Determining the Mental Status, Sleep Quality, and Eating Behaviors of University Students During the COVID-19 Pandemic: A Cross-Sectional Study

BACKGROUND

The COVID-19 pandemic has resulted in adverse effects on individuals' physical and mental health worldwide, with university students also being adversely affected by this process.

OBJECTIVES

This research aimed to determine the mental condition, sleep quality, and eating behaviors of university students during the COVID-19 process.

METHOD

This cross-sectional study was conducted with 1,065 university students. Study data were collected with an online questionnaire including a personal information form, the Depression Anxiety Stress Scale, the Pittsburgh Sleep Quality Index, and the Dutch Eating Behavior Scale.

RESULTS

Students' poor sleep quality was determined to be 69.5%. It was also determined that students' depression and stress levels were moderate that their anxiety levels were low, their eating behaviors were generally problematic, and more than half had poor sleep quality. In addition, eating disorders and poor sleep quality increased as depression, anxiety, and stress levels increased, and eating disorders increased as poor sleep quality increased (p < .05).

CONCLUSIONS

The results emphasize the importance of the strengthening of students' mental health, particularly by improving their sleep quality and eating habits. Evidence-based interventions regarding the effects of the pandemic should be made for students under the leadership of a psychiatric nurse, and effective strategies must be developed accordingly.

Role of echocardiography on early diagnosis of atrial remodelling and fibrosis in elite athletes

There is emerging data indicating that long-standing vigorous exercise may be associated with atrial structural remodelling. This remodelling process is may be the cause of the increasing frequency of atrial arrythmias in athletes. Early diagnosis of atrial remodelling by atrial imaging could have a role in management of atrial arrythmias in elite athletes. In this study we aimed to diagnose early phases of atrial remodelling in elite athletes. Two groups of athletes including professional weight lifters (n = 33), professional marathoners (n = 32) and sedentary participants (n = 30) were enrolled. We also studied patients who received cardiotoxic chemotherapy (n = 10) for comparison. Serum TGF-beta level as a marker of fibrosis was measured. Both left atrial (LA) 3D volume and strain values were analysed. There was a positive correlation between serum TGF-beta levels and LA volumes and negative correlation between TGF-beta levels and strain values. TGF-beta levels were higher among chemotherapy and weight lifter groups, compared to control and marathoner groups [mean 0.57 ± 0.3 and 0.55 ± 0.2 vs. 0.45 ± 0.2 and 0.47 ± 0.2, respectively, p = 0.005]. LA volumes were higher among chemotherapy and weight lifter groups [median 33 (26-38) and 31 (23-36) respectively, p = 0.005], and strain values were lower in these two groups [mean 20.3 ± 2.5 and 24.6 ± 4.5, respectively, p < 0.005] compared to control and marathoner groups. Total exercise volume was higher in weight lifter group compared to marathoners [13,780 (2496-36,400) vs. 4732 (780-44928), respectively, p = 0.001]. There wasn't any difference between any group regarding left ventricular systolic and diastolic functions. Vigorous exercise causes atrial remodelling and fibrosis in elite athletes. Strength exercise carries higher risk for atrial fibrosis than endurance exercise. Burden of exercise is correlated with the severity of cardiac fibrosis. Echocardiographic evaluation of the left atrium and TGF-beta levels may help to detect subclinical cardiac remodelling and fibrosis.

Is docetaxel-free interval a predictive factor for castration-resistant prostate cancer?

OBJECTIVE

Prostate cancer (PCa) is the second most common solid tumor in men and the fifth leading cause of cancer-related death. In advanced stage, palliative treatments are used instead of curative therapies. Therefore, finding predictive indicators seems crucial. Patients with castration-resistant prostate cancer (CRPC) that received Dx chemotherapy have been retrospectively reviewed. The aim of this study was to investigate whether docetaxel (Dx)-free interval could have a predictive value for PCa and influence other sequential therapies.

MATERIAL AND METHODS

This clinical trial study was performed on 104 patients at Medeniyet University Oncology Clinic in 2018-2020. All CRPC patients had metastases, received Dx as first-line treatment and underwent androgen receptor axis targeted (ARAT) therapy after disease progression. We analyzed patients' progression time after Dx therapy and the effects on sequential treatment.

RESULTS

After Dx therapy, all patients received ARAT (abiraterone (ABI) n: 49 (47.1%) and enzalutamide (ENZ) n: 54 (51.9%)) as a second-line treatment, except for one patient who received cabazitaxel. There was a statistically significant relationship between the Dx-free interval and duration of response to ARAT (p<0.001). The response time of ARAT treatment was <10.5 months in all patients whose Dx-free interval period was <9 months.

CONCLUSIONS

Our findings support the theory that Dx-free interval can be a predictive factor for CRPC. CRPC disease can be classified as Dx-sensitive disease or Dx-resistance disease, based on the Dx-free interval. Decision on subsequent treatments could be made considering this information.

Breast artery calcification as an opportunistic predictor of cardiovascular disease

BACKGROUND

Atherosclerotic cardiovascular disease is still the leading cause of mortality for women. Breast cancer screening with mammography is recommended in all women aged over 40 years.

AIMS

Whether breast artery calcification (BAC) is associated with cardiovascular disease is not clear. We aimed to evaluate the association between BAC and the presence of coronary atherosclerosis determined by CT.

METHODS

All patients who underwent both mammography and coronary CT angiography between January 2010 and December 2016 were screened, and patients with a duration of less than 12 months between CT and mammography were included.

RESULTS

A total of 320 women were included and BAC was detected in 47 (14.6%) patients. BAC was correlated with age and CT coronary calcium score. Both the frequency of critical coronary artery stenosis (34% vs 10.6%; p = 0.001) and CT coronary calcium score (5.5 vs 0; p = 0.001) was significantly higher in patients with BAC. The absence of BAC was a strong predictor of the absence of significant coronary artery disease (p = 0.001). BAC was independently associated with all-cause mortality after excluding patients with breast cancer (HR: 5.32; p = 0.013).

CONCLUSION

Breast artery calcification is associated with coronary calcium score and significant coronary stenosis. A high BAC score is related to increased mortality.

The effects of cognitive and emotional status on smoking cessation

OBJECTIVE

Smoking cessation is affected by multiple factors including cognitive status of the patients. In this study, we aimed to investigate the effects of demographic, emotional and cognitive functions of 39 male and 42 female patients who applied to the smoking cessation outpatient clinic on smoking cessation.

PATIENTS AND METHODS

This study recruited 81 healthy volunteers of equal age, gender, and educational level. Total Montreal Cognitive Assessment (MoCA) scores were compared according to age, gender, cessation methods, and Beck Depression Inventory and Beck Anxiety Inventory (BAI) scores in smoking cessation settings.

RESULTS

In our study, there were 39 (48.1%) male patients and 42 (51.9%) female patients. While 36 patients were able to quit smoking, the remaining 38 were unable to do so. During follow-up, 7 patients had yet to be reached. Age, years of smoking, number of cigarettes smoked per day, education level, first reason for starting smoking, reasons for quitting smoking, quitting method, and medical drugs used were found to have no effect on smoking cessation; however, the MoCA total score, Beck depression scale, Beck anxiety scale, and smoking cessation scale score were found to have significant effects on smoking cessation.

CONCLUSIONS

Various cognitive processes, particularly visuospatial and attention skills, have been found to be useful in quitting smoking. Furthermore, emotional states, such as depression and anxiety have a negative impact on quitting smoking. We believe that if it is provided to the patients in the smoking cessation outpatient clinic to boost cognitive capabilities and treat mood problems, the success of smoking cessation will increase.

Radiomics improves the utility of ADC for differentiation between renal oncocytoma and chromophobe renal cell carcinoma: Preliminary findings

OBJECTIVE

Differentiation between renal oncocytoma (RON) and chromophobe renal cell carcinoma (chRCC) remains challenging. We aimed to assess the accurate apparent diffusion coefficient (ADC) radiomics features in differentiating these tumors.

MATERIALS AND METHODS

This single-center retrospective study included 14 patients with histopathologically proven RON (n = 6) and chRCC (n = 8) who underwent magnetic resonance imaging. Features were extracted from ADC maps. Features with an intraclass correlation coefficient >0.90, an intergroup p < 0.01 and interrater differences with normal distribution underwent agreement and receiver operating characteristic curve analyses.

RESULTS

Overall, 6 features qualified for further analysis and Bland-Altman plots revealed acceptable agreement for all. Only 1 first order feature and 5 high order texture features successfully predicted RON with more than 90% sensitivities and specificities more than 80%.

CONCLUSION

Squared mean ADC and certain gray level run length matrix features extracted by radiomics of ADC mapping provide quite high diagnostic precision in terms of distinguishing between RON and chRCC.

Vascular complications after transcatheter transfemoral aortic valve implantation: Modified sheath-to-femoral artery ratio as a new predictor

OBJECTIVE

Vascular complications (VCs) contribute to increased morbidity and mortality in patients who have undergone transcatheter aortic valve implantation (TAVI); however, studies on their incidence and predictors show conflicting results. In this study, we sought to assess the incidence, impact, and predictors of VCs in transfemoral (TF) TAVI and also investigated the predictive role of manufacturer's size charts and a new predictor modified sheath-to-femoral artery ratio.

METHODS

A total of 223 patients undergoing TF-TAVI were categorized into 2 groups. The patients were divided as eligible and ineligible according to the manufacturer's guidelines (MG), and the same patient cohort was dichotomized into eligible and ineligible on the basis of sheath-to-femoral artery ratio (SFAR) value of less than or greater than or equal to modified SFAR (md-SFAR). VCs (defined according to the Valve Academic Research Consortium II criteria) were retrospectively compared.

RESULTS

According to the manufacturer's size charts, 65 patients were unsuitable; however, 35 patients were ineligible for TF-TAVI per the md-SFAR criteria. Although VCs occurred in 42 (18.8%) patients, 17 (27.7%) of those patients were classified as ineligible according to MG, whereas 14 (41.2%) were classified as ineligible in the md-SFAR group. In a multiple logistic regression analysis that included md-SFAR, MG, SFAR ≥1.05, peripheral artery disease, and minimum iliofemoral artery diameter, only md-SFAR was the independent predictor of VCs (odds ratio=3.71, 95% confidence interval=1.13-12.53, p=0.031).

CONCLUSION

According to our results, md-SFAR might provide better patient selection to prevent VCs and improve outcomes in TF-TAVI procedures.

Usefulness of neutrophil-to-lymphocyte ratio for predicting acute pericarditis outcomes

BACKGROUND

In daily practice, C-reactive protein (CRP) may be used to predict recurrence and treatment response in patients with acute pericarditis; however, the predictive role of CRP might be insufficient for clinical prediction in some patients. In this study, we aimed to investigate the relationship between neutrophil-to-lymphocyte ratio (NLR) and the composite endpoint of pericarditis recurrence and/or tamponade within 1 year in patients with acute pericarditis.

METHODS

A total of 104 patients diagnosed with acute idiopathic pericarditis (mean age 42.8 ± 15.2 years, 55.8% male) were included in the study. Physical examination findings of these patients, electrocardiography, echocardiography, chest X-ray and laboratory findings were evaluated and analysed. During the 1-year follow-up, the composite of cardiac tamponade and/or pericarditis recurrence was investigated as the primary endpoint of the study.

RESULTS

Compared to the group without the composite outcome, the group with the composite outcome had significantly higher rates of moderate and severe pericardial effusion (p < 0.01) and higher white blood cell (WBC) count (p:0.001), platelet count (p = 0.003), NLR (2.14 (1.49-3.02) vs 6.60 (5.50-8.68); p < 0.001) and high-sensitivity C-reactive protein (hs-CRP) (8.01 (5.1-24.5 vs 69.5 (40.8-128); p:0.001). Higher hs-CRP (p < 0.001), WBC (p:0.001), NLR (p < 0.001) and platelets (p:0.02) were associated with pericarditis recurrence. NLR and hs-CRP were independently associated with the composite endpoint (p < 0.001 and p < 0.001, respectively).

CONCLUSION

NLR and hs-CRP were found to be independent predictors for the composite endpoint of tamponade and/or recurrence in acute pericarditis patients during the 1-year follow-up. Similar to hs-CRP, NLR may also be used for risk assessment in patients with idiopathic pericarditis.

The Effect of Education Given to Children with Functional Constipation and Fecal Incontinence and Their Mothers on Anxiety and Constipation Management

AIM

This study aimed to determine the effect of multidimensional training program on children with constipation and fecal incontinence and their mothers on anxiety and their constipation management.

METHOD

The study had an experimental design with a pretest-posttest control group. The intervention group consisted of children diagnosed with functional constipation (n=20) and fecal incontinence (n=21) and their mothers in the Pediatric Surgery Clinic. The control group consisted of healthy (n=20) children who applied to two different Family Health Centers for any reason. Data were collected between February 2016 and June 2017 using a descriptive questionnaire, a nutrient consumption frequency form, the Rome III diagnostic criteria form, and the Trait Anxiety Scale for Children.

RESULTS

After the training program, the mean score of the Trait Anxiety Scale for Children decreased in both intervention groups (p<0.01) and increased in the control group (p<0.05). In addition, the frequency of the consumption of milk, caffeinated drinks, and white bread was reduced in the children of both intervention groups after the training program. The consumption of dried legumes, vegetables, and whole wheat bread increased. According to the Rome III diagnostic criteria, it was determined that constipation symptoms were not observed in 50% of the children.

CONCLUSION

The training program had a significant influence on the prevention and management of constipation and anxiety. Given that constipation is associated with both physical and mental health outcomes, the approach for the treatment should be holistic in nature, involving a multidisciplinary team.

Effects of tryptophan and probiotic supplementation on growth and behavior in quail

In laying hens, a diet supplemented with tryptophan (Trp) has been shown to affect their pecking behavior. However, unlike this positive effect, Trp is also involved in negative effects on behavior and stress through indolic pathways. Indole production can be reduced by probiotics (Pro), thus we hypothesized that Pro may prevent negative effects of Trp and increase beneficial effects on behavior in birds. Combined effects of Pro and Trp were also expected. To investigate the effects on behavior in birds of supplementing with a high level of Trp with or without Pro, Japanese quail were used because their behavior can be influenced by Pediococcus acidilactici, and they can be highly aggressive. Quails (n = 120) were assigned to 4 groups in a 2 × 2 factorial design for 55 d: C-C (control diet with usual Trp level, 0.3%; without Pro; n = 30), Trp-C (Trp: 2%; without Pro; n = 30), C-Pro (control diet; with Pro: 1 x 10⁹ CFU/L P. acidilactici in drinking water; n = 30), and Trp-Pro (Trp 2%; with Pro; n = 30). Body weight was measured every week, and different tests were conducted to investigate behavioral characteristics of each quail. Contrary to our hypothesis, there was almost no interaction between Trp and Pro treatments. Tryptophan supplementation significantly (P < 0.05) reduced live weight up to 27 d, whereas Pro treatment had no effect. There was no significant difference between groups for tonic immobility variables (P > 0.05). The birds fed the high Trp diet spent significantly less time in the periphery of the open field than those fed the control diet and moved less in the arena during the social isolation test. Interindividual distances were significantly lower in males fed with Trp 2% than with the control diet, whereas Trp and Pro supplements interacted in females. The treatments did not affect sexual motivation in males. These results indicate that a high level of Trp reduced growth and appeared to enhance emotional reactivity in quails and that supplementing with Pro did not reduce these effects. In conclusion, feeding high Trp for 55 d cannot be recommended as a strategy to improve social behavior unlike effects observed in laying hens.

The effect of rosemary extract on 3-MCPD and glycidyl esters during frying

The aim of the present work was to evaluate the effect of rosemary extract (Rosmarinus Officinalis L.) on the 3-MCPD and glycidyl ester contents during deep-fat frying. Firstly, the potato samples were soaked in different concentrations of NaCl and they were fried in sunflower oils containing different concentrations of rosemary extract. Subsequently, repeated frying was carried out with sunflower oil enriched with rosemary extract. The frying oil and the oil extracted from potato samples were analyzed in terms of the contents of 3-MCPD and glycidyl esters according to DGF C VI 18 (10) method. The results demonstrated that the content of 3-MCPD and glycidyl esters in frying oil was not significantly affected by different NaCl and rosemary extract concentrations during short term frying; however, the amount of 3-MCPD esters was found to be lower for the potato crisps enriched with rosemary extract during repeated frying cycles.

Effect of crushing temperature on virgin olive oil quality and composition

The objective of the current study was to assess the influence of a modified crushing process and kneading operation on the quality parameters, volatile compounds, and the fatty acid and sterol profiles of virgin olive oil from the Edremit yaglik variety. In the study, olive oil samples were produced in two different processes. The first one was produced without malaxation and the second one was produced with the malaxing process. During crushing, the effect of different temperatures was tested. The results demonstrate that different crushing temperatures generally did not affect the amount of free fatty acids, or peroxide value. Total phenol contents were positively affected by the additional malaxation process. Fatty acids and sterol composition were not significantly altered at different crushing temperatures or during the subsequent malaxation application. PCA enabled a clear classification of the oils obtained from different processing techniques.

Ultra-low dose of intravitreal bevacizumab in retinopathy of prematurity

AIM

We aimed to investigate the effectivity of the 0.0625 mg dose of bevacizumab in patients with retinopathy of prematurity (ROP) and compare the results with 0.625 mg dose of intravitreal bevacizumab (IVB) injection.

METHODS

The medical records of the patients with type 1 ROP who received IVB monotherapy were retrospectively reviewed. Demographic and clinical characteristics of the patients were recorded. The patients were classified into two groups with respect to received dose of bevacizumab as follows: group F (n = 46) (full dose of bevacizumab-0.625 mg/0.025 ml) and group L (n = 45) (low dose (one tenth) of bevacizumab-0.0625 mg/0.025 ml).

RESULTS

Both treatment dose regimens have similar outcomes. Moreover, the mean retinal vascularization time seemed to be significantly higher in group F compared to group L, 168 ± 65 and 97 ± 29 days, respectively (p < 0.001). Disappearance of plus sign is observed earlier in group F (2.45 ± 1.7 vs 3.66 ± 2.46 days, respectively, p = 0.03).

CONCLUSIONS

The low dose (0.0625 mg) of IVB treatment was effective as full (0.625 mg) dose in ROP treatment. Moreover, our results showed that low-dose treatment might provide faster retinal vascularization than the regular used dose. On the other hand, disappearance of the plus sign takes longer time in patients treated with low dose compared to eyes treated with full dose of IVB that should be taken into account.

[The effect of family-to-family support programs provided for families of schizophrenic patients on information about illness, family burden and self-efficacy]

OBJECTIVE

This study was conducted to determine the effects of family-to-family support programs provided for the families of schizophrenic patients on the need for information about the illness, family burden and self-efficacy

METHOD

The study was carried out with 34 relatives who have key rolesin the lives of 34 outpatients who were diagnosed with schizophrenia under DSM-IV-TR. A volunteering family member was given training about the purpose, contents and planning of the program. Thefamily member who had been trainedthen extended this training to other family members with the assistance of the psychiatric nurse. The training was done once a week, for atotal of 12 sessions. The data were collected using a Disease Information Form (DIF), the Perceived Family Burden Scale (PFBS) and the Self-Efficacy Scale (SES).

RESULTS

There was a significant decrease in the PFBS objective scores (from 11.76±3.89 to 9.82±4.03, p=0.000), subjective scores (from 37.85±14.57 to 32.74±4.39, p=0.030) and total scores (from 49.62±18.25 to 42.56±7.56, p=0.005) and a significant increase in the SESS scores (from 82.65±12.01 to 97.79±7.17, p=0.000). Before training, 58.8% of family members correctly answered that schizophrenia is a brain disease, while 94.1% correctly stated that,it must be treated with medication;however, 55.9% of caregivers incorrectly believed in magical attributions relating to the disease.After training, all caregivers were able to answer correctly.

CONCLUSION

A family-to-family support program was found to be effective in reducing caregivers' need for information, reducing their burden, and increasing their self-efficacy in our country.

Effects of a nursing intervention program on the depression and perception of family functioning of mothers with intellectually disabled children

AIMS AND OBJECTIVES

This study was conducted to examine the effect of psychosocial education provided to mothers with intellectually disabled children on the risk of depression and perception of family functioning in those mothers.

BACKGROUND

Families with intellectually disabled children need encouragement, support and training to more actively participate in their children's education and to positively affect their children's growth and development.

DESIGN

Randomised controlled study.

METHODS

The study included the mothers of 75 intellectually disabled children (40 intervention, 35 control). The mothers in the intervention group who participated in a routine program at private education and rehabilitation centres attended four different psychosocial educational sessions. Sessions were conducted once a week for four weeks and lasted 120 minutes. The control group attended only the routine program of the private education and rehabilitation centre.

RESULTS

Our study results showed that after completion of the educational program, there was a greater decrease in the risk for depression in the intervention group when compared to the control group, and the former perceived their family functions better. These differences were statistically significant (p < 0·001).

CONCLUSIONS

The education given by nurses to mothers who have children with intellectual disabilities may be effective in reducing the risk for depression and in increasing the perception of healthy family functioning.

RELEVANCE TO CLINICAL PRACTICE

Psychosocial nursing education program can contribute to the use of evidence-based education strategies in nursing practice to improve the mental health for mothers with intellectually disabled children.

A novel index in healthy infants and children - subarachnoid space: ventricle ratio

BACKGROUND

The subarachnoid space (SAS) and ventricular width (VW) in normal infants and children were studied with ultrasonography to provide the objective measurement and define a normal range for these measurements. The additional aim was to determine the stable ratio as a SAS/VW.

MATERIALS AND METHODS

A total of 100 healthy subjects, including 48 males and 52 females, were studied. The cases were divided into 3 age groups: 0-6 months(n = 65), 7-12 months (n = 24) and > 13 months (n = 11). Transfontanel ultrasonography was performed in all the cases. SAS, VW and the SAS/VW ratios were calculated. The study was approved by the ethical committee. All parents were informed about the sonographic examination and their approvals were taken.

RESULTS

SAS was calculated as 3.1 (0.5-6) mm and VW was calculated as 3.6(1.3-5) mm. SAS/VW ratio was 0.9 ± 0.3. There was no statistically significant difference among SAS, VW and SAS/VW ratios in 3-97 percentile group (p > 0.05).

CONCLUSIONS

Ultrasonography can be used as a practicable and reproducible modality in the measurement of SAS and VW in healthy children. It is a non-invasive method and allows for serial follow-up. SAS/VW ratio can be used as an index in healthy children.

NT-proBNP is associated with SYNTAX score and aortic distensibility in patients with stable CAD

OBJECTIVE

A high N-terminal pro-brain natriuretic peptide (NT-proBNP) level provides significant prognostic information on patients with coronary artery disease (CAD). It is unclear whether aortic distensibility (AD), which reflects the aortic stiffness, and the extent and complexity of CAD, assessed with the SYNTAX score (SS), affect the secretion of NT-proBNP in stable CAD. We aimed to investigate the relationship between NT-proBNP levels and AD as well as with the extent and complexity of CAD in stable CAD patients.

METHODS

The study included 411 patients with stable CAD (mean age = 61.7 ± 9.9 years, male/female = 247/164). The patients were divided into two groups according to the median NT-proBNP value (NT-proBNPlow group < 114 pg/ml and NT-proBNPhigh group ≥ 114 pg/ml). AD was calculated from the echocardiographically derived ascending aorta diameters and hemodynamic pressure measurements. Coronary angiography was performed and SS was determined in all patients. NT-proBNP and other biochemical markers were measured in all subjects.

RESULTS

The AD and ejection fraction values of the NT-proBNPhigh group were lower and their SS levels were higher compared with those from the NT-proBNPlow group (p < 0.05, for all). The NT-proBNP level was independently associated with AD (β = -0.378, p < 0.001), SS (β = 0.262, p < 0.001), and ejection fraction (β = - 0.295, p < 0.001) on multiple linear regression analysis.

CONCLUSION

NT-proBNP was independently associated with an impaired elastic property of the aorta and with the extent and complexity of CAD as well as with left ventricular systolic dysfunction.

Healthy lifestyle behaviour in university students and influential factors in eastern Turkey

This research was carried out to determine the healthy lifestyle behaviour of university students receiving education in central Erzincan. The population of this descriptive and cross-sectional research included a total of 4506 students receiving education at Erzincan University in the city centre, and the sampling included 981 students selected by a simple random sampling method from these schools. Data were collected between April and May 2008 by using an identification form and the Health Promotion Life-Style Profile (HPLP) Scale. Healthy lifestyle behaviour point averages of students were detected to be at medium level (118.41±20.90). It was established that student's grade, educational level of parents, economic status of the family and the student, the place where the student stays and smoking status of the student resulted in a significant difference in HPLP Scale total score average and the mean score of the majority of subscales.