Search

The link between the price of polluting energy supplies and the renewable energy stock index may be intricate and subtle. Investors need to conduct thorough inquiries and analyses to completely understand the correlation between these industries.

Objective: The COVID-19 pandemic, which led to an urgent public health problem, is a biological disaster that had a global impact. This study aimed to examine the views of the nurses on the "superhero" discourse in the media in this disaster.Methods: The phenomenological research method, one of the qualitative research methods, was used in the study. The research was carried out between February – April 2022 with 23 nurses working in intensive care clinics.Results: In this study, the views of nurses who worked in the intensive care unit during the COVID-19 pandemic on the "superhero" discourse in the media were investigated under the themes of rise of heroism (being noticed, heroic discourse for higher efficiency, forced hero) invisibility of heroism (invisibility before the pandemic, invisibility during the pandemic) and death of heroism (the applause, I'm real… not a toy) . The findings of the study revealed that the contribution of nursing to the health system is a little more visible in crisis conditions such as pandemic.Conclusion: The visibility that emerges as "heroism" or "superheroism", the vulnerability of nurses as human beings is ignored. This “professional invisibility and heroic visibility” emerges as a paradox, and nursing either becomes “invisible” as a profession or the needs of nurses for “material and moral support” as heroes can be ignored. During crisis periods such as pandemic, the vulnerability of nurses resulting from heavy working conditions should be taken into account and nurses should be supported physically, financially and morally.

Disorders of sex development (DSD) are a clinically and genetically highly heterogeneous group of congenital disorders. The most accurate and rapid diagnosis may be possible with a complementary multidisciplinary diagnostic approach, including comprehensive clinical, hormonal, and genetic investigations. Rapid and accurate diagnosis of DSD requires urgency in terms of gender selection and management of the case. Despite the genetic tests performed in current daily practice, the genetic cause is still not elucidated in a significant proportion of cases. Karyotype analysis can be used as a standard for sex chromosome identification. In addition, quantitative fluorescent-polymerase chain reaction or fluorescence in situ hybridization analysis can be used for faster and more cost-effective detection of the sex chromosome and SRY gene. Multiplex ligation-dependent probe amplification, single-gene sequence analysis, next-generation sequence analysis (NGSA), targeted NGSA, whole-exome sequencing, and whole-genome sequencing analyses can be performed according to preliminary diagnoses. Microarray analysis, including array comparative genomic hybridization and single nucleotide polymorphism array, should be performed in cases with syndromic findings and if no pathology is detected with other tests. In DSD cases, the use of optical genome mapping and techniques, which will probably be in daily practice in the near future, may be considered. In conclusion, the clinical and genetic diagnosis of DSD is difficult, and molecular genetic diagnosis is often not available. This has psychosocial and health implications for patients and their families. New genetic techniques, especially those targeting the whole genome, may provide a better understanding of DSD through the identification of little-known genetic causes. This review focuses on conventional genetic and next-generation genetic techniques used in the genetic diagnosis of DSD, as well as possible genetic diagnostic techniques and approaches that may be used in routine practice in the near future.

INTRODUCTION: Osteogenesis imperfecta (OI) consists of a group of phenotypically and genetically heterogeneous connective tissue disorders that share similar skeletal anomalies causing bone fragility and deformation. The aim was to investigate the molecular genetic etiology and determine the relationship between genotype and phenotype in OI patients using targeted next-generation sequencing (NGS). METHODS: A targeted NGS analysis panel (Illumina TruSight One) containing genes involved in collagen/bone synthesis was performed on the Illumina Nextseq550 platform in patients with a confirmed diagnosis of OI. RESULTS: Fifty-six patients (female/male: 25/31) from 46 different families were included. Consanguinity was noted in 15 (32.6%) families. Based on Sillence classification 18 (33.1%) were type 1 OI, 1 (1.7%) type 2, 26 (46.4%) type 3 and 11 (19.6%) type 4. Median body weight was -1.1 (-6.8, - 2.5) standard deviation scores (SDS), and height was -2.3 (-7.6, - 1.2) SDS. Bone deformity affected 30 (53.5%), while 31 (55.4%) were evaluated as mobile. Thirty-six (60.7%) had blue sclera, 13 (23.2%) had scoliosis, 12 (21.4%) had dentinogenesis imperfecta (DI), and 2 (3.6%) had hearing loss. Disease-causing variants in COL1A1 and COL1A2 were found in 24 (52.1%) and 6 (13%) families, respectively. In 8 (17.3%) of the remaining 16 (34.7%) families, the NGS panel revealed disease-causing variants in three different genes (FKBP10, SERPINF1, and P3H1). Nine (23.6%) of the variants detected by NGS panel had not previously been reported and were also classified as pathogenic based on American College of Medical Genetics guidelines pathogenity scores. In ten (21.7%) families, a disease-related variant was not found in any of the 13 OI genes on the panel. DISCUSSION AND CONCLUSION: Genetic etiology was found in 38 (82.6%) of 46 families by targeted NGS analysis. Furthermore, nine new variants were identified in known OI genes which were classified as pathogenic by standard guidelines.

Objective: In this study, we aimed to obtain real-life data on the use of antimyeloma agents, which significantly increase overall survival (OS) in multiple myeloma (MM) patients, in primary plasma cell leukemia (pPCL) patients with poor prognosis. Materials and Methods: Data from 53 patients who were diagnosed with pPCL between 2011 and 2020 and who used at least one proteasome inhibitor (PI) and/or immunomodulatory (IMID) agent were analyzed retrospectively. Depending on the year of the pPCL diagnosis, 20% leukocytes or ≥2x109/L plasma cells in the peripheral blood was used as a diagnostic criterion. Results: The median age of the patients was 58 years and 23 (43.4%) patients were over 65 years of age. For first-line treatment, PI or IMID alone was used by 31 (58.5%) patients, and PI and IMID were used simultaneously by 15 (28.3%) patients. Additionally, 21 (39.6%) patients received transplantation and 13 (24.5%) patients received maintenance treatment. The median progression-free survival was 4 (range: 1-42) months. When patients whose primary disease was refractory to first-line therapy were excluded, the duration of treatment was 6.5 months. The median OS was 15 months with a median follow-up duration of 15 months. Only 7 (13.2%) of the patients were alive at the last follow-up visit. Those with higher β2- microglobulin levels and International Staging System stage 3 and non-transplant patients receiving first-line treatment had shorter OS (p=0.005, p=0.02, and p=0.008, respectively). The concomitant use of PIs and IMIDs, the addition of chemotherapy to induction therapy, and the response to induction therapy or maintenance therapy did not affect OS. Conclusion: In this study, as in previous similar studies, we could not see an increased survival trend in pPCL, which is observed in MM. New studies are needed for pPCL, which is likely to increase with new diagnostic criteria, based on current agents and information from MM.

Vasculitis in children represents a diverse group of diseases characterized by inflammation of blood vessels, which can lead to significant morbidity if not promptly recognized and managed. This review explores the epidemiology, pathophysiology, classification, and management of key pediatric vasculitides. Classification based on vessel size aids in diagnosis and treatment. Understanding these conditions” clinical features and therapeutic options is critical for improving pediatric patient outcomes and preventing long-term complications. Continued research is essential for refining treatment strategies and enhancing patient care.

Schools and universities insisted on using live instructions and synchronous learning for the main strategy of learning during the global crisis. For this reason, it may be critical to investigate the students' use and acceptance of live instruction behaviors to see if they use it or not. The purpose of this research is to investigate the factors affecting undergraduate students' acceptance and use of learning in live instructions during the global crisis in Turkey within the context of the Unified Theory of Acceptance and Use of Technology Model (UTAUT). This model examined whether students' gender, grade, experience, and major moderated BI and use live interaction. PE and SI were the primary determinants of BI. However, EE and FC had no effect on live instruction acceptance. Students' lack of knowledge or confidence in the live instruction environment may influence effort expectancy and facilitating conditions.

Applying a socio-spatial perspective, this study examines the ethnoreligious identities of Turkish immigrant parents in Germany within home--school--society relational spaces. A total of 22 qualitative interviews with parents of children aged 3-6 years or 8-12 years were conducted and analyzed using content analysis. The findings show that parents construct a home space by adopting religious congruence with or separation from school and societal spaces based on their ethnoreligious identities. The inclusive or exclusive school and societal spaces reproduce each other and, in turn, shape parental identities that influence beliefs and practices related to ethnoreligious upbringing within the home space. Besides contributing to the spatial perspective in educational research, this study has implications for policy and practice.

Diabetes mellitus (DM) is associated with an increased risk of fractures due to deterioration of bone quality, which can be referred to as “diabetic osteodystrophy.” Furthermore, the risk of fracture is increased in DM, even if bone mineral density is normal or high and is associated with increased morbidity if a fracture develops. In addition to the pathophysiological mechanisms of DM, diabetesrelated complications and drugs used in the treatment of DM may also affect bone health. Moreover, the increased risk of falling due to microvascular complications, hypoglycemia, and postural hypotension also contributes to the development of fractures. Individuals with DM should be screened for osteoporosis with recommendations similar to those of the general population. When diagnosing osteoporosis and deciding on treatment, it should be kept in mind that DM may be an important risk factor, and lower threshold values of the T score should be used.

Objective: Extracorporeal membrane oxygenation (ECMO) is a life-saving treatment option providing cardiopulmonary support when standard therapies prove insufficient for reversible diseases. The mean objective of this study was to evaluate our center’s experience with ECMO following pediatric cardiac surgery. Materials and Methods: This retrospective study was conducted in our pediatric intensive care unit (PICU) between November 2014 and March 2021 and included patients who received ECMO following cardiac surgery. Results: Over the 7-year period, 324 patients underwent cardiac surgery, of which 24 (7.4%) required ECMO support. Among them, 13 (54.2%) were female, with a median age of 16.0 (2.0- 208) months and a median weight of 7.0 (3.5-70) kg. The mean vasoactive inotrope score (VIS) was 53.9 ± 44.5. Atrioventricular septal defect repair was the most common surgical procedure (n = 8/24, 41.6%). The primary indication for ECMO was low cardiac output syndrome (LCOS) in 14 (58.3%) patients. The median duration of ECMO support was 6.0 (1.0-46.0) days. Nonsurvivors had significantly higher Pediatric Risk Score of Mortality (PRISM) III scores (P = .014) and VIS scores during the pre-ECMO period (P = .004). Early or late neurological complications developed in 12 (50%) patients, with significant differences in lactate levels and pH levels preECMO between those with and without neurological complications (P = .01, P = .02, respectively). We successfully decannulated 16 (66.6%) patients, with a final survival rate of 12 (50%). Conclusion: ECMO plays a crucial role in providing pre- and post-cardiac surgery support for children. LCOS remains the main indication, and high PRISM III and VIS scores are valuable predictors of outcomes.

A traditional scheduling problem is one of the optimization problems that assign tasks to humans and machines in an optimal order. In real applications, many jobs do not have a fixed processing time. During production, some machines need to be cooled due to overheating. This activity, which takes place outside periodic maintenance, is called rate-modifying. During this time, the job times increase with each passing second as Jobs wait to be assigned. The rate of deterioration due to this increase is called deteriorating jobs. This paper considers scheduling a set of deteriorating jobs with rate-modifying activity with a single processor. During the speed change activity, the production process is halted, resulting in increased completion times of jobs. The problem arose from the problem of a machine and an automatic production line. This problem is classified as an NP-Hard problem. The problem addressed by the study has been tried to obtain optimal results with different methods by considering different factors by many authors. When a detailed literature review is made, it has been seen that no author has developed a dynamic programming model until today. The most significant advantage of dynamic programming models is that they provide solutions with the closest optimal result faster, especially in solving problems classified as Np-Hard. Therefore, a dynamic programming algorithm was developed for the first time for large job numbers of the focused problem. Therefore, this study presents a dynamic programming algorithm to calculate the optimal solution. The algorithm's efficiency is proven on an extensive randomly generated sample data set. The results prove that the proposed algorithm provides the optimal solution with much less effort than the mathematical model.

The aim of this action research is to develop the skills of elementary teacher candidates in designing 21st-century learning activities. Action research, one of the qualitative research methods was applied in the study. Some criteria were determined and the applicability of the criteria were tested by the participants. Data were collected from two groups in two different education terms. The criteria sampling method was used for determining participants. The first group has 52, while the second group has 42 elementary education teacher candidates (ETCs). A rubric to design learning activities was created with ETCs in the first term and they applied them as a performance homework. In the second term, ETCs experienced by applying revised rubric to design 21st-century learning activities. They also fulfilled a self-assessment form to tell their experiences. Collected data were analyzed document analysis, descriptive analysis, and content analysis methods. Findings indicated that ETCs have developed professional and personal skills by designing 21st-century learning activities.

In the COVID-19 pandemic, people's opportunities for face-to-face education have been limited, and the way they access educational content has changed. During the pandemic, both institutions providing drama lessons and drama instructors had the opportunity to rethink drama education and adapt drama studies in different ways. During the pandemic, different opinions emerged about whether creative drama classes should continue if they continue, what changes will be made in drama studies, drama education programs, and which applications will be used. This research aims to determine the changes in drama lessons during the COVID-19 pandemic, the digital platforms where online drama lessons are held, and the Web 2.0 tools used by taking the opinions of drama teachers. The interpretive qualitative research design was used in the study. The Online Drama Lessons Evaluation Form was used as a data collection tool to determine the opinions of drama teachers working in private or public institutions. 58 drama teachers answered the form. The qualitative data in the research were analyzed by descriptive analysis, the findings were first coded line by line, and the common codes were classified under appropriate categories and themes. According to the results of the research, it can be said that the drama teachers adapted the drama education programs by social distance (face-to-face studies) and transformed the drama activities to be applied on digital platforms. It can be said that the necessary changes were made in the drama activities and the drama education program while giving the drama lessons online, and the Zoom digital platform was mainly used in the online lessons. Drama teachers stated that they used Web 2.0 tools such as Padlet, Menti, Kahoot to evaluate online lessons, get or give feedback, and determine readiness/preparedness.

The period when education services were tried to be provided remotely due to the COVID-19 epidemic enabled teachers to be intertwined with technology-supported teaching platforms. The acquisition of the technology required to use the platform, adaptation of the existing teaching strategies, methods, and techniques to the platform, and the need to stay in touch with all stakeholders related to education in this process have led to new experiences for teachers and many challenging situations. During this process, it was predicted that teachers frequently use their cognitive flexibility, which enables them to think about different solutions and make functional changes for different or problematic situations. The research is a survey study. Data were collected from teachers with the Cognitive Flexibility Inventory and the Attitude Scale towards Compulsory Distance Education. Their validity and reliability were retested within this research's scope. The results of this study, in which the data were analyzed with descriptive statistics, show that the cognitive flexibility of the teachers participating in the research was high during the epidemic period. They had attitudes that could not be evaluated positively or negatively regarding compulsory distance education. Although there is a relationship between teachers' cognitive flexibility levels and their attitudes towards compulsory distance education, it is low. The cognitive flexibility of teachers can predict a very small part of their attitudes towards compulsory distance education. The findings obtained from the research are discussed with other research results.

Background Prolidase is a manganese (Mn)-dependent cytosolic exopeptidase that degrades imidodipeptides with C-terminal proline or hydroxyproline. Prolidase recycling from imidodipeptides plays a critical role in collagen resynthesis and extracellular matrix (ECM) remodelling. Following an increase in gonadotropins, ovarian and follicular collagen undergo substantial degradation. Abnormal ovarian ECM composition is associated with polycystic ovary syndrome (PCOS). This study aimed to examine prolidase activity in the serum and follicular fluid (FF) of women undergoing in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) treatment, comparing those with PCOS to those with normal ovarian function.Methods This prospective study enrolled 50 participants, of whom 44 were included. PCOS diagnosis followed the Rotterdam consensus criteria, with 20 patients constituting the study group. The control group comprised 24 individuals with mild-to-moderate male infertility. Prolidase enzyme activity in serum and FF was measured using the Chinard reagent via spectrophotometric analysis and compared between the groups.Results Serum and FF prolidase levels were significantly lower in patients with PCOS (p 0.05). A negative correlation existed between serum prolidase levels and total antral follicle (AF) count (p

Acute pancreatitis (AP) is a clinical condition that arises acutely in the pancreas through various inflammatory pathways due to multiple causes. Turkish Society of Gastroenterology Pancreas Working Group developed comprehensive guidance statements regarding the management of AP that include its epidemiology, etiology, clinical presentation, diagnostic criteria, disease severity, treatment, prognosis, local and systemic complications. The statements were developed through literature review, deliberation, and consensus opinion. These statements were ultimately used to develop a conceptual framework for the multidisciplinary management of AP.

İç kontrol sisteminin oluşturulmasıgerekliliği özel sektörde olduğu kadar kamu sektöründe de gündeme gelmiştir. Bu kapsamda ülkemizde yürürlüğe giren 5018 sayılıKanunla kamu idarelerinde iç kontrol sisteminin kurulmasıiçin gereken unsurlar ortaya konmuştur. Buradan hareketle bu araştırmanın amacı, üniversitelerin muhasebe birimlerinin iç kontrol sisteminin önemine ilişkin algılarınıtespit etmek, muhasebe birimlerinin iç kontrol sistemine ilişkin mevcut uygulama düzeylerini belirlemek ve böylece algıdüzeyi ile mevcut uygulamalar arasında farklılık olup olmadığınıortaya koymaktır. 74 devlet üniversitesinin muhasebe birimlerinin başkanlarıile anket çalışmasıyapılarak elde edilen veriler sonucunda muhasebe birim yöneticilerinin iç kontrol sistemine yönelik algıdüzeyleri ile iç kontrol sistemine yönelik mevcut uygulamaların gerçekleştirilme düzeyleri Wilcoxon eşleştirilmişiki örnek testi ile karşılaştırılmıştır. Karşılaştırma sonucunda ankette yer alan 20 ifadenin 17’sinde istatistiki olarak anlamlıbir farklılık tespit edilmiştir. Buradan daire başkanlarının iç kontrol sistemini çok önemli olarak algılamalarına rağmen yöneticisi olduklarımuhasebe birimlerinde mevcut uygulamalar açısından bu özeni göstermedikleri ve mevcut uygulamaların gerçekleştirilmesinde eksiklikleri olduğu sonucu çıkarılabilir.

Control of robots to ensure safe operation has been a current research topic ever since the manipulators were utilized in industrial applications. Humans and robots work together collaboratively more often these days. Providing a safer operation has become an issue that requires more attention. In this paper, the application of a control algorithm that combines a proportional plus derivative controller with an overshoot avoidance trajectory tracking mechanism is introduced. The operation of the algorithm is illustrated on a two-link planar manipulator. The performance is shown both by means of graphs of end effector trajectories and mean absolute error metric. The results indicate that depending on the gain of the proportional plus derivative controller, desired trajectories can be followed very closely and the error becomes negligibly small.