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Abstract Background Low back pain is an important disability problem frequently encountered in the clinic. In the literature, it has been shown that neuropathic pain in chronic low back pain is quite common in patients. Although superior cluneal nerve entrapment syndrome is an underdiagnosed cause of low back and leg pain, differential diagnosis is very important anatomically and clinically. The superior cluneal nerves are pure sensory nerves that innervate the skin of the upper part of the buttocks. In the literature, methods such as surgery, nerve blockade, prolotherapy, and acupuncture have been used in the treatment of cluneal nerve entrapment syndrome, but there are no studies on exercise. In this case report, our aim is to explain the importance of differential diagnosis in cluneal nerve entrapment syndrome, which is one of the common causes of low back pain in the clinic, and the effects of exercise in this disease. Case presentation A 22-year-old, Turkish-ethnicity, male patient with complaints of low back pain, neck–back pain, and weakness did not use alcohol or cigarettes. In his family history, there was a history of diabetes in the mother and diabetes and heart failure in the father. He had a history of osteoporosis, epilepsy, asthma, sarcoidosis, and cardiac arrhythmia. The patient reported that he suffered from constipation three to four times a month. As a result of the detailed evaluation, the planned exercise prescription was taught to the patient, and after it was confirmed that the patient did the exercises correctly for 3 days, the exercise brochure was given and followed as a home exercise program for 8 weeks. Conclusions Lumbar stabilization exercises, gluteal muscle strengthening exercises, thoracolumbar fascia mobilization, and stretching exercises, which will be given in accordance with the clinical anatomy of the disease after the correct diagnosis in cluneal nerve entrapment syndrome, have been beneficial for the patient. However, we think that randomized controlled studies with a large sample will contribute to the literature.

Invasive pulmonary aspergillosis (IPA) is the most frequent invasive fungal disease occurring in patients with hematological malignancies. Serum galactomannan (GM) antigen monitoring is thought to be helpful in the diagnosis of IPA. The aim of this study was to determine the role of a GM assay in serum samples for the diagnosis of IPA in patients with hematological disease. The data of 366 immunosuppressed patients that were hospitalized and followed up in the hematology clinic from January 2017 to December 2019 were retrospectively analyzed. The clinical and radiological findings of the patients and the GM results, requested twice a week, were evaluated. In this study, the incidence of probable and possible IPA was determined to be 15.3% (56/366). Of the cases detected, 28 (50.0%) were patients diagnosed with Acute Myeloid Leukemia (AML), and 34 (60.7%) patients who had compatible clinical and examination findings were started on antifungal treatment. Additionally, AUC (Area Under the Curve) values were calculated by ROC (Receiver Operating Characteristic) analysis, and it was determined that the diagnostic efficiency was more predictive when the cut-off was 0.5 in the GM test for IPA disease. The detection of GM antigen in serum is a very useful and rapid method for diagnosing IPA disease in immunosuppressed hematology patients. However, GM results should be evaluated together with clinical and radiological findings for early diagnosis, and the treatment approach should be determined accordingly.

The proposed expert opinion aimed to address the current knowledge on conceptual, clinical, and therapeutic aspects of diabetic peripheral neuropathy (DPN) and to provide a guidance document to assist clinicians for the best practice in DPN care. The participating experts consider the suspicion of the disease by clinicians as a key factor in early recognition and diagnosis, emphasizing an improved awareness of the disease by the first-admission or referring physicians. The proposed “screening and diagnostic” algorithm involves the consideration of DPN in a patient with prediabetes or diabetes who presents with neuropathic symptoms and/or signs of neuropathy in the presence of DPN risk factors, with careful consideration of laboratory testing to rule out other causes of distal symmetric peripheral neuropathy and referral for a detailed neurological work-up for a confirmative test of either small or large nerve fiber dysfunction in atypical cases. Although, the first-line interventions for DPN are currently represented by optimized glycemic control (mainly for type 1 diabetes) and multifactorial intervention (mainly for type 2 diabetes), there is a need for individualized pathogenesis-directed treatment approaches for DPN. Alpha-lipoic acid (ALA) seems to be an important first-line pathogenesis-directed agent, given that it is a direct and indirect antioxidant that works with a strategy targeted directly against reactive oxygen species and indirectly in favor of endogenous antioxidant capacity for improving DPN conditions. There is still a gap in existing research in the field, necessitating well-designed, robust, multicenter clinical trials with sensitive endpoints and standardized protocols to facilitate the diagnosis of DPN via a simple and effective algorithm and to track progression of disease and treatment response. Identification of biomarkers/predictors that would allow an individualized approach from a potentially disease-modifying perspective may provide opportunities for novel treatments that would be efficacious in early stages of DPN, and may modify the natural course of the disease. This expert opinion document is expected to increase awareness among physicians about conceptual, clinical, and therapeutic aspects of DPN and to assist them in timely recognition of DPN and translating this information into their clinical practice for best practice in the management of patients with DPN.

Abstract Sleep apnea (SA) is associated with risk of cardiovascular disease, cognitive decline, and accidents due to sleepiness, yet the majority (over 80%) of patients remain undiagnosed. Inertial measurement units (IMUs) are built into modern wearable devices and are capable of long-term continuous measurement with low power consumption. We examined if SA can be detected by an IMU embedded in a wristwatch device. In 122 adults who underwent polysomnography (PSG) examinations, triaxial acceleration and triaxial gyro signals from the IMU were recorded during the PSG. Subjects were divided into a training group and a test groups (both n = 61). In the training group, an algorithm was developed to extract signals in the respiratory frequency band (0.13–0.70 Hz) and detect respiratory events as transient (10–90 s) decreases in amplitude. The respiratory event frequency estimated by the algorithm correlated with the apnea–hypopnea index (AHI) of the PSG with r = 0.84 in the test group. With the cutoff values determined in the training group, moderate-to-severe SA (AHI ≥ 15) was identified with 85% accuracy and severe SA (AHI ≥ 30) with 89% accuracy in the test group. SA can be quantitatively detected by the IMU embedded in wristwatch wearable devices in adults with suspected SA.

Education in cybersecurity is crucial in the current society, and it will be extended into the artificial intelligence (AI) area, called AI security, in the near future. Although many video games for education in cybersecurity have been designed, we have two problems for education in AI security: a helpful design of a video game for users to learn cybersecurity is still unclear, and there is no game for AI security, to the best of our knowledge. In this paper, we design a video game for education in AI security, REN-A.I., to address the above problems. In designing REN-A.I., we built some hypotheses: simulating damage caused by attacks on AI and the effectiveness of their countermeasures through a video game helps a user to improve awareness of AI security with the episodic memory of the user itself. We focus on game scenarios and game functionalities to learn AI security with episodic memory in accordance with the above hypothesis. We conducted a questionnaire survey with 48 users to evaluate REN-A.I.. As a result, we confirm that both game scenarios and game functionalities are effective for learning with episodic memory. Specifically, 74% of users consider game scenarios effective, and 81% of users consider game functionalities effective. Our survey results have revealed two suggestions for beneficial design aspects in video games for education in cybersecurity. In particular, users who read game scenarios in REN-A.I. can learn AI security by the game more effectively than the other users. Furthermore, the functionality for accuracy deterioration due to attacks in REN-A.I. is effective even for users who do not read the game scenario. REN-A.I. is publicly available (https://www-infosec.ist.osaka-u.ac.jp/software/ren-ai/REN-AI(EN).html).

IntroductionSeveral neuroimaging studies have been conducted to demonstrate the specific structural and functional brain correlations of conversion disorder. Although the findings of neuroimaging studies are not consistent, when evaluated as a whole, they suggest the presence of significant brain abnormalities. The aim of this study is to investigate brain metabolic activity through F-18 fluorodeoxyglucose PET/MRI in order to shed light on the neural correlates of conversion disorder.Methods20 patients diagnosed with conversion disorder were included in the study. Hamilton Depression and Anxiety Rating Scales, Somatosensory Amplification Scale and Somatoform Dissociation Scale were administered. Then, brain F-18 FDG-PET/MRI was performed..ResultsHypermetabolism was found in posterior cingulate R, while glucose metabolisms of other brain regions were observed to be within the normal limits. When compared with the control group, statistically significant differences in z-scores were observed among all brain regions except for parietal superior R and cerebellum. No correlation was observed between the metabolisms of the left ACC and left medial PFC; left ACC and left temporal lateral cortex; cerebellum and left parietal inferior cortex despite the presence of positive correlations between these regions in the opposite hemisphere.DiscussionResults of the study suggest a potential involvement of the DMN which is associated with arousal and self-referential processing as well as regions associated with motor intention and self-agency.

Abstract Background Mosquito-specific viruses (MSVs) comprise a variety of different virus families, some of which are known to interfere with infections of medically important arboviruses. Viruses belonging to the family Mesoniviridae or taxon Negevirus harbor several insect-specific viruses, including MSVs, which are known for their wide geographical distribution and extensive host ranges. Although these viruses are regularly identified in mosquitoes all over the world, their presence in mosquitoes in Germany had not yet been reported. Methods A mix of three MSVs (Yichang virus [Mesoniviridae] and two negeviruses [Daeseongdong virus and Dezidougou virus]) in a sample that contained a pool of Coquillettidia richiardii mosquitoes collected in Germany was used to investigate the interaction of these viruses with different arboviruses in Culex-derived cells. In addition, small RNA sequencing and analysis of different mosquito-derived cells infected with this MSV mix were performed. Results A strain of Yichang virus (Mesoniviridae) and two negeviruses (Daeseongdong virus and Dezidougou virus) were identified in the Cq. richiardii mosquitoes sampled in Germany, expanding current knowledge of their circulation in central Europe. Infection of mosquito-derived cells with these three viruses revealed that they are targeted by the small interfering RNA (siRNA) pathway. In Culex-derived cells, co-infection by these three viruses had varying effects on the representative arboviruses from different virus families (Togaviridae: Semliki forest virus [SFV]; Bunyavirales: Bunyamwera orthobunyavirus [BUNV]; or Flaviviridae: Usutu virus [USUV]). Specifically, persistent MSV co-infection inhibited BUNV infection, as well as USUV infection (but the latter only at specific time points). However, the impact on SFV infection was only noticeable at low multiplicity of infection (MOI 0.1) and at specific time points in combination with the infection status. Conclusions Taken together, these results are important findings that will lead to a better understanding of the complex interactions of MSVs, mosquitoes and arboviruses. Graphical Abstract

There are many opinions on the effectiveness of the methods used in anatomy education. The aim of the study is to determine the superiority of online, video-based, and face-to-face education methods over each other. A total of 80 students, 41 female, and 39 male, participated at Malatya Turgut Ozal University Faculty of Medicine to study. A questionnaire consisting of 20 questions, seven questions questioning demographic information and internet activity, and 13 queries about anatomy education was applied by online submission. The students consider that video-recorded education is effective in terms of time management with %75, three-dimensional digital resources are effective with 47.5%, more concentrated in face-to-face education than online education with 48.8%, face-to-face education is sufficient in professionality in medical applications with 58.8%. The students stated that both face-to-face and video-recorded education were effective at a high rate, with 73.8%. In addition, anatomy lectures should be based on theory and practice, and face-to-face & video-recorded education to be together with practical education 70%. The correlation results demonstrate that the benefit of teaching method, concentration, and benefit on professionality have the highest level of correlation with other educational landmarks. Face to face method is effective in concentration and community, and the video-recorded education method is effective in time management in anatomy education. Therefore both face-to-face and video-based education called the hybrid education method, is effective in anatomy education. [Med-Science 2023; 12(3.000): 803-11]

Abstract Background Secondary bacterial infections are an important cause of mortality in patients with coronavirus disease 2019 (COVID-19). All healthcare providers acted with utmost care with the reflex of protecting themselves during the COVID-19 period. We aimed to compare the rates of ventilator-associated pneumonia (VAP) and bloodstream infections (BSIs) in our intensive care units (ICUs) before and during the COVID-19 outbreak surges. Methods This multicenter, retrospective, cross-sectional study was performed in six centers in Turkey. We collected the patient demographic characteristics, comorbidities, reasons for ICU admission, mortality and morbidity scores at ICU admission, and laboratory test data. Results A total of 558 patients who required intensive care from six centers were included in the study. Four hundred twenty-two of these patients (males (62%), whose mean age was 70 [IQR, 58–79] years) were followed up in the COVID period, and 136 (males (57%), whose mean age was 73 [IQR, 61–82] years) were followed up in the pre-COVID period. BSI and VAP rates were 20.7 (19 events in 916 patient days) and 17 (74 events in 4361 patient days) with a −3.8 difference (P = 0.463), and 33.7 (31 events in 919 patient days) and 34.6 (93 events in 2685 patient days) with a 0.9 difference (P = 0.897), respectively. The mortality rates were 71 (52%) in pre-COVID and 291 (69%) in COVID periods. Conclusion Protective measures that prioritize healthcare workers rather than patients and exceed standard measures made no difference in terms of reducing mortality.

Background and aim: Transcutaneous electrical nerve stimulation (TENS) and reflexology can be effective in pain, balance and sleep problems in the elderly. Our study aimed to examine the effect of TENS and reflexology on balance and sleep quality in geriatric individuals. Materials and Method: 60 individuals with balance and sleep problems were included in our study and randomly divided into three groups: Reflexology (N=20), TENS (N=20) and control (N=20). All individuals were evaluated with the Visual Analog Scale (VAS), Pittsburgh Sleep Quality Index (PSQI), Berg Balance Scale (BBS), and Tinetti Balance Test (TBT) method pre-treatment and post-treatment. Results: It was observed that there was a significant increase in BBS in the reflexology group after the treatment compared to the pre-treatment, while a decrease in pain and an increase in sleep quality were observed in the TENS group post-treatment. While the decrease in the risk of falling was seen in all three groups, the improvement in the risk of falling was mostly seen in the reflexology group. There was no statistical difference between the groups post-treatment (p>0.05). Conclusion: We conclude that reflexology practice increased the balance and decreased the risk of falling. We think that reflexology application as an alternative treatment will reduce the symptoms.

Recent studies have focused on the role of human herpesvirus 6 (HHV-6) and human herpesvirus 7 (HHV-7) in PR etiology with varying results. In our study, with the approach that the discrepancy between the results may be related to the different samples and techniques used, we aimed to clarify the etiology by examining tissue and plasma samples using molecular methods and evaluating the results together with serological parameters. Skin biopsies and plasma samples of twenty-five PR patients were tested to detect HHV-6 and HHV-7 DNA using calibrated quantitative real-time polymerase chain reaction (CQ RT-PCR). IgG and IgM antibodies against HHV-6 and HHV-7 were tested by enzyme-linked immunosorbent assay and indirect immunofluorescence. Of the patient group, 64% were positive for HHV-6 IgG without IgM positivity. HHV-6 DNA was present in seven tissue and ten plasma samples. HHV-7 positivity was 100% and 12% for IgG and IgM antibodies, respectively. HHV-7 DNA was detected in four tissue samples and one plasma sample. Patients with HHV-7 DNA-positive plasma and tissue samples had also HHV-7 IgM antibodies. In conclusion, our results seem to support the role of HHV-6/HHV-7 in the etiology of PR. To clarify the etiology of PR and avoid confusion, the collection of different biological materials simultaneously and the usage of CQ RT-PCR as a diagnostic technique are recommended.

Hydrogel-based dressings can effectively heal wounds by providing multiple functions, such as antibacterial, anti-inflammatory, and preangiogenic bioactivities. The ability to spray the dressing is important for the rapid and effective coverage of the wound surface. In this study, we developed a sprayable hydrogel-based wound dressing using naturally derived materials: hyaluronic acid and gelatin. We introduced methacrylate groups (HAMA and GelMA) to these materials to enable controllable photocrosslinking and form a stable hydrogel on the wound surface. To achieve sprayability, we evaluated the concentration of GelMA within a range of 5–15% (w/v) and then incorporated 1% (w/v) HAMA. Additionally, we incorporated calcium peroxide into the hydrogel at concentrations ranging from 0 to 12 mg/mL to provide self-oxygenation and antibacterial properties. The results showed that the composite hydrogels were sprayable and could provide oxygen for up to two weeks. The released oxygen relieved metabolic stress in fibroblasts and reduced cell death under hypoxia in in vitro culture. Furthermore, calcium peroxide added antibacterial properties to the wound dressing. In conclusion, the developed sprayable hydrogel dressing has the potential to be advantageous for wound healing due to its practical and conformable application, as well as its self-oxygenating and antibacterial functions.

In this paper, we present the energy efficiency (EE) analysis of a multi-tier cellular network, where intra- and inter-tier dependence in the base station (BS) locations are captured via point processes, i.e., three variants of hard-core point processes (HCPPs) and the Poisson hole process (PHP). The analytical expression for EE is derived by approximating both the average power consumption of BSs and the coverage probability using an approximate signal-to-interference ratio analysis based on the Poisson point process (PPP). It is demonstrated that the proposed Matérn HCPP Type-I-PHP model provides better EE results compared to the other HCPP-PHP and PPP models.

Aim: This study aims to reveal the current profile of personal and professional characteristics of nurse managers in Turkey. Method: The sample of this descriptive and cross-sectional study consisted of 1.222 nurse managers in Turkey. The data were collected through an online questionnaire and analyzed using descriptive statistics in SPSS 24.0 program. Results: Most of the nurses between the ages of 20-62 are married (74.7%) and have children (72.9%), take care of their children depending more on family support (49.3%), 64.9% owned a house and 62.9% owned a car. Of all, 43.6% have a bachelor's degree, 76.4% have a degree in nursing, and 30.9% are working in public hospitals and the position of first-line nurse manager (59.7%). The mean duration of professional experience of the nurse manager was 17.04+-7.67 and the mean duration of managerial experience was 7.40+-6.24. Most of them chose the nursing profession willingly (77.1%) and working with high performance (80.6%) was effective in becoming managers. More than half of the participants were not members of any professional organization (64.2%) or a trade union (67.5%), had not received any training in management (57.4%) or orientation training for managerial positions (57.9%). It has been determined that they are willing to participate in the management courses to be organized (91.7%), they mostly follow the legal regulations related to nursing (63.4%), and attend nursing-related congresses (53.3%) to support their professional and managerial development. Conclusion: This research provides important data in terms of identifying the personal and professional characteristics of nurse managers in Turkey and revealing their needs and expectations regarding their professional training and career development.

Aim: Balance disorders, postural dysfunctions, and speech disorders are common after stroke. This study aims to investigate whether there is a connection between language and speech function and posture and balance in paralyzed patients and to which speech area function the connection is related. Methods: Eighteen stroke patients with speech impairment and no cognitive impairment were included in the study. Balance and postures of stroke patients were evaluated using the Berg Balance Test (BBT) and Postural Assessment Scale for Stroke Patients (PASS-T), while their quality of life was evaluated using the Stroke and Aphasia Quality of Life-39 Test (SAQOL-39). Patients’ speech functions were evaluated using the Gülhane Aphasia Test-2 (GAT-2), voice-related assessments were made with the Voice-Related Quality of Life Scale (V-RQOL), and objective voice analysis. Results: The mean age of the participants was 59.10±14.72 years, the mean score of the Mini-Mental Test was 26.16±2.00. According to statistical analysis, there was a significant relationship between BBT score and GAT-2 (r: 0.552, p=0.017), and BBT score and SAQOL-39 mean score (r: 0.589, p=0.010), there was no significant relationship between BBT and V-RQOL (r: -0.075, p=0.768). While there was a significant relationship between PASS-T (r: 0.499, p=0.035) and SAQOL-39, no significant relationship was found with GAT-2 (r: 0.388, p=0.112). In addition, a significant correlation was found between the SAQOL-39 mean score and the GAT-2 total score (r: 0,606, p=0.008). Conclusion: It was observed that there is a significant relationship between balance functions and speech function and quality of life, and patients with good balance have better functional independence and speech functions. However, it was found that posture did not change speech function. Due to the importance of evaluation in treatment, it is thought that the evaluation of stroke patients who will receive speech and language therapy in terms of balance and postural functions will contribute to the speech functions of patients.

Jorge Selem Haddad,1,2 Clainijane Borges,2 Nathalie Dalloul Daher,2 Alexandre Mine,2 Marcella Salomão,1,3 Renato Ambrósio Jr3 1Department of Ophthalmology, Federal University of São Paulo, São Paulo, SP, Brazil; 2Instituto Oftalmológico Paulista, São Paulo, SP, Brazil; 3Instituto de Olhos Renato Ambrósio, Rio de Janeiro, RJ, BrazilCorrespondence: Jorge Selem Haddad, Instituto Oftalmológico Paulista, 35 Alameda Casa Branca, São Paulo, SP, Brazil, Tel +55 11 98999-1212, Email jshaddad2@hotmail.comPurpose: The ability to predict corneal edema and understand its relationship with imaging parameters enables optimization of decision-making in terms of cataract surgery. Therefore, we aimed to elucidate the immediate tomographic alterations after phacoemulsification.Patients and Methods: In this prospective study, we evaluated clinical and corneal tomographic data of 30 patients with cataracts, obtained using a rotating Scheimpflug tomographic system before and after cataract surgery with a phacoemulsification system. Corneal thickness and volume were measured, and Pentacam Nucleus Staging, keratometry, and specular microscopy were performed preoperatively and immediately postoperatively. The Wilcoxon signed-rank test was used to compare pre-and postoperative values. We calculated the correlations between the changes in these values and multiple parameters related to phacodynamics, including “ultrasound (US) elapsed” (phaco time), “US average” (average power used), and “US absolute” (energy effectively dissipated, a product of the other two parameters).Results: There were increases in corneal volume (p< 0.0001) and pachymetry (p< 0.0001), and a decrease in endothelial cell count (p< 0.0001) after surgery. The mean differences in pre- and postoperative specular microscopy, corneal volume, and pachymetry were − 335.13± 236.21 cells/mm3, 1.33± 0.56 mm3, and 61.33± 23.73 microns, respectively. The difference in pre-and postoperative corneal volume in patients with US elapsed ≥ 40 s was 0.75 mm3 greater than that in patients with US elapsed < 40 s (95% confidence interval [CI]: 0.24– 1.25; p=0.005); that of pachymetry in patients with US elapsed ≥ 40 s was 31.76 microns greater than that in patients with US elapsed < 40 s (95% CI: 9.55– 53.97; p=0.007). Spearman correlation revealed that, for every 1% increase in cataract density, the US average value increased by 0.31% (coef.: 0.3110; 95% CI: 0.0741– 0.5490; p=0.012).Conclusion: Knowledge of Pentacam Nucleus Staging and the effect of US elapsed on differences in corneal volume and pachymetry before and after cataract surgery should be of particular value for surgeons who routinely encounter patients with hard cataracts.Keywords: cataract surgery, corneal volume, pachymetry, phacoemulsification, ultrasound

Background/aim: We aimed to determine if there is a decrease in antiHBS titer below the protective value during Coronavirus-19 disease (COVID-19). Materials and methods: A prospective study was made of 67 patients who had positive antiHbs values checked in the last 1 year. Demographic data and the previous antiHBs values were collected from the patient files and the laboratory findings of new antiHBs titers checked after one months later following COVID-19 infection were compared with the previous ones. Results: In the postcovid evaluation, a statistically significant decrease in the antiHBs levels of COVID-19 patients was determined with respect to previous values before COVID-19 infection (p lt;0,001). Conclusion: In our study, we found that there was a statistically significant decrease in AntiHBs levels after COVID-19 infection, but none of them were below protective antiHBs levels. As a result, we can say a booster vaccination against hepatitis B is not needed during or after COVID-19 infection, but it would be appropriate to support it with studies with a higher number of patients.

Purpose: The aim of this study; to evaluate the effects of diaphragm thickness on weaning with ultrasonography (USG). Materials and Methods: In this prospective study; demographic characteristics of the patients, indications for hospitalization in the intensive care unit and mechanical ventilation, comorbidity, diaphragm thickness, Sequential Organ Failure Assessment (SOFA) score and Simplified Acute Physiology Score (SAPS) II, mortality rate, peripheral oxygen saturation (SpO2), invasive mechanical ventilator (IMV) duration, minute volume, respiratory rate (RR), expiratory volumes (VTE), RSBI values were recorded. The patients were ventilated spontaneously for 30 minutes in pressure support (PS) mode in IMV. Diaphragm thickness (DT) was measured using a 7-10 MHz linear ultrasound probe set to B mode. The right hemidiaphragm was visualized in the midaxillary line between the 8th and 10th intercostal spaces, at the junction of the diaphragm and rib cage. After the measurements were stabilized, the patients were taken to the T-tube for one hour. The patients who successfully completed T-tube spontaneous breathing trials (SBT) were extubated. The patients were divided into two groups as successful and unsuccessful weaning. Results: A total of 72 patients were evaluated by meeting the inclusion criteria. Four of the patients were excluded from the study because they received IMV support for less than 24 hours. There was no difference between the groups in the ratios of diaphragm thickness index (DTI) and diaphragmatic thickening fraction (DTF). The thickness measurements of the diaphragm, defined as diaphragm thickness at the end of inspiration (DTV) and diaphragm thickness at the end of expiration (DFRV), were higher in the successful weaning group. The best threshold value of DTV to predict weaning success was found to be 0.72 and DFRV value to be 0.669. Conclusion: Weaning success is closely related to diaphragm functions, diaphragm thickness parameters and lung capacities. USG is a practical, bedside, noninvasive method that can be used to evaluate the diaphragm. DTV and DFRV are among the parameters that can predict success in the weaning process. DTF and DTI were found to be insufficient in predicting weaning success.

The aim of this study was to investigate the compounds in the hexane extract of Cirsium vulgare (Savi.) Ten. and to determine the antibacterial, antifungal, and antioxidant activities of different extracts. The Cirsium vulgare (NGBB 7229) plant was collected from Turkey’s Trakya region. Crude extracts were obtained using different solvents. The chemical composition of Cirsium vulgare was determined in hexane extract using gas chromatography mass spectrometry. The antioxidant activities of the extracts were evaluated by Trolox equivalent antioxidant activity (TEAC), ferric-reducing antioxidant power (FRAP), cupric-reducing antioxidant capacity (CUPRAC), the β-carotene bleaching method, and the determination of superoxide anion scavenging activities. The antibacterial activity was tested against Staphylococcus aureus, Bacillus subtilis, Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis, and Salmonella typhimurium, whereas the antifungal activity was tested against Candida albicans, Candida glabrata, Candida parapsilosis, Candida krusei, Penicillium chrysogenum, and Aspergillus fumigatus by applying microdilution methods. A total of 41 bioactive compounds were identified using the GC–MS library. Terpenoids were found to be dominant (52.89%), and lup-20(29)-en-3-yl-acetate and lupeol were the most abundant terpenoids. The highest total flavonoid content (25.73 mg catechin/g) and antioxidant capacity were found in the methanolic extract. The highest antibacterial activity was detected against Bacillus subtilis in the ethyl acetate extract, and the highest antifungal activity was found against Candida krusei and Aspergillus fumigatus in the hexane extract. The observed antioxidant characteristics of the C. vulgare extracts could be attributed to the presence of flavonoids. The high antifungal activity of the hexane extract against all fungal strains can be attributed to its constituents, i.e., terpenoids. This study discloses the potential antioxidant and antimicrobial activities, including some bioactive components, of Cirsium vulgare and implies that Cirsium vulgare holds possible applications in the food and pharmaceutical industries as an antioxidant, antibacterial, and antifungal agent.

Aim: The aim of this study was to determine the effect of smartphone use on sleep quality in adolescents (13-20 years) using youth center. Method: The descriptive study was conducted between May and August 2019 at a youth center within a municipality. The population of the study consisted of adolescents consisting of 400 adolescents aged between 13-20 years who were attending courses in the youth center, and the sample consisted of 237 individuals who fulfilled the research criteria and agreed to participate in the study. Data were collected by using Introductory Form, The Smartphone Addiction Scale-Short Version and Pittsburg Sleep Quality Index. Percentage, mean, standard deviation, Mann Whitney U test, Kruskal Wallis test, pearson correlation test were used for statistical analysis. Results: In the research, it was found that 94.5% of the young people had smart phones and 72.6% of them were mostly social media. The purpose of using smart phone for internet use, time period of using smart phone, control of smart phone and seeing himself as a smart phone addict were found to affect the use of smartphones. It was determined that the sleep quality was affected by the people living with them, sharing room where they sleep, the location of the accommodation, seeing themselves as a smartphone addict and having sleep problems. There was a significant relationship between the mean scores of the The Smartphone Addiction Scale-Short Version and Pittsburg Sleep Quality Index scores of the adolescents who participated in the study (r=0.219; p=0.048). Conclusion: In this study, it was found that adolescents' The Smartphone Addiction Scale-Short Version and Pittsburg Sleep Quality Index mean scores were moderate and there was a statistically significant relationship between them. It is recommended to develop and implement training programs on smart phone use.

In this article, the surface roughness and friction coefficient values of graphene coated fabrics were examined. Fabrics were coated with three different graphene concentrations (5 %, 10 % and 20 %) with the knife-over-roll principle. The surface roughness of samples was measured by Accretech Surfcom 130A. Various surface roughness parameters of the coated fabrics were evaluated. Static and kinetic friction coefficients of coated fabrics were measured by Labthink Param MXD-02 friction tester using the standard wool abrasive cloth. It was observed that the coating concentration affected the frictional and roughness properties of fabrics. Experimental results showed that fabric surface roughness and friction coefficient values decreased significantly, especially at 20 % concentration. It was concluded that the coated fabrics produced could be used in applications such as anti-wear clothing.

Nursing students are role model related to health franchise play an important in oral health care and promotion. This study aim is assessment the caries and oral and dental health behaviors of nurse students who be able expected take upon the responsibility of oral health in future. This was descriptive observational study with cross‑sectional approach, conducted at a state university in Mediterranean, Turkey. The study population was formed from 34 nursing students who voluntary select to course of oral and dental health nursing. Firstly, data were collected by socio-demographic form and then all students had been examined by dentist researcher. It was determined that 76.5% of the nursing students included in the study had at least one tooth decay, 70.6% needed treatment, and 67.6% had debris. It was determined that there was a relationship between gender, floss use, mouthwash, regular brushing teeth twice a day before the age of 6, smoking, and D, F, M, DMFS, DMFT indices in those who were breastfed for >=6 months. Increasing the awareness level of students will have a positive impact on the health of the patients they will care for.

Abstract Background The frequency of insertion variations of cystic duct (CD) is inconsistent between studies caused to some extent by the way they give the relative frequency of the variations. Moreover, certain insertion variations have been reported to be associated with choledocholithiasis. This study aimed to assess the frequency of CD insertion variations with a comprehensive way of classification in an unselected population in whom MRCP was performed. Moreover, the relationship between the types of variant insertions and choledocholithiasis using MRCP was also assessed. Patients undergoing magnetic resonance cholangiopancreatography (MRCP) were reviewed retrospectively by two radiologists who were blinded to the clinical data. The normal insertion was defined as the union through middle one third of the lateral border of the extrahepatic bile duct. The transverse site (lateral, medial, anterior, and posterior) and the craniocaudal level (high, mid and low) of insertions and their intersections were assessed using axial and coronal slices, respectively. In addition, the frequencies of the CD insertion variations were compared between choledocholithiasis and control (no-choledocholithiasis) groups. Results A total of 307 patients (124 with choledocholithiasis and 183 controls) were analyzed. A true variant insertion was found in 149 (48.5%) cases. The insertion variations were less frequent in the choledocholithiasis group [50 (40.3%) vs. 99 (54.1%), respectively, p = 0.018]. The frequencies of craniocaudal level of insertion differed significantly between groups (p = 0.014) that was driven by a lower rate of low medial insertion (1.6% vs. 9.8%, respectively) in the choledocholithiasis group. The frequencies of transverse site of insertion were similar between groups (p = 0.314). The low medial insertion was 80.7% less likely associated with choledocholithiasis even after adjustment for age (Odds ratio: 0.193, 95% Confidence interval: 0.039–0.954, p = 0.044). The interreader agreement for insertion assessment was good (Cohen’s Kappa: 0.748, p

Bu çalışmada çekme kuvveti sebebiyle dokuma kumaşlarda gerçekleşen boyut değişikliklerinin ölçülmesi amacıyla dairesel Hough dönüşümü tabanlı bir görüntü işleme yöntemi geliştirilmiştir. Bunun için farklı yapısal parametrelere sahip dokuma kumaşlar üzerine iğneler yerleştirilerek, kumaşlar çözgü doğrultusunda çekme işlemine tabi tutulmuştur. Bu esnada 30 saniye süresince 5’er saniye aralıklarla alınan kumaş görüntüleri bilgisayara kaydedilmiştir. Kumaş görüntüleri üzerindeki iğneler arası mesafeler hem el ile çizim yöntemiyle hem de dairesel Hough dönüşümü tekniği kullanılarak geliştirilen görüntü işleme yöntemiyle ölçülmüştür. İki ölçüm yöntemi ile elde edilen sonuçlar incelendiğinde sonuçlar arasındaki sapmanın %1’den düşük olduğu görülmüştür. Tüm ölçümler hesaba katılarak hesaplanan ortalama yüzde sapma değeri ise yalnızca %0,26’dır. İki ölçüm yöntemi ile elde edilen sonuçlar arasındaki korelasyon katsayısı değeri 0,99 hesaplanmıştır. Geliştirilen görüntü işleme temelli ölçüm yöntemi, dokuma kumaşların gerilme altındaki boyut değişikliklerini kolay, hızlı ve doğru olarak ölçebilmektedir.

The aim of this study is to determine the 7-day exercise and physical activity levels of physically disabled athletes located in all geographical regions of Turkey and to examine the factors affecting this. The Physical Activity Scale for Individuals with a Physical Disability was applied as an online survey. The study group consisted of 224 physically disabled athletes, including orthopedic standing, orthopedic wheelchair, visually and hearing impaired athletes. In the analyses, MannWhitney U test for independent groups in binary categorical variables; the Kruskal-Wallis test was used for triple categorical variables. One-Way Analysis of Variance for the Obstacle Type variable, Post-Hoc multiple comparison test was applied for significant differences and Tamhane's T2 Test was used, one of the non-homogeneous Post-Hoc tests. When the 7-day physical activity status of physically disabled individuals is examined; It was determined that they participated in the activity situations in the questions in 3 subcategories for less than 1 hour. It was determined that social media had the highest score in the orientation variables and there was a significant difference between the school/physical education teacher and social media. In the analysis made on the variables of disability types, it was found that there was a significant difference between hearing and orthopedic wheelchair disabled people in repair and gardening work. As a result, it is thought that more licensed athletes should be trained and their participation in sports competitions should be supported in order to enable physically disabled athletes to participate in sports activities in their daily lives, and that individuals can lead a healthy life by increasing their physical activities.

This study investigated the effect of a paper folding activity prepared to develop the sixth-grade students' concept definitions and images of parallelism and perpendicularity concepts. The study also examined how the concept definition and images changed after the paper folding activity. A combination of quantitative and qualitative methods was used. A one-group pre-/posttest design revealed that the paper folding activity had a significant positive effect on students' concept definitions and images. In addition, the interviews after pre- and post-tests indicated that the students' personal concept definitions of parallelism and perpendicularity of two lines/line segments began to match the formal concept definitions of these concepts after the paper folding activity. Lastly, missing and mis-in concept image situations, encountered generally in the pre-test, were observed less after the paper folding activity.

The current research aimed to unpack teachers' knowledge of integers by investigating how they used the number line and counter models to represent the two meanings of division (i.e., partitive and measurement). The participants were three middle school mathematics teachers working in different cities in Türkiye. Data consisted of teachers' written responses to an open-ended questionnaire consisting of four division operations and interviews conducted thereafter. Findings revealed that although two teachers could accurately model all division operations with the number line model, one teacher could neither provide a problem context nor a model displaying one of the division operations. For the counter model, only one teacher could accurately model all division operations in the questionnaire.

ChatGPT has become a prominent tool for fostering personalized and interactive learning with the advancements in AI technology. This study analyzes 212 academic research articles indexed in the Scopus database as of July 2023. It maps the trajectory of educational studies on ChatGPT, identifying primary themes, influential authors, and contributing institutions. By employing bibliometric indicators and network analysis, the study explores collaboration patterns, citation trends, and the evolution of research interests. The findings show the exponential growth of interest in leveraging ChatGPT for educational purposes and provide insights into the specific educational domains and contexts that have garnered the most attention. Furthermore, the study reveals the collaborative dynamics and intellectual foundations shaping the field by examining co-authorship and citation networks. This bibliometric analysis contributes to a comprehensive understanding of the current state of ChatGPT research in education, offering researchers and practitioners valuable insights into evolving trends and potential future directions for this innovative aspect of AI and learning.

Faculties of Fine Arts in Turkey train artists and designers by using the universal language of art, taking into account scientific, artistic and cultural developments, developing students' creativity and productivity. In addition to the problems encountered by fine arts students and artists, who have creative personality elements, during the performance of art and the application of methods and techniques available in the literature, the level of use of technology will directly affect their artistic performances and activities. The aim of this study is to examine the creative personality traits and internet usage status-purposes of university students studying in Fine Arts Faculties on a relational basis. The study, which was conducted in the relational survey model, included 205 students studying at the fine arts faculties. Creative personality traits scale and internet usage intentions questionnaire were used to collect the data of the study. According to the findings of the study, the creativity personality traits of the participants are at a high level. In addition, creative personality traits of the students show partial differences according to gender variable. According to another result of the study, it was seen that the students of the Faculty of Fine Arts use "Social networking sites", "Video sharing sites", "Photo sharing sites" applications at a high level. Again, the internet usage purposes of the participants differ according to the gender variable. Finally, significant relationships were found between the participants' creative personality traits and their internet usage purposes.

In this study, since no candidate received more than fifty percent of the votes in the TRNC Presidential election held on October 11, 2020, the election campaign visions of the candidates who made it to the second round and their latest commercials were analyzed using discourse analysis. For this purpose, the political advertising campaign contents of Mustafa Akinci and Ersin Tatar, who made it to the second round of the Presidential election, were examined under the four headings of language clarity and understandability, transmission of political messages, informative content, political ethics and impartiality, which are four items within the scope of educational language in political advertising, and their contribution to the election result was evaluated.

Background and objectivesNon-invasive ventilation (NIV) is used in intensive care units (ICUs) to treat of respiratory failure. Sedation and analgesia are effective and safe for improving compliance in patients intolerant to NIV. Our study aimed to evaluate the effects of dexmedetomidine, remifentanil, and propofol on the clinical outcomes in NIV intolerant patients.MethodsThis prospective randomized cohort study was conducted in a tertiary ICU, between December 2018 and December 2019. We divided a total of 120 patients into five groups (DEXL, DEXH, REML, REMH, PRO). IBM SPSS Statistics 20 (IBM Corporation, Armonk, New York, USA) was used to conduct the statistical analyses.ResultsThe DEXL, DEXH, REML, and REMH groups consisted of 23 patients each while the PRO group consisted of 28 patients. Seventy-five patients (62.5%) became tolerant of NIV after starting the drugs. The NIV time, IMV time, ICU LOS, hospital LOS, intubation rate, side effects, and mortality were significantly different among the five groups (P = 0.05). In the groups that were given dexmedetomidine (DEXL, and DEXH), NIV failure, mortality, ICU LOS, and hospital LOS were lower than in the other groups.ConclusionIn this prospective study, we compared the results of three drugs (propofol, dexmedetomidine, and remifentanil) in patients with NIV intolerance. The use of sedation increased NIV success in patients with NIV intolerance. NIV failure, mortality, ICU LOS, IMV time, and hospital LOS were found to be lower with dexmedetomidine.

BackgroundThe WHO emphasized the importance of knowing the risk factors for the severity of the disease in the COVID-19 pandemic. Our aim in this study was to determine the relationship between serum Butyrylcholinesterase (BChE) level, which is rapidly affected by inflammation, and the severity of COVID-19 pneumonia and mortality.MethodsPatients diagnosed with COVID-19 pneumonia between March and May 2021 were included in the study. The patients were divided into two groups as severe and mild to moderate pneumonia according to the WHO's guidelines. Serum BChE levels were studied by ELISA method from the blood samples taken from the patients on the day of hospitalization. The severity of the disease and other factors affecting hospital mortality were also evaluated.Results147 patients with COVID-19 pneumonia were included in this study. Of these patients, 58% had severe pneumonia and 42% had mild to moderate pneumonia. The BChE level was median 13 (IQR: 11.2–21.5)ng/ml in patients with severe COVID-19 pneumonia and median 20 (IQR: 10–35.7)ng/ml in patients with mild to moderate pneumonia (p: 0.001). Hospital with mortality rate was higher in patients with low BChE levels. However, statistically, BChE hasn't associated mortality in COVID-19 pneumonia [OR 1.002 (0.957–1.049) p: 0.490]. CRP, procalcitonin, lactate, and D-dimer levels were associated mortality in COVID-19 pneumonia.ConclusionBeing not statistically significant, the mortality rate was higher in patients with low BChE levels. BChE level is an important marker in determining the severity of COVID-19 pneumonia. Early prediction of the severity of COVID-19 pneumonia will enable early planning of the treatment process.

Edebiyat gibi toplumsallaşma araçları bireyin kimlik gelişimi üzerinde önemli bir etkiye sahiptir. Toplumsallaşma araçlarını gözlemleyen birey kendisine uygun gördüğü rolleri model alır. Bu rollerin yansıdığı ve temsil edildiği ortamlardan birisi de kitaplardır. Bu doğrultuda araştırmanın amacı, ergenlerin tercih ettiği romanların başkahramanlarının meslek seçimlerinin incelenmesidir. Çalışmada nitel araştırma yöntemlerinden olan fenomenoloji deseni kullanılmıştır. Araştırmanın evrenini Konya ilinde, 15-18 yaş aralığındaki ergenler oluşturmaktadır. Araştırmanın örneklemi 2018-2019 Eğitim Öğretim yılında Konya'nın merkez ilçeleri olan Karatay, Meram ve Selçuklu ‘da bulunan üç okuldaki lise öğrencileridir. Araştırmada inceleme yapılacak kitaplar, 9,10,11,12. sınıf öğrencilere, en son okudukları beş kitabın isimlerinin sorulduğu bir form kullanılarak belirlenmiştir. Veriler doküman analizi yöntemi ile çözümlenmiştir. Daha sonra kelime ve kelime grubu kodlama şekli kullanılarak ana tema ve alt temalar oluşturulmuştur. Kitaplarda yer alan başkahraman sayısı 75 olarak belirlenirken, bu sayının 51’ini erkekler, 24’ünü ise kadınlar oluşturmaktadır. İncelemeye dâhil edilen kadın başrol kahramanların %58,3’ü herhangi bir meslekte çalışmıyor olarak gösterilirken, erkek kahramanların ise %7,8’i herhangi bir meslekte çalışmamaktadır. Elde edilmiş sayısal veriler bize bazı bilgiler sunmasının yanı sıra kahramanların meslek seçimleri istihdam oranları dikkat çekmektedir.

In this study, a new hybrid metaheuristic algorithm named Chaotic Sand Cat Swarm Optimization (CSCSO) is proposed for constrained and complex optimization problems. This algorithm combines the features of the recently introduced SCSO with the concept of chaos. The basic aim of the proposed algorithm is to integrate the chaos feature of non-recurring locations into SCSO’s core search process to improve global search performance and convergence behavior. Thus, randomness in SCSO can be replaced by a chaotic map due to similar randomness features with better statistical and dynamic properties. In addition to these advantages, low search consistency, local optimum trap, inefficiency search, and low population diversity issues are also provided. In the proposed CSCSO, several chaotic maps are implemented for more efficient behavior in the exploration and exploitation phases. Experiments are conducted on a wide variety of well-known test functions to increase the reliability of the results, as well as real-world problems. In this study, the proposed algorithm was applied to a total of 39 functions and multidisciplinary problems. It found 76.3% better responses compared to a best-developed SCSO variant and other chaotic-based metaheuristics tested. This extensive experiment indicates that the CSCSO algorithm excels in providing acceptable results.

Mosquitoes are competent vectors for many important arthropod-borne viruses (arboviruses). In addition to arboviruses, insect-specific viruses (ISV) have also been discovered in mosquitoes. ISVs are viruses that replicate in insect hosts but are unable to infect and replicate in vertebrates. They have been shown to interfere with arbovirus replication in some cases. Despite the increase in studies on ISV–arbovirus interactions, ISV interactions with their hosts and how they are maintained in nature are still not well understood. In the present study, we investigated the infection and dissemination of the Agua Salud alphavirus (ASALV) in the important mosquito vector Aedes aegypti through different infection routes (per oral infection, intrathoracic injection) and its transmission. We show here that ASALV infects the female Ae. aegypti and replicates when mosquitoes are infected intrathoracically or orally. ASALV disseminated to different tissues, including the midgut, salivary glands and ovaries. However, we observed a higher virus load in the brain than in the salivary glands and carcasses, suggesting a tropism towards brain tissues. Our results show that ASALV is transmitted horizontally during adult and larval stages, although we did not observe vertical transmission. Understanding ISV infection and dissemination dynamics in Ae. aegypti and their transmission routes could help the use of ISVs as an arbovirus control strategy in the future.

In this paper, we propose an efficient Chebyshev collocation scheme to solve diffusion problem including time fractional diffusion equation considering the fractional derivative in the Liouville-Caputo sense. By making use of shifted Chebyshev polynomial series and their orthogonality properties, the problem is reduced to the system of fractional ordinary differential equations which can be solved by residual power series method (RPSM) with the help of the given scheme and boundary conditions. The numerical examples shows that the method is reliable and effective to construct the numerical solution of fractional diffusion equation.

The motivation of this paper is to construct the solution of fractional partial differential equations (FPDEs) by the combination of Laplace transform homotopy analysis method (LHAM) and the Laplace transform residual power series method (LRPSM) with weighted Atangana-Baleanu and weighted Caputo-Fabrizio fractional derivatives with specific weighted functions. Moreover, the solutions are analyzed by comparing with exact solutions of these equations. The obtained consequences illustrate that methods LHAM and LRPSM work very well to determine the solutions of FPDEs with weighted fractional derivatives in consideration.

Preceding a core-collapse supernova (CCSN), various processes produce an increasing amount of neutrinos of all flavors characterized by mounting energies from the interior of massive stars. Among them, the electron antineutrinos are potentially detectable by terrestrial neutrino experiments such as KamLAND and Super-Kamiokande (SK) via inverse beta decay interactions. Once these pre-supernova (pre-SN) neutrinos are observed, an early warning of the upcoming CCSN can be provided. In light of this, KamLAND and SK, both located in the Kamioka mine in Japan, have been monitoring pre-SN neutrinos since 2015 and 2021, respectively. Recently, we performed a joint study between KamLAND and SK on pre-SN neutrino detection. A pre-SN alert system combining the KamLAND detector and the SK detector was developed and put into operation, which can provide a supernova alert to the astrophysics community. Fully leveraging the complementary properties of these two detectors, the combined alert is expected to resolve a pre-SN neutrino signal from a 15 M ⊙ star within 510 pc of the Earth at a significance level corresponding to a false alarm rate of no more than 1 per century. For a Betelgeuse-like model with optimistic parameters, it can provide early warnings up to 12 hr in advance.