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We introduce a class of rings which is a generalization of reflexive rings and $J$-reversible rings. Let $R$ be a ring with identity and $J(R)$ denote the Jacobson radical of $R$. A ring $R$ is called $J$-reflexive if for any $a, b \in R$, $aRb = 0$ implies $bRa \subseteq J(R)$. We give some characterizations of a $J$-reflexive ring. We prove that some results of reflexive rings can be extended to $J$-reflexive rings for this general setting. We conclude some relations between $J$-reflexive rings and some related rings. We investigate some extensions of a ring which satisfies the $J$-reflexive property and we show that the $J$-reflexive property is Morita invariant.\looseness-1

Background: Hemodialysis treatment for acute kidney injury associated with crush syndrome is very complex. In our study, we summarized the problems and complications experienced by our hemodialysis center after the Kahramanmaraş earthquake. Methods: After the earthquake, our hospital treated 1396 victims. We evaluated the initial indications for dialysis, hemodialysis complications and the mortality of patients undergoing hemodialysis, including crush-related acute kidney injury (n = 82), during the earthquake period. We also compared them with patients who were undergoing hemodialysis (n = 76) in the same period but had end-stage renal failure and acute kidney injury due to other causes (n = 15). Results: After the earthquake, 173 adult patients, 91 (52.6%) of whom were male, with a mean age of 49.5 + 19.7 years, underwent hemodialysis between 6 and 22 February 2023. Patients with crush-related acute kidney injury experienced more complications during hemodialysis, and the increase in creatine kinase activity increased the risk of hemodialysis complications. The most common complications were blood clots in the dialyzer membrane, intradialytic hypotension, and intradialytic insufficient flow. The most frequent indication for initial hemodialysis was hyperkalemia (61, 74.4%). The major problems in the hemodialysis center included inadequate equipment and an insufficient number of experienced health personnel. Conclusions: Hyperkalemia is the most important initial indication for hemodialysis in patients with crush-related acute kidney injury. Crush-related acute kidney injury patients require hemodialysis more frequently, and hemodialysis complications are higher in patients with crush-related AKI, so the hemodialysis treatment of these patients should be more cautious. In an earthquake, hemodialysis centers may face significant challenges, such as damage, transportation issues, power outages, and water outages, which can hinder hemodialysis treatment. [ABSTRACT FROM AUTHOR]

Sexual health is an important part of a healthy life. The aim of this study is to define Behçet's sexual dysfunction and the factors affecting it. Sixty-nine patients with Behçet's disease (BD) and 74 healthy controls were included in the study. International Index of Erectile Function (IIEF), the Female Sexual Function Index (FSFI), the Beck Depression Inventory (BDI), and the Short Form Health Survey (SF-36) were filled out by patients and healthy control group (HCG). Follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin and estradiol or testosterone levels according to gender were measured in Behçet's patients. The rate of sexual dysfunction and its relationship with gonadal hormones, Beck depression and SF 36 subgroups were evaluated in Behçet's patients. Sixty-nine patients with BD (mean age 39.55 ± 11.7) and 74 HCG (mean age 36.9 ± 6.84) were included in the study. Sexual dysfunction was observed in 74% (49) of BD and 59.5% (44) of HCG (p = 0.047). Prolactin level is within normal limits in all patients. Although there are abnormal levels of gonadal hormones, no relationship was found with sexual dysfunction. Depression especially is more prevalent compared to the healthy population (p = 0.016). The presence of depression negatively affects sexual life. Depression, SF 36 physical role limitations, energy vitality, vitality and mental health were associated with sexual dysfunction in patients with Behçet's disease. Sexual dysfunction was associated with the presence of depression and SF-36 subscales in Behçet's patients. [ABSTRACT FROM AUTHOR]

Background and Objectives: There is no standardised approach to toilet training in children. This study aimed to determine the factors affecting the duration of toilet training in children aged 0–5 years and to develop a tool to assess the child's readiness to start toilet training. Materials and Methods: This cross-sectional study was conducted on 409 children aged 0–5 years. Social, economic, behavioural, and developmental characteristics that are effective in toilet training in healthy children were evaluated. A scale assessing children's readiness for toilet training (Toilet Training Readiness Scale-TTRS) was developed and content validated. Results: The mean age of the 409 children included in this study was 44.69 ± 13.07 months (min = 4; max = 60 months). The mean age of initiation of toilet training was 26.8 months. Most frequently, urine and faeces trainings were started together (52.1%). In the logistic regression analysis performed to evaluate the factors affecting the duration of toilet training, it was found that the TTRS score, mother's employment status, family type, child's first reaction, toilet type, and continuity of training were important predictors. The duration of toilet training showed a weak negative correlation with the scores obtained from the TTRS and the number of children in the family but a weak positive correlation with the age at the beginning of toilet training. The TTRS scores were inversely proportional to the duration of toilet training. Conclusions: Family characteristics, socioeconomic conditions, and readiness of the child for and no interruption in toilet training are important in completing toilet training in a short time and successfully. If a child-focused approach is adopted, evaluating the child from this point of view and initiating the training at the appropriate time may help to complete a more successful and shorter toilet training. We recommend that the scale we have developed be studied in other studies and different groups. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationship between the amount of ultra‐processed food (UPF) in the diet and low‐grade inflammation in children. This cross‐sectional study was conducted in 50 healthy children recruited from children attending the Social Paediatrics Outpatient Clinic for follow‐up of normal developmental stages. Low‐grade inflammation was calculated by INFLA‐score, dietary intake by three 24‐h dietary recalls and dietary content analyses by BeBiS™ software. The mean age of the 50 children included in our study was 10.18 ± 3.98 years (5–17 years). UPF accounted for 24.5% of the total daily energy intake of children. In children with higher inflammation scores (INFLA‐score ≥ 2), the amount in grams of UPF and the percentage of total energy from UPF were found to be significantly higher (p = 0.030 and p = 0.015, respectively). A weak positive correlation was found between the INFLA‐score and the percentage of daily dietary energy intake coming from UPFs (r = 0.350, p < 0.01), the average daily energy intake from UPFs (r = 0.313, p < 0.05), and the average daily amount of UPF consumed (r = 0.260, p < 0.05). The linear regression model revealed that every one‐unit increase (1%) in the percentage of total daily energy intake coming from UPF caused an increase in β = 0.154‐unit in the INFLA‐score. It was found that obesity was not a mediator in the association between the percentages of total energy intake from UPF on the INFLA‐score, instead, the energy intake from UPF had a significant direct association with the INFLA‐score. The average amount of UPF consumed daily showed an increasing pattern in parallel with inflammation‐score quartile classes (Q1 to Q4) with 33.3% in Q1, 38.5% in Q2, 53.8% in Q3 and 66.7% in Q4 (p = 0.049). In conclusion, a positive association was found between low‐grade inflammation and UPF consumption in children, independent of obesity. [ABSTRACT FROM AUTHOR]

This study aimed to determine the prevalence and factors affecting the use of electronic cigarettes among university students. This cross-sectional study included 987 participants. The prevalence of electronic cigarette use among students was 5.4%, and the prevalence of trying electronic cigarettes at least once was 26.3%. Nicotine dependence levels of students who smoked electronic cigarettes were significantly high. Everyday electronic cigarette smokers commonly perceive traditional cigarettes to be more harmful. The rates of electronic cigarette use were significantly higher in males, those with high household income, those with a family history of traditional or electronic cigarette smoking, those who had smoked traditional cigarettes at least once in their lives, and those who were everyday cigarette smokers. Male sex and family history of electronic cigarette use were direct and effective predictors of everyday electronic cigarette use. The risk of everyday electronic cigarette use increased 7.91 times in the presence of electronic or traditional cigarette smokers in the family and 4.66 times in the presence of e-cigarette users in the family. The rates of electronic cigarette use and attempted electronic cigarette use were found to be high among university students. Awareness training and increased inspections and sanctions on the places where electronic cigarettes were purchased might prevent the growth of this problem. [ABSTRACT FROM AUTHOR]

Objective: In the modern age, the pursuit of food is now a means of pleasure and of satisfying hunger. This study examined the role of hedonic hunger and eating behaviors on obesity in older adults. Materials and Methods: This cross-sectional study was conducted on 400 older adults. The nutrition information system (BeBiS), bioelectrical impedance analysis, power of food scale-Turkish version (PFS-Tr), and Dutch eating behaviour questionnaire (DEBQ) were used to evaluate the subjects. Results: The mean age of 400 people included in the study was 67.82±2.77 years. It was found that the moderator effect of the interaction of daily energy intake and hedonic hunger behaviour (PFS-Tr) on the waist-to-hip ratio was significant. In particular, the regulatory effect of low hedonic hunger scores (PFS-Tr) was significant (p=0.019) and the waist-to-hip ratio decreased as the scores obtained from the scale decreased. The mediator effect of the restrained eating (ResE) sub-dimension (DEBQ) between the average daily energy intake and body fat mass was significant (estimate =0.221, p=0.021), and an increase in ResE behavior scores resulted in an increase in body fat mass. It was found that 89.4% of the effect of ResE behaviour on body fat mass was direct and large. There was a weak positive correlation between the average daily energy intake and food available subscale of PFS-Tr (r=0.157) and food present subscale (r=0.017). Total daily energy intake had a direct effect on body fat mass (estimate =0.008, p=0.005). Conclusion: The results of our study support a positive relationship between hedonic hunger and abdominal obesity in older adults. Decreased ResE behaviour increases the whole-body fat mass. Evaluation of hunger and implementation of programmes that support ResE behaviour may be useful in controlling obesity and its negative consequences in older adults. [ABSTRACT FROM AUTHOR]

Disasters can lead to decreased functionality in medical practice. This study aimed to quantitatively measure presenteeism and to determine the role of coping strategies among disaster‐victim doctors living in a city affected by the 2023‐Turkey earthquakes. This cross‐sectional study included 220 doctors reached through social media groups using the convenience sampling method. A weak negative relationship was found between presenteeism and positive re‐evaluation, one of the coping strategies with earthquake stress. A weak negative correlation was found between the Positive Reappraisal sub‐dimension score of the Coping with Earthquake Stress Scale (CESS) and presenteeism (r = −0.299, p < 0.001). In the linear regression analysis, the sub‐dimensions that contributed significantly to the model were found to be the Positive Reappraisal sub‐dimensions of CESS, whose increase resulted in a decrease in presenteeism and Seeking Social Support sub‐dimension, whose increase caused an increase in presenteeism. Presenteeism was higher in those who lost their loved ones, had damage in their workplace/home, and thought they were helpless or in danger. Both material and emotional factors decreased functionality at work after an earthquake. We recommend developing material and psychological support strategies to reduce presenteeism in post‐disaster periods. [ABSTRACT FROM AUTHOR]

Background and Objectives: Dementia is increasing worldwide. This study aimed to examine the impact of comorbidity burden and frailty on dementia prognosis in patients with dementia. Materials and Methods: This retrospective cohort study was conducted with 47 patients with dementia who were followed for up to two years. The Modified Charlson Comorbidity Index (MCCI), Mini-Mental State Examination (MMSE-E), and Edmonton Fragility Scale were used besides laboratory and clinical findings. Results: The mean age of the 47 patients was 78.77 ± 12.44 years. During the follow-up period, MMSE-E scores were observed to improve in 50% of the patients. Initial MMSE-E scores were found to be lowest in men and patients with coronary artery disease or depression, while final MMSE-E scores were observed to be lowest in patients with depression and low vitamin B12 or vitamin D levels. The rates of decrease in MMSE-E scores in non-, moderately and severely frail patients were 21.4%, 55.6%, and 70.6%, respectively. There was a moderate negative correlation between MMSE-E scores and both comorbidity burden and frailty scores. The mediation analysis revealed that frailty was a complete mediator, and that comorbidity burden led to an increase in frailty and a decrease in MMSE-E scores. During the follow-up period, patients with moderate frailty, hypertension, diabetes mellitus, alcohol and tobacco use, low B12 levels, or hypothyroidism showed an increased risk of decrease in cognitive functions. Conclusions: There was a significant association between dementia prognosis and both frailty and biological deficits. We recommend the adoption of a syndemic approach in the follow-up of dementia, as we believe that the prevention of frailty and associated biological deficits will contribute to slowing dementia's clinical course. [ABSTRACT FROM AUTHOR]

Background: The purposes of neoadjuvant chemotherapy are to tumor size to improve the tumor removal rate, extend survival, and prevent metastasis. In this study, the importance of CRP/albumin ratio and CEA/albumin ratio in the prediction of neoadjuvant treatment response in gastric cancer patients was evaluated. Methods: This study retrospectively included 135 gastric cancer patients who received neoadjuvant chemotherapy at Çukurova University Balcalı Hospital between January 2018 and December 2023. Preoperative CRP/albumin and CEA/albumin ratios were compared according to treatment response and multivariate logistic regression analysis was performed to determine the potential importance of these ratios in predicting pathological response. Results: The mean age of the 135 patients was 58.79 ± 10.83 (min = 26–max = 78). The CRP/albumin and CEA/albumin ratios were found to be significantly lower in patients who did not respond to neoadjuvant therapy. Each 1-unit increase in the CRP/albumin ratio was associated with a 1.16-fold decrease in the odds of pathological complete response to neoadjuvant therapy. Both CRP/albumin and CEA/albumin ratios were found to be significant in distinguishing neoadjuvant therapy response. The optimal cut-off value was 2.74 for the CRP/albumin ratio (sensitivity = 60%, specificity = 78.4%) and 1.40 for the CEA/albumin ratio (sensitivity = 74.2%, specificity = 67.6%). Values below these cut-off points favored neoadjuvant therapy response. Pathological complete response to neoadjuvant therapy was 4.75 times higher in patients with a CRP/albumin ratio below 2.74 and 5.14 times higher in patients with a CEA/albumin ratio below 1.40. Conclusions: Findings demonstrate that in patients with locally advanced gastric cancer receiving neoadjuvant treatment, CRP/Albumin and CEA/Albumin ratios are significant markers of pathological response. [ABSTRACT FROM AUTHOR]

Copyright of ESTUDAM Public Health Journal is the property of ESTUDAM Public Health Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

(1) Background: The introduction of novel therapies has led to a considerable evolution in the management of Multiple Myeloma, and chromosomal abnormalities predict the success of treatment. We aimed to characterize cytogenetic abnormalities for risk stratification in the patient population and to evaluate the predictive and prognostic value of the specified abnormalities in distinct treatment modalities. (2) Methods: This study included patients with Multiple Myeloma who applied to the Internal Medicine Clinic of the Cukurova University Faculty of Medicine. Between 2010 and 2023, 98 cases with cytogenetic abnormality data were identified. We analysed the effects of cytogenetic abnormalities on survival and response rates to first chemotherapies. (3) Results: P53 del was the most prevalent abnormality, and t(11;14) was the most common translocation. There was no significant difference in the mean survival and treatment response rates for specific cytogenetic abnormalities. When chemotherapies based on lenalidomide were initiated, patients' life-death statuses differed significantly from those of treatments without lenalidomide. Regardless of the type of chromosomal aberration, lenalidomide-based treatments independently enhanced average survival 14-fold, while there was no significant difference in overall survival among treatments. (4) Conclusions: In individuals with cytogenetic abnormalities, lenalidomide-based treatments should be started regardless of the chemotherapy to be used for the condition. [ABSTRACT FROM AUTHOR]

We introduce a class of rings which is a generalization of reflexive rings and J-reversible rings. Let R be a ring with identity and J(R) denote the Jacobson radical of R. A ring R is called J-reflexive if for any a, b ∈ R, aRb = 0 implies bRa ⊆ J(R). We give some characterizations of a J-reflexive ring. We prove that some results of reflexive rings can be extended to J-reflexive rings for this general setting. We conclude some relations between J-reflexive rings and some related rings. We investigate some extensions of a ring which satisfies the J-reflexive property and we show that the J-reflexive property is Morita invariant. [ABSTRACT FROM AUTHOR]

Introduction: With aging of population, frailty and sarcopenia have become very important issues. Therefore, we aimed to evaluate patients for frailty and sarcopenia preoperatively who aged 65≤ underwent elective surgical operation in university hospital and search complications intraoperatively and postoperatively. Materials and Method: This prospective, cross-sectional study performed between November 2021 and May 2022 at university hospital and patients aged 65 years and older underwent elective surgery included. Patients scored with frailty index. Both thickness and cross-sectional area of rectus femoris muscle were measured by ultrasound for evaluating sarcopenia in all patients, preoperatively. Anesthetic management, surgical risks were determined. Intraoperative and postoperative complications recorded. Results: Totally 1112 patients were assessed and 279 patients were included. According to the cross-sectional area 35.5%; according to rectus femoris thickness 32.2% and according to both of them 25.4% were detected as sarcopenia. While fragility was detected in 151(54.7%) patients which 112(74.2%) pre-frail, 39(25.8%) fragile. 176(63.8%) patients experienced intraoperative complications. Postoperative complications were detected in 115(41.7%). The sarcopenia, frailty, and higher surgical risk classifications are increased intraoperative and postoperative complications (4.7, 4.1, 4 and 3.7, 6.4, 3.9 fold, respectively). Length of stay hospital (6.5 and 5 days) and intensive care unit (21 and 19 days), intraoperative (91.4% and 100%) and postoperative complication (81.4% and 87.2%) was higher sarcopenia and frailty (p<0.001). Conclusion: Intraoperative and postoperative complications were observed higher in frail and sarcopenic patients. Evaluation of frailty and sarcopenia in over 65 years at preoperative period can be helpful for prediction to risk of intraoperative and postoperative complications. [ABSTRACT FROM AUTHOR]

Immunotherapy, in addition to surgery, chemotherapy, radiotherapy, and targeted therapies in cancer treatment, has emerged over the last decade as a significant contributor to improving patient survival. The prognostic nutritional index (PNI), which is a simple and useful tool that provides information about the general health status of patients and helps the treatment process, is used for many different types of cancer. This study aimed to evaluate the prognostic importance of PNI on mortality in cancer patients treated with immunotherapy. A total of 100 patients who were treated with immune checkpoint blockade in the oncology outpatient clinic were included retrospectively. According to our findings, only 23% of patients responded to immunotherapy, while 72% progressed. When PNI values were compared according to mortality status, it was determined that PNI values at baseline, first, third, sixth, and twelfth months were statistically significantly lower in patients who died during their follow-up. We also determined 44 as the cut-off value for the PNI in our study. The mortality rate was 76.7% in patients with PNI>44 and 43.5% in patients with PNI≤44. PNI appears to be a simple and useful tool for predicting mortality in cancer patients treated with immunotherapy. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study is to appraise the performance of the rapid antigen detection test (RADT) which is an immunochromatographic test to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen, compared to a real-time reverse transcriptase-polymerase chain reaction (RT-qPCR). Materials and Methods: Nasopharyngeal samples were taken from 185 volunteers and SARS-CoV-2 RADT and RT-qPCR tests were performed simultaneously. The results were evaluated in the light of parameters such as age, gender, cycle threshold (Ct) values of RT-qPCR, and symptoms. Results: RT-qPCR and SARS-CoV-2 RADT results of 148 participants from our study group were compatible, inconsistency was observed in the results of 37 participants. In general, the sensitivity and specificity for RADT were 63% and 100%, respectively. In the heterogeneous study group, the accuracy of the antigen test was found to be 80% (Cohen's K=0.690, 95%, p<0.001). When the Ct value was <20, the accuracy of the test was 85%>. Conclusion: The results highlight that COVID-19 antigen detection with the RADT we used has the potential to present as an alternative diagnostic method in patients with high viral load, especially in the early and infective stages of disease. [ABSTRACT FROM AUTHOR]

Copyright of Anatolian Clinic Journal of Medical Sciences is the property of Hayat Saglik ve Sosyal Hizmetler Vakfi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

There are hesitations about the use of surgical face masks, which are the main tools in protection from the COVID-19 pandemic, one of the biggest disasters of our age, in chronic airway diseases. The purpose of the study was to examine how stable patients with chronic obstructive pulmonary disease (COPD) responded to short-term surgical mask use in terms of in-mask air quality, oxygen saturation, and pulmonary function. Forty-one patients with stable COPD, by clinical presentation and pulmonary function tests (PFTs), were included in a quasi-experimental study. Stable COPD patients' PFTs, in-mask air quality, and pollution measures were collected before and after wearing surgical masks for two hours at rest. The findings of simultaneous tests of peripheral-blood-oxygen saturation were also recorded. The mean age of participants was 67.1 years and 87.8% were male. The pre- and post-mask PFTs parameters for GOLD (A+B) group were FEV1 (ml), FEV1 (%), FVC (ml), FVC (%), FEV1/FVC (%) and DLCO (%) (p=0.067, p=0. 065, p=0.062, p=0.083, p=0.083, p=0.269, p=0.956, respectively), whereas in GOLD (C+D) group (p=0.340, p=0.538, p=0.728, p=0.044, p=0.105, p=0.054, respectively). In post-mask measurements, the respiratory function was not impaired in GOLD-2022 (A-B-C-D) COPD subgroups. Oxygen and carbon-monoxide concentrations in exhaled air and oxygen saturation decreased after surgical mask use. The difference was statistically significant, but the difference was unimportant in terms of clinical implications. Surgical masks don't appear to have a negative effect on pulmonary function and clinical parameters in stable COPD. This study may help provide evidence-based data to overcome hesitations in use of surgical masks in chronic airway diseases. [ABSTRACT FROM AUTHOR]

Copyright of Kafkas Journal of Medical Sciences / Kafkas Tıp Bilimleri Dergisi is the property of Kafkas Journal of Medical Sciences, Kafkas Tip Bilimleri Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To investigate the perception of antibiotics, the frequency of inappropriate antibiotic use, and the factors that lead to inappropriate antibiotic use by parents who apply to primary healthcare organizations. Methods: This cross-sectional study included 973 parents who applied to primary healthcare centers. We analyzed basic concepts related to antibiotics prescribed for their children, antibiotic administration, and antibiotic resistance, as well as parents' knowledge and attitudes towards antibiotic use, and their experiences, practices, and perceptions related to purchasing antibiotics without prescription. Results: In the past one year, 78.9% of the parents gave antibiotics to their children at least once, and 39.1% gave antibiotics three or more times. Some of the participants (7.1%) reported having forced the physician to prescribe antibiotics and purchased antibiotics without a prescription (13.2%). The knowledge about antibiotics and awareness about antibiotic resistance were found to be more frequent; among parents who had university degrees, higher income levels, two or fewer children, social insurance and negative behaviours were lower in those who received information about antibiotics from healthcare professionals. The probability of taking antibiotics without prescription was lower in that of with higher income level (OR 0.460; 95% CI 0.219-0.965), and the probability of forcing antibiotic prescription was higher in those with 3 or more children (OR 6.94; 95% CI 2.37-20.26). The score obtained from the awareness of antibiotic resistance sub-dimension was found to negatively affect the behavior of forcing antibiotic prescription (OR 0.852; 95% CI 0.732-0.993) but the score obtained from the behaviour sub-dimension was positively affect this behaviour (OR 1.136; 95% CI 1.011-1.276). Conclusions: Inappropriate antibiotic use appears to be a problem with negative perception, lack of knowledge and socioeconomic dimension. Studies should be conducted to increase antibiotic knowledge in parents and to expand the scope of social insurance. [ABSTRACT FROM AUTHOR]