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Abstract Background and aim There are a significant number of Turkish speaking immigrants living in London. Their special health issues including women's health, mental health, and alcohol and smoking habits has been assessed. The aim of this study was to explore the ongoing challenges in access to health care services and its impact on Quality of Life of immigrants. Material and methods This cross-sectional population-based study was conducted between March and August 2010 with Turkish immigrants (n = 416) living in London. Of these, 308 (74%) were Turkish and 108 (26%) were Turkish Cypriots. All healthy or unhealthy adults of 17-65 years of age were enrolled. A structured questionnaire with 44 items in five subcategories and 26-items WHOQOL BREF were used. Results Mean duration of stay for Turkish Cypriots (26.9 ± 13.9 years) was significantly longer than Turkish immigrants (13.3 ± 7.5) (p < 0.001). Turkish immigrants (n = 108, 36.5%) need interpretation more often when using health services than Turkish Cypriots (n = 16, 15%) (p < 0.001). Multivariate analyses suggested significant effects of older age, non-homeownership, low socioeconomic class, poor access to health services, being ill, poor community integration and being obese on physical well-being and also significant effects of low income and poor community integration on perceived overall Quality of Life (WHOQOL) of the participants. Conclusions The results of this study demonstrate how the health and well-being of members of the Turkish speaking community living in London are affected by social aspects of their lives. Providing culturally competent care and interpretation services and advocacy may improve the accessibility of the health care.

Abstract Background The quality of life in patients with diabetes is reduced and emotional coping with the disease has great impact on patient well-being. Objectives The aim of this study was to assess the psychological well-being and treatment satisfaction in patients with type 2 diabetes mellitus in primary care. Study Design and Setting Patients (n = 112) with type 2 diabetes mellitus diagnosis for at least six months were enrolled. The Well-Being Questionnaire-22 and the Diabetes Treatment Satisfaction Questionnaire were used. Physical examination and laboratory investigations were performed. Results The rates of the achieved targets were 32.1% for hemoglobin A1c, 62.5% for cholesterol and 20.5% for blood pressure. The mean scores for the general well-being, depression, anxiety, positive well-being and energy were 44.40 ± 13.23 (range = 16-62), 12.65 ± 3.80 (range = 5-18), 10.57 ± 4.47 (range = 1-18), 12.00 ± 4.01 (range = 2-18), and 9.16 ± 2.47 (range = 2-12), respectively. The mean scores for the treatment satisfaction, perception for hyperglycemia and perception for hypoglycemia were 22.37 ± 9.53 (range = 0.00-36.00), 1.71 ± 1.59 (range = 0-6), and 0.51 ± 0.98 (range = 0-6), respectively. There were significant associations between the depression score and the educational status, compliance to diet and physical exercise, and diabetic complications; between the anxiety score and the educational status, glycemic control, compliance to diet and physical exercise; between the energy score and the educational status, compliance to physical exercise, and diabetic complications; between the positive well-being score and the educational status, compliance to diet and physical exercise, complications and type of treatment; between the general well-being score and the educational status, compliance for diet and physical exercise, and complications. Treatment satisfaction was significantly associated to the educational status, glycemic control and compliance to diet and physical exercise. A significant correlation was found between the treatment satisfaction and the well-being. Conclusions Individualized care of patients with diabetes should consider improving the quality of life. Psychosocial support should be provided to the patients with type 2 diabetes and the negative effects of psychopathological conditions on the metabolic control should be lessened.

We propose a procedure to estimate the model parameters of presented nonlinear Resistance-Capacitance (RC) and the widely used linear Resistance-Inductance-Capacitance (RIC) models of the respiratory system by Maximum Likelihood Estimator (MLE). The measurement noise is assumed to be Generalized Gaussian Distributed (GGD), and the variance and the shape factor of the measurement noise are estimated by MLE and Kurtosis method, respectively. The performance of the MLE algorithm is also demonstrated by the Cramer-Rao Lower Bound (CRLB) with artificially produced respiratory signals. Airway flow, mask pressure, and lung volume are measured from patients with Chronic Obstructive Pulmonary Disease (COPD) under the noninvasive ventilation and from healthy subjects. Simulations show that respiratory signals from healthy subjects are better represented by the RIC model compared to the nonlinear RC model. On the other hand, the Patient group respiratory signals are fitted to the nonlinear RC model with lower measurement noise variance, better converged measurement noise shape factor, and model parameter tracks. Also, it is observed that for the Patient group the shape factor of the measurement noise converges to values between 1 and 2 whereas for the Control group shape factor values are estimated in the super-Gaussian area.

Introduction: Due to most likely use of Bacillus anthracis in biological terrorism agents, the rapid and sensitive detection of its spores is crucial in both taking prophylactic measures and proper treatment. This study aimed to develop an amperometric electrochemical immunosensor for the detection of B. anthracis spores., Methods: A new amperometric biosensor was designed using a combination of magnetic beads and multiplex screen-printed electrodes. This method measures changes in current intensity resulting from oxidation and reduction in the working electrode directly to spore concentrations., Results: A standard curve was formed to test the number of live spores between 2 × 102-2 × 104 spores/ml concentrations. LOD and LOQ values were found to be 92 and 272 spores/ml, respectively. No cross-reactions were seen for Bacillus subtilis, Bacillus cereus and Bacillus thuringiencis spores., Conclusions: It is shown that the designed Anthrax immunosensor has high sensitivity and selectivity with rapid detection results., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Multidrug-resistant Acinetobacter baumannii is still a major contributor to outbreaks and infections health care-associated infections. This study aimed to investigate an outbreak of wound infection due to A baumannii in trauma patients injured in the Kahramanmaraş earthquake., Methods: This retrospective case-control study was conducted on an outbreak of wound infection caused by A. baumannii in trauma patients affected by the February 6 Turkey earthquake. Among the patients who underwent at least one extremity surgery due to earthquake-related crush-trauma injury, patients with wound infection due to A baumannii were included in the case group and without infection were included in the control group. Multivariate analysis and logistic regression were performed to identify risk factors. Environmental cultures were taken to identify the source of the outbreak. Molecular typing by pulsed-field gel electrophoresis was used to confirm the relationships of the wound infection agent A. baumannii strains., Results: A total of 44 patients were included in the case group and 62 patients in the control group. Time under the debris; 22.0 versus 35.7 (odds ratio [OR]:1.02, 95% confidence interval [CI]: 1.00-1.04) and hemodialysis (OR: 6.09, 95% CI: 1.64-22.66) were identified as risk factors for in the multivariate analysis. Performing the first intervention in a fully equipped tertiary hospital was seen as an infection-reducing factor compared to performing it in a field hospital (OR: 0.21, 95% CI: 0.06-0.68). Dressing trolleys and scissors were identified as the source of the outbreak., Conclusions: After devastating earthquakes, a large number of patients are admitted and require emergency interventions due to life-threatening conditions. Organ failure often develops and requires the use of invasive catheters and procedures. Compliance with infection control measures and clean surgical interventions reduce wound site infections and allow extremities to heal, while problems in adhering to infection control measures can lead to many problems such as outbreaks of gram-negative bacteria. This highlights the importance of infection control measures., (Copyright © 2024 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

Objectives: System approach to the human respiratory system and input/output signals which characterize the system properties were not explored in detail in the literature. The aim of this study is to propose a combination of methods to investigate the indirect relationship between the fractal properties of Respiratory Signals (RS) and Respiratory Sound Signals (RSS) and the clinically measured respiratory parameters., Methods: We used Hurst exponent to reveal the fractal properties of RS and RSS and to estimate the pressures in the respiratory system. The combination of well-known statistical signal processing methods and optimization were applied to the experimentally acquired 23 records. Pearson correlation coefficient and Bland-Altman analysis were the chosen validation methods., Results: Considerable amounts of Hurst exponent values of RSS were found to be between 0.5 and 1, which means increasing trend or decreasing trend can be seen in RSS with fractional Gaussian process properties. Results of the pressure estimator revealed that internal pressure due to tissue viscoelasticity is higher than the pressure due to static elasticity. Feature power and skewness also provided distinctive results for all recordings., Conclusion: Hurst exponent values of the RSS are fruitful representation of the signals which bring the underlaying system characteristics into the surface. We illustrated that required number of sensors can be reduced in the feature calculation to ease implementation effort on the hardware of the handheld devices., Significance: Bland-Altman plots were very successful to demonstrate the connection between the sets of measured respiratory parameters and calculated features.

Background and Objectives: Linear parametric respiratory system models have been used in the model-based analysis of the respiratory system. Although there are studies exploring the physiological correctness and fitting accuracy of the models, they are not analysed in terms of interaction between parameters and dynamics of the model. In this study we propose to use state-space modelling to yield the time-varying nature of the system incorporated by the parameters., Methods: We tested controllability, observability and stability characteristics of the equation of motion, 2-comp. parallel, 2-comp. series, viscoelastic, 6-element and mead models while using the parameters given in the literature. In the sensitivity analysis we proposed to use dual Desensitized Linear Kalman Filter (DKF) and Extended Kalman Filter (EKF) method. In this method, state error covariance revealed the parameter sensitivities for each model., Results: Results showed that all models, except 2-comp. parallel and mead models, are both controllable and observable models. On the other hand all models, except mead model, are stable models. Regarding to the sensitivity analysis, dual DKF - EKF method estimated states of the models successfully with a low estimation error. Sensitivity analysis results showed that airway parameters have higher effects on the state estimation than the other parameters have., Conclusion: We proved that state-space evaluation of the previously proposed parametric models of the respiratory system led us to quantitative and qualitative assessments of the respiratory models. Moreover parameter values found in the literature have different effects on the models., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Objectives: The purpose of this prospective study was to investigate the effect of nonsurgical periodontal treatment (PT) on anxiety/depression scale scores and on gingival crevicular fluid (GCF) cortisol (COR) and dehydroepiandrosterone (DHEA) levels., Methods: Fifty-five participants with generalized chronic periodontitis (GCP group, n: 21), with localized chronic periodontitis (LCP group, n: 19) and with gingivitis or healthy (control group, n: 15) subjects were treated and followed up for 6 months. Clinical periodontal parameters include plaque index, gingival index, bleeding on probing, probing depth and attachment level; psychosocial measurements include Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI 1-2) psychometric instruments; hormone levels in GCF including COR and DHEA were evaluated., Results: All clinical parameters were significantly decreased (except attachment loss) after PT (p < 0.05). No significant differences were observed between the two groups for STAI-1-2 and BDI scores, either at baseline or at 6 months (p > 0.05). COR levels were statistically lower following PT in GCP and LCP groups when compared to the baseline levels (p < 0.05). DHEA values at baseline and 6 months did not show significant differences., Conclusion: Within the limits of the study, decreased GCF COR and unchanged GCF DHEA levels were determined in nonsurgically treated patients regardless of the extent and severity of periodontitis., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved.)

Background and Objectives: The understanding of the bonds and the relationships between the respiratory signals, i.e. the airflow, the mouth pressure, the relative temperature and the relative humidity during breathing may provide the improvement on the measurement methods of respiratory mechanics and sensor designs or the exploration of the several possible applications in the analysis of respiratory disorders. Therefore, the main objective of this study was to propose a new combination of methods in order to determine the relationship between respiratory signals as a multidimensional data., Methods: In order to reveal the coupling between the processes two very different methods were used: the well-known statistical correlation analysis (i.e. Pearson's correlation and cross-correlation coefficient) and parallel coordinate plots (PCPs). Curve bundling with the number intersections for the correlation analysis, Least Mean Square Time Delay Estimator (LMS-TDE) for the point delay detection and visual metrics for the recognition of the visual structures were proposed and utilized in PCP., Results: The number of intersections was increased when the correlation coefficient changed from high positive to high negative correlation between the respiratory signals, especially if whole breath was processed. LMS-TDE coefficients plotted in PCP indicated well-matched point delay results to the findings in the correlation analysis. Visual inspection of PCB by visual metrics showed range, dispersions, entropy comparisons and linear and sinusoidal-like relationships between the respiratory signals., Conclusion: It is demonstrated that the basic correlation analysis together with the parallel coordinate plots perceptually motivates the visual metrics in the display and thus can be considered as an aid to the user analysis by providing meaningful views of the data., (Copyright © 2017 Elsevier B.V. All rights reserved.)

The aim of this cross-sectional study was to determine the prevalence of tonsillectomy among secondary school children and to investigate whether tonsillectomy with or without adenoidectomy is a risk factor for childhood obesity. A total of 27 secondary schools with 12,296 students between the ages 11 and 17 were screened in Denizli, Turkey. We determined 129 students who had undergone tonsillectomy; each student was matched with two healthy control subjects of the same age and sex (n = 258). A 28-item questionnaire on nutrition and physical exercise was completed by the parents. Age-adjusted body mass index and waist circumference percentiles of Turkish boys and girls were used for the assessment of overweight and obesity. The prevalence of tonsillectomy was 1.0 %. There was no significant relationship between having tonsillectomy and being overweight or obese and physical exercise and screen time (p > 0.05 for each). Logistic regression analyses suggested no significant effect of tonsillectomy on overweight or obesity of the subjects (p > 0.05). It seems that tonsillectomy had no effect on overweight and obesity among children.

A method is described for quantification of the beef tenderness marker, calpastatin, in meat samples by amperometric detection. Using a novel bovine recombinant partial calpastatin protein as standard antigen a low detection limit of 0.2 ng/mL was achieved. The influence of the complex matrix was minimised by heat pretreatment and dilution of the samples prior to detection of calpastatin. The relative error between the direct sample measurement and standard addition methods was 5.89%, confirming the accuracy of the developed amperometric immunoassay., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Defining "healthy weight" is not easy and for an adolescent with all concerns about newly developing physiognomy it is even harder. The aim of this study was to find out the frequency of obesity and the association between the body mass index (BMI), weight-control behaviors and self-perceived body weight status in high school students of a southern city of Turkey. The students from 10 schools were randomly selected among 46,271 students of 72 high schools in Adana from 1999 to 2000. The response rate was 94.8% (2352/2480). The Turkish version of Youth Risk Behavior Survey Questionnaire (YRBSQ) was completed by the students. The students' weights and heights were measured. The mean age was 16.5 +/- 1.0 years of age (range = 14-21 years). The mean BMI was 21.0 +/- 3.1, 25.5% of students were underweight, 65.7% were normal, 6.4% were overweight and 2.3% were obese (p = 0.0001). Of all students, 24.3% defined themselves as thin, 45.3% as normal, 24.9% as overweight and 5.5% as obese (p = 0.0001). The percentage of girls defining their body weight as overweight and obese was significantly higher than the boys (p = 0.0001). Of all students, 35.5% wanted to lose weight, 22.3% wanted to gain weight, 27.8% wanted to keep their current weight. Intention (p = 0.0001) and interventions to lose weight such as going on a diet (p = 0.0001), provocative vomiting (p = 0.0001) and 24-hours starving (p = 0.0001) were significantly higher in girls than boys. Of students, 26.8% (n=620) were on a diet program either to lose or to keep their body weight. There was significant relationship between being on a diet program and intention to change body weight (p = 0.047). We concluded that adolescents living in Adana have relatively higher risk of being underweight than being obese and have unhealthy weight changing plans due to their misperception of their body images. Adolescents may be unconscious on plans and attempts to change their body weights and nutrition and we suggest that education on nutrition and health is required for adolescents.

Background: The quality of life in patients with diabetes is reduced and emotional coping with the disease has great impact on patient well-being., Objectives: The aim of this study was to assess the psychological well-being and treatment satisfaction in patients with type 2 diabetes mellitus in primary care., Study Design and Setting: Patients (n = 112) with type 2 diabetes mellitus diagnosis for at least six months were enrolled. The Well-Being Questionnaire-22 and the Diabetes Treatment Satisfaction Questionnaire were used. Physical examination and laboratory investigations were performed., Results: The rates of the achieved targets were 32.1% for hemoglobin A1c, 62.5% for cholesterol and 20.5% for blood pressure. The mean scores for the general well-being, depression, anxiety, positive well-being and energy were 44.40 +/- 13.23 (range = 16-62), 12.65 +/- 3.80 (range = 5-18), 10.57 +/- 4.47 (range = 1-18), 12.00 +/- 4.01 (range = 2-18), and 9.16 +/- 2.47 (range = 2-12), respectively. The mean scores for the treatment satisfaction, perception for hyperglycemia and perception for hypoglycemia were 22.37 +/- 9.53 (range = 0.00-36.00), 1.71 +/- 1.59 (range = 0-6), and 0.51 +/- 0.98 (range = 0-6), respectively. There were significant associations between the depression score and the educational status, compliance to diet and physical exercise, and diabetic complications; between the anxiety score and the educational status, glycemic control, compliance to diet and physical exercise; between the energy score and the educational status, compliance to physical exercise, and diabetic complications; between the positive well-being score and the educational status, compliance to diet and physical exercise, complications and type of treatment; between the general well-being score and the educational status, compliance for diet and physical exercise, and complications. Treatment satisfaction was significantly associated to the educational status, glycemic control and compliance to diet and physical exercise. A significant correlation was found between the treatment satisfaction and the well-being., Conclusions: Individualized care of patients with diabetes should consider improving the quality of life. Psychosocial support should be provided to the patients with type 2 diabetes and the negative effects of psychopathological conditions on the metabolic control should be lessened.

An immunological capacitive biosensor for calpastatin was developed, optimized and applied for the analysis of meat extract samples. Anti-calpastatin antibody was immobilized on a gold electrode modified with a self-assembled monolayer of mercaptoundecanoic acid and Protein A from Staphylococcus aureus, and the obtained immunosensor was inserted as the working electrode in an electrochemical cell of a flow injection system. The dynamic range of the sensor was 20 to 160 ng/mL calpastatin. The electrode could be regenerated and re-used for more than 7 days with minimal reduction in sensitivity. For the analysis of real samples, the target analyte was extracted from the Longissimus dorsi muscle from beef carcasses directly after slaughtering. The extract was analyzed both with the developed immunosensor and microtiter plate ELISA, and a good correlation was obtained. However the immunosensor offers advantages of speed, simplicity, sensitivity and possibility for miniaturization over conventional assays for calpastatin quantification.