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The liver is the largest internal organ in the body and has vital functions such as metabolism, elimination of toxins, and bile production. Liver diseases include various conditions that affect the functions of this organ. The most common liver diseases include hepatitis, cirrhosis, fatty liver disease, and liver cancer. These diseases can develop due to genetic factors, alcohol consumption, viral infections, and obesity. A healthy lifestyle is of great importance in preventing liver diseases. Measures such as a balanced diet, regular exercise, limiting alcohol consumption, and protection from viral infections (e.g., vaccinations) help protect liver health. In addition, avoiding exposure to toxins is also important. Interest in phytotherapy has increased considerably in recent years, except for medical applications, in the protection of liver health and the treatment of liver diseases. Among the plants used for this purpose, foods such as artichoke, pomegranate, grapes, and grapefruit, teas such as chamomile, or extracts containing active ingredients such as ellagic acid, resveratrol, and curcumin can be listed. This article will discuss the effects of some plants on liver health. In addition to the plants mentioned here, many other plants are used in this area. While plants are beneficial when used in food format for general health, if they are used for treatment purposes and as an extract, they should be used under the supervision of a physician who has received phytotherapy training. As a result, liver diseases can be prevented, and when they do occur, most of them can be treated. A healthy lifestyle, regulating habits, healthy choices in food intake, and herbal supplements can play an important role in this process.

Objective: The survival rates of children with acute lymphoblastic leukemia (ALL) have improved over the years, but infections remain a significant cause of morbidity and mortality. Chemotherapy has a range of harmful side effects including the loss of protective antibodies against vaccine-preventable diseases. The objective of this study was to evaluate the serological status of pediatric ALL cases before and after intensive chemotherapy. Materials and Methods: Children treated and followed for ALL at Dokuz Eylül University were included in this retrospective crosssectional study. Antibody levels against hepatitis A, hepatitis B, and rubella were routinely assessed at both the time of diagnosis and 6 months after completion of chemotherapy. Measles, mumps, and varicella antibody levels were evaluated at only 6 months after treatment. Results: Seventy-eight children who completed chemotherapy for ALL were enrolled in the study. All participants had non-protective antibody levels for at least one of the diseases. The highest seropositivity rate was found for hepatitis A (55.1%) and the lowest for measles (17.9%) after chemotherapy. Overall, 50.7%, 30.6%, and 45.7% of the patients significantly lost their humoral immunity against hepatitis B, hepatitis A, and rubella, respectively. Patients in the higher-risk group for ALL had lower seropositivity rates than patients of the other risk groups. There were statistically significant relationships between the protective antibody rates for hepatitis A and varicella and the ages of the patients. Except for hepatitis A vaccination, pre-chemotherapy vaccination did not affect post-chemotherapy serology. On the other hand, all children with a history of varicella before diagnosis showed immunity after chemotherapy. Conclusion: Patients with ALL, including those previously fully vaccinated, are at great risk of infection due to the decrease in protective antibody levels after chemotherapy. There is a need for routine post-chemotherapy serological testing and re-vaccination based on the results obtained.

This case report describes a 32-year-old male who underwent ketamine procedural sedation and experienced a generalized tonic–clonic seizure. Despite its rapid onset and favorable tolerance profile, this case emphasizes the potential convulsive side effects of ketamine, which is commonly used for procedural sedation. While ketamine has shown promise in treating acute pain, refractory status epilepticus, and treatment-resistant depression and schizophrenia, it is associated with side effects such as hallucinations, visual disturbances, dizziness, nausea, and vomiting. The patient in this case received a carefully titrated dose of 40 mg of ketamine intravenously and underwent successful shoulder reduction while under sedation. However, within 60 s of receiving the ketamine, the patient experienced a 60-s seizure that was stopped with the administration of 5 mg of diazepam intravenously. The patient was hospitalized for further evaluation, including an electroencephalography (EEG) that showed no abnormalities. This case highlights the need for health-care professionals to be aware of the potential convulsive side effects of ketamine and to carefully monitor patients who receive ketamine sedation.

Gastrointestinal disorders include various disorders affecting organs such as the stomach, intestines, and liver, and while they have an important place in human health, their treatment processes are also complex. These disorders constitute an increasing health problem today and pose a significant burden on both health services and individuals. In the treatment of these disorders, phytotherapy (herbal treatment) is considered an important alternative in addition to traditional medicine. The use of phytotherapy has become preferred because it offers more natural options for patients with fewer side effects. Phytotherapy provides positive effects on the digestive system with its many properties such as anti-inflammatory, antioxidant, and antimicrobial features. In this article, various phytotherapeutic agents (e.g., aloe vera, turmeric, bitter melon, pomegranate, St. John’s wort, mint, black cumin, berberine, garlic, olive leaf, cinnamon, tea, ginger, carnation and nettle) used in gastrointestinal disorders such as gastroesophageal reflux, peptic ulcer, inflammatory bowel disease, irritable bowel syndrome, colon polyps, colorectal and stomach cancer are discussed and their effects on the digestive system and potential properties in managing symptoms are discussed.

Aim: Being overweight or obese are characterized by excess fat accumulation and pose substantial health risks representing significant public health challenges in the 21st century. Overweight or obese children will potentially be overweight or obese adults in the future. Individuals who are obese during childhood are more likely to develop non-communicable chronic diseases at an earlier age compared to those who are not obese. Therefore, this study aimed to investigate the obesity rates and the associated risk factors for obesity of primary school students in one of İzmir’s districts. Materials and Methods: This study focused on primary school students aged five to nine years in the Bayraklı district of the İzmir province. A total of 535 children were initially included in this study. We excluded 128 children who had chronic diseases or were taking medicine associated with obesity or those who did not agree to participate. The dependent variable was obesity and the independent variables were defined by socio-demographic and natal features, physical activities, eating habits, screen time (television and computer usage), family structure and parental weight. We administered a questionnaire to the parents and measured the children’s weight and height thus calculating their body mass index. Chi-square analysis, t-test and the Mann-Whitney U test were used for statistical calculations. A probability rate was used for obesity and overweight associated factors. Results: The mean age was 8±1.1 years for the 407 children. The overweight rate was 12% and the obesity rate was 12%. We detected that gender was not associated with obesity or being overweight (p=0.486). Birth weight (p

INTRODUCTION: The hypothalamic-pituitary-gonadal axis is active during minipuberty, the timing of which coincides with infantile colic. To the best of our knowledge, the relationship between these entities has not been previously investigated. METHODS: Saliva samples were collected from 15- to 60-day-old term infants (n=139) between 9 am and 5 pm. Group 1 included infants with infantile colic (n=68, 54.4% female) while the remaining healthy infants constituted Group 2 (n=71, 47.9% female). Salivary levels of estradiol (Esal) in females and testosterone (Tsal) in males were measured by ELISA in duplicate. RESULTS: The median (25th-75th centile) age and birth week for all infants were 33 (29-43) days and 39 (38.1-40) weeks, respectively. Levels of Tsal in males [Group 1, 73.35 (59.94-117.82) pg/mL vs Group 2, 77.66 (56.49-110.08) pg/mL, p=0.956] and Esal in females [Group 1, 3.91 (2.76-5.31) pg/mL vs Group 2, 4.03 (1.63-12.1) pg/mL, p=0.683] were similar. However, in subjects with infantile colic (Group 1), Esal and body mass index (BMI) standard deviation scores of females were slightly correlated (Group 1, rs= 0.393, p=0.016 vs. Group 2, rs= 0.308, p=0.076) and there was a significant correlation between the sampling time and Tsal in males (Group 1, rs= 0.469, p=0.009 vs. Group 2, rs= -0.005, p=0.976). DISCUSSION AND CONCLUSION: Random salivary sex steroid levels were similar in infants with and without infantile colic. However, in subjects with infantile colic, Esal levels in females were positively correlated with BMI and Tsal levels were higher later in the day among males. Thus, sex steroid production may be altered during minipuberty in subjects with infantile colic.

Addressing the critical issue of heat generation in electronic devices due to miniaturization and higher power density is essential. As electronic components become more compact, they generate more heat flux, necessitating efficient thermal management solutions. Traditional methods and fluids, such as water, struggle to meet the demand for efficient heat dissipation. To address this challenge, the utilization of nanofluids presents a promising solution. The objective of this study is to use CFD methods to examine how a nanofluid can improve heat transmission and lower the maximum temperature in a microchannel heatsink. This article presents the study of microchannel heatsinks with two distinct channel counts (five and eight). A constant flow, incompressible, laminar model was used to verify the findings. The working fluids used in the study were water in various concentrations, water-based nanofluids of Fe3O4-water and MWCNTs. CFD simulations revealed that a MWCNT-water nanofluid at 0.2 % concentration significantly improved cooling performance compared to water, demonstrating the potential of nanofluids for efficient thermal management in electronic devices.

Glomerular hyperfiltration (GHF) is an early marker of chronic kidney disease (CKD) and may predict coronary microvascular dysfunction, presenting as reduced coronary flow velocity reserve (CFVR) in patients with a history of gestational diabetes (GDM). This study aimed to assess the glomerular filtration rate (GFR) and compare CFVR in patients with a history of GDM. We screened patients referred to the Cardiology Department of Istanbul Medeniyet University for angina pectoris, excluding those with positive treadmill test results. Women with a history of GDM were categorized into three groups based on GFR levels: Group 1 (60-89 ml/min), Group 2 (90-119 ml/min), and Group 3 (≥ 120 ml/min). Coronary diastolic peak velocities were measured at baseline and after dipyridamole administration, with CFVR defined as the ratio of hyperemic to baseline diastolic peak velocities. The homeostasis model assessment of insulin resistance (HOMA-IR) and body mass index were derived from patient files. A total of 166 patients were included: 57 in Group 1, 80 in Group 2, and 29 in Group 3. HOMA-IR was higher in Group 3 compared to Group 2 (P < 0.05). Group 1 had the lowest CFVR (2.3 ± 0.3%), Group 2 had the highest (2.5 ± 0.3%), and Group 3 showed a moderate decrease in CFVR (2.4 ± 0.3%). Multivariate linear regression analysis revealed that HbA1c was independently associated with CFVR. In patients with GDM, GHF is associated with reduced CFVR, linked to metabolic parameters such as HbA1c and HOMA-IR. Interventions to improve metabolic health may prevent cardiovascular disease in these patients.

Fibromyalgia (FM) is characterized by chronic widespread pain accompanied by fatigue, poor sleep quality, and numerous accompanying conditions. Its prevalence worldwide is around 2.7%, and it is more common in women. Although its epidemiology and pathophysiology cannot be precisely explained, it is known that various factors coexist. Over the years, guidelines containing various criteria have been established for the diagnosis of the disease. The goal of treatment in FM is to improve the patient’s quality of life and minimize symptoms as much as possible. The success of treatment in FM is limited. Many patients seek alternative treatment methods, including diet and lifestyle changes. Recently, medical nutritional therapies and phytotherapy products have been at the forefront of research in this area. Phytotherapy products can be added alone or in combination with other treatment methods and can enhance the success of treatment. In this article, the epidemiology, pathophysiology, diagnostic methods, pharmacological and non-pharmacological methods used in the treatment of FM syndrome will be discussed, and the most widely used phytotherapeutic products will be addressed.

Resumo Fundamento Apesar dos avanços nas modalidades de diagnóstico e tratamento, há necessidade de marcadores preditivos para acidente vascular cerebral (AVC) recorrentes. Objetivos Este estudo teve como objetivo investigar a relação entre calcificação do arco aórtico (CAA) e recorrência de AVC em pacientes com AVC durante o acompanhamento de um ano. Métodos Todos os pacientes com AVC que sofreram seu primeiro evento foram avaliados para participação no estudo. Foram registrados pacientes que sofreram AVC recorrentes durante o acompanhamento de um ano. A CAA foi avaliada por radiografia de tórax. Com base na ocorrência de AVC recorrente, os pacientes foram divididos em dois grupos. A CAA foi classificada em quatro categorias de acordo com o seu grau, e a presença de CAA foi incluída na análise estatística. A relação entre CAA e AVC recorrente foi avaliada por meio de uma curva característica de operação do receptor. Um nível de significância

Fossil fuels, predominant in fulfilling current energy demands, are implicated in global warming, prompting a global shift towards renewable energy sources. Among these, photovoltaic (PV) solar power plants have garnered significant attention, experiencing a rapid surge in installed power capacity. However, a notable drawback of PV solar power plants is their considerable spatial footprint, emphasizing the pivotal role of efficient space utilization and shading mitigation in their design. Notably, pitch distance, array design, and PV type emerge as critical parameters influencing the performance of these power plants during installation. In the present study, eight distinct PV solar power plant designs were conceptualized, incorporating four different PV array configurations (2P-3P-2L-3L) and two PV types (monofacial-bifacial), each with specified orientations (portrait-landscape). Other parameters were held constant across designs. Leveraging PVsyst software, simulations were conducted for each design, yielding crucial performance metrics, including the annual energy output delivered to the grid (E-grid), performance ratio (PR), and associated CO2 emissions. Subsequently, a Taguchi analysis facilitated optimization based on these results. The outcome of this analysis identified the optimal PV array design as 3D and the optimal PV type as bifacial. Further insight was gained through an ANOVA analysis, revealing the substantial contributions of parameters to overall variability. Specifically, PV type exhibited a significant contribution of 65.27%, while PV array configuration contributed 34.72% to the observed variability in plant performance. These findings not only enhance the understanding of PV power plant design intricacies but also underscore the paramount significance of array design in achieving heightened efficiency and sustainability.

In this study, the effective reactivity and burnup analyses have been performed for heterogeneous three-dimensional high-temperature gas-cooled thorium reactor (HTGR) which has 60 MWth full core geometry by using continuous-energy multi-purpose three-dimensional Monte Carlo particle transport Serpent code with ENDF/ B-VII data libraries. Nuclear fuel have been selected as 50 % ThO2+50% RG-PuO2. Firstly, effective reactivity for three different qualities of graphite for operation period have been determined. The effective reactivity showed better performance with increasing densities of graphite. Secondly, it has been also examined to ZrC and SiC cladding materials effect on the effective reactivity. It is observed that SiC has a positive effect on reactivity compared to ZrC. As a results, the full core life low-power thorium-burner HTGR have been calculated as up to ~4500 days depending on the graphite material whereas, the corresponding burn−ups came out to be ~ 189 GWd/ton, for end of life.

Propafenone is a class 1C antiarrhythmic drug that blocks sodium channels and is used in the treatment of arrhythmia. Because of its rapid effect on terminating paroxysmal episodes of atrial fibrillation, it can be used as a pill-in-the-pocket. In patients with structural heart disease, it is less preferred due to cardiotoxic effects in long-term use. Although propafenone use is known to cause several cardiovascular side effects, the development of Takotsubo cardiomyopathy is unknown. Propafenone toxicity at standard doses is a rare condition. Propafenone plasma concentrations may increase through inhibition of cytochrome P450 2D6 and complete inhibition of 2D6 metabolism can increase propafenone levels by up to 3 to 10 times. In this case report, we aimed to present a 37-year-old female patient who developed Takotsubo cardiomyopathy and cardiogenic shock after the first dose of propafenone use and recovered with medical treatment.

Abstract Prognosis estimation in patients with cardiogenic shock (CS) is important to guide clinical decision making. Aim of this study was to investigate the predictive value of opportunistic CT-derived body composition analysis in CS patients. Amount and density of fat and muscle tissue of 152 CS patients were quantified from single-slice CT images at the level of the intervertebral disc space L3/L4. Multivariable Cox regression and Kaplan–Meier survival analyses were performed to evaluate the predictive value of opportunistically CT-derived body composition parameters on the primary endpoint of 30-day mortality. Within the 30-day follow-up, 90/152 (59.2%) patients died. On multivariable analyses, lactate (Hazard Ratio 1.10 [95% Confidence Interval 1.04–1.17]; p = 0.002) and patient age (HR 1.04 [95% CI 1.01–1.07], p = 0.017) as clinical prognosticators, as well as visceral adipose tissue (VAT) area (HR 1.004 [95% CI 1.002–1.007]; p = 0.001) and skeletal muscle (SM) area (HR 0.987 [95% CI 0.975–0.999]; p = 0.043) as imaging biomarkers remained as independent predictors of 30-day mortality. Kaplan–Meier survival analyses showed significantly increased 30-day mortality in patients with higher VAT area (p = 0.015) and lower SM area (p = 0.035). CT-derived VAT and SM area are independent predictors of dismal outcomes in CS patients and have the potential to emerge as new imaging biomarkers available from routine diagnostic CT.

IntroductionThe COVID-19 pandemic significantly impacted the mental health of individuals with chronic conditions such as Wilson’s Disease (WD). This study investigates stress, anxiety, depression, quality of life, cognitive function, vaccination rates, infection rates, and perceptions related to the pandemic and vaccines among WD patients.MethodsThe study analyzed COVID-19 perceptions and vaccine attitudes of 62 adult WD patients enrolled in the international multisite WD Registry. A subgroup of 33 participants completed a series of mental health scales. The effect of working essentially, income loss, wellness activity initiation, and infection of COVID-19 during the pandemic was observed.ResultsResults indicate that, overall, the pandemic did not exacerbate anxiety or cognitive function in WD patients but did lead to increased depression among essential workers. Patients experiencing income loss exhibited higher levels of stress and anxiety. Despite these challenges, WD patients showed high vaccination rates and positive attitudes towards vaccines.DiscussionThe findings underscore the significant impact of the pandemic on the mental health of WD patients.

Objective: In this study, the aim was to compare the results of mini and standard percutaneous nephrolithotomy (PCNL) for the treatment of pediatric kidney stones. Materials and Methods: Data for 128 patients < 18 years of age who underwent mini and standard PCNL due to pediatric kidney stones were retrospectively examined. Patients were divided into two groups: mini-PCNL (16-20 Fr) and standard PCNL (26 Fr). Surgery time, number of punctures to the pelvicalyceal system, hospital stay, postoperative hemoglobin drop, complications and stone-free status (SFR) were compared between the groups. Additional surgical intervention (double-J stent, ureterorenoscopy, secondary PCNL) performed after the surgery was recorded. The absence of residual stones or < 3 mm residual stones on kidney, ureter and bladder radiography (KUB) and ultrasonography (USG) performed in the third postoperative month were accepted as success criteria. Results: There were 32 (43.8%) patients in the mini-PCNL group and 41 (56.2%) patients in the standard PCNL group. The mean age was 9.3 ± 4.1 years in the mini-PCNL group and 10.1 ± 5.4 years in the standard PCNL group. Mean stone size in the mini-PCNL group was 2.1 ± 1.2; while for standard PCNL it was 2.3 ± 1.4. The mean surgery time was statistically significantly higher in the mini-PCNL group (p = 0.005). There was no difference between the groups in terms of intraoperative double J stent use, postoperative complications and SFR. A double J stent was inserted in two patients in the mini-PCNL group and in one patient in the standard PCNL group due to urine leakage from the nephrostomy tract in the postoperative period. Although the postoperative hemoglobin drop was found to be significantly higher in standard PCNL (p = 0.001), hematuria and blood transfusion rates were low in both groups. Mean hospital stay was shorter in the mini-PCNL group compared to standard PCNL (3.6 ± 1.2 days vs. 2.5 ± 1.1; p = 0.018). Conclusions: Although mini-PCNL has longer surgery time compared to standard PCNL, it should be preferred for the treatment of pediatric kidney stones due to advantages such as similar success and complication rates to standard PCNL, short hospital stay and less postoperative hemoglobin drop.

Study objectives: Patients with carpal tunnel syndrome (CTS) show manifestations of arterial abnormalities, including carotid intimal thickening and increased vascular stiffness. As carpal tunnel syndrome is associated with amyloidosis, we hypothesized that previously observed abnormalities can largely be related with concomitant amyloidosis rather than CTS itself. Design: Prospective observational study. Setting: Medeniyet University Goztepe Hospital Participants: 61 patients with CTS (of whom 32 had biopsy-proven amyloidosis) and 36 healthy controls. Interventions: Subjects underwent ultrasound examinations for the measurement of coronary flow velocity reserve (CFVR), flow-mediated vasodilatation (FMD) and carotid intimal-media thickness (CIMT). Main outcome measures: Comparison of CFVR, FMD and CIMT in CTS patients with or without amyloidosis. Results: Patients with either CTS or CTS with concomitant amyloidosis (CTS-A) had significantly lower FMD (9.7 % ± 4.0 % in CTS and 10.3 % ± 4.6 % in CTS-A groups, p

Gas Metal Arc Welding is a joining technique with numerous uses in manufacturing. Since welding process parameters have a considerable impact on the welding quality, online monitoring systems are utilized on production lines to achieve standard welding quality with minimum welding faults. This study presents preliminary work to develop a monitoring system for defect analysis in a Gas Metal Arc Welding process. This study aims to eliminate the need for laboratory tests with a model to reduce welding quality control costs. In this study, welding data such as voltage, current, and wire feeding rate were collected during the welding process in real-time. New features were derived from the gathered data at the preprocessing stage using statistical approaches. The determination of whether the welding process is defective or flawless was made using the Extreme Gradient Boosting Algorithm. The hyperparameters of the algorithm were optimized with Particle Swarm Optimization. The accuracy value was obtained as 93.15% after repeating the conducted experiments ten times. The recall, precision, specificity, and F1-Score values in these experiments were calculated as 97.22%, 94.75%, 72.35%, and 95.94%, respectively. The mean current value was found to be the most relevant and meaningful feature that describes the welding quality based on intensive experiments. In addition to the proposed algorithm, some other machine-learning algorithms were tested on the welding dataset. With this study, the significance of feature derivation from the acquired welding current data has been discovered to analyze welding quality.

In order to meet the energy demand, energy production must be done continuously. Hydrogen seems to be the best alternative for this energy production, because it is both an environmentally friendly and renewable energy source. In this study, the hydrogen fuel production of the peaceful nuclear explosives (PACER) fusion blanket as the energy source integrated with Fe–Cl thermochemical water splitting cycle have been investigated. Firstly, neutronic analyzes of the PACER fusion blanket were performed. Necessary neutronic studies were performed in the Monte Carlo calculation method. Molten salt fuel has been considered mole-fractions of heavy metal salt (ThF4, UF4 and ThF4+UF4) by 2, 6 and 12 mol. % with Flibe as the main constituent. Secondly, potential of the hydrogen fuel production as a result of the neutronic evaluations of the PACER fusion blanket integrated with Fe–Cl thermochemical cycle have been performed. In these calculations, tritium breeding (TBR), energy multiplication factor (M), thermal power ratio (1−ψ), total thermal power (Phpf) and mass flow rate of hydrogen (m˙H2) have been computed. As a results, the amount of the hydrogen production (m˙H2) have been obtained in the range of 232.24x106 kg/year and 345.79 x106 kg/year for the all mole-fractions of heavy metal salts using in the blanket.

The prevalence of obesity, which is defined by the World Health Organization as abnormal or excessive fat accumulation in the body that impairs health, is increasing day by day. In addition to behavioral therapy aimed at changing the individual’s lifestyle based on the strategies developed against the disease, diet therapy, exercise, medical nutrition therapy, pharmacological and, as a last resort, surgical treatment are recommended. The effect of methods other than surgical treatment on weight loss is slow. For this reason, many obese patients prefer obesity surgery to lose weight quickly, but these methods have many complications such as weight regain, tachycardia, fistula, bleeding, herniation, anastomotic stenosis, gastric erosion, small bowel obstructions, deep vein thrombosis and pulmonary embolism. Post-surgical weight regain and complications have recently led to new searches, and the use of medical nutrition and phytotherapy products has again come to the fore as hope. Phytotherapy products can also be used alone or in combination with other methods. Natural anti-obesity products have functional ingredients such as phytochemicals, polyphenols, flavonoids and phytosterols. There are many natural products used in this field and therefore there are different classifications. Phytotherapeutics are classified according to their effectiveness as those that increase fat burning and stimulate metabolism, suppress appetite, create a feeling of satiety, control blood sugar and insulin, inhibit the absorption of carbohydrates and fats, and inhibit inflammation. However, more clinical research is needed to elucidate the antiobesity effectiveness and mechanism of action of natural products. The risks and side effects of the method to be chosen in obesity treatment should be discussed with the patient. Recommendations to the patient should be given after a multidisciplinary evaluation. Treatment should be started with the most appropriate and least risky method for the patient's current condition. It should be explained to the patient that it is most likely that he/she will lose weight with one of these methods, but that the important thing is to maintain his/her weight through behavioral changes.

The winter and spring frosts are an important problem in some walnut cultivation areas. The frost damage of catkins and female flowers results in low fruit set and yield. The temperature dropped -17.2 °C in January 2021 in the Yenişehir, Bursa, an important walnut production area in North-Western Turkey. The present study was carried out to determine the natural frost damage on catkins of some walnut cultivars and the effectiveness of an unmanned aerial vehicle (UAV) pollination, which has been developed and used in artificial pollination studies recently, on fruit set and fruit characteristics. In the experiment, two pollen concentrations (T1: 5% pollen two times; T2: 5% pollen in the first, 20% pollen in the second time) and the open pollination (control) were tested. Observations showed that frost damage on catkins varied from 57.31% (Ronde de Montignac) to 99.33% (Franquette). The initial fruit set was significantly higher in the T1 (87.74%) followed by T2 (83.89%). The final fruit set in T2 (75.16%) was higher than the T1 (74.11%), but the difference was insignificant. The box and whisker plot shows that UAV pollination treatments (T1, T2) increased the fruit set, but it was not uniform on the tree compared to open pollination. The highest nut weight, thickness, and length were obtained from control, followed by T1. The results showed that the fruit set was higher in pollination with UAV, and using less pollen (T1) was sufficient. The research results provide support for UAV treatment on supplementary pollination for walnut.

Objective:Breast cancer (BC) is the most common cancer type in women and may be inherited, mostly in an autosomal dominant pattern. The clinical diagnosis of BC relies on the published diagnostic criteria, and analysis of two genes, BRCA1 and BRCA2, which are strongly associated with BC, are included in these criteria. The aim of this study was to compare BC index cases with non-BC individuals in terms of genotype and diagnostic features to investigate the genotype/demographic information association.Materials and Methods:Mutational analyses for the BRCA1/BRCA2 genes was performed in 2475 individuals between 2013-2022 from collaborative centers across Turkey, of whom 1444 with BC were designated as index cases.Results:Overall, mutations were identified in 17% (421/2475), while the percentage of mutation carriers in cases of BC was similar, 16.6% (239/1444). BRCA1/BRCA2 gene mutations were detected in 17.8% (131/737) of familial cases and 12% (78/549) of sporadic cases. Mutations in BRCA1 were found in 4.9%, whereas 12% were in BRCA2 (p

Objective: In this retrospective study, we assessed the efficacy of oral lactase in infants with lactose intolerance in terms of sex, birth weight, and interference by other medications. Methods: The study was conducted on patients aged 0–6 months who had been diagnosed with lactose intolerance on admission to the Department of Social Pediatrics at Dokuz Eylul University. Demographic data, the onset of symptoms, and medications used were recorded. Results: We found that 86.7% of the infants responded to lactase, with no significant differences based on sex, birth weight, or age at symptom presentation. We observed, however, that the efficacy of treatment did improve over time, thereby deriving benefits from intestinal development and adaptation. Interestingly, the response to lactase was reduced in infants receiving concomitant simethicone for colic symptoms, suggesting a potential drug interaction, while probiotics had no impact on treatment outcomes. Conclusions: We advise against using additional medications with oral lactase, pointing out a possible interaction with simethicone that might decrease the effectiveness of treatment.

Günümüzde enerji talebinin artmasıyla birlikte, fotovoltaik panellerin performansının artırılması önem kazanmaktadır. Bu nedenle, tek yüzeyli ve çift yüzeyli fotovoltaik panellerin (FV) performanslarının karşılaştırılması ve değerlendirilmesi önemli bir araştırma konusudur. Bu çalışmada, PVsyst yazılımı kullanılarak tek yüzeyli ve çift yüzeyli panellerin performansları karşılaştırılmıştır. Çalışma, hesaplamaların hem tek taraflı hem de çift taraflı paneller için aynı koşullar altında yapılmasını sağlamak için Ankara ilinde aynı model tek yüzeyli ve çift yüzeyli FV paneller ile iki farklı güneş enerji santrali tasarlanmıştır. Bu iki tasarımın verimlilikleri kıyaslanmış, albedo etkisi incelenmiş, CO2 emisyon analizi ve teknik analizleri yapılmıştır. Çalışmanın sonuçları, tek yüzeyli panellerin ortalama %82,21 performans oranıyla 1537 kWh/yıl ve çift yüzeyli panellerin ortalama %93,06 performans oranıyla 1740 kWh/yıl üretim potansiyeline sahip olduğunu göstermektedir. Çift yüzeyli panellerin tek yüzeyli panellere göre daha yüksek performans gösterdiği ve yıllık ortalama enerji üretiminin %13 daha yüksek olduğu tespit edilmiştir. Bu sonuçlar, çift yüzeyli güneş paneli sistemlerinin verimliliği ve çevresel faydaları nedeniyle tek yüzeyli sistemlere göre daha yaygın hale getirilmesi, sürdürülebilir enerji üretimi için önemli bir adım olabilir.

Hanefî âlim Muhammed Emîn İbn Âbidîn (1198-1252/1784-1836), yaşadığı dönemde Vehhâbîler’in tarihi için önemli olan gelişmelere şahit olmuştur. Vehhâbîler Hicaz’ı ele geçirmiş ancak Mısır valisi Kavalalı Mehmet Ali Paşa ve oğulları Tosun Paşa ile İbrahim Paşa Hicaz’ı geri almış, Vehhâbîler’in kurdukları ilk Suûdî yönetimini ortadan kaldırmıştır. İbn Âbidîn Reddü’l-Muhtâr adlı kitabında, Vehhâbîleri devlete karşı isyan etmiş olan bağîler olarak değerlendirir. Onları Halife Hz. Ali’ye karşı isyan etmiş Hâricîler gibi görür ve onlardan “zamanı-mızda Hâricîler” diye söz eder. İbn Âbidîn’e göre Vehhâbîler Hanbelî mezhebini kabul eder. Ancak Vehhâbîler sadece kendilerinin Müslüman olduklarına inanırlar, muhaliflerini müşrik sayarlar. Ehl-i Sünnet mensuplarının öldürülmelerini mubah görürler. Hint alt kıtasında yakın tarihte ortaya çıkan Hanefî cemâatler Vehhâbîler’i tenkit etmişlerdir. Birelviler cemaatinin kurucusu olan Ahmed Rızâ Hân Birelvî (1272-1340/1856-1921), Hanefî Mâtürîdî ve sûfî olup Vehhâbî karşıt-lığıyla bilinir. Birelvî, kendisi gibi Hanefî Mâtürîdî ve sûfî olan Diyûbendîler’i Vehhâbî olmakla itham eder. Aynı dönemde yaşayan Diyûbendî alim Halîl b. Ahmed Sehârenpûrî (1269-1346/1852-1927), Vehhâbîler’i İbn Âbidîn’nin ifadelerini naklederek Hâricîler olarak değerlendirir ve kendilerine yapılan Vehhâbî yakıştırmasını reddeder. Sehârenpûrî’nin bu ifadeleri dönemin önde gelen Diyûbendî alimleri tarafından da tasdik edilmiştir. Vehhâbî karşıtlığı Osmanlı taraftarlığı anlamına gelmemektedir. Kureyş neslinden olmadıkları için Osmanlı hilafetini meşru görmeyen Birelvîler’in hilafet görüşü, İngilizler ile anlaşıp hilafet iddiasıyla Osmanlı’ya karşı isyan edecek olan Şerif Hüseyin’in hilafet iddiası ile uyumludur. Şerifler de Vehhâbîlere karşı mücade etmiştir. Diyûbendîler Şerif Hüseyin’in hilafet iddiasını reddetmiş, Osmanlı hilafetine desteğini sürdürmüş-tür. Bu çalışmada bu iki Hanefî ekolün Vehhâbîlik hakkındaki görüşleri bölgede-ki tarihi gelişmeler ile ilişkisi kurularak ele alınmaktadır.

Background and Aim:Using two-dimensional speckle tracking echocardiography (2D-STE), the ventricular functions of hospitalized coronavirus disease-2019 (COVID-19) patients were assessed. However, there is limited information about cardiac functions in the first year after recovery from the intensive care unit (ICU). This research aims to assess the right ventricular functions of COVID-19 patients and their changes within the first year after ICU discharge using 2D-STE.Materials and Methods:The study was conducted prospectively. The study included 68 consecutive patients and 70 control patients. Echocardiography was performed in the ICU and the first year after discharge from the hospital. Right ventricular global longitudinal strain (RVGLS) was measured using the 2D-STE method.Results:The mean age of the study group was 48.67±8.10 and 37 (54.4%) patients were males. There were no substantial differences across the groups, including age, gender, body mass index, heart rate, diabetes, dyslipidemia, and smoking (P > 0.05). A substantially significant positive correlation was detected between right ventricular dimension (RAD) (r = 0.644, P < 0.001), right ventricular diastolic dimension (RVDD) (r = 0.573, P < 0.001), ferritin (r = 0.454, P < 0.001), D-dimer (r = 0.305, P = 0.011) values and RVGLS in the in-hospital and after-discharge first-year groups. The RVGLS values of the control, in-hospital, and after-discharge first-year groups were -20.36±3.06, -16.98±3.78, and -17.58±6.45, indicating a statistically significant difference across the groups (P < 0.001). Tricuspid annular plane systolic excursion was higher in the control group (P < 0.05).Conclusion:RVGLS was found to be depressed during the in-hospital period and showed no improvement in the 1 year post discharge.

Prognostics and Health Management occupy an important place in modern industrial maintenance to increase the reliability of systems. Determining the Remaining Useful Life of the system or its parts is vital accurately to maintaining critical parts of the system and successful prognostics and health management. This study proposes a data-based Remaining Useful Life prediction method with a network consisting of a cascade-connected Self-Attention and Residual Network layer. The network is fed by multiple sensor signals to monitor the aero-engines. The proposed model contains four main parts: The Gaussian Noise Layer, the Self-Attention Layer, the Residual Network Layer, and the layer to estimate Remaining Useful Life. The model is created to be more robust and susceptible to noise using the Gaussian Noise Layer. The Self-Attention Layer focuses on crucial points through time. The Residual Network Layer uses feature extraction and makes the model more profound help of the skip connection. Finally, the Remaining Useful Life estimation is made using highly correlated features obtained from the fully connected layer and the output layer. In addition, a new loss function has been offered, similar to the evaluation metrics in the literature. With the proposed model and loss function, 11.017 and 12.629 in root mean square error, 157.19 and 218.6 in score function are obtained in the FD001 and FD003, respectively. The superior performance of these results on the C-MAPSS dataset is demonstrated by comparing the other state-of-the-art methods in the literature.

Lactate and glucose are widely used biochemical parameters in current predictive risk scores for cardiogenic shock. Data regarding the relationship between lactate and glucose levels in cardiogenic shock are limited. Thus, we aimed to analyze glucose and lactate as early markers for in-hospital mortality in cardiogenic shock. In this retrospective cohort study, 312 patients presenting with cardiogenic shock to a tertiary-care hospital between 2016 and 2018 were included. Apparent cardiogenic shock was defined as hypoperfusion with hemodynamic compromise and biochemical marker increase due to diminished tissue perfusion, corresponding to SCAI shock stages. In-hospital mortality was assessed as the primary endpoint. The median age of the study population was 71 (60-79) years and the etiology of cardiogenic shock was acute myocardial infarction in 45.8%. Overall in-hospital mortality was 67.6%. In the receiver operating curve analysis, the area under the receiver-operating curve (AUC) for prediction of in-hospital mortality was higher for lactate (AUC: 0.757) than for glucose (AUC: 0.652). Both values were significantly associated with outcome (groups created with best cutoff values obtained from the Youden index). Correlation analysis showed a significant non-linear association of both values. In a multivariable stepwise Cox regression analysis, lactate remained an independent predictor for in-hospital mortality, whilst glucose, despite being implicated in energy metabolism, was not independently predictive for mortality. Together, these data suggest that lactate at admission is superior for mortality prediction in patients with apparent cardiogenic shock. Glucose was not independently predictive for mortality.

ObjectivesPrevious studies suggest urinary luteinizing hormone (LH) and follicle-stimulating hormone (FSH) measurements by immunofluorometric assays (IFMA) as noninvasive alternatives to serum assays for puberty assessment. However, these studies excluded patients with other endocrine disorders and those taking medications. Besides, the recent discontinuation of IFMA manufacturing is a concern. We explored the utility of luminometric assays (LIA) for urinary gonadotropins and thyroid-stimulating hormone (TSH) determinations in euthyroid patients with thyroid pathologies.MethodsWe used LIA and IFMA assays to measure serum and first-morning-voided (FMV) urine LH, FSH, and TSH concentrations in euthyroid patients with various thyroid disorders. Of the 47 euthyroid patients with normal serum TSH (S-TSH) levels, 14 were receiving levothyroxine therapy.ResultsFMV total urinary LH (U-LH) concentrations correlated significantly with those measured in serum using either LIA (r=0.67, P

Background: Coronary care units are sophisticated clinics established to reduce deaths due to acute cardiovascular events. Current data on coronary care unit mortality rates and predictors of mortality in Turkey are very limited. The MORtality predictors in CORonary care units in TURKey (MORCOR-TURK) trial was designed to provide information on the mortality rates and predictors in patients followed in coronary care units in Turkey. Methods: The MORCOR-TURK trial will be a national, observational, multicenter, and noninterventional study conducted in Turkey. The study population will include coronary care unit patients from 50 centers selected from all regions in Turkey. All consecutive patients admitted to coronary care units with cardiovascular diagnoses between 1 and 30 September 2022 will be prospectively enrolled. All data will be collected at one point in time, and the current clinical practice will be evaluated (ClinicalTrials.gov number NCT05296694). In the first step of the study, admission diagnoses, demographic characteristics, basic clinical and laboratory data, and in-hospital management will be assessed. At the end of the first step, the predictors and rates of in-hospital mortality will be documented. The second step will be in cohort design, and discharged patients will be followed up till 1 year. Predictors of short- and long-term mortality will be assessed. Moreover, a new coronary care unit mortality score will be generated with data acquired from this cohort. Results: The short-term outcomes of the study are planned to be shared by early 2023. Conclusion: The MORCOR-TURK trial will be the largest and most comprehensive study in Turkey evaluating the rates and predictors of in-hospital mortality of patients admitted to coronary care units.

Listeriosis is a rare but severe foodborne infection caused by Listeria monocytogenes. In this study, we performed comparative whole-genome sequencing (WGS) on 28 Listeria monocytogenes from seven invasive listeriosis cases in animals and 21 food samples in Türkiye for the first time. Food isolates were delineated into eleven clonal complexes (CCs), namely CC1, CC2, CC3, CC8, CC9, CC20, CC69, CC124, CC155, CC204, ST3002. The isolates from meningoencephalitis cases were associated with CC1, whereas CC9 and CC7 were associated with the isolates from sheep abortus cases. All the isolates carried the fosX, lin, norB, and sul genes. In addition, emrC (n=15), bcrC (n=4), emrE (n=2), qacA (n=1), cadA (n=5) and cadC (n=1) genes, conferring resistance to stress and disinfectants were detected. Listeria pathogenicity island (LIPI)-1 and LIPI-2 were distributed in all isolates, but LIPI-3 was closely related to CC1, CC3, and ST3002 isolates. LIPI-4 was not found in any of the L. monocytogenes isolates. The Inc18(rep25) and Inc18(rep26) plasmids were found in 16 (57.1%) isolates. A total of 15 different intact prophage genomes ranging from one to three were detected in the genomes of 24 isolates. The hypervirulent CC1 and CC2 clones that pose a significant threat to food safety and public health were detected among food isolates. These findings highlight the importance of continuous surveillance of hypervirulent L. monocytogenes strains in different settings.

Palliative care is a specialty that aims to prevent and reduce the distress of patients and their families who encounter life-threatening diseases. Especially, it aims to eliminate the problems caused by the cancer itself or the treatment methods. Patients diagnosed as having cancer experience many problems such as nausea, vomiting, anxiety, depression and sleep disturbance due to the disease and its treatment. Patients can search for complementary treatment methods such as aromatherapy in order to reduce or eliminate these symptoms and increase their well-being and quality of life. Aromatherapy is defined as the use of essential oils obtained from plants for therapeutic purposes. Essential oils used in aromatherapy are applied in the form of massage, bath or inhalation. In this review, the use of aromatherapy in the treatment of common symptoms in cancer patients receiving palliative care will be discussed.

Objective: Due to the difficulties in determining reference intervals with conventional methods, it determines them using modern machine learning methods. Methods: The results of the newborns' inorganic phosphorus, calcium, creatinine, neonatal bilirubin, and urea nitrogen tests, which were studied in the Dokuz Eylül University Central Laboratory for the years 2018-2019-2020, were obtained from the hospital database. The unsupervised machine learning algorithm we developed calculated test-specific age intervals and related reference intervals. Results: It was determined that the unsupervised machine learning method we developed is a new, contemporary alternative to indirect methods for determining reference intervals. With this method, the age ranges in which the test results showed significant variability were found in a high-resolution test-specific manner. Conclusion: Increases in computer processing power, new original artificial intelligence and machine learning-based algorithms, and databases that store large amounts of data offer a contemporary solution for determining reference intervals. In this study, an unsupervised machine learning algorithm solution based on mathematical and statistical foundations, which can determine age ranges, which is the basic step in the calculation of reference intervals, with high resolution is presented. By using the algorithmic method developed in the study, each laboratory will be able to calculate reference intervals suitable for their population and analytical methods in an easy, fast, safe, and economical way.

Alzheimer’s disease (AD) is a major global health challenge, especially among individuals aged 65 or older. According to population health studies, Turkey has the highest AD prevalence in the Middle East and Europe. To accurately determine the frequencies of common and rare APOE single nucleotide polymorphisms (SNPs) in the Turkish population residing in the Marmara Region, we conducted a retrospective study analyzing APOE variants in 588 individuals referred to the Bursa Uludag University Genetic Diseases Evaluation Center. Molecular genotyping, clinical exome sequencing, bioinformatics analysis, and statistical evaluation were employed to identify APOE polymorphisms and assess their distribution. The study revealed the frequencies of APOE alleles as follows: ε4 at 9.94%, ε2 at 9.18%, and ε3 at 80.68%. The gender-based analysis in our study uncovered a tendency for females to exhibit a higher prevalence of mutant genotypes across various SNPs. The most prevalent haplotype observed was ε3/ε3, while rare APOE SNPs were also identified. These findings align with global observations, underscoring the significance of genetic diversity and gender-specific characteristics in comprehending health disparities and formulating preventive strategies.

Summary: Background: Multisystem inflammatory syndrome in children (MIS-C) is a severe complication of SARS-CoV-2 infection. It remains unclear how MIS-C phenotypes vary across SARS-CoV-2 variants. We aimed to investigate clinical characteristics and outcomes of MIS-C across SARS-CoV-2 eras. Methods: We performed a multicentre observational retrospective study including seven paediatric hospitals in four countries (France, Spain, U.K., and U.S.). All consecutive confirmed patients with MIS-C hospitalised between February 1st, 2020, and May 31st, 2022, were included. Electronic Health Records (EHR) data were used to calculate pooled risk differences (RD) and effect sizes (ES) at site level, using Alpha as reference. Meta-analysis was used to pool data across sites. Findings: Of 598 patients with MIS-C (61% male, 39% female; mean age 9.7 years [SD 4.5]), 383 (64%) were admitted in the Alpha era, 111 (19%) in the Delta era, and 104 (17%) in the Omicron era. Compared with patients admitted in the Alpha era, those admitted in the Delta era were younger (ES −1.18 years [95% CI −2.05, −0.32]), had fewer respiratory symptoms (RD −0.15 [95% CI −0.33, −0.04]), less frequent non-cardiogenic shock or systemic inflammatory response syndrome (SIRS) (RD −0.35 [95% CI −0.64, −0.07]), lower lymphocyte count (ES −0.16 × 109/uL [95% CI −0.30, −0.01]), lower C-reactive protein (ES −28.5 mg/L [95% CI −46.3, −10.7]), and lower troponin (ES −0.14 ng/mL [95% CI −0.26, −0.03]). Patients admitted in the Omicron versus Alpha eras were younger (ES −1.6 years [95% CI −2.5, −0.8]), had less frequent SIRS (RD −0.18 [95% CI −0.30, −0.05]), lower lymphocyte count (ES −0.39 × 109/uL [95% CI −0.52, −0.25]), lower troponin (ES −0.16 ng/mL [95% CI −0.30, −0.01]) and less frequently received anticoagulation therapy (RD −0.19 [95% CI −0.37, −0.04]). Length of hospitalization was shorter in the Delta versus Alpha eras (−1.3 days [95% CI −2.3, −0.4]). Interpretation: Our study suggested that MIS-C clinical phenotypes varied across SARS-CoV-2 eras, with patients in Delta and Omicron eras being younger and less sick. EHR data can be effectively leveraged to identify rare complications of pandemic diseases and their variation over time. Funding: None.

Summary: Background: Characterizing Post-Acute Sequelae of COVID (SARS-CoV-2 Infection), or PASC has been challenging due to the multitude of sub-phenotypes, temporal attributes, and definitions. Scalable characterization of PASC sub-phenotypes can enhance screening capacities, disease management, and treatment planning. Methods: We conducted a retrospective multi-centre observational cohort study, leveraging longitudinal electronic health record (EHR) data of 30,422 patients from three healthcare systems in the Consortium for the Clinical Characterization of COVID-19 by EHR (4CE). From the total cohort, we applied a deductive approach on 12,424 individuals with follow-up data and developed a distributed representation learning process for providing augmented definitions for PASC sub-phenotypes. Findings: Our framework characterized seven PASC sub-phenotypes. We estimated that on average 15.7% of the hospitalized COVID-19 patients were likely to suffer from at least one PASC symptom and almost 5.98%, on average, had multiple symptoms. Joint pain and dyspnea had the highest prevalence, with an average prevalence of 5.45% and 4.53%, respectively. Interpretation: We provided a scalable framework to every participating healthcare system for estimating PASC sub-phenotypes prevalence and temporal attributes, thus developing a unified model that characterizes augmented sub-phenotypes across the different systems. Funding: Authors are supported by National Institute of Allergy and Infectious Diseases, National Institute on Aging, National Center for Advancing Translational Sciences, National Medical Research Council, National Institute of Neurological Disorders and Stroke, European Union, National Institutes of Health, National Center for Advancing Translational Sciences.

Eyob Assefa Betiru,1 Ephrem Mamo,2 Dube Jara Boneya,3 Abebawork Adem,4 Dessie Abebaw5 1General Public Health Department, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia; 2Public Health Departments, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia; 3Departments of Public Health College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 4Departments of Public Health College of Health Sciences, Gambi Medical College, Addis Ababa, Ethiopia; 5Public Health Department of Reproductive Health’s, Yekatit 12 Hospital Medical College, Addis Ababa, EthiopiaCorrespondence: Eyob Assefa Betiru, Email eyoba116@gmail.comBackground: Diabetes mellitus and hypertension are the most prominent conditions causing chronic kidney disease and eventually end-stage renal disease. Renal replacement therapy, particularly hemodialysis (HD), is the mainstay of treatment. The aim of this study is to assess the overall survival status of HD patients and potential survival predictors at Saint Paul hospital millennium medical college (SPHMMC) and Myungsung Christian Medical Center (MCM) in Addis Ababa, Ethiopia.Methods: A retrospective cohort study was conducted on HD patients at SPHMMC and MCM general hospital from January 1, 2013 to December 30, 2020. Kaplan Meier, Log-rank, and Cox proportional regression models were used for the analysis. Estimated risks were reported as hazard ratios with 95% confidence intervals and P< 0.05 was considered as having a significant association.Results: A total of 128 patients were included in the study. Median survival time was 65 months. The predominant co-morbid condition was found to be diabetes mellitus with hypertension (42%). The total risk time for these patients was 143,617 person years. The overall incidence rate of death was 2.9 per 10,000 person years (95% CI=2.2– 4). Patients who developed blood stream infection were 2.98-times more likely to die than those without infection. Those using an arteriovenous fistula were 66% less likely to die than those using a central venous catheter. Additionally, patients treated in a government-owned facility were 79% less likely to die.Conclusion: The study identified that the median survival time of 65 months was comparable with developed nations. Significant predictors of death were found to be blood stream infection and type of vascular access. Government-owned treatment facilities showed better patient survival.Keywords: survival status, survival predictors, hemodialysis predictors

Temperature distribution and flue gas emissions in gas turbine combustion chambers have attracted the attention of researchers in recent years. In this study, the combustion chamber temperature distribution and flue gas emission values at different equivalence ratios were determined by diluting the methane flame with Helium at the rate of 20% by volume. Aswirl generator which has high swirl number (1.6) was placed at the burner outlet and the combustor power was kept constant at 3 kW. In this way, the equivalence effect in a swirled combustion was investigated. The following results emerged in the study, in which 0.7, 0.8, 0.9, 1.0, 1.1 values were tested as the equivalence ratio. The results showed that with the increase of the equivalence ratio, the flame temperature and brightness at theburner outlet increased, reaching its maximum at 0.9 equivalence ratio. After this critical value, there was a tendency to decrease in temperature and luminous intensity again. As the distance from the burner axially in the combustion chamber increased, the average temperatures increased with the increase in the equivalence ratio. On the other hand, The CO value in flue gas emissions decrease by half as the equivalency ratio increased from 0.7 to 1.0.

BACKGROUND: There are conflicting results in studies investigating the effects of percutaneous coronary intervention (PCI) on the prognosis of patients with ST-segment elevation myocardial infarction (STEMI) during or outside of usual hospital working hours. While some researchers have reported higher mortality rates in STEMI patients admitted outside of working hours, others did not find a statistically significant difference. OBJECTIVES: Investigate the short-term endpoints and long-term outcomes of STEMI patients by time of admission. DESIGN: Retrospective SETTING: Tertiary percutaneous coronary intervention center. PATIENTS AND METHODS: Patients were grouped by admission, which consisted of four intervals: 06:00 to

Cancer is defined as a complex disease that occurs with the uncontrolled proliferation of cells and develops under the influence of genetic and environmental conditions. Chemotherapy and radiotherapy are frequently used in cancer treatment. Side effects related to these treatments are observed in most of the patients. Palliative care, which is an important part of cancer management today, aims to alleviate the symptoms and side effects of these treatments and to increase the quality of life of the patient. A growing number of patients with cancer are inclined towards complementary and integrative medicine, including herbal medicine. The interest in this field is increasing because it has been shown by preclinical and clinical studies that some phytotherapeutic products can reduce the side effects of chemotherapy and radiotherapy. This review summarizes phytotherapeutic approaches supported by clinical studies for palliative care in cancer patients.

Purpose: This study is aimed at measuring the efficiency of 37 OECD countries for 2020 using the Data Envelopment Analysis (DEA) method. Besides, it is aimed at ranking the efficient decision making units by using the super-efficiency DEA model. Design/methodology/approach: In the study, analyses were carried out with input-oriented Charnes, Cooper and Rhodes (CCR), input-oriented Banker, Charnes and Cooper (BCC) models and super-efficiency models of these models by using 4 inputs and 3 outputs. Findings: As a result of the analysis, 14 countries in the CCR model and 20 countries in the BCC model were efficient. According to the results of the super-efficiency models, the efficient countries were ranked. Research limitations/implications: The limitations of the study are the analyses are based on input-oriented DEA models and the research was conducted in OECD countries. Originality/value: Performance evaluation of health systems has gained importance in recent years. Many countries are making efforts to improve their health systems. Due to epidemics such as COVID-19, OECD countries, like many countries around the world, have increased the share of health expenditures in GDP. Because of this situation, the evaluation of the performance of OECD countries in the field of health has emerged as a very important research topic.

Abdu Mohammed,1 Abate Bane Shewaye,1,2 Fozia Abdela,1,2 Zebeaman Tibebu Gorfu,1 Ahmed Adem1,2 1Department of Internal Medicine, Adera Medical Center, Addis Ababa, Ethiopia; 2Department of internal Medicine, Addis Ababa University, College of Health Sciences, Addis Ababa, EthiopiaCorrespondence: Abdu Mohammed, Tel +251-913-103-656, Email abdumohammed7@gmail.comAbstract: Myeloproliferative neoplasms (MPN) are the commonest causes of non-cirrhotic abdominal vein thrombosis. MPN was observed in 30− 40% with Budd Chiari Syndrome (BCS) and portal vein thrombosis (PVT), whereas this is the cause in only a minority of other types of venous thrombosis. Herein, we report 10 cases of chronic PVT secondary to Janus Kinase 2 gene (JAk 2) positive myeloproliferative neoplasm (MPN). The median age was 35 years with M:F 1:1. Portal hypertension was present at presentation in all of them. Nine patients have esophageal varices, of which 6 have bleeding at presentation. Classical MPN phenotype on complete blood count (CBC) was not present in 6 of them. Management of patients with anticoagulation was difficult with 4 patients experiencing bleeding during anticoagulation, and bleeding occurring despite the target international normalized ratio (INR) in 2 of them. Portal hypertension leading to hypersplenism and hemodilution may mask erythrocytosis and thrombocytosis, which are the main criteria used to diagnose MPN. The resulting absence of a typical MPN phenotype in routine laboratory studies alongside accessibility issues, and the need for a multidisciplinary treatment approach imparts a diagnostic as well as a therapeutic challenge for chronic PVT associated with Jak 2 positive MPN in sub-Saharan patients.Keywords: portal cavernoma, cholangiopathy, Jak 2 mutation, MPN, Ethiopia, sub-Sahara

Millî Eğitim Bakanlığı tarafından, 2018 yılında güncellenen programlar ile ilkokul müfredatının düzeltilmesi kapsamında, eğitim sistemi içinde, “kök değerlere” özellikle vurgu yapılmıştır. Program içinde yer alan bu kök değerler, “adalet, dürüstlük, dostluk, yardımseverlik, sabır, saygı, özdenetim, sevgi, sorumluluk, vatanseverlik” olarak ifade edilmektedir. Bu çalışmada ilkokul öğrencilerinin değerlere bakış açıları “kök değerler” açısından ele alınmıştır. Nitel araştırma yöntemlerinden olgu bilim deseni kullanılarak hazırlanan bu çalışma sonucunda; öğrenciler değer sözcüğünü iş birliği, dürüstlük ve iyi geçinmek olarak nitelendirmektedirler. Katılımcılara göre insanlarda olması gereken en önemli değerin yardımseverlik olduğu, ebeveyn ve öğretmenlerinin öğrencilerde en çok sorumluluk değerini görmek istedikleri anlaşılmıştır. Ayrıca öğrencilerin en çok sabır değerine ihtiyacı olduğunu, arkadaşlarında ise dürüstlük değerini görmek istediklerini belirtmişlerdir. Katılımcılar okulun insana kazandırdığı en önemli değerin “eğitimli olma” olduğunu, insanların sabır ve özdenetim sayesinde değerli olacaklarına vurgu yapmışlardır. Bununla beraber ailelerinde ise en çok dürüstlük, sevgi ve yardımlaşma değerlerini görmek istemektedirler. Değerler ilkokul öğrencilerine kazandırılırken öğrencilerin ihtiyaç duyduğu bu görüşler mutlaka dikkate alınmalıdır.