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Psychometric Properties of Fears of Cancer Recurrence Scales in Turkish Hematologic Cancer Patients
No full textBackground and Objectives: Fears of cancer recurrence (FCR) represents one of the most common psychological problems in cancer patients. Therefore, valid and reliable measurement tools are needed to assess FCR in this population. The purpose of this study was to examine the psychometric properties of FCR scales (Fears of Cancer Recurrence-7 Item Version [FCR-7]; FCR-4 Item Version [FCR-4]; FCR-6 Item Version [FCR-6]) in Turkish hematological cancer patients. Materials and Methods: The study sample consisted of 239 hematological cancer patients undergoing treatment at four different state hospitals in T & uuml;rkiye. Results: Confirmatory factor analysis results showed that all three scales had a single-factor structure (FCR-7: CFI = 0.981, TLI = 0.969, RMSEA = 0.071, SRMR = 0.028; FCR-4: CFI = 1.000, TLI = 1.001, RMSEA = 0.000, SRMR = 0.004; FCR-6: CFI = 0.981, TLI = 0.965, RMSEA = 0.087, SRMR = 0.028). The model allowing for correlated error terms between the first and second items provided the best fit. Research findings also indicated that the scales possessed strict measurement invariance across gender. Convergent and discriminant validity analyses also demonstrated expected associations between FCR scale scores and psychological well-being (r = -0.25 to -0.34) and psychological distress (r = 0.33 to 0.46) variables. The known-groups validity analysis indicated that the scales were effective at differentiating between groups and that they replicated the well-established finding from previous research that women report significantly higher levels of FCR than men (d = 0.42-0.47). Reliability analyses indicated that all three versions of the FCR scales had high internal consistency (Cronbach's alpha = 0.91-0.93) and strong test-retest reliability (r = 0.85-0.87). Conclusions: Overall, the findings indicated that FCR-7, FCR-4, and FCR-6 are psychometrically sound, valid, and reliable instruments for assessing FCR in Turkish hematological cancer patients. These instruments can be used in clinical practice and research studies, as well as for evaluating intervention effectiveness in this population
A Psychometric Evaluation of the Hypoglycemia Problem-Solving Scale (HPSS) in Turkish Older Adults with Diabetes
No full textIntroduction: Hypoglycemia is a significant complication in diabetes management and presents an even greater risk for older adults. These individuals are particularly vulnerable to hypoglycemic episodes, which can result in serious health consequences. The Hypoglycemia Problem-Solving Scale (HPSS) evaluates problem-solving skills related to hypoglycemia; however, it has not yet been validated in T & uuml;rkiye. This study aimed to evaluate the validity and reliability of the Turkish adaptation of the HPSS. Materials and Methods: A descriptive, methodological, and cross-sectional study was conducted with 623 older adults (aged 65 and above) diagnosed with Type 2 diabetes and with a history of hypoglycemic episodes. The HPSS was adapted into Turkish, and its psychometric properties were assessed through content validity, Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and reliability analyses. Results: The mean age of participants was 72 +/- 5.5 years. Expert agreement on the items was high (Kendall's W = 0.83, p < 0.05), and all items had a Content Validity Ratio (CVR) above 0.56. The overall Content Validity Index (CVI) was 0.97. Exploratory Factor Analysis (EFA) revealed seven factors explaining 74.22% of the total variance. The Kaiser-Meyer-Olkin (KMO) value was 0.85, and Bartlett's test of sphericity was significant (chi(2) = 7590.85, p < 0.001). Confirmatory Factor Analysis (CFA) demonstrated acceptable model fit (CFI = 0.952; chi(2)/df = 2.536). The scale demonstrated high internal consistency (Cronbach's alpha = 0.88) and excellent test-retest reliability (r = 0.99, p < 0.001). Discussion/Conclusions: The Turkish version of the Hypoglycemia Problem-Solving Scale is a valid and reliable instrument for evaluating problem-solving skills related to hypoglycemia in older adults with diabetes. It can be effectively utilized in clinical practice to support better hypoglycemia management and improve overall diabetes care
Türkiye Sağlık Hizmetleri Etkinliğinin Değerlendirilmesi: İBBS-1 Düzeyinde Veri Zarflama Analizi
No full textSağlık hizmetleri yönetiminin temel mücadele alanı toplumun sağlık hizmeti ihtiyacını kalite, etkililik ve verimlilik hedefleri gerçekleştirilerek karşılanmasıdır. Bu nedenle sağlık hizmetleri performansının sürekli olarak değerlendirilmesi ve iyileştirilmesi çalışmaları yapılması elzemdir. Bu çalışmanın amacı, 2011-2020 yılları arasında Türkiye’de sağlık hizmetleri etkinliğinin Veri Zarflama Analizi yöntemi ile değerlendirilmesidir. Çalışmada İBBS-1 düzeyinde tüm sağlık hizmet sunucuları ve Sağlık Bakanlığı’na bağlı sağlık kuruluşları için etkinlik karşılaştırmaları yapılmaktadır. Karar verme birimlerinin yıllara göre toplam etkinlik skor tabloları, 10 yıllık analiz sonuçları değerlendirildiğinde; tüm sağlık hizmet sunucuları kapsayan verilere göre, tüm bölgelerin en düşük ortalaması 2011 yılında %89 olarak tespit edilmiştir. Bu oranın, her yıl artarak, 2020 yılında %98’e yükseldiği görülmektedir. Sağlık Bakanlığı’na bağlı sağlık kuruluşlarına ait veriler değerlendirildiğinde, tüm bölgelerin en düşük ortalaması yine 2011 yılında %70 olarak bulunurken, bu oranın da her yıl artarak, 2020 yılında %89’a yükseldiği görülmektedir. Bununla birlikte çalışmada yıllar itibariyle etkin olan ve olmayan bölgeler tespit edilmiştir. Kaynak kullanımından kaynaklı etkinsizlikler olduğu belirlenmiştir. Çalışma bulguları değerlendirildiğinde, kaynak tahsisinin ve kullanımının bölgeler arası demografik değişiklikler dikkate alınarak güncel olarak takip edilmesi, kamu ve özel sağlık hizmet sunucularının kaynak tahsisisinde tüm sektördeki kaynak varlığının ve kullanımının birlikte değerlendirilerek bir planlama yapılması önerilmektedir
Pneumomediastinum Following Revision Septorhinoplasty with Costal Cartilage Graft: A Case Report
No full textPneumomediastinum and subcutaneous emphysema are rare complications following septorhinoplasty. A 39-year-old male underwent revision septorhinoplasty with costal cartilage graft harvesting due to insufficient septal cartilage. Postoperatively, a routine chest X-ray revealed pneumomediastinum and cervical subcutaneous emphysema, although the patient remained asymptomatic with normal oxygen saturation. Thoracic CT confirmed the diagnosis, and conservative management, including oxygen therapy and intravenous antibiotics, was initiated. By postoperative day 4, complete resolution was observed, and the patient was discharged in good condition. Pneumomediastinum is usually self-limiting but may lead to severe complications such as mediastinitis. This case highlights the potential risks associated with costal cartilage harvest, particularly in the presence of calcification, which may increase the likelihood of tissue damage. Routine postoperative chest imaging, even in asymptomatic patients, is crucial for early detection and management. Proper intraoperative techniques, vigilant postoperative monitoring, and awareness of potential complications are essential for optimizing patient safety and surgical outcomes in septorhinoplasty procedures. © 2025 Elsevier B.V., All rights reserved
Therapeutic effects of cinnamic acid in a rat model of collagenase-induced Achilles tendinopathy
No full textBackground Achilles tendinopathy is a common degenerative disorder characterized by pain, impaired function, and poor tissue regeneration. Effective treatment remains a challenge due to the tendon's limited healing capacity. Cinnamic acid, a naturally occurring phenolic compound, has demonstrated anti-inflammatory and antioxidant effects in various tissue repair models. However, its therapeutic potential in tendon injury remains unexplored, and this study represents the first study to evaluate its effects in an experimental Achilles tendinopathy model. Methods In this experimental study, tendinopathy was induced in male rats via ultrasound-guided collagenase injection into the right Achilles tendon. Animals were randomly assigned to six groups (n = 7 each): Sham, Injury Control, vehicle control (Tendinopathy + DMSO), and three cinnamic acid treatment groups (10, 30, and 90 mg/kg). Cinnamic acid was administered intraperitoneally once daily for four weeks, starting on day 7 post-injury. Tendon healing was evaluated on days 21 and 35 using ultrasound imaging and histological analysis based on semi-quantitative scoring systems. Results Cinnamic acid treatment led to dose-dependent improvements in tendon healing. Ultrasound scores significantly decreased in the 30 mg/kg group, indicating preservation of echogenicity and reduced neovascularization. Modest improvement was observed with 10 mg/kg, whereas 90 mg/kg showed no significant benefit. Histological findings paralleled the ultrasound results, with the 30 mg/kg group displaying improved collagen fiber organization, normalized nuclear morphology, and reduced inflammation. Both 10 mg/kg and 90 mg/kg groups showed improvements over the injury control group, but the difference between these two doses was not statistically significant. A strong correlation (rho = 0.794, p < 0.001) between ultrasound and histological scores confirmed the consistency of imaging-based assessment. Conclusions These findings support the utility of ultrasound as a non-invasive monitoring tool and highlight cinnamic acid as a promising therapeutic agent for tendinopathy.Izmir Bakircay University, Office of Scientific Research ProjectsNot applicable
Rehabılıtatıon ın neuromuscular dıseases: best turkısh practıce recommendatıons by multıdıscıplınary experts
No full textBackground and aim:Neuromuscular diseases (NMDs) are a heterogeneous group of diseases including motor neurone diseases (MND), muscle diseases (MD), neuropathies and neuromuscular junction diseases (NMJD). NMDs are characterized by a wide range of symptoms and findings, depending on different underlying issues. Therefore, the literature includes specific management and/or rehabilitation recommendations for each subgroup and even for some diseases within these subgroups. Currently, neither in our country nor globally is there a comprehensive recommendation study that thoroughly addresses all aspects of NMD rehabilitation developed by experienced and specialized multidisciplinary experts in the field.Materials and methodsThe recommendations in this paper have been created by a multidisciplinary team for all patients without age limitation under the headings of peripheral neuropathy/polyneuropathy, MND, MD and NMJD using the seven-step and 3 round modified Delphi method via e-mail. The strength of agreements (SOA) was calculated for each item (recommendation) using percentages (response of between 8 and 10%), median values, and interquartile range with Kappa method.ResultsThe opinions of the experts were analysed according to the 3-round modified Delphi method, and a list of 110 items of recommendations for patients with NMDs of all ages was prepared in as much detail as possible to shed light on almost all questions and problems that may be encountered in clinical practice. There were 5 recommendations in the general management subsection, 20 recommendations in the rehabilitation indications subsection, 8 recommendations in the rehabilitation contraindications section, and 77 recommendations in the rehabilitation section (general principles 7 recommendations, modalities 13 recommendations, exercise characteristics 57 recommendations).ConclusionWe think that this study will be a light for physicians dealing with this patient group in clinical practice, as it includes fine details up to exercise prescriptions
İkame İşçi
No full textİkame işçi kavramı, bir işyerinde çalışan işçinin yerini almak üzere görevlendirilen yeni bir işçi için kullanılmaktadır. Özellikle bir işçi hastalandığında, izinde olduğunda ya da başka bir sebeple işe gelmediğinde, onun yerine geçici olarak ikame işçi çalıştırılabilir. Dolayısıyla, bu işçilerin çalışması genellikle geçici ve kısa süreli olur. İkame işçinin yerine, belirli bir süre sonunda eski işçi geri döner ya da başka bir işçi işe alınır. Mevzuatımızda ikame işçiye ilişkin açık bir hüküm bulunmamaktadır. Ancak, İş Kanunu’nun 13. maddesinin 5. fıkrasında, “Kısmi süreli çalışmaya geçen işçinin tam zamanlı çalışmaya başlaması durumunda yerine işe alınan işçinin iş sözleşmesi kendiliğinden sona erer.” denilmektedir. Bu düzenlemeden kısmi süreli çalışmaya geçen işçinin yerine işe alınan işçinin, ikame işçi olduğu anlaşılmaktadır. Çalışmada, ikame işçi kavramı, ikame işçiye ihtiyaç duyulan haller ve ikame işçinin iş sözleşmesinin türü, öğreti görüşleri ve yargı kararlarının yanı sıra yabancı hukuktaki düzenlemeler dikkate alınarak açıklanmıştır
Divergent priorities, convergent goals: semantic analysis of publications and patents in healthcare smart contracts
No full textThis study presents a comprehensive comparative analysis of smart contract applications in healthcare across scholarly publications and patents, addressing the growing importance of blockchain technology in healthcare systems. Through a multi-stage computational analysis pipeline, we examined 4156 scholarly publications and 10,204 patents to identify knowledge transfer patterns, keyword evolution, and innovation dynamics. Our findings challenge traditional models of knowledge diffusion by revealing a bidirectional flow of innovation between academic and commercial domains, with technical keywords often appearing in patents years before scholarly exploration (mean lag of - 8.12 years). The analysis demonstrates distinct but complementary conceptual emphases: patents focus primarily on technical implementation mechanisms while publications emphasize governance frameworks, interoperability standards, and ethical considerations. Geographic analysis revealed striking asymmetries, with European institutions dominating scholarly output while the United States holds overwhelming dominance in patent activity. Using advanced semantic analysis through SciBERT embeddings, we identified two distinct clusters within scholarly publications, with application-oriented research representing the largest thematic focus (79.4% of publications).This research contributes to understanding the complex ecosystem of healthcare blockchain innovation and highlights significant opportunities for improved knowledge integration between academic research and commercial development to advance secure, ethical implementations of smart contract technology in healthcare
Search for dark matter production in association with a single top quark in proton-proton collisions at TeV
No full textA search for the production of a single top quark in association with invisible particles is performed using proton-proton collision data collected with the CMS detector at the LHC at TeV, corresponding to an integrated luminosity of 138 fb?1. In this search, a flavor-changing neutral current produces a single top quark or antiquark and an invisible state nonresonantly. The invisible state consists of a hypothetical spin-1 particle acting as a new mediator and decaying to two spin-1/2 dark matter candidates. The analysis searches for events in which the top quark or antiquark decays hadronically. No significant excess of events compatible with that signature is observed. Exclusion limits at 95% confidence level are placed on the masses of the spin-1 mediator and the dark matter candidates, and are compared to constraints from the dark matter relic density measurements. In a vector (axial-vector) coupling scenario, masses of the spin-1 mediator are excluded up to 1.85 (1.85) TeV with an expectation of 2.0 (2.0) TeV, whereas masses of the dark matter candidates are excluded up to 0.75 (0.55) TeV with an expectation of 0.85 (0.65) TeV. © 2025 Elsevier B.V., All rights reserved
Cutaneous immune cell levels in patients with hard-to-heal wounds after maggot therapy and surgical debridement therapy
No full textObjective: This study aimed to investigate and compare the effects of maggot therapy (MT) and surgical debridement therapy (SDT) on the inflammatory phase of healing, a phase which does not favour tissue regeneration in hard-to-heal wounds. Method: SDT was performed in sterile operating theatre conditions. MT was applied with a dose of 5-7 maggots/cm(2). The levels of neutrophils, macrophages, M1 cells, M2 cells, T-cells and B-cells were analysed by using flow cytometry analysis which was performed on wound biopsy samples collected from hard-to-heal foot ulcers in patients with diabetes before and after either SDT or MT. Results: The experimental cohort comprised 25 patients. Patients in the MT group (n=13) demonstrated a shorter time to complete debridement, required fewer debridement sessions and had a higher rate of complete recovery than patients in the SDT group (n=12). Both therapies were able to reduce neutrophil, macrophage and M1 cell levels, and to elevate M2 cell, T-cell and B-cell frequencies. Statistically significantly higher variations were reported after MT than after SDT in neutrophil, M2 cell, T-cell and B-cell counts. Conclusion: The higher cell numbers detected in the MT group could be associated with an increased healing rate and reduced debridement time in comparison with SDT. MT not only debrided the wound effectively, but also positively influenced wound healing through its effect on the inflammatory process. Declaration of interest: Selcuk University Scientific Research Projects Coordination Unit, Konya, Turkey supported this study financially (grant number: 21401077). The authors have no conflicts of interest.Selcuk University Scientific Research Projects Coordination Unit, Konya, Turkey [21401077]Acknowledgements The authors thank Thorvacs, Ankara, Turkey for technical support and Selcuk University Scientific Research Projects Coordination Unit, Konya, Turkey for financial funding (grant number: 21401077)