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Predictors of Self-Rated Health by Considering Socio-Economic and Regional Differences in Turkey
No full textSelf-rated health (SRH) is a generic measure of health influenced by socioeconomic status and regional disparities. Recognizing the underlying factors of SRH is critically important to better serve the community's needs and improve health and social services research. However, few studies identify the predictors of SRH by considering rural-urban dynamics from a developing country perspective by using a multistep machine learning (ML) analysis strategy. This study fills this void, by examining predictors of SRH using socioeconomic, poverty dynamics, and rural-urban differences. Data came from a cross-sectional national Income and Living Conditions Survey (ILCS) by the Turkish Statistical Institute (TurkStat) for the year 2020. Totally, 25,706 households were surveyed by TurkStat, and information was gathered by face-to-face interviews with individuals. A multidimensional ML analysis strategy is applied, and study findings show that chronic disease is the most important predictor of SRH. Our findings suggest that health and social services professionals should consider regional differences and the dynamics of chronic diseases to better understand the factors behind SRH. Future studies will incorporate the quality of care and accessibility dynamics of care to predict SRH. This will be helpful to better design, deliver, utilize, and evaluate health and social services
Integrating Ultrasound-Guided Injections and Peripheral Magnetic Stimulation in Chronic Myofascial/Lumbar Pain
No full textMyofascial pain syndrome (MPS) is a common musculoskeletal disorder that significantly affects quality of life. Conventional treatment approaches include pharmacological interventions, physical therapy, and procedures such as dry needling. Among these, ultrasound-guided injections (USGIs) have gained recognition for their precision and therapeutic benefits. Additionally, repetitive peripheral magnetic stimulation (rPMS) has emerged as a non-invasive neuromodulatory technique for pain management. This perspective article examines the physiological mechanisms and clinical applications of USGIs and rPMS, particularly in the lumbar multifidus muscle, and explores their potential synergistic effects. MPS is often associated with chronic muscle dysfunction due to energy depletion, leading to persistent pain and motor impairment. USGIs play a crucial role in restoring muscle perfusion, disrupting pain cycles, and providing diagnostic insights in real time. In parallel, rPMS modulates neuromuscular activation, enhances endogenous pain control, and promotes functional recovery. Ultrasound guidance enhances the precision and effectiveness of interventions, such as dry needling, interfascial plane blocks, and fascial hydrodissection, while rPMS complements these strategies by facilitating neuromuscular reconditioning and reducing pain via central and peripheral mechanisms. The preliminary findings suggest that combining multifidus USGIs with rPMS results in significant pain relief and functional improvements in patients with chronic low back pain. Integrating USGIs with rPMS represents a promising multimodal strategy for managing MPS. By combining targeted injections with non-invasive neuromodulation, clinicians may optimize therapeutic outcomes and provide sustained relief for patients with chronic musculoskeletal pain. Further research is needed to refine treatment protocols and assess the long-term efficacy
Reconstructing the volcanic history of the Ulukisla Caldera: A collapse structure within the Hasandag Volcanic Complex, Central Anatolia (Turkey)
No full textThe Ulukisla Caldera is a collapse structure within the active Hasanda.g Volcanic Complex (Central Anatolia), situated along the southern branch of the Tuz Golu Fault Zone (TGFZ). This study aims to reconstruct the volcanic history of the Ulukisla Caldera by characterising its associated pyroclastic deposits using tephrostratigraphy, glass chemistry (major and trace elements), and geochronological data (Ar-40/Ar-39 and U-(Th)-Pb). Our findings reveal that the Ulukisla Caldera has undergone at least three major explosive rhyolitic eruptions, which formed the pyroclastic deposits of the Yenipinar Eruption (similar to 442 ka), the Belbashani Eruption (similar to 400 ka), and the Ulukisla Eruption (similar to 326 ka). The Yenipinar unit was produced by an unsteady eruption column originating from paleo-Ulukisla volcanic structure, that deposited pumice fallout layers and interbedded pyroclastic density current (PDC) deposits. The Belbashani Eruption began with a Plinian column that deposited the Belbashani Pumice fallout. This phase was followed by the emplacement of thick PDC deposits and co-ignimbrite lithic lag breccias during the collapse, which ultimately led to the formation of the Ulukisla Caldera. The volume of the Belbashani deposits, including the pumice fallout and the caldera-forming ignimbrite, could reach up to 10 km3 DRE (Dense Rock Equivalent), corresponding to an eruption of magnitude similar to 6. The Ulukisla Pumice resulted from a post-caldera eruption, which did not generate PDCs. The Ulukisla Caldera exhibits an elongated morphology, which is strongly influenced by the NW-SE alignment of the TGFZ. Based on this morphology and the regional tectonic setting, we conclude that the Ulukisla Caldera is a strike-slip/graben caldera. Reconstructing the volcanic history of this newly identified caldera is essential for enhancing our understanding of the Hasanda.g Volcanic Complex. Our findings offer valuable context for future eruptive behaviour, improving the hazards assessment for potential caldera collapses, and contribute to mitigating associated risks
Combined endoscopic-percutaneous approach for magnetic compression anastomosis in post-transplant anastomotic biliary strictures
No full textObjectivesTo investigate long-term outcomes of combined endoscopic-percutaneous methods for endoscopically unmanageable anastomotic biliary strictures in living donor liver recipients.Materials and methodsThis retrospective single-center study included 144 patients referred for biliary stricture between November 2017 and May 2023. Eighty-eight patients (leak = 8, non-anastomotic stricture = 3, treatment refused = 12, successful ERCP = 65) were excluded. Patients initially underwent percutaneous biliary drainage. Patients for whom percutaneous intervention was successful in traversing stricture were followed up with fully-covered self-expandable metallic stents and/or plastic catheter stents. However, in case of failure, magnetic compression anastomosis (MCA) was performed.ResultsA total of 56 patients (mean age, 59 years +/- 11; 35 men) comprised the study group. Percutaneous intervention was successful in traversing the stricture in 26/56 patients. Among the remaining 30 patients, 26 were eligible for MCA, which was performed successfully in 24 patients (92%). The mean duration from magnet placement to internalization was 7.71 +/- 2.77 days (95% CI: 6.54-8.88). Altogether, in 47 patients (24 of whom underwent MCA), percutaneous drains were removed following biliary stenting. The mean follow-up was 1082.5 +/- 668.2 days (95% CI: 907.49-1257.51). In 19 patients (40%), recurrent stricture was evident at ERCP during a median follow-up of 90 (IQR: 60-210) days following stent removal. The recurrent stricture rate following MCA (n = 6/24) was significantly lower compared to patients in whom MCA was not performed (n = 13/23; p = 0.026). Overall, stent type had no significant effect on patency (p = 0.189).ConclusionPercutaneous biliary procedures are essential for endoscopically unmanageable post-transplant anastomotic biliary strictures. MCA seems to provide higher patency rates even in patients with total biliary occlusion.Key PointsQuestionWhat steps can be taken when endoscopy fails in the treatment of post-transplant anastomotic biliary strictures?FindingsPercutaneous biliary access and magnetic compression anastomosis can be applied to increase graft survival in the setting of endoscopically unmanageable post-transplant biliary strictures.Clinical relevanceImpassable biliary obstructions are unfortunate complications and not uncommon in liver transplant recipients. Magnetic compression anastomosis is an alternative minimally invasive method of treatment for complete biliary occlusions.Key PointsQuestionWhat steps can be taken when endoscopy fails in the treatment of post-transplant anastomotic biliary strictures?FindingsPercutaneous biliary access and magnetic compression anastomosis can be applied to increase graft survival in the setting of endoscopically unmanageable post-transplant biliary strictures.Clinical relevanceImpassable biliary obstructions are unfortunate complications and not uncommon in liver transplant recipients. Magnetic compression anastomosis is an alternative minimally invasive method of treatment for complete biliary occlusions.Key PointsQuestionWhat steps can be taken when endoscopy fails in the treatment of post-transplant anastomotic biliary strictures?FindingsPercutaneous biliary access and magnetic compression anastomosis can be applied to increase graft survival in the setting of endoscopically unmanageable post-transplant biliary strictures.Clinical relevanceImpassable biliary obstructions are unfortunate complications and not uncommon in liver transplant recipients. Magnetic compression anastomosis is an alternative minimally invasive method of treatment for complete biliary occlusions
Genome-wide association of gene regions controlling selenium and magnesium accumulation in walnuts (Juglans regia L.)
No full textWalnut (Juglans regia L.) is one of the most economically important species. It is of great importance to the food industry due to its nutritional value, and high content of many beneficial components such as macro and microelements. In the current study, the aim was to determine markers of single nucleotide polymorphism (SNP) associated with the gene(s) controlling the accumulation of Selenium (Se) and Magnesium (Mg) in walnuts. Se and Mg concentrations were measured in 154 genotypes of Juglans regia in 2021 and 2022. A total of 16,473 SNP markers were used for association mapping to analyze the marker-trait associations. The Se and Mg concentrations exhibited a normal distribution pattern with high heritability values (0.96 for Se and 0.98 for Mg) for the two years. Association mapping analysis was carried out with TASSEL software (v5.2.87) using the mixed linear model method. The result was that 17 markers for Se and 15 markers for Mg were significantly associated. A total of 189 and 86 putative candidate genes were detected for markers significantly associated with the Se and Mg levels, respectively. Among these genes, 33 genes are involved in ion binding, one gene in the binding and transport of Mg ions, 10 in hormone metabolism, and 53 in DNA and RNA binding. These potential candidate genes and markers observed in this study can be used in marker-assisted breeding programs to improve biofortified walnut varieties and further explore the genetic mechanisms underlying the Se and Mg accumulation
A novel approach to the follow up of children with otitis media with effusion: wideband absorbance findings
No full textPurposeOtitis media with effusion (OME) is one of the most common childhood diseases. It is recommended to use tympanometry in addition to otoscopy and/or pneumatic otoscopy for the diagnosis and follow-up of OME. Clinitians are using Wideband absorbance (WBA), which is one of the methods of evaluating the middle ear in the diagnosis of OME, more widely.MethodsThe relationship between the changes in the examination findings obtained by otoscopy and pneumatic otoscopy and the findings of WBA in the monthly follow-ups performed during the three-month period of children diagnosed with OME, was examined. In the study, 48 ears of 26 individuals aged 24-71 month who were diagnosed with OME were evaluated. Otoscopy, pneumatic otoscopy, 226 Hz tympanometry and WBA measurements were performed at the initial, first, second and third month examinations. The relationship between the difference between consecutive measurements was examined because it was thought that consecutive measurements might be more significant in the relationship between measurements. The Spearman test was used to determine whether there was a relationship between WBA and otoscopic and pneumatic otoscopic examination results. For assessing parameters where there was a significant difference between the groups compared, the variables were assessed using Kruskal-Wallis analysis of variance. The Dunn test was used for post hoc testing.ResultsThe change observed with both otoscopy and pneumatic otoscopy between the initial and first month control could not be adequately determined by 226 Hz tympanometry, but the change in the amount absorbance at 2520 Hz and 3175 Hz was moderately correlated with the examination findings. However, it was observed that the change between the first and the second follow-up examinations was significant at the frequency range of 226-630 Hz in WBA and the change between the second and third months was significant at the frequency range of 226-4000 Hz in WBA.ConclusionsThe findings obtained in the study show that, 226 Hz tympanometry may be insufficient to reflect the change in examination findings while WBA can provide more detailed information to support the examination findings during the follow-up period as well as the diagnosis of OME
Does unilateral reflux have a protective effect in posterior urethral valve patients?
No full textObjectives To evaluate the protective role of unilateral reflux on renal function in PUV patients. Various protective mechanisms have been proposed in patients with posterior urethral valves (PUV). The role of unilateral reflux as a protective factor is debated. Methods A retrospective analysis was conducted on 92 male PUV patients treated between January 1986 and July 2023. Unilateral VUR patients and ipsilateral renal function < 15% were classified as having valve unilateral reflux dysplasia (VURD) syndrome. Data from 92 patients were analyzed using scintigraphy. Renal function was considered abnormal if serum creatinine levels exceeded age-specific norms. Univariate and multivariate analyses assessed various parameters. Results The median age at primary surgery was 5 months, with a median follow-up of 35 months. Bilateral VUR patients (55.2%, 16/29) had worse renal outcomes than those with no VUR (25%, 8/32) or unilateral VUR (19.3%, 6/31; (p = 0.016, p = 0.004, respectively). Thirteen of 31 patients with unilateral VUR had VURD. Abnormal renal function distribution was similar between unilateral VUR patients, regardless of VURD status. Nadir creatinine value were independent risk factors for abnormal renal function. Conclusion Although some studies suggest unilateral reflux protects the contralateral kidney, others indicate worse outcomes due to dysplasia. Our findings show that renal outcomes in unilateral VUR patients are comparable with those without VUR, implying a protective effect independent of ipsilateral dysplasia. Patients with unilateral VUR exhibit similar outcomes to those without VUR. Nephrectomy should be cautiously considered due to potential protective effects
Küresel iklim değişikliği çözümünde sürdürülebilir yaşam stratejisi: Yenilenebilir kaynak kullanımı ile yüzen ev
No full textImpact of geohazards on cadastral data: an assessment after the 6 February 2023 Kahramanmaras earthquakes (Türkiye)
No full textHumans set boundaries on land for thousands of years. Cadastre emerged as a system for registering them, whether they are marked on the ground (visible) or unmarked (invisible). Parcel boundary data stored in geospatial databases and supported with registration documents are legally binding in many countries. They are however subject to change physically due to anthropogenic activities and natural processes. Seismic activities inducing surface rupture, lateral spread, landslide, liquefaction, and rockfall are among the main natural causes yielding physical boundary alterations. Spatial pattern and magnitude of alterations depend on the geohazard type and geological characteristics of the area. If a cadastral database is not updated, the physical and registered boundary begins to diverge, leading to uncertainty that needs to be understood by both people and authorities. As a prominent example, the 6 February 2023 Kahramanmaras (Turkiye) earthquakes (Mw7.7 and Mw7.6), which affected a very large region covering approximately 100,000 km2, caused enormous alterations on the physical boundaries of approximately 5 million land parcels. In this study, we analyzed different boundary changes caused by this major event and proposed a conceptual framework based on physical, documentary, and spatial boundary definitions of cadastral parcels with examples from the Kahramanmaras earthquakes. Considering the size of the area and the immense cost of cadastral renovation projects, we analyzed the deformation patterns and possible magnitudes from an interdisciplinary perspective and presented an overview. The study findings provide insights for addressing boundary discrepancies, although additional research is required for comprehensive quantitative assessments across the entire area
