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The aim of this study was to examine the relationship between inflammatory mediators (tumor necrosis factor-alpha, interleukin-6, and interleukin-10), oxidative stress parameters, and obstetric-neonatal outcomes in maternal blood of pregnant patients with multiple sclerosis and healthy pregnant patients, and to identify biomarkers that may be useful in predicting relapse in pregnant patients with multiple sclerosis. This prospective, single-center study was conducted at Ankara City Hospital between July 2024 and May 2025 and included a total of 72 patients: 36 pregnant women diagnosed with multiple sclerosis and 36 healthy pregnant women as the control group. The patients with multiple sclerosis were further divided into two groups: those who experienced relapses during pregnancy and those who did not. Clinical and demographic data, biochemical tests (interleukin-6, interleukin-10, tumor necrosis factor-alpha, total antioxidant status, and total oxidant status), and obstetric and neonatal outcomes were recorded. Data were analyzed statistically using SPSS 22.0, and appropriate statistical tests and correlation analyses were applied. Levels of interleukin-6, interleukin-10, tumor necrosis factor-alpha, total oxidant status, and total antioxidant status were significantly higher in patients with multiple sclerosis compared to controls (p<0.01). These parameters were even more elevated in patients who experienced relapses. Receiver operating characteristic analysis demonstrated that cut-off values of 237.8 pg/mL for tumor necrosis factor-alpha and 1.75 for interleukin-6/interleukin-10 provided high sensitivity and specificity in predicting multiple sclerosis relapse. Inflammatory and oxidative stress markers were elevated in pregnant women with multiple sclerosis, and tumor necrosis factor-alpha levels and the interleukin-6/interleukin-10 ratio were identified as potential biomarkers for predicting disease relapse.
The aim of this study was to compare the performance of different fetal growth reference standards-Hadlock, INTERGROWTH-21st, and World Health Organization-in pregnancies complicated by systemic lupus erythematosus. This retrospective cohort study was conducted at a tertiary referral center and included singleton pregnancies delivered at ≥22 weeks of gestation. Pregnant women were classified into two groups: those with systemic lupus erythematosus, defined by ≥4 American College of Rheumatology criteria, and controls without autoimmune disease. Estimated fetal weight obtained from routine obstetric ultrasonography was converted into gestational age-specific percentiles using the Hadlock, INTERGROWTH-21st, and World Health Organization reference standards. Correlations between ultrasound-based fetal weight percentiles and birth weight percentiles were assessed using Spearman's rank correlation coefficient. Of 225 initially identified pregnancies, 179 fetuses were included in the final analysis, comprising 124 from women with systemic lupus erythematosus (69.3%) and 55 from controls (30.7%). Data distribution was non-normal. Across all growth standards, fetuses from women with systemic lupus erythematosus demonstrated lower mean weight percentiles than those from controls. Mean percentiles for controls versus the systemic lupus erythematosus group were 47.1% versus 38.4% using Hadlock, 63.3% versus 55.2% using INTERGROWTH-21st, and 51.7% versus 42.6% using World Health Organization. No statistically significant differences were observed among the three reference standards; however, INTERGROWTH-21st consistently yielded higher percentile values in both groups. Although fetal weight classification varied according to the growth standard used, pregnancies complicated by systemic lupus erythematosus consistently exhibited lower fetal weight percentiles. Awareness of systematic differences among commonly used growth references is essential, as these may influence the detection of fetal growth restriction.
Excessive screen exposure is associated with musculoskeletal discomfort, postural alterations, visual fatigue, and increased anxiety among young adults. This study investigated the effects of a virtually delivered multimodal exercise program integrating sensorimotor, oculomotor, and postural components on postural awareness, musculoskeletal complaints, visual fatigue, and anxiety among screen-exposed university students and staff. Fifty-seven participants (mean age: 23.35±1.2 years) with ≥6 h of daily screen use completed an 8-week program consisting of twice-weekly live virtual sessions and daily video-guided exercises. Outcomes included the Postural Habits and Awareness Scale, Cornell Musculoskeletal Discomfort Questionnaire, Rapid Office Strain Assessment, ASTHENOPIA Eye Fatigue Scale, and State-Trait Anxiety Inventory. Pre-post differences were analyzed using paired-sample t-tests and Wilcoxon signed-rank tests. Significant improvements were observed in Postural Habits and Awareness Scale Factor 1 and Factor 3 (p<0.05), accompanied by reduced musculoskeletal discomfort across all Cornell Musculoskeletal Discomfort Questionnaire sections (p<0.05). Visual fatigue decreased substantially (z=-4.185; p<0.001), whereas Rapid Office Strain Assessment scores showed no significant change (p>0.05). State anxiety increased slightly (p<0.05), while trait anxiety remained stable. This preliminary single-group study suggests that virtual multimodal exercise programs may be effective, accessible preventive strategies for reducing musculoskeletal symptoms, enhancing posture awareness, and alleviating visual fatigue among individuals with high daily screen exposure. Controlled trials with larger and more diverse populations are recommended to establish causal effectiveness.
The aim of this study was to compare the accuracy, scientific quality, and clarity of responses generated by GPT-4o and Gemini to frequently asked patient questions related to carotid artery disease and carotid endarterectomy. In total, 40 unique carotid endarterectomy-related questions were compiled from online sources and clinical experience. Each was entered into separate new sessions with GPT-4o and Gemini 2.5 Flash in Turkish, and responses were collected without modification. Notably, four blinded cardiovascular surgeons independently rated each answer (1-5 Likert scale) in three domains: Accuracy, Scientific Quality, and Clarity. Mean response lengths and domain scores were compared using appropriate paired tests. GPT-4o produced longer responses than Gemini (258.1±101.6 vs. 193.2±43.7 words; p<0.001). Overall, GPT-4o had higher Accuracy scores (4.33±0.39 vs. 4.16±0.33; p=0.04), with no significant differences in Scientific Quality or Clarity (p=0.377 and p=0.154, respectively). In rater-level analyses, Gemini scored higher in Clarity for one rater, whereas GPT-4o was superior in Accuracy and Scientific Quality for another. Overall mean scores were comparable (4.17±0.36 vs. 4.13±0.31; p=0.636). Physician referral was recommended in 62.5% of GPT-4o and 52.5% of Gemini (p=0.366). Both GPT-4o and Gemini provided "good"-quality responses to carotid endarterectomy patient questions, with GPT-4o showing a modest accuracy advantage, with no difference in other domains. Explicit disclaimers on both platforms underscore their supportive, not definitive, role in patient education. Physicians should remain the primary source for individualized decisions, and AI-generated information should always be verified.
The quality of sedation critically affects the success and safety of minor gynecologic surgeries. Ciprofol, a novel analog of propofol, offers rapid onset and recovery with a potentially improved safety profile. This study compared the efficacy and safety of ciprofol and propofol for sedation during minor gynecologic surgery. In this single-center, randomized, double-blind trial, 342 patients scheduled for minor gynecologic procedures were assigned to receive either ciprofol or propofol for anesthesia induction and maintenance. The primary outcomes were anesthesia onset time and surgical success rate. Secondary outcomes included recovery time, hemodynamic stability, body movement, injection pain, satisfaction ratings, and adverse events such as respiratory depression and hypotension. Both agents achieved a 100% anesthesia success rate, with comparable onset times (ciprofol: 37.2±10.4 s vs. propofol: 38.7±11.2 s; p=0.214). Ciprofol required a fivefold lower total dose (68.5±31.7 mg vs. 359.6±164.6 mg; p<0.001) and demonstrated superior safety, including fewer body movements (2.4 vs. 15.3%), absence of injection pain (0 vs. 36.5%), and reduced hypotension (10.1 vs. 41.2%; all p<0.001). Satisfaction was higher among surgeons and patients receiving ciprofol. Ciprofol provides anesthesia efficacy equivalent to propofol with significantly enhanced safety and tolerance, supporting its use as a preferred agent for outpatient gynecologic surgery.
The aim of this study was to evaluate the clinical, ultrasonographic, and elastographic parameters in the risk stratification of malignancy for thyroid nodules with indeterminate cytology according to The Bethesda System for Reporting Thyroid Cytology. This retrospective, single-center study analyzed 838 thyroid nodules from 716 consecutive patients for six years. The diagnostic performance of nodule size, Doppler ultrasonography features, American Thyroid Association risk of malignancy guidelines, and Tsukuba elasticity scores via strain elastography was assessed. A multinomial logistic regression analysis was employed to compare indeterminate categories (III, IV, and V) with benign cytology (II) to identify independent predictors of malignancy. Indeterminate nodules exhibited larger mean diameters compared to benign ones (20.83±9.89 vs. 18.65±9.08 mm; p<0.05), and significant associations were identified between III, IV, and V categories and increased peripheral/central vascularization, higher-risk American Thyroid Association risk of malignancy classifications, and elevated Tsukuba elasticity scores (4 and 5). Histopathological malignancy rates were higher in indeterminate groups (p<0.05), whereas patient age and nodule location demonstrated no significant predictive value. Integrated assessment of nodule size, Doppler vascularity, American Thyroid Association risk stratification, and strain elastography significantly enhances the predictive accuracy for malignancy in nodules with indeterminate cytology. These multiparametric indices provide essential guidance for optimizing surgical indications and clinical management in cases of diagnostic uncertainty.
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Temporomandibular disorders are among the most common causes of orofacial pain, often leading patients to seek information online. The increasing use of large language models such as chat generative pre-trained transformer in healthcare communication has raised questions about the reliability and readability of artificial intelligence-generated patient information. The aim of this study was to evaluate the accuracy, comprehensiveness, readability, and inter-rater reliability of chat generative pre-trained transformer-generated responses to common patient questions regarding temporomandibular disorders. ChatGPT (version 4.0) was prompted to generate 50 potential patient questions about temporomandibular disorders. Ten representative questions were selected and independently evaluated by five experts (two oral and maxillofacial surgeons, two physiotherapists, and one physical medicine specialist). Responses were rated using a four-point quality scale assessing accuracy and completeness. Readability was calculated using the Flesch-Kincaid method, and inter-rater reliability was assessed using the Intraclass Correlation Coefficient. The responses demonstrated variable but generally acceptable quality. The overall Intraclass Correlation Coefficient value was 0.862, indicating good inter-rater agreement. Readability levels ranged from grade 6.2-10.7 (mean 8.0), corresponding to middle-to-high school comprehension. While most responses were rated satisfactory, several lacked sufficient clinical detail, particularly in differentiating professional consultation pathways. chat generative pre-trained transformer provides moderately reliable and readable information about temporomandibular disorders, supporting its potential role in patient education. However, reliance on artificial intelligence-generated frequently asked questions introduces methodological limitations and authority bias. Future studies should incorporate real patient data and external fact-checking to enhance clinical relevance.
Artificial intelligence represents a rapidly advancing innovation in healthcare with the potential to revolutionize the field of clinical nutrition. The aim of this study was to evaluate ChatGPT's potential to support the clinical decision-making process regarding nutrition in older adults. Twelve questions and three clinical vignettes addressing fundamental concepts of malnutrition, including general information, diagnosis, follow-up, and treatment, were created and asked to ChatGPT. Three geriatricians independently examined ChatGPT's responses. The quality of the responses was assessed using the Quality Analysis of Medical Artificial Intelligence tool. The inter-rater reliability among the authors was calculated, and an excellent intraclass correlation coefficient of 0.84 (95%CI 0.77-0.89; p<0.001) was found. The total mean Quality Analysis of Medical Artificial Intelligence score for the ChatGPT-generated responses to questions related to malnutrition was 26.60, indicating very good quality. In evaluating the clinical scenarios, the lowest scores were observed in source use. The total Quality Analysis of Medical Artificial Intelligence, accuracy, relevance, and use of sources scores for the clinical scenario involving the patient with a hip fracture were statistically significantly lower compared to other scenarios. Our study highlighted that ChatGPT has the potential to generate correct answers related to complex clinical scenarios about malnutrition. ChatGPT can help clinicians make more informed decisions regarding patients' nutritional requirements and management by utilizing more up-to-date medical resources and guidelines.
The aim of this study was to evaluate the performance and perception of a 360-degree video as an educational tool for medical students in the management of premature rupture of membranes. A prospective interventional study was conducted with fifth-year medical students. Participants watched a 10-min, 360-degree video simulating a complete premature rupture of membranes case, from anamnesis to prescription. Student perceptions were assessed using a questionnaire with a five-point Likert scale, covering technical quality, comprehension of clinical procedures, and pedagogical impact. A subgroup analysis compared outcomes based on the viewing device (mobile phone vs. computer). A total of 60 medical students were included in this study. The video intervention received a highly favorable evaluation. Students reported high rates of comprehension for key clinical decision-making elements, including the indication for hospital admission (60 students, 100%) and the rationale for antibiotic therapy (59 students, 98.3%). The experience positively influenced student motivation (53 students, 88.3%) and heightened their interest in obstetrics (45 students, 75.0%). No statistically significant (p>0.05) differences were found between the proportion of positive responses (agree and strongly agree) according to the device used to watch the 360-degree video: mobile phone (n=34, 56.7%) vs. computer (n=26, 43.3%). The use of 360-degree video is an effective and well-received pedagogical tool for teaching complex obstetric scenarios. Its comparable effectiveness on both mobile and computer platforms underscores its potential as an accessible and scalable resource to better prepare students for the practical challenges of the obstetrics and gynecology clerkship.
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The aim of this study was to assess the quality and readability of ChatGPT and Gemini's responses to frequently asked questions about early intervention for individuals with at-risk infants. Ten frequently asked questions about early intervention were selected by three researchers (a child development specialist, a physiotherapist, and a midwife) from a list generated by ChatGPT and Gemini. Questions were sent to ChatGPT version 4.0 and Gemini 1.5, and initial responses were recorded without follow-up queries. Ten independent experts (two special education specialists, two child development specialists, two physiotherapists, two midwives, and two pediatricians) The quality of ChatGPT and Gemini's responses was assessed using a four-grade rating system. Readability levels were analyzed using the Flesch-Kincaid Grade Level through WordCalc software. One of the answers given by ChatGPT was of higher quality than Gemini (p=0.025), while one answer given by Gemini was of higher quality than ChatGPT (p=0.033). The answers to the other questions were of similar quality, with Gemini having a lower level. This study compares the quality and readability of the answers given by artificial intelligence-based language models to demonstrate their potential to appeal to different user groups. While the models generally provided answers of similar quality, quantitative differences in readability were observed, suggesting potential suitability for different audiences. These findings contribute to understanding the role of AI tools in health communication.
Pediatric solid tumors require accurate imaging for staging, treatment planning, and follow-up. Whole-body magnetic resonance imaging has emerged as a promising radiation-free alternative to positron emission tomography-computed tomography, offering superior soft tissue contrast. This study compares the diagnostic performance of whole-body magnetic resonance imaging and positron emission tomography-computed tomography in detecting primary tumors, metastases, and recurrences in pediatric solid tumors. This retrospective study included 47 pediatric patients (27 boys and 20 girls; age range: 3-18 years; mean age: 11.3±3.5 years) with suspected or confirmed solid tumors who underwent both whole-body magnetic resonance imaging and positron emission tomography-computed tomography between 2017 and 2020. Lesional and per-patient agreement between modalities was evaluated using positron emission tomography-computed tomography as the reference. Statistical analysis was performed to assess inter-modality agreement. Positron emission tomography-computed tomography detected pathological findings in 35 patients (74.4%), including 27 primary tumors (57.4%), 18 metastases (38.2%), and one recurrence (2.1%). Whole-body magnetic resonance imaging showed high diagnostic concordance, detecting all primary tumors and the recurrence, and 16 of 18 metastatic cases. Per-lesion analysis revealed 66 lesions on positron emission tomography-computed tomography and 64 on whole-body magnetic resonance imaging, with two metastatic lesions (an ossified pulmonary metastasis and an osteoblastic femur lesion) missed by magnetic resonance imaging. Cohen's kappa (κ) for abnormality detection was 0.89, indicating almost perfect agreement (95%CI 0.75-1.00). McNemar's test showed no statistically significant difference between the modalities (p=0.479). Whole-body magnetic resonance imaging demonstrates excellent agreement with positron emission tomography-computed tomography for evaluating pediatric solid tumors, offering a radiation-free alternative, particularly advantageous in long-term follow-up. While limitations remain in detecting sclerotic metastases, whole-body magnetic resonance imaging is a primary alternative in specific scenarios.
Chronic venous disease is a highly prevalent condition with significant morbidity. Although there is a well-documented predominance of chronic venous disease among women, the differences in surgical treatment based on sex, especially in low- and middle-income countries, are not well understood. The aim of this study was to investigate these disparities within Brazil's public healthcare system. This cross-sectional study analyzed all varicose vein surgeries (n=1,114,625) performed in the public sector from 2007 to 2024. Data were extracted from the national open database (Sistema de Informações HospitalaresDepartamento de Informática do Sistema Único de Saúde (Department of Informatics of the Unified Health System). We compared demographics, procedural and mortality rates, age at surgery, length of hospital stays, and patterns of travel for surgery between the sexes. Women constituted most of the procedures (80.5%). Men underwent bilateral surgery at a significantly older median age than women (49 vs. 47 years, p<0.01). Men were more likely to travel between cities (38.89 vs. 37.22%, p<0.01), while women traveled more between states (0.35 vs. 0.39%, p<0.021). Mortality rates were low for both sexes, but higher for men (0.0197 vs. 0.0023%, p<0.01). This study reveals significant gender disparities in the surgical treatment of varicose veins in Brazil, extending beyond mere prevalence to include differences in the age at which intervention occurs and geographic access patterns. The findings suggest that biological factors alone cannot account for these disparities, highlighting that healthcare-seeking behaviors, mortality rates, and structural inequities also play a crucial role. Further qualitative research is needed to elucidate the underlying motivations for these differences and to guide the development of more equitable healthcare policies.
Familial Mediterranean fever, an autoinflammatory disease, is characterized by recurrent stereotypic febrile attacks associated with an inflammatory syndrome. Malondialdehyde, a lipid peroxidation marker, and soluble transferrin receptor, a key regulator of cellular iron homeostasis, are important markers associated with ferroptosis. The aim of this study was to investigate the levels of these markers in children with familial Mediterranean fever in remission. The study included 30 pediatric familial Mediterranean fever patients in remission who were being monitored in the hospital and 30 healthy children. Malondialdehyde and soluble transferrin receptor levels were analyzed using enzyme-linked immunosorbent assay. Malondialdehyde and soluble transferrin receptor levels were compared between groups. Correlation analyses were also performed separately for each group to assess the relationship between these two parameters. Serum amyloid A, erythrocyte sedimentation rate, and creatinine levels were higher and hematocrit levels were lower in the familial Mediterranean fever group compared to the control. No significant difference was found in malondialdehyde and soluble transferrin receptor levels between the two groups. There was a positive correlation between malondialdehyde and soluble transferrin receptor levels in both groups (familial Mediterranean fever r=0.803, control r=0.599). Although there was no significant difference in mean malondialdehyde and soluble transferrin receptor levels between children with familial Mediterranean fever in remission and a healthy control group, the high correlation coefficient between these two parameters in familial Mediterranean fever patients suggests a possible link between iron imbalance and oxidative stress in the pathophysiology of the disease. These findings highlight the need for larger, multicenter studies, including patients in the exacerbation phase, to better elucidate the role of ferroptosis in familial Mediterranean fever.
Exclusive breastfeeding for 6 months and continued breastfeeding for 24 months remain low due to various challenges. The aim of this study was to examine the impact of mothers' infant feeding attitudes and parenting styles, as modifiable factors, on breastfeeding duration. This cross-sectional descriptive study was conducted at Akdeniz University Faculty of Medicine Hospital between April 1, 2023, and April 1, 2024. The sample comprised 224 mothers of children aged 2-3 years who attended the child health follow-up clinic. Data were obtained through face-to-face interviews using the Introductory Information Form, Child Nutrition Questionnaire, Iowa Infant Feeding Attitudes Scale, and Parenting Styles Scale. Group differences were examined with t-tests and analysis of variance, correlations with Pearson's coefficient, and categorical data with chi-square tests. A binary logistic regression evaluated the effects of parenting style and feeding attitudes on breastfeeding beyond 2 years. While 98.7% of participants breastfed at least once, only 38.8% exclusively breastfed for the first 6 months, and 40.6% continued breastfeeding for 24 months or longer. It was found that a one-unit increase in the Iowa Infant Feeding Attitudes Scale score increased the probability of breastfeeding beyond 24 months by 5.4%, while each unit increase in the authoritarian attitude decreased it by 9.7%. Formula feeding duration was also positively correlated with authoritarian and overprotective parenting styles. Parenting styles and mothers' infant feeding attitudes are two important factors affecting the rates of exclusive breastfeeding for the first 6 months and continuing breastfeeding beyond 24 months.
The global burden of peripheral artery disease is increasing worldwide. A subset of 5% of these patients ultimately reach the final stage with trophic defects, a condition clinically defined as critical limb-threatening ischemia. Revascularization remains the paramount treatment modality offering the greatest potential for limb preservation. We investigated whether performing direct revascularization according to the angiosome concept significantly influences (i) the superior healing of ischemic defects, (ii) optimized limb salvage rates, and (iii) reduced patient mortality in a cohort treated with femoropopliteal bypass. This rigorous prospective clinical cohort study processed data from 143 patients after femoropopliteal bypass procedures performed at the AGEL Ostrava Vítkovice Hospital between January 2016 and December 2021-all patients presented with critical limb-threatening ischemia, specifically Fontaine stage IV. We employed advanced statistical methods, including Kaplan-Meier survival analysis and the Cox regression model, to evaluate the effect of direct revascularization versus indirect revascularization on primary outcomes: defect healing, limb salvage, and patient mortality. Statistical analysis robustly confirmed a statistically significant benefit of direct revascularization on (i) defect healing (p=0.02), (ii) limb salvage (p=0.02), and (iii) patient mortality (p=0.04). Specifically, direct revascularization significantly reduced amputation rates and improved overall survival compared to indirect revascularization. Despite the controversies in the literature and the absence of dedicated, large-scale, English-language published studies focusing specifically on the application of the angiosome concept in femoropopliteal bypasses, we demonstrated a statistically significant benefit of direct revascularization on defect healing, limb salvage, and mortality in this specific patient cohort. This evidence suggests that the angiosome concept extends its predictive power proximally to the femoropopliteal bypass targets. Practical application: In patients with critical limb-threatening ischemia, where the indication for femoropopliteal bypass is rendered borderline due to advanced local findings (high-risk Wound, Ischemia, and foot Infection classification) or severe overall comorbidity status, surgical intervention should be preferentially reserved for scenarios guaranteeing direct revascularization, as patients derive minimal benefit from non-targeted indirect revascularization in high-risk settings.
Predicting in-hospital mortality rates following tricuspid valve surgery is imperative, especially in light of the recent advancements in treatment modalities. The Naples prognostic score serves as an indicator of systemic inflammation, malnutrition, and prognostic outcomes across a spectrum of medical conditions. In this investigation, we sought to assess the efficacy of the Naples prognostic score in predicting in-hospital mortality among patients undergoing tricuspid valve surgery. A total of 360 consecutive patients diagnosed with severe tricuspid valve disease, who underwent tricuspid valve surgery, were included in this retrospective study. The study population was categorized based on the Naples prognostic score classification into two groups: low (0-1-2) and high (3-4). The study's primary outcome-in-hospital mortality-was significantly higher in patients with a high Naples prognostic score group than in those with a low Naples prognostic score group (35 [28.2%] vs. 8 [5.1%], p<0.001). In the receiver operating characteristic analysis, the Naples prognostic score optimal cut-off value of >2 predicted in-hospital mortality with 81.4% sensitivity and 62.5% specificity (area under the curve: 0.782 [95%CI 0.729-0.829, p<0.0001]). The findings of this study indicate that the Naples prognostic score serves as an independent predictor of in-hospital mortality among patients undergoing tricuspid valve surgery.
In recent years, cesarean section rates have been increasing worldwide. Identifying changes in birth preferences during pregnancy is crucial for reducing cesarean section rates. The aim of this study was to determine the Turkish validity and reliability of the Theory-Based Intention for cesarean section scale, originally developed by Naghibi et al. This methodological study was conducted with 300 pregnant women. Data were collected using the Introductory Information Form and the Theory-Based Intention for cesarean section scale. Analyses were performed using IBM SPSS 25.0 and AMOS 22.0. Language validity was evaluated through translation from the original Persian into Turkish as well as from English into Turkish. Content validity was calculated with nine experts using the Davis technique, and a pilot test was conducted with 30 pregnant women. Construct validity was assessed through Exploratory Factor Analysis and Confirmatory Factor Analysis. Internal consistency was examined with Cronbach's Alpha coefficient and test-retest reliability. Exploratory Factor Analysis revealed a five-factor structure with 24 items for the scale. According to Confirmatory Factor Analysis, the model fit indices indicated a good model fit. The Cronbach's Alpha coefficient of the scale was 0.76. The item-total correlations and test-retest reliability of the scale were found to be high. The Theory-Based Intention for cesarean section scale is a valid and reliable measurement tool for use among Turkish pregnant women.
The aim of the study was to determine the prevalence of insomnia and identify associated sociodemographic and clinical factors among individuals aged 80 years and older. This descriptive cross-sectional study was conducted between October and November 2025 in the Advanced Age Unit of Elazığ City Hospital, Turkey. A total of 419 participants aged ≥80 years were enrolled. Sociodemographic and clinical data were collected using a structured questionnaire. The presence and severity of insomnia were assessed using the Insomnia Severity Index. An Insomnia Severity Index score ≥8 was accepted as indicative of insomnia. The prevalence of insomnia was 38.2%. Insomnia was significantly more frequent among women compared with men (p=0.010). Low economic status was associated with a higher rate of insomnia (p=0.033). A history of falls, hypertension, diabetes, and polypharmacy showed significant associations with insomnia (all p<0.05). Insomnia Severity Index score demonstrated a positive correlation with the number of chronic diseases (r=0.487; p<0.001) and the number of medications used (r=0.455; p<0.001). Insomnia is common among individuals aged 80 years and older and is associated with female gender, low economic status, polypharmacy, multiple chronic diseases, and a history of falls. Insomnia in older adults should not be considered a normal part of aging, but a manageable condition that affects overall well-being. Routine sleep assessment and management of underlying risk factors should be integral components of geriatric care.