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Mehmet Yaman,1,2 Uğur Arslan,1 Adil Bayramoğlu,2 Osman Bektaş,2 Ahmet Karataş3 1Cardiology Department, Samsun Training and Research Hospital, Health Sciences University, Samsun, 2Cardiology Department, 3Nephrology Department, Education and Research Hospital, Ordu University, Ordu, Turkey Background: Arterial stiffness (AS) can be determined by some noninvasive tests such as pulse wave velocity (PWV). Atherosclerosis is also detectable by some ultrasonographic techniques such as color M-mode-derived propagation velocity measured along the origin of the descending aorta (AVP).Aim: The aim of the study was to find out a possible relationship between atherosclerosis and AVP and whether AVP can be used as a parameter of AS.Materials and methods: The study group was composed of 134 people from routine screening examination who were ≥40 years old, completely healthy, and without any known disease and use of any drug. PWV has been determined to show aortic stiffness, and carotid artery intima–media thickness (CIMT) was measured for subclinical atherosclerosis. AVP values were obtained from all participants, and correlations were calculated between these parameters and age.Results: AVP decreased (r=−0.902, P

Abstract The goal of this mixed-methods study was to identify and compare the key capacity considerations regarding public health system resilience before and after the 2023 Türkiye-Syria earthquakes. Public health system resilience was assessed through online and face-to-face workshops using the United Nations Public Health System Resilience Scorecard. The pre-earthquake evaluation was conducted in Istanbul and Trabzon in 2021; the post-earthquake evaluation took place in Hatay and Kahramanmaraş in 2023, with a total of 41 participants each. The online workshops lasted approximately four days, while the face-to-face workshops lasted one day. The study found a significant decrease in the scores for most scorecard resilience indicators in the post-earthquake assessment. Qualitative analysis showed that this decline was largely due to infrastructure collapse. Additionally, defining the roles of health disciplines in disaster management and having data transmission procedures between public health system stakeholders in disasters were among the main capacity considerations in both the pre-and post-earthquake assessments. The post-earthquake evaluation revealed several capacity gaps that had not been addressed in pre-earthquake assessments in areas such as disaster preparedness of vulnerable populations and logistics. The findings highlight the critical importance of strengthening building stock and infrastructure to establish a disaster-resilient public health system.

Abstract Background This study aims to compare the biomechanics of six zygomatic implants (ZIs) and dental implants (DIs) combined with four ZIs with different maxilla defects. Methods Three-dimensional constructs of the ZIs, DIs human skulls, and maxillary prostheses were created using SolidWorks Software (Version 2015, Dassault Systems SolidWorks Corporation, Waltham, MA, USA). Eight finite element models of the skull with four different alveolar defect types (0–4) were constructed. Type 0: No defect; Type 1: Bilateral posterior defects; Type 2: Right posterior defect; Type 3: Anterior and left posterior defects; Type 4: Bilateral posterior and anterior defects. In two models with the same defect type (for defect types 0–2), six ZIs or two DIs combined with four ZIs were inserted into the maxilla. Six ZIs were inserted in the maxilla models with defect types 3 and 4. Vertical (150 N) and masseteric (300 N) loads were simulated on the prosthesis. The maximum Von Mises stress in the implants/surrounding bone and bone deformation were evaluated. Results The maximum Von Mises stresses in bone/implant were found highest in the defect type 2 model with four ZIs combined with two DIs. The lowest maximum Von Mises stress for bone was detected in the model with defect type 0 and with six ZIs. Conclusion Among the four types of defects, the posterior unilateral defect caused the highest stress value.

Çocuğun okul ortamına fiziksel, duygusal, psikolojik olarak uyum sağlayabilmesi ve kendini iyi hissedebilmesi için bir olgunluğa ulaşmış olabilmesi gerekmektedir. Bu araştırmada ilkokul 1. sınıf düzeyindeki öğrencilerin hazırbulunuşluklarının birçok değişken açısından incelenmesi hedeflenmiştir. Araştırmanın yürütülmesinde tarama modelinden yararlanılmıştır. Araştırma evreni 2020-2021 öğretim yılında Samsun ilindeki ilkokul 1. sınıfları okutan sınıf öğretmenlerinden meydana gelmektedir. Araştırmada veri toplama araçları olarak İlkokula Hazırbulunuşluk Ölçeği ve araştırmacılar tarafından geliştirilen Kişisel Bilgi Formu kullanılmıştır. Verilerin analizinde kullanılan testler; parametrik olarak bağımsız gruplar için t testi, nonparametrik olarak Kruskal Wallis H testi ile Mann Whitney U testidir. Araştırmada, ilkokul 1. sınıf öğrencilerinin ilkokula hazırbulunuşluk düzeylerinin okula başlamadan önce sanatsal, sportif faaliyetlere katılma durumları, okula başlama ayları, anne ile babanın eğitim durumları, ailenin kaçıncı çocuğu oldukları, annenin çalışma durumu, veli ile evde etkinlik yapma durumu ve ailenin teknolojiyi kullanma sürelerine göre anlamlı farklılıklar tespit edilmiştir. Ancak öğrencilerin cinsiyetlerine göre ilkokula hazırbulnuşlukları arasında anlamlı bir farklılık görülmemiştir. Elde edilen bulgulara göre ailenin ilk çocuğu olanların okula hazırbulunuşluk düzeyleri diğerlerinden daha yüksek bulunurken, bu değişkenin ilkokula hazırbulunuşluk düzeyini belirlemede anlamlı bir farklılık oluşturmadığı tespit edilmiştir. Okul öncesinde sanatsal, sportif kurslara katılan çocukların, katılmayanlara göre; velisi ile evde etkinlik yapan çocukların yapmayanlara göre daha iyi hazırbulunuşluğa sahip oldukları ve ailenin teknoloji kullanma süresinin azaldığı durumlarda çocuklarının ilkokula hazırbulunuşluklarının arttığı görülmüştür.

In response to global warming and pollution, the use of alternative fuels in diesel engines is becoming increasingly important. The purpose of this research is to evaluate the effects of hydrogen and ammonia additions to diesel fuel on carbon emissions and energy and the exergy efficiency of diesel engines and to evaluate sustainability. In this study, the effects of adding 5%, 10%, and 15% of both hydrogen and ammonia to conventional diesel fuel on specific fuel consumption, carbon emissions, energy, exergy, and sustainability index (SI) were examined parametrically. Ammonia and hydrogen fuels reduce CO2 emissions because they are carbon-free. as a result of the research, it was found that compared with ammonia addition, increasing hydrogen addition lowered specific fuel consumption while decreasing engine performance. The findings obtained show that mechanical energy and exergy values increase by 5.5% in the case of hydrogen addition and decrease by approximately 1.1% in the case of ammonia addition. The thermal efficiency and SI increased in the case of hydrogen addition and decreased in the case of ammonia addition. The exergy efficiency was estimated to be 63.37%, an increase of approximately 2.3% over pure diesel. The highest SI and exergetic performance coefficient values were determined 2.73 and 1.63, respectively. In line with the first and second law analyses, the usability of ammonia and hydrogen in diesel engines was evaluated thermodynamically.

This study examines the problems arising from that the agricultural sector has become a significant employment area for migrant labor due to migrant migration. The presence of migrant labor in the agricultural sector has increased because of the cost advantages provided by agricultural operators of cheap labor supply despite informal working conditions. Migrant labor has crucial contributions to the sustainability of production activities, especially in the agricultural sector, where the local labor does not want to be employed. However, the perspective of local people toward migrants differs over time, especially due to different social and cultural characteristics. Since these differences are more noticeable in small settlements, such as rural areas people who are migrant to society or national identity become unwanted in the living spaces of local people over course of time, this study aimed to determine the perspective toward migrant labor and to evaluate the impact of this situation on the sustainability of production. In line with the results obtained, policy recommendations were made for the integration of migrant labor and the planning of agricultural activities.

The aim of this study is to examine the marketing strategies of ornamental plants in Konya province, to determine the target markets that the sector can best serve, and to evaluate all the components that can contribute to the development of the sector on a provincial basis. In this context, the sales and marketing strategies of the companies producing and selling in Konya province were identified, suggestions for improvement were presented and the potential of ornamental plants in the region was determined. It is believed that the study will make an important contribution to the literature in this area. The main body of the research consists of ornamental plant companies selling in Konya province. In order to answer the questions of the study, a face-to-face survey was conducted with 32 operators representing the main mass. Porter’s Diamond model was used to evaluate the competitiveness. As a result of the analysis of the data, it was observed that the competitiveness of the companies is low and they are not looking for alternative markets. The lack of legislation defining the sector, the problem of organisation, the fact that they consider their income to be sufficient and the lack of information at the point of sale are the main obstacles to competitiveness. In fact, the main priority for a company is to gain a competitive position in order to increase profit margins. For this reason, companies need to evaluate the opportunities that may present themselves, develop strategies to add value to customers in the long term, and determine strategies to be close to the market in order to create new markets.

Abstract Background A chronic autoimmune disease with an increasing incidence rate, type 1 diabetes mellitus (T1DM) is typified by the degeneration of the pancreatic beta cells. Diabetes management is significantly impacted by nutrition. Although it has been demonstrated that following the Mediterranean diet (MD) improves metabolic control with type 2 diabetes in children and adults, its effects on children with T1DM have not received much attention. Objective Therefore, the purpose of this study was to assess whether adherence to Mediterranean diet is associated with better metabolic control and body composition in youths with Type 1 Diabetes Mellitus. The study recruited T1DM patients aged 6-18 years at İstanbul University Cerrahpaşa Medical Faculty Hospital's Pediatric Endocrinology and Diabetes Outpatient Clinic for follow-up. Methods In addition to demographic variables, some anthropometric measurements, body composition and biochemical parameters such as: Trygliceride(TG), Total cholesterol (TC), High density lipoprotein cholesterol (HDL-C), Low density lipoprotein cholesterol (LDL-C), (Aspartate aminotransferase) AST, Alanine transaminase (ALT) and glycated hemoglobin (HbA1c) was analyzed. The time in range (TIR) is a value obtained from continuous glucose monitoring. KIDMED was used to assess the participants' adherence with the MD. Results Good adherence to the MD resulted in much larger height SDS than poor adherence. Poor adherence to MD resulted in higher body fat than moderate and good adherence. There is positivite correlation between TIR and KIDMED score. Adherence to MD is negatively associated with HbA1c. The regression anaylsis showed that a one-point rise in the KIDMED score would result in a 0.314-unit reduction in the HbA1c value (p < 0.01). Conclusions In conclusion, this study found that adhering to MD led to improved anthropometric measurements, biochemistry, and diabetes outcomes. Awareness among children, adolescents with T1DM, and their parents about the benefits of MD compliance for glycemic and metabolic control should be raised.

ObjectivesThis study aims to provide an overview of the diagnosis, treatment, and follow-up management of vulvar and vaginal leiomyomas through the presentation of two rare cases.MethodsDetailed clinical presentations, surgical procedures, histopathological examinations, and follow-up outcomes of two cases of vulvar and vaginal leiomyomas are described. Relevant literature is also reviewed to contextualize the findings.ResultsBoth patients underwent successful surgical excision of the leiomyomas with no perioperative or postoperative complications. Histopathological examinations confirmed the diagnosis of leiomyoma based on characteristic microscopic features and immunohistochemical analyses.ConclusionVulvar and vaginal leiomyomas are rare benign tumors that require careful evaluation for accurate diagnosis and appropriate management. Surgical excision remains the primary treatment modality, and long-term follow-up is essential for monitoring recurrence and ensuring favorable outcomes.

Background: Violence in healthcare is a global issue that healthcare professionals experience. The concerning increase in violent incidents in Turkiye particularly makes it a significant problem to explore by examining the underlying psychological factors. In this sense, this study focuses on the concept of Schadenfreude, the malicious joy of someone else's misfortune, towards doctors, which is an under-researched topic in healthcare violence. Particularly, there is a lack of research on patients' and relatives' perceptions of doctors. Objective: This study aims to determine the level of schadenfreude in Turkish society towards the violence experienced by doctors and to develop a model revealing the underlying causes. Methods: Using a convenience sampling method, we recruited 402 participants, who are not first-degree relatives of healthcare professionals, for this quantitative study. For data collection, we developed a survey instrument to measure the level of schadenfreude and six different psychological factors including empathy, sympathy, anger, aggression, and deservingness. For data analysis, we used structural equation modeling. Results: The results showed that the lower the levels of empathy and sympathy towards doctors were, the higher the levels of both schadenfreude and aggression were. Envy had no significant effect on either schadenfreude or aggression, while deservingness directly affected aggression. The perceptions of participants regarding doctors that they deserve violence increased their aggression levels. Schadenfreude had a positive and significant effect on anger and aggression. Implications: The examination of underlying factors of violence towards doctors points to a lack of mutual understanding between patients and doctors. The results of this study indicate a need for increasing empathy towards health professionals by creating societal awareness of their experiences. Local authorities and healthcare organizations can create environments that bring together the public and health professionals to share their experiences with each other or conduct campaigns to draw public attention to the issue. Moreover, training sessions on effective communication can be offered for health professionals to help improve patient-doctor relationships and healthcare outcomes.

Bu araştırmada tarım işletmelerinin sürdürülebilirlik algısının ve düzeyinin belirlenmesi amaçlanmıştır. Araştırma alanı olarak Konya ilinin seçilmesinde Türkiye genelinde önemli tarımsal üretim merkezlerinden biri olması belirleyici olmuştur. Çalışmanın kapsamında tabakalı tesadüfi örnekleme yöntemi kullanılmıştır. Toplamda 268 tarımsal işletme sahibiyle yüz yüze görüşülerek anket verileri derlenmiştir. Çevresel sürdürülebilirlik algı indeksinin hesaplanması için literatür verileri dikkate alınarak sürdürülebilirlik algı indeksi oluşturulmuştur. Araştırmada katılımcıların sürdürülebilirlik algıları beşli likert tipindeki ölçekle aldığı toplam puan alabileceği maksimum toplam puana oranlanarak “Sürdürülebilirlik Algı İndeksi” hesaplanmıştır. Çevresel sürdürülebilirlik düzeylerinin (uygulama/kullanma) tespit edilmesi için işletmecilerin sürdürülebilirlik düzey durumları anket verileri ile elde edilmiş olup toplam puan alabileceği maksimum puana oranlanarak “sürdürülebilirlik Düzey İndeksi” hesaplanmıştır. Birinci grupta yer alan işletmelerde sürdürülebilirlik algı indeks puanı %83,67, bu oran ikinci grupta %84,77, üçüncü grupta %89,39 ve dördüncü grupta %88,67 olarak belirlenmiştir. İşletmeler ortalaması sürdürülebilirlik indeks puanı %86,62 olarak belirlenmiştir. İşletme ölçeği büyüdükçe sürdürülebilirlik algı indeksi de artmaktadır. Araştırma sonuçlarına göre sürdürülebilirlik algı ve düzey indeksleri işletmeler ortalamasında karşılaştırıldığında sürdürülebilirlik düzey indeksinin %67,59 algı indeksinin ise %86,62 olduğu görülmektedir. Tarım işletmecilerinde sürdürülebildik algı indeksinin yüksek olması sürdürülebilirlikle ilgili konularda algılarının olduğunu fakat düzey (uygulama/kullanma) yetersiz kaldıkları görülmektedir. Tarım işletmecilerinin bilinç düzeylerinin artırılması ve eyleme geçirmek adına eğitim ve yayım çalışmalarına ağırlık verilmelidir.

Climate change is defined as one of the biggest problems of the third millennium. All countries in the world are striving to produce policies on this issue and achieve a common consensus. Regulations are being made in various sectors and efforts are continuing to adopt ecofriendly production techniques. Just as climate change affects all sectors, it is also affected by the production activities of the sectors. One of these sectors is the agricultural sector. Inputs and production techniques used in agriculture create direct environmental costs. The production techniques used by countries depending on their income level and development level contribute to the climate change process to a certain extent. In this research, the effects of the inputs used in agricultural production on CO2 emissions according to the income levels of the countries of the world were investigated by panel data analysis. According to the results obtained, the effect of the arable land size of low and low-middle income group countries, the pesticides they use in agriculture, the animal fertilizers they use in agricultural production, the CO2 level released from the energy they use in agriculture, and the effect of their agricultural nitrogen use on the total CO2 level is statistically significant. While the effect of pesticide uses and the amount of nitrogen used in agriculture by middle-high income countries is statistically significant, it can be said that the amounts of pesticides used by high-income countries in agriculture, animal fertilizers used in agricultural production, the level of CO2 released from the energy they use in agriculture and their use of agricultural nitrogen are statistically significant. While the results obtained reveal the relationship between the amount used and CO2 emissions, they also indicate that the inputs used can be quality and environmentally friendly inputs. In classical suggestions, suggestions are made such as controlling input levels and preventing excessive use. However, the increasing world population and the resulting increase in nutritional needs emphasize the importance of optimal input use in agricultural production. It makes it important that qualitative, ecofriendly and effective inputs should be used rather than input usage possibilities and quantity-dimensional control.

In this research, it is aimed to determine the factors affecting the innovation level of agricultural enterprises. Konya province was chosen as the research area because it is one of the important agricultural production centres in Türkiye. Stratified random sampling method was used within the scope of the study. A total of 268 agricultural enterprise owners were interviewed face to face and survey data were compiled. Multiple regression model was applied in the analysis of the factors affecting the perception of innovations by the operator. In this research, considering the characteristics of the data collected by the questionnaire, the linear regression model, which uses functional forms in regression models, was used. In the study, innovation index was taken as the dependent variable in the linear regression model. Independent variables were determined as education, experience, number of parcels, amount of land, active capital, amount of land, agricultural income, following innovations, receiving training on agricultural issues, participating in agricultural activities, following events related to agriculture on social media and cooperation with institutions. As a result of the model, a positive relationship was determined between education, experience, number of parcels, amount of land, active capital, amount of land, agricultural income, following innovations, receiving training on agriculture-related issues, participating in agriculture-related activities, following agriculture-related events on social media and cooperation with institutions and innovation index.

Objective: Mercury poisoning is a condition with multiple-organ dysfunction that has effects on the central nervous system, gastrointestinal system, cardiovascular system, skin, lungs, and kidneys. It can be fatal or may result in sequelae such as neurological disturbances, if treated late or left untreated. The endocrinological effects of mercury exposure are not well-known. We aimed to evaluate patients with mercury poisoning. Materials and Methods: A total of 6 cases of mercury poisoning from 3 families were included in the study. Clinical, laboratory, and follow-up data were recorded. Results: Thyroid dysfunction was presented as high thyroid hormones and normal thyrotropin level (unsuppressed) in 5 cases (83.3%). On the other hand, pheochromocytoma-like syndrome was detected in 5 cases (83.3%) with hypertension. The 4 cases were the first to use methimazole for mercury poisoning due to tachycardia and hypertension despite antihypertensive treatment due to catecholamine excess and thyroid dysfunction. Hyponatremia was detected in 3 cases (50%). Conclusion: Mercury poisoning is difficult to diagnose because it is rare and presents with nonspecific physical and laboratory findings. Early diagnosis and providing appropriate treatment are essential in order to prevent sequelae. Mercury poisoning should be considered in patients with unexplained hypertension and tachycardia suggesting the involvement of thyroid hormones and catecholamines

A female infant born with a gestational age of 35 weeks and birth weight of 2500 g was referred for ophthalmic examination on the second postnatal day. Bilateral venous dilatation and arterial tortuosity, severe extraretinal fibrovascular proliferation, and peripheral ischemia were detected. Fluorescein angiography showed profoundly delayed arteriovenous transit and peripheral avascularity. Both eyes were treated with diode laser photocoagulation and bevacizumab injection. Cranial magnetic resonance imaging (MRI) revealed hydrocephalus, ventricular dilatation, and cerebral atrophy. Her family history revealed that the patient’s brother presented to the ophthalmology outpatient clinic at postnatal 3 months with inoperable total retinal detachment and similar cranial MRI findings. No systemic or ocular findings were detected in the parents. A recent study showed that in 13 cases, including our patients, bi-allelic variants in the ESAM gene lead to a new neurodevelopmental disease whose main clinical features include impaired speech and language development, seizures, varying degrees of spasticity, ventriculomegaly, intracranial hemorrhage, and developmental delay/mental disability. Newborn siblings of children with serious pathological retinal findings should undergo a detailed ophthalmic examination as soon as possible after birth to prevent total retinal detachment, even without a diagnosis of specific inherited retinal vascular diseases. Further investigations performed in collaboration with an international network may reveal more candidate gene variants possibly related to retinopathy of prematurity-like ophthalmological findings such as extraretinal fibrovascular proliferation.