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Abstract Background The present study aimed to determine the problems, unmet needs and expectations of phenylketonuria (PKU) patients in Türkiye regarding follow-up and treatment in order to provide data for future planning and implementations on PKU. Methods The study included patients diagnosed with PKU and/or their parents. They were informed about the study via phone calls and their verbal consents were obtained. Questions in the data collection forms, which were established separately for pediatric, adolescent, and adult age groups, were applied during the interviews and the answers were recorded. Results Among 182 classical PKU patients, 66 (36.3%) were in the pediatric group (0–12 years old), 44 (24.2%) were in the adolescent group (13–19 years old), and 72 (39.5%) were in the adult group (≥ 20 years old). In all patient groups, phenylalanine-restricted diet and medical nutrition products were the main options for treatment. The median of the last measured blood phenylalanine concentration (patient-reported) was 290 µmol/L, 425 µmol/L, and 750 µmol/L in the pediatric, adolescent, and adult groups, respectively. The frequency of blood testing for serum phenylalanine level according to the age groups was appropriate in nearly half of the patients. While the majority of the patients have been visiting the metabolism center they have been diagnosed with PKU for control, considerable proportion of the patients would like to change the center or the doctor they visit for control if they could. It was determined that nearly half of the patients had trouble in accessing the metabolism center. Treatment options’ being limited and expensive were the major problems. The main requests of the patients and patient relatives included easier access to the metabolism centers and more options for treatment and diet. Conclusions Access to the services should be easier to improve the patients’ follow-up and treatment. There is need for low-cost, easily applicable, and accessible nutrition products and effective novel pharmacological agents. Focusing on these issues in health policies by providing pedagogic/psychological support, establishing support programs also comprising the families, and increasing the awareness activities were the key outcomes.

Over the past decades, increase in food shortages and food costs with the drought caused by population growth and climate change, it becomes more important to prevent food losses with the widespread use of cold storage. That’s why many countries provide incentives for the widespread use of cold stores. However, with cold storages becoming more widespread, keeping energy consumption under control becomes an important issue. Especially in most developing countries, the status and energy performance of installed cold stores are unknown. In this study, energy consumption data were examined by using data from cold stores from different countries. The relationships between some parameters (capacity, volume, etc.) affecting energy consumption were analyzed for 67 established cold stores. In order to measure the energy consumption data of the system under ideal operating conditions, experiments were carried out in the test room under laboratory conditions and comparisons were made according to the data obtained from the field. The data obtained showed that energy consumption in cold stores increased by up to 30%, depending on operating conditions. Therefore, it is very important that cold stores are inspected by the relevant institutions after they are established and during their operation.

Researchers state that people spend about 90 percent of their time indoors, and accordingly, the place of HVAC systems in our lives is increasing day by day. This brings about an increase in energy consumption. Considering the amount of energy consumption for developed and developing countries today, it is seen that the role of HVAC systems is quite high. Therefore, energy consumption costs and investment costs are the main factors to be considered in HVAC system selection. In this study, for a sample office building, six different HVAC systems (water-cooled and air-cooled variable flow cooling systems, air handling unit system, fan coil systems, water source and air source heat pump systems and split air conditioning system) are analyzed in terms of energy consumption, initial investment costs, operating costs and ease of operation. The advantages and disadvantages of the systems were compared with each other, and as a result of the calculations, it was seen that air-cooled systems consume an average of 33% less energy than water-cooled systems and their investment costs are 30% lower.

Background: The data related to the neurologic manifestations of coronavirus disease 2019 (COVID-19) in children are limited. The frequency of the neurologic manifestations and the risk factors in the development of these symptoms are not clear. Objectives: We aimed to determine the exact frequency of the neurological symptoms in pediatric patients with confirmed COVID-19 and to identify the risk factors for the development of neurological manifestations. Materials and Methods: We included pediatric Covid-19 patients admitted to the Children's Hospital of Ankara City Hospital between March 22 and June 1, 2020. Neurological findings were questioned by interviewing the patients and their families and detailed neurologic examinations were performed within protection measures. Results: A total of 312 pediatric patients with the diagnosis of COVID-19 were enrolled in the study. Sixty-six participants (21.15%) showed neurologic symptoms during COVID-19. Headache was the most common neurologic symptom and present in 14% (n: 44) of the cases. The other neurologic symptoms were myalgia (n: 30, 9.6%), anosmia/hyposmia (n: 6, 1.9%), ageusia (n: 2, 0.6%), and vertigo (n: 1, 0.3%). Neutrophil-to-lymphocyte ratio (NLR) (P = 0.002) and platelet-to-lymphocyte ratio (PLR) (P = 0.001) were significantly elevated in patients with neurological symptoms when compared to the patients without the symptoms. Conclusions: Physicians should be alert to the neurologic involvement of COVID-19 disease in children. NLR and PLR ratios could have a predictive value for the development of neurological manifestations.

Synthetic cannabinoid (locally named ‘Bonzai’ in Turkey) use is increasing worldwide (especially among people with low income). One of its harmful adverse effects is an increase in serum levels of muscle enzymes (i.e., creatine kinase [CK]). The aim of this study was to determine the prevalence of Bonzai use in patients admitted with elevated CK levels and to compare the 1-month survival status of Bonzai users with that of non-Bonzai users. This retrospective study was conducted on a total of 468 patients, median (min-max) age 48±22 (18-93) years. It was found that 10.68% (n=50) of the patients presenting with elevated CK levels were using Bonzai (group 1), while the remaining 418 (89.32%) patients were non-Bonzai users (group 2). Median age was higher in group 2 as compared with group 1 (p=0.001). In group 1, the predominance of male (M) over female (F) patients was interestingly high, yielding a F:M ratio of 1/49 (χ2=110.03, p

Widespread construction of cold storage buildings is important to ensure sustainability of the agricultural industry and reduce food loss. However, the number of cold storage buildings in most developing countries is insufficient because of financial difficulties. Currently, the most critical factor for encouraging investors to finance such projects is the payback period. In this study, the power consumption and profitability of cold storage buildings were investigated based on their capacities using data from selected cold stores in Turkey. The optimal storage capacity was calculated by simulation, and the relationship between the payback period and the capacity of cold stores was analysed using the obtained results. It was found that the amount of power consumed per unit volume for stores with capacities from 100 to 2100 t of apples was 63.8% while that from 2100 to 10000 t was 33.3%. Additionally, the optimal cold storage capacity was determined to be 3500 t with a two-year payback period.

Objectives: Invasive aspergillosis (IA) is an important cause of mortality and morbidity in children with hematological malignancies. The monitoring of serum galactomannan (GM) antigen is considered useful in the diagnosis of IA . The aim of this study was to determine the utility of serum GM monitoring in the early diagnosis of IA and the role of positive antigenemia in the management of children with acute lymphoblastic leukemia (ALL). Methods: The cases of 141 children who were being treated for ALL in the Division of Pediatric Hematology of the Medical School of Ege University between January 2006 and February 2015 were reviewed retrospectively. Cases of proven and probable IA were defined according to the European Organization for the Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria. Results: The incidence of proven and probable IA was 3.5% (5/141). The incidence of positive GM antigenemia among 3264 serum samples was 5.5% (n = 179). Of the cases detected, 21.7% were true-positive, 52.1% were false-positive, and the remaining 26.1% were classified as ‘undetermined.’ An increase in the incidence of true-positive tests and induction of antifungal therapy was determined through multiple consecutive positive tests. Conclusions: GM may be detected in the serum before the clinical signs of IA appear, but its sensitivity and specificity are variable. False-positivity is a significant disadvantage, and consecutive positive GM must be taken into account in the case of clinical and imaging findings that are relevant to IA.

Invasive fungal infections are most commonly seen in immunocompromised patients and usually affect the respiratory system. Gastrointestinal system involvement of mucormycosis and invasive aspergillosis is rarely reported in childhood. Here we describe a 5 year old boy with acute lymphoblastic leukaemia who developed invasive fungal infection particularly affecting the lower gastrointestinal system to emphasise the difficulties in diagnosis and management of invasive fungal infections in immunocompromised patients.

Empirical antifungal therapy is most often given to patients with leukemia. However breakthrough fungal infections under antifungal therapy are not uncommon. Four children, with hematologic malignant disease developed mycotic breakthrough infections while on empirical caspofungin treatment for a median of 14 (range 11–19) days. Trichosporon asahii was detected in the blood culture of two patients and Geotrichum capitatum in the other two (one patient also had positive cerebrospinal fluid culture). Because the patients’ clinical situation worsened, voriconazole was empirically added for two patients three and five days before the agent was detected. The first sterile blood culture was obtained 3–7 days of voriconazole treatment. All patients reached clear cultures but one patient died. One patient with central nervous system infection with G. capitatum had severe neurological sequelae. Very severe fungal infections can occur during empirical caspofungin therapy. Therefore, patients should be followed closely. Keywords: Geotrichum capitatum, Trichosporon asahii, Invazive fungal infection, Febrile neutropenia

Brevibacterium spp. are catalase-positive, non-spore-forming, non motile, aerobic Gram-positive rods that were considered apathogenic until a few reports of infections in immunocompromised patients had been published. To the best of our knowledge, this is the first report of B. casei catheter-related bloodstream infection in a child with acute leukemia. We aim to enhance the awareness of pediatric hematology and infectious disease specialists about this pathogen and review of the literature. Keywords: Brevibacterium casei, Bloodstream infection, Child, Leukemia

BCR-ABL fusion gene t(9;22)(q34;q11) occurs in only 3% of pediatric acute lymphoblastic leukemia (ALL) cases. Previously, less than 40% of Philadelphia-positive ALL patients were cured with intensive chemotherapy. The use of imatinib (340 mg/m2/day) added to an intensive chemotherapy regimen has improved the outcome in this population at 3 years to an event-free survival of 80%. Imatinib treatment alone was administered after remission induction chemotherapy to a patient with Philadelphia-positive ALL who presented with serious chemotherapy toxicity, so that intensive chemotherapy could not be maintained. This is the only patient in the literature who survived remission for more than 2.5 years with imatinib treatment only.

The combined effect of spin-flavor precession (SFP) and the nonstandard neutrino interaction (NSI) on the survival probability of solar electron neutrinos (assumed to be Dirac particles) is examined for various values of ϵ11, ϵ12, and μB. It is found that the neutrino survival probability curves affected by SFP and NSI effects individually for some values of the parameters (ϵ11, ϵ12, and μB) get close to the standard MSW curve when both effects are combined. Therefore, the combined effect of SFP and NSI needs to be taken into account when the solar electron neutrino data obtained by low energy solar neutrino experiments is investigated.

This study aims to investigate and compare mathematics teachers' knowledge of pedagogical content, knowledge of students' understanding and knowledge of instructional strategies, subcomponents of pedagogical content knowledge, student errors in the relationship between perimeter and areas in rectangles, squares, and parallelograms. 10 pre-secondary school in-service mathematics teachers and 10 prospective mathematics teachers participated in the study. The qualitative case research approach was used. To collect the data, an interview form consisting of four questions showing student errors related to perimeter and area was prepared. The participants were asked to comment on the questions given in the form, and their answers were recorded. Later, they were asked to write down their answers to these questions. According to the outcomes, there is a lack of knowledge of students' understanding and knowledge of instructional strategies, which are the subcomponents of the pedagogical content knowledge of prospective mathematics teachers. Moreover, prospective teachers are found to be incompetent as regards the necessary mathematical subject matter knowledge. To prevent difficulties, when the concepts of perimeter and area are taught, instead of giving formulae initially, concrete materials or real-life examples about these concepts should be provided.

Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract. In this report, we aimed to represent a case of intestinal perforation, caused by double Meckel’s diverticulum, which is a very rare entity in surgical practice. The patient was a 20-year-old Caucasian man, admitted to hospital with complaints of abdominal pain, nausea, and vomitting during the last 3 days. Physical examination indicated tenderness, rebound, and guarding in the right lower quadrant of abdomen. Abdominal X-ray revealed a few air-liquid levels in the left upper quadrant. In the operation, 2 Meckel’s diverticula were observed, one at the antimesenteric side, at 70 cm distance to the ileocecal valve, approximately in 3 cm size, and the other between the mesenteric and antimesenteric sides, approximately in 5 cm size. The first one had been perforated at the tip and wrapped with omentum. A 30 cm ileal resection, including both diverticula with end-to-end anastomosis, was performed. The diagnosis of symptomatic Meckel’s diverticulum is considerably hard, especially when it is complicated. Diverticulectomy or segmentary resections are therapeutic options. In patients with acute abdomen clinic, Meckel’s diverticulum and its complications should be kept in mind, and the intestines should be observed for an extra diverticulum for caution although it is a very rare condition.

The aim of this study is to investigate pre-service mathematics teachers' beliefs towards mathematics and modelling in mathematical modelling processes. To achieve this aim, a phenomenology design was utilized. The study was conducted with 30 elementary level pre-service mathematics teachers receiving mathematical modelling courses. A semi-structured interview form was used to explore teachers' beliefs. At the end of the study, it was seen that mathematical modelling applications caused an increase of application-oriented beliefs. It was also observed that pre-service teachers who had schema and formalism-oriented beliefs evaluated mathematical modelling practices as time consuming and incomprehensible. Findings imply that modelling applications should be included in all levels of mathematics instructional curricula, in addition to the undergraduate curriculum.

This study aims to compare two different learning environments designed online in terms of their contributions to the development of mathematical modelling competencies. In the research, which was designed with the triangulation method, among the mixed research methods in which the qualitative and quantitative research methods are used together. The participants, determined with the purposeful sampling technique, consisted of 53 fourth class students who were studying at the mathematical teaching department of a faculty of education. In the research, while the quantitative data were analyzed with the paired samples t-test and Wilcoxon test, the qualitative data were analyzed with the content analysis. As a result of the analyses, while a significant difference was found in favour of the post-test between the modelling test questions of the pre-service teachers who attended the distance education in groups, the modelling test results of the pre-service teachers who attended individually did not differ. In addition, while it was observed that the participants who attended individually had difficulty in expressing themselves more throughout the process, it was determined that those who worked with groups tried to verify the results they reached more during the modelling process compared with those who participated individually.

This study investigated whether the Science on Stage, a theatre and drama project, taught middle-school students more about the lives and discoveries of great scientists and whether it helped them develop positive views and attitudes towards the science course and scientists. This 8-month study employed an embedded design. The sample consisted of 20 eight graders. Quantitative data were collected using a Scientists Success Test, a Scale of Attitude towards the Science Course, and a Questionnaire of Views on Scientists, and then, were analysed using a one-sample t-test and Wilcoxon signed ranks test. Qualitative data were collected through interviews with a semi-structured interview form developed by the researchers, and then, were analysed using inductive content analysis. The Science on Stage helped participants learn more about the lives and discoveries of great scientists but had no impact on their attitudes towards the science course and scientists. It contributed not only to the history of science but also to academic and personal development. It helped participants recognise scientific facts and develop social and academic skills and made them more curious and motivated about science and art. The study discussed the results with reference to the literature and made suggestions for future research.

This study addressed in-class activities with concrete mathematics (math) materials developed by preservice math and primary school teachers in woodworking workshops and investigated what preservice teachers and primary and secondary school students thought about lectures with those materials. The study employed an embedded mixed design, a predominantly quantitative approach. The sample consisted of 23 preservice math and primary school teachers and 30 secondary school and primary school students in Turkey. Quantitative data were collected using the Torrance Test of Creative Thinking Test. Qualitative data were collected using a Material Design Evaluation Rubric and a Semi-Structured Interview Form. The results showed that the woodworking workshops improved the figural creativity of the preservice math teachers and both the figural and verbal creativity of the preservice primary school teachers. The preservice teachers had no idea about what woodworking workshops were and had difficulty mostly with sandpapering and cutting. The primary and secondary school students stated that they enjoyed using the math materials and learned better. In line with the results of the research, it can be suggested that woodworking workshops be expanded not only in universities but also in primary and secondary schools. [ABSTRACT FROM AUTHOR]