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Health literacy, defined as the ability to obtain, understand, evaluate, and apply health information with knowledge, motivation, and skills, is crucial for maintaining and improving quality of life. Despite the availability of health information, limited health literacy is linked to health disparities, inadequate self-management of chronic diseases, and poorer health outcomes. The purpose of this study is to assess the health literacy of pregnant women who visit the Perinatology Outpatient Clinic for follow-up care. It seeks to identify gaps in knowledge and understanding that may impede effective healthcare delivery and inform targeted health education and public awareness programs to enhance health literacy. This prospective survey study included 210 pregnant women aged 18 to 40 years attending the Perinatology Outpatient Clinic at Giresun Obstetrics and Gynecology Training and Research Hospital, Turkey. Participants completed a questionnaire on health literacy, sociodemographics, and basic health status via Google Forms (Google Inc., Mountain View, CA, USA). Statistical analysis was performed using SPSS Statistics version 26.0 (IBM Corp., Armonk, NY, USA), employing tests such as Kolmogorov-Smirnov, Mann-Whitney U, Kruskal-Wallis, Student's t-test, ANOVA, Spearman, and Pearson correlation, and multivariate linear regression analysis. The mean age of participants was 29.97±5.44 years, with a mean health literacy score of 29.89±7.05. Education level and living place significantly influenced health literacy scores, with higher scores among those with higher education and urban living (p = 0.014 and p = 0.038, respectively). Economic status also significantly impacted health literacy, with lower scores among those with poor economic status (p<0.001). Health literacy scores were higher among those receiving health information from healthcare professionals (p = 0.006) and lower among those finding medical information from doctors insufficient (p = 0.008). Health literacy is significantly influenced by education level, living place, and economic status. The study emphasizes the necessity of focused health education initiatives, especially for individuals with lower educational attainment and those residing in rural regions. Improving health literacy via efficient communication from medical professionals can benefit expectant mothers and their unborn children by lowering medical expenses and improving health outcomes.

Background and Objectives: This study aimed to determine the effects of tourniquet use and the complications of total knee arthroplasty (TKA) in patients without comorbidities to investigate whether tourniquet application can be employed without adverse effects and to assess its impact on the occurrence of any complications. Materials and Methods: A total of 106 patients who underwent unilateral TKA were divided randomly into two groups according to whether a tourniquet was used during the surgery or not. Patients with comorbidities (except arterial hypertension) were excluded from the study. Knee Injury and Osteoarthritis Outcome Score, joint range of motion, visual analog scale (VAS) score, total blood loss during and after surgery, postoperative analgesic consumption, and side effects were the main factors evaluated in the study. Results: In the tourniquet group, where the VAS scores were higher, the use of analgesics was also significantly higher. While there was no statistically significant difference in total blood loss between the tourniquet and non-tourniquet groups, the postoperative and occult blood losses were higher in the tourniquet group. The differences between the two groups in all other parameters were very small and not statistically significant. Conclusions: The findings of the current study suggest that when the comorbidities of patients are thoroughly documented and clarified prior to surgery, tourniquets should be applied selectively to individuals without any pre-existing health conditions.

A growing literature in archaeological theory has embraced the “material turn,” especially what is branded as “Object-Oriented Ontology” (OOO). Some archaeologists view this as an opportunity for the discipline which is, by definition, a practice of knowing objects. Others argue that the material turn may open up hitherto-unexplored ways of looking at historical processes. While this all sounds very exciting for a new generation of archaeologists, we see a genuine need to be cautious about the implications of subscribing to OOO-inspired archaeologies. These new theoretical developments have a direct impact on how archaeologists narrate, conceptualize, and interpret the past, present and future. In this article, we scrutinize the philosophical pathway behind this perspective and discuss its relation to archaeological theory. We advocate a modest, responsive version of new materialist archaeologies that can engage more thoughtfully with the past and Anthropocene social crises of systemic injustice and inequality.

Background/Objectives: Preeclampsia is a systemic condition that can result in liver impairment and potentially lead to negative outcomes for both the mother and baby. Various indices have been created to facilitate the early detection of liver issues. Among these, the Fibrosis-4 index (FIB-4) and Fibrosis-5 index (FIB-5) have been utilized for several years to forecast liver dysfunction. In our research, we aimed to apply these indices to patients with preeclampsia for the first time. Methods: This retrospective study, conducted at Giresun University from 2017 to 2024, included 207 patients with preeclampsia and 205 healthy controls. Data on maternal age, BMI, obstetric history, delivery method, gestational age, birth weight, and Apgar scores were extracted from medical records for analysis and biochemical parameters. Data were analyzed statistically. Results: The study found that FIB-4 index values were significantly higher and FIB-5 index values were lower in preeclampsia patients compared to the controls. FIB-4 demonstrated a better diagnostic performance with higher sensitivity and specificity. Although the difference between the two indices was not statistically significant, both were independently predictive of preeclampsia. The correlation coefficient showed that FIB-4 was positively correlated with spot urine protein/creatinine ratio (SPCR) and aspartate aminotransferase (AST), while FIB-5 was negatively correlated with these parameters and with alkaline phosphatase. Conclusions: This study found that FIB-4 and FIB-5 are useful for predicting preeclampsia, with FIB-4 showing superior diagnostic performance. These findings highlight their potential in the early detection and management of preeclampsia. Further research is needed for clinical validation.

Objective: This study investigated the impact of maternal subclinical hypothyroidism on fetal thymus size and development and explored how inadequate thyroid hormone production in pregnant women affects the fetal thymus. Methods: Conducted at the Giresun Obstetrics, Gynecology, and Pediatrics Training and Research Hospital, this case–control study involved 86 pregnant women, 43 with hypothyroidism and 43 without. Maternal thyroid function was assessed using TSH and free T4 levels, and fetal thymus size and thymus–thorax ratio were measured using ultrasound. Exclusion criteria were chronic hypertension, gestational hypertension or eclampsia, multiple pregnancies, infectious diseases, renovascular diseases, diagnosed with hypothyroidism prior to pregnancy and other endocrine disorders, fetal cardiac diseases, and morbid obesity. Data collected included maternal age, gestational week, number of pregnancies, parity, number of living children, thyroid-stimulating hormone (TSH) and Free thyroxine 4 (T4) levels, and fetal thymus measurements (transverse diameter and thymus/thorax ratio). Statistical analyses were performed using the Mann–Whitney U test and logistic regression analysis. The relationships between TSH, thymus diameters, thorax diameters, and the thymus–thorax ratio were evaluated using Spearman’s correlation coefficient. Results: The thymus–thorax ratio was significantly reduced in the hypothyroid group (p = 0.003). Logistic regression analysis identified TSH as an independent risk factor for a low thymus–thorax ratio, with each unit increase in TSH associated with a 1.345-fold higher likelihood of having a low thymus–thorax ratio. A significant negative correlation was found between TSH levels and the TTR ratio (Spearman’s correlation coefficient r = −0.338, p = 0.001). Conclusions: An association was identified between maternal TSH levels and the thymus–thorax ratio, with increasing TSH levels correlating with a decrease in the thymus–thorax ratio. Regular monitoring of thyroid hormone levels during pregnancy and appropriate replacement treatment in cases of deficiency are crucial for optimal fetal thymus development. Further multicenter studies are needed to confirm these findings and investigate the long-term implications of altered fetal thymus development.

Background Hallux valgus is a deformity characterized by lateral deviation of the big toe and medial deviation of the first metatarsal, causing difficulty in walking and requiring various treatments. Despite its multifactorial etiology, the role of the tibialis anterior tendon in hallux valgus and its variations in the morphology of tibialis anterior tendon distal insertion sites have not been fully explored. This study aimed to evaluate the effect of such variations on hallux valgus using magnetic resonance imaging. Methods This was a retrospective study and included 115 individuals aged 18 years and older who underwent foot radiographs and MRI. The participants were divided into a hallux valgus group of 53 patients and a control group of 62 people based on radiographic measurements. Tibialis anterior tendon distal attachment was classified into five types according to the attachment morphology. Statistical analyses were performed to evaluate the relationship between the tibialis anterior tendon types and hallux valgus severity. Results Among the participants, patients who underwent foot radiography and MRI due to any medical indication 70.4% were female, with a mean age of 43.83 ± 15.25 years. In terms of tibialis anterior tendon distal attachment, the most common type was Type 5 (40.9%), followed by Type 2 (34.8%). Type 4 was not observed in any case. In all participants, the mean hallux valgus angle was 20.63 ± 8.42 o , and the mean intermetatarsal angle was 9.69 ± 2.68 o . Tibialis anterior tendon distal attachment Type 5 was significantly associated with an increased hallux valgus angle but not with the intermetatarsal angle. We found a significant relationship between the diameter of the tibialis anterior tendon and hallux valgus angle. Conclusions This study revealed a significant association between hallux valgus and Type 5 tibialis anterior tendon distal attachment, suggesting that tibialis anterior tendon morphology influences hallux valgus severity. The findings underscore the importance of considering variations in tibialis anterior tendon distal attachment sites in the etiopathogenesis and treatment planning of hallux valgus.

Background This study evaluates the effects of exenatide (EXE), a glucagon-like peptide-1 (GLP-1) receptor agonist, on bone healing in rats using a single radius cortical defect model and histopathological, biochemical, and in silico methods. Methods Forty-two male Sprague–Dawley rats, excluding controls, were divided into 7 groups after receiving a standard radius defect. The serum levels of total protein (TP), calcium (Ca 2+ ), phosphorus (P), alkaline phosphatase (ALP), osteocalcin (OC), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) in each specimen were measured. Radius samples were examined histopathologically using hematoxylin and eosin (H&E) and Masson’s trichrome staining. Molecular docking analyses were used to assess EXE interactions with the GLP-1 receptor and osteogenic transcription factors. Statistical significance was set at p < 0.05. Results Changes in the selected serum markers were observed in the blood samples obtained from the specimens; however, these changes may not have been due to EXE administration. No significant negative effect on bone healing was observed in the groups that received subcutaneous EXE after the bone defect was created. By contrast, it was observed that for the treatment group that received EXE for 7 consecutive days before the bone defect was created on Day 7, bone healing progressed more slowly than in the groups treated with saline. Regarding the binding of EXE to the other target receptors, root mean square deviation (RMSD) values were low, bruised surface area (BSA) was high, and electrostatic interactions were strong, indicating that the ligand (i.e., EXE) binds to the selected receptor surfaces. Conclusion Although the data obtained from the in vitro analyses in this study were verified using molecular docking, it should be noted that its design is preclinical. Given the widespread clinical use of GLP-1 receptor agonists in the management of type 2 diabetes mellitus (T2DM), our research findings may have translational relevance. Although derived from an experimental animal model, these results suggest that GLP-1 agonists such as EXE can exert additional effects on bone healing and inflammatory processes, thus warranting further studies, including controlled clinical investigations, to elucidate the potential implications for patient care.

IntroductionScoliosis, a multifaceted spinal deformity commonly affecting pediatric and adolescent populations, has spurred extensive scientific inquiry to understand its origins and impacts. Early-onset scoliosis (EOS), characterized by spinal curvature exceeding 10° before the age of 10, presents a unique challenge necessitating a comprehensive understanding of its etiological factors. Within this context, the potential role of hypoxia-induced by adenoid hypertrophy in contributing to the pathogenesis of EOS has emerged as an intriguing avenue of investigation.Materials and methodsThis retrospective study was conducted focusing on radiological and clinical data pertaining to children below 10 years of age who underwent isolated adenoidectomy for adenoid hypertrophy. Preoperative posteroanterior standing chest radiographs were utilized for scoliosis assessment, with Cobb angles serving as the primary measurement metric. To ensure accuracy and reliability, Cobb angle measurements were independently performed by two experienced observers. Statistical analyses encompassed the Mann-Whitney U test, Spearman correlation analysis, and intraclass correlation coefficient calculations to evaluate interobserver agreement.ResultsAmong the cohort of 218 pediatric adenoidectomy patients, 177 individuals had radiographs suitable for EOS evaluation. The mean age of the participants was 5.72±2 years, with a nearly equal distribution of 52.5% male and 47.5% female patients. Strikingly, the study identified a 10.2% prevalence of coronal plane curvatures exceeding the critical threshold of 10°, indicative of EOS. The robust interobserver reliability was demonstrated by a commendable mean interclass correlation coefficient (ICC) value of 0.926, affirming consistent and accurate Cobb angle measurements between the observers.ConclusionIn light of the heightened prevalence of EOS observed in children undergoing adenoidectomy, this study provides a compelling impetus for exploring the potential interrelationship between adenoid hypertrophy, hypoxia, and the emergence of early-onset scoliosis. The study underscores the importance of prospective research to elucidate the complex mechanisms connecting these factors, offering insights into potential risk factors and underlying pathogenic pathways associated with the development of early-onset scoliosis.

Background This study aimed to investigate the effects of Lopinavir/Ritonavir (Lop/r) on chondrocyte structure and extracellular matrix (ECM) integrity, as well as its impact on key proteins involved in anabolic and catabolic pathways, using both in vitro and in silico approaches. Methods Drug-target interaction networks were constructed through bioinformatics analyses, and molecular docking was performed. Human primary chondrocytes were treated with Lop/r, and untreated cells served as controls. Cell viability, proliferation, and protein expression levels were assessed using standard in vitro techniques, including spectrophotometric assays and Western blotting. Results Molecular docking analyses revealed strong binding affinities between Lop/r and osteoarthritis-related targets such as HIF-1α, EP300, TNF, IL-6, KCNA5, and IL-1β, suggesting modulation of hypoxia, inflammatory, and epigenetic pathways. In vitro, Lop/r did not alter chondrocyte morphology or ECM structure and was not cytotoxic ( p  < 0.05). However, it significantly reduced the expression of critical proteins including HIF-1α, SOX9, and IL-1β ( p  < 0.05). Conclusion These findings suggest that Lop/r may exert regulatory effects on cartilage-related molecular pathways and holds promise as a repurposed therapeutic agent for osteoarthritis. Further studies are warranted to confirm its potential in clinical applications.