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Objectives: We aimed to present preoperative ultrasonographic features, distribution of histopathological diagnosis and molecular subtypes of malignant tumors, and to compare sonographic and pathological tumor dimensions in patients with subcentimeter breast lesions. Methods: Eighty six women with newly diagnosed breast cancer were included in the study who underwent preoperative biopsy and surgical resection between 2015 and 2020. Sonographically tumor margins were grouped as circumscribed, microlobulated, irregular-indistinct, angular and spiculated. By taking 25% of the pathological tumor size and value of ± 5 mm as cut-off, the presence of sonopathological concordance was evaluated. Results: The median tumor sizes were 10 mm (4-10 mm) sonographically and 11 mm (2-45 mm) histopathologically. The spiculated and irregular-indistinct margins were the most frequent sonog-raphic features (35% and 35%). Value of ±5 mm and 25% of the pathological tumor size according to cut-off, the sonopathological concordance rates were calculated as 74% and 55%, the underestimation rates were 20% and 35%, the overestimation rates were 6% and 10%, respectively. Conclusion: In our study, the most common sonographic features was spiculated and irregular-indistinct margins. We found sonopathological concordance rates similar to current literature. Especially in patients with DCIS, invasive lobular carcinoma, and HER2 enriched subtype, sonopathological discordance should be considered when planning the optimal treatment. [ABSTRACT FROM AUTHOR]

Ground-Penetrating Radar (GPR) can successfully image the buried archaeological findings depending on changes in the electromagnetic features of the researched materials. The GPR survey in the Akçakale (Kordyle) castle built in the 13th century was presented in this study. The castle is located at Akçakale district of Trabzon province on the Eastern Black Sea Coast of Turkey. The key focus of this research is to investigate whether there are archaeological findings in the inner area of the castle with GPR. For this purpose, GPR data were collected by using 250 and 500 MHz antennas at 95 transects within grid lengths ranging 30-50m in the study area. Anomalies considered to be important by evaluating the filtered data were marked on a sketch where the measurement lines are located. On this sketch, the overlapping areas of the anomalies obtained from the data in different directions on the measurement lines were shown by ellipses with red-cut as priority possible anomaly areas. Possible archaeological structures were been successfully determined from 2D and 3D images obtained GPR data in the study area. As a result, it has been suggested that archaeological excavations which will be planned in the study area should be conducted by considering these areas. After the excavations, archaeological findings which are compatible with anomalies were found in the studied area. Thus, it was seen that successful results were obtained with the GPR method in the study area. [ABSTRACT FROM AUTHOR]

Meningococcal carriage studies and transmission modeling can predict IMD epidemiology and used to define invasive meningococcal disease (IMD) control strategies. In this multicenter study, we aimed to evaluate the prevalence of nasopharyngeal Neisseria meningitidis (Nm) carriage, serogroup distribution, and related risk factors in Turkey. Nasopharyngeal samples were collected from a total of 1267 children and adolescents and were tested with rt-PCR. Nm carriage was detected in 96 participants (7.5%, 95% CI 6.1–9.0), with the peak age at 13 years (12.5%). Regarding age groups, Nm carriage rate was 7% in the 0–5 age group, was 6.9%in the 6–10 age group, was 7.9% in the 11–14 age group, and was 9.3% in the 15–18 age group. There was no statistically significant difference between the groups (p > 0.05). The serogroup distribution was as follows: 25% MenX, 9.4% MenA, 9.4% MenB, 2.1% MenC, 3.1% MenW, 2.1% for MenY, and 48.9% for non-groupable. The Nm carriage rate was higher in children with previous upper respiratory tract infections and with a high number of household members, whereas it was lower in children with antibiotic use in the last month (p < 0.05 for all). In this study, MenX is the predominant carriage strain. The geographical distribution of Nm strains varies, but serogroup distribution in the same country might change in a matter of years. Adequate surveillance and/or a proper carriage study is paramount for accurate/dynamic serogroup distribution and the impact of the proposed vaccination. [ABSTRACT FROM AUTHOR]

The purpose of the study is to examine the impact of early childhood teachersí reading attitudes, the total number of the books they have read about their profession, the total number of the books they have read on general topics, and their teaching experience on their teaching efficacy. Participants consist of 362 early childhood teachers from 51 different cities in Turkey. Of the 362 participants, 333 are female (91%) and 29 are male (9%). The ages of the teachers range from 21 to 50, with a mean age of 27.47. The participants responded to a personal questionnaire; Early Childhood Teachersí Teacher Efficacy Scale (ECTTES) and Reading Attitude Scale (RAS). Stepwise regression analyses for subtests CM, SE, PI, P and for total teaching efficacy indicate that reading attitude and teaching experience are significant predictors. For subtest C, reading attitude and age appear as significant predictors. For subtest IS, only reading attitude appears as a significant predictor. Accordingly, in order to improve early childhood teachersí reading attitudes, book clubs and peer reading groups are recommended. [ABSTRACT FROM AUTHOR]

Energy planning involves a perpetual process of reevaluating alternative energy strategies. Authorities responsible for energy planning and management have to adjust their strategies according to new and improved alternative solutions based on the sustainability criteria. In this study, we propose an integrated hybrid methodology for the analysis of Turkey’s energy sector using Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis, Analytic Network Process (ANP) process, and weighted fuzzy Technique for Order Performance by Similarity to Ideal Solution (TOPSIS) to formulate and holistically analyze the energy strategy alternatives and priorities. The methodology proposed in this study allowed identifying the relevant criteria and sub-criteria using a SWOT analysis. Then, ANP approach, which is one of the popular multi-criteria decision making (MCDM) methods, is employed to determine the weights of each SWOT factors and sub-factors. Finally, fuzzy TOPSIS methodology is conducted to prioritize alternative energy strategies. We discuss the obtained results for the development of long-range alternative energy strategies. The results showed that turning the country into an energy hub and an energy terminal by effectively using the geo-strategic position within the framework of the regional cooperation is the most important priority. On the other hand, using the nuclear energy technologies within the energy supply strategies found to be the least favored priority. [ABSTRACT FROM AUTHOR]

Aim: Multisystem inflammatory syndrome in children (MIS-C) may cause shock and even death in children. The aim of this study is to describe the clinical features, laboratory characteristics and outcome of children diagnosed with MIS-C in 25 different hospitals in Turkey., Methods: The retrospective study was conducted between 8 April and 28 October 2020 in 25 different hospitals from 17 cities. Data were collected from patients' medical records using a standardised form. Clinical and laboratory characteristics and outcomes according to different age groups, gender and body mass index percentiles were compared using multivariate logistic regression analysis., Results: The study comprised 101 patients, median age 7 years (interquartile range (IQR) 4.6-9.3); 51 (50.5%) were boys. Reverse-transcriptase polymerase chain reaction (PCR) assay was positive in 21/100 (21%) patients; 62/83 (74.6%) patients had positive serology for SARS-CoV-2. The predominant complaints were fever (100%), fatigue (n = 90, 89.1%), and gastrointestinal symptoms (n = 81, 80.2%). Serum C-reactive protein (in 101 patients, median 165 mg/L; range 112-228), erythrocyte sedimentation rate (73/84, median 53 mm/s; IQR 30-84) and procalcitonin levels (86/89, median 5 μg/L; IQR 0.58-20.2) were elevated. Thirty-eight patients (37.6%) required admission to intensive care. Kawasaki disease (KD) was diagnosed in 70 (69.3%) patients, 40 of whom had classical KD. Most patients were treated with intravenous immunoglobulin (n = 92, 91%) and glucocorticoids (n = 59, 58.4%). Seven patients (6.9%) died., Conclusion: The clinical spectrum of MIS-C is broad, but clinicians should consider MIS-C in the differential diagnosis when persistent fever, fatigue and gastrointestinal symptoms are prominent. Most patients diagnosed with MIS-C were previously healthy. Immunomodulatory treatment and supportive intensive care are important in the management of cases with MIS-C. Glucocorticoids and intravenous immunoglobulins are the most common immunomodulatory treatment options for MIS-C. Prompt diagnosis and prompt treatment are essential for optimal management., (© 2022 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)

Background: Cystic fibrosis (CF) registries play an essential role in improving disease outcomes of people with CF. This study aimed to evaluate the association of newly established CF registry system in Turkey on follow-up, clinical, growth, treatment, and complications of people with this disease., Methods: Age at diagnosis, current age, sex, z-scores of weight, height and body mass index (BMI), neonatal screening results, pulmonary function tests, history of meconium ileus, medications, presence of microorganisms, and follow-up were evaluated and compared to data of people with CF represented in both 2017 and 2019 registry data., Results: There were 1170 people with CF in 2017 and 1637 in 2019 CF registry. Eight hundred and fourteen people were registered in both 2017 and 2019 of whom z-scores of heights and BMI were significantly higher in 2019 (p = 0.002, p =0.039, respectively). Inhaled hypertonic saline, bronchodilator, and azithromycin usages were significantly higher in 2019 (p =0.001, p = 0.001, p = 0.003, respectively). The percent predicted of forced expiratory volume in  1 sec and forced vital capacity were similar in 2017 and 2019 (88% and 89.5%, p = 0.248 and 84.5% and 87%, p =0.332, respectively). Liver diseases and osteoporosis were significantly higher, and pseudo-Bartter syndrome (PBS) was significantly lower in 2019 (p = 0.011, p = 0.001, p = 0.001, respectively)., Conclusions: The z-scores of height and BMI were higher, the use of medications that protect and improve lung functions was higher and incidence of PBS was lower in 2019. It was predicted that registry system increased the care of people with CF regarding their follow-up. The widespread use of national CF registry system across the country may be beneficial for the follow-up of people with CF., (© 2022 Wiley Periodicals LLC.)

Crimean-Congo hemorrhagic fever (CCHF) is an acute tick-borne viral zoonotic disease which is endemic in Turkey. Bradycardia has been reported among pediatric and adult patients with CCHF. But, it remains unclear, whether bradycardia is associated with ribavirin treatment or the severity of CCHF. In this study 26 hospitalized CCHF patients were reviewed in terms of age, gender, history of tick bite, duration of hospitalization, presence of bradycardia, laboratory features, ribavirin treatment, and blood products requirement. The demographic, clinical, laboratory and treatment characteristics of CCHF patients with or without bradycardia were compared. The mean age of the patients was 126.42±48.21 months. There were 8 female and 18 male patients. Sinus bradycardia was noted in 15 patients (mean age was 120.20±50.59 months, 5 female). Ribavirin had been administered 18 (69.2%) patients and 11 of them had bradycardia. There was not statistically significant relationships between bradycardia and ribavirin treatment (p=0.683). Furthermore the occurrence of bradycardia was not associated with disease severity according to Swanepoel severity criteria (p=0.683). We concluded that independent of the disease severity and the ribavirin treatment, transient sinus bradycardia might occur during the clinical course of CCHF in pediatric patients. For this reason clinicians should be aware of this finding and all CCHF patients should be monitored closely., (Copyright © 2014 Elsevier GmbH. All rights reserved.)

Coalescent-based inference of phylogenetic relationships among species takes into account gene tree incongruence due to incomplete lineage sorting, but for such methods to make sense species have to be correctly delimited. Because alternative assignments of individuals to species result in different parametric models, model selection methods can be applied to optimise model of species classification. In a Bayesian framework, Bayes factors (BF), based on marginal likelihood estimates, can be used to test a range of possible classifications for the group under study. Here, we explore BF and the Akaike Information Criterion (AIC) to discriminate between different species classifications in the flowering plant lineage Silene sect. Cryptoneurae (Caryophyllaceae). We estimated marginal likelihoods for different species classification models via the Path Sampling (PS), Stepping Stone sampling (SS), and Harmonic Mean Estimator (HME) methods implemented in BEAST. To select among alternative species classification models a posterior simulation-based analog of the AIC through Markov chain Monte Carlo analysis (AICM) was also performed. The results are compared to outcomes from the software BP&P. Our results agree with another recent study that marginal likelihood estimates from PS and SS methods are useful for comparing different species classifications, and strongly support the recognition of the newly described species S. ertekinii.

Objective: We aimed to investigate the influence of reproductive factors on chronic respiratory symptoms and pulmonary function in a cross-sectional study of premenopausal and postmenopausal women 44-61 years of age., Methods: Self-reported data on respiratory symptoms were obtained from 1082 women. Usable forced expiratory volume in 1 second (FEV(1)) (2.27 +/- 0.44 L) and forced vital capacity (FVC) (2.75 +/- 0.55 L) measurements were obtained from 1070 women. The influence of reproductive factors on FEV(1), FVC, and chronic respiratory symptoms was assessed by linear and logistic regression analyses., Results: Menopause is associated with lower FEV(1) (p < 0.0001, r = -0.181) and FVC (p < 0.0001, r = -0.198) only in univariate analysis. The association disappears when age is adjusted for. However, association of menopause with increased odds of chronic cough plus phlegm is significant in multivariate analysis (odds ratio [OR] 1.84, 95% confidence interval [CI] 1.16-2.92, p = 0.0088). Among reproductive factors, only age at first birth is independently associated with FEV(1) (p = 0.01, r = 0.008) and FVC (p = 0.004, r = 0.013). Results were similar when restricting analyses to those who never smoked and after exclusion of asthmatics., Conclusions: Postmenopausal status is independently associated with increased odds of chronic cough plus phlegm, whereas it does not appear to be independently associated with FEV(1) or FVC. Among the reproductive factors, age at first birth is the only independent predictor of FEV(1) and FVC. These findings suggest that reproductive factors may influence women's pulmonary health.

Objective: The influence of body weight and weight change on age at natural menopause (ANM) is controversial. We aimed to explore these associations by overcoming two possible reasons for inconsistent findings: (1) a lack of information on weight change from a fixed time point up until menopause and (2) a possibility of capturing a spurious association between later ANM and greater weight gain because of a longer time span., Methods: Cross-sectionally, we evaluated static (body mass index [BMI] at age 25 y and height) and dynamic (history of premenopausal episodic weight loss and BMI gain rate) anthropometric indicators as predictors of ANM in Cox proportional hazards models. BMI gain rate was calculated based on weight change from age 25 y to menopause (or to current age in premenopausal women)., Results: Of 1,106 women, 46% were postmenopausal. Dynamic anthropometric indicators were stronger determinants of ANM compared with static indicators. Being in the higher quartile of BMI gain rate and having a history of episodic weight loss of more than 5 kg were independently associated with later ANM (hazard ratio [95% CI], 0.832 [0.765-0.905] and 0.433 [0.344-0.546], respectively). After controlling for history of episodic weight loss of more than 5 kg, smoking and premenopausal type 2 diabetes emerged as time-dependent predictors of ANM (hazard ratio [95% CI], 1.371 [1.093-1.720] and 1.640 [1.141-2.356], respectively)., Conclusions: Premenopausal BMI gain rate and premenopausal history of episodic weight loss of more than 5 kg are independently associated with later ANM. Smoking predicts an earlier menopause after the age of initiation and type 2 diabetes predicts an earlier menopause after the age of diagnosis. The latter two associations are significant only after adjusting for a history of episodic weight loss of more than 5 kg.

This report presents an evaluation of the impact of the 'Training of Trainers' (TOT) courses conducted since 1997. The effects of TOT programmes were studied using a questionnaire given to the course participants immediately after and again following a minimum period of six months after completion of the course. The 85 participants included in this analysis were medical teachers from the Istanbul Faculty of Medicine, of whom 17% were instructors, 39% were associate professors and 44% full professors. Some 72% of the medical teachers stated that they were able to implement the knowledge/skills they had acquired during the TOT course in their teaching. The majority of the participants reported more feedback from students and enhancement of student-faculty interaction in their teaching experience after the course. These results appear promising and indicate that TOT courses indeed motivate the teaching staff and provide them with tools and opportunities for more effective teaching. They also appear to have a lasting impact.