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Background/Aims: This awareness study aimed to determine the ultrasound (US) examination rates in relation to US-confirmed metabolic dysfunction-associated fatty liver disease (MAFLD) diagnosis in internal medicine outpatients with type 2 diabetes (T2D) across Türkiye. Materials and Methods: A total of 6283 T2D patients were included in this multicenter retrospective cohort study conducted at 17 internal medicine clinics across Türkiye. The presence and indications for US performed within the last 3 years were recorded along with US-confirmed MAFLD rates, laboratory findings on the day of US, and referral rates. Fibrosis-4 (FIB-4) index was calculated to estimate the risk of advanced liver fibrosis (FIB-4 index ≥ 1.3). Results: Overall, 1731 (27.6%) of 6283 patients had US examination, which revealed MAFLD diagnosis in 69.9% of cases. In addition, 24.4% of patients with US-confirmed MAFLD were at risk of advanced fibrosis (FIB-4 index ≥ 1.3), and the referral rate was 15.5%. Conclusion: In conclusion, our findings emphasize an insufficient MAFLD awareness among clinicians and the likelihood of most of T2D patients to be at risk of living with an unknown status regarding their MAFLD and advanced fibrosis risk.

Cystinosis is a rare autosomal recessive lysosomal storage disease associated with high mortality and morbidity rates. The most distinctive ocular manifestations of cystinosis are photophobia, tearing, and blurred vision. Herein, we assessed the ocular involvement of four patients from two families diagnosed with infantile nephropathic cystinosis using optical coherence tomography (OCT) and in vivo confocal microscopy (IVCM). Anterior segment OCT demonstrated multiple hyperreflective punctate deposits, and IVCM revealed needle-shaped bright crystal deposits in the corneal stroma in all patients. Three patients also had crystal deposits in the epithelium, where epithelial cell disruption was observed. Crystal deposits around the subepithelial nerve plexus were noted in some sections. In one patient, round and needle-shaped bright deposits along with inflammatory cells were observed in the limbal region of the conjunctiva. Infrared fundus images of two female siblings revealed hyperreflective crystal-like deposits around the optic disc, macula, and peripheral retina, and enhanced depth imaging OCT showed accumulation of crystals in all layers of the retina.

Purpose: The aim of this study was to investigate whether there is a difference in hand bone mineral density (BMD) between patients with traumatic hand injuries and healthy volunteers during the immobilization process, as well as to examine the change in BMD during follow-up and the effect of denervation on BMD. In addition, we aimed to compare the BMD in the dominant and nondominant hands. Methods: The study involved patients aged 18–55 years who had undergone surgery for hand tendon injuries (TIs), with or without accompanying nerve injury, and subsequently sought rehabilitation at our outpatient clinic. The study groups were comprised patients with TI, those with tendon and nerve injury (TNI), and healthy volunteers. Results: The study examined 24 patients with TI, 23 with TNI, and 31 healthy volunteers. In the healthy control group, the BMD of the dominant hand was significantly higher than that of the nondominant hand (P < 0.001). At 4 weeks, there was no significant decrease in BMD observed in the TI and TNI groups compared to controls (P > 0.05). However, at the 4th month, both groups showed a significant decrease in BMD, with the TNI group exhibiting higher changes (P < 0.05). Injuries to the dominant hand did not result in significant changes in BMD at 4 weeks and 4 months (P > 0.05). However, a significant decrease in BMD was observed in injuries to the nondominant hand compared to controls at 4 months (P < 0.05). Notably, nondominant hand TNI patients experienced a significant reduction in BMD during the 4th month compared to the 4th week (P < 0.05). In addition, a significant correlation (r = 0.567) was found between grip strength and BMD value in the 4th month of patients with hand injuries. Conclusion: In patients with traumatic hand injuries, nondominant hand injury and/or nerve injury may lead to a decrease in BMD in addition to immobilization.

Abstract Background/aim The most commonly prescribed anti-seizures medications (ASMs) for the treatment of epilepsy are currently topiramate, zonisamide, lacosamide, carbamazepine and levetiracetam. The objective of this study was to examine the correlation between preoperative, intraoperative, and postoperative metabolic acidosis and the use of ASMs prior to craniotomy operations. Materials and methods This retrospective cross-sectional study evaluated patients who underwent intracranial surgery with craniotomy under general anaesthesia between May 2020 and April 2023 and used ASMs. The patients were classified into four groups based on the pharmacological mechanisms of action of the ASMs administered before intracranial surgery (Group-I, zonisamide or topiramate; Group-II, lacosamide; Group-III, carbamazepine; Group-IV, levetiracetam). Metabolic acidosis severity was defined based on base excess (BE) levels: mild (-3 to -5), moderate (-5 to -10), and severe (below − 10). The study investigated the correlation between ASMs and the severity of metabolic acidosis in preoperative, intraoperative, and postoperative blood gas measurements. Results Out of 35 patients, 24 patients underwent intracranial surgery and 11 patients underwent epilepsy surgery. There were statistically significant differences in the severity of metabolic acidosis between preoperative (p

Abstract The desire for lightweight, carbon-negative materials has been increasing in recent years, particularly as the transportation sector reduces its global carbon footprint. Natural fibers, such as flax fiber and their composites, offer a compelling combination of properties including low density, high specific strength, and carbon negativity. However, because of the low modulus and high variability in performance, natural fibers can’t compete with glass fibers as structural reinforcements in polymer composites. In this study, flax technical fibers were treated in supercritical CO2 (scCO2), and the effects of this treatment on the morphology and properties of flax fibers are reported. Treatment in scCO2 successfully resulted in higher fiber modulus and strength by 33% and 40%, respectively. Fiber porosity was reduced by 50% and morphological changes to the fibers were observed. Specifically, fiber lumen collapsed during treatment and micro/mesoporosity was reduced by 27%. Treated flax fibers were used to create 30 vol% unidirectional flax-epoxy composites. ScCO2 treatment raised composite modulus and strength by 33% and 25%, respectively. Because of the dependence between technical fiber size and mechanical properties, the relationship between fiber modulus and fiber size were created and applied to the rule-of-mixtures. This relationship were found to be viable representations of the fiber performance within each composite. Overall, the treatment developed in this study has the potential to significantly improve natural fiber properties, enabling their consideration for use in lightweight, semi-structural composites.

Abstract Background Triple negative breast cancer (TNBC) is an aggressive subtype with poor prognosis. We aimed to determine whether circulating tumor DNA (ctDNA) and circulating tumor cell (CTC) could predict response and long-term outcomes to neoadjuvant chemotherapy (NAC). Methods Patients with TNBC were enrolled between 2017–2021 at The University of Texas MD Anderson Cancer Center (Houston, TX). Serial plasma samples were collected at four timepoints: pre-NAC (baseline), 12-weeks after NAC (mid-NAC), after NAC/prior to surgery (post-NAC), and one-year after surgery. ctDNA was quantified using a tumor-informed ctDNA assay (SignateraTM, Natera, Inc.) and CTC enumeration using CellSearch. Wilcoxon and Fisher’s exact tests were used for comparisons between groups and Kaplan–Meier analysis used for survival outcomes. Results In total, 37 patients were enrolled. The mean age was 50 and majority of patients had invasive ductal carcinoma (34, 91.9%) with clinical T2, (25, 67.6%) node-negative disease (21, 56.8%). Baseline ctDNA was detected in 90% (27/30) of patients, of whom 70.4% (19/27) achieved ctDNA clearance by mid-NAC. ctDNA clearance at mid-NAC was significantly associated with pathologic complete response (p = 0.02), whereas CTC clearance was not (p = 0.52). There were no differences in overall survival (OS) and recurrence-free survival (RFS) with positive baseline ctDNA and CTC. However, positive ctDNA at mid-NAC was significantly associated with worse OS and RFS (p = 0.0002 and p = 0.0034, respectively). Conclusions Early clearance of ctDNA served as a predictive and prognostic marker in TNBC. Personalized ctDNA monitoring during NAC may help predict response and guide treatment.

Abstract The present study focused on the physiological and biochemical aspects of Tricleocarpa fragilis, red seaweed belonging to the phylum Rhodophyta, along the South Andaman coast, with particular attention given to its symbiotic relationships with associated flora and fauna. The physicochemical parameters of the seawater at the sampling station, such as its temperature, pH, and salinity, were meticulously analyzed to determine the optimal harvesting period for T. fragilis. Seaweeds attach to rocks, dead corals, and shells in shallow areas exposed to moderate wave action because of its habitat preferences. Temporal variations in biomass production were estimated, revealing the highest peak in March, which was correlated with optimal seawater conditions, including a temperature of 34 ± 1.1 °C, a pH of 8 ± 0.1, and a salinity of 32 ± 0.8 psu. GC‒MS analysis revealed n-hexadecanoic acid as the dominant compound among the 36 peaks, with major bioactive compounds identified as fatty acids, diterpenes, phenolic compounds, and hydrocarbons. This research not only enhances our understanding of ecological dynamics but also provides valuable insights into the intricate biochemical processes of T. fragilis. The established antimicrobial potential and characterization of bioactive compounds from T. fragilis lay a foundation for possible applications in the pharmaceutical industry and other industries.

Abstract Background In 2022, fewer than half of persons with tuberculosis (TB) had access to molecular diagnostic tests for TB due to their high costs. Studies have found that the use of artificial intelligence (AI) software for chest X-ray (CXR) interpretation and sputum specimen pooling can each reduce the cost of testing. We modeled the combination of both strategies to estimate potential savings in consumables that could be used to expand access to molecular diagnostics. Methods We obtained Xpert testing and positivity data segmented into deciles by AI probability scores for TB from the community- and healthcare facility-based active case finding conducted in Bangladesh, Nigeria, Viet Nam, and Zambia. AI scores in the model were based on CAD4TB version 7 (Zambia) and qXR (all other countries). We modeled four ordinal screening and testing approaches involving AI-aided CXR interpretation to indicate individual and pooled testing. Setting a false negative rate of 5%, for each approach we calculated additional and cumulative savings over the baseline of universal Xpert testing, as well as the theoretical expansion in diagnostic coverage. Results In each country, the optimal screening and testing approach was to use AI to rule out testing in deciles with low AI scores and to guide pooled vs individual testing in persons with moderate and high AI scores, respectively. This approach yielded cumulative savings in Xpert tests over baseline ranging from 50.8% in Zambia to 57.5% in Nigeria and 61.5% in Bangladesh and Viet Nam. Using these savings, diagnostic coverage theoretically could be expanded by 34% to 160% across the different approaches and countries. Conclusions Using AI software data generated during CXR interpretation to inform a differentiated pooled testing strategy may optimize TB diagnostic test use, and could extend molecular tests to more people who need them. The optimal AI thresholds and pooled testing strategy varied across countries, which suggests that bespoke screening and testing approaches may be needed for differing populations and settings.

Background: Many studies across the globe have observed the significant effect of sleep disturbance on the academic achievement of medical students. Objective: This research was conducted to define the prevalence of sleep disturbance and to discover the consequences and management of this condition among undergraduate pharmacy students of Mohammed Al-Mana College for Medical Sciences (MACHS). Methods: We conducted a questionnaire-based online survey among different levels of MACHS pharmacy students. Results: A total of 165 students participated in the study, of whom 132 (80%) were females and 33 (20%) were males. Most of the participants, 142 (86.06%), were staying with their parents, whereas few of them were staying alone (23; 13.94%). While a handful of them, 29 (17.58%), did not have their bedrooms, most of them had their bedrooms (136; 82.42%). When asked about drinking caffeine-rich products in the afternoon or at night, most of them responded “sometimes” (78; 47.27%), followed by the category “always” (61; 36.97%), “rarely” (15; 9.09%), and then the category of students who responded “not at all” (11; 6.67%). Overall, 35 (21.21%) of the study participants had a smoking habit, 72 (43.63%) tried to treat their sleep disturbance, whereas 42 (25.45%) were getting treatment for insomnia. Conclusion: Most pharmacy students at MACH College, especially females, have sleep problems. Mostly, the prevalence is common during exam periods, and it mildly affects their grade point average.

Abstract Purpose The purpose of this multicenter retrospective study was to analyze the clinical and radiological effects of bevacizumab (BV) on radionecrosis (RN) that developed after stereotactic radiotherapy (SRT) for brain metastasis. Methods Forty patients with SRT related symptomatic brain RN treated in 10 radiation oncology centers were analyzed. The clinical response to BV treatment was categorized as follows: complete (no additional treatment required), partial (requiring either steroids or repeat BV), and unresponsive (requiring surgery). The radiological features of brain RN were analyzed in 10 patients whose serial MRI scans were available after corticosteroid and BV treatments. Results BV was used as a first line treatment in 11 (27.5%) and as a second line treatment in 29 (72.5%) of patients. The neurological symptoms regressed in 77.5% of patients after treatment with BV (45% complete response, 32.5% partial response). The median edema volume increased from 75.9 cc (range: 5.9-125.8 cc) at RN to 113.65 cc (range: 1.5-382.1 cc) after use of corticosteroids, representing a rate of 39.8% increase (p = 0.074). However, after BV treatment the median volume of edema decreased to 19.5 cc (range: 0-163.3 cc) which represents a difference of 62.2% (p = 0.041) from RN. Conclusion The use of BV caused clinical response rate of 77.5% and a good radiological response in corticosteroid unresponsive patients. The role of BV should be further investigated in prospective studies.

Aim: The aim of this study was to evaluate the effect of proanthocyanidin and C. sinensis-polyphenols on microtensile bonding properties of prepared teeth with resin-modified glass ionomer cement (GIC). Setting and Design: This was an in vitro study. Materials and Methods: Seventy-eight maxillary premolars were selected and mounted into auto-polymerizing acrylic resin blocks. The samples were prepared and metal crowns were fabricated. The samples were randomly divided into three groups. Samples under Group 1 were not treated with any of the extracts and followed conventional bonding protocol. Samples under Group 2 and Group 3 were treated with proanthocyanidin and C. sinensis-polyphenols, respectively. After dentin treatment, these samples were luted to metal crowns using resin-modified GIC. Universal testing machine was used to measure the load at which the crowns were debonded and microtensile bond strength in MPa was calculated. Statistical Analysis: The results were statistically analyzed using one-way ANOVA and post hoc Tukey HSD. Results: Samples treated with C. sinensis polyphenols (Group 3) had maximum bond strength followed by Group 2, where the samples were treated with proanthocyanidin. Conclusion: C. sinensis polyphenols due to their anti-proteolytic and antioxidant properties showed improved bond strength compared to proanthocyanidin, a cross-linking agent, followed by conventional bonding protocol.

This international community service program aims to enhance teachers' skills in developing market economics teaching modules at the Indonesian School in Davao, Philippines. The program includes a series of workshops and intensive mentoring sessions for teachers, focusing on developing market economics teaching materials that align with the curriculum and local context. The approach involves problem identification, preparation, and coordination, activity socialization, implementation through online and offline mentoring, group discussions, and ongoing evaluation to ensure that the knowledge and skills acquired can be effectively applied. The program results significantly improve teachers' ability to design innovative and relevant teaching modules and an increased understanding of market economics concepts. Other positive impacts include establishing a more robust collaborative network between educators in both countries and enhancing the quality of economics education at the Indonesian School in Davao, Philippines. The program has successfully created a more interactive and engaging learning environment for students.

Background Electrodiagnostic testing (EDX) is important in the diagnosis and follow-up of neuropathic and myopathic diseases. This study aimed to demonstrate the compatibility between clinical prediagnosis and electrophysiological findings. Methods EDX results from 2004 to 2020 at the physical medicine and rehabilitation (PM&R) clinic were screened. Tests with missing data, reevaluation studies, and cases of peripheral facial paralysis were excluded. The clinical prediagnosis and EDX results were recorded, and their compatibility was evaluated. Results A total of 2,153 tests were included in this study. The mean age was 49.0±13.9 years and 1,533 of them (71.2%) were female. The most frequently referred clinic was the PM&R clinic (90.0%). Numbness (73.6%) was the most common complaint, followed by pain (15.3%) and weakness (13.9%). The most common prediagnosis was entrapment neuropathy (55.3%), radiculopathy (16.1%), and polyneuropathy (15.7%). Carpal tunnel syndrome was the most frequently identified type of entrapment neuropathy (78.3%). Six hundred and seventy EDX results (31.1%) were within normal limits. While the EDX results were consistent with the prediagnosis in 1,328 patients (61.7%), a pathology different from the prediagnosis was detected in 155 patients (7.2%). In the discrepancy group, the most common pathologies were entrapment neuropathy (51.7%), polyneuropathy (17.3%), and radiculopathy (15.1%). The most common neuropathy type was carpal tunnel syndrome (79.3%). Conclusion After adequate anamnesis and physical and neurological examinations, requesting further appropriate tests will increase the prediagnosis accuracy and prevent unnecessary expenditure of time and labor.

Abstract Background This study aimed to translate and culturally adapt the Assessment of Quality of Life (AQoL)-6D into Malay (Malay-AQoL-6D), and assesses the instrument’s acceptability, reliability, and validity among Malaysians living with chronic heart failure (HF). Methods The translation and cross-cultural adaptation process adhered to international guidelines. The Malay-AQoL-6D underwent content and face validity assessments via expert review, and pretesting among healthy individuals and patients with chronic conditions. Subsequent psychometric validation utilised clinico-sociodemographic data and paired AQoL-6D and EQ-5D-5L data from a health-related quality-of-life (HRQoL) survey involving Malay-speaking patients with HF, which encompassed assessments of Malay-AQoL-6D acceptability, internal consistency and test-retest reliability, as well as its construct, concurrent, convergent and divergent, and known-group validity. Results The Malay-AQoL-6D was deemed acceptable among clinicians and local patients, achieving a 90.8% completion rate among 314 patients surveyed. The instrument demonstrated strong content validity (item-level content validity index [CVI]: 0.83–1.00, average CVI: 0.98), internal consistency (Cronbach’s alpha: 0.72–0.89; MacDonald’s omega: 0.82–0.90, excluding the Senses dimension), and test-retest reliability (average intraclass correlation coefficients: 0.79–0.95). Confirmatory factor analysis confirmed the instrument’s two-level, six-factor structure (Satorra-Bentler [SB]-scaled χ2(df: 164): 283.67, p-value

Objective Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine and metabolic disorder characterized by hyperandrogenism, hyperinsulinemia, and insulin resistance. The prevalence of PCOS is increasing worldwide. Although the etiology of this disease is currently unknown, it is thought to be closely related to inflammation and oxidative stress. Our study aimed to compare patients have PCOS to healthy volunteers and assess the changes in oxidative stress and inflammatory parameters in these patients. Methods Thirty patients between the ages of 18-45 diagnosed with PCOS and 30 healthy volunteers with the same demographic characteristics were included in this study. Clinical parameters were measured using immunoassays. Oxidative stress biomarkers, total oxidant (TOS), total antioxidant (TAS), total thiol (TT), and native thiol (NT) levels were measured using photometric methods according to Erel’s method. The dynamic disulfide level (DIS) and oxidative stress index (OSI) were calculated using mathematical equations. Among the inflammatory parameters, values for interleukin (IL)-1β, IL-6, and tumor necrosis factor-α (TNF-α) were measured photometrically using commercially purchased kits. Results Moreover, TT and NT levels were lower in patients with PCOS compared to those in the healthy group statistically significantly (P

Abstract Aim The aim of this study was to evaluate the removal efficiency of PRMTA and ECMPremixed applied to the coronal third according to the RET by UI and to examine the effect of different solutions on material removal. Materials and methods 40 permanent upper central teeth were used to simulate immature teeth. The samples were irrigated with 1.5% NaOCl and calcium hydroxide was placed. Samples were incubated in PBS. Then irrigation was done with 17% EDTA, the samples were randomly divided into 2 groups (n = 20):Group 1: PRMTA, Group 2: ECM Premixed. The materials were placed in the samples. Then the samples were scanned with micro-CT. Materials were removed by UI. Micro-CT scan of the samples was performed. Each material group was divided into 2 subgroups (n = 10): Group1 was MTAD, group2 was irrigated with 10% CA; then micro-CT was performed. Obtained images were positioned in DataViewer and analyzed with CTAn. The obtained data were statistically analyzed in IBM SPSS 25. The significance level was determined as 5%. Results There was no significant difference between the initial volumes of the materials (p > 0.05). The amount of the remaining material after UI was significantly higher in the PRMTA (0.7471%) group compared to the ECM Premixed (0.0093%). There was no significant difference in terms of remaining material after irrigation with MTAD and CA in both groups (p > 0.05). Conclusion A great deal of the materials were removed by UI under the operation microscope. ECM Premixed was removed more effectively compared to the PRMTA. And, acidic solutions did not provide any additional benefit in material removal.

Helminth infections are prevalent in poverty-stricken areas and developing countries with warm, humid climates and poor sanitary conditions. The limited availability of anthelmintic drugs and the emergence of drug resistance have prompted the search for new treatment options. Medicinal plants, traditionally used for treating various ailments, including parasitic infections, have been explored as sources of novel anthelmintic compounds. To evaluate the preliminary phytochemical analysis and in vitro anthelmintic activity of Colchicum autumnale L. corm extract. The anthelmintic activity of C. autumnale corm extract was tested against Pheretima posthuma (earthworms). Five different concentrations (20, 40, 60, 80, and 100 mg/ml) of the C. autumnale extract were used, alongside the standard drug albendazole at the same concentrations. The time taken for paralysis and death of the worms was recorded. The preliminary phytochemical qualitative analysis of the ethanolic extract showed the presence of alkaloids, carbohydrates, glycosides, saponins, phenols, tannins, and steroids. The study highlighted the potential of C. autumnale extract as a natural anthelmintic agent. The dose-dependent activity suggested that higher concentrations of the extract provided more effective anthelmintic action. However, further research is necessary to establish the optimal dosing, safety, and in vivo efficacy of the extract.

Background: Xeroderma pigmentosum (XP) is a rare inherited disorder with a high incidence of malignant tumours. Literature data on dermoscopic and in vivo reflectance confocal microscopy (RCM) findings in patients with XP are very limited. Methods: Dermoscopic findings in 32 biopsy-proven BCCs and RCM findings in 10 biopsy-proven BCCs developed in seven XP patients were reviewed. Results: Of 32 BCCs, 28 were pigmented. On dermoscopy, BCCs exhibited multiple grey-blue globules/dots (81, 3%), short-fine telangiectasias/fine arborising vessels (65, 6%), multiple grey-blue ovoid nests (53, 1%), white structures (white-red structureless areas/shiny white areas/lines/strands) (56, 3%), arborising vessels (37, 5%), brown nests/globules/dots (28, 1%), spoke-wheel structures (9, 4%), leaf-like areas (9, 4%), ulceration (28, 1%), peripheral network (21, 9%), and multiple aggregated yellow-white globules (3, 1%). In 10 lesions in which further imaging with RCM was performed, RCM findings differentiated BCC from other tumours, including primary melanoma. Conclusions: Although the dominancy of pigmented structures may imitate melanoma clinically, dermoscopy is a valuable tool in the early diagnosis of BCCs in patients with XP. For suspicious lesions, RCM can help in differentiating pigmented BCC from primary melanoma.

Objective: This study investigated the effects of psychological distress on the work ability of intensive care nurses during the COVID-19 pandemic in Turkey. Materials and Methods: The sample size of this descriptive and cross-sectional study was determined to be at least 220 nurses, with a level of significance of 0.05, a confidence interval of 99%, and the ability to represent the population of 80%. The research was completed with 233 nurses. A Participant Information Form, the COVID-19-related Psychological Distress Scale, and the Work Ability Index were used to collect data online using Google Forms and email or social media accounts. In the analysis of data, Pearson and Spearman correlation analysis was used along with descriptive statistics. Results: A statistically significant positive correlation was found between the nurses’ length of time working in the profession and their WAI scores (r=0.132, p=0.043), and a negative correlation was found with their COVID-19 PDS scores (r=-0.162, p=0.013). A statistically significant difference was found about WAI total scores in the effect on work ability of the working conditions of the COVID- 19 pandemic (p

Objective: This study aims to determine the complementary and alternative therapy (CAM) methods used among infertile women in Turkiye, the prevalence of their use and the factors affecting their use. Method: The sample of the descriptive and cross-sectional study consisted of 142 women who applied to the Assisted Reproductive Treatment Centre of a public hospital and volunteered to participate in the study. The data were collected with "Personal Information Form" and "Complementary and Alternative Medicine Approaches Scale (CAMAS)". Descriptive statistics, Mann-Whitney U, Kruskal Wallis Test were used in the evaluation of the data.Results: While the average age of the women who contributed to the study was found to be 29.77±4.83 years. When the CAM methods used by women are examined, they are mostly prayer (88.0%), prayer (namaz) (78.2%), vow (25.4%), visit to the tomb (24.6%), amulet (20.4%), black pepper (17.6%), ginseng (15.5%), astralagus (13.4%), going to a teacher and having yourself read (13.4%), shark cartilage (13.4%), turtle blood (13.4%), lead casting (4.2%), reiki (2.8%), bioenergy (2.1%) and hypnosis it was determined to be (1.4%). When the mean scores in the CAMAS subscales were examined, it was determined that the highest score was body-mind approaches (40.46±17.37).Conclusion: In line with the research findings, it was determined that the use of CAM was common among infertile women in Turkiye and the most frequently used approaches were spiritual and herbal methods. Health professionals need to evaluate infertile women about their use of CAM methods and inform women about these methods.

This case report aims to present the findings of in vivo confocal microscopy (IVCM) and anterior segment optical coherence tomography (AS-OCT) in three patients with iridocorneal endothelial (ICE) syndrome. Three female patients 37, 50, and 57 years of age presented with complaints of unilateral visual impairment and elevated intraocular pressure (IOP). Biomicroscopy revealed unilateral pupil irregularities and anterior synechiae, and gonioscopy demonstrated synechiae in the iridocorneal angle. IOP was within normal limits with medical treatment in two patients, while one patient had an IOP of 44 mmHg despite maximal antiglaucomatous treatment. IVCM revealed large, polymorphic, and hyperreflective cells in the corneal endothelial layer of the affected eyes and normal corneal epithelium, stroma, and endothelium in the fellow eyes. AS-OCT findings were normal in healthy eyes, while the affected eye showed synechiae in the iridocorneal angle and a hyperreflective, thickened endothelial layer. The patient with refractory glaucoma underwent trabeculectomy surgery with 5-fluorouracil. In conclusion, IVCM and AS-OCT allow a detailed examination of endothelial cell abnormalities and iridocorneal membranes in ICE syndrome, which is characterized by unilateral pupil and iris irregularities and anterior synechiae mainly in women.

A 78-year-old man with a history of lung cancer, chemotherapy, radiotherapy, and coronavirus disease 2019 infection experienced visual deterioration of two-weeks’ duration in his right eye. There was multifocal, yellowish-white retinitis foci, vascular engorgement, and scattered intraretinal hemorrhages extending from posterior pole to retinal periphery in the right eye, whereas the left eye was normal. Intravitreal vancomycin, ceftazidime, clindamycin, and dexamethasone were given for endogenous endophthalmitis initially. Vitreous culture confirmed the presence of Aspergillus lentulus, and he was treated with intravitreal amphotericin-B and voriconazole injections together with systemic amphotericin-B, voriconazole, posaconazole, and micafungin therapy. During follow-up, vitreoretinal surgery was performed because of rhegmatogenous retinal detachment, and he received one additional cycle of chemotherapy due to recurrence of the cancer. Although the retina was attached, enucleation was eventually required due to painful red eye. Atypical squamous cells beneath the neurosensory retina suggesting metastasis were noted on histopathological examination. Timely ocular examination is crucial for any immunocompromised patient having ocular symptoms. High level of suspicion for a fungal etiology is a must in these patients.

Precision Livestock Farming (PLF) is a mechanism that manages a production system. This mechanism includes mathematical models and controllable inputs that can predict inputs with processes and results that can be monitored periodically. These parameters of PLF systems can improve resource use efficiency and reduce cultivation costs. Many situations, such as the behaviour of animals on farms, their nutrition, estrus cycles, and epidemics, can be monitored with wearable devices containing various sensors. However, real-time monitoring of the data collected by these devices is possible with Internet of Things (IoT) technology. IoT is a multi-layered network that enables sensors within the system to communicate with each other and implement certain decisions when necessary. Sensors and IoT devices extract information from the raw data they collect from the environment, which is then shared with other objects, devices, or servers via the internet. The real-time data collection, processing, and analysis provided by IoT enables improvements in the management of animal farms. This systematic review addresses IoT concepts and applications in the livestock sector from a systematic perspective for different animal farms.

Background: Coronary artery disease (CAD) results from the narrowing of coronary arteries that leads to inadequate blood supply to the heart muscles, resulting in Acute Coronary Syndrome (ACS). The coronary collaterals which develop will be an alternative source of blood flow in CAD. Myocardial ischemia stimulates the development of coronary collaterals by releasing various angiogenic growth factors, like the Vascular Endothelial Growth Factor (VEGF). Serum VEGF will serve as an important biomarker in CAD; thus, it can predict coronary collateral development. Aim: To study the factors affecting the development of coronary collaterals in hypertensive and non-hypertensive patients with CAD. Methods: The study includes 100 patients who have done coronary angiography, with an average age of 60±15. Consent was obtained from all patients, and 2 ml of blood was collected. The serum VEGF concentration and cystatin-C were quantified. Coronary Angiograms, along with other reports, were collected and analyzed. CAD was diagnosed for those with ≥ 70% stenosis inany one of the major coronary artery. Coronary collateral gradings was performed as per Rentrop Scoring system. The serum VEGF and cystatin-C levels were correlated with the collateral scores and other cardiovascular risk factors. Results: A significant correlation was found between the collateral scores and serum VEGF level in hypertensive patients only. No significant correlation was found between VEGF level, collateral scores and cardiovascular risk factors. Conclusions: Cardiovascular risk factors in turn increase the serum VEGF level, which results in collateral development. Age and sex did not show show any significant association especially old age and females, with serum VEGF levels.

The aim of the study was to monitor the occurrence of selected vector-borne diseases in anaemic dogs arriving in or returning to Poland from areas endemic for these diseases.

This research aims to design a promotional e-catalog for fishing business groups using the User Centered Design (UCD) method to improve the quality of their promotional services online. The partners in this research are the Fisheries Supervisory Community Group in Batu Basar Village, Nongsa District, Batam City, Riau Islands. So far, this group and fishermen have often faced obstacles in promoting their products effectively to potential consumers, especially in the rapidly developing digital era. The UCD method used in this research is a user-focused approach. The initial stage of research includes gathering information regarding the needs and preferences of potential users, including fishing business groups and potential consumers. This information was obtained through interviews, observations and literature studies. Based on the data collected, a promotional e-catalog was designed that took into account user needs and promotional objectives which included features such as complete product descriptions, product photos, price information, user testimonials and contact information. After the design is complete, the manufacturing stage is carried out and then continues to the testing stage involving potential users. This testing aims to maximize usability, efficiency and user satisfaction. The test results used the Nielsen model with five indicators with the results of Easy To Learn getting a score of 3.85, Efficiency To Use getting a score of 3.75, the Easy To Remember indicator getting a score of 3.85, and the Few Errors indicator getting a score of 4.05. Then the fun to use indicator has a value of 3.95.

India has been actively pursuing digital financial transformation, and the government has implemented various initiatives to promote a cashless economy. The recent demonetization policy led to a significant push towards digital payments and a surge in the usage of digital wallets, mobile banking, and other cashless methods. These digital transformations aimed to enhance financial inclusion by providing banking and financial services to a larger population segment, especially in rural areas. Despite the push for digital transactions, certain challenges persisted, especially the existence of physical cash. This paradox is evident in many economies worldwide, including India. This study tries to analyze the trend towards the digital financial transformation of the Indian economy and prove the paradoxical situation of the cash-based economy. The study also examines the impact of digital infrastructures (DI) and payment modes and channels (PMC) on total digital payment (TDP) in India.

This research article explores the role of Environmental, Social, and Governance criteria as a strategic initiative for reinforcing the Circular Economy paradigm. Through a comprehensive review of literature and empirical data, this article demonstrates how ESG integration can incentivize businesses to adopt Circular Economy practices. It uncovers the mechanisms of ESG – driven investments on circular innovation and technology development. This intends to illuminate the compelling connection between ESG principles and the Circular Economy, offering insights for policymakers, business leaders, and investors seeking to drive the evolving landscape of sustainable practices. It advocates for the integration of ESG considerations as a composite for reinforcing the Circular Economy, ultimately contributing to a more resilient, equitable, and environmentally responsible global economy.

Abstract During the COVID-19 pandemic, the Province of Ontario, Canada, launched a wastewater surveillance program to monitor SARS-CoV-2, inspired by the early work and successful forecasts of COVID-19 waves in the city of Ottawa, Ontario. This manuscript presents a dataset from January 1, 2021, to March 31, 2023, with RT-qPCR results for SARS-CoV-2 genes and PMMoV from 107 sites across all 34 public health units in Ontario, covering 72% of the province’s and 26.2% of Canada’s population. Sampling occurred 2–7 times weekly, including geographical coordinates, serviced populations, physico-chemical water characteristics, and flowrates. In doing so, this manuscript ensures data availability and metadata preservation to support future research and epidemic preparedness through detailed analyses and modeling. The dataset has been crucial for public health in tracking disease locally, especially with the rise of the Omicron variant and the decline in clinical testing, highlighting wastewater-based surveillance’s role in estimating disease incidence in Ontario.

Birth control pills are widely used around the world for birth control and prevention of unwanted pregnancy. However, there are concerns about their safety during pregnancy and possible effects on the fetus. This article aims to examine in depth the current evidence on the impact of birth control on the foetus. By analysing the mechanism of action of birth control pills, relevant clinical trials and associated potential complications, the risks and safety of contraceptive use during pregnancy are explored. The different types of contraceptives and the specific risks associated with each are discussed, providing recommendations for women who use birth control and become or become pregnant. Through this literature review, the aim is to provide a clearer understanding of this topic and to provide practical guidance for healthcare professionals and women in this situation. Further investigation into the mechanisms of action of birth control pills during pregnancy and how they may influence fetal development could provide useful information for managing and counseling women who are pregnant or planning to become pregnant.

Oral rehabilitation of elderly hypertensive patients presents specific challenges, given the increased prevalence of systemic complications in this group. Hypertension can significantly influence dental management through drug interactions, oral side effects of antihypertensive therapies, and special needs during dental procedures. The complex and interdisciplinary approach to the management of oral rehabilitation of elderly hypertensive patients is essential to ensure safe and effective treatment. By implementing personalized assessment, intervention and education strategies, the quality of care provided to this group of patients can be significantly improved, optimizing treatment outcomes and improving their quality of life. This article reviews existing literature and explores the main risks and considerations for optimizing oral care in these patients.

Abstract A detailed understanding of the ultrafast dynamics of halogen-bonded materials is desired for designing supramolecular materials and tuning various electronic properties by external stimuli. Here, a prototypical halogen-bonded multifunctional material containing spin crossover (SCO) cations and paramagnetic radical anions is studied as a model system of photo-switchable SCO hybrid systems using ultrafast electron diffraction and two complementary optical spectroscopic techniques. Our results reveal a sequential dynamics from SCO to radical dimer softening, uncovering a key transient intermediate state. In combination with quantum chemistry calculations, we demonstrate the presence of halogen bonds in the low- and high-temperature phases and propose their role during the photoinduced sequential dynamics, underscoring the significance of exploring ultrafast dynamics. Our research highlights the promising utility of halogen bonds in finely tuning functional properties across diverse photoactive multifunctional materials.

This research aims to determine the effectiveness of the Wordwall website-based learning media on the learning outcomes of class V students in science and science subjects on balanced ecosystems at SDN Batuplat 1. This type of research is quantitative research using a quasi-experimental research design. The form of quasi-experimental design used is a Nonequivalent control group design. This research was located at SDN Batuplat 1 Kupang City. The subjects of this research were 60 class V students who were divided into 2 study groups or 2 classes, namely the experimental class and the control class. Data collection in this research was carried out using observation techniques and comprehension tests (pretest-posttest). The results of research conducted by researchers show that there is an influence of Wordwal website-based learning media on learning outcomes. This is proven by the t-test (independent sample t-test) and obtained a sig (2-tailed) value of 0.00 < 0.05, which means Ho is rejected and Ha is accepted. Then this wordwall website-based learning media is also quite effective in improving student learning outcomes. This was proven by the N-Gain Score test and obtained an average N-Gain score for the experimental class of 65.32 or 65% which was included in the quite effective category with a minimum N-Gain score of 30% and a maximum of 100%. So it can be concluded that the use of wordwall website-based learning media is quite effective in improving the learning outcomes of class V students in science and science subjects with balanced ecosystem material at SDN Batuplat 1.

Isotretinoin is a vitamin A derivative frequently employed in the treatment of acne. Although it is highly effective in acne treatment, menstrual irregularities are a frequently reported as a side effect. This study retrospectively analyzed the data of 122 female patients undergoing systemic isotretinoin therapy for the treatment of acne. Demographic and clinical information of the patients were recorded. The mean age was 20.2 years and the mean age of onset for menstruation was 13.3 years. Menstrual irregularities were observed during treatment in 65 patients (68.4%), whose menstruation was regular before treatment. Among them, 45.3% (43 patients) started to have less frequent menses, 18.9% (18 patients) started to have more frequent menses, 2.1% (2 patients) started to have prolonged menstrual bleeding, and 2.1% (2 patients) started to have shorter menstrual bleeding during treatment. Hirsutism during treatment was statistically more prevalent in those with menstrual irregularities during treatment (p=0.02). In conclusion, our study indicates that patients with regular menstrual cycles prior to isotretinoin treatment developed irregular menstrual cycles after initiation of the medication with a higher prevalence of hirsutism. Further clinical research is necessary to elucidate the mechanism by which isotretinoin affects hormonal imbalances, thereby leading to menstrual irregularities. [Med-Science 2024; 13(3.000): 629-32]

This study aims to reveal the economic and political issues underlying the remarks related to initial teacher education (ITE) in the documents published by international institutions, European Union (EU), Organization for Economic Co-operation and Development (OECD), and United Nations (UN), and to examine these issues from the perspective of consensus and conflict approaches to education. The study is designed as a systematic review. ITE-related 67 documents published by UN, EU, and OECD were analyzed following several coding steps. According to the results, international institutions promote entrepreneurship, life-long learning, and information and communication technologies as economic issues in ITE. As political issues, they put forward social themes including preparing for diversity, quality in ITE including accountability and standards, and structure of ITE including flexibility and autonomy. Although the documents are mainly parallel with the consensus approach, economic and political issues revealed in the study were discussed from perspectives of both approaches. One perspective considers promoting the economic issues in ITE the economic efficiency and growth which is beneficial for all. The other reminds that division of this benefit may include class-based inequalities. Also, different perspectives emphasize different social themes and they bring different explanations for how the quality assurance functions. [This article includes an extended summary in Turkish.]

The concept of twice-exceptional is used to define individuals who are gifted or talented in one or more domains while having disability, disorder or difficulty in certain areas. This situation has made the definition and acceptance of the concept difficult since giftedness and disability are mentioned together. In order to clarify current understanding of the concept, a conceptual analysis of the term "twice-exceptional" was conducted in this study using Rodgers' evolutionary concept analysis method. Firstly, the epistemological and ontological structure of the concept was discussed. It was seen that the concept was used in different terms in literature such as "twice exceptional", "dual exceptionality", "gifted with learning difficulties", "gifted handicapped". Instead of looking for an alternative term for the concept, existing studies were reviewed and the characteristics of the concept were tried to be revealed. Although the concept has been used for almost four decades, its implications date back to gifted studies addressing learning difficulties a century ago. It was later associated with Asperger's Syndrome, Attention Deficit and Hyperactivity Disorder, Autism Spectrum Disorder and other deficits. It was concluded that definition and characteristics of relevant concepts of twice exceptionality such as giftedness and disability have changed over time, which has also affected the evolution of twice exceptionality. Therefore, a clear definition or sharp boundary of the concept cannot be claimed, but its importance has been revealed by the field studies which also contributes to the further development of the concept.

The aim of this study is to examine the effects of emergency distance education implementations carried out during the COVID-19 process on metacognition, social skills, active participation, communication with faculty members, as well as learning and teaching processes based on the views of education faculty teacher candidates. The research is a case study. The study was carried out in the Education Faculty of the Kafkas (n:31) and Education Faculty of the Trakya (n:20) in the 2020-2021 Fall semester. Opinions about the process were taken from 51 volunteer participants using a semi-structured interview form. Data was analyzed using content analysis and inductive analysis. As a result of the research, the elements that prospective teachers think that emergency distance education applications increase the effectiveness of the learning-teaching process were obtained in the themes of metacognition, social skills, active participation, effective communication with faculty members, and learning-teaching process. The factors that have a negative impact on the emergency distance education process are again expressed as increasing homework load, insufficient explanation of educational tasks, problems caused by the pandemic, problems originating from the internet, systemic-technological problems, inadequacies in gaining metacognition skills, and uniformity in methods and techniques.

The study aimed to determine the effect of a brain-based environmental program for preschool children aged 5-6 years on their sustainable environmental behaviors. For this purpose, an experimental study was designed for a period of 8 weeks. The participants of the study were composed of 20 children from middle socio-economic level families who attend two branches of a kindergarten in the province of Kütahya. Out of those 20 children, 10 were in the experimental group and 10 in the control group. The program applied to the experimental group was prepared by the researchers considering the principles of the brain-based learning approach. The 16 activities prepared for pre-school children were finalized by taking expert opinion from 5 experts in the field of pre-school education. The classrooms where the activities were implemented were arranged according to brain-based learning (such as heat, light, visual materials), fruits and drinking water were kept at the activity tables in order to meet the glucose and water needs of the brain, which are important in brain-based learning and that the brain needs for learning. Relaxation exercises were carried out and classical music was provided during all activities. Activities were held outside whenever the weather conditions are suitable. In the control group, the activities were prepared by the researchers according to the achievements in the 2013 Preschool Program of the Ministry of Education (MoNE). In the pretest and posttests, the "Environmentally Sustainable Behavior Assessment Scale for 60-72 Months-Old Children" developed by Özkan, Tugluk and Yigitalp (2019) was used. The scale consists of 20 items, consciousness and awareness, and 2 sub-dimensions. The scale is a 5-point Likert-type scale and is filled by the child's teacher for each child. Cronbach Alpha value of the scale; It is .92 for the awareness sub-dimension, .94 for the consciousness sub-dimension, and .92 for the whole scale (Özkan, Tugluk & Yigitalp, 2019). The results revealed that there was a significant difference between the pretest and posttest scores of the experimental group, and the posttest scores of the experimental and control groups.

Background: The abrupt transition to virtual language learning environments due to the COVID-19 pandemic has brought considerable challenges to educational practices. In the context of foreign/second language learning and teaching, it has become more difficult to ensure that learners have the necessary engagement and motivation levels along with sufficient support and guidance. As educators and researchers report, the adversities in today's online learning environments need to be challenged. Purposes: The study is meant to contribute to language learning and teaching practices by sharing the results of the implementation of a self-supporting tool, namely, Self-Monitoring Chart for Effective Writing Strategies. The chart has been developed by the researchers for an online academic English writing course at higher education level to assist learners their writing improvement and to become self-regulated learners while maintaining their engagement in their writing tasks. Methodology/Approach: The study was designed as a qualitative case study and the opinions of the participants on their experiences of using the chart were elicited using semi-structured interviews. The participants were students at English Language Teaching departments of two state universities (N=48). The qualitative data gathered was analyzed using systematic content analysis. Findings and Discussion: The results indicate that the learners greatly benefited from using the SMC. In particular, they reported to have become aware of SRL writing strategies, to have learned how to implement them, to be more engaged and more motivated in writing tasks. The implications are meant to contribute to online language learning and teaching contexts.

A good assessment system is one of the preconditions for quality education. Formative assessment is comparatively an emerging idea to assess the students throughout the academic year with the intention to identify and overcome the weaknesses of the students and enhance their learning outcome. Taking these into account, this study attempted to explore the teachers' perceptions of the use of formative assessment in enhancing teaching and learning in Bangladesh higher education. A mixed-method study was employed with survey and semi-structured interview as the data collection methods. 100 participants were randomly (simple random) selected for the survey, and 6 participants were purposively selected for the interviews. For analysing the data, descriptive analysis and content analysis were used. The findings of the study revealed majority of the participants agreed that formative assessment is crucial to enhance teaching and learning in Bangladeshi colleges. Nonetheless, there are some challenges like - teachers' biasness, shortage of teachers, large class, poor infrastructure, insufficient power supply, and heavy workload of the teachers. As a whole, this study will provide a fundamental ground for future research in formative assessment in Bangladeshi colleges specifically and for comparative study with other higher education institutions globally.

This study examined the effects of using "captions", "subtitles" and "keyword captions" on the comprehension of audiovisual materials by English as a foreign language (EFL) learners, who were divided into two different groups, proficient and less proficient learners. It also investigated the participants' awareness of the distinction between different types of input they were exposed to and their benefits with the help of the interviews conducted. After the participants watched the videos, they answered comprehension questions. The results of the study indicated that in the less proficient group, those who watched the videos with Turkish subtitles outperformed those who didn't. However, in the proficient group, the videos with keyword-captions led to better results. The data gathered via the interviews revealed that the participants could identify the differences between different types of input and, while the proficient group displayed positive attitudes towards keyword-captions, the less proficient group preferred the videos with captions. The findings of this study are expected to contribute to the related research with the help of the results of each experimental condition for different levels of learners.

The surge of information in the digital age has impacted social problems. Accordingly, digital citizenship had been discussed mostly within topics related to digital security, IT education. A systematic review is needed to provide an overview for educators and policymakers in Indonesia to address ethical and technical issues to improve the online environment safely. However, there are limited studies that systematically review the existing literature on implementing digital citizenship in Indonesia. The present study was guided by PRISMA review protocol using three databases, i.e., Scopus, Google Scholars, and ProQuest, concerned with digital citizenship, digital competence, digital literacy, and information and communications technology (ICT) skills. There were 205 articles screened; this study obtained 20 articles that fit the predetermined inclusion criteria. This study used content analysis to encode, organize categories, and develop the themes. Based on the thematic analysis, this study has three main themes namely digital readiness, digital citizenship competencies, and educational policies. This review contributes to the existing literature by providing direction to future study and embedded digital citizenship competencies in the educational setting as a catalyst for a new literacy.