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Testing the Turkish version of the breastfeeding literacy assessment instrument: a validity and reliability study

2026-08-18T11:53:53Z

Testing the Turkish version of the breastfeeding literacy assessment instrument: a validity and reliability study Küçük Erdöl, Ebru; Yeşilçiçek Çalık, Kıymet; Aygün, Özcan; Tayar Öztürk, Nazan Background: Breastfeeding literacy is an essential component of maternal and child health, as it enables women to make informed decisions about breastfeeding practices. The objective of this study was to adapt the Breastfeeding Literacy Assessment Instrument for women in the perinatal period into Turkish and to conduct validity and reliability analyses. Methods: This study was conducted face-to-face between September 2023 and February 2024 and involved 470 women in the perinatal period. The data were analysed and evaluated using factor analysis, Cronbach’s alpha coefficients, and item–total correlations. The level of statistical significance was accepted at 0.05. Results: The scale has 26 items within four subdimensions, namely Access, Understand, Appraise, and Apply. According to the factor analysis, the scale explains 55.65% of the variance with four factors. While the Cronbach’s alpha value for the scale as a whole is 0.935, it varies between 0.773 and 0.860 for the subdimensions. The fit indices are as follows: χ2 = 613.82, p < 0.001, χ2/SD = 2.09, GFI = 0.82, CFI = 0.88, and RMSEA = 0.069 (95% CI: 0.061–0.077). The model fit of the Turkish version of the Breastfeeding Literacy Assessment Instrument is at an acceptable level and the scale maintained its original four-factor structure, demonstrating a robust factor structure. Conclusion: The Breastfeeding Literacy Assessment Instrument is a validated and reliable tool for the assessment of breastfeeding literacy among Turkish women in the perinatal period, and it can be used by health professionals.

The role of lipid-derived indices in patients with MASLD in Turkey: a nationwide, multicenter cross-sectional study

2026-06-26T14:13:58Z

The role of lipid-derived indices in patients with MASLD in Turkey: a nationwide, multicenter cross-sectional study Şahin, Cem; Solmaz, İhsan To investigate the role of lipid-derived indices-the monocyte-to-HDL cholesterol ratio (MHR), visceral adiposity index (VAI), atherogenic index of plasma (PAI), and cardiometabolic index (CMI)-in determining hepatic steatosis and fibrosis among patients with metabolic dysfunction-associated steatotic liver disease (MASLD) across Turkey. This nationwide, multicenter, retrospective cross-sectional study included 14,322 individuals from 44 internal medicine clinics in 31 provinces of Turkey. Anthropometric, clinical, and biochemical data were collected, and Participants were classified as MASLD (+) if ultrasonographic hepatic steatosis was present in the setting of >= 1 cardiometabolic risk factor according to current EASL-EASD-EASO guidelines; individuals without ultrasonographic steatosis were classified as MASLD (-). FIB-4 scores were calculated to assess the risk of advanced hepatic fibrosis. Cardiometabolic risk factors included obesity (BMI >= 25 kg/m & sup2; or increased waist circumference), type 2 diabetes mellitus, hypertension, impaired fasting glucose, and dyslipidemia as defined by international guidelines. The relationships between MHR, VAI, PAI, CMI, and MASLD presence and fibrosis severity were analyzed via nonparametric statistical tests. MASLD was detected in 10,836 participants (75.7%). The VAI, PAI, and CMI were significantly greater in the MASLD (+) group than in the MASLD (-) group (p < 0.001 for all), whereas the MHR was not significantly different (p = 0.453). Among MASLD (+) patients, 1,214 (11.2%) had high FIB-4 scores (>= 1.3; >= 2.0 if > 65 years) yet none of the lipid indices correlated significantly with FIB-4 levels. In multivariable logistic regression analysis restricted to MASLD-positive individuals, none of the lipid-derived indices were independently associated with high FIB-4 risk after adjustment for metabolic covariates. A weak negative correlation was observed only between FIB-4 score and the MHR (r=-0.030, p = 0.002). VAI, PAI, and CMI are significantly associated with hepatic steatosis in MASLD, suggesting their potential role as supportive, noninvasive markers in identifying individuals at increased risk of MASLD. However, these indices are not reliable predictors of advanced hepatic fibrosis risk based on FIB-4. The combination of these tools with other noninvasive fibrosis assessment tools may increase diagnostic accuracy in MASLD management.

Grey water footprint of pharmaceuticals and personal care products discharged via urban wastewater

2026-06-26T14:06:13Z

Grey water footprint of pharmaceuticals and personal care products discharged via urban wastewater Stejskalova, Lada; Ansorge, Libor; Rosendorf, Pavel; Fiala, Daniel; hernysh, Yelizaveta Urban wastewater is a significant source of micro- and macropollutants in aquatic ecosystems, posing a high potential risk to drinking water sources. Pharmaceuticals and personal care products (PPCPs) are widely recognized as contaminants of emerging concern, although their relative burden compared to traditional pollutants remains insufficiently quantified. This study presents a comprehensive assessment of 92 micropollutants together with conventional pollution represented by nutrients and organic pollutants across 19 municipalities in the catchment of the largest Czech drinking water reservoir. More than one hundred 24-hour composite measurements were analysed. The Grey Water Footprint methodology integrates ecotoxicological thresholds, enabling a consistent comparison across PPCPs, nutrients, and organic pollution. Results reveal that the most critical micropollutants released from centralized wastewater treatment plants are Ibuprofen or Diclofenac, depending on treatment technology and plant size. However, nitrogen remains the dominant stressor approximately one kilometer downstream of urban discharges. These findings highlight that despite the increasing attention to micropollutants, conventional pollutants still account for the largest share of pollution in recipients. The methodological framework applied in this study allows stakeholders to compare the risks of different types of pollutants in a specific region. It offers a transferable tool for prioritizing contaminants and treatments, and guiding local wastewater management strategies under the EU Water Framework Directive, risk assessments under the revised Urban Wastewater Treatment Directive, and beyond.

Determination of Morphological and Biochemical Responses of Prunus Cerasifera Myrobolan 29C Rootstock to Stepwise Increasing NaCl Stress Under in Vitro Culture Conditions

2026-06-26T13:58:36Z

Determination of Morphological and Biochemical Responses of Prunus Cerasifera Myrobolan 29C Rootstock to Stepwise Increasing NaCl Stress Under in Vitro Culture Conditions Uyduran, Elif; Şan, Bekir; Çelik, Civan; Doğan, Meral; Yıldız, Hasibe; Vildan Pepe, Ayşe; Seraj, Nasir Ahmad This study aimed to evaluate the morphological and biochemical responses of the clonal rootstock Prunus cerasifera Myrobolan 29C to stepwise increasing NaCl doses (target levels: 0, 40, 80, 120, and 160 mM) under in vitro culture conditions. Morphological assessments included regeneration rate, injury severity, shoot and leaf number, shoot length, and shoot fresh weight. Biochemical analyses comprised the activities of ascorbate peroxidase (APX), peroxidase (POD), superoxide dismutase (SOD), and catalase (CAT), as well as malondialdehyde (MDA) level, proline accumulation, total phenolics, total flavonoids, and total protein content. With increasing salinity doses, regeneration and vegetative growth parameters generally decreased; growth indicators were relatively preserved under the lower doses, whereas declines became more pronounced under the higher doses (120-160 mM NaCl). Biochemical responses suggested activation of salinity-associated defense responses, as reflected by increased proline accumulation, antioxidant enzyme activities, and total phenolic and flavonoid contents, particularly under the higher doses. In contrast, total protein content decreased at higher salinity, and elevated MDA levels indicated enhanced oxidative damage under severe conditions. Overall, the results indicate that Myrobolan 29C exhibits a limited capacity to maintain growth under low-to-moderate salinity, while growth and tissue integrity are more strongly constrained under severe salinity in in vitro culture.