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This study was carried out within the scope of a nature education and science camp project. It aimed to investigate the effects of STEM activities conducted in out-of-school environments on teachers' STEM awareness and 21st-century skills. The research was designed according to the explanatory sequential pattern of the mixed method, and the quantitative and qualitative methods are the continuation of each other. Twenty-three science, elementary math, technology, and design teachers who worked at public middle schools participated in a six-day program that integrated STEM subjects with out-of-school learning. Seven different STEM-integrated out-of-school activities were implemented for six days in one of the central Anatolian regions in Turkey. STEM awareness and 21st-century skills scales were implemented in the study for data collection. A semi-structured interview was also conducted with teachers. The aim was for the teachers who participated in the project to integrate out-of-school and STEM education and then transfer this newly gained knowledge to their students. Both quantitative and qualitative findings support that teacher's acquisition of knowledge and skills throughout the science camp would support their students' craft, analytical thinking, motivation, problem-solving skills, and self-esteem. As such, out-of-learning environments should be used more in both STEM and 21st-century skills education.

Rill erosion, a significant issue in agricultural regions, is intricately linked to initial soil moisture conditions, affecting the development of concentrated flow erosion processes. However, understanding its dynamics amidst varying soil moisture conditions remain challenging. This study aimed to assess the impact of different soil moisture levels on rill erodibility parameters in the Water Erosion Prediction Project (WEPP) model and to evaluate soil cohesion across a spectrum of soils. Through laboratory experiments employing a small V-shaped rill channel, we investigated rill erodibility (Kr) and critical hydraulic shear stress (τcr), under three soil moisture scenarios: initially dry, saturated, and drainage, with incremental surface inflow rates. Additionally, we examined the efficiency of soil cohesion obtained from an Automated Soil Cohesion Measurement Apparatus in predicting Kr and τcr across various soil textures. Our analysis encompassed twenty soils representing nine texture classes, revealing significant correlations between basic soil properties, cohesion parameters, and WEPP model rill erodibility. Notably, initial soil moisture conditions exerted substantial influence on erodibility potentials. Soils with higher silt contents demonstrated better fits in terms of Nash-Sutcliffe model efficiency, particularly under initially dry and saturated conditions. However, predictions for initially drained soils yielded poor fits, emphasizing the intricate interplay between soil properties and hydrological conditions. In conclusion, our findings emphasize the critical role of topsoil water dynamics in rill erodibility. We propose that soil cohesion serves as a valuable predictor, complementing friction forces within the soil and enhancing simulations of rill erodibility under shallow flow conditions in rills, particularly in next-generation process-based modeling approaches.

Flooding is a natural disaster that causes loss of life and property worldwide. Floods can be predicted and their damages can be reduced. Various natural and man-made factors can cause floods. Sediment movement can be counted as one of the causes of floods, albeit rarely. The Sakarya River bed and river mouth is one of the risky areas for flooding due to sediment deposition. Due to the activities of quarries on the Sakarya River, the amount of sediment carried by the river increases, and the damage to the river bed morphology. In rare cases, the mouth of the river is completely closed due to sedimentation, which has caused many disasters such as coastal flooding and capsizing of marine vessels, leading to loss of life and property. Therefore, the occurrence of floods due to sediment deposition at the mouth of Sakarya River was investigated. The 5, 10, 25, 50, 100, and 500-year return period flows in the downstream part of the Sakarya River and Karasu district were analyzed with the 2D flood model in case of insufficient discharge from the river mouth. Water depth, velocity, and flood hazard maps for these return periods were prepared. The impact of flooding on Karasu district was analyzed in terms of affected buildings and affected area (ha). Thus, the effects of the floods occurring in the downstream region as a result of the interventions to the river bed in the upstream region were analyzed.

Abstract Background The clinical manifestations and course of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) exhibits considerable heterogeneity. In this study, we aimed to explore radiographic progression over a defined period, employing the Warrick score as a semi-quantitative measure in early RA-ILD, and to assess the associated risk factors for progression. Methods RA-ILD patients underwent consecutive Warrick scoring based on initial high-resolution computed tomography (HRCT) at diagnosis and the first follow-up. Associations between Warrick scores, pulmonary function tests, and patient characteristics were analyzed. The ROC curve assessed the predictive performance of the Warrick score change rate for ILD progression, while multivariable logistic regression analysis identified risk factors for progression. Results Significant correlations were found between Warrick scores and age at RA-ILD diagnosis, age at ILD diagnosis, and baseline DAS28-ESR. For the severity score, correlations were r = 0.359, r = 0.372, and r = 0.298 (p = 0.001, p 50 years (OR 7.7; p = 0.028) and baseline usual interstitial pneumonia (UIP) pattern (OR 3.1, p = 0.041) were identified as risk factors for progression. Conclusions Advanced age and UIP pattern were significant risk factors for progression. Warrick scoring may may help predict progression in RA-ILD, particularly through changes in severity, extent, and total scores. Due to the retrospective design and small sample size, further prospective studies with larger cohorts are needed to confirm these findings and validate Warrick scoring as a reliable marker for RA-ILD progression.

This study aimed to measure the success of teaching volleyball in the physical education course with the mind map technique. The study employed a quasi-experimental pre-posttest design with an experimental group and a control group. The study was completed with a total of 66 students, including 33 students in the experimental group and 33 in the control group. A pretest was administered to the groups to explore the cognitive and psychomotor skill levels of the students in relevant subjects to be taught. The experimental group was taught using mind maps in 40-min classes every week for 9 weeks, while the control group was taught using conventional teaching methods. At the end of the 9-week period, the tests were administered again. To collect data, a Volleyball Knowledge Test and a Volleyball Skill Test were used. The posttest results showed that the cognitive domain, overhead pass, and bump pass scores of the experimental group were higher. In the comparisons of the cognitive and psychomotor skill levels of the two groups, a statistically significant difference was found in favor of the experimental group in the cognitive and psychomotor domains.

This study explores the early childhood education teachers experiences of continuing educational activities with children living in low SES rural districts of Turkey during COVID-19 pandemic. In order to achieve this task phone interviews were conducted with 18 pre-school teachers working in low SES districts. Interviews were audio recorded and basic qualitative analysis was utilized on transcribed data. Findings revealed that early childhood teachers make an effort to sustain their communication and educational activities with both children and parents during school closures, yet it does not sustainable during the whole semester. Teachers' main concerns were related to loss of learning outcomes during home confinement and its negative consequences in the future for low-SES children. Parents lack of ability to deal with their children at home resulted in increased use of screen time and lack of distance education opportunities for young children living in poverty additional concerns of teacher working with low-SES children.

The aim of this study is to compile the literature in the context of business motivation of the online education process, the importance of which is once again understood in educational sciences during the pandemic process. When literature is looked at, it is clearly seen that the importance and effectiveness of distance education has increased with the pandemic. As a result, the quality and quantity of distance education has been questioned before, it is seen that distance education is considered as an opportunity with the pandemic.

Antiviral DNA cytosine deaminases APOBEC3A and APOBEC3B are major sources of mutations in cancer by catalyzing cytosine-to-uracil deamination. APOBEC3A preferentially targets single-stranded DNAs, with a noted affinity for DNA regions that adopt stem-loop secondary structures. However, the detailed substrate preferences of APOBEC3A and APOBEC3B have not been fully established, and the specific influence of the DNA sequence on APOBEC3A and APOBEC3B deaminase activity remains to be investigated. Here, we find that APOBEC3B also selectively targets DNA stem-loop structures, and they are distinct from those subjected to deamination by APOBEC3A. We develop Oligo-seq, an in vitro sequencing-based method to identify specific sequence contexts promoting APOBEC3A and APOBEC3B activity. Through this approach, we demonstrate that APOBEC3A and APOBEC3B deaminase activity is strongly regulated by specific sequences surrounding the targeted cytosine. Moreover, we identify the structural features of APOBEC3B and APOBEC3A responsible for their substrate preferences. Importantly, we determine that APOBEC3B-induced mutations in hairpin-forming sequences within tumor genomes differ from the DNA stem-loop sequences mutated by APOBEC3A. Together, our study provides evidence that APOBEC3A and APOBEC3B can generate distinct mutation landscapes in cancer genomes, driven by their unique substrate selectivity.

In this study, the impact of the apolipoprotein B mRNA-editing catalytic subunit-like (APOBEC) enzyme APOBEC3B (A3B) on epidermal growth factor receptor (EGFR)-driven lung cancer was assessed. A3B expression in EGFR mutant (EGFRmut) non-small-cell lung cancer (NSCLC) mouse models constrained tumorigenesis, while A3B expression in tumors treated with EGFR-targeted cancer therapy was associated with treatment resistance. Analyses of human NSCLC models treated with EGFR-targeted therapy showed upregulation of A3B and revealed therapy-induced activation of nuclear factor kappa B (NF-κB) as an inducer of A3B expression. Significantly reduced viability was observed with A3B deficiency, and A3B was required for the enrichment of APOBEC mutation signatures, in targeted therapy-treated human NSCLC preclinical models. Upregulation of A3B was confirmed in patients with NSCLC treated with EGFR-targeted therapy. This study uncovers the multifaceted roles of A3B in NSCLC and identifies A3B as a potential target for more durable responses to targeted cancer therapy.

The Enhanced Recovery After Surgery (ERAS) protocol refers to multifaceted evidence-based interventions applied to reduce the duration of hospital stay and the risk of complications for patients after the surgical procedure. In this context, it is effective in different types of major surgery, including surgery of gynecological cancers. Especially since the Hyperthermic Intraperitoneal Chemotherapy After Cytoreductive Surgery (SRCHIPEK) procedure is a major and complex procedure with high complication, morbidity and mortality rates, preparation and care in the preoperative period are of great importance. For patients planned for SRCHIPEC, gynecology nurses have responsibilities such as informing and counseling the patient with the ERAS protocol approach within the scope of evidence-based practices, teaching healthy lifestyle behaviors, evaluating nutrition and anemia status, ensuring immunonutrition, assessing cardiac risk and function, and avoiding unnecessary premedication, monitoring sedative/anxiolytic use and side effects, preventing long-term fasting before the procedure with planned preoperative preparations, maintaining and frequent monitoring of normothermia and normoglycemia. Thus, the incidence of complications in women with ovarian cancer who have undergone SRCHIPEC will decrease, patients will be able to meet their basic needs independently, they will be able to be discharged earlier, and therefore they will be able to return to social life more quickly. The aim of this review is to examine the evidence-based practices used in the preoperative management of the hyperthermic intraperitoneal chemotherapy procedure after cytoreductive surgery, which is planned to be applied to patients with ovarian cancer, and the roles and responsibilities of nurses in the ERAS protocol.

Objective: Primary Sjögren’s syndrome (pSS) is a systemic autoimmune disease characterized by lymphocytic infiltration of the exocrine glands, affecting many organs. Celiac disease (CD), which causes inflammatory damage to the small intestine, develops as a result of the immunological response to gluten. The incidence of CD has increased in pSS. This research aims to investigate the frequency of CD in pSS. Methods: This is a cross-sectional study conducted in a single-center between 2019 and 2020. A total of 90 patients diagnosed with pSS were questioned regarding CD symptoms. Laboratory tests and small bowel biopsies were requested from patients with suspected CD. Anti-gliadin immunoglobulin (Ig)A and IgG, anti-tissue transglutaminase (anti-TTG) IgA and IgG antibodies from celiac antibodies were evaluated using the ELISA method, and anti-endomysium IgA and IgG were evaluated by indirect immunofluorescence. Upper gastrointestinal endoscopy was performed in patients with CD symptoms and autoantibody positivity. The diagnosis of CD was made according to endoscopic biopsy results. Results: The pSS patients comprised 98% females, with a mean age of 51.6±11.5 years. The rates of CD symptoms were as follows: 10% loss of appetite, 13.3% abdominal pain, 11.1% diarrhea, 18.9% constipation, 37.8% flatulence, and 2.2% weight loss. Anti-gliadin IgA positivity was determined in 6.7%, anti-gliadin IgG in 6.7%, anti-endomysium IgA in 2.2%, anti-endomysium IgG in 15.6%, and IgA in 1.1%. Gastroscopy was planned for 43 patients with suspected CD based on clinical and laboratory findings. CD was diagnosed in two patients before this study; subsequently, four more patients were diagnosed with CD. Conclusion: The findings of this investigation revealed a 6.7% prevalence of CD in pSS. The diagnosis of CD in pSS was supported by histopathology. According to these findings, CD is more prevalent in pSS patients, and the risk of developing CD is higher than that in the general population.

Abstract Background Fixation of trochanteric fractures with an intramedullary nail in a non-physiological position can cause poor functional outcomes. The aim of this study is to evaluate the effect of intraoperative patient position on rotational alignment in intramedullary nail fixation of trochanteric fractures. Methods The femoral rotational alignment of 84 trochanteric fracture patients who underwent intramedullary nailing was measured by computed tomography (CT) images. Patients were divided into two groups: the supine position on the fracture table (FT) (Group 1, n = 42) and the lateral decubitus (LD) position (Group 2, n = 42). Femoral malrotation angles were measured and divided into three subgroups: insignificant, significant, and excessive. The number of intraoperative fluoroscopy images, preparation time, surgery time, and anesthesia time in both groups were compared. Results The malrotation degrees of patients in Group 1 ranged from 17° external rotation (ER) to 57° internal rotation (IR), with a mean of 10° IR. Of the patients in Group 1, 27 were insignificant, 5 were significant, and 10 were in the excessive subgroup. The malrotation degrees of patients in Group 2 ranged from 33° ER to 47° IR, with a mean of 11° IR. Of the patients in Group 2, 21 were insignificant, 12 were significant, and 9 were in the excessive subgroup. There was no statistically significant relationship between patient position and malrotation angle. The number of intraoperative fluoroscopy images, preparation time, and anesthesia time were statistically lower in Group 2. There was no statistically significant difference between Group 1 and Group 2 in terms of surgery time. Conclusion Intramedullary nailing in the LD position is a reliable and practical surgical method in the treatment of femoral trochanteric fractures since there is no need for the use of a FT, the surgeon is exposed to less radiation, there is no risk of complications related to the traction of the FT, and there is a shorter operation time.

Bu araştırmada okul öncesi öğretmenlerinin karşılıklı konuşma uygulamaları ve ihtiyaçları derinlemesine incelenmeye çalışılmıştır. Araştırmanın yönteminde nitel araştırma desenlerinden durum çalışması kullanılmıştır. Çalışma grubu Samsun ilinde görev yapan 10 okul öncesi öğretmeninden oluşmaktadır. Çalışma grubunu belirlemek için amaçlı örnekleme yöntemi türlerinden kartopu örnekleme kullanılmıştır. Veri toplama sürecinde öğretmenlerle yüz yüze yarı yapılandırılmış görüşmeler gerçekleştirilmiştir. Verilerin analizinde içerik analizi kullanılmıştır. Sonuç olarak bulgular; çocukların sözel etkileşim becerilerine ilişkin görüşler, öğretmen dili özelliklerine ilişkin görüşler, karşılıklı konuşmaları destekleyen çalışmalar, kelime bilgisini destekleyen çalışmalar ve mesleki gelişim ihtiyaçları temaları altında sunulmuştur. Öğretmenler çocukların sözel etkileşim becerilerinde geçmişe kıyasla değişimler olduğunu, çocukların ihtiyaçlarının çok çeşitli olduğunu, karşılıklı konuşmaları ve kelime bilgisini desteklemek için dil etkinliklerinde kullanılan yöntemlerden yararlandıklarını ve bu konuda eğitimlere ihtiyaç duyduklarını vurgulamıştır. Bulgulardan hareketle çocukların sözel etkileşim becerilerine yönelik bireysel farklılıkları temel alan bir desteğe ve öğretmenlerin ise bilimsel dayanaklı karşılıklı konuşma uygulamaları konusunda bir eğitime ihtiyacı olduğu söylenebilir.

The Science, Technology, Engineering, Arts and Mathematics (STEAM) approach has a variety of benefits for all children as it triggers multiple senses through hands-on activities, experiential learning, exploration opportunities on different scientific topics, and various tools and materials. Five STEAM activities were designed and implemented with fifteen 60-72-month-old children over a five-week period. Each activity required children to make their own designs to create their product, and was prepared to emphasize a particular feature of STEAM education. Instrumental case study was utilized in this study. It was observed that children engage more and spend more time, demand additional materials and use their imagination to design more creative and various products in STEAM activities.

Early diagnosis is extremely important for children with autism spectrum disorder (ASD), as other children having developmental disabilities. In early diagnosis, which is one of the most important elements of the treatment process, parents have a special place with different factors. Considering the importance of parents in early diagnosis, the aim of the study is to examine the opinions of the mother on early developmental differences in children with autism. The research is a case study designed in a qualitative research model. Accordingly, an interview form was developed by the researchers and data were collected in the scanning model in the first step of the study. In the second step of the study, data were obtained by using the semi-structured interview method, which is one of the qualitative research methods. In the study group of the research, 110 mothers were interviewed, whom were selected via purposeful sampling, and 87 mothers, who gave full answers to the questions, were included in the study. The data obtained were subjected to descriptive and thematic analysis. As a result of the study, it was found that children diagnosed with autism and children with development showed similar developmental characteristics during pregnancy and after birth. It was observed that mothers with a child diagnosed with autism have the awareness on the suspicion of autism in their children when they are between 18 and 24 months and 31 and 36 months, and they experienced problems in breast-feeding and falling asleep.

Aim: Given the significant mortality and sequelae due to meningitis, rapid diagnosis and initiation of treatment have a major impact on patient outcomes. In many cases of meningitis/meningoencephalitis, empirical treatment should be initiated immediately. This empirical treatment regimen is initiated based on the cumulative antibiotic susceptibility results in the region. The aim of our study was to retrospectively determine the causative agents in cerebrospinal fluid samples of patients who received a presumptive diagnosis of meningitis, using Multiplex Polymerase Chain Reaction (PCR) tests. Materials and Methods: The study included 206 cerebrospinal fluid samples from different patients with a preliminary diagnosis of meningitis sent from various clinics. The Biospeedy viral nucleic acid isolation kit (Bioeksen, Türkiye) was used for the isolation of genetic material. Genetic materials (DNA/RNA) related to Herpes simplex virus 1-2, Humman herpesvirus 6-7-8, Varicella zoster virus, Enterovirus, Cytomegalovirus, Human Parechoviruses, Haemophilus influenzae, Listeria monocytogenes, Streptococcus pneumoniae, Neisseria meningitidis, Streptococcus agalactiae, Escherichia coli K1, Cryptococcus gattii/neoformans in cerebrospinal fluid samples were investigated using the Meningitis/Encephalitis RT-qPCR MX-17 Panel (RT-qPCR MX-17S Panel, Bio-Speedy®, Bioeksen, Türkiye) multiplex PCR kit. Results: According to the PCR results, the causative agent was identified in a total of 19 patients. Nine patients were found to have Streptococcus pneumoniae, two had Varicella zoster virus, and two had Enterovirus. Additionally, six patients had separate detections of Haemophilus influenzae, Cytomegalovirus, Herpes simplex virus 1, Human herpesvirus 6, Human herpesvirus 8, and Parechoviruses. Conclusion: Recently, simple and rapid molecular tests such as PCR have contributed to an increase in the early detection of causative agents. Based on the performance of diagnostic tests, we propose an algorithm for the use of both syndromic and specific tests in patients at risk for meningitis/encephalitis.

Objectives Although patients with immune-mediated inflammatory diseases (IMID) are thought to be more susceptible to viral infections, it is unclear whether their presentation differs between patients with IMID and healthy controls. This study aimed to investigate the symptom pattern of common viral infections in patients with IMID and compare it with controls without IMIDs.Design A cross-sectional study conducted between 1 February and 30 April 2020, using a questionnaire.Setting Seven tertiary regional care centers in Germany, which specialised in the care of patients with IMID (namely, in gastroenterology, dermatology, rheumatology and immunology clinical care).Participants One thousand nine hundred nine participants completed the survey (757 patients with IMID; 1152 non-IMID controls).Primary outcome measure The occurrence of 11 common viral illness symptoms within the preceding 3 months in patients with IMID and non-IMID controls.Results Symptom data were clustered, based on number and co-occurrance, into 3 major clusters and 2 subclusters ranked by the average number of symptoms. Patients with inflammatory bowel disease and psoriasis were significantly overrepresented in the lower-frequency subcluster of the polysymptomatic cluster. Patients with rheumatoid arthritis were overrepresented in the lower-frequency subclusters of the intermediate and oligo-/asymptomatic clusters. Controls were over-represented only in the higher-frequency subclusters of each major cluster where none of the IMIDs were over-represented. Spondyloarthritis and other IMIDs were also overrepresented in the low-frequency subcluster, but the results were not significant. Overall, patients with rheumatoid arthritis patients reported fewer symptoms (rate ratio=0.68, 95% CI, 0.59 to 0.80) than non-IMID controls.Conclusion Patients with IMID are over-represented in low-frequency subclusters, even among individuals who have reported a broad range of viral infection symptoms. This pattern suggests that the manifestations of viral infections are different between patients with IMID and controls, thus challenging the accurate and early diagnosis of infections.