Bolu Abant İzzet Baysal University

Background/Objectives: Secondary hyperparathyroidism (SHPT) is a common and clinically significant complication of advanced chronic kidney disease and may require surgical intervention when medical therapy fails. This study aimed to evaluate the association between parathyroid gland burden, defined by gland number and size parameters, and biochemical disease severity in patients undergoing parathyroidectomy for SHPT, and to assess the concordance between preoperative imaging findings and intraoperative observations. Although parathyroid gland enlargement is a hallmark of SHPT, the clinical relevance of parathyroid gland number and overall gland burden in relation to biochemical disease severity and the accuracy of preoperative imaging remains incompletely defined. Methods: This single-center, retrospective observational study included adult patients who underwent parathyroidectomy for secondary hyperparathyroidism between January 2015 and December 2020. Demographic, clinical, laboratory, imaging, intraoperative, and histopathological data were analyzed. Parathyroid gland burden was assessed based on gland number, largest gland diameter, and total gland burden. Associations between gland morphology and biochemical parameters were evaluated using correlation analyses and multivariable logistic regression. Agreement between preoperative imaging and intraoperative findings was assessed using diagnostic performance metrics, contingency analysis, and the weighted kappa coefficient. Results: A total of 101 patients were included. Patients with three or more enlarged parathyroid glands had significantly higher preoperative parathyroid hormone and alkaline phosphatase levels, higher serum phosphorus levels, and lower calcium and vitamin D levels (all p < 0.05). Total gland burden and largest gland diameter were positively correlated with parathyroid hormone and alkaline phosphatase levels. In multivariable analysis, higher parathyroid hormone levels, longer dialysis duration, and vitamin D deficiency were independently associated with high gland burden. Preoperative imaging demonstrated moderate agreement with intraoperative findings (weighted kappa = 0.46; 95% CI, 0.29-0.63). Separate evaluation of imaging modalities showed that both ultrasonography and scintigraphy had relatively high sensitivity but limited specificity for detecting extensive gland involvement. Conclusions: In patients undergoing parathyroidectomy for secondary hyperparathyroidism, increased parathyroid gland burden is associated with greater biochemical disease severity. Preoperative imaging shows limited concordance with intraoperative findings and should be interpreted cautiously, particularly in the presence of multiglandular disease. These findings support the integration of morphological parameters into comprehensive preoperative assessment while highlighting the need for larger prospective, multicenter studies with standardized imaging protocols and long-term follow-up.

Bu çalışma, Gerede Panayırı’nın yerel kalkınma üzerindeki ekonomik, kültürel ve sosyal etkilerini incelemek amacıyla gerçekleştirilmiştir. Kasıtlı ve maksimum çeşitlilik örneklemesiyle seçilen 29 katılımcı ile etik onayı alınarak 3–5 Ekim 2025 tarihlerinde yüz yüze görüşmeler yapılmış; elde edilen veriler içerik ve tematik analiz yöntemleriyle çözümlenmiştir. Bulgular, panayırın kısa sürede ticari hareketliliği artırdığını, üreticilere doğrudan pazar erişimi sağladığını ve yerel ekonomiyi belirgin biçimde canlandırdığını göstermektedir. Kültürel açıdan panayır, yöresel kimliği görünür kılan ve geleneksel pratikleri sürdüren önemli bir miras alanı olarak öne çıkmaktadır. Sosyal boyutta ise panayırın topluluk buluşmalarını, sosyalleşmeyi ve dayanışma ilişkilerini güçlendirdiği görülmüştür. Bununla birlikte altyapı yetersizlikleri, ulaşım sorunları, organizasyonel eksiklikler ve yönetimsel kısıtlar panayırın sürdürülebilirliğini sınırlandıran temel zorluklar olarak belirlenmiştir. Araştırma bulguları doğrultusunda panayırın sürdürülebilirliğinin artırılmasına ve gelecekte yapılacak çalışmalara yönelik çeşitli öneriler geliştirilmiştir.

Bu araştırmanın amacı, termal turistlerin termal turizm farkındalığı ile sağlık okuryazarlığı düzeylerini değerlendirmeyi ve sosyo-demografik özelliklerinin bu düzeyler üzerindeki etkilerini belirlemektir. Bu araştırma Bolu ilinde yer alan termal tesislere gelen 406 kişiyle gerçekleştirilmiştir. Çalışmanın verileri, Sosyodemografik Veri Formu, Termal Farkındalık Ölçeği ve Türkiye Sağlık Okuryazarlığı Ölçeği (TSOY-32) aracılığıyla toplanmıştır. Verilerin değerlendirilmesinde SPSS paket programı kullanılmıştır. Katılımcıların termal farkındalıkları ile sağlık okuryazarlıkları arasında pozitif yönde orta düzeyde anlamlı bir ilişki bulunmaktadır. Ayrıca sağlık okuryazarlığının katılımcıların termal farkındalıkları üzerinde olumlu etkisinin olduğu ve termal farkındalıklarının %16’sını yordadığı ortaya konmuştur. Sağlık okuryazarlığının, bireylerin termal kaynaklar hakkında bilinçli kararlar almalarını sağlaması, termal farkındalığın güçlendirilmesinde önemli bir rol oynamaktadır. Bu ilişkinin taşıdığı potansiyel, turizm alanında daha bilinçli tercihler yapılmasını sağlayarak sektöre önemli katkılar sunmaktadır.

among university faculty members in Türkiye. The present study seeks to construct and validate a robust measurement scale capturing the multidimensional nature of academic fatigue among academics or teachers. After constructing a preliminary item pool, the proposed scale was administered to 443 academics across Turkish higher education institutions to assess its factorial validity and reliability. First, a pilot study was conducted on the research data. The items were simplified, and exploratory and confirmatory factor analysis were performed. Construct, convergent, and discriminant validity and reliability tests were also performed on the data. The Academic Fatigue Scale consists of three subdimensions: Structural Problem Areas, Functional Problem Areas, and Managerial Problem Areas, with 28 statements. The study results demonstrate that the Academic Fatigue Scale is a measurement tool with high internal consistency, reliability, and construct validity, assessing academics’ or individuals’ perceptions of academic fatigue in the education profession.

Introduction: Endobronchial tuberculosis (EBTB) is a microbial and histopathologically proven tuberculosis (TB) infection of the tracheobronchial tree. Because bronchoscopy is not routinely performed in all patients with TB, we aimed to investigate the incidence of EBTB in patients who underwent bronchoscopy in our clinic. Materials and Methods: We investigated the frequency of EBTB in 483 patients who underwent fiberoptic bronchoscopy (FOB) in our clinic between January 1, 2021, and July 11, 2023. Routinely, at each FOB, cytology, acid-resistant bacteria (ARB) staining, and mycobacteria culture are requested from the bronchoscopic lavage material. We analyzed the clinical, radiologic, and bronchoscopic features and treatment processes of EBTB cases. Results: The frequency of EBTB in patients who underwent FOB was 0.62%. EBTB was diagnosed by mycobacterial culture of bronchoscopic lavage material. The general characteristics of our patients were advanced age, 2/3 of them were male, they had never had TB before, and 2 of them had malignancy (1 of them had concurrent lung cancer). Conclusions: EBTB cases may present at an advanced age, in patients presenting with nonspecific symptoms; with radiology as nodules, masses, or consolidations; and with tumor lesions on FOB. Even if the bronchial lavage is ARB negative, we must follow the mycobacteria culture. Although EBTB can occur simultaneously with lung cancer, it can also be a very good cancer imitator.

Aggression is a persistent clinical challenge, particularly prevalent in individuals with psychotic disorders. This systematic review aimed to compile current non-restrictive clinical interventions for aggression management in this population and identify those supported by a high level of evidence. A systematic literature search was conducted across Scopus/Elsevier/ClinicalKey/Embase, PubMed, Cochrane Library and CINAHL from 27 March to 10 May 2024. The review included randomized controlled trials (RCTs), non-randomized controlled trials and pre-post studies without a control group. From an initial pool of 575 records, 17 studies met the inclusion criteria for evidence assessment. The 17 included studies comprised 15 RCTs, 1 non-randomized controlled trial and 1 pre-post study. Eleven studies demonstrated that the tested interventions were effective for aggression management, with evidence levels rated as high to moderate. Interventions were categorized into six groups: risk assessment (n = 2), cognitive skills improvement interventions (n = 2), social skills improvement interventions (n = 1), environmental management (n = 1), staff training (n = 3) and multicomponent interventions (n = 8). The findings underscore the necessity of multicomponent, holistic approaches over single-dimensional strategies. The review confirms the benefits of cognitive and social interventions and reinforces the effectiveness of staff de-escalation training. The positive results for sleep hygiene and therapeutic environment interventions support their integration into multidimensional aggression management protocols. Future research should employ larger RCTs to assess long-term sustainability, identify patient subgroups most likely to benefit from specific interventions and evaluate cost-effectiveness. This review is registered with PROSPERO (CRD42024579465).

This study aimed to evaluate the obturation quality of furcation perforations repaired using two different calcium silicate-based materials under two different magnification levels, using micro-computed tomography analysis. Forty-eight standardized dentin disks with artificially created perforations were randomly assigned into four groups: White MTA (Angelus, Londrina, Brazil) under 4×, Bio-C Repair (Angelus, Londrina, Brazil) under 4×, White MTA under 10×, and Bio-C Repair under 10× magnification (n = 12). The perforated dentin disks were bonded to a resin crown using composite resin and subsequently mounted onto a phantom head model. The repairs were performed using a dental operating microscope (DOM), and a single experienced endodontist completed all procedures. After setting, the samples underwent micro-CT scanning. The volumes of materials, gaps, and voids were measured and differences between groups were analyzed using Kruskal Wallis test, t-test and Mann Whitney U test. All samples exhibited some degree of voids and gaps. Magnification level (4× vs. 10×) did not significantly affect obturation quality (p > 0.05). However, the type of repair material had a significant impact on the outcome. White MTA exhibited significantly fewer voids, gaps, and total unfilled volume compared to Bio-C Repair (p < 0.05). Increasing the magnification level from 4× to 10× did not improve the sealing quality in furcation perforation repair. However, White MTA demonstrated superior adaptation and condensation characteristics to Bio-C Repair, regardless of magnification. While handling the properties of powder-liquid MTA may pose clinical challenges, it remains a more effective option for achieving superior sealing in furcation perforation repairs than premixed putty formulations.