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Is using inhaled corticosteroid effective against COVID-19 pneumonia severity and mortality?
(TURKISH ASSOC TUBERCULOSIS & THORAX, 2024) Kılıç, Hatice; Argüder, Emine; Civak, Musa; Demir, Emre
Introduction: It is known that the use of inhaled corticosteroids increases the incidence of pneumonia in patients followed up with the diagnosis of chronic asthma and chronic obstructive pulmonary disease (COPD). This study aimed to investigate the contribution of inhaled steroid use to pneumonia severity and mortality in cases with COVID-19 pneumonia. Materials and Methods: The study is a retrospective, observational study. Among the cases admitted to the pandemic clinic, patients diagnosed with COVID-19 pneumonia were included. The plan was to compare cases who received and did not receive inhaled corticosteroids in terms of pneumonia severity and mortality. In order to define risk factors for mortality, univariate and multivariable negative binomial regression analyses were performed. Results: In our study, it was observed that n= 540 (75%) cases did not receive inhaled corticosteroids (group 1), and 180 (25%) cases used inhaled corti costeroids (group 2). Group 1 and group 2 cases were compared in terms of pneumonia severity with no significant difference between the two groups (p= 0.11). Then, risk factors affecting mortality in all cases were examined with univariate analyses. Increasing age, applying mechanical ventilation, having severe pneumonia, having interstitial lung disease, and applying prone position were found to be statistically significant factors in mortality (p< 0.05). Conclusion: In conclusion, in our study, it was observed that the use of inhaled corticosteroids did not increase the severity of pneumonia and mortality. It was thought that the treatment they received could be continued when the patients treated with inhaled corticosteroids due to asthma and COPD had COVID-19 pneumonia.
The effect of aerobic and high-intensity interval training on plasma pentraxin 3 and lipid parameters in overweight and obese women
(PEERJ INC, 2024) Çiçek, Güner; Özcan, Oğuzhan; Akyol, Pelin; Işık, Özkan; Novak, Dario; Küçük, Hamza
Background. It is unclear whether different exercise programs lead to an increase in the concentration of plasma Pentraxin3 (PTX3), an anti-inflammatory protein. This study aimed to investigate the effects of aerobic exercise (AE) and high-intensity interval training (HIIT) on plasma PTX3 levels in overweight and obese women. Method. A total of 45 sedentary women aged between 32.26 ± 6.30 voluntarily participated in the study. The control group (CG, n = 15) was selected among normalweight women. Women in the group of participants who partook in exercise consisted of overweight and obese women according to a random method, including the AE group (n = 15) and the HIIT group (n = 15). The AE session conducted was 50 min in duration and consisted of warm-up exercises (5 min), and primary exercises (40 min, basic aerobic-step exercises). HIIT consists of warm-up exercises (5 min), primary exercises (work intervals: 6?10 × 1 min (80–90% HRmax), rest intervals: 1 min (walk, 50% HRmax), 21–29 min running. The exercises were applied for three sessions/week for 12 weeks. Fasting blood samples were taken from all participants before and after exercise and their body composition was measured. Results. As a result of two different 12-week exercises, serum PTX3 levels increased significantly by 47.53% in the AE group and 50.21% in the HIIT group (p < 0.01). It was determined that the mean PTX3 before and after exercise increased from 1.71 ± 0.43 to 2.47 ± 0.40 ng/dL and HIIT from 1.62 ± 0.39 to 2.31 ± 0.33 ng/dL. A significant decrease in body mass index (BMI) values were detected, approximately 5.81% in the AE group and 5.06% in the HIIT group (p < .01). A significant decrease was detected in glucose, insulin, HOMA-IR, LDL-C, and hsCRP whereas HDL-C and VO2max value increased significantly in both exercise groups (p < .05; p < .01). There were no significant differences in TG and TC levels between groups (p > .05). Also, no significant differences were found between the two types of exercises in terms of parameters. A significant negative correlation in the total sample was found between PTX3 with BMI, fat mass, LDL-C, and hsCRP.
Do We Know the Long-Term Effects of the Most PopularTraditional Swallow Maneuvers on the Submental Muscles?
(WILEY, 2024) Söyler, Ayşe Kübra; Kıylıoğlu, Nefati; Arslan, Selen Serel; Demir, Numan; Gök, Mustafa; Ertekin, Ersen; Düger, Tülin
Background: Various trainings focus on the submental muscles (SMs) for dysphagia rehabilitation because of their importancefor swallowing safety and efficiency. According to the current literature, swallow-specific tasks may be optimal exercises fordysphagia. The effortful swallow (ES) and the Masako maneuver (MM) are the most commonly used swallow-specific tasks inthe clinical settings for dysphagia for years, but long-term effects for these trainings is insufficient.Objectives: This study aims to investigate and compare the effects of ES and MM on SM activity, strength and thickness.Methods: Thirty-seven healthy adults were randomised to ES, MM and control groups, and ES and MM groups completed6 weeks of swallowing training. Participants in both training groups performed a total of 120 swallows in each session, whilecontrol group did not participate in any swallowing training. Surface electromyography was used to evaluate SM activity, digitaldynamometer for SM strength and ultrasonography for SM thickness.Results: Both trainings did not change SM activity (p > 0.05), but increased SM strength (p < 0.05). MM increased the thicknessof all SM (p < 0.05), and ES increased the thickness of mylohyoid (right, left) and digastric muscle (right) (p < 0.05), and therewas no change in all evaluation parameters in the control group (p > 0.05). Also, trainings were not superior to each other in anyparameter (p > 0.05).Conclusion: The results of this study provided new evidence to the literature to show that ES and MM trainings are effectivefor improving SM strength and thickness. Considering that SM is important in terms of swallowing safety and effectiveness, it isthought that both trainings may be promising by increasing the strength and mass of SM, especially in individuals with reducedSM strength and mass.
Güvencesiz Çalışmaya Karşı Sendika Özgürlüğü Güvencesini Geliştirme İhtiyacı: 6356 Sayılı Kanun’un 25. Maddesinin Yeniden Düzenlenmesi Üzerine Öneriler
(ISTANBUL UNIV, FAC LAW, 2024) Göktaş, Naim; Onur, Orhan Ertuğrul
Neo-liberal dönüşüm süreciyle birlikte çalışma ilişkilerinde güvencesizlik norm hâline gelmiştir. Bu dönemde güvencesizliğe yol açan standart-dışı istihdam biçimleri ülkelerin hukuk sistemlerinde yerini almıştır. Türkiye’de de 4857 sayılı İş Kanunu ile esnek çalışma türlerinin önü açılmış ve güvencesiz çalışmaya hukuki dayanak sağlanmıştır. Güvencesizliğin yaygınlaşmasıyla birlikte işçilerin işverenler karşısındaki gücü zayıflamış ve sendikaların örgütlenme koşulları daralmıştır. Sendikalar güç kaybettikçe işçiler eğreti koşullarda çalışmaya daha fazla mecbur olmuştur. Bu yüzden, temel uluslararası sözleşmelerde düzenlenmiş olan ve Türkiye’de anayasal bir hak niteliği bulunan sendika hakkına erişim, günümüz şartlarında daha önemli bir ihtiyaç hâline gelmiştir. Fakat 6356 sayılı Sendikalar ve Toplu İş Sözleşmesi Kanunu’nun (STİSK) 25. maddesinde düzenlenmiş olan sendika özgürlüğü güvencesi, Avrupa İnsan Hakları Mahkemesi’nin (AİHM) Tek Gıda-İş Sendikası’nın başvurusu üzerine verdiği kararda belirtildiği üzere amacını karşılamaktan oldukça uzaktır. Bu çalışmada Türkiye’de sendika özgürlüğü güvencesinin geliştirilmesine katkı sağlamak amaçlanmıştır. Söz konusu amaç doğrultusunda doküman analizi yöntemi benimsenerek konuya ilişkin belgeler incelenmiş, maddenin sendika özgürlüğü güvencesini kısıtlayan yönleri açıklanmıştır. AİHM kararına da uyumlu olarak çalışmada iki ayrı öneri yapılmıştır. Kanun’un 24. maddesinde işyeri sendika temsilcileri için hüküm altına alınmış olan mutlak işe iade hakkının, 25. maddeye uyarlanması çalışmanın temel önerisidir. Bu düzeyde güvence sağlamasa da işverenin, iş sözleşmesi sendikal nedenle feshedilen işçiyi işe başlatmadığı durumda işçiye iş güvencesi tazminatı ödemesi gerekliliği çalışmanın ikincil önerisidir. Son yıllarda sendikalar giderek zayıflamakta ve işçiler güvencesiz koşullara artan oranda maruz kalmaktadır. Bu bağlamda bireysel sendika özgürlüğünü ve dolayısıyla kolektif sendika özgürlüğünü genişletmeye yönelik öneriler getirmesi bu çalışmanın önemini göstermektedir.
Impact of Metastatic Lymph Node Ratio on Survival and Prognosis in Rectal Carcinoma: A Retrospective Cohort Study
(SPRINGERNATURE, 2024) Kartal, Bahadır; Tutan, Mehmet Berksun
Objective This study aimed to evaluate the impact of the metastatic lymph node ratio (mtLNR) on survival outcomes and prognosis in patients with rectal carcinoma, in comparison with other clinicopathological factors. Methods A retrospective cohort analysis was conducted on 97 patients with rectal adenocarcinoma who underwent surgical treatment at Erol Ol & ccedil;ok Training and Research Hospital between January 2017 and December 2022. The inclusion criteria consisted of patients over 18 years of age and the absence of hematological disorders or concurrent inflammatory conditions. The patients' demographic data, tumor characteristics, surgical details, lymph node (LN) status, mtLNR, and survival outcomes were analyzed. The optimal cutoff value of mtLNR for predicting mortality was determined using receiver operating characteristic (ROC) curve analysis. Kaplan-Meier survival analysis was employed to estimate overall survival (OS) and disease-free survival (DFS), and differences between groups were evaluated using the log-rank test. The Cox proportional hazards model was used to calculate hazard ratios (HRs) for all-cause mortality. Statistical significance was set at p<0.05. Results The mean age of the patients was 70.31 +/- 11.57 years, with 65.98% being male. Low anterior resection (LAR) was performed in 83.51% of the patients, and laparoscopic surgery was conducted in 26.8%. The median OS for the entire cohort was 24 months (range: 3-60). Patients were divided into two groups based on mtLNR, with the cutoff value set at 0.2183. A high mtLNR was significantly associated with poorer DFS and OS (p=0.021 and p=0.003, respectively). Moreover, patients with an mtLNR>0.2183 exhibited significantly higher rates of recurrence, lymphovascular invasion (LVI), and perineural invasion (PNI) compared to those with a lower mtLNR (all p<0.001). The optimal cutoff value of mtLNR predicted mortality with a specificity of 81.4% and a sensitivity of 48.1% (area under the curve (AUC) 0.662, p=0.012). Kaplan-Meier analysis showed a significant difference in survival between the two groups; the risk of all-cause mortality was 3.71 times higher in patients with mtLNR>0.2183 (p=0.002). Conclusion The mtLNR is a strong determinant of survival and prognosis in patients with rectal carcinoma. High mtLNR values are associated with worse survival outcomes and more aggressive tumor characteristics. The findings suggest that mtLNR should be considered in clinical decision-making processes. These results indicate that mtLNR could be a valuable prognostic tool in clinical decision-making.
A study of crashworthiness performance in thin-walledmulti-cell tubes 3D-printed from different polymers
(WILEY, 2024) Tunay, Merve; Bardakcı, Alperen
Multicellular, thin-walled impact tubes have been intensely studied and usedin various engineering fields in recent years due to their lightweight, high per-formance, ease of application, superior energy absorption, and stable deforma-tion characteristics. In this study, energy absorption, crashworthinessperformances, and deformation properties of thin-walled structures manufac-tured from polylactic acid (PLA+) and acrylonitrile butadiene styrene (ABS)using fused deposition modeling (FDM) technology were compared underquasi-static axial compression. Thin-walled structures consist of multicellulartubes connected by concentric corner-edge connections with square and hex-agonal cross-sections. Experimental testing outcomes indicate that the energyabsorption capacity increases with increasing the number of corners in multi-cellular structures. The tubes with square wall-to-wall (S-WW) and hexagonalwall-to-wall (H-WW) cross-sections exhibit superior crashworthiness perfor-mance compared to other cross-sections. Based on the experimental results,the absorbed energy by WW patterned PLA+ square tubes are 19%, 7%, and46% more than that of wall-to-corner (WC), corner-to-wall (CW), and corner-to-corner (CC) patterned tubes, respectively, while it is 11%, 19%, and 80%more in hexagonal cross-section tubes, respectively. This study provides aninformative reference for easier applicability of multicellular energy-absorbingstructures with 3D-print and the design of corner-edge connections of internalconnections in multicellular structures.
Health benefits and risks of fermented foods—the PIMENTO initiative
(FRONTIERS MEDIA SA, 2024) Todorovic, Smilja; Akpınar, Aslı; Assunção, Ricardo; Güzel, Mustafa
Worldwide, fermented foods (FF) are recognized as healthy and safe. Despite the rapid increase of research papers, there is a lack of systematic evaluation of the health benefits and risks of FF. The COST Action CA20128 "Promoting innovation of fermented foods" (PIMENTO) aims to provide a comprehensive assessment on the available evidence by compiling a set of 16 reviews. Seven reviews will cover clinical and biological endpoints associated with major health indicators across several organ systems, including the cardiovascular, gastrointestinal, neurological, immune, and skeletal systems. Nine reviews will address broader biological questions associated with FF including bioactive compounds and vitamin production, nutrient bioavailability and bioaccessibility, the role of FF in healthy diets and personalized nutrition, food safety, regulatory practices, and finally, the health properties of novel and ethnic FF. For each outcome assessed in the reviews, an innovative approach will be adopted based on EFSA's published guidance for health claim submissions. In particular, each review will be composed of three parts: (1) a systematic review of available human studies; (2) a non-systematic review of the mechanism of action related to the clinical endpoints measured by the human studies identified in part 1; and (3) a non-systematic review of the characterization of the FF investigated in the human studies identified in part 1. The evidence and research gaps derived from the reviews will be summarized and published in the form of a strategic road map that will pave the way for future research on FF.
Psychological Needs in Sports, Spirituality Index of Well-Being, and Motivation in Sports
(MDPI, 2024) Eryücel, Mehmet Emre; Ceyhun, Serdar; Eryücel, Sema; Şahan, Hasan; Turna, Bülent; Yıldırım, Sibel; Erdoğan, İbrahim Halil
Abstract: The aim of this study is to examine the relationship between the psychological needs of athletes who attend gyms, the spirituality index of well-being, and motivation in sports, and to determine the mediating role of the spirituality index of well-being between psychological needs in sports and motivation in sports. Although sports spirituality is rapidly developing in the international literature, sports and spirituality have not been studied together in the national literature before. Therefore, this study holds the distinction of being one of the pioneering research efforts on the subject of spirituality in athletes in Türkiye. In this context, the data of 422 athletes, 176 women and 246 men, who have been attending gym facilities in Antalya for at least one year, were included in the research. Participants were administered a personal information form, Psychological Need States. It was found that the spirituality index of well-being is positively related to all satisfaction subscales and negatively related to all frustration subscales of psychological needs and that the life scheme is related to many subscales of sport motivation. Furthermore, it was also found that the spirituality index of well-being is a mediating variable between psychological needs in sports and motivation in sports. The data draw attention to the importance of sports spirituality. It is recommended to integrate spirituality into healthcare for athletes.
Comparison of pre-post operation of cardiac outputs in breast reduction with Simpson’s rule and Teichholz’s formula
(BAYRAKOL MEDICAL PUBLISHER, 2024) Muslu, Ümran; Demir, Emre; Aydoğdu, Gülçin; Şenen Demirez, Dilek; Yüksel, İsa Öner
Aim: This study aims to compare pre- and post-operative cardiac outputs in patients undergoing breast reduction surgery using Simpson's rule and Teichholz's formula. The assessment focuses on ejection fraction (EF), end-systolic volume (ESV), end-diastolic volume (EDV), and stroke volume (SV). Material and Methods: Comparisons across the repeated measurements (pre and post operation values for EF, EDV, ESV and SV) were made by either using Paired Samples t-test or Wilcoxon signed-rank tests. Results: Statistically significant differences were observed in EF, EDV, and SV pre- and post-operative mean scores using the Simpson method (p<0.001, p=0.004, p<0.001, respectively). No significant difference was found for ESV (p=0.061). Using the Teichholz method, significant differences were found in EF, ESV, and SV (p<0.001, p<0.001, p<0.001), but not for EDV (p=0.646). According to Bland-Altman graphics, pre-post measurements were within the limits of agreement in all cardiac outputs. Discussion: Numerous studies in the literature have demonstrated the positive effects of breast reduction surgery on both aesthetic and functional health. Our study makes a significant contribution by revealing the positive impact of this surgery on cardiac performance. Our findings underscore the cardiac benefits of breast reduction surgery and support its role in enhancing overall patient well-being. Future research could investigate in greater detail the long-term cardiovascular benefits and potential respiratory improvements associated with this procedure.
Downregulation of HSP27 by isoindole-derived pyrrolidines suppressing multidrug resistance (MDR) and inducing apoptosis in MCF-7 and DLD-1 cell lines
(NATL INST SCIENCE COMMUNICATION-NISCAIR, 2024) Mesci, Seda; Yazgan, Burak; Gül, Melek; Yıldırım, Tuba
In most cancer treatments, major problem arises from the prevention of cell death (apoptosis suppression) with the development of drug resistance. Anticancer agents that ensure elimination of drug resistance and drug-resistant cells to apoptosis, are among the main targets. Here, we evaluated a series of synthesized N-phenyl maleimide substituents in tetracyclic compounds as anticancer drug candidate. We selected compounds may lead to death and eliminate drug resistance in breast and colon cells. In MCF-7 and DLD-1 cell lines; multidrug resistance genes (ABCB1, ABCC3, ABCC10, ABCC11 and ABCG2), apoptosis mechanism genes (BAX, BCL-2, p53, PARP and CASP3), heat shock genes (HSP27, HSP40, HSP60, HSP70 and HSP90?) and endoplasmic reticulum (ER) chaperone genes (GRP78 and GRP94) mRNA levels were determined by qPCR method. Amounts of proteins of apoptosis and signalling pathways were measured by human apoptosis antibody array. The compounds have been shown to have downregulation on multidrug resistance genes other than ABCC3. It was found that all compounds in MCF-7 and DLD-1 cells showed significant increase in p53, BAX and CASP3 gene expressions. Also, the compounds have the potential to reduce gene expression of heat shock genes (HSPs). While the compounds have been determined to increase protein expression in BAD, BAX, BID, BIM, Caspase-3, Caspase-7, Caspase-8, Cytochrome-C, Fas, TNF, TRAIL, p27, p38 and p53; decrease protein expression in AKT, BCL-2, ERK1/2, HSP27, HSP60, IGFs, JNK, NFKB, PARP, TAK1, Survivin in MCF-7 and DLD-1 cells. The compounds stand out with their inhibition of HSP27 in DLD-1 cells and their inhibition with HSP27 and NFkB in MCF-7 cells. Overall, it has been shown that these compounds increase intrinsic and extrinsic proapoptotic proteins, decrease antiapoptotic proteins, decrease HSPs and some growth factors, and they may serve as potential anticarcinogenic molecules.
Teachers' digital competences: a scale construction and validation study
(FRONTIERS MEDIA SA, 2024) Aydın, Mehmet Kemal; Yıldırım, Turgut; Kuş, Metin
Introduction: Improving teachers’ digital competences is sine qua non for eective teaching and learning in today’s digital society. However, there is a limited number of comprehensive and reliable scales to measure teachers’ digital competences. Regarding this, the present study aimed to develop and validate a comprehensive scale to assess teachers’ digital competences. Methods: Building on previous studies, a draft scale developed and piloted with a sample of teachers from all educational levels. The procedures of Exploratory Factor Analysis (EFA) were followed to refine the scale, resulting in a fivepoint Likert scale with 36 items loaded onto four factors. The final scale was called as Teachers’ Digital Competences Scale (TDC-S). Confirmatory factor analysis (CFA) was employed to validate the four-factor structure. Reliability analysis was performed using Cronbach’s alpha (?), McDonald’s omega (?), and Composite Reliability (CR), indicating high psychometric properties. Convergent and discriminant validity analyses were also performed to assess the validity of the latent structures in TDC-S. Results and discussion: The findings suggest that the TDC-S is a valid and reliable instrument for assessing teachers’ digital competences at all grade levels from primary to high schools. It can be used to inform teacher training and development programs, and to identify teacher candidates who need additional assistance regarding improving their digital competences
Heart Failure Awareness Survey in a Turkish Population: HFAS-TR
(KARE PUBL, 2024) Karabulut, Dilay; Günay, Şeyda; Sert Şekerci, Sena; Bekar, Lütfü
Objective: Heart failure is a leading cause of death and the most common diagnosis leading to hospitalization. Its awareness is lower than that of other cardiovascular diseases, both in the general population and among patients with heart failure (HF). This study aimed to establish the current level of knowledge about HF in patients with HF with reduced ejection fraction (HFrEF) and mildly reduced ejection fraction (HFmrEF) in Türkiye. Methods: This questionnaire-based survey study is multicenter, conducted across 34 centers from December 2021 to July 2022. We performed a survey consisting of two sets of questions focusing on individual characteristics of the patients and HF-related knowledge. Results: The study included a total of 2,307 outpatient HF patients, comprising 70.5% males and 29.5% females with a mean age of 64.58 ± 13 (56-74) years and a mean body mass index value of 32.5 ± 10 kg/m2. HFrEF and HFmrEF were determined in 74.7% and 25.3% of patients, respectively. Thirty percent of the patients were unaware that they had HF. While 28.7% of the patients thought that they had sufficient information about HF, 71.3% believed they lacked adequate knowledge. In the study, 25.2% of the participants identified dyspnea, 22% identified tiredness, and 25.4% identified leg edema as the most common symptoms of HF. Only 27.4% of patients recognized all three typical symptoms of HF. Conclusion: We found that the study population’s knowledge about HF symptoms and the nature of the disease was poor. Educational and awareness activities are necessary to optimize outcomes and benefits.
Investigating AXIN1 gene polymorphisms in Turkish children with cryptorchidism: A pilot study
(ELSEVIER SCI LTD, 2024) Doğan, Gül; Yılmaz, Akın; İpek, Hülya; Metin, Mehmet; Peltek Kendirci, Havva Nur; Afşarlar, Çağatay Evrim
Introduction Cryptorchidism is one of the most common congenital anomalies in male children, occurring in 2e5% of full-term male infants. Both genetic and environmental factors are observed to play a role in its etiology. A study conducted in Japan identified the AXIN1 gene as being associated with cryptorchidism. Objective We aimed to conduct a pilot study on AXIN1 gene polymorphism in Turkish children with cryptorchidism, and whether AXIN1 gene polymorphism is a risk factor for cryptorchidism. Study design Between January 2023 and December 2023, we have planned a prospective controlled study including 84 boys operated for cryptorchidism as study group, and 96 boys operated for circumcision as control group. The remaining blood samples of preoperative laboratory tests in ethylenediamine tetraacetic acid (EDTA) tubes were kept at 20 Co freezer for genomic studies. Patient demographics, physical examination and operative findings were recorded, study patients were grouped according to testis localization. After collecting all samples, genomic DNA isolation procedure was done, and analysis of the 3 polymorphisms (rs12921862, rs1805105 and rs370681) of AXIN1 gene was performed using conventional Polymerase Chain Reaction Restriction Fragment Length Polymorphism (PCR-RFLP) method. Genotype and allele frequencies of each group was analyzed and compared. Results The most common location of cryptorchid testis was proximal inguinal (53%), followed by distal inguinal (25.3%), bilateral (13.3%), and intra-abdominal (8.4%). Regarding the 3 polymorphisms of AXIN1 gene, there was no significant difference between study and control groups, in terms of genotype and allele frequencies (P > 0.05). Eight haplotype blocks were estimated for 3 polymorphisms of AXIN1. However, no significant difference was observed between study and control groups regarding haplotype distributions (P > 0.05). In addition, the comparison of the localization of testis with AXIN1 gene polymorphism did not show any significant difference among cryptorchid testis groups (P > 0.05). Discussion The AXIN1 gene is located on chromosome 16p and its polymorphisms have been associated with various diseases. In a Chinese study, the rs370681 polymorphism was found to be associated with cryptorchidism. However, our results showed no association between the AXIN1 gene haplotypes for the studied polymorphisms and cryptorchidism. Conclusion In this study we have investigated the AXIN1 gene polymorphism in Turkish children with cryptorchidism as a pilot study. Although we could not identify any difference as compared to control group, further research is necessary to uncover the underlying molecular mechanisms contributing to the development of cryptorchidism.
Predictive Value of Serial Rapid Shallow Breathing Index Measurements for Extubation Success in Intensive Care Unit Patients
(MDPI, 2024) Turhan, Semin; Tutan, Duygu; Şahiner, Yeliz; Kısa, Alperen; Önen Özdemir, Sibel; Tutan, Mehmet Berksun; Kayır, Selçuk; Doğan, Güvenç
Abstract: Background and Objectives: Extubation success in ICU patients is crucial for reducing ventilator-associated complications, morbidity, and mortality. The Rapid Shallow Breathing Index (RSBI) is a widely used predictor for weaning from mechanical ventilation. This study aims to determine the predictive value of serial RSBI measurements on extubation success in ICU patients on mechanical ventilation. Materials and Methods: This prospective observational study was conducted on 86 ICU patients at Hitit University between February 2024 and July 2024. Patients were divided into successful and unsuccessful extubation groups. RSBI values were compared between these groups. Results: This study included 86 patients (32 females, 54 males) with a mean age of 54.51 ± 12.1 years. Extubation was successful in 53 patients and unsuccessful in 33. There was no significant difference in age and intubation duration between the groups (p = 0.246, p = 0.210). Significant differences were found in RSBI-1a and RSBI-2 values (p = 0.013, p = 0.011). The median RSBI-2a was 80 in the successful group and 92 in the unsuccessful group (p = 0.001). The ?RSBI was higher in the unsuccessful group (p = 0.022). ROC analysis identified optimal cut-off values: RSBI-2a ? 72 (AUC 0.715) and ?RSBI ? ?3 (AUC 0.648). RSBI-2a ? 72 increased the likelihood of successful extubation by 10.8 times, while ?RSBI ? ?3 increased it by 3.4 times. Using both criteria together increased the likelihood by 28.48 times. Conclusions: Serial RSBI measurement can be an effective tool for predicting extubation success in patients on IMV. These findings suggest that serially measured RSBI may serve as a potential indicator for extubation readiness.
Data privacy-aware machine learning approach in pancreatic cancer diagnosis
(BMC, 2024) Akmeşe, Ömer Faruk
Problem Pancreatic ductal adenocarcinoma (PDAC) is considered a highly lethal cancer due to its advanced stage diagnosis. The fve-year survival rate after diagnosis is less than 10%. However, if diagnosed early, the fve-year survival rate can reach up to 70%. Early diagnosis of PDAC can aid treatment and improve survival rates by taking necessary precautions. The challenge is to develop a reliable, data privacy-aware machine learning approach that can accurately diagnose pancreatic cancer with biomarkers. Aim The study aims to diagnose a patient’s pancreatic cancer while ensuring the confdentiality of patient records. In addition, the study aims to guide researchers and clinicians in developing innovative methods for diagnosing pancreatic cancer. Methods Machine learning, a branch of artifcial intelligence, can identify patterns by analyzing large datasets. The study pre-processed a dataset containing urine biomarkers with operations such as flling in missing values, cleaning outliers, and feature selection. The data was encrypted using the Fernet encryption algorithm to ensure confdentiality. Ten separate machine learning models were applied to predict individuals with PDAC. Performance metrics such as F1 score, recall, precision, and accuracy were used in the modeling process. Results Among the 590 clinical records analyzed, 199 (33.7%) belonged to patients with pancreatic cancer, 208 (35.3%) to patients with non-cancerous pancreatic disorders (such as benign hepatobiliary disease), and 183 (31%) to healthy individuals. The LGBM algorithm showed the highest efciency by achieving an accuracy of 98.8%. The accuracy of the other algorithms ranged from 98 to 86%. In order to understand which features are more critical and which data the model is based on, the analysis found that the features “plasma_CA19_9”, REG1A, TFF1, and LYVE1 have high importance levels. The LIME analysis also analyzed which features of the model are important in the decision-making process. Conclusions This research outlines a data privacy-aware machine learning tool for predicting PDAC. The results show that a promising approach can be presented for clinical application. Future research should expand the dataset and focus on validation by applying it to various populations.
From Captivity to Liberty: A Study on the Prison Writings of Martin L. King, Ngugi and Soyinka
(Rector CIU Cyprus Int Univ, 2024) Bolat, Eren; Ekler, Onur
Prisons, like other disciplining apparatuses of the state, are used to reform the prisoners so that they can be re-conditioned back to a set of pre-ordained roles designed in the system. These are places hostile to individuality, freedom, and creativity. They function like rehabilitating institutes to suppress the reactionary or rebellious voices of the prisoners by effacing their individuality under harsh conditions so that they can make them docile bodies. However, this objective fails when the prisoner-intellectuals are of concern. For them, prisons become their shrines where they are overwhelmed by the transformative power of imprisonment. The experience of confinement shapes their perspectives, deepens their commitment to social justice, and fuels their advocacy for change. Although the physical conditions of the prisons hamper their urge to write, they never give up writing. Some write on the prison walls and some on toilet papers. Despite such horrible conditions, they manage to produce their most influential works which can be classified in prison literature. The writings of these prisoner-writers have paved the way for the liberation of colonized/discriminated people in their own countries and in diverse diasporas. Martin L. King’s Letter from Birmingham Jail (2018), Ngugi wa Thiong’o’s Detained: A Writer’s Prison Diary (1981) and Wole Soyinka’s The Man Died: The Prison Notes (1988) are three significant works to be featured in this genre. Through an interdisciplinary approach, this article identifies the distinctive elements and commonalities in the prison writings of King, Ngugi, and Soyinka. This study explores the universal concepts of incarceration, resistance to oppressive systems, and the struggle for freedom as portrayed in the works of these writers, and aims to examine how these writers have transformed their works into tools of resistance.
MO-CCCII-Based Single-Input Multi-Output (SIMO) Current-Mode Fractional-Order Universal and Shelving Filter
(MDPI, 2024) Şen, Fadile; Kırcay, Ali; Sonbaş Cobb, Buket; Akgül, Akif
This study introduces an innovative filter topology capable of providing simultaneous positive and negative gain outputs for one-fractional order LP, with high-pass, all-pass, and fractional-order shelving filter responses. The circuit, utilizing multi-output second-generation current-controlled conveyors, stands out as the first to deliver ten outputs, incorporating both integer and fractional-order filter responses, without requiring additional components. Its current-mode design simplifies the process, employing minimal active and grounded passive elements, making it appropriate for low-voltage/low-power applications. The filter utilizes fifth-order Oustaloup approximation and Foster type-I RC networks for fractional-order capacitors, providing enhanced control over the transition slope. PSpice simulations confirmed a 1 kHz cut-off, showcasing low power consumption, minimal noise, and a wide dynamic range, positioning the filter as suitable for sensors, control, and acoustic applications.
Service Quality and Related Factors in Primary Health Care Services: A Cross-Sectional Study
(MDPI, 2024) Değer, Mehmet Sait; Issever, Halim
Primary health care services aim to prevent diseases and improve health efficiently and effectively. This study measures perceived service quality in a primary healthcare organization and examines the effect of personality traits on service quality. The cross-sectional study population comprised individuals over the age of 18 who applied to the Bing & ouml;l Central Community Health Centre. A total of 460 participants were included in the study between November 2018 and March 2019. The participants completed a face-to-face questionnaire that included socio-demographic characteristics, the SERVQUAL Scale, and an abbreviated form of the revised Eysenck Personality Questionnaire. This study is based on doctoral research in public health. The study found median values for personality trait sub-dimensions as follows: neuroticism: 2, psychoticism: 2.65, extraversion: 4, and lying: 5. The SERVQUAL Score was -0.02. The study revealed that the quality of primary health care services did not meet the participants' expectations. The study findings also indicated that age, educational attainment, and extraverted and psychotic personality traits were significantly associated with the satisfaction of service quality expectations (p < 0.05). It is recommended to provide primary health care services in facilities with good physical characteristics, with sufficient and competent health personnel, and in a timely and accurate manner to improve service quality.
Assessment of frailty, daily life activities, and nutrition of elderly immigrants: A household based cross-sectional study
(LIPPINCOTT WILLIAMS & WILKINS, 2024) Değer, Mehmet Sait; Sezerol, Mehmet Akif; Atak, Muhammed
With the global migrant population on the rise, it's imperative to focus on the health status of more vulnerable groups within these communities. The elderly immigrants face myriad physical and psychosocial challenges that significantly impact their health and quality of life. This study aims to investigate the nutrition, daily life activities, and clinical frailty status of elderly immigrants residing in T & uuml;rkiye. A cross-sectional design was employed in the Sultanbeyli District, focusing on Syrian immigrants aged 65 and over. Participants were surveyed face-to-face by interpreters proficient in Arabic. The questionnaire comprised sociodemographic details, health status, and scales like Katz Daily Life Activities, Clinical Frailty, and Mini Nutritional Assessment. The data analysis was executed using SPSS 22. Continuous variables were presented as mean +/- standard deviation (SD) and median, while categorical ones were expressed in numbers and percentages (%). A significance level of P < .05 was considered for the analyses. The average age of the participants was determined as 71.64 +/- 6.20 years. In the study group, 49.7% were female, 75.5% were younger than 75 years old, 47.7% had less than primary school education, 56.3% were married, 42.4% had a low income level, and 56.9% lived in the same household with 5 or more people. Among the participants in the study group, 47% had walking and balance problems, 29.1% had a history of falls in the last year, 10.6% were disabled, 69.5% complained of pain, 82.8% had a chronic illness, and 43% had polypharmacy. The median value of the KATZ Daily Living Activities scale was 6, the mean score of the Clinical Frailty Score scale was 3.25 +/- 1.25, and the mean score of the Mini Nutritional Assessment scale was 12.40 +/- 2.15. Among immigrant elderly individuals, 88.1% were able to sustain their lives independently, 13.9% were clinically frail, and 3.3% were at risk of malnutrition. Factors such as age, level of education, socioeconomic status, marital status, number of cohabitants in the household, BMI, neurological problems, walking-balance disorders, disability, and presence of chronic diseases are associated with daily life activities, frailty, and malnutrition status. It is believed that broader field research with greater participation would be beneficial for evaluating the nutritional status of immigrant elderly individuals.
Experimental modeling and optimization of pullulan production by Aureobasidium pullulans AZ?6
(SPRINGER, 2024) Müjdeci, Gamze Nur; Bozdemir, Melek Tijen; Özbaş, Zekiye Yeşim
Abstract The objective of this study was to optimize the fermentation parameters by using response surface methodology for increasing pullulan production of Aureobasidium pullulans AZ-6 in synthetic fermentation medium. The optimum conditions were determined as follows: the initial sucrose concentration (X1): 100 g/L; the initial peptone concentration (X2): 11.31 g/L; the initial pH (X3): 6.48; and the temperature (X4): 24.2 °C. In the optimum conditions, the maximum exopolysaccharide (EPS) concentration (Y1), the maximum pullulan concentration (Y2), the specifc growth rate (Y3), the maximum specifc pullulan formation rate (Y4), and the pullulan yield (Y5) were expected to be obtained as 37.078 and 35.372 g/L, 0.062 h?1, 0.021 [g pullulan/(g mo.h)], and 53.681%, respectively. The observed values of Y1, Y2, Y3, Y4, and Y5 were 36.950 g/L, 35.470 g/L, 0.064 h?1, 0.036 [g pullulan/(g mo.sa)], and 54.480%, respectively, as a result of validation experiments. EPS samples were characterized by Fourier-transform infrared spectroscopy and scanning electron microscope analyses. The optimization process caused more than a 50% increase in EPS and pullulan concentrations. This study showed that the color-variant A. pullulans AZ-6 strain could become a signifcant industrial strain if it is explored further in the future to produce pullulan on a larger scale.

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