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Sleep hygiene education in older adults: effectiveness and association with comprehensive geriatric assessment
No full textObjectives: This study aimed to evaluate the results of sleep hygiene education via a comprehensive geriatric assessment. Method: A cross-sectional research was conducted on insomnia outpatients at a tertiary hospital, and all participants received sleep hygiene education as well as a comprehensive geriatric assessment. Sleep parameters were assessed before and four weeks after education. Results: The study included 141 participants. A significant improvement was obtained in all four scales' scores before and after education (PSQI score 11 [8-13] vs. 5 [3-9], p < .001; SHI score 12 [8-16] vs. 4 [1-8], p < .001; ESS score 6 [3-8] vs. 2 [0-6], p < .001; Jenkins SS score 15 [10-19] vs. 7 [5-11], p < .001). Female gender ratios, as well as the presence and risk of malnutrition, differed between groups with and without the PSQI score improvement. In the regression analyses, female gender and the presence of malnutrition or malnutrition risk were evaluated as possible factors affecting the PSQI responses (respectively, OR: 3.48, CI 95%: 1.21-10.00, p = .020; OR: 0.29, CI 95%: 0.09-0.949, p = .041). Conclusion: Sleep hygiene education and interdisciplinary interventions are crucial in the management of sleep disorders in older adults
A Narrative Review of RAS Mutations in Early-Stage Colorectal Cancer: Mechanisms and Clinical Implications
No full textColorectal cancer (CRC) is the third-most common cancer globally and a leading cause of cancer-related deaths. While the prognostic and predictive roles of RAS mutations in advanced CRC are well-established, their significance in early-stage CRC remains a topic of debate. Studies have been conducted for many years on clinical and pathological parameters that may be associated with RAS mutation, and there are inconsistent results in this regard. Currently, the only biomarker used in early-stage CRC is microsatellite status. KRAS mutations are detected in 40-50% of patients with colorectal cancer. RAS activating mutations cause loss of EGFR regulation by acting on the RAS/RAF/MAPK signaling pathways. In advanced colorectal cancer, these mechanisms cause a decrease in the effectiveness of EGFR inhibitors. However, studies on patients with early-stage colorectal cancer have inconsistent results. This review highlights the prognostic and clinical significance of KRAS mutations in early-stage CRC, particularly in MSS tumors. In the MSS group, KRAS mutations were associated with shorter TTR and OS compared to DWT patients. In contrast, in the MSI-H group, KRAS mutations showed no prognostic effect in TTR and OS. However. KRAS mutations were associated with shorter SAR in both MSI-H and MSS groups of patients. The findings underscore the need for routine molecular profiling, including KRAS and MSI status, to refine risk stratification and guide adjuvant therapy decisions. Further studies are warranted to explore targeted therapeutic approaches for KRAS-mutant CRC in the adjuvant setting
Children Who Offend in Turkey: The Case of the Ankara Child Education Center
No full textThis paper investigates the underlying causes of children’s involvement in criminal behavior, and the rehabilitation programs which seek to reintegrate them into society after their release. The data needed were gathered from children’s case files and semi-structured interviews with professionals who work in a child education institution. The findings of the study, which include the demographic and socio-economic background of children who offend, the types of crimes they have committed, their causes, and the nature of the applied rehabilitation programs provided for the children who were serving their sentences in the education center are explained and discussed. It is found that these children are victims of social, cultural, economic, and political structures of the society. They are generally from migrants’ families with middle and low incomes and live in gecekondu neighborhoods.1 Poor living conditions, lack of parental affection, poverty, deprivation, neglect, abuse, addiction, the lack of preventive and protective institutions, the lack of NGOs which work with children, are, inter alia, among the causes of youth crime in Turkey. A lack of engagement or intervention by local authorities or municipalities to tackle the problem of youth crime in their regions is a further factor. The problems are aggravated by a trial and prosecution process that takes up to 2 years. When pending trial, children receive almost no training or rehabilitation in institutions, and this impairs their personal development. There is an urgent need to establish a monitoring system which can regularly monitor children who offend and provide support for at least several months after their release. This would help children to reintegrate into society on a more positive level
Polycystic ovary syndrome as a metabolic disease
No full textPolycystic ovary syndrome (PCOS) is a heterogeneous familial disorder affecting up to one in five women. The aetiology remains unclear, but available evidence suggests it is a polygenic disorder with epigenetic, developmental, and environmental components. The diagnostic criteria for PCOS are based on reproductive features, and the syndrome is categorized into several phenotypes that can vary by race and ethnicity. Insulin resistance and metabolic dysfunction have a crucial role in the pathogenesis of the syndrome and contribute to many adverse metabolic outcomes that place a substantial burden on the health of women with PCOS across their lifespan. Metabolic abnormalities like those identified in women with PCOS are also present in their female and male first-degree relatives. Overall, more emphasis is required on defining PCOS as a metabolic disorder in addition to a reproductive one. This approach could affect the management and future treatment options for the syndrome. The rationale of the current review is to identify and analyse existing evidence for PCOS as a metabolic, as well as a reproductive, disease. Polycystic ovary syndrome (PCOS) is characterized not only by reproductive symptoms and hyperandrogenism but also by metabolic abnormalities, such as insulin resistance and obesity. This Review discusses the evidence of metabolic disorders in PCOS and for understanding PCOS as a metabolic disease. Beyond reproductive features, polycystic ovary syndrome (PCOS) is associated with an increased prevalence of several metabolic abnormalities, some of which are also observed in the first-degree relatives of women with PCOS.Insulin resistance and compensatory hyperinsulinaemia, intrinsic to PCOS and exacerbated by obesity, are major drivers of metabolic complications and strong determinants of reproductive dysfunction and hyperandrogenaemia in affected women.The clinical presentation of PCOS is heterogeneous and can be categorized into several phenotypes that can vary by life stage, race and/or ethnicity and degree of adiposity.Cluster analysis suggests that there are reproducible reproductive and metabolic PCOS subtypes with distinct genetic architecture, which cannot be identified by the current diagnostic criteria.With advances in omics-based studies and artificial intelligence-based methods, it might be possible to classify women with PCOS into subgroups that correlate with the clinical severity and identify those at high risk of long-term metabolic complications
Work-related musculoskeletal disorders (WRMSDs) through the lens of previous studies: social sustainability-inhibiting features
No full textPurpose - This study aims to identify the theoretical linkage between work-related musculoskeletal disorders (WRMSDs) and social sustainability to increase awareness of WRMSDs' social sustainability-inhibiting features and preventive strategies. Design/methodology/approach - This qualitative research adopts a systematic literature review (SLR) approach. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, 303 documents from the Scopus database (2003-2024) were analysed using bibliometric technique and content analysis. Findings - The study identified key bibliometric metrics such as top journals, most recent authors and publications. The trend shows that documents and citations initially progressed, then stagnated but later rose, and recently, documents have risen independently of citations. Only six journals contribute the most (43 of 85% overall citations; 23 of 73% overall publications), and 13 authors are the most influential. The content analysis revealed that 80% of the recent studies centred on risk assessment (RA) with only 5% on health assessment impact (HAI). Research limitations/implicationsThe findings are limited to the review period. Social implications - WRMSD is injurious to well-being, impairs performance, and impacts society through reduced productivity, medication use and time off work. Therefore, proactive strategies must be implemented to minimise its occurrence and severity. Originality/value - This study's novelty lies in text mining WRMSD literature by raising awareness of its social inhibiting features so that occupational ill health is minimised, project health and workers' well-being are enhanced, and the industry's social sustainability is raised
Sustaining the "frozen footprints" of scholarly communication through open citations
No full textThis review examines the role of open citations in fostering transparency, reproducibility, and accessibility in scholarly communication. Through a critical synthesis of diverse sources-articles, proceedings, presentations, datasets, and blog posts-it explores the motivations behind citing, the evolving meanings of citations, and key milestones in the open citation movement. Particular attention is given to initiatives like OpenCitations and the Initiative for Open Citations (I4OC), highlighting their contributions to advancing open scholarship. Key findings indicate that open citations democratize research by providing free access to citation data, improving discoverability, and facilitating the creation of public citation graphs. Technological advancements, such as advanced data models and reference mining tools, have significantly contributed to the management and utilization of citation data. Despite these benefits, challenges such as ensuring data quality and standardization, addressing structural inequalities in citation networks, and achieving universal publisher adoption persist. The study concludes with recommendations for future efforts, emphasizing policy advocacy, technological innovation, global collaboration, and educational initiatives to promote the widespread adoption and effective use of open citations. These strategies aim to make the "frozen footprints" of scholarly communication accessible to all, fostering a more equitable and transparent scientific landscape
Intraoperative impedance and ECAP results in cochlear implant recipients with inner ear malformations and normal cochlear anatomy: a retrospective analysis
No full textBackgroundThe intraoperative measurements are essential steps in cochlear implant (CI) surgery for confirming correct electrode placement.ObjectivesTo examine the intraoperative impedance and electrically evoked action potential (ECAP) measurement results of cochlear implant (CI) users with normal cochlear anatomy (NCA) and to compare them with CI users with inner ear malformations (IEM).Material and methodsThis retrospective study included intraoperative data of 300 ears from 258 individuals using Medel (R) and Cochlear (Nucleus (R)) CI devices.ResultsImpedance values differed through all regions, and that differences in ECAPs results mainly stemmed from the basal region in Cochlear users, when comparing the impedance values and ECAPs recording prevalence between the NCA and IEM groups, it was observed that there was no significant difference in the impedance values across the intracochlear regions of the groups (apical; p = .26, middle; p = .12, basal; p = .99). However, it was found that the prevalence of measurable ECAPs in all intracochlear regions of the NCA group was higher than the IEM group (p = .000).Conclusion and significanceThe robustness of cochlear structures is a crucial factor in the recording of ECAPs. Furthermore, findings in the IEM group demonstrated that proper placement of intracochlear electrodes did not guarantee effective auditory nerve stimulation. (sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic) (CI) (sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic).(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic) (NCA) (sic)(sic)(sic)(sic)(sic)(sic)(sic) (CI) (sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic) (ECAP) (sic)(sic)(sic)(sic)(sic), (sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic) (IEM) (sic) CI (sic)(sic)(sic)(sic)(sic)(sic)(sic).(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic) 258 (sic)(sic)(sic) Medel (R) (sic) Cochlear (Nucleus (R)) CI (sic)(sic)(sic)(sic)(sic)(sic) 300 (sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic).(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic).ECAPs(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic).(sic)(sic)(sic) NCA (sic)(sic) IEM(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic) ECAPs(sic)(sic)(sic)(sic)(sic)(sic), (sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)((sic)(sic);p = 0.26, (sic)(sic);p = 0.12, (sic)(sic);p = 0.99).(sic)(sic), (sic)(sic)(sic)(sic) NCA (sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic) ECAPs (sic)(sic)(sic)(sic)(sic) IEM (sic)(p=.000).(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic) ECAPs(sic)(sic)(sic)(sic)(sic).(sic)(sic), IEM(sic)(sic)(sic)(sic)(sic)(sic), (sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)
