Yunus Emre

Department of Management Information Systems, Faculty of Economics and Administrative Sciences, Fırat University, 23119 Elazığ, Türkiye

The study aimed to develop a valid and reliable tool to assess teachers’ differentiated instructional behaviors in science, technology, engineering, and mathematics (STEM) education toward gifted students. The Differentiated Teaching Behavior Scale in STEM Education for Gifted Students (DTBS-GiftedSTEM) was designed based on Maker’s differentiation model, addressing four key dimensions: content, process, product, and learning environment. The scale development process included a comprehensive literature review, expert feedback, and data collection from STEM teachers. Exploratory factor analysis revealed a four-factor structure with 30 items, explaining 74.89% of the total variance. Confirmatory factor analysis supported the model’s fit. Measurement invariance analyses supported configural, metric, and scalar invariance across discipline and grade level groups. Reliability analyses, including Cronbach’s alpha, composite reliability, and test-retest methods, indicated strong internal consistency across subdimensions. Item analysis showed high item discrimination through corrected item–total correlations and top–bottom group comparisons. High DTBS-GiftedSTEM scores indicate that teachers report a higher frequency of using differentiated instruction strategies in STEM contexts. Overall, the DTBS-GiftedSTEM is a psychometrically sound instrument for evaluating and enhancing differentiated teaching practices in STEM education for gifted students.

Background Intravenous (IV) albumin is widely used in intensive care units (ICUs), yet its use often deviates from evidence-based recommendations, leading to unnecessary costs. This study evaluates the indications for the use of IV albumin in critically ill patients, compliance with the 2024 “Use of Intravenous Albumin” guidelines, and the associated cost burden. Methods A prospective, point prevalence-based observational study was conducted across seven hospitals in Türkiye over one week. Data on IV albumin utilization, guideline compliance, patient demographic and clinical characteristics, and associated costs were collected and analyzed. Statistical analyses included the Kruskal–Wallis test for comparisons of albumin utilization and logistic regression to assess factors influencing its use. Results Among 385 ICU patients monitored, 56 (14.5%) received IV albumin therapy. The median age was 68 years (Interquartile range-IQR: 54.2–77.7), and 67.9% were male. The most common physician-reported indications for initiating albumin therapy were low serum albumin levels (41.1%), fluid shifts or intravascular volume support (21.4%), and sepsis or septic shock (14.3%). The desired clinical target was achieved in 73.2% of cases; however, guideline compliance was 0%. Albumin use differed significantly across ICU types (p = 0.049), with a median consumption of 667 (IQR: 250–1,083) vials per 1,000 patient-days and an estimated cost of $70,617.86. Logistic regression identified total hospital stay (p = 0.028) and Acute Physiology and Chronic Health Evaluation (APACHE) II score (p = 0.040) as significant predictors, while mechanical ventilation (MV) duration showed borderline significance (p = 0.070). The model’s classification accuracy was 78.6%. Conclusion This study highlights widespread non-compliance with guidelines for IV albumin use in ICUs, resulting in substantial costs. These findings underscore the need to improve compliance with evidence-based guidelines to optimize albumin utilization and reduce economic burden. Future studies should explore the potential impact of targeted interventions, including pharmacist involvement, on improving prescribing practices. Clinical trial number Not applicable. Trial registration Not applicable.

Background Glaucoma requires lifelong topical therapy, making medication adherence a persistent clinical challenge. However, the sociodemographic and clinical factors that influence this relationship are not well established. This study evaluated the relationship between medication adherence and quality of life in glaucoma patients and to identify the clinical and sociodemographic factors influencing this relationship. Methods This cross-sectional study included 78 patients attending routine follow-up at the Glaucoma Unit of a training and research hospital in Istanbul between March 1 and April 30, 2025. This strict two-month recruitment window was bounded by institutional administrative approval and fixed research project timelines. Data were collected via face-to-face questionnaires including sociodemographic and clinical questions, the General Medication Adherence Scale (GMAS), and the Modified GlauQOL-17 Scale. Mann–Whitney U, Kruskal–Wallis, and Spearman correlation tests were used; significance was set at p < 0.05. Results The mean age was 64.47 ± 8.97 years; 64.1% were female. Mean GMAS and Modified GlauQOL-17 scores were 30.69 ± 3.13 and 55,14 ± 11.18, respectively. 76.9% of participants demonstrated high medication adherence. A moderate positive correlation was found between adherence and quality of life (ρ = 0.374, 95% CI [0.185, 0.534], p < 0.001). Female gender (p = 0.023) and non-working status (p = 0.010) negatively affected quality of life. Educational level, income, age, and diagnosis duration showed no significant effects. Conclusion A significant positive correlation exists between medication adherence and quality of life in glaucoma patients. However, the mean Modified GlauQOL-17 score of 55.14 ± 11.18 out of 72 points indicates that quality of life remains at a moderate level despite high adherence, suggesting that adherence alone is insufficient. Psychosocial factors, particularly among female patients and those lacking retirement security, should be incorporated into holistic glaucoma management strategies.

Background Potentially inappropriate prescribing (PIP), potential drug–drug interactions (pDDIs), and elevated medication regimen complexity co-occur frequently in older adults and collectively constitute the “iatrogenic triad” of geriatric pharmacotherapy. Methods This cross-sectional analytical observational study with prospective recruitment included patients aged 65 years and older attending the Geriatrics Outpatient Clinic. Patients were screened during routine visits using the 2023 American Geriatrics Society Beers Criteria and classified by the presence or absence of at least one PIP. Enrollment continued until 40 patients per group were included; therefore, the study was not designed to estimate PIP prevalence. Clinically significant pDDIs were identified using Micromedex® and UpToDate®. Medication regimen complexity was assessed with the Medication Regimen Complexity Index (MRCI), and independent factors associated with PIP were evaluated using binary logistic regression. Results Eighty patients were analyzed: 40 with PIP and 40 without PIP. Overall, 48.8% were women, the median age was 71 years (IQR: 67–76), 25% reported a fall within the previous year, and 65% had polypharmacy. Micromedex® detected clinically significant pDDIs in 75% of patients with PIP versus 37.5% without PIP (odds ratio [OR] = 5; p = 0.002) and UpToDate® in 47.5% and 15% (OR = 5.13; p = 0.004). In total, 215 clinically significant pDDIs were identified: 172 major interactions by Micromedex® and 43 D- or X-category interactions by UpToDate®. Total MRCI scores were significantly higher in Group A than in Group B (median 22.8 vs. 15.0; p = 0.005). Polypharmacy (OR = 9.91; p = 0.001) and Anticholinergic Cognitive Burden score (OR = 1.87; p = 0.031) were independently associated with the presence of PIP. Conclusion In this equal-group outpatient cohort, PIP was associated with higher pDDI burden and greater medication regimen complexity. Polypharmacy and anticholinergic burden were the main modifiable factors associated with PIP. These findings suggest that systematic pharmacist-led medication review may represent a useful strategy for identifying interconnected medication-related risks in geriatric outpatient settings.

Purpose Delayed remote epidural hematoma (EDH) is an exceptionally rare complication of non-traumatic neurosurgical procedures. Although venous bleeding related to abrupt intracranial pressure or volume redistribution has been proposed, the bleeding source is usually inferred rather than directly visualized. We report a delayed contralateral remote EDH after supratentorial tumor resection with direct radiographic evidence of a superficial cortical venous source and provide a review of the literature. Methods A comprehensive literature search was performed across PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library without temporal restriction. Studies were eligible if they reported individual patient-level data on delayed postoperative epidural hematoma located remote from the operative field after a non-traumatic neurosurgical procedure. Reports of traumatic, intraoperative, immediate, operative-site, or contiguous epidural hematomas were excluded. Two reviewers (E.A.U., O.B.) independently screened records, assessed eligibility, and extracted demographic, clinical, radiological, management, and outcome data for descriptive synthesis. The illustrative case was analyzed with emphasis on clinical and radiographic findings, venous anatomy, and hematoma evolution. Results The structured review identified 14 previously reported patients with delayed remote postoperative EDH; with the present case, 15 patient-level observations were analyzed. Hydrocephalus was documented in 11 patients (73.3%), and CSF diversion or outflow alteration in 8 (53.3%). Altered mental status was the most common presentation at EDH recognition, occurring in 8 patients (53.3%). Surgical evacuation was performed in 14 patients (93.3%) and the present case was the only patient managed entirely without operative evacuation. Overall, 12 patients (80.0%) had favorable outcomes, 3 (20.0%) had residual neurological deficit or functional decline, and no deaths were reported. Conclusions Delayed remote EDH after large-volume supratentorial tumor resection may arise from a superficial cortical venous source. Postoperative sequential imaging in high-risk resections, with preoperative hydrocephalus, superficial venous anomaly, or CSF diversion, may identify remote EDH before neurological deterioration. In selected neurologically intact patients with stable or decreasing hematoma volume, conservative management under close neurosurgical surveillance may be a reasonable approach.

Background Atlantoaxial instability (AAI) is a well-recognized complication of rheumatoid arthritis (RA); however, its occurrence in elderly individuals without inflammatory rheumatic disease remains insufficiently investigated. Age-related degenerative and biomechanical changes may predispose geriatric patients to upper cervical instability independent of RA. This study aimed to evaluate the prevalence of radiographic atlantoaxial subluxation (AAS) in geriatric patients with and without RA and to assess whether radiographic AAS may be underrecognized in older adults without rheumatoid arthritis. Methods In this retrospective cross-sectional study, patients who underwent cervical computed tomography or magnetic resonance imaging between January and September 2024 were evaluated. The study population included 206 patients aged ≥ 65 years with RA, 168 age-matched non-RA individuals, and 183 non-RA individuals younger than 65 years. Radiographic atlantodental interval measurements were obtained using standardized techniques, and AAS was defined as an interval exceeding 3 mm. Multivariable logistic regression analysis was performed with adjustment for sex. Results Atlantoaxial subluxation was detected in 25.7% of geriatric RA patients, 12.5% of geriatric non-RA individuals, and 6.0% of younger non-RA individuals (p < 0.001). Compared with younger non-RA individuals, geriatric patients with RA had significantly higher odds of radiographic AAS (OR 5.39, 95% CI 2.72–10.69), as did geriatric non-RA individuals (OR 2.27, 95% CI 1.06–4.86). Advanced cervical imaging was infrequently requested because of a prior clinical suspicion of atlantoaxial instability (AAI). Conclusions Radiographic atlantoaxial subluxation (AAS) was observed not only in patients with rheumatoid arthritis but also in older adults without RA undergoing advanced cervical imaging. These findings suggest that radiographic AAS may be more frequently observed among older adults undergoing advanced cervical imaging than is generally appreciated. However, the observed prevalence should not be interpreted as representative of the general geriatric population. Further prospective studies are warranted to determine the clinical significance of radiographic AAS and its implications for patient management.

Pre-training transformer-based foundational models has recently emerged as a promising direction in the time series forecasting domain. However, most foundational models rely on a single-task pre-training approach, which limits generalization, introduces bias toward specific aspects, and reduces robustness. To address these limitations, we propose ConTemPreT, a novel transformer-based foundational model pre-trained through a sequential multi-task mechanism that combines self-supervised masked autoencoding and contrastive learning. Foundational models are pre-trained on universal datasets and subsequently fine-tuned to task-specific levels. Experimental results show that the proposed model outperforms all benchmark models across most few-shot forecasting settings and surpasses baselines on several zero-shot forecasting datasets; however, performance under the full-shot forecasting setting requires further improvement. Cross-domain ablation studies validate the generalizability of the proposed model and the individual contribution of each component.

Google shipped Gemini 3.8 Flash and 3.8 Flash Cyber three weeks after 3.7 Flash: same price, more reasoning, a split benchmark table. Every number explained.

Background Visual assessment of wound healing is essential in clinical practice but can show inter-observer variability. This study evaluated whether publicly accessible multimodal large language models (LLMs) could provide reliable wound assessment with minimal calibration, comparing their performance to periodontology specialists. Methods Seventy palatal wound images from a rat experimental model were evaluated by 24 periodontology specialists and two multimodal LLMs, GPT-5 (OpenAI; accessed via the ChatGPT web interface) and Gemini 2.5 Pro (Google; accessed via the Gemini web interface), using a 1–10 scoring scale. Both LLMs were exposed to six reference images with detailed scoring criteria as calibration input. Each model completed five independent evaluation rounds. Agreement with the specialist mean score and within-model reliability were assessed using intraclass correlation coefficients (ICC), Pearson and Spearman correlations, and Bland–Altman analysis. Results Inter-specialist reliability was excellent (ICC(2,24) = 0.985). Gemini 2.5 Pro demonstrated good agreement with specialists (ICC = 0.810; 95% CI: 0.711–0.877; r = 0.81), a mean bias of + 0.13 points, and a mean absolute error of 1.10 points. Its repeatability across single scoring runs was moderate (ICC(2,1) = 0.699), while the reliability of the five-run mean was excellent (ICC(2,5) = 0.921). In contrast, GPT-5 showed poor agreement (ICC = 0.296; 95% CI: 0.068–0.494; r = 0.52), poor reliability at both levels (ICC(2,1) = 0.071; ICC(2,5) = 0.277), and a mean absolute error of 1.53 points. Conclusions After brief calibration with six reference images, Gemini 2.5 Pro achieved good agreement with the mean specialist score and high reliability of the five-run mean score, although the repeatability of a single scoring run was only moderate. In contrast, GPT-5 showed poor agreement and poor reliability at both levels. Performance in rubric-based visual wound scoring was therefore strongly model-dependent, and results obtained with one multimodal LLM should not be generalized to others.