Cesarean section (CS) rates continue to rise globally because of various factors. Medically unnecessary cesarean operations have no benefit to the mother or child’s health. Since the World Health Organization (WHO) has determined that the acceptable CS rate should not be more than 10-15%, it also stated the use of a classification system to compare different patient groups and facilities. Turkey has the highest CS rates globally and has been rising over the years. This study aims to assess CS rates between 2018 and 2023 using National Health Data and to analyze them according to the Robson classification system and WHO reference values to discuss possible measures against increasing rates. In this study, we assessed the rates of CSs between 2018 and 2023; the CS rate including all 5-years and analysis of CS rates for each Robson group as advocated by WHO. Also, another assessment was done of the facilities where the CSs were applied (Public, private, or university hospitals). The total number of births recorded between 2018 and2023 was 6.161.976. The overall CS rate was 57.55%. The number of total CS operations was 3.546.049. The primary CS rate was 28.83% (N:1.776.503). Significant differences were observed between the public and private centers for each Robson group. The CS rates of Groups 1-4 are obviously higher than expected. The CSs of these groups cumulatively affect the rates of other groups. Nulliparous women have CSs mostly in private hospitals. There is a need for improvements in the health system in this regard for better maternal and child health.

Background/aim: To have country-wide information about multidrug resistance (MDR) in isolates from community-acquired urinary tract infections (CAUTI) of Turkey, in terms of resistance rates and useful options. Materials and methods: We used a geocode standard, nomenclature of territorial units for statistics (NUTS), and a total of 1588 community-acquired isolates of 20 centres from 12 different NUTS regions between March 2019 and March 2020 were analysed. Results: Of the 1588 culture growths, 1269 (79. 9%) were Escherichia coli and 152 (9.6%) were Klebsiella spp. Male sex, advanced age, and having two or more risk factors showed a statistically significant relation with MDR existence (p < 0.001, p: 0.014, p < 0.001, respectively) that increasing number of risk factors or degree of advancing in age directly affects the number of antibiotic groups detected to have resistance by pathogens. In total, MDR isolates corresponded to 36.1% of our CAUTI samples; MDR existence was 35.7% in E. coli isolates and 57.2% in Klebsiella spp. isolates. Our results did not show an association between resistance or MDR occurrence rates and NUTS regions. Conclusion: The necessity of urine culture in outpatient clinics should be taken into consideration, at least after evaluating risk factors for antibacterial resistance individually. Community-acquired UTIs should be followed up time- and region-dependently. Antibiotic stewardship programmes should be more widely and effectively administrated.

Background: Manganese (Mn) exposure is common in welding and metal-processing occupations and has been implicated in both thyroid disruption and endothelial dysfunction through oxidative and nitric-oxide–related pathways. However, endocrine and vascular biomarkers have rarely been examined together in occupational settings. Methods: In this cross-sectional study, 95 Mn-exposed workers and 95 non-exposed controls were evaluated. Whole-blood Mn, triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), arginine and citrulline were measured using validated Inductively Coupled Plasma—Mass Spectrometer and chemiluminescent immunoassays. Group differences were assessed using independent samples t-tests, and exposure–biomarker associations were evaluated using Pearson correlations (p < 0.05). Results: Mn-exposed workers had significantly higher blood Mn levels than controls (19.82 ± 4.54 vs. 10.22 ± 3.07 µg/L; p < 0.001). Thyroid hormones (T3, T4, and TSH) were significantly lower among Mn workers, representing a non-classical hormonal pattern, including T3 (2.47 ± 0.31 vs. 3.14 ± 0.42 ng/L; p < 0.001), T4 (1.02 ± 0.13 vs. 1.21 ± 0.18 ng/L; p < 0.001), and TSH (1.75 ± 0.53 vs. 2.88 ± 0.37 mIU/L; p < 0.001). Endothelial biomarkers also differed: ADMA (0.26 ± 0.14 vs. 0.19 ± 0.08 µmol/L; p < 0.001) and SDMA (0.24 ± 0.06 vs. 0.20 ± 0.03 µmol/L; p < 0.001) were higher, while citrulline was lower (18.77 ± 10.23 vs. 22.82 ± 6.70 µmol/L; p = 0.002). In Mn workers, blood Mn showed negative correlations with T3 (r = –0.535, p < 0.01), T4 (r = –0.331, p < 0.01), and TSH (r = –0.652, p < 0.01), and positive correlations with ADMA (r = 0.205, p < 0.05) and SDMA (r = 0.193, p < 0.05). Conclusions: These findings indicate measurable differences in thyroid hormones and dimethylarginine-related endothelial markers among Mn-exposed workers. While the cross-sectional design precludes causal inference, the combined pattern suggests a possible unusual biological response involving both endocrine regulation and nitric-oxide–related pathways. Further longitudinal studies incorporating oxidative stress markers, co-exposure assessment, and functional endothelial testing are needed to clarify the biological relevance of these associations.

Motorcycle couriers are increasingly central to urban delivery systems, yet they experience disproportionately high rates of traffic-related injuries. Existing research often attributes crash involvement primarily to individual riding behaviours, overlooking the potential influence of employment models, environmental exposure, and physical strain. Evidence distinguishing rider-related errors from systemic working conditions, particularly for active accidents in which the rider is at fault, remains limited. This cross-sectional study was conducted between June and December 2025 among 372 motorcycle couriers actively working in Ankara, Türkiye. Participants were recruited using a snowball sampling strategy through face-to-face and online networks. Data were collected via an electronic questionnaire capturing sociodemographic characteristics, employment model, working conditions, accident history, psychosocial status (Depression Anxiety Stress Scale-21), risky riding behaviours (Motorcycle risk-taking behaviour), and musculoskeletal symptoms. Self-reported active accident involvement (defined as at-fault crashes) within the previous 12 months was the primary outcome. Associations were examined using bivariate analyses and multivariable binary logistic regression. Overall, 79.6% of participants reported at least one active accident in the previous 12 months. Compared with freelance couriers, company-employed (OR = 7.066; 95% CI: 2.104 to 23.727) and self-employed couriers (OR = 2.783; 95% CI: 1.109 to 6.984) had significantly higher odds of active accident involvement. Non-collision falls showed the strongest association with active accident involvement, with four or more falls associated with markedly higher odds of active accident involvement (OR = 12.887; 95% CI: 4.623 to 35.923). Bad weather conditions (OR = 2.049; 95% CI: 1.029 to 4.083) and motorcycle ownership (OR = 5.540; 95% CI: 2.250 to 13.644) also remained significantly associated with active accident involvement, whereas heavy traffic exposure and risky riding behaviour scores did not. In this sample, active accident involvement was more strongly associated with employment model, non-collision falls, bad weather conditions, and motorcycle ownership than with self-reported risky riding behaviour. These findings should be interpreted cautiously in light of the cross-sectional design, self-reported outcome definition, and non-probability sampling approach.