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This study investigated erosion along the approximately 18.5 km coastal section of the Yeşilırmak Delta, a nationally important wetland, using remote sensing and Geographic Information Systems (GIS). Landsat-5 TM/Landsat-8 OLI satellite images from 1985 to 2022 (1985, 1990, 1996, 2001, 2006, 2011, 2017, and 2022) were used to determine shoreline changes. The shoreline determination process involved the combination of the normalized difference water index (NDWI) and the modified normalized difference water index (MNDWI). Annual rates of shoreline change were calculated using the linear regression rate (LRR) method within a 95% confidence level. Results showed a maximum erosion rate of -25.8 m/year in Zone-1, located in the western part of the Yeşilırmak River, and -7.7 m/year in Zone-2, situated in the eastern part. Erosion affected 61% of the delta, with 34% experiencing high-level erosion, 9% medium-level erosion, and 18% low-level erosion. Overlay analysis identified a total loss of 261.45 ha during 1985-2022, with 179.23 ha in Zone-1 and 82.22 ha in Zone-2. These findings enhance understanding of coastal dynamics by delineating erosion, accretion, and stable areas in the Yeşilırmak Delta. Furthermore, the study highlights the effectiveness of Landsat images and the LRR method in assessing shoreline changes. [ABSTRACT FROM AUTHOR]

Objective: Acute abdomen is a dangerous condition that necessitates attentive care. The etiology of acute abdomen is quite complex and alternative diagnostic methods are very valuable as it may indicate life-threatening conditions. The purpose of this study was to examine the role of physical examination and laboratory indicators in relation to surgical and medical treatment options in the emergency department (ED). Methods: This single-center retrospective study was conducted on 735 patients aged between 18 and 90 years admitted to the ED of our hospital between January 01, 2019, and January 01, 2020. Patients' demographics (age and gender), hospitalization data, presence of rebound and involuntary guarding, differential diagnosis, treatment approach (medical or surgical treatment), and laboratory parameters were analyzed. Results: The mean age of all patients was 45.5±18.6 years and male patients were dominant (51.1%). The most common diagnoses were acute appendicitis, acute gastroenteritis, and acute cholecystitis, respectively. Patients who had surgical treatment were significantly younger than those who received medical treatment (p<0.001). Rebound tenderness and involuntary guarding were more pronounced in the patients who received medical treatment. Inflammatory laboratory parameters were higher in patients who received surgical treatment. The presence of rebound tenderness, decreased age, elevated leukocyte, and neutrophil levels, as well as decreased red cell distribution width showed significant associations in favor of surgical treatment. Conclusion: Results suggest that the presence of rebound tenderness, elevated neutrophil, and decreased age may be predictive for the treatment modality in patients with acute abdomen. [ABSTRACT FROM AUTHOR]

Determining the bathymetry of shallow waters is important for managing coastal areas, river basins, and water resources. However, economic and practical difficulties in collecting bathymetric data cause disruptions in bathymetric studies. To overcome these challenges, a recent focus has involved the use of remote sensing technology as an alternative approach to the bathymetric mapping of shallow waters. This study uses Landsat-5 TM satellite imagery, which is free and open data, to determine the digital bathymetric model (DBM) of Atikhisar Reservoir. The study also uses the Normalized Difference Water Index (NDWI) and Modified Normalized Difference Water Index (MNDWI) to determine the reservoir’s surface area and the Stumpf algorithm to perform the bathymetric mapping. Satellite image-based DBMs were obtained using the linear regression equations created from the blue/green log-ratio values from the Landsat-5 TM satellite image and the values obtained from a 1/5000 scale digital bathymetric map for five different training reference point sets. The root mean square error (RMSE) values were calculated by comparing the DBMs with the test data. The model with the best results showed the regression determination coefficient (R2 ) to be 0.701 and the RMSE to be 2.1 m. These results reveal the potential of low-cost bathymetric map production for preliminary investigation and general evaluation in reservoirs with easy data processing from Landsat images. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate the role of serum uric acid and lactate levels and mean platelet volume in predicting treatment success in patients with ischemic stroke. Methods: One hundred and five patients who were diagnosed with cerebrovascular disease and received thrombolytic or thrombectomy treatment were included in the study. Patients were divided into two groups as patients who developed complications and who did not develop complications. Demographical characteristics, laboratory findings, the National Institutes of Health Stroke Scale (NIHSS) scores at admission and at discharge, and Modified Rankin Scale (mRS) score were investigated retrospectively. Results: Of all patients, 58.1% of the were male. There were no differences in terms of laboratory parameters between the groups. NIHSS score at admission, NIHSS score at discharge, and mRS score were significantly higher in the group that developed complications after treatment (p<0.05). Laboratory values did not differ significantly between the groups. Early mortality rate in the group which developed complications was significantly higher than the group which did not develop complications (p<0.05). Univariate model revealed significant effectiveness of NIHSS score at admission and at discharge, and mRS score in the differentiation of patients with and without complications (p<0.05). In the multivariate model, a significant and independent effectiveness of the NIHSS score at discharge was observed in the differentiation of patients with and without complications (sensitivity =83.3%, positive prediction =30.8%, specificity =57.1% and negative prediction =93.8%; p<0.05). Conclusion: We found no significant associations between the development of complications after thrombolytic therapy and laboratory findings. The NIHSS score may be a suitable parameter in predicting complications. [ABSTRACT FROM AUTHOR]

The main raw materials of the food industry are agricultural products. It is necessary to select the right suppliers in the industry to produce healthy, safe and high quality food products. The aim of this study was to use AHP and TOPSIS methods together in order to solve the problem of selecting the ideal raw material supplier for a company operating in the food products manufacturing sector. The purchasing manager of the company was consulted as the decision maker. The main criteria were quality, cost, delivery and supplier profile. The subcriteria were raw material quality, amount of available raw materials, affordable raw materials, discount, transportation cost, fast delivery, safe delivery, geographic proximity, past performance, reliability and relationship. The results showed that "quality" was the most important criterion, followed by cost, delivery, and supplier profile. The supplier D1 had the highest score and therefore was selected as a current supplier for the company. The use of AHP-TOPSIS methods in raw material supplier selection in the food industry was evaluated, and suggestions were made based on the results. [ABSTRACT FROM AUTHOR]

This study was conducted to determine the effect of domain-specific innovativeness on unplanned purchasing behavior and compulsive purchasing behavior. For this purpose, created research model was tested with new fashionable clothes online survey method on the consumer within the general category of products for Turkey. The collected survey data was transferred to the computer environment and analyzed with the help of SPSS program. In particular, it has been investigated whether the consumers follow the innovations of fashion products and whether they display unplanned and compulsive buying behavior. Within the scope of this research, a moderate, positive and statistically significant correlation relationship was observed between domain-specific innovativeness and unplanned purchasing behavior and compulsive purchasing behavior. In addition, regression analysis was performed to determine the causal relationship between variables; It has been observed that domain-specific innovativeness explains 31.3% of the change in unplanned purchasing behavior and 36.1% of the change in compulsive buying behavior of domain-specific innovativeness. In addition to these results, it was determined that the participants' perceptions of domain-specific innovativeness did not differ by gender. [ABSTRACT FROM AUTHOR]

Boutique hotels, which have become more popular in recent years, are accommodation places that have fewer rooms, a special architectural structure, a unique character, a friendly, unique decoration, a small number of staff and personalized customer service and that adopt a perception of guest rather than a perception of customer. The aim of this study is to determine the effect of service quality on customer satisfaction in boutique hotels. For this purpose, boutique hotels in Antalya were included in the survey and 400 boutique hotel customers were surveyed.Servqual Quality of Service scale was used for quality of service measurement. Cronbach Alpha method, Normality test, Correlation, Confirmatory Factor Analysis, Structural Equation Model were used in the analysis of the data. In the study, it is concluded that out of the Quality of Service dimensions, physical characteristics, reliability and trust have a significant effect on customer satisfaction. Physical characteristics had the highest impact on customer satisfaction. [ABSTRACT FROM AUTHOR]

Timely, fast and reliable delivery of medicines from pharmaceutical warehouse to pharmacies is important for both parties. The aim of this study is to use AHP and TOPSIS methods to select the most suitable motorized courier for a pharmaceutical warehouse operating in the pharmaceutical sector. As a decision maker a specialist opinion was consulted who was responsible for the firm's personnel selection. Literature review and as a result of interviews conducted with the firm's personnel manager were defined five main criteria (technical competence, physical competence, social competence, professional competence and personal characteristics) and subcriteria. Weights of the main and subcriteria were determined using the AHP method. Motorized courier candidates were ranked separately using AHP and TOPSIS methods. Analysis results showed that the most and least important criteria for motorized courier selection were technical competence and social competence, respectively and "Courier 3" is the most suitable candidate according to both methods. [ABSTRACT FROM AUTHOR]

The dismissal resulting from various reasons such as downsizing, performance or behaviour is an integral part of working life. With advancing technology and the common usage of social media tools that people can access anywhere, the reasons for dismissal have changed. The purpose of the study is to determine whether employees' social media posts is a cause of dismissal. Social media posts of employees are evaluated in the context of dismissal and privacy. In the research, examples which are the representative of dismissal and social media phenomena are examined in depth using the case study method, which is among the qualitative research types. As a result of the research, it is seen that the employees' posts on social media platforms could be the reason of dismissal. It is also revealed that sharing the holiday photo from the beach on social media when the employee is on sick leave, insulting human resources management from social media, describing the labour contract as a contract of slavery, sharing photos from workplace which includes logo of the institution that disrupts the business discipline may be the reason for dismissal. The most important contribution of the study is to examine the dismissal phenomenon due to social media in the context of self-exposure and surveillance, which are modern threats to privacy. Now, social media has become an evaluation factor for employers not only in recruitment but also in dismissal. [ABSTRACT FROM AUTHOR]

Employees' wages are important not only for human resources management in terms of employees but also for production management in terms of a cost element as an input of productive factors. Wage, which can be regarded as an important means of increasing productivity, is also an effective means of economic incentive that ensures employees' commitment to the business. The aim of this study is to determine whether hotel employees' perceptions of wage management implemented by hotels differ by some demographic characteristics. As a result of the analysis, according to in wage management perspective of employees in terms of working time, working provinces, education status and working department variables; in the employment outlook of the employees within the scope of wage management in terms of education status variable; in the perspective of motivation of employees within the scope of wage management in terms of working department variable; in view of wage policy of employees within the scope of wage management in terms of education status and working department variables; in view of salary system of employees within the scope of wage management in terms of age, working provinces and working department variables, significant differences were found. [ABSTRACT FROM AUTHOR]

There has been a steady increase in competition and customer expectations in the airline industry in recent years, and therefore, airlines have begun to pay more attention to service quality, which should, therefore, be assessed. The aim of this study was to prioritize factors affecting the service quality of the airline industry. To this end, the service quality of three airlines was determined using AHP and TOPSIS methods. Three airlines (A, B, C) were selected using a questionnaire. Study sample consisted of 150 customers of these three airline companies in Samsun. A model developed by Chang and Yeh (2001) was used. The model consists of five factors (cabin comfort, courtesy of crew, reliable service, convenient service, crew's approach to unexpected situations) describing fifteen service dimensions. Results show that cabin comfort is the most important service quality factor and that A has the best service performance. Of the three airlines, A, however, has the lowest "courtesy of crew" score, indicating that the company should focus on improving this aspect to maintain its public image. The managers should, therefore, prioritize the training of their employees in this respect. [ABSTRACT FROM AUTHOR]

Probiotics can be defined as living microorganisms that positively contribute to human health by regulating the intestinal flora of a host and stimulating the immune system. As stated in many studies carried out in recent years, probiotic microorganisms are known to be very useful for human health. Saccharomyces cerevisiae var. boulardii is the only probiotic yeast that has been patented. In this study, it was aimed to determine the physical, rheological, chemical, and microbiological quality parameters of probiotic yogurts manufactured using this yeast microencapsulated via extrusion method during storage. Black cherry jam was used in order to enrich the sensory properties of products and the products were stored for 21 days. Microbiological characteristics such as total mesophilic aerobic bacteria, total coliform, total lactic acid bacteria, total yeast-mold, and viability of the S. boulardii were determined by analyzing the samples. We also investigated sensory properties such as external appearance, consistency (with spoon and by mouth), odor, flavor, and overall acceptability throughout the storage to evaluate the acceptability of the product by consumers. [ABSTRACT FROM AUTHOR]

Aim:Analysis of genes that play roles in multiple myeloma pathogenesis and their pathways are current research topics. We aimed to detect expression of some genes in ErbB and insulin signaling pathways. Methods:Bone marrow samples were taken from three healthy volunteers and 17 treatment-naive patients. Firstly RNA isolation was made and then cDNA were synthesized. There are eight genes that are related to ErbB and insulin signaling pathways. Specific primers for these genes were designed. Gene expression analysis was performed by the real-time polymerase chain reaction method. Results: In the patient group, expressions of MTOR, RPTOR, PIK3CA, AKT1, ErbB4, PRKAR2A and PRKACB genes were detected to be 3-10 times up-regulated than in control group. There were no differences in the expression levels of RICTOR and GYS1 genes between control group and patient group. GYS1, PRKACB and PRKAR2A genes have been analyzed for the first time. Conclusion: In this study, PRKAR2A and PRKACB genes expressions were detected to be upregulated and this has not been reported in the literature before. MTOR, RPTOR, PIK3CA, AKT1, and ErbB4 genes expression were detected to be upregulated as has been reported in the literature. All these results will be useful to understand the pathogenesis of multiple myeloma. [ABSTRACT FROM AUTHOR]

The present study examines perceptions of gifted students toward visual arts course. We used to phenomenology model, which is qualitative research design. Twelve students in elementary school participated in the study. Participated students are registered Bayburt Science and Art Center and voluntary for participated study. To achieve this purpose, semistructured interview form developed by researcher form was applied. Content analysis was used for data analysis. The analyses show that perceptions toward visual arts course of elementary gifted students collected two patterns: personal evolution and visual arts course as a tool. Participated students say that visual arts course is develop cognitive, affective and psychomotor skills. It also they emphasize this course is providing relation to interdisciplinary and put forward cultural values. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate suspected cases of mushroom poisoning that were admitted to the emergency department of a metropolitan education and research hospital. Material and Methods: Suspicious cases of mushroom poisoning and determined mushroom poisoning patients were investigated in the medical records of patients who were older than 18 years old in 1 year. We examined patient's demographic information, admission date, complaints, time of complaint starting, and clinical and laboratory findings. Treatments and results were evaluated. Results: We analyzed 74 patients who were diagnosed with mushroom poisoning. The most common complaints of the patients were nausea and vomiting. Increases in the number of admission were observed in November and December. A total of 25 patients were externed from emergency medicine, and 39 patients were hospitalized. 5 patients treatment with hemodialysis and both of them died. Conclusion: Mushroom poisoning is known to vary according to seasonal distribution, type of mushroom, geographic shape, and climate of the region. Therefore, emergency physicians should investigate the characteristics and ecology of the region and the geographic shape, so that provision services can facility the emergency departments principles working and organizated. The importance of regional characteristics is lost in a metropolitan hospital. [ABSTRACT FROM AUTHOR]

Detection thresholds limiting and directing the urban development in planning is of great importance to generate development plans based on the balance of protection and use. Preparation of natural and institutional thresholds and constraints that constitute the basis in planning and integration with plans correctly are very important to make the right planning decisions. In present study to analyze in detail the problems faced in the integration of institution views with planning process while development plans are prepared, this study has been limited to one institution alone. In the preparation of development plans flood protection boundaries, irrigation projects and similar data that must be obtained from State Hydraulic Works (DSİ), legal regulations related to data production and integration with plans and experienced problems have been elaborated; insufficiencies in the quality of base maps employed in studies and problems that arise when plan decisions that lack institution's approval or clash with the institution's views are employed shall be explored at length. [ABSTRACT FROM AUTHOR]

Urinary calculi disease is considered as endemic in our countr y and has an incidence of approximately 15%. Cystolithiasis constitutes only 5% of the whole urinary tract calculuses. It is commonly seen in elderly men. Prostatic hyperplasia, infection, neurogenic bladder, foreign bodies and anti-incontinence surgery in women may be a predisposing factor for cystolithiasis. Most of the patients with cystolithiasis admit to the hospital with pain, bleeding, infection and recurrent lower urinary tract symptoms. In this case report, we aimed to pr esent a patient who admitted to the emergency department with complaints of anuria and at whose direct graphy a lot of opacity detected compatible with calculi. [ABSTRACT FROM AUTHOR]

Swallowing of a foreign object is the second most common endoscopic emergency after gastrointestinal bleeding. We aimed to report a case of razor blade swallowing that presented with abdominal pain. A 33-year-old man was brought to the emergency department by his relatives with the complaint of abdominal pain that had started after swallowing a razor blade 1 day earlier. His past history was notable for schizoaffective disorder. A plain abdominal radiogram showed multiple appearances consistent with metallic, shiny foreign objects (razor blade) at multiple levels. [ABSTRACT FROM AUTHOR]

Secondary spontaneous pneumothorax occurs in people with a wide variety of pulmonary pathology especially in chronic obstructive pulmonary disease, bullous emphysema, bronchial asthma, congenital cysts, malignancies, interstitial fibrosis, pneumonia and cystic fibrosis. Secondary spontaneous pneumothorax is a lifethreatening condition due to underlying chronic pulmonary pathology and commonly seen in elderly patients. In this case we want to remind possibility of underlying pulmonary malignancy with pneumothorax in an elderly patient. [ABSTRACT FROM AUTHOR]

Introduction: Substernal thyroid goiter is defined as extension of the thyroid gland into the mediastinum. Vocal cord paralysis, vena cava superior syndrome due to the compression on major vessels, and Horner syndrome can be rarely seen in patients. Case Report: A 77-year-old female patient presented to our emergency department with complaints of dyspnea, flushing, and edema on her face. Her vital signs were as follows: BP: 140/90 mm Hg, HR: 135 bpm, respiratory rate: 28 per minute, and SpO2: 88%. On her physical examination, there was increased jugular venous distension, both thyroid lobes were palpable, and breath sounds decreased in the right lung. A contrast-enhanced pulmonary computed tomography (CT) was planned, and substernal goiter was seen on CT. Then, 4 L/min supplemental O2, 2 puffs of 200 mcg budenoside 3 times a day and 250 mg IV methylprednisolone therapy were started. Conclusion: In patients presenting with dyspnea, retrosternal (substernal) goiter should also be considered. [ABSTRACT FROM AUTHOR]

The aim of this study is to retrospectively examine invasive diagnostic methods, structural anomalies accompanying cystic hygroma, and pregnancy outcomes in cystic hygroma cases admitted to a tertiary centre. The population of the study consisted of 29 live foetuses with cystic hygroma in the foetal neck only in the first or second trimester. In the study, pregnant women who applied to our centre were included. Amniocentesis or chorionic villus sampling was performed for genetic analysis according to the weeks of the pregnant women who were diagnosed with cystic hygroma by ultrasound examination by two clinicians experienced in foetal anomaly. Of the pregnant women included in the study, 10 had normal karyotype, 12 had abnormal karyotype and 13 had structural abnormality. It is very important to provide genetic counselling to the families of foetuses with cystic hygroma with a multidisciplinary team approach consisting of neonatologists, paediatric surgeons and experienced sonographers. What is already known on this subject? Cystic hygroma, also known as cystic lymphangioma, is a congenital cystic malformation often seen in the first trimester, which occurs in the foetal neck due to the failure of the connections between the cervical lymphatic vessels and the jugular venous system to develop normally. Cystic hygroma may be isolated, but highly associated with foetal aneuploidy, hydrops fetalis, abnormal foetal nuchal translucency. What do the results of this study add? Invasive prenatal diagnostic tests (CVS or amniocentesis) should be performed in all patients with cystic hygroma, as cystic hygromas can be diagnosed by first trimester foetal genetic sonogram screening and are largely accompanied by chromosomal abnormalities. What are the implications of these findings for clinical practice and/or further research? In foetuses with cystic hygroma, foetal karyotyping, detailed sonography and their documentation, genetic counselling is important to families of cystic hygroma foetuses with a multidisciplinary team approach consisting of neonatologists, paediatric surgeons and maternal foetal medicine specialists, since there is a high risk for aneuploidy and foetal malformation. [ABSTRACT FROM AUTHOR]

Ibn Khaldun's understanding of labor makes important contributions to the field. It is important in the formation of a research problem that the study of the labor that has become systematic with Marx, have examined centuries ago in Muqaddimah by Ibn Khaldun. The main aim of the study is to examine the conceptions of Ibn Khaldun and Marx in terms of labor. The main problem is: What kind of differences / similarities exists in Ibn Khaldun and Marx's conception of labor? In this study, which brings a different perspective to labor debates, a qualitative approach was adopted and the work Muqaddimah was examined in depth and a code list was created from the data related to labor. The data obtained were evaluated by content analysis; Marx and Ibn Khaldun's understanding of labor were presented comparatively. According to the results it was determined that they had different understandings in the division of labor, different approaches to worker wages, had similar views in the labor theory of value in terms of perceiving labor as a source of wealth, they attributed different meanings to labor and they were associated alienation with oppression. While Khaldun emphasized the labor that has turned into worship, Marx emphasized alienated labor. [ABSTRACT FROM AUTHOR]

Objective: Pulmonary thromboembolism (PTE) is a cardiovascular disease that occurs as a result of occlusion of the main pulmonary artery and/or its branches due to thrombus or another reason, requiring urgent diagnosis and treatment. Several scoring systems are used to predict mortality due to PTE. In our study, we aimed to show the superiority of the right ventricular/left ventricular (RV/LV) ratio in predicting 30-day mortality using simplified pulmonary embolism severity index (sPESI), shock index (SI), and computed tomography pulmonary angiography (CTPA). Methods: This was a retrospective, cross-sectional study. The study was conducted on patients diagnosed with acute PTE who were admitted to the Emergency Department of University of Health Sciences Turkey, Şişli Hamidiye Etfal Training and Research Hospital between January 01, 2017 and November 17, 2021. Demographic characteristics, clinical features, and vital parameters of the patients were recorded. SI, sPESI score, and RV/LV ratio were calculated. SI ≥1.0, sPESI ≥1.0, and RV/LV ≥1.0 were considered high risk. Results: A total of 205 patients, of which 55.6% were female, were included in the study. The mean age of the patients in our study was 67.1±16.6 (minimum-maximum =20.0-105.0). We found statistically significant differences in sPESI, SI, and RV/LV ratio between the mortality and survival groups (p<0.05). In our study, we accepted PESI [area under the curve (AUC) =0.776] as the gold standard and performed receiver operating characteristic curve analysis to determine mortality in sPESI (AUC =0.697), SI (AUC =0.654), and RV/LV ratio (AUC =0.605). We found that the sPESI, SI, and RV/LV ratios were moderately predictive and statistically significant, respectively (p<0.001, p<0.001, p=0.001, p=0.0028). Conclusion: We believe that CTPA can be used as a single procedure for diagnosis and risk stratification in patients with acute PTE. SI, sPESI, and RV/ LV ratios were found to be significant in predicting 30-day mortality. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented related to the use of transcatheter aortic valve implantation (TAVI) as an alternative therapy to surgical aortic valve replacement (AVR) in patients with severe aortic stenosis.

Purpose: Pediatric head traumas constitute the majority of admissions to emergency departments (ED) due to trauma. This study aims to draw attention to the use of cranial computerized tomography (CT) scans in the evaluation of children with head trauma under the age of 18, and to determine CT scans' usefulness in terms of cost-effectiveness. Materials and Methods: Age, gender, mechanism of trauma and Glasgow Coma Scale (GCS), diagnosis, time of admission to hospital, hospitalization and operation, cranial computerized tomography and hospitalization costs of all cases were retrospectively analyzed. Results: A total of 26,412 patients younger than 18 years old who were admitted to the emergency department due to head trauma and who had a cranial tomography were analyzed. They had a mean age of 7.74 ± 5.66 years. In total, 26,363 (99.8%) of these patients had a GCS greater than 14. Out of these patients, only 402 (1.5%) had brain injury revealed by cranial CT, 41 (0.2%) of these patients were operated and 3 of the patients lost their lives. The total cost of patients admitted to the emergency department with a head injury amounts to USD 583,317. Furthermore, 75.78% of this cost comes from negative cranial CTs. A cost analysis according to different age groups did not show a meaningful difference between 0–2 years and 3–5 years (p = 1.000), but there was a meaningful difference for all the other age groups. Conclusion: Our findings show that applying algorithms to predict traumatic brain injury in children with mild head injury rather than scanning all patients with cranial CT will enable more reliable and cost-effective patient care. Current practices should be reviewed to avoid unnecessary radiation exposure and expense in the ED. It is also necessary to inform and educate parents about the risk/benefit ratio of cranial CT scans. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to define effects of the endemic infective processes on the hand-washing habits of the emergency department staff in contact with the patients. Methods: The study was prospectively conducted in Emergency Clinic of Ankara Numune Training and Research Hospital. Information recorded in the study forms consisted of the title of health care staff, type of the contact with the patients, whether the hands were washed before and after the contact with the patients, duration of the hand-washing, using soap or disinfectant, hand-drying, proper use of the glove and whether the gloves were destroyed in a proper way. Ki-kare test assay was used in the statistical analysis and p<0.05 values were considered significant. Results: Following all the clean and dirty contacts, hand washing was made in 237 (28.9%) of total 819 contacts. Of the total 819 contacts, 538 (65.7%) were found to be clean and 281 (34.3%) dirty contacts. Incidence of the hand-washing was found as 84 times (15.6%) in 538 clean and 153 times (54.4%) in 281 dirty contacts. Frequency of the hand-washing was found higher in the dirty than in the clean contacts. Totally, 462 gloves were used during the study. When areas of use for 462 gloves were examined, it was observed that 219 gloves (47.4%) was used in the clean and 243 gloves (52.6%) in the dirty contacts. It was found during the observation that, soap was used in 134 (56.5%), while no soap was used in 103 (43.5%) of 237 hand-washing. Paper towel was defined to be used in 123 (51.9%) of 237. In addition, durations of the hand-washing following the clean and dirty contacts were also examined during the study. Durations of the hand-washing were found longer after the dirty than after the clean contacts. No significant difference was found between the genders in terms of the duration and incidence of the hand-washing. In the period before the study, number of the personnel who had experienced hospital-acquired infections was found higher than those had not experienced. Conclusion: In the emergency department in which the study was conducted, incidence of the hand-washing was found to be more than in the previous studies, but still it was not at a desired level. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to investigate demographic data of patients who were arrested in an emergency department and outside the hospital, who died despite effective cardiopulmonary resuscitation (CPR), how they were admitted to the emergency department, blood parameters, additional diseases, and duration of CPR. Methods: Two hundred two patients whose complete records can be accessed were included in the study. Demographic data of patients, emergency department arrival patterns, vital signs, additional diseases, blood gas pH, lactate, base minus values, CPR duration and adrenaline doses used in CPR were recorded. Results: Two hundred twenty-one (59.90%) of the patients were male and 81 (40.09%) were female. Of the men, 69 (57.02%) were in the emergency department and 52 (42.97%) were outside the hospital. Fifty (61.72%) of the women were arrested in the emergency department and 31 (32.27%) were arrested outside the hospital. The average age of men was 70 and the average age of women was 80. In the group with non-hospital arrest, there was a significant difference between base minus, lactate and pH values in arterial blood gas compared to the group with in-hospital arrest. Conclusion: Cardiopulmonary arrest is a very important health problem that is common in emergency departments and has a high rate of mortality. The society should be made aware of early diagnosis, timely and correct intervention, and rapid transfer of arrested cases outside the hospital. Advanced age, concomitant comorbid diseases, and prolonged CPR times are directly associated with mortality. [ABSTRACT FROM AUTHOR]

Objectives: In our country and all over the world, the overcrowding of Emergency Service is seen as a problem. Our goal in this study is to determine Family Practice awareness of patients who applies to Emergency Service with green triage code and to find out reasons for using Emergency Service instead of Family Practice. Materials and Methods: This study was performed in a training and research hospital emergency department for one month of the period. After patients, who applied to Emergency Service, were evaluated in Triage Department, the patients with Green Triage Code were assessed by a physician. Patients without acute emergency pathology were informed about the study, and informed consent was taken. It was provided to patients to answer the questionnaire. One thousand twenty-six patients were taken to the study and divided into two groups as emergencies and non-emergencies. Results: There were 305 patients in the emergency group, and there were 721 patients in non-emergency group. There was no significant difference between an emergency and non-emergency group according to gender, age, education, and the number of emergency applications. The most frequent application was from the younger group of 18-29 age range in both groups. With the increase in the patient age, the number of applications to the Emergency Department due to emergency and non-emergency reasons decreased. 57.30% of the patients who applied to the Emergency Department for non-emergency reasons know who the Family Physician is; 42.70% stated that they did not know who the Family Physician was. 52,10% of the patients who applied to the Emergency Department for non-emergency reasons stated that they knew the location of the health center where the Family Physician worked, and 47.90% of them stated that they did not know the location of the health center where the Family Physician worked. Conclusion: It can be provided to reduce the density of Emergency Service by creating Family Practice awareness. Application difficulties in Family Practice lead patients to apply to Emergency Service more. We believe that to ease application to Family Practice could reduce redundant applications to Emergency Service. [ABSTRACT FROM AUTHOR]

We present preliminary statistics on the precipitable water vapor (PWV) content over the Karakaya Hills in Erzurum city, where the largest optical and near-infrared astronomical telescope in Turkey will be operated. Since the observatory will observe in the near-infrared (NIR), it is intended to perform PWV measurements of the atmosphere above the site by using signal delays in Global Positioning System (GPS) communication. The analysis of the GPS data recorded on the summit for almost one year shows that the atmosphere over the site of the observatory, which has an altitude of 3170 m, has favorable conditions for NIR observations. From GPS measurements, we report that the site had an average PWV of 3.2 mm and a median PWV of 2.7 mm between October 6, 2016, and June 15, 2017. We also present the time dependency of the PWV content and the correlations between the amount of PWV and the other meteorological records gathered from radiosonde flights and ground-based measurements. [ABSTRACT FROM AUTHOR]

Aim: Familial Mediterranean Fever (FMF) is the most frequent and historically the oldest autosomal recessive autoinflammatory disorder. No pathogen or auto-antibody has been shown to be associated with FMF. The disorder manifests with bouts of fever and abdominal pain, which are called "attacks". In the present study, we aimed to find the most frequent mutations in the MEFV gene in the Turkish population. Methods: Thousand eight hundred and forty patients with an initial diagnosis of FMF were enrolled in the study. DNA was extracted from the peripheral blood according to the kit protocol. Twenty-two target sequences of the MEFV gene were amplified with polimeraze chain reaction and sequenced with the pyrosequencing method. Results: When the patients were divided into two groups according to age, the mean age of 866 patients was 8.5±7.5 years in <18 age group, and that of 974 patients was 35.4±12.5 years in ≥18 age group. No mutations associated with FMF were found in 547 of patients in <18 age and 479 of the patients in ≥18 age groups. Conclusion: In the present study, we evaluated the frequency of 22 mutations in MEFV in 1840 patients, who had been admitted to the medical genetics division between the years 2014 and 2016 with an initial diagnosis of FMF. Analysis of our findings showed that our data are in agreement with previous publications concerning Turkish population. [ABSTRACT FROM AUTHOR]

We sought to examine the diagnostic accuracy of tissue Doppler imaging (TDI) for the localization of the accessory pathways (APs) in Wolff-Parkinson-White (WPW) syndrome. Material and Methods: We prospectively studied 35 patients with evidence of pre-excitation on electrocardiography. Patients were categorized into three groups according to the site of the AP: left ventricular free wall; septal; and right ventricular free wall. The recordings obtained using TDI from the lateral mitral annulus, septal annulus, and lateral tricuspid annulus were respectively compared with the electrophysiological study (EPS) results for the location of the AP. Electromechanical interval (p-Sm) was defined as the time difference between the onset of the p wave and the onset of regional myocardial contraction (Sm) on echocardiography. Results: In patients with left free access in EPS, electromechanical interval (pre-p-Sm) in the lateral mitral annulus was significantly shorter in the other two regions (septal annulus, and lateral tricuspid annulus) in TDI before treatment (p=0.0001). In patients with septal AP and right free AP detected at EPS, the pre-p-Sm interval was shorter, respectively, at the septal annulus and lateral tricuspid annulus, but was not statistically significant, due to the small numbers of patients in both regions. Conclusion: The p-Sm interval in TDI before the ablation procedure, specifically in patients having a left free AP, was found to be short due to early stimulus. This was especially detected without using a free electrocardiogram (ECG) algorithm. The prediction of AP in TDI may play an important role in planning and performing the radiofrequency catheter ablation (RFCA). [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the procedural, 30-day, and one-year follow-up Valve Academic Research Consortium-2 (VARC-2) defined outcomes using either the LOTUS valve or the conventional the SAPIEN XT valve. Material and Methods: 50 patients (25 with LOTUS and 25 with SAPIEN XT) with severe symptomatic aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) were included in this study. We evaluated the procedural outcomes, early safety, and clinical efficacy endpoints of patients who were treated with the LOTUS or the SAPIEN XT valve delivered via the transfemoral route. Results: Accordingly, the Valve Academic Research Consortium-2-defined safety endpoints within 30 days and combined efficacy endpoints at one-year follow-up were the same in both groups (p=0.569, p=0.529, respectively). The need for permanent pacemaker implantation in the LOTUS group was higher than in the SAPIEN XT group at 30 days (20% vs. 8%, p=0.221, respectively) and at one-year (24.0% vs. 16%, p=0.480, respectively). Echocardiography upon discharge demonstrated that trivial or mild paravalvular leakage in SAPIEN XT patients was significantly higher than in LOTUS patients (52% vs. 24%, p=0.041, respectively). Moderate or severe paravalvular leakage was observed in only one patient in a SAPIEN group. Conclusion: 30 days and one-year follow-up results according to Valve Academic Research Consortium-2 were similar in both groups. The permanent pacemaker rate was higher in LOTUS group despite an insignificant difference between the groups. LOTUS was associated significantly lower rate of trivial or mild paravalvular leakage compared with the SAPIEN XT. TAVI with LOTUS valve was associated with no moderate or severe paravalvular leakage and a low rate of mild paravalvular leakage. [ABSTRACT FROM AUTHOR]

We assessed the prognostic value of the platelet to lymphocyte ratio (PLR) in primary percutaneous coronary intervention (pPCI). Patients (n = 440) with acute myocardial infarction (AMI) who underwent pPCI were divided into 2 groups: low PLR (<137) and high PLR (>137). “Thrombolysis In Myocardial Infarction” (TIMI) flow grades and Syntax scores (SXS) were calculated from initial angiograms. In-hospital mortality rate and cardiac adverse events were obtained from medical records. Patients with high PLR had more no-reflow, higher SXS and higher mortality rate (p < 0.001,p < 0.001 andp = 0.008, respectively). In receiver operating characteristic curve analysis, high PLR predicted development of no-reflow (specificity 71% and sensitivity 85%), SXS>22 (specificity 52% and sensitivity 61%) and adverse events (specificity 67% and sensitivity 63%). In multivariate regression analysis, PLR was an independent risk factor for no-reflow, SXS>22 and in-hospital adverse events. In addition to PLR, we present the relationship between mean platelet volume, red cell distribution width and neutrophil to lymphocyte ratio and no-reflow, SXS and in-hospital adverse events. [ABSTRACT FROM PUBLISHER]

Objective: In the pathophysiology of rheumatic heart valve disease, chronic systemic inflammatory process plays an important role. In this study, we aimed to investigate whether the percutaneous transluminal mitral balloon valvuloplasty (PTMV) has any effect on the chronic systemic inflammatory response in patients with rheumatic mitral stenosis (RMS). Methods: In this study, we used neutrophil to lymphocyte ratio (NLR), which is a simply available and inexpensive biomarker of systemic inflammatory response, to evaluate the level of inflammation. A total of 41 consecutive patients with severe RMS undergoing successful PTMV were included in the study. Laboratory assessments of all patients by the measuring of NLR before and after the PTMV procedure were performed. Results: Before and after the PTMV, the mean lymphocyte counts were found 2.1±0.6 x103 /μL and 1.9±0.6 x103 / μL (p=0.01), and the mean leukocyte counts were 4.8±1.4 x103 /μL and 4.4±1.3 x103 /μL (p=0.069) respectively. NLR values were determined as 2.7 ± 1.0 and 2.2 ± 0.8. After the PTMV, there was a significant decrease in NLR in patients with rheumatic mitral stenosis patients (p=0.001). In the correlation analysis, there was significant negative correlation between the mitral valve area and NLR (p= 0.004- r=0.440), and there was significant positive correlation between left atrial diameter and NLR (p=0.028 r=0.344). Conclusion: This study showed significant decrease in NLR after PTMV in patients with RMS, which means reduced inflammation after PTMV. Larger studies are needed to confirm the results. [ABSTRACT FROM AUTHOR]