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The Role of Socioeconomic Conditions in the Severity of Violence Against Women: A Retrospective Cross-Sectional Study
No full textPathogen detection and antibiotic use in granulomatous lobular mastitis: a comparison of mNGS and culture
No full textObjective: This study aimed to evaluate the clinical microbial profile of patients with granulomatous lobular mastitis (GLM) and compare various detection methods to identify the most effective approach for pathogen detection, which could help enhance clinical diagnosis and treatment. Methods: We retrospectively analyzed data from 84 patients diagnosed with GLM, assessed the composition of pathogenic microorganisms in these patients, and compared the effectiveness of different sampling methods and detection techniques. Results: Corynebacterium kroppenstedtii (C. kroppenstedtii) was identified as the predominant microorganism among GLM patients. The positivity rate was low in skin swabs (10%) but similar in pus (40%) and tissue samples (37%). After antibiotic treatment, the pathogen detection rate of metagenomic next-generation sequencing (mNGS) (54.55%) was found to be higher than that of culture-based methods (27.27%). Among the GLM cases with pathogenic infection, although mNGS demonstrated higher sensitivity (75.0%) than culture tests (50.0%), both methods exhibited 100.0% specificity. However, the time for obtaining results with mNGS was significantly shorter (1.2 ± 0.41 days) compared to bacterial culture (5.5 ± 0.64 days) (P < 0.05). Conclusions: Our findings indicate that pus was the most suitable sample type for microbial evidence collection in patients with GLM. mNGS demonstrated superior performance compared to culture in distinguishing infectious from non-infectious cases, with reduced antibiotic interference, faster turnaround time, and higher accuracy. Based on our single-center experience, empirical cephalosporin treatment may be appropriate for these patients. Additionally, surgical intervention remains the most efficient approach for rapid and complete resolution
The Classification of Impacted Third Molar and Their Relationship with Distal Caries on the Second Molar Gömülü Üçüncü Azı Dişlerinin Sınıflandırılması ve İkinci Azı Dişindeki Distal Çürüklerle İlişkisi
No full textBackground: Teeth are referred to as impacted/mucosa retention impacted when they cannot reach the expected coronal level in occlusion within the expected eruption period due to adjacent teeth on the eruption path, surrounding bone or soft tissue, or different anomalies. They are directly or indirectly linked to various disorders in the dentomaxillofacial region, including caries. The aims of this study are to assess the frequency of impacted third molars and to examine their association with caries formation on the distal surface of adjacent second molars. Methods: Panoramic radiographs of 705 patients meeting inclusion criteria were analyzed to assess the prevalence and positioning of impacted third molars. The study employed Pell & Gregory (for classify depth of impacted third molar and retromandibular space to anterior border of mandibular ramus) and Winter (impacted third molar relative to second molar) classification systems to classify impacted teeth. Chi square and Z tests were used to evaluate the obtained data. Results: While vertical angulation has highest rate among angulation types, position C and class 2 were most prevalent types according to Pell & Gregory classification. Statistical analysis revealed a significant association between horizontal angulation and position A with caries occurrence on the distal surface of second molars. Conclusion: In terms of preventive dentistry, it may be recommended to extract horizontally or mesioangularly positioned third molars, and also those in A position, to prevent the formation of caries in the second molars
Health services in the context of Third Age Tourism: Expectations andService Satisfaction of Older Tourists
No full textObjective: Third age tourism, a subset of healthtourism, is gaining importance with the rise of theelderly population, which poses challenges inhealthcare provision. Countries offering affordabletreatment and care have facilitated the growth of thistourism segment. This study aims to provide ascientific basis for future research by examiningacademic publications related to health services andelderly tourist satisfaction within third age tourismusing bibliometric analysis.Materials and Methods: A search was conducted inthe WOS database using keywords including "oldertourists," "health services," "expectations,""satisfaction," "health tourism," and "medicaltourism" for publications up to March 15, 2025. Atotal of 125 interdisciplinary studies were identifiedand analyzed using VOSviewer 1.6.18 and MicrosoftExcel. Analyses included publication year trends,citation counts, countries of origin, institutionsinvolved, and major funding organizations. Findings:The first relevant study was published in 2010. Adecline in publication numbers occurred after 2014,2018, and 2022, with fluctuating annual output since2013. "Medical tourism" was the most frequentkeyword (f=156), and Malaysia led in publicationcount (n=15). The most cited article was by Han andHyun (2015), with 362 citations. Fundação para aCiência e a Tecnologia (FCT) was the top fundingbody, while University Sains Malaysia was the mostactive and well-funded institution. Conclusion: Thirdage tourism is increasingly significant due to the agingpopulation’s healthcare needs. The growing academicinterest reflects this trend. The findings offer valuableinsights for researchers aiming to explore elderlysatisfaction and healthcare services in this context.</p
A Comparison of Mental Health Literacy and Depression Levels of Nurses Working in Two Different Hospitals: A Cross-Sectional Study
No full textComparison of AI-generated and clinician-designed multiple-choice questions in emergency medicine exam: a psychometric analysis
No full textBackground: Artificial intelligence (AI) has shown promise in generating multiple-choice questions (MCQs) for medical education, yet the psychometric quality of such items remains underexplored. This study aimed to compare the psychometric properties of MCQs created by ChatGPT-4o and those written by emergency medicine clinicians. Methods: Eighteen emergency medicine residents completed a 100-item examination comprising 50 AI-generated and 50 clinician-authored questions across core emergency medicine topics. Each item was analyzed for difficulty (P_index), discrimination (D_index), and point-biserial correlation (PBCC). Items were also categorized based on standardized index classifications. Results: ChatGPT-4o-generated questions exhibited a higher mean difficulty index (P_index: 0.76 ± 0.23) compared to those created by clinicians (0.65 ± 0.24; p = 0.02), indicating that the AI-generated items were generally easier. Participants achieved significantly higher scores on AI-generated items (76.8 ± 8.18) than on clinician-authored questions (67.3 ± 9.65; p = 0.003). The mean discrimination index did not differ significantly between AI-generated (0.172 ± 0.23) and clinician-generated items (0.196 ± 0.26; p = 0.634). Likewise, the mean point-biserial correlation coefficient (PBCC) was nearly identical between the two groups (AI: 0.23 ± 0.28; clinicians: 0.23 ± 0.25; p = 0.99), suggesting similar internal consistency. Categorical analysis revealed that 56% of AI-generated items were classified as “easy,” compared to 36% of clinician-designed items. Furthermore, based on PBCC values, 36% of AI-generated items and 24% of clinician items were identified as “problematic” (p = 0.015), indicating a higher rate of psychometric concerns among AI-generated questions. Conclusion: The findings suggest that AI-generated questions, while generally easier and associated with higher participant scores, may pose psychometric limitations, as evidenced by a greater proportion of items classified as problematic. Although the overall internal consistency and discrimination indices were comparable to clinician-authored items, careful quality control and validation are essential when integrating AI-generated content into assessment frameworks
Association of MTHFR and DNMT-1 Gene Polymorphisms with Acute Coronary Syndrome in Patients Admitted to the Emergency Department
No full textForensic Cases in the Emergency Department: Associations Between Life-Threatening Risk, Medical Treatability, and Patient Outcomes
No full textAbstract: Background: This study aimed to evaluate the clinical and forensic characteris-tics of cases admitted to a high-volume tertiary emergency department, focusing on se-verity-based classification using treatability with simple medical intervention (SMI) andlife-threatening status. Methods: We retrospectively analyzed 3014 forensic cases overone year. Patients were classified based on injury severity, anatomical region, and clinicaloutcomes. Documentation practices and report types were also reviewed. Results: Amongall the cases, 60.4% were treatable with SMI, and 10.5% were identified as life threatening.Notably, all patients who died (1.3% mortality) were in the life-threatening group, andnone of the SMI-treated patients died, underscoring the accuracy of early triage and align-ment between documentation and outcomes. Road traffic accidents were the leadingcause of life-threatening injury and hospitalization, while assault cases were predomi-nantly minor and managed conservatively. Seasonal variation peaked in July, and sex-based differences revealed a higher SMI eligibility among female patients. Final forensicreports were more frequently issued in SMI cases, while preliminary reports were pre-dominant in severe trauma. Conclusions: Severity-based classification using SMI and life-threatening categories offers valuable insight for clinical decision-making and forensicdocumentation. Integrating structured triage, anatomical injury mapping, and standard-ized report templates can enhance both patient safety and legal reliability.</p
