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With the effect of the pandemic, higher education is maintained all over the world with the help of online education methods. How to make online exams, which are an important part of distance education processes, in a way to prevent cheating and illegal behavior is an important issue that brings with it discussions. This research, in which the solutions to this issue were discussed theoretically, evaluated in terms of educational sciences, and the studies carried out in this context were examined, was carried out in the form of a systematic review. Within the scope of the research, the data of 15 studies were evaluated. The findings of the research were evaluated in a way that will reveal the trends in this subject, the results of the researches and compare the proctored exams and unproctored exams. Based on the findings, it has been determined that the proctored exam application, in which various technology-based authentication and supervision methods are used in online education processes, is beneficial to use these methods with the same technological opportunities to prevent cheating. It can be said that these efforts can be effective for assessment and evaluation processes, and unproctored applications can be used in online education in various ways.

The purpose of this study was to examine pre-service teachers' treatment integrity (TI) in the use of constant time delay (CTD) and simultaneous prompting (SP) while teaching discrete and chained behaviours. A descriptive research design was used. A total of 28 pre-service special education teachers (16 females and 12 males), whose ages ranged from 20 to35 years, participated in the study. The data were collected by applying four different observation and self-assessment checklists to video recordings. A descriptive analysis was conducted. The findings reveal that pre-service teachers implemented CTD and SP in discrete behaviours with higher TI than the CTD and SP in chained behaviours. Recommendations for future research and practice are provided.

The modulatory effect of C-Vx, a novel therapeutic agent, on the immune system of COVID-19 patients was investigated. The functions of T and NK cells of COVID-19 patients with different disease severity were evaluated by flow cytometry in response to C-Vx stimulation. The levels of pro- and anti-inflammatory cytokines were detected by multiplex assay in supernatants after cell culture with C-Vx. Bradykinin, IRF3, and IFN-α levels were also measured by ELISA in the presence or absence of C-Vx stimulation. As a result, increased CD107a expression was observed on NK cells in response to C-Vx addition. The proliferation of T cell subsets was increased by C-Vx, decreasing by disease severity. IL-4 and IL-10 levels were elevated while IFN-γ and IL-17 levels were reduced in T cells following C-Vx stimulation. However, the levels of pro-inflammatory IL-1β, IL-6, IL-8, IFN-γ and GM-CSF were significantly increased upon C-Vx stimulation. IFN-α levels tended to increase after incubation with C-Vx. These findings support an immunomodulatory action of C-Vx on the immune system of patients with a mild and moderate phase of COVID-19.

Abstract Background Type 1 diabetes (T1D) is a T-cell-mediated autoimmune disease characterized by the irreversible destruction of insulin-producing β-cells in pancreatic islets. Helper and cytotoxic T-cells and cytokine production, which is impaired by this process, take a synergetic role in β-cell destruction, and hyperglycemia develops due to insulin deficiency in the body. Mesenchymal stem cells (MSCs) appear like an excellent therapeutic tool for autoimmune diseases with pluripotent, regenerative, and immunosuppressive properties. Paracrine factors released from MSCs play a role in immunomodulation by increasing angiogenesis and proliferation and suppressing apoptosis. In this context, the study aims to investigate the therapeutic effects of MSC’s secretomes by conditioned medium (CM) obtained from human umbilical cord-derived MSCs cultured in 2-dimensional (2D) and 3-dimensional (3D) environments in the T1D model. Methods First, MSCs were isolated from the human umbilical cord, and the cells were characterized. Then, two different CMs were prepared by culturing MSCs in 2D and 3D environments. The CM contents were analyzed in terms of total protein, IL-4, IL-10, IL-17, and IFN-λ. In vivo studies were performed in Sprague-Dawley-type rats with an autoimmune T1D model, and twelve doses of CM were administered intraperitoneally for 4 weeks within the framework of a particular treatment model. In order to evaluate immunomodulation, the Treg population was determined in lymphocytes isolated from the spleen after sacrification, and IL-4, IL-10, IL-17, and IFN-λ cytokines were analyzed in serum. Finally, β-cell regeneration was evaluated immunohistochemically by labeling Pdx1, Nkx6.1, and insulin markers, which are critical for the formation of β-cells. Results Total protein and IL-4 levels were higher in 3D-CM compared to 2D-CM. In vivo results showed that CMs induce the Treg population and regulate cytokine release. When the immunohistochemical results were evaluated together, it was determined that CM application significantly increased the rate of β-cells in the islets. This increase was at the highest level in the 3D-CM applied group. Conclusion The dual therapeutic effect of MSC-CM on immunomodulation and homeostasis/regeneration of β-cells in the T1D model has been demonstrated. Furthermore, this effect could be improved by using 3D scaffolds for culturing MSCs while preparing CM.

We explored the self-reported antibiotic stewardship (AS), and infection prevention and control (IPC) activities in intensive care units (ICUs) of different income settings. A cross-sectional study was conducted using an online questionnaire to collect data about IPC and AS measures in participating ICUs. The study participants were Infectious Diseases–International Research Initiative (IDI-IR) members, committed as per their institutional agreement form. We analyzed responses from 57 ICUs in 24 countries (Lower-middle income (LMI), n = 13; Upper-middle income (UMI), n = 33; High-income (HI), n = 11). This represented (~5%) of centers represented in the ID-IRI. Surveillance programs were implemented in (76.9%−90.9%) of ICUs with fewer contact precaution measures in LMI ones (p = 0.02); (LMI:69.2%, UMI:97%, HI:100%). Participation in regional antimicrobial resistance programs was more significantly applied in HI (p = 0.02) (LMI:38.4%,UMI:81.8%,HI:72.2%). AS programs are implemented in 77.2% of institutions with AS champions in 66.7%. Infectious diseases physicians and microbiologists are members of many AS teams (59%&50%) respectively. Unqualified healthcare professionals(42.1%), and deficient incentives(28.1%) are the main barriers to implementing AS. We underscore the existing differences in IPC and AS programs’ implementation, team composition, and faced barriers. Continuous collaboration and sharing best practices on APM is needed. The role of regional and international organizations should be encouraged. Global support for capacity building of healthcare practitioners is warranted.

Abstract Background The therapeutic potential of mesenchymal stem cells (MSCs)-derived conditioned media (CM) can be increased after preconditioning with various chemical agents. The aim of this study is comparative evaluation of effects of N-CM and DFS-CM which are collected from normal (N) and deferoxamine (DFS) preconditioned umbilical cord-derived MSCs on rat diabetic nephropathy (DN) model. Methods After incubation of the MSCs in serum-free medium with/without 150 µM DFS for 48 h, the contents of N-CM and DFS-CM were analyzed by enzyme-linked immunosorbent assay. Diabetes (D) was induced by single dose of 55 mg/kg streptozotocin. Therapeutic effects of CMs were evaluated by biochemical, physical, histopathological and immunohistochemical analysis. Results The concentrations of vascular endothelial growth factor alpha, nerve growth factor and glial-derived neurotrophic factor in DFS-CM increased, while one of brain-derived neurotrophic factor decreased in comparison with N-CM. The creatinine clearance rate increased significantly in both treatment groups, while the improvement in albumin/creatinine ratio and renal mass index values were only significant for D + DFS-CM group. Light and electron microscopic deteriorations and loss of podocytes-specific nephrin and Wilms tumor-1 (WT-1) expressions were significantly restored in both treatment groups. Tubular beclin-1 expression was significantly increased for DN group, but it decreased in both treatment groups. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL)-positive apoptotic cell death increased in the tubules of D group, while it was only significantly decreased for D + DFS-CM group. Conclusions DFS-CM can be more effective in the treatment of DN by reducing podocyte damage and tubular apoptotic cell death and regulating autophagic activity with its more concentrated secretome content than N-CM. Graphical Abstract

This study used a scoping review to examine the systematic instruction studies for individuals with disabilities published in the last four decades (1983–2022) in Türkiye. We included 332 single-case and 61 group experimental studies. We collected inter-rater reliability data for 30% of the studies and determined that the mean of inter-rater coefficients was 99.2%. The findings indicate that the studies have been mainly self-funded and performed by one or two special education researchers. Studies conducted with single-case studies were more prevalent than group experimental studies. Male participants were more than females, and more school-age children than infants and adults. Participants with intellectual disabilities and autism were the most frequently involved, and school-related academic and cognitive skills were the most commonly targeted. The most frequently used interventions were response prompting strategies, strategy instruction, video modelling and prompting, and direct instruction. Finally, we discussed the findings and made recommendations for practice and future research. [ABSTRACT FROM AUTHOR]

Background: The objective of this study was to evaluate the levels of Vascular Peroxidase 1 (VPO1), humanin, and MOTS-c in relation to miR-200c expression in untreated preeclamptic pregnancies, and to compare these findings with endoglin levels. Methods and results: In this study, blood samples were collected from preeclamptic patients presenting to the clinic prior to the initiation of treatment. The levels of endoglin, VPO1, humanin, and MOTS-c were measured using enzyme-linked immunosorbent assay (ELISA), while miR-200c expression was quantified using reverse transcription polymerase chain reaction (RT-PCR). Receiver operating characteristic (ROC) analysis was performed to assess diagnostic accuracy. Statistical significance was determined at p < 0.05. The levels of endoglin, VPO1, and miR-200c were found to be significantly elevated in the preeclampsia group compared to the control group (p < 0.05), whereas MOTS-c levels were significantly reduced (p < 0.05). No significant difference was observed in humanin levels between the two groups. A positive correlation was identified between endoglin levels and VPO1 (r = 0.943, p < 0.001), humanin (r = 0.421, p < 0.01), and uric acid (r = 0.314, p = 0.02) in the preeclamptic group. Conclusions: Our findings suggest that the elevation of VPO1 and miR-200c levels, along with the reduction of humanin and MOTS-c levels, may contribute to the increased endoglin levels and subsequent endothelial dysfunction observed in preeclampsia. These changes may be associated with the pathogenesis and severity of the disease. [ABSTRACT FROM AUTHOR]

The ability to consistently recognize an object despite variable sensory input is termed perceptual constancy. This ability is not innate; rather, it develops with experience early in life. We show that, when mice are naive to an odor object, perceptual constancy is absent across increasing concentrations. The perceptual change coincides with a rapid reduction in activity from a single olfactory receptor channel that is most sensitive to the odor. This drop in activity is not a property of circuit interactions within the olfactory bulb; instead, it is due to a sensitivity mismatch of olfactory receptor neurons within the nose. We show that, after forming an association of this odor with food, the sensitivity of the receptor channel is matched to the odor object, preventing transmission failure and promoting perceptual stability. These data show that plasticity of the primary sensory organ enables learning of perceptual constancy. [ABSTRACT FROM AUTHOR]

Purpose: Immunocompromised hosts are underrepresented in clinical trials. The goal of the study to search for the unmet needs in the management of CAP in immunocompromised hosts. Patients and Methods: An observational study was conducted with CAP patients documented immunocompromise or those aged over 65 who have at least one chronic visceral disease. We clinically assessed the eligible patients at the time of the presentation with a follow-up assessment on day three of admission. The data were statistically analyzed to assess the impact of variables on mortality. Results: During a 15-month study period, 140 CAP patients were observed. The overall 30-day mortality rate was 17.8%. The mortality rate was significantly higher in patients with sputum cultures positive for Pseudomonas aeruginosa, or two bacteria (p=0.049). Tachypnea was a stronger predictor of mortality. Failure to achieve a treatment response within three days of treatment identified the population with the worst outcomes. Less than half of such patients survived past one month. Conclusion: Dynamic response assessment emerged as potentially the strongest predictor of outcomes in CAP of susceptible hosts. We propose that immunocompromised CAP patients who fail to respond early to treatment face extremely high rates of mortality, identifying an unmet need. [ABSTRACT FROM AUTHOR]

In recent years, lignocellulosic materials have become regarded as attractive and noteworthy natural resources owing to their renewability, recyclability, easy processability, abundance, biodegradability, and low cost. The developments in nanotechnology have opened new doors in the field of bio-based nanosensor technology, which is utilized in electronics, optical products, communication, automotive, packaging, tissue engineering, biomedical, textile, etc. This paper mainly focuses on the usage of lignocellulosic materials in nanosensors. [ABSTRACT FROM AUTHOR]

Aim: The objective of this study is to explore the association between inflammation and the severity of hypertension by analyzing inflammation biomarkers, such as CRP, IL-1, proBNP, leptin, and PTX-3 levels, in children with obesity-related hypertension. Material and Methods: The study included 30 children (20 girls, 10 boys) with obesity-related hypertension and 30 healthy children (22 girls, 8 boys) as controls. Clinical and demographic data were collected for all participants. Echocardiographic measurements of left ventricular systolic and diastolic diameters, volumes, and wall thicknesses were taken and adjusted for body surface area. After echocardiographic evaluation, blood samples (10 cc) were drawn from both groups to measure IL-1, CRP, leptin, proBNP, and PTX-3 levels. Results: The patient group had significantly higher systolic and diastolic blood pressure, height, weight, and body mass index compared to the control group. Echocardiographic assessments revealed significantly increased interventricular diastolic diameter (IVSd), left ventricular diastolic diameter (LVIDd), left ventricular posterior wall diastolic diameter (LVPWd), interventricular systolic diameter (IVSs), and left ventricular systolic diameter (LVIDs) in the patient group. Leptin and CRP levels were notably higher in the obesity group. In healthy children, there was a moderate positive correlation between leptin and systolic blood pressure. A moderate negative correlation was observed between proBNP and systolic blood pressure, and a weak positive correlation between leptin and diastolic blood pressure was noted in the obesity group. Leptin, blood pressure, height, weight, body mass index, and cardiac dimensions were significantly elevated in obese patients requiring anti-hypertensive treatment. Conclusion: Inflammatory markers may be crucial for early diagnosis of obesityrelated hypertension, guiding the development of therapeutic approaches to reduce target organ damage. Elevated inflammation markers in obese patients may indicate the severity of hypertension, aiding in organ damage prevention through lifestyle changes. [ABSTRACT FROM AUTHOR]

Aim: This study aims to determine the value of 24-hour Rhythm Holter monitoring (HM) in diagnosing and treating pediatric patients. Somebody reviewed our clinic's indications and results of 24-hour rhythm Holter monitoring. Materials and Methods: The files of 1670 patients who applied to our clinic between January 1, 2015 and December 31, 2022, were scanned retrospectively. Somebody retrospectively evaluated and recorded age, gender, reason for admission, presence of cardiac disease, presence of cardiac disease in the family, treatment histories, family consanguineous marriages, Electrocardiography (ECG) findings, Echocardiography (ECHO) findings, and HM findings were from the hospital computer archive files. Results: Found to be expected in 1,005 (60.2%) of the patients who underwent Holter monitoring (HM). Detected tachyarrhythmia in 408 (24.4%) patients, bradyarrhythmia in 85 (5.1%) patients, preexcitation syndrome in 73 (4.4%) patients, right bundle branch block in 27 (1.6%) patients, atrial-derived arrhythmia in 27 (1.6%) patients, genetic-related arrhythmia in 12 (0.7%) patients, pace rhythm in 12 (0.7%) patients, and other different Holter findings in 21 (1.3%) patients. Conclusion: Since arrhythmic symptoms often occur intermittently in childhood, detecting them at presentation may not be possible. A missed ECG taken at rest provides information for a short period of cardiac rhythm and many arrhythmias, so the 24-hour Holter method (HM) is helpful for diagnosis. Our study has supported that HM is used increasingly frequently and is beneficial as an easy-to-apply, noninvasive method in diagnosing arrhythmia and in monitoring and treatment planning of cases with arrhythmia. [ABSTRACT FROM AUTHOR]

In the study, we compared the effectiveness and efficiency of two error correction (EC) procedures--a model of the correct response (MoCR) and remove and re-present (RRp)--when using discrete trial training (DTT) in teaching to identify the community signs to children with autism spectrum disorder. We also examined the maintenance and generalization effects on children's behaviours and the preferences of neurotypical peers about the EC procedures. Four children participated in the study. We used an adapted alternating treatments design. The findings demonstrated that MoCR and RRp did not differ significantly in terms of their effectiveness, although DTT with MoCR was more efficient than DTT with RRp for all participants. Moreover, the findings revealed that all participants had maintained the behaviours, while three of the four participants were able to generalize. The neurotypical peers had a more definite preference for MoCR over RRp. Implications for future research were discussed. [ABSTRACT FROM AUTHOR]

Abstract Background To investigate the topographic measurements and densitometry of corneas in Wilson’s disease (WD) patients with or without a Kayser-Fleischer ring (KF-r) compared to healthy individuals. Methods This cross-sectional study included 20 WD patients without a KF-r (group I), 18 WD patients with a KF-r (group II), and 20 age-matched controls (group III). The Pentacam high resolution imaging system is used to determine corneal topographic measurements and densitometry. Results Mean age for groups I, II and III was 25.40 ± 6.43 years (14–36 years), 25.38 ± 6.96 years (16–39 years), 23.60 ± 6.56 years (17–35 years), respectively (P = 0.623). There was no significant difference between the groups in terms of the anterior corneal densitometry values (P > 0.05), while the 6–10 mm and 10–12 mm mid stroma and the 2–6 mm, 6–10 mm, and 10–12 mm posterior corneal densitometry values in group II were significantly higher than those in groups I and III (for all values, P

Abstract Background Tuberculous meningitis (TBM) represents a diagnostic and management challenge to clinicians. The “Thwaites’ system” and “Lancet consensus scoring system” are utilized to differentiate TBM from bacterial meningitis but their utility in subacute and chronic meningitis where TBM is an important consideration is unknown. Methods A multicenter retrospective study of adults with subacute and chronic meningitis, defined by symptoms greater than 5 days and less than 30 days for subacute meningitis (SAM) and greater than 30 days for chronic meningitis (CM). The “Thwaites’ system” and “Lancet consensus scoring system” scores and the diagnostic accuracy by sensitivity, specificity, and area under the curve of receiver operating curve (AUC-ROC) were calculated. The “Thwaites’ system” and “Lancet consensus scoring system” suggest a high probability of TBM with scores ≤4, and with scores of ≥12, respectively. Results A total of 395 patients were identified; 313 (79.2%) had subacute and 82 (20.8%) with chronic meningitis. Patients with chronic meningitis were more likely caused by tuberculosis and had higher rates of HIV infection (P

Abstract Background Treatment of pandrug-resistant isolates often necessitates combination therapy. Checkerboard synergy and time-killing assay tests were performed to evaluate the benefits of a triple combination with meropenem, ertapenem, and colistin against 10 colistin-resistant K. pneumoniae clinical isolates harboring different β-lactamases. (blaOXA-48, blaNDM). Materials and methods In this study, ertapenem and meropenem (ERT/MEM), meropenem and colistin (MEM/COL), ertapenem, meropenem and colistin (ERT/MEM/COL) combinations were tested using checkerboard techniques and time-kill assays of each antibiotic alone and in combination against 10 colistin-resistant clinical K. pneumoniae isolates. An analysis of K. pneumoniae isolate B6 using a scanning electron microscope revealed morphologic changes in the cell surface after treatment with each antibiotic both alone and in combination. The whole genome of K. pneumoniae KPNB1 was sequenced using an Ion Torrent PGM sequencer. Results According to the checkboard results, synergistic combinations were observed with ertapenem/meropenem (5/10 isolates), meropenem/colistin (7/10) and ertapenem/meropenem/colistin (9/10); no antagonism was observed for all combinations. For the time-kill assay results; synergism and bactericidal effects were observed with meropenem/colistin (10/10) and with ertapenem/meropenem/colistin (10/10) combinations, and an indifference effect was observed with the ertapenem and meropenem (10/10) combination. Strain number 1 was found 100% identical to Klebsiella pneumoniae subsp. pneumoniae HS11286 according to the outcomes of complete genome sequence analysis, and the strain carried the genes blaOXA-181, blaCTXM-15, blaNDM, arr-3, aac (6′)-Ib-cr, rmtF, and catB1. Conclusion Using double carbapenem antibiotics with colistin could be a potential alternative to treat colistin and carbapenem-resistant K. pneumoniae. The present study is the first Turkish report of OXA–181-type carbapenemase causing colistin resistance.