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'Purpose: 'To evaluate the diagnostic value of magnetic resonance diffusion-weighted imaging (DWI) using apparent diffusion coefficient (ADC) values to the characterization of breast lesions and differentiation of benign and malignant lesions. 'Materials and methods: 'Thirty-seven women (mean age, 38 years) with 37 enrolled in the study. DWI and ADC maps in the axial plane were obtained using a 1.5 Tesla MRI device. Mean ADC measurements were calculated among cysts, normal fibroglandular tissue, benign lesions and malignant lesions were evaluated. 'Results: 'Out of 37 women, 4 had normally breast MRI findings. The diagnosis of remaining 33 patients with 37 breast lesions were as follows; malign lesions (n = 23), benign lesions (n = 10) and simple breast cyst (n = 4). The ADC values were as follows ( in units of 10-3 mm2/s ): Normal fibroglandular tissue (range: 1.39-2.06; mean:1.61 ± 0.23), benign breast lesions (range: 1.09-1.76; mean: 1,47 ± 0.25), cyts (range: 2.27-2.46, mean: 2,37 ± 0.07) and malignant breast lesions (range: 0.78-1.26, mean: 0.96 ± 0.25). The mean ADC obtained from malignant breast lesions was statistically different from that observed in benign solid lesions (p < < 0.01) and normal fibroglandular breast tissue (p < 0.01). Furthermore, the mean ADC values of benign breast lesions was not statistically different from cyst (p = 0,01) and normal fibroglandular breast tissue (p = 0,01). A ADC value of 1.1 × 10-3 mm2/s as a treshold value provided differentiation for malign and benign lesions, with a sensitivity of 91.3% and a specificity of 85.7% compared with conventional breast MRI values. 'Conclusion: 'DWI with quantitative ADC measurements is a reliable tool for differentiation of benign and malignant breast lesions.

In this paper, He's variational approach is extended to investigate coupled nonlinear multi-degree-of-freedom (mdof) oscillatory systems. A mass-spring system with nonlinear stiffness is considered as an example and approximate amplitude-frequency relations for 2-DOF and 3-DOF nonlinear systems are obtained. [ABSTRACT FROM AUTHOR]

In this paper, we use He's max-min approach for obtaining a periodic solution of generalized nonlinear discontinuity equation. Although the method is quite simple, it is very efficient in the solution of a nonlinear oscillator. The solutions obtained using the approach presented here are then compared to those found in the literature and they are found to agree well with each other. [ABSTRACT FROM AUTHOR]

In this paper a new variational method is applied to nonlinear oscillators with discontinuities. The method is originally proposed by Ji-Huan He for nonlinear oscillators. Two groups of examples are given to illustrate the effectiveness of the method. The results are valid for whole solution domain. [ABSTRACT FROM AUTHOR]

In this paper, Hamiltonian approach is extended to investigate coupled nonlinear multi-degree-of-freedom oscillatory systems. At the beginning of the study, basic principles of Hamiltonian approach are provided for multiple coupled oscillators. In the next section, the amplitude-frequency relation for the two-degree-of-freedom nonlinear mechanical systems is obtained via Hamiltonian approach. The natural frequency expression is compared to show the agreement between the present and published results. Additionally, the approximate and numerical periodic solutions are plotted. [ABSTRACT FROM AUTHOR]

In this study, pre-processes for urban areas detection in synthetic aperture radar (SAR) images are examined. These pre-processes are image smoothing, thresholding and white coloured regions determination. Image smoothing is carried out to remove noises then thresholding is applied to obtain binary image. Finally, candidate urban areas are detected by using white coloured regions determination. All pre-processes are applied by utilizing the developed software. Two different SAR images which are acquired by TerraSAR-X are used in experimental study. Obtained results are shown visually.

Background: Postorgasmic illness syndrome is characterized by flu, rhinitis, conjunctivitis, loss of appetite, muscle weakness, and fatigue after ejaculation, lasting 2-7 days. The multidisciplinary treatment approach, incorporating omalizumab and antidepressants, has rarely been documented in literature., Case Presentation: In this article, we present the case of a 33-year-old single Turkish male with postorgasmic illness syndrome, characterized by typical clinical symptoms and a positive autologous semen test. Notably, his serum estrogen and progesterone levels were elevated. The patient's Beck anxiety score was 42 points, the depression scale score was 37, and suicidal thoughts. Fresh autologous semen taken at the hospital was diluted with 0.9% saline, and prick and intradermal skin tests were performed., Conclusion: The patient's symptoms improved significantly with the combination of omalizumab and escitalopram. This case not only provides a new perspective on the management of postorgasmic illness syndrome but also highlights the potential roles of allergic, psychiatric, and endocrinological mechanisms in the etiology and treatment of this complex condition., Competing Interests: Declarations. Ethics approval and consent to participate: All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from the participant. The original article is not under consideration by another publication, and its substance, tables, or figures have not been published previously and will only be published elsewhere. Consent for publication: Written informed consent was obtained from the patient for publication of this case report and all accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests: The authors declare that they have no competing interests., (© 2024. The Author(s).)

Objective: We aimed to assess the real-world label adherence of non-vitamin K antagonist oral anticoagulant (NOAC) dosing patterns, including apixaban, edoxaban, and rivaroxaban, in Turkish patients with atrial fibrillation., Methods: This was an observational, prospective, cross-sectional, multicenter study. Patients with atrial fibrillation (AF) who were prescribed NOACs within the last 4 months were recruited from 34 cardiology clinics in Türkiye. Baseline data were initially collected, and patient awareness was evaluated at 3-4 weeks., Results: A total of 903 patients were enrolled in the study. The mean age was 72.84 ± 10.17 years. We found that 140 (15.5%), 721 (79.8%), and 42 patients (4.7%) were prescribed off-label low, on-label, and off-label high dosing, respectively. The age of the patients in the on-label group was significantly lower than that of those in the off-label low and off-label high groups (both P < 0.001). Female patients were more frequently observed in the off-label high group (P = 0.019). The body mass index values of the patients in the off-label high-dose group were significantly lower than those in the other groups (P < 0.001). The perception of income levels also revealed significant differences between the groups (P = 0.010). Furthermore, the HAS-BLED scores (the Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile International Normalized Ratio, Elderly, Drugs/Alcohol Concomitantly) were significantly lower in the on-label group than in the other groups (P < 0.001). Similarly, the CHA2DS2-VASc [the Congestive Heart Failure, Hypertension, Age ≥75 (Doubled), Diabetes, Stroke (Doubled), Vascular Disease, Age 65-74, and Sex Category (Female)] scores were significantly lower in the on-label group than in the off-label group (P < 0.001)., Conclusion: The clinical impact off-label NOAC prescriptions may vary. Therefore, raising clinician awareness about proper NOAC dosing could aid in improve the outcomes.

The present study investigated the characteristics of rare but often fatal cases of acute coronary syndrome and aortic dissection and the factors affecting mortality. HEART score, aortic dissection detection risk score, and Global Registry of Acute Coronary Event (GRACE) Score were calculated by evaluating biochemical tests and symptoms/signs of the 20 patients who were admitted to our clinic with a preliminary diagnosis of acute myocardial infarction and subsequently diagnosed with aortic dissection. The assumption of normal distribution was checked with the Shapiro-Wilk test, and independent group comparisons were made with the t test or the Mann-Whitney U test. Relationships between qualitative variables were analyzed with chi-square tests. Relationships between quantitative variables were analyzed with Pearson or Spearman correlation coefficients. Patients with conditions like hypertension and diabetes are at higher risk for aortic dissection. We recommend the use of the GRACE Score with the risk parameters we have determined for the prediction of operative mortality. We suggest that the axillary region and antegrade cerebral perfusion may be preferred as the cannulation area in dissection repair. We emphasize preliminary risk assessment according to the aortic dissection detection risk score and remind physicians that ECG ST-T and troponin changes may be misleading., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Takotsubo syndrome (TTS) still remains as an enigmatic phenomenon. In particular, long-term challenges (including clinical recurrence and persistent symptoms) and specific entities in the setting of TTS have been the evolving areas of interest. On the other hand, a significant gap still exists regarding the proper risk-stratification of this phenomenon in the short and long terms. The present paper, the second part (part-2) of the consensus report, aims to discuss less well-known aspects of TTS including specific entities, challenges after recovery and risk-stratification., Competing Interests: Conflict of Interest: The authors declare that they have no conflict of interest.

In the recent years, there has been a burgeoning interest in Takotsubo syndrome (TTS), which is renowned as a specific form of reversible myocardial dysfunction. Despite the extensive literature available on TTS, clinicians still face several practical challenges associated with the diagnosis and management of this phenomenon. This potentially results in the underdiagnosis and improper management of TTS in clinical practice. The present paper, the first part (part-1) of the consensus report, aims to cover diagnostic and therapeutic challenges associated with TTS along with certain recommendations to combat these challenges., Competing Interests: Conflict of Interest: The authors declare that they have no conflict of interest.

Background and Objectives : Hereditary angioedema (HAE) is characterized by unpredictable skin and mucosal angioedema attacks. We aimed to find the frequency of sexual-activity-triggered attacks (STAs) and understand how the sexual life of HAE with C1-inhibitor deficiency (HAE-C1INH) patients is affected. Materials and Methods : Adult HAE-C1INH patients were included in this cross-sectional study, which started in March 2020. Demographic information, marriage properties, gender-specific sexual life characteristics, and the HAE-specific histories of the patients were collected. The Hospital Anxiety and Depression Scale (HADS) and the Turkish version of the New Sexual Satisfaction Scale (NSSS) were applied to all participants. Results : Among 42 symptomatic HAE patients, 33 (78.57%) had genital attacks and 17 (42.5%) had STAs. Ten (58.8%) had genital pain, tenderness, or swelling, and five (29.4%) had isolated abdominal and groin pain. Eight (47.1%) patients with STAs experienced a HAE attack during their first time engaging in sexual intercourse. Anxiety/depression scales, NSSS scores, and distribution of other HAE attack localizations were similar in patients with and without STAs, and no gender differences were observed. Compared to the patients without STAs, the ratio of patients who stated that their sexual lives were negatively affected and that they lost their sexual desire was higher in patients with STAs. Conclusions : Genital or abdominal attacks triggered by sexual activity may be more common than thought. Sexual activity should also be questioned for evaluating attack triggers. There is a possibility of triggering an attack with the first and ongoing sexual intercourse, and patients should be informed to keep their attack treatment medications ready in advance.

The rise of generative AI tools has sparked debates about the labeling of AI-generated content. Yet, the impact of such labels remains uncertain. In two preregistered online experiments among US and UK participants ( N = 4,976), we show that while participants did not equate "AI-generated" with "False," labeling headlines as AI-generated lowered their perceived accuracy and participants' willingness to share them, regardless of whether the headlines were true or false, and created by humans or AI. The impact of labeling headlines as AI-generated was three times smaller than labeling them as false. This AI aversion is due to expectations that headlines labeled as AI-generated have been entirely written by AI with no human supervision. These findings suggest that the labeling of AI-generated content should be approached cautiously to avoid unintended negative effects on harmless or even beneficial AI-generated content and that effective deployment of labels requires transparency regarding their meaning., (© The Author(s) 2024. Published by Oxford University Press on behalf of National Academy of Sciences.)

Media literacy tips typically encourage people to be skeptical of the news despite the small prevalence of false news in Western democracies. Would such tips be effective if they promoted trust in true news instead? A pre-registered experiment (N = 3919, US) showed that Skepticism-enhancing tips, Trust-inducing tips, and a mix of both tips, increased participants' sharing and accuracy discernment. The Trust-inducing tips boosted true news sharing and acceptance, the Skepticism-enhancing tips hindered false news sharing and acceptance, while the Mixed tips did both. Yet, the effects of the tips were more alike than different, with very similar effect sizes across conditions for true and false news. We experimentally manipulated the proportion of true and false news participants were exposed to. The Trust and Skepticism tips were most effective when participants were exposed to equal proportions of true and false news, while the Mixed tips were most effective when exposed to 75% of true news - the most realistic proportion. Moreover, the Trust-inducing tips increased trust in traditional media. Overall, we show that to be most effective, media literacy tips should aim both to foster skepticism towards false news and to promote trust in true news., (© 2024. The Author(s).)

Objective: This study aimed to analyse clinical and radiological features (phenotypes) to predict revision risk after functional endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyps., Method: Phenotype characteristics of the patients with chronic rhinosinusitis with nasal polyps who underwent functional endoscopic sinus surgery were analysed retrospectively., Results: The rates of asthma, aspirin sensitivity, smoking and a positive prick test result were significantly higher in revision functional endoscopic sinus surgery cases ( p < 0.001, 0.001, < 0.001 and < 0.001, respectively). Multivariate analysis demonstrated that only gender, pre-operative nasal steroid use, pre-operative systemic steroid use, intra-operative systemic steroid use and smoking were significant risk factors for revision functional endoscopic sinus surgery ( p = 0.034, 0.001, 0.010, 0.007 and 0.001, respectively). In addition, only eosinophilia and aspirin sensitivity were significant risk factors for multiple revision functional endoscopic sinus surgery procedures ( p = 0.043 and 0.005, odds ratio = 2.4 and 5.2)., Conclusion: Beyond the endotype of chronic rhinosinusitis with nasal polyps, defining clinical and radiological factors enables a valid prediction of patients at high risk of revision functional endoscopic sinus surgery.

Hypertension is a common public health issue, and its incidene increases parallel to age. It is inevitable that certain occupational conditions may pose risks for high blood pressure or cause difficulties in managing blood pressure. Working under specific circumstances may compromise the safety of individuals with hypertension and potentially others. Therefore, it is crucial to implement activities that enhance awareness of hypertension, to ensure regular periodic examinations, and to establish necessary precautions in the workplace for the health of employees and the public. Given the limited resources offering guidance on hypertension in the context of occupational health, the authors of this paper, who hail from different disciplines, have prepared a set of consensus-based suggestions.

Purpose: Primary immunodeficiency disorder (PID) is a heterogeneous group of diseases characterized by immune dysregulation and increased susceptibility to infections, with various cognitive, emotional, behavioral, and social effects on patients. This study aimed to evaluate loneliness, social adaptation, anxiety, and depression and to identify associated factors in adults with immunodeficiency., Methods: A cross-sectional study in Turkey (Feb-Aug 2022) obtained sociodemographic data from patient records. The Social Adaptation Self-Evaluation Scale (SASS), UCLA-Loneliness Scale (UCLA-LS), and Hospital Anxiety and Depression Scale (HADS) were administered in individual patient interviews. HADS-Anxiety (HADS-A) and HADS-Depression (HADS-D) scores were assessed using cut-offs of 10 and 7, respectively; SASS cut-offs for social imbalance and normalcy were < 25 and > 35, respectively., Results: A total of 104 patients (60 women, 44 men) with a median age of 34 years (range: 18-89) were included in the study. Mean scores were SASS: 34.46 ± 8.11, UCLA-LS: 44.89 ± 12.66, HADS-A: 9.87 ± 4.77, and HADS-D: 9.12 ± 4.80. SASS score was negatively correlated with HADS-A, HADS-D, and UCLA-LS scores. There were positive correlations between UCLA-LS and HADS-A (r = -0.355, p < 0.01) and HADS-D (r = -0.614, p < 0.01) and between HADS-A and HADS-D (r = -0.454, p < 0.01). Low-income level was associated with higher HADS-A, HADS-D, and UCLA-LS scores and lower SASS score (p = 0.012, p = 0.041, p = 0.008, and p = 0.001, respectively)., Conclusion: Adults with PID are at risk for depression and experience high levels of loneliness. Social maladjustment and loneliness contribute to anxiety and depression, and loneliness is correlated with impaired social functioning. These findings emphasize the importance of biopsychosocial evaluation of individuals diagnosed with PID., (© 2024. The Author(s).)

Background: Atrial fibrillation (AF) is strongly associated with an increased risk of ischemic events. Anticoagulation focuses on reducing the risk of embolism. Guideline recommended CHA2DS2-VASc scoring system is most widely used; however, different scoring systems do exist. Thus, we sought to assess the impact of anticoagulant treatment and different scoring systems on the development of stroke, myocardial infarction, and all-cause mortality in patients with nonvalvular AF., Methods: The present study was designed as a prospective cohort study. The enrollment of the patients was conducted between August 1, 2015, and January 1, 2016. The follow-up period was defined as the time from enrollment to the end of April 1, 2017, which also provided at least 12 months of prospective follow-up for each patient., Results: A total of 1807 patients with AF were enrolled. During the follow-up, 2.7% (48) of patients had stroke, 0.8% (14) had myocardial infarction, and 7.5% (136) died. The anticoagulation and risk factors in AF (ATRIA) score had a better accuracy for the prediction of stroke compared to other scoring systems (0.729, 95% CI, 0.708-0.750, P <.05). Patients under low-dose rivaroxaban treatment had significantly worse survival (logrank P <.001). Age, CHA2DS2-VASc score, R2CHADS2 score, ATRIA score, chronic heart failure, prior stroke, and being under low-dose rivaroxaban treatment were independent predictors of clinical endpoint (P <.001)., Conclusion: Low-dose rivaroxaban treatment was independently and strongly associated with the combined clinical endpoint. Furthermore, the ATRIA score proved to be a stronger predictor of stroke in the Turkish population.

Objective: The aim of this study was to determine adiponectin and copeptin levels that might be prognostic for cardiovascular mortality (CvsM) in ST-segment elevation myocardial infarction (STEMI) patients who had percutaneous coronary intervention (PCI)., Methods: Patients who underwent PCI between November 2010 and April 2011 were enrolled and followed for more than eight years. The baseline, demographic and angiographic findings, in-hospital follow up, laboratory results including adiponectin and copeptin levels, and echocardiographic data of the patients were evaluated., Results: There were 78 males and 20 females. The CvsM rate was 26.66% at 112 months of follow up. Some factors were significantly related to CvsM and adiponectin level was an independent predictor of mortality. A cut-off value of ≥ 8 950 ng/ml for adiponectin and ≥ 7.41 ng/ml for copeptin was related to a 3.01- and 2.83-times higher CvsM risk, respectively., Conclusion: Adiponectin level was a predictor for CvsM. Higher levels of adiponectin and copeptin could predict a higher risk of CvsM in STEMI patients.