Determination of perception levels of student nurses about nursing diagnosis.

OBJECTIVE: To determine perception levels of student nurses about nursing diagnosis. METHODS: The descriptive, comparative, cross-sectional study was conducted at the Nursing Department, Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey, in December 2015, and comprised nursing students studying in the 2nd, 3rd and 4th grades. Data was collected using a personal information form and the Perceptions of Nursing Diagnosis Survey. Data was analysed using SPSS 18. RESULTS: Of the 386 students, 317(82%) were female and 321(83%) considered themselves competent enough to make diagnosis. Also, 268(69%) students thought that nursing diagnosis was useful in providing planned, correct and systemised diagnosis. Mean total score of perception of nursing diagnosis of female students was higher than males (p=0.005). CONCLUSIONS: The students' perception level of nursing diagnosis was positive.

Serum activities of dipeptidyl peptidase-4 and adenosine deaminase in polycystic ovary syndrome: association with obesity.

Dipeptidyl peptidase-4 (DPP-4) plays a role in metabolic and inflammatory diseases. Increased adenosine deaminase (ADA) has been suggested to induce insulin resistance and inflammation. We measured serum DPP-4 and ADA activities. Serum ADA activity was significantly higher in PCOS group (p = .006), whereas there was no difference in serum DPP-4 activity between the groups (p > .05). When the study subjects were divided into four groups in terms of obesity; an increasing trend in serum ADA activity between the groups was observed and ADA activity was significantly higher in overweight and obese patients with PCOS than nonobese controls (p = .016), there were no significant differences between the other groups (p > .05). A positive correlation was found between ADA and BMI in the whole group (p = .022). Multivariate regression analyses revealed that significant determinants were diastolic blood pressure, ADA, and the presence of PCOS for DPP-4 (R2 = 0.344, F = 9.079, p < .001); the presence of PCOS and DPP-4 for ADA (R2 = 0.123, F = 6.302, p = .003). We demonstrated increased serum ADA activity as well as its association with obesity in PCOS, while there was no change in serum DPP-4 activity in women with PCOS.

Is thyroid autoimmunity itself associated with psychological well-being in euthyroid Hashimoto's thyroiditis?

Recent studies imply that euthyroid Hashimoto's thyroiditis (HT) might be related with impaired HRQoL, depression and anxiety. Ninety three patients with euthyroid HT and 31 age- and gender-matched euthyroid control subjects were enrolled into this study. SF-36 questionnaire, Beck Depression Inventory and Beck Anxiety Inventory tests were used for evaluating HRQoL, depression and anxiety. Beck Depression Inventory scores were higher in patients with HT compared to control subjects (7.5 (4.0-14.75) vs. 5.0 (2.25-9.0), p=0.008). Beck Anxiety Questionnaire scores were also higher in patients with HT than controls (9.50 (5.0-17.0) vs. 5.0 (2.0-11.75), p=0.021). In SF-36 questionnaire; physical functioning (26.0 (20.0-28.0) vs. 29.0 (26.0-30.0), p=0.038), general health (16.4 (13.4-20.4) vs. 19.4 (16.3-21.2), p=0.026) and mental health (20.5 (16.0-23.0) vs. 23.0 (21.0-25.0), p=0.001) scores were lower in patients with HT than control subjects. There were no significant differences between patients with HT under levothyroxine replacement therapy compared to those without therapy in terms of depression and anxiety scores and components of SF-36 questionnaire. Beck Depression Inventory scores were positively correlated with TSH (r=0.250, p=0.01). In SF-36, role physical (r=0.192, p<0.05) and vitality (r=0.181, p<0.05) were positively correlated with fT4. Role emotional was negatively correlated with TSH (r=-0.185, p<0.05) and anti-TPO (r=-0.234, p<0.05). Mental health was negatively correlated with anti-TPO (r=-0.287, p<0.01). HRQoL is impaired and depression and anxiety scores are high in patients with euthyroid HT independent of levothyroxine replacement. Therefore, our results indicate that thyroid autoimmunity itself may have an impact on psychological well-being in euthyroid patients with HT.

ASYMMETRIC DIMETHYLARGININE LEVELS AND ATHEROSCLEROSIS MARKERS IN CUSHING SYNDROME.

OBJECTIVE: As a consequence of hypercortisolism, Cushing syndrome (CS) is frequently observed with other diseases that are associated with atherosclerosis, including diabetes mellitus, dyslipidemia, hypertension, and obesity. Cardiovascular disease (CVD) is the primary cause of mortality and morbidity in CS. We investigate CVD risk markers such as asymmetric dimethylarginine (ADMA), lipoprotein-associated phospholipase A2 (Lp-PLA2), highsensitive C-reactive protein (hsCRP), homocysteine, lipid levels, ankle-brachial index (ABI), and carotid intimamedia thickness (CIMT) in CS. METHODS: Our study included 27 patients with CS and 27 age-, sex-, body mass index (BMI)-, and comorbid disease-matched control subjects. RESULTS: Plasma ADMA levels were significantly lower in the CS group than the control group (P = .013). Total cholesterol, low-density lipoprotein, triglycerides, high-density lipoprotein, and apolipoprotein A1 and apolipoprotein B levels were higher in patients with CS than the control group (P<.05). We did not find any statistically significant differences in levels of hsCRP, Lp-PLA2, or homocysteine or CIMT and ABI measurements between the CS group and comorbidity-matched control group (P>.05). CONCLUSION: We found that ADMA levels were lower in CS, the finding that should be further investigated. Levels of hsCRP, Lp-PLA2, and homocysteine levels and CIMT and ABI measurements were similar between the CS group and comorbidity-matched control group. None of these markers was prominent to show an increased risk of CVD in CS, independent of the comorbidities of CS. ABBREVIATIONS: ABI = ankle-brachial index Apo = apolipoprotein ADMA = asymmetric dimethylarginine BMI = body mass index CVD = cardiovascular disease CIMT = carotid intima-media thickness CS = Cushing syndrome DM = diabetes mellitus DDAH = dimethylarginine dimethylaminohydrolase ELISA = enzyme-linked immunosorbent assay HDL = high-density lipoprotein hsCRP = high-sensitive C-reactive protein HOMA-IR = homeostatic model assessment of insulin resistance HT = hypertension LDL = low-density lipoprotein Lp-PLA2 = lipoprotein-associated phospholipase A2 Lp-a = lipoprotein a NO = nitric oxide.

Lymph node fine-needle aspiration washout thyroglobulin in papillary thyroid cancer: Diagnostic value and the effect of thyroglobulin antibodies.

PURPOSE: Thyroglobulin (Tg) assessment in the needle washout after fine-needle aspiration biopsy (FNAB) of a suspicious neck lymph node (LN) is known to improve the diagnostic accuracy in patients with papillary thyroid cancer (PTC). However, there is still controversy on the best diagnostic cut-off levels for FNAB-Tg and whether thyroglobulin antibody (TgAb) positivity affects FNAB-Tg. The objectives of this study were to determine (i) the diagnostic power of different cut-offs for FNAB-Tg and (ii) if serum TgAb(+) negatively affects the FNAB-Tg evaluation. METHODS: This was a retrospective cohort study analyzing PTC patients with suspicious neck LNs, in a university hospital setting, from October 2009 to October 2013. In total, 103 patients with PTC (226 LNs) undergoing ultrasound-guided FNAB for LNs were included. Cytology and FNAB-Tg levels were compared in reference to LN histopathology and the effect of TgAb(+) on FNAB-Tg levels was evaluated. RESULTS: The diagnostic accuracies of FNAB-Tg cut-off of 1 and 10 ng/mL were 94.1% and 88.2%, respectively. Raising the cut-off from 1 to 10 ng/mL led to decreased sensitivity rates (91.9% vs. 83.9%). The receiver operating characteristic curve analysis demonstrated that the best FNAB-Tg cut-off was 1.2 ng/mL. There were no LNs with an FNAB-Tg ≥ 10 ng/mL that turned out to be cytologically or histopathologically benign. FNAB-Tg levels of the histopathologically malignant LNs were similar between TgAb (+) and TgAb (-) patients (p = 0.546). Serum Tg predicted FNAB-Tg levels above 1 ng/mL (p = 0.002) and FNAB-Tg predicted malignant histopathology (p = 0.004), both independently of the TgAb status of the patient. CONCLUSIONS: FNAB-Tg ≥ 1 ng/mL has a superior diagnostic power, irrespective of TgAb (+), in PTC patients with suspected LN involvement.

Cephalometric assessment of soft tissue morphology of patients with acromegaly.

AIM: To assess the sagittal soft tissue morphology of patients with acromegaly in comparison with a healthy control group. METHODS: Twenty-seven patients with acromegaly (11 male, 16 female; mean age 47.3 ± 11.5 years) and 30 healthy subjects (15 male, 15 female; mean age 42.2 ± 17.4 years) were included in the study. Linear and angular measurements were made on lateral cephalograms to evaluate soft tissue and skeletal characteristics. The intergroup comparisons were analysed with the Student's t-test. RESULTS: Facial convexity (p < 0.01) and the nasolabial angle (p < 0.001) were reduced in patients with acromegaly, whereas nose prominence (p < 0.01), upper lip sulcus depth (p < 0.01), upper lip thickness (p < 0.01), basic upper lip thickness (p < 0.01), lower lip protrusion (p < 0.05), mentolabial sulcus depth (p < 0.05) and soft tissue chin thickness (p < 0.001) were increased. Anterior cranial base length (p < 0.05), the supraorbital ridge (p < 0.01), the length of the maxilla and mandible (p < 0.001, p < 0.01, respectively) were significantly increased, and mandibular prognathism was an acromegalic feature (p < 0.05). CONCLUSION: Acromegalic coarsening and thickening of the craniofacial soft tissues was identified from lateral cephalograms, which may therefore contribute to early diagnosis when evaluated together with other changes caused by the disease.

Markers of early atherosclerosis, oxidative stress and inflammation in patients with acromegaly.

PURPOSE: Data regarding atherosclerosis in acromegaly is controversial in literature. We aimed to investigate the markers of early atherosclerosis, oxidative stress, inflammation and their relationships with each other in acromegaly. METHODS: Thirty-nine patients with acromegaly and 40 control subjects were enrolled. Patients were classified into two groups; active acromegaly (AA) and controlled acromegaly (CA). Controls were matched by age, gender, body mass index and presence of cardiovascular risk factors. Flow mediated dilatation (FMD), carotid intima media thickness (CIMT), epicardial adipose tissue thickness (EAT) were measured and serum levels of oxidative stress parameters, high mobility group box 1 protein (HMGB1) and high sensitive CRP (hs CRP) were evaluated. RESULTS: Significantly decreased FMD, increased CIMT and EAT were found in patients with acromegaly compared to controls (p < 0.01, p < 0.05, p < 0.001, respectively). EAT correlated negatively with FMD (r = -0.24, p = 0.038) and positively with CIMT (r = 0.37, p < 0.01). Presence of acromegaly, hypertension and age were found to be the predictors of early atherosclerosis (p < 0.05). Hs CRP was decreased in AA compared to controls (p = 0.01). There were no significant differences for HMGB1 and oxidized LDL (ox-LDL) cholesterol levels and total antioxidant capacity (TAC) between AA, CA and controls (p > 0.05). CONCLUSION: Early atherosclerosis measured with FMD, CIMT and EAT may exist in acromegaly. However, decreased hs CRP and unchanged HMGB1, ox-LDL and TAC levels suggest that inflammation and oxidative stress do not seem to contribute to the development of atherosclerosis in these patients.

Proprotein convertase subtilisin/kexin type 9 (PCSK9), soluble lectin-like oxidized LDL receptor 1 (sLOX-1) and ankle brachial index in patients with differentiated thyroid cancer.

The cardiovascular effects of short-term overt hypothyroidism are not well known. We investigated proprotein convertase subtilisin/kexin type 9 (PCSK9), soluble lectin-like oxidized LDL receptor 1 (sLOX-1) and the ankle brachial index (ABI) in thyroid cancer patients with short-term overt hypothyroidism due to thyroid hormone withdrawal (THW). Twenty-one patients requiring radioactive iodine (RAI) ablation or scanning and 36 healthy control subjects were enrolled. Patients were evaluated in the subclinical thyrotoxic phase when they were on suppressive levothyroxine therapy and in the overt hypothyroid phase due to THW for four weeks. PCSK9, sLOX-1, lipids and ABI were measured in the patient and control groups. Total cholesterol, LDL cholesterol, triglycerides and Apo B levels were increased in short overt hypothyroidism compared with the control group (p<0.001). PCSK9 levels increased before THW and after THW in the patients compared to control group (p<0.001, p=0.004, respectively). sLOX-1 levels were not different between patients with short term overt hypothyroidism and control group (p=0.27). ABI was found to be significantly decreased in patients with thyroid cancer before and after THW compared to control group (p=0.04, p=0.002 respectively). PCSK9 levels were correlated negatively with ABI (r=-0.38, p=0.004). In conclusion; our study demonstrated that patients with differentiated thyroid cancer both before and after THW which is a short term overt hypothyroid phase, had increased PCSK9 levels and decreased ABI. Short term overt hypothyroidism also leads to increased HDL, LDL, total cholesterol, Apo A and Apo B levels.

Selenoprotein P is not elevated in gestational diabetes mellitus.

Selenoprotein P concentrations have been found to be associated with insulin resistance and elevated in patients with type 2 diabetes mellitus (DM). The aim of the present study was to investigate circulating selenoprotein P level and its possible relationship with metabolic parameters in gestational diabetes mellitus (GDM). Plasma selenoprotein P concentrations were measured in 30 pregnant women with GDM, 35 pregnant women without GDM and 22 healthy nonpregnant women. No difference in selenoprotein P levels was observed among the groups [6.2 (4.5-8.2), 7.9 (4.5-10.7) and 6.7 (5.3-9.1) ng/ml, respectively, p = 0.69]. In pregnant women with and without GDM, selenoprotein P did not correlate with age, gestational age, prepregnancy body mass index (BMI), HbA1c, glucose concentrations at oral glucose tolerance test (OGTT), area under curve (AUC) glucose, total cholesterol, LDL cholesterol and triglycerides levels (p > 0.05). But, there were statistically significant correlations between selenoprotein P and current BMI (r = -0.28, p = 0.04) and HDL cholesterol levels (r = 0.43, p = 0.01). We found that selenoprotein P concentrations are not elevated in women with GDM but associated with BMI and HDL cholesterol.

Craniofacial and pharyngeal airway morphology in patients with acromegaly.

OBJECTIVE: The aim of this study was to assess differences in craniofacial characteristics, upper spine and pharyngeal airway morphology in patients with acromegaly compared with healthy individuals. MATERIALS AND METHODS: Twenty-one patients with acromegaly were compared with 22 controls by linear and angular measurements on cephalograms. The differences between the mean values of cephalometric parameters were analyzed with Mann-Whitney U-test. RESULTS: With respect to controls, anterior (p<0.05), middle (p<0.01) and posterior (p<0.05) cranial base lengths were increased, sella turcica was enlarged (p<0.001) and upper spine morphology demonstrated differences in the height of atlas (p<0.01) and axis (p<0.05) in patients with acromegaly. Craniofacial changes were predominantly found in the frontal bone (p<0.01) and the mandible (p<0.05). As for the airway, patients with acromegaly exhibited diminished dimensions at nasal (p<0.001), uvular (p<0.01), mandibular (p<0.01) pharyngeal levels and at the narrowest point of the pharyngeal airway space (p<0.001) compared to healthy controls. Soft palate width was significantly higher (p<0.001) and the hyoid bone was more vertically positioned (p<0.01) in patients with acromegaly. CONCLUSIONS: Current results point to the importance of the reduced airway dimensions and that dentists and/or orthodontists should be aware of the cranial or dental abnormalities in patients with acromegaly.

Destructive thyroiditis followed by hypothyroidism associated with infliximab therapy.

OBJECTIVE: To present the rare case of a patient who developed destructive thyroiditis accompanied by transient thyrotoxicosis resulting from infliximab therapy for the treatment of psoriasis. METHODS: The clinical presentation and management of a case with infliximab-associated thyroiditis is described with a brief review of the literature. RESULTS: A 57-year-old male who suffered from psoriasis was treated with infliximab therapy for 4 years. Thyroid function tests were normal before infliximab therapy. When the patient presented in our clinic, he had thyrotoxicosis and was using propylthiouracil. A 99m Technetiumpertechnetate thyroid scintigraphy scan showed no visualization of either thyroid lobe or decreased thyroid iodine uptake. Thyroid-stimulating hormone (TSH) receptor antibody, thyroid peroxidase antibody (anti-TPO Ab) and thyroglobulin antibody (anti-Tg Ab) were negative. Thyroid ultrasonography revealed a heterogeneous thyroid gland without nodules. After stopping propylthiouracil therapy, we advised monitoring of his thyroid function tests in the following weeks, and infliximab therapy for psoriasis was continued. Four weeks later, his thyroid function tests showed an elevated TSH level with normal levels of free triiodothyronine and thyroxine (FT3 and FT4, respectively), and levothyroxine treatment was administered to the patient. Thyroid function tests normalized after levothyroxine treatment. One year later, infliximab therapy was stopped because of clinical remission. Simultaneously, levothyroxine treatment was also stopped. His thyroid function tests were normal 6 weeks after the cessation of levothyroxine treatment. CONCLUSION: To our knowledge, the present report is the third infliximab-associated thyroid disorder case. Periodic follow-up of thyroid function tests is necessary during infliximab therapy.

Effectiveness of a hybrid approach in integrating GLP-1 agonists and lifestyle guidance for obesity and pre-diabetes management: RWE retrospective study.

Aim: Emerging anti-obesity pharmacotherapy provides an option to correct maladaptive physiological and hormonal changes associated with obesity. One of the widely used medications in this context is glucagon-like peptide 1 (GLP-1) agonists. However, the misuse of these medications without any guidance and monitoring of lifestyle modifications can lead to unfavorable outcomes. The study aims to evaluate the effectiveness of a hybrid care model, incorporating GLP-1 and GLP-1/GIP agonist therapies, in managing obese patients with/without pre-diabetes. This study showcases the midway results of a 6-month program, which includes a multidisciplinary care team and digital technology for continuous engagement and monitoring of patients, both in-clinic and remotely. Methods: In a retrospective observational study, 115 participants were treated with GLP-1s (semaglutide, tirzepatide, and liraglutide). Physicians, dietitians, and coaches worked together to support behavioral changes using a dedicated app provided to patients. At the care team end, an integrated portal enabled continuous data flow allowing for the care team to provide personalized care via chat at regular intervals. Data collected included food logs, continuous glucose monitoring (CGM), and digital biomarkers such as sleep and activity. Results: At the midpoint of the program, participants exhibited statistically significant improvements in various metabolic parameters. Mean weight reduction was 8 %, with significant reductions in BMI, fat mass, and cholesterol levels. 24 (20.9 %) of patients lost ≥5 % of body weight, 55 (47.8 %) patients lost ≥10 % weight, and 36 (31.3 %) patients lost ≥15 % weight. Sub-analysis of pre-diabetic patients (n=36) demonstrated substantial improvements, including control of pre-diabetes in 80.6 % of cases and reduced HbA1c levels back to normoglycemia (5.39 ± 0.27). Conclusion: The Zone.Health's program, which combines pharmacotherapy with continuous engagement and monitoring to enable sustainable lifestyle modifications, demonstrated significant improvements in weight, body composition, and metabolic markers. Pre-diabetes was also effectively addressed. It is necessary to conduct further research to assess the long-term sustainability and optimal adoption of such care models into clinical practice.

Effectiveness of a hybrid technology enabled care model as measured by ICHOM standard set on established and managed type 2 diabetes already using medications: A RWE retrospective study.

Aims: Diabetes is a pressing global health issue, demanding innovative strategies for improved treatment. However, traditional care often falls short of patient goals. To address this, digital health solutions, including smartphone apps and remote monitoring, have emerged as crucial in diabetes management. This study aims to assess a comprehensive intervention, combining remote continuous data monitoring (RCDM) with in-clinic care, for enhancing diabetes-related outcomes. Additionally, it seeks to evaluate the effectiveness of the digital RCDM component by comparing adherent and non-adherent patients. Methods: Conducted in the United Arab Emirates, a retrospective study involved 89 patients primarily on anti-diabetic medications. They were split into two groups based on adherence to RCDM. Over time, significant improvements were observed across various parameters. Results: Notably, patients exhibited weight loss (-4.0 ± 5.3, p < 0.001), reduced waist circumference (-4.74 ± 7.8, p < 0.001), lowered HbA1c levels (-1.00 ± 1.3, p < 0.001), decreased systolic BP (-3.1 ± 13.1, p = 0.035), and diminished diastolic BP (-3.4 ± 9.9, p = 0.002) annually. Furthermore, patients adhering to the GluCare model demonstrated substantial HbA1c reductions (-1.53 ± 1.5, p < 0.001), improved lipid profiles, notably decreased total Cholesterol (-16.6 ± 50.3, p = 0.034), and lowered LDL levels (-18.65 ± 42.6, p = 0.006). Conclusions: The intervention model effectively managed T2D patients through a comprehensive approach, yielding notable improvements in HbA1c levels and other outcomes within a year. The study underscores the limitations of traditional care and reliance simply on pharmacotherapy, and emphasizes the need for a hyper-personalized, and continuous approach for T2D management.

Investigating the interaction of x-ray free electron laser radiation with grating structure.

The interaction of free electron laser pulses with grating structure is investigated using 4.6±0.1 nm radiation at the FLASH facility in Hamburg. For fluences above 63.7±8.7 mJ/cm2, the interaction triggers a damage process starting at the edge of the grating structure as evidenced by optical and atomic force microscopy. Simulations based on solution of the Helmholtz equation demonstrate an enhancement of the electric field intensity distribution at the edge of the grating structure. A procedure is finally deduced to evaluate damage threshold.

Comparison of the effects of face-to-face and electronic peer mentoring on students' care plan preparation and motivation levels.

BACKGROUND: It is a basic requirement in professional nursing education that nursing students learn the process of caring as the entity at the center of nursing practice. Peer mentoring programs can be beneficial for the mutual growth of mentors and mentees and improve the care competencies of nursing students. OBJECTIVE: To compare the effects of face-to-face and electronic peer mentoring on students' nursing process-based patient care plan preparation and motivation levels for the course. DESIGN: The study used an experimental three-group design. SETTINGS AND PARTICIPANTS: This experimental study was conducted with 83 first- and 6 fourth-year nursing students. METHOD: The data were collected with the information and opinion form, the Instructional Materials Motivation Survey (IMMS), and the Nursing Care Plan Rubric (NCPR). In the study, conducted with three subgroups of each group, the experimental group received electronic peer mentoring (EPM), and the experimental group 2 received face-to-face peer mentoring (FPM), while the control group did not receive any intervention. RESULTS: It was statistically significant that the students in the EPM group had higher patient care plan preparation scores than the FPM and control groups, and the FPM group had higher patient care plan preparation scores than the control group (p < 0.05). Also, the students in the FPM group had statistically significantly higher confidence-satisfaction sub-dimension scores on the IMMS than those in the EPM and control groups (p < 0.05). CONCLUSION: While electronic peer mentoring was effective on the patient care plan preparation levels of first-year nursing students, face-to-face peer mentoring was more effective in increasing the students' confidence and attitude levels and thus their motivation levels.

Synthesis and Application of Reactive Acrylic Latexes: Effect of Particle Morphology.

The aim of the study is the synthesis and characterization of epoxy functional reactive polyacrylic latexes, e.g., poly (BA-co-MMA-co-AN-co-GMA) with core/shell and non-structured (random) particle morphologies. Additionally, their performance as binders and coating ability in leather finishing were studied. The epoxy functional polymers were synthesized via the seeded emulsion polymerization technique and the obtained latexes were characterized by means of particle size, zeta potential, FTIR, TEM, DSC, DMTA, and TGA. The results showed that the particle size and zeta potential values were very similar for both latexes, except core/shell latex had slightly higher particle size. DSC, TEM, and DMTA studies verified the successful synthesis of core/shell latex morphology. The copolymer films were elastic in nature and had low Tg values (-13 and -20 °C). The performance results showed some different behavior for core/shell and random copolymer coatings. The abrasion resistance of the leather finish with random copolymer as binder exhibited slightly better values, especially in wet conditions. On the other hand, the leathers finished with core/shell binder showed better performance in flexing endurance and the water spotting test.

Nursing students' classroom climate perceptions: A longitudinal study.

BACKGROUND: As a versatile and dynamic process, classroom climate directly affects the learning levels of students and their quality of life while in school. OBJECTIVES: The study was conducted to explore and compare nursing students' perceptions of classroom climate throughout four years of university education and to evaluate the influencing factors. DESIGN AND SETTINGS: The longitudinal study was conducted between 2017 and 2020 in the nursing department of a university in Turkey. PARTICIPANTS: The study was carried out with 134 nursing students who enrolled in their first year and agreed to participate in the study. METHODS: The data were collected at the end of the fall semester of each of the four years using the Student Information Form and the Classroom Climate Inventory. RESULTS: The mean score of students' perceptions of classroom climate was 2.88 ± 0.83 for all academic years. The classroom climate inventory mean scores of fourth-year students were statistically significantly higher than their scores in the first and third years (p = 0.000). The students' classroom climate levels were statistically significantly affected by the positive classroom communication among students in all academic years in a positive direction. Statistically significant effective factors in students' classroom climate perceptions by year were as follows: the sense of belongingness to the class in the second and third years (although significantly lower in the first year), socio-cultural activities organized at school the second and fourth years (p < 0.05), instructors' attitudes supporting classroom communication in the first year, and opportunities supporting communication in the school environment in the fourth year (p < 0.05). CONCLUSIONS: Students' perception of the classroom climate was moderate overall and affected by positive classroom communication among students in all academic years. School administrators and educators can develop strategies and organize activities to increase positive communication in the classroom.

The impacts of wave energy conversion on coastal morphodynamics.

In recent decades, utilization of renewable energy resources, including ocean waves, has been promoted as part of a global effort to transition away from the use of fossil fuels. This is largely due to the accompanying greenhouse gas emissions and its catastrophic impacts on the environment, which are expected to worsen with the changing climate. Energy from ocean waves can be harnessed and converted into electricity with devices referred to as wave energy converters (WECs). Many researchers have studied the impacts of the WECs on coastal hydrodynamics, however, the impact on morphodynamics is not as well understood. In this paper, we review studies that assess the impacts of wave farms on coastal erosion. The results of a number of studies that focus on various locations around the world show that WECs often generate clean and renewable energy without negatively impacting local coastlines, and in fact often mitigate coastal erosion.

Evaluation of controlled-drift detectors in X-ray spectroscopic imaging applications.

A detector that looks promising for advanced imaging modalities--such as X-ray absorption contrast imaging, X-ray fluorescence imaging, and diffraction-enhanced imaging--is the controlled-drift detector (CDD). The CDD is a novel two-dimensional X-ray imager with energy resolving capability of spectroscopic quality. It is built on a fully depleted silicon wafer and features fast readout while being operated at or near room temperature. The use of CDDs in the aforementioned applications allows translating these techniques from synchrotron-based experiments to laboratory-size experiments using polychromatic X-ray generators. We have built a dedicated and versatile detection module based on a 36 mm2 CDD chip featuring pixels of 180 x 180 microm 2, and we evaluated the system performance in different X-ray imaging applications both with synchrotron-based experiments and in the laboratory environment.

Possible use of corn starch as tanning agent in leather industry: Controlled (gradual) degradation by H2O2.

High molecular weight/size and poor solubility of native starch seems to be preliminary drawbacks in its possible use in leather processing as a tanning/retanning agent. For this purpose, firstly the native starch which has too large molecular size to penetrate between skin fiber matrix was oxidized with H2O2 in different molar ratios for disintegrating into appropriate molecular size that can be used in tanning process. Then, the product yields, water solubilities and degree of substitutions of oxidized starches were determined. Also, the oxidized starch samples were characterized by Fourier Transforms Infrared (FT-IR) Spectroscopy, Gel Permeation Chromatography (GPC) and Proton Nuclear Magnetic Resonance (1H NMR) Spectroscopy. According to the GPC results, the oxidized starch samples which their molecular weights were reduced for penetrating into skin fibers were selected and they were used in tanning process of goat skins. The tanning effects of selected oxidized starches were evaluated according to shrinkage temperatures, filling coefficients and Scanning Electron Microscopy (SEM) analysis. From the results, it was revealed that the native corn starch can be oxidized with H2O2 in a controlled manner and oxidized starch can be utilized as a tanning/retanning agent in leather making.