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Hepatitis-associated aplastic anemia (HAA) is a form of acquired aplastic anemia (AA) in which bone marrow failure develops after an acute attack of hepatitis. Bone marrow failure leading to AA is generally severe in cases of HAA and fatal if left untreated. This retrospective multicenter study investigated clinical and laboratory characteristics, possible causes, treatment, and outcome of HAA in children. Twenty patients from 8 centers were included in the study. Aspartate aminotransferase and alanine aminotransferase were 10×ULN in 16 patients. Acute liver failure developed in 5 (29%) patients. Pancytopenia was simultaneously present in 6 of 20 (30%) patients. Eleven of the 20 patients (55%) were alive, in remission and transfusion free. Those who were alive either had undergone hematopoietic stem cell transplantation and/or immunosuppressive treatment, except 1 patient who had received no treatment. Patients with the diagnosis of acute hepatitis should be evaluated and followed up carefully for presence of cytopenia, so that definitive treatment of AA can be initiated in a timely and appropriate manner when needed. Copyright r 2021 Wolters Kluwer Health, Inc. 34669357

The main objective of this study was to provide an overview of the current practice for transverse mandibular and maxillary discrepancies in the Netherlands using a web-based survey. Orthodontists (ORTHO) and Oral and Maxillofacial Surgeons (OMFS) in the Netherlands were invited to the web-based survey via their professional association. Three cases were presented which could be treated non-surgically and surgically. Participants were asked what treatment they preferred: no treatment, orthodontic treatment with optional extractions or surgically assisted orthodontic treatment. The web-based survey ended with questions on various technical aspects and any experienced complication. Invitation was sent to all 303 members of professional association for ORTHO and to all 379 members of professional association for OMFS. Overall response number was 276 (response rate of 40.5%), including 127 incomplete responses. Generally, ORTHO prefer orthodontic treatment with optional extractions and OMFS lean towards surgically assisted orthodontic treatment. Mandibular Midline Distraction appears to be less preferred, possibly due to lack of clinical experience or knowledge by both professions despite being proven clinical stable surgical technique with stable long-term outcomes. There seems to be consensus on technical aspects by both professions, however, there are various thoughts on duration of consolidation period. Complications are mostly minor and manageable.

This study aimed to biochemically and histopathologically investigate the effect of sunitinib on oxidative testicular damage induced by ischemia/reperfusion in rats.Experimental animals were divided into three groups of six rats each: testicular torsion-detorsion (TTD), sunitinib+testicular torsion-detorsion (STD), and sham control (SC). Sunitinib (25mg/kg) was administered orally to the STD group by gavage. Normal saline (0.9% NaCl) was administered orally to the TTD and control groups as the solvent. One hour after administration of sunitinib and 0.9% NaCl, all animal groups were done torsion-detorsion. Then, all the rats were killed by high-dose anesthesia, and their testicles were removed. Biochemical and histopathological examinations were performed on the removed testicular tissues.Malondialdehyde; it was observed that the results in the STD group were close to those of the SC group and statistically significant lower compared to the TTD group (p=0.001). The glutathione values were statistically significantly higher in the STD group compared to the TTD group (p0.001). Nuclear factor kappa B values, revealing a statistically significant difference between the TTD and STD groups (p0.001). The TNF-α levels were measured and indicating that the results of the STD group were statistically significantly lower than those of the TTD group (p0.001). Histopathologically, animal tissues given sunitinib were observed to resemble normal tissues.Sunitinib was shown to prevent histopathological changes in testicular tissue against ischemia/reperfusion damage.

Introduction The purpose of this study was to identify the relation of daily prosthesis usage time (DPUT) of individuals with amputation with quality of life (QoL) questionnaires. Methods The research was carried out on 125 individuals with amputation. Prosthetic-related parameters were searched, as well as demographic data. A generic (Nottingham Health Profile [NHP]) questionnaire and a questionnaire specific to individuals with amputation (Trinity Amputation and Prosthesis Experience Scales [TAPES]) QoL measurements were used. Results Ninety-one males and 28 females with a mean age of 42.4 ± 14.7 years participated in the study. The average DPUT was 11.1 ± 4.4 hrs/d. Study results showed that there was significant correlation between both of the QoL questionnaires (NHP and TAPES) and DPUT. High correlation was determined between DPUT and NHP total score and NHP-Pain, and very high correlation was found between DPUT and NHP-Physical Activity subscale. A moderate negative correlation was found between DPUT and NHP-Energy Level, NHP-Emotional Reaction, NHP-Social Isolation, and NHP-Sleep. A moderate negative correlation was found between DPUT and TAPES-Activity Restriction. A high correlation was found between DPUT and residual limb pain, prosthetic satisfaction, time interval after amputation, and number of prosthetic fittings. A moderate correlation was found between DPUT and walking aids, whereas a poor relationship was shown between phantom pain and DPUT. Conclusions This study showed that "the average DPUT"may be used in terms of short assessment of QoL of individuals with amputation. The outcomes of this study pointed out that especially prosthetic-related parameters affected the QoL in individuals with amputation. In problems resulting from routine assessment and questionnaires having so many items, a single-item question, "the average DPUT,"may be used effectively in a shorter period and is helpful for organizing a rehabilitation program. Clinical Relevance A single-item question, "The average daily prosthesis usage time (DPUT),"be used effectively in a shorter assessment of quality of life of individuals with amputation and is helpful for organizing a rehabilitation program. © Lippincott Williams & Wilkins.

While data on the efficacy and safety of continuous glucose monitoring (CGM) exist across a broad age spectrum, it is limited in very young children with type 1 diabetes (T1D). We aimed to assess real-world data in this high-risk population, focusing on glycemic variability and metrics beyond HbA1c. A 12-month multi-national, prospective, observational, registry-based cohort study in children with T1D aged 1-7 years compared glucose control using real-time CGM and using fingerstick blood glucose monitoring (BGM) alone. The prespecified primary endpoint was a difference in coefficient of variation (CV) between the CGM users and BGM-only cohort. Among 227 individuals using insulin pumps (42% female, age 5.3 years), 175 were CGM and 52 were BGM-only users. The median (IQR) CV was 39.1% (36.6-41.9) among CGM and 46.8% (42.3-51.2) among BGM-only users (P

Personality analysis is an important area of research in several fields, including psychology, psychiatry, and neuroscience. With the recent dramatic improvements in machine learning, it has also become a popular research area in computer science. While the current computational methods are able to interpret behavioral cues (e.g., facial expressions, gesture, and voice) to estimate the level of (apparent) personality traits, accessible assessment tools are still substandard for practical use, not to mention the need for fast and accurate methods for such analyses. In this study, we present multimodal deep architectures to estimate the Big Five personality traits from (temporal) audio-visual cues and transcribed speech. Furthermore, for a detailed analysis of personality traits, we have collected a new audio-visual dataset, namely: Self-presentation and Induced Behavior Archive for Personality Analysis (SIAP). In contrast to the available datasets, SIAP introduces recordings of induced behavior in addition to self-presentation (speech) videos. With thorough experiments on SIAP and ChaLearn LAP First Impressions datasets, we systematically assess the reliability of different behavioral modalities and their combined use. Furthermore, we investigate the characteristics and discriminative power of induced behavior for personality analysis, showing that the induced behavior indeed includes signs of personality traits.

Purpose: The study aims to investigate the impact of financial derivatives use on bank risk. For this purpose, the banks operating in D-8 countries, are investigated. Design/Methodology: While the relationship between the bank risk and derivative utilize is examined, some of the bank-specific control variables are added to the model. Due to the sample structure and endogeneity problem in the study, hypotheses were tested again by using Generalized Moments Method. Findings: The analysis results showed a statistically significant and negative relationship between financial derivative use and bank risk and using financial derivatives is reduced the bank's risk. Limitations: From D-8 countries, Iran and Bangladesh were excluded from the study because of the inaccessibility of the data related to the financial derivatives. Originality/Value: While the relationship between "Banking Risk and Use of Derivative Financial Instruments" in the literature is mainly tested in developed countries, there is a gap in the literature on how this relationship is in developing countries. This study aims to contribute to the literature by revealing the relationship between the use of financial derivatives and bank risk in D-8 countries, which are classified as developing countries.

Background: Metabolic or non-metabolic many bone diseases can be distinguished in sickle cell anemia. Patients with sickle cell anemia have a high risk of osteopenia and osteoporosis. The aim of this study is to reveal bone mineral density abnormalities and related factors in patients with sickle cell anemia. Methods: A total of 70 patients with sickle cell anemia were retrospectively included in our study. Complete blood count (CBC) parameters, serum creatinine, lactate dehydrogenase (LDH), total bilirubin, direct bilirubin, uric acid, calcium, phosphorus, parathormone, alkaline phosphatase, 25 (OH) vitamin D, ferritin, C reactive protein (CRP) and calculated bone mineral densitometry measurements by Dual-Energy X-ray Absorptiometry (DEXA) were assessed and recorded to the statistics program. We diagnosed osteopenia and osteoporosis according to World Health Organization (WHO) criteria. To determine the status of avascular necrosis and bone fracture, we examined x-ray and magnetic resonance imaging reports and epicrisis reports of patients from the records. Results: The average age was 30.01 ± 8.64 years. Eighteen (26.5%) of the 68 patients whose Z-score was evaluated by DEXA had bone mass below the expected age-related range according to the Z score, while 50 (73.5%) had bone mass within the expected age-related range. Of the patients whose T score was evaluated by DEXA, 46.8% were normal (n=29), 45.1% were osteopenic (n=28) and 8.1% were osteoporotic (n=5). Conclusion: Patients with sickle cell anemia are at increased risk for osteoporosis, osteopenia, and osteomalacia. Bone health should be emphasized in these patients.

Objective: Hypoglycemia is a common acute complication of type 1 diabetes (T1D), which may cause seizure, loss of consciousness, and temporary motor or sensory impairment. Glucagon administration is an effective way of treating severe hypoglycemia, especially in a free-living setting. Nonetheless, families have difficulties in managing severe hypoglycemia due to their anxiety and challenges with current glucagon administration techniques. The aim of the current study was to explore the associations between parental fear of hypoglycemia (FoH) and their general anxiety level, and in particular, their attitudes towards and thoughts on glucagon administration. Methods: Parents of children with T1D completed questionnaires assessing background and clinical information, FoH, generalized anxiety disorder (GAD) and parental anxiety for glucagon administration (PAGA). Results: sixty-eight parents participated. Positive correlations were found between parental GAD-7 score and both FoH and the number of night-time blood glucose measurements and there was a negative correlation with the child's age. Parents mean self-evaluation score of their competence in glucagon administration was 6 (standard deviation +/- 2.9) on a scale of 0 to 10. Unsurprisingly, this score was negatively correlated with the PAGA scores. There was no significant difference between children using continuous glucose monitoring system and self-monitoring of blood glucose in terms of parental FoH, anxiety and misconceptions about glucagon administration. Conclusion: the results showed that parents of children with T1D had anxiety and fear connected with hypoglycemia and glucagon administration. Structured and practical training should be implemented to increase parents' self-confidence including annual refresher training for home glucagon administration., NA

Adenoid hypertrophy (AH) has been identified as a cause of otitis media with effusion (OME), which is the most common cause of childhood hearing loss. Indeed, there may be other upper airway-related predisposing factors such as, location of the adenoid, accompanying tonsillar hypertrophy (TH) and nasal septal deviation (NSD) for the development of OME. In this study, we aimed to evaluate the associations between the upper airway physicals and OME with auditory functions.Eighty-six ears of 43 children, aged 3-11 years were included in this prospective clinical study. Findings of otolaryngologic examinations were noted. Data of pure tone audiometry (PTA), traditional tympanometry (TT) and wideband tympanometry (WBT) parameters were collected. Cluster analysis was performed to the following variables: age, sex; the adenoid choana percentage (ACP), the presences of adenoid around torus tubarius (AATT), TH, NSD and OME; peak pressure (PP) values on TT, resonance frequencies (RF) on WBT, ambient pressure absorbance ratios (APAR) and PTA hearing thresholds.Two groups of ears revealed by clustering; cluster-1 (n = 46) and cluster-2 (n = 40), at the similarity level of 0.662. The presences of AH, AATT, OME and the medians of ACP, PP, RF, WBT APARs at all frequencies except 5656 Hz and 8000 Hz, all PTA thresholds were significantly different between two clusters (p0.05). The lower WBT APARs and higher PTA thresholds were associated with higher levels of ACP and higher frequencies of the presence of AATT and OME in cluster-1.There are associations between AH, AATT and OME together with decline in hearing and SEA. Whereas, TH and NSD are not related to the formation of clusters and they are insignificant factors.

In this study, the situation of waste management and zero waste applications in educational institutions was investigated in Turkey. For this purpose, the wastes collected and separated within the scope of zero waste and the wastes collected without separating them in trash cans were determined at certain periods and the total amount of waste generated per unit time and per person was calculated for an engineering faculty, vocational school, high school and primary school. A questionnaire study was conducted to determine the viewpoints of the students studying at the engineering faculty on zero waste management. According to the obtained data, the amount of waste collected in the faculty was calculated as 184 kg day-1 and only 27 kg day-1 of this amount is being recycled. Considering all types of waste in the whole schools, waste generation rates were found to be 17,6, 32,3, 93,7 and 113 g person-1 day-1 respectively for primary school, high school, vocational school, and engineering faculty. One of the important results obtained in the study is that the necessary training and awareness-raising activities in zero waste implementation are very important, and every stage from the reduction of the number of trash cans to the correct placement of zero waste sets requires detailed planning.

Objective: to determine homocysteine, vitamin B12, and folate levels in patients with Parkinson's disease and to investigate the effect of entacapone use on homocysteine levels. Materials and methods: the records of patients who were followed up in our outpatient clinic between 2009 and 2010 were reviewed retrospectively. The demographic, clinical characteristics, and laboratory findings of the patients were recorded. The control group consisted of healthy subjects with similar demographic characteristics. The patients were divided into two groups according to the treatment they received. Results: the control group consisted of 22 healthy subjects (group 1), group 2 comprised 22 patients [entacapone (+)], and group 3 constitued 50 patients [entacapone (-)]. The homocysteine levels of the control group were significantly lower than the entacapone (-) and entacapone (+) groups. The vitamin B12 level of the control group was significantly higher than in the entacapone (-) group. The folate levels of the control group were significantly higher than those of the entacapone (-) group. There was no significant difference between the entacapone (-) and entacapone (+) groups in terms of homocysteine, vitamin B12, and folate levels. Conclusion: levodopa treatment affects homocysteine levels in patients with Parkinson's disease. The effect of levodopa + entacapone on plasma homocysteine levels should be evaluated together with basal vitamin B12 and folate levels and genetic features. / Amaç: parkinson hastalarında homosistein, vitamin B12 ve folat düzeylerinin belirlenmesi ve entakapon kullanımının homosistein düzeylerine etkisinin araştırılması amaçlanmıştır. Gereç ve yöntem: hareket bozuklukları polikliniğimizde 2009-2010 tarihleri arasında takipli olan hastaların dosyaları retrospektif olarak incelendi. Hastaların demografik, klinik özellikleri ve laboratuvar bulguları kayıt edildi. Benzer demografik özelliklere sahip laboratuvar değerleri incelenmiş olan sağlıklı kişiler kontrol grubunu oluşturdu. Hastalar aldıkları tedaviye göre 2 gruba ayrılarak değerlendirme yapıldı. Bulgular: grup 1: Yirmi iki sağlıklı kişiden (kontrol grubu), grup 2: Yirmi iki hastadan [entakapon (+)], grup 3: Elli hastadan [entakapon (-)] oluşmaktadır. Kontrol grubunun homosistein düzeyi entakapon (-) ve entakapon (+) gruba göre anlamlı derecede düşük saptandı. Kontrol grubunun vitamin B12 düzeyi entakapon (-) grupa göre anlamlı olarak yüksek saptandı. Kontrol grubunun folat düzeyi entakapon (-) gruba göre anlamlı olarak yüksek saptandı. Entakapon (-) ve entakapon (+) gruplar arasında homosistein, vitamin B12 ve folat düzeyleri açısından anlamlı fark saptanmadı. Sonuç: Parkinson hastalarında levodopa tedavisi homosistein düzeyini etkilemektedir. Levodopa + entakapon kullanımının plazma homosistein düzeylerine etkisinin plazmanın bazal vitamin B12 ve folat düzeyleri ve genetik özelliklerle birlikte değerlendirilmesi gerektiği düşünülmüştür., NA

Background: Evaluation of the fallopian tubes are important for infertile patients. The two most important diagnostic procedures used to evaluate tubal patency are hysterosalpingography and laparoscopy. Objectives: To asses the hysterosalpingography and laparoscopy results of patients diagnosed with infertility and investigate the diagnostic value of hysterosalpingography in patients with tubal factor infertility. Methods: The hysterosalpingography and laparoscopy results of 208 patients who presented to the Obstetrics and Gyne- cology Clinic at Dicle University, Faculty of Medicine between January 2014- January 2018 were retrospectively evaluated. Hysterosalpingography and laparoscopy results were compared with regard to the investigation of the presence of tubal obstruction and of the pelvic structures that could cause tubal obstruction. The specificity, sensitivity, positive, and negative predictive values of hysterosalpingography were computed. Results: The number of patients evaluated was 208. The ratio of primary infertile patients was 57.2% and 42.8% was secondary infertile. Hysterosalpingography was found to have a specificity of 64.6%, the sensitivity of 81.3%, the positive predictive value of 56.4%, and a negative predictive value of 86% in the determination of tubal obstruction. Conclusion: Patients with suspected tubal infertility can primarily be examined using hysterosalpingography in considera- tion of the invasive nature and the higher complication rate of laparoscopy. Keywords: Infertility; hysterosalpingography; laparoscopy; tubal factor.

OBJECTIVE: To determine the perinatal mortality rate in patients with HELLP syndrome in our clinic and to investigate the factors affecting perinatal mortality. It also makes recommendations to reduce perinatal mortality and contributes to the literature. STUDY DESIGN: Three-hundred-and-eighty-three patients were retrospectively evaluated in this cohort study. The patients' demographic, clinical data, laboratory results, gestational week at delivery, method of delivery, neonatal birth weight, fetal gender, 1- and 5-minute APGAR scores, place of delivery, maternal morbidity, mortality rates, and perinatal mortality rates were recorded. The relationship of these factors with perinatal mortality was investigated. RESULTS: The rate of perinatal mortality was determined as 6%. Patients with HELLP syndrome who experienced perinatal mortality showed significantly lower birth weight, gestational age at delivery, and 1- and 5-minute APGAR score values (p

The gut commensal Anaerobutyricum soehngenii is an anaerobe that can produce both propionate and butyrate, metabolites that have been shown to have a positive effect on gut and overall health. Murine and human dose finding studies have shown that oral intake of A. soehngenii has a positive influence on peripheral insulin resistance, thereby reducing the risk of type 2 diabetes. A recent human intervention provided support for the mode of action of A. soehngenii as it affected gene expression in the duodenum, stimulated the secretion of GLP-1 and improved insulin sensitivity. For these reasons A. soehngenii has been proposed as a food ingredient. Before introducing this bacterium to the food chain, however, it must be established that oral intake of live A. soehngenii bacteria does not pose any health risk. As part of the safety analysis of A. soehngenii strain CH106, we performed genotoxicity assays to determine its mutagenic potential (bacterial reverse mutation and in vitro mammalian cell micronucleus tests) and a 90-day subchronic toxicity study in rats to determine overall toxicity potential. The results of both genotoxicity studies were negative, showing no genotoxic effects. For the 90-day subchronic toxicity study, no adverse events were registered that could be attributed to the feeding with A. soehngenii strain CH106. Even at the highest dose, which exceeds the expected daily human intake more than 100-fold, no adverse events were observed. These result support the conclusion that the use of A. soehngenii strain CH106 as a food ingredient is safe.

Lower limb amputation causes difficulties in mobility together with motor and sensory loss. Challenging situations such as concurrent tasks cause gait parameters to deteriorate. Understanding the effect of concurrent tasks on gait is important for the rehabilitation of amputees.Are the effects of concurrent cognitive and motor tasks on gait parameters at fixed speed different in individuals with transtibial amputation, or transfemoral amputation compared to healthy individuals?The gait parameters were evaluated of 20 individuals with transtibial amputation, 13 individuals with transfemoral amputation and 20 healthy individuals while walking on a motorized treadmill under single task (ST), cognitive dual task (CDT) and motor dual task (MDT) conditions. The self-selected comfortable velocity, which was determined in the single-task gait, was used in all three walking tests.ST, CDT and MDT gait parameters of individuals with transtibial amputation, transfemoral amputation and healthy individuals were significantly different (p 0.01). Covariance of step length variability increased in amputees when walking under MDT (p 0.05). The dual task cost (DTC) for all the gait parameters was similar in all three groups (p 0.05). The motor DTC of covariance of step length was greater than cognitive DTC (p 0.05).Individuals with lower limb amputation have the capacity to walk with cognitive and motor tasks without changing velocity on the treadmill, but concurrent motor tasks cause an increase in gait variability. The results of this study suggest that there is an increase in gait variability especially with motor tasks, which may cause a higher risk of falling. Trial number: NCT04392466 (clinicaltrials.gov).

Purpose To compare hemodynamic effects of two different modes of ventilation (volume-controlled and pressure-controlled volume guaranteed) in patients undergoing laparoscopic gynecology surgeries with exaggerated Trendelenburg position. Methods Thirty patients undergoing laparoscopic gynecology operations were ventilated using either volume-controlled (Group VC) or pressure-controlled volume guaranteed mode (Group PCVG) (n = 15 for both groups). Hemodynamic variables were measured using Pressure Recording Analytical Method by radial artery cannulation in addition to peak and mean airway pressures and expired tidal volume. Results The only remarkable finding was a more stable cardiac index in Group PCVG, where other hemodynamic parameters were similar. Expired tidal volume increased in Group VC while peak airway pressure was lower in Group PCVG. Conclusion PCV-VG causes less hemodynamic perturbations as measured by Pressure Recording Analytical Method (PRAM) and allows better intraoperative hemodynamic control in exaggerated Trendelenburg position in laparoscopic surgery.

Fuel cells have been attracting many researchers and industry partners' attention due to their clean, quiet, modular, and flexible operation characteristics. As Power-to-Gas technologies evolve and get more sustainable, well-developed fuel cells will be needed to convert the chemical energy stored in the gas form to useful products such as power and heat. For that reason, a comprehensive sustainability investigation of fuel cells is conducted by taking their economic, environmental, social, and technical performance into account. The selected fuel cells are polymer electrolyte membrane, alkaline, phosphoric acid, molten carbonate, and solid oxide. These fuel cells’ performance is comparatively investigated based on four primary and 15 sub-criteria. The selected performance criteria are economic (initial and running costs), environmental (GHG emissions, land use, solid waste generation, and water discharge quality), social (employment and training opportunities, impact on public health, and public acceptance), and technical (energy and exergy efficiencies, process control, start-up time, and scalability). This study is the first in the literature to conduct an in-detail and very inclusive sustainability evaluation of fuel cells. It is expected to guide many professionals from academia and industry towards developing cleaner, safer, more affordable, and efficient fuel cells.

Objective: Trigeminal autonomic headaches are the primary headache group that occurs with autonomic stimulation of the cranial nerves. The most common type of this group is cluster headache (CH). This study aimed to report the clinical features and pain characteristics of patients with CH. Materials and Methods: Patients of the outpatient headache center between 2010 and 2020 were retrospectively analyzed. Inclusion criteria were diagnosis of CH and a minimum of 1-year follow-up. Records were reviewed using the International Headache Classification-3β. The sociodemographic characteristics of patients, types of pain, pain characteristics, and treatments that were used were documented. Clinical features were compared with sociodemographic characteristics and factors that could affect the pain features. Results: The mean age of 32 patients (25 male and 7 female) was 41.8 (23-68) years, and the mean age at disease onset was 31.7 (15-65) years. Lacrimation followed by conjunctival injection were the most common autonomic findings. According to gender, no statistical significance was found between pain character (p=0.166), painful side (p=0.572), month of onset (p=0.562), accompanying autonomic findings (p=0.495), pain duration (p=0.650), pain occurrence time during the day (p=0.394), and localization (Retroorbital/orbital, p=0.602; temporal, p=0.650; and forehead p=0.394). Nine patients had migraine-like features (MLF). The pain duration of patients with MLF was found to be 1.14±0.6 months and this period was longer than the results of other patients. No statistically significant difference was found between pain characteristics. Conclusion: The delay in diagnosis due to MLF that may accompany shows the importance of increasing awareness in the definition of CH.

Aim:This study was carried out to determine the effect of obstetric characteristics of pregnant women who had relatives diagnosed with SARS-COV2 (COVID-19) on depression, anxiety and stress levels. Material and Methods:This descriptive study was conducted between 17 April 2020 and 30 May 2020 with 450 pregnant women in the Obstetrician Clinic of a private hospital in Istanbul. The study data were collected face-to-face with the Introductory Information Form, State-Trait Anxiety Index (STAI), and the Depression Anxiety Stress Scale (DASS-21). Results:All pregnant women were aware of COVID-19 pandemic (100.0%), and 40.0% of them had a relative diagnosed with COVID-19. A total of 64.4% of those with no relatives diagnosed with COVID-19 had depression, 80.4% had anxiety and 81.5% had stress. A total of 100.0% of those who had relatives diagnosed with COVID-19 had depression, anxiety, and stress (DASS). Conclusions:It was found that DASS-21 scores were high in all pregnant women who had relatives diagnosed with COVID-19. Presence of chronic diseases and parity count were decisive in depression and anxiety levels in pregnant women who had relatives diagnosed with COVID-19, unlike those who did not. Clinical evaluations should be made carefully with this situation in mind..

Aim:The aim of this study was to determine the status of intern nurses to protect and maintain patient privacy and affecting factors. Methods:The study planned as cross-sectional study and conducted between December 2017 and February 2018 at a nursing faculty in Turkey. In the collection of data, 252 intern nurses were reached. The data of the study were gathered by questionnaire method using “Individual Identification Form,” Intern Nursing Students’ Information Form Related to Privacy,” and “Patient Privacy Scale”. In statistical analysis, frequency, mean and standard deviation, Kruskal–Wallis and Mann–Whitney U-test were used. Results: Of the intern nurses, 82.5% were female and their ages were in the range of 21-24 years. The mean score of the Patient Privacy Scale of them was 4.56 ± 0.40. In the subscales, “physical privacy” displayed the highest mean score (4.67 ± 0.47), while “gender-related privacy” was the lowest (4.41 ± 0.51). In addition, it was found that there was a statistically significant relationship between the variables of Patient Privacy Scale total score, gender, hospitalization experience, having knowledge about privacy, believing privacy was always necessary and meeting the privacy needs of their patients variables (P < .05). Conclusion: It was determined that the intern nurses’ approaches to protect and maintain patient privacy were found to be positive. It should be observed whether this is reflected in care during clinical practice.

Objective:This study aimed to determine the factors affecting the mortality of patients in critical condition with coronavirus disease-2019 (COVID-19) in the intensive care unit (ICU).Materials and Methods:We included a total of 445 patients who are admitted in the ICU due to COVID-19. Patients were divided into two groups-those who survived and those who died during the ICU follow-up-and their demographic, clinical and laboratory characteristics were compared. Factors affecting mortality were also determined.Results:Older age, high Kidney Disease: Improving Global Outcome (KDIGO) stage and Sequential Organ Failure Assessment (SOFA) scores at first admission to the ICU, high neutrophil/lymphocyte ratio, high D-dimer levels, low bicarbonate (HCO3) values and high lactate dehydrogenase (LDH) and creatinine levels were determined as independent risk factors for mortality in patients in critical condition with COVID-19 admitted in the ICU. Particularly, a substantial relationship was observed between the KDIGO stage and mortality during the ICU admission.Conclusion:Age, KDIGO stage and SOFA scores at first admission, neutrophil/lymphocyte ratio and D-dimer, HCO3, LDH and creatinine levels were independent risk factors for mortality in patients in critical condition with COVID-19 admitted in the ICU.

Light-activated photodynamic therapy (PDT) has long been used in dermatology, carcinology, otolaryngology, gynecology, gastroenterology, urology, etc. and it’s a type of treatment that approved for various diseases. PS used in PDT is a substance that can absorb light with the suitable wavelength and form reactive oxygen species (ROS). ROS shows antimicrobial activity by producing cytotoxic effects in target cells without mutagenic or genotoxic effects. In addition, microorganisms cannot develop resistance in this process. The light-induced formation of the harmful radicals such as reactive oxygen (ROS) and reactive nitrogen (RNS) species that are capable of killing cells depends on the intensity and the wavelength of the light and the type and amount of the PS used. It is envisaged that the concentration of these reactive species studied in the study will be adjusted by various factors so as to eliminate the internal and external microorganisms that can cause infection in the damaged tissue without causing harm to healthy tissues. Furthermore, the hydrogel dressings containing a fixed photosensitizer dye in the matrix are synthesized so as to protect the moisture balance on the wound area, to promote tissue formation, to reduce pain by cooling the wound area, to prevent the contamination of the wound while being permeable to gases and to contribute to the healing of the wound by absorbing excess liquid formed by the damaged tissue., Işıkla aktive olan fotodinamik tedavi (FDT), uzun zamandan beri dermatoloji, kanseroloji, kulak burun boğaz, jinekoloji, gastroenteroloji, üroloji vb. Çeşitli hastalıklar için onaylanmış bir tedavi türüdür. FDT'de kullanılan FS, uygun dalga boyunda ışığı absorblayarak reaktif oksijen türlerini (ROS) oluşturabilen bir maddedir. ROS, hedef hücrelerde mutajenik veya genotoksik etki olmadan sitotoksik etkiler üreterek antimikrobiyal aktivite göstermektedir. Ek olarak, bu süreçte mikroorganizmalar da direnç geliştiremezler. Fotosensitizör maddede bulunan kromofor gruplar spesifik dalga boyundaki ışığa maruz kalmasıyla hücreleri öldürme yeteneğine sahip olan reaktif oksijen türleri (ROS) ve reaktif azot (RNS) gibi zararlı radikallerin üretimi; ışığın dalga boyuna, şiddetine, kullanılan PS’ün miktarına ve çeşidine bağlıdır. Bu araştırmada oluşan bu reaktif türlerin konsantrasyonu çeşitli faktörler ile ayarlanarak vücut dokularına zarar vermeden hasarlı dokuda enfeksiyona neden olabilecek iç ve dış kaynaklı mikroorganizmalardan arındırması öngörülmektedir. Ayrıca fotosensitizör boyar maddenin içerisine sabitlendiği hidrojel yara örtüsünün; yaranın nem dengesini koruması, doku oluşumunu arttırıcı etki göstermesi, yarayı soğutarak acıyı azaltması, gaz geçişini optimum düzeyde tutarak ortam kaynaklı kontaminasyonu engellemesi, matriks sisteminin emici özelliği sayesinde hasarlı doku üzerindeki fazla sıvıyı emerek yaranın daha çabuk iyileşmesine katkı sağlaması gibi fiziksel özelliklere sahip olması hedeflenmiştir.

Diabetes care at school has recently appeared on the agenda of international diabetes organizations, the basic principles of which have been newly determined. The aim of this review was to summarize the activities and output of the Diabetes at School Program - a program that has been delivered in Turkey for the last 10 years - and to focus on different aspects of Diabetes Care at School through a national model. Recently, a detailed set of national regulations, including the basic principles proposed by the International Society for Pediatric and Adolescent Diabetes and the experience in Turkey, was prepared and has come into force. The future agenda includes giving priority to socio-economically disadvantaged regions, provision of an Individual Treatment Plan at School for each child with diabetes and ensuring that each school has an action plan for the care of children with diabetes. We believe that if all countries have programs and structured national regulations similar to the Diabetes at School Program, this will enable significant progress in the level of care delivered to children with diabetes.

Aim: This study aimed to determine the incidence, predisposing factors, clinical presentation, and treatment options for portomesenteric and splenic vein thrombosis (PMSVT) in patients undergoing l...

Purpose: The importance of health workers has revealed more with the epidemic process. This process also required healthcare workers to be in contact with more individuals than in the normal process. This study aims to reveal the relationship between emotional intelligence and communication skills of healthcare workers. Design/Methodology: 150 questionnaires have been applied to healthcare workers by using the “Emotional Intelligence Scale” of Wong and Law (2002) and “Communication Skills Scale-Adult Form” of Korkut-Owenand Demirbaş-Çelik, (2017). Findings:. Reliability, frequency, correlation, and regression analyses have been made via the SPSS statistical program and the outcomes have been interpreted. It is clear that there is a positive and significant relationship between employees’ communication skills and perception of emotional intelligence (r=0.823, p

BACKGROUND Defect treatment with tendon autograft in osteochondral lesions has been published in the literature with an experimental study in dogs. To demonstrate that it is possible to treat knee osteochondral lesions with the technique of autologous tendon transplantation. AIM To evaluate the clinical and radiological results of patients with knee osteochondral lesions who were treated with autologous tendon transplantation. METHODS Twenty patients (22 knees) with osteochondritis dissecans (OCD) lesions involving the knee were treated with autologous tendon transplantation between 2005-2018. All lesions were International Cartilage Repair Society grade IV. All patients were evaluated clinically at final follow-up with knee injury and osteoarthritis outcome score (KOOS); and radiologically with magnetic resonance observation and cartilage repair tissue (MOCART) and Kellgren-Lawrence (KL) classification. RESULTS A total of 20 patients (22 knees) with a mean age of 25.5± 6.8 years were included. The average defect size was 4.2 ± 2.1 cm2, and the average defect depth was 0.9 ± 0.4 cm. Total KOOS score was preoperatively 29.4 ± 5.5 and was later found to be 81.5 ± 5.9 after an average of 68.7 ± 37.7 mo follow-up. The mean MOCART score was 56.2 ± 10.7. Preoperatively, all of the patients had KL grades of 0–1; during the follow-up period, 80% of the patients showed no radiological progress of osteoarthritis. Patients with less than 4 cm2 lesion had statistically significantly better overall KOOS than patients whose more than 4 cm2 lesion, particularly in sport and quality of life subscales. CONCLUSION The autologous tendon transplantation is a single-step, safe, simple, cost-effective method for the treatment of knee OCD with satisfactory clinical and radiological outcomes, particularly in patients with less than 4 cm2 lesion.

Aims We aimed to determine parents' levels of anxiety and fear and suspicion in relation to the COVID-19 period and the possible predictive factors for these variables in families admitted to a child and adolescent psychiatry outpatient clinic of a university hospital in Turkey. In this way, it is hoped to contribute to the identification of priority target groups in psychosocial support services. Method The research study group consisted of 600 patients aged 0-18 years and their parents who were referred to a child and adolescent psychiatry outpatient clinic of a university hospital. Parents completed the COVID-19-related psychological distress (CORPD) scale and the data recording form developed specifically for this study. All cases included in the study were examined by a child and adolescent psychiatrist for diagnostic evaluation and their current diagnoses were recorded. Results Parents of children with any psychiatric diagnosis had higher suspicion scores on the CORPD scale and parents of children with high COVID-19-related anxiety also had higher anxiety and fear scores on the same scale. Logistic regression analysis revealed that negative changes in family relationships increased the risk of higher maternal COVID-19-related suspicion. Conclusions The most important factors associated with parental high CORPD levels were negative changes in family relationships and children with high COVID-19-related anxiety. Children's high COVID-19-related anxiety levels were associated with living with a single parent or separation from parents, negative changes in family relationships, previous COVID-19 infection in the family, and changes in daily routines.

Background/Aim: It is possible to find studies in the literature evaluating the relationship among self-reported bruxism, psychological factors, and myogenous temporomandibular disorder. In addition, the relationship between these issues has not yet been clarified. The objective of this study was to evaluate the association between peripartum depression, self-reported bruxism, and myogenous temporomandibular disorders among postpartum women in Turkey. Material and Methods: This study included 220 women, who were asked about their bruxism behavior during day and during sleep. Besides, all of them assessed with Short-Form Fonseca's Anamnestic Index for myogenous temporomandibular disorder and the Edinburgh postnatal depression scale for peripartum depression. Results: The results showed that, self-reported bruxism was observed at a statistically significantly higher rate (94.3%) in peripartum depression group. 86.5% of the patients with self-reported bruxism had myogenous temporomandibular disorder (p

The increasing importance of maritime transportation in entire logistics flows have increased the interest in maritime logistics. Despite the growing body of the literature on this emerging discipline, there is lack of a detailed investigation regarding the categorization and emerging topics. The primary aim of this study is to analyse the advances in the literature and to suggest a research agenda for this concept by exploring the main research domains in this phenomenon. To achieve these aims, this study adopts content analysis-based review method to examine the concept and citation analysis to explore the latent structure of maritime logistics. The research streams have been obtained through two databases; the main themes, highlighted topics, and related analytical categories have been investigated through content analysis. Citation and co-citation analysis were conducted to understand the intellectual structure of the studies and the relationship of the analytical categories. The study presents a comprehensive synthesis of existing research suggesting a systematic source of information for both scholars and practitioners, shaping the future research agenda. The findings indicate that there is an increasing emphasis on design, optimization, and planning of port and ship operations while sustainability and marketing perspectives are somehow neglected in the researches.

Yönetici kimdir ve ne yapar sorusuna en kısa ve net olarak “karar alıcıdır” yanıtı verilebilir. Günlük işleyiş içerisinde bazen rutin bazen de ani ve beklenmedik şekilde gelişen olaylar karşısında her defasında seçim yaparak karar vermek durumunda olan yöneticilerin etkin olup olmadıkları aslında verdikleri bu kararlar sonucunda ortaya çıkmaktadır. Karar verme süreci, karar verme yöntem ve teknikleri, etkin karar verme, karar verme stilleri ve bunlar üzerinde etkili olan faktörlere ilişkin araştırmalar gittikçe artmaktadır. Özellikle kararlara katılım, etik karar verme, etik ikilemler, pazarlamada satın almaya ilişkin kararlar ve son zamanlarda davranışsal iktisat alanında incelenen karar verme biçimleri alan yazında güncel araştırma alanlarındandır. Karar verme süreci incelenirken ele alınan önemli unsurlardan birisi de bireylerin karar verme stilleridir. Karar verme stilleri bireylerin karar verme aşamasında sergiledikleri tutum ve yaklaşımları açıklamaktadır. Karar verme stilleri üzerinde bireysel pek çok değişken etkili olmakla beraber ilk akla gelen değişkenlerden birisi de kişiliktir. Bu araştırma kapsamında da kişilik özelliklerinin karar verme stilleri üzerindeki etkilerinin tespit edilmesi amaçlanmıştır. Bu doğrultuda yazında karar verme stilleri ve kişilik arasındaki ilişkiyi inceleyen makale ve doktora tezleri, araştırma kapsamında kullandıkları ölçekler, ölçeklerin alt boyutları ve sonuçları bağlamında analiz edilerek kişilik özellikleri ve karar verme stilleri arasındaki ilişkiye dair bir değerlendirme yapılması ve sonuçların tablolar halinde sunulması hedeflenmiştir. Bu değerlendirme sonucunda yazında sıklıkla kullanılan karar verme stilleri ve kişilik özellikleri arasında tutarlı sayılabilecek ilişkilerin gözlemlendiği görülmüştür. A manager is someone who makes decisions, and the degree of accuracy of those decisions—whether made daily or in times of crisis—largely determines how well that person can manage. A lot of attention is being paid to research on the decisionmaking process, decision-making strategies, marketing and behavioral economics. One of the main topics for research is decision-making styles. The primary attitudes and behaviors of decision makers are explained by their decision-making styles. Personality is one of its primary antecedents. The purpose of this study is to determine the effect of personality traits on decision-making styles. In this regard, articles and dissertations that examine the relationship between personality and decisionmaking styles were analyzed in the terms of their scales, sub-dimensions and results. Results reveal that there are consistent relationships between personality traits and decision-making styles.

Çalışanların örgüte katkı sağlamak amacıyla fikir, görüş ve endişelerini gönüllü olarak dile getirmesini ifade eden çalışan sesliliği, organizasyonlar için giderek daha fazla önem kazanmaktadır. Alan yazında, çalışan sesliliğinin önemi vurgulanmakla beraber, bu davranışı teşvik eden liderlik davranışlarının ve psikolojik mekanizmaların açıklanmasına yönelik bir boşluğun bulunduğu belirtilmektedir. Literatürde belirtilen güncel çağrılara yanıt vermek üzere bu araştırmanın amacı, Sosyal Öğrenme Teorisi ve Sosyal Değişim Teorisi bağlamında çalışan sesliliği üzerinde etik liderlik davranışlarının etkisini ve bu ilişkide psikolojik güvenlik algısının rolünü incelemektir. Araştırmanın verileri, İstanbul ilinde çeşitli sektörlerdeki organizasyonlarda görev yapmakta olan 337 beyaz yakalı çalışandan oluşan bir örneklem grubundan online anket yoluyla toplanmıştır. Elde edilen araştırma verilerinin geçerlilik, güvenilirlik ve yapısal eşitlik modeli analizleri gerçekleştirilmiştir. Araştırmanın bulguları, teorik yapıyla tutarlı olarak etik liderliğin çalışan sesliliği üzerinde olumlu yönde etkisi olduğunu ve psikolojik güvenliğin bu ilişkide aracı rolü bulunduğunu ortaya koymaktadır. Araştırmanın sonuçları, çalışan sesliliğine ilişkin literatürdeki mevcut bilgi birikiminin geliştirilmesine ve gelecekteki araştırmaların ilerletilmesine teorik katkıda bulunmaktadır. Ek olarak, araştırmanın sonuçları iş yerinde çalışan sesliliğinin geliştirilmesi için etik liderlik davranışlarının ve psikolojik güvenliğin önemini vurgulamakta ve işletmelerde yönetim süreçleri açısından pratik çıkarımlar sunmaktadır. Employee voice, which means that employees voluntarily express their ideas, opinions, and concerns to contribute to the organization, is gaining more importance for organizations. Although the importance of employee voice is emphasized in the literature, it is also stated that there is a gap in the explanation of leadership behaviors and psychological mechanisms that encourage this behavior. In order to respond to recent calls, the purpose of this research is to examine the effect of ethical leadership on employee voice and the role of psychological safety in this relationship, based on Social Exchange Theory and Social Learning Theory. Research data were collected via an online survey from 337 white-collar employees working in organizations in various sectors in Istanbul. Research data were performed validity, reliability, and structural equation model analysis. We found that ethical leadership has a positive effect on employee voice and psychological safety has a mediating role in this relationship, consistent with the theoretical structure. Our research contributes theoretically to enhance existing knowledge and understanding of the literature on employee voice and offers suggestions for future research. Besides, our research provides practical implications for management processes by emphasizing the importance of ethical leadership and psychological safety for the promotion of employee voice in the workplace.

Objective: The aim of the study was to determine the effects of age, gender and season on vitamin D status in healthy urban population at reproductive age. Also, we investigated the distribution of population into different groups regarding 25(OH)D levels. Methods: Serum 25(OH)D levels of 21,317 participants: 5,364 men (25.1%) and 15,953 women (74.8%), aged between 18-45 years, applying to two medical centres for check-up located in the same city were retrospectively analyzed. Group I consisted of 14,720 participants (11,257 women and 3,463 men) in the first centre and Group II consisted of 6,597 participants (4,696 women and 1,901 men) in the second centre. Results: The mean 25(OH)D levels did not differ between women and men in both groups: 23.4 (SD = 14.4) and 23.1 (SD = 12.6) in Group I, and 22.6 (SD = 15.9) and 23.1 (SD = 14.3) in Group II, respectively, (p > 0.05). Similar trends exhibiting lower mean 25(OH)D levels at younger ages and higher levels at later ages were observed in both groups; a seasonal variation of 25(OH)D levels was observed in both genders with the highest levels in August and September and the lowest levels from February through April; percentages of women with 25(OH)D level of < 5 ng/ml were significantly higher than of men in Group I (1.4% vs. 0.2%, respectively, p < 0.001) and in Group II (4.1% vs. 1.1%, respectively, p < 0.001). Conclusion: There is a slight increase in serum 25(OH)D levels from 18 through 45 years of age in healthy population. The seasonal variation of 25(OH)D levels is prominent in both genders with men having slightly lower levels in some months of winter and higher levels in summer as compared to women. The prevalence of women having 25(OH)D levels less than 5 ng/ml is higher than that of men.

The current experimental pre-/posttest study sought to determine the effect of psychoeducation on the stress levels of parents of children with attention-deficit/hyperactivity disorder (ADHD). A total of 172 parents participated and were randomly assigned to experimental ( n = 86) and control ( n = 86) groups. There was no significant difference between mean pretest scores of parents in the experimental and control groups on the Caregiver Stress Scale ( p > 0.005); however, significant differences were found between pre- and posttest scores in the experimental group after psychoeducation and at 6-month follow up ( p < 0.001). There were also significant differences between pre- and posttest scores and pretest scores and 6-month follow-up scores in the experimental group ( p < 0.05). In the light of the findings, psychiatric nurses can use psychoeducation programs to support families of children with ADHD to reduce their stress levels. [ Journal of Psychosocial Nursing and Mental Health Services, 58 (7), 34–41.]

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Background Developmental delay in infancy includes cognitive-language delay, fine motor delay, gross motor delay, and social-self help delay. Delay in one intellectual domain frequently effects the other areas of development; therefore, determining risk factors are essential. In this study, we evaluated the relationship between maternal psychiatric symptoms and developmental delay types of infants who have not a known risk factor and are expected to show healthy development but have some behavioral and developmental problems. Methods The sample consisted of 79 infant–mother (26 girls, 53 boys) dyads who had been admitted to the Department of Child and Adolescent Psychiatry at Gulhane Research and Training Hospital over a one year period. Brief Infant-Toddler Social and Emotional Assessment Scale, Brief Symptom Inventory and Ankara Developmental Screening Inventory were used. Results The most frequent developmental delay types were fine motor and social -self-help delay in this sample. For all developmentally delayed infants, maternal interpersonal sensitivity, and depression scores were higher than healthy developed ones. Logistic regression analyses revealed the risk factors: Higher maternal paranoid ideation increases the language-cognitive delay; maternal hostility and anxiety increase the gross motor delay; maternal psychoticism increases the social and self-help delay, and maternal depression increases the total development delay of infants. Conclusion Maternal depression, anxiety, psychoticism, and paranoid ideation are important risk factors for infants' developmental delay types and should be addressed while evaluating infant-mother dyads in clinical practice.

Juvenile idiopathic arthritis (JIA) is a heterogeneous group of idiopathic inflammatory arthritis affecting children younger than 16 years of age. Tocilizumab (TCZ) is a humanized anti-interleukin 6 (IL-6) receptor antibody that was approved for systemic and polyarticular JIA patients. However, the studies regarding patients’ satisfaction while receiving TCZ therapy is scarce. Herein, we aimed to evaluate the effect of subcutaneous (SC) TCZ administration on patient satisfaction and disease control of JIA patients. All JIA patients receiving TCZ were included in the study. Clinical features, laboratory findings and JADAS71 scores were recorded at baseline and every 3 months during follow-up. Nine of the patients on intravenous (IV) TCZ treatment were switched to SC form. All patients receiving TCZ-SC were questioned by a clinical nurse specialist (CNS) to assess patient satisfaction. A total of 39 patients receiving TCZ were included in the study. Among them, treatment of nine patients (five female, four male) was switched to SC form with a median of 11.5 (8–69) months after initiation of TCZ. Patients were stable both clinically and in laboratory means at the 3rd month of TCZ-SC treatment. There was no deterioration in terms of active joint counts, physician’s VAS, patient’s VAS and JADAS71. According to patient satisfaction questionnaire, eight of the patients felt satisfied with SC administrations in terms of life quality, school success and reduced school absenteeism. However, one patient did not agree that the SC form is as effective as IV form and wanted to continue with IV form. TCZ is an effective treatment option in JIA and switching from IV to SC route when necessary is found to be an effective and acceptable alternative by the patients as well.

Introduction: Because of the adverse effects on human health of some antimicrobial ingredients in traditional toothpaste, consumers are increasingly turning to toothpastes with natural ingredients. This study evaluates the antimicrobial effect of toothpastes containing different natural active agents against three oral pathogens: Streptococcus mutans, Streptococcus sanguinis, and Enterococcus faecalis. Methodology: This study tested one traditional toothpaste and seven different natural toothpastes containing theobromine, aloe vera, miswak, propolis, chitosan, enzymes and probiotics. The agar-well diffusion method was used to test the antimicrobial effect. Inhibition zones formed around toothpastes after 24 hours of incubation were measured and the data collected were statistically analyzed. Results: Toothpastes containing theobromine and chitosan and the traditional toothpaste showed antimicrobial efficacy for all tested bacteria. Toothpastes containing aloe vera, miswak, and propolis were only effective on S. mutans, while toothpastes containing probiotics and enzymes did not show any antimicrobial effect on the bacteria. Among toothpastes with natural ingredients, the theobromine-containing toothpaste showed the highest efficacy on S. mutans, while the aloe vera- and propolis-containing toothpastes had the lowest efficacy (p < 0.05). Conclusions: Theobromine- and chitosan-containing toothpastes, which showed antimicrobial activity against all bacteria, can be recommended as alternatives to traditional toothpastes.

Objective: The onset, severity and progression of periodontal diseases are mainly related to the inflammatory host response against periodontal pathogens. The aim of this study was to evaluate salivary interleukin (IL) -1β, IL-13, IL-21 and IL-33 levels in patients with stage III grade C periodontitis and compare it with periodontally healthy individuals. Methods: A total of 58 individuals, including 28 periodontally healthy and 30 stage III grade C periodontitis patients were included in this study. Periodontal parameters including plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD) and clinical attachment level (CAL) were measured. Saliva samples were obtained from all patients. Salivary interleukin (IL) -1β, IL-13, IL21, IL-33 levels were assessed using enzyme-linked immunosorbent assay (ELISA). Results: All clinical parameters were significantly higher in periodontitis patients compared to healthy individuals (p

Purpose The main objective of this study is to demonstrate the diagnostic accuracy of susceptibility-weighted angiography (SWAN) in the diagnosis of slow-flow cerebral vascular malformations, especially developmental venous anomaly (DVA). We also aimed to determine the prevalence of DVAs identified by SWAN at 1.5 T. Methods We retrospectively evaluated 1,760 axial SWAN images for the diagnosis of low-flow vascular anomaly. Among them were 305 patients who underwent contrast-enhanced examination due to different indications. Postcontrast images were analyzed by different radiologists who were blinded to patients. The presence of DVA and other features such as location, length, depth, and direction of drainage vein was evaluated. Results Twenty-six patients with DVA had both SWAN and postcontrast images. There were four false-negative patients with SWAN. The sensitivity of the SWAN sequence was 84.6%. In addition, totally 77 DVA (4.36%), 2 capillary telangiectasia (0.11%), and 2 cavernous malformations (0.11%) were detected in 1,760 patients. Conclusion SWAN is an effective method for the diagnosis of developmental venous anomalies and other low-flow cerebral vascular malformations. Especially in the pediatric age, susceptibility-weighted imaging sequences are useful to limit contrast use.

INTRODUCTION: COVID-19 pandemic created concerns among patients receiving immunosuppressive therapy. Frequency of COVID-19 and impact of lockdown on treatment compliance in patients with vasculitis are largely unknown. PATIENTS AND METHOD: Patients with ANCA-associated and large vessel vasculitis that have been followed-up in our clinic were contacted by phone and a questionnaire containing home isolation status, treatment adherence and history of COVID-19 between March 1st and June 30th, 2020 was applied. RESULTS: The survey was applied to 103 patients (F/M: 59/44, mean age: 53.2±12.5). Thirty-three (32%) patients didn?t attend at least one appointment; 98(95.1%) noted that they spent 3 months in home isolation. Five patients (4.8%) received immunosuppressives irregularly and 3(2.9%) developed symptoms due to undertreatment. Four (3.9%) patients admitted to hospital with a suspicion of COVID-19, but none of them had positive PCR or suggestive findings by imaging. COVID-19 diagnosed in a patient with granulomatosis with polyangiitis during hospitalization for disease flare and she died despite treatment. DISCUSSION: Frequency of COVID-19 was low in patients with vasculitis in our single center cohort during the first months of pandemic. Although outpatient appointments were postponed in one-third of our patients, high compliance with treatment and isolation rules ensured patients with vasculitis overcome this period with minimal morbidity and mortality.

In Turkey, the seven-valent pneumococcal conjugated vaccine (PCV7) was included in the childhood national immunization programme in April 2008 and was replaced by the 13-valent pneumococcal conjugated vaccine (PCV13) in April 2011. In this retrospective, single-center study, it was aimed to determine the serotype distribution and antimicrobial resistance in Streptococcus pneumoniae isolates of pediatric patients with invasive pneumococcal disease (IPD) after the introduction of PVC7 and PVC13. Fifty pediatric patients diagnosed with meningitis and sepsis/bacteremia between October 2009 and October 2019 were included in the study. The pediatric patient group consisted of previously healthy patients diagnosed with meningitis and sepsis/bacteremia with S.pneumoniae isolated in their blood or cerebrospinal fluids. Patients with pneumonia-associated bacteremia and empyema were not included in the study. Serotyping of the isolates was performed by Quellung reaction using specific antisera (Statens Serum Institute, Denmark) and antibiotic (penicillin and ceftriaxone) susceptibility was determined by antibiotic gradient method based on Clinical Laboratory Standards Institute (CLSI) criteria. Of the children, 29 (58%) were boys and 21 (42%) were girls. The median age of the patients was 19 months (1 month-18 year). When the children under the age of five were evaluated, it was found that 30 (79%) patients were diagnosed with occult bacteremia/sepsis and 8 (21%) with meningitis. The overall annual incidence rate of IPD among the healthy children aged5 years decreased significantly from 9.35/100000 to 0.83/100000 (p0.001). Serotype identification was determined for 44 of 50 pneumococcal isolates . However, since six patients with underlying disease were not included in the evaluation, the remaining 38 isolates were found to be one of the serotypes included in PCV7 and PCV13 at a rate of 28.9% (n= 11) and 44.7% (n= 17), respectively. While the rate of PCV13 serotypes seen in the PCV7 period was 81.8%, this rate decreased to 29.6% within eight years after PCV13 administration. The rate of non-vaccine serotypes was determined as 54.5% in PCV7 period and 70.3% in PCV13 period. The rate of non-vaccine serotypes in patients under 5 years was 60% in the period of PCV7 and 75% in the period of PCV13. The proportion of non-vaccine serotypes has increased over time. However, this difference was not statistically significant (p0.05). The most common serotypes detected in isolates were 19F, 23F, 7F, 31 and 24B. According to the minimum inhibitory concentration values of the isolates recovered from patients with meningitis, penicillin and ceftriaxone resistance rates were found as 43.9% and 9.8%, respectively. In conclusion, our study showed that there was a 91.1% decrease in the incidence of IPD in healthy children aged under five years after the implementation of PCV7 and PCV13. It was determined that while the rate of serotypes in vaccine content decreased, there was an increase in non-vaccine serotypes. In addition no significant change was observed in antibiotic resistance rates over the years.

The study was planned to determine the most common nursing diagnoses according to NANDA International (NANDA-I) taxonomy and difficulties experienced in using of nursing process in COVID-19 outbreak. The sample of the descriptive cross-sectional study consisted of nurses cared for patients with COVID-19 ( n = 114). Average age of nurses is 26.86 ± 6.68. Commonly determined nursing diagnoses according to NANDA-I taxonomy in patients with COVID-19 were imbalanced nutrition (66.7%), impaired gas exchange (40.4%), insomnia (21.1%), acute confusion (31.6%), hopelessness (96.5%), difficulty playing caregiver (84.2%), anxiety (38.6%) willingness to strengthen religious bond (71.9%), risk for infection (64.9%), nausea (49.1%). Twenty-four-years old and younger, high school graduates, caring for intubated patients, and those who stated that they did not use nursing diagnosis had more difficulty in using nursing process (

Purpose: To investigate the effect of age- and sex-related differences on macular and choroidal perfusion in healthy Turkish individuals by optical coherence tomography angiography (OCTA).Methods: Two hundred-eight eyes of 116 healthy Turkish individuals (60 females and 56 males, mean age 40.35 ± 12.64 years) were included in this study. OCTA was performed on a 3 × 3-mm region on the macula. The superficial macula wholeimage vessel density (wiVD), foveal VD and parafoveal VD vessel density, foveal avascular zone (FAZ) as well as choriocapillaris flow index (CFI) were quantified.Results: The mean vessel density was 53.1% ± 2.8% in superficial macula wiVD, 31.7% ± 6.9% in superficial foveal VD and 55.2% ± 3.4% in superficial parafoveal VD for 3 × 3-mm OCTA images. Analysis of 3 × 3-mm scan has revealed a mean value of FAZ area was 0.313 ± 0.112 mm2. The mean CFI for 3 × 3-mm scan was 1.937 ± 0.059. A significant decrease was observed in the mean values of wiVD, parafoveal VD and CFI with age (p < 0.001, p = 0.001, and p < 0.001, respectively), with average yearly reductions of 0.3%, 0.4% and 0.4%, respectively. However, there was no correlation between age and foveal VD (p > 0.05). The FAZ area has shown an age-dependent annual increment, showing an average of 1.26%. The parafoveal VD and FAZ area were significantly higher in females than males (p = 0.027 and p = 0.015, respectively) while other parameters seemed similar (p > 0.05 for all).Conclusions: Our results suggest that age- and sex-related variations were effective on macular and choroidal perfusion. These normative values obtained using OCTA may be clinically useful to the evaluation of retinal and choroidal disorders.

As a critical component of sustainable development, a transportation system should be designed such that it has a positive impact on the economic, environmental, and social sustainability of the served region. In response, this study introduces the concept of passenger dissatisfaction with additional walking and waiting as an indicator of social sustainability and uses the concept while optimizing the transit network for economic, environmental, and social perfectives. Due to a lack of knowledge about the actual value of different passenger dissatisfaction levels and uncertainty in demand, a multi-objective robust possibilistic programming approach (RPP⁎) is proposed and solved by using an interactive fuzzy programming approach. Different from other robust possibilistic approaches, RPP⁎ optimizes not only the mean of the objective function and chance constraint violations but also the risk value inherited by uncertain parameters through considering the absolute deviation of the objective function. Both the advantage of RPP⁎ versus the deterministic model and its superiority against several robust possibilistic approaches are demonstrated in the numerical studies. Furthermore, the outcomes of the numerical study demonstrate that the transportation network should be designed in a decentralized way as the risk coefficients, i.e., risk-taking attitude, increase.

This study evaluated the performance of the metal artifact reduction (MAR) tool in cone-beam computed tomographic scans using different fields of view (FOVs) in the detection of a root isthmus in mandibular molars with intraradicular posts.Twenty-eight teeth were scanned by micro-computed tomographic imaging (gold standard images). Thereafter, specimens were allocated into the following groups: gutta-percha (teeth without posts, n = 10), a prefabricated metal post (n = 9), and a fiberglass post (n = 9). Cone-beam computed tomographic scans were taken using 8 acquisition protocols, varying the size of the FOV (10 × 5.5 cm and 5 × 5.5 cm) and the MAR tool (disabled, low, normal, and high modes). A root isthmus was evaluated considering a 5-point scale. Data were analyzed considering a 5% significance level.Intra- and interexaminer agreement varied from moderate to substantial. The frequency of correct diagnosis varied significantly in all groups regardless of the image acquisition protocol selected (P .05). In the gutta-percha group, there was no difference in the accuracy, sensitivity, and specificity values between the tested protocols. In the metal and fiberglass post groups, the accuracy values were higher with the "disabled" and "low" modes of the MAR tool regardless of the FOV size. This was also observed for the sensitivity values in the metal post group (P .05).The size of the FOV did not affect the performance of the MAR tool in the diagnosis of a root isthmus in molars with intraradicular posts. Our findings suggest that the use of the tool in the "normal" and "high" modes is contraindicated for this purpose.