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Health service need refers to the essential care required to achieve optimal health outcomes within resource constraints. When necessary services to address identified health issues are not received, unmet needs arise. This research focuses on the determinants of unmet healthcare needs across the 34 countries within the European region from 2011 to 2019, focusing on Andersen's Behavioral Model's enabling factors. We employed a static and robust panel regression model using Stata 14.0 software. Key determinants analyzed include GDP per capita, urbanization rate, and physicians per capita. Findings reveal that lower GDP per capita and lower urbanization rates are significantly correlated with higher levels of unmet healthcare needs, highlighting income level and geographical accessibility as critical factors. Additionally, a higher number of physicians per capita is associated with reduced unmet healthcare needs, indicating the importance of healthcare resources in addressing healthcare access gaps. These findings underscore the importance of targeted healthcare policies that address income level, improve healthcare accessibility, and enhance healthcare resource allocation to reduce unmet healthcare needs effectively. These findings equip policymakers and administrators with empirically grounded insights to comprehend the factors contributing to unmet healthcare needs and to develop policies aimed at addressing this challenge.

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OBJECTIVE: Ventricular arrhythmias following acute coronary syndrome (ACS) range from benign to life-threatening fatal arrhythmias. Tpeak-end (Tp-e) interval has been shown to be an important parameter in the assessment of repolarization dispersion. We aimed to evaluate the relationship between SYNTAX and Global Registry of Acute Coronary Events (GRACE) risk score calculated on admission and Tp-e interval and Tp-e/QTc ratio. METHODS: A total of 421 patients were included in the study. The patients were divided into 2 groups as low SYNTAX score (≤22) and moderate and high risk SYNTAX score (>22). According to the GRACE risk score, the patients were divided into 2 groups; high-risk patients ≥140 and <140 low-risk patients. RESULTS: In the group with SYNTAX score >22, the Tp-e interval (p<0.001) and Tp-e/QTc ratio (p<0.001) was found to be significantly higher than in the group with a SYNTAX score ≤22. Tp-e interval (p<0.001) and Tp-e/QTc ratio (p=0.002) was higher in patients with GRACE risk score ≥140 compared with patients with a GRACE risk score <140. The correlation between Tp-e interval and Tp-e/QTc ratio and SYNTAX score (r=0.489; p<0.001) and GRACE risk score (r=0.274; p<0.001) were found to be significant. A significant and independent correlation was found between the SYNTAX score and Tp-e/QTc ratio (ß=0.385; p<0.001). CONCLUSION: Tp-e interval and Tp-e/QT ratio increased in patients with severe coronary artery disease assessed with SYNTAX score. Tp-e interval and Tp-e/QT ratio increased in patients with a high GRACE risk score.

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A pyrene-functional polystyrene copolymer was prepared via 1,3-dipolar cycloaddition reaction (Sharpless-type click recation) between azide-functional styrene copolymer and 1-ethynylpyrene. Subsequently, nanofibers of pyrene-functional polystyrene copolymer were obtained by using electrospinning technique. The nanofibers thus obtained, found to preserve their parent fluorescence nature, confirmed the avoidance of aggregation during fiber formation. The trace detection of trinitrotoluene (TNT) in water with a detection limit of 5 nM was demonstrated, which is much lower than the maximum allowable limit set by the U.S. Environmental Protection Agency. Interestingly, the sensing performance was found to be selective toward TNT in water, even in the presence of higher concentrations of toxic metal pollutants such as Cd(2+), Co(2+), Cu(2+), and Hg(2+). The enhanced sensing performance was found to be due to the enlarged contact area and intrinsic nanoporous fiber morphology. Effortlessly, the visual colorimetric sensing performance can be seen by naked eye with a color change in a response time of few seconds. Furthermore, vapor-phase detection of TNT was studied, and the results are discussed herein. In terms of practical application, electrospun nanofibrous web of pyrene-functional polystyrene copolymer has various salient features including flexibility, reproducibility, and ease of use, and visual outputs increase their value and add to their advantage.

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A novel method was developed for the immobilization of Saccharomyces cerevisiae invertase within supermacroporous polyacrylamide cryogel and was used to produce invert sugar. First, the cross-linking of invertase with soluble polyglutaraldehyde (PGA) was carried out prior to immobilization in order to increase the bulkiness of invertase and thus preventing the leakage of the cross-linked enzyme after immobilization by entrapment. And then, in situ immobilization of PGA cross-linked invertase within cryogel synthesis was achieved by free radical polymerization in semi-frozen state. The method resulted in 100 % immobilization and 74 % activity yields. The immobilized invertase retained all the initial activity for 30 days and 30 batch reactions. Immobilization had no effect on optimum temperature and it was 60 °C for both free and immobilized enzyme. However, optimum pH was affected upon immobilization. Optimum pH values for free and immobilized enzyme were 4.5 and 5.0, respectively. The immobilized enzyme was more stable than the free enzyme at high pH and temperatures. The kinetic parameters for free and immobilized invertase were also determined. The newly developed method is simple yet effective and could be used for the immobilization of some other enzymes and microorganisms.

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A novel visible light sensitive photoinitiator system for the cationic polymerization of typical monomers, for example, of oxiranes, such as cyclohexene oxide, vinyl ethers, such as iso-butyl vinyl ether, and other vinyl monomers, such as N-vinylcarbazole, using fullerene derivatives is described. The cationic polymerization of these monomers was initiated at room temperature upon irradiation in the visible region (λinc > 400 nm) in bulk or chlorobenzene solutions with polystyrene-C60 (PS-C60) adduct or bare C60, respectively, in the presence of oxidizing salts such as silver hexafluorophosphate (AgPF6) and diphenyliodonium hexafluorophosphate (Ph2I+PF6-). A feasible mechanism, as correlated with optical absorption measurements, free energy changes (ΔG), and proton scavenging studies, involves formation of exciplex by the absorption of light in the first step. Subsequent electron transfer from excited C60 or PS-C60 to oxidizing salt yields radical cations of the fullerene derivatives. Both radical cations and a strong Brønsted acid derived by hydrogen abstraction initiate the cationic polymerization of a variety of monomers.

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This study was conducted at a bottomland hardwood site with heavy textured soil in Akyazi, Turkey to determine the effect of initial spacing (3.0 x 3.0, 3.0 x 2.0, 2.5 x 1.6 and 2.5 x 1.2 m) and post-planting treatments (untreated check, moving, hoeing, disking, and hoeing plus disking) on early survival and growth of Fraxinus angustifolia Vahl. One-year old bare-root seedlings (70 +/- 5 cm in height) were hand-planted in December 2004. Through three years survival was perfect with a rate of 98% in all treatments. Spacing and the interaction between spacing and post-planting treatment did not significantly affect seedling growth through three years. However height and diameter growth increased overtime and differed significantly among post-planting treatments. The hoeing and hoeing plus disking treatments gave the highest growth, and resulted in about 31% increase in diameter and height increment, and in total diameter and height about 20%. These results suggest that post-planting treatments on bottomland sites with heavy textured soil give promising results.

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The effect of fertilization in the first growing season on early survival and growth of narrow-leaved ash (NLA) (Fraxinus angustifolia ssp. oxycarpa) was evaluated throughout the first 3 years of growth in Adapazari, Turkey. A randomized complete block design with four replications was established to investigate fertilization effects. Granular N urea [46%, (NH2)2CO, NH2-N] and NPK (15/15/15%; NH3-N, P2O5, K2O) fertilizers were applied in mid-May of the first growing season. Fertilization treatments per tree were control, 67 g NPK (equal to 10/10/10 g N/P2O5 /K2O tree(-1)), 133 g NPK (20/20/20 g N/P2O5 /K2O tree(-1)), 33 g urea N (15 g N tree(-1)) and 54 g urea N (25 g N tree(-1)). After three growing seasons under these fertilizer treatments, 98% of trees were still viable. Compared to the control treatment, fertilization had a large and positive effect on diameter and height growth during the first 3 years of growth. However, since there were no significant differences among the fertilized plots in terms of tree diameter and height growth, addition of P and K to the fertilizer regime was not beneficial. The results show that N fertilization in the first growing season has the potential to improve early field growth of narrow-leaved ash.

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A newly synthesized poly(glycidyl methacrylate-co-3-thienylmethylmethacrylate) [poly(GMA-co-MTM)] was designed to fabricate various HRP electrodes for detection of phenol derivatives. The results showed that the poly(GMA-co-MTM)/polypyrrole composite film microarchitecture provided a good electroactivity as a result of pyrrole and thiophene interaction, and provided chemical bonds for enzyme immobilization via the epoxy groups of poly(GMA-co-MTM). The glassy carbon-based working electrode displayed significantly higher performance for the same composite film configuration comparing to the gold-based working electrode. Poly(GMA-co-MTM)/polypyrrole/HRP coated glassy carbon electrode exhibited a fast response less than 3s, a high sensitivity (200 nA microM(-1)for hydroquinone), a good operational stability (%RSD values ranged between 2 and 5.1 for all phenolics), a long-term stability (retained about 80% of initial activity at the end of 40th day) and a low detection limit ranging between 0.13 and 1.87 microM for the tested.

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