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Abstract This multicentre (22 centres in Turkey) retrospective cohort study aimed to assess the clinical outcomes of patients with neutropenic fever and SARS-CoV-2 positivity. Study period was 15 March 2020–15 August 2021. A total of 170 cases (58 female, aged 59 ± 15.5 years) that fulfilled the inclusion criteria were included in the study. One-month mortality rate (OMM) was 44.8%. The logistic regression analysis showed the following significant variables for the mentioned dependent variables: (i) achieving PCR negativity: receiving a maximum of 5 days of favipiravir (p = 0.005, OR 5.166, 95% CI 1.639–16.280); (ii) need for ICU: receiving glycopeptide therapy at any time during the COVID-19/FEN episode (p = 0.001, OR 6.566, 95% CI 2.137–20.172), the need for mechanical ventilation (p

Background: In this study it was aimed to evaluate the efficacy and timing with technique of the source control for the subgroup of septic shock (SS) patients with intraabdominal infections (IAI) in a tertiary-care educational hospital. Methods: Patients who had SS with IAI and consulted by Infectious Diseases consultants between December 2013 and October 2022 in our centre were analyzed retrospectively. Results: A total number of 390 patients were included. Overall day-30 mortality (OMM) was 42.5% on day 3 while day 14 and 30 mortality rates were 63.3% and 71.3%, respectively. Source control by surgical or percutaneous operation was performed in 123 of 390 cases (31.5%) and mortality rate was significantly lower in cases that were performed source control at anytime during SS (65/123-52.8% vs 213/267-79.8%, p3 mg/dl (p

Neurobrucellosis is a rare and challenging complication of brucellosis. Its non-specific clinical presentation makes it challenging to diagnose. The coexistence of neurobrucellosis with subdural empyema is extremely rare, with only a few cases reported in the literature. Herein, we present the case of a 27-year-old male with a ventriculoperitoneal shunt in-situ and a history of exposure to Brucella via animal care and consumption of raw milk. The patient presented with a left frontal headache and vertigo following a head trauma. The initial cranial imaging demonstrated a left-sided subdural hematoma and slit ventricles. The patient underwent drainage by craniotomy. Brucella spp. was detected in the drained sample, and the patient was treated with a multi-modal approach, which included antibiotics and surgical drainage. The follow-up plan involved a repeat cranial computed tomography and shunt adjustment for recurrent subdural effusions. This case adds to the few reports of neurobrucellosis associated with subdural empyema. Furthermore, it highlights the importance of considering neurobrucellosis in patients with neurological symptoms and a subdural collection in brucellosis-endemic areas.

Abstract Background Herein, we analyzed the efficacy of main antibiotic therapy regimens in the treatment of healthcare-associated meningitis (HCAM). Materials/methods This retrospective cohort study was conducted in 18 tertiary-care academic hospitals Turkey, India, Egypt and Romania. We extracted data and outcomes of all patients with post-neurosurgical meningitis cases fulfilling the study inclusion criteria and treated with empirical therapy between December 2006-September 2018. Results Twenty patients in the cefepime + vancomycin-(CV) group, 31 patients in the ceftazidime + vancomycin-(CFV) group, and 119 patients in the meropenem + vancomycin-(MV) group met the inclusion criteria. The MV subgroup had a significantly higher mean Glasgow Coma Score, a higher rate of admission to the intensive care unit within the previous month, and a higher rate of antibiot herapy within the previous month before the meningitis episode (p 0.05) among the three cohorts. No regimen was effective against carbapenem-resistant bacteria, and vancomycin resulted in an EOT clinical success rate of 60.6% in the methicillin-resistant staphylococci or ampicillin-resistant enterococci subgroup (n = 34). Conclusions Our study showed no significant difference in terms of clinical success and mortality among the three treatment options. All regimens were ineffective against carbapenem-resistant bacteria. Vancomycin was unsuccessful in approximately 40% of cases involving methicillin-resistant staphylococci or ampicillin-resistant enterococci.

Isabel Morales-Muñoz,1,2 Buse Beril Durdurak,1 Ayten Bilgin,3 Steven Marwaha,1,4 Catherine Winsper5 1Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK; 2Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland; 3School of Psychology, University of Kent, Canterbury, UK; 4The Barberry National Centre for Mental Health, Birmingham and Solihull Mental Health Trust, Birmingham, UK; 5Coventry and Warwickshire Partnership NHS Trust, Research and Innovation, Coventry, UKCorrespondence: Isabel Morales-MuñozInstitute for Mental Health, School of Psychology, University of Birmingham, 52 Pritchatts Road, Birmingham, B15 2TT, UKEmail I.Morales-Munoz@bham.ac.ukObjective: Recent research indicates that sleep problems in childhood precede the development of borderline personality disorder (BPD) symptoms, but the mechanisms by which sleep problems associate with BPD are still unknown. This narrative review aims to provide some potential explanations for how early sleep problems might associate with BPD.Methods: We used the biosocial developmental model of BPD as a framework to discuss how sleep problems may associate with BPD. Articles were identified via PubMed and Embase, and papers published between January 1991 and April 2021 were extracted. Authors made a series of literature searches using the following keywords: Sleep problems, Insomnia, Nightmares, Hypothalamic–Pituitary–Adrenal Axis (HPA), Prefrontal Cortex, Family Psychopathology, Disrupted Attachment, Child Maltreatment, Impulsivity, Emotion Regulation, Internalizing, Externalizing, Rumination, Childhood, Adolescence, Young people. The inclusion criteria were published in peer-reviewed journals; human studies or reviews; published in English. The exclusion criteria were commentaries; abstracts from conferences; studies with animal samples. A total of 96 articles were included for the purpose of this review.Results: The evidence from this review suggests that some biological factors and core features of BPD act as potential mechanisms mediating the associations between early sleep and subsequent BPD, while some family-related factors might constitute common risk factors for sleep problems and BPD.Conclusion: The biosocial developmental model of BPD provides a plausible characterization of how sleep disruption might lead to subsequent BPD. Further research on new developmental and early intervention approaches to understand how sleep in early stages associates with BPD could have significant clinical impact on these patients and could inform targeted therapeutic interventions.Keywords: sleep, borderline personality disorder, biosocial developmental model, childhood, adolescence, mechanisms

Point of care (PoC) devices are highly demanding to control current pandemic, originated from severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). Though nucleic acid-based methods such as RT-PCR are widely available, they require sample preparation and long processing time. PoC diagnostic devices provide relatively faster and stable results. However they require further investigation to provide high accuracy and be adaptable for the new variants. In this study, laser-scribed graphene (LSG) sensors are coupled with gold nanoparticles (AuNPs) as stable promising biosensing platforms. Angiotensin Converting Enzyme 2 (ACE2), an enzymatic receptor, is chosen to be the biorecognition unit due to its high binding affinity towards spike proteins as a key-lock model. The sensor was integrated to a homemade and portable potentistat device, wirelessly connected to a smartphone having a customized application for easy operation. LODs of 5.14 and 2.09 ng/mL was achieved for S1 and S2 protein in the linear range of 1.0–200 ng/mL, respectively. Clinical study has been conducted with nasopharyngeal swabs from 63 patients having alpha (B.1.1.7), beta (B.1.351), delta (B.1.617.2) variants, patients without mutation and negative patients. A machine learning model was developed with accuracy of 99.37% for the identification of the SARS-Cov-2 variants under 1 min. With the increasing need for rapid and improved disease diagnosis and monitoring, the PoC platform proved its potential for real time monitoring by providing accurate and fast variant identification without any expertise and pre sample preparation, which is exactly what societies need in this time of pandemic.

Introduction: Ventilator-associated pneumonia (VAP) is one of the major hospital-acquired infections in the intensive care unit (ICU). The Centers for Disease Control and Prevention (CDC) made changes in the definitions of VAP. In this study, we aimed to prospectively evaluate patients in the tertiary-level chest diseases ICU between December 2016 and May 2017 in terms of ventilator-related events using the new surveillance criteria for patients requiring invasive mechanical ventilation. Materials and Methods: Patients in the chest diseases ICU were prospectively evaluated in terms of VAP development, and the incidence was calculated according to the old and new CDC criteria. Results: A total of 82 patients (31 women, 51 men) were followed up in the chest diseases ICU. Twenty-four patients who met the new surveillance criteria (survived >4 days) with 1632 patient-days and 601 ventilator days were included in the study. The incidences of VAP according to the old and new criteria were 31.6 and 1.6 per 1000 ventilator days, respectively. Conclusion: Our data suggest that new CDC definitions underdiagnose pneumonia in the daily practice. We may conclude that it does not seem rational to switch to the newer VAP definitions in the daily practice from the elder CDC definitions.

Objectives: The aim of this study was to compare the antibacterial activity of ceftaroline versus vancomycin in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) meningitis in an experimental rabbit meningitis model. Methods: The antibacterial activity of ceftaroline was compared with vancomycin in the treatment of meningitis induced by MRSA strain ATCC 43300 in an experimental rabbit meningitis model. Quantitative cerebrospinal fluid (CSF) cultures were performed at the beginning of antibiotic treatment and 24 h and 73 h after the first antibiotic dose. Furthermore, in vitro time–kill data were investigated at 0, 2, 4, 6, 8, 12 and 24 h in sterile human serum. Results: The difference between the control group versus both treatment groups was significant when comparing the decrease in colony counts in CSF both at 24 h and 73 h after the first antibiotic dose (P

Vegetable oils can be considered as an alternative or emergency fuel for diesel engine. However, vegetable oils result in operational and durability problems for the long-term operation because of being much more viscous than diesel fuel. To eliminate this drawback, blending of vegetable oils with diesel fuel or alcohol is one of the most widely used techniques. In the existing literature, many studies are available on the measurement and prediction of density and viscosity of binary blends (especially biodiesel (BD)-diesel fuel (DF) blends), although, there is still the lack of comprehensive studies in which reliable density and viscosity data are presented, new regression models are proposed and compared with other regression models for waste cooking oil (WCO)-DF binary blends. Therefore, in the present study, (1) WCO was blended with DF on the volume basis of 2, 4, 6, 8, 10, 15 and 20 %, (2) the measurements of viscosities and densities of the binary blends were performed at various temperatures (278.15–343.15 K) in accordance with DIN 53015 and ISO 4787 standards, respectively, (3) the variations of viscosity and density values of binary blends vs. temperature were evaluated, (4) the new rational and exponential models as a function of temperature were fitted to the experimental data measured by the authors and Baroutian et al. (regarded as typically different data), and finally (5) the models were also compared to Yoon et al. and linear models, previously proposed by other authors, in order to investigate their reliability. According to results, (i) the best correlation was obtained by the rational model with the lowest maximum relative errors of 2.9679 % and 3.2725 % for the viscosity data measured by the authors (WCO-DF blends) and Baroutian et al. (palm oil (PO)-DF blends), and (ii) for the density data of WCO-DF and PO-DF binary blends, the best correlation was obtained using the exponential model giving the lowest maximum relative errors of 0.0470 % and 0.0581 %, respectively.

Nowadays, biodiesel is drawing attention as a renewable and clean alternative to fossil diesel fuel because of numerous advantages such as higher flash point, cetane number and density. However, the high viscosity of biodiesel is one of the critical shortcomings and it causes poor atomization, decrease in engine performance and increase in exhaust emissions. To overcome this shortcoming, in this study, the effects of main transesterification reaction variables on the viscosities of produced safflower oil methyl and ethyl esters (biodiesel) were investigated as a full factorial experimental design, and optimum parametric values giving the lowest viscosity were determined. Density and viscosity were measured according to ISO 4787 and DIN 53015 standards. Sodium ethoxide (C2H5ONa) was utilized as a catalyst, and 90 and 120 minutes of reaction duration were kept constant for methanolysis and ethanolysis reactions. According to the results, the optimal reaction parameters were determined as: 0.75 % catalyst concentration, 8:1 alcohol to oil molar ratio and 56 °C reaction temperature for methanolysis; 1.00 % catalyst concentration, 12:1 alcohol to oil molar ratio and 70 °C reaction temperature for ethanolysis. Based on the reaction parameters, the methyl and ethyl esters were produced with the lowest viscosities of 3.989 mm2/s and 4.393 mm2/s, respectively. In the light of results obtained in this study, similar studies on production of biodiesels from different oils and alcohols can be performed.

Nowadays, biodiesel and vegetable oils have received increasing attention as renewable clean alternative fuels to fossil diesel fuel because of decreasing petroleum reserves and increasing environmental concerns. However, the straight use of biodiesel and vegetable oils in pure form results in several operational and durability problems in diesel engines because of their higher viscosity than fossil diesel fuel. One of the most used methods for solving the high viscosity problem is to blend them with fossil diesel fuel or alcohol. The reliable viscosity and density data of various biodiesel-diesel-alcohol ternary blends or biodiesel-diesel binary blends are plentifully available in existing literature, however, there is still the scarcity of dependable measurement values on different biodiesel-diesel-vegetable oil ternary blends at various temperatures. Therefore, in this study, waste cooking oil biodiesel (ethyl ester) was produced, and it was blended with fossil diesel fuel and waste cooking oil at different volume ratios to prepare ternary blends. Viscosities and densities of the ternary blends were determined at different temperatures according to DIN 53015 and ISO 4787 standards, respectively. The variation in viscosity with respect to temperature and oil fraction and the change of density vs. temperature were evaluated, rational and exponential models were proposed for these variations, and these models were tested against the density and viscosity data measured by the authors, Nogueira et al. and Baroutian et al. by comparing them to Gupta et al. model, linear model, Cragoe model and ANN (artificial neural networks) previously recommended in existing literature.

This study examines the commitments of an alternative teacher education program in linking theory and practice, one of the most prominent problems of the field. This qualitative phenomenological study drew from semi-structured interviews with seven faculty members and associate instructors, electronic surveys with seven program students, participant observation and field notes in seminar sessions, one program faculty meeting, and one community meeting, and curriculum materials. The findings suggest that the design of the program and the roles and (inter)actions of the stakeholders within the program created a dialectical interplay. Linked with this interplay, Teachers' Society provided a setting for collaborative learning during which theory is extracted from experience.

The present study aims to examine the effect of the life skills training guide on the development of pre-service science teachers' professional knowledge of entrepreneurial skills. The study included 82 pre-service science teachers studying in the third year of a public university in Turkey during the 2019-2020 academic year. The data of the study, which was conducted with a one-group pre-test-post-test experimental design, were collected using the entrepreneurship skills professional knowledge test. The data were analyzed using the professional knowledge assessment rubric and entrepreneurship skill indicators. The results of the study revealed that there was a significant difference between the pre-and post-test scores of the pre-service teachers in favor of the post-test scores. Following the experimental process, their professional knowledge about entrepreneurship increased. However, the number of pre-service teachers who were able to improve their professional knowledge scores to a high level was limited. Furthermore, following the experimental process, there was an increase in the number of pre-service teachers who were able to develop appropriate activities for students to gain entrepreneurial skills and to prepare tools for measuring and evaluating students' entrepreneurial skills in a way to include stressed indicators. Consequently, the present study provides science teacher educators with educational activities that they can model within the scope of teaching professional knowledge of entrepreneurship skills to pre-service science teachers.

This study aims to evaluate mathematics curriculum used in social sciences high schools' preparatory classes based on Stufflebeam (CIPP) evaluation model in terms of context, input, process and product dimensions. With this aim, this study seeks to answer "How is preparatory class mathematics curriculum (PCMC) evaluated in terms of its context, input, process and products?" from the viewpoint of teachers and students. Case study method which is one of qualitative research methods is used in this study. The study is carried out in the first term of 2021-2022 academic year in a social sciences high school which uses National Ministry of Education's curriculum. Participants of the study are 65 students and four mathematics teachers. Mathematics achievement test and interview forms are used as data gathering tools. The results of the study revealed that both teachers and students have critical views of context, input, process and product dimensions of the curriculum; however, the criticisms intensify in process and product dimensions of the curriculum. Another finding of the study is that specific conditions of schools and characteristics of students and teachers have a major impact on commitment to curriculum, teaching-learning processes and learning outcomes. Some recommendations are made for implementers and researchers based on the findings of the study. [This article includes an extended summary in Turkish.]

This study was carried out to determine the effect of Scratch-based coding applications integrated into the 5E learning model used in science teaching on students' computational thinking skills and self-efficacy towards block-based programming. In addition, students' perceptions of the activity were measured after each Scratch activity, which was applied at different stages of the course and with different difficulty. The study employed the pretest-posttest control group less design, one of the quasi-experimental methods. The study sample consist of 22 6th grade students attending a public school in Turkey located in a district center in the Eastern Black Sea region. The study was carried out in a five-week period in the 2022-2023 academic years. Computational thinking scale and robotics attitude scale, self-efficacy perception scale related to block-based programming and activity perception scale were used as data collection tools. The data were analyzed using the dependent samples t-test. The findings suggest that computational thinking skills level of students and their self-efficacy perception related to block-based programming increased significantly with the Scratch-based activities integrated into 5E learning model applied in science subjects. In addition, students have positive attitudes towards these activities. Thus, it is recommended to apply Scratch-based coding applications in teaching science subjects.

Relevant literature has an unexplored question on how prediction-observation-explanation (POE) worksheets affect science process skills of students with mild intellectual disabilities (SMID). Therefore, this research aimed to examine the effect of POE worksheets developed for the "matter and its nature" subject on SMID's science process skills. Through pre-experimental research design, 12 fifth grade SMID participated in the research. To collect data, the researchers used science process skills development forms and rubrics to score their observations. During the teaching intervention, SMID implemented three POE worksheets, which included buzz 22 technique in the 'prediction' stage, hands-on experiments and QR codes in the 'observation' stage and snowball, learning gallery or card showing techniques in the 'evaluation' stage. The results indicated that the POE worksheets are effective at developing SMID's science process skills of the "matter and its nature" subject. This research recommends that future comparative research should unveil how the POE worksheets with/without active learning techniques impact the SMID's SPS.

Introduction: Hand hygiene is one of the most cost-effective infection control measures. In this multicenter study we analyzed the hand hygiene compliance observation results of 15 hospitals in Turkey. Materials and Methods: This study was performed in the intensive care units of 15 hospitals (eight tertiary-care educational hospitals, six state hospitals, and one private hospital) from 11 cities located in six regions of Turkey. The observations were made by infection control practitioners according to the World Health Organization (WHO) - Five Moments for Hand Hygiene (WHO-5) indications rule for hand hygiene and overall compliance rates were calculated. Observations were unblinded (healthcare professionals knew that they were observed). The study period included 2015 and 2016 calendar years. Results: There was a statistically significant increase in hand hygiene compliance rates in 2016 versus 2015. The overall number of hand hygiene opportunities and instances of compliance in 2015 and 2016 were 60071/78116 (76.9%) and 66551/83607 (79.6%) (p=0.0001), respectively. Nurses were the most compliant group in both years. The highest compliance was after body fluid exposure (88.2% in 2015 and 91.4% in 2016), while the lowest compliance was before patient contact (61.3% in 2015 and 65% in 2016). Conclusion: The presented data suggest that under unblinded observations, hand hygiene compliance seems to be in relatively acceptable rates in Turkey. Centers with compliance rates below the 50th percentile in any of the five moments should increase efforts to enhance compliance for that indication.

Introduction: Hand hygiene is one of the most effective infection control measures to prevent the spread of healthcare-associated infections (HCAI). Water, soap, paper towel and hand disinfectant must be available and adequate in terms of effective hand hygiene. The adequacy of hand hygiene products or keeping water-soap and paper towel is still a problem for many developing countries like Turkey. In this multicenter study, we analyzed the adequacy in number and availability of hand hygiene products. Materials and Methods: This study was performed in all intensive care units (ICUs) of 41 hospitals (27 tertiary-care educational, 10 state and four private hospitals) from 22 cities located in seven geographical regions of Turkey. We analyzed water, soap, paper towel and alcohol-based hand disinfectant adequacy on four different days, two of which were in summer during the vacation time (August, 27th and 31st 2016) and two in autumn (October, 12th and 15th 2016). Results: The total number of ICUs and intensive care beds in 41 participating centers were 214 and 2357, respectively. Overall, there was no soap in 3-11% of sinks and no paper towel in 10-18% of sinks while there was no alcohol-based hand disinfectant in 1-4.7% of hand disinfectant units on the observation days. When we compared the number of sinks with soap and/or paper towel on weekdays vs. weekends, there was no significant difference in summer. However, on autumn weekdays, the number of sinks with soap and paper towel was significantly lower on weekend days (p

The purpose of this research is to examine how working individually and as a team in solving pedagogical scenarios for teaching science subjects is reflected in the teaching preferences of preservice science teachers. This interpretive case study was conducted with 69 preservice science teachers studying at a university in eastern Turkey. The data of the study were collected using the teaching pedagogy preference form. The data analysis included descriptive analysis based on four instructional pedagogies: direct instruction, direct active, guided inquiry, and open inquiry. The research results revealed that preservice teachers did not sufficiently turn to inquiry-based teaching pedagogy for solving problem scenarios in both individual and teamwork. In addition, the results indicated that preservice science teachers' professional knowledge of teaching various science subjects is largely based on traditional teaching pedagogy. Based on these results, it is recommended that science educators use problem scenarios to reveal preservice teachers' inquiry-based teaching preferences.

Zero-valent iron (ZVI) represent a promising agent for environmental remediation. The research was aimed to determine the influence of copper in doses of 0, 80, 150, 300, and 600 mg Cu·kg−1 of soil as well as ZVI, and lignite additives on the content of macroelements in the Indian mustard (Brassica juncea (L.) Czern.). The average accumulation of analyzing elements in Indian mustard grown in copper contaminated soil were found to follow the decreasing order Mg > Na > P > Ca > K > N. Soil contamination at 600 mg Cu·kg−1 of soil led to the highest increase in P, Mg, N, and Ca content. The application of ZVI had a positive influence on the average phosphorus and potassium content of Indian mustard. Moreover, the application of ZVI and lignite had a positive influence on the average Mg and Ca content in the above-ground parts of Indian mustard. From the analyzed reactive materials, the application of lignite was shown to be the most effective resulting in the decrease in the average nitrogen and calcium content when compared to the control crop. Calcium content in plants from the control group, without the addition of zero-valent iron, and powered lignite (control), was positively correlated with increasing doses of copper.

Any science teacher must first acquire analytical thinking skills in order to give their students the ability to think analytically. Therefore, the candidacy period is important for teachers to develop and transform this skill into professional knowledge. Based on this idea, the current research aims to determine the ability of third-grade preservice science teachers to use analytical thinking skills. An Analytical Thinking Test is used in the research conducted survey method. This test consists of twenty case-based science scenarios in total from four different learning fields. These scenarios are designed according to the analytical thinking skill dimensions of Marzano's Taxonomy. Preservice science teachers (N=158) from two public universities have participated in the study. It was determined that the majority of preservice science teachers weakly used their analytical thinking skills. It was revealed that preservice science teachers had difficulties respectively in classification -- specification -- error analysis -- generalization -- comparison according to Marzano's taxonomy from most to least while solving scenarios. It is recommended that the science educators develop the designs to improve the analytical thinking skills of the candidates in the courses they conduct on the basis of the results of the research. In addition, science educators should pay attention to development in the dimensions of classification and specification by considering the alternative conceptions of the preservice science teachers.

Introduction: In this multicenter study, we analysed the magnitude of healthcare worker (HCW) [infection control practitioner (ICP), nurses and others] workforce in hospitals participated in the study. Materials and Methods: This study was performed in 41 hospitals (with intensive care units-ICU) located in 22 cities from seven regions of Turkey. We analysed the ICP workforce, nursing and auxiliary HCW (AHCW) workforce in ICUs, number of ICU beds and occupied beds in four different days [two of which were in summer during the vacation time (August 27 and 31, 2016) and two others in autumn (October 12 and 15, 2016)]. The Turkish Ministry of Health (TMOH) requires two patients per nurse in level 3 ICUs, three patients per nurse in level 2 ICUs and five patients per nurse in level 1 ICUs. There is no standardization for the number of AHCW in ICUs. Finally, one ICP per 150 hospital beds is required by TMOH. Results: The total number of ICUs, ICU beds and ICPs were 214, 2377 and 111, respectively in he 41 participated centers. The number ICPs was adequate only in 12 hospitals. The percentage of nurses whose working experience was 2. The number of patients per other HCW was minimum 3.75 and maximum 4.89 on weekdays and on day shift while it was minimum 5.02 and maximum 7.7 on weekends or on night shift. When we compared the number of level 1, 2 and 3 ICUs with adequate nursing workforce vs inadequate nursing workforce, the p value was