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BACKGROUND: The role of arterial collateral and venous outflow status on the response to intravenous tissue plasminogen activator (IV-tPA) has not been sufficiently clarified in acute major cerebral occlusions. PATIENTS AND METHODS: A total of 130 patients (mean age: 71 years; 73 females) with acute middle cerebral artery M1/M2 segment or terminal internal carotid artery occlusion treated solely with IV-tPA were analyzed. Regional leptomeningeal score (rLMC) was used for cerebral arterial collateral scoring, and the cortical vein opacification score (COVES) and modified Prognostic Evaluation based on Cortical vein score difference In Stroke (PRECISE) superficial and deep scores were used for venous outflow profile. Exploratory logistic models for response to IV-tPA [positive response: National Institutes of Health Stroke Scale (NIHSS) decrease 4 (or decrease to 0) at 24 h; dramatic response: NIHSS decrease ≥8 (or decrease to 0 or 1)], functional outcome (modified Rankin’s score 0–1 as “excellent” and 0–2 “good”) and tPA-associated hemorrhagic transformation were constructed. RESULTS: IV-tPA efficacy was positive in 47% and dramatic in 32%. Dramatic response was linked to better arterial collateral status (exp[B] =1.115 [95% confidence interval (CI), 1.016–1.223]). Excellent outcome was noted in 26% and good in 45%. One-point increase in rLMC score independently increased good prognosis (exp[B] =1.209 [1.034–1.412]). Patients with good prognosis had higher (by 0.5 points) modified PRECISE deep score (P = 0.047) and less frequent nonsufficient modified PRECISE deep score (0–2) (P = 0.017) in univariate analyses. However, these associations failed to survive in multiple regression. Any type tPA-associated cerebral hemorrhagic transformation was observed in 23% and parenchymal hemorrhage type 2 in 5.4%. While rLMC score showed a borderline strength correlation to hemorrhage (exp[B] =0.899 [95% CI, 0.808–1.001]), outflow scores not. CONCLUSION: While arterial collateral status modifies the effect of tPA in acute anterior circulation major artery occlusions, venous outflow capacity is not so critical.

Abstract Nanoscience and Technology (NST) have revolutionized the world. It has led to many innovations since it entered our lives. Meanwhile, the number and quality of people trained in this field gained importance. Currently, initiatives are being taken to integrate this field into the primary education curriculum in many countries. This study focuses on integrating NST into the curriculum as a primary education topic. In this context, meta-synthesis research was used. First, developed countries’ well-known initiatives on adapting NST to the curriculum will be discussed in the paper. Then, the works on NST in the literature, especially experimental ones, will be addressed. Finally, based on the results, some suggestions will be made for creating a curriculum in this field. Although there are differences in countries’ curriculums, the basic knowledge necessary for education in this field is also outlined.

Background: Small fiber neuropathy (SFN) leads to sensory and autonomic dysfunction by affecting small-diameter myelinated A-delta and unmyelinated C fibers, with vitamin B12 deficiency identified as one of its causes. Objectives: To achieve early diagnosis of SFN in patients with vitamin B12 deficiency and to illustrate the impact of vitamin B12 replacement therapy using noninvasive electrophysiological tests. Materials and Methods: Patients aged 18 to 65 with vitamin B12 deficiency experiencing neuropathic pain or autonomic symptoms were included. A control group consisted of asymptomatic, healthy volunteers with normal B12 levels. Neurological examinations, cutaneous silent period (CSP), sympathetic skin response (SSR), and cardiovascular autonomic tests (R-R interval variability during the Valsalva maneuver [RRIV-VM] and standing [RRIV-S]) were performed at admission and six months later. Patients received 1000 mcg cyanocobalamin intramuscularly daily for one week, weekly for one month, and monthly for three months. Results: The final analyses included 25 patients and 25 controls. At admission, patients had significantly longer CSP and SSR latencies compared to controls (P = 0.047, P < 0.001) and shortened CSP durations (P = 0.043). The SSR amplitude was lower in patients but not significantly (P = 0.823). Post-treatment, CSP latency, CSP duration, and SSR latency significantly improved (P < 0.001, P = 0.002, P < 0.001). Positive symptoms and autonomic symptoms improved significantly after treatment (P = 0.039, P = 0.016). The number of patients with neuropathic pain significantly decreased (P = 0.008). Conclusion: CSP latency, CSP duration, and SSR latency are effective, non-invasive, and cost-effective screening tests for diagnosing SFN in individuals with B12 deficiency. These tests are also valuable for monitoring the progression of SFN following vitamin B12 replacement therapy. The study supports the use of these noninvasive electrophysiological tests to enhance early diagnosis and treatment efficacy in SFN associated with vitamin B12 deficiency.

Abstract Background This study aimed to investigate the range of angles and depths necessary for effective entry into the TMJ using CBCT images, focusing on classical Holmlund Hellsing points and a two-needle approach. Methods A retrospective cohort of CBCT images from January 2020 to November 2023 was analysed using 3D analysis to determine the variance in the required angles and depths. Results The average age of the 68 participants included in the study was 29.5 ± 11.1, 58.8% of the participants were female and 41.2% were male. The anterior needle measurements showed a relatively low standard deviation(SD) in depth(SD:3.6) with a low variance coefficient(12.5%), whereas the axial and coronal angles exhibited greater variability(SD:9.1 and 7.6, respectively). For the posterior needles, moderate SDs in depth(SD:3.5) and greater variabilities in axial and coronal angles(SD:9.6 and 5.3, respectively) were observed. A weak negative correlation was observed between the axial angle of the posterior needle and age(p: 0.028, Pearson r: -0.29) Anterior needle depth (p:0.037) and posterior needle axial angle(p:0.014) were greater in males than females. The anterior needle depth in patients with temporamandibular disease was greater than in those without(p:0,03). Conclusion There were significant differences in the angle measurements for both anterior and posterior needles, but lower variance in depth. The depths and angles of the needles did not correlate with age.

Objective(s): We aimed to investigate the levels of transient receptor potential melastatin (TRPM) gene expression, and the antioxidant and histopathologic effect of thymoquinone (Tmq) in the hepatic I/R rat model.Materials and Methods: Fifty Wistar rats were divided into 5 groups. Group 1: Control; Group 2: Sham; Group 3: Hepatic I/R (45 min/45 min); Group 4: Tmq (50 mg/kg); Group 5: Tmq+I/R (ten days before I/R at the dose of 50 mg/kg of Tmq). The hepatic I/R (45min/45min) model was performed at the portal vein and the hepatic artery with atraumatic vascular clamp in the ischemia groups. The liver tissues and blood samples that were taken at the end of the study were evaluated for histopathologic and biochemical analysis. Besides TRPM gene expression levels were determined in liver tissues. It was seen that cellular swelling, congestion, PNL, and apoptosis parameters statistically decreased in Tmq and Tmq+I/R groups in comparison with the I/R group in histopathological evaluation.Results: It was observed that biochemical parameters, AST, ALT, GGT, LDH, creatinine, and urea levels significantly increased in the I/R group as compared with, sham, Tmq, and Tmq+I/R groups. It was found that TRPM2,6,7,8 gene expression decreased significantly in Tmq+I/R groups as compared to the I/R group. Conclusion: We showed that thymoquinone can inhibit the entry of Ca+2 into the cell by decreasing TRPM2,6,7,8 gene expression. Based on our findings, we think that Tmq application in the treatment of liver diseases due to I/R damage may be important in terms of both ischemia and apoptosis and can also be used in the treatment of liver-related diseases.

All countries have been deeply affected by the coronavirus disease 2019 pandemic, both economically and in situations that strain health systems, such as workforce and workload. Therefore, various measures should be taken to control the disease and prevent its spread. Since the disease onset, real-time PCR tests have been used as the gold standard for disease diagnosis. Owing to the rapid progress of the pandemic and the spread of the disease, validation, consistency, and optimization tests of some commercial kits have been conducted directly in the field. Therefore, it is important to compare the results of these kits and improve the existing ones.

The characteristics of human silhouette shape can be used for action recognition and classification. In this paper, a novel feature extraction method for the silhouette-based classification of human actions in videos is proposed. The proposed method is based on polygonization of silhouette images and coding. Since conventional silhouette generation methods do not satisfy the integrity of silhouettes, Yolact++ is modified as a silhouette generator. Our innovative approach Yolact++ masks are used as silhouettes to overcome this problem. For this purpose, a new image form called Poly Silhouette (PoS), a new Polygonization (PoG) algorithm and a new Polygon Coding (PoC) algorithm have been developed. The polygonization step is based on, but is not similar to curve and image polygonization. It is fast, adaptable, and accurate on the contour coordinates of the PoS images. PoCs were generated by projecting each edge vector generated from the corner coordinates of the PoS onto the angular areas and codes for the PoS were formed. These codes are grouped into k-mers similar to genetic algorithms and are used as features. The proposed innovative feature extraction method guarantees that feature vectors of equal length are generated from any action video. Thus, no additional action is required to overcome the dimensionality problem. By using different k-mer lengths, the classification accuracy of the method versus computation time was analyzed and depicted in figures. The method developed was tested on HMDB51 & UCF101 datasets: for SVM 20.98%, 1.63% for k-NN 4.96%, 6.83%, respectively, and significant improvements were achieved.

Patients in need of Palliative Care (PC) often receive medical help from Emergency departments (ER) and sometimes due to healthcare system-related issues the time spent at the ER exceeds the expectations. In order to provide effective care, ER employees should have sufficient knowledge and skills about end-of-life care and PC in ER. This study aims to evaluate the knowledge levels of ER employees on PC, in addition to their educational background and their approach to PC and its possible relation with ethical sensitivity. The present study is a cross-sectional and descriptive study consisting of 100 emergency service employees working in the city centers of Tokat and Kayseri between August 2017 and May 2019. The data were collected using a questionnaire form containing sociodemographic characteristics of the ER employees and their views on PC in addition to the Ethical Sensitivity Questionnaire (ESQ). The sample of the study consisted of 100 ER workers; 52 (52%) female and 48 (48%) male. The mean age was 32.16±7.91 years. It was determined that the vast majority of the participants (63%) had not received PC training before. While the average score regarding knowledge levels on PC was found to be 49.10±8.25, the average total score of the Ethical Sensitivity Questionnaire was found to be 78.73±20.97. The participants had a higher ethical sensitivity and moderate knowledge levels about PC. There was no significant difference in the total ESQ scores of the ER employees according to the variables of "gender, education, occupation, palliative knowledge and in-service education in the institution" (p>0.05). In order to raise awareness of PC, there is a need for pre-graduation PC training and in-service training after graduation. These practices should be repeated at certain intervals to keep the knowledge up-to-date. [Med-Science 2022; 11(4.000): 1593-8]

The design and mission requirements of aero vehicles, which vary on a day-to-day basis, have become major study concerns in the burgeoning aviation sector. In addition to the design and mission criteria that must be met in an aero vehicle design, the designers' primary goals are to construct original, innovative, environmentally friendly, fuel-efficient, and sustainable designs. In this study, a detailed conceptual design of a helicopter that does not need a notable runway for operation and is limited by mission and design requirements is offered. Within the scope of this research, a competitor analysis study was undertaken in accordance with the defined criteria, and design approaches were chosen based on the outcomes of competitor analysis. In addition, this research, which looks for an environmentally friendly and sustainable design, was developed with the aviation industry's demands in mind by analyzing the International Helicopter Safety Team's (IHST) data. As a result of the reports analyzed and considering the causes and consequences of accidents that have happened, the objective of the design research was to achieve a sustainable, ecologically friendly, and fuel-efficient design by reducing the number of accidents and damage. The planning and design processes as a result of this examination are essential as a step towards the helicopter being an original design and in the context of solution methodologies. This archetypal design aims to shed light on helicopter design studies and serve as a roadmap for future research.

Nursing education involves a practice-oriented curriculum in which emphasis is placed on both theoretical knowledge and psychomotor skills. In skill-based education, where learning through practice occupies a central role, it is important to ensure the integration of theoretical knowledge into practice. In this context, simulations represent an innovative teaching method that stimulates a number of senses at the same time among learners. Simulation is a method which can be designed to reflect real-life conditions, and which provides the opportunity to work in contexts that are closer and more representative of real settings. Depending on the clinical situation or scenario; the simulation method will involve a student or a group of students performing a number of patient care activities on a manikin, player or standardized patient. The simulation method allows students to repeatedly practice their clinical skills until they develop a sense of proficiency; to learn at their own pace; and to freely make mistakes. Simulations is an educational process that can replicate clinical practices in a safe environment. Nursing students who take part in education programs involving simulations perform less medical mistakes in clinical settings, and are able to better develop their critical thinking and clinical decision-making skills. For these reasons, we recommend that simulations, which represent an interactive learning method, are rendered more common in institutions providing nursing education.

With rapid developments being made in science and technology, there is also an increasing need for different educational methods. Distance education allows increased access to education and more flexibility for the students. This descriptive study was conducted to establish the opinions of nursing students about distance education being adopted for the first time. The study comprised 261 nursing students, who were applied a data collection form in class. Of these students, 55.6% stated that they had problems while taking courses through distance education, 83.1% stated that it was not beneficial, 90.8% stated that distance education could not be used for applied vocational courses. It was found the mean scale scores were lower for the students who thought that distance education was not beneficial, who would like to take these courses through formal education and who believed that the applied vocational courses could not be provided through distance education. The students had difficulties in accessing the internet during the courses. The students' attitudes towards distance education were at moderate level and the negative conditions adversely affected the students' opinions. In addition, the majority of the students thought that the vocational courses could not be made through distance education, and this is considered to be a positive finding.

Background: The most common problems in individuals with autistic spectrum disorders are eye contact, being able to follow objects for a long time and lack of attention. Sports activities are known to prevent the negative symptoms of Autistic Spectrum Disorder. The Badminton sports branch has a positive effect on the individual's object control, ball focus, and attention, reaction, perception and coordination characteristics. For this reason, racket sports are considered to be an important tool in reducing the lack of attention in individuals with Autistic Spectrum Disorder. Aim: The aim of this study, Investigation of the effect of simplified Badminton exercises on attention focus development of individuals with Autistic Spectrum Disorder and is the assessment of the level of retention of an acquisition. Material and Method: The study group was randomly selected 3 out of 6 children who are not mentally retarded and responded to commands among 10 children aged 12-14 years in Isparta Gülsen Önal Autistic Children Education Centre. The mean age of children was 12.6 ± 1.15 years, height was 154,3±5,13 cm and weight was 52±3 kg. Benton Visual Memory Test, Bourdon Visual Attention Test and Stroop Effect Test were used as the measurement tool. Children were performed adaptation exercises for 2 weeks and from simple to difficult badminton exercise drills for 10 weeks. For each individual, 3 studies were performed at different times and 60 minutes per week. Tests were performed at 3 different periods, to be 10 weeks Badminton exercise process before and after and also retention test after 8 weeks interval. The obtained data were evaluated by Wilcoxon test. Results: According to the results of all measurement instruments of the students participating in the research, there is a numerical rise between pre-test and post-test values. When the results of the retention test with the last test are evaluated, there was no decrease in the two participants according to the Benton visual memory test results, but the other participant had also decline, although not at the beginning level. Burdon attention test and Stroop effect test showed that there was no return to baseline in all participants despite a numerical decrease. Conclusion: We can say that Badminton exercise program has a positive effect on attention level. Individuals with autistic spectrum disorder can be said to have a positive influence on the development of eye contact, long-time focus of objects and attention level development. Badminton exercises can be offered as a model to improve attentiveness to children with Autistic Spectrum Disorder if the duration of participatory study is increased.

Objective: We aimed to determine anatomic features of the temporal branch (TB) of the facial nerve and its relation to various anatomic landmarks on the face in order to prevent damage in the surgical approach after head trauma or in planned neurosurgical interventions. Methods: Nine male cadavers preserved with formalin, were bilaterally dissected under a microscope at the laboratory of anatomy department of the university. The anatomical features of the branch and branching pattern of facial nerve and its relationships with adjacent neurovascular structures were evaluated using descriptive statistical data. Results: The mean distance at the lateral canthus level between the far most anterior branch and far most posterior branch of the TB (APD) was 14.93 mm. The mean distance to the tragus of the entrance point of the TB to the orbicularis oculi muscle (ETT) was 74.72 mm. The mean distance between the origin point of the TB to the tragus (TT) was 24.50 mm. The angle between the far most anterior branch and far most posterior branch at the level of the lateral canthus (APA) was minimum 15°, maximum 40° and the mean value of APA was 24.61°. The number of branches originating from the TB (NB) were one to three branches which lay under the zygomatic arch and two to five branches upper the zygomatic arch, respectively. The number of anastomosis between the TB and zygomatic branch (AN) varies between 1 and 4; AN was found to be less intense in 10 sides and very intense in eight sides. Conclusion: The APA and APD value is mentioned for the first time in this study and nerve angle is considered to be as important as temporal branching in directing facial neurosurgical operations. We found that the unsafety zone may be exist for a 40 degree and 1.5 cm long area at the lateral canthus level, especially on the zygomatic arc where branching pattern is greater and 2.5 cm in front of the tragus. The data is significant for neurosurgeons to reach exactly this area without causing postoperative complications such as facial paralysis. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Carotid revascularisation improves haemodynamic compromise in cerebral circulation as an additional benefit to the primary goal of reducing future thromboembolic risk. We determined the effect of carotid artery stenting on cerebral perfusion and oxygenation using a perfusion-weighted MRI algorithm that is based on assessment of capillary transit-time heterogeneity together with other perfusion and metabolism-related metrics. PATIENTS AND METHODS: A consecutive series of 33 patients were evaluated by dynamic susceptibility contrast perfusion-weighted MRI prior to and within 24 h of the endovascular procedure. The level of relative change induced by stenting, and relationship of these changes with respect to baseline stenosis degree were analysed. RESULTS: Stenting led to significant increase in cerebral blood flow (p  2s decreased from 24 ml to 12 ml (p = 0.009), with CTH > 2s from 29 ml to 19 ml (p = 0.041), and with RTH

A variety of conditions may affect the trigeminal nerve. Magnetic resonance imaging is the modality of choice when trigeminal nerve pathology is suspected, and this modality plays an essential role in detecting causes. This review illustrates some of the pathological conditions relevant to the trigeminal nerve in magnetic resonance imaging.