) were the most prevalent traditional CV risk factors. Hypertension (HR = 3.147, 95% CI 1.461–6.778, p = 0.003), dyslipidemia (HR = 3.476, 95% CI 1.631–7.406, p = 0.001), and cancer history (HR = 5.852, 95% CI 1.189–28.810, p = 0.030) were the independent predictors for CV disease. A multi-center cross-sectional study using the BioSTAR (Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Registry) database was performed on patients with spondyloarthritis. Socio-demographic, laboratory, and clinical data were collected. Patients with and without major adverse cardiovascular events (MACE) were grouped as Group 1 and Group 2. The primary outcome was the overall group's prevalence rates of CV disease and CV risk factors. The secondary outcome was the difference in socio-demographic and clinical characteristics between the groups and predictive risk factors for CV disease. There were 1457 patients with a mean age of 45.7 ± 10.9 years. The prevalence rate for CV disease was 3% (n = 44). The distribution of these diseases was coronary artery disease (n = 42), congestive heart failure (n = 4), peripheral vascular disorders (n = 6), and cerebrovascular events (n = 4). Patients in Group 1 were significantly male (p = 0.014) and older than those in Group 2 (p < 0.001). There were significantly more patients with hypertension, diabetes mellitus, chronic renal failure, dyslipidemia, and malignancy in Group 1 than in Group 2 (p < 0.05). Smoking (36.7%), obesity (24.4%), and hypertension (13.8%) were the most prevalent traditional CV risk factors. Hypertension (HR = 3.147, 95% CI 1.461–6.778, p = 0.003), dyslipidemia (HR = 3.476, 95% CI 1.631–7.406, p = 0.001), and cancer history (HR = 5.852, 95% CI 1.189–28.810, p = 0.030) were the independent predictors for CV disease. The prevalence rate of CV disease was 3.0% in patients with spondyloarthritis. Hypertension, dyslipidemia, and cancer history were the independent CV risk factors for CV disease in patients with spondyloarthritis. [ABSTRACT FROM AUTHOR]

Environmental and economic problems arising from cement production have made it necessary to find alternative binders. At this point, geopolymer mortars have come to the fore as an alternative construction material. In this study, 40% metakaolin + mineral additives (20% fly ash + 20% granulated blast furnace slag + 20% red mud) were used as binding material. NaOH (12M) and Na2SiO3 solutions were used. Recycling concrete aggregate and marble powder (MP) were used in equal proportions as aggregate. Different types of fibers (steel fiber (SF), polyamide fiber (PAF), and polypropylene fiber (PPF)) were used with different ratios (0.25, 0.50, 0.75, and 1%). In addition to mechanical properties (7, 28, and 56 days) such as compressive strength (CS), flexural strength (FS), and ultrasonic pulse velocity, high temperature, freezing–thawing, and sulfate resistances were performed. Results indicated that the series with 1% vol. SF had the highest unit weight and low water absorption, with the highest CS 38.5 MPa and FS 27.88% higher than the reference. However, considering the durability resistance, the best performance was observed in the series with 1% PPF by volume. The residual CS of this series after freezing–thawing was 32.95 MPa, the FS was 4.90 MPa, the CSs after Na2SO4 and Mg2SO4 were 38.32 MPa and 41.40 MPa, and FSs were 5.05 MPa and 4.41 MPa, respectively. Considering the abrasion resistance loss, the sequence of the series was as follows: 0.5% by volume PPF > 0.75% by volume PAF = 0.25% by volume SF. [ABSTRACT FROM AUTHOR]

There are various dynamics in the emergence of eco-innovation applications in businesses. It has been determined that a significant part of the literature on determining these dynamics is directed to developed countries. Unlike other studies, this study aims to determine the eco-innovation dynamics in terms of a developing country and contribute to the literature. Determining the dynamics that create eco-innovation within the framework of manufacturing enterprises has considered economic growth theory, natural resource–based theory, and the Porter hypothesis. The questionnaire was administered to the first 500 manufacturing companies in Turkey. According to the path analysis, dynamics that significantly trigger eco-innovation practices have been determined. Eco-innovation is considered a solution to overcoming sustainability and environmental crisis challenges. Therefore, eco-innovation adoption depends on explaining clearly the dynamics at every economic level. In this respect, this study guides decision-makers who want to create environmental benefits by spreading eco-innovation practices. [ABSTRACT FROM AUTHOR]

Patients with rheumatoid arthritis (RA) have increased morbidity and mortality due to cardiovascular (CV) comorbidities. The association of CV diseases (CVD) and traditional CV risk factors has been debated, depending on patient and RA characteristics. This study aimed to find the prevalence of CVD and CV risk factors in patients with RA. A multi-center cross-sectional study was performed on RA patients using the BioSTAR (Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Registry) in September 2022. Socio-demographic, clinical, and follow-up data were collected. Myocardial infarction, ischemic heart disease, peripheral vascular disorders, congestive heart failure, ischemic stroke, and transient ischemic attack were regarded as major adverse cardiovascular events (MACEs). CVD was defined as the presence of at least one clinical situation of MACE. Group 1 and Group 2 included patients with and without CVD. Prevalence rates of CVD and traditional CV risk factors were the primary outcomes. Secondary outcomes were the differences in the clinical characteristics between patients with and without CVD. An analysis of 724 patients with a mean age of 55.1 ± 12.8 years diagnosed with RA was conducted. There was a female preponderance (79.6%). The prevalence rate of CVD was 4.6% (n = 33). The frequencies of the diseases in the MACE category were ischemic heart disease in 27, congestive heart failure in five, peripheral vascular disorders in three, and cerebrovascular events in three patients. The patients with CVD (Group 1) were significantly male, older, and had higher BMI (p = 0.027, p < 0.001, and p = 0.041). Obesity (33.4%) and hypertension (27.2%) were the two CV risk factors most frequently. Male sex (HR = 7.818, 95% CI 3.030–20.173, p < 0.001) and hypertension (HR = 4.570, 95% CI 1.567–13.328, p = 0.005) were the independent risk factors for CVD. The prevalence of CVD in RA patients was 4.6%. Some common risk factors for CVD in the general population, including male sex, older age, and hypertension, were evident in RA patients. Male sex and hypertension were the independent risk factors for developing CVD in patients with RA. [ABSTRACT FROM AUTHOR]

Clinical identification and fundamental study of viruses rely on the detection of viral proteins or viral nucleic acids. Yet, amplification-based and antigen-based methods are not able to provide precise compositional information of individual virions due to small particle size and low-abundance chemical contents (e.g., ~ 5000 proteins in a vesicular stomatitis virus). Here, we report a widefield interferometric defocus-enhanced mid-infrared photothermal (WIDE-MIP) microscope for high-throughput fingerprinting of single viruses. With the identification of feature absorption peaks, WIDE-MIP reveals the contents of viral proteins and nucleic acids in single DNA vaccinia viruses and RNA vesicular stomatitis viruses. Different nucleic acid signatures of thymine and uracil residue vibrations are obtained to differentiate DNA and RNA viruses. WIDE-MIP imaging further reveals an enriched β sheet components in DNA varicella-zoster virus proteins. Together, these advances open a new avenue for compositional analysis of viral vectors and elucidating protein function in an assembled virion. The study of viruses relies on the detection of viral proteins or viral nucleic acids. Here, the authors present a widefield interferometric defocus-enhanced mid-infrared photothermal (WIDE-MIP) microscope for high-throughput fingerprinting of single viruses. [ABSTRACT FROM AUTHOR]

The present systematic review aimed to investigate natural killer (NK) cell ex vivo expansion protocols within the scope of clinical trials targeting hematological cancer and to conduct a meta-analysis to assess the effect of NK cell infusion on survival. Research articles of clinical studies in which cell products produced by ex vivo expansion, consisting of a certain amount of NK cells and infused to patients with hematological cancer, were included in the systematic review. We conducted a proportion analysis with random effects for product purity and viability values. Studies having control groups were included in the survival meta-analysis. Among 11.028 identified records, 21 were included in the systematic review. We observed statistically significant heterogeneity for viability (I2 = 97.83%, p < 0.001) and purity values (I2 = 99.95%, p < 0.001), which was attributed to the diversity among isolation and expansion protocols. In addition, the survival meta-analysis findings suggested that NK cell therapy favors disease-free survival (DFS) of patients with myeloid malignancies but limited to only two clinical studies (odds ratio = 3.40 (confidence interval:1.27–9.10), p = 0.01). While included protocols yielded cell products with acceptable viability, the utility of immunomagnetic methods; feeder cells such as K562 expressing membrane-bound IL15 and 4-1BBL or expressing membrane-bound IL21 and 4-1BBL might be preferable to achieve better purity. In conclusion, NK cell therapy has a potential to improve DFS of patients with myeloid malignancies. [ABSTRACT FROM AUTHOR]

In the concept of green geopolymer, a good start would be if all/many of the geopolymer components were made from recycled materials. In this research, high recycled material consumption was aimed for forming a geopolymer. Binder materials were selected as 40% metakaolin, 20% fly ash, 20% granulated ground furnace slag, and 20% red mud, and, also the aggregates were selected as recycled material (50% recycled aggregate powder and 50% marble powder). In addition, different types of fibers (brass-coated steel fiber, polyamide fiber and polypropylene fiber) at different ratios (0–0.25–0.50–0.75–1.00%) were used. Compressive strength, bending strength, ultrasound pulse velocity were obtained in the tests and nonlinear fracture parameters such as initial fracture toughness and unstable fracture toughness were determined by equations. Besides, the durability properties (abrasion resistance, high-temperature (up to 600 °C) resistance, freeze–thaw (up to 300 cycles) resistance, and sodium/magnesium sulfate attack) of the best geopolymers were considered and the best series for each fiber type was determined by a decision support system. According to the test results, the bending strength was improved by curing age and all types of fibers. Besides, the first crack and unstable crack propagation are delayed by fibers. 0.75% polypropylene fiber with a high curing time (up to 56 days) can be proposed for higher performance of geopolymer. In addition, consideration of a decision support system eases finding the best solution among the huge experimental data and gives better results instead of the conventional singular evaluation approach. [ABSTRACT FROM AUTHOR]

Due to the prevalence of cyberbullying in adolescence and its association with a number of negative psychosocial consequences, there is a need to develop programs to prevent this phenomenon. In this study, the aim was to examine the effect of the Cyberbullying Awareness Program on adolescents' awareness of cyberbullying and their coping skills. A total of 38 adolescents were included in the study, where 17 adolescents were assigned to the intervention group and 21 to the control group. The mean age of the adolescents was 13.8 (SD = 0.44). The Cyberbullying Awareness Program was administered to the intervention group in 10 sessions. The Cyberbullying Awareness Scale for Adolescents and Coping with Cyberbullying Scale were used as data collection tools in the study. As a result of the study, it was determined that the Cyberbullying Awareness Program was effective in increasing the awareness level of the adolescents in the intervention group about cyberbullying, as well the development of their skills to cope with cyberbullying. In line with the results of the study, suggestions are presented to educators and policy makers. It is recommended that policy makers include cyberbullying prevention programs in their national curriculums in order to increase the awareness of adolescents about cyberbullying and improve their coping skills, and these programs should be implemented by educators to children and adolescents nationwide. [ABSTRACT FROM AUTHOR]

A moderate earthquake with a magnitude Mw of 6.8 hit the Elazig Province of Turkey on January 24th, 2020, causing fatalities and structural damage/failure. Following the earthquake, a field reconnaissance was conducted at the Administration and Operation Campus of Karakaya Dam, which is 19 km from the earthquake epicenter. The exhibited performances in two side-by-side nominally identical reinforced concrete (RC) buildings with the same material properties and soil conditions differed significantly. The main reason lies in the preventive action taken before the earthquake in one of the buildings. The building retrofitted with additional structural walls had a slight/no damage level. However, the non-retrofitted building suffered severe damage due to large cracks in numerous infill walls, some of which were exposed to partial collapse. That makes the non-retrofitted building unserviceable, requiring evacuation after the earthquake. The field-observed building damage was compared with the seismic performances acquired from their refined numerical models for the recorded ground motions. The photographic documentation exposing the entire performance and damage level in non-retrofitted and retrofitted buildings was quantified by static pushover and nonlinear response history analyses. The post-earthquake performance of nonstructural members in retrofitted and non-retrofitted buildings was simulated with reasonable accuracy. [ABSTRACT FROM AUTHOR]

Peripheral neuropathy may cause serious complications such as foot ulcers and Charcot joint which can prevent by early diagnosis. We aimed to analyze the diagnostic value of ultrasonographic measurements of nerves and muscles in distal symmetric axonal polyneuropathy (DSAP). Study included 51 DSAP patients and 51 controls. Nerve conduction studies were performed. Median, ulnar, tibial, superficial peroneal, and sural nerves and the abductor pollicis brevis (APB), abductor digiti minimi (ADM), first dorsal interosseous (FDI), extensor digitorum brevis (EDB), abductor hallucis (AH) and tibialis anterior (TA) muscles were evaluated with ultrasound. The Toronto clinical scoring system (TCSS) was used to assess the severity of neuropathy. The median, ulnar, and tibial nerve cross-sectional areas (CSA) were higher in the DSAP group (p = 0.025, p = 0.011, p < 0.001 respectively) while superficial peroneal and sural nerve CSAs were not differed. Only AH and EDB ultrasonographic findings from the muscles differed between the two groups. Effect of diabetes and DSAP on sonographic findings were assessed with two-way ANOVA. Results indicated that only DSAP had a significant effect on sonographic nerve and muscle examination. The area under the ROC curve was 0.831 ± 0.042 for tibial nerve CSA (p < 0.001) with a cut-off value of 15.5 mm2 (sensitivity 74% and specificity 83%). Median, ulnar and tibial nerve CSAs were found to be larger in polyneuropathy patients and they were associated with the clinical and electrophysiological severity of polyneuropathy. ROC analysis showed that tibial nerve CSA may have a predictive value in the diagnosis of DSAP. [ABSTRACT FROM AUTHOR]

Today, the aerospace industry is improving competitive systems because of potential development in new aircraft demand, which are to be supplied on a unique manufacturing system while diminishing components changeover time and developing the total quality management program of the manufacturing system. It should be successfully using special jigs and fixtures in the production system. A specialized modular fixture includes standard components that can be applied to success flexibly and rapidly respond to engineering design characteristics. In our study, the purpose of the concept is to design and analyze flexible modular fixtures for aircraft fuselage panel assembly for the aerospace industry. The developed modular fixturing system can be easily adapted to other sectors such as automobiles or machinery due to its flexibility. [ABSTRACT FROM AUTHOR]

Purpose: Determining the frequency and distribution of pathogenic germline variants (PGVs) in Austrian prostate cancer (PCa) patients and to assess the accuracy of different clinical risk scores to correctly predict PGVs. Methods: This cross-sectional study included 313 men with advanced PCa. A comprehensive personal and family history was obtained based on predefined questionnaires. Germline DNA sequencing was performed between 2019 and 2021 irrespective of family history, metastatic or castration status or age at diagnosis. Clinical risk scores for hereditary cancer syndromes were evaluated and a PCa-specific score was developed to assess the presence of PGVs. Results: PGV presence was associated with metastasis (p = 0.047) and castration resistance (p = 0.011), but not with personal cancer history or with relatives with any type of cancer. Clinical risk scores (Manchester score, PREMM5 score, Amsterdam II criteria or Johns Hopkins criteria) showed low sensitivities (3.3–20%) for assessing the probability of PGV presence. A score specifically designed for PCa patients stratifying patients into low- or high-risk regarding PGV probability, correctly classified all PGV carriers as high-risk, whereas a third of PCa patients without PGVs was classified as low risk of the presence of PGVs. Conclusion: Application of common clinical risk scores based on family history are not suitable to identify PCa patients with high PGV probabilities. A PCa-specific score stratified PCa patients into low- or high-risk of PGV presence with sufficient accuracy, and germline DNA sequencing may be omitted in patients with a low score. Further studies are needed to evaluate the score. [ABSTRACT FROM AUTHOR]

In this study, 4-(3-methoxyphenyl)piperazin-1-ium 4-(3-methoxyphenyl)piperazine-1-carboxylate monohydrate was synthesized and characterized by using spectroscopic (XRD, FT-IR, FT-Ra, and NMR) techniques. Theoretical calculations were performed in the DFT method using the B3LYP functional and the 6–311 + + G(d,p) basis set and compared with the experimental results. It was determined that the geometric parameters and spectroscopic data obtained from the DFT calculations were in high agreement with the experimental results. The HOMO–LUMO energy gap was calculated at 5.19 eV, while this value was experimentally found at 4.26 eV from the UV–Vis absorption spectrum. Although the experimental and theoretical values are different from each other, according to both results, this synthesized structure has low reactivity and a tendency to be stable. Also, the electronic (MEP, Fukuki functions, and charge analyses), nonlinear optical, and thermodynamic properties (heat capacity, entropy, enthalpy change, and Gibbs free energy) of the title complex were investigated. Electrophilic and nucleophilic regions were found to be the same in all of the electronic investigation analyses. The first hyperpolarizability value was calculated to be 25 times (9.27 × 10–30 esu) greater than that of the urea used for comparison. Therefore, it has very good nonlinear optical properties. The change in the values of calculated thermodynamic properties depending on the temperature change shows that the thermodynamic system of the structure changed. Finally, antimicrobial activity studies were carried out to evaluate the biological activity of this synthesized complex, the experimental results were supported by molecular docking studies, and the toxicological and physicochemical properties of the complex were investigated. [ABSTRACT FROM AUTHOR]

Autoimmune rheumatic diseases have their own specific clinical presentation, and can affect multiple systems. Neurological involvement of autoimmune rheumatic diseases may involve both the central and peripheral nervous systems. Inflammation of neural tissue, autoantibody-mediated reactions, and small vessel vasculitis may be effective in the pathogenesis of neuropathy in autoimmune rheumatological diseases. Autoimmune rheumatic disease with pure motor neuron involvement is very rare in the literature. The case is here presented of a 58-year-old female patient who presented with the complaints of increasing pain and weakness in the extremities and was diagnosed with lower motor neuron disease and overlap syndrome. The patient was treated with cyclophosphamide, pulse steroid, hydroxychloroquine and intravenous immunoglobulin. After 3 months of treatment, a significant improvement was observed in the patient's clinical complaints and laboratory parameters. In conclusion, some patients with undiagnosed autoimmune rheumatic diseases may have neurological complaints. Clinicians should investigate patients with such neurological complaints for autoimmune rheumatic diseases. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the clinical features, possible etiological reasons, and treatment results in children who developed acute acquired comitant esotropia (AACE) without strabismus in previous years. Methods: Medical records of the patients who were diagnosed with AACE between July 2017 and June 2021 were retrospectively reviewed. The children with ocular and orbital pathology, hypermetropia > 2.00 diopters, and anisometropia > 1.00 diopters were not included in the study. Possible etiological factors that could cause esotropia, treatment results, motor, and sensory functions were investigated. Results: The mean age at first admission, and the onset of AACE, was 8.8 ± 2.9 (4–13) years of three female (23.1%) and 10 male (76.9%) cases. The causes of AACE were determined to be occlusion of the eye due to corneal foreign body removal in one (7.7%), emotional stress in one case (7.7%), and excessive close work, on computer and smartphone screens in the other 11 cases (84.6%). Orthotropia was achieved in cases who underwent strabismus surgery (n = 10) and in cases using the prism (n = 2); except for one case, all (92.3%) achieved binocular single vision (100 s/arc stereopsis and fusion) after treatment, while there was no binocular single vision in any of the cases before treatment. Conclusions: Acute acquired comitant esotropia is a rare clinical entity. Successful motor and sensory outcomes can be achieved by strabismus surgery or by prism therapy. It is critical to investigate the patientş with AACE in terms of intracranial pathologies, although rarely seen. [ABSTRACT FROM AUTHOR]

Background: Patients with Covid-19 disease could present with flu-like symptoms. However, nearly half of the subjects with positive test results for Covid-19 remain asymptomatic. Data on factors related to the duration of hospital stay in Covid-19 patients with diabetes mellitus remain limited. Objective: We aimed to identify risk factors predicting prolonged hospital length of stay (LOS) among diabetic patients hospitalized with Covid-19. Methods: This cohort study involved patients with type 2 diabetes (T2D) admitted to a tertiary hospital with mild or moderate Covid-19 between August 1 and November 31, 2020. Data on demographics, laboratory parameters, and clinical treatments were extracted from the medical records. Prolonged LOS was defined as equal to or greater than the median hospitable stay time. We used univariate and multivariate logistic regression analyses to explore risk factors associated with LOS. Results: We included 87 hospitalized T2D patients with mild or moderate Covid-19. The mean age was 69.5 ± 6.9 years, and 59.8% were female. In the unadjusted analysis, factors influencing the length of hospitalization were as follows: undertreatment of diabetes, high procalcitonin level, glycated hemoglobin, and low lymphocyte count. After adjustment for all covariates, subjects with a low lymphocyte had a 3.9 fold increased risk of prolonged LOS (OR:3.925 CI:1.044–14.755 p = 0.043). Conclusions: A lower lymphocyte count on admission was associated with prolonged hospital LOS in older T2D patients with Covid-19, suggesting this marker could help clinicians predict complications for an adverse outcome. [ABSTRACT FROM AUTHOR]

We aimed to describe the increased rate of Acinetobacter baumannii infections during the COVID-19 pandemic and define its significance within the last five years. This study was performed in a tertiary hospital with 280 beds and included all patients infected with A. baumannii in the intensive care unit between January 1, 2018, and June 30, 2022. A. baumannii-infected patients in the intensive care unit 27 months before the pandemic and 27 months during the pandemic were included. Pulsed-field gel electrophoresis was performed to assess clonal relatedness. The infection control measures were specified based on the findings and targeted elimination. In total, 5718 patients were admitted to the intensive care unit from January 1st, 2018, to June 30th, 2022. A. baumannii infection was detected in 81 patients. Compared to the pre-pandemic era, the rate of A. baumannii infection during the pandemic was 1.90 times higher (OR: 1.90, 95% CI: [1.197, 3.033]). Clonality assessment of multidrug-resistant A. baumannii samples revealed eight clusters with one main cluster comprising 14/27 isolates between 2021 and 2022. The case fatality rate of the pre-pandemic and pandemic era was not different statistically (83.33% vs. 81.48%, p = 0.835). Univariate analysis revealed the association of mechanical ventilation (p = 0.002) and bacterial growth in tracheal aspirate (p = 0.001) with fatality. During the COVID-19 pandemic, potential deficits in infection control measures may lead to persistent nosocomial outbreaks. In this study, the introduction of enhanced and customized infection control measures has resulted in the containment of an A. baumannii outbreak. [ABSTRACT FROM AUTHOR]

In this study, the combustion characteristics and kinetics of various mixtures of both raw and torrefied rose pulp and red pine sawdust with each other and with Elbistan lignite were investigated in the context of lignocellulosic biomasses' potential use as fuel. Ignition temperatures, peak temperatures, burnout temperatures, and comprehensive combustion indexes of the fuel mixtures were found to rise with the torrefaction process. This finding indicates that the fuel/combustion performance of the waste biomass can be improved by the torrefaction process. Moreover, the combustion behavior of rose processing waste and pine sawdust has been significantly improved by adding lignite to the samples to be torrefied. Average activation energies of raw pine sawdust, rose processing waste, and Elbistan lignite were found to be 178, 187, and 91 kJ mol–1, respectively. However, the activation energies of both raw samples and their mixtures with lignite as well as each other decreased with the torrefaction process. Furthermore, a synergistic effect was also observed during the combustion of the mixtures of both raw and torrefied biomass with Elbistan lignite. [ABSTRACT FROM AUTHOR]

This study aims to develop a zirconia-based ceramic with high mechanical properties for welding pin applications. 3 mol% yttria-stabilized tetragonal zirconia polycrystalline (3Y-TZP) nanopowders were synthesized by the hydrothermal method. According to the powder characteristics, the obtained powders only consisted of t-ZrO2 grains with high surface area (107 ± 1.1 m2/g) and nano-sized individuals (7.2 ± 0.2 nm average) as well as Y0.05ZrO1.5 at % chemical composition. The 3Y-TZP nanopowders were densified up to 99.10 ± 0.1% relative density by pressureless sintering at 1500 °C for 2 h. Crystalline phases were determined as 73.5 ± 1 vol.% t-ZrO2 and 26.5 ± 1 vol.% m-ZrO2 in the sintered body using X-ray diffraction (XRD) analysis. Vickers hardness and indentation fracture toughness values were measured as 9.5 ± 0.4 GPa and 15.17 ± 0.2 MPa·m1/2 in 3Y-TZP sintered ceramics, respectively. Scanning electron microscopy (SEM) observations showed homogeneous microstructure with submicron grains (780 ± 5 nm) in sintered samples. Aberration-corrected scanning transmission electron microscopy (AbC-STEM) revealed the presence of t-ZrO2 to m-ZrO2 phase transformation in twinning grains giving rise to high fracture toughness in 3Y-TZP ceramics. As an end-product, ceramic welding pins were produced from hydrothermally synthesized 3Y-TZP nanopowders. They withstood the 300,000.00 ± 5000.00 welded nuts in the performance test. This makes the 3Y-TZP ceramics an outstanding material in the projection nut welding process. [ABSTRACT FROM AUTHOR]

This paper presents a combined usage of axiomatic design principles and simulation in developing and comparison of alternative assembly systems for airplane fuselage panels. In the application, four assembly system alternatives are obtained with axiomatic design methodology; and their performance results are obtained using simulation. The simulation results are made available for system designers to see each alternative's capabilities and make a comparison among the alternatives. The application of the proposed combined application of axiomatic design principles and simulation provides a reference guide for system designers to apply in designing other assembly systems' design. [ABSTRACT FROM AUTHOR]

It is assumed that in candidates for TNF-alpha inhibitor (TNFi) treatment, tuberculin skin test (TST) may be unreliable, since BCG vaccination causes false positive and drugs cause false negative results, favoring the use of Quantiferon or T-spot assays. However, these tests may not be readily available in all parts of the world. We aimed to determine the reliability of TST with respect to BCG vaccination and drugs in candidates for TNFi treatment, and how isoniazid is tolerated, assuming that the use of TST would result in increased isoniazid use. We included 1031 adult patients who were prescribed a TNFi for the first time. We analysed the association of BCG and drugs with TST and Quantiferon results, the determinants of a positive TST, and evaluated the tolerability of isoniazid. BCG vaccination and male sex were associated with positive TST (OR 3.56, 95% CI 1.98–6.41 and OR 2.54, 95% CI 1.75–3.68, respectively), while prednisolone and azathioprine were associated with negative TST (OR 0.63, 95% CI 0.43–0.91 and OR 0.40, 95% CI 0.11–0.76). Isoniazid was prescribed to 684 (66.3%) patients and had to be discontinued in 12.2% of these before 9 months, most commonly due to hepatotoxicity (44%). One patient developed tuberculosis despite isoniazid use. BCG vaccination may be associated with false positive TST, despite a long time since vaccination in candidates for TNFi treatment. Prednisolone and azathioprine use were associated with negative TST. Despite the high frequency of isoniazid use associated with using TST instead of QTF, isoniazid was generally well tolerated. [ABSTRACT FROM AUTHOR]

Objectives: Factors associated with disease activity of axial spondyloarthritis (axSpA) and switching of biologic disease-modifying anti-rheumatic drugs have not been clearly defined. We aimed to evaluate clinical characteristics of patients with axSpA, factors related to remission in treat to target era and predictive factors for biologic disease-modifying anti-rheumatic drug switching. Method: A multicenter, observational cross-sectional study was performed between February 2019 and August 2019. We included all consecutive patients ≥ 18 years with axSpA. Demographic and clinical variables were prospectively recorded. Clinical tools included Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ASDAS-CRP), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Metrology Index (BASMI), and Maastricht Ankylosing Spondylitis Enthesitis Score (MASES). Results: There were 969 patients with a mean age of 43.4 ± 10.8 years. There were 143 patients (14.8%) with remission and 223 (23.1%) patients with low disease activity. Male sex (p = 0.021), positive family history (p = 0.036), and human leukocyte antigen-B27 (p = 0.011) were predictors of remission by ASDAS-CRP. There were 654 patients (67.5%) who did not switch to another drug. The highest BASMI and MASES scores were calculated in patients with very high disease activity (p < 0.05). In patients with drug switching, the disease duration was significantly higher (p < 0.001) and the age at diagnosis was significantly lower (p = 0.016). There were significantly more patients with uveitis and higher scores of MASES and BASMI in patients who switch to another biologic disease-modifying anti-rheumatic drugs (p = 0.003, p = 0.009, and p = 0.004, respectively). Conclusions: In patients with axSpA, male sex, younger age, and HLA-B27 positivity are associated with remission, while longer disease duration and accompanied uveitis appear to be related with drug switching. Clinical trial registration number and date: NCT04139954/25.10.2019. Key Points • Achievement of remission and/or low disease activity rates in patients with axSpA were assessed in a big registry from a real-life data. • Predictive factors for switching to another bDMARD were evaluated in axSpA patients. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the parental mediation of children's internet use from middle school students' point of view. In doing so, we first developed a Parental Mediation Scale. Exploratory factor analysis suggested a four-factor structure (monitoring, safety, active, technical mediation), which was then verified through confirmatory factor analysis. After conducting validity and reliability studies of the scale, we applied it to 416 Turkish middle school students in the 2018-2019 school year. To examine the parental mediation of internet use in terms of demographic characteristics, we employed group comparison tests (i.e., independent samples t-Test and one-way ANOVA). The results indicated that middle school students perceived the mediation of their parents at a medium level. Moreover, parental mediation of internet use did not differ based on the age of children, child's level of education, the gender of children, number of children in the family, parents' level of education, and family's income level. [ABSTRACT FROM AUTHOR]

A new dichloro(1,10-phenanthroline)(1,2,4-triazole-3-carboxylic-acid)copper(II) was synthesized, and the most stable optimized structure was determined using the B3LYP/LANL2DZ basis set, followed by FTIR and NMR characterization. The molecular geometric structure analysis and vibrational frequencies of the Cu(II) complex were calculated by using density functional theory calculations in the ground state. Metal-ligand and intra-ligand vibrations were investigated using vibrational analysis, and the obtained computational values were compared with the experimental values. The ProTox-II webserver was utilized for toxicological evaluation of the organism and organ, as well as molecular mechanisms of toxicity evidenced by the median lethal dose (LD50). SwissADME prediction was performed ADMET properties. Reduced density gradient (RDG) analysis is employed to study the weak interactions within the molecule. The nature of the chemical bonds in the [Cu(phen)(TCA)2Cl2] complex is investigated using electron localization function (ELF) analysis. MEPs, HOMO, LUMO, global reactivity descriptors, and Fukui functions are performed to study the chemical reactivity of the compound. Molecular docking studies are performed to predict the antibacterial, antidepressant, and anti-anxiety active site of the complex. Cu(phen)(TCA)2Cl2 was defined and used to evaluate the antibacterial properties of this Cu(II) complex against B. subtilis. [ABSTRACT FROM AUTHOR]

This study focused on the effect of pulsed electric field (PEF) as a pretreatment on coffee beans. PEF was applied with the specific energies of 1.742, 3.484 and 7.840 kJ/kg to Ethiopian Coffee Arabica beans before and after the roasting process, and beans were further brewed to investigate the effect of PEF on extraction yield and formation of Maillard Reaction Products (MRP). Antioxidant activity (DPPH, FRAP and ABTS methods) and total phenolic content (TPC) were determined after the brewing process. UV/Vis, fluorescence and ATR-FTIR spectra of samples were also recorded to evaluate the extraction of phenolic compounds and formation of MRP. It was observed that the PEF treatment increased the extraction of phenolic compounds and antioxidant activity compared to untreated beans up to 24% and 31%, respectively, while reducing the MRP. It was concluded that PEF pretreatment may be a valuable technique for obtaining better extraction yield and caffeine concentration, and lower MRP. Furthermore, application of PEF treatment on green coffee beans showed more promising results. [ABSTRACT FROM AUTHOR]

Fourier transform infrared (FT-IR) and Raman (FT-Ra) spectra of 1-(4-methoxyphenyl)-1H-imidazole were recorded and analyzed. The vibrational wavenumbers of the structure were computed by using the density functional theory (DFT)/Becke three Lee–Yang–Parr (B3LYP)/6–311 ++ g(d,p) basis set. The highest occupied molecular orbital (HOMO) and the lowest unoccupied molecular orbital (LUMO) energy values were determined to be − 1 eV and − 6.27 eV, respectively. The HOMO–LUMO energy gap value was found to be 5.27 eV. A large HOMO–LUMO gap means low reactivity in chemical reactions, indicating the high stability of the molecule. The HOMO–LUMO energy gap for the existing structure is relatively high, as a result the title molecule is hard. 1H, 13C NMR, and UV–Vis experimental and theoretical spectral analyses were given. Molecular electrostatic potential, Fukui functions, and charge analysis were performed to predict electrophilic and nucleophilic regions or atoms. The nonlinear optical properties of the structure were investigated, and it was found that the structure showed an important nonlinear optical property. Basic thermodynamic properties such as entropy (S), enthalpy changes (ΔH), heat capacity (Cp), Gibbs free energy (G), and zero-point vibration energy were calculated under constant pressure in the gas phase for different temperature values. It was determined that this compound has a significant antibacterial effect against some bacterial strains. Also, to support the antibacterial activity studies of the title molecule, molecular docking studies were carried out with protein structures of some microorganisms used in the antibacterial activity studies. [ABSTRACT FROM AUTHOR]

To compare the effectiveness of ultrasound-guided genicular nerve block (GNB) and physical therapy (PT) in patients with chronic knee osteoarthritis. A prospective randomised study with 102 patients (45–70 years) was performed wherein the patients received ultrasound-guided GNB (n = 51) and PT (n = 51) along with a standard home exercise programme. Scores for pain on a Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and 6-min walking test (6MWT) were assessed pre-treatment and at 2- and 12-weeks post-treatment. Both groups were comparable for sociodemographic characteristics. VAS scores (in mm) in the ultrasound-guided GNB group at 0, 2 and 12 weeks were 7.01 ± 1.36; 3.71 ± 2.18; 5.08 ± 2.22 (p < 0.001) and 6.64 ± 1.99; 4.35 ± 1.09; 5.25 ± 1.33, (p < 0.001) in the PT group. While the increase in the 6MWT test in the 2nd week was similar for both groups (p = 0.073), the increase in walking distance was greater in the ultrasound-guided GNB group at 12 weeks (p = 0.046). As compared to PT, ultrasound-guided GNB is beneficial in reducing pain and increasing functional and physical capacity, with greater retention of effects on the physical capacity seen at 12 weeks. Trial registration number: ClinicalTrials.gov (NCT04782401). [ABSTRACT FROM AUTHOR]

This article aims to evaluate the possible effect of obesity on quality of life, psychological status, and other clinical variables in Psoriatic arthritis (PsA). PsA patients have been recruited by the Turkish League Against Rheumatism-Network from various centers in Turkey in this cross-sectional study. Patients with a body mass index (BMI) ≥ of 30 kg/m2 were considered obese. Differences among patients with regard to obesity status were assessed with health-related quality of life measures (PsA Quality of Life Questionnaire [PsAQoL]), psychological status (Hospital Anxiety and Depression Scale [HADS]), and disease activity parameters (the Disease Activity index for PSoriatic Arthritis [DAPSA], Disease Activity Score 28-C-reactive protein [DAS28-CRP], Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Psoriasis Area and Severity Index [PASI]), physical functions (Ankylosing Spondylitis Functional Index [BASFI], Health Assessment Questionnaire [HAQ], and Health Assessment Questionnaire for the spondyloarthropathies [HAQ-S]). Pain was assessed using visual analog scale of pain (VAS-P), and fatigue was evaluated using visual analog scale of fatigue (VAS-F) and Functional Assessment of Chronic Illness Therapy (FACIT). A total of 1033 patients with PsA, 650 (62.9%) non-obese and 383 (37.1%) obese were included in the study. The PsAQoL, HADS-Anxiety, HADS-Depression, DAPSA, DAS28-CRP, BASDAI, BASFI, HAQ and HAQ-S scores of the obese group were higher than the non-obese group (p < 0.05). VAS-P and PASI scores were similar between group of patients with and without obesity. Obese patients had higher median scores of VAS-F and FACIT than non-obese patients (p < 0.05). Linear regression analysis showed that BMI affects the quality of life, depression, and disease activity. Consequently, obesity has significant associations with higher disease activity, lower QoL, risk of anxiety, depression, and fatigue. Therefore, obesity should also be taken into account in the management of PsA patients. [ABSTRACT FROM AUTHOR]

Financial performances of commercial banks are commonly determined with various multi-criteria decision-making (MCDM) models. For example, Analytic Hierarchy Process (AHP) method is one of the most widely used MCDM approaches in the formation of performance measurement models. In this study, a hybrid model is developed with the usage of AHP and Design of Experiments (DOE) to obtain overall financial performance scores by combining performance scores at the financial ratios for 18 Turkish commercial banks and their rankings within the commercial banking sector. In obtaining performance scores of the banks at the financial ratios the rationing process is used. In the applied rationing process, three different thresholds (quartiles: Q1, Q2, and Q3) are determined for each financial ratio. In the paper, the results of the proposed hybrid model are compared with the results of the AHP approach to determine its advantages over the usage of the AHP approach alone. The comparisons show that the hybrid model provides statistically similar but more robust performance scores and ranking results. [ABSTRACT FROM AUTHOR]

Flexibility is one of the most important strategy parameters to achieve a long-term successful performance for a manufacturing company. Studies in the literature aim to operate a manufacturing system at optimum levels of flexibility parameters under its own manufacturing environment. This study aims to present an interactive analysis framework based on TOPSIS and Taguchi parameter design principles for investigating the effects of different levels of flexibility parameters on the performance of a flexible manufacturing cell (FMC). The main performance metric used in this study is manufacturing lead time. Other important metrics to evaluate quality control and inspection policies are also investigated in this study. To conclude, a combined model of an interactive approach based on TOPSIS and Taguchi methods are used to assess the effectiveness of the flexibility parameters for a FMC. [ABSTRACT FROM AUTHOR]

Introduction: Rheumatoid arthritis is a chronic inflammatory disease with different disease activity grades. Several registries have been designed to determine the appropriate regimens of disease-modifying antirheumatic drugs to obtain sustained clinical remission. We examined epidemiological and clinical characteristics of rheumatoid arthritis patients using a clinical registry database (BioSTaR) and analyzed the differences in patients with sustained and switched therapies. Methods: A multicenter, observational cross-sectional study for rheumatoid arthritis was performed between February 2019 and September 2020 using the BioStaR-RA registry. Demographic and clinical characteristics were prospectively recorded into a specifically designed electronic database. The patients were divided into three groups due to the heterogeneity of the study cohort. Patients were grouped as Group I (Initial; within the first 6 months of treatment with biological/targeted synthetic drugs), Group ST (Sustained Treatment; any first drug lasting for at least 6 months without any change), and Group S (Switch; any switching to another drug). Comparative analysis was performed between sustained treatment (Group ST) and drug switching (Group S) groups. Results: The study included a total of 565 patients. The mean age was 53.7 ± 12.8 years, and the majority were female (80.4%). There were 104, 267, and 194 patients in Groups I, ST, and S, respectively. Erosive arthritis and hematological extra-articular involvement were more frequently detected in Group S than Group ST (p = 0.009 and p = 0.001). The patients in Group S had significantly higher disease activity scores (DAS28-CRP, CDAI, and SDAI) (p = 0.025, p = 0.010, and p = 0.003). There were significantly more patients with moderate disease activity in Group S (p < 0.05). Conclusions: The groups with sustained treatment and switching included patients with different disease activity status, although higher disease activity was determined in switchers. Overall, moderate disease activity and remission were the most common disease activity levels. Lower disease activity scores, lower hematologic manifestations, better functional status, and lesser radiographic damage are associated with sustained treatment. [ABSTRACT FROM AUTHOR]

This study aimed to detect patients' characteristics who suffered severe and critical COVID-19 pneumonia admitted to the post-acute COVID-19 rehabilitation clinic in Ankara City Hospital, Physical Medicine and Rehabilitation Hospital and to share our experiences and outcomes of rehabilitation programmes applied. This study was designed as a single-centre, retrospective, observational study. Severe and critical COVID-19 patients, admitted to the post-acute COVID-19 rehabilitation clinic, were included in patient-based rehabilitation programmes, targeting neuromuscular and respiratory recovery. Functional status, oxygen (O2) requirement and daily living activities were assessed before and after rehabilitation. Eighty-five patients, of which 74% were male, were analysed, with the mean age of 58.27 ± 11.13 and mean body mass index of 25.29 ± 4.81 kg/m2. The most prevalent comorbidities were hypertension (49.4%) and diabetes mellitus (34.1%). Of the 85 patients, 84 received antiviral drugs, 81 low-molecular-weight heparin, 71 corticosteroids, 11 anakinra, 4 tocilizumab, 16 intravenous immunoglobulin and 6 plasmapheresis. 78.8% of the patients were admitted to the intensive care unit, with a mean length of stay of 19.41 ± 18.99 days, while those who needed O2 support with mechanic ventilation was 36.1%. Neurological complications, including Guillain–Barré syndrome, critical illness-related myopathy/neuropathy, cerebrovascular disease and steroid myopathy, were observed in 39 patients. On initial functional statuses, 55.3% were bedridden, 22.4% in wheelchair level and 20% mobilised with O2 support. After rehabilitation, these ratios were 2.4%, 4.7% and 8.2%, respectively. During admission, 71 (83.5%) patients required O2 support, but decreased to 7 (8.2%) post-rehabilitation. Barthel Index improved statistically from 44.82 ± 27.31 to 88.47 ± 17.56. Patient-based modulated rehabilitation programmes are highly effective in severe and critical COVID-19 complications, providing satisfactory well-being in daily living activities. [ABSTRACT FROM AUTHOR]

In this study, thermogravimetric analysis (TGA) was performed under the air environment for four different heating rates (10, 20, 30, and 40 °C min−1) in order to find out thermal degradation and mechanisms of the chicken manure, a Turkish lignite, and their blends (25 lignite + 75 manure, 50 lignite + 50 manure, and 75 lignite + 25 manure). To calculate thermal kinetics and responsible solid-state mechanisms of the samples, the Flynn-Wall-Ozawa and Coats-Redfern methods were applied. Significant differences between Turkish lignite and chicken manure samples were observed in terms of thermal kinetics and mechanisms. D1 and D4 mechanisms were found to be the responsible mechanisms for the main oxidation region of the lignite and chicken manure/blends, respectively. A similar decreasing trend for the calculated activation energies and pre-exponential constants was observed with increasing biomass content in the manure blends from 25 to 75% by both Flynn-Wall-Ozawa and Coats-Redfern methods. Furthermore, biomass content has an effect on the mechanisms of chicken manure blends during the combustion. D3 was found to be the responsible solid-state mechanism for the third regions (pre-combustion of the manure) of the chicken manure samples. However, D1 and D2 mechanisms were found to be responsible mechanisms for the blends. [ABSTRACT FROM AUTHOR]

Nontraditional manufacturing processes (NTMPs) bring the processing capabilities such as machining high strength and hard materials with desired accuracies and surface finish to the manufacturing companies. Therefore, there has been a significant increase in the use and number of NTMPs. Hence, choosing a particular NTMP for a specific application turns out to be a complex decision-making problem, which involves conflicting qualitative and quantitative ranking criteria. In recent NTMP ranking literature, it is noted that fuzzy approaches are better suited for handling uncertainties and incomplete information that exist within the NTMP ranking environment. This paper introduces such a fuzzy approach using the hesitant fuzzy preference selection index (PSI) method for the assessment of the criteria weights and the hesitant fuzzy correlation coefficient principle for ranking and recommending the most appropriate NTMP for a specific application. The proposed methodology and its efficiency in dealing with incomplete information under the fuzzy decision-making environment are explored with a case study. As a result of the study, the proposed model preferred the electron beam machining (EBM) as the most suitable nontraditional manufacturing process. On the other hand, triangular fuzzy TOPSIS methods offered the electrochemical machining (ECM) as the best choice among the alternatives. The differences among the ranking decisions are also analyzed in the paper. It can be concluded from the authors' various applications of the proposed hesitant fuzzy PSI method that it is extremely effective in representing fuzzy decision-making environments in NTMP ranking decisions. [ABSTRACT FROM AUTHOR]