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Nursing students' readiness for intercultural care: The relationship between cultural sensitivity, intercultural communication apprehension, and xenophobia in Turkiye: A cross-sectional study
No full textBackground For future nurses, who are of critical importance for public health, research and determinations based on universal standards should be conducted to ensure that they avoid xenophobic attitudes and provide culturally sensitive care in the face of different cultures and values. Methods The present study aims to investigate the relationship between cultural sensitivity, intercultural communication apprehension, and xenophobia among nursing students. This descriptive and cross-sectional study was conducted on 242 nursing students at a state university's Faculty of Health Sciences in T & uuml;rkiye during the spring academic semester of the 2023-2024 academic year. Data were collected online between 1st March 2024 and 28th March 2024 by using a web-based survey tool. Data collection included a "Sociodemographic Data Collection Form", the Intercultural Sensitivity Scale, the Intercultural Communication Apprehension Scale, and the Xenophobia Scale. Results The mean total scores obtained by students on scales were determined to be 85.72 +/- 11.41, 40.70 +/- 4.38, and 54.60 +/- 9.61, respectively. The explanatory power of the regression model established was 0.297, which indicates that the model can explain 29.7% of the variance in the xenophobia variable with cultural sensitivity and intercultural communication apprehension variables. Conclusions Students exhibited high levels of cultural sensitivity and moderate levels of intercultural communication apprehension and xenophobia. A positive correlation was found between xenophobia and intercultural communication apprehension, a negative correlation between xenophobia and cultural sensitivity, and a positive correlation between intercultural communication apprehension and cultural sensitivity
Antidiabetic drug modifications in type 2 4. diabetic patients with chronic kidney disease
No full textThe number of patients with type 2 diabetes mellitus (T2DM) is increasing worldwide, and T2DM patients constitute the majority of patients initiated on renal replacement therapy (RRT) with a diagnosis of chronic kidney disease (CKD). Approximately 20% of adult patients with T2DM have a low estimated glomerular filtration rate (eGFR <60 mL/min/1.73 m²), and 30-50% have increased protein excretion. The United Kingdom Prospective Diabetes Study reported rates of both low eGFR (<60 mL/min/1.73 m 2 ) and albuminuria of 28% after a median followup of 15 years. Patients with T2DM have more comorbidities. Therefore, other causes of CKD (such as hypertension, dyslipidemia, obesity, renal vascular disease, acute kidney injury, glomerular atherosclerosis, or age-related kidney loss) are frequently present in this population. CKD affects 20-50% of patients with T2DM. Approximately one-third of patients with end-stage kidney disease (ESKD) are diabetic, and two-thirds of these patients have T2DM. The incidence of diabetes in patients who started RRT for the first time in our country in 2024 was 38.3%. This rate was 40.3% for in-centre and home hemodialysis (Type 1: 7.8% and T2DM: 32.2%), 33.9% for peritoneal dialysis (Type 1: 7.5% and T2DM: 26.1%), and 14.8% for kidney transplantation (Type 1: 3.41% and T2DM: 11.8%). Diabetes mellitus (DM) and CKD increase the risk of cardiovascular disease-related morbidity and mortality. The introduction of new antidiabetic drugs, improved glycemic control, and advances in cardiovascular diagnosis and interventions have extended the survival of patients with T2DM
Artificial neural network-infused polar fox algorithm for optimal design of vehicle suspension components
No full textOptimizing real-world engineering design challenges is inherently complex and difficult, especially when optimal solutions are expected. To this end, the creation of new and efficient optimization algorithms is not an option but a necessity. This paper presents an improved version of the recently developed Polar fox optimization technique. The addition of dynamic adversarial learning improves the dynamic adversarial learning Polar fox optimization algorithm by improving the performance of the algorithm to optimize real-world optimization problems not only very quickly but also accurately. Using test problems from the field of engineering disciplines, such as car crash test, welded beam structure, three-bar truss, and cantilever beam problem, the new optimizer known as the modified Polar fox optimization algorithm (MPROA) was validated before being used to optimize an automobile suspension arm. MPROA achieved superior results in achieving the goal quickly and accurately and proved its potential to solve complex engineering problems. Moreover, the comparison will also reveal the power of the MPROA developed in this work to tackle multiple issues that constrained the reach of a globally optimal solution
Performance investigation and system design of grid-integrated vehicular pem fuel cell to protect against voltage sags/swells with series voltage injection circuit
No full textThis study explores the integration of a battery electric vehicle (BEV) to a fuel cell vehicle (FCV) supported vehicle-to-grid (V2G) system for voltage support. In the designed system, a series voltage injection circuit supplied by the Li-ion batteries of BEV is utilized for voltage support to protect vehicular fuel cells and interface components by injecting controlled voltage during voltage sag/swell problems at the grid side. The designed vehicular fuel cell supported V2G system with a series voltage injection circuit supplied by BEV provides more effective results to compensate deeper sag/swell problems by using voltage injection to eliminate the disadvantage of current injection in conventional systems. For this purpose, in the current study, an FCV with a rating of 95 kW is connected to the grid, and a detailed analysis is performed for the series voltage injection circuit connected to the V2G system supported by an additional BEV in the rating of 52 kWh. In the operating system, the actual power ratings of the vehicular PEM fuel cell and the battery in electric vehicles are designed and analyzed according to the parameters for Nexa and Zoe, respectively. In the proposed system, compared to the conventional system, performance analysis reveals that the system maintains stability on the FCV-side responding swiftly and smoothly to voltage sags of up to 50 % and swells of up to 22 %. It is also noted that the proposed system delivers approximately 91 kW of electrical power to the grid, and is not affected by the fault conditions occurring in the grid
Flood algorithm-tuned pid-f controller with a modified objective function for robust and noise-resilient speed control of nonlinear sparkignition engines
No full textThis study presents a novel control strategy for the regulation of engine speed in nonlinear four-cylinder spark ignition (SI) engines by integrating a proportional-integral-derivative controller with a filter (PID-F) tuned using the flood algorithm (FLA). The approach leverages the dual-phase exploration and exploitation mechanism of FLA to determine optimal controller parameters efficiently, addressing the nonlinear and time-varying behavior of SI engines. A modified objective function is formulated to penalize overshoot and cumulative tracking error simultaneously, ensuring rapid transient response and precise steady-state accuracy. The proposed control framework is modeled and validated in MATLAB/Simulink and benchmarked against existing tuning techniques, including the Simulink PID tuner and selected metaheuristic optimizers such as the whale optimization algorithm, sinh-cosh optimizer, and cuckoo search. Comparative analyses demonstrate the superiority of the FLA-optimized PID-F controller in achieving stable, robust, and noise-resilient speed regulation under varying load and disturbance conditions. The findings establish the FLA as an efficient and scalable optimization tool for real-time controller tuning in automotive applications, contributing to a practical and computationally efficient solution for advanced engine control systems
The state of the art in anti-aging: Plant-based phytochemicals for skin care
No full textPhytochemicals help mitigate skin aging by scavenging free radicals, modulating key enzymatic pathways, and promoting the skin's structural integrity. Carotenoids, vitamins, essential fatty acids, and phenolic compounds work by acting as antioxidants, inhibiting enzymes like hyaluronidase, collagenase, and elastase, which degrade skin structure, and reducing levels of inflammatory markers (IL-6, IL-8, etc.) and matrix metalloproteinases (MMP-1, MMP-2) linked to aging. Recent research highlights that plant-based phytochemicals can improve skin elasticity, reduce hyperpigmentation, prevent the breakdown of important skin proteins, and support wound healing, making them valuable components for skin care and treatments. This review explores the multifaceted roles of phytochemicals in maintaining and improving skin health, highlighting their mechanisms of action and potential in skin anti-aging innovations
Evaluation of clinicopathological features and potential recurrence-associated factors in patients with stage 1 nonseminomatous testicular cancer
No full textAmaç: Bu çalışmanın amacı, evre 1 nonseminomatöz testis kanserli hastaların klinik ve patolojik özelliklerini değerlendirmek ve bu özelliklerin nüks gelişimiyle olan ilişkisini araştırmaktır. Özellikle tümör boyutu, histolojik alt tipler ve multifokalite gibi faktörlerin nüks öngörüsündeki rolleri incelenmiştir. Gereç ve Yöntem: 2010–2024 yılları arasında Bursa Uludağ Üniversitesi Tıp Fakültesi’nde evre 1 nonseminomatöz testis kanseri tanısı almış, radikal orşiektomi uygulanmış ve en az 12 ay düzenli izlem verisi bulunan toplam 92 erkek hasta çalışmaya dahil edilmiştir. Veriler hasta dosyaları ve elektronik kayıt sistemlerinden elde edilmiştir. Demografik bilgiler, tümör boyutu, histolojik alt tip, lenfovasküler invazyon, nekroz, rete testis invazyonu ve preoperatif serum tümör belirteçleri analiz edilmiştir. Nüks ve sağkalım Kaplan-Meier yöntemiyle değerlendirilmiş; risk faktörleri ROC analizi ve çok değişkenli Cox regresyon modeliyle incelenmiştir. Bulgular: Hastaların yaş ortalaması 28,4±8,4 yıl idi. Beş yıllık genel sağkalım (OS) oranı %94,5, nükssüz sağkalım (RFS) oranı ise %84,6 olarak bulunmuştur. ROC analizinde tümör boyutunun nüksü öngörmede anlamlı olduğu gösterilmiştir. Kaplan-Meier analizine göre, tümör boyutu ≥5,25 cm olan ve multifokal tümörü bulunan hastalarda RFS anlamlı derecede düşüktü. Çok değişkenli analizde büyük tümör boyutu ve multifokalite bağımsız nüks risk faktörleri olarak saptanmıştır. Sonuç: Evre 1 nonseminomatöz testis kanserinde tümör boyutu ve multifokalite nüks riskini önemli ölçüde etkilemektedir. Bu parametrelere göre bireyselleştirilmiş hasta yönetimi planlanmalı ve yüksek riskli hastalarda adjuvan tedavi seçenekleri erken dönemde değerlendirilmelidir. Bulguların daha geniş ve çok merkezli çalışmalarla doğrulanması gerekmektedir.Objective: This study aimed to evaluate the clinical and pathological characteristics of patients with stage 1 non-seminomatous testicular cancer and to investigate their relationship with recurrence. Specifically, the roles of tumor size, histological subtypes, and multifocality in predicting recurrence were assessed. Materials and Methods: A total of 92 male patients diagnosed with stage 1 non-seminomatous testicular cancer between 2010 and 2024 at Bursa Uludağ University Faculty of Medicine were included. All patients underwent radical orchiectomy and had at least 12 months of regular follow-up. Data were collected from patient files and electronic records. Parameters including demographic data, tumor size, histological subtype, lymphovascular invasion, necrosis, rete testis invasion, and preoperative serum tumor markers were analyzed. Recurrence and survival were evaluated using the Kaplan-Meier method. Risk factors were analyzed using ROC curves and multivariate Cox regression models. Results: The mean age was 28.4±8.4 years. The 5-year overall survival (OS) rate was 94.5%, and the recurrence-free survival (RFS) rate was 84.6%. ROC analysis revealed that tumor size significantly predicted recurrence. Kaplan-Meier analysis showed that RFS was significantly lower in patients with tumors ≥5.25 cm and those with multifocal tumors. Multivariate vi analysis confirmed that larger tumor size and multifocality were independent risk factors for recurrence. Conclusion: In stage 1 non-seminomatous testicular cancer, tumor size and multifocality significantly affect recurrence risk. Personalized riskbased management strategies should be considered, and adjuvant treatment may be preferable for high-risk patients. Further validation in larger, multicenter studies is needed