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The aim of this study was to develop a novel assessment tool utilizing Schlossberg's 4S model (Situation, Self, Support, and Strategies), with a specific focus on assessing the career transition of high school senior students to university. The study group consisted of high school students from five different high schools. The pilot and trial administration involved a total of 85 individuals; the exploratory factor analysis included an additional 1099 participants, and the confirmatory factor analysis collected data from 273 individuals. The reliability and validity approaches employed, such as expert opinions, exploratory and confirmatory factor analysis, test-retest administration, item discrimination, internal consistency findings, and model fit indices, all demonstrated satisfactory values, indicating that the scale is valid and reliable. The factor analysis research reveals that the scale comprises three distinct dimensions: situation, self, and support, with a total of 23 items. However, the dimension of strategies is needed to demonstrate an adequate fit for this research's specific demographics. This assessment instrument is anticipated to substantially impact the field of education by enhancing the ability of school counselors and teachers to intervene more effectively in students' career planning efforts.

This study aimed to determine the experiences of gifted children with autism spectrum disorder, their parents, and teachers with the COVID-19 pandemic and holistically reveal the reflections of the restrictions in this process and the transition to distance education on the lives and especially the education of gifted children with autism spectrum disorder (ASD). The study was designed with a phenomenological research design, one of the qualitative research methods. The study participants were gifted children with ASD, aged between 6-14 and continuing their education through inclusion, their parents and teachers. The research data were collected through semi-structured interviews and analyzed in detail by interpretive phenomenological analysis. As a result of the data analysis, two themes, "The impacts of the COVID-19 pandemic on life" and "Distance education and its impacts in the COVID-19 process", and 12 categories were reached. Recommendations were presented in line with the study findings and the literature.

We conducted a descriptive analysis and meta-analysis of single-case research design (SCRD) studies investigating the effectiveness of the graduated guidance procedure. Once we identified studies through electronic databases and reference lists, we used What Works Clearinghouse (WWC) Standards to evaluate each study. Then, we described studies in terms of various descriptive variables, calculated effect sizes through three non-parametric effect size methods, and analyzed results across studies. Results showed 11 of the 27 studies met WWC Standards or met standards with reservation. Of the 11, seven studies resulted in a large effect. We found the graduated guidance procedure to be an evidence-based practice when evaluating the findings against contemporary evidence standards. However, this review also showed that the majority of the reviewed studies (n = 20) had no effects and only one third of the studies had moderate or strong effects. Implications for researchers and practitioners are discussed.

BackgroundThe optimal timing of noncardiac surgery (NCS) following transcatheter aortic valve replacement (TAVR) for aortic stenosis has not been elucidated by current national guidelines.ObjectivesThe aim of this study was to evaluate the effect of the time interval between TAVR and NCS (Δt) on the perioperative risk of major adverse events (MAEs).MethodsAll adult admissions for isolated TAVR for aortic stenosis were identified in the 2016 to 2020 Nationwide Readmissions Database. Patients who received NCS on subsequent admission were included for analysis and grouped by Δt as follows: ≤30, 31 to 60, 61 to 90, and >90 days. Multivariable regression models were constructed to examine the association of Δt with ensuing outcomes.ResultsOf 3,098 patients (median age = 79 years, 41.6% female), 19.1% underwent NCS at ≤30 days, 22.9% at 31 to 60 days, 16.7% at 61 to 90 days, and 41.3% at >90 days. After adjustment, the odds of MAEs were similar for operations performed at ≤30 days (adjusted OR [AOR]: 1.05; 95% confidence interval [CI]: 0.74-1.50), 31 to 60 days (AOR: 0.97; 95% CI: 0.71-1.31), and 61 to 90 days (AOR: 0.95; 95% CI: 0.67-1.34), with those at >90 days as reference. When examining the average marginal effect of the interval to surgery, risk-adjusted MAE rates were statistically similar across Δt groups for elective status and NCS risk category combinations.ConclusionsNCS within 30, 31 to 60, or 61 to 90 days after TAVR was not associated with increased odds of MAEs compared with operations after 90 days irrespective of NCS risk category or elective status. Our findings suggest that the interval between NCS and TAVR may not be an accurate predictor of MAE risk in this population.

Türkiye’de anayasal bir hak olan sağlık sosyal, ekonomik ve siyasi olaylar ile iç içe bir kavramdır. Cumhuriyetin kuruluşundan günümüze kadar Türkiye’de sosyal, ekonomik ve siyasi değişime neden olan olayların kronolojik olarak ele alındığı bu çalışmanın amacı yaşanan dönüşümün Türkiye’nin sağlık politikaları üzerindeki etkilerini ve devletin sağlık politikaları üzerindeki rolüne bağlı olarak sağlık bütçesinin nasıl değişim gösterdiğini incelemektir. Bu amaçla, sağlık politikaları 1923-1960, 1961-1979, 1980-2023 yılları olmak üzere üç ana döneme ayrılmıştır. Devletin sağlık politikaları üzerindeki rolünün sağlık bütçesi üzerinde etkili olup olmadığı sorgulanmıştır. Nitel bir araştırma yönteminin tercih edildiği çalışmada Cumhuriyetin ilanından günümüze kadar sağlık harcamalarına bütçeden ayrılan pay ilgili kurumların ürettiği ikincil verilerden yararlanarak tanımlayıcı istatistik yöntemlerle analiz edilmiştir. Sonuç olarak Sağlık Bakanlığı için bütçeden ayrılan pay genel olarak artış göstermekle birlikte devletin sağlık alanındaki rolüne ve izlediği sağlık politikalarına dayalı olarak Sağlık Bakanlığına ayrılan bütçenin payının merkezi bütçe içindeki ağırlığının değişim gösterdiği görülmüştür. Artan sağlık harcamalarına paralel olarak Sağlık Bakanlığı için bütçeden ayrılan payın kullanım alanlarının da bütçenin etkin kullanımını sağlayacak şekilde tahsis edilmesi önem taşımaktadır.

Objective: The aim of this study was to determine the long-term clinical, laboratory and radiologic findings, long-term follow-up findings after acute infection and complications in patients who recovered from COVID-19 infection, especially in patients with insufficient data on long-term effects.Material and Method: Patients who were admitted to the pulmonology outpatient clinic of our hospital and recovered from COVID-19 infection were included in the study. Demographic data, peripheral oxygen saturation, mMRC score, 6-minute walk test data, ongoing symptoms, laboratory data, radiologic findings and complications during follow-up were recorded. Patients admitted up to the first 4 weeks from the time of diagnosis were grouped as visit 1, patients admitted between 4 and 12 weeks were grouped as visit 2, and patients admitted after 12 weeks were grouped as visit 3.Results: A total of 520 patients were evaluated, including 190 patients at the first visit interval, 203 patients at the second visit interval and 127 patients at the third visit interval, including duplicate patients. 54% of the participants were female, 46% were male and the mean age was 54 years. Patients had at least one ongoing symptom in 96.3%, 90.6% and 89.8% of the visits, respectively. The most common symptoms were exertional dyspnea, fatigue and cough. The most common pathologic radiographic findings were ground glass opacities in the early period and linear/reticular opacities in the late period. The rates of complications during follow-up were 4.7%, 23.2%, 24.4% according to the visit intervals, respectively and the most common complication was pulmonary fibrosis.Conclusion: COVID-19 patients; while struggling with the problems associated with the acute disease in the early period, they also have to struggle with persistent symptoms and newly developing complications in the long term. In this context, we think that our study will form a basis for the data of our country and contribute to the literature.

Background: Severe burns induce volume shifts via capillary leaks, eventually requiring massive fluid resuscitation and promoting tissue edema. Albumin may help to mitigate the edema, thereby improving perfusion. This study shows that sublingual microcirculation measurements can quantify both tissue perfusion and edema. Methods: This prospective observational study was conducted between November 2018 and December 2019 in the intensive care unit of Maasstad Hospital Burn Center, Rotterdam, The Netherlands. Patients with severe burns affecting >15% of the total body surface area were included. Fluid management was conducted in accordance with the Parkland formula. Albumin (20%) was administered at a rate of 0.5 mL/(kg·h), starting 12 h after the burn incident. Alterations in the sublingual microcirculation, including capillary perfusion and density, were measured at admission (T0) and 4 h (T4) and 12 h (T12) after admission. Sublingual depth of focus (DOF) of the microcirculation was used to quantify the tissue edema. Results: Nine patients were recruited with a mean total body surface area of 36% ± 23%. By T12, a median of 4085 mL (interquartile range [IQR]: 3714–6756 mL) of crystalloids and 446 mL (IQR: 176–700 mL) of 20% albumin were administered. The DOF increased significantly after crystalloid administration (T4 vs. T0, mean difference [MD]=27.4 µm, 95% confidence interval [CI]: 3.4 to 50.9, P=0.040). Following albumin administration, DOF significantly decreased (T12 vs. T4, MD=−76.4 µm, 95% CI: −116.6 to −36.1, P=0.002). Total vessel density decreased significantly with crystalloid administration (T4 vs. T0, MD=−3.5 mm/mm2, 95% CI: −5.7 to −1.4, P=0.004) but increased after albumin administration (T12 vs. T4, MD=6.2 mm/mm2, 95% CI: 3.2 to 9.3, P=0.001). Conclusion: Sublingual microcirculation measurement of DOF and other parameters provide a valuable tool for the assessment of tissue perfusion and edema in patients with severe burns. Further investigation is required to evaluate the role of albumin in increasing microcirculatory convection and reducing tissue edema.

After the Volkswagen AG Emission Crisis, the automobile industry took special measures in terms of marketing, business management and other managerial sides. This research aims to measure the after-crisis period and whether or not other companies take necessary financial measures toward environmental sustainability. Basic OLS Regression and OLS Regression with dummy variables are utilized on the market-adjusted financial returns of the companies. There are three important findings of this research. Volkswagen AG suffered from the emission crisis not only on the marketing side but also in terms of financial management. Secondly, Mercedes AG and BMW AG did not take the necessary financial lessons from the Volkswagen Emission Crisis because of the same results. And thirdly sustainability variables have an impact on financial management near reputation and brand management. According to findings and discussions, the behaviour of the investors toward the emission scandals is negative. They are comprehensively impacted by these events. The situation can be more complex if corporal investors are added to this equation. Also, It seems that Mercedes AG and BMW AG did not take the necessary lessons from the emission scandal of Volkswagen AG despite of 3 years between events in terms of corporal financial management and automobile-technical details. More interestingly, sustainability or environmental sustainability is one of the main elements not only for the marketing and branding sides of the business but also for the financial management side of corporal management. The sustainability policies of these brands should include financial management. This situation will help the investors and companies if a new sustainability crisis occurs in the market with exact information.

There is a growing emphasis to improve every student's academic, social-emotional, and career and college development as schools strive to design and deliver comprehensive counseling programs that support students' development in these areas. The purpose of this study is to explore a large urban high school teachers' counselors and admins' perspectives on improving a high-poverty urban school's counseling services to extend school leaders' and counselors' knowledge about delivering effective school counseling programs as, ultimately, success lies with an effective principal and school counselor partnership. Particularly, data from our study will allow urban school principals and school counselors to identify the high and low program needs of urban students to become college, career, and life ready. The next set of comparisons was conducted for social-emotional needs. Like academic development needs, the entire ANOVA summary tables showed non-significant differences. The findings indicated that some responses varied significantly across (1) special education faculty, (2) regular classroom teachers and (3) school counselors in terms of rating of students' counseling needs. School leaders and school counselors can apply the findings of this study to create systemic and comprehensive student services in their schools. Particularly, school leaders and counselors can apply the results in decision-making, discussions, and time allocation in prevention/education versus reactive/responsive academic and counseling services.

There is widespread acknowledgement that importance of reading skill is increasing day by day. Reading is the first step to learning and revealing something new. Beyond the primary grades, it plays a vital role in keeping up with the requirements of the age. Individuals who read, understand, question, think and produce develop societies. Thus, it is inevitable that individuals who have difficulties in acquiring reading skill will encounter difficulties both in school life and in society. To remove barriers of people presence in academic and daily life, students with these difficulties should be identified as early as possible and the difficulties they experience should be eliminated. The proficiency of primary school pre-service teachers regarding the concepts of "reading'' and "reading difficulty'' gives clues for identifying and remedying individuals with reading disabilities. It is aimed to determine the metaphorical perceptions of primary school pre-service teachers towards the concepts of "reading'' and "reading disability'' in order to help address this issue. The study group of the research consists of 89 4th-grade primary school pre-service teachers who continue their education at a state university in the Black Sea Region in Turkey in the fall semester of the 2017-2018 academic year. The model of this research is phenomenology which is one of the qualitative research methods. A questionnaire developed by the researchers was used as a data collection tool. Content analysis method was used in the analysis of the data. Five different categories related to reading skills and reading disabilities emerged as a result of the analysis of the data. Categories related to the concept of reading skills are 'Discovering Something New', 'Fun Source', 'Embarking on Adventure', 'Decoding' and 'Other'. The categories related to the concept of reading disability are 'Difficulty', 'A problem in itself', 'Visual impairment', 'Deficiencies' and 'An insurmountable problem'. [This study was presented as an oral presentation at the 17th International Primary Teacher Education Symposium 11-14 April 2018/Ankara.]

The purpose of this research is to investigate how Web based and computer technologies impact studies, in teaching Turkish as a foreign language. Through a qualitative approach the study extensively explores this subject matter. To examine studies related to the use of Web based technology in teaching Turkish, a document analysis technique was employed. Data were collected from scientific journal articles and thesis studies published between 2010 and 2023 with a focus on teaching Turkish as a foreign language using Web based technology. The research specifically looked at studies conducted from 2010 onwards and twelve articles and thesis studies on the subject were examined. These studies demonstrated the effects of Web 2.0 tools and applications like Voki, Kahoot! ChatGPT, blogs and podcasts on language learning processes. The findings indicate that effectively integrating technology into language instruction plays a role in enhancing students language skills and motivation. Furthermore, remote education platforms have the potential to revolutionize language learning experiences. The results also highlight that technology supported experimental studies can be successfully utilized in teaching Turkish as a foreign language. Overall, these findings emphasize the potential of technology and Web based applications, in language instruction.

Purpose: This study aims to develop and validate a scale to determine university students' attitudes toward assessment and evaluation in online exams. Background: Measuring students' attitudes toward online exams is crucial, especially in the context of emergency transitions to online learning and the impact of external factors such as the COVID-19 pandemic. Students' perspectives on online examination practices in higher education institutions are significant in understanding students' attitudes and perceptions of online exams for effective implementation. Method: During the developmental phase of the scale, 13 items were created and presented for expert opinion. The scale propositions are designed to question the compliance of the courses with the curricula in the online education process, the transparency of online exams, and the University's technological infrastructure for online exams. The participants in the study consist of 1095 students studying in different programs at the Vocational Schools of three foundation universities in Istanbul, and they were reached via e-mail. Explanatory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were conducted. Findings: The results obtained prove that the 13-question scale is valid and reliable and is a good measurement to determine university students' attitudes to online exams. Implications for Research and Practice: Attitudes are likely determinants of academic achievement. Furthermore, utilizing e-tests positively impacts higher education students' performance and participation in online testing. Therefore, it is essential to consider students' attitudes towards online exams to increase academic success in online courses and provide better learning outcomes. Thus, scale development plays a pivotal role in advancing knowledge within specific domains of social science research, and it is integral to ensuring the quality and reliability of online exam instruments used in higher education.

The purpose of this study is to examine the effect of the story map on elementary school firstgrade students' listening and reading comprehension levels and their attitudes towards reading in literacy teaching process. It was conducted on 69 students studying in the first-grade in an elementary school in the Western Black Sea region and assigned by matching. In the research, "Quasi-experimental Design", one of the quantitative research methods, was used. During the data collection process, the Reading Attitude Scale with "Garfield Picture" for 1-6thGrade Students to Turkish was implemented in the experimental and control groups as a pretest and post-test. While the story map was implemented in the lessons in the experimental group, the implementation process was completed by teaching the lesson without any implementation in the control group. The texts in which listening and reading comprehension questions were implemented included 26 narrative texts in the elementary school 1st-grade Turkish book. The data collected with the "Listening and Reading Comprehension Achievement Test" and Reading Attitude Scale with "Garfield "Picture for 1-6th-Grade Students to Turkish implemented after the experimental procedure were evaluated with the SPSS 20 statistical software. At the end of the study, it was concluded that the experimental group, in which the story map was implemented before the listening and reading comprehension questions, was more successful in comprehension than the control group. When the effects of the story map on the attitude towards listening and reading comprehension were examined, a positive improvement was found in listening and reading comprehension in the experimental group.

Sustainable urban transformation practices play a critical role in implementing the economic, environmental, and social dimensions of sustainable development in cities. Sustainability indices are important parameters for achieving sustainable development goals. The use of these indices supports the making of strategic decisions for the future of cities, such as in urban transformation practices. Indicators and data are defined as vital tools for evaluating the success of sustainability policies and monitoring the economic, environmental, and social performance of cities. Establishing more comprehensive and accessible data collection systems at the local level and effectively sharing this data is crucial for developing policies based on these indices. This study aims to emphasize the critical importance of sustainable urban transformation practices in relation to Sustainable Development Goals (SDGs) by showcasing the experiences gained during the development of a Sustainability Index for Bağcılar, a densely urbanized district in Istanbul. Bağcılar offers an important area of study in terms of sustainability with its dynamics such as rapid population growth, dense construction and socio-economic differences. Planning urban transformation projects within the framework of sustainability principles is a strategic necessity for Istanbul and similar metropolitan cities. By establishing a system that tracks regular, reliable, and internationally standardized data, it will be possible to create measurable, reportable, and comparable targets for sustainable urban transformation practices. However, in developing countries like Turkey, deficiencies in data collection and analysis processes make it difficult to achieve sustainability goals. This study suggests that improving data collection processes and increasing transparency are fundamental steps to ensuring sustainable urban transformation.

Aim: This study aimed to evaluate whether concomitant alcohol positivity is an effective factor in trauma characteristics and severity in geriatric trauma patients and evaluate the relationship with poor composite outcomes in alcoholic patients. Materials and Methods: Patients aged 60 and over who presented to the emergency department due to trauma and whose blood ethanol level was studied were included in the study. Patients were assigned to the poor composite outcome group according to the intensive care unit stay, need for emergency blood transfusion/operation, or in-hospital mortality, and the groups with and without poor composite outcomes were compared. Results: Three hundred thirty-six patients with complete data were included in the study. There were 101 patients with an ethanol level of >0.5 mg/dL. Ethanol-positive patients had more head trauma, and their Injury Severity Scores and liver function tests were higher (p

ÖZ: Bu araştırmanın amacı, genç yetişkinlerin romantik ilişki doyumlarını yordamada, retrospektif baba algıları ve duygu düzenleme becerilerinin incelenmesidir. Genç yetişkinlerin romantik ilişki doyumunu yordamak için bağımsız değişken olarak retrospektif baba algısı ve aracı değişken olarak duygu düzenleme becerisi incelenmiştir. Araştırmanın modeli çok faktörlü karmaşık yordayıcı kolerasyonel desendir. Araştırmanın çalışma grubu 21-35 yaş aralığında bulunan 392 genç yetişkinden oluşmaktadır. Araştırmada katılımcılara Kişisel Bilgi Formu, Baba Katılım Ölçeği, Baba Duygusal Yakınlık Ölçeği, Baba Bakım Verme ve Bağlanma Stilleri Ölçeği, Duygu Stilleri Ölçeği ve İlişki Doyumu Ölçeği uygulanmıştır. Araştırmada verilerin analizi AMOS Programı kullanılarak Yapısal Eşitlik Modellemesi (YEM) ile yapılmıştır. Yapılan YEM analizi sonucunda retrospektif baba algısı ile romantik ilişki doyumu arasında, duygu düzenleme/duyguları ayarlama becerisinin aracı rolüne dair modelin uyum indekslerinin iyi olduğu görülmüştür. Araştırma bulgularına göre, retrospektif baba algısının, romantik ilişki doyumu üzerinde doğrudan etkisinin anlamlı olduğu (β=.23), retrospektif baba algısının, becerisi üzerinde doğrudan etkisinin anlamlı olduğu (β=.24) ve duygu düzenleme/ duyguları ayarlama becerisinin romantik ilişki doyumu üzerinde doğrudan etkisinin anlamlı olduğu (β=.32) tespit edilmiştir. Araştırmada son olarak becerisinin retrospektif baba algısı ve romantik ilişki doyumu üzerinde kısmi aracılık etkisi olduğu (β=.059) sonucu elde edilmiştir. Sonuçlar alanyazındaki araştırmalar ve kuramsal bilgilerle karşılaştırılarak tartışılmıştır. Elde edilen bulgular doğrultusunda, uygulayıcı ve araştırmacılara yönelik önerilerde bulunulmuştur. ABSTRAC: This study aims to examine retrospectively father perceptions and emotion regulation style in predicting the romantic relationship quality of young adults. In the study, to predict the romantic relationship quality of young adults, retrospective father perception as an independent variable and emotion regulation style as a mediating variable were examined, and a model of the research is the multi-factor complex predictive correlational design. The study group of the research consists of 392 young adults between the ages of 21-35. The Personal Information Form, Father Participation Scale, Father Emotional Intimacy Scale, Father Care, Attachment Styles Scale, Emotion Styles Scale, and Relationship Satisfaction Scale were applied to the participants to test the research model. The data analysis in the research was made with Structural Equation Modeling (SEM) using the AMOS Program. As a result of the SEM analysis, it was determined that the fit indexes of the model on the mediating role of the ability to regulate emotions between the retrospective father perception and the quality of the romantic relationship were well. According to the research findings, retrospective father perception has a significant direct effect on romantic relationship quality (β=.23), also has a significant direct effect on emotion regulation ability (β=.24), and emotion regulation skill has a significant direct effect on romantic relationship quality (β=.32). Finally, it was concluded that the emotion regulation skills have a partial mediation effect (β=.059) on retrospective father perception and romantic relationship quality. The results were discussed and compared in line with the studies in the literature and theoretical information, and suggestions were made for practitioners and researchers according to the findings.

In this study, zinc oxide nanoparticles (ZnONPs), a promising alternative biomaterial, were synthesized using a non-toxic, cost-effective green synthesis approach using various fungal species (Penicillium citrinum, Fusarium solani, Aspergillus flavus and Aspergillus niger). The effect of different fungal species on the structural, optical, morphological and antimicrobial properties of ZnO nanoparticles (ZnONPs) was compared. ZnO nanoparticles (ZnONPs) crystallized in a hexagonal wurtzite structure with grain sizes ranging from 45 to 61 nm. Fungal species had a significant effect on the surface plasmon resonance (SPR) peak observed at 302 nm. ZnONPs were obtained in different morphologies such as nanodiscs, nanospheres, nanorchins and nanonuts, and it was determined that fungal species had a significant effect on these structures. The antibacterial activity of ZnONPs against Candida albicans, Streptococcus mutans, Pseudomonas aeruginosa, Eosinophilic pneumonia and Staphylococcus aureus was investigated. The effect of these nanoparticle shapes on antibacterial activity was evaluated. ZnONPs were found to have a significant antimicrobial effect especially on Candida albicans and Streptococcus mutans. ZnONPs produced only with Aspergillus niger fungus were found to have a strong antimicrobial effect especially on Staphylococcus aureus. Based on these results, the biosynthesis of ZnO nanoparticles (ZnONPs) using Penicillium citrinum, Fusarium solani, Aspergillus flavus and Aspergillus niger fungal species is proposed for the production of ZnONPs as a biomaterial with remarkable antibacterial properties and various morphologies.

Abstract Background Ticks are crucial vectors of a wide range of pathogens, posing significant threats to human and animal health globally. Understanding the genetic basis of tick biology and host–parasite interactions is essential for developing effective control programs. This study investigates the fine-scale genetic structure of Hyalomma marginatum Koch, 1844, the primary vector of Crimean-Congo hemorrhagic fever (CCHF) in Türkiye. Despite its significant public health importance, information regarding its population structure and genetic diversity is quite limited. Methods We used restriction site-associated DNA sequencing (RAD-Seq) to obtain genome-wide sequence data from 10 tick populations in Türkiye, collected from regions with low, moderate, and high incidence rates of CCHF. Based on these data, we determined population structure and diversity of populations using principal component analysis (PCA) and admixture analysis. Furthermore, we calculated pairwise FST and utilized discriminant analysis of principal components (DAPC) to understand genetic differentiation between populations. Results PCA and admixture analysis indicated minimal genetic structure between populations, but we detected notable genetic differentiation and high genetic diversity from regions with high CCHF rates. Furthermore, our DAPC identified 31 significant single-nucleotide polymorphisms (SNPs) associated with regions with high CCHF incidence, with 25 SNPs located near genes involved in critical biological functions such as nucleic acid binding, transmembrane transport, and proteolysis. These findings suggest that genetic variations in these regions may confer adaptive advantages in environments with high pathogen loads. Conclusions This study provides the first comprehensive analysis of H. marginatum genetic diversity in Türkiye, revealing significant differentiation in populations from CCHF-endemic regions. These results underscore the importance of considering fine-scale genetic diversity to fully understand the drivers of genetic variation in ticks and their implications for vectorial capacity. Graphical Abstract

Abstract Various processes, including benign or malignant (mostly metastasis) processes, contribute to the occurrence of multiple pulmonary nodules. For differential diagnosis, metastasis must be excluded as an etiological factor in patients who have multiple pulmonary nodules with a known primary malignancy. However, differential diagnosis of multiple pulmonary nodules caused by benign diseases and malignant processes is challenging. Multiple pulmonary nodules resulting from metastasis may mimic those resulting from infections, inflammatory processes, and rare benign diseases. Some rare diseases, such as pulmonary sclerosing pneumocytoma and pulmonary epithelioid hemangioendothelioma, or common diseases with a rare presentation of multiple nodules must be considered in the differential diagnosis of metastasis. In addition to the clinical and laboratory findings, radiological features are crucial for differential diagnosis. The size, density, location, and border characteristics (well-defined or poorly defined) of pulmonary nodules, as well as their internal structure (solid, subsolid, or ground glass nodule), growth rate during follow-up, and associated pulmonary and extrapulmonary findings are important for differential diagnosis along with clinical and laboratory data. This article summarizes the general features and imaging findings of these diseases, which less frequently present with multiple pulmonary nodules, and the clues that can be used to distinguish these diseases from metastasis. Critical relevance statement The radiological features, clinical findings, and temporal changes during follow-up are important in distinguishing non-metastatic causes of multiple pulmonary nodules from metastatic causes and guiding diagnosis and early treatment, especially in patients with primary malignancy. Key Points Multiple pulmonary nodules have a wide range of etiologies, including metastatic disease. Metastasis as an etiology must be excluded in patients with multiple pulmonary nodules. Correlation of radiological findings (nodule size, position, and associated findings) with clinical history is crucial for differential diagnosis. Graphical Abstract

Abstract Background The impact of routine preoperative anesthesia evaluations on potential perioperative complications remains unclear. This study aimed to investigate the effect of preoperative evaluation on early perioperative hemodynamic and respiratory complications. Methods This prospective observational study analyzed data from patients aged 18 to 80 who underwent elective surgery between October 15, 2023, and February 15, 2024. The study evaluated the effect of preoperative anesthesia evaluation on hemodynamic and respiratory complications occurring during surgery and within the first 24 h postoperatively, as well as its impact on the length of hospital stay. Results The analysis included 1117 patients for whom complete data was available. Hemodynamic and respiratory complications were observed in 545 patients (48.7%), occurring within the first 24 h intraoperatively and postoperatively. Because no additional examinations beyond routine blood tests, radiological imaging, and electrocardiograms were performed in the preoperative period, the impact of these tests on the development of hemodynamic and respiratory complications could not be determined. There was no statistically significant association between the presence or absence of preoperative consultation and the occurrence of early perioperative hemodynamic and respiratory complications [OR (95% CI): 0.879 (0.646–1.195); P = 0.411], nor did it affect the length of hospital stay [median (IQR); 2 (3) vs. 2 (3); P = 0.245]. Conclusion While the impact of routinely requested laboratory and imaging methods before surgery could not be assessed in this study, consultations that were requested did not affect hemodynamic and respiratory complications in the early perioperative period or on the duration of hospital stay. Trial registration number Samsun University Samsun Training and Research Hospital, following ethics committee approval (Samsun University clinical research ethics committee (KAEK) 2.12.2023) and Clinical Trials (NCT06203171 / 04.18.2024) registration.

Hotels that serve customers having different cultural values should improve their service capabilities to achieve customer satisfaction. This study researches how empathy, trust and cultural values affect hotel customer satisfaction and looks at the combinations of these components that lead to high customer satisfaction. The current literature on Hofstede’s five-dimensional cultural values, cognitive and affective dimensions of empathy, trust and customer satisfaction were used to develop the research model and present recommendations. To ensure cultural diversity, a face-to-face survey was administered to 553 tourists from six countries. The data obtained were evaluated using partial least squares structural equation modelling and fuzzy set qualitative comparative analysis (fsQCA). According to the results, the effects of hotel customers’ empathy levels on their satisfaction occur through their trust in the business. The fsQCA revealed combinations of cultural values, empathy and trust that would generate high levels of satisfaction. The present study contributes to the relevant literature by addressing the relatively under-emphasized components that ensure that hotel customers are highly satisfied.

Telehealth is a broad term that describes the use of communication technologies to deliver diagnoses and educational services. Recent guidelines for practicing telehealth indicate that interventions directly delivered to individuals with autism spectrum disorder (ASD) via telehealth may be appropriate and effective. However, as few studies have directly delivered interventions to individuals diagnosed with a disability via telehealth, more research is needed. This study examined the effects of telehealth-delivered simultaneous prompting combined with observational learning in young children with ASD. Two children aged 5 years who were diagnosed with ASD participated in this study. The students and implementers were located in different physical settings. A multiple-probe design across behaviors replicated across participants was used to examine the effects of the procedure. The students acquired the target and observational responses. Importantly, both students maintained the acquired responses one, two, and six weeks after the intervention and generalized them across different conditions. The students' teachers had positive opinions regarding the procedures and outcomes. The findings of this single-subject study have important implications for delivering interventions directly to young children with ASD via telehealth. The study's limitations and implications for future research are also discussed.

The study aimed to assess the effectiveness of a comprehensive intervention program (including PA and RAN interventions) on improving early literacy skills in preschoolers from low socioeconomic backgrounds while exploring participant perspectives. The experimental group showed significant improvements in PA, RAN-object, and RAN-color performance compared to the control group. These improvements were observed immediately after the intervention and were maintained even after a 16-week follow-up period. The experimental group's scores in PA, RAN-object, and RAN-color increased significantly from pretest to posttest and were further improved at the follow-up. These findings suggest that the interventions effectively enhanced participants' performance in these areas and that the experimental group consistently outperformed the control group. The intervention had a significant positive impact on early literacy performance, with the experimental group outperforming the control group. The findings highlight the effectiveness of the program and its favorable reception among families, teachers, and children.

The aim of this study is to characterize upper secondary school teachers' views on and use of digital learning resources (DLR) for teaching and explore whether there are differences between teachers' profiles in relation to demographic aspects. The data was collected through an online survey from a sample of 243 teachers from 23 upper secondary schools in Sweden. The survey included questions on why and how teachers used DLR for teaching. The data was analysed using exploratory factor, cluster, and post hoc analyses. Five different teacher profiles were identified: high, high general, medium, medium general, and low DLR capacity. These profiles differed significantly concerning self-reported skills, use, and purposes of DLR. Moreover, the five profiles also differ significantly on demographic factors such as teacher degree. These findings have important implications for the design of in-service teacher training and pre-service teacher education programs concerning teachers' skills, didactic purposes, and use of DLR.

This study investigated the effects of behavioral skills training (BST) in teaching earthquake preparedness skills to students with developmental disabilities within a small group arrangement. A multiple probe design across behaviors and replicated across participants evaluated the effectiveness of BST when teaching three high school students to prepare an earthquake emergency kit, do drop-cover-hold, and share location through a personal safety app. All students acquired, maintained, and generalized the target behaviors. Participating students and their teachers had positive opinions regarding the target behaviors, procedure, and outcomes. Limitations and implications for future research are discussed.