Manisa Celal Bayar University

Objectives Activin-A belongs to the transforming growth factor-beta superfamily and is a multifunctional cytokine that plays a role in inflammation, immune response, tissue repair and regeneration. Proinflammatory cytokine interleukin-1beta (IL-1β) can increase Activin-A expression in various cell types. This study aims to evaluate gingival crevicular fluid (GCF) and salivary Activin-A and IL-β levels in stage III periodontitis. Materials and methods 23 patients with stage III periodontitis, 26 with gingivitis and 26 periodontally healthy individuals were included. Full-mouth clinical periodontal indices were recorded, unstimulated whole saliva and GCF samples were obtained, Activin-A and IL-1β total amounts were determined by ELISA. Statistical comparisons were performed using non-parametric tests. Receiver operating characteristics curve was used for estimating the area under the curve (AUC). Results Periodontitis group exhibited significantly lower GCF Activin-A levels but higher IL-1β levels than the periodontally healthy group (p < 0.05). Gingivitis group had similar GCF Activin-A and IL-1β levels to the periodontitis and periodontally healthy groups (p > 0.05). Salivary Activin-A and IL-1β concentrations were similar among study groups (p > 0.05). GCF Activin-A level showed an excellent diagnostic performance (an AUC value of 0.82 with 87% sensitivity) to discriminate periodontitis from periodontal health. Conclusions For the first time, this study demonstrated oral biofluid levels of Activin-A in periodontal health and diseases. Within the limits of the study, it might be suggested that diseased sites in periodontitis are associated with reduced Activin-A and increased IL-1β levels in GCF. Clinical relevance. Reduced GCF Activin-A levels and the accompanying increase in IL-1β might be associated with diseased sites in stage III periodontitis.

According to the theoretical frameworks and teaching practice, the constructs of the Technology acceptance model - TAM and the Cognitive load theory - CLT are in a close cause-and-effect relationship, and gaining insights into this issue is essential for educators. Our study aimed to examine continuous teaching intention (CTI) with emerging technologies (ET) through perceived usability (PUS), attitudes towards teaching (ATT) and perceived cognitive load (PCL) from the aspect of teachers’ perceptions. A survey research design using a cross-sectional survey technique was applied. The research involved 801 primary and lower secondary school teachers. Results showed that the TAM-CLT scale model is aligned and fits the overall sample well. In addition, teachers’ PUS can be a crucial factor in shaping ATT and CTI of ET because this construct positively influences these variables underlining the importance of designing user-friendly ET. However, our study reveals the lack of a significant negative relationship between teachers’ PCL and PUS, and the absence of mediation between PCL and CTI through PUS. These unexpected findings highlight the complexity of users’ experiences with ET and the need for a more nuanced understanding of the interplay between these constructs. One of the implications of our study refers to further investigation of the underlying mechanisms between PCL, PUS, and CTI. Other recommendations are stated in the discussion.

Background Cognitive impairment is frequently observed in bipolar disorder (BD). Previous findings indicated that predominant polarity could have an effect on cognitive deficits. This study aimed to examine the association between predominant polarity and cognitive impairments in BD. Materials and methods Euthymic BD patients with manic (MPP, n = 31), depressive (DPP, n = 25), undetermined predominant polarity (UPP, n = 28), and healthy controls (HC, n = 27) participated in the study. A battery of neurocognitive and social cognitive tests was implemented. Neurocognitive domains were identified via principal component analysis. Results The MPP group performed worse in the Controlled Oral Word Association Test (COWAT), Reading the Mind in the Eyes Test (RMET), and Hinting Test (HT) compared to the DPP group and reasoning/problem-solving skills compared to the UPP group. Both MPP and UPP groups showed impairments in processing speed compared to HC. Among patient groups, there was no significant difference in working memory, attention, processing speed, verbal, and visual domain scores. The MPP group had poorer scores compared to controls in most of the social cognitive and neurocognitive domains in the study, while the overall cognitive impairment in the DPP group was relatively milder. Conclusions Although our sample size was relatively small, the MPP group yielded more severe cognitive impairment in verbal fluency and social cognition tests compared to DPP. Patients with MPP are particularly vulnerable to cognitive impairment, making them a priority for cognitive enhancement interventions. Future studies should focus on the outcomes of cognitive and pharmacological interventions in these polarity subgroups.

Numerical estimation for the impacts of the conductive partitions having different positions on the mixed laminar convection of air in a 2D vented enclosure was examined. The variable parameters are accepted as Reynolds number (Re = 10–1000), Richardson number (Ri = 0–5), and size of the partition (0.25H, 0.5H, and 0.75H). Twelve cases having several partition arrangements were analyzed. It was observed that excellent convection control can be obtained by using conductive partitions depending upon the Re and Ri combinations. Generally, at small Re, the mean Nu was not affected by the variation of geometry and Ri at small Re. The highest Nu is achieved in Case 12, a cavity with two partitions having a length of 0.75. At Re = 1000, the rate of increase in Nu at Ri = 0, 1, and 5 are obtained at 2.085, 1.868, and 1.43 according to the bare cavity, respectively. In addition, the effect of the solid–fluid thermal conductivity ratio (K = 0.002, 0.2, 1, 5, and 40) on heat transfer was investigated for Case 12. Empirical power‐law Nusselt number correlation was derived for a 2D vented cavity with/without conductive partitions. In conclusion, the maximum heat transfer enhancement rate is obtained in the vented cavity with two length partitions of 0.75. At Re = 1000, the increases in heat transfer rate (Nu/Nu0) for Ri = 0, 1, and 5 are 2.085, 1.87, and 1.43 times higher, respectively, compared with the bare cavity. In terms of effectiveness, Case 12 is the optimum case after Case 0.

Image segmentation is a pivotal phase in the image processing pipeline, offering detailed insights into various image features. Traditional segmentation methods grapple with challenges such as local minima and premature convergence when navigating intricate pixel search spaces. Additionally, these algorithms experience prolonged processing times as the number of threshold levels increases. To mitigate these issues, we implemented the Chaotic Gravitational Search Algorithm (CGSA), a robust optimizer, for the multi-level thresholding of COVID-19 chest CT scan images. CGSA amalgamates the Gravitational Search Algorithm (GSA) for exploration with chaotic maps for exploitation. Kapur’s entropy method was employed to partition the sample images based on optimal pixel values. The segmentation performance of CGSA was rigorously assessed on various COVID-19 chest CT scan imaging datasets from Kaggle, utilizing metrics such as Peak Signal to Noise Ratio (PSNR), Structural Similarity Index Measure (SSIM), and Feature Similarity Index Measure (FSIM). The qualitative analysis encompassed convergence curves, segmented graphs, colormap images, histogram curves, and boxplots. Statistical validation was conducted using the signed Wilcoxon rank sum test, and eight sophisticated heuristic algorithms were enlisted for comparative analysis. The comprehensive evaluation unequivocally demonstrated CGSA's superiority in terms of processing time efficiency and its ability to provide optimal values for image quality metrics, establishing it as a powerful tool for quickly assessing COVID-19 disease severity.

Background This study aimed to evaluate attitudes toward and exposure to gender discrimination in work life by chest diseases specialists and thoracic surgeons. Methods A total of 275 members of Turkish Thoracic Society (TTS) were included on a voluntary basis in this online cross-sectional questionnaire-survey using an internal member-only social media platform of TTS. The questionnaire form elicited items on sociodemographic characteristics, occupational characteristics and gender discrimination in work life (general opinions, attitudes and exposure). Results Female doctors (vs. males) were less likely to be a thoracic surgeon (13.8% vs. 34.5%, p < 0.05) and a professor of thoracic surgery (0.0% vs. 26.7% vs. p < 0.05), and more likely to consider housework as a considerable burden (89.8 vs. 73.6%, p = 0.02) and the significant role of discriminatory, negative and dissuasive attitudes of male physicians in their career choice (67.6 vs. 35.6%, p = 0.039). Male doctors were more likely to considered that men are more successful in specialties that require active physical strength (65.5 vs. 27.7%, p = 0.005) and those with very long working hours and heavy shifts (57.5 vs. 39.4%, p = 0.001). Female thoracic surgeons were more likely than males to consider that specialties with very long working hours and heavy shifts are more suitable for men (26.9 vs. 6.0%, p = 0.027) and men are given priority in academic career promotion (64.0 vs. 13.3%, p < 0.001). Younger (vs. older) females reported higher rate of exposure to gender discrimination (p = 0.041) and considerable impact of social roles on the specialty (p = 0.007), while female doctors working as a resident (33.8%) and a specialist (50.05%) indicated higher rate of exposure to gender discrimination during their career (p = 0.024). Conclusion In conclusion, our findings revealed that exposure to gender discrimination in work life was more commonly expressed by female members of TTS, particularly in terms of burden of social roles, career advancement options and leadership positions, along with significant role of discriminatory, negative and dissuasive attitudes of male physicians in their career choice. Accordingly, women remain underrepresented in thoracic surgery, particularly in the academic rank of full professor and in leadership positions with inability to promote after a definite step in their careers.

Background The aim was to investigate which of two different b values (b 500 s/mm² and b 800 s/mm²) are more effective in the differentiation of benign-malignant nodules using Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI). Materials and methods Patients presenting with a preoperative diagnosis of nodular goiter or multinodular goiter were included in this study. These patients underwent neck MRI examinations, and their cases were analyzed retrospectively. A total of 26 patients were included in the study. A total of 46 nodules meeting the study criteria were examined. Measurements were performed on Apparent Diffusion Coefficient (ADC) maps of patients at two different b values (b 500 s/mm² and b 800 s/mm²), and the results were compared with histopathological findings. Results Out of a total of 46 nodules, 37 were identified as benign, and 9 as malignant based on histopathological analysis. The mean ADC value at b 500 was lower in malignant nodules (1259.65 ± 328.13) compared to benign nodules (19037.48 ± 472.74). Similarly, the mean ADC value at b 800 was lower in malignant nodules (1081.72 ± 200.23) compared to benign nodules (1610.44 ± 418.06). When a cut-off value of 1.1 × 10− 3 was accepted for the differentiation of pathology, the sensitivity for distinguishing pathology with ADC values at b 500 was 83.3%, with a specificity of 90.0%, and for ADC values at b 800, the sensitivity was 71.4%, with a specificity of 89.7%. Conclusion DW-MRI without the need for contrast agent administration is a useful method in the differentiation of benign-malignant thyroid nodules.

Purpose This study investigates the natural progression of quiescent macular neovascularization (qMNV) using optical coherence tomography angiography (OCTA). Methods The study monitored 30 eyes of 28 qMNV patients over a period of at least six months. Best-corrected visual acuity (BCVA), optical coherence tomography (OCT), and OCTA were used to perform qualitative and quantitative analyses, noting any cases of activation during follow-up. Results Among the 30 eyes (14 female, mean age 69.70 ± 7.63 years), 21 had age-related macular degeneration (AMD) and 9 had pachychoroid neovasculopathy (PNV). The mean follow-up duration was 18.9 months. There were no significant changes in qualitative morphological features, BCVA, or choroidal thickness ( p > 0.05). However, there was a statistically significant increase in the areas of MNV and flow ( p = 0.043 and p = 0.018, respectively). BCVA and MNV area showed no significant correlation ( p = 0.103). Four cases (13.33%) showed activation after an average follow-up period of 27.75 months (6 to 48). Additionally, extrafoveal location was identified as a significant risk factor for exudation ( p = 0.033). Conclusion OCTA is a valuable tool for monitoring qMNV and identifying potential predictors of disease activation. The qMNV area may increase over time, even in the absence of activation. Extrafoveal location appears to be a potential risk factor for qMNV activation.

Increasing the mold service life via improving the surface properties of AISI P20 + Ni steel, which is frequently used in the production of plastic injection molds, through the boronizing process may have significant implications for the industrial sector in terms of enhancing production efficiency. In this study, AISI P20 + Ni mold steel was borided at various temperatures (850, 900, and 950 °C) and durations (3, 6, and 9 h) employing a non-commercial boriding admixture containing H3BO3 via powder-pack boronizing method. The layer’s morphology and thickness were assessed using optical microscopy and scanning electron microscopy. Boride layers exhibiting a saw-tooth morphology, uniformly distributed across the substrate surface, were identified. X-ray diffraction and energy-dispersive X-ray analysis were employed to analyze the phase constituents and chemical composition of the boride layer. As a result of these analyses, the presence of a single-phase (Fe2B) boride layer was detected. Microhardness tests indicated that the boronized sample surface had an average hardness of around 1900 HV. Wear tests were conducted utilizing the ball-on-disk method at ambient (room) temperature under dry sliding conditions, revealing an approximately 23-fold increase in the wear resistance of boronized materials. Contact angle analysis was employed to evaluate the wettability behavior of the substrate and borided samples. Corrosion tests were conducted using the linear polarization resistance method in a 3.5 wt% NaCl solution, and it was observed that the corrosion rate of the sample boronized at 900 °C for 6 h was approximately six times lower than that of the substrate material. Indentation fracture (IF) toughness tests of the boride layers were performed using a Vickers microindentation. The IF toughness value of boride layers decreased with increasing process duration and temperature. Graphical abstract

This study addresses the critical need for high-strength, corrosion-resistant materials in renewable energy, biomedical and maritime applications, necessitating effective heat treatment processes. Focusing on AISI 52100 steel, the research employs finish hard turning with coated carbide inserts under dry cutting conditions. Five machine learning methods are applied to model surface roughness (Ra) and cutting forces (Fx, Fy, Fz) using a Taguchi L36 orthogonal array. Results indicate SVM, XGB, DT, and XGB are superior algorithms for Ra, Fx, Fy, and Fz prediction. Key findings highlight feed rate predominant influence (96.55%) on surface roughness, while depth of cut significantly affects cutting forces. Optimal cutting parameters, 0.1 mm depth of cut, 0.15 mm/rev feed rate, 160 m/min cutting speed, 0.4 mm nose radius, and 40.9 HRC hardness are identified via response surface methodology (RSM) and desirability function. The study underscores the importance of optimizing cutting parameters to enhance surface quality and machining efficiency in challenging material processing scenarios.

Introduction: Nursing cultural competence is crucial for enhancing the quality of care for refugees. While innovative game-based teaching methods have been used to foster in a wide range of clinical competences, little is known about its use on refugees’ care. This study aims to evaluate the effect of these methods on nursing students’ cultural competence and attitudes toward refugees. Methodology: An explanatory sequential mixed design was conducted from March to May 2023. Results: One-hundred forty-one nursing students participated. There were no statistically significant differences in total Outgroup Threat Perception Scale and Cultural Competence Assessment Scale scores between the experimental and control groups, pre- or post-intervention. However, students reported increased awareness and empathy for refugee issues. Discussion: The study showed that innovative game-based teaching methods effectively increased nursing students’ awareness of health-related issues faced by refugees. It recommends incorporating transcultural nursing courses into curricula and professional training, with updated content on migration and refugee issues.

There has been a significant growth in the service sector in recent years. In addition to the growth in the service sector, the critical role played by services in the development of the manufacturing sector may signal that many manufacturing businesses are moving toward providing quality and efficient services. One of the critical points of delivering a quality and effective service is to create loyal customers, provide engagement, and make innovation because while other sectors are more product innovation-based, service works process-based. Creating brand loyalty and consumer engagement and being an innovator enable retaining existing customers, protecting companies against competitors, and contributing to their financial values. On the other hand, creating brand loyalty has become more complex and sensitive. For this reason, it is crucial to examine the issue in terms of services and different service sectors. In this part of the book, service trends, brand co-creation, service brand innovation, and customer–brand relationships in tourism are evaluated, and examples of business practices are discussed.

This study aimed to investigate the cytotoxicity and apoptotic activity of different endodontic sealers: Sealapex, Apexit Plus, AH Plus, MTA-Fillapex and TotalFill BC Sealer in the culture of human periodontal ligament fibroblast (HPDLF) cells. The sealers were mixed, set for 24 h, and then covered with culture medium to obtain extracts, which were diluted to 1:0, 1:1, 1:2, 1:4, and 1:8. Simultaneously, HPDLF cells (1 × 10⁴) were seeded in 96-well plates and incubated for 24 h at 37 °C 5% CO2 conditions. The cells were then exposed to 100 µL of diluted extract medium. Cytotoxicity was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay to check cell viability, while apoptosis was assessed by TUNEL assay. Statistical analyses were performed using Kruskal-Wallis and Dunn post hoc tests with Mann Whitney U. In MTT and TUNEL assay cells were treated with sealers both 24 and 72 h. All materials showed higher toxicity at 72 h compared to 24 h. AH Plus exhibited the highest cytotoxicity, followed by MTA-Fillapex, Apexit Plus, Sealapex, while TotalFill BC Sealer had the lowest cytotoxicity. Consuquently, it was considered that TotalFill BC Sealer had the lowest cytotoxic potency when compared to other sealers, so it can be considered biocompatible.

Breaks or cracks in eggshells offer substantial food safety issues. Bacteria and viruses, in particular, are more likely to enter the egg through breaks and cracks, increasing the risk of food poisoning. Furthermore, deformations in the shell may compromise the integrity of the protective shell, exposing the egg to more external variables and causing it to lose freshness and decay faster. To reduce such hazards, this research created an innovative crack detection system based on an autoencoder (AE) that uses acoustic signals from eggshells. A system that creates an acoustic effect by hitting the eggshell without damaging it was designed, and these effects were recorded through a microphone. Acoustic signal data of size 1 × 1000 was fed into k nearest neighbor (kNN), decision tree (DT), and support vector machine (SVM) classifiers. AE was employed to reduce data size in order to accommodate the raw data's unique features. This AE model, which reduces data size, was used with many classifiers and was able to accurately distinguish between intact and cracked eggs. The built AE‐based classifier model completed the classification procedure with 100% accuracy, including microcracks that are invisible to the naked eye.

Silymarin has been utilized as a traditional, complementary, and integrative medicine for centuries, despite a poor molecular‐level understanding of its interactions with other medicinal compounds and enzyme structures. However, recent studies indicate that this supplement, as with many others, should be considered with caution because it has the potential to interact with many drugs, medical plants, and foods. Silymarin is composed of several compounds that are either enantiomeric or have similar structures. Thus, this study presents the electronic structure properties and reactivity characteristics of silymarin components and warfarin through density functional theory modeling at the M06‐2X/6–311 + G(d,p) level of theory. The ligand‐protein interactions of the compounds with human serum albumin, cytochrome P450 (CYP2C9, CYP2C19, CYP2D6, and CYP3A4) enzymes, and alanine transaminase were presented using molecular docking. The critical residue‐based interactions of silymarin components and warfarin were fingerprinted. Furthermore, their drug‐likeness and toxicity characteristics were compared to those of warfarin and the well‐known flavonoids, taxifolin, and quercetin. The possibility of inhibiting the target enzymes to reduce the effectiveness of warfarin has been highlighted.