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Item Antibiotic Management Programme In A Tertiary Intensive Care Unit: Effects Of A Carbapenem-Restricted Period On Clinical And Laboratory Parameters And Costs Of Infections(Başkent Üniversitesi Sağlık Bilimleri Fakültesi, 2024-06-13) Asilturk, D; Guner, R.; Kalem, A. Kaya; Turan, I. Ozkocak; Hasanoglu, I.; Eser, F.; Malhan, S.; Kayaaslan, B.Background: Carbapenems are antibiotics used for serious infections. The consumption of carbapenems has increased worldwide due to increasing microbial resistance. Aim: To investigate the effects of a carbapenem-restricted antimicrobial stewardship programme (ASP) on changes in the resistance profiles of infectious agents, the amount of antibiotics used, length of stay in the intensive care unit (ICU), mortality, and costs. Methods: Patients hospitalized in ICU between July 1st, 2020 and May 1st, 2021 were divided into two periods: the carbapenem-non-restricted period (CNRP); and the carbapenem-restricted period (CRP) in which alternative antibiotics to carbapenems were preferred during infection. The defined daily dose (DDD) per 100 patient-day methodology was used to calculate the antibiotic consumption. Findings: Of the 572 patients included in the study, 62.2% were male, and mean age was 70.5 years. In the blood culture the most frequently Gram-negative agent was Acinetobacter baumannii (25%). A. baumannii bloodstream infections with multidrug-resistant and extensively drug resistant micro-organisms were significantly different between the two periods (CNRP: 95.6% (N = 22), CRP: 66.6% (N = 8); P = 0.04). There was a gradual decrease in the incidence density and rate of nosocomial infection (P = 0.06), and a significant decrease in meropenem consumption between the two periods (CNRP vs CRP: 21.19 vs 6.37 DDD per 100 patient-days respectively; P = 0.007). ASP yielded US$8,600 of antibiotic cost savings and a total of 14% patient cost savings (P < 0.05) per patient. Conclusion: Combining an effective ASP with a comprehensive infection control programme may mitigate the emergence of antimicrobial-resistant bacteria. (c) 2024 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.Item Ceftobiprole Mono-Therapy Versus Combination Or Non-Combination Regimen Of Standard Antibiotics For The Treatment Of Complicated Infections: A Systematic Review And Meta-Analysis(Başkent Üniversitesi Eczacılık Fakültesi, 2024-06-10) Jame, Wissal; Basgut, Bilgen; Abdi, AbdikarimObjective: Various bacteria produce complicated infections that are difficult to treat worldwide. Ceftobiprole is effective against resistant Gram-positive and Gram-negative bacteria. Methods: This review assessed effectiveness and safety of ceftobiprole monotherapy for severe infections. A systematic review and meta-analysis of randomized controlled trials comparing clinical cure, microbiological cure, and safety of ceftobiprole alone to a combination or non-combination antibiotic regimen was conducted. Until December 20, 2022, we searched a major databases. Results: This study includes 4168 patients from six trials. Ceftobiprole and comparator-received patients had similar clinical responses for all patient population. Also, the eradication rate of all organisms and specific pathogenic bacteria in microbiologically examined patients was comparable between the groups. Ceftobiprole induced more gastrointestinal side events than comparable drugs, mostly nausea [OR 1.91 (1.26-2.90), p = < 0.01]. While skin-related adverse events were significantly associated with comparator antibiotics [6 trials, 4062 patients; OR 0.77 (0.60-0.99), p=0.03]. Conclusion: Ceftobiprole monotherapy is effective and safe for severe infections caused by Gram-positive or Gram-negative bacteria.Item A 'Flawless' Constitutional Engineering Project In Turkey: Regime Transformation Through Constitutional Amendments Of 2007, 2010, And 2017(Başkent Üniversitesi Hukuk Fakültesi, 2024-04-17) Genckaya, Omer Faruk; Dunbay, SedaA functional legislature is very vital for democratisation. During the time of democratic consolidation, parliament changes from its primary roles of oversight, representation and legislation into 'important public arenas of partisan dispute, of encounters with social topics, of negotiations and of important decision-making'. Populist leaders in parliamentary systems like Turkey recently either led to sui generis presidential systems or transformed them into illiberal democracies by expanding the executive branch's power to amend the constitution, which contradicts the favourable conditions of the third wave of democratisation at the turn of the twenty-first century. By streamlining legislative processes, the Turkish Constitution of 1982 envisaged an empowered executive that would subordinate the parliament. The three constitutional modifications passed after 2007 resulted in de-democratisation, de-parliamentarisation and eventually, a regime change from democratic consolidation to autocracy. The parliamentary debates on these constitutional amendments, which included popular presidential election, judicial reform and the so-called 'Turkish style' presidential governance system, failed to reach a consensus and were marked by an adversarial rather than deliberative approach. Have constitutional reforms made in the name of re-democratisation resulted in de-democratisation, with the legislature entirely crippled, the judiciary reliant and the executive exercising sole authority? This study aims to analyse the impact of three consequential constitutional amendments on democratic backsliding in Turkey, with special reference to the decline of parliament. Parliamentary minutes on the relevant constitutional amendments, procedural changes disabling the parliament from performing its legislative and oversight functions and the actual outcomes of these amendments in terms of executive-legislative relations will be discussed. In conclusion, potentials for strengthening parliament, checks and balances, and re-democratisation will be presented.Item Competitive Yet Unfair: May 2023 Elections And Authoritarian Resilience In Turkey(Başkent Üniversitesi İktisadi İdari Bilimler Fakültesi, 2024-04-20) Esen, Berk; Gumuscu, Sebnem; Yavuzyilmaz, HakanOn May 14, Turkish voters headed to the polls to vote for presidential and parliamentary elections. This was the most challenging race yet for authoritarian populist Erdogan, as the ongoing economic crisis and deadly earthquakes severely diminished his performance legitimacy. Moreover, the opposition parties united against his regime by rallying behind a joint presidential candidate. However, Erdogan turned the tables on the opposition and won the presidential race for a third consecutive term while his electoral bloc secured a majority in the parliament. This paper analyses the context and results of Turkey's 2023 twin elections. We highlight the features of the competitive authoritarian regime, Erdogan's religio-nationalist electoral strategy, and the opposition's fragile state and weak strategy to explain Erdogan's electoral resilience.Item Comprehensive Data Analysis Of White Blood Cells With Classification And Segmentation By Using Deep Learning Approaches(Başkent Üniversitesi Mühendislik Fakültesi, 2024-04-05) Ozcan, Seyma Nur; Uyar, Tansel; Karayegen, GokayDeep learning approaches have frequently been used in the classification and segmentation of human peripheral blood cells. The common feature of previous studies was that they used more than one dataset, but used them separately. No study has been found that combines more than two datasets to use together. In classification, five types of white blood cells were identified by using a mixture of four different datasets. In segmentation, four types of white blood cells were determined, and three different neural networks, including CNN (Convolutional Neural Network), UNet and SegNet, were applied. The classification results of the presented study were compared with those of related studies. The balanced accuracy was 98.03%, and the test accuracy of the train-independent dataset was determined to be 97.27%. For segmentation, accuracy rates of 98.9% for train-dependent dataset and 92.82% for train-independent dataset for the proposed CNN were obtained in both nucleus and cytoplasm detection. In the presented study, the proposed method showed that it could detect white blood cells from a train-independent dataset with high accuracy. Additionally, it is promising as a diagnostic tool that can be used in the clinical field, with successful results in classification and segmentation.Item Biochemical And Molecular Analyses Of Insecticide Resistance In Greenhouse Populations Of Bemisia Tabaci (Hemiptera: Aleyrodidae) In Türkiye(Başkent Üniversitesi Fen Edebiyat Fakültesi, 2024-04-04) Erdogan, Cem; Toprak, Umut; Gurkan, M. OktayThe sweet potato/cotton whitefly Bemisia tabaci (Gennadius) (Hemiptera: Aleyrodidae) is one of the most destructive vegetable pests in greenhouses in Turkiye. While the preferred method of control primarily relies on insecticides such as neonicotinoids, organophosphates and pyrethroids, their intensive use has caused whiteflies to rapidly become resistant. Samples were collected from 13 Turkish B. tabaci greenhouse populations. Bioassays from the Marmara Region identified as high as a 53-fold increase in resistance to chlorpyrifos-ethyl, a 303-fold increase to imidacloprid and a 282-fold increase to acetamiprid. Bioassays in the Central Anatolia Region reported a 76-fold increase in resistance to deltamethrin and-15-fold increase to thiamethoxam. Most of the populations showed cross-resistance for neonicotinoids. All collected B. tabaci populations were determined to be MEAM 1 (also referred to as biotype B) for diagnostic band E0.14. The E0.14 esterase variant that helps to diagnose biotype B insects was found in all individuals from field populations. Almost all populations showed higher non-specific esterase, glutathione-S-transferase (GST) and monooxygenase activity when compared to susceptible SUD-S population. AChE insensitivity assays for individual B. tabaci suggest a target-site modification as a mechanism of resistance to chlorpyrifos-ethyl. This is the first report of AChE variants identified based on their sensitivities to chlorpyrifos ethyl-oxon and pirimicarb in Turkish B. tabaci populations. Fixed ace mutations in the target-site of organophosphates and pyrethroids were identified in six populations. Resistance to organophosphates and neonicotinoids were at least partially related to both ace mutations and insensitive AChE and monooxygenase activities, respectively. The results will help develop effective resistance management programs of B. tabaci in Turkiye.Item Comment on 'Accelerated Hypofractionated Chemoradiation For Locally Advanced Head And Neck Cancer During Covid-19 Pandemic: A Tertiary Care Experience'(Başkent Üniversitesi Diş Hekimliği Fakültesi, 2024-10-30) Somay, Efsun; Topkan, Erkan; Selek, Ugur; Pehlivan, BerrinItem A Pilot Study on Comparison of Teaching Workloads of Academicians Based on Working Periods During and Before the COVID-19 Pandemic(Başkent Üniversitesi Mühendislik Fakültesi, 2025-01-25) Yorulmaz, Muhammed; Can, Gulin Feryal; Toktas, PelinThe COVID-19 pandemic has had a profound impact on society, greatly changing the structure of social and working lives. Educational institutions, especially in higher education, were forced to suspend face-to-face education and switch to distance education. This change inevitably affected the working styles and workloads of academics. This study aims to explore the effects of the COVID-19 pandemic on academic teaching workloads by examining transaction data for a one-year period before and during the pandemic. The data were obtained from the system logs of a learning management system platform, which was used extensively during the pre-pandemic and pandemic periods, and were analyzed in terms of transaction density, day, and time of transactions. The findings from the pre-pandemic period showed that the academic workload was higher on weekdays than on weekends. However, with the transition to distance education during the pandemic, the difference between weekday and weekend workloads diminished significantly. Additionally, the working hours shifted during the pandemic by approximately one hour to later hours in the day.Item Azoles Display Promising Anticonvulsant Effects Through Possible Ppar-Α Activation(Başkent Üniversitesi Eczacılık Fakültesi, 2024-05-25) Sari, Suat; Yurtoglu, Sibel; Zengin, Merve; Marcinkowska, Monika; Siwek, Agata; Sarac, SelmaAzoles such as nafimidone, denzimol and loreclezole are known for their clinical efficacy against epilepsy, and loreclezole acts by potentiating gamma-aminobutyric acid (GABA)-ergic currents. In the current study, we report a series of azole derivatives in alcohol ester and oxime ester structure showing promising anticonvulsant effects in 6 Hz and maximal electro shock (MES) models with minimal toxicity. The most promising of the series, 5f, was active in both 6 Hz and MES tests with a median effective dose (ED50) of 118.92 mg/kg in 6 Hz test and a median toxic dose (TD50) twice as high in mice. The compounds were predicted druglike and blood-brain barrier (BBB) penetrant in silico. Contrary to what was expected, the compounds showed no in vitro affinity to GABAA receptors (GABAARs) in radioligand binding assays; however, they were found structurally similar to peroxisome proliferator-activated receptors alpha (PPAR-alpha) agonists and predicted to show high affinity and agonist-like binding to PPAR-alpha in molecular docking studies. As a result, 5f emerged as a safe azole anticonvulsant with a wide therapeutic window and possible action through PPAR-alpha activation.Item A Robust Aluminum Material Selection Process in the Aviation Industry: A Linear Discrete System Stability Test Perspective for Fuzzy Multicriteria Decision-Making(Başkent Üniversitesi Mühendislik Fakültesi, 2024-04-10) Ic, Yusuf Tansel; Hamzaoglu, Burak Meric; Yurdakul, MustafaAluminum parts are used in the aviation industry because of the need for light. However, in addition to lightness, critical parts that must have high strength properties have also been developed. The corrosion resistance, resistance to high temperatures, and workability were investigated in this case. It becomes difficult to choose among many aluminum materials that can be alternatives to each other when these features are included. The developed approach, which considers many of the features listed above and ultimately recommends to the user the most suitable aluminum material for the relevant critical part, will be used in overcoming the difficulties in this process. A material selection model is proposed in this paper for this purpose, and the decision-making model is demonstrated with examples from the aviation industry. Therefore, the developed model, which will enable the selection of the most suitable materials among alternative materials, especially for critical parts in the aviation industry, will guide professionals working in this field. For this purpose, the fuzzy TOPSIS method is used in the study, and suitable alternatives are determined. Finally, a robustness analysis is proposed to determine the most suitable aluminum material for highly uncertain situations. We apply a stability evaluation study based on process control theory in the robustness analysis.