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Stromatolites are the oldest recognized fossil recordings of life on Earth. Therefore, their study of them represents one of the most interesting topic that investigates the physio-chemical environmental conditions (formations and precipitations) at which the stromatolites formed. This work deals with the rare earth elements (REEs) geochemical characteristics and the redox-sensitive trace elements behavior of the stromatolites newly formed in Salda Lake, a closed system alkaline lake surrounded by serpentinite rocks in SW Turkey. The representative stromatolite samples collected from Salda Lake show higher contents of MgO (up to 41.5 wt.%), CO2+OH (up to 56.6 wt.%), and MgO/CaO ratio (up to 42.2 wt.%) referring to the stromatolites had been controlled by microorganisms and deposited in subtidal areas having hydro-magnesite and aragonite mineralogy. The average trace element contents of the stromatolites are 8.4 ppm V, 0.09 ppm Cr, 3.50 ppm Co, 95.6 ppm Ni, 0.73 ppm Cu, 1.55 ppm Rb, 37.6 ppm Sr, 0.59 ppm Y, 17.7 ppm Zr, 3.60 ppm Nb, 21 ppm Ba, 0.05 ppm Hf, 3.5 ppm As, 0.02 ppm Cd, 0.05 ppm U, 0.05 ppm Th, 2.85 ppm Pb, and 6.60 ppm Zn. The Post-Archean Australian Shale (PAAS)-normalized REE patterns of the stromatolites reveal that the heavy REEs (HREEs) are enriched relative to the light REEs (LREEs) with highly negative Y and Ce-anomalies and positive Eu-anomalies. This refers to the stromatolites formed in predominantly oxidizing environmental conditions at partially warm lake waters. In addition, the hydromagnesite composition of the Salda Lake stromatolites indicates that they were precipitated from the waters influenced by Mg-rich meteoric waters fed from the serpentinite rocks around the Lake.

The use of family planning services prevents about one in three pregnancy-related deaths and 44% of neonatal deaths. The study was conducted with the aim of assessing the effectiveness of family planning education given to refugee women coming from Syria to Hatay province in Turkey. The research was planned as a quasi-experimental study with a non-randomized control group and a pre/post-test design. The experimental group were interviewed at the beginning, right after training and after one month. The control group were not given education. A personal information form, a Family Planning Information Form, and the Family Planning Attitude Scale were used to collect data. Data analysis was performed with the use of frequencies, percentages, means, minimum and maximum values, medians, standard deviations, the chi-square test, and the paired sample t test. After providing education to the Syrian refugee women, family planning knowledge and attitudes had significantly improved in the experimental group compared to the control group (p

Bu çalışma, bir dahiliye-onkoloji kliniğine yatan 40 yaş üstü yetişkinlerin Covid-19 pandemi sürecinde sağlık anksiyeteleri ve uyku kalitelerinin değerlendirilmesi amacıyla yapılmıştır. Tanımlayıcı-kesitsel tipte olan bu çalışma 200 katılımcı ile tamamlanmıştır. Çalışmada, katılımcıların sosyo-demografik özelliklerini ve genel sağlık durumunu sorgulayan kişisel veri formu, “Sağlık Anksiyetesi Ölçeği (SAÖ)” ve “Pittsburgh Uyku Kalitesi İndeksi (PUKİ)” kullanılmıştır. Veriler, tanımlayıcı istatistikler, Mann Whitney U testi, Kruskal Wallis H testi ve Spearman’s korelasyon testi ile analiz edilmiştir. Anlamlılık düzeyi P < 0,05 olarak kabul edilmiştir. Elde edilen verilere göre, katılımcıların PUKİ toplam ölçek puanı 6,585±3,265 olarak saptanmıştır. PUKİ toplam puanı 5 eşik değerinin üzerinde olan 96 kişinin (%48) uyku kalitesi kötü olarak değerlendirilmiştir. SAÖ toplam puanı ise, 17,315±4,243 olarak belirlenmiştir. PUKİ toplam puanı, uyku süresi, uyku bozukluğu alt boyutları ile SAÖ toplam puanı, bedensel belirtilere aşırı duyarlılık ve kaygı alt boyutu arasında istatistiksel olarak anlamlı pozitif korelasyon saptanmıştır (P < 0,05). Pandemi sürecinin olumsuz etkileri ile mücadele için destek mekanizmaları oluşturulurken ve yaşam kalitesini yükseltmek adına atılacak adımlar planlanırken, salgın sürecinin uyku kalitesi üzerine olumsuz etkisi de göz önünde bulundurulmalıdır.

Bu çalışma, ortaokul öğrencilerinin pandemi sürecindeki fiziksel aktivite tutumu ve stresle başa çıkma durumlarının değerlendirilmesi amacıyla yapılmıştır. Tanımlayıcı tipte olan bu çalışma 99 ortaokul öğrencisi ile tamamlanmıştır. Çalışmada katılımcıların sosyodemografik özelliklerini (yaş, cinsiyet, sınıf düzeyi vb.) sorgulayan veri formu, Ortaokul Öğrencileri için Fiziksel Aktivite Tutum Ölçeği (FATÖ) ve Çocuklarda Stresle Başa Çıkma Ölçeği (ÇSBÖ) kullanılmıştır. Veriler, tanımlayıcı istatistikler (yüzde, ortalama vb.), Mann Whitney U testi, Kruskal Wallis H testi ve Spearman’s korelasyon testi ile analiz edilmiştir. Elde edilen verilere göre, öğrencilerin FATÖ puan ortalamasının 96,26±15,37 olduğu bulunmuştur. ÇSBÖ alt boyut puan ortalamalarına bakıldığında, en yüksek puan ortalamasının dış yardım arama alt boyutunda (13,82±3,11) olduğu, öke/saldırganlık alt boyut puan ortalamasının ise en düşük puan ortalamasına (8,21±2,67) sahip olduğu saptanmıştır. FATÖ genel toplam ve alt boyutları ile ÇSBÖ alt boyutları arasında istatistiksel olarak anlamlı ilişkiler belirlenmiştir. Ortaokul öğrencilerinin pandemi döneminde, olumlu fiziksel aktivite tutumunun ve egzersiz planlamalarının stresle başa çıkma süreçlerine katkı sağlayacağı düşünülmektedir. Sınava girecek 8. sınıf öğrencileri için bu planlamaların önemi ayrıca vurgulanmaktadır.

Amaç: Bu çalışma, bir pandemi hastanesinde görev yapan temizlik personelinin koronavirüs kaygısı ve koruyucu önlemleri uygulama durumlarını değerlendirmek amacıyla yapılmıştır. Gereç ve Yöntem: Tanımlayıcı tipte olan bu çalışma 189 katılımcı ile tamamlanmıştır. Çalışmada katılımcıların sosyodemografik özelliklerini (yaş, eğitim, genel sağlık durumu vb.) ve koruyucu önlemleri uygulama durumlarını sorgulayan kişisel veri formu ve Koronavirüs Kaygı Ölçeği kullanılmıştır. Veriler, tanımlayıcı istatistikler (sayı, yüzde, ortalama, ortanca, standart sapma, minimum ve maksimum değerler), Mann Whitney U testi, Kruskal Wallis H testi ve Spearman’s Korelasyon Testi ile analiz edilmiştir. Bulgular: Elde edilen verilere göre, katılımcıların Koronavirüs Kaygı Ölçeği puan ortalamasının 2,22±3,30 olduğu bulunmuştur. En çok kullanılan koruyucu ekipmanın maske ve eldiven olduğu belirlenmiştir. İş yerinde maske ve özel kıyafetlerin değiştirme sıklığının ise 3-4 saat aralığında olduğu saptanmıştır. Sonuç: Pandemi döneminde hastane çalışanlarının sağlığının korunması ve risklerin azaltılması için, bireysel uygulamaların yeterliliğinin ve çevresel şartların uygunluğunun sağlanması, hem bireylerin hem de toplumun sağlığı için büyük önem taşımaktadır. Bu konuda, daha geniş örneklemi olan ve çok merkezli çalışmaların yapılması önerilmektedir.

While the firm-level distributional consequences of market liberalization are well understood, previous studies have paid only limited attention to how variations in domestic institutions across countries affect the winners and losers from opening up to trade. We argue that the presence of coordinated wage-bargaining institutions, which impose a ceiling on wage increases, and state-subsidized vocational training, which creates a large supply of highly skilled workers, generate labor market frictions. Upward wage rigidity, in particular, helps smaller firms weather the rising competition and increasing labor costs triggered by trade liberalization. We test this hypothesis using a firm-level data set of European Union countries, which includes more than 800,000 manufacturing firms between 2003 and 2014. We find that, for productive firms, gains from trade are 20 percent larger in countries with liberal market economies than they are in coordinated market economies. Symmetrically, less productive firms in coordinated market economies experience significantly smaller revenue losses compared to liberal market economies. We show that both the presence of an institutionalized wage ceiling and the availability of subsidized vocational training are key mechanisms for reducing the reallocation of revenue from unproductive to productive firms in coordinated market economies compared to liberal market economies. In line with our theory, we find that wages and employment in liberalized industries increase differentially across both types of labor markets. Finally, we provide suggestive evidence that trade liberalization triggers a differential demand for redistribution at the individual level across different labor markets, which is in line with our firm-level analysis.

Amac: Doku Doppler kaynakli isovolumik akselerasyon (IVA) her iki ventrikulun sistolik fonksiyonunu on ve ard yukten etkilenmeden degerlendiren bir parametredir. Bu calismada asemptomatik aort darligi (AD) olan hastalarda, sol ventrikul sistolik disfonksiyonun IVA ile erken asamada tespiti amaclanmistir. Gerec ve Yontemler: Calismaya izole AD bulunan 75 hasta ve herhangi bir kapak hastaligi bulunmayan 30 hasta olmak uzere toplam 105 hasta dahil edildi. AD hastalari, transtorasik ekokardiyografi ile belirlenen aort kapak alani (AKA) ve aortik pik velositeye gore uc gruba (hafif, orta ve ileri) ayrildi. Konvansiyonel ekokardiyografi parametreleri, sistolik ve diyastolik doku Doppler parametreleri [isovolumik kontraksiyon esnasinda olusan pik miyokardiyal velosite (IVV), ejeksiyon fazinda olusan miyokardiyal velosite (Sm), erken diyastolik miyokardiyal velosite (e'), gec diyastolik miyokardiyal velosite (a'), akselarasyon zamani (AT)] tum hastalarda hesaplandi. IVA, IVV akim hizinin AT suresine bolunmesiyle elde edildi. Bulgular: Sistolik parametrelerden IVV (p

This descriptive, cross-sectional study administered a questionnaire to 616 Syrian refuges, evaluating the participants’ sociodemographic characteristics and their views on the processes associated with social acceptance and cultural and social accommodation. The problems encountered among Syrian refuges after migration included expensive housing costs, language problems, difficulties making a living and education problems. Various problems were identified among subgroups, associated with working life and cultural differences. However, according to this study, Syrian refugees believed that the processes of social acceptance and the social accommodation of refugees by local populations had begun.

Introduction Obstructive sleep apnea (OSA) and endothelial dysfunction are associated with cardiovascular risk factors and the development of atherosclerosis. Endocan is a marker of endothelial dysfunction, while obstructive sleep apnea is one of the causes of endothelial dysfunction. In this study, we investigated the relationship between endocan and obstructive sleep apnea severity. Material and methods A total of 179 patients with snoring complaints were included. All patients underwent polysomnography, and based on the results, the participations were allocated to the control group (n = 39) or to the obstructive sleep apnea group (n = 140). The OSA group was classified as having mild (apnea-hypopnea index (AHI) = 5–15; n = 43), moderate (AHI = 15–30; n = 42), or severe OSA (AHI > 30; n = 55). All participations had their endocan levels measured. Results Endocan levels in OSA patients were significantly higher than in the control group (11.8 (3.13–200) vs 3.13 (3.13–23) ng/ml, p < 0.001). Also, endocan levels were significantly higher in the severe OSA group than moderate and mild obstructive OSA (13.2 (3.13–200), 12.6 (3.13–200) and 8.44 (3.13–50.5) ng/ml, p = 0.015, respectively). Multiple logistic regression analysis showed that smoking, age and endocan levels were independent predictors of OSA severity (p = 0.024, p = 0.037, p = 0.004, respectively). Conclusions Endocan seems to be a potential risk stratification marker in this patient population.

This study was conducted to evaluate the health anxiety and sleep quality of adults over the age of 40 who were hospitalized in an internal medicine-oncology clinic during the Covid-19 pandemic period. This descriptive-cross-sectional study was completed with 200 participants. In the study, the personal data form which questioned the socio-demographic characteristics and general health status of the participants, “Health Anxiety Scale” and “Pittsburgh Sleep Quality Index (PSQI)”, were used. Data were analyzed with descriptive statistics, Mann Whitney U test, Kruskal Wallis H test, and Spearman's correlation test. The significance level was accepted as P < 0.05. According to the data obtained, the participants' PSQI total scale score was determined as 6.585±3.265. The sleep quality of 96 (48%) individuals whose PSQI total score was above the cutoff value of 5 was evaluated as poor. The Health Anxiety Scale total score was determined as 17.315±4.243. A statistically significant positive correlation was found between the PSQI total score, sleep duration, sleep disturbance sub-dimensions, and the Health Anxiety Scale total score, hypersensitivity to somatic symptoms and anxiety sub-dimensions (P < 0.05). While establishing support mechanisms to combat the negative effects of the pandemic process and planning the steps to be taken to improve the quality of life, the negative impact of the epidemic process on sleep quality should also be considered., Bu çalışma, bir dahiliye-onkoloji kliniğine yatan 40 yaş üstü yetişkinlerin Covid-19 pandemi sürecinde sağlık anksiyeteleri ve uyku kalitelerinin değerlendirilmesi amacıyla yapılmıştır. Tanımlayıcı-kesitsel tipte olan bu çalışma 200 katılımcı ile tamamlanmıştır. Çalışmada, katılımcıların sosyo-demografik özelliklerini ve genel sağlık durumunu sorgulayan kişisel veri formu, “Sağlık Anksiyetesi Ölçeği (SAÖ)” ve “Pittsburgh Uyku Kalitesi İndeksi (PUKİ)” kullanılmıştır. Veriler, tanımlayıcı istatistikler, Mann Whitney U testi, Kruskal Wallis H testi ve Spearman’s korelasyon testi ile analiz edilmiştir. Anlamlılık düzeyi P < 0,05 olarak kabul edilmiştir. Elde edilen verilere göre, katılımcıların PUKİ toplam ölçek puanı 6,585±3,265 olarak saptanmıştır. PUKİ toplam puanı 5 eşik değerinin üzerinde olan 96 kişinin (%48) uyku kalitesi kötü olarak değerlendirilmiştir. SAÖ toplam puanı ise, 17,315±4,243 olarak belirlenmiştir. PUKİ toplam puanı, uyku süresi, uyku bozukluğu alt boyutları ile SAÖ toplam puanı, bedensel belirtilere aşırı duyarlılık ve kaygı alt boyutu arasında istatistiksel olarak anlamlı pozitif korelasyon saptanmıştır (P < 0,05). Pandemi sürecinin olumsuz etkileri ile mücadele için destek mekanizmaları oluşturulurken ve yaşam kalitesini yükseltmek adına atılacak adımlar planlanırken, salgın sürecinin uyku kalitesi üzerine olumsuz etkisi de göz önünde bulundurulmalıdır.

The aim of this study was to investigate the relationship between coping with pain in individuals with chronic pain and their levels of spiritual wellbeing. The research was conducted as a cross-sectional study. It was conducted with 148 participants who were experiencing chronic pain. Data were collected using Sociodemographic Questionnaire, Pain Coping Questionnaire (PCQ) and Spiritual Well-Being Scale (SWBS). Data were analyzed using Kolmogorov-Smirnov/Shapiro-Wilk's test, skewness, kurtosis, Cronbach's α, mean, standard deviation, mean rank and binary logistic regression analysis. According to the data obtained, it was concluded that participants' levels of spiritual wellbeing were high, and spiritual wellbeing could be used as an effective mechanism for coping with pain. It is therefore recommended that training sessions and information meetings be organized to create awareness in health care and social work professionals and in those living with chronic pain and their families.

Aim: This study was conducted to evaluate the fear of Covid 19 and the use of health services in individuals over the age of 18 who were diagnosed with a chronic disease.Method: The study was designed in a descriptive-cross-sectional type. It was conducted with individuals over the age of 18 who received inpatient treatment in training and research hospital clinics between March-June 2021, was completed with 200 participants (91 women, 109 men). In the study, the personal information form questioning the sociodemographic characteristics (age, education, general health status, etc.) of the participants diagnosed with chronic diseases, their use of health services and the Covid 19 Fear Scale were used. Data were analyzed with descriptive statistics, non-parametric tests. The conformity of the data to the normal distribution was evaluated with the Kolmogorov-Smirnow test, skewness and kurtosis values. In the evaluation of the data, p, Amaç: Bu çalışma, kronik hastalık tanısı almış 18 yaş üstü bireylerin Covid 19 korkusunu ve sağlık hizmetlerini kullanma durumlarını değerlendirmek amacıyla yapılmıştır.Yöntem: Çalışma tanımlayıcı-kesitsel tipte tasarlanmıştır. Bir eğitim ve araştırma hastanesi kliniklerinde Mart-Haziran 2021 tarihleri arasında yataklı tedavi hizmeti alan 18 yaş üstü bireyler ile yapılan bu çalışma, 200 katılımcı (91 kadın, 109 erkek) ile gerçekleştirilmiştir. Çalışmada kronik hastalık tanısı almış katılımcıların sosyodemografik özelliklerini (yaş, eğitim, genel sağlık durumu vb.) ve sağlık hizmeti kullanma durumlarını sorgulayan kişisel bilgi formu ve Kovid-19 Korkusu Ölçeği kullanılmıştır. Veriler, tanımlayıcı istatistikler (sayı, yüzde, ortalama, ortanca, standart sapma, minimum ve maksimum değerler), non-parametrik testler (Mann Whitney U testi, Kruskal Wallis H testi ve Spearman’s korelasyon testi) ile analiz edilmiştir. Verilerin normal dağılıma uygunlukları Kolmogorov Smirnow testi, çarpıklık ve basıklık değerleri ile değerlendirilmiştir. Verilerin değerlendirilmesinde, anlamlılık düzeyi olarak p

We investigated the natural and artificial radioactivity levels of soil samples from Saklikent, Antalya due to the radioactive isotopes of 238U, 232Th, 40K and 137Cs via gamma spectroscopy. While 137Cs is the only contributor of artificial radioactivity, the rest of the isotopes contributes natural radioactivity. Absorbed dose rates, radium equivalent activities, annual effective dose equivalents and internal and external hazard indexes are also calculated from measured levels. Results were compared with reported limit values of literature. Anomalies were observed in the activity concentration of the 238U, 232Th and 40K. It is concluded that these anomalies explicitly come from the quarries. On the other hand, the anomaly observed in 137Cs is clearly dependent on the fallout from nuclear accidents like Fukushima. This study will be a useful reference for literature, especially after a nuclear plant is established in Mersin, Akkuyu region of Turkey.

Background Evidence suggests that the effect of 0.12% chlorhexidine (CHX) use for oral care on the development of ventilator-associated pneumonia (VAP) and ventilator-associated tracheobronchitis (VAT) is lacking. Evidence-based approaches to the prevention of VAP and VAT are of paramount importance for improving patients' outcomes. Objectives This study aimed to (1) compare the effect of 0.12% CHX use for oral care on preventing VAP and VAT with the placebo group, as well as (2) compare its effect on oral health and prevention of oral microbial colonization with the placebo group. Methods Prospective, single-blinded, randomized controlled trial performed in 2 intensive care units at a hospital. The sample comprised 57 mechanically ventilated adults randomly allocated to the 0.12% CHX group and the placebo group. Barnason's oral assessment guide was used to evaluate the oral health of both groups before oral care during the first 24 hr of tracheal intubation (Day 0) and at Day 2 and Day 3. Oropharyngeal secretion, endotracheal tube aspirate, and nonbronchoscopic bronchoalveolar lavage samples were collected on Day 0 and Day 3. Results The rate of VAT development was not statistically different between the groups (p = .318). However, a significant difference existed in the rate of VAP development (p = .043). The frequency of oropharyngeal colonization significantly decreased in the 0.12% CHX group compared with the placebo group at Day 3 (p = .001). Conclusion The use of 0.12% CHX for oral care could be effective for VAP prevention and reducing microbial colonization in mechanically ventilated patients.

Objectives: The aim of this study was to investigate the free time management according to the departments and some sociodemographic variables of health sciences students.Study Design: The population of the study consisted of 2120 students studying in a faculty of health sciences. 405 students were selected as the sample with stratified sampling method, In this study, data form that questions the sociodemographic characteristics of the participants (age, gender, etc.) and Free Time Management Scale were used. Data were analyzed with descriptive statistics (percent, means etc.), independent samples t test, one way ANOVA test, Mann Whitney U test, Kruskal Wallis H test and Spearman’s correlation test in SPSS24.0 program.Results: The obtained data show that the scores of the participants are high in the Free Time Management Scale and its sub-dimensions. It was found that the scores of Nursing department students in the scale programming sub-dimension were higher than the students of Physiotherapy and Rehabilitation and Child Development departments students. It was found that parental attitudes and participation in free time activities may also be effective in the development of free time management skills.Conclusion: It is foreseen that motivation of university students about free time management and interviews with experts will have a positive effect on skill acquisition. Furthermore, it is thought that information meetings and the provision of counseling services may contribute to the development of healthy family communication, positive parenting attitude. In addition, it is recommended to increase the number of activities in universities in line with the interests of students., Amaç: Bu çalışma, sağlık bilimleri fakültesi öğrencilerinin okudukları bölüm ve bazı sosyodemografik değişkenlere göre boş zaman yönetimlerinin incelenmesi amacıyla yapılmıştır.Çalışma Planı: Araştırmanın evrenini bir sağlık bilimleri fakültesinde öğrenim gören 2120 öğrenci oluşturmuştur. Tabakalı örnekleme yöntemi ile 405 öğrenci örneklem olarak seçilmiştir. Çalışmada katılımcıların sosyodemografik özelliklerini (yaş, cinsiyet, vb.) sorgulayan veri formu ve Boş Zaman Yönetimi Ölçeği kullanılmıştır. Veriler, SPSS24.0 programında tanımlayıcı istatistikler (yüzde, ortalama vb.), bağımsız örneklemler t testi, tek yönlü ANOVA testi, Mann Whitney U testi, Kruskal Wallis H testi ve Spearman’s korelasyon testi ile analiz edilmiştir. Bulgular: Elde edilen veriler, katılımcıların Boş Zaman Yönetimi Ölçeği toplam ve alt boyutlarından elde edilen puanlarının yüksek olduğunu göstermektedir. Hemşirelik bölümü öğrencilerinin ölçek programlama alt boyutundan aldıkları puanın, Fizik Tedavi ve Rehabilitasyon ile Çocuk Gelişimi bölümü öğrencilerine göre yüksek olduğu bulunmuştur. Anne-baba tutumunun ve boş zaman etkinliklerine katılma durumunun da boş zaman yönetimi becerisinin gelişiminde etkili olabileceği saptanmıştır.Sonuç: Üniversite öğrencilerinin boş zaman yönetimi konusunda motivasyonlarının sağlanmasının ve uzman kişilerle planlanacak söyleşilerin beceri kazanımına olumlu etki edebileceği öngörülmektedir. Ayrıca sağlıklı aile iletişimi, pozitif anne-baba tutumunun geliştirilmesi adına bilgilendirme toplantıları ve danışmanlık hizmetlerinin sunumunun katkı sağlayabileceği düşünülmektedir. Ek olarak, üniversitelerde öğrencilerin ilgileri doğrultusunda etkinlik sayılarının artırılması önerilmektedir.

WOS: 000464336000011 PubMed ID: 30982818 The implantation of aortic transcatheter heart valves has been successfully performed throughout the world in hundreds of patients with severe dysfunction of a degenerated mitral bioprosthesis or those at high surgical risk for re-operation. The transseptal approach may be more technically challenging, but is a less invasive procedure and may have a lower mortality rate compared with a transapical approach, and also offers a quick patient recovery. This report is a description of a rare case in Turkey: a successful transseptal mitral valve replacement in a case of a failed bioprosthetic valve. This case illustrates the feasibility and safety of percutaneous valve-in-valve implantation to treat a degenerated bioprosthesis. Transkateter aort kapak, dejenere mitral biyoprotez kapak işlev bozukluğu olan ve tekrar ameliyat riski yüksek olgularda dünyada yüzlerce hastada başarılı bir şekilde kullanılmıştır. Transseptal yaklaşım teknik olarak daha zor olsa da transapikal yaklaşıma kıyasla daha az invaziv, muhtemel daha düşük mortaliteye sahip olup hastanın daha hızlı toparlanması ile ilişkilidir. Burada, dejenere biyoprotez kapağa sahip bir olguda transseptal yaklaşımla başarılı mitral kapak değişimini anlatan ülkemizdeki nadir uygulanmış olan olguyu bildiriyoruz. Bu yazıda, dejenere biyoprotez mitral kapak varlığında güvenli ve etkin bir şekilde perkütan kapak içi kapak implantasyonundan bahsedilmiştir.

Aim: Non-culprit lesion severity has often been exaggerated at the time of acute ST segment elevation myocardial infarction (STEMI). We aimed to determine changes in non-culprit lesions severity on follow-up coronary angiography (CAG) and independent predictors of these changes.Material and Methods: We retrospectively evaluated the changes in non-culprit lesion stenosis on follow-up CAG which was done within 2 months after primary percutaneous coronary intervention (P-PCI) in patients presenting with STEMI. Results: 154 patients were included in this study and 207 non-culprit lesions (percentage diameter stenosis (PDS) ≥50%) were compared using quantitative coronary analyses (QCA). Minimal lumen diameter (1.30 ± 0.38 mm vs. 1.54 ± 0.46 mm, p, Amaç: Akut ST segment yükselmeli miyokard enfarktüsü (STEMI) sırasında sorumlu olmayan lezyonlar sıklıkla olduklarından daha ciddi görünürler. Kontrol koroner anjiyografi (KAG)'de sorumlu olmayan lezyonların şiddetindeki değişiklikleri ve bu değişikliklerin bağımsız prediktörlerini belirlemeyi amaçladık.Gereç ve Yöntem: STEMI ile başvuran ve primer perkütan koroner girişimden (P-PKG) sonraki 2 ay içinde kontrol KAG yapılan hastalarda sorumlu olmayan lezyonlardaki değişiklikleri retrospektif olarak değerlendirdik.Bulgular: Bu çalışmaya 154 hasta dahil edildi ve 207 (yüzde çap darlığı (YÇD) ≥50%) sorumlu olmayan lezyon kantitatif koroner analizler (QCA) kullanılarak karşılaştırıldı. Minimal lümen çapı (1,30 ± 0,38 mm'ye karşı 1,54 ± 0,46 mm, p

NUMEN proposes an innovative technique to access the nuclear matrix elements entering the expression of the lifetime of the double beta decay by cross-section measurements of heavy-ion induced Double Charge Exchange (DCE) reactions. Despite the fact that the two processes, namely neutrinoless double beta decay and DCE reactions, are triggered by the weak and strong interaction respectively, important analogies are suggested. The basic point is the coincidence of the initial and final state many-body wave functions in the two types of processes and the formal similarity of the transition operators. The main experimental tools for this project are the K800 Superconducting Cyclotron and MAGNEX spectrometer at the INFN-LNS laboratory. However, the tiny values of DCE cross-sections and the resolution requirements demand beam intensities much higher than those manageable with the present facility. The on-going upgrade of the INFN-LNS facilities promoted by the POTLNS a project in this perspective is intimately connected to the NUMEN project. This paper describes the solutions proposed as a result of the R&D activity performed during the recent years. The goal is to develop suitable technologies allowing for the measurements of DCE cross-section under extremely high beam intensities. a PIR01_00005 — potenziamento dell’infrastruttura di ricerca Laboratori Nazionali del Sud per la produzione di fasci di ioni ad alta intensitá.

There is a rapid emergence of transcatheter mitral valve-invalve (TMVIV) and valve-in-ring (TMVIR) techniques as an alternative to the conventional surgical valve replacement in ineligible patients requiring repeat surgery (1).The selection of a new transcatheter heart valve (THV) for degenerated surgical valves is relatively simple; however, the selection of valves for mitral rings is more nuanced because the rigidoval or D-shaped rings will not conform to the round shape of theprosthesis, thus posing a high risk of paravalvular leak (PVL).Although prior reports have described simultaneous TMVIVand percutaneous PVL closure techniques, our case report provides the first description of simultaneous transapical valve-invalve implantation and the closure of severe PVL after a failedtransseptal valve-in-ring procedure (2, 3).

Double charge exchange (DCE) reactions could provide experimentally driven information about nuclear matrix elements of interest in the context of neutrinoless double-β decay. To achieve this goal, a detailed description of the reaction mechanism is mandatory. This requires the full characterization of the initial and final-state interactions, which are poorly known for many of the projectile-target systems involved in future DCE studies. Among these, we intend to study the 20Ne + 130Te and 18O + 116Sn systems at 15.3 AMeV, which are particularly relevant due to their connection with the 130Te→130Xe and 116Cd→116Sn double-β decays. We measure the elastic and inelastic scattering cross-section angular distributions and compare them with theoretical calculations performed in the optical model, one-step distorted wave Born approximation, and coupled-channel approaches using the São Paulo double-folding optical potential. A good description of the experimental data in the whole explored range of transferred momenta is obtained provided that couplings with the 21+ states of the projectile and target are explicitly included within the coupled-channel approach. These results are relevant also in the analysis of other quasi-elastic reaction channels in these systems, in which the same couplings should be included.

The prevalence of obesity in young people around the world. The written and visual media have an important role to play in increasing student awareness in the prevention of obesity. This study was planned with the aim of determining the effect on attitudes and beliefs concerning obesity of the levels of media literacy of university students. This cross-sectional descriptive study was conducted with 300 obese students. The Media Literacy Scale, and the Obesity Health Belief Model Scale were used in the collection of data for the study. The Student t test and the one-way ANOVA test were used in the analysis of the data. A weak, positive statistically significant correlation was found between media literacy and the subscales of perceived severity, perceived barriers, and perceived benefit (

Patients with stroke experience various challenges such as motor and cognitive and sensory problems, which can increase the caregiver burden of family members in long-term care. Understanding the factors related to caregiver burden is important to develop strategies to support informal caregivers. Therefore, this study aimed to examine the relationship of religious coping strategies and family harmony to caregiver burden for family members of patients with stroke.The sample of this descriptive, cross-sectional study consisted of 181 family caregivers who completed the Religious Coping Scale, Burden Interview Scale, and Family Harmony Scale - Short Form. Multiple linear regression and Pearson's correlation were performed.Pearson's correlation analysis indicated a significant positive relationship between caregiver burden and negative religious coping. A significant negative relationship was found of caregiver burden and family harmony with positive religious coping. Multiple regression analysis indicated that family harmony, amount of time spent on caregiving, and negative and positive religious coping were predictors of caregiver burden.Given the significant relationship of caregiver burden and family harmony to positive religious coping, future research should integrate religious coping strategies into multidisciplinary caregiver intervention programs to reduce caregiver burden.

First published online: 16 August 2020 EU trade policy increasingly focuses on the achievement of non‐trade policy objectives (NTPOs) such as the promotion of human rights or environmental protection, motivating research on the political economy determinants and effectiveness of linking trade policy and NTPOs. This research reports selected findings from a new expert survey of stakeholder perceptions of trade–NTPO linkages. These suggest that the views of EU institutions align with those of civil society organizations more than with business, but also reveal significant differences in the perceived effectiveness of trade–NTPO linkage strategies. Many stakeholder groups believe that policy instruments other than trade agreements are more effective tools to pursue NTPOs. These findings suggest that further research on EU trade policy and non‐trade issues should consider the broader range of external policy tools available to the EU in pursuit of NTPOs and the determinants of differences in preferences for alternative policy instruments. The preparation of this article was supported by the European Union Horizon 2020 research and innovation programme under grant agreement no. 770680 (RESPECT).

Objective This study was conducted with the aim of determining the fertility characteristics of Syrian refugee women and their knowledge, attitudes and behaviours with regard to family planning. Design and sample The research was designed as a descriptive and cross-sectional type of study. The study group consisted of 389 refugee women in the 15- to 49-year age group who had migrated from Syria to Hatay. Measure Study data were collected between October 2018 and January 2019 using forms containing questions on participants' sociodemographic characteristics, and their knowledge, attitudes and behaviour regarding family planning. Data analysis was performed with the use of frequency, percentage, mean, median, standard deviation values and the chi-square test. Results Most of the participants reported that they used a family planning method, 47.9% that they preferred traditional methods, 15.2% that the method used was supported by their husbands. Most of the participants had mistaken beliefs about pregnancy and family planning methods. Participants' information on modern family planning methods was affected by their age, income level and social security status; their knowledge of traditional family planning methods was affected by their income level, their family structure and their use of a traditional method. Women's use of family planning was affected by their age, income level and their knowledge of modern and traditional methods. Conclusions Determination of the knowledge, attitudes and practice of refugee women regarding family planning and establishing the influential factors will enable nurses to make a contribution to the future provision of specific and culturally sensitive care to sick and healthy refugee women.

Changes in the aging process affect the duration and quality of sleep. Not having a quality night's sleep leads to a reduction in daytime wakefulness in older adults. We examined the effect of aromatherapy on the cognitive functions and daytime sleepiness of older adults living in a nursing home. The research was a pretest and posttest design, which was conducted without a control group. The sample included 39 elders. A rosemary-lemon oil mixture was smelled by elders in the mornings for a week. After a 1-week washout period, lavender oils were smelled in the evenings for a week. After application of the rosemary-lemon oil mixture, the mean score of participants' daytime sleepiness was lower, but that decline was not statistically meaningful (P > .050). After the same application, the mean score of the participants' cognitive functions was significantly lower (P < .001). After application of lavender oil, the scores were significantly lower (P < .001). Lower scores on the scales used indicate lower sleepiness. The results showed that the 2 applications can be used to improve cognitive functions in older adults; in addition, lavender oil has an advantage in reducing daytime sleepiness. Changes in the aging process affect the duration and quality of sleep. Not having a quality night's sleep leads to a reduction in daytime wakefulness in older adults. We examined the effect of aromatherapy on the cognitive functions and daytime sleepiness of older adults living in a nursing home. The research was a pretest and posttest design, which was conducted without a control group. The sample included 39 elders. A rosemary-lemon oil mixture was smelled by elders in the mornings for a week. After a 1-week washout period, lavender oils were smelled in the evenings for a week. After application of the rosemary-lemon oil mixture, the mean score of participants' daytime sleepiness was lower, but that decline was not statistically meaningful (P > .050). After the same application, the mean score of the participants' cognitive functions was significantly lower (P < .001). After application of lavender oil, the scores were significantly lower (P < .001). Lower scores on the scales used indicate lower sleepiness. The results showed that the 2 applications can be used to improve cognitive functions in older adults; in addition, lavender oil has an advantage in reducing daytime sleepiness.

We aimed to investigate the diagnostic value of urinary High Mobility Group Box-1 (HMGB1) level as a noninvasive tool that can be potentially used for diagnosis and during follow-up in patients with bladder cancer patients.The study was conducted in a total of 121 participants including 61 patients diagnosed with primary bladder cancer, 30 patients with an acute urinary tract infection and 30 healthy controls. Age, gender and urinary HMGB1 levels of the study groups were evaluated. The association of clinical features (tumor diameter, number of foci, pathological grade, muscle invasion) with urinary HMGB1 levels was investigated in patients with bladder cancer.All 3 groups showed a normal age and gender distribution with no significant difference among them (P = 0.775 and P = 0.967, respectively). A significant difference was detected in urinary HMGB1 levels among the 3 groups (P0.001). When urinary HMGB1 levels were compared between patients with high grade vs. low grade tumors, the mean HMGB1 level was 44.39 pg/ml (12.1-505.2) in patients with low grade tumors and 280 pg/ml (18.7-2685.3) in patients with high grade tumors (P0.001). Patients with a greater number of tumor foci had higher HMGB1 levels in comparison to patients with a single tumor focus (P = 0.008). Urinary HMGB1 levels were higher in patients with a tumor diameter of ≥3 cm than in patients with a tumor diameter less than 3 cm (P = 0.001). Patients with muscle-invasive bladder cancer exhibited higher urinary HMGB1 levels compared to patients with non-muscle-invasive bladder cancer (P = 0.033). The cut-off values derived from the ROC analysis were 63.30 pg/ml for distinguishing bladder cancer from urinary tract infection, 30.94 pg/ml for urinary tract infection versus control group and 38.70 pg/ml for bladder cancer vs. control group, respectively. Sensitivity was 59% and specificity was found 77%.In future controlled studies involving larger patient groups, urinary HMGB1 levels can be used for diagnostic and screening purposes in bladder cancer patients.

Under what conditions do WTO Members change domestic policies or measures that are challenged in WTO litigation? This chapter tests the hypotheses put forward in the previous chapter and argues that the degree of integration into value chains of the economic sectors affected by a WTO dispute influences members’ propensity to change domestic policies when targeted in WTO litigation. I propose that compliance with WTO rulings is faster when a domestic coalition consists of pro-trade liberalization groups composed of exporters seeking to avoid the imposition of retaliatory measures and import-dependent firms integrated into value chains wishing to exploit the opportunity to access cheaper imports. Under these circumstances, trade-liberalizing responses to WTO legal challenges are therefore more likely. I test this theory by relying on a novel database of WTO trade disputes and by estimating a Cox proportional hazard model. The results support my hypothesis and indicate that indeed when WTO-targeted measures involve sectors highly integrated into value chains, compliance with WTO panel rulings is faster.