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Letter to Application of local volume reduction of the dorsal glans groove in the repair of hypospadias with small glans: a retrospective study
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The Effects of Chronic Neck Pain on Spinal Posture, Spinal Mobility and Handgrip Strength in Older Adults
No full textAim: The objective of the study was to compare spinal posture, spinal mobility, and handgrip strength between the participants aged 65 and over with and without Chronic Neck Pain (CNP). Material and Method: A total of 35 participants aged 65 and over, 17 older people with a diagnosis of CNP (CNP group) and 18 older people without CNP (control group), were included in this cross-sectional study. The Spinal Mouse device was used to measure spinal posture for the positions of vertebral column and spinal mobility for the movements in sagittal and frontal planes for the vertebral column. Handgrip strength was measured with a hand dynamometer. Results: The mean age of the CNP group and the control group were 69.88±4.66 years and 71.50±4.61 years (p>0.05), respectively. There were significant differences in right and left handgrip strength between the CNP group and the control group, respectively (p=0.008, p=0.022). According to the spinal posture values, the mean length of the vertebral column in CNP group was higher than the controls (p=0.028). In addition, the lumbar and pelvic inclination angles were different between the groups in maximum flexion positions (p=0.040 and p=0.027, respectively). According to the spinal mobility values, the mean pelvic inclination angle was lower in the CNP group than the controls from the upright position to the flexion movement (p=0.023). In addition, the lumbar and pelvic inclination angles were lower in the CNP group than the controls from the maximum extension to the maximum flexion movement (p=0.017 and p=0.013, respectively). Conclusion: This study showed that the length of the vertebral column and the grip strength were higher in the older adults with CNP than the controls. According to the spinal posture, the lumbar angle and pelvic inclination angle were lower in the older adults with CNP than the controls. According to the spinal mobility, the pelvic inclination and lumbar angles in the older adults with CNP were lower than the controls
ULUSLARARASI SİLAHLI ÇATIŞMALARDA GAZETECİLERİN KORUNMASI
No full textUluslararası silâhlı çatışma bölgelerinde tehlikeli görevlerde bulunan gazeteciler, uluslararası kamuoyuna sahadan ve sıcak çatışma bölgelerinden her türlü bilgi akışını sağlayan en önemli meslek grubudur. Bu çalışma kapsamında, uluslararası silâhlı çatışma alanlarında faâliyet yürüten gazetecilere yönelik uluslararası insancıl hukuk bağlamında sağlanan hukukî korumanın mahiyeti ve pratik düzlemde, fiilen ne ölçüde, etkili olduğu ele alınmıştır. Böylece uluslararası silâhlı çatışmalarda gazetecilerin korunmasına yönelik 1949 Cenevre Sözleşmeleri ve Ek Protokolleri, 1899- 1907 La Haye Düzenlemeleri ve uluslararası insancıl hukukun örfî normlarının oluşturduğu hukukî rejim incelenmiştir. Devamında, gazetecilere, tıbbî personel, dinî personel, sivil savunma personeli gibi sınıflara sağlanan özel hukukî statüye benzer bir statü sağlanması; gazeteciler tarafından sahada kullanılmak üzere ayırt edici/koruyucu nitelikte yeknesak bir amblem belirlenmesi gibi güncel tekliflerin değerlendirilmesi yapılmıştır. İlâveten, gazetecilerin silâhlı çatışmalarda korunmasına yönelik bir uluslararası sözleşme ihdâs edilmesi önerisi, süregelen uluslararası insancıl hukuk ihlâllerinin çözümünde etkili olup olamayacağı açısından ele alınmıştır
Fuzzy Clustering Based on Activity Sequence and Cycle Time in Process Mining
No full textClustering plays a vital role in process mining as it organizes complex event logs into meaningful groups, helping to identify common patterns, outliers, and inefficiencies. This simplification enables organizations to detect bottlenecks and optimize workflows by uncovering trends and variations that might otherwise remain hidden. Fuzzy clustering addresses the challenge of overlapping behaviors, providing actionable insights for targeted improvements and enhanced operational efficiency. Nevertheless, conventional clustering algorithms for process mining focus either on activity sequences or cycle times, resulting in incomplete insights due to the neglect of temporal or structural variations. This work introduces a new fuzzy clustering methodology that incorporates both activity sequences and cycle times through a weighted distance metric. The proposed approach balances the weights of similarity in sequences as well as time variation flexibly using the parameter alpha, enabling clusters to represent both structural as well as performance-based process attributes. Through using fuzzy C-means clustering, the method allows cases to have multiple memberships with different membership degrees, providing flexibility regarding overlapping process behavior. An experimental evaluation using real-life event logs demonstrates the effectiveness of the method in discerning process variants. It yields superior results compared to conventional methods that account for only sequence-based clustering scenarios, as well as time-based clustering methods. The results describe the significant importance of optimizing clustering results by varying alpha, where a balanced weighting (alpha=0.5) gives more meaningful clusters. Ultimately, the framework enhances process mining by offering detailed insights for analyzing operational inefficiencies, bottlenecks, and resource allocation mismatches, providing substantial real-world benefits for industries that demand effective process improvement
Artificial Intelligence in Vaccine and Drug Studies
No full textIn an era increasingly defined by the advent and integration of digital technologies in healthcare, the effective management and utilization of patient data have become crucial. Patient data, the lifeblood of healthcare systems, patient data drives diagnosis, informs treatment, enables research, and supports all aspects of care delivery. It provides a comprehensive understanding of patient health histories and current conditions for doctors, guiding treatments and outcomes. Thus, it plays an indispensable role in enhancing the equality and effectiveness of healthcare. © 2025 Elsevier B.V., All rights reserved
An Overview of Treatment in Pediatric Bladder-bowel Dysfunction: A Single-Center Experience
No full textObjective: This study aimed to evaluate the clinical characteristics, treatment responses, and outcomes of pediatric patients diagnosed with bladder-bowel dysfunction, highlighting a structured management approach including urotherapy, pharmacotherapy, and rehabilitation techniques. Method: A retrospective study was conducted with 1846 children aged 5-18 years diagnosed with bladder-bowel dysfunction at Bak & imath;r & ccedil;ay University & Ccedil;i & gbreve;li Training and Research Hospital between 2022 and 2025. Patients with neurological disorders were excluded. Data on demographics, bladder-bowel symptom scores, treatment modalities, uroflowmetry results, and treatment outcomes were collected. Conservative treatments included use of osmotic-laxatives and urotherapy. Patients unresponsive to initial therapies received treatment with antimuscarinics, biofeedback, and transcutaneous electrical nerve stimulation where appropriate. Results: The mean age of the patients was 104.4 months. Female predominance (67%) was observed. Conservative management alone successfully resolved symptoms in 512 patients without vesicoureteral reflux or recurrent urinary tract infections. Patients with higher bladder-bowel symptom scores (>20) and pathological uroflowmetry results required biofeedback and, in some cases, transcutaneous electrical nerve stimulation. No relapse was observed in any subgroup of patients during the 6-month follow-up period. Effective management of constipation and lifestyle modifications were critical for treatment success. Conclusion: A stepwise treatment protocol focusing on bowel regulation, urotherapy, and individualized interventions provides effective symptom control and prevents disease progression in pediatric bladder-bowel dysfunction. Early diagnosis, attention to modifiable risk factors such as constipation, and long-term adherence to behavioral strategies are essential for optimal treatment outcomes. Prospective studies with extended follow-up periods are warranted
Enhancing Patient Outcomes: Stress Ball Use as a Non-Pharmacological Intervention in Port Catheterization
No full textPurposeThe insertion of a port catheter can cause discomfort and distress to cancer patients, which may impair their comfort. The use of distraction techniques, such as stress balls, can help to alleviate pain and stress, thereby enhancing the patient experience. This study aimed to determine the effect of stress ball application on perceived stress, pain, and satisfaction during port catheter needle insertion in cancer patients.MethodsThis quasi-randomized controlled experimental study involved 74 cancer patients undergoing chemotherapy, who were randomly assigned to either the intervention group (n = 37) and the control group (n = 37). Prior to the implementation of the port catheter needle, the demographic and clinical data of the patients were recorded. Subsequently, the Perceived Stress Scale (PSS) was administered as a pre-test to ascertain their stress levels. During the procedure, patients in the intervention group were provided with a stress ball, which they were instructed to squeeze and release for approximately 5-10 min until the port catheter needle was inserted. After the procedure, the satisfaction levels of patients in the intervention group regarding the use of the stress ball were evaluated with the Visual Analog Scale (VAS). As a post-test, VAS was applied to patients in both groups to determine their pain levels, and PSS was applied to evaluate their stress levels. No intervention was made to patients in the control group during the procedure.ResultWhile no difference was found between the mean PSS scores of the study groups before the procedure (p = 0.743), a statistically significant difference was found between the groups after the procedure (p = 0.002). The stress levels of the IG, who received stress ball intervention, were lower than those of the CG. A statistically significant difference was found in the mean VAS scores of the groups after the procedure (p = 0.001). The post-test pain score mean of the IG, who received stress ball intervention, was lower than that of the CG. The mean satisfaction level score for the IG concerning the stress ball application during the port catheter needle insertion process was 7.57 +/- 1.70.ConclusionThe utilisation of a stress ball during port catheter insertion is effective in reducing perceived stress and pain levels while also enhancing patient satisfaction
Differentiating pure cognitive disengagement syndrome and attention-deficit/hyperactivity disorder-restrictive inattentive presentation with respect to depressive symptoms, autistic traits, and neurocognitive profiles
No full textThis study aimed to differentiate pure cognitive disengagement syndrome (CDS) from attention-deficit/hyperactivity disorder-restrictive inattentive presentation (ADHD-RI) by examining their neurocognitive profiles and associations with autistic traits (ATs) and depressive symptoms. A cross-sectional study was conducted involving three groups: pure CDS (n = 24), ADHD-RI (n = 32), and controls (n = 31). Participants underwent neuropsychological assessments using Computerized Neurocognitive Assessment Software (CNS) Vital Signs, alongside evaluations for ATs with the Autism Spectrum Screening Questionnaire, depressive symptoms with the Children's Depression Inventory, and CDS symptoms with the Barkley Child Attention Scale. A semi-structured interview was also conducted with all participants and their parents to ensure the diagnostic validity of the groups. Findings indicated no dimensional symptomatological distinctions between CDS and ADHD-RI, except for CDS symptoms, and demonstrated no significant differences in neurocognitive test profiles between CDS and ADHD-RI, except for the neurocognition index and reaction time. ATs and depressive symptoms did not significantly differ between the pure CDS and ADHD-RI groups but were significantly elevated in both groups compared to controls. The ADHD-RI group exhibited significantly worse performance than CDS concerning the neurocognition index and reaction time, and worse than controls regarding the neurocognition index, reaction time, psychomotor speed, and complex attention. This study elucidates that ADHD-RI and pure CDS have substantially overlapping neurocognitive and phenotypic profiles despite certain minor differences, which is detrimental to subjects with ADHD-RI in terms of overall neurocognition and reaction time. It can be argued that, compared to pure CDS, executive dysfunction might be slightly more specific to ADHD-RI, while depressive symptoms and ATs are common in both psychological constructs
Uluslararası Barajlar ve Silâhlı Çatışmalar Hukuku
No full text20. yüzyıl, silâhlı çatışmalar hukukunda ilerici bir gelişmeye tanıklık etmiştir. Silâhlı çatışmalar hukuku, sivillere öncelik vererek daha etik hâle gelmiştir. Sivillere ve mülklerine, 1949'da imzalanan Cenevre Sözleşmeleri ve 1977'de imzalanan Protokolleri ile hem genel hem de özel korumalar verilmiştir. Bu basit sebeple, alan yaygın olarak "uluslararası insancıl hukuk" olarak yeniden adlandırılmıştır. Bu bağlamda, söz konusu Protokoller tarafından sağlanan özel korumalardan biri de sivilleri, barajlar ve setlerden veya elektrik üreten nükleer santrallerden salınacak tehlikeli kuvvetlerden korumaktır. Bu makale, özellikle Kahovka barajı hâdisesine odaklanarak, birinci Protokolün 56’ncı maddesi ve ikinci Protokolün 15’inci maddesi tarafından ortaya koyulduğu üzere baraj ve setlerin rejimini analiz edecektir
A Case of AIDS Diagnosed in the Intensive Care Unit with Concurrent Influenza Infection and Pneumocystis jirovecii Pneumonia
No full textIntroduction: People living with HIV (PLWH) are highly susceptible to respiratory infections, particularly pneumonia, which is often polymicrobial. A rapid decline in CD4 T lymphocytes, especially with concurrent influenza, increases the risk of Pneumocystis jirovecii pneumonia (PCP). Case Presentation: This report discusses a newly diagnosed Acquired Immunodeficiency Syndrome (AIDS) patient with influenza and PCP coinfection, highlighting diagnosis, follow-up, and prognosis. Conclusions: Community-acquired pneumonia is common in PLWH, especially among those not receiving antiretroviral therapies (ART). Co-infections with bacterial, viral, and fungal pathogens are common. Early identification of etiological agents and prompt treatment are crucial for improving patient outcomes. © 2025 Elsevier B.V., All rights reserved