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Alpha1-antitrypsin (A1AT) is an anti-inflammatory mediator with antiprotease activity associated with anti-inflammatory and immunomodulatory effects in various inflammatory conditions. A1AT deficiency (A1ATD) has been associated with various hyperinflammatory diseases, such as lung disease (emphysema and bronchiectasis), liver disease (chronic hepatitis, cirrhosis, and hepatoma), and skin diseases (panniculitis). Migraine with aura is one of the common migraine subtypes associated with neuroimmunologic activation and neuroinflammation which is associated with cortical spreading depression and glial hyperinflammation in etioradiopathogenesis, and the main mechanisms explained so far are hyperinflammation of pro-inflammatory mediators, sensitivity of trigeminal nerve fibers and pain-conjugated glial cells activation. In this case report, a causative perspective of migraine with aura and A1ATD was presented through etioradiopathogenetics mechanisms that show the central reflections of systemic hyperinflammatory processes, and the importance of peripheral hyperinflammatory conditions in migraine etiology was examined.

INTRODUCTION: Pica is one of the symptoms of iron deficiency and a pathology that exacerbates the condition. In this study, we sought to identify the biomarkers associated with pica in iron-deficient patients. METHODS: The study included female iron deficient clinic applicants from April 2021 to August 2022. The main iron deficit inclusion criterion was ferritin

Bu çalışmanın amacı, üniversite öğrencilerinin deprem algılarını metafor analizi yoluyla incelemektir. Araştırmada nitel araştırma desenlerinden biri olan fenomenoloji araştırma deseni kullanılmıştır. Araştırmanın katılımcılarını, Doğu Anadolu Bölgesi'nde bulunan bir kamu üniversitesinde öğrenim gören öğrenciler oluşturmuştur ve toplamda 96 kişi araştırmaya katılım sağlamıştır. Araştırma verileri görüşme formu yoluyla, "Deprem... gibidir, çünkü..." ifadesiyle toplanmıştır. Verilerin analizinde içerik analizi tekniği kullanılmıştır. Araştırmadan elde edilen bulgulara göre, katılımcılar tarafından depreme yönelik olarak toplamda 84 geçerli metafor üretilmiştir. Araştırmada, öğrencilerin genellikle olumsuz metaforlar ürettiği tespit edilmiştir. Katılımcıların ürettikleri metaforlar; korku, ölüm, yıkım, kayıp, terkedilme, sarsıntı ve inancı hatırlatan bir kavram olmak üzere toplamda yedi kavramsal kategori altında gruplandırılmıştır.

This study aimed to compare tissue levels of CD80 (pro-inflammatory macrophage-related surface marker), CD163, and CD206 (anti-inflammatory macrophage-related surface markers), and their ratios in periodontal and peri-implant health and disease. Altogether, 36 tissue samples were obtained from 36 participants with clinically healthy gingiva (n = 10), healthy peri-implant mucosa (n = 8), periodontitis lesions (n = 9), and peri-implantitis lesions (n = 9). CD80, CD163, and CD206 levels were assessed with immunoblotting. CD163 levels were found to be decreased (p = 0.004), and the CD80/CD163 ratio was found to be elevated (p = 0.002) in periodontitis lesions compared to healthy gingiva. Peri-implantitis lesions showed a tendency towards a higher CD80/CD163 ratio than in healthy peri-implant mucosa with a borderline difference (p = 0.054). No statistically significant difference was detected in CD80, CD163, and CD206 levels of periodontitis lesions when compared to peri-implantitis, and in healthy gingiva when compared to healthy peri-implant mucosa. A disruption in CD80/CD163 balance seems to be related to the pathogenesis of periodontitis and peri-implantitis, being less prominent in the latter. The reason behind this phenomenon may be either suppressed CD163 expression or reduced CD163+ anti-inflammatory macrophage abundance.

Objective: Posterior circulation ischaemic strokes (PCIs) are a clinical syndrome associated with ischemia related to stenosis, in situ thrombosis, or embolic occlusion of the posterior circulation and differ from anterior circulation ischaemic strokes (ACIs) in many aspects. In this study, ACIs and PCIs were evaluated in terms of clinico-radiological and demographic aspects, and the relevance of objective scales to early disability and mortality was investigated. Methods: The definition of ACIS or PCIS was classified according to the Oxfordshire Community Stroke Project (OCSP). There are mainly two groups divided into ACIs and PCIs. ACIs were included as total anterior circulation syndrome (TACS), partial anterior circulation syndrome (PACS) (right and left), and lacunar syndrome (LACS) (right and left), and PCIs were posterior circulation syndrome (POCS) (right and left). Arrival NIH Stroke Scale/Score (NIHSS) and Glasgow Coma Scale (GCS) scores were evaluated in clinical assessment and modified SOAR Score for Stroke (mSOAR) was for early mortality-based scale prediction. All data were compared, and mean, IQR (if applicable) values and ROC curve analysis were determined. Results: A total of 100 AIS patients, 50 of whom were ACIs and 50 were PCIs, were included in the study and were evaluated within the first 24 h. Hypertension was the most common disease for both groups. The second most common was hyperlipidemia (82%) in the ACIs and diabetes mellitus (40%) in the PCIs. The frequency of right hemisphere ischemia was higher in ACIs (63.6%) and PCIs (48%). The mean NIHSS and GCS score (also median IQR) was higher in the right ACIs and the highest NIHSS mean was in the right partial anterior circulation syndrome (PACS) (respectively median (IQR): 9.5 (13) and median (IQR):14.5 (3)). The mean NIHSS and GCS score of bilateral posterior circulation syndrome (POCS) were the highest in PCIs (median (IQR):3 (17), (IQR):15 (4) respectively). The mSOAR mean was the highest in the right PACS in ACIs (median (IQR):2.5 (2)) and in bilateral POCs among PCIs (median(IQR):2(2)). Conclusion: The association of PCIs with hyperlipidemia and the male gender was interpreted, and anterior infarcts were found to cause higher early clinical disability scores. The NIHSS scale was effective and reliable, especially in anterior acute strokes, but also emphasized the necessity of using the GCS assessment together in the first 24 h in the assessment of PCIs. mSOAR scale is a helpful predictor in estimating early mortality not only in ACIs but also in PCIs, similar to GCS.

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Objective: Although women comprise nearly half of medical school graduates globally, female orthopedic surgeons in many countries, including Turkey, represent less than 10% of all orthopedists. However, the number of female orthopedic residents is increasing in Turkey. The aim of this cross-sectional study was to assess and compare the experiences of female orthopedic surgeons in Turkey with their male counterparts, focusing on workplace challenges and surgical inclinations.Methods: A survey was conducted among 110 age-matched orthopedic surgeons (54 females, 56 males). Of the 81 female orthopedic surgeons in Turkey, 54 participated in the study. The demographic data, career satisfaction, experiences of mobbing, surgical interests, and dynamics with colleagues were examined. Ethical approval was obtained.Results: The study included residents and specialists with a mean age of 35.08±8.94 years. The largest pre-residency prejudice for women was mobbing, while for men, it was long working hours (P =.001). The most significant challenge for both genders halfway through residency was long working hours (P =.453). Women reported higher career satisfaction (67.4%) compared to men (58.9%). No significant difference was found between the genders in respect of the incidence of experiencing mobbing at least once in their professional lives (P = .714) Conclusion: Mobbing is a significant issue, particularly for women in surgery, although long working hours affect both genders the most. However, the female surgeons reported experiencing more prejudice from colleagues than was reported by men, highlighting the importance of gender equity in the workplace.

Background: Number of organ transplant recipients continues to rise worldwide with increasing accessibility and growing advancements in transplant medicine. Transplant patients have at least a two-to-four fold higher risk of developing cancer compared to the general population. As the prevalence of transplant patients increases, a growing number of these patients are expected to present with concurrent conditions such as cancer, requiring more complex and interdisciplinary care. Case: A 44-year-old patient with an intraperitoneal pelvic renal transplant, found to have high-grade ovarian adenocarcinoma most likely arising from endometriosis, successfully underwent surgical staging, adjuvant chemotherapy, and subsequent pelvic radiation for recurrence. Her kidney function and graft viability were preserved throughout her treatment with careful monitoring. Conclusion: Management of reproductive tract cancers in kidney transplant recipients is complex. Current practices largely rely on evidence from observational studies and case reports for these cancers and more research is needed in this area.

Objective: Cognitive disengagement syndrome, formerly known as sluggish cognitive tempo, is defined as mental fogginess, daydreaming, and sluggishness. This study aimed to determine the prevalence and sociodemographic characteristics of children with cognitive disengagement syndrome and to examine the relationship between cognitive disengagement syndrome and psychiatric disorders. Methods: About 268 randomly chosen Turkish primary school children aged 7-11 years from 4 different cities were included in this study. Both teachers and parents completed the cognitive disengagement syndrome scanning scale of the Child Behavior Checklist and the Barkley Child Attention Survey. Psychiatric diagnoses in children were assessed using a semi-structured clinical interview. Four separate cognitive disengagement syndrome measurements were performed, matching informants with scales. Results: The prevalence of cognitive disengagement syndrome was estimated with a range of 4.9%-10.9%, depending on the way of measurement. Logistic regression analyses revealed that paternal psychopathology (odds ratio=6.7) and low maternal education (odds ratio=3.1) increased while advanced maternal age (odds ratio=0.7) decreased the risk of cognitive disengagement syndrome. Although cognitive disengagement syndrome was found to be more prevalent in children with chronic diseases, this association no longer remained in the full logistic regression model. Attention-defic it/hyperactivity disorder was the most observed disorder and accompanied 42.9%-75% of the cases with higher cognitive disengagement syndrome. However, there was no strong support in favor of associations between cognitive disengagement syndrome and depression and anxiety as a whole. Conclusion: This study provides the first estimates regarding the prevalence and the sociodemographic characteristics of Turkish children with cognitive disengagement syndrome. Cognitive disengagement syndrome seems to be relatively more prevalent in Turkey than in Western cultures. Children whose fathers had a psychiatric disorder, whose mothers had low education, and who were at younger ages should be scrutinized for cognitive disengagement syndrome.

Amaç: Bu çalışmanın amacı, Türkiye'de kurulacak Güneş Enerjisi Santrali (GES) için mevcut alternatif iller olan İstanbul, Nevşehir ve Bilecik arasından Çok Kriterli Karar Verme (ÇKKV) tekniği kullanılarak en uygun yerin seçilmesidir. Bu amaçla ilk aşamada AnalitikHiyerarşi Süreci (AHP) yöntemi kullanılarak kriter ağırlıkları hesaplanmış, ikinci aşamada ise VIKOR yöntemiyle belirlenen alternatifler üstünlüklerine göre sıralanarak uzlaştırıcı ortak bir çözüm elde edilmiştir.Yöntem: Güneş enerji santralleri için nihai yer seçim kriterlerini belirlemek için mevzuatlar açısından, santrallerin verimliliği açısından ve sosyal, coğrafik ve ekonomik etkiler açısından yer seçim koşulları dikkate alınarak Çok Kriterli Karar Verme metotlarından AHP ve VIKOR yöntemleri uygulanmıştır. Bilgisayar programı olarak da AHP yöntemi uygulamalarında sıklıkla kullanılmakta olan Super Decisions bu çalışmaya eşlik etmiştir. Literatürde daha önce bu konu üzerine yapılan çalışmalar incelendiğinde; AHP ve VIKOR yöntemini ayrı ayrı kullanan birçok çalışmaya rastlanmasına rağmen bunların birlikte etkisinin incelendiği akademik çalışma sayısının oldukça sınırlı ve çalışmalarda kullanılan kriter sayısının da oldukça az olduğu görülmüştür. Araştırmada AHP kullanılmasının nedeni hala güncel bir yöntem olması ve yöneylem araştırmasında en sık kullanılan Çok Kriterli Karar Verme tekniği olmasıdır. Diğer yandan, farklı bir karar verme yaklaşımından daha faydalanılarak uygulamacılara yol göstermesi ve literatüre de katkı yapılması amaçlandığı için VIKOR kullanılmıştır.Bulgular: Ekonomik, teknik, sosyal ve coğrafi ana kriterleri ile bu ana kriterlere bağlı arazi maliyeti, enerji nakil hattına uzaklık, bölgesel teşvikler, güneşlenme süresi, sıcaklık, arazi ışınım miktarı, eğim, fay hatlarına uzaklık, yağış miktarı, karlı gün sayısı, yerleşim alanına uzaklık ve işgücü olarak tanımlanan on iki adet alt kriter tespit edilmiştir. Bu kriterlerin ağırlıkları bulunmuş ve alternatifler sıralanmıştır.Sonuç: Araştırmada Nevşehir'in güneş enerjisi santrali için en iyi seçim yeri olduğu sonucu elde edilmiştir. Araştırma sonuçlarının solar enerji konusunda çalışma yapan uygulamacılara ve akademisyenlere yol göstermesi beklenmektedir.

Abstract Background Interpersonal distance (IPD), which reflects the physical space between people, ensures the regulation of social behavior in interaction as part of nonverbal communication. Our research aims to reveal whether there is a difference in personal distance preference between individuals with hearing loss and normal hearing (NH). Methods Thirty-five adults (26.54 ± 7.05 years) were divided into three groups according to hearing status: hearing aid (HA) users, cochlear implant (CI) users, and NH individuals. The preferred interpersonal distance scale (PIPDS) and a stop distance paradigm were employed for measurements in various environments. Personal space violations were monitored using an electrodermal activity (EDA) wristband. Results Our findings showed a significant relationship between preferred interpersonal distance (PID) and hearing loss duration (r = 571; p

In our present day, consuming water and energy sources at a rapid rate, losing green areas, air pollution which is caused by gas emissions, global warming and actions that damage the balance in the ecosystem have made it necessary to take precautions. In this perspective, using water and energy sources sufficiently, finding new energy sources and using ecofriendly roofs are crucial for the world's future. Green roof systems, built for the purpose of preventing global warming, and stopping climate change, are the eco-friendly systems that reduce the heat in a city, prevent air pollution, and eliminate too much water accumulation in the city's infrastructure by holding rain water. In this study, decreasing the climate change by holding carbon emissions with green roof, finding the solutions for problems of water scarcity by saving water with the rain harvest system, saving the electricity by lightening the street lamps with stocking the energy coming from the solar system have been aimed. It has been tried to decrease the negative effects of climate change to the environment. The appropriate building has been determined for the inclination and height of roof where a green roof can be built by analyzing some buildings' roofs in Sakarya University in the study. In the scope of experimental study, an extensive green roof system has been designed on the roof of boiler room building. By gathering the rain water on green roof, green places have been watered regularly. The garden has been lightened by producing electricity with solar energy. The contributions have been added to sustainability owing to these sensitive systems for environment.

Bu çalışmada BİST 100 ile gelişmiş dünya ülkelerinden seçilen altı endeks arasındaki volatilite yayılım etkisi 4 Ocak 2016 ve 9 Haziran 2021 tarihleri arasındaki günlük endeks kapanış verileri kullanılarak araştırılmıştır. Dünya ülkeleri arasındaki volatilite yayılım etkisi araştırılırken çok değişkenli GARCH modellerinden biri olan Diyagonal VECH GARCH modeli uygun model olarak seçilmiştir. Getiri serilerine ilk olarak birim kök testleri uygulanarak durağanlık araştırması yapılmıştır. Ardından VAR modeli analizi ile ortalama denklemi tahmin edilmiştir. Son olarak kurulan altı model için Diyagonal VECH GARCH yöntemiyle volatilite yayılım etkileri araştırılmıştır. Sonuç olarak BİST 100 endeks getiri volatilitesini pozitif olarak en çok etkileyen endeksin %95 oranıyla DAX olduğu tespit edilmiştir. DAX’ı %89 oranıyla NASDAQ ve DJIA endeksleri takip etmektedir. BİST 100 endeks getiri volatilitesini %87 oranda pozitif olarak etkileyen diğer endeks ise S P 500’dür. Bu endekslerde oluşan %1’lik şokların BİST 100 endeksi volatilitesinde artışlara sebep olduğu saptanmıştır.

The aim of this study is to determine the functioning of adults with autism spectrum disorders (ASDs) diagnosed in childhood and depression and burnout levels among their parents. A total of 261 adults with ASDs and their parents were recruited for the study. Both parents completed the Beck Depression and Maslach Burnout Inventories and reported the functioning of their adult offspring with ASDs. Only 5.4 % of our sample reported “good” or “very good” outcomes. The most common psychiatric comorbidities were intellectual disabilities and attention-deficit/hyperactivity disorder. Maternal burnout and depression scores were significantly elevated compared to those of fathers. There is an undeniable urgent need for more research to identify the needs of adults and families suffering from ASD. Modifications for those with ASD may have to be made for support in workplaces, achieving driving licenses, using public transportation and attendance at tertiary education.

Different schools and approaches have appeared in marketing management since the beginning of the twentieth century due to customers’ attitudes, needs, expectations, and market conditions. Emerging schools generally included some features of the previous theories. Following the emergence of services marketing as a sub-discipline, some scholars believe in the fragmentation of the marketing thought and the obsolescence of the traditional division between goods and services during the last quarter of the previous century. The service-dominant logic (SDL), which mainly focused on the customer value creation concept, was developed by Vargo and Lush in 2004. This conceptual study aims to broadly review the previous works on the service-dominant logic and related subjects, which are customer-centric view, value creation concept, relationship marketing, and promise management, for the last two decades. The service-dominant logic approach and its components being the critical components of the marketing’s future, were also strategically evaluated to guide organizations as a roadmap. This integrated compact study will contribute to the marketing management literature to catch permanent success.

Background: Acute cerebral infarction (ACI) occurs as a result of instant disruption of vascular flow that causes disbalance between oxidative/antioxidative activity. We examined the relationship of serum neuro-oxidative stress parameters with stroke severity and infarct volume in ACI and emphasized the qualitative importance of high-density lipoprotein (HDL) on its relationship with myeloperoxidase (MPO) and paraoxonase-1 (PON1) in the acute period of stroke., Methods: One hundred ACI patients applied within the first 24 h and 50 healthy volunteers were included. The patient group was evaluated with demographic data (including arrival serum biochemical assessment), clinical disability scores, infarct volume, serum oxidative/antioxidative parameters (lipid hydroperoxide (LOOH), MPO, PON1, MPO/PON ratio). The relevant serum parameters were compared with the control group. Dysfunctional HDL measurement was based on detecting dysfunctionality as a result of a high positive correlation between the dysfunctional feature of HDL and the MPO/PON ratio. The correlation of serum parameters, clinical disability score, and infarct volume were evaluated, and independent analyses of variability with comorbidities were performed., Results: A negative correlation between PON1 and arrival NIH score/scale (NIHSS), LOOH and discharge modified rankin scale (mRS), triglyceride level, and infarct volume; a positive correlation between MPO\PON ratio and infarct volume was determined. Logistic regression analyses showed that hypertension, diabetes, and high HbA1C may be predictors of stroke severity, and diabetes mellitus, high HbA1C, infarct volume, and high NIHSS score may be predictors of early disability (p < 0.005). The ROC curve analysis revealed that determining the cut-off value for LOOH is of importance in determining early disability scores (7.2 and 6.2, respectively)., Discussion: The balance between oxidative and antioxidative stress parameters and their quantitative/qualitative changes is of importance, especially in the acute period of ACI. Dysfunctional HDL's evolution and its relationship with other oxidants are significant not only in the cardiovascular aspect but also in the clinicoradiological aspect.