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Natural disasters have become one of the leading events that have seriously affected human life and shaken society, both in Turkey and in the world lately. Natural disasters that have a wide impact cause material morale losses and have a traumatic effect on individuals. Earthquakes are one of the compelling life events that cause losses and traumatic experiences due to their destructive effects. After such an event, it is important to ensure the adaptation of individuals to normal life, to cope with the traumas that may occur, to increase their psychological resilience in the face of challenging life events, and to ensure their subjective well-being with psychosocial support activities to be carried out. In this context, the aim of this study is to examine the effect of the earthquake psychoeducation program on the perception of coping with trauma, psychological resilience, and subjective well-being of high school students affected by earthquakes. The research participants consisted of students who came to Sirnak from the earthquake region and continued their high school education. In the research, a pretest-posttest single-group quasi-experimental design was used, and 11 high school students were included as participants. The Perceived Ability to Cope with Trauma Scale (PACT), the Brief Resilience Scale (BRS), and the Adolescent Subjective Well Being Scale were used to collect the data. The earthquake psychoeducation program for high school students consisting of eight modules and 11 sessions was applied to the participants. The data were analyzed with the Wilcoxon Signed Ranks test for the significance of the pre-test and post-test score differences. The findings obtained as a result of the research showed that the earthquake psychoeducation program was effective on the perception of coping with trauma and psychological resilience of high school students affected by the earthquake, but it was not significantly effective on their subjective well-being. Based on the research findings, comments were made, and suggestions for practice and research were developed.

Digital technologies are increasingly integrated into early childhood education (ECE), prompting discussions regarding their potential benefits and drawbacks. Research has shown that technology designed for children's developmental needs can enhance learning and development, while also improving communication between parents, teachers, and children. However, issues like access, equity, ethics, and teacher workload require careful consideration. This qualitative study explores the expected outcomes of integrating e-portfolios into ECE through one-on-one interviews with key stakeholder groups. After gathering general opinions, the participants were asked to provide detailed feedback on how the application affects children, teachers, and parents. In addition to revealing a diverse range of voices regarding the implementation of e-portfolios, this study aims to utilize the information gathered from participants for informed decision-making, offering valuable insights for the improved e-portfolio design and implementation. The study involved 34 Turkish participants from five stakeholder categories: ECE and primary school teachers, faculty members from ECE and primary school education departments, and parents. Results revealed that e-portfolios were viewed as highly beneficial, providing permanent and comprehensive documentation, facilitating data transfer to subsequent schooling levels, enabling multidimensional assessment, promoting child-centred practices, improving communication, enhancing reflective thinking and digital skills, and allowing resource utilization. However, participants raised concerns about workload, documentation gaps, and ethical issues. While e-portfolios hold promise for integrating digital technologies into ECE, current teacher education may lack sufficient training in key areas like digital literacy, documentation, assessment, and ethics. Further education in these areas can help ensure effective implementation and positive outcomes.

ObjectiveOur objective was to gauge adherence to nationally endorsed protocols in implementation of pulse oximetry (POx) screening for critical congenital heart disease (CCHD) in infants after mandate by all states and to assess associated characteristics.Study designBetween March and October 2019, an online questionnaire was administered to nurse supervisors who oversee personnel conducting POx screening. The questionnaire used eight questions regarding performance and interpretation of screening protocols to measure policy consistency, which is adherence to nationally endorsed protocols for POx screening developed by professional medical societies. Multilevel linear regression models evaluated associations between policy consistency and characteristics of hospitals and individuals, state of hospital location, early versus late mandate adopters, and state reporting requirements.ResultsResponses from 189 nurse supervisors spanning 38 states were analyzed. Only 17% received maximum points indicating full policy consistency, and 24% selected all four options for potential hypoxia that require a repeat screen. Notably, 33% did not recognize ≤90% SpO2 as an immediate failed screen and 31% responded that an infant with SpO2 of 89% in one extremity will be rescreened by nurses in an hour rather than receiving an immediate physician referral. Lower policy consistency was associated with lack of state reporting mandates (beta = -1.23 p = 0.01) and early adoption by states (beta = -1.01, p

Abstract Background The clustered regulatory interspaced short palindromic repeats (CRISPR)-Cas13a system has strong potential for highly sensitive detection of exogenous sequences. The detection of KRAS G12 point mutations with low allele frequencies may prove powerful for the formal diagnosis of pancreatic ductal adenocarcinoma (PDAC). Results We implemented preamplification of KRAS alleles (wild-type and mutant) to reveal the presence of mutant KRAS with CRISPR-Cas13a. The discrimination of KRAS G12D from KRAS WT was poor for the generic KRAS preamplification templates and depended on the crRNA design, the secondary structure of the target templates, and the nature of the mismatches between the guide and the templates. To improve the specificity, we used an allele-specific PCR preamplification method called CASPER (Cas13a Allele-Specific PCR Enzyme Recognition). CASPER enabled specific and sensitive detection of KRAS G12D with low DNA input. CASPER detected KRAS mutations in DNA extracted from patients’ pancreatic ultrasound-guided fine-needle aspiration fluid. Conclusion CASPER is easy to implement and is a versatile and reliable method that is virtually adaptable to any point mutation.

Background: Following the Pazarcık (Kahraman Maraş) Earthquake in February 2023, both immediate and lasting effects of the disaster were observed in Turkey. As with any natural disaster, this event had a significant societal impact and resulted in various psychological consequences.Objective: This study aims to assess the factors influencing the anxiety and attitudes of emergency service personnel in the aftermath of the earthquake.Methods: The study utilized a questionnaire distributed to physicians, auxiliary healthcare staff, and other personnel in the emergency department of a tertiary care and research hospital following the Pazarcık (Kahramanmaraş) earthquake in February 2023. The questionnaire, which included demographic information, history of exposure to earthquakes and natural disasters, and the Earthquake Anxiety Scale (EAS), comprised 42 items. All participants completed the questionnaires.Results: Ninety-nine physicians, auxiliary healthcare staff, and emergency department personnel participated in the study, with 49.5% being female. The mean age of the participants was 34.74±7.04 years. When comparing demographic data, it was found that male participants had significantly lower EAS scores (p

Purpose: The purpose of this study is to examine the relationships between middle school students' school burnout, problem-solving skills, peer relationships, and perceived school experiences and to determine the predictive power of perceived school experiences, problem-solving skills, and peer relationships on academic burnout. Method: The research was created based on the survey model. The sample of the study composed of 2538 secondary school students (1257 girls and 1281 boys) who attended ten official secondary schools during the 2018-2019 academic year. In the research, "Elementary School Student Burnout Scale for Grades 6-8", "Problem Solving Inventory for Children at the Level of Primary Education", "Peer Relationship Scale" and "Perceived School Experiences Scale" were used. Pearson Product Moment Correlation Analysis and Multiple Hierarchical Regression Analysis were used for the statistical analysis of the study. "p[less than or equal to]0.05" was considered as the significance level for the study. Findings: According to the study results, it was determined that there are significant relationships between the predicted variable and the predictor variables. Significant predictors of the school burnout score were determined to be variables of gender and age, school engagement, academic motivation, confidence in problem-solving skills, self-control, avoidance, self-disclosure and loyalty subscales, respectively. Implications for Research and Practice: The importance of including activities related to protective factors in individual and group counselling services planned to prevent or reduce students' school burnout was emphasized. Risk factors that may affect school burnout are discussed and recommendations are made for further research.

The purpose of this study is to examine the effect of career days on 10th grade students' irrational beliefs about career choice and on their career decision-making skills. This research was conducted in two high schools affiliated to the Ministry of National Education in the 2019-2020 academic year. There are totally 102 students in the experimental and control groups. In the research, a quasi-experimental model with pretest-posttest control group was used. Within the scope of the research, ten-week career days were organized for the students in the experimental group. No career days were organized for the students in the control group. In the study, personal information form, irrational beliefs relating to career choice scale and career decision inventory were used as data collection tools. Frequency, Percentage and Arithmetic Average analysis was used for statistical information on demographic variables; Mann Whitney U test was used for the significance of the pre-test post-test difference scores of the experimental and control groups. As a result of the research it has been observed that career days are effective in reducing the irrational beliefs relating to career choice and career indecisions of the students in the experimental group. The results of this study emphasize the importance of career days on students' irrational beliefs about career choice and career decision making skills. The research findings were discussed and suggestions for future research and applications were developed. [Note: The page range (454-467) shown on the PDF is incorrect. The correct page range for this article is p454-466.]

The sixth cranial nerve (CN VI) is a rare site of complication associated with spinal anesthesia and can produce secondary symptoms of ocular muscle palsy. A 38-year-old man was admitted to the emergency department with complaint of diplopia and limited lateral gaze in the first week after endoscopic urological surgery under spinal anesthesia. Isolated unilateral CN VI palsy was considered after excluding differential diagnoses. Ocular palsy and diplopia regressed with conservative treatment during follow-up, and the patient was discharged. This article aims to show that CN VI palsy is a rare complication of spinal anesthesia, which can be observed in the emergency department.

Background: Disasters cause significant material and spiritual destruction within communities, resulting in significant damage to societal structures. Objective: This study aims to assess disaster awareness and attitudes toward disasters among emergency and disaster management students. Materials and Methods: This study included undergraduate students enrolled in the Department of Emergency and Disaster Management during the 2022–2023 academic year. A total of 85 students participated in this study and were contacted via an online Google form to assess their disaster awareness and attitudes toward disasters. The survey, consisting of a total of 23 items, was designed to assess participants’ cognitive, affective, and behavioral characteristics. Results: The study included 85 participants studying in the Emergency and Disaster Management department. Females made up 64.7% of the participants. The mean score of the responses given in the cognitive subfactor was 2.69 ± 0.56, the mean score of the responses given in the affective subfactor was 3.13 ± 0.47, and the mean score of the responses given in the behavioral subfactor was 2.67 ± 0.76. Conclusion: Having previously experienced a disaster, being male, belonging to a higher socio-economic class, and being older increase the average Disaster Attitude Scale score, and the increase in the average score indicates an increase in disaster awareness.

Heart failure (HF) is a structural and functional disease that affects millions of people worldwide. The role of inflammation has been demonstrated in many diseases. However, the impact of the Systemic Inflammatory Response Index (SIRI) and the Systemic Immuno-Inflammation Index (SII) on mortality in HF patients has not been adequately investigated. Therefore, in this study, we aimed to demonstrate the effect of SIRI and SII on mortality in patients diagnosed with HF.

We evaluated the association between implementation of state-mandated pulse oximetry screening (POS) and rates of emergency hospitalizations among infants with Critical Congenital Heart Disease (CCHD) and assessed differences in that association across race/ethnicity. We hypothesized that emergency hospitalizations among infants with CCHD decreased after implementation of mandated POS and that the reduction was larger among racial and ethnic minorities compared to non-Hispanic Whites. We utilized statewide inpatient databases from Arizona, California, Kentucky, New Jersey, New York, and Washington State (2010-2014). A difference-in-differences model with negative binomial regression was used. We identified patients with CCHD whose hospitalizations between three days and three months of life were coded as emergency or urgent or occurred through the emergency department. Numbers of emergency hospitalizations aggregated by month and state were used as outcomes. The intervention variable was an implementation of state-mandated POS. Difference in association across race/ethnicity was evaluated with interaction terms between the binary variable indicating the mandatory policy period and each race/ethnicity group. The model was adjusted for state-specific variables, such as percent of female infants and percent of private insurance. We identified 9,147 CCHD emergency hospitalizations. Among non-Hispanic Whites, there was a 22% (Confidence Interval [CI] 6%-36%) decline in CCHD emergency hospitalizations after implementation of mandated POS, on average. This decline was 65% less among non-Hispanic Blacks compared to non-Hispanic Whites. Our study detected an attenuated association with decreased number of emergency hospitalizations among Black compared to White infants. Further research is needed to clarify this disparity.

Cet article démontre comment le législateur congolais a protégé la maternité en révisant le code du travail et en votant la loi fixant les règles relatives au régime général de sécurité sociale. Cependant, au regard d’un constat amer sur terrain, l’exécution de certaines dispositions de ladite loi souffre encore de la non-application dans le chef de certains employeurs, surtout dans le secteur privé. Aussi, il se constate que la majorité de femmes travailleuses ignorent encore leurs droits, faute de sensibilisation et de vulgarisation du nouveau code du travail et de la loi fixant les règles relatives au nouveau régime de sécurité sociale en RDC, ce qui constitue encore un autre handicap pour l’application stricte de la volonté du législateur congolais. Cette étude se veut un véritable canal de sensibilisation du personnel féminin, des employeurs et de tout autre membre de la société congolaise sur la protection de maternité.

Background: Renal colic is a frequently encountered condition in the emergency department (ED), characterized by the sudden and severe onset of flank pain. To assess the risk of cardiac arrhythmia in patients with renal colic, electrocardiography (ECG) was used to investigate several ventricular arrhythmia characteristics, such as the Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio.Objective: This study aimed to investigate the role of the Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio as cardiac arrhythmia stimulators in patients with renal colic. By evaluating these parameters, the risk of developing cardiac arrhythmia in individuals with renal colic could be better understood.Methods: The study included patients who presented to the tertiary emergency department with renal colic over a period of six months, from June 10, 2022, to December 31, 2022. Upon admission, all patients underwent an ECG, and measurements of QT interval and Tp-e interval were conducted in leads D2 and V5. These measurements served as indicators for assessing the potential risk of cardiac arrhythmia in patients with renal colic.Results: The levels of D2 TPE were significantly elevated in patients experiencing renal colic attacks compared to both the pain-free period and the control group (p=0.036). Additionally, the levels of D2 Tpe and QTc were significantly higher during the renal colic attack period as well as the pain-free period when compared to the control group (p=0.041).Conclusions: The Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio may potentially be associated with fatal ventricular arrhythmias in patients who present to emergency departments with renal colic pain.

Cam, şekillendirilmesi oldukça zor ve maliyetli bir malzemedir. Özellikle geleneksel yöntemler kullanılarak elde şekillendirilen cam, bazı formların oluşturulmasında zorlayıcı olabilmekte, bu durum da camı şekillendiren kişiyi tasarım ve uygulama yönünden sınırlandırabilmektedir. Ancak son zamanlarda araştırmaları ve denemeleri yapılan üç boyutlu cam yazıcıların, gelecekte cam alanında çalışanlar için de alternatif bir şekillendirme yöntemi sunacağı aşikârdır. Bunun sonucunda, cam alanında yapılan araştırma ve çalışmaların hangi aşamada olduğunu analiz etmek ve gelişime yön verebilmek için bu araştırmaya ihtiyaç doğmuştur. Dolayısıyla çalışmanın amacı, cam alanında kullanılan uygulama yöntemlerindeki değişimleri göz önünde bulundurarak, üç boyut yazıcıların cam ürün tasarımında kullanılabilirliğini araştırmaktır. Bu bağlamda çalışmanın araştırılmasında, nitel veri toplama yöntemleri olan gözlem ve doküman analizi kullanılarak üç boyutlu yazıcılar hakkında bilgi elde edilmiştir. Akademik yazılı kaynaklar, internet kaynakları ve çalışmalar incelenerek üç boyutlu yazıcılar ve uygulama çeşitlilikleri hakkında bilgi edinilmiştir. Ayrıca, bu teknoloji ile cam ürün denemeleri yapan özel firmaların ürün üretim süreçleri ve sonuçları incelenerek teknolojinin avantajları ve dezavantajları belirlenmiştir. Çalışmanın sonucunda, üç boyutlu yazıcıların camın şekillendirilmesinde kullanılabilirliği değerlendirilmiş ve bu teknolojiyle üretilen cam nesnelerin henüz prototip aşamasında olduğu gözlenmiştir. Ancak geleneksel yöntemlerle şekillendirilmesi zor olan cam formların, gelişim sürecindeki bu yeni üretim yöntemiyle, gelecekte daha kolay üretilebileceği ve tasarım alanına da adapte edilebileceği görülmüştür.

ObjectiveTo assess differences in rates of postpartum hospitalisations among homeless women compared with non-homeless women.DesignCross-sectional secondary analysis of readmissions and emergency department (ED) utilisation among postpartum women using hierarchical regression models adjusted for age, race/ethnicity, insurance type during delivery, delivery length of stay, maternal comorbidity index score, other pregnancy complications, neonatal complications, caesarean delivery, year fixed effect and a birth hospital random effect.SettingNew York statewide inpatient and emergency department databases (2009-2014).Participants82 820 and 1 026 965 postpartum homeless and non-homeless women, respectively.Main outcome measuresPostpartum readmissions (primary outcome) and postpartum ED visits (secondary outcome) within 6 weeks after discharge date from delivery hospitalisation.ResultsHomeless women had lower rates of both postpartum readmissions (risk-adjusted rates: 1.4% vs 1.6%; adjusted OR (aOR) 0.87, 95% CI 0.75 to 1.00, p=0.048) and ED visits than non-homeless women (risk-adjusted rates: 8.1% vs 9.5%; aOR 0.83, 95% CI 0.77 to 0.90, p

Abstract The CRISPR-Cas9 system has revolutionized our ability to precisely modify the genome and has led to gene editing in clinical applications. Comprehensive analysis of gene editing products at the targeted cut-site has revealed a complex spectrum of outcomes. ON-target genotoxicity is underestimated with standard PCR-based methods and necessitates appropriate and more sensitive detection methods. Here, we present two complementary Fluorescence-Assisted Megabase-scale Rearrangements Detection (FAMReD) systems that enable the detection, quantification, and cell sorting of edited cells with megabase-scale loss of heterozygosity (LOH). These tools reveal rare complex chromosomal rearrangements caused by Cas9-nuclease and show that LOH frequency depends on cell division rate during editing and p53 status. Cell cycle arrest during editing suppresses the occurrence of LOH without compromising editing. These data are confirmed in human stem/progenitor cells, suggesting that clinical trials should consider p53 status and cell proliferation rate during editing to limit this risk by designing safer protocols.

Thanks to its very high genome-editing efficiency, CRISPR-Cas9 technology could be a promising anticancer weapon. Clinical trials using CRISPR-Cas9 nuclease to ex vivo edit and alter immune cells are ongoing. However, to date, this strategy still has not been applied in clinical practice to directly target cancer cells. Targeting a canonical metabolic pathway essential to good functioning of cells without potential escape would represent an attractive strategy. We propose to mimic a genetic metabolic disorder in cancer cells to weaken cancer cells, independent of their genomic abnormalities. Mutations affecting the heme biosynthesis pathway are responsible for porphyria, and most of them are characterized by an accumulation of toxic photoreactive porphyrins. This study aimed to mimic porphyria by using CRISPR-Cas9 to inactivate UROS, leading to porphyrin accumulation in a prostate cancer model. Prostate cancer is the leading cancer in men and has a high mortality rate despite therapeutic progress, with a primary tumor accessible to light. By combining light with gene therapy, we obtained high efficiency in vitro and in vivo, with considerable improvement in the survival of mice. Finally, we achieved the preclinical proof-of-principle of performing cancer CRISPR gene therapy.

Abstract Background Pancreatic ductal adenocarcinoma is a deadly malignancy resistant to current therapies. It is critical to test new strategies, including tumor-targeted delivery of therapeutic agents. This study tested the possibility to target the transfer of a suicide gene in tumor cells using an oncotropic lentiviral vector. Results Three cell surface markers were evaluated to target the transduction of cells by lentiviruses pseudotyped with a modified glycoprotein from Sindbis virus. Only Mucin-4 and the Claudin-18 proteins were found efficient for targeted lentivirus transductions in vitro. In subcutaneous xenografts of human pancreatic cancer cells models, Claudin-18 failed to achieve efficient gene transfer but Mucin-4 was found very potent. Human pancreatic tumor cells were modified to express a fluorescent protein detectable in live animals by bioimaging, to perform a direct non invasive and costless follow up of the tumor growth. Targeted gene transfer of a bicistronic transgene bearing a luciferase gene and the herpes simplex virus thymidine kinase gene into orthotopic grafts was carried out with Mucin-4 oncotropic lentiviruses. By contrast to the broad tropism VSV-G carrying lentivirus, this oncotropic lentivirus was found to transduce specifically tumor cells, sparing normal pancreatic cells in vivo. Transduced cells disappeared after ganciclovir treatment while the orthotopic tumor growth was slowed down. Conclusion This work considered for the first time three aspect of pancreatic adenocarcinoma targeted therapy. First, lentiviral transduction of human pancreatic tumor cells was possible when cells were grafted orthotopically. Second, we used a system targeting the tumor cells with cell surface antigens and sparing the normal cells. Finally, the TK/GCV anticancer system showed promising results in vivo. Importantly, the approach presented here appeared to be a safer, much more specific and an as efficient way to perform gene delivery in pancreatic tumors, in comparison with a broad tropism lentivirus. This study will be useful in future designing of targeted therapies for pancreatic cancer.

Aim: Acute pancreatitis (AP) is a disease with inflammation, and patients present with severe acute upper abdominal pain in emergency departments. AP can result in higher mortality as its clinical severity increases. Therefore, in this study, we want to investigate the clinical utility of the systemic inflammation response index (SIRI) and systemic immune-inflammation index (SII) in showing the severity of AP. Material and methods: Among the patients admitted to our emergency department between January 2020 and December 2022, 201 patients diagnosed with AP were included in the study. These patients were divided into two groups according to the severity of the disease as mild and severe AP (MAP and SAP). Demographic data and laboratory data of the patients (white blood cell count, such as SIRI, SII and C-reactive protein, SIRI, SII and C-reactive protein) were recorded. Differences between groups of AP patients divided according to disease severity were analyzed. Results: 165 (82.1%) patients had MAP and 36 (17.9%) patients had SAP. 52.8% of the patients were male. The mean of the SAP group was significantly higher than the SII MAP group (3165.71±3058.42 vs.1043.31±849.15; p Conclusion: High SII and SIRI are useful markers that can show the severity of AP. Key words: acute pancreatitis severity, SII, SIRI, biomarker

The goal of this work is to build a low cost pedagogical device able to improve the comprehension of weather phenomena for African students in particular and in general for students across the world. This experimental and didactic device can be seen as an easy teaching tool to measure meteorological and climatic data. This structure is called a micro weather station. The investigation is done in Metipkwale one of the village of Ebolowa town in Cameroon (Central Africa). Some weather data automatically obtained from the micro weather station (sensors) such as temperature, humidity and pressure, are directly transmitted by a modem (Wi-Fi connection) to the ThingSpeak platform in order to be registered online and plotted as a diagram. The illustration process is assured by a computer or a smartphone. Moreover, the prediction process of climatic behaviour and the reactions of students have been also outlined. Further, some notions such as Internet of Things and Deep Learning associated with exponential smoothing algorithms are also presented.