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Amaç: Bu araştırma, aile sağlığı merkezinde çalışan hemşire ve ebelerin emzirme danışmanlığı vermelerini etkileyen faktörlerin belirlenmesi amacıyla yapılmıştır. Yöntem: Tanımlayıcı tipteki bu çalışma, Ankara Yenimahalle İlçe Sağlık Müdürlüğü’ne bağlı aile sağlığı merkezlerinde çalışan 280 hemşire ve ebe ile Haziran-Eylül 2021 tarihleri arasında yapılmıştır. Veriler 32 maddelik bir veri formu ile toplanmıştır. Bulgular: Katılımcıların yaş ortalaması 38,27±7,05 (yıl) (min:22, maks:59), 183’ü (%65,3) lisans mezunu ve 117’sinin (%41,8) aile sağlığı merkezinde çalışma süresi 10 yılın üzerindedir. İki yüz yirmi dokuzu (%81,8) emzirme danışmanlığı eğitimi almış, 182’sinin (%65,0) emzirme danışmanlığı sertifikası vardır. İki yüz yirmi dokuzu (%81,8) emzirme danışmanlığına yeterli zaman ayıramadığını, zaman ayıramama nedeni olarak 212’si (%92,6) iş yükü ve 187’si (%81,7) zaman yetersizliğini bildirmiştir. Hemşire ve ebelerin 170’i (%60,7) emzirme danışmanlığı vermekte güçlük yaşadığını, yaşadıkları güçlük olarak 170’i (%100) zaman problemini, 140’ı (%82,4) danışmanlık verilen alanda başka uygulamaların yapılıyor olmasını belirtmişlerdir. Hemşire ve ebelerin emzirme danışmanlığı vermekte güçlük yaşama durumu ile eğitim alınan zaman (χ2=7,345; p=0,025) ve yeterli zaman ayırdığını düşünme durumu arasında (χ2=13,211; p=0,000) istatistiksel olarak anlamlı bir ilişki bulunmuştur. Ayrıca emzirme danışmanlığı için özel bir alan bulunma durumu ile, emzirme danışmanlığına yeterli zaman ayırabilme arasında da istatistiksel olarak anlamlı bir ilişki saptanmıştır (χ2=10,279; p=0,001). Sonuç: Çalışma sonucunda, emzirme danışmanlığını etkileyen faktörler olarak öncelikli olarak iş yükü ve zaman yetersizliğinin belirtildiği, emzirme danışmanlığına yeterli zaman ayıramayanların emzirme danışmanlığı verirken güçlük yaşadıkları görülmüştür. Ayrıca çoğunluğunun emzirme danışmanlığı eğitimi aldığı, alınan eğitimin yakın zamanda olması ve emzirme danışmanlığı için özel bir alan bulunmasının emzirme danışmanlığını olumlu yönde etkilediği belirlenmiştir. Bu sonuçlar hemşire ve ebelerin verdikleri emzirme danışmanlığının etkinliğini artırmaya yönelik bir dizi girişim için yol gösterici olabilir.

Introduction: Transposition of great arteries is one of newborns' most common cyanotic CHDs, and its treatment is arterial switch operation in the first days of life. Low cardiac output syndrome may develop in the early postoperative period. In this study, we evaluated perfusion index and left ventricular output blood flow changes in patients who underwent arterial switch operation and developed low cardiac output syndrome. Methods: This study was conducted prospectively in newborns with transposition of great arteries who underwent arterial switch operation between 1st August 2020 and 1st August 2022. Low cardiac output syndrome score and left ventricular output were investigated. Initially, 6th, 12th, 18th, and 24th hour perfusion index and left ventricular output values of patients with and without low cardiac output syndrome were recorded. The results were evaluated statistically. Results: A total of 60 patients were included in the study. Sex distribution was equal. The median age at the time of surgery was 5 days (interquartile range 3–7 days), and the median weight was 3.1 kg (interquartile range 2.9–3. 4). Low cardiac output syndrome was detected in 30% (n = 18) of cases. The median perfusion index of patients who developed low cardiac output syndrome was significantly lower at the 12th, 18th, and 24th hours (p < 0.05) (0.99 versus 1.25, 0.86 versus 1.21, and 0.96 versus 1.33, respectively). Similarly, the median left ventricular output of patients who developed low cardiac output syndrome was significantly lower at 12th, 18th, and 24th hours (p < 0.05) (95 versus 110 ml/kg/min, 89 versus 109 ml/kg/min, and 92 versus 112 ml/kg/min, respectively). There was a significant correlation between perfusion index values and left ventricular output at all measurements (r > 0.500, p < 0.05). Conclusion: Perfusion index and left ventricular output measurements decreased in newborns who developed low cardiac output syndrome after arterial switch operation, especially at 12th and 18th hours. Serial perfusion index and left ventricular output measurements can be instructive in predicting low cardiac output syndrome development.

Bu araştırmada Kahramanmaraş il merkezinde yaşayan bireylerin sosyoekonomik yapıları ile bu kişilerin beden kitle indeksleri (BKİ) arasındaki ilişki analiz edilerek, fazla kilolu ve obez olmalarını etkileyen faktörlerin betimsel olarak belirlenmesi amaçlanmaktadır. Çalışma, Kahramanmaraş Onikişubat ve Dulkadiroğlu İlçe Sağlık Müdürlüğüne Bağlı Aile Sağlığı Merkezlerine kayıtlı, 18 yaş ve üstü, gönüllü olarak araştırmaya katılmayı kabul eden 551 kişiyle gerçekleştirilmiştir. Araştırma kapsamında, katılımcıların cinsiyeti, yaşı, medeni durumu, çocuk sayısı, eğitim düzeyi, çalışma durumu ve gelir seviyesi gibi sosyoekonomik faktörlerin obezite üzerindeki etkilerini ortaya koymak amacıyla anket uygulanmıştır. Çalışmaya katılanların %38,1’inin fazla kilolu, %20,1’inin ise obez oldukları gözlenmiştir. Bireylerin fazla kilolu ve obez olma durumlarının, cinsiyet, yaş, medeni hal, çocuk sayısı, eğitim düzeyi, çalışma durumu, gelir seviyesi gibi sosyoekonomik özellikleriyle ilişkili olduğu bulunmuştur. Erkeklerin kadınlara; evli ve eşi ölmüş olanların hiç evlenmemişlere; ev hanımı ve emeklilerin diğer meslek gruplarına göre BKİ değerlerinin istatistiki olarak anlamlı bir şekilde yüksek olduğu tespit edilmiştir. Ayrıca, bireylerin yaşları, çocuk sayıları ve gelir seviyeleri arttıkça BKİ değerlerinin de arttığı görülmüştür. Eğitim durumu ile BKİ değerleri arasında erkeklerde istatistiki olarak anlamlı bir ilişki bulunamazken, kadınlarda orta düzeyde ve negatif yönde bir ilişki saptanmıştır.

Aim: Abnormal positioning of the patella, of which the superior position is defined as patella alta (PA), whereas the inferior position is defined as patella baja (PB). Most of the measurements of patellar position evaluations are time-consuming. In this study, we aimed to examine the diagnostic accuracy of visual evaluation of the patellar position according to the physeal line and to determine the inter- and intraobserver agreement of this evaluation in MRI examinations. Material and Methods: Knee MRI examinations performed between 2019-2021 with different knee symptoms and prediagnoses were retrospectively analyzed in this study. As a reference test, Insall-Salvati Ratio was calculated by the following formula: Tendon length/patellar length. Two visual evaluation methods were used; physis line to the patella (PLP) and physis line to patellar joint cartilage (PLC). Results: Three hundred and sixty consecutive children aged 60-215 months were included in the study. There was excellent an agreement of both intra- and interobserver on PLP and PLC for two observers (κ > 0.800, for all). When we evaluated intra- and interobserver agreements according to groups, almost perfect agreements were detected (κ > 0.750, for all). Diagnostic accuracy for both two observers on the visual evaluation of PLP was almost perfect (Sensitivity 95.5%, specificity 87.2% for observer 1, and Sensitivity 94.7%, specificity 87.2% for observer 2), and on the PLC evaluation was also good (Sensitivity 89.3%, specificity 82.9% for observer 1, and Sensitivity 88.1%, specificity 85.5% for observer 2). Conclusion: Even though direct radiography is used in the diagnosis of PA and PB, it has been shown that MRI can also be used in pediatric patients in daily practice. Instead of the time-consuming measurements used in MRI, it may be kept in mind to use these methods in our study for practical and accurate diagnosis.

Instagram ülkemizde gençler arasında en çok kullanılan sosyal ağ uygulamasıdır. İnstagram kullanıcıları gün içerisinde önemli bir süreyi intagram kullanarak geçirmektedirler. Kimi instagram kullanıcıları instagrama karşı bağımlılık geliştirebilmektedir. Bu durum kullanıcıların akademik yaşantılarını olumsuz etkileyebilmekte ve akademik sorumluluklarını ertelemelerine sebep olabilmektedir. Bu araştırmada İnönü Üniversitesi Müzik Öğretmenliği programı öğrencilerinin, instagram bağımlılıkları durumu ile akademik ertelemecilik davranışları arasındaki ilişki incelenmiştir. Araştırma ilişkisel tarama modelinde yürütülmüştür. Araştırma örneklemini İnönü Üniversitesinde öğrenim gören 104 öğrenci oluşturmuştur. Araştırma verileri demografik bilgiler formu, instagram bağımlılığı ölçeği ve akademik ertelemecilik ölçeği ile toplanmıştır. Araştırma verilerinin analizinde yüzde, frekans, aritmetik ortalama değerleri incelenmiş ve basit doğrusal korelasyon testi yapılmıştır. Katılımcıların %91.35’inin instagram kullanıcısı olduğu görülmüştür. Katılımcıların günlük yaşantılarında önemli bir süreyi instagram kullanarak geçirdikleri sonucuna ulaşılmıştır. Katılımcıların %29,5’inin instagram bağımlısı oldukları bulgusuna ulaşılmıştır. Katılımcıların akademik ertelemecilik davranışları ortalama düzeydedir. İnstagram bağımlılığı ile akademik ertelemecilik ve genel akademik başarı not ortalaması (GANO) arasında anlamlı bir ilişki bulunamamıştır.

Objective: To determine the cut-off values of the serum anti-Müllerian hormone (AMH) concentration for different age groups (21–25, 26–30, 31–35 years) to diagnose polycystic ovary syndrome (PCOS). Methods: In total, 187 women aged 21–35 years were included in this descriptive study. Patients diagnosed with PCOS according to the Rotterdam Criteria formed the PCOS group (n = 93), whereas those without symptoms related to PCOS formed the control group (n = 94). Follicular phase serum hormone concentrations were evaluated during the endocrinological assessment of patients with PCOS. Serum levels of estradiol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, total testosterone, dehydroepiandrosterone sulfate, sex hormone-binding globulin, androstenedione, and AMH were measured. The free androgen index and LH/FSH ratio were calculated. Cut-off values of serum AMH concentrations for the age groups were measured using receiver operating characteristic curve analysis. Results: The prevalence rates of frank, ovulatory, normoandrogenic, and non-polycystic ovary PCOS were 69.9, 10.8, 10.8, and 8.6%, respectively. Serum AMH concentrations >5.56 ng/mL were associated with PCOS in the 21–25-year-old group. The cut-off value was 4.01 ng/mL in the 26–30-year-old group, whereas it was 3.42 ng/mL in the oldest age group. The correlation between the antral follicle count (AFC) and serum AMH level was strong for each age group. Conclusions: The serum AMH concentration is a valuable parameter for assessing patients with symptoms indicative of PCOS. We recommend measuring serum AMH levels to support the diagnosis or to use them instead of the AFC for the Rotterdam criteria.

The frequency of vitamin D deficiency is higher in children with mental motor retardation(MMR). We aimed to investigate the effect of vitamin D supplementation on postoperative pain in children with MMR who underwent dental treatment under general anesthesia. Materials-Methods: Dental treatment was planned for a total of 62 patients with MMR, aged 7-17 years. Participants were divided into two groups. Children were prescribed vitamin D (600 IU of vitamin D per day) or Saline. Serum vitamin D levels were measured. Participants continued to intake oral vitamin D 600 IU (Group D) or 2ml saline (Group C) throughout 12 weeks. All participants were observed postoperative 1st hour, and Non-communicating Children's Pain Checklist–Postoperative Version (NCCPC-PV), Ramsay sedation scores, length of stay in post-anesthesia care unit, and analgesic requirements were recorded. Results: The study was completed with fifty children (35 in Group D, 15 in Group C). Serum vitamin D levels were higher in Group D than Group C at 12 weeks(p=0.007). Vitamin D deficiency was found at 13 patients (37.1%) and 6 (40%), and vitamin D sufficiency was found 18 (51.4%) and 7 (46.7%) in Groups D and C, respectively at first admission. There was statistically significant difference between groups in NCCPC-PV score at 15th, 30th and 60th minutes in PACU(p

This research was conducted to determine the effect of educational games developed on “Household Wastes and Recycling” on raising awareness of this issue. In the research, a quasi-experimental design with a pre-test-post-test control group was used. The study group consisted of ninety-six 7th-grade students in total from two secondary schools located in the province of Rize and the district of Çayeli of Rize province. In the province experimental and control group, 29 students were included while the district experimental and control group comprised of 19 students. In teaching the subject of Household Wastes and Recycling, instructional plays called “Who Won the Cup?”, “I Got it?”, “Reflection” and “Ring!” developed by the researcher were played with the experimental groups while instructional program activities of the science lessons were used with the control groups. The quantitative data of the research were collected with the "Household Wastes and Recycling Knowledge Test" administered to all groups as the pre-test and post-test, and the qualitative data were collected with the “Semi-structured Interview Form” administered to the experimental groups. Quantitative data were analyzed using parametric and non-parametric techniques, while qualitative data were analyzed using content analysis. It was determined that the instructional plays used in teaching the subject of household waste and recycling are effective in enhancing the knowledge level and awareness of the students regarding household waste, recycling, the advantages of recycling, and what needs to be done for effective recycling and reuse. Instructional plays were determined to be evaluated as an effective tool in cognitive and affective aspects by students. In this regard, it was concluded that instructional plays facilitate learning, ensure effective learning, inform, raise awareness, develop affirmative emotions for the subject or lesson, hinder the boringness in the course of the lesson or subject, and help assure concentration.

Aim: To compare fetal and maternal outcomes between elective and emergency cesarean sections in patients with gestational diabetes mellitus (GDM). Material and Methods: Data from patients with GDM delivered by cesarean section between January 2015 and July 2020 were retrospectively reviewed. Patients were grouped according to whether the cesarean section was elective (n=129) or emergency (n=158). Results: The cesarean section rate was higher in patients with GDM (31.16%) than in patients without GDM. There were more patients with inadequate maternal care in the emergency cesarean section group than in the elective cesarean section group (p=0.003). One neonate in the elective group and six in the emergency C/S group died, but the rates of neonatal mortality were similar (p=0.198). Maternal morbidity (wound infection, fever, blood transfusion, and maternal intensive care) and fetal morbidity (birth asphyxia, respiratory morbidity, and neonatal intensive care) were higher in the emergency C/S group (p

COVID-19 pandemisi ile birlikte çevresel değişiklikler, sosyal yaşam ve hizmetlere erişimin azalması, rutinlerin bozulması özel gereksinimi olan çocuklar ve aileleri üzerinde olumsuz bir etkiye neden olmaktadır. Özel gereksinimi olan çocukların geçmişte de yeterince karşılanamamış sağlık bakım gereksinimleri pandemi döneminde giderek artmıştır. Pandemi sırasında özel gereksinimi olan çocukların hali hazırda var olan ayrımcılık, sosyal dışlanma ile karşı karşıya kalma durumu devam etmiş ve bu durum gelişimlerinin yanı sıra tedavi ve sağlık hizmetlerinden yararlanmalarında da aksaklıklara neden olarak ciddi sorunlara yol açmıştır. Özel gereksinimi olan çocuklar, COVID-19 pandemisine bağlı ortaya çıkan sınırlılıkların azaltılması için değerlendirilmesi ve stratejik girişimlerin planlanması gereken bireylerdir. Bu doğrultuda özel gereksinimi olan çocuklar ve ailelerine yönelik önlemlerin arttırılması gerekmektedir.

Bu araştırmanın amacı, anaç performansları yönünden öne çıkan türler arası melez patlıcan anaç adaylarının, kontrollü koşullarda tuz stresine karşı dayanım düzeylerinin belirlenmesidir. Araştırmada genetik materyal olarak, 0832.STZ.2014 no’lu SAN-TEZ Projesi kapsamında geliştirilmiş olan 8 adet türlerarası melez patlıcan anaç adayı (Solanum melongena x Solanum aethiopicum) değerlendirilmiştir. Ayrıca AGR-703 ve AGR-704 ticari hibrit patlıcan anaçları kullanılmıştır. Aşılı bitkilerin elde edilmesinde Karabey F1 çeşidi de kalem olarak kullanılmıştır. Tuz stresi uygulanan aşılı ve aşısız patlıcan fidelerinde, incelenen kriterler yönünden artan tuz düzeyine bağlı olarak kontrol bitkilerine göre değişen oranlarda azalışlar olduğu belirlenmiştir. Farklı tuz dozları ile oluşturulan tuz stresi aşılı ve aşısız patlıcan fidelerinin bitki büyüme ve gelişmesini olumsuz yönde etkilemiştir. Ancak bu olumsuz tepkiler, anaç/kalem kombinasyonlarına bağlı olarak farklılıklar göstermiştir. Araştırma sonucunda, fide aşamasındaki aşılı patlıcan genotiplerinin aşısız Karabey çeşidine oranla daha iyi bir performans gösterdiği, tuz stresi koşullarında en iyi performans gösteren kombinasyonların AGR-704/K ticari anaç/kalem kombinasyonu ile RS-5/K ve RS-7/K anaç/kalem kombinasyonlarının olduğu belirlenmiştir. Araştırma sonucunda; anaç kullanımının sadece toprak kökenli biyotik etmenlere karşı değil, abiyotik stres faktörlerine karşı da etkin bir mücadele yöntemi olduğu ve tuz stresinin olumsuz etkilerinin önemli düzeyde azaltılabileceği sonucuna varılmıştır.

The gender gap in wages that is accepted as a major economic and social issue, can arise from the behaviours of individuals. The fact that the labor force participation rate of women in Turkey is quite low compared to other OECD countries is also an important problem. Women really may accept lower wages in negotiations. However, perceptions that women may accept lower offers may affect offers made by employers. This attitude of employers may cause a gender gap in wages and a low female labor force participation rate. We explore the behavioural gender differences during bargaining by using the ultimatum game. Altruism, risk aversion, generosity, and self-confidence have a significant impact on preferences and so the results of wage bargaining. The ultimatum game is an effective tool for understanding altruism, risk aversion, and generosity. We found two important results in this study. First; when the proposer knows the gender of the other party, his/her offers to women are lower than those to men. Latter; When the gender of the other party is known, female proposers bid higher than men. These results provide evidence that gender income inequality in the labor market may be due to the attitudes of employers (especially men employers). These results can actually explain why the female labor force participation rate is low in Turkey, but more detailed studies are needed on this subject. This study contributes to the literature as one of the few studies examining the wage bargaining of employers with male and female workers in Turkey.

Amaç: Bu çalışma, “Evde Bakım Hemşireliği Kalite Ölçeği Türkçe formunun geçerlik ve güvenirliğini değerlendirmek amacıyla yapılmıştır. Gereç ve Yöntem: Metodolojik tipte olan çalışmanın evrenini bir devlet hastanesinin evde sağlık hizmetleri biriminden sağlık hizmeti alan hasta yakınları oluşturmaktadır. Araştırmanın örneklemini ise Mart-Haziran 2021 tarihleri arasında evde sağlık hizmeti alan ve araştırmaya katılmayı kabul eden 225 katılımcı oluşturmuştur. Veri toplamada “Katılımcılara İlişkin Bilgi Formu”, “Hasta Deneyimi Anketi” ve “Evde Bakım Hemşireliği Kalite Ölçeği” kullanılmıştır. Bulgular: 22 maddelik ölçeğin Cronbach Alpha güvenirlik katsayısı 0.98 bulunmuştur. Modelin uyum iyiliğine ilişkin df değeri 4.710 (p

Amaç: Araştırmada hemşirelik öğrencilerinin akademik başarılarına göre yaratıcı düşünce ve bilişsel esneklik düzeylerinin karşılaştırılması amaçlandı. Gereç ve Yöntem: Kesitsel tipte planlanmış olan araştırmanın evreni 1.2.3. ve 4. sınıf hemşirelik bölümü öğrencilerinden oluştu (N=800). Araştırmada örneklem seçimi yapılmamış olup evrenin tamamına ulaşılmaya çalışıldı (n=744). Araştırma verileri; Tanıtıcı Bilgi Formu, Marmara Yaratıcı Düşünme Eğilimleri Ölçeği ve Bilişsel Esneklik Envanteri kullanılarak toplandı. Bulgular: Araştırmaya katılan öğrencilerin %52.0’si 21 yaş altında, %75.5’i kadın, %40.5’i birinci sınıf öğrencisi, %70.8‘i ders başarı durumu algısını orta düzeyde olarak ifade etmektedir. Hemşirelik öğrencilerinin Bilişsel Esneklik Envanteri puan ortalamaları 74.88±9.64; Marmara Yaratıcı Düşünme Eğilimleri Ölçeği puan ortalamaları ise 96.29±12.12 olarak bulundu. Öğrencilerin akademik başarıları ile ölçeklerin puan ortalamaları karşılaştırıldığında; akademik başarı durumu “iyi” düzeyde olanların “orta” düzeyde olanlara göre; “orta” düzeyde olanların da “geçer” düzeyde olanlara göre daha yüksek puan ortalamalarına sahip olduğu belirlendi (p

The ecological effects from artificial light are complex and can affect species and life-stages differently. Ships are a dynamic source of light pollution, often brightly lit and temporarily increasing light levels in otherwise relatively dark areas. Because several nocturnal seabird species display reduced activity and avoidance of natural or artificial light, we expect that bright vessel lights may affect colony attendance patterns. Here, we test whether the presence of ships in front of coastal cliffs affects colony attendance in the Yelkouan Shearwater (Puffinus yelkouan). Ship presence at the site was obtained from an automatic identification system database, and a data logger measured light levels at the colony autonomously for four breeding seasons (2017–2020). Moreover, a Radio Frequency Identification (RFID) system was deployed at a cavernous colony entrance to register arrivals and departures of shearwaters. Direct illumination from ships increased cliff face brightness, and colony attendance was significantly reduced in brighter conditions. Ship presence reduced the number of shearwaters entering the colony per hour by a mean of 18% (SD ± 24). Disruption of natural attendance patterns is likely to have short- and long-term effects on breeding success, physiological condition, and colony viability. Therefore, we propose mitigation measures to reduce the impact from commercial shipping on burrow-nesting seabirds. Local regulations are necessary for colony-specific impact reduction, while incorporation of measures such as black-out blinds, fixture shielding and maximum brightness limits into international conventions can have additional far-reaching benefits.

İklim değişikliği sebebiyle oluşan kuraklık, zamanında incelenip gerekli önlemler alınmadığı takdirde büyük felaketlere yol açabilen doğal bir olaydır. Yağışların azlığı, meteorolojik kuraklığın oluşumunda rol almaktadır. Meteorolojik kuraklık zamanla yerini hidrolojik kuraklığa bırakabilir ve büyük sorunlar çıkarabilir. Hidrolojik kuraklığı incelemek için kullanılan indislerden biri Akım Kuraklık İndisi (AKİ) dir. Çalışmada Uşak İli çevresinde yedi farklı akım gözlem istasyonu kullanılarak bu bölgedeki hidrolojik kuraklık incelenmiştir. 1986-2015 yılları arasındaki ortalama aylık akım değerleri kullanılarak 3- aylık, 6- aylık ve 12- aylık periyotlarda kurak dönemler araştırılmıştır. Yedi farklı periyotta yapılan incelemeler sonucunda, beş periyotta nemli yıl sayısının daha fazla, iki tanesinde ise nemli yıl sayısı ile kurak yıl sayılarının birbirlerine eşit olduğu gözlenmiştir. Ayrıca, veri aralığı iki eşit parçaya bölünerek nemli ve kurak sınıflarda artış ve azalmalar incelenmiştir. Görülme yüzdelerine bakıldığı zaman en çok orta nemli ve orta kurak sınıflar görülmüştür. AKİ-3 Ocak değerlerine göre 1991-1992 yıllarında şiddetli kuraklık görülürken; AKİ-6 Nisan değerlerine göre ise 2006-2007 yıllarında şiddetli kuraklık gözlemlenmiştir.

Introduction This study investigated the relationship between body tissue composition analysis and complications according to the Clavien–Dindo classification in patients with renal cell carcinoma (RCC) who underwent partial (PN) or radical nephrectomies (RN). Methods We obtained all data of 210 patients with RCC from the 2019 Kidney and Kidney Tumor Segmentation Challenge (C4KC-KiTS) dataset and obtained radiological images from the cancer image archive. Body composition was assessed with automated artificial intelligence software using the convolutional network segmentation technique from abdominal computed tomography images. We included 125 PN and 63 RN in the study. The relationship between body fat and muscle tissue distribution and complications according to the Clavien–Dindo classification was evaluated between these two groups. Results Clavien–Dindo 3A and higher (high grade) complications were developed in 9 of 125 patients who underwent PN and 7 of 63 patients who underwent RN. There was no significant difference between all body composition values between patients with and without high-grade complications. Conclusion This study showed that body muscle-fat tissue distribution did not affect patients with 3A and above complications according to the Clavien–Dindo classification in patients who underwent nephrectomy due to RCC.

Bu araştırma, önde gelen dört turizm dergisinde yayınlanan makalelerin başlık ve anahtar kelimelerini analiz ederek turizm çeşitlerinin dönemsel olarak gösterdiği değişimi belirlemeyi amaçlamaktadır. Analizler dönemsel olarak her dergi için ayrı ayrı ve bütünsel şekilde yapılmış ve kelime bulutlarını kullanarak görselleştirilmiştir. Böylece turizm çeşitlerindeki eğilime ilişkin yaklaşık elli yıla dayanan anlık bir görüntü sağlanmaktadır. Yayınlanan makalelerde; (1) 404 farklı turizm çeşidinden bahsedildiği, (2) en çok sürdürülebilir turizm çeşidine (n=176) değinildiği, (3) en fazla turizm çeşidine (n=241) Tourism Management dergisinde yer verildiği, (4) en fazla sayıda turizm türünün 2012-2021 arası dönemde görüldüğü ve bu dönemde 271 farklı turizm çeşidinin çalışıldığı ortaya çıkmıştır. Çalışma, turizm çeşitlerindeki değişimi sadece dergiler ve dönemler arasında öne çıkan türler üzerinden göstermekle kalmamakta; turizm çeşitlerini ortak başlıklar altında çeşitli şekillerde sınıflandırarak çeviri sorunlarını ayrıca türler arasındaki benzerlikler ve farklılıkları da ifade etmektedir. Aynı zamanda çalışmada bazı turizm türlerinin zamanla alt boyutlara ayrıldığı bazılarının da farklı isimler altında tekrardan çalışıldığının altı çizilmektedir. Alternatif turizm türlerinin artışı görsel olarak sunulmaktadır.

Bu araştırmanın amacı günümüzün kanaat önderleri sayılabilecek sosyal medya fenomenlerinin gezilecek yerlerin tanıtımındaki rolünü ortaya koymaktır. Araştırma, 1,4 milyon takipçi sayısı ile ünlüler kategorisinde yer alan gezilecek yerler hakkında içerik paylaşımlarında bulunan bugünnereyegidelim hesabı üzerinden yapılmıştır. Seçilen bu hesap, 2021 yılındaki en fazla beğeni ve yorum yapılmış olan seyahat paylaşımlarına sahiptir. Belirlenmiş olan bu hesabın 2021 yılındaki en fazla beğeni ve yorum yapılmış olan seyahat paylaşımındaki yorumlara araştırma soruları kapsamında içerik analizi uygulanmıştır. Analiz sonucunda sosyal medya kanaat önderlerinin rolüne ilişkin beş tanımlayıcı ana temaya ulaşılmıştır. Yorumlamalar bu temalar bağlamında ve katılımcı ifadelerinden oluşan doğrudan alıntılara yer verilerek sunulmuştur. Araştırmanın sonuçlarına göre kanaat önderinin takipçileri üzerinde gezilecek yerler hakkında bilgilendirme, destinasyonu keşfetme, beğenme ve merak etme bağlamında rolleri vardır. Yabancı takipçilere ise Türkiye’nin tanıtımı yapılmaktadır. Sosyal medya fenomenlerinin takipçi sayısı, deneyimli olması ve alanında uzman olması onların güvenilir olduğunu göstermektedir. Ayrıca, sosyal medya fenomenleri, destinasyonu tekrar ziyaret etme, gelecekte oraya taşınma isteği yaratma ve tatil planlarında değişiklikler yapma isteği de uyandırmaktadır.

Rural settlements are settlements with relatively low population density where agriculture and animal husbandry activities are carried out or come to the fore, and the character of the settlement can be explained in the light of human-environment-culture relations. Rural residences and additions create the characteristic texture of rural settlements. Rural dwellings can be defined as spaces that contain not only a sheltered shell, but also add-ons with storage and production volumes according to the economic activity of the owner and the needs of the region. In order to sustain life in rural settlements, houses, unlike the residences in central settlements, meet the needs of the life of the region and contain many additions. In order to ensure the continuity of life in the countryside, the necessity of semi-open or fully closed volumes for different needs, as well as the storage areas necessary for economic activities such as animal husbandry and agriculture, are determinant on rural housing add-ons. The importance of fuel storage areas is better understood as the heating requirement in the coops and ovens in the garden or in rural houses in Anatolia is mostly met by stoves. While analyzing rural residences and rural settlements created by these dwellings, evaluating rural dwellings not only over closed areas where activities such as sleeping and sheltering at night, but also with open areas with add-ons, due to the rural life characteristics, It is also important in terms of determining the conditions and evaluating the projects to be proposed for the said regions within this scope. In this study, within the scope of the master's thesis study titled "A Research on Rural Houses and Their Extensions: The Example of Tongurlar Village", analysis studies were carried out on the add-on types and building materials of the houses in Tongurlar Village, and without considering the settlement characteristics and the need for add-ons, The types of options that determine the housing morphology in accordance with the needs of rural life are discussed.

Bu çalışma içinde bulunduğumuz COVID-19 pandemisinde Miyokard Enfarktüsü (STEMI-NSTEMI) geçiren bireylerin ilk semptomların başlaması ile hastaneye başvurusu arasında geçen süre ile COVID-19 korkusu arasındaki ilişkiyi değerlendirmek amacıyla gerçekleştirilmiştir. Tanımlayıcı türdeki bu çalışma 10 Aralık 2020 ile ülkemizde ilk vakanın saptanmasının yıldönümü olan 10 Mart 2021 tarihi arasında, bir eğitim ve araştırma hastanesine başvuran, STEMI ve NSTEMI tanı kriterlerine uyan ve primer perkütan koroner girişim (PPKG) yapılan 31 hasta ile yapıldı. Bir yıl önce aynı zaman aralığında PPKG yapılan, aynı tanıya sahip 31 hasta kontrol grubu olarak çalışmaya dahil edildi. COVID-19 pandemisi öncesinde hastaların ilk semptom ile hastaneye başvuru arasında geçen süre 33.95±61.64 (median 2 saat) saat iken, pandemi döneminde bu sürenin 264±586.064 (median 12 saat) saat olduğu ve aralarındaki farkın anlamlı olduğu belirlendi. Yapılan çoklu regresyon analizine göre COVID-19 döneminde ertelenen tedavi ile hastaların COVID-19 korkusu arasında bir ilişki olmadığı saptandı. Hastaların COVID-19 korkusuna karşı farkındalık geliştirebilecekleri varsayılsa da yüksek kardiyovasküler hastalık riskine sahip hastalara yardımcı olmak için önlemler alınmalı ve akut olaylar durumunda hastaneye zamanında erişim sağlamaları için rehberlik edilmelidir.

Rapid population growth, natural events, and increasing industrialization are among the factors affecting land use. To keep this change under control and to make sound plans, it is necessary to control the changes. In this study, the spatial use change in the Eskişehir region between the years 1990-2018 was examined with CORINE data. Based on this determined change, an urban change model was created with the multivariate regression method. As a result of the evaluations, while an increase was observed in urban areas and pastures between 1990-2018, a decrease was determined in agricultural and forest areas. This change is defined as 43.74% in urban areas, 3.28% in agricultural areas, 7.78% in forest areas, and 60.10% in pasture areas. SMOReg, MLP Regressor, and M5P Model Tree methods were used for the estimation study to be carried out with the obtained spatial change data. Urban values for 2018 were estimated to find the best method. Finally, the areas of 2030 were estimated with the method that gave the best results. The results demonstrated the usability of modeling using CORINE data.

Since Turkey is surrounded by seas on three sides and has different climatic characteristics, it has an extremely rich biodiversity. Identifying fish species and varieties is of great importance for protecting them from drought conditions seen in recent years and using them as a source of human food protein. The purpose of this study was to identify the genetic diversity of Diplodus, one of the fish species the importance of which is under appreciated, in Turkish seas. To this end, the polymorphism between the populations of two species (Diplodus vulgaris and Diplodus sargus) from the Sparidae (Coral fish) family was determined using the nucleotide sequence of the mitochondrial cytochrome c oxidase I (COI) gene, which is 652 base pairs long. 143 specimens of Diplodus were collected from the locations in the Eastern Mediterranean (İskenderun and Mersin) and Western Mediterranean (Antalya). The COI gene was amplified by PCR, genetic diversity analyses of these loci were carried out, and a phylogenetic tree was created to show the relationships between the isolates with a high difference. In conclusion, based on the haplotype and nucleotide diversity patterns, it was found that the COI gene had a low genetic variation among the populations.

Pesticides are products that were developed for the benefit of humanity. However, now they are one of the critical risk factors threatening the environment, and they create a significant threat to the environmental health of children. Organophosphate (OP) and pyrethroid (PYR) pesticides are widely used in Turkey as well as all over the world. The main focus of this presented study was to analyze the OP and PYR exposure levels in urine samples obtained from 3–6 year old Turkish preschool children who lives in the Ankara (n:132) and Mersin (n:54) provinces. In order to conduct the determination of three non-specific metabolites of PYR insecticides and four non-specific and one specific metabolite of OPs LC-MS/MS quantitative analyses were employed. The non-specific PYR metabolite 3-phenoxybenzoic acid (3-PBA) (87.1%; n = 162) and the specific OP metabolite 3,5,6-Trichloro-2-pyridinol (TCPY) (60.2%; n = 112) were the most frequently detected metabolites in all urine samples. The mean concentrations of 3-PBA and TCPY were 0.38 ± 0.8 and 0.11 ± 0.43 ng/g creatinine, respectively. Although due to the large individual variation no statistically differences were found between 3-PBA (p = 0.9969) and TCPY (p = 0.6558) urine levels in the two provinces, significant exposure differences were determined both between provinces and within the province in terms of gender. Risk assessment strategies performed in light of our findings do not disclose any proof of a possible health problems related to analyzed pesticide exposure in Turkish children.

Introduction: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is the leading cause of death from infectious diseases in the world. With the antiretroviral treatments developed over the years, viral replication is suppressed even though the disease cannot be cured yet. However, antiretroviral therapy (ART), like all drugs, has brought with it undesirable side effects as well as positive effects. In addition, demographic characteristics, accompanying comorbidities, organ dysfunctions, viral load, CD4 T lymphocyte count, ART resistance status, coinfections, pregnancy are also effective factors in the initial ART decision and change. In this study, we aimed to show the treatment status of HIV-positive patients followed in the infectious diseases outpatient clinic of our hospital and to determine the factors that affect ART change. Materials and Methods: Demographic data of HIV-positive patients followed in the infectious diseases outpatient clinic between January 2016 and May 2021, HIV-RNA and CD4 T lymphocyte results obtained before and after antiretroviral therapy, and the reasons for changing treatment were evaluated retrospectively. Results: The mean age of the patients included in the study was 40.0 ± 13.9 (min: 20-max: 76), and 16 (18%) were female and 71 (82%) were male. Treatment was changed in 32% of the patients. Changes were made due to drug-related side effects in 43%, patient-related reasons (such as single tablet request, non-compliance with treatment) in 25%, and virological unresponsiveness in 18% of patients who underwent treatment change. The most common cause of drug changes due to side effects was hyperlipidemia. The treatment regimens that changed the initial treatment were most frequently TDF/FTC/LPV/r and TDF/FTC/EFV, respectively. Conclusion: As a result of our study, we found that the most common cause of ART change in HIV-positive patients in our hospital was drug-related side effects, and patient non-compliance was the second most common. It is important to know the factors that cause these changes in advance and to make choices accordingly when starting the treatment, in order to increase patient compliance and facilitate follow-up.

Objective: Technological advances increased prolonged life expectancy of the terminal patients, who had end-stage diseases. End-of-life care in intensive care units (ICU) has increased with the rise in admissions of terminal patients to ICU. Our aims in this study were to determine the prevalence of terminal patients, and to find the reasons for potentially inappropriate treatments in ICUs. Materials and Methods: It was nationwide, multicenter, point prevalence and observational study. All adult patients, who stayed more than 48 h in the ICU, were enrolled. All patients were recorded on an electronic case record form, consisting of data on patient demographics, treatments, family participation and mini survey for physicians. The study was conducted on October 15, 2018 with a follow-up for 30 days. Results: Of 1127 patients 286 (25%) ICU patients were diagnosed as terminal patients by ICU physicians depending on primary physician statement. Terminal patients relatives requests and physicians legal concerns reduced end-of-life care quality. Terminal patients had significantly increased usage of mechanical ventilation, inotropic drugs, and poor end-of-life care quality (p

The purpose of present research was to detect the efficacies of various vinegars (aronia, grape and hawthorn) used as marination solutions on the physicochemical, technological, textural and sensory properties of spent chicken meat. The pH, colour parameters, cooking loss, marinade absorption, yield, texture (TPA and MORS), characteristics

Objective: The COVID-19 pandemic has deeply affected societies and individuals in all aspects, including mental and physical health. In this study, we aimed to determine the effects of COVID 19 pandemic on anxiety and depression levels and related factors in women. Methods: As a descriptive cross-sectional study, it was conducted with a total of 728 women between December 2020 and March 2021. Data were collected by Google survey using the descriptive information form, the Coronavirus Anxiety Scale (CAS), and the Hospital Anxiety and Depression Scale (HADS). Results: Having concerns about own health had a strong effect on coronavirus-related anxiety (p

Objective: Exposure to Radio Frequency (RF) and Extremely Low Frequency (ELF) radiation is increasing steadily with the progress of technology and industrialization. The aim of this study was to investigate whether RF and ELF radiation are oxidative stress effects in the plasma and brain tissue of diabetic and non-diabetic rats. Methods: Experiment groups were designed as follows; C (control), S (sham), ELF (ELF radiation exposure), RF (RF radiation exposure), ELF+RF (ELF and RF radiation exposure), D-C (Diabetic Control), D-S (Diabetic Sham), D-ELF (Diabetic ELF), D-RF (Diabetic RF), D-ELF+RF (Diabetic ELF+RF). The experimental diabetes model was induced with a single dose of 65mg/kg streptozotocin (STZ). 2100 MHz RF and 50 Hz ELF radiation groups exposed for 1 month. Total nitric oxide (NOx), malondialdehyde (MDA) and total sulfhydryl groups (RSH) / glutathione (GSH) levels were measured in plasma and brain tissue. Results: RF + ELF radiation exposure caused an increase in NOx and MDA levels in plasma and brain tissue of diabetic and non-diabetic rats (p

To compare umbilical cord blood pro-BNP levels in newborns of SARS-COV-2 positive pregnancies to those of SARS-COV-2 negative pregnancies.Prospectively cord blood samples from newborns of 42 SARS-COV-2 positive women, and 42 negative pregnant were collected at birth and analyzed for pro-BNP levels.The mean cord blood pro-BNP level was significantly higher in newborns of SARS-COV-2 positive women than in controls. Furthermore, the pro-BNP level was an independent predictor of NİCU admission in both SARS-COV-2 positive and control patients.Cord blood pro-BNP level may be a parameter that can predict the under-stress fetus and adverse perinatal outcomes especially, in cases where placental involvement is present as in SARS-COV-2 infection.

© 2023, The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).Background: This study aimed to assess the mortality of PsA before and during the COVID-19 pandemic. Methods: From the prospective, multicenter PsART-ID (Psoriatic Arthritis Registry-International Database), patients from Turkey were analyzed by linking the registry to the Turkish Cause of Death Registry. The outcome of interest was death from any cause, pre-pandemic (since the onset of registry—March 2014–March 2020), and during the pandemic (March 2020–May 2021). The crude mortality rate and standardized mortality ratio (SMR) were determined. Results: There were 1216 PsA patients with a follow-up of 7500 patient-years. Overall, 46 deaths (26 males) were observed. In the pre-pandemic period, SMR for PsA vs the general population was 0.95 (0.61–1.49), being higher in males [1.56 (0.92–2.63)] than females [0.62 (0.33–1.17)]. The crude mortality rate in PsA doubled during the pandemic (pre-pandemic crude mortality rate: 5.07 vs 10.76 during the pandemic) with a higher increase in females (2.9 vs 8.72) than males (9.07 vs 14.73). Conclusion: The mortality in PsA was found similar to the general population in the pre-pandemic era. The mortality rates in PsA doubled during the pandemic. Whether PsA patients have more risk of mortality than the general population due to COVID-19 needs further studies.Key Points• Decrease in mortality in PsA might be expected with the more effective treatment options and better disease control.• A crude mortality rate is comparable to the general population and not increased until the pandemic.• Currently, there is a 2-fold increase in crude mortality rate possibly due to the COVID-19.

Public expectations of forests as high-quality restorative environments that facilitate subjective well-being and stress relief along with numerous health benefits have been rising sharply during recent decades. In addition, the COVID-19 pandemic and its accompanying restrictive measures also transformed forests into some of the few places to spend time away from home. The presented study drew on the assumption that the pandemic situation and a rise in the number of forest visits would affect the experience, recognition, and appreciation of the well-being aspects related to spending time in forests. The study goal was to elucidate the potential effects of the COVID-19 pandemic on the relationships between forest visits, well-being and stress relief, emotions, perception of nature and forest value and importance, pro-environmental behavior, and societal expectations of the role of forests and forest ecosystem services. A survey using a digital questionnaire was conducted several months after the pandemic outbreak on a representative sample of the Slovak population. The Wilcoxon test and ordinal regression analysis were used to identify significant relationships, e.g., between the recency of anger episodes and the number of forest visits. The results showed that the pandemic strengthened the perception of forests as a high-quality restorative environment and that emotions associated with forest visits played an important role in the perceived importance of forests and their possible overexploitation. The results underscore the urgent need to put demands for forest recreation on par with the forest bioeconomy and to sensitize forest visitors to management and conservation requirements.

The aim of this study is to make a differential diagnosis and prognosis of the ampullary adenocarcinoma subtypes. We also investigated the role of prognostic markers PD-1 and PD-L1, and epidermal growth factor receptor (EGFR).Local or locally advanced stage ampullary adenocarcinoma patients who had undergone pancreaticoduodenectomy at the time of diagnosis were included. MUC1,MUC2, MUC5AC, CDX2, CK7, CK20, PD-1, and PDL-1 were analysed immunohistochemically, and EGFR was analysed by real-time polymerase chain reaction.According to histopathological and immunohistochemical evaluation, we found27 patients as pancreatobiliary type and 56 patients as intestinal type adenocarcinoma. The median survival of patients with intestinal and pancreatobiliary typeadenocarcinoma was 23 months and 76 months (p = 0.201), respectively.When the survival of PD1-positive (n = 23) and PD-L1-positive (n = 18) patientswere compared with the patients with negative staining (n = 60, n = 65), no significant difference was found. Epidermal growth factor receptor mutation was detected in a total of 6 patients, and 5 of these 6 mutations were shown in intestinaltype tumours and one in a pancreatobiliary type tumour. A significant differencewas determined in terms of overall survival for the patients with EGFR mutationscompared to those without (p = 0.008). In conclusion, we could reveal the prognostic significance of EGFR mutation, which is also a target molecule.

Acupuncture and myofascial meridians show great anatomical and clinical compatibility.We aimed to compare the effects of myofascial meridian stretching exercises and acupuncture in patients with low back pain.We randomized 81 subjects with acute/subacute low back pain into three groups: an acupuncture (A) group, a myofascial meridian stretching (MMS) group, and a control (C) group. We recorded the Numerical Rating Scale (NRS) and Roland- Morris Disability Questionnaire (RMQ) scores at baseline and weeks two and six. We evaluated posterior pelvic tilt and transversus abdominis muscle strenghth with a pressure biofeedback unit, back extensor muscle strength by the Sorenson test, and lumbar range of motion (ROM) with an inclinometer. Group A received acupuncture (BL 57 and BL 62 acupoints) and stretching exercises according to the posterior superficial line were applied to the MMS group.Improvements in the NRS score were more prominent in group A than in group C (Stretching exercises according to the myofascial meridian system and acupuncture contributed to improved symptoms in the first two weeks in patients with acute/subacute low-back pain.