TR-Dizin İndeksli Açık & Kapalı Erişimli Yayınlar
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Item Heart failure with non-reduced ejection fraction: Epidemiology, pathophysiology, phenotypes, diagnosis and treatment approaches(2022) Cavusoglu, Yuksel; Celik, Ahmet; Altay, Hakan; Nalban, Sanem; Ozden, Ozge; Temizhan, Ahmet; Ural, Ditek; Unlu, Serkan; Yilmaz, Mehmet Birhan; Zoghi, Mehdi; 35969235Heart failure (HF) has been classified as reduced ejection fraction (HFrEF), mildly reduced ejection fraction (HFmrEF) and preserved ejection fraction (HFpEF) by the recent HF guidelines. In addition, HF with improved ejection fraction has been defined as a subgroup of HFrEF. In HFrEF, diagnostic workup and evidence-based pharmacological and device-based therapies have been well established. However, HFpEF, which comprises almost half of the HF population, represents significant uncertainties regarding its pathophysiology, clinical phenotypes, diagnosis and treatment. Diagnostic criteria of HFpEF have been changed a few times over the years and still remained a matter of debate. New paradigms including a prominent role of co-morbidities. inflammation, endothelial dysfunction have been proposed in its pathophysiology. As a complex, multifactorial syndrome HFpEF consists of many overlapping clinical and hemodynamic phenotypes. In contrast to HFrEF, clinical outcomes of HFpEF have not improved over the last decades due to lack of proven effective therapies. Although HFrEF and HFpEF have different clinical spectrums and proposed pathophysiological mechanisms, there is no clear defining syndrome postulated for HFmrEF. Clinical characteristics and risk factors of HFmrEF overlap with HFrEF and HFpEF. HFmrEF is also referred as a transitional zone for dynamic temporal changes in EF. So. HFpEF and HFmrEF, both namely HF with non-reduced ejection fraction (HF-NEF), have some challenges in the management of HF. The purpose of this paper is to provide a comprehensive review including epidemiology, pathophysiology, clinical presentation and phenotypes of HF-NEF and to guide clinicians for the diagnosis and therapeutic approaches based on the available data in the literature.Item 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, HalilTripoli 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.Item Evaluation of performance levels of students for moodle learning management system in terms of usability Criteria with PSI-Entropy-Marcos integration(2022) Yorulmaz, Muhammet; Can, Gulin FeryalThe study, it is aimed to determine and compare the end-user performances within the scope of achieving the determined objectives while using the Moodle Learning Management System (LMS). Accordingly, considering multiple usability criteria, 18 users were prioritized in terms of their performances in using Moodie LMS. In this direction, Preference Selection Index (PSI) and Entropy integration was used to determine the importance weights of usability criteria, and the Measurement of Alternatives and Ranking according to Compromise Solution (MARCOS) method was used to prioritize the end-users. A new hybrid weighting method has been proposed by integrating the PSI method with the Entropy method, taking into account both the uncertainty in the performance values of the end-users according to the criteria and the preference change values of the criteria. This proposed method is applied for a three-dimensional initial decision matrix Thus, the traditional two-dimensional initial decision matrix which consists of the alternatives and the values that the alternatives take according to the criteria, has been developed and made more flexible. The objective criteria taken into account in the analysis were measured by the Morae V3 program, with the tasks defined as predetermined goals being performed by the users on the Moodie LMS. In addition, the criteria weights obtained from the proposed PSI-Entropy integration were used in the MARCOS method to rank the end-users according to their performance levels.Item Effect of Inhaled Corticosteroid Treatment on Body Composition Parameters in Children with Asthma(2021) Koksal, Burcu Tahire; Yilmaz Ozbek, OzlemObjective: Prolonged treatment with low doses of inhaled corticosteroids may affect the growth rate; however, limited data are currently available for body composition parameters in children with asthma. We examined whether treatment with inhaled corticosteroids has an effect on body mass index, basal metabolic rate, percentage body fat, obesity degree, fat mass, and muscle mass in children with mild asthma. Materials and Methods: The study was performed in 45 children with mild persistent asthma being treated with inhaled corticosteroids and 45 healthy controls. Body composition parameters; body mass index, percentage body fat, obesity degree, basal metabolic rate, body fat mass, muscle mass, and waist-hip circumferences were measured. Written questionnaires including duration of television/computer viewing, frequency of fast food consumption, and weekly physical activity were completed. Results: There was no difference in body composition parameters and waist-hip circumference measurements between the groups. A positive correlation was demonstrated between the duration of inhaled corticosteroid treatment and the percentage of body fat, muscle mass, fat mass, and hip circumference. When compared with healthy controls, a significant increase in the duration of television/ computer viewing and frequency of fast food consumption and a significant decrease in weekly physical activity were observed in children with asthma. Conclusion: Body composition parameters seem not to be affected in the inhaled steroid-using children with asthma. However, as the duration of inhaled corticosteroid treatment increased, the percentage of body fat, body fat mass, and hip circumference also increased. Children with asthma should be encouraged to increase physical activity and be recommended to decrease the duration of television/computer viewing.Item The relationship between serum ferritine levels and subtypes and the severity of symptoms on non-anemic adult ADHD(2020) Tunel, Munevver; 0000-0001-7140-1803; AAD-8660-2021Objective: To compare serum ferritin levels in non anemic adult patients who were diagnosed as attention deficit hyperactivity disorder (ADHD) with a matched healthy control group, and to evaluate the relationship between serum ferritin levels and the severity of ADHD symptoms and ADHD subtypes. Methods: A prospective study was performed on 91 adult non-anemic and cognitively normal ADHD patients (according to the DSM-5 criteria) and 51 healthy controls. They were divided into three subgroups according to the clinical interview and the results of the scale; Group 1, 31 patients with compound type; Group 2, 30 patients with attention deficit subtype; Group 3, 30 patients with impulsivity-hyperactivity subtype. Wender-Utah Rating Scale and Adult Attention Deficit Hyperactivity Assessment Scale were used. Serum ferritin levels were determined. Results: The ferritin levels of the patient groups were found to be significantly lower than the control group. Mean ferritin level was 23 ng/ml in ADHD compound type, 37 ng/ml in attention deficit subtype, 46 ng/ml in hyperactivity and impulsivity subtype, and 65 ng/ml in the control group. Ferritin level was not different between Group 1, Group 2, and Group 3 while the ferritin level of the patients in Group 4 (control group) was significantly higher than the other groups. Conclusion: Our findings revealed the low ferritin levels in ADHD patients. Low ferritin levels without anemia may play a role in the pathophysiology of the disorder. Testing for the ferritin levels may be considered during the general evaluation of this disorder.Item Development of an Innovative Product Using Axiomatic Design Methodology(2020) Uluturk, Ibrahim; Yurdakul, Mustafa; Ic, Yusuf TanselIn this study, axiomatic design methodology is applied to design an innovative rifle butt. The developed rifle butt model is sized to fit into common rifle types and ANSYS Workbench program is used for its structural analysis. So that, this study presents in detail a new product design and engineering process to develop a completely new product that satisfies customer requirements without copying any existing products designs.Item Evaluation of Blood Culture Practices: Use of System (Epicenter) Data(2019) Basustaoglu, Ahmet; Suzuk Yildiz, Serap; Mumcuoglu, Ipek; Karahan, Zeynep Ceren; Ogunc, Dilara; Kaleli, Ilknur; Kursun, Senol; Evren, Ebru; Ozhak, Baysal Betil; Demir, Melek; Murray, Patrick; 30683035Sepsis is a serious clinical problem and estimated to be responsible for 18 million annual deaths worldwide. Therefore, the use and the rapid processing of blood cultures are important for the transition from empiric therapy to directed therapy. The aim of this study was to assess the best blood culture practices in Turkey. We have examined the collection practices and techniques at four different hospitals, and a total of 165.443 blood culture bottles were evaluated (2013-2015). At the preanalytical phase most of the data which were important and which could support hospital quality systems/practices were not entered into the HIS and EpiCenter system. At the analytical phase loading of the bottles and removal of positive bottles primarily occurred between 6:00 and 9:00 AM but the positivity rate of the bottles showed a homogeneous distribution throughout the day. In other words, there were significant delays at processing positive blood culture bottles related to laboratory workers. The effect of education regarding best practices, transition from single bottle to two bottle cultures was successful in all hospitals. Single bottle usage decreased below 10% in all hospitals. Significantly more positive cultures were detected at multiple cultures when compared with the single bottle collection practice. In retrospective patient records, it was seen that all the laboratories reported the results of Gram staining to the clinics. However, these data were not recorded to the Epicenter. The contamination rates of Ankara Numune Hospital and Akdeniz University Faculty of Medicine Hospital are 6.2% and 5.4% respectively, contamination rates were not reported in other hospitals. The most common isolates detected in blood cultures were Escherichia coli, Klebsiella pneumoniae, Enterococcus faecium, Staphylococcus aureus, and Acinetobacter baumannii. The mean time for the detection of these organisms were less than 20 hours in the aerobic bottle and anaerobic bottles. A total of 79.6% of facultative anaerobic isolates were detected in both bottles; 9.8% were detected only in the aerobic bottles; 10.6% of the isolates were detected only in the anaerobic bottles. As a result, the educational efforts in Turkey have met with success for transition from collecting single bottle blood culture sets to two bottle blood cultures. However, further efforts are needed to increase the number of blood culture sets collected during a 24 hour's period. In addition, errors at the preanalytical, analytical and postanalytical periods (taking samples, loading bottles into the system and processing positive blood cultures) should be eliminated.Item The Necessity of Sector Carrying Capacity in Multinational Companies' FDI Location Choice(2019) Baskici, Cigdem; Ercil, Yavuz; AAI-6607-2020The aim of this study is to define the carrying capacity as a new criterion in multinational companies' foreign direct investment (FDI) location choice. The validity of such a definition requires the existence of a causal relationship between FDI and the number of companies at the investment location. As carrying capacity is a function of the sector population, FDI refers to the decisions of foreign investors regarding location choice. With this in mind, the company numbers and FDI data used belonging to 34 sub-sectors of Agriculture, Industry and Services sectors in Turkey between the years of 2006-2016 were analyzed. The Granger causality test was applied to investigate the causal relationship between the company numbers and FDI. As a result of the findings, a causality relationship between the number of companies and FDI was determined in 29 of the 34 sub-sectors. A causality relationship could not be found in 2 sub-sectors. Analysis was not possible in the remaining 3 sub-sectors because of a lack of data. The results show that carrying capacity can be used as decision criterion in multinational companies' FDI location choice. In addition to this main result of the study, predictions for the investment decision are presented in the light of the analyses along with evaluations of the carrying capacity of the Agriculture, Industrial and Services sectors.Item POSTOPERATIVE ANTICOAGULANT AND ANTIAGGREGANT STRATEGY FOR THE PATIENTS WITH ATRIAL FIBRILLATION FOLLOWING CAROTID ENDARTERECTOMY-SINGLE CENTER EXPERIENCE(2019) Oztas, Didem Melis; Ugurlucan, Murat; Akay, Hakki Tankut; Erdinc, Ibrahim; Aydin, Kubilay; Alpagut, UfukObjective: Literature does not contain a standard procedure about anticoagulant therapy aimed at patients with atrial fibrillation and carotid artery stenosis following carotid endarterectomy. In this paper, we present our therapy modality at these patients in our clinic. Material and Method: The study includes 424 patients and 498 carotid endarterectomy operations performed by two surgeons with the same technique between June 2010 and December 2017. Fourty-five patients had chronic or paroxysmal atrial fibrillation. Therefore, the patients were receiving Coumadin and aspirin. The median age was 63.4 +/- 7.9. There were 27 female and 18 male patients. Thirty seven patients were hypertensive and 17 patients were diabetic. Nine patients underwent bilateral carotid endarterectomy operations. Thirty three patients were symptomatic. Eleven patients had coronary artery disease and 5 patients had cardiac valvular pathologies. Results: The whole carotid endarterectomy operations were performed under locoregional anesthesia. Early mortality occured in one patient because of hypertensive intracranial bleeding. The median follow up period was 68.4 +/- 19.2 months. One patient was lost due to aging and co-morbid factors and one patient was lost due to malignancy in late follow up period. Three patients required revisions for hematoma at incision region but an active bleeding focus could not be detected. There was no re-stenosis in any patient during follow-up. Conclusion: The large and multi-centered studies are needed for the anticoagulant therapy protocol for the patients with atrial fibrillation following carotid endarterectomy. We prefer combination of warfarin, providing INR value between 2-3, and 100 mg aspirin per day at our patients as therapy modality.Item Terrorism Strategy or Strategies of Terrorism?(2019) Gungor, UgurTerrorism is both a strategy in itself and also has several strategies. While terrorism can be seen as a strategy which is used by countries and terrorist organizations, terrorist organizations also use several strategies. There are five principal strategic logics of costly signaling at work in terrorist campaigns: attrition, intimidation, provocation, spoiling, and outbidding. Effective counterstrategies cannot be designed without first understanding the strategic logic that drives terrorist violence. This paper will analyze the relations among goal, strategy and tactic and investigate whether terrorism is a strategy or not. In the concluding section, paper will discuss the strategies of terrorism and conditions favorable to each strategies.