Akdeniz University

Background: The use of virtual reality is increasing in nursing to ensure patient safety and to improve the quality of care in the education of nurses. Aim: To develop a virtual reality software for intensive care patient care management and to investigate the effect of this software on novice intensive care nurses. Study Design: This study protocol contains a randomized controlled experimental design research. The nurses will be divided into control (n = 34) and study groups (n = 34) by randomization. The research will be conducted in four steps: (1) according to Kolcaba's Comfort Theory, the protocol for care management of an intensive care patient will be prepared and transferred to the virtual reality software, (2) the nurses in both groups will be given theoretical training, (3) a routine orientation training programme will be applied to the nurses in the control group, and those in the study group will be given virtual reality goggles. (4) Tools such as a ‘Clinical Practice Skills Observation Form and Knowledge Level Questionnaire’ and ‘Problem-Solving Inventory’, ‘Clinical Decision-Making Scale in Nursing’, ‘State Anxiety Inventory’ and ‘Satisfaction Level Questionnaire’ will be applied to both groups before commencing the theoretical training, 1 week after the application and in the first month of the application. Results: This protocol describes an experimental study aiming to test the impact of virtual reality software on novice intensive care nurses in the care management of an intensive care patient. Conclusions: The results and recommendations will be shared after the study is completed. Relevance to Clinical Practice: Within the scope of the research, the virtual reality software to be developed for the care management of an intensive care patient will provide important contributions to the development of nurses' problem-solving and clinical decision-making skills and reduce state anxiety levels in orientation to the intensive care unit (ICU).

Purpose Identifying prognostic indicators for risk stratification in metastatic renal cell carcinoma (mRCC) is crucial for optimizing treatment strategies and follow-up plans. This study aims to investigate the prognostic role of the glucose-to-lymphocyte ratio (GLR) in patients with mRCC receiving tyrosine kinase inhibitors (TKIs) as first-line therapy. Methods A retrospective cohort study was conducted using data from the Turkish Oncology Group Kidney Cancer Consortium Database. GLR was calculated by dividing the fasting glucose (mmol/L) by the lymphocyte count (×10 ⁹ /L). We categorized patients into two categories based on their median GLR level. Results The analysis included a total of 598 patients. We found that progression-free survival (PFS) was significantly longer in the GLR-low group, with a median PFS of 15.05 months (95% CI 12.7–17.4) compared to 7.79 months (95% CI 6.6–9.0) in the GLR-high group ( p < 0.001). Multivariate analysis identified GLR as an independent risk factor for poor PFS (HR 1.39, 95% CI 1.12–1.72; p = 0.003). Overall survival (OS) was also significantly longer in the GLR-low group, with a median OS of 38.47 months (95% CI, 30.9–46.0) compared to 24.15 months (95% CI 18.0–30.2) in the GLR-high group ( p = 0.001). GLR was an independent predictor for OS in multivariate analysis (HR 1.45, 95% CI 1.12–1.86; p = 0.004). Conclusion The GLR can be a valuable prognostic marker for glucose metabolism and systemic inflammatory status in this patient population. Our research highlights the potential prognostic value of GLR in patients with mRCC receiving TKIs, indicating its potential as a useful tool for clinical decision-making.

In this study, we aimed to examine the factors affecting the culturally responsive teaching competencies of academics and tested whether the personality traits and personal meaning profiles of the academics had significant effects on culturally responsive teaching self-efficacy. Data were obtained from 1,883 academics by using the Culturally Responsive Teaching Self-Efficacy Scale, Ten-Item Personality Inventory and Personal Meaning Profile Scale — Short Form. Correlation, regression and structural equation modelling analyses were run to analyse the data. We found that culturally responsive teaching self-efficacy is low. In terms of personal meaning profiles, ‘openness to experience’, ‘agreeableness’ personality traits and ‘self-transcendence’ and ‘fair treatment’ had a significant effect on culturally responsive teaching self-efficacy while ‘religion’ and ‘self-acceptance’ were found to have no effect. Based on the findings, we made various suggestions for academics to participate in training on culture-sensitive teaching pedagogy to be more sensitive to different cultures.

Purpose Mammary carcinoma is comprised heterogeneous groups of cells with different metastatic potential. 4T1 mammary carcinoma cells metastasized to heart (4THM), liver (4TLM) and brain (4TBM) and demonstrate cancer-stem cell phenotype. Using these cancer cells we found thatTGF-β is the top upstream regulator of metastatic process. In addition, secretion of bone morphogenetic protein 1 (BMP-1), which is crucial for the proteolytic release of TGF-β, was markedly high in metastatic mammary cancer cells compared to non-metastatic cells. Although TGF-β inhibitors are in clinical trials, systemic inhibition of TGF-β may produce heavy side effects. We here hypothesize that inhibition of BMP-1 proteolytic activity inhibits TGF-β activity and induces anti-tumoral effects. Method and Results Effects of specific BMP-1 inhibitor on liver and brain metastatic murine mammary cancer cells (4TLM and 4TBM), as well as on human mammary cancer MDA-MB-231 and MCF-7 cells, were examined and compared with the results of TGF-β inhibition. Inhibition of BMP-1 activity markedly suppressed proliferation of cancer cells and enhanced anti-tumoral effects of doxorubicin. Inhibition of BMP-1 activity but not of TGF-β activity decreased colony and spheroid formation. Differential effects of BMP-1 and TGF-β inhibitors on TGF-β secretion was also observed. Conclusions These results demonstrated for the first time that the inhibition of BMP-1 activity has therapeutic potential for treatment of metastatic mammary cancer and enhances the anti-tumoral effects of doxorubicin.

This study examines the morphological and chemical characteristics of seeds from five Fritillaria species: Fritillaria pinardii , Fritillaria pontica , Fritillaria kittaniae , Fritillaria imperialis and Fritillaria alfredae Post subsp. glaucoviridis (Turrill) Rix. Morphological measurements included total length, total width, embryo length, embryo width, seed left-wing coverage width, seed right-wing coverage width and the distance between crossing points. These measurements revealed significant differences among the species. For example, F. imperialis exhibited the longest seeds and the largest embryos, while F. alfredae Post subsp. glaucoviridis had the smallest dimensions. Chemical analyses were conducted using gas chromatography-mass spectrometry, identifying various significant compounds across the species. High proportions of 2,2-dimethoxybutane were found in the seed samples. In F. pontica , compounds such as 2,2-dimethoxybutane (66.33%) and 1,1-dipropoxypropane (13.24%) were prevalent. Fritillaria kittaniae seeds showed high levels of benzene, 1,1′-(3,3-dimethyl-1-butenylidene) bis- (25.57%) and cyclohexene, 3-methyl-6-(1-methylethylidene)- (6.89%). In F. imperialis , significant compounds included 1,3-dioxolane-4-methanol, 2-ethyl-2-methyl (9.73%) and dodecane (5.73%). Fritillaria pinardii had notable amounts of 3,6-dimethyloctane (4.81%), while F. alfredae subsp. glaucoviridis contained 2-methoxyethyl(trimethyl)silane (13.21%). Principal component analysis and cluster analysis revealed clear groupings based on morphological and chemical similarities. Fritillaria pinardii , F. pontica and F. kittaniae formed a cluster due to their similar morphological and chemical characteristics, whereas F. imperialis and F. alfredae subsp. glaucoviridis formed a distinct group. These findings provide valuable insights into the identification and classification of Fritillaria species. Integrating morphological and chemical data can enhance the accurate identification of these species. This study contributes to understanding the natural diversity of Fritillaria species and has implications for ecological studies.

In today’s world, there is almost no homogeneous culture without interaction, and multiculturalism has become the most important phenomenon for all societies. Therefore, this cultural diversity, consisting of differences in culture, language, identity, religion, etc. has also brought along many problems. In the United Nations Educational, Scientific and Cultural Organization’s in “Convention for the Safeguarding of Intangible Cultural Heritage”, it is stated that identifying, documenting and surveying intangible cultural heritage of communities contributes to social harmony and tolerance. This research has been conducted on the identity, language, and communication of the Cretan in Türkiye. The purpose of the study is to contribute to social peace and tolerance by examining the identity, language, and communication perceptions and concerns of the Crete-origin community living in Türkiye as a subculture group, within the context of multiculturalism and intercultural communication. In this direction, preliminary interviews, observations and semi-structured in-depth interviews were made in the fieldwork carried out between May-July 2024 in the of the Cretan immigrants who have migrated and settled in Antalya at the first settlements one of the world cities with intense multiculturalism. In the study, an answer has been sought to the question “What are the identity and linguistic anxiety, harmony and conflict situations in the communication and interaction of Cretans living in Turkey as a subculture with the dominant culture?”. The findings were subjected to thematic and descriptive analysis and interpreted. It is predicted that the findings and results of this research can be used to contribute to studies aimed at preventing identity, linguistic and cultural incompatibility and possible conflicts caused by increasing migration movements.

Relative Age Effects (RAEs) have been widely reported trends in basketball participation, but research on the relationship between RAEs and competitive performance has been contradictory. We aimed to determine the magnitude of RAEs in elite youth basketball players and to analyze RAEs on key performance indicators (KPIs). We recorded and analyzed the incidence of early birthdates and the KPIs of 2487 youth basketball players (aged 16–19 years). We evaluated RAEs by means of the incidence of early birthdates using (i) Chi-square (χ2) goodness-of-fit tests to compare player differences in birthdate quartiles and (ii) Poisson regression analysis to evaluate birthdates as a continuous variable. We conducted Kruskal-Wallis tests separately for each age group to assess possible relationships between birthdate quartile differences and KPIs. We observed consistent moderate RAEs across all ages. The Poisson regression analysis showed that athletes born near the beginning of the year were 4.6–8.4 times more likely to have been included on the squad than athletes born towards the end of the year. We observed no significant differences between KPIs for differently aged athletes. However, 16-year-old athletes with first quartile birthdates showed higher KPIs than those with fourth quartile birthdates of the same calendar year. The potential bases for RAEs are complex and include the characteristic demands of sports competition at various competition levels and athletes’ ages, individual factors and social factors. We discuss these and other potential bases. Basketball coaches and managers should keep RAEs in mind when selecting youth players to avoid a selection bias towards players born at the beginning of the year which may close out training opportunities and cause drop outs for talented but slightly younger players.

Patients presenting with suspected acute coronary syndrome (ACS) in the emergency department (ED) require rapid and accurate electrocardiographic (ECG) evaluation. This study aims to assess conventional ECG markers for diagnosing non-ST-elevation ACS (NSTE-ACS) in patients with chest discomfort and right bundle branch block (RBBB). A nested case–control design was employed to compare patients with RBBB admitted to the ED for suspected cardiac ischemia, focusing on those who developed NSTE-ACS versus those who did not. The sample consisted of 352 patients with suspected ACS and RBBB identified on ECG. Among them, 88 were diagnosed with NSTE-ACS. In the presence of RBBB, ST-segment elevation on the isoelectric line and/or positive T-waves on the ECG were significantly associated with the diagnosis of NSTE-ACS (p < 0.05). In patients who developed NSTE-ACS, the likelihood of an isoelectric ST-segment was 3.48 (95% CI 2.07–5.82) times higher, the likelihood of positive T-waves was 4.16 (95% CI 2.51–6.91) times higher, and the combination of an isoelectric ST-segment with positive T-waves was 4.81 (95% CI 2.28–8.25) times higher (p < 0.05). In addition, ST-segment depression and non-negative T-waves were significantly more frequent in patients who developed NSTE-ACS, with odds ratios of 5.78 (95% CI 3–11.3), compared to those who did not (p < 0.05). The odds ratios for ST-segment and T-wave changes were 2.81 and 3.47, respectively, with an 80% correct classification rate for predicting NSTE-ACS. Clinicians should closely monitor the presence of an isoelectric ST-segment and positive T-waves in patients with RBBB to assess for potential cardiac ischemia.

Atomic scaled rings are included as mechanical components in nano-electro-mechanical systems (NEMS). It is known from experimental results that the classical elasticity solution is insufficient in the mechanical analysis of such components. This problem is eliminated with the nonlocal elasticity solution. In this study, it is aimed to investigate the size-dependent dynamics of nano scaled rings embedded in linear elastic medium for the first time in the scientific literature. First, the nonlocal in-plane free vibration of nanorings is formulated. Then the free vibration frequency equation is obtained. The nondimensional frequencies of different modes of nanorings are presented according to different parameters and the numerical results are discussed in detail. According to the results, while nonlocal parameter reduces the nondimensional frequencies, nanoring radius increases the nondimensional parameters. Additionally, frequencies of nanorings are increased by elastic medium. The results show that the atomic size effect and elastic environment are important on the mechanical behavior of nanorings.

This study aims to classify honey bee genotypes by integrating explainable artificial intelligence techniques, particularly decision trees, with both morphometric and molecular data. A total of 4949 samples were collected from 500 colonies across five regions in Türkiye, representing diverse subspecies and ecotypes. Morphometric data included 16 key wing characteristics, while molecular data contained 26 highly informative SSR loci. First, we used 16 morphometric wing parameters to classify bees into five regions where they originate. The decision tree algorithm resulted in a tree with wing length and O26 and L13 angles, but the classification accuracy was low (51%). Later, we included 26 molecular variables and obtained a decision tree with four SSR loci—Ap218, Ap274, Ap001, and Ap289—and achieved a high classification accuracy of 96.38%. The findings also revealed the first-ever identification of a SSR locus (Ap218) strongly associated with wing length in honey bees. Finally, we explained wing length with molecular data by modeling a regression decision tree. This tree identified Ap218, Ap223, and Ap001 as the most significant SSR loci for the wing length model. This study provides a powerful approach for differentiating honey bee genotypes while offering valuable insights into the genetic factors influencing wing morphology. The results have significant implications for the conservation and sustainable management of honey bee genetic resources, particularly in regions like Türkiye where genetic diversity is at risk.

The aim of this study was to compare the performance, egg quality and economic aspects of laying hybrids of different genotypes in free-range system. In the study, three different laying genotypes (Lohmann Brown, Lohmann Sandy and ATAK-S genotype) were used. Each group consisted of four replicates and each replicate contained 20 hens. Egg production, broken–cracked egg ratio, egg weight, feed consumption, feed efficiency, and viability were determined as performance traits. Eggshell strength, Haugh unit, yolk color, and shell color were determined as egg quality traits. The costs of eggs were assessed for economic analysis. The Lohmann Sandy genotype produced more eggs than the Lohmann Brown genotype (p < 0.05). The ATAK-S genotype reached 50% egg production age sooner than other genotypes (p < 0.05). The Lohmann Sandy and Lohmann Brown genotypes produced fewer broken eggs and heavier eggs compared to the ATAK-S genotype (p < 0.05). The ATAK-S genotype consumed more feed than the Lohmann Sandy and Lohmann Brown genotypes (p < 0.05). The Lohmann Sandy and Lohmann Brown genotypes have better feed efficiency compared to the ATAK-S genotype (p < 0.05). Eggs from the Lohmann Sandy genotype exhibit greater resistance to breakage compared to those from other genotypes (p < 0.05). The highest quality of albumen was identified in the eggs of the Lohmann Brown genotype (p < 0.05). The yolk color of Lohmann Brown genotype eggs is darker than those of other genotypes (p < 0.05). The shell color of Lohmann genotype eggs is a darker brown compared to eggs of other genotypes (p < 0.05). The cheapest egg cost was determined from eggs produced from the Lohmann Sandy genotype (p < 0.05). According to the results obtained from our study, it would be more appropriate to prefer the Lohmann Sandy genotype in the free-range system.

Background: This study investigated the integration of professional athletes into social security systems to enhance their welfare. It comprehensively examined the risk factors that necessitate social security for athletes across various sports disciplines. Moreover, it explored the conditions required for professional athletes to be recognized as insured employees (sports workers) within the sports industry. This research offers a definitive guide to the occupational, physiological, and socioeconomic risks professional athletes encounter, highlighting branch-specific differences in necessary social security measures. Method: A phenomenological qualitative research design was employed. Data collection involved semi-structured interviews using an 11-question form developed by the researcher. Purposeful sampling ensured diverse perspectives among the 22 participants, including unofficial and open professional athletes, club directors, national coaches, international referees, sports agents, social security experts, and private insurance specialists. NVivo 10 software facilitated data analysis, with findings presented through content and descriptive analysis. Results: The overarching theme identified was "Social Risks in Sports," with seven subthemes encompassing Work Accidents and Injury in Sports, Disease in Sports, Maternity in Sports, Unemployment in Sports, Disability in Sports, Old Age in Sports, and Death in Sports. The results reveal distinct risk factors in sports, necessitating tailored social security provisions. The study also demonstrates that conditions can be established to safeguard professional athletes against these social risks through specialized practices. Conclusion: This research confirms the significant impact of occupational, physiological, and socioeconomic risks on the careers of both active and retired athletes transitioning into various sports-related fields. It underscores the critical importance of a secure future and social security protection for athletes to achieve optimal performance and motivation. Addressing these concerns through specialized policies will likely enhance success in sports and encourage broader participation.

Montelukast, a leukotriene receptor antagonist (LTRA) approved for the treatment of asthma and allergic rhinitis, is widely used, though real-world data on its application in asthma management remain limited. This registry-based study evaluated the use of montelukast in adult asthma patients, examining demographic and disease characteristics, asthma control status, asthma phenotypes, presence of atopy, and treatment regimens. Among 2053 patients analyzed, 61.76% (n = 1268; mean age: 46.2 ± 14.3 years), predominantly females (~76%), received montelukast. Montelukast users showed higher rates of allergic rhinitis (P < 0.001), hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) (P = 0.008), and chronic rhinosinusitis (P = 0.008). Montelukast group also had higher atopy and total IgE levels and tended to be more eosinophilic. Montelukast was commonly preferred in allergic, eosinophilic, NSAID-exacerbated respiratory disease, and severe asthma phenotypes (P < 0.001). Patients receiving Steps 4 and 5 treatments are more likely to be prescribed montelukast (P < 0.001). Montelukast usage was higher among patients with uncontrolled asthma [ACT< 20 (OR:1.29, 95%CI:1.052–1.582, P = 0.014)]. In addition, logistic regression analyses identified the main factors associated with increased montelukast use as; female gender (OR:1.33, 95%CI:1.041–1.713, P = 0.02), presence of atopy (OR:1.46, 95%CI:1.157–1.864, P = 0.002), comorbid allergic rhinitis (OR:2.12, 95%CI:1.679–2.293, P < 0.001), and severe asthma (OR:2.18, 95%CI:1.712–2.784, P < 0.001). These findings reveal that montelukast use is prevalent among asthma patients,particularly in females, middle-aged adults, and those with comorbid allergic rhinitis, uncontrolled asthma, or specific asthma phenotypes, underscoring the factors that influence its prescription in asthma management.

Objective This retrospective study aimed to assess the presence and amount of external apical root resorption (EARR) in endodontically treated teeth (ETT) and contralateral teeth with vital pulp (VPT) following orthodontic treatment. Methods The study sample included panoramic radiographs of 503 patients (314 females and 189 males; 16.29 years±3.98) with 620 ETT and 580 VPT. The tooth length was measured on digital panoramic radiographs, which were collected at the beginning and end of the orthodontic therapy for each subject. The pre- and post-orthodontic treatment radiographic evaluation included the percentage of EARR in ETT and contralateral VPT for all tooth types. Any relationship between EARR and orthodontic treatment type (one- and two-phase; extraction and non-extraction), duration, and patients’ age and gender were investigated. Mann-Whitney U, Wilcoxon signed rank, Kruskal-Wallis and Spearman correlation tests were applied for comparisons and to test the correlations. Results A statistically significant difference was observed in all orthodontic treatment groups when ETT and VPT were compared in terms of EARR (p<0.05). EARR was positively correlated with orthodontic treatment duration and type (p<0.05) but was not influenced by patient age or gender. Statistically significant EARR was observed in the two-phase extraction orthodontic treatment group for both ETT and VPT. In VPT, a statistically significant EARR was found in the one-phase extraction treatment group compared with the non-extraction treatment group, whereas no significant difference was found in ETT. Conclusion ETT showed significantly lower EARR than VPT. ETT can therefore be moved safely during orthodontic treatment.