bluuebunny/crossref_metadata_2025 huggingface dataset:
Öğretmen Adaylarının Kaynaştırma Eğitimine Yönelik Öz Yeterliklerinin Belirlenmesi
Authors: KARABULUT Havva Aysun
Published: September 2023

Bu araştırmada öğretmen adaylarının kaynaştırma eğitimine yönelik öz yeterliklerinin belirlenmesi amaçlanmıştır. Araştırmaya Bolu Abant İzzet Baysal Üniversitesinde okul öncesi öğretmenliği, ingilizce öğretmenliği, fen bilgisi öğretmenliği, ilköğretim matematik öğretmenliği, Türkçe öğretmenliği son sınıfta okuyan 110’u kadın, 15’i erkek olmak üzere 125 öğretmen adayı katılmıştır. Bu araştırma tekil tarama modeliyle desenlenmiştir. Araştırmadaki veriler araştırmanın alt amaçları doğrultusunda oluşturulan Kişisel Bilgi Formu ve Öğretmen Adaylarının Kaynaştırma Eğitimine Yönelik Öz Yeterlik Ölçeği ile toplanmıştır. Öğretmen adaylarının kaynaştırma eğitimine yönelik öz yeterlikleri yüksek bulunmuştur. Araştırmada öğretmen adaylarının kaynaştırma eğitimine yönelik öz yeterliklerinin cinsiyete, bölüme ve özel eğitim ve kaynaştırma ile ilgili bir ders alma durumuna göre farklılık göstermediği; ancak yaşa göre farklılık gösterdiği sonucuna ulaşılmıştır. 26-45 yaş aralığındaki öğretmen adaylarının iş birliği boyutunda ve ölçeğin genelinde kaynaştırma eğitimine yönelik öz yeterliklerinin 18-25 yaş aralığında olanlardan daha yüksek olduğu anlaşılmıştır. Araştırmadan elde edilen bulgular ilgili literatür ışığında tartışılmış ve yorumlanmıştır. Uygulamaya ve ileri araştırmalara yönelik önerilerde bulunulmuştur.
Çocuk Dergilerinde Bilimin Doğası ve Bilim İnsanları: Bilim Çocuk Dergisi Örneği
Authors: ŞİMŞEK Canan Laçin , KÜÇÜK ERGEN Ayşe
Published: September 2023

Fen eğitiminin temel amaçlarından olan fen okuryazarı bireyler yetiştirebilmek için bilimin nasıl işlediğinin iyi kavranması gereklidir. Bilimin doğası fen bilimleri dersi kapsamında kazandırılmaya çalışılsa da bilimin doğası ve bilim insanı ile ilgili anlayışların oluşmasında formal eğitim dışında birçok kaynak etkili olmaktadır. Bu kaynaklar içinde yazılı kitle iletişim araçlarından olan dergiler önemli bir yere sahiptir ve içeriklerinde bilimin ve bilim insanının nasıl sunulduğu oldukça önemlidir. Bu çalışmada önemli bir informal öğrenme kaynağı olan ve TÜBİTAK tarafından yayınlanan Bilim Çocuk dergisinin “Simit ve Peynir’le Bilim İnsanı Öyküleri” adlı çizgi öykülerinde yer verilen bilimin doğası bileşenlerinin ve bilim insanının özelliklerinin tespit edilmesi amaçlanmıştır. Araştırmada, nitel araştırma yöntemlerinden doküman analizi kullanılmıştır. 2007-2020 yılları arasındaki sayılarda yer alan 168 çizgi öykü içerik analizi ile analiz edilmiştir. Analizlerde araştırmacılar tarafından hazırlanan “Bilimin Doğası Bileşenleri Kontrol Listesi” ve “Bilim İnsanı Özellikleri Kontrol Listesi” kullanılmıştır. Yapılan incelemelerde, çizgi öykülerde bilimin doğası ve bilim insanı ile ilgili birçok özelliğe değinildiği tespit edilmiştir. Bilimin doğası ile ilgili olarak en sık değinilen bileşenlerin, “bilimsel bilginin kanıta dayalı olduğu”, “bilimsel çalışmalarda gözlemin önemli olduğu”, “bilimsel bilginin, gözlemlerin ve çıkarımların birleşimini içerdiği”; en az değinilen bileşenlerin ise “bilimsel çalışmalar, içinde bulunduğu toplumun politik, sosyal ve kültürel yapısından etkilendiği”, “bilimsel bilginin değişebildiği”nin olduğu görülmüştür. Bilim insanları ile ilgili olarak en çok “meraklı” ve “iyi bir gözlemci” olmalarına değinildiği, en az ise “hayal gücüne sahip olma”nın vurgulandığı belirlenmiştir. Bilim Çocuk dergisinde yer alan çizgi anlatımların, bilimin doğası ve bilim insanı ile ilgili uygun bilgi ve düşünceler oluşturma konusunda iyi bir araç olacağı söylenebilir.
Evaluation of Vitamin D Levels in Kütahya Province: A Hospital-Based Retrospective Study
Authors: ARIK Özlem , ARIKAN İnci , PAŞALI KİLİT Türkan , KOÇAK Havva
Published: October 2023

Objective: The general health status and quality of life of individuals are negatively impacted by symptoms arising from vitamin D deficiency. Vitamin D, a steroid vitamin, is primarily synthesized in the skin (90-95%) under the influence of sunlight. This study aimed to determine the vitamin D status of outpatients admitted to Kütahya Health Sciences University Evliya Çelebi Training and Research (KHSU-ECTR) Hospital between 2017 and 2021, considering age, gender, and season.

Material and Methods: Retrospective analysis was conducted on patients whose 25-Hydroxy Vitamin D (25-OH VitD) levels were studied, using data from the hospital database. The study included a total of 121,727 patients. Logistic regression was utilized to determine factors influencing vitamin D deficiency, and risk assessments were conducted across different categories.

Results: The mean and standard deviation values of 25-OH VitD levels were 16.73±11.11 ng/ml. Using a cut-off value of 20 ng/ml, it was found that 71.5% of the patients exhibited vitamin D deficiency. Notably, vitamin D levels were particularly low among women and the elderly, especially during the winter season.

Conclusion: Vitamin D deficiency is prevalent among patients admitted to the hospital in Kütahya. We think that increasing sun exposure during the spring and summer seasons, as well as implementing dietary and lifestyle changes, will have a positive impact on vitamin D levels.
JWST/NIRSpec Measurements of Extremely Low Metallicities in High Equivalent Width Lyα Emitters
Authors: Maseda Michael V. , Lewis Zach , Matthee Jorryt , Hennawi Joseph F. , Boogaard Leindert , Feltre Anna , Nanayakkara Themiya , Bacon Roland , Barger Amy , Brinchmann Jarle , Franx Marijn , Hashimoto Takuya , Inami Hanae , Kusakabe Haruka , Leclercq Floriane , Rowland Lucie , Taylor Anthony J. , Tremonti Christy , Urrutia Tanya , Schaye Joop , Simmonds Charlotte , Vitte Eloïse
Published: October 2023

Deep Very Large Telescope/MUSE optical integral field spectroscopy has recently revealed an abundant population of ultra-faint galaxies (M
UV ≈ −15; 0.01 L
⋆) at z = 2.9−6.7 due to their strong Lyα emission with no detectable continuum. The implied Lyα equivalent widths can be in excess of 100–200 Å, challenging existing models of normal star formation and indicating extremely young ages, small stellar masses, and a very low amount of metal enrichment. We use JWST/NIRSpec’s microshutter array to follow up 45 of these galaxies (11 hr in G235M/F170LP and 7 hr in G395M/F290LP), as well as 45 lower-equivalent width Lyα emitters. Our spectroscopy covers the range 1.7−5.1 micron in order to target strong optical emission lines: Hα, [O iii], Hβ, and [N II]. Individual measurements as well as stacks reveal line ratios consistent with a metal-poor nature (2%−40% Z
⊙, depending on the calibration). The galaxies with the highest equivalent widths of Lyα, in excess of 90 Å, have lower [N II]/Hα (1.9σ) and [O iii]/Hβ (2.2σ) ratios than those with lower equivalent widths, implying lower gas-phase metallicities at a combined significance of 2.4σ. This implies a selection based on Lyα equivalent width is an efficient technique for identifying younger, less chemically enriched systems.
3HWC J0631+107/LHAASO J0631+1040: A TeV Halo Powered by the Pulsar J0631+1036?
Authors: Zheng Dong , Wang Zhongxiang , Xing Yi
Published: October 2023

PSR J0631+1036 is a middle-aged pulsar with properties similar to those of the nearby Geminga pulsar. It is bright in γ-rays, and has been noted as the only source possibly associated with the TeV source 3HWC J0631+107 (also the LHAASO J0631+1040). For understanding the nature of the TeV source, we analyze the GeV γ-ray data obtained with the Large Area Telescope on board the Fermi Gamma-ray Space Telescope for the source region. We are able to remove the pulsar’s emission from the region from timing analysis, and find that the region is rather clean without possible GeV γ-ray emission present as the counterpart to the TeV source. By comparing this pulsar to Geminga and considering the spectral feature of the TeV source, we argue that it is likely the TeV halo powered by the pulsar.
Fitting the Light Curve of 1I/‘Oumuamua with a Nonprincipal Axis Rotational Model and Outgassing Torques
Authors: Taylor Aster G. , Seligman Darryl Z. , Hainaut Olivier R. , Meech Karen J.
Published: October 2023

In this paper, we investigate the nonprincipal axis (NPA) rotational state of 1I/‘Oumuamua—the first interstellar object discovered traversing the inner solar system—from its photometric light curve. Building upon Mashchenko, we develop a model which incorporates NPA rotation and Sun-induced, time-varying outgassing torques to generate synthetic light curves of the object. The model neglects tidal forces, which are negligible compared to outgassing torques over the distances at which ‘Oumuamua was observed. We implement an optimization scheme that incorporates the NPA rotation model to calculate the initial rotation state of the object. We find that an NPA rotation state with an average period of 〈P〉 ≃ 7.34 hr best reproduces the photometric data. The discrepancy between this period and previous estimates is due to continuous period modulation induced by outgassing torques in the rotational model, as well as different periods being used. The best fit to the 2017 October data does not reproduce the 2017 November data (although the later measurements are too sparse to fit). The light curve is consistent with there being no secular evolution of the angular momentum, which is somewhat in tension with the empirical correlations between nuclear spin-up and cometary outgassing. The complex rotation of ‘Oumuamua may be the result of primordial rotation about the smallest principal axis if (i) the object experienced hypervolatile outgassing and (ii) our idealized outgassing model is accurate.
Les nouvelles demandes de réparation de la Pologne à l’Allemagne pour les dommages que celle-ci lui a infligés pendant la Seconde Guerre mondiale
Authors: Standke Klaus-Heinrich , Vaillant Jérôme
Published: September 2023

Le 1 er  septembre 2022, 77 ans après la fin de la fin de la Deuxième Guerre mondiale, sur la demande M. Jaroslaw Kaczynski, chef du parti national-conservateur au pouvoir en Pologne, le rapport d’une commission parlementaire d’experts a été présenté au public qui a estimé que les dommages causés à la Pologne par l’occupation allemande pendant la Seconde Guerre mondiale s’élèvent à 1,3 billion d’euros. Pourtant selon le gouvernement allemand la question des réparations allemandes à la Pologne à la suite de la Seconde Guerre mondiale a été définitivement réglée le 22 septembre 1990 dans le cadre des négociations « Deux plus quatre » à Moscou par la cession irrévocable des territoires allemands à l’est de la ligne Oder-Neisse. Ces territoires représentaient environ un cinquième de la superficie du Reich allemand et ont entraîné l’expulsion d’un septième de sa population. L’acceptation de cette cession territoriale a été la précondition pour la réunification allemande le 3 octobre 1990.
The internationalisation of European Space Policy – from ESA to Starfleet Academy
Authors: Hoerber Thomas
Published: September 2023

Cet article se base sur l’histoire des politiques spatiales européennes et expose les réticences, la dynamique croissante, le danger et la nécessité potentielle de la militarisation des politiques spatiales européennes. Il avance que le commandement civil et les objectifs pacifiques sont au cœur des politiques spatiales européennes, et que cette base a le potentiel de se développer en une politique spatiale internationale différente, pacifique et collaborative, plutôt qu’en une lutte de pouvoir réaliste dans l’espace. L’ouverture de l’Agence spatiale européenne à une coopération internationale plus poussée pourrait associer d’autres puissances spatiales du globe, dont les États-Unis et la Chine, pour autant qu’une telle politique spatiale internationale reste sous contrôle civil et à des fins exclusivement pacifiques. Certes, des programmes militaires seront mis en œuvre, mais la création d’institutions au sein d’une Agence spatiale internationale permettrait de réaliser des projets civils et pacifiques, et constituer une force modératrice majeure en matière de politiques spatiales internationales.
Entomofauna cadavérica en vertebrados marinos varados en la costa central del Perú
Authors: Iannacone‍ José , Alvariño Lorena , Minaya David , Alarcón Geancarlo , Rodríguez Amparo , Ávila‍ Enrique
Published: October 2023

La presente investigación evalúa la entomofauna cadavérica en vertebrados marinos varados en la costa central del Perú. Se determinó la diversidad de la entomofauna presente en diferentes estados de descomposición de 291 carcasas de 18 especies de vertebrados marinos. Cada vertebrado fue asignado a uno de los cinco estados de descomposición del cadáver: (1) fresco, (2) hinchado, (3) descomposición activa, (4) descomposición avanzada y (5) restos esqueléticos. Con relación al número total de cadáveres y de riqueza de especies, las aves fueron las dominantes. Las cuatro especies de vertebrados con mayor número de cadáveres correspondieron a Otaria flavescens (Shaw, 1800), Sula variegata (Tschudi, 1843), Pelecanus thagus (Molina, 1782) y Phalacrocorax brasilianus (Gmelin, 1789). La descomposición avanzada y los restos esqueléticos fueron los cadáveres más frecuentes. Los cuatro Órdenes de la entomofauna cadavérica presentes fueron Dermaptera, Hymenoptera, Coleoptera y Diptera, siendo Tenebrionidae y Muscidae las dos familias más abundantes. Para los coleópteros las cuatro especies principales fueron Phaleria gayi, Dermestes maculatus, Phaleria maculata y Dermestes frischii, y para los dípterosfueron Musca domestica, Lucilia sericata, Sarcophaga sp., Piophila casei y Calliphora nigribasis. Con relación a los servicios ecosistémicos, se observó la siguiente secuencia con base en la riqueza y abundancia de especies: necrófagos > necrófilos > omnívoros. Los índices de diversidad alfa y beta mostraron diferentes patrones según el estado de desarrollo de la entomofauna, el estado de descomposición de los cadáveres, los años de evaluación y según los cuatro cadáveres de vertebrados más frecuentes.
Balrit, port local et rural sur les rives de l’Oust du milieu ixe siècle?
Authors: Bachelier Julien
Published: September 2023

Au milieu du ixe siècle, dans le secteur de la confluence de l’Oust et de la Vilaine, trois monastères se disputent les droits sur le tonlieu du port de Balrit. Les deux premiers, Ballon et Busal, sont modestes, alors que le troisième, Saint-Sauveur de Redon est en train de s’imposer avec le soutien des autorités. L’article reprend l’acte conservant le souvenir du contentieux juridique et le replace dans son contexte à la fois géographique, social mais aussi commercial et politique. Balrit relevait de l’autorité publique et disparaît alors que s’affirme un nouveau centre : Saint-Sauveur qui est certes une abbaye, mais aussi un lieu d’échanges qui semble alors concentrer les activités à son profit et à l’ombre des murs du monastère.
An autonomy-supportive climate for facilitation of self-leadership in health sciences educators
Authors: Matahela Vhothusa E. , Van Rensburg Gisela H.
Published: October 2023

Background: The authors have observed that studies on autonomy-supportive climates in academic settings mostly focus on educator-facilitated supportive environments that motivate students towards improved performance. Yet, little is known about how academic institutions teaching nursing can facilitate autonomy-supportive climates that enhance health sciences educators’ self-leadership practices.Aim: This article discusses ‘autonomy-supportive climate’, a factor that emerged as a self-leadership practice construct, and how it can be promoted in academic institutions to facilitate self-leadership practices in health sciences educators.Setting: The study was conducted in purposively selected academic institutions (N = 15) located in two provinces in South Africa.Methods: Quantitative methods were employed to describe the factor ‘autonomy-supportive climate’, which yielded as a self-leadership practice construct, from a broader mixed methods project that sought to formulate guidelines that could promote health sciences educators’ self-leadership. The data were analysed using exploratory factor analysis.Results: The construct ‘autonomy-supportive climate’ is one of the five constructs in the Self-leadership Practices Subscale that was found to be meaningful and valid, with its Cronbach alpha coefficient of 0.82 being the highest in the subscale. The perceptions of participants were that an autonomy-supportive climate promotes the facilitation of the educators’ self-leadership in a nursing education setting.Conclusion: An academic institution could play a significant role in enabling self-leadership in educators, which would in turn improve their teaching performance.Contribution: This study describes autonomy-supportive climate as a facilitator of self-leadership in health sciences educators. The study’s recommendations could assist institutions in facilitating a climate that strengthens educators’ self-leadership.
A Case Series of Trichotillomania; Impact of Therapeutic Intervention: Clinical Out-turn
Authors: Algin Sultana , Akter Asha , Jalil Sumaiya Bente , Joti Fatema Tuj Johora , Hridi Humayra Shahjahan , Ahmad Rahnuma , Haque Mainul
Published: October 2023

Trichotillomania (TTM) is a less addressed cause of alopecia. Refusal to accept this condition as a psychiatric illness causes marked delay in seeking help. This article aims to evaluate the treatment response of TTM patients. This is a case series study on 5 patients (4 females, 1 male) of TTM, of whom 3 patients took treatment on an outpatient basis (obsessive-compulsive and related disorders clinic) and 2 patients at indoor (orange unit) at the Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, from January 2022 to July 2023. Out of 7 cases, 2 patients did not come after the 1stfollow-up. Pharmacological management was chosen according to established guidelines. All patients were given basic psychoeducation and relevant psychological intervention. A total of 5 cases were described. The median time to receive effective psychiatric treatment is 8.6 years (4–15 years). The median time to respond after starting therapy is 6 weeks. All patients responded well to selective serotonin reuptake inhibitors. Augmentation with low-dose antipsychotics and the addition of specific pharmacologic agents have been shown to improve outcomes. Psychological management helped patients most in achieving long-term remission. Despite the prolonged treatment gap, patients of TTM showed marked improvement with combined pharmacological and psychological intervention in a short time. Further study involving a more significant number of cases is needed to support the findings.
Posterior Gastric Perforation with an Opening in Transverse Mesocolon: A Rare Case Report
Authors: Singla Anand , Singh Sandeep , Kaur Gagandeep , Jindal Deepak , Singh Navjot , Langstang Sakini
Published: September 2023

Posterior gastric perforation is a very rare finding, difficult to diagnose due to the insidious onset of upper abdominal symptoms, and no air under the diaphragm on X-ray. Posterior gastric perforation which opens into transverse mesocolon is even rarer. This is a case report done to entail such a rare case, with only two cases reported in the past. We present the case of a 21-year-old female with pain in the epigastric region spreading to involve the whole abdomen, fever, vomiting, and anorexia. In our case, radiological findings revealed pneumoperitoneum. Intraoperatively, a tract was identified between the posterior wall of the stomach and transverse mesocolon. Tract was excised and primary repair was done using the Graham patch method.
Dosimetric correlation of bone marrow irradiation with acute hematological toxicity in concurrent chemoradiation of cervical carcinoma patients
Authors: Pruthi Deep S , Nagpal Puneet , Pandey Manish , Singh Harpreet
Published: September 2023

Background:

Many acute toxicities are associated with concurrent chemoradiation in cervical carcinoma, which includes burning micturition, burning defecation, pain lower abdomen, increased frequency of stools along with Acute Hematological Toxicity (AHT). AHT is often an expected adverse effect, which can lead to treatment interruptions and decreased response rates. The purpose of this study is to analyze if there are any dosimetric constraints on the volume of bone marrow irradiated with AHT in cervical carcinoma patients treated with concurrent chemoradiation.

Material and Methods:

In this retrospective study of 215 patients, a total of 180 patients were eligible for analysis. Multiple parameters of bone marrow volumes (whole pelvis bone marrow and its sub-volumes––ilium, lower pelvis, and lumbosacral spine) which were contoured individually for all patients were assessed to have any statistically significant association with AHT.

Results:

The median age of the cohort was 57 years and majority of cases were locally advanced (stage IIB-IVA: 88.3%). Grade I, II, III leukopenia was seen in 44, 25, and 6 patients, respectively. A statistically significant correlation between grade 2+ and 3+ leukopenia was seen if bone marrow V10, V20, V30, and V40 were more than 95%, 82%, 62%, and 38%, respectively. In subvolume analysis, volumes of lumbosacral spine V20, V30, and V40 more than 95%, 90%, and 65%, respectively, were statistically significant for AHT.

Conclusion:

Bone marrow volumes should also be given a constraint and should be tried to be achieved so that it leads to minimal treatment breaks due to AHT.
Association of Abdominal Volume Index with Glycemic Control (Glycated Hemoglobin) and Urine Albumin Levels in Type 2 Diabetes Mellitus
Authors: Muzaffar Majida , Chaudhury Debasish , Bansal Priya , Bansal Rohit
Published: September 2023

Context:

Anthropometric parameters can play an important role in monitoring the progression and management of diabetes mellitus (DM). This study was planned to highlight the relationship of abdominal volume index (AVI) with glycemic control and the microvascular complication of albumin excretion.

Aims:

We aimed to study the association of AVI with glycemic control and urine albumin excretion in patients of type 2 DM.

Settings and Design:

This was a descriptive, observational, cross-sectional, hospital-based study.

Subjects and Methods:

The study conducted in a tertiary care health center of North India recruited thirty consecutive patients of type 2 DM attending the Medicine outpatient department. Anthropometric assessment was made, and samples for blood biochemistry including glycated hemoglobin (HbA1c) and urine albumin excretion were taken.

Statistical Analysis Used:

The association of AVI with degree of glycemic control and urine albumin levels was expressed as correlation coefficients (r) by using Spearman or Pearson correlation measures for qualitative and quantitative variables respectively. The ability of AVI to predict HbA1C and urine albumin–creatinine ratio was calculated by a simple linear regression technique. P <0.05 was considered statistically significant.

Results:

There was no statistical significance in the predictive ability of AVI and glycemic control, and microalbuminuria.

Conclusions:

Our study showed that AVI is not a reliable marker in diabetic patients to predict the degree of glycemic control and microalbuminuria.
A Catastrophic Combination of Kikuchi–Fujimoto Disease and Systemic Lupus Erythematosus Complicated with Autoimmune Hemolytic Anemia in a Pregnant Woman
Authors: Bembey Raghavi Abhilesh , Babu Ram , Tanwar Ajay , Sareen Manoj , Jain Mansi , Goyal Kush
Published: September 2023

Kikuchi–Fujimoto disease (KFD) or histiocytic necrotizing lymphadenitis is a benign, idiopathic, self-limiting, and systemic disorder involving lymph nodes (LNs) of unknown etiology. The first case was reported in Japan, with an increasing incidence globally. The disease is a challenge because of the nonspecific clinical features, and the disease is easily mistaken for other forms of lymphadenitis leading to misdiagnosis and mistreatment. It is associated with many autoimmune disorders, of which systemic lupus erythematosus (SLE) is the most common association. The diagnosis is based on the histological examination of LNs, which typically reveals necrosis surrounded by histiocytes with crescentic nucleus, immunoblasts and plasma cells, and absence of neutrophils. We report the case of a 24-year-old pregnant Indian female patient without any relevant past medical history to demonstrate the correlation between KFD and SLE complicated with autoimmune hemolytic anemia.
Assessment of Out-of-Pocket Expenditure on Noncommunicable Diseases in Urban Slum of Mysuru City
Authors: Choedon  , Murthy M. R. Narayana , Shree Amogha , N Chandan
Published: September 2023

Background:

Noncommunicable diseases (NCDs) are the leading cause of death and disability globally, and the burden is expected to grow rapidly in developing countries. In the absence of health insurance, public provisioning, and donor funds, the management and treatment of NCDs such as hypertension and diabetes might result in very large out-of-pocket expenditures (OOPEs) for households.

Objectives:

The objectives were as follows: to estimate OOPE and to study the association between sociodemographic characteristics and OOPE among patients suffering from NCDs.

Materials and Methods:

The sample size was estimated based on a mean OOPE of 63.5 Indian rupees (INR), with a standard deviation (SD) of 110 INR, a sample size of 464 was obtained, and individuals with NCDs were interviewed.

Results:

Of the total 464 participants, 325 (70%) were female and 139 (30%) were male, with a mean (SD) age of 55.78 ± 13.204. Three hundred and two (65.1%) participants were having hypertension and 232 (50%) were having diabetes. The mean total OOPE was 1173.0603 (INR), with a SD of 1424.54108 (INR), and the mean direct cost incurred was 1141.03. The mean (SD) direct cost spent for medication was 895.61 ± 1100.32, for the laboratory was 148.38 ± 440.7, and for consultation was 97.04 ± 113.86. Only 34 (7.7%) participants were having health insurance. There was an association between the OOPE and sociodemographic profiles such as occupation, educational status, and economic status where the P (<0.05) was noted as P = 0.004, P = 0.024, and P < 0.001, respectively.

Conclusion:

Knowledge and awareness about health insurance scheme and their benefits help in reducing the OOPE.
Congenital Lobar Emphysema
Authors: Rajendran Sivanthi Sapna , Ramakrishnan Gayathri Anur
Published: September 2023

A 29-year-old male had complained of right-sided chest pain for the past 2 years. On evaluation, breath sounds were diminished in the right mammary, axillary, infra-axillary, and infrascapular areas on auscultation, and hyperresonance was noted on percussion. Computed tomography chest plain done showed right lower lobe superior segment emphysema with obliterated segmental tertiary bronchus suggestive of congenital segmental emphysema. Bronchoscopy done showed narrowed right lower lobe lateral segment and Bronchoalveolar lavage (BAL) analysis done was normal. He became symptomatically better and hence managed conservatively. Congenital lobar emphysema is a rare developmental malformation of the lungs due to deficient development of bronchial cartilages, leading to overinflation of the affected lobe. With a wide range of presentations, it poses a diagnostic and therapeutic dilemma. Hence, knowledge of the diagnosis and treatment is essential.
A Roadmap for Tuberculosis Elimination
Authors: Viswanathan Vinod Kumar
Published: September 2023

India has set the ambitious goal of elimination of tuberculosis (TB) by 2025. The current microbiological approach of earlier diagnosis and treatment through success in reducing morbidity and mortality, alone is not sufficient to meet the targets set for TB elimination. It is time to focus on the comorbidities and social determinants which play a major role in the causation of the disease. A roadmap for TB elimination including addressing these social determinants is discussed in this article.
Evaluation of the Prevalence of Xpert Ultra Trace Calls and its Clinical Significance in Pulmonary and Extrapulmonary Tuberculosis in High Tuberculosis-Endemic Setting
Authors: Prakash Keerthi A. , Ramakrishnan Gayathri A. , Vasudevan A.
Published: September 2023

Introduction:

This study was done to evaluate the significance of “trace calls” in Xpert Ultra for Mycobacterium tuberculosis/rifampicin and to clear clinical dilemmas for treating Xpert Ultra trace calls with antituberculosis therapy (ATT).

Materials and Methods:

This is an observational retrospective study that was done at Apollo Hospital, Greams Road, Chennai, between April 2022 and January 2023 (10 months). Presumptive pulmonary and extrapulmonary tuberculosis (TB) patients above 18 years of age with at least one Xpert Ultra load trace result on their biological samples, and in whom the same sample was tested for histological/cytological analysis, MGIT 960 system culture during diagnostic workup were included in the study. The significance of Xpert Ultra “trace calls” was evaluated by comparing them with the composite reference standard (CRS). In the study period of 10 months, among 2130 presumptive TB cases, 954 (44.78%) were Xpert Ultra detected positive. Among the 954 Xpert Ultra detected cases, 157 (16.45%) were Xpert Ultra positive with Xpert Ultra trace load. After applying the exclusion criteria, 143 Xpert Ultra trace calls were included in this study.

Results:

After categorizing based on the CRS, confirmed TB accounted for 30 (21%), probable TB 82 (57.34%), possible TB 22 (15.38%), and non-TB 9 (6.3%). All cases in the non-TB category were in pulmonary TB. Among the 9 non-TB cases, 8 were diagnosed with carcinoma lung by histopathology/cytology, and 1 was diagnosed with nontuberculous mycobacterium (NTM) disease. There was no history of prior anti-TB treatment (ATT) in these 9 non-TB cases except one case, which was now diagnosed with NTM.

Conclusion:

All extrapulmonary “trace calls” should be treated with ATT, and in the case of pulmonary “trace calls,” the other clinical and laboratory variables should be considered, especially in cases with prior ATT history.
The Effect of Atrial Fibrillation on Recanalization and Prognosis in Patients with Acute Ischemic Stroke Undergoing Mechanical Thrombectomy and/or Intravenous Thrombolysis
Authors: Erdoğan Hacı Ali , Acır İbrahim , Albuz Özlem Yalınkaya , Olgun Hülya , Yayla Vildan Ayşe
Published: September 2023

ABSTRACT

Background:

Atrial fibrillation (AF) is the most common cause of cardioembolic ischemic strokes. It causes large-vessel occlusions and a poor prognosis. Regardless of ischemic stroke etiology, hyperacute therapy strategies are effective treatment modalities.

Methods:

Patients who were diagnosed as having AF were classified as AF (+) and others without AF were classified as AF (-). It is not clear which treatment should be preferred in patients with stroke who are AF (+). We studied demographic characteristics, recanalization rates, and clinical outcomes in acute patients with ischemic stroke with or without nonvalvular AF who underwent hyperacute treatments.

Results:

We detected that clinical findings were more severe and the NIHSS scores were significantly higher at admission inpatients who were AF (+). In our study, mechanical thrombectomy rates were high in patients who were AF (+), whereas intravenous tissue plasminogen activator treatment rates were higher in patients who were AF (-). Thrombolysis in cerebral infarction scores were similar in our patient groups. We found high rates of both symptomatic (PH 2) and asymptomatic hemorrhagic transformation in patients who were AF (+) in 24th-h cranial computed tomography. A positive correlation was found between symptom-admission, symptom-needle, and symptom-groin times and discharge-modified Rankin Scale scores regardless of the hyperacute treatments in all patient groups.

Conclusion:

As a result, physicians should focus on the diagnosis of AF, and appropriate anticoagulant treatment is important for primary prevention.
Normal Nerve Conduction Values of Median and Ulnar Nerves in the Turkish Population
Authors: Esmeli Figen , Sucu Hasan Kamil , Gökmen Aytül Erol , Özdemirkiran Tolga
Published: September 2023

ABSTRACT

Background:

Nerve conduction studies (NCS) are an important tool for the diagnosis of neuromuscular diseases. In NCS, factors such as temperature, age, sex, body metrics, and recording technique can affect the values. There are currently no universal normative data. The standardization of NCS is essential for the reliable and consistent identification of pathologic conditions for each laboratory.

Aim:

We wanted to obtain normal values of our electrophysiology laboratory for the Turkish population.

Materials and Methods:

The volunteer group consisted of 120 people aged 15–74 years. They were distributed into 12 subgroups according to their age. Each subgroup included five male and five female subjects. Age, sex, weight, height, profession, body mass index, and hand preferences were recorded. Median and ulnar NCS were performed by two experienced clinical neurophysiologists. The skin temperature was corrected to 35.5°C, which was the highest measured value.

Results:

Age 50 years was used for the cutoff point for nerve conduction velocities (NCVs) because there was no significant difference within the groups aged ≥50 years and <50 years. However, the NCVs of groups aged <50 years and >50 years were significantly different. NCVs and action potential amplitudes were higher in females than males in both age groups. Women had higher NCV values and action potential amplitudes of motor and sensory fibers.

Conclusion:

Age, temperature, and sex are important factors that affect NCS. We believe this study will provide normal values for future studies, especially in the Turkish population.
Paired Associative Stimulation with Interstimulus Intervals of Short-latency Afferent Inhibition on Motor Plasticity
Authors: Boran H. Evren , Cengiz Bülent
Published: September 2023

ABSTRACT

Background:

Short-latency afferent inhibition (SAI) is a method used to assess sensorimotor integration. Inhibition typically occurs at an interstimulus interval (ISI) of 20–22 ms or N20 + 2 ms. Paired associative stimulation (PAS) applied at certain ISIs consecutively can induce changes in corticospinal excitability. Usually, ISIs of 10 and 25 ms are applied in PAS. In this study, we aimed to investigate the relationship between ISIs of SAI and PAS, a neuromodulation paradigm. To achieve this, we first identified the optimal ISIs that produced maximum inhibition and facilitation during SAI by evaluating multiple ISIs. Subsequently, we applied the PAS paradigm with these ISIs.

Materials and Methods:

Twelve healthy participants were recruited for the study conducted over three sessions. During the first session, we examined the ISI of maximum inhibitory and ISI of facilitatory or minimum inhibitory (if facilitation was absent) in each participant at multiple ISIs. In the other two sessions, we applied PAS at the ISI of maximum inhibitory and the ISI of facilitatory or minimum inhibitory. We compared the motor-evoked potential (MEP) amplitudes before PAS, immediately after PAS, and 30 min after PAS.

Results:

The highest inhibition in SAI was observed at an ISI of 22 ms. In 60% of the participants, inhibition was most prominent at this ISI. Facilitation was not observed in 50% of the participants. During the PAS paradigm, which used the ISI of maximum inhibitory, significant facilitation was observed 30 min after the procedure compared with baseline (P = 0.011) and immediately post-PAS (P = 0.026). The mean MEP amplitude decreased significantly 30 min after the procedure compared with the baseline in ISI of only detected facilitation (P = 0.041).

Conclusion:

Our findings suggest that the ISI of maximum inhibition can vary among individuals, and that facilitation may not be observed in everyone within the ISI range of 22 ms to 40 ms. The results indicate that paired stimuli at ISI of maximum inhibitory in SAI increase corticospinal excitability. In addition, PAS at ISI of only facilitation decreases excitability. These changes in excitability may be explained by spike-timing-dependent plasticity.
Determination of Women’s Level of Knowledge and Attitudes towards AIDS
Authors: ASLAN Gülpınar , BAKAN Ayşe Berivan
Published: September 2023

Objective: This study aims to determine women’s level of knowledge and attitudes towards HIV/AIDS.
Method: Cross-sectional design was used for this study. It included women who were aged 18 to 65 years and registered in FHCs (Family Health Centers) a city in eastern Turkey between May and August 2021. Women registered in these centers meeting the research criteria consisted of the target population, and the sample was 384 women selected using the sampling method with an unknown target population. Data collection was performed using the Personal Information Form, the AIDS Knowledge Scale, and the AIDS Attitude Scale.
Results: Participating women’s average age was 26.91±9.20, and 74.7% reportedly heard about HIV/AIDS before; 62.5% knew about HIV/AIDS; and 75.8% of these women obtained information from friends, social circle, or media. The HIV/AIDS Knowledge Scale mean score of the group was 7.81±4.92, and the HIV/AIDS Attitude Scale mean score was 53.38±10.23. The HIV/AIDS Knowledge Scale mean was significantly higher in university graduates, in those worked and reportedly knew about HIV/AIDS (p<0.05). University graduates’ HIV/AIDS Attitude Scale mean was significantly higher (p<0.05).
Conclusion: In this study, it was determined that higher education level had a positive effect on knowledge and attitude toward HIV/AIDS. Public health nurses could organize education programs about the issue by using appropriate materials and methods for women with low education levels.
Şizofreni Hastalarının Primer Bakım Vericilerinin Yük ve Tükenmişliğini Etkileyen Faktörler
Authors: GÖK Nilüfer , ARSLANTAŞ Hülya
Published: September 2023

Amaç: Bu çalışma şizofreni hastalarının primer bakım vericilerinin bakım yükünü ve tükenmişlik düzeylerini etkileyen faktörleri belirlemek amacıyla kesitsel olarak yapılmıştır.
Yöntem: Araştırma Aydın ilindeki bir üniversite hastanesi, devlet hastanesi ve Toplum Ruh Sağlığı Merkezinde şizofreni tanısıyla takip edilen 183 hastanın primer bakım vericileriyle Şubat 2019-Haziran 2022 tarihleri arasında yürütülmüştür. Verilerin toplanmasında hastaların ve bakım vericilerin sosyodemografik özelliklerine ilişkin formu,Algılanan Aile Yükü Ölçeği ve Maslach Tükenmişlik Ölçeği kullanılmıştır.Verilerin değerlendirilmesinde sayı, yüzde ve medyan dağılımları,Kolmogorov-Smirnov, Mann Whitney U, Kruskal Wallis H testi ve Spearman Korelasyon Analizi kullanılmıştır.
Bulgular: Araştırmada bakım vericilerin %73.2’sinin kadın, %42.6’ sının hastanın eşi, %73.8’inin ruhsal hastalığının olmadığı belirlenmiştir.Bakım vericilerin bakım yükü toplam puan ortalaması 20.77±15.13, Maslach Tükenmişlik Ölçeği Toplam puan ortalaması 58.59±15.49 olarak bulunmuştur.Bakım vericilerin en yüksek tükenmişlik düzeyi kişisel başarı alt boyutunda 25.33±5.23 görülmüştür.Bakım verilen yıl arttıkça yükün ve tükenmişliğin azaldığı, hasta ile geçirilen vakit arttıkça kişisel başarı puanının arttığı tespit edilmiştir.
Sonuç: Bakım vericilerin sorunlar karşısında uygun baş etme yöntemleri hakkında kapsamlı ve düzenli bir eğitim programı ve danışmanlık almalarının, tükenmişlik düzeylerini ve dolayısıyla bakım yükünü azaltabileceği sonucuna varılmıştır.
The Effect of Planned Education on Quality of Life and Sleep of Children with Epilepsy
Authors: DEMİRBAĞ Selin , ERGİN Dilek , POLAT Muzaffer
Published: September 2023

Objective: The purpose of this research is to evaluate the effect of planned education on life and sleep quality given to children with epilepsy.
Method: The study was conducted as a quasi-experimental study with a total of 74 epileptic children, 37 of whom were intervention and 37 of whom were controls between 2nd of June-2nd of November 2017 at Manisa Celal Bayar University Hospital, Turkey. Planned education and written education material were provided to the intervention group. One month after the first questionnaire (pretest) application, the second questionnaire form (posttest) was applied to both groups. At the end of the study, education, and written education material (education booklet) were provided to the control group. Child Introduction Form, The Generic Children's Life Quality Measure, KINDL Epilepsy Related Quality of Life Module for Children, Pittsburgh Sleep Quality Index were used to collect research data.
Results: It was found that the intervention group's Generic Children's Life Quality Measure posttest average scores were higher than their pretest average scores and the difference between them was significant (p<0.05). It was found that the Pittsburgh Sleep Quality Index posttest average scores of the intervention group were lower than the pretest average scores, the sleep quality of children increased and the difference between them was significant (p<0.05).
Conclusion: Pediatric nurses should increase life and sleep quality of child by planning and ensuring the continuity of education for child evaluating child's level of knowledge about the disease, his/her perception form, and compliance with treatment.
Multiple Sklerozda D vitamininin Rolü
Authors: KÜÇÜKYILMAZ Kübra
Published: September 2023

Multiple Skleroz (MS), merkezi sinir sisteminde miyelin ve aksonal hasar ile ilişkili sık görülen kronik otoimmün bir nörolojik hastalıktır. Etiyolojisi tam olarak bilinmemekle beraber D vitamini, hem genetik hem de çevresel risk faktörü olarak MS gelişiminde rol oynar. Epidemiyolojik ve deneysel çalışmalar MS’li bireylerde serum 25-hidroksivitamin D (25(OH)D) yetersizliğinin olduğunu belirtmektedir. Buna ek olarak düşük serum D vitamini düzeylerinin MS semptomlarının şiddetlenmesine ve nüks oranlarının artmasına sebep olduğu bildirilmiştir. D vitamininin ise immünomodülatör etkileri sayesinde MS patofizyolojisinde önemli bir potansiyel role sahip olduğu öngörülmektedir. Bu doğrultuda serum 25(OH)D düzeylerini optimal seviyede tutmak amacıyla ılımlı dozlarda D vitamini takviyesinin MS’in önlenmesi ve tedavisinde etkili bir yöntem olduğu düşünülmektedir. Bu derlemede, MS ve D vitamini ilişkisi mevcut literatür doğrultusunda ele alınmıştır.
Effect of Individual Counseling Intervention on Weight Management Based on Stages of Change Model Conducted on Infertile Women
Authors: YEYĞEL Çiler , KAVLAK Oya
Published: September 2023

Objective: Evaluate the effect of individual counseling intervention on weight management based on Stages of Change Model conducted on infertile women
Methods: This study consisted of two stages: counseling and follow-up. The research population consisted of 146 infertile women who applied to the in vitro fertilization center of a state hospital in İzmir between January 4, 2019, and June 22, 2019. Among the 104 infertile women who met the inclusion criteria and declared their willingness to participate in the study, 51 women constituted the intervention group, and 53 women constituted the control group. While an individual counseling program based on Stages of Change Model was conducted on the initiative group, the control group was followed routinely. Research data were analyzed using SPSS 22.0 software.
Results: Most recent follow-up anthropometric values of infertile women in the intervention group were lower compared to the pre-follow-up values. The difference between these two data was statistically significant (p = 0.000). Infertile women in the intervention group tended to increase their consumption of daily milk and dairy products and vegetable and fruits in their most recent follow-up stage compared to that in the pre-follow-up stage, whereas their consumption of and daily calories from meat products, sugary products, fats, cereals, and bread decreased. The difference between these two data was statistically significant (p = 0.000).
Conclusion: Individual counseling intervention based on Stages of Change Model aiming to evaluate the weight management caused infertile women to adopt healthy behaviors in terms of physical activity and nutritional habits.
Sosyal Medya Kullanımının Fonksiyonel Gıdalara Yönelik Tutuma Etkisi ve BKİ ile İlişkisi
Authors: TURALİOĞLU Gülşah , ARSLAN Müge
Published: September 2023

Amaç: Bu çalışmanın amacı Erzurum ilinde yaşayan bireylerinin sosyal medya kullanımlarının fonksiyonel gıdalara yönelik tutuma etkisinin değerlendirilmesi ve beden kitle indeksi ile ilişkisinin incelenmesidir.
Yöntem: Katılımcılara yüz yüze olarak sosyodemografik bilgi formu, Fonksiyonel Gıdalara Yönelik Tutum Ölçeği ve Sosyal Medya Kullanımı Ölçeği’nden oluşan anket uygulanmıştır ve verilerin istatistiksel Analizi SPSS ile yapılmıştır.
Bulgular: Katılımcıların beden kitle indeksi ortalaması; 24.00±4.31kg/m2 ve %42.3’ü erkek, %57.7’si kadındır. Katılımcıların sosyal medya kullanım düzeyleri ve fonksiyonel gıdalara yönelik tutum düzeyleri yüksek bulunmuştur (p<0.05). Beden kitle indeksi gruplarına göre; Sosyal Medya Kullanımı Ölçeği alt faktör ve toplam puanları değişmemiştir (p>0.05) ve Fonksiyonel Gıdalara Yönelik Tutum Ölçeği’nin “Fayda” alt faktör puanında (H=8.668; p<0.05) ve “Güven” alt faktör puanında (H=7.949; p<0.05), normal kilolu ve zayıf bireylerin ortancası, obez ve preobez bireylere göre daha yüksektir. Katılımcıların Fonksiyonel Gıdalara Yönelik Tutum Ölçeği ve Sosyal Medya Kullanımı Ölçeği puanları arttıkça beden kitle indeksi değerleri azalmaktadır (p<0.05). Beden kitle indeksi değerleri arttıkça, Sosyal Medya Kullanımı Ölçeği’nin “Süreklilik’’ alt faktör ve Sosyal Medya Kullanımı Ölçeği toplam puanları ile Fonksiyonel Gıdalara Yönelik Tutum Ölçeği’nin “Fayda”, “Güven” alt faktör ve Fonksiyonel Gıdalara Yönelik Tutum Ölçeği toplam puanları azalmaktadır (p<0.05).
Sonuç: Sosyal medya kullanımı, fonksiyonel gıda tutum düzeyini etkilememekte ve beden kitle indeksi değeri arttıkça sosyal medya kullanım düzeyleri azalmaktadır.
Kanserli Hastada Sarkopeni’ye Güncel Bakış
Authors: TORUK Ezime , AKBULUT Gamze
Published: September 2023

Malnütrisyon, onkoloji hastalarında tümör ya da tedaviye bağlı olarak sıklıkla gözlenmektedir. Bu hasta grubunda malnütrisyona ek olarak fiziksel hareketsizlik de eklendiğinde kas kaybının olması kaçınılmazdır. Kanser hastalarında sarkopeninin çeşitli kanser türlerine sahip hastaların sonuçlarını olumsuz etkilediği bilinmektedir. Sarkopeni teşhisinin doğru konulması açısından hastaların azalmış iskelet kası kütlesi, kuvveti ve performansının saptanması önemlidir. İskelet kas kütlesinin saptanmasında Çift enerjili X-ışını absorpsiyometrisi(DEXA), bilgisayarlı tomografi(BT), biyoelektrik impedans analizi(BİA) gibi güvenilirliği tanımlanmış yöntemlerin kullanılması önerilmektedir. Hastaların ilk tanı konulmasından itibaren vücut bileşim analizinin yapılması, beslenme durumunun değerlendirilmesi ve beslenme danışmanlığı verilmesi tedaviye uyumu, tolerasyonu ve yaşam kalitesinin arttırılmasında etkili olacaktır.