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Prognostic Factors of Late-onset Hearing Loss in Infants With Congenital Cytomegalovirus and Normal Audiologic Assessment at Birth
No full textBackground and aims: Children with congenital cytomegalovirus (cCMV) can develop late-onset sensorineural hearing loss (LO-SNHL). In this study, we aim to assess the characteristics and predictors of LO-SNHL in infants with cCMV having normal hearing at the first neonatal assessment. Methods: A retrospective study within the European Registry of Children with cCMV (www.ccmvnet.org) was performed. Included children had cCMV and a normal first audiological assessment by Auditory Brainstem Response (ABR). Late-onset hearing loss (LO-SNHL) is defined as the presence of sensorineural hearing loss after an initial normal hearing test. Hearing evaluation was performed at birth, at 6 months of age, and at least annually up to 6 years of age. Results: Seven hundred twenty-one children with normal audiological tests at birth were included, and 47/721 (6.5%) developed LO-SNHL. LO-SNHL was diagnosed at a range of 4-65 months of age [median (IQR) age: 34.3 (15.1-48.7) months]. Children with LO-SNHL had a higher proportion of abnormalities on physical examination at birth (45.7% vs. 20.8%; P < 0.001): petechiae (17.4% vs. 6.0%; P = 0.008), splenomegaly (8.7% vs. 2.3%; P = 0.031), hepatomegaly (13% vs. 2.9%; P = 0.001), microcephaly (15.2% vs. 4.5%; P = 0.005) and small for gestational age (21.7% vs. 8.3% P = 0.005). Children with LO-SNHL showed lower platelet count at birth [177500.0 (88750.0-261250.0)/μL vs. 243500.0 (173000.0-304000.0)/μL; P = 0.012], and higher blood viral load at birth [3.7 log (3.3-4.4) vs. 3.4 log (2.7-3.9) IU/mL; P = 0.013] and had more frequent white matter involvement (27.7% vs. 14.7%; P = 0.03) and ventriculomegaly (20.7% vs. 4.6%; P = 0.001) on birth magnetic resonance imaging. Overall, symptomatic children at birth showed a higher risk of developing LO-SNHL than asymptomatic children (32/317, 10.1%, vs. 15/404, 3.7%; P < 0.0001). Among asymptomatic children, only 0.3% developed severe or profound LO-SNHL in the best ear. In multivariate logistic regression analysis, ventriculomegaly [odds ratio (OR): 7.503 (1.78-27.9)], white matter abnormalities [OR: 3.19 (1.010-9.01)], and splenomegaly [OR: 3.679 (1.56-8.506)] at birth were associated with the development of LO-SNHL (Fig. 1). Conclusions: Among this large cohort of children with cCMV and a first normal audiological assessment, the risk of LO-SNHL was 6.5%. Asymptomatic children developed LO-SNHL in 3.7% of the cases versus 10.1% in symptomatic cases. In multivariate logistic regression analysis, ventriculomegaly, white matter abnormality, and splenomegaly at birth were associated with LO-SNHL
Sosyoloji 101 - Anomiden Şiddet Kültürüne, Modernleşmeden Toplumsal Cinsiyete Sosyoloji Hakkında Bilmeniz Gereken Her Şey
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Investigation of Lipid Production of Microalgae Species in Fruit Juice-based Nutrient Medium
No full textIn this study, Schizochytrium limacinum PA-968 and Crypthecodinium cohnii CCMP-316 were produced in the media including apple (AJ) and grape juices (GJ), which contain carbon sources that are alternatives to standard carbon containing media (SM). The S. limacinum biomass productions were 9.52±0.08 g L-1 (AJ), 8.70± 0.05 g L-1 (GJ), and 8.58±0.02 g L-1 (SM). C. cohnii produced biomass as 3.45±0.06 g L-1 (GJ), 1.52±0.04 g L-1 (AJ), and 1.35±0.02 g L-1 (SM). The fruit juice-based media enhanced biomass production. It was observed that the lipid production of S. limacinum increased by 17.6% in the medium with apple juice (2.54±0.02 g L-1), while this increase was 65.3% in the grape juice-based medium (3.57±0.02 g L-1). The addition of apple juice caused an increase in the lipid amount 1.9 times higher (0.23±0.02 g L-1 ), while grape juice induced 5.3 times more lipid production in C. cohnii culture (0.50±0.03 g L-1). The study emphasized that these wastes or by-products can be considered as sustainable and financially supportive solutions to be alternatives to carbon sources in production with S. limacinum and C. cohnii cultures
Development and psychometric evaluation of the delirium detection and management scale for pediatric intensive care nurses
No full textAim This research was conducted to develop the Delirium Detect and Management Scale for Pediatric Intensive Care Nurses and investigate its Psychometric Properties. Study design This methodological study was conducted with pediatric intensive care nurses between January 20 and February 20, 2025. Two hundred thirteen pediatric intensive care nurses were included in the study. The “Nurse Identification Form” and “Delirium Detection and Management Scale for Pediatric Intensive Care Nurses” were used in the study. The scale's content validity, explanatory and confirmatory factor analysis, Cronbach's alpha, item-total correlation, and split-half analysis were used in the psychometric analysis. Results Cronbach's alpha analysis, item-total score correlation methods, and explanatory and confirmatory factor analysis were used in data evaluation. The scale consists of 19 items and three sub-dimensions. In both explanatory and confirmatory factor analysis, all factor loadings were found to be more than 0.30. In the confirmatory factor analysis, all fit indices were determined to be more than 0.80, and the RMSEA value was less than 0.08. Cronbach's alpha coefficients for the entire scale and subscales were 0.93, 0.89, 0.84, and 0.82, respectively. The scale is a practical and reliable clinical tool that helps nurses obtain accurate, consistent, and meaningful patient data. Conclusions Findings indicated that the developed scale is a valid and reliable tool. Practice implication Determining the in-service training needs of pediatric intensive care nurses regarding delirium, developing their delirium-related care competencies, and increasing the quality of patient care can be achieved
Beyond conventional measures: body composition analyses and the role of Tri-Ponderal mass index in assessing adiposity in children with type 1 diabetes mellitus
No full textBackground: Children with type 1 diabetes mellitus (T1DM) are at increased risk of excess adiposity due to sedentary lifestyle, dietary factors, and insulin therapy. Body mass index (BMI), the most commonly used measure of adiposity, cannot distinguish between fat and lean mass. To address this limitation, alternative indices such as the tri-ponderal mass index (TMI) have been proposed; however, its role in pediatric T1DM remains unclear. Objective: To compare body composition between children with T1DM and healthy peers, and to assess the utility of TMI in evaluating adiposity. Subjects and methods: This cross-sectional study included 65 children with T1DM and 65 age- and sex-matched healthy controls. Anthropometric data, waist-to-height ratio (WHR), disease duration, daily insulin dose, insulin regimen, and mean HbA1c values over the previous year were recorded. TMI was calculated as weight (kg)/height³ (m³). Body fat percentage (BFP), fat mass (FM), and fat-free mass (FFM) were assessed using bioelectrical impedance analysis (BIA). Results: The median age of children with T1DM was 14.4 (12.2–16.9) years, with a median disease duration of 4.3 (2.6–7.5) years. No significant differences were found between groups regarding SD scores of BMI, WHR, and TMI. Compared with controls, children with T1DM showed significantly higher BFP and BFP SD scores (p = 0.005 and p = 0.002), and elevated FM SD scores (p = 0.01). The FFM/FM ratio did not differ significantly (p = 0.09). Longer disease duration (≥ 5 years) was associated with higher BFP and FM (p < 0.05). TMI correlated positively with BFP (r = 0.66 ), BFP SD score (r = 0.78), FM SD score (r = 0.83), and WHR (r = 0.87), and negatively with the FFM/FM ratio (r = − 0.68) (all p < 0.001). Conclusion: Children with T1DM exhibit higher adiposity than healthy peers, particularly with longer disease duration. TMI showed strong correlations with body fat parameters and may serve as a simple, reliable, and clinically useful tool for assessing adiposity in pediatric T1DM
A systematic approach to the sports scheduling problem for the Turkish professional football league
No full textScheduling of sports competitions has become an area of interest for researchers with the globalization of sports and its spread to large crowds. Round Robin tournament derivatives are generally applied among different types of tournaments, especially in leagues. This study aims to create schedules for the Turkish Professional Football League. Indicators such as the number of breaks, weighted carry-over effect, and specific requirements are considered as characteristic values reflecting the league's quality. In this study, an integer programming (IP) model is developed to solve the scheduling problem, and it is observed that the IP model gives the optimum schedule for small-sized problems only. As a remedy, a two-phase heuristic solution procedure is proposed. The heuristic procedure first finds a pattern set and then constitutes the schedule. Different pattern sets and schedules are presented in the experimental results. The results show that the proposed heuristic method obtains the best schedules concerning the current schedule and the proposed IP models for various problem characteristics
