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Objective: This study aimed to investigate the quality of life of patients with central precocious puberty (CPP) who required treatment and premature thelarche (PT) followed up without treatment and to compare the groups with and without treatment among themselves and with healthy children., Design, Patients and Measurement: This study is designed as a case-control study. A total of 193 children including 59 children with CPP, 53 children with PT, 81 healthy children and their parents were included in the study. A questionnaire was applied to evaluate the sociodemographic characteristics that would affect the quality of life. The 'Pediatric Quality of Life Inventory (PedsQL)' was used to assess the quality of life., Results: The PedsQL total scale score was 78.10 ± 17.13, 79.35 ± 11.54 and 79.52 ± 14.65, the psychosocial health summary score was 78.86 ± 16.83, 79.40 ± 12.54 and 79.94 ± 14.94 and physical health summary score was 75.81 ± 20.69, 79.41 ± 15.04 and 78.25 ± 17.52 in CPP, PT and control groups, respectively; however, there was no statistical difference (p > .05). In the scale administered to the parents, scores were similar in the three groups. No difference was found between CPP, PT and control groups in terms of sociodemographic data in the study (p > .05)., Conclusion: Unlike previous studies, in this study the effects of sociodemographic characteristics and whether treatment was initiated or not on quality of life were investigated. Although the scale scores of the CPP group were lower than the PT and control group, there was no statistically significant difference, indicating that quality of life was not negatively affected in the CPP group receiving treatment., (© 2024 John Wiley & Sons Ltd.)

Objective: This randomized controlled study focused on mothers of children with disabilities to determine the effect of a training program on family stress and life satisfaction., Method: The sample consisted of 52 mothers of children with disabilities (intervention group = 26 and control group = 26). The intervention group participated in a five-session training program on coping mechanisms and life satisfaction. Data were collected using the Questionnaire On Resource And Stress (QRS-FT) and the Satisfaction with Life Scale (SWLS)., Results: After the intervention, the mean life satisfaction scores of the intervention group participants increased (p < 0.05), while their mean total score of family stress decreased (p > 0.05). In the control group, the mean life satisfaction scores decreased (p > 0.05), while the mean total score of family stress increased (p < 0.05)., Conclusion: The intervention helped mothers of children with disabilities experience more satisfaction with life and less family stress. Authorities should consider the outcomes of educational intervention studies and formulate training programs for mothers of children with disabilities., Practical Implications: Nurses can use interactive educational programs as nursing interventions to help mothers of children with disabilities experience less family stress and more life satisfaction., Competing Interests: Declaration of competing interest The authors declare that there are no conflict of interests., (Copyright © 2024. Published by Elsevier Inc.)

The current cross-sectional descriptive study was performed to determine the effect of young adults' attitudes regarding social gender roles on perceived social support level in health behaviors. Participants comprised 209 young adults aged 18 to 21 years. Data collection tools included a sociodemographic characteristics form, the Gender Roles Attitude Scale, and Child and Adolescent Social Support Scale for Healthy Behaviors (CASSS-HB). Data were analyzed using percentile, correlation, and regression analysis. A significant positive correlation was found between total CASSS-HB score and the egalitarian gender role subdimension of the Gender Roles Attitude Scale. It was determined that participants with an egalitarian perspective toward gender roles had increased levels of social support in health behaviors. [ Journal of Psychosocial Nursing and Mental Health Services, 62 (4), 17-23.].

Peanut is rich in oil and protein and has a large content of bioactive constituents consisting of tocopherols, phytosterols, and so on. Generally, Virginia, Spanish, Valencia and Runner market types are grown of peanut. In this study, it is aimed to determine the antioxidant activity, total phenolic content and total flavonoid content of peanuts from four different market types, for the first time, and group them with principal component analysis (PCA) and hierarchical cluster analysis (HCA). For PCA, PC1 and PC2 explained 87.655 % of the total variation and, according to the HCA of peanut samples, two main groups were determined. The total phenolic content changed 1.556 to 2.899 mg GAE/g. The lowest value have seen at Spanish merket type to determine the antioxidant activities of peanut samples were maked FRAP and DPPH assay, the lowest FRAP value (8.136 μmol FeSO 4 7H 2 O/g sample) was seen at Valencia market type, the highest (14.004 μmol FeSO 4 7H 2 O/g sample) was seen at Virginia market type. It was determined that the total flavonoid, total phenolic content, and antioxidant activities of the Virginia, Valencia, Spanish, and Runner market types included in the study were different from each other, and the Virginia market type showed superior characteristics compared to the others. The results obtained suggest that Virginia market type may be preferred more especially in peanut cultivation for food uses. It is thought that this study can be a source for future studies by eliminating a deficiency in the literature., (© 2024 Wiley‐VHCA AG, Zurich, Switzerland.)

Epidermal growth factor receptor (EGFR) is the most frequently overexpressed receptor histologically exhibited by oral squamous cell carcinoma (OSCC) patients. Aberrated EGFR signaling may lead to recurrence and metastasis, thus laying the foundation of targeted therapy. Deactivating EGFR is likely to prevent downstream signaling thus resulting in apoptosis. Tyrosine kinase inhibitors (TKIs) have come into play to revert aggressiveness of OSCC. We exploited comparative proteomic analyses based on anti-EGFR potential of varlitinib, using cellular proteomes from treated and untreated groups of oral cancer cells to identify protein players functional during oral carcinogenesis. Following separation by two-dimensional electrophoresis, differentially expressed cellular proteins (varlitinib-treated and untreated cells) were analyzed and later identified using QTOF mass spectrometer. In silico analysis for protein-protein interaction was carried out using STRING. Six differentially expressed proteins were identified as binding immunoglobulin protein (BiP), heat shock protein 7 C (HSP7C), protein disulfide isomerase 1 A (PDIA1), vimentin (VIME), keratin type I cytoskeletal 14 (K1C14), and β-Actin (ACTB). Relative expression of five proteins was found to be downregulated upon varlitinib treatment, whereas only K1C14 was upregulated in treated cells compared to control. Protein network analysis depicts the interaction between BiP, PDIA1, VIME, etc. indicating their role in oral carcinogenesis. Oral cancer cells show proteome shift based on varlitinib treatment compared to corresponding controls. Our data suggest candidature of varlitinib as a potent therapeutic agent and BiP, PDIA1, HSP7C, VIME, and β-Actin as complementary/prognostic markers of OSCC., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Inappropriate disposal of plastic wastes and their durability in nature cause uncontrolled accumulation of plastic in land/marine ecosystems, also causing destructive effects by bioaccumulating along the food chain. Microplastics may cause chronic inflammation in relation to their permanent structures, especially through oxidative stress and cytotoxic cellular damage, which could increase the risk of cancer development. The accumulation of microplastics in the liver is a major concern, and therefore, the identification of the mechanisms of their hepatotoxic effects is of great importance. Polymethyl methacrylate (PMMA) is a widely used thermoplastic. It has been determined that PMMA disrupts lipid metabolism in the liver in various aquatic organisms and causes reproductive and developmental toxicity. PMMA-induced hepatotoxic effects in humans have not yet been clarified. In our study, the toxic effects of PMMA (in the range of 3-10 μm) on the human liver were investigated using the HepG2/THP-1 macrophage co-culture model, which is a sensitive immune-mediated liver injury model. Cellular uptake of micro-sized PMMA in the cells was done by transmission electron microscopy. Determination of its effects on cell viability and inflammatory response, oxidative stress, along with gene and protein expression levels that play a role in the mechanism pathways underlying the effects were investigated. The results concluded that inflammation, oxidative stress, and disruptions in lipid metabolism should be the focus of attention as important underlying causes of PMMA-induced hepatotoxicity. Our study, which points out the potential adverse effects of microplastics on human health, supports the literature information on the subject., (© 2024. The Author(s).)

Laminin receptor 1 (LAMR) may have a role in the progression of premalignant squamous epithelial lesions to cervical cancer. Therefore, we aimed to investigate the expression of laminin receptor 1 (LAMR) in normal, premalignant, and malignant tissues of the uterine cervix. Paraffin blocks of 129 specimens with the diagnoses of normal cervical tissue (n = 33), cervical intraepithelial neoplasia (CIN) 1 (n = 30), CIN 2 (n = 14), CIN 3 (n = 28), and squamous cell carcinoma (n = 24) were immunohistochemically stained with LAMR antibody and its expression percentage, pattern, and intensity in these tissues were assessed. Compared to the other groups, the nonstaining with LAMR was highest in low grade squamous intraepithelial lesion (LSIL) (p < 0.0001). LAMR expression, which was positive in less than 50% of cells with weak staining, increased significantly between normal cervical epithelium and high-grade squamous intraepithelial lesion (HSIL) or invasive carcinoma, as well as between LSIL and HSIL (p < 0.0001). Between LSIL and invasive carcinoma, a significant increment was also observed for weak staining in less than 50% of cells (p < 0.001). LAMR expression, which was positive in more than 50% of cells with strong staining, was significantly higher in normal cervical tissue compared to the other groups (p < 0.0001). Disease progression related gradual increment of LAMR expression from normal cervical epithelium or LSIL towards HSIL or cervical cancer reveals that LAMR may play an important role in the transition from premalignant to malignant state in cervical lesions.

Purpose: To assess how living with patients with acromegaly affects people's psychology and quality of life (QoL)., Methods: Acromegaly patients and their cohabitants included in this study. Patients were administered Acromegaly Quality of Life Questionnaire (AcroQoL), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). Cohabitants were administered quality of life questionnaire (SF-36), BAI, BDI, and Zarit Caregiver Burden Interview (ZBI)., Results: This study included 84 patients with acromegaly and 84 cohabitants. Sixty-nine patients (n = 84, 82.1%) had an acromegalic appearance. Cohabitants who were affected by the acromegalic appearance had higher BAI, BDI, and ZBI scores than those who were not affected (p < 0.001 for all). Cohabitants who were affected by the acromegalic appearance had a significantly lower SF-36 score (p = 0.015). The BAI (r=-0.535, p < 0.001), BDI (r=-0.592, p < 0.001), and ZBI (r=-0.465, p < 0.001) scores of the cohabitants showed a negative correlation with AcroQoL. SF-36 scores showed correlation with AcroQoL (r = 0.387, p < 0.001)., Conclusion: The chronic process of acromegaly and the external appearance of patients with this disease can negatively affect both the patients and the people living with them. Physicians being aware of this effect and taking counteractive measures may contribute positively to the course of acromegaly., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Multisystemic findings of inherited bone marrow failure syndromes may cause difficulty in diagnosis. Exome sequencing (ES) helps to define the etiology of rare diseases and reanalysis offers a valuable new diagnostic approach. Herein, we present the clinical and molecular characteristics of a girl who was referred for cytopenia and frequent infections., Case Report: A 5-year-old girl with cytopenia, dysmorphism, short stature, developmental delay, and myopia was referred for genetic counseling. Reanalysis of the ES data revealed a homozygous splice-site variant in the DNAJC21 (NM&#95;001012339.3:c.983+1G>A), causing Shwachman-Diamond Syndrome (SDS). It was shown by the RNA sequencing that exon 7 was skipped, causing an 88-nucleotide deletion., Conclusions: Precise genetic diagnosis enables genetic counseling and improves patient management by avoiding inappropriate treatment and unnecessary testing. This report would contribute to the clinical and molecular understanding of this rare type of SDS caused by DNAJC21 variants and expand the phenotypic features of this condition., Competing Interests: The authors have no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: The aim of this national, multicenter, cross-sectional, retrospective chart review study was to determine the proportion of patients in Turkey who received hepatitis C virus (HCV) treatment after receiving positive anti-HCV results during HCV screening., Methodology: Data related to patients' demographics, laboratory results, time interval from obtaining a positive anti-HCV result to treatment initiation, specialty of the physician requesting anti-HCV screening, and type of hospital were analyzed., Results: Among 1,000 patients who received a positive anti-HCV result, 50.3% were male and 78.5% were screened for HCV-RNA. Among HCV-RNA screened patients, 54.8% (n = 430) had a positive result. Among patients who tested positive for HCV-RNA, 72.8% received HCV treatment in line with their positive anti-HCV results. The median time from obtaining a positive anti-HCV result to initiation of HCV treatment was 91.0 days (interquartile range 42.0 to 178.5). Non-surgical branches requested HCV-RNA testing more frequently than surgical branches (p < 0.001). The rate of access to HCV treatment was higher among patients screened in university hospitals than among patients screened in training and research hospitals (p < 0.001)., Conclusions: Our results indicate a higher rate of treatment initiation among patients with HCV infection than is described in the published literature. Furthermore, the time from screening to treatment initiation was considerably shorter compared with other international studies. However, since HCV-RNA testing was not requested in a significant portion of patients with a positive anti-HCV test result, there might be a large patient population with HCV who do not receive treatment., Competing Interests: Mustafa K Çelen has served as a consultant for AbbVie, Gilead, MSD, Pharmactive, İlko, GSK, and Abdi İbarahim; as a speaker for Gilead, MSD, Pharmactive, İlko, and GSK; and has received research funding from AbbVie, Gilead, MSD, and GSK. Buket Ertürk Şengel has served as a consultant for AbbVie, and has received research funding from AbbVie. Şafak Kaya has served as a consultant for AbbVie; as a speaker for Gilead, Abdi İbrahim, and Pharmactive; and has received research funding from AbbVie. Neşe Demirtürk has served as a speaker for Nobel, Gilead, and Abdi İbrahim; and has received research funding from AbbVie. Alpay Azap has served as a consultant for AbbVie, and has received research funding from AbbVie. Hüsnü Pullukçu has served as a consultant for AbbVie, Gilead, GSK, and MSD; as a speaker for AbbVie, Gilead, GSK, İlko, and MSD; and has received research funding from AbbVie, and Gilead. Esma Eroğlu has received research funding from AbbVie. Figen Yıldırım has served as a consultant for AbbVie, Gilead, GSK, Santa Farma, and İlko; as a speaker for Gilead, GSK, Santa Farma, and İlko; and has received research funding from AbbVie, and Gilead. Hüseyin Ş Barut has received research funding from AbbVie. Esra Zerdali has served as a consultant for Gilead, GSK, and MSD; as a speaker for Gilead, İlko, and GSK; and has received research funding from AbbVie, and Gilead. Ayşe Sağmak Tartar has served as a speaker for Pharmactive, Pfizer, and Astellas; and has received research funding from AbbVie. Ayşe Ö Mete has served as a consultant for AbbVie and Gilead; has served as a speaker for AbbVie, Gilead, Pharmactive, Pfizer, GSK, and Abdi İbrahim; has received research funding from AbbVie, Pfizer, and Neutec; and has received congress participation support from Gilead, and Pfizer. Ahmet M Şahin has served as a consultant and a speaker for AbbVie, and has received research funding from AbbVie. Bedia Mutay Suntur has served as a speaker for Gilead, and has received research funding from AbbVie. Nagehan D Sarı has served as a consultant for AbbVie, and has received research funding from AbbVie. Emel Yılmaz has served as a speaker for AbbVie, İlko, and Abdi İbrahim; and has received research funding from AbbVie. Aslıhan Candevir has served as a consultant and a speaker for AbbVie, Gilead, Pfizer, GSK, Pharmactive, Santa and Farma; and has received research funding from AbbVie, Gilead, Pfizer, GSK, Pharmactive, and Santa Farma. Funda Şimşek has served as a consultant and a speaker for Gilead, and has received research funding from AbbVie. Dilara İnan has served as a consultant for Gilead, GSK, and MSD; as a speaker for AbbVie, Gilead, GSK, İlko, and MSD; and has received research funding from AbbVie. Sıla Akhan has served as a consultant for AbbVie, and has received research funding from AbbVie. Ali Asan has served as a consultant for AbbVie; as a speaker for AbbVie and Gilead; and has received research funding from AbbVie, and Gilead. Özgür Günal has served as a consultant and a speaker for AbbVie, and has received research funding from AbbVie. Onur Ural has received research funding from AbbVie. Mehmet Parlak has received research funding from AbbVie. Mehmet Çabalak has served as a consultant and a speaker for AbbVie, Gilead, MSD, and Pharmactive; and has received research funding from AbbVie. Selçuk Nazik has served as a consultant for AbbVie; as a speaker for İlko; and has received research funding from AbbVie. Kenan Hızel has received research funding from AbbVie. Sami Kınıklı has served as a speaker for Gilead, and has received research funding from AbbVie. Zehra Beştepe Dursun has received research funding from AbbVie. Ayşe Batırel has served as a consultant and a speaker for Gilead, Pfizer, and Santa Farma; and has received research funding from AbbVie. Çiğdem Mermutluoğlu has no conflict of interest to declare., (Copyright (c) 2024 Mustafa K Çelen, Buket Ertürk Şengel, Şafak Kaya, Neşe Demirtürk, Alpay Azap, Hüsnü Pullukçu, Esma Eroğlu, Figen Yıldırım, Hüseyin Ş Barut, Esra Zerdali, Ayşe Sağmak Tartar, Ayşe Ö Mete, Ahmet M Şahin, Bedia Mutay Suntur, Nagehan D Sarı, Emel Yılmaz, Aslıhan Candevir, Funda Şimşek, Dilara İnan, Sıla Akhan, Ali Asan, Özgür Günal, Onur Ural, Mehmet Parlak, Mehmet Çabalak, Selçuk Nazik, Kenan Hızel, Sami Kınıklı, Zehra Beştepe Dursun, Ayşe Batırel, Çiğdem Mermutluoğlu.)

Background: It is essential to develop future nurses' privacy consciousness and attitudes toward patient privacy to recognise threats to patient privacy and take the necessary precautions., Objectives: To determine the effect of digital storytelling and case studies teaching methods on nursing students' privacy consciousness and attitudes toward patient privacy., Research Design: Pretest-posttest, factorial group randomised controlled study., Participants and Research Context: Eligible 113 nursing students were randomised to the intervention I ( n = 38), intervention II ( n = 38), and control group ( n = 37) by stratified block randomisation method. The education program consisted of two theoretical sessions and three practical sessions. Data were collected using questionnaires pre-, post-, 4 weeks, and 16 weeks after the intervention between November 2020 and May 2021 in Türkiye., Ethical Considerations: Written approval was obtained from the university's Ethics Board. Informed written and verbal consent were obtained from the participants., Findings: The results showed a significant time effect on nursing students' privacy consciousness and attitudes toward patient privacy ( p < .05), no significant difference between the groups ( p > .05), and a significant, positive, and strong relationship between the privacy consciousness and the attitudes toward patient privacy. Students stated that digital storytelling was beneficial in focusing on the subject, memorability, interest, curiosity, and attention., Conclusions: Besides the ethics course, the privacy education program with digital storytelling and case studies develops nursing students' privacy consciousness and attitudes toward patient privacy. It is recommended to integrate privacy education into ethics courses and popularise digital storytelling and ethical case studies in ethics education., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

MIRAGE syndrome is a rare multisystemic disorder characterized by various manifestations, such as myelodysplasia, susceptibility to infections, growth retardation, adrenal hypoplasia, genital anomalies, and enteropathy. In the literature, there have been rare cases of dysautonomia. We present a 6.5-year-old girl, who was first admitted to our department with short stature. On follow up, she exhibited multiple endocrinological issues, including transient hypothyroidism, primary hypoparathyroidism and dysautonomia, along with multisystem involvement. Further investigations revealed recurrent moniliasis, low IgM levels, and transient monosomy 7 in the bone marrow. Whole exome sequencing revealed a heterozygous pathogenic variant of SAMD9 (c.2159del; p.Asn720ThrfsTer35). Additional complications observed during follow-up included medullary nephrocalcinosis, hypomagnesemia, hypermagnesiuria, hypophosphatemia, decreased glomerular filtration rate, and nephrotic proteinuria. The patient also developed hyperglycemia, which was managed with low-dose insulin. This case highlights the diagnostic challenges and the diverse phenotypic presentation observed in MIRAGE syndrome.

Objective: : To evaluate the effect of clear aligner treatment and differential sequence distalization of maxillary posterior teeth on anchorage loss in the upper incisors (U1s)., Methods: : This study used lateral cephalometries and digital models of 12 patients treated with 33% sequential distalization (group 1, mean age: 22.9 ± 0.7 years, five males, seven females) and 12 treated with 50% sequential distalization (group 2, mean age: 25.83 ± 0.5 years, three males, nine females) acquired before and after distalization of upper second premolars (U5) and upper first molars (U6) and upper second molars (U7). The amount of distalization was determined as 2.5 mm in both the groups. Independent Samples t test was used to compare normally distributed parameters. Mann-Whitney U and Wilcoxon tests were used to compare parameters that were not normally distributed., Results: : In both groups, the posterior teeth significantly moved by tipping distally and the U1s were displaced anteriorly. Increase in maxillary posterior transverse width ( P < 0.001) and distopalatal rotation were observed in U5, U6, and U7 after distalization. It was also observed that U1 was significantly more proclined (1.82°; P < 0.001) and protruded (0.62 mm; P < 0.001), and the overjet (0.45 mm; P < 0.001) increased more in group 1 than in group 2., Conclusions: : After sequential distalization of maxillary posterior teeth, more anchorage loss was observed in the anterior region in group 1 than in group 2.

Objectives: This study aimed to investigate coronavirus disease 2019 (COVID-19) vaccination rates and factors affecting vaccination in children with rheumatic diseases., Patients and Methods: This multicenter cross-sectional survey-based study was conducted between July 2022 and September 2022. Four hundred seventy-four patients (256 females, 218 males; median age: 15 years; interquartile range, 13 to 16 years) were included in the patient group, and 211 healthy children (124 females, 87 males; median age: 15 years; interquartile range, 13 to 16 years) were included in the control group. A questionnaire was administered to the parents face-to-face during routine outpatient visits., Results: Of the patients, 220 were followed up with the diagnosis of autoinflammatory disease, 174 with juvenile idiopathic arthritis, 48 with connective tissue disease, 23 with vasculitis, eight with uveitis, and one with sarcoidosis. In the study group, 256 (54%) patients and 115 (54.5%) healthy children received at least one dose of COVID-19 vaccine. Parents' concern regarding potential side effects of the vaccine was the most common reason for COVID-19 vaccination hesitancy in both groups. The median patient age, follow-up period, colchicine treatment rates, childhood vaccination and influenza vaccination rates, median parental age, parental vaccination rate, and parental education level were higher in vaccinated patients (p<0.001)., Conclusion: Parents' concerns about safety and side effects were found to be the most important factors affecting vaccination success. Identification of the underlying causes of parental vaccine hesitancy will facilitate the development of effective vaccination strategies for potential future outbreaks., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2024, Turkish League Against Rheumatism.)

Objective: This study aimed to develop machine learning (ML) algorithms for the differential diagnosis of adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome (CS) based on biochemical and radiological features., Methods: Logistic regression algorithms were used for ML, and the area under the receiver operating characteristics curve (AUROC) was used to measure performance. We used Shapley Contributed Comments (SHAP) values, which help explain the results of the ML models to identify the meaning of each feature and facilitate interpretation., Results: A total of 106 patients, 80 with Cushing's disease (CD) and 26 with ectopic ACTH syndrome (EAS), were enrolled in the study. The ML task was created to classify patients with ACTH-dependent CS into CD and EAS. The average AUROC value obtained in the cross-validation of the logistic regression model created for the classification task was 0.850. The diagnostic accuracy of the algorithm was 86%. The SHAP values indicated that the most important determinants for the model were the 2-day 2-mg dexamethasone suppression test, the > 50% suppression in the 8-mg high-dose dexamethasone test, late-night salivary cortisol, and the diameter of the pituitary adenoma. We have also made our algorithm available to all clinicians via a user-friendly interface., Conclusion: ML algorithms have the potential to serve as an alternative decision support tool to invasive procedures in the differential diagnosis of ACTH-dependent CS., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Ozone, widely recognized as an environmentally friendly gas, is extensively used in various textile industry applications. These include pre-treatment processes like bleaching and desizing, as well as creating pattern and vintage effects, wastewater clarification, and surface modification. This study focuses on ozone as a novel solution to a specific challenge: addressing the reduction in flame retardancy properties experienced by flame-retardant (FR) polyester fabrics during post-treatment processes in the production line. Experimentation involved subjecting the fabrics to ozonation and exploring different combinations of ozone flow rates and treatment durations. Mechanical and functional properties of the fabrics were examined, with flammability tested according to International Maritime Organization (IMO) standards. Notably, treatment with a 5 L/min ozone flow rate, a 7.01 g/h ozone concentration ratio, and a duration of 10 min showed significant improvements in IMO values, ensuring compliance with required standards. Furthermore, treated samples underwent comprehensive tests for fastness and strength, yielding results within acceptable ranges. Fourier-transform infrared (FT-IR) and thermogravimetric analysis (TGA) measurements were conducted to evaluate the impact of ozonation. FT-IR results indicated that the presence of C-H groups associated with dyestuff contributed to decreased flame retardancy in the original fabric post-dyeing. However, these groups were effectively eliminated through ozonation, thereby enhancing the fabric's flame retardancy.

Hawthorn plant is used among people due to its cardiovascular, anti-inflammatory, and antihistamine properties. But no scientific study has been done about Crataegus orientalis (Mill.) M.Bieb. The presented study was planned to determine the effects of ethanol and n-hexane extracts of Crataegus orientalis leaves on human plasma ACE enzyme. In the study, the effect of plant extracts on ACE was studied by the spectrophotometric method. The chemical composition of the plant extracts was determined by HPLC-DAD analyses. In addition, molecular doking and ADME prediction studies were carried out. As a result, the obtained data showed that Crataegus orientalis could have an important place in the pharmaceutical industry and drug discovery studies, as it supports the traditional use of Crataegus orientalis as hypotensive. The results of the molecular docking studies revealed that the interactions of the selected compounds with the human ACE enzyme caused inhibition.

Introduction: More than two-thirds of patients with type 1 diabetes (T1D) are overweight (OW) and/or obese (OB) in the USA and Western Europe, resulting in insulin resistance as in type 2 diabetes. None of the currently available glucagon like polypeptide 1 (GLP-1) analogs are approved for patients with T1D. A higher dose of semaglutide has been approved by the Food and Drug Administration (FDA) for subjects with body mass index (BMI) >27 kg/m 2 . We evaluated the real-world use of semaglutide in patients with T1D. Methods: This was a retrospective chart review study of 50 OW or OB patients with T1D who were initiated on semaglutide and followed for 1 year. The control group comprised of 50 computer-matched patients (for sex, race, weight, BMI, and diabetes duration) during a similar time period and were not on any weight loss medications. Results: Most patients (92%) were non-Hispanic white in both arms. Mean ± standard deviation (SD) age and duration of diabetes were 42 ± 11 and 27 ± 12 years, respectively. The continuous glucose monitors (CGM), insulin pump use, baseline BMI and body weight were also similar in the two groups. Baseline glycosylated hemoglobin (HbA1c) was insignificantly lower in the semaglutide group (7.6% vs. 8.2%, respectively; P  = non-significant [NS]). Total daily insulin dose (TDD) and insulin dose per kg body weight were higher in the semaglutide group at baseline with no difference in basal or prandial insulin dose. There were significantly greater declines in mean (±SD), BMI (7.9% ± 2.6%), body weight (15.9 lbs ± 5.4 lbs), HbA1c, CGM glucose SD and coefficient of variation (CV), and increase in CGM time in range (TIR) in the semaglutide group compared to the control group with no difference in insulin dose changes, time above range (TAR), or time below range (TBR). Conclusions: We conclude that use of semaglutide in patients who are OW and/or OB with T1D was effective in lowering body weight and BMI, and improving glycemic metrics in this pilot real-world study. We strongly recommend performing prospective, large-randomized clinical trials with newer GLP-1 analogs like semaglutide and tirzepatide (twin-cretin) for subjects with T1D associated with OW and/or OB.

Aim: We aimed to investigate the preventive effects of carvacrol against ketamine-induced cardiotoxicity biochemically and histopathologically in an experimental model., Material and Method: The rats were divided into three groups; healthy control (HC), ketamine alone (KG), and ketamine + carvacrol (KCG) groups. Serum Creatine Kinase Myocardial Band (CK-MB) and Troponin I (TP I) levels were determined. Malondialdehyde (MDA), Glutathione (GSH), Superoxide Dismutase (SOD), Tumor Necrosis Factor α (TNF-α), Interleukin 1 beta (IL-1beta), and Interleukin 6 (IL-6) levels were measured in the heart tissues of the rats. Heart tissues were also evaluated histopathologically., Results: In the ketamine-treated group, tissue MDA, TNF-α, IL-1beta, and IL-6 levels increased while tissue GSH and SOD levels decreased significantly compared with the control group. However, in the ketamine plus carvacrol applied group, all those alterations were significantly less pronounced, close to the healthy controls. Severe mononuclear cell infiltrations, degenerated myocytes and hemorrhage were determined in the ketamine alone administered group, and these alterations were at a mild level in the carvacrol + ketamine administered group., Conclusion: Prolonged exposure to ketamine resulted in induced oxidative stress in rat heart tissue; concomitant carvacrol application could counteract the negative effects of ketamine by protecting tissues from lipid peroxidation and decreasing the inflammatory response.

Background: It is known that health professionals who work with chronic patients for a long time are at risk in terms of compassion fatigue and burnout. Purpose: The study aims to compare the levels of compassion fatigue, burnout, and compassion satisfaction of nurses working on oncology-hematology and dialysis and determine the predictors. Methods: This study was carried out using descriptive and correlational research design. The research was conducted with 278 nurses. Participants were enrolled using a convenience sampling technique from the oncology-hematology inpatient services, outpatient chemotherapy units, and bone marrow transplant units and dialysis nurses of purposively selected hospitals in Istanbul, Turkey. Personal information form and Professional Quality of Life-IV. Potential predictors were analyzed using univariate analysis. We conducted multiple stepwise linear regression analyses to reveal the outcome variables. Results: A sub-analysis comparing the dialysis specialty with the oncology-hematology revealed that dialysis nurses report significantly higher compassion fatigue scores than oncology nurses. Working willingly in the current unit and the level of received social support were determined as predictors for all outcome variables. Conclusions: This is the first study comparing compassion fatigue, burnout, and compassion satisfaction levels of oncology-hematology and dialysis nurses. This study indicates the need for nurse managers to be aware of compassion fatigue and plan compassion fatigue prevention programs. In addition, this study guides the interventional studies to be conducted in the future., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: Colchicine forms the mainstay of treatment in FMF. Approximately 5-10% of FMF patients are colchicine resistant and require anti-IL-1 drugs. We aimed to compare the characteristics of colchicine-resistant and colchicine-responsive patients and to develop a score for predicting colchicine resistance at the time of FMF diagnosis., Methods: FMF patients (0-18 years) enrolled in the Turkish Paediatric Autoinflammatory Diseases (TURPAID) registry were included. The predictive score for colchicine resistance was developed by using univariate/multivariate regression and receiver operating characteristics analyses., Results: A total of 3445 FMF patients [256 (7.4%) colchicine-resistant and 3189 colchicine-responsive) were included (female:male ratio 1.02; median age at diagnosis 67.4 months). Colchicine-resistant patients had longer, more frequent attacks and were younger at symptom onset and diagnosis (P < 0.05). Fever, erysipelas-like erythema, arthralgia, arthritis, myalgia, abdominal pain, diarrhoea, chest pain, comorbidities, parental consanguinity and homozygosity/compound heterozygosity for exon 10 MEFV mutations were significantly more prevalent among colchicine-resistant than colchicine-responsive patients (P < 0.05). Multivariate logistic regression analysis in the training cohort (n = 2684) showed that age at symptom onset, attack frequency, arthritis, chest pain and having two exon 10 mutations were the strongest predictors of colchicine resistance. The score including these items had a sensitivity of 81.3% and a specificity of 49.1%. In the validation cohort (n = 671), its sensitivity was 93.5% and specificity was 53.8%., Conclusion: We developed a clinician-friendly and practical predictive score that could help us identify FMF patients with a greater risk of colchicine resistance and tailor disease management individually at the time of diagnosis., (© The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology.)

Objective: In this study, we investigated the effects of calreticulin ( CALR ) and JAK2 V617F mutational status on clinical course and disease outcomes in Turkish patients with essential thrombocythemia (ET)., Materials and Methods: Seventeen centers from Türkiye participated in the study and CALR - and JAK2 V617F-mutated ET patients were evaluated retrospectively., Results: A total of 302 patients were included, of whom 203 (67.2%) and 99 (32.8%) were JAK2 V617F- and CALR -positive, respectively. CALR -mutated patients were significantly younger (51 years vs. 57.5 years, p=0.03), with higher median platelet counts (987x10 9 /L vs. 709x10 9 /L, p<0.001) and lower median hemoglobin levels (13.1 g/dL vs. 14.1 g/dL, p<0.001) compared to JAK2 V617F-mutated patients. Thromboembolic events (TEEs) occurred in 54 patients (17.9%), 77.8% of which were arterial. Compared to CALR mutation, JAK2 V617F was associated with a higher risk of thrombosis (8.1% vs. 22.7%, p=0.002). Rates of transformation to myelofibrosis (MF) and leukemia were 4% and 0.7%, respectively, and these rates were comparable between JAK2 V617F- and CALR -mutated cases. The estimated overall survival (OS) and MF-free survival of the entire cohort were 265.1 months and 235.7 months, respectively. OS and MF-free survival durations were similar between JAK2 V617F- and CALR -mutated patients. Thrombosis-free survival (TFS) was superior in CALR -mutated patients compared to JAK2 V617F-positive patients (5-year TFS: 90% vs. 71%, respectively; p=0.001). Age at diagnosis was an independent factor affecting the incidence of TEEs., Conclusion: In our ET cohort, CALR mutations resulted in higher platelet counts and lower hemoglobin levels than JAK2 V617F and were associated with younger age at diagnosis. JAK2 V617F was strongly associated with thrombosis and worse TFS. Hydroxyurea was the most preferred cytoreductive agent for patients with high thrombosis risk., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2024 by Turkish Society of Hematology Turkish Journal of Hematology, Published by Galenos Publishing House.)

Objective: A bidirectional relationship between family functioning and parenting styles and Attention Deficit and Hyperactivity Disorder (ADHD) is proposed. The aim of this study is to examine the effect of ADHD symptoms on parenting styles and the general functionality of the family as well as symptoms of depression and anxiety., Methods: 73 children with ADHD (56%) and 56 controls (43%) (a total of 129 participants, 31% female, 69% male) with a mean age of 11.3 (7-17, n: 129) were included in the study, which was conducted in Gaziantep University Hospital Child Psychiatry Department in 2022. The participants completed psychometric scales., Results: Parents of children with ADHD showed higher positive parenting scores than the control group ( p  < 0.05). Inconsistent discipline scores were substantially higher in the ADHD combined subtype (14.38 ± 5.2) than in the attention deficit dominant group (17.59 ± 3.96) In addition, a strong correlation was found between familial functionality scores and ADHD severity in the ADHD attention deficit dominant subtype (r:0.601; p:0.027) and as ADHD severity increased, family functionality decreased., Conclusions: This study shows that parents of children with ADHD have different parenting styles and ADHD affects the overall functionality of the family in the Turkish sample.

The purpose of the present study was to investigate the effectiveness of video modeling to teach safety skills during earthquakes and postearthquake evacuation to children with autism. Three male children with autism, aged 9-10 years, participated in the study. The results indicate that video modeling was effective at promoting the acquisition of "drop, cover, and hold on" and evacuation skills for all three students. Furthermore, the skills generalized to a new setting for all three participants and maintained up to 4 weeks after video modeling for the two participants for whom maintenance was evaluated. Social-validity data were also collected from participants, their parents, and a teacher, and the findings were positive overall. Implications for instruction and future research are discussed based on the results of the study., (© 2024 The Authors. Journal of Applied Behavior Analysis published by Wiley Periodicals LLC on behalf of Society for the Experimental Analysis of Behavior (SEAB).)

Objective: Tinnitus is one of the most common otologic symptoms and has a serious effect on the quality of life. The pathophysiology of tinnitus is not fully understood and no consensus has been reached on an effective treatment method for tinnitus. To evaluate the effectiveness of the kinesiotape (KT) method in subjective tinnitus treatment., Material and Method: KT is a method used for sensory simulation. It is a method that aims to increase muscle function, positively affect lymphatic fluid and blood circulation, and stimulate the neurological system. In this study, KT method was applied and the study was prospective. 34 individuals with subjective tinnitus, and normal hearing were included. The study group (n = 17) was informed about tinnitus and KT was applied for 4 weeks, the control group (n = 17) was only informed about tinnitus. The information about tinnitus given to both groups included verbal information about what tinnitus is, how to deal with tinnitus and basic recommendations. All individuals were initially administered tinnitus measurements (pitch, loudness, minimal masking level, residual inhibition), Tinnitus Handicap Inventory (THI), Visual Analogue Scale (VAS), SF-36, and Beck Depression Inventory (BDI). All evaluations were repeated after 4 weeks., Results: Tinnitus loudness and pitch decreased in the KT group (P < .05). In both groups, there was a significant difference between the first and last measurements of the severity of tinnitus, the degree of discomfort from tinnitus with VAS, and the catastrophic and total scores of THI (P < .05). KT group, the emotional sub-score of THI improved significantly with KT (P < .05), and significant improvement was achieved in the BDI scores (P < .05). There was a significant difference in the SF-36 after the application of KT (P < .05)., Conclusion: In subjective tinnitus, the pathophysiology of which is unknown and there is no consensus on an effective treatment method, improvement in tinnitus severity, quality of life and depression perception in both audiologic and perceptual evaluations were obtained as a result of KT application. We believe that KT, which has no side effects and is easy to apply, is a method that can be easily used in individuals with subjective tinnitus.

Type I interferons (IFN), immediately triggered following most viral infections, play a pivotal role in direct antiviral immunity and act as a bridge between innate and adaptive immune responses. However, numerous viruses have evolved evasion strategies against IFN responses, prompting the exploration of therapeutic alternatives for viral infections. Within the type I IFN family, 12 IFNα subtypes exist, all binding to the same receptor but displaying significant variations in their biological activities. Currently, clinical treatments for chronic virus infections predominantly rely on a single IFNα subtype (IFNα2a/b). However, the efficacy of this therapeutic treatment is relatively limited, particularly in the context of Human Immunodeficiency Virus (HIV) infection. Recent investigations have delved into alternative IFNα subtypes, identifying certain subtypes as highly potent, and their antiviral and immunomodulatory properties have been extensively characterized. This review consolidates recent findings on the roles of individual IFNα subtypes during HIV and Simian Immunodeficiency Virus (SIV) infections. It encompasses their induction in the context of HIV/SIV infection, their antiretroviral activity, and the diverse regulation of the immune response against HIV by distinct IFNα subtypes. These insights may pave the way for innovative strategies in HIV cure or functional cure studies.

The study aimed to investigate the relationship of perioperative inadvertent hypothermia with anxiety and thermal and general comfort in surgical patients. Inadvertent perioperative hypothermia occurs after surgery and affects many patient outcomes. However, the relationship between hypothermia and anxiety has been given little attention. The research is of descriptive type. A total of 117 surgical patients who met the inclusion criteria were sampled and divided into two groups: hypothermic ( n  = 54) and normothermic ( n  = 63). Patients undergoing surgery were monitored for body temperature, systolic and diastolic blood pressure, heart rate, pain intensity, anxiety (Numeric Rating Scale [NRS] and State Anxiety Scale [SAI]), and comfort (Perianesthesia Comfort Questionnaire) levels. The groups were similar in terms of descriptive characteristics ( p  > 0.05). Among the patients undergoing surgical intervention, 46.1% were hypothermic. Compared with the normothermic group, the hypothermic group had significantly lower body temperature until the second postoperative hour, lower thermal comfort score until the third postoperative hour, and higher heart rate and anxiety (NRS) score until the first postoperative day. Furthermore, there was a significant difference between the groups in terms of pain intensity up to the first 30 minutes after surgery ( p  < 0.05). Moreover, there was no significant difference between the groups in terms of pre and postoperative day one anxiety (SAI) and Periantesthesia Comfort Scale mean scores ( p  > 0.05). The study findings showed that hypothermia affected thermal comfort up to the first 3 hours after surgery, pain intensity up to the first 30 minutes, and heart rate and anxiety (NRS) levels up to the first day.

Background: Anaplastic thyroid cancer (ATC) is a rare and aggressive neoplasm. We still lack effective treatment options, so survival rates remain very low. Here, we aimed to evaluate the activity of the combination of lenvatinib and pembrolizumab as systemic first-line therapy in ATC., Methods: In a retrospective analysis, we investigated the activity and tolerability of combined lenvatinib (starting dose 14 to 24 mg daily) and pembrolizumab (200 mg every three weeks) as first-line therapy in an institutional cohort of ATC patients., Results: Five patients with metastatic ATC received lenvatinib and pembrolizumab as systemic first-line therapy. The median progression-free survival was 4.7 (range 0.8-5.9) months, and the median overall survival was 6.3 (range 0.8-not reached) months. At the first follow-up, one patient had partial response, three patients had stable disease, and one patient was formally not evaluable due to interference of assessment by concomitant acute infectious thyroiditis. This patient was then stable for more than one year and was still on therapy at the data cutoff without disease progression. Further analyses revealed deficient DNA mismatch repair, high CD8 + lymphocyte infiltration, and low macrophage infiltration in this patient. Of the other patients, two had progressive disease after adverse drug reactions and therapy de-escalation, and two died after the first staging. For all patients, the PD-L1 combined positive score ranged from 12 to 100%., Conclusions: The combination of lenvatinib and pembrolizumab was effective and moderately tolerated in treatment-naïve ATC patients with occasional long-lasting response. However, we could not confirm the exceptional responses for this combination therapy reported before in pretreated patients., (© 2024. The Author(s).)

Background: Geriatric syndromes may be more common in older cancer patients than in those without cancer. Geriatric syndromes can cause poor clinical outcomes. The Eastern Cooperative Oncology Group Performance Status (ECOG-PS) is often used as a clinically reported functional status score in oncology practice., Methods: Our study was designed as a cross-sectional study and included 218 older cancer patients. This study aimed to determine the prevalence and relationship of geriatric syndromes according to the ECOG-PS in older cancer patients., Results: The mean age of 218 participants was 73.0 ± 5.6 years, with 47.7% being women and 52.3% men in our study. ECOG-PS 0, 1, and 2 groups contained 51, 39, and 10% of the patients, respectively. The mean number of geriatric syndromes in the ECOG 0, 1, and 2 groups was 2.3 ± 2.2, 4.3 ± 2.4, and 5.7 ± 2.1, respectively ( p  < 0.001). After adjusting for age and sex, it was determined that dynapenia was 2.9 times, probable sarcopenia was 3.5 times, frailty was 4.2 times, depression was 2.6 times, malnutrition was 3.3 times, insomnia 2 was.2 times, falls was 2.5 times, and the risk of falling (TUG) was 2.4 times more likely in those with ECOG-PS 1 compared to those with ECOG-PS 0. In addition, it was found that dynapenia was 6 times, probable sarcopenia was 6.8 times, frailty was 10.8 times, depression was 3.3 times, malnutrition was 6.3 times, the risk of falling (Tinnetti Balance) was 28 times, and the risk of falling (TUG) was 13.6 times more likely in those with ECOG-PS 2 compared to those with ECOG-PS 0., Conclusion: Our study found that the prevalence of geriatric syndromes increased as the ECOG-PS increased. Geriatric syndromes and their co-incidence were common in older cancer patients, even in normal performance status. Oncologists should incorporate geriatric syndromes into the decision-making process of cancer treatment to maximize the impact on clinical outcomes in older patients with cancer., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Topcu, Yasin, Besiroglu, Sucuoglu Isleyen, Alaca Topcu, Simsek, Turk, Seker and Soysal.)

Background: Neurodevelopmental disorders are heterogeneous due to underlying multiple shared genetic pathways and risk factors. Intellectual disability, epilepsy and autism spectrum disorder phenotypes overlap which indicates the diverse effects of common genes. Recent studies suggested the probable contribution of CNTNAP2 gene polymorphisms to the comorbidity of these neurological conditions., Methods and Results: This study was conducted to investigate the role of CNTNAP2 polymorphisms rs147815978 (G>T) and rs2710102 (A>G) as a risk factor for comorbidity of intellectual disability and epilepsy in a group of 345 individuals including 170 patients and 175 healthy controls recruited from various ethnic groups of Pakistani population. Our case-control study group was genotyped by tetra primer ARMS-PCR technique and results were analysed to know the effects of CNTNAP2 rs147815978 (G>T) and rs2710102 (A>G) polymorphisms in the group. The frequency of risk allele T (rs147815978) and risk allele G (rs2710102) for homozygous recessive genotypes (TT/GG) in our study group was 36.47% while odds ratios for risk allele T (rs147815978) was 5.45 (3.90-7.61: 95% CI, P = 0.000) and that for risk allele G (rs2710102) was 2.39 (1.76-3.24: 95% CI, P = 0.0001). Homozygous recessive genotypes (TT/GG) appeared only in cases and not in control group which indicated these as suspected risk genotypes and the significant association (p < 0.05%) of CNTNAP2 gene polymorphisms rs147815978 (G>T) and rs2710102 (A>G) with co-occurrence of intellectual disability and epilepsy phenotypes in our study group which is in HWE (χ 2  = 174, P < 0.0001). Logistic regression analysis shows additive (p < 0.0001) and multiplicative (p < 0.001) models which confirms significant association of both the polymorphisms in our data, which are closely located on same haplotype (D' = - 0.168)., Conclusions: We propose that CNTNAP2 rs147815978 (G>T) and rs2710102 (A>G) polymorphisms are possible risk loci for overlapping neurodevelopmental disorders in Pakistani population. We propose the role of a previously reported common SNP rs2710102 (A>G) with a rarely reported novel SNP rs147815978 (G>T) for CNTNAP2 gene association with neurodevelopmental disorders in our data. Our study has expanded the knowledge of CNTNAP2 gene polymorphisms as probable biomarkers for susceptibility of co-occurrence of intellectual disability and epilepsy phenotypes in Pakistani population. We hope that our study will open new horizons of CNTNAP2 gene variants research to cure the neurological conditions in Pakistani population where consanguinity is a tradition and prevalence of neurodevelopmental disorders has increased from 1 to 2% during last 5 years., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Purpose: The purpose of this study is to investigate whether the presence and pattern of enhancement at the internal acoustic canal (IAC) could help in discriminating between leptomeningeal carcinomatosis (LCa) and meningeal inflammation/infection (MMI)., Methods: Magnetic resonance (MR) images of patients with leptomeningeal enhancement were retrospectively evaluated. MR images of the LCa group (n = 33), MMI group (n = 19) and control group (n = 33) were evaluated for the presence, type (moderate/prominent), and localization (unilateral/bilateral) of the IAC enhancement., Results: The presence of IAC enhancement was significantly more common in patients with LCa (p < 0.001). In 73.7 % of patients with MMI, no contrast enhancement was observed in the IAC. In patients with contrast enhancement in the IAC, the risk of LCa in the etiology is 20 times greater than the risk of having MMI. Seventy-five percent of the IAC enhancement seen in LCa patients and 20 % of the IAC enhancements seen in MMI patients was bilateral. This difference was statistically significant (p = 0.029)., Conclusion: Intense contrast enhancement of the IAC can be a marker for LCa., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Aim: This study aimed to identify the effects of a web-based birth preparation programme based on the Health Belief Model and supported by motivational interviews on fear of childbirth, self-efficacy and the labour process in primigravida women., Methods: The study was conducted in a single-blind, randomized controlled design with 73 pregnant women. The Birth Health Belief Scale, the Wijma Delivery Expectation/Experience Questionnaire A-B, the Childbirth Self-efficacy Scale and the Labour Process Assessment forms were used to collect data. Five sessions of motivational interviews were held with the pregnant women in the experimental group, while those in the control group were administered placebo education., Results: Fear of birth was lower, and the birth self-efficacy total score was higher in the experimental group. None of the groups indicated significant differences in terms of their mode of delivery., Conclusion: Health Belief Model-based web-based birth preparation programme and motivational interviews were found to reduce the fear of birth, increase self-efficacy and positively affect the birth process in primigravida women., (© 2023 The Authors. International Journal of Nursing Practice published by John Wiley & Sons Australia, Ltd.)

Polylactic acid (PLA) is a brittle biodegradable thermoplastic due to its relatively high glass transition temperature (T g  ∼ 60 °C). This T g limits the using of PLA in flexible applications, for example packaging films. In this study, it has been shown for the first time that the Liquidambar Orientalis (LO) oil as a nontoxic, environmentally friendly, and green additive can be successfully used as a natural, renewable, and sustainable plasticizer to produce flexible PLA parts and improve its thermal and physical properties and application potential. Natural oil obtained from Liquidambar Orientalis tree was introduced into PLA (as 10, 20, and 30 phr) by melt compounding (MC) and solution mixing (SM) methods. Effect of LO oil amount on the glass transition temperature, melt and cold crystallization behaviors, and degree of crystallinity values of samples were determined with differential scanning calorimetry (DSC). In addition, solid state viscoelastic properties of PLA films were also characterized with dynamic mechanical analysis (DMA) tests. Results showed that LO oil significantly reduced the T g and storage modulus (E') value of PLA and LO oil showed an excellent plasticizing effect for PLA due to reducing strong hydrogen bonds and secondary interactions between PLA chains., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Magnetic resonance imaging (MRI) has significantly advanced the understanding of osteoarthritis (OA) because it enables visualization of noncalcified tissues. Cartilage is avascular and nurtured by diffusion, so it has a very low turnover and limited capabilities of repair. Consequently, prevention of structural and detection of premorphological damage is key in maintaining cartilage health. The integrity of cartilage composition and ultrastructure determines its mechanical properties but is not accessible to morphological imaging. Therefore, various techniques of compositional MRI with and without use of intravenous contrast medium have been developed. Spin-spin relaxation time (T2) and spin-lattice relaxation time constant in rotating frame (T1rho) mapping, the most studied cartilage biomarkers, were included in the recent standardization effort by the Quantitative Imaging Biomarkers Alliance (QIBA) that aims to make compositional MRI of cartilage clinically feasible and comparable. Additional techniques that are less frequently used include ultrashort echo time with T2*, delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), glycosaminoglycan concentration by chemical exchange-dependent saturation transfer (gagCEST), sodium imaging, and diffusion-weighted MRI., Competing Interests: Zehra Akkaya receives consultation fees from Calico Life Sciences. The remaining authors have no conflicts of interest to declare., (Thieme. All rights reserved.)

The unfolded protein response (UPR) detects increased misfolded proteins and activates protein refolding, protein degradation and inflammatory responses. UPR sensors in the endoplasmic reticulum, IRE1α and PERK, bind and are activated by proteins with unexpected surface hydrophobicity, whereas sensor ATF6 is activated by proteolytic cleavage when released from complexation with protein disulfide isomerases (PDIs). Metabolic dysfunction leading to the formation of misfolded proteins with surface hydrophobicity and disruption of ATF6-PDI complexes leading to activation of UPR sensors remains unclear. The cellular concentration of reactive dicarbonyl metabolite, methylglyoxal (MG), is increased in impaired metabolic health, producing increased MG-modified cellular proteins. Herein we assessed the effect of high glucose concentration and related increased cellular MG on activation status of IRE1α, PERK and ATF6. Human aortal endothelial cells and HMEC-1 microvascular endothelial cells were incubated in low and high glucose concentration to model blood glucose control, with increase or decrease of MG by silencing or increasing expression of glyoxalase 1 (Glo1), which metabolizes MG. Increased MG induced by high glucose concentration activated IRE1α, PERK and ATF6 and related downstream signalling leading to increased chaperone, apoptotic and inflammatory gene expression. Correction of increased MG by increasing Glo1 expression prevented UPR activation. MG modification of proteins produces surface hydrophobicity through arginine-derived hydroimidazolone MG-H1 formation, with related protein unfolding and preferentially targets PDIs and chaperone pathways for modification. It thereby poses a major challenge to proteostasis and activates UPR sensors. Pharmacological decrease of MG with Glo1 inducer, trans-resveratrol and hesperetin in combination, offers a novel treatment strategy to counter UPR-related cell dysfunction, particularly in hyperglycemia associated with diabetes., Competing Interests: Declaration of competing interest Mingzhan Xue, Naila Rabbani and Paul J Thornalley are co-inventors in the patent of Glo1 inducer, tRES + HESP. Commercial rights to the patent are owned by Glocentrica Ltd (UK). Naila Rabbani and Paul J Thornalley are founding co-directors of Glocentrica Ltd (UK)., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Aim: This study aims to investigate nursing students' perspectives on virtual reality technologies and their self-directed learning skills, specifically focusing on how these variables interact and influence each other in the context of nursing education. We also discern potential disparities in these skills based on descriptive characteristics, using both traditional statistical and advanced machine learning approaches for a comprehensive analysis., Background: Rapid developments in technology, particularly during the Covid-19 pandemic, have brought virtual reality technologies to the forefront of nursing education. However, there is a gap in understanding how nursing students' perceptions of these technological relate to their development of self-directed learning skills., Design: A descriptive and cross-sectional study design is employed to both quantify nursing students' perspectives on virtual reality in their education and assess their self-directed learning skills. This approach integrates traditional statistical methods with advanced machine learning techniques, with the intention of offering a comprehensive and nuanced analysis to inform future teaching strategies in nursing., Methods: The study used a blend of survey scales and a tree-based machine learning model to measure and analyze nursing students' views, attitudes and self-directed learning levels. This dual approach allows for a more detailed assessment of the factors influencing self-directed learning abilities. Traditional statistical techniques were also applied to assess the reliability of the machine learning findings., Results: Findings reveal that nursing students generally held positive views towards virtual reality technologies and exhibited a high level of self-directed learning skills. Notable differences in self-directed learning skills were influenced by gender on the overall scale (p <0.001), with male students scoring higher than their female counterparts in both specific sub-dimensions and on the overall scale, but not by academic year. The machine learning analysis provided deeper insights into these variations, highlighting subtle distinctions in student demographics that traditional statistical methods did not fully capture., Conclusions: The study offers valuable insights into interconnected nature of nursing students' views on virtual reality technologies and their self-directed learning skills. The results support the integration of virtual reality in nursing curriculum programs and underscore the importance of customizing teaching strategies based on insights gained from machine learning analyses. This approach has the potential to substantially improve both the learning experience and the overall quality of nursing education., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Aim: To investigate the relationship of serum lipoprotein(a) [Lp(a)] and other serum lipids with presence of Graves' ophthalmopathy (GO). Methods: A total of 99 consecutive patients diagnosed with Graves' disease (GD), aged 18-65 years, who had not received prior treatment for GO, thyroid surgery, or radioactive iodine therapy, were recruited between June 2020 and July 2022. In addition, 56 healthy controls (HCs) were included as the control group. All patients underwent an ophthalmological examination, and were classified based on the presence of GO into the GO group ( n  = 45) and no GO group ( n  = 54). Fasting blood samples were collected from all participants to analyze serum lipid parameters, including Lp(a), total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides. Results: The median serum levels of Lp(a) were 5.7 [4.3-9.2] in the GO group, 6.7 [3.7-9.9] in the no GO group, and 4.7 [3-7.6] in the HC group. The intergroup comparisons of serum Lp(a) levels showed no significant result. The serum levels of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides were also similar between the groups ( P  > 0.05 for all). However, when analyzing only euthyroid GD patients and the control group, the serum LDL cholesterol levels were found to be significantly higher in the euthyroid GO group [median: 132 interquartile range (IQR) (110-148) mg/dL] than in the HCs [median: 96 IQR (94-118) mg/dL] ( P  = 0.002). Conclusion: The findings of our study did not support the association between serum Lp(a) levels and GO.

This study aims to compare the effect of substituents (position and number) and reduced graphene oxide on the supercapacitive properties of cobalt(II) phthalocyanines. For this purpose, three new tetra- and octa-substituted cobalt(II) phthalocyanines bearing 9 H -carbazol-2-yloxy groups on peripheral or non-peripheral positions (1-3) were synthesized. The characterization of the resultant cobalt(II) phthalocyanines was carried out by applying several spectroscopic approaches. The newly synthesized macromolecules were used for the functionalization of reduced graphene oxide (rGO). The obtained nanocomposites (rGO-(1-3)) were utilized for the modification of Ni foam (NiF) electrodes through a facile one-step electrodeposition strategy performed for electrochemical supercapacitor applications. Simultaneous polymerization of the cobalt phthalocyanines and electrochemically reduction of graphene oxide led to the formation of a fabricating layer on the surface of the NiF electrode. The resulting electropolymerized films were characterized by Raman, Fourier-transform infrared (FT-IR), and Field emission scanning electron microscope (FESEM) spectroscopic techniques as well as electrochemical methods. The prepared electrodes possessed superior electrochemical activities owing to the synergistic effect of the cobalt(II) phthalocyanines and rGO. All the modified electrodes displayed high supercapacitaive properties and the highest activity was obtained for the NiF/rGO2-1 electrode. The NiF/rGO2-1 electrode exhibited higher specific capacitance (655.2 F g -1 at 0.5 A g -1 ) than NiF/1 (338.0 F g -1 ). Additionally, a specific capacitance of 85.2% was obtained for NiF/rGO2-1 electrode after 3000 charge-discharge cycles. As a result, all the prepared metallophthalocyanines-reduced graphene oxide can be considered alternative agents to develop high performance-next-generation energy storage devices.

Antimicrobial resistance (AMR) is a growing concern for the future of mankind. Common antibiotics fail in the treatment of microbial infections at an alarming rate. Morbidity and mortality rates increase, especially among immune-compromised populations. Medicinal plants and their essential oils, as well as iodine could be potential solutions against resistant pathogens. These natural antimicrobials abate microbial proliferation, especially in synergistic combinations. We performed a simple, one-pot synthesis to prepare our formulation with polyvinylpyrrolidone (PVP)-complexed iodine (I 2 ), Thymus Vulgaris L. (Thyme), and Aloe Barbadensis Miller (AV). SEM/EDS, UV-vis, Raman, FTIR, and XRD analyses verified the purity, composition, and morphology of AV-PVP-Thyme-I 2 . We investigated the inhibitory action of the bio-formulation AV-PVP-Thyme-I 2 against 10 selected reference pathogens on impregnated sterile discs, surgical sutures, cotton gauze bandages, surgical face masks, and KN95 masks. The antimicrobial properties of AV-PVP-Thyme-I 2 were studied by disc diffusion methods and compared with those of the antibiotics gentamycin and nystatin. The results confirm AV-PVP-Thyme-I 2 as a strong antifungal and antibacterial agent against the majority of the tested microorganisms with excellent results on cotton bandages and face masks. After storing AV-PVP-Thyme-I 2 for 18 months, the inhibitory action was augmented compared to the fresh formulation. Consequently, we suggest AV-PVP-Thyme-I 2 as an antimicrobial agent against wound infections and a spray-on contact killing agent.

Purpose: The aim of this study was to measure residual monomer, cell adhesion, and cell viability of 3-dimensional printable permanent resin (PR), hybrid ceramic block (HCB), and indirect composite (IC) produced with additive, subtractive, and conventional techniques., Methods: Five 8 × 8 × 2 mm 3 samples of each material were prepared for each experiment. In a 24-h period, monomer release was analyzed with high-performance liquid chromatography, and cell viability and adhesion were evaluated with the water-soluble tetrazolium salt test. Data were analyzed with IBM SPSS Statistics 26.0 statistical software, and results were regarded as significant at α = 0.05., Results: Monomer release (triethylene glycol dimethacrylate, urethane dimethacrylate, and Bisphenol A glycerolate dimethacrylate) was significantly higher in the IC group. Mean cell viability was significantly lower in the HCB group than in the IC group., Conclusion: All monomers in the tested materials were released at rates that were below clinical significance. Cell adhesion rates in the groups were similar. Cytotoxic response was classified as minor in the HCB and PR groups and non-cytotoxic in the IC group.

Nanomaterials can provide unique solutions for the problems experienced in tissue engineering by improving a scaffold's physico-bio-chemical properties. With its piezoelectric property, bone is an active tissue with easy adaptation and remodeling through complicated mechanisms of electromechanical operations. Although poly( ε -caprolactone) (PCL) is an excellent polymer for bone tissue engineering, it is lack of conductivity. In this study, piezoelectric barium titanates (BaTiO 3 ) and boron nitride nanotubes (BNNTs) are used as ultrasound (US) stimulated piezoelectric components in PCL to mimic piezoelectric nature of bone tissue. Electric-responsive Human Osteoblast cells on the scaffolds were stimulated by applying low-frequency US during cell growth. Biocompatibility, cell adhesion, alkaline phosphatase activities and mineralization of osteoblast cells on piezo-composite scaffolds were investigated. BaTiO 3 or BNNTs as reinforcement agents improved physical and mechanical properties of PCL scaffolds. In vitro studies show that the use of BaTiO 3 or BNNTs as additives in non-conductive scaffolds significantly induces and increases the osteogenic activities even without US stimulation. Although BaTiO 3 is one of the best piezoelectric materials, the improvement is more dramatic in the case of BNNTs with the increased mineralization, and excellent chemical and mechanical properties., (© 2024 IOP Publishing Ltd.)

Introduction: In clinical practice, inadequate pain inhibition leads to increased morbidity and mortality. Increased intracellular calcium, oxidants, and proinflammatory cytokines are known to play a role in the pathogenesis of postoperative pain. Therefore, we investigated the analgesic effects of benidipine, paracetamol, and benidipine-paracetamol combination (BPC) on postoperative and normal pain thresholds in rats. Material and methods: Sixty-four male albino Wistar rats weighing 285-295 g were used. The without-incision rats were divided into 4 subgroups: healthy control, benidipine alone, paracetamol alone, and BPC. The scalpel-incision rats were divided into 4 subgroups: scalpel incision, scalpel incision + benidipine, scalpel incision + paracetamol, and scalpel incision + BPC. Paw pain thresholds of rats were measured using a Basile algesimeter. Biochemical analyses were performed on the paw tissues of 6 rats randomly taken from the experimental groups, each containing 8 rats. Rats were sacrificed immediately after the measurements. After the pain threshold tests were finished, the paw tissues were removed and malondialdehyde (MDA), total glutathione (tGSH), cyclooxygenase (COX), and interleukin-6 (IL-6) levels were measured. Results: There was no significant difference between the groups in paw pain threshold and measured biochemical parameters in rats without incision. The decrease in the pain threshold of the incised paw was also best prevented by BPC, followed by benidipine and then paracetamol. Furthermore, increases in scalpel-incised paw tissue MDA, COX-2, and IL-6 levels and the decrease in tGSH were significantly suppressed by benidipine and BPC, while paracetamol could only significantly inhibit the increase in IL-6 production. Conclusion: The combination of the L-type Ca 2+ channel blocker benidipine and paracetamol (BPC) may provide potent analgesia. Our experimental results support that BPC may be useful in the treatment of severe pain that cannot be adequately inhibited by paracetamol., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Bedir, Ozkaloglu Erdem, Doymus, Suleyman, Yavuzer, Cicek, Altuner, Mammadov, Yilmaz, Coban, Suleyman and Bulut.)

Background: Juvenile idiopathic arthritis (JIA) is a prevalent childhood chronic arthritis, often persisting into adulthood. Effective transitional care becomes crucial as these patients transition from pediatric to adult healthcare systems. Despite the concept of transitional care being recognized, its real-world implementation remains inadequately explored. This study aims to evaluate the thoughts and practices of healthcare providers regarding transitional care for JIA patients., Methods: A cross-sectional survey was conducted among pediatric and adult rheumatologists in Turkey. Based on the American Academy of Pediatrics' six core elements of transitional care, the survey included 86 questions. The respondents' demographic data, attitudes towards transitional care, and practical implementation were assessed., Results: The survey included 48 rheumatologists, with 43.7% having a transition clinic. The main barriers to establishing transition programs were the absence of adult rheumatologists, lack of time, and financial constraints. Only 23.8% had a multidisciplinary team for transition care. Participants agreed on the importance of coordination and cooperation between pediatric and adult healthcare services. The timing of the transition process varied, with no consensus on when to initiate or complete it. Participants advocated for validated questionnaires adapted to local conditions to assess transition readiness., Conclusions: The study sheds light on the challenges and perspectives surrounding transitional care for JIA patients in Turkey. Despite recognized needs and intentions, practical implementation remains limited due to various barriers. Cultural factors and resource constraints affect the transition process. While acknowledging the existing shortcomings, the research serves as a ground for further efforts to improve transitional care and ensure better outcomes for JIA patients transitioning into adulthood., (© 2023. The Author(s).)

Objectives: We aimed to evaluate feto-maternal blood flow parameters using Doppler ultrasonography (USG) in pregnant women with intrahepatic cholestasis of pregnancy (ICP) and the effect of ursodeoxycholic acid (UDCA) treatment on these parameters., Material and Methods: This prospective cohort study was performed at Dr. Sami Ulus Women's and Children's Health Teaching and Research Hospital, in Turkey between September 2022 and February 2023. Sixty pregnant women, 30 with ICP disease and 30 healthy women were included in the study. Obstetric Doppler parameters were measured by USG at diagnosis and after 48 hours of UDCA treatment for the ICP group., Results: The obstetric Doppler parameters did not significantly differ in the ICP group and the healthy control group. The Doppler findings were similar after UDCA treatment in the ICP group. Gestational week at delivery and birth weight were lower in the ICP group in our study., Conclusions: We demonstrated that pregnant women with ICP had similar obstetric Doppler parameters when compared with healthy pregnant women and that the UDCA agent used for treatment of ICP disease did not affect these parameters.

Introduction: Today, preoperative fasting guidelines have changed, allowing clear liquid intake up to 1 h before surgery. However, concerns remain regarding the risk of aspiration associated with clear liquid intake. This study aimed to investigate the impact of clear fluid given 1 h before surgery on child anxiety and gastric volumes., Methods: A prospective, randomized, controlled study included 90 patients aged 5-12 years. The patients were randomly allocated into three groups by a computer-generated randomization: group F (n = 30): standard fasting group, group W (n = 30): patients who received oral water at a dose of 5 mL/kg 1 h before surgery, group C (n = 30): patients who received oral carbohydrate fluid at a dose of 5 mL/kg 1 h before surgery. All patients were assessed using the modified Yale Preoperative Anxiety Scale (m-YPAS) before and 1 h after fluid administration. Antral cross-sectional area (CSA) was measured with ultrasonography after intubation, and gastric residual volume (GRV) was calculated. Hemodynamic data, blood sugar level, and parental satisfaction were also recorded., Results: The m-YPAS scores obtained after 1 h were significantly lower in group C than in the other groups (p &lt; 0.001). Antral CSA and GRV values were lower in group C and group W than in the fasting group (p &lt; 0.001). Parental satisfaction was highest in group C., Conclusion: This study suggests that allowing a carbohydrate-rich clear liquid intake 1 h before surgery can significantly reduce preoperative anxiety in pediatric patients without increasing the risk of aspiration., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

Aim: To investigate the autoimmune and genetic relationship between primary hypophysitis (PH) and celiac disease (CD)., Methods: The study was retrospective and patients with PH followed in our clinic between 2007 and 2022 were evaluated. Clinical, endocrinologic, pathologic, and radiologic findings and treatment modalities were assessed. Patients diagnosed with CD in the Gastroenterology outpatient clinic in 2020-2022 were included in the study as a control group. Information such as sociodemographic data, year of diagnosis, human leukocyte antigen (HLA) DQ2/8 information, CD-specific antibody levels, pathologic results of duodenal biopsy, treatment received, follow-up status, additional diseases, hormone use, and surgical history was obtained from patient records at PH.In patients diagnosed with PH, a duodenal biopsy was obtained, and the tissue was examined for CD by experienced pathologists. Anti-pituitary antibody (APA) and anti-arginine-vasopressin (AAVP) antibody levels of individuals with PH and CD were measured., Results: The study included 19 patients with lymphocytic hypophysitis, 30 celiac patients, and 30 healthy controls. When patients diagnosed with lymphocytic hypophysitis were examined by duodenal biopsy, no evidence of CD was found in the pathologic findings. The detection rate of HLA-DQ2/8 was 80% in celiac patients and 42% in PH (p=0.044). (APA and AAVP antibodies associated with PH were tested in two separate groups of patients and in the control group. APA and anti-arginine vasopressin (AAVP) levels in PH, CD and healthy controls, respectively M [IQR]: 542 [178-607];164 [125-243]; 82 [74-107] ng/dL (p=0.001), 174 [52-218]; 60 [47-82]; 59 [48-76] ng/dL (p=0.008) were detected. The presence of an HLA-DQ2/8 haplotype correlates with posterior hypophysitis and panhypophysitis (r=0.598, p=0.04 and r=0.657, p=0.02, respectively)., Conclusion: Although patients with PH were found to have significant levels of HLA-DQ2/8, no CD was found in the tissue. Higher levels of pituitary antibodies were detected in celiac patients compared with healthy controls, but no hypophysitis clinic was observed at follow-up. Although these findings suggest that the two diseases may share a common genetic and autoimmune basis, the development of the disease may be partially explained by exposure to environmental factors., Competing Interests: The authors have no conflicts of interest to declare., (Thieme. All rights reserved.)

Hydatid disease is an infective picture caused by echinococcus, which progresses with cysts in various organs, especially in the liver. Renal involvement is an unusual location in the course of the disease. Although mostly asymptomatic renal cysts are seen, rarely glomerular or tubular associated nephropathy develops. In addition, the development of amyloidosis has been shown previously in patients with untreated chronic hydatid cysts. We wanted to bring a 27-year-old female patient with a 10-year history of hydatid cyst and AA amyloidosis to the literature. In addition, in our literature review for hydatid disease-associated nephropathies, we brought together data from 12 studies involving a total of 21 cases. Of these cases, 3 were membranous glomerulonephritis (MGN), 5 were, membranoproliferative glomerulonephritis (MPGN), 1 was minimally change disease (MCD), 5 were AA amyloidosis (including our case), 3 were immunoglobulin A nephropathy (IgAN), 1 was tubulointerstitial nephritis (TIN), 1 was chronic kidney disease (CKD), 1 was TIN with mesangioproliferative glomerulonephritis (MesPGN), 1 was TIN with IgAN, 1 was MPGN with immunoglobulin M nephropathy (IgMN). In this way, we wanted to shed light on the relationship between Echinococcus and nephropathy. In this way, we wanted to emphasise the necessity of doing renal examinations in the follow-up of hydatid cyst patients.