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This article considers a Volterra-Fredholm integro-differential equation including multiple time-varying delays. The aim of this article is to study the uniqueness of solution, the Ulam–Hyers–Rassias stability and the Ulam–Hyers stability of the Volterra-Fredholm integro-differential equation including multiple time-varying delays. We prove four new results in connection with the uniqueness of solution, the Ulam–Hyers–Rassias stability and the Ulam–Hyers stability of the considered Volterra-Fredholm integro-differential equation, respectively. The new results of this article involve sufficient conditions. The techniques of the proofs depend on the fixed point method according to the definitions of a suitable metric, operators and the related calculations. In particular case of the considered Volterra-Fredholm integro-differential equation, two illustrative examples are presented to verify the applications of the results. This article also involves some new complementary outcomes in connection with qualitative theory of Volterra-Fredholm integro-differential equations with delays. [ABSTRACT FROM AUTHOR]

Objectives: To assess the association between fibromyalgia (FM) and insulin resistance (IR) using multiple IR indices in FM patients and to investigate how these indices vary with the severity of FM. Methods: This cross-sectional study included 70 female patients diagnosed with FM and 70 age-matched female healthy controls. The data collected included demographics, clinical characteristics, and laboratory parameters. FM severity was evaluated using the Fibromyalgia Impact Questionnaire-Revised (FIQR). The metabolic indices calculated were the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), Quantitative Insulin Sensitivity Check Index (QUICKI), triglyceride – glucose index (TyG), triglyceride to HDL cholesterol ratio (TG/HDL-C), and Metabolic Score for Insulin Resistance (METS-IR). Results: FM patients exhibited significantly higher HOMA-IR values (p = 0.002), and lower QUICKI values (p = 0.000) than controls. METS-IR also showed significant differences between FM patients and controls (p = 0.026). HOMA-IR and METS-IR values increased with FM severity, whereas QUICKI values decreased (p < 0.05). Duration of FM showed a moderately positive correlation with HOMA-IR (r = 0.249, p = 0.027). For TG/HDL-C and METS-IR, the correlations were weaker, but still positive (r = 0.094, p = 0.378, and r = 0.184, p = 0.056, respectively). Conclusion: This study observed a significant association between FM and IR, as evidenced by metabolic indices in FM patients compared to controls. IR levels tended to increase with FM severity and duration. These findings suggest that IR could play a role in FM pathogenesis. Non-invasive and practical methods, such as METS-IR, may provide advantages for metabolic screening in FM patients; however, further studies are needed to establish their clinical utility. [ABSTRACT FROM AUTHOR]

Myoepithelial cells (MECs) are known to play an active role in mixed mammary tumors and are found in dogs as well as in humans. The study aimed to assess the morphologic features of epithelial and mesenchymal cells and MECs and investigate their roles in epithelial-mesenchymal transformation in different tumor types in canine mammary tumors. Immunohistochemical staining was performed on 165 specimens from benign mixed tumors (BMT), carcinosarcomas, and simple carcinomas (SC). Double immunohistochemical staining was for the antigen pairs p63/actin, p63/vimentin, p63/CK19, p63/CK8, p63/CK14. BMP6 was demonstrated only by single immunostaining. For BMP6, epithelial cells were positive in BMTs, carcinosarcomas, and SCs. Myoepithelial cells were variably positive for p63, actin, vimentin, and CK14. Epithelial cells were usually positive for CK19 and CK8. MECs include both epithelial and mesenchymal components, so metaplasia in epithelial cells can also form in MECs, and these two cell types should be evaluated together. [ABSTRACT FROM AUTHOR]

Background: Restless genital syndrome (RGS), also known as persistent genital arousal disorder, is a distressing condition characterized by unwanted genital arousal in the absence of sexual desire. This study explores the prevalence of RGS in women with restless legs syndrome (RLS), investigates the associated psychological impacts, and assesses the overall effect on quality of life. Methods: This retrospective study included 69 female patients who were diagnosed with RLS at two university medical centers. Data were collected via the RGS diagnostic form, Beck Depression Inventory, Beck Anxiety Inventory, and WHOQOL-BREF quality of life scale. Statistical analyses were used to assess the correlation between RGS and psychological health measures. Results: Approximately 44.9% of the participants with RLS also reported symptoms of RGS. Significant findings included increased nighttime and rest-related exacerbation of RGS symptoms. Compared with those without RGS, participants with RGS presented significantly higher anxiety and depression scores. Moreover, RGS significantly impacted physical health and social relationships, as indicated by lower WHOQOL-BREF scores. Conclusion: This study highlights a significant overlap between RGS and RLS, with substantial impacts on psychological well-being and quality of life. These findings underscore the importance of considering RGS in the clinical management of RLS, suggesting a need for integrated treatment strategies to address both the neurological and the psychological aspects of these conditions. [ABSTRACT FROM AUTHOR]

The fractional Kundu–Eckhaus (FKE) equation, a nonlinear mathematical model, holds significance in assessing optical fibre communication systems. It takes into account various factors, including dispersion, noise and nonlinearity, which can impact the quality of signal and rates of data transmission in the systems of optical fibre. Utilizing the FKE model can contribute to optimizing the features of optical fibre network. In this academic investigation, an innovative mapping approach is applied to the FKE model to unveil novel soliton solutions. This is achieved through the utilization of beta derivative by employing the new mapping method and computer algebraic system such as Maple. The derived results are expressed in terms of hyperbolic and trigonometric functions. Our study elucidates a variety of soliton patterns such as periodic, dark, kink, bright, singular, dark–bright soliton solutions. To facilitate comprehension, certain solutions are visually depicted through two-dimensional, three-dimensional, and phase plots depicting bifurcation characteristics utilizing Maple software. Furthermore, the sensitivity of the model is explored across diverse initial conditions. Our study establishes a connection between computer science and soliton physics, emphasizing the pivotal role of soliton phenomena in advancing simulations and computational modelling. [ABSTRACT FROM AUTHOR]

Measles is a highly contagious disease that mainly affects children worldwide. Even though a reliable and effective vaccination is available, there were 140,000 measles deaths worldwide in 2018, and most of them were children under the age five years. In this paper, we comprehensively investigate a novel fractional SVEIR (Susceptible-Vaccinated-Exposed-Infected-Recovered) model of the measles epidemic powered by nonlinear fractional differential equations to understand the epidemic's dynamical behaviour. We use a non-singular Atangana-Baleanu fractional derivative to analyze the proposed model, taking advantage of non-locality. The existence, uniqueness, positivity and boundedness of the solutions are shown via concepts of fixed point theory, and we also perform the Ulam-Hyers stability of the considered model. The parameter sensitivity is discussed in the context of the variance with each parameter using 3-D graphics based on the basic reproduction number. Moreover, with the Atangana-Toufik numerical scheme, numerical findings are depicted for different fractional-order values. The presented approach produce results that are efficiently consistent and in excellent agreement with the theoretical results. [ABSTRACT FROM AUTHOR]

Objective: Comparison of hormonal, metabolic and inflammatory markers of glutathione with metformin and Diane-35 in a rat model of PCOS induced by dehydroepiandrosterone. Methods: Twenty-five female rats were randomized into four groups. Group 1 was administered a subcutaneous dose of 0.2 ml saline/day. Group 2 was given 0.2 ml of 1% carboxymethyl cellulose (CMC)/day orally for 28 days. A PCOS model was established with DHEA in rats. Group 3 was given 4.5 mg/kg/day of Diane-35 orally dissolved in 1% CMC for 28 days. Group 4 was given 300 mg/kg/day of metformin orally dissolved in 1 ml of saline for 28 days, and Group 5 was administered 100 mg/kg of glutathione intraperitoneally on days 35, 42, and 49. On day 56, the rats were sacrificed. Serum markers and follicle count were examined. Results: Serum IL-6, hs-CRP, insulin, testosterone, SHBG, and MDA values were significantly lower in the glutathione group than in the PCOS group (p = 0.0006, p = 0.023, p = 0.0082, p = 0.0007, p = 0.0048, and p < 0.0001, respectively). The number of all follicles was similar between the control and glutathione groups (p < 0.05). When we compared the other groups with the PCOS group, the number of primary, secondary, atretic, and cystic follicles was significantly lower in the metformin and glutathione groups. The number of primordial and antral follicles was significantly higher than in the PCOS group. Conclusions: Glutathione plays anti-inflammatory and antioxidant roles, similar to metformin, by lowering serum IL-6, insulin, testosterone, CRP, and MDA levels; decreasing atretic/cystic follicle count; and improving antral follicle count and folliculogenesis in PCOS patients. [ABSTRACT FROM AUTHOR]

The aim of this research is to examine the effectiveness of individual intervention based on reality therapy in individuals under probation due to substance use. While conducting the research using the mixed-method approach, a single-subject experimental design was employed in the research’s quantitative dimension and employed a case study was done in its qualitative dimension. Two females and five males participated in the research. It was found that following the experimental intervention, there was a tendency for all participants to experience an increase in the levels of love/belonging, power and entertainment needs, as well as partially meeting freedom needs and increasing internal locus of control and responsibility levels. [ABSTRACT FROM AUTHOR]

AbstractThis study’s purpose is to determine the effect of mindfulness-based psycho-education program for parents of children with leukemia on ruminative thought, perceived stress, and well-being. This experimental randomized controlled study was adopted with the parents of children. Mindfulness-based psychoeducation program was applied on online platform with parents. After the intervention, ruminative thinking styles, perceived stress levels and well-being levels of the parents in the experimental group were found to be significantly different from the control group (p < 0.05). The mindfulness-based psychoeducation program applied in this study was found to be effective in reducing ruminative thinking and perceived stress in parents of children diagnosed with leukemia. It was also concluded that the program was effective in maintaining parents’ level of well-being. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate the impact of hypothyroidism and levothyroxine (LT4) treatment on arrhythmic risk by concurrently analyzing multiple electrocardiogram (ECG) parameters such as the Index of Cardio-Electrophysiological Balance (iCEB), frontal QRS-T angle, Tpeak-Tend (Tp-e) interval/QT interval ratio, and QT dispersion (QTd). Methods: This cross-sectional study included 132 adult patients with primary hypothyroidism who had been receiving LT4 treatment, and 132 demographically matched healthy controls. The hypothyroid group was also stratified by thyroid-stimulating hormone (TSH) levels (subclinical <4.5 and overt ≥ 4.5). Participants underwent a series of thyroid function and ECG measurements. Results: The hypothyroid and healthy control groups were matched for age and gender (p = 0.080; p = 0.176). Participants with hypothyroidism had higher Tp-e/QT ratios, iCEB, median frontal QRS-T angle, and corrected QT dispersion (cQTd) than healthy controls (p = 0.004; p = 0.025; p = 0.004; p = 0.004, respectively). In the overt group, the Tp-e/QT ratio, iCEB, and median frontal QRS-T angles were all higher (p = 0.012, p = 0.037, and p = 0.016, respectively). Logistic regression analysis indicated that a higher iCEB score (β = 0.60, p = 0.003) was significant for the detection of arrhythmia risk. ROC analysis showed that iCEB had the highest sensitivity (0.80), moderate specificity (0.60), and AUC 0.70. Conclusion: Patients with hypothyroidism have a higher risk of arrhythmia. To assess this risk, it is important to analyze the Tp-e interval, iCEB, frontal QRS-T angle, and QTd. Differentiating between patients with subclinical and overt hypothyroidism can help minimize the risk of arrhythmia. iCEB is the most effective method for identifying arrhythmic risk. Using all these parameters can improve the accuracy of arrhythmic risk detection in patients with hypothyroidism. [ABSTRACT FROM AUTHOR]

Aims: To investigate the effects of a telerehabilitation program on walking performance, lower and upper extremity function, fall frequency, respiratory function, and satisfaction in individuals with Duchenne muscular dystrophy (DMD). Methods: Thirty children (mean age 8.8 ± 4.2 years) were ambulant (Group 1), and 12 youth (18.5 ± 4.7 years) were non-ambulant (Group 2). The telerehabilitation program was applied by physiotherapists for 24 sessions (3 days/week). The 10-meter walking test, stand up from the supine position test, the modified upper extremity performance test, repetition of Lower and upper extremity movements, and the single breath count (SBC) test were administered. Fall frequency and satisfaction level were also recorded. Results: Significant improvement was found after telerehabilitation in upper extremity performance, repetition of lower and upper extremity movements, fall frequency, and SBC scores in Group 1. Changes in the 10-minute Walk and Stand Up from the Supine Position tests were not significant. There was a significant improvement in SBC scores in Group 2. Satisfaction with the service was 88%. Conclusions: The 8-week telerehabilitation program was effective in improving aspects of upper and lower extremity function, fall frequency, pulmonary function, and satisfaction levels in individuals with DMD. [ABSTRACT FROM AUTHOR]

AbstractCaffeic acid (CA) based polyurethane (PU) films were synthesized and characterized for the simultaneous determination of melatonin (MT) and serotonin (5-HT). The CA based PUs were synthesized using a polyol mixture of 4,4’-diisocyanodiphenylmethane (MPI), polyethylene glycol-200 (PEG), and CA. The PEG–CA monomer units in the polyol were varied in molar ratios of 99:1, 97:3, 95:5, and 90:10. The synthesized PUs were characterized by FTIR spectroscopy and thermal analysis. These CA based PU films were coated onto screen-printed carbon electrodes (SPCEs) with varying thicknesses and used for the simultaneous determination of MT and 5-HT. Electrochemical responses of MT and 5-HT were evaluated using differential pulse voltammetry. The limit of detection and correlation coefficient for MT were 280 µM and 0.9797, respectively, while for 5-HT, the detection was 150 µM with a correlation coefficient of 0.9690. The precision, expressed as the relative standard deviation was 2.633% for MT and 4.668% for 5-HT. These findings suggest that CA based PU-modified electrodes hold potential in medical and biomedical applications. [ABSTRACT FROM AUTHOR]

Objective: Inflamatory processes play an important role in the etiology of psychiatric disorders. The aim of this study was to evaluate inflammatory complete blood count (CBC) parameters in substance use disorder (SUD). Methods: The study included 90 patients with SUD and 90 healthy controls (HC). The Student t-test was used to compare CBC parameters between the groups. The Kruskal – Wallis test was used to compare the data on the basis of substance types. Results: Leukocyte, lymphocyte, and monocyte levels were higher in SUD group than HC. Leukocyte and neutrophil levels of patients with opioid use disorder (OUD) were higher than HC. Platelet levels and neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune inflammation index values were higher in patients with OUD than in patients with non-opioid substance use disorder (nOUD). Moreover, lymphocyte and monocyte levels were higher in patients with nOUD than in HC. Monocyte levels were increased in patients with cannabinoid use disorder compared to HC. Conclusion: The results suggested that inflammatory CBC parameters play an important role in the etiology of SUD according to type of substance. However, there is not enough data for supporting the clinical use of these parameters.. [ABSTRACT FROM AUTHOR]

To provide quality mathematics education for disadvantaged groups of middle school students and continue to offer quality practicum experience to future teachers during the Covid 19 outbreak, we founded the Online Laboratory School. This school was free and open to public school students: 130 middle school students throughout Turkey attended for a 5-week period. There were 25 pre-service teachers actively involved in teaching, under the close supervision of 7 university supervisors. The entire gamut of planning, teaching and reflection sessions for each virtual class were recorded via an e-learning platform. Additionally, survey data was collected from the participating students, parents, pre-service teachers and supervisors. Our findings indicate that we were able to build a unique and virtual learning community. While pre-service teachers and middle school students benefited the most, university supervisors also reported improving their skills on when and how to give feedback. We describe how the school functioned and the range of opportunities it provided to all participants considering situated-learning perspectives and building online-learning communities. We also discuss how this model can be used in the future as a strong asset for teacher education programs and adaptation of fieldwork practices. [ABSTRACT FROM AUTHOR]

AbstractThis article examines the transformation of Direklerarası Street, located on Istanbul’s historical Divanyolu, from the 1720s to the 1920s. Originally built in 1729 as an arasta to generate revenue for Ibrahim Pasha’s madrasa, it featured an innovative architectural style comprising rows of shops facing each other and colonnaded sidewalks. It served as a commercial and social centre for the Janissary Corps until their abolition in 1826. Around the 1860s, Direklerarası integrated into the entertainment and social milieu surrounding Beyazıt Square, particularly during the Ramadan months, and evolved into the primary promenade street of intramural Istanbul with the proliferation of literary cafés, teahouses, and theatres from the 1880s onwards. However, starting from the 1910s, changing socio-cultural and urban dynamics led to the decline of Direklerarası’s reputation and popularity. Conceptualizing Direklerarası as both a spatial entity and a reflection of the cultural dynamics of the late Ottoman capital, this article scrutinizes its transformation driven by social interactions, local entrepreneurship, and political interventions, focusing on spatial experiences, entertainment, spectacle, promenade culture, and clientele. [ABSTRACT FROM AUTHOR]

By using canonical transformation technique, we convert the nonlinear weakly canonical fourth-order delay differential equations into strongly canonical equations. Then we apply oscillation results for canonical equations to get similar results for the studied equation. The significance and novelty of our results are illustrated via numerical examples. [ABSTRACT FROM AUTHOR]

Around 70 percent of cases of Primary Ovarian Insufficiency (POI) etiology remain unexplained. The aim of our study is to contribute to the etiology and genetic background of POI. A total of 37 POI patients and 30 women in the reproductive period were included in this prospective, case-control study between August 2020 and December 2021. The women were examined for 36 genes with next-generation sequencing (NGS) panel. Gene variations were detected in 59.5 percent of the patients in the case group. FSHR p.S680N (rs6166, c.2039 G>A) and FSHR p.A307T (rs6165, c.919 G>A) gene variants, which are most frequently located in exon 10 of the FSHR gene, were detected in both groups. Although it was not found that these gene variants were significantly different between the groups, it was also found that they were significantly different in POI patients under 30 years of age and in those with a family history of POI. Variations were detected in 12 genes in POI patients. Two gene variants (FGFR1 [c.386A>C, rs765615419] and KISS1 [c.58 G>A, rs12998]) were detected in both groups, and the remaining gene variants were detected only in POI patients. No differences were detected between the groups in terms of gene variations. However, the gene variations detected only in POI patients may play a role in the etiology of POI. [ABSTRACT FROM AUTHOR]

Doxorubicin (DOX)-induced cardiotoxicity is a well known clinical problem, and many investigations have been made of its possible amelioration. We have investigated whether diazoxide (DIA), an agonist at mitochondrial ATP-sensitive potassium channels (mitoKATP), could reverse DOX-induced apoptotic myocardial cell loss, in cultured rat cardiomyocytes. The role of certain proteins in this pathway was also studied. The rat cardiomyocyte cell line (H9c2) was treated with DOX, and also co-treated with DOX and DIA, for 24 h. Distribution of actin filaments, mitochondrial membrane potential, superoxide dismutase (SOD) activity, total oxidant and antioxidant status (TOS and TAS, respectively), and some protein expressions, were assessed. DOX significantly decreased SOD activity, increased ERK1/2 protein levels, and depolarised the mitochondrial membrane, while DIA co-treatment inhibited such changes. DIA co-treatment ameliorated DOX-induced cytoskeletal changes via F-actin distribution and mitoKATP structure. Co-treatment also decreased ERK1/2 and cytochrome c protein levels. Cardiomyocyte loss due to oxidative stress-mediated apoptosis is a key event in DOX-induced cytotoxicity. DIA had protective effects on DOX-induced cardiotoxicity, via mitoKATP integrity, especially with elevated SUR2A levels; but also by a cascade including SOD/AMPK/ERK1/2. Therefore, DIA may be considered a candidate agent for protecting cardiomyocytes against DOX chemotherapy. [ABSTRACT FROM AUTHOR]

This study aimed to examine the effects of low-level laser therapy (LLLT) combined with levothyroxine replacement therapy on thyroid function, oxidative stress (OS), and quality of life in patients with Hashimoto's thyroiditis (HT). Forty-six patients diagnosed with HT were randomized to receive active LLLT (n = 23) and sham LLLT (n = 23) twice a week for three weeks. Clinical and laboratory evaluations of the participants were performed before treatment and three months after treatment. Biochemical parameters were taken from the patient file requested by the physician as a routine examination. Malondialdehyde and nitricoxide indicating oxidant stress and superoxide dismutase, catalase, and glutathione, which indicate antioxidant capacity, were used in OS evaluation. The Oxidative Stress Index was calculated by measuring the Total Antioxidant Status and the Total Oxidant Status. At the end of our study, a significant improvement in oxidant and antioxidant biomarker levels showing OS and quality of life was observed in the treatment groups (p < 0.05). There was no change in thyroid function and autoimmunity at the end of the treatment between the two groups (p > 0.05). Improvements in glutathione levels and quality of life were significantly higher in the active treatment group than in the sham-controlled group. LLLT was found to be more effective on OS and quality of life in patients with HT than in patients in the sham-controlled group. It was concluded that LLLT is a safe and effective method that can be used in the treatment of patients with HT. [ABSTRACT FROM AUTHOR]

The aim of this study is to determine the correlation between burnout and parenting self-efficacy and satisfaction with life among academician mothers. Correlational survey model was used in the study. The sample of the study consisted of 385 academician mothers working in universities in Turkey in the 2021–2022 academic year. Personal Information Form, Maslach Burnout Inventory, Satisfaction with Life Scale and Parenting Self-Efficacy Scale Among Mothers were used to collect data. Data were collected through online interview. Mothers’ perceptions of parenting self-efficacy vary depending on how they define being a mother, their titles and long working hours. These variables also caused differences in the feeling of burnout. Additionally, a negative relationship was found between burnout level and parents’ ages. It was concluded that the burnout of academic mothers affected both their self-efficacy and life satisfaction. It is recommended to conduct further studies on academician mothers and to determine support systems that will increase their parenting self-efficacy and satisfaction with life and reduce their feeling of burnout. [ABSTRACT FROM AUTHOR]

Globally, it is evident that vaccination and social media significantly influence the spread of diseases. Research has demonstrated that the spread of diseases can be affected by unforeseen events. Therefore, a stochastic hepatitis B virus (HBV) dynamical model is constructed that incorporates media coverage, while also Lévy noise is included. Itô's formula and the Lyapunov function approach are employed to analyze the existence of a positive global solution. Furthermore, the necessary conditions for disease eradication as well as long-term survival are also established to facilitate the general understanding. The statistics indicate that the media's impact is not immediate and does not lead to disease eradication. To effectively manage the spread of diseases, it is essential to employ a combination of significant noise disruption and a low rate of decline in vaccine effectiveness. Numerical simulations are conducted to demonstrate the analytical findings. [ABSTRACT FROM AUTHOR]

This study focuses on the nonlinear fractional functional integral equation (FFIE) concerning the Riemann-Liouville operator. In certain weaker conditions, the authors demonstrate that the FFIE has a solution, which is defined within the Banach algebra $ C [0, a], a>0 $ C [ 0 , a ] , a > 0. Our analysis relies on the Petryshyn's fixed point theorem and the notion of measure of non-compactness (MNC). In addition, our results include numerous authors' work under less restrictive conditions. Furthermore, we provide an illustrative example of fractional functional integral equations to support our proven results. [ABSTRACT FROM AUTHOR]

Our article proves inequalities for interval optimization and shows that feasible and descent directions do not intersect in constrained cases. Mainly, we establish some new interval inequalities for interval-valued functions by defining LC-partial order. We use LC-partial order to study Karush–Kuhn–Tucker (KKT) conditions and expands Gordan's theorems for interval linear inequality systems. By applying Gordan's theorem, we can determine the best outcomes for interval optimization problems (IOPs) that have constraints, such as Fritz John and KKT conditions. The optimality conditions are observed with inclusion relations rather than equality. We can use the KKT condition for binary classification with interval data and support vector machines(SVMs). We present some examples to illustrate our results. [ABSTRACT FROM AUTHOR]

The Cream-coloured Courser, a bird species well adapted to desert environments, is known to breed in the Middle East and northern Africa. However, a new breeding area has been discovered at Tuz Gölü in central Anatolia, Turkey. The breeding area is located in a Specially Protected Area with saline soil and sparse vegetation. The presence of the Cream-coloured Courser in this area is a recent development, as local residents were not previously aware of the species. This finding highlights the importance of systematic monitoring and local ecological knowledge in understanding shifts in species distribution. [Extracted from the article]

We present two sufficient conditions for the oscillatory behaviour of a class of noncanonical fourth-order dynamic equations on arbitrary time scales. An illustrative example is included to show that new criteria improve related results reported in the literature. [ABSTRACT FROM AUTHOR]

Insulin resistance (IR) is a significant metabolic disturbance that plays a pivotal role in various health conditions, including hypothyroidism. Homeostatic Model Assessment For Insulin Resistance (HOMA-IR) is widely used for assessing IR. However, alternative indices, such as the Metabolic Score for Insulin Resistance (METS-IR), have been developed for diverse applications. This study aimed to meticulously investigate IR in patients with hypothyroidism and to compare the effectiveness of METS-IR with HOMA-IR. To enrich our analyses, additional metrics, including the Triglyceride Glucose (TyG) Index, the Triglyceride to High-Density Lipoprotein Cholesterol Ratio (TG/HDL-C), and the Quantitative Insulin Sensitivity Check Index (QUICKI) have been incorporated. This cross-sectional study included 260 non-diabetic adults, 130 with hypothyroidism (case group), and 130 healthy volunteers (control group). Parameters, including Thyroid-Stimulating Hormone (TSH), free thyroxine (T4), fasting blood glucose, HbA1c, insulin levels, and lipid profiles, were measured. IR indices were calculated. The groups were matched for age and gender (p =.143; p =.099). The case group demonstrated a notably elevated mean METS-IR of 195.58, in contrast to the control group's mean METS-IR of 131.10 (p =.044). The mean HOMA-IR was significantly higher in the case group than in the control group, with average of 2.00 and 1.81, respectively (p =.027). METS-IR was positively correlated with TyG (r = 0.505, p =.001) and TG/HDL-C (r = 0.844, p =.001). Meanwhile, the relationships between METS-IR, HOMA-IR, and QUICKI were significant at r = 0.194 (p =.027) and r =.210 (p =.016), respectively. METS-IR was significantly higher in patients with overt hypothyroidism (p =.016). This study emphasizes the efficacy of METS-IR as a diagnostic tool for IR in patients with hypothyroidism, establishing it as a proficient alternative to HOMA-IR. These findings were substantiated by the correlations observed with the TyG, TG/HDL-C, and QUICKI measurements. Variations in METS-IR between individuals with subclinical and overt hypothyroidism accentuate its effectiveness in identifying metabolic abnormalities in hypothyroid conditions. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate anxiety, postpartum depression (PPD), and hopelessness in the mothers of newborns receiving therapeutic hypothermia for hypoxic ischemic encephalopathy (HIE) in NICU. A total of 104 mothers and infants were analyzed as a study group with HIE (n = 52) and a control groups of non-HIE (n = 52). All the mothers completed The State-Trait Anxiety, Beck Hopelessness and Edinburgh Postpartum Depression Scales (EPDS). The EPDS scores, the rate of PPD, state-trait anxiety and hopelessness levels were similar in the two groups. In the HIE group, chest compression and persistent pulmonary hypertension in infants were associated with maternal anxiety, hopelessness, and PPD. The absence of a statistical difference between the two groups in the current study does not mean that these differences do not exist. These results demonstrate the need for further detailed studies on this subject. [ABSTRACT FROM AUTHOR]

This study assessed postoperative mortality, morbidity, and complications associated with anesthesia administration for gynecologic oncology abdominal surgery and investigated the risk factors for the development of these complications We conducted a retrospective cohort study analyzing the data of patients who underwent elective gynecologic oncology surgery between 2010 and 2017. The demographic data; comorbidities; preoperative anemia; Charlson Comorbidity Index; anesthesia management; complications; preoperative, intraoperative, and postoperative periods; mortality; and morbidity were investigated. The patients were classified as surviving or deceased. Subgroup analyses of patients with endometrial, ovarian, cervical, and other cancers were performed. We analyzed 416 patients; 325 survived and 91 were deceased. The postoperative chemotherapy rates (p < 0.001), and postoperative blood transfusion rates (p = 0.010) were significantly higher in the deceased group, while the preoperative albumin levels were significantly lower in the deceased group (p < 0.001). Infused colloid amount was higher in the deceased group of endometrial (p = 0.018) and ovarian cancers (p = 0.017). Perioperative patient management for cancer surgery requires a multidisciplinary approach led by an anesthesiologist and surgeon. Any improvement in the duration of hospital stay, morbidity, or recovery rate depends on the success of the multidisciplinary team. Cancer surgeries in the female reproductive system can sometimes cause severe complications, including death. Proper anesthesia management is crucial to reducing such negative outcomes. This study looked at patient records to understand the factors that led to bad results with anesthesia. Researchers focused on both pre-surgery preparations and post-surgery care. They found that factors like needing a blood transfusion, wound infections, getting chemotherapy after surgery, and low blood albumin levels increased the death rate. Strict monitoring of fluid balance and blood circulation during surgery improved survival chances. The work begins long before the operating theater. Anesthesiologists should carefully assess patients before surgery, and teamwork between the anesthesiologist and surgeon is vital throughout treatment. Identifying risks, taking precautions, and minimizing high-risk interventions can decrease the days passed at the hospital, improve recovery, and reduce deaths from surgery complications. [ABSTRACT FROM AUTHOR]

Background: Opioid use disorder (OUD) is associated with significant functional impairment and neurocognitive dysfunction, but only a handful of studies have investigated social cognitive abilities in this condition. This study aimed to investigate facial emotion recognition accuracy/biases and two different aspects of theory of mind (ToM) (ToM-decoding vs ToM-reasoning) in people with recovered OUD. Methods: The participants included 32 people with recovered OUD who were on Buprenorphine + Naloxone (B/N) maintenance treatment and 32 healthy controls. In addition to neurocognitive tasks, both groups were assessed by a facial emotion recognition task, the faux pas recognition task, and the reading the mind from the eyes task. Results: In comparison to healthy controls, people on B/N maintenance treatment showed deficits in facial emotion recognition (d = 1.32) and both aspects of ToM (d = 0.87–1.21). In analyses of individual emotions, people on B/N maintenance treatment had decreased accuracy in recognition of anger and fear and had a bias to identify other emotions as sad. The duration of opioid use was robustly associated with difficulties in the recognition of anger. Conclusion: People in B/N maintenance treatment have significant difficulties in recognizing the emotions and mental states of others. Deficits in social cognition might be important for understanding the difficulties in interpersonal and social functioning in people with OUD. [ABSTRACT FROM AUTHOR]

In this manuscript, a Bazykin–Berezovskaya model with diffusion by strong Allee effects is studied. Neumann boundary conditions are used to see the positive solution of a diffusion system. Local stability analyses are discussed for all the equilibrium points. The analysis of stability for the proposed scheme is also given. Implicit finite difference schemes like: Euler, Crank–Nicolson (CN) and non-standard finite difference (NSFD) are used to verify the simulation by numerically. A comparison reveals that NSFD method is unconditionally stable for any temporal step-size. [ABSTRACT FROM AUTHOR]

Our main concern in this study is to present the generalized results to investigate the existence of solutions to nonlinear fractional boundary value problems (FBVPs) with generalized nonlinear boundary conditions. The framework of the presented results relies on the lower and upper solutions approach which allows us to ensure the existence of solutions in a sector defined by well-ordered coupled lower and upper solutions. It is worth mentioning that the presented results unify the existence criteria of certain problems which were treated on a case-by-case basis in the literature. Two examples are supplied to support the results. [ABSTRACT FROM AUTHOR]

This research was planned to investigate the relationship between physical activity level and plantar sensitivity, static and dynamic balance in postmenopausal women. Forty women between the ages of 50 and 65, who had not had a menstrual period for at least 12 months, and who had undergone menopause due to hormonal, surgical or natural means were involved in the research. International Physical Activity Questionnaires Short Form (IPAQ-SF) was used to assess the level of physical activity. Light touch pressure threshold on soles of the individuals and two-point discrimination sense were evaluated bilaterally from 6 different regions of the sole of the foot. Single leg and tandem stance tests were used for static balance assessment. Dynamic balance was evaluated with Berg Balance Scale (BBS) and Timed Up and Go Test (TUG). As a result of the statistical analysis, a negative correlation was found between the total physical activity level of the participants and the light touch pressure of the right big toe. There was a significant negative correlation between total physical activity level and left big toe, and the 1st and 5th metatarsal heads of the left foot. A significant negative correlation between total physical activity level and TUG test was detected. However, no significant difference between total physical activity and BBS, static balance tests was found. As a result of this research, it was concluded that the level of physical activity affects the light touch sense of big toes of both feet, and the 1st and 5th metatarsal heads of left foot. During this study, it was seen that if total physical activity level decreases, then the score of TUG can increase. Physical activity level and related factors should be examined with a larger number of samples. [ABSTRACT FROM AUTHOR]

This article explores the rise of etiquette books in late Ottoman world as a genre and analyses the emergence of this literature in late nineteenth century as the response of Ottomans to the age of civility in etiquette and lifestyle. It discusses the attitudes and approaches of the Ottoman authors in composing etiquette book, creating content and defining the etiquette by addressing the particular conditions of the late Ottoman socio-cultural milieu. By studying etiquette books as a genre representing the realms of aspirations, ideals and visions, this article reveals insights into how Ottoman authors defined the Ottoman etiquette under the increasing impact of European lifestyle and how they confronted, negotiated and coped with the predicaments of alla franca. [ABSTRACT FROM AUTHOR]

The method for predicting the risk of intubation in patients with coronavirus disease 2019 (COVID-19) is yet to be standardized. This study aimed to introduce a new disease prognosis scoring model that may predict the intubation risk based on the symptoms, signs, and laboratory tests of patients hospitalized with the diagnosis of COVID-19. This cross-sectional retrospective study analyzed the intubation status of 733 patients hospitalized with COVID-19 diagnosis between March and December 2020 at Ondokuz Mayıs University Faculty of Medicine, Turkey, based on 33 variables. Binary logistic regression analysis was used to select the variables that significantly affect intubation, which constitute the risk factors. The Chi-square Automatic Interaction Detection algorithm, one of the data mining methods, was used to determine the threshold values of the important variables for intubation classification. The following variables found were mostly associated with intubation: C-reactive protein, lactate dehydrogenase, neutrophil-to-lymphocyte ratio, age, lymphocyte count, and malignancy. The logistic function based on these variables correctly predicted 81.13% of intubated (sensitivity), 99.52% of nonintubated (specificity), and 96.86% of both intubated and nonintubated (accurate classification rate) patients. The scoring model revealed the following risk statuses for the intubated patients: very high risk, 75.47%; moderate risk, 20.75%; and very low risk, 3.77%. On the basis of certain variables measured at admission, the OTO-COVID-19 scoring model may help clinicians identify patients at the risk of intubation and subsequently provide a prompt and effective treatment at the earliest. [ABSTRACT FROM AUTHOR]

The removal of paracetamol pharmaceutical from the aqueous solution by activated carbon prepared from wood sawdust (WSAC) was studied in the current research. The Response Surface Methodology (RSM) was used to model WSAC paracetamol removal, optimize operational parameters, and determine the impact of operational parameters such as adsorbent dosage, initial concentration of paracetamol, and contact time. According to the results of variance analysis (ANOVA), the quadratic model was statistically significant (P < 0.0001), and the determination coefficient value (R2=0.9847) was high. The high determination coefficient value of the quadratic model indicated that the experimental results adapted well with the predicted results, that is, the model was valid for envisaging the experimental results. The optimum conditions were obtained to be 0.16 g/100 mL WSAC dosage, 11.52 mg/L initial paracetamol concentration, and 90.52 min contact time by the desirability function, resulting in the paracetamol removal of 99.24%. The results of the isotherm studies indicated that the isotherm equations of Langmuir, Temkin, and Dubinin all fit the paracetamol adsorption data. The maximum adsorption capacity (qmax) of WSAC was calculated as 15.90 mg/g using the Langmuir isotherm equation. Kinetic study results revealed that the pseudo-second-order kinetic model adapted well to the paracetamol adsorption data. [ABSTRACT FROM AUTHOR]

Antibacterial polyurethanes as wound-dressing material with high biocompatibility and thermal stability were developed from polyethylene glycol-200 (PEG200), 4,4′-methylenebis(cyclohexyl isocyanate) (HMDI) and β-cyclodextrin (βCD). βCD was preferred in this material because of providing biocompatibility and supporting the absorption/desorption characteristics of ciprofloxacin due to its hydrophobic gap. The β-cyclodextrin-PEG based polyurethane structures (PU-200-βCDs) was synthesized with different β-cyclodextrin:PEG:HMDI ratios. PU-200-βCDs were characterized by FTIR spectroscopy, thermal analysis, SEM, and water contact angle techniques. The biocompatibility property of polyurethane materials was determined according to the indirect cytotoxicity assay results and the PU-200-βCDs exhibited cell viability ranging from, 83.04 ± 7.28% to 99.73 ± 10.3% against L-929 cells. The hydrolytic degradability test was applied to the highest biocompatible PU-200-βCD3 structure. The mass loss of PU-200-βCD3 was determined 4.75 ± 0.86% at the end of the 28-day. Antibacterial properties of ciprofloxacin doped PU-200-βCD3 were investigated using Escherichia coli and Bacillus subtilis. The ideal polyurethane structure was selected according to its biocompatibility and antibacterial properties. This polyurethane structure was converted into wound dressing material via electrospinning technique. The obtained dressing material showed mechanical stable fiber structure. Therefore, prepared β-cyclodextrin-PEG-based polyurethane structure can be suitable for the production of wound-dressing material due to its good ciprofloxacin release properties, high stability and biocompatibility. [ABSTRACT FROM AUTHOR]

It is possible to use plant-derived antioxidant molecules in the form of dietary supplements. However, dietary supplement–drug interaction pattern has not been well defined for most of these products. The aim of this study was to determine the effects of berberine, resveratrol, and glibenclamide on xenobiotic metabolizing enzyme activities in diabetic rats. Streptozotocin was administered to create experimental diabetes. Resveratrol (5 mg/kg) (R), glibenclamide (5 mg/kg) (G), and berberine (10 mg/kg) (B) were administered individually or in combinations in DMSO by intraperitoneal administration route to the diabetic rats. DMSO was also given to non-diabetic control (C) and diabetic control (D) groups. Livers of rats were taken under anesthesia at the end of the treatment period (12 days). Ethoxyresorufin O-deethylase (EROD), pentoxyresorufin O-depentylase (PROD), aniline 4-hydroxylase (A4H), erythromycin N-demethylase (ERND), glutathione S-transferase (GST), catalase (CAT), and glutathione reductase (GR) activities were measured in microsomes and cytosols. In addition, histomorphological studies were also performed in the liver tissues. EROD activity of D+R was significantly higher than C and D+R+B. PROD activity of D+R was significantly higher than C, D, D+R+G, D+R+B, and D+R+B+ G. PROD activity of D+B was significantly higher than C and D+R+B. ERND activity of D+R was significantly higher than D+R+G and D+R+B. GST activity of D+R was significantly higher than D+R+G. CAT activity of D+B was significantly lower than C. It is clear that co-administration of resveratrol, berberine, and glibenclamide modifies some of the important xenobiotic metabolizing enzyme activities. Resveratrol and berberine have the potential to cause dietary supplement–drug interaction. [ABSTRACT FROM AUTHOR]

Myofascial Pain Syndrome (MPS) is known as a chronic pain syndrome, which is often associated with decreased life quality, depressive, and anxiety disorders. Affective temperament characteristics are mental illness signs that may assist in anticipating and detecting a tendency to depression and anxiety in MPS. The properties and impacts of affective temperament on pain, disability, life quality, depressive, and anxiety disorders in MPS patients were intended to explore by this study. This case-control study was carried out in the physical medicine and rehabilitation clinic of a university hospital, Turkey, from October 2018 to January 2019 with 51 MPS patients and 47 healthy controls (HC). Physical examination, clinical history, visual analog scale (VAS), neck disability index (NDI), Short Form (36) Health Survey (SF-36), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego- Autoquestionnaire (TEMPS-A) scale were performed for all volunteers. TEMPS-A depressive, cyclothymic, and anxious scores were remarkably higher in MPS patients than in the HC group. In MPS patients, SF 36 physical and mental health summary scores were remarkably lower than the control group. Additionally, BDI and BAI scores were significantly higher in patients with MPS than in the control group. There was a significant positive correlation between depressive and anxious temperament scores and NDI. Moreover, a negative correlation was found between the SF36 physical health summary score and depressive and anxious temperament scores. Also, the mental health summary score was negatively correlated with depressive, cyclothymic, and anxious temperament scores. This research assesses for the first time of the affective temperament characteristics of MPS patients. Myofascial pain syndrome patients have distinct temperaments than the control group. Myofascial pain syndrome patients had remarkably higher TEMPS-A depressive, cyclothymic, and anxious scores than the healthy control group. Life quality, clinical severity, and courses can be affected by differences in temperament. Clinicians can readily apply the TEMPS-A temperament scale in patient application to demonstrate these differences. The anticipation of a psychiatric situation plays a more significant role in evaluating the higher mood symptom rates and their effect on life quality. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate prospective middle school mathematics teachers' proportional reasoning before and after receiving a practice-based instruction based on proportional reasoning. The Proportional Reasoning Test, semi-structured interviews and observations of student teachings were used to collect data about the participants' proportional reasoning. The results indicated that prospective teachers improved their proportional reasoning by completing a practice-based instruction. Before the instruction, they generally applied algebraic procedures without associating meaning and used a limited number of strategies to solve problems. Furthermore, they had difficulties in distinguishing proportional from nonproportional situations. However, by the end of the instruction, while they mostly preferred to use informal strategies, they relied less on formal strategies. Additionally, they utilized a broader range of strategies to solve problems and made sense of these strategies. Further, they could determine whether the quantities in a situation were related additively, multiplicatively, or in some other way. [ABSTRACT FROM AUTHOR]

Brainstem involvement (BSI) has been reported as a major predictive factor for future disability in Multiple Sclerosis (MS). To evaluate whether Cervical Vestibular Evoked Myogenic Potentials (cVEMPs) and Video Head Impulse Test (vHIT) can be used to detect demyelinating lesions in vestibular pathways in MS. Fifty three people with MS and 40 controls were evaluated with Dizziness Handicap Inventory (DHI), vHIT and cVEMP. The median value of DHI in MS group was significantly higher than controls (p<.001). According to vHIT results, while the results of horizontal canal vestibulo-ocular reflex gain in group with brain stem involvement (gBSI (+)) were significantly different from both controls and group without brain stem involvement (gBSI (−)) (p=.036 and.024, respectively), results of gBSI (−) were similar with controls (p=.858). When cVEMP results were examined, mean P1 wave latency in gBSI (+) was significantly longer than controls (p=.002), but difference between gBSI (−) and controls and gBSI (+) was not statistically significant (p=.104 and.279, respectively). vHIT and cVEMP can be used in diagnosis and follow-up of people with MS without demyelinating brainstem lesions on MRI. [ABSTRACT FROM AUTHOR]

In the current work, we deal with a class of stochastic time-fractional integral equations in Hilbert space by studying their well-posedness and regularity. Precisely, we use the celebrity fixed point theorem to prove the well-posedness of the problem by imposing the global Lipschitz and the linear growth conditions. Further, we prove the spatial and temporal regularity by imposing only a regularity condition on the initial value. An important example is considered in order to confirm and support the validity of our theoretical results. [ABSTRACT FROM AUTHOR]

We investigate a new class of boundary value problems of a nonlinear coupled system of sequential fractional differential equations and inclusions involving Caputo fractional derivatives and boundary conditions. We use standard fixed-point theory tools to deduce sufficient criteria for the existence and uniqueness of solutions to the problems at hand. Examples are discussed to illustrate the validity of the proposed results. [ABSTRACT FROM AUTHOR]

Obsessive-compulsive disorder (OCD) is a condition characterized by obsessions and/or compulsions. S100B protein is shown to be involved in microglial activation besides intracellular signaling, intercellular communication and cell growth. The relation between S100B protein and various psychiatric disorders except OCD has been studied so far. This study aimed to analyze serum S100B levels for the first time in medication naive OCD diagnosed children and adolescents and to compare them with the control group. Peripheral blood S100B levels of 27 children and adolescents with OCD were compared to 27 control group subjects to assess any possible association between OCD and S100B levels. All the children and adolescents completed the child version of the Obsessive-Compulsive Inventory (OCI - CV). Compared to control group, higher serum S100B levels were found in OCD group (z = −2.258, p = 0.024). We also found that obsessing and washing subscales' scores and total score of OCI - CV were statistically significantly correlated with S100B levels (respectively, r =.292, p = 0.032; r =.306, p = 0.025; r =.296, p = 0.030). The present study's findings are in accord with previous studies demonstrating the significance of S100B protein in other psychiatric disorders and suggesting a relation in children and adolescents with OCD for the first time. The role of S100B protein in OCD etiology and pathogenesis should be evaluated further. [ABSTRACT FROM AUTHOR]

Keratoconus is the most common corneal ectatic disease and the most common cause of corneal transplantation in developed countries. The etiopathogenesis of the disease remains unclear. The human body hosts a remarkably abundant and diverse community of microbial species called microbiota. Advances in next-generation sequencing (NGS) technology and bioinformatics have facilitated the characterization of human microbiota. Previous studies have shown that there is an alteration of ocular microbiota in inflammatory and autoimmune ocular diseases. The purpose of this review article is to evaluate the potential effect of ocular microbiota on the pathophysiology of keratoconus. Recent studies have shown the low-level chronic inflammatory process in keratoconus. A regulatory interaction has been demonstrated between human microbiota and Toll-like receptors, which are innate immune system receptors. In addition, Toll-like receptor activity in keratoconus has been shown to be higher than in normal individuals. Therefore, the alteration of ocular microbiota may have a potential role in keratoconus etiopathogenesis. Further research is required on this subject. [ABSTRACT FROM AUTHOR]

We aimed to explore whether the mental health status of professional athletes was affected by the isolation period in which organized sports were suspended due to the COVID-19 pandemic. A total of 612 volunteers between the ages of 18–38 enrolled in the study, 418 of them were athletes engaged in team sports or individual sports and 194 of them were non-athletes. Participants completed the Depression – Anxiety – Stress Scale 21 (DASS-21), the Impact of Events Scale-Revised (IES-R) and International Physical Activity Questionnaires (IPAQ). Non-parametric methods were used for comparisons between groups. The presence of a linear relationship was tested with the Spearman Correlation Test. A value of p < 0.05 was accepted statistically significant. A total of 571 participants, 372 males and 199 females, completed the study. Depression and anxiety symptoms were lower in athletes compared to non-athletes (p < 0.05). Depression, anxiety and stress symptoms were similar in team athletes and individual athletes (p = 0.232, p = 0.444, p = 0.116; respectively). The post-traumatic stress symptoms were lower in male team athletes than female team athletes (p = 0.020) and non-athletes (p < 0.001). Depression, anxiety and stress symptoms were found to be similar in men and women (p > 0.05). There was a negative correlation between physical activity level and mental health symptoms (p < 0.05). The mental health status of athletes was better than non-athletes, and the positive effect of sport, which was done until the break due to the isolation period, on mental health continued. These findings show that physical activity may help to protect mental health. [ABSTRACT FROM AUTHOR]

This study investigated patients who underwent bilateral hypogastric artery ligation (BHAL) due to postpartum haemorrhage (PPH). Patients who underwent BHAL because of PPH following a conservative treatment were included in this study. Placental abnormalities were referred to as placenta accreta. A total of 130 BHAL procedures took place at the study hospital as a result of PPH. Of these, 39 (30%) were referred to the hospital. The rate of BHAL requirement was 62 out of 10,000 births. Among the 130 patients, the most frequent indication for BHAL was placenta accreta (58.5%). Haematological parameters were poorer among the referral patients. Four of the exitus patients (80%) were referral patients. The mortality rate among the referral patients was 10.25%, whereas this rate was only 1.01% among the patients who gave birth at the hospital. PPH is a life-threatening condition that requires immediate medical attention. BHAL, with its fertility-preserving features, is a good option that can be employed in all PPH patients. BHAL not only preserves patients' fertility, but it also gives them a higher chance of survival.IMPACT STATEMENTWhat is already known on this subject? PPH is a life-threatening condition. Due to the worldwide increase in caesarean sections, placenta accreta has also increased. BHAL is a vital treatment method for PPH.What do the results of this study add? Placenta accreta is one of the most common causes of PPH. Traditional hysterectomy rates can be reduced by replacing this treatment with BHAL in this group of patients. Without early intervention in PPH, a patient's mortality risk can increase by up to 10 times. As research and surgeons' experience grows, PPH can be controlled with treatments with less complex modalities without the need for BHAL.What are the implications of these findings for clinical practice and/or further research? The need for BHAL should be kept in mind when addressing PPH, especially in cases of placenta accreta. The need for hypogastric artery ligation, which is a more aggressive treatment for the surgical correction of the pathology, can be reduced as surgeons' experience increases. Early intervention and/or referral in cases of PPH is of great importance. [ABSTRACT FROM AUTHOR]