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Clinical outcomes and mortality in patients with implantable cardioverter-defibrillator for primary prevention
No full textBackground: Implantable cardioverter-defibrillator (ICD) is indicated for primary prevention in patients with left ventricular ejection fraction (LVEF) <= 35% and New York Heart Association class II or III heart failure despite 3 months of optimal medical therapy. However, studies that support this recommendation are over 20 years old, and they may not reflect modern heart failure patients' characteristics. Objectives: Retrospectively evaluate patients who received an ICD for primary prevention. Methods: All-cause and sudden death rates were compared in patients who received ICD between January 1, 2015 and March 1, 2020 and those who did not accept ICD. Variables were analyzed at a 95% confidence interval, and p < 0.05 was considered as significant. Results: When comparing mortality rates between patients with and without ICD, 67 of 228 patients (29.4%) in the ICD group and 39 of 150 patients (26%) in the control group died from all causes (p = 0.473). Age, LVEF, BNP value, and hospitalization were found to be independent predictors of all-cause mortality. Patients with BNP above 508.5, LVEF below 24.5%, and age over 68.5 years had a 25-fold increased all-cause mortality. Coronary artery disease was not found to be an independent risk factor. Survival in the control group was statistically significantly better in the first months. Although there was no statistical difference in the long term, survival was numerically better in the ICD arm. This could be attributed to the fact that ICD implantations were performed on patients with worse clinical conditions. The higher survival rate observed in patients with ICD may be due to the fact that they came in for device control and remained in follow-up. Conclusions: With advances in the treatment of heart failure, ICD implantation should be performed in selected patients
Effects of eccentric versus concentric strengthening in patients with Subacromial pain syndrome: A randomized controlled trial
No full textBackground: Subacromial pain syndrome (SPS) is the most common cause of shoulder pain. Therapeutic exercise is the first-line treatment for SPS; however, the ideal exercise type remains unclear. Here, we compared the effects of eccentric and concentric strengthening in patients with SPS. Hypothesis: Adding isolated eccentric strengthening to a multimodal physiotherapy program (MPP) would lead to greater improvements in outcomes compared with either MPP alone or adding isolated concentric strengthening to the MPP. Study Design: Randomized controlled trial. Level of Evidence: Level 2. Methods: A total of 45 patients were randomized to eccentric strengthening (ESG), concentric strengthening (CSG), and control (CG) groups; all groups received the MPP. The strengthening groups also performed group-specific strengthening. Shoulder pain, abduction and external rotation (ER) strength, joint position sense (JPS), the Constant-Murley Score (CMS), and the Disabilities of the Arm, Shoulder and Hand score were collected at baseline, after 12 weeks of treatment, and at week 24. Results: For CMS, ESG exhibited a greater, but not clinically meaningful, improvement than CSG and CG (P 0.05). Conclusion: In SPS, eccentric strengthening provided added benefits, improving shoulder abduction strength and JPS at abduction, and was superior to concentric strengthening for improving shoulder abduction strength. Neither strengthening approach had an additional effect on shoulder function, pain, ER strength, or rotational JPS. Clinical Relevance: Clinicians could implement eccentric strengthening as a motor control retraining for strength and proprioception gain rather than for pain relief and reducing disability.Scientific and Technological Research Council of Turkey (TUBITAK)The present study was supported by The Scientific and Technological Research Council of Turkey (TUBITAK) within the scope of 2211-A General National Scholarship Program for PhD students
Foreign direct investment in the era of raising nationalism: a bibliometric analysis and a proposal for future research
No full textPurpose - This study aims to assess the situation of a nascent field of research dealing with the impact of nationalism on foreign direct investment (FDI) by providing a general overview of the field, critically reviewing the literature to identify the gaps and making suggestions for future research directions. Design/methodology/approach - This study uses a combination of a bibliometric analysis and a critical literature review. A total of 154 papers were included in the sample. They were selected from the Web of Science database based on specific criteria. Findings - The study concluded with the presentation of the key descriptive information - most prolific authors, journals, affiliations, countries and disciplines; number of publications per year; and most cited articles - from the bibliometric analysis to illustrate the structure of the literature. Moreover, the critical discussion focused on six main categories: constituents of nationalism, types of nationalism, relevant ideologies, related actors, outcomes of nationalism and the contexts investigated. Furthermore, the need for further empirical research to shed light on the relationship between nationalism and FDI was emphasized and suggestions for future research directions were made. Originality/value - This study represents one of the pioneering attempts to comprehensively examine the relationship between nationalism and FDI. Moreover, the systematic review of the methodical sections of the articles examined and the suggestions made have the potential to contribute to improving the quality of future research in this area
Real-world data on direct oral anticoagulants in BCR
No full textBCRMPN scientific subcommittee activity of the Turkish Society of Hematology (TSH); Turkish Hematology Association (TSH)We emphasize that this study was conducted as a CML & MPN scientific subcommittee activity of the Turkish Society of Hematology (TSH), and thanks should be given to the Turkish Hematology Association (TSH) for their support
Analysis of Logistics 4.0 Service Provider Alternatives with CRITIC-Based WASPAS Method
No full textAmaç: Bu çalışmanın amacı, dijital dönüşüm ve Endüstri 4.0 teknolojileriyle şekillenen Lojistik 4.0 kavramı çerçevesinde, lojistik hizmet sağlayıcılarının değerlendirilmesi ve en uygun hizmet sağlayıcının belirlenmesidir. Lojistik 4.0, akıllı sistemler ve büyük veri analitiği gibi yenilikçi teknolojileri kullanarak lojistik süreçleri optimize etmeyi hedefler. Bu bağlamda, doğru hizmet sağlayıcıyı seçmek, işletmeler için stratejik bir öneme sahiptir. Çalışma, işletmelerin bu karmaşık süreçte doğru kararlar almasına yardımcı olmayı amaçlamaktadır. Yöntem: CRITIC (Criteria Importance Through Intercriteria Correlation) tabanlı WASPAS (Weighted Aggregated Sum Product Assessment) yöntemi kullanılmıştır. CRITIC yöntemi ile kriterlerin objektif ağırlıkları belirlenmiş, WASPAS yöntemi ise bu ağırlıkları kullanarak alternatiflerin genel performans skorlarını hesaplamıştır. Bulgular: Çalışma sonuçları, işletmelerin Lojistik 4.0 hizmet sağlayıcılarını seçerken dikkat etmeleri gereken önemli kriterleri ve en iyi performans gösteren hizmet sağlayıcıları ortaya koymuştur. Özgünlük: Bu çalışma, CRITIC ve WASPAS yöntemlerinin birlikte kullanımının, lojistik sektöründe hizmet sağlayıcı seçiminde sağladığı avantajları ve yöntemlerin etkinliğini vurgulamaktadır. Ayrıca, lojistik sektöründe Lojistik 4.0 hizmet sağlayıcılarının seçimi konusunda literatüre katkı sağlamaktadır.Purpose: This study aims to evaluate and identify the most suitable logistics service providers within the framework of Logistics 4.0, shaped by digital transformation and Industry 4.0 technologies. Logistics 4.0 seeks to optimize logistics processes using innovative technologies such as smart systems and big data analytics. In this context, selecting the right service provider is of strategic importance for businesses. This study intends to assist companies in making accurate decisions in this complex process. Method: The CRITIC (Criteria Importance Through Intercriteria Correlation) based WASPAS (Weighted Aggregated Sum Product Assessment) method was employed. The CRITIC method was used to determine the objective weights of the criteria, while the WASPAS method utilized these weights to calculate the overall performance scores of the alternatives. Findings: The results of the study reveal the key criteria that businesses should consider when selecting Logistics 4.0 service providers and identifying the top-performing service providers. Originality: This study highlights the advantages and effectiveness of using the combined CRITIC and WASPAS methods in the selection of service providers in the logistics sector. Additionally, it contributes to the literature on the selection of Logistics 4.0 service providers.Sanayi ve Teknoloji Bakanlığ
Longitudinal investigation of brain and spinal cord pericytes after inducible PDGFRβ+ cell ablation in adult mice
No full textCentral nervous system (CNS) pericytes play crucial roles in vascular development and blood-brain barrier maturation during prenatal development, as well as in regulating cerebral blood flow in adults. They have also been implicated in the pathogenesis of numerous neurological disorders. However, the behavior of pericytes in the adult brain after injury remains poorly understood, partly due to limitations in existing pericyte ablation models. To investigate pericyte responses following acute ablation and characterize a novel rodent model for pericyte research, we developed a tamoxifen-inducible PDGFR beta(+) cell ablation model by crossing PDGFR beta-P2A-CreER(T2) and Rosa26-DTA176 transgenic mouse lines. Using this model, we studied the effects of different tamoxifen doses and conducted histological examinations 15 and 60 days post-injection to assess the impacts of PDGFR beta(+) cell ablation in both acute and chronic phases, respectively. Our results demonstrate that a low dose of tamoxifen effectively ablates PDGFR beta(+) cells of the CNS in mice without reducing survival or causing significant systemic side effects, such as weight loss. Additionally, we found that the extent of PDGFR beta(+) cell depletion varies between the cortex and the spinal cord, as well as between the gray and white matter regions of the spinal cord. Importantly, we observed that both pericyte coverage and numbers increased in the weeks following acute ablation, indicating the regenerative capacity of CNS pericytes in vivo. This study offers a valuable tool for future studies on the role of pericytes in neurological disorders by overcoming the limitations of constitutive pericyte ablation models and providing its longitudinal characterization in the CNS.imageTUBIdot;TAK [116S252]; TUBIdot;TAK 2236 Co-Funded Brain Circulation Scheme 2 [119C018]This study was funded by TUB & Idot;TAK (project no: 116S252). Dr. Atay Vural was supported by TUB & Idot;TAK 2236 Co-Funded Brain Circulation Scheme 2 (Project No: 119C018)
Interrelated evaluation of WT1 and E-cadherin expressions in the prostate adenocarcinoma
No full textObjective: This study aimed to perform concomitant evaluation of the expressions of WT1 and E- cadherin in benign prostatic hyperplasia (BPH), high-grade prostate intraepithelial neoplasia (HGPIN), and prostate acinar adenocarcinoma (PAC) and analyze the relationships of these potential markers with clinicopathological parameters. Materials and Methods: The study included 60 cases of 38 PAC, 10 HGPIN, and 12 benign BPH tissues. E-cadherin and WT1 stains were applied by immunohistochemical method. Results: In the PAC group, a significant increase in WT1 expression was determined compared to BPH (p0.05) was detected between HGPIN and BPH. Also, an important relationship was detected between the Gleason score and the expressions of E-cadherin and WT1 (p0.05). In addition, a negative correlation was found between E-cadherin and WT1 in PAC (r=-0.341; p=0.008). Conclusion: After evaluating all the data together, it was concluded that WT1 expressed in PAC epithelial cells could suppress E-cadherin and promote the progression of the PAC
Determination of women's genital appearance satisfaction levels and influencing factors
No full textKADINLARIN GENİTAL GÖRÜNÜM MEMNUNİYET DÜZEYLERİ VE ETKİLEYEN FAKTÖRLERİN BELİRLENMESİ Öykü BATI Hemşirelik Anabilim Dalı Kadın Sağlığı ve Hastalıkları Hemşireliği YL Programı İzmir Bakırçay Üniversitesi, Lisansüstü Eğitim Enstitüsü, Haziran 2025 Danışman: Doç. Dr. Serpil ABALI ÇETİN Amaç: Bu çalışma kadınların genital görünüm memnuniyet düzeyleri ve etkileyen faktörlerin belirlenmesi amacıyla tanımlayıcı ve kesitsel tipte yapılmıştır. Yöntem: Araştırma verileri Ocak-Nisan 2025 tarihleri arasında sosyal medya platformlarından 18-65 yaş arası kadınlara ulaşılarak "Google Forms" aracılığı ile online olarak toplanmıştır. Araştırma dahil edilme kriterlerine uyan 303 kadınla yürütülmüştür. Araştırmanın verileri, Tanıtıcı Bilgi Formu, Genital Görünüm Memnuniyet Ölçeği (GGMÖ) ve Beden İmajı Ölçeği (BİÖ) kullanılarak toplanmıştır. Araştırmada veriler, tanımlayıcı istatistiksel yöntemler, bağımsız örneklem t testi, tek yönlü varyans analizi (ANOVA), pearson korelasyon analizi ve çoklu regresyon analizi kullanılarak incelenmiştir. Bulgular: Kadınların GGMÖ toplam puan ortalaması 7,81±6,12 olarak bulunmuştur. Kadınların GGMÖ ile BİÖ arasında negatif yönde orta düzeyde anlamlı ilişki (r=-0,497, p<0,001) saptanmıştır. Yapılan regresyon analizinde maddi durum ((?=0,214), egzersiz yapma durumu (?=0,183), kronik hastalık varlığı (?=-0,163), doğum sırasında anomali yaşama (?=-0,423) genital bölgede sorun yaşama (?=-0,297), küretaj yaptırma (?=0,146), doğum öyküsü (?=0,393), vajinal şikayet yaşama durumu (?=-0,246), iç çamaşırı kumaşının pamuklu olup olmama durumu (?=-0,130), iç çamaşırı değiştirme sıklığı (?=0,293) vajinal duş alma durumu (?=0,120), medyadaki cinsel paylaşımlardan etkilenme durumu (?=-0,216) olumsuz cinsel deneyim yaşama durumu (?=-0,198) ve cinsel işlev bozukluğu tanısı almış olma (?=-0,227) değişkenlerinin GGMÖ'nün belirleyicileri olduğu saptanmıştır. Sonuç: Araştırmaya katılan kadınların genital görünüm memnuniyet düzeylerinin düşük olduğu, genital görünüm memnuniyetinin sosyodemografik özellikler, beden imajı, obstetrik/jinekolojik özellikler, genital bölgeye ilişkin uygulamalar ve cinsel işlev/cinsel ilişki özelliklerinden etkilendiği sonucuna varılmıştır. Anahtar Sözcükler: genital görünüm, memnuniyet, etkileyen faktörlerABSTRACT DETERMINATION OF WOMEN'S GENITAL APPEARANCE SATISFACTION LEVELS AND INFLUENCING FACTORS Öykü BATI Department of Nursing Women's Health and Diseases Nursing Master Program İzmir Bakırçay University, Graduate Education Institue, June 2025 Supervisor: Associate Professor Dr. Serpil ABALI ÇETİN Objective: This descriptive and cross-sectional study was conducted to determine women's satisfaction levels with their genital appearance and the factors influencing this satisfaction. Method: The research data were collected online via "Google Forms" between January and April 2025, through social media platforms, targeting women aged 18–65 years. A total of 303 women who met the inclusion criteria participated in the study. Data were gathered using a Descriptive Information Form, the Genital Self-Image Scale (GSIS), and the Body Image Scale (BIS). The data were analyzed using descriptive statistics, independent samples t-test, one-way analysis of variance (ANOVA), Pearson correlation analysis, and multiple regression analysis. Results: The mean total score on the GSIS was found to be 7.81±6.12. A moderate negative correlation was found between GSIS and BIS scores (r = -0.497, p < 0.001). Multiple regression analysis revealed that financial status (?=0.214), exercise habits (?=0.183), presence of chronic illness (?=-0.163), experience of anomalies during childbirth (?=-0.423), genital health problems (?=-0.297), history of curettage (?=0.146), childbirth history (?=0.393), experience of vaginal complaints (?=-0.246), type of underwear fabric (?=-0.130), frequency of changing underwear (?=0.293), vaginal douching (?=0.120), exposure to sexual content in media (?=-0.216), negative sexual experiences (?=-0.198), and presence of sexual dysfunction (?=-0.227) were significant predictors of genital appearance satisfaction. Conclusion: The findings indicate that women's satisfaction with their genital appearance was generally low. Genital appearance satisfaction was found to be influenced by sociodemographic characteristics, body image, obstetric and gynecological factors, practices related to genital health, and characteristics of sexual function and experiences. Keywords: genital appearance, satisfaction, influencing factor
The association between gut microbiota composition and cardiometabolic parameters in healthy adults
No full textBackgroundThe human gut microbiota comprises approximately 100 trillion microbial cells and produces a wide range of metabolites. Its composition is shaped by factors such as geography, dietary habits, and genetic background. Dysbiosis-an imbalance in this microbial ecosystem-has been associated with the development of metabolic diseases. This study aimed to characterize the gut microbiota composition in adults without diagnosed chronic diseases and assess its potential associations with cardiometabolic parameters.MethodsVolunteers over the age of 18 residing in Izmir province who met the inclusion criteria were enrolled in the study. Fecal and blood samples were collected from all participants. Bacterial DNA from fecal samples was extracted, and the full-length 16 S rRNA was amplified. Full-length 16 S rRNA PCR amplicons were sequenced using Oxford Nanopore Technologies. Taxonomic classification, Firmicutes/Bacteroidetes ratio, and Shannon index were determined using Massbiome Fecal Microbiome Analysis (Massive Bioinformatics, T & uuml;rkiye). Dominant bacterial genera were also analyzed using the Epi2Me database. Blood samples were analyzed for metabolic health markers. Associations between bacterial taxa and blood-based metabolic parameters were examined statistically.ResultsA total of 82 participants were included in the study. According to BMI, 34 (41.4%) of the participants were classified as having a healthy weight, 23 (28.1%) as overweight, and 25 (30.5%) as obese. Segatella (Prevotella) copri was identified as the dominant species in most participants (51%). Other dominant species included Ruminococcus torques (13%), Faecalibacterium prausnitzii (13%), Faecalitalea cylindroides (5%), Bacteroides uniformis (4%), and Phocaeicola vulgatus (3%). S. copri was identified as the dominant bacterial species in 45 participants (54.8%) according to the Epi2Me database. The Shannon index and Firmicutes/Bacteroidetes ratio varied among the three BMI groups. Both Lachnospira and Ruminococcus genera had a significant negative correlation with BMI, indicating that higher levels of BMI are associated with lower abundances of these genera. In the regression analysis, Lachnospira was found to be less abundant at higher HbA1c levels. HOMA-IR was found to be a significant predictor for the relative abundance of Vescimonas. Ruthenibacterium is found to be more abundant at higher HDL levels.ConclusionThe dominant bacterial taxa differed from those reported in other populations, suggesting region-specific microbial profiles. Notably, specific gut microbial genera were associated with metabolic health indicators, including BMI, HbA1c, HOMA-IR, and HDL level. These findings underscore the potential role of gut microbiota in metabolic regulation and support the need for further region-specific research. This study is among the few in T & uuml;rkiye focusing on healthy adults and contributes to the understanding of gut microbiota in relation to cardiometabolic parameters.This research was supported by the Dokuz Eylul University Research Foundation grant TSG-2023-3174. The funders had no role in the study design, data collection, or analysis.The authors extend their gratitude to the study participants and acknowledge the assistance of the data collectors. All authors have read and approved the final manuscript and had access to the study's data
Multiparametric MRI characteristics for differentiating primary cancer origin in brain metastases
No full textBackground Accurate identification of primary cancer origin in brain metastases (BMs) is crucial for diagnosis and treatment planning. Identification is challenging, particularly in unknown primary cases. Multiparametric Magnetic Resonance Imaging (MRI) offers non-invasive imaging characteristics as diagnostic clues. This study aimed to investigate the relationship between multiparametric MRI features of BMs and their primary tumor origin. Methods This retrospective study included 125 patients with intra-axial brain metastases, classified as breast cancer, small cell lung cancer (SCLC), non-small cell lung cancer (NSCLC), malignant melanoma, and other cancers. Multiparametric MRI, including T2-FLAIR, contrast-enhanced 3D T1-weighted imaging, apparent diffusion coefficient (ADC) maps, susceptibility-weighted imaging (SWI), and cerebral blood volume (CBV) maps, was performed. Lesion volume, necrotic volume, necrosis ratio, peritumoral edema volume, and edema ratio were measured. 3D Slicer (R) software was used for semi-automated volumetric measurements. Quantitative ADC and rCBV values, intratumoral susceptibility signal (ITSS) scores, and metastasis number and location were analyzed to differentiate primary tumor origins. Results 291 metastatic lesions from 125 patients were analyzed. NSCLC metastases showed significantly higher necrosis ratios than breast (p = 0.905 mm(2)/s (AUC: 0.775). Malignant melanoma and SCLC metastases had significantly higher rCBV values than breast cancer metastases. Malignant melanoma metastases consistently showed the highest ITSS scores among all groups, with an optimal cut-off of >= 1 (AUC: 0.769). Furthermore, multiple metastases <= 0.5 cm(3) were significantly associated with breast cancer (p = 0.041). Infratentorial metastases were more prevalent in breast cancer (OR = 2.490, p = 0.001). Conclusion Brain metastases exhibit distinct multiparametric MRI characteristics by primary cancer origin. Breast cancer metastases tend to be smaller, multiple, and infratentorial. NSCLC metastases show greater necrosis and higher ADC values, while melanoma metastases demonstrate higher intratumoral susceptibility. These features offer valuable diagnostic clues for differentiating primary cancer types in patients with brain metastases. Clinical trial numberNot applicable