Explore the vast range of titles available.

In this study, we focus on the possible roles of second-order syntactic recursion and working memory in terms of simple and complex span tasks in the development of second-order false belief reasoning. We tested 89 Turkish children in two age groups, one younger (4;6-6;5 years) and one older (6;7-8;10 years). Although second-order syntactic recursion is significantly correlated with the second-order false belief task, results of ordinal logistic regressions revealed that the main predictor of second-order false belief reasoning is complex working memory span. Unlike simple working memory and second-order syntactic recursion tasks, the complex working memory task required processing information serially with additional reasoning demands that require complex working memory strategies. Based on our results, we propose that children's second-order theory of mind develops when they have efficient reasoning rules to process embedded beliefs serially, thus overcoming a possible serial processing bottleneck.

In educational settings, students rely on metacognitive processes to determine whether or not to exert effort. We investigated ways to minimize cognitively disengaged responses (i.e., not-fully-effortful responses) during a low-stakes mathematics assessment. Initially, we established theory-driven time thresholds for each item to detect such responses. We then administered the test to 800 eighth-graders across three conditions: (a) control (n = 271); (b) instruction (n = 267); and (c) nudge (n = 262). In the instruction condition, students were told to exert their best effort before starting the assessment. In the nudge condition, students were prompted to give their best effort following each first-attempt response that was both incorrect and not-fully-effortful. Therefore, students had multiple opportunities to adjust their level of effort. Nudges, but not effort instruction, significantly reduced students’ not-fully-effortful responses. Neither the nudges nor the effort instruction significantly impacted performance. In a post-test survey, most students reported that they received nudges whenever they did not know the answer (55%). Overall, these findings suggest that while nudges reduce cognitively disengaged responses, most students appear to strategically modulate their level of effort based on self-monitoring their knowledge and response effort.

BackgroundThe purpose of this study was to investigate the long-term mortality rates of patients with obstructive sleep apnea (OSA) who received an overnight polysomnogram (PSG) for obtaining the diagnosis and to determine the relationship between PSG parameters and overall mortality.MethodsBetween 2007 and 2013, patients who had overnight PSG and were diagnosed with OSA were included in the study. Factors which are thought to influence mortality were assessed for 5-year and overall survival using the log rank test and Kaplan-Meier survival curves. Using multivariable Cox regression analysis, a model was constructed for factors influencing 5-year and overall survival.ResultsA total of 762 patients with a mean age of 52.7 (±10.8) and a dominance of men (74.7%) were studied. Gender, OSA severity subgroups, and apnea hypopnea index (AHI) were not statistically significantly associated with either 5-year or overall mortality (p<0.05 for both). Age, having a cardiovascular comorbidity, proportion of rapid eye movement (%REM), and total sleep time with an oxyhemoglobin saturation of less than 90% (T90) all showed a significant correlation with overall all-cause mortality in the model. For 5-year mortality and overall mortality, the hazard ration (HR) for T90 was 3.6 (95% CI (1.6–8.0) p=0.001) and 3 (95% CI (1.6–5.7) p=0.001), respectively.ConclusionThe study findings suggest that not AHI but PSG parameters of hypoxia, mainly T90, having cardiovascular comorbidity, and %REM sleep were significant risk factors for all-cause mortality in patients with OSA. The association of OSA, hypoxia, and mortality is an area that deserves further study.

Herein, two title compounds, N-benzoyl-N′-(4′-cyanophenyl)thiourea (1) and N-(4-nitrobenzoyl)-N′-(4′-cyanophenyl)thiourea (2) were synthesized in a high yield, via different applications of aroyl isocyanate and 4-aminobenzonitrile. The structure of the prepared compounds was characterized by elemental analysis and FT-IR, 1H, and 13C-NMR spectroscopic methods. The crystal structure of the title compound 1 was determined by an X-ray single-crystal technique and an intramolecular C=O…H-N hydrogen bond and intermolecular C=S…H-N and C=S…H-C hydrogen interactions, which were observed for the crystal structure. The molecular electrostatic potential (MEP) and the Mulliken atomic charges of title compounds 1 and 2 were theoretically calculated and interpreted. Cyclic voltammetric (CV) experiments for the compounds were performed with the glassy carbon electrode. The reduction in potential values of the different functional groups such as nitro and cyano in title compounds were investigated using CV curves.

Background and Objectives: Metabolic tumor volume (MTV) and inflammation-based indices have recently gained attention as potential prognostic markers of diffuse large B-cell lymphoma (DLBCL). We aimed to evaluate the prognostic significance of metabolic and systemic inflammatory parameters in predicting treatment response, relapse, and overall survival (OS) in patients with DLBCL. Materials and Methods: This retrospective cohort study included 70 patients with DLBCL. Clinical characteristics, laboratory values, and metabolic parameters, including maximum standardized uptake value (SUVmaxliver and SUVmax), heterogeneity indices HI1 and HI2, and MTV were analyzed. Survival outcomes were assessed using Kaplan–Meier and log-rank tests. Receiver operating characteristic analyses helped evaluate the diagnostic performance of the selected biomarkers in predicting relapse and mortality. Univariate and multivariate logistic regression analyses were conducted to identify the independent predictors. Results: The mean OS and mean relapse-free survival (RFS) were 71.6 ± 7.4 and 38.7 ± 2.9 months, respectively. SUVmaxliver ≤ 22 and HI2 > 62.3 were associated with a significantly shorter OS. High lactate dehydrogenase (LDH) levels and HI2 > 87.9 were significantly associated with a reduced RFS. LDH, SUVmaxliver, and HI2 had a significant predictive value for relapse. SUVmaxliver and HI2 levels were also predictive of mortality; SUVmaxliver ≤ 22 and HI2 > 62.3 independently predicted mortality, while HI2 > 87.9 independently predicted relapse. MTV was not significantly associated with survival. Conclusions: Metabolic tumor burden and inflammation-based markers, particularly SUVmaxliver and HI2, are significant prognostic indicators of DLBCL and may enhance risk stratification and aid in identifying patients with an increased risk of relapse or mortality, potentially guiding personalized therapy.

OBJECTIVE: The purpose of this study was to evaluate the predictive power of the screening questionnaires including Epworth Sleepiness Scale (ESS), Berlin questionnaire (BQ) and STOP-Bang questionnaire (SBQ) to identify the high-risk patients for OSA in a sleep clinic setting considering age, gender and comorbidities. MATERIAL AND METHODS: 1003 patients who admitted to our sleep center with the preliminary diagnosis of OSA between June 2016- May 2018 were included in the study. All patients underwent in-lab polysomnographic examination and filled out ESS, Berlin and STOP-Bang questionnaires. Predictive parameters for each screening questionnaires were calculated. RESULTS: For apnea-hypopnea index (AHI) ≥5/h, the sensitivity and the specificity of the EES, BQ and SBQ were 50.6%, 89.8%, 97.9% and 56.6%, 27.3%, 16.2% respectively. The STOP-Bang questionnaire had the highest sensitivity in both males and females (99.1%, 94.8% respectively) and in the different age groups (97.3% for ≥45 age-group, 99.2% for ≥65 age-group). In the groups of patients with hypertension, diabetes mellitus, coronary artery disease, chronic obstructive pulmonary disease and asthma, the sensitivity of the STOP-Bang questionnaire was 99.5%, 100%, 99.5%, 100%, 97.4%, respectively. CONCLUSION: The STOP-Bang questionnaire had the highest sensitivity for detecting high-risk patients for OSA in a sleep clinic setting. STOP-Bang questionnaire was superior to the Berlin questionnaire and ESS in the different groups of age, gender, and comorbidities. Considering the close relationship between OSA and comorbidities, it is critical to screen patients in terms of OSA in outpatient clinics of internal medicine, cardiology, and chest disease departments. The STOP-Bang questionnaire, with its high sensitivity, may be useful for screening OSA. However, the low specificity should be improved in the questionnaire.

Objective: To evaluate the differences in demographic and polysomnographic (PSG) features between the board and restricted definitions of rapid eye movement (REM)-related obstructive sleep apnea (OSA), and whether different diagnostic criteria lead to different clinical classifications and treatment approaches. Materials and Methods: A total of 1096 patient files were screened for REM-related OSA. Patients with REM-related OSA were included in the study and classified into two groups according to the board and restricted definition of REM-related OSA. Demographic and PSG features and treatment approaches were compared between both groups. Results: This study Included a total of 154 patients: 33 (21.4%) were classified as restricted REM-related and 121 (78.6%) as board REMrelated OSA. There were no differences between the two groups in terms of age (p=0.061), sex (p=0.274), Body Mass index (p=0.055), and co-morbidities (p=0.299). Significant differences were observed between the groups with regard to Epworth Sleepiness scale (p=0.033). The total Apne-hipopne index (AHI), AHIREM, and AHINREM in the board REM-related OSA group were significantly higher than those in the restricted REM-related OSA group (p<0.001). Treatment with only lifestyle interventions was recommended to fifty-one (35.1%) patients, whereas positive airway passage therapy was recommended to 100 (64.9%) patients. Forty-one (26.6%) patients refused PAP titration. Lifestyle interventions only were recommended more commonly to patients with restricted REM-related OSA than to those with board REMrelated OSA (p=0.004). Conclusion: The restricted definition of REM-related OSA yields milder but sleepy patients compared with the board definition. Particular attention should be given to sleepy patients with milder REM-related OSA with regard to the treatment options. Not only lifestyle interventions, but also PAP therapy should be considered in the treatment of patients who are sleepier

Students exhibit many behaviors when responding to items on a computer-based test, but only some of these behaviors are relevant to estimating their proficiencies. In this study, we analyzed data from computer-based math achievement tests administered to elementary school students in grades 3 (ages 8–9) and 4 (ages 9–10). We investigated students’ response process data, including the total amount of time they spent on an item, the amount of time they took to first respond to an item, the number of times they “visited” an item and the number of times they changed their responses to items, in order to explore whether these behaviors were related to overall proficiency and whether they differed across item formats and grades. The results indicated a non-linear relationship between the mean number of actions and proficiency, as well as some notable interactions between correctly answering an item, item format, response time, and response time latency. Implications for test construction and future analyses in this area are discussed.

Objective: The purpose of this study is to evaluate the subjective sleep quality, factors affecting sleep quality, and the risk of Obstructive Sleep Apnea syndrome (OSAS) in the patients with stable Chronic Obstructive Pulmonary disease (COPD). Materials and Methods: We included the patients who were admitted to our chest diseases clinic and evaluated as stable COPD in the study. Pittsburgh Sleep Quality index (PSQI) and STOP-Bang survey were applied to the patients to evaluate the sleep quality and the risk for OSA. Results: We included 75 patients (67 males and 8 females) in this study. In total, 38.7% of the patients had a PSQI >5, whereas 61.3% of them had a PSQI ≤5. The comparison of groups revealed a significant difference in terms of diagnosis of hypertension, excessive daytime sleepiness, and sleep efficiency (p=0.005, p=0.049, p<0.001, respectively). There was no significant difference regarding the COPD stages between the groups (p=0.141). The question “to go to the toilet at night” from PSQI was the question had the highest score. According to the STOP-Bang score, 15 (20%) patients were identified at a low risk, 27 (36%) were at a medium risk, and 33 (44%) at a high risk for OSA. Conclusion: We determined that 37.8% of patients with stable COPD had a poor sleep quality and 44% of them were at a high risk for OSA. Patients with a poor sleep quality were more hypertensive and had lower subjective sleep efficacy. “To go to the toilet at night” was one of the factors that negatively affect sleep quality. Questioning patients with COPD at an advanced age in terms of nocturia can help in revealing an underlying co-morbid condition. Moreover, it is also important to implement measures that may lead to an increase in sleep quality.

Macroscopic portal vein invasion (PVT) by hepatocellular carcinoma (HCC) in the liver is one of the most important negative prognostic factors for HCC patients. The characteristics of a large cohort of such patients were examined. We found that the percent of patients with PVT significantly increased with increasing maximum tumor diameter (MTD), from 13.7% with tumors of MTD <5cm to 56.4% with tumors of MTD >10cm. There were similar numbers of HCC patients with very large tumors with and without PVT. Thus, MTD alone was insufficient to explain the presence of PVT, as were high AFP levels, since less than 50% of high AFP patients had PVT. However, the percent of patients with PVT was also found to significantly increase with increasing blood alpha-fetoprotein (AFP) levels and tumor multifocality. A logistic regression model that included these 3 factors together showed an odds ratio of 17.9 for the combination of MTD>5.0cm plus tumor multifocality plus elevated AFP, compared to low levels of these 3 parameters. The presence or absence of macroscopic PVT may therefore represent different HCC aggressiveness phenotypes, as judged by a significant increase in tumor multifocality and AFP levels in the PVT positive patients. Factors in addition to MTD and AFP must also contribute to PVT development.