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Aims and Objectives To evaluate the effectiveness of cold application methods in reducing postpartum episiotomy pain. Background Many women suffer from pain after giving birth due to an episiotomy. This prolonged pain affects their daily lives as they recover. Various methods can help alleviate this pain; however, the effects of cold application specifically are still under discussion. Design Systematic review and meta-analysis were used. Methods In this review, we investigated studies from the CINAHL, PubMed, Google Scholar and Science Direct databases that met PICOS inclusion criteria. We also assessed the studies' methodological quality with the JADAD and JBI checklists. This study was performed based on the Guidelines of Systematic Reporting of Examination presented in the PRISMA checklist (Appendix S1). The search protocol has been registered at the PROSPERO International Prospective Register of Systematic Reviews. Results A total of seven published studies including 700 total participants were included in this review. Various cold application methods (cold gel pack/pad, crushed ice gel pad, ice pack) significantly reduced the pain after an episiotomy. Ice packs in particular did not significantly differ from lavender oil and acupressure in reducing pain after an episiotomy. Conclusions Cold application methods can be an effective, non-pharmacological midwifery and nursing intervention to reduce pain after an episiotomy. Relevance to clinical practice The use of cold application methods to reduce pain after episiotomy may reduce the need for pharmacological medication in women due to the reduction in pain in the perineum.

Structural Equation Models (SEMs) with latent variables provide a general framework for modelling relationships in multivariate data. Although SEMs are most commonly used in studies involving intrinsically latent variables, such as happiness, quality of life, or stress, they also provide a parsimonious framework for covariance structure modelling. For this reason, they have become increasingly used outside of traditional social science applications. Frequentist inferences are based on point estimates and hypothesis tests for the measurement and latent variable parameters. Although most of the literature on SEMs is frequentist, Bayesian approaches have been proposed in the last years. This study aims to provide an easily accessible overview of a Classic and a Bayesian approach to SEMs. Due to the flexibility of the Bayesian approach, it is straightforward to apply the method in a comprehensive class of SEM-type modelling frameworks, allowing nonlinearity, interactions, missing data, mixed categorical, count, and continuous observed variables. The WinBUGS software package, which is freely available, can be used to implement Bayesian SEM analysis. Bayesian model fitting typically relies on MCMC, which involves simulating draws from the joint posterior distribution of the model unknowns (parameters and latent variables) through a computationally intensive procedure. The advantage of MCMC is that there is no need to rely on broad sample assumptions because exact posterior distributions can be estimated for any function of the model unknowns. In small to moderate samples, these exact posteriors can provide a more realistic measure of model uncertainty. Therefore, we use the MCMC method for the Bayesian approach in this study. All approaches given above are applied to the data obtained from Samsun Chamber of Commerce and Industry.

Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral zoonosis. The incidence of zoonotic diseases has been shown to be affected by climatic factors. In this study, we evaluated patients endemic to the CCHF region and examined the relationship between the number of patients and climatic properties of the region where they lived. The study included 548 CCHF patients. Along with the patient demographic and clinical characteristics, we recorded temperature, humidity and precipitation in the places where they lived at the time of their admission to the hospital. In addition to temperature, humidity and precipitation at the time of patient admission, these values were assessed at one month and three months prior to admission. The relationship between the number of patients and the above-mentioned values was examined. Humidity at the time of and one month prior to hospital admission, and precipitation three months prior to hospital admission were found to affect the number of patients admitted to the hospital for CCHF. In conclusion, climate appeared to affect the number of CCHF patients. We believe that the number of patients presenting to the hospital with CCHF could be predicted by taking into account climatic properties of the places where CCHF has been recorded, along with under-taking necessary measures., Krimsko-kongoanska hemoragijska groznica (KKHG) je virusna zoonoza koju prenose krpelji. Dokazano je da klimatski čimbenici utječu na incidenciju zoonotskih bolesti. U ovom smo istraživanju ispitivali bolesnike endemske za područje KKHG te odnos broja bolesnika i klimatskih svojstava područja u kojem oni žive. U istraživanje je bilo uključeno 548 bolesnika s KKHG. Uz demografske i kliničke značajke bolesnika bilježili smo temperaturu, vlagu i količinu padalina u mjestu gdje su bolesnici živjeli u vrijeme prijma u bolnicu. Uz vrijednosti temperature, vlage i količine padalina u vrijeme prijma bolesnika u bolnicu, vrijednosti ovih parametara procijenjene su za jedan mjesec i tri mjeseca prije prijma u bolnicu. Tada smo ispitali odnos broja bolesnika i gore spomenutih vrijednosti. Pokazalo se da razina vlage u vrijeme prijma i jedan mjesec prije prijma u bolnicu, kao i količina padalina tri mjeseca prije prijma u bolnicu utječu na broj bolesnika primljenih u bolnicu zbog KKHG. U zaključku, čini se da klima utječe na broj bolesnika s KKHG. Vjerujemo da bi se broj bolesnika koji dolaze u bolnicu zbog KKHG mogao predvidjeti uzimajući u obzir klimatska svojstva u mjestima gdje je zabilježena KKHG, a time bi se isto tako mogle poduzeti odgovarajuće mjere.

WOS: 000505058700028 As a first contact point of a company with customers, call centers are important to keep customers happy and satisfied. There are key performance metrics and other minimum requirements that a Call Center has to meet. In order to improve service quality, performance metrics are monitored by routine daily calls. In this study, the performance metrics of an inbound hospital call center located in Samsun were studied to measure and understand the variability in performance metrics. The control charts were used to detect assignable causes of variability in average speed of answer, abandonment rate and service level so that necessary precautions can be taken to improve process. Since autocorrelation was recognized in data, Autoregressive Integrated Moving Average (ARIMA) model was used to model correlative structure and then control chart were applied to the independent and identically distributed stream of residuals. ARIMA (6,1,1) for all performance metrics was determined as the best time series model to eliminate autocorrelation. The results showed that the call center process was not under statistical control and sources of variability should be investigated and eliminated.

Teknoloji kullanımın her geçen gün artmasıyla birlikte sosyal medya ve internet kullanımı hızla yaygınlaşmaktadır. Özellikle sosyal medya kullananların sayısının artmasıyla insanlar duygu ve düşüncelerini, gündemle ilgili görüş ve fikirlerini sosyal medya araçlarını kullanarak paylaşmaktadır. En çok kullanılan sosyal medya araçlarından biri olan Twitter ve Facebook gibi sosyal ağ uygulamalarında paylaşılan içerikler yapısal olmayan veri türleridir. Bunun gibi yapısal olmayan metin içerikli verilerin yapısal hale dönüştürülmesinde ve analiz edilmesinde metin madenciliği yöntemleri kullanılmaktadır. Bu çalışmada, 24 Haziran Cumhurbaşkanlık ve Milletvekili Seçimlerinde ‘Tamam’ ve ’Devam’ etiketleriyle atılan tweetler metin madenciliği yöntemleri kullanılarak analiz edilmiştir. Metin ön işlem aşamasında kelimelerin köklerini bulmak için Zemberek kök bulma yöntemi ve ağırlıklandırma yöntemi olarak ise terim frekansı (TF) ağırlıklandırma yöntemi uygulanmıştır. Oluşturulan sınıflar arasındaki ilişkiyi ölçmek amacıyla korelasyon analizi yapılmıştır. Kruskal Wallis Testi ile frekans terim ağırlıklarının sınıflara göre farklılığı test edilmiştir. Elde edilen özelliklerin terim frekansı (TF) değerlerine göre kelime bulutları oluşturulmuştur., As the use of technology increases day by day, the use of social media and internet is rapidly spreading. Especially with the increasing number of people who use social media, people share their feelings and thoughts, opinions and ideas about the agenda by using social media tools. Contents that is shared in social network applications like Twitter and Facebook, one of the most used social media tools, are non-structural data types. Text mining methods are used to transform non-structured textual data such as these into structured and analyze data. In this study, the tweets shared with the tags 'Tamam' and 'Devam' in the 24 June Presidential and Parliamentary Elections were analyzed using text mining methods. The Zemberek stemming method were used to find words root and the term frequency (TF) weighting method were used as the weighting method at text pre-processing stage. Correlation analysis was performed to measure the relationship between the created classes. With Kruskal Wallis Test, the frequency term weights were tested according to the classes. Word clouds was formed according to the term frequency (TF) values of the obtained features.

Summary Objective The aim of this experimental study was to investigate whether hypertonic saline or sodium bicarbonate administration prevented the development of cardiotoxicity in rats that received toxic doses of amitriptyline. Method Thirty-six Sprague Dawley rats were used in the study. The animals were divided into six groups. Group 1 received toxic doses of i.p. amitriptyline. Groups 2 and 3 toxic doses of i.p. amitriptyline, plus i.v. sodium bicarbonate and i.v. hypertonic saline, respectively. Group 4 received only i.v. sodium bicarbonate, group 5 received only i.v. hypertonic saline, and group 6 was the control. Electrocardiography was recorded in all rats for a maximum of 60 minutes. Blood samples were obtained to measure the serum levels of sodium and ionised calcium. Results The survival time was shorter in group 1. In this group, the animals’ heart rates also decreased over time, and their QRS and QTc intervals were significantly prolonged. Groups 2 and 3 showed less severe changes in their ECGs and the rats survived for a longer period. The effects of sodium bicarbonate or hypertonic saline treatments on reducing the development of cardiotoxicity were similar. The serum sodium levels decreased in all the amitriptyline-applied groups. Reduction of serum sodium level was most pronounced in group 1. Conclusion Empirical treatment with sodium bicarbonate or hypertonic saline can reduce the development of cardiotoxicity during amitriptyline intoxication. As hypertonic saline has no adverse effects on drug elimination, it should be considered as an alternative to sodium bicarbonate therapy.

WOS: 000402799800005 Objectives: The aim of this study is to develop the scale of Self-perception of Pregnants, and to determine validity and reliability of that scale. Methods: The sample of present study consists of 326 volunteer pregnants who applied for their routine controls at Ondokuz Mayis University, Faculty of Medicine. The Cronbach alpha value is found by analyzing inner consistency to determine the reliability of the scale. In addition, explanatory factor analysis is used for the construct validity of the scale. Results: Exploratory factor analysis revealed that the structure of scale is involved in 12 items and two components. The Cronbach Alpha reliability coefficient calculated for the first factor was found to be 0.86; and the Cronbach Alpha was 0.75 for the second factor. A total of 12 items are identified by factor analysis in which the 33.28% of the total variance is explained with factor 1, and the 53.83% of the total variance is explained with factor 2. It is indicated that the Kaiser-Meyer-Olkin coefficient of the scale is 0.86, and the factor loads are between 0.38 and 0.95. The Chi-square value is found to be significant in factor analysis (chi(2)= 128.117; sd= 50, p= 0.00). According to confirmatory factor analysis' results, GFI (. 92), NFI (. 94), RMSEA (. 078), CFI (. 96), AGFI (. 88) as goodness fit indices were calculated and the findings indicated the model was fit to observed structure. Conclusion: The findings of reliability studies, exploratory and confirmatory factor analysis studies revealed that the scale was reliable and valid data collection tool to identify the pregnants' self-perception level.

Bu çalışmada, grup ardışık test yöntemlerinin sağkalım analizinde uygulamaları için kullanılabilecek uygun örnek hacmi büyüklüğü değerleri araştırıldı. Klinik çalışmalarda iki tedavi yöntemi/grubu karşılaştırılıyorsa, çalışmanın sonu beklenmeden hangi tedavi yönteminin/grubunun daha iyi sonuç verdiği grup ardışık test yöntemleri ile tespit edilebilir. Böylece belli bir aşamadan sonra hastalar diğer tedavi yöntemine/grubuna yönlendirilerek, hastaların sağkalım süreleri uzatılabilir. Bu tür çalışmalarda örnek hacminin kaç alınacağı ve hastalardan ne kadarının ölü olacağı, ne kadarının sansürlü olacağı önemli bir sorundur. Bunun için grup ardışık test yöntemlerinde kullanılan 5 harcama fonksiyonu için simülasyon çalışması yapıldı. Her bir harcama fonksiyonu için örnek hacmi değerleri ve çalışmada gerçekleşmesi beklenen ölü birey sayıları bulundu

Lung contusion is an important factor that affects mortality and morbidity of lung injury after blunt chest trauma (BCT). The present study aims to evaluate the effectiveness of different treatment regimens on BCT-induced lung injury.A total of 35 Sprague Dawley rats were divided into five experimental groups (n=7): sham, control; BCT; BCT + MP, BCT group treated with methylprednisolone (MP; 30 mg/kg on first day and 3 mg/kg/d on the following days); BCT + Q, BCT group treated with quercetin (Q; 50 mg/kg/d for seven days); and BCT + MP + Q, BCT group treated with the same doses of MP and Q. Serum Clara Cell Protein-16 (CC-16), thiobarbituric acid reactive substances (TBARS), and superoxide dismutase (SOD) levels were analyzed to determine histopathological changes in the lung tissues.Elevated serum CC-16 and TBARS levels and reduced serum SOD levels were found in the BCT group compared to the Sham group. There was a significant change in the serum CC-16 levels in the BCT + MP group compared to the Sham group. Serum TBARS levels were significantly lower in the BCT + MP and BCT + Q group compared to the BCT group. The combined therapy regimen yielded significantly decreased CC-16 levels and increased serum SOD levels compared to the individual treatment groups. Serum TBARS levels did not significantly differ between the BCT + MP + Q group and the other treatment groups. Compared to the BCT + MP + Q group, the BCT + MP group showed significantly lower alveolar edema (AED) and alveolar exudate (AEX) scores, while the BCT + Q group showed significantly lower peribronchial inflammatory cell infiltration (PICI) and AED scores.The combined usage of quercetin and low dose MP treatment after initial high dose MP at the early stage of lung injury after BCT is more effective.

WOS: 000341415700009 PubMed: 24577981 The aim of the study was to describe the characteristics of patients who applied to the Emergency Department (ED) due to submersion injury; to recognize the risk factors, complications, causes of death, and the educational needs of families and caregivers about unsafe environments for submersion; and to develop preventive strategies. All patients were analyzed retrospectively according to demographic features, clinical and laboratory findings, association between clinical variables and submersion injuries, and patient outcomes. Fifty-five patients with submersion injury were analyzed. The mean age of patients was 10.9 +/- 4.7 years. The most common Szpilman clinical scores were Grade 1 (24 patients, 43.8%), Grade 2 (15 patients, 27.3%), and Grade 5 (10 patients, 18.2%). The common location of the submersion injuries included the sea (74.5%), pool (18.4%), bathtub (7.3%), river (3.6%), and lake (3.6%). A limited swimming ability or exhaustion and suffocation (49.1%) due to unknown reasons were the most common causes of submersion injury among all patients. Most complications were due to aspiration pneumonia and hypoxic ischemic encephalopathy (HIE). Thirty-nine patients (70.9%) were followed in the ED, while 16 patients (29.1%) were admitted to the pediatric intensive care unit (PICU); 11 patients (20.0%) died. All of the risk factors of drowning should be taken into account when designing preventive measures and family education. In addition, all pediatricians should be trained periodically about the complications of submersion and the treatment strategies, particularly in coastal cities and areas where drownings occur frequently.

Kayhan, Servet/0000-0003-4226-2781; yilmaz, adnan/0000-0001-9769-9791 WOS: 000328462500017 PubMed: 24255777 Background and objective: Recent evidence suggests that YKL-40 is a relatively new biomarker of inflammation and it is involved in the pathogenesis of several pulmonary diseases. Details of serum and pleural YKL-40 in pleural effusions however, remain unknown. We aimed to assess whether serum and pleural YKL-40 is an accurate biomarker of pleural effusions. Methods: This clinical study was prospective, observational and cross-sectional. the concentrations of serum and pleural fluid YKL-40 and conventional pleural marker levels were measured in 80 subjects with pleural effusions, including 23 transudates caused by congestive heart failure (CHF), and 57 exudates including 23 parapneumonic, 22 malignant and 12 tuberculous pleural effusions (TBPEs). Results: Median pleural fluid YKL-40 levels were higher in exudates than in transudates (219.4 and 205.9 ng/mL, respectively, P215 ng/mL, yielded a 73% sensitivity, 73% specificity, likelihood ratio 2.8 for diagnosing exudate, with an area under the curve of 0.770 [95% confidence intervals (CI): 0.657-0.884]. Pleural YKL-40/serum YKL-40 ratio >1.5 yielded a 75% sensitivity, 72% specificity and likelihood ratio 2.6 for diagnosing TBPE, with an area under the curve of 0.825 (95% CI: 0.710-0.940). Conclusions: High concentrations of pleural YKL-40 level may help to differentiate exudate from transudate and a high pleural YKL-40/serum YKL-40 ratio may be helpful in seperating TBPE from non-tuberculous effusions.

Taneli ürünler muhafaza edildiği depo ve silolarda yatay ve düşey doğrultularda basınç oluştururlar. Depolanmış taneli ürünlerin oluşturduğu ürün basıncının saptanmasında ürünün yarı akışkan sıvı özelliğine sahip olduğu esası temel alınır. Bu bağlamda ürün basıncına yönelik mühendislik hesaplamalarda klasik yöntemler kullanılmaktadır. Bu çalışmada, konuya yönelik kullanılabilir bir bilgisayar programı geliştirilmiştir., Taneli ürünler muhafaza edildiği depo ve silolarda yatay ve düşey doğrultularda basınç oluştururlar. Depolanmış taneli ürünlerin oluşturduğu ürün basıncının saptanmasında ürünün yarı akışkan sıvı özelliğine sahip olduğu esası temel alınır. Bu bağlamda ürün basıncına yönelik mühendislik hesaplamalarda klasik yöntemler kullanılmaktadır. Bu çalışmada, konuya yönelik kullanılabilir bir bilgisayar programı geliştirilmiştir