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The Blockade of the Dardanelles Strait and the Occupation of Bozcaada During the Tripoli and Balkan Wars, Through the Eyes of Telegrapher Ihsan (Pere) Bey
(2022) Ozcan, Halil
Tripoli and Balkan Wars accelerated the process leading to the collapse of the Ottoman Empire. In these wars, the Dardanelles Strait and the islands near the strait were the common target chosen by Italy and Greece for the surrender of the Ottoman Empire. In both wars, Ihsan (Pere) Bey served as the telegraph officer of the British Eastern Cable Company in Bozcaada. The Tripoli War was continuing when Ihsan Bey, who had started his civil service as an officer of the Istanbul Beyoglu British Cable Company, was appointed as officer to Bozcaada for the second time. Ihsan Bey's witnessing in Bozcaada to the hot war of the Italian Navy and the Turkish Redoubts on April 18, 1912 and the detailed information he has given are important. In addition, the occupation of Bozcaada by Greece during the Balkan War is also included in detail in Ihsan Bey's memoirs. The originality of this study results from the fact that Ihsan Bey's memoirs when Italians reached to the entrance of the Dardanelles and regarding the occupation of Bozcaada are evaluated scientifically and published for the first time.
Can Computerized Adaptive Testing Work in Students' Admission to Higher Education Programs in Turkey?
(2017) Berberoglu, Giray; Kalender, Ilker
Admission into university in Turkey is very competitive and features a number of practical problems regarding not only the test administration process itself, but also concerning the psychometric properties of test scores. Computerized adaptive testing (CAT) is seen as a possible alternative approach to solve these problems. In the first phase of the study, a series of CAT simulations based on real students' responses to science items were conducted in order to determine which test termination rule produced more comparable results with scores made on the paper and pencil version of the test. An average of 17 items was used to terminate the CAT administration for a reasonable reliability level as opposed to the normal 45 items. Moreover, CAT based science scores not only produced similar correlations when using mathematics subtest scores as an external criterion, but also ranked the students similarly to the paper and pencil test version. In the second phase, a live CAT administration was implemented using an item bank composed of 242 items with a group of students who had previously taken the exam the paper and pencil version of the test. A correlation of.76 was found between the CAT and paper and pencil scores for this group. The results seem to support the CAT version of the subtests as a feasible alternative approach in Turkey's university admission system.
Compliance with Long-Term Use of Orthoses Following Spinal Cord Injury
(2022) Yemisci, Oya U.; Ozen, Selin; Cosar, Sacide N. Saracgil; Afsar, Sevgi, I; 35532629
Background: Prescription of orthoses and assistive devices that facilitate physical function is a major component of the rehabilitation process in spinal cord injury (SCI). Objective: To evaluate the long-term use of orthoses prescribed during inpatient rehabilitation in people with SCI and investigate the factors related to discarding the device. Materials and Methods: Medical records of 202 SCI patients who were included in an inpatient rehabilitation program of a tertiary research hospital were reviewed retrospectively. Patients' demographic data, neurological level of spinal cord injury functional state and use of assistive devices for ambulation (orthoses, walkers, etc.) at discharge were recorded. At follow-up, study participants were contacted by telephone and queried regarding the frequency and duration of use of orthoses; if the individual had discontinued using the orthoses, the reasons for discarding the device were sought. Results: The majority of the study participants (62.7%) had been prescribed a knee-ankle-foot orthosis during their inpatient stay. At follow-up, the regular use of orthoses was ongoing in 67.6% of the participants, and nonuse was determined in 32.4%. The most common cited reasons for discarding the device were difficulty in donning and doffing, functional improvement, and mechanical problems of the orthoses. Conclusions: A significant number of patients had discarded their orthoses at the long-term follow-up and the main reasons for discarding the devices were orthotic factors. Timely reevaluation of the patient and orthosis modification according to patients' needs is necessary to achieve long-term compliance.
Conservation Genetics of the European Fallow Deer: A Reply to Marchesini et al.
(2021) Baker, Karis H.; Gray, Howard W. I.; Peksen, Cigdem Akin; Hoelzel, A. Rus; 0000-0001-5736-3062
In this letter, we revisit a study we published in 2017, following comment in a paper by Marchesini et al. published in this volume. We provide some further analyses that help us to reinforce the original conclusions of our earlier paper, and to address the points raised by Marchesini et al. We conclude that the concerns raised in their review do not alter the inference we presented earlier, and we identify issues with analyses presented by Marchesini et al. that limit their utility. The key points of inference remain that this species in Europe shows remarkably low levels of diversity within populations and strong structure among populations which can be explained by a combination of natural and anthropogenic processes.
A cross-cultural comparison of the self-efficacy of middle-school mathematics teachers across Turkey and the United States
(2021) Sevgi, Sevim; Berberoglu, Giray; Cobb, Paul; Smith, Thomas M.
This study aims to compare teachers' self-efficacy across Turkish and American in-service middle-school mathematics teachers. The samples consist of 379 Turkish and 245 American in-service middle-school mathematics teachers. The self-efficacy questionnaire of the Middle-school Mathematics and the Institutional Setting of Teaching (MIST) scale was used in the study. The exploratory factor analysis revealed two dimensions of the self-efficacy measures across the American and Turkish teachers, such as classroom management and student support strategies. The measurement invariance property of the scale was evaluated before comparing the means of the groups. Despite the differences between the education systems, teachers' efficacy beliefs function quite similarly across the countries. The statistically significant mean differences in the subscale scores of efficacy measures between Turkish and American samples have no practical value. In both countries, teachers reported high level of confidence in efficacy beliefs in classroom management and student support strategies.
A Cross-Sectional Survey on Consequences of Nurses' Burnout: Moderating Role of Organizational Politics
(2016) Basar, Ufuk; Basim, Nejat; 0000-0003-0008-5131; 26988276; ABD-9381-2021; J-2510-2016
AimThe aim of the study was to assess whether perceptions of organizational politics (defined as self-serving behaviours at the expense of others) influence the prospective associations between nurses' burnout and its consequences, namely, intention to quit and neglect of work. BackgroundResearchers have previously investigated relationships between nurses' burnout, intention to quit, neglect of work and perceptions of organizational politics in different research models and from different perspectives. As far as we know, no studies have considered whether nurses' perceptions of organizational politics moderate the influence of burnout. DesignA cross-sectional survey using self-report questionnaires. MethodData were collected by questionnaire from a sample of 456 nurses from six private hospitals in Ankara, Turkey in March 2015. Four different previously designed scales were used to measure research variables (burnout, intention to quit, neglect of work and perceptions of organizational politics). Following confirmatory validity and reliability analyses of data collection instruments, descriptive statistics for each research variable were analysed. Structural regression models were created to assess relationships among variables. FindingsBurnout resulted in intention to quit and neglect. Intention to quit partially mediated the association between burnout and neglect. Burnout gave rise to intention to quit slightly more strongly in nurses who had greater perceptions of organizational politics. ConclusionThis study uncovers and emphasizes the moderating role of perceptions of organizational politics in consequences of burnout. This may help hospital managers and nurses to improve costs, efficiency, satisfaction and productivity.
Detection of Resistance to Pyrethroid And Neonicotinoid Insecticides in the Greenhouse Whitefly, Trialeurodes Vaporariorum (Westw.) (Hemiptera: Aleyrodidae)
(2021) Erdogan, Cem; Velioglu, A. Sibel; Gurkan, M. Oktay; Denholm, Ian; Moores, Graham D.
In Turkey as elsewhere, control of the greenhouse whitefly, Trialeurodes vaporariorum (Westw.) (Hemiptera: Aleyrodidae), relies extensively on the use of insecticides, which can promote the development of insecticide resistance. In this study, resistance to commonly used pyrethroid and neonicotinoid insecticides was investigated using bioassays and biochemical analyses. Full dose-response bioassays using 11 samples of T. vaporariorum from three locations in Turkey disclosed resistance up to 8.1-fold, 16-fold and 11.4-fold for the neonicotinoids acetamiprid, imidacloprid and thiamethoxam, respectively. Corresponding figures for pyrethroids were 56.5-fold for cypermethrin and 116.4-fold for deltamethrin. All samples were characterized using polyacrylamide gel electrophoresis (PAGE) and by measuring non-specific esterase and glutathione-S-transferase (GST) activity. There is no positive relationship between esterase activity and resistance pyrethroid or neonicotinoid resistance. It is thought that esterase enzyme activity seen in T. vaporariorum may be at lest partially related to the resistance to insecticides, but it cannot be responsible as a single mechanism. No relationship has been determined between GST activity and resistance to pyrethroids or neonicotinoids. The practical implications of these results for control of whiteflies are discussed.
Determining Prospective Teachers' Self-Efficacy Perception on Scientific Skills Via Pair-Wise Comparison Method
(2014) Kart, Arife; Gelbal, Selahattin
The aim of this study is to determine the factors which are considered to be effective in self efficacy perceptions relating to scientific research skills of preservice teachers by using scalling through the pair-wise comparison methods. The study was carried out in fall 2012-2013 at Ankara University and Baskent University. The data of the study was collected from 180 preservice teachers who took scientific research methods course. According to the data obtained from the study, preservice teachers relating to scientific research skills, have the highest level of competence in self-efficacy perceptions in terms of data collection and reporting features, although they have the lowest competence in the analysis of data and identifying variables.
Disease Characteristics of Psoriatic Arthritis Patients May Differ According to Age at Psoriasis Onset: Cross-Sectional Data from the Psoriatic Arthritis-International Database
(2021) Bilgin, E.; Aydin, S. Z.; Tinazzi, I.; Bayindir, O.; Kimyon, G.; Ozisler, C.; Dogru, A.; Dalkilic, E.; Aksu, K.; Cetin, G. Yildirim; Yilmaz, S.; Solmaz, D.; Omma, A.; Can, M.; Kucuksahin, O.; Yavuz, S.; Ersozlu, E.D.; Kilic, L.; Tarhan, E.F.; Tufan, M.A.; Akyol, L.; Cinar, M.; Erden, A.; Gonullu, E.; Yildiz, F.; Bakirci, S.; Erbasan, F.; Esmen, S.Ergulu; Kucuk, A.; Tufan, A.; Balkarali, A.; Mercan, R.; Erten, S.; Akar, S.; Kasifoglu, T.; Duruoz, T.; Yazisiz, V.; Kalyoncu, U.; 32662407
Objective To explore the impact of early versus late-onset psoriasis (PsO) on the disease characteristics of psoriatic arthritis (PsA) in a large-multicentre cohort. Methods The data from a multicentre psoriatic arthritis database was analysed. Patients were grouped according to age at psoriasis onset (early onset; 40 years of age, late-onset; 40 years of age) and disease characteristics of the groups were compared by adjusting for BMI and PsA duration, where necessary. Results At the time of analyses, 1634 patients were recruited [62.8% females; early onset 1108 (67.8%); late-onset, 526 (32.2%)]. The late-onset group was more over-weight [66.8% vs. 86.8%, p<0.001; adjusted for age -aOR 1.55 (1.11-2.20; 95% CI)]. The early onset group had more scalp psoriasis at onset (56.7% vs. 43.0%, p<0.001), whereas extremity lesions were more common in the late-onset group (63.8% vs. 74.2%, p<0.001). Axial disease in males and psoriatic disease family history in females were significantly higher in the early onset group [38.0% vs. 25.4%; p=0.005; adjusted for PsA duration -aOR 1.76 (1.19-2.62; 95% CI) / 39.5% vs. 30.1%; p=0.003; OR 1.51 (1.15-1.99; 95% CI), respectively]. Psoriatic disease activity parameters, patient-physician reported outcomes and HAQ-DI scores were similar in both groups. Conclusion Clinical features of PsA may be affected by the age at onset of PsO. Different genetic backgrounds in early and late-onset PsO may be driving the differences in psoriasis and PsA phenotypes.
Early Postoperative Acute Kidney Injury Among Pediatric Liver Transplant Recipients
(2021) Sahinturk, Helin; Ozdemirkan, Aycan; Zeyneloglu, Pinar; Gedik, Ender; Pirat, Arash; Haberal, Mehmet; 0000-0003-0159-4771; 0000-0001-5324-0348; 0000-0002-3462-7632; 30880650; AAJ-1419-2021; AAD-8682-2022; AAJ-8097-2021
Objectives: Acute kidney injury after pediatric liver transplant is associated with increased morbidity and mortality. Here, we evaluated children with acute kidney injury early posttransplant using KDIGO criteria to determine incidence, risk factors, and clinical outcomes. Materials and Methods: In this retrospective cohort study, medical records of all patients < 16 years old who underwent liver transplant from April 2007 to April 2017 were reviewed. Results: Of 117 study patients, 69 (59%) were male and median age at transplant was 72 months (range, 12-120 mo). Forty children (34.2%) had postoperative acute kidney injury, with most having stage 1 disease (n = 21). Compared with children who had acute kidney injury versus those who did not, preoperative activated partial thromboplastin time (median 35.6 s [interquartile range, 32.4-42.8 s] vs 42.5 s [interquartile range, 35-49 s]; P = .007), intraoperative lactate levels at end of surgery (median 5.3 mmol/L [interquartile range, 3.3-8.6 mmol/L] vs 7.9 mmol/L [interquartile range, 4.3-11.2 mmol/L]; P = .044), and need for open abdomen (3% vs 15%; P = .024) were significantly higher. Logistic regression analysis revealed that preoperative high activated partial thromboplastin time (P = .02), intraoperative lactate levels at end of surgery (P = .02), and need for open abdomen (P = .03) were independent risk factors for acute kidney injury. Children who developed acute kidney injury had significantly longer intensive care unit stay (7.1 +/- 8.5 vs 4.4 +/- 5.4 days, P = .04) and mortality (12.8% vs 1.8%; P = .01). Conclusions: Early postoperative acute kidney injury occurred in 34.2% of pediatric liver transplant recipients, with patients having increased mortality risk. High preoperative activated partial thromboplastin time, high intraoperative end of surgery lactate levels, and need for open abdomen were shown to be associated with acute kidney injury after pediatric liver transplant.
The effect of elastic therapeutic taping and rigid taping on pain, functionality, and tissue temperature in lumbar radiculopathy: a randomized controlled study
(2021) Bozkurt, Tugce; Kilic, Rabia Tugba; Yosmaoglu, Hayri Baran; 34635000
Purpose To compare the therapeutic effects of different taping materials and techniques on pain, functionality, and tissue temperature in patients with lumbar radiculopathy. Methods: Patients with lumbar radiculopathy were included in the study (n = 51). Patients were randomly divided into three groups, which were the elastic taping (n = 17), rigid taping (n = 17), and placebo taping groups (n = 17). All patients were enrolled in a physiotherapy and rehabilitation program that included thermotherapy, electrotherapy, and exercise five times a week for 2 weeks. The pain was measured before and after treatment using the Visual Analogue Scale. Functionality and quality of life were measured using the Oswestry Low Back Pain Disability Questionnaire and Roland-Morris Disability Questionnaire. The tissue temperature of the treated area in the lumbar region was measured by digital electronic infra-red thermography. Results: After the treatment, pain, functionality, and quality of life were improved in all groups (p < 0.05). Elastic taping was more effective in decreasing pain and increasing functionality than placebo taping (p < 0.05), but no difference was observed between placebo taping and rigid tapping. Local tissue temperature did not change before and after treatment in the elastic taping group (p > 0.05). Tissue temperature increased in the rigid and placebo taping groups (p < 0.05). Conclusion: Taping therapy in patients with lumbar radiculopathy has a positive effect on pain and functional status. Elastic taping can be recommended for clinical use because its effect is superior in some recovery parameters and its ease of use.
Effectiveness Of Negative-Pressure Wound Therapy Compared To Wet-Dry Dressing In Pressure Injuries
(2022) Sahin, Ezgi; Rizalar, Selda; Ozker, Emre; 35022147
This study aims to compare the effects of Negative-Pressure Wound Therapy (NPWT) and wet-to-dry dressing on Stages 3 and 4 pressure injuries (PI), This study is a randomized controlled trial. A total of 30 patients with Stages 3 and 4 pressure injuries were included in the study. The patients were divided into two groups: NPWT group and the wet-to-dry dressing group. All patients received 3 rounds of treatment. Data were collected with a Patient Identification Form, Pressure Ulcer Scale for Healing (PUSH) Tool and the findings of the Three-Dimensional Wound Measurement (3DWM) device. We found that granulation tissue formation was more significant in the experimental group (p < .05), and that there was more significant wound shrinkage (p < .05) with a more significant decrease in the PUSH Tool scores (p < .05). The wounds were assessed with the tool and the 3DWM system. Device measurements were found to be correlated with PUSH Tool findings (p < .05). There was a significant correlation between device-measured granulation findings and PUSH Tool score results of the experimental group's third measurements (p < .05). We conclude that NPWT is an effective treatment method for pressure injuries, and 3DWM device is a useable wound assessment tool.
The Effects of Clinical Pilates Exercises on Patients with Shoulder Pain: A Randomised Clinical Trial
(2017) Atilgan, Esra; Aytar, Aydan; Caglar, Aslican; Tigli, Ayca Aytar; Arin, Gamze; Yapali, Gokmen; Kisacik, Pinar; Berberoglu, Utku; Sener, Hulya Ozlem; Unal, Edibe; 29037638; HIR-3735-2022
Aim: The purpose of this study was to determine the effect of Clinical Pilates exercises on patients with shoulder pain. Material and methods: Thirty-three patients, experiencing shoulder pain continuously for at least four weeks were selected as study subjects. The patients were randomly divided into two groups, namely Clinical Pilates exercise (n = 17) group and conventional exercise (n = 16) group. The patients were treated for five days a week, the total treatment being carried out for 10 days. The assessment of pain and disability amongst the patients were done at the baseline and at the end of the treatment sessions, using Visual Analogue Scale (VAS) and Shoulder Pain and Disability Index (SPADI). Results: The clinical Pilates exercise group showed a significant improvement in all scores used for assessment (p < 0.05), while the conventional exercise group demonstrated a significant improvement only in the SPADI total score (p < 0.05). A comparison of scores for the VAS, SPADI-Pain and SPADI-Total between the two groups, revealed a significant improvement in the Clinical Pilates exercise group (p < 0.05). Conclusion: It was demonstrated by the study that Clinical Pilates exercise is an efficient technique for patients experiencing shoulder pain, as it helps reduce pain and disability among them. (c) 2017 Elsevier Ltd. All rights reserved.
The effects of enteral supplementation of glutamine and arginine in lipopolysaccharide (LPS) induced sepsis
(2019) Bakir, Binnur Okan; Oztezcan, Serdar; Saka, Mendane; Karalti, Iskender; Ozkan, Ferda; Ok, Mehtap Akcil; AAZ-8170-2020
Sepsis is the leading cause for death in critically ill patients. While the exact mechanisms are not clear, multiple organ dysfunction syndrome induced by sepsis might cause mitochondrial dysfunction. Spesific nutrients may help regulating immunological and inflammatory responses. Glutamine and arginine amino acids have both important roles in growth, tissue repair, cell renewal and collagen synthesis. There are different results of studies with immunmodulatory nutrients in critically ill patients such, they have no effect on mortality or decrease sepsis incidance. The aim of this study is to evaluate the effects of enteral supplementation of glutamine, arginine and glutamine and arginine combination in lipopolysaccharide (LPS) induced sepsis. Twenty eight male Sprague Dawley rats were randomly divided into four groups: Glutamine, Arginine, Glutamine + Arginine and Control. Glutamine group received 500 mg/kg/day glutamine, Arginine group recieved 500 mg/kg/day arginine, Glutamine + Arginine group received 250 mg/kg/day glutamine and 250 mg/kg/day arginine containing suspension. Rats were fed for 10 days and 3 mg/kg LPS was implemented. 24 hours later, all rats were sacrified. C-Reactive Protein (CRP), Interleukin (IL)-1 beta, IL-6, Tumor Necrosis Factor-alpha(TNF-alpha), Aspartat aminotransferase (AST) and Alanine aminotransferase(ALT) levels were studied, livers were examined histopathologically. Serum TNF-alpha levels were significantly lower in Glutamine + Arginine group in comparison with Control group. Liver histopathology analysis showed that apsis, hepatocyte damage, kupffer cell proliferation and portal inflammation were more frequent and severe in control group than all groups. These results revealed that enteral supply of glutamine, arginine and their combination have positive effects on liver damage and inflammation.
Effects of Non-Pharmaceutical Interventions Against COVID-19: A Cross-Country Analysis
(2021) Gokmen, Yunus; Baskici, Cigdem; Ercil, Yavuz; 0000-0003-0712-1481; 33819370
Prolonging non-pharmaceutical interventions (NPIs) used in the control of pandemics can cause a devastating effect on the overall economic and social welfare levels. Therefore, policymakers are facing a difficult duty in terms of implementing economically and socially sustainable and acceptable measures. The aim of this study is to investigate the effectiveness of NPIs implemented to control the COVID-19 pandemic. To this end, eight NPI measures were analysed, and their effects on the number of cases were investigated for France, Spain, China, and South Korea. In the study, the treatment effect of these mechanisms on the daily increase rate of the total number of cases during a certain period was analysed by using logarithmic linear regression with a dummy variables model. The findings indicate that the measures are effective against the spread of the pandemic at different levels. The findings also suggest that the most effective measure in decreasing the number of cases is workplace closure. An analysis comparing the effectiveness of countrywide measures and regional measures shows that school closing is the most effective measure to decrease the number of cases when implemented countrywide as opposed to regional implementation.
Effects of Repair Techniques and Scarf Angles on Mechanical Performance of Composite Materials
(2023) Karaduman, Beyza Naz; Elaldi, Faruk; https://orcid.org/0000-0003-0592-6868; AAG-5060-2019
Today, composite materials, which have the advantage of strength and lightness ratio, have gained great importance especially in the aeronautical industry and automotive sector. With widespread use of composites, the repair of damages caused by external factors has also become an important research topic. In this study, the effects of different repair methods and scarf angles on the mechanical performance of the material were investigated. Scarf angles of 20 degrees, 30 degrees, and 45 degrees have been selected in order not to create too many scarf areas and to find a quick repair method. Also, a comparison of single scarf and double scarf repair was made to find a more robust solution. The samples were produced from carbon fiber prepreg and with the [45/0/90/0/45](2s) fiber orientation. Tensile, compression, and flexural (3-point bending) tests according to ASTM standards were applied to composite samples prepared with single scarf and double scarf repair configurations at different angles. The stress-strain curves obtained as a result of the tests showed that the specimens repaired at 20 degrees had the highest strength. In addition, it has been determined that the samples repaired with double scarf withstand higher forces compared to the samples repaired with single scarf at the same angle.
Exposure of Pregnant Women to Violence by Partners and Affecting Factors in Turkey
(2016) Alan, Hacer; Koc, Gulten; Taskin, Lale; Eroglu, Kafiye; Terzioglu, Fusun
This study aims to determine the exposure of women to violence by their partners during pregnancy and the factors affecting this condition. The current study conducted as descriptive included a total of 442 pregnant women who were married and at the last trimester of their pregnancy. The data were collected using a semi-structure questionnaire and face to face interview with the pregnant women and were evaluated using descriptive statistics, chi-square test, and logistic regression analysis. Of the pregnant women, 39.8 % experienced at least one type of violence, and the most common type of violence experienced was verbal violence (31.4 %). Among the participants, 18.2 % exposed to violence expressed that their partners perpetrated violence because of jealousy, and 30.1 % reported that they just cried when exposed to violence. According to the results of the logistic regression analysis, insufficient prenatal care increases all types of violence in pregnancy. Working with pregnant women and their partners together under the scope of prenatal care services, and especially planning the attempts to prevent violence by discussing the causes of violence with couples, will facilitate more successful violence prevention programs.
Extended use up to 5 years of the etonogestrel-releasing subdermal contraceptive implant: comparison to levonorgestrel-releasing subdermal implant
(2016) Ali, Moazzam; Akin, Ayse; Bahamondes, Luis; Brache, Vivian; Habib, Ndema; Landoulsi, Sihem; Hubacher, David; 0000-0003-2379-3325; 27671673; AAK-1688-2021
Is it possible to extend the use of the 3-year one-rod etonogestrel (ENG)-releasing subdermal contraceptive implant to 5 years? The extended use of the one-rod ENG-releasing subdermal contraceptive implant showed 100% efficacy in years 4 and 5. The initial regulated trials on the ENG-releasing subdermal contraceptive implant conducted in the 1990 s were designed to measure cumulative 3-year efficacy. The ENG-implant has both well established safety and efficacy for up to 3 years. Pharmacokinetic data on ENG show high levels at 3 years and some previous clinical research confirms efficacy beyond the current approved duration of 3 years. Today, many women, because the labeled duration has been reached, have the ENG implant removed at 3 years, increasing costs, inconvenience and risks. For the first 3 years, this study was an open-label, multi-centre randomized trial comparing the 3-year ENG implant to the 5-year levonorgestrel (LNG)-releasing implant. After 3 years, a subset of 390 ENG participants, consented to extended use. We compared efficacy, side effects and removal procedures of both implants. We used Kaplan-Meier (K-M) analysis. We included an observational cohort of copper intrauterine device (IUD) users as non-users of hormonal contraceptive method for comparative purposes. The study took place in family planning clinics in seven countries worldwide. Women were enlisted after an eligibility check and informed consent, and 1328 women were enrolled: 390, 522 and 416 in the ENG-implant, LNG-implant and IUD groups, respectively. Over 200 women used the ENG implant for at least 5 years. No pregnancies occurred during the additional 2 years of follow up in the ENG or LNG implant group. The overall 5-year K-M cumulative pregnancy rates for ENG- and LNG- implants were 0.6 per 100 women-years (W-Y) [95% confidence interval (CI): 0.2-1.8] and 0.8 per 100 W-Y [95% CI: 0.2-2.3], respectively. Complaints of bleeding changes were similar; however, ENG-users were more likely than LNG-users to experience heavy bleeding (p < 0.05). The median duration of the implant removal procedure was 64 seconds shorter for the one-rod ENG-implant (inter-quartile range (IQR) = 30.5, 117.5) compared to the two-rod LNG product (IQR = 77.0, 180.0). The 2-year rate for pregnancy in the IUD group compared with the two implant groups combined was 4.1 per 100 W-Y [95% CI: 2.5-6.5]. Few women were a parts per thousand currency sign19 years old or nulligravida. Although there was no weight limit for enrolment in the study, the number of women a parts per thousand yen70 kg were few. The results from this study corroborate previous evidence showing high contraceptive efficacy through 4 years for the ENG-implant. Data through 5 years are a novel contribution and further proof of the product's capability to provide safe and effective contraception that rivals the current 5-year LNG-subdermal implant. The findings provide valuable information for policy makers, family planning programmers and clinicians that the ENG-releasing subdermal implant is still highly effective up to 5 years after insertion. Compared to previous efforts, our study population was geographically diverse and our study had the highest number of participants completing at least 5 years of use. The trial was registered as ISRCTN33378571. The contraceptive devices and funds for conduct of the study were provided by the United Nations Development Programme/United Nations Population Fund/World Health Organization (WHO)/UNICEF/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research (RHR), WHO. This report contains the collective views of an international group of experts, and does not necessarily represent the decisions or the stated policy of the WHO. All stated authors have no conflict of interest, except Dr Hubacher who reported grants from United States Agency for International Development, during the conduct of the study; other from Advisory Boards (Teva, Bayer, OCON), outside the submitted work.
HNF1A gene p.I27L is associated with co-existing preeclampsia in gestational diabetes mellitus
(2019) Beysel, Selvihan; Pinarli, Ferda Alparslan; Eyerci, Nilnur; Kizilgul, Muhammed; Hepsem, Sema; Alhan, Ali; Kan, Seyfullah; Caliskan, Mustafa; Bozkurt, Erhan; Cakal, Erman; 31825269
The association of the FTO gene and HNF1 alpha gene on gestational diabetes mellitus (GDM) and preeclampsia remains unclear. This is the first study to examine whether HNF1 alpha gene and FTO gene were associated with having GDM and preeclampsia in Turkish women. Healthy pregnant women (n = 101) and women with GDM (n = 169) were included. GDM was divided into two groups as GDM-only (n = 90) and GDM-preeclampsia (n = 79). Genotyping of HNF1 alpha gene p.I27L, p.A98V, and p.S487N, and FTO gene rs9939609 SNPs were performed using RT-PCR. The frequency of p.S487N, p.A98V, and FTO genotype were similar between the groups (p > .05). p.I27L GG-wild, GT, and TT genotype were 56.5%, 36.6%, and 6.9% in controls; 40.0%, 51.1%, and 8.9% in GDM-only; and 26.6%, 51.9%, and 21.5% in GDM-preeclampsia (p = .034). TT and GT genotype was more frequent in GDM-preeclampsia than in controls (p < .05). GT genotype was increased in GDM-only compared with controls (p < .05). TT genotype was more frequent in GDM-preeclampsia than in GDM-only (p < .05). p.I27L TT genotype was independently associated with increased blood pressure (BP) and urinary protein. p.I27L TT genotype was associated with increased preeclampsia risk in patients with GDM by increasing BP and urinary protein.
HNF1A gene p.I27L is associated with early-onset, maturity-onset diabetes of the young-like diabetes in Turkey
(2019) Beysel, Selvihan; Eyerci, Nilnur; Pinarli, Ferda Alparslan; Kizilgul, Muhammed; Ozcelik, Ozgur; Caliskan, Mustafa; Cakal, Erman; 31109344
BackgroundThe molecular basis of the Turkish population with suspected maturity-onset diabetes of the young (MODY) has not been identified. This is the first study to investigate the association between HNF1A-gene single-nucleotide polymorphisms (SNPs) and having early-onset, MODY-like diabetes mellitus in the Turkish population.MethodsAll diabetic patients (N=565) who presented to our clinic between 2012 and 2015 with a clinical suspicion of MODY were included in the study. Analysis of HNF1A, HNFB, HNF4A, GCK gene mutations was performed using real-time polymerase chain reaction sequencing. After genetic analysis, diabetics (n=46) with HNF1A, HNF1B, HNF4A, GCK gene mutations (diagnosed as MODY) and diabetics (n=30) with HNF1B, HNF4A, GCK gene SNPs were excluded. Patients with early-onset, MODY-like diabetes (n=486) and non-diabetic controls (n=263) were included. Genetic analyses for the HNF1A gene p.S487N (rs2464196), p.A98V (rs1800574) and p.I27L (rs1169288) SNPs were performed using Sanger-based DNA sequencing among the control group.Resultsp.S487N and p.A98V was similar between the diabetics and controls in dominant and recessive models with no association (each, p>0.05). p.I27L GT/TT carriers (GT/TT vs. GG, OR=1.68, 95% CI: [1. 21-2.13]; p=0.035) and p.I27L TT carriers had increased risk of having MODY-like diabetes (GT/GG vs. TT, OR=1.56, 95% CI: [1. 14-2.57]; p=0.048). Family inheritance of diabetes was significantly more common in patients with the p.I27L TT genotype. The p.I27L SNP was modestly associated with having diabetes after adjusting for body mass index and age (=1.45, 95% CI: [1. 2-4.2]; p=0.036).ConclusionsThe HNF1A gene p.I27L SNP was modestly associated with having early-onset, MODY-like diabetes in the Turkish population. HNF1A gene p.I27L SNP might contribute to age at diabetes diagnosis and family inheritance.