21241 research outputs found
Sort by
Evaluation of rosier and ABCD2 scores, Whiteley Index, and Bradford Somatic Symptom Inventory results in patients presenting to the emergency department with suspected transient ischemic attack
Get PDFAmaç: Bu çalışmada inme ve Geçici İskemik Atakta görülebilen semptomlarla acil servise başvuran hastalarda tanısal değerlendirmeye ilaveten hastalara uygulanan skorlamalar ve hastaların klinik sonlanımlarla olan ilişkileri incelenmiştir. Elde edilen verilerin Geçici İskemi Atak ve inme hastalarıyla inme taklitçilerinin ayırıcı tanısında kullanılması hedeflenmiştir. Metod: Prospektif olarak planlanan bu çalışma Düzce Üniversitesi Acil Tıp Anabilim Dalı'na 01/03/2024 ile 01/02/2025 arasında başvuran hastalarda son 24 saat içinde geçirilmiş senkop, konvülziyon, fokal nörolojik semptom tarifleyen hastalarda tanısal değerlendirmeye ilaveten ABCD2, ROSIER, WI-7, BBBE-44 skorlamaları hesaplanmış ve hastaların klinik sonlanımları arasındaki ilişkiler istatistiksel olarak incelenmiştir. Verilerin analizinde SPSS 25 kullanıldı. 24 saat içinde kafa travması geçiren, kanser ve epilepsi tanısı olan, ileri derece afazisi olan hastalar çalışmaya dahil edilmemiştir. Bulgular: İnme şüphesiyle takip edilen 115 hastanın %28.7'si (n=33) nörovasküler hastalık tanısı alırken %71,3'ü (n=82) inme taklitçisi olarak değerlendirilmiştir. Başvurular içinde en sık görülen semptom baş dönmesidir(%33,9). Nörovasküler hastalık tanısı alan hastaların içinde baş dönmesi semptomu olanların oranı (%15.2) tanı almayan hastaların içindeki baş dönmesi semptomu olanların oranından (%41.5) anlamlı şekilde düşüktü(p=0.007). Nörovasküler hastalık tanısı alanlar ve inme taklitçileri karşılaştırıldığında; afazi (p<0.001), üst kstremitede parestezisi (p=0.009), alt ekstremitede pleji (p=0.001) bulguları ve ABCD2 skoru (p<0.001), ROSIER skoru (p<0.001) anlamlı olarak yüksek bulundu. Nörovasküler hastalık tanısı alan hastaların içinde WI7 skoru orta-yüksek olanların oranı %30.3, tanı almayan hastaların içindeki WI7 skoru orta-yüksek olanların oranı ise %34.1 şeklinde daha düşük olsa da aralarında anlamlı bir fark yoktu (p=0.692). Hasta semptomlarının ve skorlama sistemlerinin inme tanısı açısından lojistik regresyon analizi yapıldığında modelin; duyarlılığı (sensitivite) %66.7, özgüllüğü (spesifisite) ise %95.1 olarak hesaplandı ve %87 doğruluğa sahip olduğu görüldü. Sonuç: Duyarlılığın %66.7 olması, modelin nörovasküler hastalık tanısı konan hastaların üçte ikisini doğru şekilde belirleyebildiğini gösterirken, %95.1 özgüllük, modelin nörovasküler hastalığı olmayan bireyleri büyük oranda doğru şekilde dışladığını göstermektedir. %87 doğruluk oranı, modelin genel olarak başarılı bir performans sergilediğini desteklemektedir. Yaptığımız regresyon analizlerindeki sonuçlarda; inmeyi taklit eden patolojileri tarayan skorlamalar ile inmeyi ön gören skorlamaların birlikte kullanımının tanısal performansta daha güvenilir sonuçlar elde edilebileceğini gördük. Modelin özellikle yüksek özgüllüğe sahip olarak yanlış pozitif tanı oranının düşük olması inme taklitçilerini ayırt etme açısından klinik kullanımda umut vadetmiştir.Objective: This study aimed to evaluate the relationship between clinical outcomes and various scoring systems applied to patients presenting to the emergency department with symptoms that can be seen in stroke and Transient Ischemic Attack (TIA), in addition to diagnostic evaluations. The goal was to use the data obtained to help differentiate between patients with TIA or stroke and those with stroke mimics. Method: This prospective study was conducted at the Emergency Medicine Department of Düzce University between 01/03/2024 and 01/02/2025. Patients who presented within the last 24 hours with syncope, convulsion, or focal neurological symptoms were evaluated diagnostically. In addition, ABCD2, ROSIER, WI-7, and BBBE-44 scores were calculated, and the relationships between these scores and clinical outcomes were statistically analyzed. SPSS 25 was used for data analysis. Patients with head trauma within the last 24 hours, a diagnosis of cancer or epilepsy, or severe aphasia were excluded from the study. Results: Of the 115 patients followed with suspected stroke, 28.7% (n=33) were diagnosed with a neurovascular disease, while 71.3% (n=82) were evaluated as stroke mimics. The most common symptom among the presentations was dizziness (33.9%). Among patients diagnosed with neurovascular disease, the proportion experiencing dizziness (15.2%) was significantly lower than in those not diagnosed with neurovascular disease (41.5%) (p=0.007). When comparing patients diagnosed with neurovascular disease to stroke mimics, the presence of aphasia (p<0.001), paresthesia in the upper extremity (p=0.009), plegia in the lower extremity (p=0.001), ABCD2 score (p<0.001), and ROSIER score (p<0.001) were found to be significantly higher. Although the proportion of patients with a moderate-to-high WI-7 score was lower in the diagnosed group (30.3%) compared to the undiagnosed group (34.1%), this difference was not statistically significant (p=0.692). Logistic regression analysis of patient symptoms and scoring systems in terms of stroke diagnosis showed that the model had a sensitivity of 66.7%, specificity of 95.1%, and an overall accuracy of 87%. Conclusion: A sensitivity of 66.7% indicates that the model correctly identifies about two-thirds of patients diagnosed with neurovascular disease, while a specificity of 95.1% shows that it correctly excludes the vast majority of those without neurovascular disease. The 87% accuracy supports that the model demonstrates overall strong performance. Our regression analysis results suggest that combining scoring systems that screen for stroke mimics with those that predict stroke may provide more reliable diagnostic performance. The model's particularly high specificity and low false-positive rate show promise for distinguishing stroke mimics in clinical practice
Laminated Wood Material Reinforced with Bacterial Cellulose Sheets Derived from Kombucha Pellicles: Part 1 Some Physical Properties
Get PDFIn this study, the usability of kombucha pellicles as a source of bacterial cellulose (BC) in the production of laminated wood was investigated to improve its physical properties. Within this scope, the kombucha culture was produced at room temperature through a fermentation process of approximately 25 days and then dried to obtain BC sheets with a thickness of approximately 1 mm. These sheets were used in the production of laminated wood material, along with wood species of Scots pine (Pinus sylvestris L.), Oriental beech (Fagus orientalis L.), and Anatolian chestnut (Castanea sativa Mill.), using urea-formaldehyde, polyurethane, and polyvinyl acetate adhesives. To evaluate the physical properties of the manufactured samples, density, thickness swelling, and water absorption tests were performed. Furthermore, the structural and thermal properties of the BC were analyzed using scanning electron microscopy and thermogravimetric analysis techniques. The findings indicated that BC is a high-performance biomaterial for lamination. The results unveiled BC's remarkable potential for developing eco-friendly materials, though certain technical challenges remain to be addressed before its full capabilities can be realized
Effect of diabetic kidney disease on sarcopenia and quality of life in patients with type 1 diabetes
Get PDFPurpose Sarcopenia can develop at a younger age as a complication in patients with type 1 diabetes (T1D). This study aimed to evaluate the association of sarcopenia with diabetic kidney disease (DKD) in non-elderly patients with T1D. Methods This cross-sectional study enrolled 100 patients with T1D, including 50 individuals with DKD and 50 without. Median age of patients was 31 years (25-75th percentile: 24.2-44) and a median duration of T1D was 10.1 years (25-75th percentile: 9-13). Hand grip strength (HGS), skeletal muscle mass index (SMMI) were utilized to assess the presence of sarcopenia. The Sarcopenia Quality of Life (SarQoL) and Pittsburgh Sleep Quality questionnaires were used to evaluate the quality of life. Results Sarcopenia was diagnosed in 19 out of 100 patients (19%). The prevalence of sarcopenia was 36% (18 out of 50) in the DKD group and 2% (1 out of 50) in the non-DKD group. Sarcopenia was more prevalent in the DKD group (p < 0.001). Urinary albumin-to-creatinine ratio (UACR) levels were a significant predictor of sarcopenia (odds ratio 1.031, 95% CI 1.009-1.058; p = 0.005). The median HGS and SMMI values were lower in the sarcopenia group than in the non-DKD group (p = 0.006 and p = 0.001 respectively). Furthermore, the SarQol scores and sleep quality were lower in the sarcopenia group compered to the non-DKD group (p = 0.018 and p < 0.05, respectively). Conclusions Sarcopenia may occur earlier in non-elderly patients with T1D and DKD, adversely affecting the quality of life. Early screening for sarcopenia should be considered in individuals with DKD.Society of Endocrinology and Metabolism of TurkeyWe express our gratitude to our patients for their willingness to share their clinical data for publication. Preparation for the publication of this article was supported by the Society of Endocrinology and Metabolism of Turkey
Strategic site selection methodology for small modular reactors: A case study in Türkiye
Get PDFSelecting the optimal site for Small Modular Reactors (SMRs) ensures operational efficiency and safety and aligns with growing energy demands and environmental goals. Given the unique challenges of climate change and the need for sustainable energy solutions, this study's innovative approach provides critical insights for making informed decisions that balance economic, environmental, and social factors. This study introduces a novel hybrid multi-criteria decision-making (MCDM) approach for selecting optimal sites for SMR in T & uuml;rkiye. The proposed methodology integrates Picture Fuzzy SWARA (PiF-SWARA) and Picture Fuzzy WASPAS (PiF-WASPAS) techniques to address site selection's complexities by evaluating criteria weights and alternative scores. PiFSWARA is employed to determine the relative importance of five main criteria and 28 sub-criteria, providing a nuanced understanding of each criterion's impact. Subsequently, PiF-WASPAS ranks the alternative sites based on these weighted criteria. This approach ensures a robust evaluation by accommodating various uncertainties inherent in the decision-making process. The case study applied to T & uuml;rkiye demonstrates the effectiveness of this method in identifying the most suitable locations for SMRs, highlighting its potential to advance the strategic planning of nuclear energy infrastructure. The study provides valuable insights for policymakers and stakeholders involved in energy planning and development.Introduction Abbreviations SMR Small Modular Reactors MCDM Multi-criteria decision-making SWARA Step-Wise Weight Assessment Ratio Analysisplanning of nuclear energy infrastructure. holders involved in energy planning 1. Introduction Abbreviations SMR Small Modular Reactors MCDM Multi-criteria decision-making SWARA Step-Wise Weight Assessment Ratio Analysis
Using Trees to Monitor Airborne Cr Pollution: Effects of Compass Direction and Woody Species on Cr Uptake during Phytoremediation
Get PDFAmong the heavy metals (HMs) whose concentrations in natural environments have risen considerably in the last era, chromium (Cr) is one of the most toxic. Because of the risks it poses to human and environmental health, it is of great importance to screen the variation in Cr contamination in the atmosphere and decrease the pollution. This study aimed to determine the proper tree species that can be used to monitor and reduce Cr contamination. For this aim, studies were conducted on Tilia tomentosa, Robinia pseudoacacia, Cedrus atlantica, Pseudotsuga menziesii, and Fraxinus excelsior species growing in D & uuml;zce, which is among the 5 most contaminated European towns according to the World Air Pollution report. Samples taken from these trees were examined, and changes in Cr concentration depending on species, organs, compass direction, and age range in the last 60 years were evaluated. Results indicated higher Cr pollution in recent years, consistent with higher traffic density, but that there was no consistent effect of compass direction. It was also determined that the tree species most appropriate for screening the variation in Cr contamination in the airborne were Tilia tomentosa, and the most appropriate species for decreasing pollution were Robinia pseudoacacia and Cedrus atlantica
Examining influencer-follower interaction through source credibility strategy within the framework of the theory of planned behavior
Get PDFAraştırmanın temel amacı, Planlı Davranış Teorisi kapsamında influencer takipçi etkileşiminin kaynak kullanım stratejisiyle belirlenmesine yönelik etkileri tespit etmektir. Araştırmada, nicel ve nitel teknikleri aynı çerçeve içerisinde kullanıma olanak sağlayan karma yöntem kullanılmıştır. Nitel veriler, anne influencerların sosyal medya kanalı olan İnstagram hesaplarında yer alan kullanıcı yorumlarından elde edilerek netnografik analiz tekniğiyle analiz edilmiştir. Netnografik analiz sonucunda, kadın takipçilerin takip ettikleri "anne" ismini bir ek ya da ad olarak kullanan influencerı çok sevdikleri, pozitif kelimeler kullanarak destekledikleri ve paylaşım yaptıkları ürünleri satın alma niyetinde oldukları ya da satın aldıkları yönünde ifadeler olduğu tespit edilmiştir. Nicel veriler ise çevrim içi anket tekniğiyle anne influencerı takip eden kadın takipçilerden toplanmıştır. Veri analizinde AMOS 22 ve SPSS 18 paket programlarından yararlanılmıştır. Doğrulayıcı faktör analizi ve doğrudan- dolaylı etkileri tespit etmek amacıyla çoklu regresyon analizi tercih edilmiştir. Analiz sonucunda, influencerın fiziksel çekici olmasının, güvenilir olmasının, paylaşımını yaptığı ürünle uyumlu olmasının ve influencerın taşıdığı değerlerin markaya aktarması yani anlam transferinin tüketici tutumunu olumlu bir şekilde etkileyerek satın alma niyetine dönüştürdüğü tespit edilmiş olup tüketici tutumu bu etkide tam aracı değişken rolünü üstlenmiştir. Uzmanlık değişkenin ise tüketici tutumu ve satın alma niyeti üzerinde bir etkisinin olmadığı tespit edilmiştir. Tüketici tutumu, sübjektif norm ve algılanan davranışsal kontrol satın alma niyetini olumlu şekilde etkilemiştir. Olumlu etkilenen satın alma niyeti satın alma davranışını olumlu yönde etkilenirken, algılanan davranışsal kontrol satın alma davranışını olumsuz yönde etkilediği bulunmuştur. Araştırmanın bir diğer bulgusu, influencerı takip eden kadın takipçilerin yaptığı yorumların satın alma niyeti üzerinde olumlu etkisidir. Kadın takipçilerin yaptığı yorumlar ile tüketici tutumlarını olumlu etkilediği ve olumlu olan tüketici tutumları satın alma niyetine dönüştürdüğü tespit edilmiş olup bu etkide elektronik ağızdan ağıza pazarlama kısmi aracı değişken rolünü üstlenmiştir. Aracılık modellerinin istatistiksel olarak anlamlılığını belirlemek için Sobel Testi kullanılmış ve sonuç istatiksel olarak anlamlı çıkmıştır.The main purpose of the research is to determine the effects of determining influencer-follower interaction with the resource use strategy within the scope of the Theory of Planned Behaviour. In the research, which the mixed research design that allows the use of quantitative and qualitative techniques within the same framework, was used. The qualitative data obtained from the user comments on the Instagram accounts, which are the social media channels of mother influencers, were analysed with the netnographic analysis technique. As a result of the netnographic analysis, it was determined that the female followers loved the influencers they followed who used the name "mother" as a suffix or a name, supported them using positive words, and intended to buy or purchased the products they shared. Quantitative data was collected from the women followers who followed mother influencers with the online survey technique. AMOS 22 and SPSS 18 package programs were used in the data analysis. Confirmatory Factor Analysis and multiple regression analysis were preferred in the data analysis to determine the direct-indirect effects. As a result of the analysis, it was determined that the influencer's physical attractiveness, reliability, compatibility with the product they share, and the influencer's transfer of values to the brand, in other words, the transfer of meaning positively affected consumer attitude and transformed it into purchase intention, and consumer attitude played the role of a full mediator variable in this effect. It was determined that the expert variable had no effect on consumer attitude and purchase intention. Consumer attitude, subjective norm, and perceived behavioural control positively affected purchase intention. While positively affected purchase intention positively affected purchase behaviour, perceived behavioural control was found to negatively affect purchase behaviour. Another finding of the research is the positive effect of the comments made by female followers who follow the influencer on purchase intention. It was determined that the comments made by female followers positively affected consumer attitudes and transformed positive consumer attitudes into purchase intention, and electronic word-of-mouth marketing played the role of a partial mediator variable in this effect. Sobel Test was used to determine the statistical significance of the mediation models, and the result was statistically significant
Evrensel Tasarıma Dayalı Öğrenme Modeli’nin Ortaokul Kademesinde Uygulanmasının Öğretmen ve Öğrencilerin Deneyimlerine Göre Değerlendirilmesi
Get PDFAraştırmada Evrensel Tasarıma Dayalı Öğrenme Modeli’nin ortaokul kademesinde uygulanmasının öğretmen ve öğrencilerin deneyimlerine göre değerlendirilmesi amaçlanmaktadır ve nitel araştırma desenlerinden durum çalışması kullanılmıştır. Çalışma grubu, bir devlet ortaokulunun 7. sınıfında öğrenim gören 20 öğrenci ve uygulamayı yürüten öğretmenden oluşmaktadır. Evrensel tasarımın temel ilkelerine uygun olarak Türkçe dersinde dört hafta, 20 ders saati uygulama yapılmıştır. Öğretmen ve öğrenci yansıtıcı günlükleri ve yarı yapılandırılmış görüşme formlarıyla toplanan veriler, içerik analizi yöntemiyle analiz edilmiştir. Bu modele ilişkin öğrenciler, aktif ve etkileşimli bir ders olduğunu, çoklu temsil ve ifade araçlarını kullandıklarını, farklı bakış açısı geliştirdiklerini belirtmişlerdir. Öğretmen bu model ile öğrencilerin bireysel farklılıklarına daha fazla önem verdiğini ifade etmiştir. Bazı öğrenciler ise, derste aktif olmalarının beklenmesi sebebiyle, öğrenme sürecini zaman zaman yorucu bulduklarını belirtmiştir. Evrensel Tasarıma Dayalı Öğrenme Modeli, bireysel farklılıkların değerine ve öğrenmenin önündeki engellerin ortadan kaldırılmasına odaklandığından, eğitimciler tarafından eğitim sisteminin her kademesinde ve alanında uygulanabilir
Poly(ethylene-co-(acrylic acid)) and maleic anhydride effect on micro crystalline cellulose and lignin-filled EPDM automotive sealing profiles
Get PDFIn this study, the effect of Poly(ethylene-co-(acrylic acid)) and maleic anhydride on cellulose and lignin-filled EPDM elastomers was investigated. Poly(ethylene-co-(acrylic acid)) and maleic anhydride were added in certain amounts (3.5 phr) to determine their chemical, thermal, rheological, mechanical, and morphological properties. With the addition of Poly(ethylene-co-(acrylic acid)) and maleic anhydride, higher thermal stability and slower vulcanization with retarded ts2 and t90 were seen. Improved elongation and tear strength were also observed. However, maleic anhydride-added cellulose and lignin-filled EPDM had a higher tensile strength value since it formed adequate chain mobility and had good interfacial compatibility that made stress transfer easy. Despite some immiscibility phases (especially after maleic anhydride) and microvoid structures, no considerable aggregation was observed in all elastomers. In conclusion, Poly(ethylene-co-(acrylic acid)) and maleic anhydride on cellulose and lignin-filled EPDM elastomers can be recommended for mechanical, rheological, and ecological benefit to industries that are interested in biopolymer-filled EPDM elastomers.Duzce University Research Fund [2018.07.05.807]The author wish to thank Standard Profile Corporation, Turkey, for technical support and collaborative partnership (especially for Yusuf GUNER and Ali ERKIN). The author gratefully acknowledges the financial support of this work supplied by the Duzce University Research Fund (Project No: 2018.07.05.807)
State-of-the-art preclinical techniques to study the impact of spreading depolarizations in awake rodents
Get PDFBackgroundUnderstanding the mechanisms of pathological brain network activity and the efficacy of therapies requires testing hypothesis in vivo, where brain circuitry remains preserved. Therefore, animal models are a key tool in the study of primary neurological disorders such as migraine, stroke and epilepsy. These models not only have advanced our understanding of the underlying neurobiology of these disorders but have also provided novel pharmacological targets and insights on shared pathophysiological processes such as spreading depolarizations (SD). SD, the electrographic correlate of migraine with aura, are transient waves of near-complete neuroglial depolarization associated with transmembrane ionic and water shifts.BodyMany studies investigating the impact of SD in preclinical models have done so in the presence of anesthesia. However, the use of anesthesia is a well-known confounding factor that not only influences SD threshold or frequency but also SD-evoked hemodynamic responses as common anesthetics affect cerebral blood flow and neurovascular coupling, limiting translation. Therefore, here we discuss research methods that have recently been developed or refined to allow the study of SD in awake rodents with a focus on migraine with aura. We discuss advantages, limitations and also efforts made to transition towards minimally-invasive procedures. Methods include optogenetic approaches to induce SD, multisite high-fidelity DC-coupled electrophysiological recordings, and measurements of neurovascular signals detected at both mesoscopic/macroscopic (e.g., fluorescent reporters, functional ultrasound system) and microscopic levels (e.g., two-photon microscopy, miniscopes). Additionally, we discuss continuous wireless telemetry recordings to detect spontaneous SD frequency over weeks to months in freely moving animals.ConclusionImplementation of these methods in awake brain will close the translational gap and improve the relevance of preclinical animal models.Medical Research CouncilWe are customers of Open Source Instruments, Inc., with no financial or professional affiliation to the company and no conflicts of interest to declare
The Effect of Positive Psychotherapy on Pain Perception, Daily Functioning, and Mental Health in Patients With Fibromyalgia
Get PDFBackground: Fibromyalgia syndrome (FMS) is a complex chronic pain syndrome disorder characterized by several symptoms, including widespread pain, fatigue, sleep disturbance, cognitive dysfunction, and mood disorders, with an unknown etiology, and unclear pathophysiology. Purpose: In this study, a Positive Psychotherapy Program for Patients with Fibromyalgia Syndrome was developed to change the pain perception of patients with fibromyalgia syndrome, optimize their activities of daily living, and improve their mental state, and the effectiveness of the program was confirmed. Design: We employed a randomized controlled design in this investigation, utilizing a pretest (at baseline), posttest (at the end of the ten-week intervention), and follow-up (in the third month) approach. Methods: The study was conducted from July 2023 to May 2024 with 72 outpatients diagnosed with fibromyalgia syndrome (experimental group=36, control group=36) who agreed to participate in the study. Data were collected using the Descriptive Information Form, Visual Analog Scale (VAS), Fibromyalgia Impact Questionnaire (FIQ) and General Health Questionnaire-28 (GHQ-28). The data were analyzed using SPSS for mac version 26 software. The 36 patients in the experimental group participated in a program consisting of 10 sessions of 90 minutes each based on positive psychotherapy theory for 10 weeks. Results: The analysis revealed that there were significant differences between the experimental and control groups in terms of pain, FIQ scores, depression sub-dimension, anxiety sub-dimension, social functioning sub-dimension and somatic symptoms sub-dimensions (VAS: p=0.001, η²=0.438; FIQ: p=0.001, η²=0.517; GHQ-28 total p=0.001, η²=0.522). Conclusions Clinical Implications: In line with these results, it is recommended that the Positive Psychotherapy Program for Patients with Fibromyalgia Syndrome be used to help fibromyalgia patients improve their symptoms. The research was registered in the Clinical Trials Number protocol registration system with the number NCT06147882. © 2025 Elsevier B.V., All rights reserved