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Abstract Background In this study, we observed the frequency of side effects encountered when the neural integrity monitor electromyogram endotracheal tube (NIM-EMG-ETT) was used in thyroidectomy and parathyroidectomy surgeries. Methods After obtaining hospital ethics committee approval, 239 cases affiliated with the American Society of Anesthesiologists (ASA II-IV) who used NIM EMG tubes in thyroid and parathyroid surgery were included in the prospective observational study. Tube and patient-related complications encountered with two different NIM EMG-ETT (silicone and polyvinyl chloride-PVC) were recorded. Results The average age of the patients is 49.50 ± 13.44 years, the average BMI is 28.25 ± 4.91 kg/m2, the median surgery time is 115 (32–475) minutes, 75.7% are women, 97.5% are ASA II. Additional diseases other than thyroid and parathyroid problems were present in 77.3%. Thyroidectomy was performed in 73.2% of the patients. In our study, only 0.8% of patients with transient recurrent laryngeal nerve RLN paralysis were observed in thyroid and parathyroid surgeries performed using NIM-EMG tubes, 3 patient already had nerve involvement in the preoperative period. The most common complication was loss of stimulation response related to tubes and patient-related ventilation failure. There was no difference between the complications of silicone and PVC tubes except for irregular EMG response. Conclusions There was no significant difference in side effects other than irregular EMG response in the two different tubes we used in our study. It was observed that prolonging the surgical time increased the risk of irregular EMG response. It should not be forgotten that no matter which NIM-EMG tube is used, additional risks are encountered during the intubation and extubation process. In order to avoid negative consequences, it is necessary to follow the usage rules recommended by the manufacturer when using NIM-EMG tubes.

Abstract Background Growth factors embedded in the extracellular matrix of the dentin play an important role in the migration, proliferation, and differentiation of dental pulp stem cells in regenerative endodontics. In regenerative endodontic treatments, the type of irrigation solution used is crucial for the release of growth factors (GFs) from the dentin matrix. This study evaluated the effectiveness of different irrigant activation techniques (IAT) using two different chelating agents, 17% ethylenediaminetetraacetic acid (EDTA) and 9% etidronic acid (HEDP), in terms of their GF release. Methods Seventy-two mandibular premolar teeth were prepared to simulate an open apex. The root fragments were irrigated with 20 ml of 1.5% sodium hypochlorite and 20 ml of saline solution. Eight root fragments were randomly separated for the control group, and the remaining 64 fragments were randomly separated into eight groups based on two different chelating agents (17% EDTA and 9% HEDP) and four different IAT ((conventional needle irrigation (CNI), passive ultrasonic irrigation (PUI), sonic activation with EDDY, and XP-endo Finisher (XPF)). TGF-β1, VEGF-A, BMP-7 and IGF-1 release levels were determined using an ELISA, and statistical analysis was performed using the Kolmogorov–Smirnov test, ANOVA, and the Tukey test (p

Objective: To evaluate the effectiveness of caudal block and penile block methods, in patients who underwent circumcision surgery in preventing postoperative pain. Materials and Methods: Patients who underwent elective circumcision surgery between January 2019 and May 2022 were retrospectively evaluated. After the exclusion criteria, 56 patients were included in the study. They were divided into two groups as penile block (group P, n=31) and caudal block (group C, n=25). Anesthesia technique applied, anesthesia duration, postoperative first micturition time, postoperative complications, time of first analgesia, analgesia need in the first six hours, observer pain score and Modified Pediatric Objective Pain Scale scores (MPOPS) were scanned. Results: When the first micturition time in the postoperative period was compared, it was found that group P took a significantly shorter time than group C (p=0.001). It was determined that group C needed analgesia in a shorter time than group P (p=0.028). When the MPOPS at 30th min (p=0.031), 90th min (p=0.043) and 6th hour (p=0.016) were compared, group C higher scores than group P. Conclusion: As a result, both methods can be used effectively and safely for appropriate pain control in patients who will undergo circumcision surgery. Both methods have advantages and disadvantages over each other. The choice of methods may vary with the experience of the surgeon and anesthetist.

Objective: Cardiologists are the most frequently consulted specialists during pre-operative evaluations. However, unnecessary cardiology consultations (CC) can increase cardiologists’ workload without impacting anaesthesia practice, resulting in delayed surgeries and additional financial burdens. We hypothesize that using Gupta during the preoperative period can reduce these adverse effects. Methods: This prospective study included patients scheduled for elective noncardiac, nonvascular surgeries who underwent pre-operative assessment. Patients who had no specific risk index used for preoperative cardiac risk evaluation were classified as Group I, and those evaluated using the Gupta scale were classified as Group II. The study compared preoperative CC, diagnostic tests, surgical delays, major adverse cardiac event (MACE), length of hospital stay and intensive care unit (ICU) stay, mortality, and costs. Results: A total of 898 patients were included in the study, with 487 in Group I and 411 in Group II. The Gupta group reduced the demand for preoperative CC (P

Objective:This prospective randomized study compared 2 different methods for ProsealTM Laryngeal Mask Airway (PLMA) fixation.Methods:Patients scheduled for ureterorenoscopic lithotripsy surgery in the lithotomy position were included in the study. General anaesthesia with PLMA was administered to the patients. To achieve PLMA fixation, patients were randomly assigned to either adjustable elastic band (Group I) or adhesive tape fixation (Group II). Fiberoptic bronchoscope (FOB) evaluation and glottic image grading (grade 1-4) and lip margin distances of PLMA (M1 and M2) were evaluated before and after the surgical procedure.Results:We enrolled 116 patients. Surgery of 7 patients was postponed. PLMA dislocated in 2 patients in group II during positioning. For another patient who used adhesive tape in Group II, it was removed because it could not adhere to properly, and a new sticking plaster was used. The study was completed with 106 patients. In FOB evaluation, the number of patients with optimal FOB grade (FOB grade 1) after PLMA was inserted and fixed was more in Group I than in Group II (P = 0.01). FOB evaluation was repeated at the end of the operation, and the number of patients with the worst FOB grade (FOB grade 4) was 0 (0%) and 11 (10.5%) in Groups I and II, respectively. PLMA displaced more than 1 cm in 10 (18.9%) patients in Group I and in 30 patients (56.6%) in Group II.Conclusion:The adjustable elastic band method is simple, easy, and convenient and can be used in any surgical procedure for PLMA fixation.

Objective: Various products are used to strengthen immunity in prevention and treatment during the COVID-19 pandemic affecting the whole world, which has no cure yet, and the vaccine has just been used. This study was planned to learn about the supplements used by healthcare professionals. Methods: A questionnaire was applied to the physicians, nurses, technicians, secretaries, and staff working in the operating room, intensive care, ward, and outpatient clinic by e-mail, WhatsApp, or face-to-face interview method. Results: There was no difference between the groups in terms of being COVID-19-positive. The most used products were primarily Mg and vitamin D, and vitamin C, ginger, Zn, turmeric, green tea, vitamin complex, thyme, black elderberry (sambucus nigra), propolis, prebiotic/probiotic, acetylsalicylic acid (ASA), black cumin (niger sativa), N-acetyl cysteine (NAC), selenium (Se), Coenzyme-Q10, cinnamon, glutathione (GSH) and quercetin respectively. No one had used alpha lipoic acid (ALA). The products that showed significant differences between the groups with and without COVID-19 were vitamin C, prebiotic/probiotic, propolis and ASA. Conclusıon: Since it is not asked when the product is used, although it is not possible to evaluate its effectiveness for preventive or therapeutic purposes, known to be natural, inexpensive, and easily accessible antiviral products may be preferred.

Precipitation is one of the climate parameters with the widest effects. Not all precipitation seeps into the ground; some may evaporate; another part may turn into the runoff. Only part of the stored water will be taken up by the roots to meet the transpiration needs of the plant. Therefore, it is necessary to know the effective precipitation. This study was prepared to calculate the effective precipitation amount and to compare the different methods used for effective precipitation forecasting. For this purpose, the effective precipitation values were calculated by using the average monthly precipitation data of 15 stations in the Middle Euphrates Section, which is important in terms of agricultural potential and at the same time-sensitive. Comparison of 3 different methods recommended by FAO: USDA-SCS, FAO/AGLW and Empirical. According to the results, the most applicable method for the Middle Euphrates Section was determined as the USDA-SCS method. however, considering these methods integrated with soil balance methods, especially in sensitive areas, provides a more complete overview of the simulation quality of the methods.

Abstract Background Cordia myxa L. (Boraginaceae) is widely distributed in tropical regions and it’s fruits, leaves and stem bark have been utilized in folk medicine for treating trypanosomiasis caused by Trypanosoma cruzi. A population-based study showed that T. cruzi infection is associated with cognitive impairments. Therefore, if C. myxa has ameliorating activities on cognitive function, it would be useful for both T. cruzi infection and cognitive impairments. Methods In this study, we evaluated the effects of an ethanol extract of leaves of C. myxa (ELCM) on memory impairments and sensorimotor gating deficits in mice. The phosphorylation level of protein was observed by the Western blot analysis. Results The administration of ELCM significantly attenuated scopolamine-induced cognitive dysfunction in mice, as measured by passive avoidance test and novel object recognition test. Additionally, in the acoustic startle response test, we observed that the administration of ELCM ameliorated MK-801-induced prepulse inhibition deficits. We found that these behavioral outcomes were related with increased levels of phosphorylation phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt) and glycogen synthase kinase 3 beta (GSK-3β) in the cortex and extracellular signal-regulated kinase (ERK) and cAMP response element-binding protein (CREB) in the hippocampus by western blot analysis. Conclusions These results suggest that ELCM would be a potential candidate for treating cognitive dysfunction and sensorimotor gating deficits observed in individuals with neurodegenerative diseases.

Acute respiratory distress syndrome (ARDS) is a critical, life-threatening condition involving both lungs, characterized by capillary endothelial damage, diffuse pulmonary infiltration, and oxygen-resistant hypoxemia. The incidence in intensive care units is between 7.1-12.5% and its mortality can be up to 40% in severe cases. Pathological processes with exudative, proliferative and fibrotic stages in the lungs in response to different etiological factors in ARDS result in hypoxemia, hypercapnia and decreased lung compliance. There is no drug with proven efficacy in treatment. The most crucial parameter of ARDS management is protective mechanical ventilation, including low tidal volume, high positive end-expiratory pressure regulations, prone position, and recruitment maneuvering. In addition, supportive approaches such as fluid management, nutritional support, reduction of oxygen consumption, prevention of ventilator-associated pneumonia, pain management, deep vein thrombosis prophylaxis, peptic ulcer prophylaxis, blood sugar regulation, and maintaining skin/tissue integrity are applied. This review will briefly describe ARDS and related factors, then focus on treatment, care, and patient follow-up from the physician and nurse perspective.

ABSTRACT Purpose: The effects of hesperidin application on the wound caused by esophageal burns were investigated in this study. Methods: Wistar albino rats were divided into three groups: Control group: only 1 mL of 0.09% NaCl was administered i.p. for 28 days; Burn group: An alkaline esophageal burn model was created with 0.2 mL of 25% NaOH orally by gavage—1 mL of 0.09% NaCl was administered i.p. for 28 days; Burn+Hesperidin group: 1 mL of 50 mL/kg of hesperidin was given i.p. for 28 days to rats after burn injury. Blood samples were collected for biochemical analysis. Esophagus samples were processed for histochemical staining and immunohistochemistry. Results: Malondialdehyde (MDA) and myeloperoxidase (MPO) levels were significantly increased in Burn group. Glutathione (GSH) content and histological scores of epithelialization, collagen formation, neovascularization was decreased. After hesperidin treatment, these values were significantly improved in the Burn+Hesperidin group. In the Burn group, epithelial cells and muscular layers were degenerated. Hesperidin treatment restored these pathologies in Burn+Hesperidin group. Ki-67 and caspase-3 expressions were mainly negative in control group; however, the expression was increased in the Burn group. In the Burn+Hesperidin group, Ki-67 and caspase-3 immune activities were reduced. Conclusions: Hesperidin dosage and application methods can be developed as an alternative treatment for burn healing and treatment.

This study aims to reveal the need-support profiles of science teachers by using three variables (teachers’ autonomy support, involvement, and structure support), as well as the role of the teachers with such profiles in students’ collective engagement. Within the scope of the study, first of all, the observation form developed by Reeve, Jang, Carrell, Jeon, and Barch (2004) was adapted into Turkish. Then, 41 science lessons taught by different teachers were observed using the form during a class hour. Descriptive statistics, cluster analysis, and independent samples t-tests were performed using IBM SPSS Statistics 20 to analyze the data. The cluster analysis showed that teachers in most classes (n = 35) were highly need-supportive, while a few teachers (n = 6) were moderately need-supportive. The independent samples t-test analysis demonstrated that the collective engagement of the students in the classrooms where the teachers were highly need-supportive was more than those of the students in the classrooms where the teachers were moderately need-supportive. Students’ collective engagement varied according to the teachers’ need-supportive profiles. In other words, it can be assumed that teacher behaviors play a crucial role in students’ collective engagement.

Amaç: Bu çalışmanın amacı, bir endodontik hasta popülasyon örneğinde cinsiyet ve diş tiplerine göre kök dilaserasyonu sıklığını ve dağılımını belirlemektir. Gereç ve Yöntemler: 2016 ile 2018 tarihleri arasında Kütahya Sağlık Bilimleri Üniversitesi Diş Hekimliği Fakültesi Endodonti Ana Bilim Dalı’na başvuran 500 hastanın dijital panoramik radyografileri kullanılarak retrospektif bir çalışma gerçekleştirildi. Tüm daimi dişler incelendi. Dilaserasyon gözlenen hastaların cinsiyeti ve dilaserasyon görülen dişin tipi ve bulunduğu çene kaydedildi. Elde edilen verilerin istatistiksel analizi Pearson ki-kare ve Z-oran testi ile yapıldı. Bulgular: Çalışmada toplam 500 adet panoramik radyografi değerlendirildi. Bu radyografların 68 (%13.6)’inde ve incelenen 13014 dişin 74 (%0.57)’ünde dilaserasyon saptandı. Bu dilasere dişlerin 20 (%27.0)’sinin maksillada, 54 (%73.0)’ünün ise mandibulada olduğu görüldü. Bu dilasere dişlerin 8 tanesi (%10.8) kesici dişlerde, 6 tanesi (%8.1) premolar dişlerde ve 60 tanesi (%81) ise molar dişlerdeydi. Kök dilaserasyonunun sıklığı mandibulada, maksilladan anlamlı derecede farklı bulundu (p0.05). Sonuç ve Öneriler: Endodontik tedavinin başarısında kök kanalların biyomekanik preperasyonu ve mikroorganizmaların kök kanal sisteminden etkili bir şekilde uzaklaştırılması önemlidir. Bu nedenle endodontik tedaviden önce kök dilaserasyonunu teşhis etmek hem tedavi sırasındaki komplikasyonları önlemek hem de iyi bir tedavi yapabilmek için kritik önem taşımaktadır.

Abstract Background Coats plus syndrome, cerebroretinal microangiopathy with calcifications and cysts, is a rare disease with autosomal recessive pattern occurring due to a mutation in CTC1, encoding conserved telomere maintenance component 1, gene. Besides retinal involvement, abnormalities in brain and osteopenia, serious life-threatening bleeding in gastrointestinal tract and portal hypertension can be observed. Case presentation A 6-year-old girl with Coats plus syndrome presented to the pediatric emergency department with vomiting blood and blood in stool. An upper and lower gastrointestinal endoscopy revealed esophageal varices and vascular telangiectasia in the pyloric antrum, duodenum, and colon. She received palliative care and the bleeding was stopped after receiving intravenous octreotide. She then was followed in the pediatric gastroenterology, neurology, and ophthalmology clinics. She was later hospitalized and admitted to the intensive care unit as she continued to have intermittent gastrointestinal system bleeding. She eventually died due to severe gastrointestinal system bleeding. Conclusions Coats plus syndrome can lead to life-threatening gastrointestinal bleeding and portal hypertension. As Coats plus syndrome is quite rare, there is little published data on this syndrome. This report presents a case of Coats plus syndrome as a rare cause of gastrointestinal bleeding and portal hypertension.

Bu çalışmanın amacı öğretmenlerin sınıf içi gündelik deneyimlerini irdelemek ve söz konusu deneyimleri nasıl anlamlandırdıklarını ortaya çıkarmaktır. Bu amaç doğrultusunda öğrencilerle olan iletişim ve etkileşim, sınıf yönetimi süreçleri ve öğrenme ortamına ilişkin öğretmenlerin sınıf içi gündelik deneyimleri irdelenmiştir. Araştırmada nitel araştırma desenlerinden fenomonoloji deseni; verilerin toplanıp işlenmesi için yarı yapılandırılmış görüşme formu ve içerik analizi teknikleri kullanılmıştır. Çalışma grubu kamu okullarında görev yapan 5 öğretmenden oluşmaktadır. Çalışma grubunun belirlenmesi için amaçlı örnekleme yöntemi kullanılmıştır. Toplanan veriler içerik analizi ile analiz edilmiş; öğretmenlerin sınıf içi gündelik deneyimlerine ilişkin düşünceleri tespit edilmiştir. Yapılan analizler sonucunda öğretmenlerin sınıf içi gündelik deneyimlerinde, olumlu sınıf ikliminin oluşmasında öğrencilerle olan iletişim ve etkileşime önemli ölçüde vurgu yapmışlar ve sınıf içi otorite kurmanın sınıf yönetimiyle yakından ilgili olduğunu belirtmişlerdir. Bunun yanı sıra katılımcılar, öğretmen öğrenci arasındaki mesafenin ilişkileri şekillendirici bir özelliğe sahip olduğunu ve istenmeyen öğrenci davranışlarına yönelik öğretmen müdahalesinin sınırlı düzeyde olduğunu vurgulamışlardır. Buna ek olarak, öğrenciyle kurulan sağlıklı iletişimin öğrencinin kendini ifade edebilme becerisini geliştirdiği, öğretmenlerle öğrenciler arasında oluşturulan mesafenin karşılıklı saygıyı oluşturduğu ve olumlu sınıf ikliminin ortaya çıkmasına katkı sağladığı söylenebilir.

Objective:This study aims to evaluate outcomes of redo orchiopexy and the effect of redo surgery timing upon testicular volume.Materials and Methods:This prospective study involved children receiving redo orchiopexy for recurrent undescended testis. Patients were recruited to assess testicular position, volume, blood flow and presence of microlithiasis. Testis volume was measured by ultrasound and compared with recently developed normative values for testicular size.Results:A total of 38 patients (40 testes) required redo orchiopexy were reviewed in the study. Thirty three of invited boys could be investigated as long term participation. As a result of long term follow up; 28 of the testes were at scrotum, 2 of them were at inguinal canal and 3 of them were non-palpable, with a 15% failure rate of redo orchiopexy. For all patients evaluated in the control visit mean testis volume was 1.23 mL, at 24 of whom were significantly smaller than the normative values for the same age (p

This study examined the spatiotemporal climate variability over the Ceyhan River basin in Southern Anatolia, Türkiye using historical rainfall and temperature observations recorded at 15 meteorology stations. Various statistical and geostatistical techniques were employed to determine the significance of trends for each climatic variable in the whole basin and its three sub-regions (northern, central, and southern regions). The results revealed that the recent years in the basin were generally warmer compared with previous years, with a temperature increase of approximately 4 °C. The standardized temperature index analysis indicated a shift towards hotter periods after 2005, while the coldest periods were observed in the early 1990s. The spatial distribution of temperature showed non-uniform patterns throughout the basin. The first decade of the study period (1975–1984) was characterized by relatively cold temperatures, followed by a transition period from cold to hot between 1985 and 2004, and a hotter period in the last decade (2005–2014). The rainfall analysis indicated a decreasing trend in annual rainfall, particularly in the northern and central regions of the basin. However, the southern region showed an increasing trend in annual rainfall during the study period. The spatial distribution of rainfall exhibited considerable variability across the basin, with different regions experiencing distinct patterns. The standardized precipitation index analysis revealed the occurrence of multiple drought events throughout the study period. The most severe and prolonged droughts were observed in the years 1992–1996 and 2007–2010. These drought events had significant impacts on water availability and agricultural productivity in the basin.

Aim:The Coronavirus disease-2019 pandemic has effects on the healthcare system, as well as on the care of child burns. In our study, we aimed to compare the numbers and demographic data of patients who were treated and followed up during the pandemic period in our burn intensive care center with the data of patients in the same period one year prior.Methods:The patients who were admitted to our tertiary pediatric burn center were divided into two groups: pandemic period (March 10-September 30, 2020) and pre-pandemic period (March 10-September 30, 2019). The groups were compared in terms of age, gender, city of origin, means of transport to the hospital, total burn surface area, burn etiology, duration of hospitalization, intubation status, and mortality from their medical records.Results:In the pandemic period group, 414 children were admitted to the pediatric burn unit and 126 (30.4%) were hospitalized; however, in the pre-pandemic period group, 728 children were admitted to the pediatric burn unit and 98 (13.4%) were hospitalized (p

ABSTRACT: In this study, the share of land rent in the fixed costs of wheat production was examined, and the aim of the study was to find land values using cost tables. To this purpose, we showed the effect of these on land values from the difference between field rents and net income. The study covered the district of Polatlı in Ankara province. Data on wheat production in Polatlı in 2017 was collected from six villages and 37 farms by means of a questionnaire. In selecting the farms, the ability to determine the land rent was taken into account as a selection criterion. The farms examined used on average per hectare, 11.9 hours of labor, 7.7 hours of draft power, 354.3 kg of fertilizer, 205.5 kg of seed, and 1.5 liters of agricultural chemicals. The average wheat production cost per hectare was $865.42; the average unit production cost was $0.23, and the production value was reported to be $1012.40/da. In this study, the land rent was of $225.40, and the net income from the land was reported to be $372.42. It was reported an evaluation performed using the taxation tables that land values according to rental incomes were $4508.80/ha, and $7448.40 when the land was worked by the landowner. Land rent constituted 26.05% of total production costs, and were equivalent to 22.26% of production value. When crop prices increased by 1%, income from the land increased by 4.49%.

In this study, chestnut honey-based silver nanoparticles (CH-AgNPs) were synthesized at different temperatures (30, 60 and 90 °C) and these nanoparticles were characterized by different techniques such as UV–vis spectrophotometer, Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and energy dispersive X-ray (EDX). The DPPH free radical scavenging assay was used to determine the antioxidant activity of the obtained nanoparticles. The inhibition effects of these nanoparticles for some clinically important enzymes such as myeloperoxidase and collagenase were investigated. In addition, the disk diffusion method (DDM), agar well diffusion (AWD), and minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) techniques were used to determine the antibacterial activity of CH-AgNPs. In honey-based silver nanoparticle production processes using green synthesis, it was determined that the nanoparticle sizes decreased from 55 to 27 nm with an increase in temperature. In addition, it was determined that the rate of inhibition of myeloperoxidase (36.4% to 34.0%) and collagenase enzymes (74.2% to 68.7%) increased with a decrease in particle size. As a result of the antibacterial activity tests, it was observed that CH-AgNPs have antibacterial activity against all target pathogens including Gram-positive and Gram-negative bacteria. The obtained results show that CH-AgNPs produced using chestnut honey have the potential to be used in fields such as medicine, pharmacy and cosmetic technology.

Anadolu’da eski bir gelenek olan kuş evlerinin geçmişi Osmanlı mimarisinde görülen örneklere dayanmaktadır. Genellikle saray, cami, ev, han, medrese, kütüphane ve türbe gibi tuğla ve taş malzeme üzerine inşa edilen kuş evleri, mimari bir yapı kadar emek gerektiren kendine özgü yapılardır. Yapım aşamasındaki zorluklar sebebi ile günümüzde yapılan mimari eserlerde kuş evlerinin üretiminin yok olmaya yüz tuttuğu, var olanlarının ise korunamadığı görülmektedir. Günümüzde farklı malzemeler kullanılarak yapılan kuş evlerinin birçoğu basit formlardan oluşmakta ve mimari yapıların üzerlerine inşa edilmekteyken bazı kuş evleri yapıdan bağımsız olarak açık alanlarda sergilenmektedir. Bu çalışma, geçmişten günümüze varlıklarını sürdüren kuş evlerini konu almaktadır. Bu kapsamda öncelikle kuş evleri hakkında literatüre taraması yapılmıştır. Seramik malzeme kullanarak kuşevleri çalışan günümüz yerli ve yabancı seramik sanatçıların çalışmaları görsel açıdan incelenmiştir. Bu doğrultuda kuşevi çalışan seramik sanatçıları alfabetik sıra ile anlatılmıştır. Buna göre yurt içinden üç (Cihat Burak, Deniz Onur Erman, Mezahir Ertuğ Avşar), yurt dışından beş (Douglas Fey, Jim Schatz, Joop Van Ulden, Michael Mcdowell, Stanley Cleve Bi Bitters) seramik sanatçısının yaptığı çalışmalar görselleri ile birlikte sunulmuştur. Bununla birlikte, Karamanoğlu Mehmetbey Üniversitesi kampüs alanı içine çalışılan, seramik kuş evleri yapım, uygulama süreçleri aşamalı olarak anlatılmıştır.

Çok eskiden beri yönetim açısından önemsenen örgütsel dikotomi kavramının son yıllarda makale, bildiri, tez, kitap ya da kitap bölümlerinde sıklıkla kullanılır hale geldiği görülmektedir. Temel örgütsel dikotomi kavramı ile, içinde belirli kişilikleri ve ihtiyaç eğilimleri olan bireyler ile belirli rolleri ve beklentileri olan örgütlerden bahsedilmektedir. Bu çalışmanın amacı, örgütsel dikotomi kavramının yönetim açısından öneminin ortaya konulmasıdır. Bu bağlamda Google Scholar veri tabanında yayınlanan çeşitli akademik yayınlar kapsamlı literatür taraması ile değerlendirilmiştir. Örneklem olarak incelenen 125 uluslararası akademik çalışma SPSS 22.0 programında çözümlenmiştir. Dolayısıyla bu çalışmada hem nitel hem nicel yöntem birlikte kullanılmıştır. Çalışmanın amacına ulaşmak için istatistiki programda frekans ve yüzde dağılım analizleri ile ki-kare analizlerinden yararlanılmıştır. Genel olarak, betimsel analiz sonuçlarına göre örgütsel dikotomi kavramı ile ilgili çalışmaların, büyük çoğunluğunun (%62,4’ünün) 2000-2020 yılları arasında yayınlandığı, iktisadi ve idari bilimler alanı (%36) ile ilgili olduğu ve çoğunlukla Amerika Birleşik Devletleri’nde (%63,2) yayınlandığı bulgusuna ulaşılmıştır. Ayrıca, örgütsel dikotomi ile ilgili çalışmaların yapıldığı ülkeler ile söz konusu çalışmaların yayın yılları arasında bir ilişki olup olmadığına yönelik yapılan ki-kare testi sonucunda, çalışmaların yayınlandığı ülkeler ile çalışmaların yayın yılları arasında anlamlı bir ilişki olduğu (0,0240,005) hem de yayın yılları (p=0,5417>0,005) açısından anlamlı bir ilişkiye sahip olmadığı belirlenmiştir.

Abstract This note is concerned with establishing the existence of solutions to a fractional differential inclusion of a ψ-Caputo-type with a nonlocal integral boundary condition. Using the concept of the endpoint theorem for φ-weak contractive maps, we investigate the existence of solutions to the proposed problem. An example is provided at the end to clarify the theoretical result.

Rhabdomyolysis (RML) is a clinical condition that results in the release of the cellular content into the circulation due to musculoskeletal damage caused by various causes. For this reason, emergency departments should recognize RML and start treatment without any delay. In this study, we present a case of secondary RML in a 14-year-old patient followed up with the diagnosis of subacute sclerosing panencephalitis. Respiratory and circulatory support was provided in the emergency unit and alkalization was started. All medications used by the patient were cut off. Hemodiafiltration treatment was performed in our intensive care unit. It was learned that the patient have used the senna plant regularly for five years because of constipation. It has been reported in the literature that the senna plant has toxic effects on the brain, liver, kidney, heart and muscle, and also may cause renal tubular necrosis, centrilobular hepatic necrosis and muscle fiber necrosis. In this case report, we aimed to emphasize that the senna plant sold by herbalists and used frequently by people may cause secondary RML which may be a life-threatening condition.

Introduction:We have limited information about the clinical importance of plasma B-type natriuretic peptide (BNP) level and its prognostic value in children with bronchiolitis. In this study, we aimed to determine basal plasma BNP levels and their relationship with left ventricular systolic functions and prognosis in patients hospitalized with moderate to severe bronchiolitis.Methods:The study was conducted prospectively on 37 patients aged 1-24 months with a modified Wang respiratory score of 6 and above and diagnosed with bronchiolitis. The patients with high (>100 pg/mL, n=6) and normal (≤100 pg/mL, n=31) serum BNP levels were compared in terms of left ventricular systolic functions, and vital, laboratory, and radiological findings. The relationship between serum BNP level and prognosis was evaluated.Results:The mean basal plasma BNP level in the patients was significantly higher than in controls (61.75±65 pg/mL vs. 13.99±8.79 pg/mL; p=0.001). There was no significant difference in ejection fraction and fractional shortening values between the patients with normal and high BNP levels and controls (p>0.05). Patients with high BNP levels had higher mean partial carbon dioxide values than patients with normal BNP levels (p=0.037). There was a positive correlation between plasma BNP level and length of hospital stay (r=0.286; p=0.007) and intensive care unit stay (r=0.645; p=0.000).Conclusion:An increase in serum BNP levels may be seen in patients with moderate to severe bronchiolitis without myocardial dysfunction. It was argued that this BNP increase may be related to the degree of deterioration of gas exchange associated with the disease. Plasma BNP level is a potential prognostic factor in moderate to severe bronchiolitis.

OBJECTIVE: The SYNTAX Score was recently developed to characterize the coronary vasculature with respect to the number of lesion's location, complexity, and functional impact and it is a quantitative scoring system to assist with patient selection for optimal revascularization strategy between percutaneous coronary intervention (PCI) and coronary artery by-pass surgery (CABG). β2-glycoprotein I (β2GPI), a plasma protein that binds cardiolipin, acts as a modulator of platelet aggregation and coagulation. Antibodies to β2GPI may have a role in atherosclerosis by inducing endothelial cell activation. We investigated the relationship between anti beta 2 GPI and severity of coronary artery stenosis by calculating the SYNTAX Score among patients undergoing CABG surgery. PATIENTS AND METHODS: We prospectively investigate 612 patients who undergo elective coronary angiography between September 2012 and June 2013. Patients were evaluated for blood chemistry and anti-β2GPI IgA, IgM and IgG. Ninety seven patients with complete biochemical analysis including anti Beta 2 GPI antibodies and undergone CABG have been enrolled in this study. We divided patients in to 2 groups according to the SYNTAX scores. Group 1 included 48 patients with low SYNTAX scores (<23) and group 2 included 49 patients with intermediate and high SYNTAX scores (>23). RESULTS: There was significant correlation between elevated anti β2GPI IgG levels and higher SYNTAX score which indicate advanced and complex CAD. In this study, lesion complexity increased progressively with increasing anti-β2GPI-IgG type of antibody levels. According to this findings, anti-β2GPI-IgG is a strong predictor of higher SYNTAX score. CONCLUSIONS: In addition to the traditional risk factors for atherosclerosis, the proinflammatory and procoagulant activities of antiphospholipid antibodies appear to be important risk factors for atherosclerotic occlusive disease. [ABSTRACT FROM AUTHOR]

Aim - This study aims to measure the level of entrepreneurship, professionalism, and leadership intention of the Z generation. This effort is to investigate whether the socio-demographic characteristics of the Z generation, such as gender, education level, work experience, family income level, the presence of entrepreneurs in the family, or the immediate vicinity, leading to significant differences on the levels of entrepreneurship, professionalism and leadership intention. Methodology – The simple random sampling method was used to collect data. A total of 563 questionnaires was collected for the study. The participants were mainly the students in high schools and vocational schools of higher education in the Adiyaman-Kahta district. SPSS 22.0 program was used to analyze the data set. Findings - Cronbach's alpha value of the scale of entrepreneurship, professionalism, and leadership intention was measured as 0.89. Moreover, non-parametric analysis methods were used to test the hypotheses of the study because the data did not show normal distribution (p

Craniospinal hypotension is the syndrome of orthostatic headache associated with low cerebrospinal fluid pressure. Imaging findings are usually explained by Monro-Kellie hypothesis stating that the craniospinal compartment is incompressible and any increase in volume of one of the craniospinal constituents (blood, cerebrospinal fluid, and parenchyma) must be compensated by a decrease in volume of another constituent or vice versa. We report a case of craniospinal hypotension in whom drainage of subdural hematoma upon clinical impairments resulted in pontine hemorrhage, supporting Monro-Kellie hypothesis.

INTRODUCTION: The aim of this study is determining the intensive care unit nurses' opinions on physical restraint application. METHODS: This descriptive research has been performed with 90 nurses working at the Intensive Care Units of a private University Hospital in Ankara. The data has been obtained with data collection form. Percentage and chi-square test have been used for data evaluation. RESULTS: 73.3% of nurses are female, 26.7% male. 54.4% works at internal medicine intensive care unit, 45.6% works at medical surgical intensive care unit. The majority have been working at intensive care unit for more than a year. 41.1% of nurses have been trained previously on physical restraint. The nurses think that purpose of physical restraint is to protect patient from harming himself and his surroundings (82.2%) What nurses think about who should give the decision for starting and ending of the physical restraint application; doctors (22.2%), the nurse (21.3%), the nurse and doctor together (43.3%) should decide. According to nurses, the advantages of physical restraint application are: to provide the continuity of the treatment (24.4.%), to protect patient from harming himself and his surroundings (65.6%) and to decrease the work load of the nurses (6.7%). DISCUSSION AND CONCLUSION: Nurses consider physical restraint as an application that needs to be done in terms of patient safety. It has been determined that the physician's directive isn't paid enough attention to the initiation and termination of physical detection. Therefore; It's recommended that the knowledge about nurses' responsibilities related to physical detection and implementation should be reinforced and updated

Background: Mucosal melanoma is a rare malignancy arising from melanocytes of the mucosal surfaces. The pattern and frequency of oncogenic mutations and histopathological biomarkers have a role on distinct tumour behaviour and survival. Aims: To assess the rate of C-KIT positivity and its effect on survival of surgically treated sinonasal malignant melanoma patients with other histopathological biomarkers and clinical features. Study Design: Retrospective cross-sectional study. Methods: Seventeen sinonasal malignant melanoma patients with a mean age of 65.41 (39-86) years were included. Overall survival and disease-specific survival rates were calculated. The impact of age, gender, stage and extent of the disease, type of surgery, and adjuvant therapies were also taken into consideration. The effect of mitotic index, pigmentation, S100, HMB-45, Melan-A and C-KIT on survival were evaluated. Results: Median tumour size was 20 mm (interquartile range=27.5 mm). Pigmentation was present in 7 (41.2%) cases. Median number of mitoses per millimetre squared was 11 (interquartile range=13). Melan A was positive in 7 (41.2%) patients, ulceration was present in 6 cases (35.3%), and necrosis was present in (47.1%) 8 cases. Six patients (35.3%) were positive for S100, 14 (82.4%) specimens stained positive for HMB-45 and C-KIT (CD117) was positive in 9 cases (52.9%). Three patients (16.7%) developed distant metastasis. Five year overall and disease free survival rates were 61.4% and 43.8%, respectively. Conclusion: Although C-KIT positive sinonasal malignant melanoma patients (52.9%) can be candidates for targeted tumour therapies, the studied clinical or histopathological features along with C-KIT seem to have no significant effect on survival in a small group of patients with sinonasal malignant melanoma

Status epilepticus (SE) is one of the most important pediatric emergent conditions because of major cause of morbidity and mortality. SE should be diagnosed and treated emergently, because it is one of the diseases that may lead to serious sequalea. The aim of the study is to evaluate neuroimaging methods and electroencephalography (EEG) findings of patients with SE, who were under follow up at our hospital. 162 patients (age range, 0-18 years) with SE treated and followed at our hospital between December 2006 and May 2009 were enrolled in our study. Patients age, sex, MRI- CT imaging and EEG findings were recorded from patients files. Patients age and sex were similar. CT was available in 41 patients and MRI was available in 36 patients. CT results of 28 patients were normal, but some pathologies were found in 13 patients. MRI results of 14 patients were normal, but some alterations were detected in 22 patients. EEG was present in 97 patients. EEG results of 49 patients (%50.5) were normal. Consequently, there is no enough data regarding the necessity of the use of neuroimaging methods in case of previous etiology-confirmed SE. However, neuroimaging methods may be considered useful to determinate etiology of SE, response to treatment, and effects on long-term prognosis. Moreover, we can highlight that the early period EEG may be important in determining prognosis. [Med-Science 2015; 4(3.000): 2356-63]

Objectives:The incidence of new-onset epilepsy is high among the elderly. This study presents the demographic characteristics, etiological factors, seizure types and response rates to treatment in a group of patients aged 65 years or over with delayed-onset epilepsy.Methods:The study comprised a retrospective evaluation of the records of 43 patients aged 65 or older with a diagnosis of delayed-onset epilepsy who were admitted to the epilepsy clinic in the Neurology Department of Bezmialem University Faculty of Medicine.Results:Patient mean age was 74.9 (66–92 years). Underlying disease was found to be cerebrovascular disease in 37.2%. Based on seizure type, 67.4% (n=29) patients had partial-onset and 32.6% (n=14) had generalized seizure. Treatment protocol in 93% (n=40) of the patients was monotherapy antiepileptic drugs, the most commonly used being levetiracetam (53.5%). Assessment of drug side effects showed no complaint in 86% (n=37) of the patients. During the three months prior to the study, 95.3% of the patients had been seizure free.Conclusion:The study found cerebrovascular disease to be the most common etiological factor in delayed-onset epilepsy. Partial-onset secondary generalized seizure was the most common seizure type. All patients responded well to monotherapy and have a good prognosis.

Objective. We aimed to investigate the effect of peritubal local anesthetic and opioid infiltration on pain scores and analgesic consumption in patients who underwent percutaneous nephrolithotomy. Material and Methods. Patients aged between 18 and 65 years and ASA I-III were included in this double-blind, randomized study. The patients were divided into two groups. All patients underwent spinoepidural anesthesia. 20 mL of 0.25 percent bupivacaine + 5 mg morphine (0.5 mL), in Group P (n=66), infiltrated the renal capsule, perinephric fat, muscles, subcutaneous tissue, and skin under fluoroscopy. In Group C (n=64), none of the patients received a peritubal injection. In the first 24 h pain scores, time of the first analgesic demand, the mean number of analgesic demands, and postoperative complications were compared between groups. Results. The mean VAS score at postoperative 8, 12, and 24 h and dynamic VAS score at postoperative 4, 8, 12, and 24 h were significantly lower in Group P. VAS score at postoperative 4 h was not significant. Time of the first analgesic demand was significantly longer in Group P. Conclusion. Our study results suggest that peritubal infiltration of bupivacaine with morphine after percutaneous nephrolithotomy is an effective method for postoperative pain control and reduces analgesic consumption.

Trauma refers an distinct experience with excessive stressful and destructive characteristics. According to criteari of diagnose in DSM-III (1980), traumatic events create death or threat of death, serious injury, threat to pyhsical integrity as well as feeling of intense fear, horror and helplessness. Many of individuals with traumatic events is not develop Post Trauma Stress Disorder (PTSD). Only 5 to 25 percent of individuals exposured to traumatic experiences develops PTSD. In this context, it may be concluded that traumatic event can not be cause of PTSD itself. However, the type of traumatic event, in terms of context, appears to be a significant factor. The present study aims to provide the impacts on mental health of traumatic event in terms of “Gezi Activity” which is an example of mass movements. Thus, it was interwieved with 11 participants who involved in “Gezi Activity” by using semi-structured interwiev. In this context, a semi-structured interwiev form was created related to determine the political participation, the motivation to be involved in the “Gezi” process, the traumatic exposure in the process, and the effects on mental health of individuals. 2 of 11 participants to the research are individuals who injured in the process of “Gezi” and have received inpatient treatment for a while. The data has been established by making qualitative research, was evaluated by content analysis. The findings were that the majority of the participants answered in the direction of “yes” to questions related to political participant, the traumatic exposure and emotions (fear, horror and helplessness). However small of the participants answered in the direction of “yes” to questions of post traumatic re-experiencing, avoidance and hyperarousal. To sum up the findings, while the participants expressed traumatic exposure and emotions in the process of “Gezi”, they reported that they did not experience post trauma re-experiencing, avoidance and hyperarousal. The findings on the possible effects of traumatic experience will be discussed in terms of both variables such as severity of traumatic experience and type of traumatic experience (political trauma) because of that discussed case is an example of a mass movement. Gezi, traumatic exposure, traumatic effects, mass movement, political trauma

The aim of this paper is to investigate the potential of local stakeholders in developing a rural tourism product. With this aim, a traditional harvest day event was initiated by the researchers and the event was organized and set up by the local stakeholders. Kastamonu, a rural destination in Turkey with a great potential for but with very limited rural tourism development, was selected for the conduct of this harvest day event. Participant observations and in-depth interviews are used to identify the factors that facilitate involvement of the local community in rural tourism product development. The results are expected to provide insights for the development of a framework relating to the assessment of the potential for sustainable rural tourism development in a given area.

INTRODUCTION: Cerebral palsy is the most common cause of physical disability in children. Spasticity is a disabling clinical symptom that is prevalent among patients suffering from cerebral palsy. The treatment of spasticity with botulinum toxin type A (BTX-A) is a well-established option in the interdisciplinary management of spasticity, providing focal reductions in muscle tone in cerebral palsy patients. OBJECTIVE: The aim of this retrospective study was to describe the effect of multilevel BTX-A injections in the lower extremities, focusing mainly on gross motor function and functional status in cerebral palsy patients. METHODS: Data from 71 cerebral palsy patients (64% male, 36% female, mean age 6.7 ±3.2 years) were analyzed retrospectively. We used the Ashworth and Tardieu scales to evaluate the degree of spasticity. Motor function was measured by the Gross Motor Function Measure (GMFM-88), and functional status was classified by the Gross Motor Function Classification System (GMFCS I-V). Multilevel BTX-A injections were applied after sedation and with electrostimulation guidance. The evaluations were repeated every three months, and the patients were followed for six months. RESULTS: We found that the Ashworth and Tardieu scores decreased significantly at the three-month evaluation (p0.05). Although the improvement in spasticity was not maintained at the six-month evaluation, GMFM-88 scores increased significantly at the three- and six-month assessments. GMFSC levels showed no change in the three- and six-month assessments. CONCLUSION: We believe that a single multilevel BTX-A injection reduces spasticity and improves motor function in children with cerebral palsy.

OBJECTIVE: The aim of this prospective, randomized study was to evaluate the hemodynamic and analgesic effects of ketamine by comparing it with propofol starting at the induction of anesthesia until the end of sternotomy in patients undergoing coronary artery bypass grafting surgery. INTRODUCTION: Anesthetic induction and maintenance may induce myocardial ischemia in patients with coronary artery disease. A primary goal in the anesthesia of patients undergoing coronary artery bypass grafting surgery is both the attenuation of sympathetic responses to noxious stimuli and the prevention of hypotension. METHODS: Thirty patients undergoing coronary artery bypass grafting surgery were randomized to receive either ketamine 2 mg.kg-1 (Group K) or propofol 0.5 mg.kg-1 (Group P) during induction of anesthesia. Patients also received standardized doses of midazolam, fentanyl, and rocuronium in the induction sequence. The duration of anesthesia from induction to skin incision and sternotomy, as well as the supplemental doses of fentanyl and sevoflurane, were recorded. Heart rate, mean arterial pressure, central venous pressure, pulmonary arterial pressure, pulmonary capillary wedge pressure, cardiac index, systemic and pulmonary vascular resistance indices, stroke work index, and left and right ventricular stroke work indices were obtained before induction of anesthesia; one minute after induction; one, three, five, and ten minutes after intubation; one minute after skin incision; and at one minute after sternotomy. RESULTS: There were significant changes in the measured and calculated hemodynamic variables when compared to their values before induction. One minute after induction, mean arterial pressure and the systemic vascular resistance index decreased significantly in group P (p

OBJECTIVE: To report the clinical follow-up, side effects, and magnetic resonance imaging (MRI) findings of mitoxantrone treatment in patients in the early phase of secondary progressive and exacerbating relapsing-remitting multiple sclerosis. METHODS: Patients that completed and/or were undergoing treatment between 2001 and 2008 were included in the study. All patients were definitive progressive multiple sclerosis patients and met ‘non-responder’ criteria for immunomodulatory the- rapy. They did not have active infection, cardiac disease, or any contraindication for immunosuppressive treatment. Baseline comp- lete blood count, liver function tests, and transthoracic echocardiography were performed. Mitoxantrone was given as induction the- rapy (1 dose per month for 3 months) and then as maintenance therapy (with 3 month periods, 12 mg/m2 until to the cumulative dose was reached). Patients were followed-up regularly for the appearance of any side effects. RESULTS: The study included 33 female and 15 male patients. Mean age was 36.6 ± 7.8 years, mean disease duration was 9.38 ± 4.8 years, mean expanded disease severity scale (EDSS) score was 5.8, and mean treatment duration was 11.16 ± 7.4 months. Fol- lowing the end of treatment, 17 patients were stabilized, 10 improved, and 14 progressed. There were no side effects observed du- ring or after treatment in 16 patients. Among the other 32 patients, the observed side effects were as follows: nausea (n= 18), per- manent leucopenia (n= 1), transient thrombocytopenia (n= 4), alopecia (n= 13), neutropenic fever (n= 1), and amenorrhea (n= 18). MRI follow-up was performed in a subgroup of patients and showed that the lesion loads were stabilized. CONCLUSION: We reported the efficacy, and clinical and MRI follow-up results of multiple sclerosis patients treated with mitoxantro- ne. Patient selection and therapy timing was very important for maximum efficacy. Patients that responded to mitoxantrone treat- ment benefited beginning with the induction phase and their disability was limited or improved

Bu çalışmanın amacı Türkiye’de yarı-kurak bölgelerde bulunan tarım işletmelerinde kırsal fakirlik riskini belirlemektir. Bu amaca ulaşmak için İç Anadolu Bölgesi’nde yer alan Kırıkkale ili yarı kurak alanları temsil eden il olarak seçilmiştir. Çalışmada kullanılan veriler basit tesadüfi örnekleme yöntemi ile seçilen işletmelerden anket yoluyla toplanmıştır. Risk analizi, işletmelerde elde edilen gelirin Brüt Tarımsal Gelir ve Toplam Aile Geliri stokastik değerlerinin simülasyonu yoluyla yapılmıştır. Araştırma sonuçlarına göre incelenen işletmelerde ortalama işletme büyüklüğü 89.59 dekardır. Tarla arazisinin %95.16’sı kuru tarım arazisi olup tahıl üretimi ile uğraşmaktadır. İşletmelerde bitkisel üretim yanında hayvancılık da yapılmakta olup, işletmeler ortalamasında 2 baş süt ineği, 2.19 baş besi sığırı, 13.03 baş koyun ve 1.45 baş keçi bulunmaktadır. Brüt Tarımsal Gelir 4988$ olup bunun %70.98’i bitkisel üretime %29.02’si ise hayvansal üretime aittir. Toplam Aile Geliri 5565$ olarak bulunmuştur. Kırsal fakirlik riski işletmelerin Brüt Tarımsal Geliri dikkate alındığında %26.66, Toplam Aile Geliri dikkate alındığında ise %17.29 olarak bulunmuştur

Fetal type PCA may positively affect clinical outcome in patients with ischemic stroke such as protection of a reserve blood flow capacity as well as negative effect on clinical outcome such as certain atypical pathological manifestations. We presented a patient with a posterior cerebral artery territory infarction due to an unexpected etiology as stenosis of internal carotid artery (ICA) with existence of fetal type PCA.

Temporal arteritis is most common vasculitis in elderly and imitated by miscellaneous disorders. Temporal artery biopsy is the gold standard test in the diagnosis of giant cell arteritis (GCA). Hereby, we describe a case of a 67-year-old man who presented initially with temporal arteritis; however, a lip biopsy then revealed AL amyloidosis. In this respect, temporal artery biopsy should be performed for definitive diagnosis of GCA particularly patients with systemic symptoms and treatment resistant.