Occupational Health and Safety in Operating Rooms

Nurses are one of the most endeavored members of healthcare services. Operating rooms, on the other hand, require special caution and contain various hazards for healthcare professionals. Operating rooms contain various risk factors related to applications, infrastructure and humans. It is one of the areas that need nursing care the most since patients are dependent on their nurses to meet their personal needs. Nurses are exposed to various risk and health problems in operating rooms. Healthcare service provided by nurses working in a healthy environment directly affects the health and quality of life of those who receive the service. In order to prevent these problems, intensive up-to-date educations on occupational risks and employee safety should be provided for the nurses working in operating rooms. In addition to the general occupational hygiene measures, different precautions should be taken for the operating rooms. Working in a healthy and safe environment is a human right that every individual must have. Managers of the medical institutions should be attentive to follow the laws and sanctions on occupational health and safety, institutions should be inspected frequently and monitored carefully. In this section, this subject will be studied in line with actual data and resources

Tamamlanmış blok ve tamamen rasgele tasarımdan oluşan bir karma tasarımda genel alternatif için önerilen testler

Two nonparametric tests are proposed in testing for a general alternative under a mixed design consisting of a randomized complete block portion and a completely randomized block portion. In this paper, the proposed tests are a combination of the Doksum test, Modified Page test and Friedman test. A simulation study is conducted to estimate the powers of the tests for 4 and 5 treatment effects under a variety of different location parameters and sample sizes. We compare the performance of the tests in terms of the empirical type I error rates and power of tests. The simulation results show that at least one of the proposed test versions generally has higher power than the other tests. Finally, the usefulness of proposed tests is implemented on a real data set.Rasgele tamamlanmış blok ve tamamen rasgele bloktan oluşan bir karma tasarım altında, genel alternatifleri test etmek için iki parametrik olmayan test önerilmiştir. Bu makalede, önerilen testler Doksum testi, uyarlanmış Page testi ve Friedman testlerinin kombinasyonlarıdır. Farklı konum parametreleri ve örnek çapları altında 4 ve 5 işlem etkilerinin testlerinin güçlerini tahmin etmek için bir simülasyon çalışması yapılmıştır. Deneysel I. Tip hata oranı ve testin gücü bakımından testlerin performansları karşılaştırılmıştır. Simülasyon sonuçlarından, önerilen testlerden en az bir tanesinin diğer testlerden daha yüksek güç değerine sahip olduğu görülmüştür. Son olarak, önerilen testlerin kullanışlılığı, gerçek bir veri seti üzerinde uygulanmıştır

Structural Phase Transformation, Intermediate States and Electronic Properties of PbTe Under High Pressure

In this work, density functional theory calculations in the framework of local density approximation (LDA) are performed using the Siesta software package in order to theoretically predict the phase transition mechanism and electronic properties of lead telluride (PbTe) under high hydrostatic pressure. PbTe undergoes a structural phase transformation from the cubic NaCl-type structure (B1) belongs to Fm3m space group to another cubic CsCl-type structure (B2) belongs to Pm3m space group with the influence of external pressure through the simulations. According to simulation results, we suggest a phase transition mechanism having four intermediate states with space groups of P 1; C2=m; R3m and Cmmm

STATISTICAL ANXIETY AND METACOGNITIVE AWARENESS LEVELS OF GRADUATE STUDENTS STUDYING IN MATHEMATICS EDUCATION PROGRAM

Graduate students are faced with some difficulties in determining statistical methods to be used in their assignments and researches and this leads to anxiety in them. In this study, it was aimed to examine the relationships between statistical anxiety and metacognitive awareness levels of graduate students studying in the field of mathematics education and to compare these levels in terms of some variables. The research study group consists of 101 students studying at the master's and doctorate levels in the department of mathematics education and participated in the research voluntarily. As a data collection tool in the research, Statistical Anxiety Scale (SAS) and Metacognitive Awareness Scale (MCAS) were used. In the analysis of the data, descriptive statistics, t-test, ANOVA and Correlation Coefficient were used. According to the research results, it was determined that there is a negative and moderately significant relationship between statistical anxiety and metacognitive awareness levels of graduate students studying in the field of mathematics education. As a result of the analyzes, it was observed that the statistical anxiety and metacognitive awareness of the students were high, the statistical anxiety and metacognitive awareness levels differed statistically according to the variables of graduate education level and stage of graduate education, but did not differ significantly according to the variables of gender and taking statistics course.   Article visualizations

The Impact of Using Technological Devices on Mental and Physical Health in Adolescents

Objectives: In recent years, adolescents spend increasingly more time on technologic devices such as smartphones, televisions, computers, and tablets. The aim of the present study was to investigate the relationship between the usage of digital technology and health-related problems among adolescents. Methods: A cross-sectional exploratory study was conducted by using a face-to-face survey administered to a sample of students studying at 4 randomly chosen public middle school and 4 randomly chosen public high school in the city of Istanbul. In this study recruited 1147 volunteer adolescents. All participants were answered a questionnaire regarding the demographic characteristics, technological devices useage patterns and health-related problems. Results: Most of the adolescents had smartphones (99.4%) and the fewest had game consoles (18.2%). The rate of using television and smartphone for more than two hours a day among adolescents was 13.1% and 28.4%, respectively. A decrease in sleep duration, increase in falling asleep time, distraction, fatigue, eating disorders and psychological symptoms were significantly more present for individuals using smartphone more than two hours. A positive and very weak relationship was detected between the duration of smartphone use and neck (r=0.096; p=0.002), wrist (r=0.079; p=0.008) and shoulder (r=0.069; p=0.021) pain. Also, positive and very weak relationship was detected between the duration of computer use and upper back (r=0.102; p=0.001), lower back (r=0.078; p=0.011) and shoulder (r=0.069; p=0.041) pain. Conclusion: This study showed the most widely used technological device among adolescents is smartphones and it was observed that the excessive use of this device among adolescents is more associated with many different health-related problems than other technological devices

Podwyższony poziom greliny w stanie przedrzucawkowym: czy grelina jest przyjacielem czy wrogiem?

Objectives: To investigate maternal serum ghrelin levels in pregnancies complicated by preeclampsia and to explore the relationship between ghrelin level and disease severity. Materials and methods: This case-control study included 40 healthy pregnant women, 42 women with mild preeclampsia, and 40 women with severe preeclampsia. The groups were matched in terms of maternal and gestational age and body mass index. Serum ghrelin levels were measured via enzyme immunoassay. Results: Serum ghrelin levels were significantly higher in women with mild and severe preeclampsia than in healthy controls (p < 0.001). Although serum ghrelin levels were somewhat higher in the severe compared to the mild preeclampsia group, the difference was not statistically significant (p > 0.05). In the control group, no significant correlation was observed between ghrelin level and any other parameter, but in the preeclampsia group, serum ghrelin levels were negatively correlated with uterine artery Doppler index values and both systolic and diastolic blood pressure (all p-values < 0.05). Multivariate stepwise linear regression analysis revealed that systolic blood pressure (β = 0.493, p = 0.023) was independently associated with serum ghrelin level. Conclusion: Elevated blood ghrelin levels were correlated with disease severity in pregnancies complicated by preeclampsia.Cel pracy: Ocena poziomu greliny w surowicy kobiet w ciąży powikłanej stanem przedrzucawkowym i określenie związku między poziomem greliny a ciężkością choroby. Materiał i metoda: Do badania włączono 40 zdrowych kobiet w ciąży, 42 z łagodnym stanem przedrzucawkowym i 40 z ciężkim stanem przedrzucawkowym. Grupy były dobrane pod względem wieku ciążowego, wieku matek i wskaźnika masy ciała. Poziom greliny w surowicy był mierzony metodą immunoenzymatyczną. Wyniki: Poziom greliny w surowicy był istotnie wyższy u kobiet z łagodnym i ciężkim stanem przedrzucawkowym niż w grupie kontrolnej (p < 0,001). Chociaż poziom greliny w surowicy był wyższy w grupie z ciężkim stanem przedrzucawkowym niż w grupie z łagodnym stanem przedrzucawkowym, to ta różnica nie była istotna statystycznie (p > 0,05). W grupie kontrolnej nie obserwowano żadnych istotnych związków pomiędzy poziomem greliny a jakimkolwiek innym parametrem, ale w grupie ze stanem przedrzucawkowym poziom greliny w surowicy był ujemnie skorelowany z indeksami przepływów Dopplera w tętnicy macicznej oraz ciśnieniem krwi skurczowym i rozkurczowym (all p-values < 0,05). Wieloczynnikowa analiza regresji liniowej wykazała, że skurczowe ciśnienie krwi było niezależnym czynnikiem związanym z poziomem greliny w surowicy (β = 0,493, p = 0,023). Wnioski: Podwyższony poziom greliny we krwi był związany z ciężkością choroby w ciążach powikłanych stanem przedrzucawkowym

Comparison of efficacy and safety of generic plerixafor vs original plerixafor in the mobilization of myeloma patients

Introduction The commonest indication for an Autologous Stem Cell Transplantation (ASCT) is still Multiple Myeloma. A successful mobilization of hematopoietic stem cells (HSC) is a sine qua non of ASCT. The introduction of Plerixafor, which is a partial agonist of the alfa-chemokine receptor CXCR4 has added an important value and impact on mobilization. Plerixafor is successfully integrated into both growth factor-only and cyclophosphamide and growth factor mobilization strategies with significantly reducing the mobilization failure rate in myeloma patients. In addition, plerixafor + G-CSF has also been shown to successfully mobilize the majority of patients who previously failed to mobilize with either growth factor alone or in combination with chemotherapy. Even a Just-in-Time algorithm which induces plerixafor in patients who lacks a certain threshold of CD34 positive HSCs on the day of mobilization led to a cost-effective and successful mobilization with highly restricted rates of mobilization failure. In this study we tried to demonstrate the efficacy and safety of a novel generic Plerixafor (Pleksor - Gen Ilac) and to compare it with original one (Mozobil - Sanofi) in a retrospective manner. Method Patients who were transplanted in two centers who adopted the same mobilization standard operating procedures (SOP) were included in the study. An age and sex matched cohort of patients who received Mozobil (from 2020-2022 - Group A) were compared with the ones who received Pleksor (2021-2022 Group B) as a Just-in-Time conjunct to GCSF alone or chemo mobilization. Poor mobilization was defined as a final yield of 2 million CD34 positive HSCs per kg. Our aim was to collect enough stem cells for at least two ASCTs, thus our current SOP's indicated a minimum CD34 positive HSC threshold of at least 4 million per kg and an ideal HSC threshold of 6 million per kg. Results A total of 28 patients were included and they were equally distributed among Group A (n=14) and B (n=14). Median age of the patients at the time of mobilization were as follows, 60 (35-72) in Group A and 61 (38-70) in Group B. 14 patients who received Pleksor achieved a median yield of 8.40 million CD34 positive HSCs per kg (4.8-21) and the patients who received Mozobil have ended with a yield of 6.7 million CD34 positive HSCs per kg (4.5-13) (p=0.210). None of the patients in both groups were named to be a poor mobilizer according to the threshold of 2 million CD34 positive HSCs per kg but 3 of the patients in Group A and 2 of the patients in Group B ended with a yield of 6 million CD34 positive cells which was below to the ideal threshold for two transplants. Regarding lenalidomide exposure before mobilization, history of radiotherapy, line of the therapies received before mobilization, number of leukapheresis and the mobilization policy (chemo vs gcsf alone) there were no statistically significant difference between two groups (p=0.120, 0.702, 0.842, 0.769 and 0.420 respectively). The median neutrophil engraftment time in days were as follows for Group A and B, 11(10-14) vs 11 (10-16), p=0.541 and the median platelet engraftment time in days were 17 (10-30) in Group A and 16 (10-28) in Group B with a p value of 0.571. In none of the cases any specific side effects were noted which could be attributable to Pleksor or Mozobil. Conclusion Our study demonstrated a comparable efficacy of a generic form of Plerixafor when compared with the originator. This would lead to a decrease in the cost of total process of mobilization with a similar efficacy and toxicity profile. We are now planning to initiate a prospective trial to validate these results in a larger patient population. Up to our knowledge this is the first study comparing the efficacy of a generic Plerixafor in a sole myeloma patient cohort

BRAF V600E mutation in papillary thyroid cancer is correlated with adverse clinicopathological features but not with iodine exposure

Introduction: BRAFV600E activating mutation is the most frequent genetic abnormality in the pathogenesis of papillary thyroid carcinoma. We aimed to evaluate the association between BRAFV600E mutation and well-established prognostic clinicopathological characteristics as well as iodine exposure. Material and methods: From 2000 to 2012, the data of PTC patients admitted to Dr. Lutfi Kirdar Kartal Education and Research Hospital in Turkey were reviewed retrospectively. Clinicopathological parameters were collected. BRAFV600E mutation was analysed by DNA sequencing method in tumour specimens. We hypothesised that BRAFV600E mutation prevalence is positively correlated with prolonged iodine exposure and expected to be higher in the second half of the recruitment period due to the increment in time spent from the iodisation process of the table salt in our country. Thus, iodine exposure was categorised as short-term (2000–2006) and long-term (2006–2012). Results: A total of 197 patients were accrued. The study population predominantly consisted of conventional variant. A statistically significant relationship was observed between BRAFV600E mutation presence and age (p = 0.03), conventional variant PTC (p = 0.00002), T4 stage (p = 0.002), vascular invasion (p = 0.036), thyroid capsule invasion (p < 0.00001), extrathyroidal tissue invasion (p < 0.00001), and lymph node metastasis (p < 0.00001). When categorised as long-term and short-term, iodine exposure was not statistically significantly related with BRAFV600E mutation; however, there were far more PTC cases in the long-term group (86.3% vs. 13.7%). Conclusion: We revealed that BRAFV600E mutation is associated with adverse clinicopathological parameters. There appeared to be no relation between long-term iodine exposure and BRAFV600E.

Respiratory Health Symptoms among Students Exposed to Different Levels of Air Pollution in a Turkish City

In this study, we aimed to investigate the frequency of respiratory health symptoms among high school students attending schools at industrial, urban and rural areas in a Turkish city. Three schools located in different zones of the city having different pollution characteristics were chosen based on the pollutant distribution maps using Geographical Information Systems (GIS) software. A cross-sectional survey was performed among 667 high school students in the schools. Outdoor and indoor nitrogen dioxide (NO2) and ozone (O3) concentrations were also measured by passive samplers in the same schools to investigate possible routes of exposure. Chronic pulmonary disease (OR = 1.49; 95%CI: 1.11–1.99; p = 0.008), tightness in the chest (OR = 1.57; 95%CI: 1.22–2.02; p = 0.001), morning cough (OR = 1.81 95%CI: 1.19–2.75; p = 0.006) were higher among students in the industrial zone where nitrogen dioxide and ozone levels were also highest. There were no indoor sources of nitrogen dioxide and ozone exists in the schools except for the dining hall. As a conclusion, this study has noticed that air pollution and respiratory health problems among high school students are high in industrial zones and the use of passive samplers combined with GIS is an effective tool that may be used by public health researchers to identify pollutant zones and persons at risk