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Micro- and nanoplastics have become increasingly relevant as contaminants to be monitored due to their potential health effects and environmental impact. Nanoplastics, in particular, have been shown to be difficult to detect in drinking water, requiring new capture technologies. In this work, we applied the acoustofluidic seed particle method to capture nanoplastics in an optimized, tilted grid of silica clusters even at the high flow rate of 5 mL/min. Moreover, we achieved, using this technique, the enrichment of nanoparticles ranging from 500 nm to 25 nm as a first in the field. We employed fluorescence to observe the enrichment profiles according to size, using a washing buffer flow at 0.5 mL/min, highlighting the size-dependent nature of the silica seed particle release of various sizes of nanoparticles. These results highlight the versatility of acoustic trapping for a wide range of nanoplastic particles and allow further study into the complex dynamics of the seed particle method at these size ranges. Moreover, with reproducible size-dependent washing curves, we provide a new window into the rate of nanoplastic escape in high-capacity acoustic traps, relevant to both environmental and biomedical applications.

Introduction: Molecular fingerprinting analyses of the pathogens isolated from healthcare-associated infections (HAIs) in an off-outbreak period can provide important data which cannot be obtained by prospective surveillance. Such data may indicate unnoticed breaks in infection control measures and guide in determining targeted interventions or reinforcements. The study aimed to analyze the clonal relatedness of pathogens isolated from HAIs during a period when the facility's HAI rate remained stable. Methodology: A prospective cross-sectional study was conducted in a university hospital. A total of 105 bacterial pathogens isolated from HAIs in a one-week period were genotyped using pulsed-field gel electrophoresis. Results: All 12 enterococci isolates belonged to one of the genotypes that infected more than one patient. There was an epidemic clone in Staphylococcus aureus responsible for 7 out of 12 HAIs caused by this species. Among the Gram-negative bacteria, Acinetobacter baumannii showed the highest clonality, with 3 genotypes responsible for 13 out of 16 HAIs caused by this species. Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa showed the lowest clonality, and their spreads involved a pair of patients in a total of 7 events. Conclusions: This study showed that almost half of HAIs were due to clonal spread that was not detected by active surveillance. Enterococci, S. aureus, and A. baumannii had the highest clonality, suggesting that a significant proportion of HAIs could be prevented in healthcare facilities where these pathogens predominate. Repeating comprehensive studies in hospitals at regular intervals will be useful to identify unnoticed breaks in infection control measures.

Cystic fibrosis (CF) is an autosomal recessive disease. The genetic transition occurs with CF transmembrane conductance regulator ( ) gene mutation. We aimed to determine the frequency of CF mutations and also new mutations in the gene in neonates with respiratory distress. Newborn babies hospitalized due to respiratory distress were included in the patient group. The control group consisted of infants who had no respiratory distress. The genes of both groups were analyzed using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) methods. A total of 40 patients (20 in the patient group and 20 in the control group) were evaluated. The gene analysis was normal in 16 neonates in the patient group, whereas in others: A46D (c.137C>A) ( = 1), D1312G (c.3935A>G) ( = 1), R117H (c.350G>A) ( = 1), S1426P (c.4276T>C) ( = 1) heterozygotes were detected; gene analysis was normal at 14 neonates in the control group, whereas in others: E1228G (c.3683A>G) ( = 1), E217G (c.650A>G) ( = 1), E632TfsX9 (c1894_1895delAG) ( = 1), I807M (c.2421 A>G) ( = 2), S573F (c.1718C>T) ( = 1) heterozygotes were detected. There was no significant difference in the patient and control groups’ gene analysis ( = 0.340). This study demonstrates the importance of gene analysis in asymptomatic newborn infants for follow-up and early diagnosis of -related disorders. In this study, a c.1894_1895delAG (E632TfsX9) heterozygous mutation detected in the gene in an asymptomatic newborn infant, was first encountered in the literature.

This study investigated the prevalence and antimicrobial resistance (AMR) profiles of bacte­rial pathogens linked to subclinical mastitis in dairy cows, as well as their occurrence in milk, faecal, and environmental samples collected in eastern Turkey between February and May 2024. A total of 2,400 milk samples were collected from 600 cows affected with subclinical mastitis, along with 292 rectal faecal samples, 150 raw milk samples consumed by the public, and hand and fecal samples obtained from animal breeders in 25 cattle enterprises. In addition, environ­mental samples such as water, soil, feed, and bedding (five samples per enterprise), were collect­ed. Bacterial isolates cultured from all samples were identified using Matrix-Assisted Laser De­sorption/Ionization Time-of-Flight (MALDI-TOF) mass spectrometry. Of the 600 cows examined, 292 (48.6%) were CMT-positive, and bacterial growth was detected in 261 (89.7%) of these samples. The predominant isolates were coagulase-negative staphylococci (CoNS, 30.8%), Staphylococcus aureus (19.5%), Escherichia coli (8.9%), and Aerococcus viridans (5.8%). Anti­microbial susceptibility of S. aureus and CoNS against 15 antibiotics and E. coli against 17 anti­biotics was assessed using the disc diffusion method, and the mecA gene was screened by PCR. Among 121 E. coli isolates, no mcr, carbapenemase, or β-lactamase genes were detected by multiplex PCR. Tetracycline resistance was highest among E. coli isolates, particularly in milk samples from mastitic cows, rectal fecal samples, unpasteurised cow’s milk, farmer’s feces, soil, and feed, while resistance to amikacin, cefepime, cefoxitin, cephalexin, ertapenem, and norflox­acin remained lower. No resistance was observed against kanamycin. The mecA gene was identi­fied in three S. aureus isolates (3/57, 5.3%): two from cows affected with subclinical mastitis and one from a farmer’s hand. These findings highlighted the prevalence of major bacterial patho­gens, potential therapeutic challenges and public health risks associated with the presence of AMR bacteria and raw milk consumption.

This study aims to compare student-generated nursing care plans with ChatGPT-generated care planning texts for patients undergoing laparoscopic cholecystectomy surgery. Given the increasing significance of technology in nursing education, the integration of AI-driven tools into educational methodologies demonstrates potential for enhancing nursing students' preparation for clinical practice by providing access to more comprehensive and current information sources. This descriptive comparative study evaluated 14 nursing care plans developed by nursing students for laparoscopic cholecystectomy patients alongside care plans generated by ChatGPT for identical patient scenarios, using the DISCERN scale as the assessment instrument. The quality of student-generated care plans was determined to be satisfactory, whereas the quality of ChatGPT-generated texts was assessed as moderate. Both student care plans and ChatGPT-generated texts demonstrated moderate reliability and information quality regarding nursing care. Students exhibited the highest accuracy rate in formulating correct nursing diagnoses (90.22 %), while ChatGPT-generated texts demonstrated superior performance in correctly establishing nursing goals (90.35 %) and developing appropriate nursing interventions (91.07 %). The findings indicate that while student-generated care plans demonstrated generally acceptable quality, ChatGPT's performance in this domain was moderate, particularly in formulating surgical nursing goals and interventions. Although clinical outcomes were not evaluated in this study, the results suggest that ChatGPT may serve as a valuable supplementary resource for surgical nursing education and care plan development. Further research is warranted to determine its impact on patient care quality and clinical effectiveness.

The present study aimed to search for the presence of the plasmid-mediated antimicrobial resistance genes in 106 Escherichia coli (E. coli) isolates from a total of 240 fresh fecal samples collected from 12 private cattle farms in Bingol province of East Turkey from November 2021 to January 2022. In those colistin-resistant E. coli (mcr-1 to -9), the major carbapenemase (blaOXA-48, blaNDM-1, blaIMP, blaVIM, and blaKPC), β-lactamase (blaTEM-1, blaCTX-M and blaSHV-1) and OXA-48 like β- lactamase (blaOXA-162, blaOXA-163, blaOXA-181, blaOXA-204 and blaOXA-232) resistance genes were searched for determined a multiplex polymerase chain reaction (PCR) method and Next-generation sequencing (NGS) - PCR Amplicons with Nanopore Technology. Only the mcr-4 gene was found in one isolate and the remaining genes (mcr-1-9) were not shown in all E. coli isolates from cattle. The minimal inhibitory concentration (MIC) to colistin was detected in mcr-4 positive E. coli isolates using broth microdilution. We assessed the antimicrobial susceptibilities of mcr-4 positive E. coli isolates using the Kirby-Bauer disk diffusion method. E coli isolate was detected as negative for carbapenemase and OXA-48 like β-lactamase resistance genes and positive for β-lactamase. In addition, E. coli isolates carrying mcr-4 were more resistant to colistin. Antimicrobial susceptibility testing using the disk diffusion assay indicated that all 106 E. coli isolates (100%) were sensitive to AMK, 105 E. coli isolates (99.1%) exhibited sensitivity to imipenem, meropenem and doripenem, and 1 E. coli isolate (0.9%) had intermediate resistance to imipenem, meropenem and doripenem; It was observed that all strains (100%) were resistant to cefotaxime. E. coli isolates are resistant to ampicillin (95.3%), amoxicillin/clavulanic acid (95.3%), cefepime (14.2%), cefixime (19.8%), cephalexin (74.5%), gentamicin (42.5%), kanamycin (37.7%), streptomycin (69.8%), tetracycline (80.2%), ciprofloxacin (60.4%), norfloxacin (13.2%), chloramphenicol (59.4%) and trimethoprim/sulfamethoxazole (68.9%). When we investigated the sequence in the Blast database, the genome of the E. coli isolate indicated high similarity with the mcr-4 sequences. To our knowledge, this is the first report investigating on the mcr-4 gene in E. coli identified from cattle in Turkey. Our results highlighted that cattle might be a potential risk in transmitting mcr genes.

Background Preoxygenation is crucial for airway management safety. The standard method for preoxygenation is tidal volume breathing (TVB). This study aimed to determine whether an algorithmic approach, which involves stepwise adding pressure support ventilation (PSV) and positive end-expiratory pressure (PEEP) when TVB is inadequate, would improve preoxygenation. Methods Two hundred patients planned for general anesthesia and having end-tidal oxygen (ETO 2 ) < 90% after 3 min TVB were randomly divided into two: TVB was continued or 6 cmH 2 O PSV was added. After 1 min PSV (i.e., at minute 4), patients still with ETO 2  < 90% were divided into two again: either PSV was continued or 4 cmH 2 O PEEP was also added to PSV. The primary outcome was the time required to achieve ETO 2  ≥ 90%. Adverse effects were noted. Results After 4 min, patients with adequate preoxygenation were significantly higher with PSV (76%) compared with TVB (52%, P  < 0.001). After 5 min, it was 97% and 100%, respectively. The mean durations of adequate preoxygenation with TVB, PSV, and PSV-PEEP between 4 and 5 min were 274.90 ± 18.55, 268.94 ± 12.24, and 252.38 ± 7.46 s, respectively. The differences between TVB and PSV-PEEP ( P  < 0.001) and between PSV and PSV-PEEP ( P  = 0.001) were significant. Total time was significantly longer with TVB (237.17 ± 40.31 s) compared with PSV (222.63 ± 27.24 s; P  = 0.003). Conclusions An algorithmic approach, stepwise adding PSV and PEEP in patients inadequately preoxygenated with standard TVB, may improve adequate preoxygenation in all patients and reduces the time required. This statistical difference was significant, and although its clinical relevance may differ based on patient condition, it may support safer airway management in critically ill or high-risk patients. No serious adverse effects were observed. Trial registration NCT06736197.

Background and Aims Abdominal compartment syndrome refers to multiorgan failure secondary to increased intraabdominal pressure and circulatory failure. Early diagnosis and treatment of this clinical syndrome resulting with high mortality in children is possible via intravesical pressure (IVP)measurements. Data on IVP is limited in newborns with increased abdominal pressure due to diseases like necrotizing enterocolitis (NEC). We aimed to investigate the predictive value of consecutive IVP measurements for diagnosis and outcome of NEC. Methods IVP was measured twice daily for 10 days in 61 premature infants below 1500 grams. Measurements of infants with and without NEC were compared. Results Infants were grouped as; Group 1: without NEC, Group 2: NEC medically treated, Group 3: operated for NEC. Group 1 had lower IVP values compared to infants with NEC (p=0.001). Group 2 and 3 had similiar IVP values (p=0.155). A 10% increase in the consecutive IVP measurements was valuable for predicting NEC. Infants who died due to NEC had higher IVP values compared to surviving infants with NEC (p=0.043). Conclusion IVP measurements may be helpful for the diagnosis of NEC. Mortality due to NEC in premature infants may also be predicted with high IVP values.

Background. Current viral load tests for human immunodeficiency virus (HIV) can only be performed in laboratory environments, require highly trained operators and expensive equipment, and have a turnaround time of several hours to days. The Liat HIV Quant Assay proves that such nucleic acid testing can be performed rapidly and easily, allowing application at the point of care. Methods. The Liat Analyzer automates the entire assay, including sample preparation, amplification, and detection, in a self-contained and closed-tube system. Dynamic range, limit of detection, and subtype specificity were evaluated. Clinical samples were tested retrospectively to correlate the result of this assay with those of commercial HIV load assays. Results. The Liat assay demonstrated linearity of >6 logs (R2, 0.98) and a limit of detection of 57 copies/mL. HIV-1 group M (clades A-H), group O, and HIV-2 were detected. Testing of clinical samples showed a high degree of concordance between the copy numbers detected by the Liat assay and those detected by the Siemens and Roche assays (92.0% and 88% correlation coefficient of the log copy number, respectively). The time from sample collection to result was 88 min. Conclusions. Results suggest that the Liat HIV Quant Assay has performance equivalent to that of commercial HIV load assays and significantly reduces assay time, simplifies test operation, and provides biocontainment to allow operation in nonlaboratory settings.

Study design: A case report of temporary anterior spinal artery syndrome secondary to peripheral angiography of the lower limbs. Objectives: To report a rare case of spinal cord ischemia following a straightforward peripheral angiography with femoral access. Setting: Istanbul, Turkey. Case report: A 70-year-old patient with peripheral vascular disease developed temporary paraplegia after angiography caused by anterior spinal ischemia. His motor weakness improved gradually over a 2 month period. Conclusion: Spinal complications are extremely rare after peripheral angiography. The possible mechanisms of spinal cord damage are discussed, and the relevant data regarding the etiology are reviewed.