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Background and Objectives: Vancomisin-resistant Enterococci (VRE), is a resistant microorganism that colonizes and causes infections in hospitalized patients. The aim of this study was to show the spread of vancomycin-resistant Enterococcus faecium (VREfm) step-by-step in all intensive care units, which started with the growth of VREfm on 2 December 2021 in the blood culture of a patient hospitalized in the anesthesia intensive care unit of our hospital and was found to have reached epidemic size in the surveys. Materials and Methods: Rectal swab samples were taken from all patients hospitalized in intensive care units, VRE colonization was determined, the VanA and VanB resistance genes associated with the vancomycin resistance of VREfm isolates were determined by PCR method, and clonal association analysis was performed by Arbitrarily Primed-PCR (AP-PCR) and PFGE (pulsed-field gel electrophoresis). Results: In our study, VRE were detected in 61 of 2601 rectal swab samples. In total, fifty-four (85.52%) of the VRE isolates were Enterococcus faecium, three (4.91%) was Enterococcus faecalis, three (4.91%) was Enterococcus gallinorum, and one (1.63%) was Enterococcus casseliflavus. It was determined that all of the 54 VREfm isolates, which were the most detected among all VRE isolates, carried the vanA gene. In the clonal association analysis of the isolates by AP-PCR and PFGE methods, it was found that they had 12 different genotypes, 48 of them were included in any cluster, the clustering rate was 88.8%, and the largest cluster was the genotype 1 cluster, with 36 isolates. Of the 54 patients with VREfm isolated recently, 18.51 percent of the clinical samples were isolated before the survey, and 9.25% were isolated after the survey. It was determined that 100% of VREfm isolates were resistant to ampicillin, levofloxacin, ciprofloxacin, high-level gentamicin, trimethoprimsulfamethoxazole, and teicoplanin, 7.4% to tigecycline, and 1.85% to linezolid. Conclusions: In our study, in the clonal association analysis performed by isolating VREfm in rectal swab samples, it was found that 88.8% of the samples were indistinguishably similar, and that the increase in the number of VREfm infections after the index case in our hospital was associated with the epidemic. VREfm infections cause long-term hospitalization, costs and also deaths, which shows the seriousness of the event, and the importance of the combination of epidemiological and molecular analysis in epidemic research.

Background and Objectives: Similar to diabetes, the presence of left ventricular (LV) diastolic function (DD) has been reported in various studies which were conducted with people with a diagnosis of an impaired fasting blood glucose (FBG). This study aimed to examine the effects of the fasting blood glucose (FBG) levels on the left atrial strain (LAS) estimated by two-dimensional echocardiography speckle tracking analyses in patients without known diabetes. Material and Methods: The study included 148 participants (74 female and 74 male) without a history of diabetes mellitus or chronic disease. The patients were divided into two groups as follows: individuals with an FBG < 100 mg/dL and those with an FBG between 100 and 125 mg/dL after at least 8 h of overnight fasting. According to these FBG levels, speckle tracking echocardiography (STE) measures were compared. Results: There was a significant decrease in the LA reservoir (52.3 ± 15 vs. 44.5 ± 10.7; p = 0.001) and conduit strain (36.9 ± 11.7 vs. 28.4 ± 9.7; p = 0.001) in the impaired FBG group. When the STE findings of both ventricles were compared, no significant difference was observed between the groups in right and left ventricular strain imaging. Conclusions: In the earliest stage of LVDD, changes in atrial functional parameters become particularly evident. Echocardiographic analyses of these parameters can help to diagnose and determine the degree of LVDD while the morphological parameters are still normal. The addition of LAS imaging to routine transthoracic echocardiography (TTE) studies in patients with an impaired FBG but without a DM diagnosis may be helpful in demonstrating subclinical LVDD or identifying patients at risk for LVDD in this patient group.

Objective: Here, we compared the impact of different polices on the epidemiology of Vancomycin-resistant Enterococcus faecium bloodstream infections (VRE-BSIs) in a tertiary care hospital including two hospital buildings (oncology and adult hospitals) in the same campus. Material and Methods: All patients who were hospitalized in high-risk units were screened weekly for VRE colonization via rectal swab between January 2006 and January 2013. After January 2013, VRE screening was only performed in cases of suspicion of VRE outbreak and during point prevalence studies to evaluate the epidemiology of VRE colonization. Contact precautions were in place for all VRE-positive patients. The incidence density rates of hospital-acquired (HA)-VRE-BSIs were compared between two periods. Results: While the rate of VRE colonization was higher in the second period (5% vs. 9.5% (p < 0.01) for the adult hospital, and 6.4% vs. 12% (p = 0.02 for the oncology hospital), there was no increase in the incidence rate HA-VRE BSIs after the cessation of routine rectal screening in either of the hospitals. Conclusion: Screening policies should be dynamic and individualized according to the epidemiology of VRE as well as the workforce and cost. Periodical rectal screening of VRE can be discontinued if suspicion of an outbreak can be carefully monitored.

Objective(s): Oral colonization of Acinetobacter baumannii can lead to infections such as pneumonia and sepsis. We aimed to evaluate oral colonization of hospitalized patients in ICUs and to examine risk factors for oral colonization, molecular epidemiology, and incidence of pneumonia and sepsis. Materials and Methods: The study began in February 2021. Oral cultures were taken. The microorganisms were identified by a Maldi-tof MS mass spectrometry device. Colistin resistance genes were investigated by polymerase chain reaction. Clonal relationships were determined by pulsed-field gel electrophoresis. Results: A. baumannii was found in 21 of 96 patients’ oral cultures. Pneumonia and sepsis due to A. baumannii were detected in 14 and 5 patients, respectively. The mean growth time of A. baumannii from oral cultures was 11.8 days, and the meantime for the occurrence of pneumonia after oral growth was 5.2 days. We determined a plasmid mediated mcr-2 colistin resistance gene in a colistin susceptible A. baumannii strain. It is the first report of the plasmid mediated mcr-2 colistin resistance gene in our country. In total, fourteen different A. baumannii genotypes were determined in PFGE. It was determined that the effects of antibiotic use, oral motor dysfunction, mechanical ventilation, intubation, orogastric tube use, and total parenteral nutrition intake on oral colonization were statistically significant.Conclusion: Oral colonization of A. baumannii is a significant concern in ICUs. We believe that it is important to take oral cultures and follow the risk factors and take infection control measures to prevent oral colonization of resistant isolates in ICUs.

Abstract Background The purpose of the present study was to comprehensively examine the measurement aspects, the prevalence, and the psychological correlates of problem shopping among a large-scale national sample of Turkish adults. Result Participants (N = 24,380, 50% men, M age = 31.79 years, age range = 18–81 years) completed a questionnaire that comprised the Shopping Addiction Risk Questionnaire, the Brief Symptom Inventory, the Positive and Negative Affect Schedule, and the Experiences in Close Relationships-Revised. Results showed that 1.8% of the participants had probable shopping addiction. Being female, being younger, psychiatric distress, positive affect, negative affect, anxious attachment, and avoidant attachment were positive correlates of problem shopping. Conclusion The results of this large sample size study suggest that shopping addiction is not a rare condition in Turkey. Further research is needed to understand different motives that underlie the problematic shopping behavior in the young and female population in comparison to older and male populations. Preventive programs or any interventions for people with PSB needs to address regulation difficulties and development of healthy strategies to cope with psychiatric distress.

Induction heating (IH) technology is very popular in domestic applications because of its efficiency and safe operating properties. Resonant inverter circuits are widely used in IH systems owing to their high efficiency and soft-switching capability. Among the resonant inverters used in IH systems, the single-switch quasi-resonant inverter topology is generally preferred for low-cost and low-output-power applications. Despite the low-cost advantage of the quasi-resonant inverter, the soft-switching range is quite narrow, and it is not stable depending on the electrical parameters of the load that is desired to be heated. In other words, there is a critical relationship between the electrical characteristics of the pan, turn-on, and turn-off times, which are the control parameters of the semiconductor switch, and the safe working conditions. In addition, when the importance of closed-loop control methods is evaluated together with the selection of resonant circuit elements, it is essential to determine whether the load is suitable for heating, and to determine the electrical properties of the load to provide both reliable and efficient operating conditions. This study focuses on a new load-detection method based on circuit analysis for quasi-resonant induction hobs. After determining the load parameters, the turn-on and turn-off times of the semiconductor switch were determined to obtain the lowest possible switching loss. Therefore, the boundary conditions of the semiconductor switch are maintained within these limits. The proposed method and its advantages for the switch safe operating area were theoretically examined and proved through simulations and prototype circuits.

Introduction: The transmission rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by blood transfusion is thought to be low; however, it has not yet been proven whether the virus is transmitted by blood transfusion. Published studies have reported that SARS-CoV-2 RNA has been detected in the blood, plasma, or serum of infected individuals. This study aimed to investigate the presence of SARS-CoV-2 RNA in the serum of blood donors and evaluate the risk of transmission of SARS-CoV-2 by transfusion. Materials and Methods: In this study, 200 blood samples were taken from volunteer blood donors. In all serum samples, SARS-CoV-2 RNA was detected by reverse-transcription quantitative polymerase chain reaction assay. Medical records of the donors and recipients were retrospectively reviewed. Results: SARS-CoV-2 RNA was detected in seven (3.5%) of the donor serum samples. None of the positive donors had symptoms of coronavirus disease 2019 (COVID-19), and none had been admitted to the hospital after donation. Seven SARS-CoV-2 RNA-positive donor blood components were given to 12 recipients. No medical records indicated that COVID-19 occurred after the transfusion of blood components for recipients. Conclusion: This study demonstrated the presence of SARS-CoV-2 RNA in the serum of asymptomatic donors. Although our data suggest that the transfusion of blood products from asymptomatic donors to recipients with SARS-CoV-2 RNA in their serum may not result in COVID-19, further studies are needed to prove that SARS-CoV-2 is not transmitted by blood transfusion.

Introduction: Interest in fosfomycin, an old antibiotic, has been reignited because of the use of its intravenous formulation (fosfomycin sodium) in resistant infections. The aim of this study was to screen for carbapenem resistance in Enterobacterales isolates from the bloodstream, and determine the frequency of carbapenamases types and fosfomycin resistance genes in carbapenem-resistant Enterobacterales (CRE) strains. Materials and Methods: Enterobacterales isolates from the bloodstream of liver transplant patients aged 18 years and older were screened for carbapenem resistance between 2017 and 2019. In isolates that were resistant to at least one carbapenem antibiotic were further screened for fosfomycin susceptibility. Carbapenem susceptibility was tested for by the E-test, fosfomycin susceptibility was tested for by the agar dilution methods, and evaluated in accordance with European Committee on Antimicrobial Susceptibility Testing criteria. The frequency of OXA-48, NDM, KPC, VIM, and IMP type carbapenemases and fosA, fosA3, and fosC2 fosfomycin resistance genes were screened for using the polymerase chain reaction method. Results: A total of 115 Enterobacterales isolates from bloodstream infections were obtained. Carbapenem resistance was detected in 34 (29.3%) isolates, 41.2% of them were Escherichia coli and 58.8% of them were Klebsiella pneumoniae. Out of the 34 isolates, 61.8% produced carbapenemases, and OXA-48 was the most common type of carbapenemase. The fosfomycin resistance rate was 73.5%. Among the 34 carbapenem-resistant isolates, the frequency of the fosA gene was 5.9%. The genes fosA3 and fosC2 were not detected in any isolates. FosA + OXA-48 and fosA + NDM genes were detected in CRE isolates. Conclusion: This is the first study reporting on the screening for fosfomycin resistance genes in blood isolates of liver transplant patients in Turkey. Despite high fosfomycin resistance, detection of only two resistance genes reveals that there may be fosfomycin resistance due to other resistance mechanisms.

Mobility as a Service (MaaS) aims to offer travelers easy and convenient access to transportation modes via a joint digital channel, often in a mobile application. MaaS has the potential to fundamentally change the way we commute as it encourages a more sustainable travel behavior. MaaS, as a business model, is an innovative concept that integrates a variety of these solutions and can significantly change the mobility environment by encouraging sustainable travel behavior. Despite the existing initiatives and efforts toward MaaS solutions, there is still no consensus on the essential features of MaaS platforms for actors from the supply and demand sides. This study explores the critical features of MaaS platforms from the perspective of mobility service providers - MSP (i.e., supply-side) and travelers (i.e., demand-side). We collected data via interviews with mobility experts for the supply side and a survey for the users' side. Based on a Gaussian Graphical Model, our results show that optimizing the number and use of the vehicles and appropriate data handling are the essential features of a MaaS platform for the MSPs. For the travelers, although retrieval of personal information and enhancing services, such as suggestions on local events and concert tickets, are expected, they are considered less significant. Our study provides insights into the features of MaaS platforms through synthesized and prioritized features -including their relationships-which would be helpful both for research and practice.

Amaç: Obezite Farkındalığı ve İçgörü Ölçeğinin (OFİ Ölçeği) (OASIS: The Obesity Awareness and Insight Scale) Türkçeye ve Türk kültürüne uyarlanarak geçerlilik ve güvenirlik çalışmalarının yapılmasıdır. Gereç ve yöntem: Metodolojik tipteki bu araştırma bir eğitim ve araştırma hastanesinin endokrinoloji ve metabolizma hastalıkları polikliniğine ile bir eğitim aile sağlığı merkezinde yürütülmüştür. Araştırma örneklemini bu birimlere başvuruda bulunan165 fazla kilolu/obez birey oluşturmuştur. Veriler Görüşme Formu ve “Obezite Farkındalığı ve İçgörü Ölçeği (OFİ)” ile toplanmıştır. Ölçeğin geçerlilik analizleri “Kapsam Geçerlilik İndeksi, Açımlayıcı Faktör Analizi” ile, güvenilirlik analizleri “değişmezlik, iç tutarlılık ve madde toplam puan korelasyonu” ile yapılmıştır. Bulgular: Bireylerin yaş ortalaması 50,27±16,58 olup, %63,6’sı kadındır. Geçerlilik analizlerinde KMO=0,89, χ2 =468,137; p=0,000’dır. OFİ güçlü iç tutarlılık (Cronbach alpha 0,86), test tekrar test güvenirliği (0,79) göstermiştir. Madde toplam korelasyonu değerleri 0,428-0,746 arasında değişmektedir. Açımlayıcı faktör analizine göre ölçek tek boyutludur. OFİ toplam puan ortalaması 6,87±2,48 olup, bireylerin obezite farkındalıklarının ortanın üstünde olduğu belirlenmiştir. Sonuç: Obezite Farkındalığı ve İçgörü Ölçeği, fazla kilolu/ obez bireylerin obezite farkındalıklarını belirlemek amacıyla kullanılabilecek geçerli ve güvenilir bir ölçme aracıdır.

Bu çalışma, içerisinde bulunduğumuz Covid-19 salgınının beraberinde getirdiği krizin nasıl yönetilmesi gerektiği ve bu çerçevede nasıl bir kriz yönetimi mekanizması oluşturulmalı sorularına yanıt aramaktadır. Amaç, Covid-19 krizinin kriz yönetiminde yaşattığı koordinasyon eksikliğini gözler önüne sererek etkisiz kriz yönetim mekanizmalarının nasıl etkin hale getirebileceğine ilişkin öneriler geliştirebilmektir. Bu sebeple bu çalışma kapsamında sekiz farklı ülke örneği, Covid-19 kriziyle mücadele politikası bağlamında karşılaştırmalı analize tabi tutulmuştur. Elde edilen bilgiler ışığında, Türkiye özelinde Covid-19 krizi ve sonrasındaki muhtemel krizlere dönük olarak daha hızlı, daha esnek ve daha güçlü kararlar alabilme potansiyeline sahip bir kriz yönetimi ofisinin kurulması önerilmektedir. Bu ofisin nasıl şekilleneceği, yapısal-işlevsel özelliklerinin neler olması gerektiği, devlet kapasitesinin hangi yönlerini geliştirmesi gerektiği ve gelecekteki krizlerle nasıl başa çıkacağının köşe taşlarının reform yaklaşımı ile karşılaştırmalı kamu politikası perspektifinden gerçekleştirilecek analizlerle belirlenmesi bu çalışmanın yöntemini oluşturmaktadır.

Amaç: Bu çalışmada amacımız yargının son aşaması olan Yargıtay’a taşınan ortopedi ve travmatoloji alanında tıbbi uygulama hataları ile ilgili kararları incelemek ve bu alanda aydınlatıcı bulgular ortaya konularak literatüre katkı sağlamaktır. Gereç ve Yöntem: T.C. Yargıtay Başkanlığı resmi internet sitesi ile Kazancı veri bankası üzerinden “ortopedi” ve “ortopedi ve travmatoloji” anahtar kelimeleri kullanılarak ulaştığımız Yargıtay temyiz kararlarından, Ocak 2013 y ile Haziran 2020 yılları arasındaki ortopedi ve travmatoloji alanındaki tıbbi uygulama hatası ile ilgili olan 55 karar çalışma kapsamına alınmıştır. Veriler ceza ve hukuk tazminat davaları olarak sınıflandırıldı ve içerik analizleri yapıldı. Bulgular: Kararların 37’si %67,3 ceza davası, 18‘i %32,7 hukuk tazminat davasıydı. Hasta ve hasta yakınlarının yargı mercilerine başvurma gerekçelerinde 22 olgu %40 ile ilk sırada tedavi eksikliği/hatası, ikinci sırada 15 olgu % 27,3 ile ilgisizlik/özensizlik iddiaları vardı. 28 olguda % 50,9 organ fonksiyon azalması ya da kaybının geliştiği, 16 olguda %29,1 ölüm meydana geldiği tespit edilmiştir. Olguların 39’unun %70,9 travma alanında olduğu, bunu omurga ve artroplasti hastalarının takip ettiği, travma olgularının 22’sinin %56,4 yüksek enerjili travma olduğu tespit edilmiştir. Yargıtay ilgili dairesinin 55 davanın 32’sinde %58,2 yerel mahkeme kararını bozma, 21’inde %38,2 kararı onama kararı . 2’inde %3,6 ise görevsizlik kararı alındığı tespit edildi. Bu 32 davanın 23’ünde %71,8 karar bozma gerekçesi olarak bilirkişi raporunun eksik, yetersiz veya çelişkili olduğu tespit edilmiştir. Yargıtay ilgili dairesinin bozma kararı aldığı yerel mahkeme kararlarından hukuk tazminat davası olanların anlamlı p

Abstract The main purpose of this study is to identify suitable potential areas for agricultural activities in the semi-arid terrestrial ecosystem in the Central Anatolia Region. MCDA was performed in fuzzy environment integrated with GIS techniques and different geostatistical interpolation models, which was chosen as the basis for the present study. A total of nine criteria were used, as four terrain properties and five soil features to identify potential sites suitable for agriculture lands in Central Anatolia which covers approximately 195,012.7 km2. In order to assign weighting value for each criterion, FAHP approach was used to make sufficiently sensitive levels of importance of the criteria. DEM with 10 m pixel resolution used to determine the height and slope characteristics, digital geology and soil maps, CORINE land use/land cover, long-term meteorological data, and 4517 soil samples taken from the study area were used. It was identified that approximately 30.7% of the total area (59,921.8 ha) is very suitable and suitable for potential agriculture activities on S1 and S2 levels, 42.7% of the area is not suitable for agricultural uses, and only 27% of the area is marginally suitable for agricultural activities. Besides, it was identified that 34.8% of the area is slightly suitable.

The COVID-19 restrictions have impacted people’s lifestyles in all spheres (social, psychological, political, economic, and others). This study explored which factors affected the level of anxiety during the time of the first wave of COVID-19 and subsequent quarantine in a substantial proportion of 23 countries, included in this study. The data was collected from May to August 2020 (5 June 2020). The sample included 15,375 participants from 23 countries: (seven from Europe: Belarus, Bulgaria, Croatia, Hungary, Italy, Romania, Russia; 11 from West, South and Southeast Asia: Armenia, India, Indonesia, Iran, Iraq, Jordan, Malaysia, Pakistan, Saudi Arabia, Thailand, Turkey; two African: Nigeria and Tanzania; and three from North, South, and Central America: Brazil, Canada, United States). Level of anxiety was measured by means of the 7-item Generalized Anxiety Disorder Scale (GAD-7) and the 20-item first part of The State-Trait Anxiety Inventory (STAI)—State Anxiety Inventory (SAI). Respondents were also asked about their personal experiences with COVID-19, attitudes toward measures introduced by governments, changes in attitudes toward migrants during a pandemic, family income, isolation conditions, etc. The factor analysis revealed that four factors explained 45.08% of variance in increase of anxiety, and these components were interpreted as follows: (1) personal awareness of the threat of COVID-19, (2) personal reaction toward officially undertaken measures and attitudes to foreigners, (3) personal trust in official sources, (4) personal experience with COVID-19. Three out of four factors demonstrated strong associations with both scales of anxiety: high level of anxiety was significantly correlated with high level of personal awareness of the threat of COVID-19, low level of personal reaction toward officially undertaken measures and attitudes to foreigners, and high level of presence of personal experience with COVID-19. Our study revealed significant main effects of sex, country, and all four factors on the level of anxiety. It was demonstrated that countries with higher levels of anxiety assessed the real danger of a pandemic as higher, and had more personal experience with COVID-19. Respondents who trusted the government demonstrated lower levels of anxiety. Finally, foreigners were perceived as the cause of epidemic spread.

Introduction: The biofilm formation ability plays an important role in the pathogenesis of Staphylococcus aureus infections. This study aimed to investigate the biofilm production ability of methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) isolates and evaluate the relationship between their antimicrobial resistance profile and biofilm formation ability. Materials and Methods: A total of 50 MRSA and 50 MSSA isolates were examined. The antimicrobial susceptibility testing of isolates was performed using the disk diffusion method. The broth microdilution method was used to determine the minimum inhibitor concentrations (MICs) of vancomycin and teicoplanin. The biofilm formation ability of isolates was tested on Congo Red Agar. The presence of icaA, icaD, IS256, and eno genes was investigated by polymerase chain reaction. Results: Both MRSA and MSSA isolates were found susceptible to vancomycin, teicoplanin, chloramphenicol, and linezolid. Two MRSA and 2 MSSA isolates were determined as heterogeneous vancomycin-intermediate S. aureus. No significant difference was observed between the biofilm formation ability of MRSA and MSSA isolates. The eno and icaD genes were detected in 100% of both MSSA and MRSA isolates. The icaA gen was detected in all MRSA and 49 MSSA isolates. The IS256 was detected in 35 of the 50 MRSA isolates. None of the MSSA isolates were positive for the IS256. The amikacin, gentamicin, ciprofloxacin, levofloxacin, rifampin, clindamycin, and tetracycline resistance rates in IS256- positive MRSA isolates were significantly higher than those IS256-negative MRSA isolates. The mean MIC values of vancomycin and teicoplanin in IS256-positive MRSA isolates were significantly higher than those in IS256-negative MRSA isolates. Conclusion: This study revealed that the presence of the IS256 sequence was correlated with antimicrobial resistance, especially MRSA isolates.

This study aimed to investigate the effect of science teaching, based on the Common Knowledge Construction Model (CKCM), on cognitive and psychomotor learning in 7th-grade students. The study group consisted of 29 students from two public schools affiliated with the Ministry of National Education in the 2018-2019 academic year. The study was carried out following a semi-experimental pre-test post-test control group research design. The data were collected with a “Scientific Inquiry Skills Test,” and a “Psychomotor Skills Rubric” (PSR) developed by the researchers. The PSR was used to evaluate the practice exam results of both groups. Data were analyzed with a standard statistics package. It was determined that the scientific inquiry skills post-test scores of the experimental group (X=15.87) were higher than the control group (X=10.92). The difference was observed to be significant. Also, a comparison of the total post-test PSR scores showed a statistically significant difference between the experimental (X=15.44) and control groups (X=13.30).

Objective:To perform an analysis of the surgical approach choice in subaxial cervical spine (SCS) facet dislocations.Method:The inclusion criteria were as follows: radiologically confirmed traumatic SCS facet dislocation, 18-70 years of age, stable medical condition, and isolated cervical trauma. The management scheme was based on the presence of traumatic disc herniation (TDH) and the grade of dislocation according to the Allen and Ferguson classification (AFC). In the absence of TDH, the reduction was attempted via traction under general anesthesia before surgery. In the presence of TDH, the reduction was attempted after anterior discectomy. Posterior open reduction was performed in case of an unsuccessful reduction attempt. Anterior stabilization was sufficient in AFC distractive flexion stage (DFS) 2 fractures while combined stabilization was performed in DFS 3 and 4 fractures.Results:Thirty-two patients were included in the study. TDH was detected in 14 patients. The number of patients with DFS 2, 3, and 4 fractures was 6, 18, and 8, respectively. Posterior open reduction was needed in 9 patients. Anterior stabilization was performed in 6 patients (3 with TDH, 3 without TDH) and combined stabilization was performed in 26 patients (11 with TDH, 15 without TDH) via 6 anterior, 7 anterior-posterior, 15 posterior-anterior, and 4 anterior-posterior-anterior approaches. Satisfactory follow-up results were achieved in radiological and neurological evaluations, and neck pain scores.Conclusion:The treatment algorithm for subaxial facet dislocations based on DFS and TDH presence provided satisfactory results.

Stenotrophomonas maltophilia is a gram-negative bacterium. Hospitals can be a source of S. maltophilia because it adheres to nonliving surfaces and forms a biofilm. This study was performed to investigate the clonal relationship between S. maltophilia isolates obtained from kidney stone samples. Samples of kidney stones taken from patients and surrogate samples from nephroscopes, cleaning solution, disinfectant solution were included in the study. The clonal relationship between isolates was determined by PFGE. S. maltophilia was isolated from 34 of 94 kidney stone samples sent from the urology operating room between July 2017 and January 2018. A total of 26 S. maltophilia strains (21 from kidney stone samples, three from nephroscopes, and two from urine culture) were isolated. PFGE showed that the 21 kidney stone isolates and the 3 S. maltophilia isolates obtained from the nephroscope belonged to the same clone. The two urine culture isolates showed no clonal relationship to the outbreak isolates and were considered sporadic. Molecular typing confirmed that this pseudo-outbreak was attributed to inadequate disinfection of the nephroscopes. After disinfection protocols were reviewed and revised as needed, especially regarding the removal of organic material from nephroscopes after use, no further bacterial growth was detected from kidney stone specimens obtained with nephroscopes. [Med-Science 2020; 9(3.000): 589-94]

Not only do university campuses consist of a variety of social and educational buildings, they also create an integrated system with their outdoor spaces and furniture, recreation and landscape areas. Outdoors have the potential to create social interaction, rest and relaxation, recreation, exchange of ideas and a strong sense of ownership and belonging. Creating a common identity for social life by enabling people to communicate and socialize with each other is the most important function of outdoor spaces. However, although the rationality of external spaces is designed, it is possible to use other than what is expected in practice. The relationship between the external spaces and the building groups, the adequacy, the duration of use, the accessibility and the interaction of the physical environment should be examined with a holistic approach to understand the difference between expectations and reality. In order to identify user needs in outdoor spaces as a way to assess if human use and design intentions are in fact successful, post occupancy evaluation (POE) is recommended as the most significant advanced method. Unfortunately, although studies on the evaluation of indoor spaces have been increasing day by day, there is no comprehensive study of POE that can be applied to the outdoor spaces, especially in university campuses. In this study, a POE method which discusses the variables that affect the use of outdoor space and the interaction between these variables is introduced. The proposed method was applied in a suburban university campus and the results were evaluated in terms of outdoor use.

Background: Colistin and carbapenem-resistant Acinetobacter calcoaceticus- Acinetobacter baumannii complex (CCR-Acb complex) was isolated from two consecutive patients in the neurological intensive care unit (NICU). An urgent reaction to this desperate situation was required. Patients and methods: Screening cultures were taken from the other patients sharing the NICU with index patients and repeated periodically. NICU was closed for new admissions. Infection control precautions (ICP) such as hand hygiene, cohorting patients colonized with CCR-Acb complex, cohorting the staff caring for these patients, daily bathing with chlorhexidine gluconate impregnated clothes, using gowns when contacting with patients and patient care area, and sodium hypochlorite tablets for environmental cleaning were enforced. Results: Screening cultures revealed carbapenem-resistant Acb complex in 12 out of 32 patients and 8 of them were colonized with CCR-Acb complex. NICU was opened for new admissions one month later. No further new cases with CCR-Acb complex were detected by screening cultures after 6 weeks with enforcement of ICP. Moreover, the rate of nosocomial infections caused by other multi-drug resistant Gram-negative bacilli (MDR-GNB) decreased significantly when rates before and after closing the NICU were compared. Conclusion: ICP were effective not only to limit the spread of CCR-Acb complex but also decreased the incidence of other MDR-GNB infections when applied adequately. Keywords: Acinetobacter baumannii, Carbapenem resistance, Colistin resistance, Intensive care unit, ICU

Anosmi, olfaktör oluk meningiomlarının (OGM) erken belirtilerinden biridir. Ek olarak, anosminin, saptanması durumunda, operasyon sonrasında düzelmesi beklenmemektedir. Olgumuzda 42 yaşında kadın hasta, bilateral anosmi ve görme bozukluğu ile başvurmaktaydı. Radyolojik incelemelerde belirgin peritümoral ödem ile birlikte büyük bir OGM saptandı. Tümör, pterional yaklaşımla, sol olfaktör sinirinin korunmasıyla, total rezeke edildi. Postoperatif erken dönemde görme bozukluğu düzeldi. Ayrıca, 6 aylık takipte sol burundan koku duyusu alınması sağlandı. Buna göre, anosminin OGM cerrahisi sonrasında kalıcı olacağı yaygın kabul gören bir durum olsada, olfaktör sinirlerin korunması ile nadir vakalarda koku alma duyusu geri kazanılabilir.

Digit ratio (2d/4d) in humans is commonly used as a proxy for the exposure to oestrogens and androgens in prenatal life. Masculinisation/feminisation in adults may be also related to digit ratio and therefore to the oestrogen/androgen ratio in prenatal life. It has been shown, for instance, that Waist-to-Hip ratio (WHR) and the amount and distribution of body fat are related to digit ratio in women. A species-specific, sexually dimorphic morphological trait in humans is also a pair of permanent breasts that develop during puberty, under the influence of oestrogens. Here we test if prenatal exposure to oestrogens (in relation to androgens), measured by digit ratio, may also be related to breast size in young, nulliparous women. 133 Turkish students (mean age 22.2) were measured. Breast size was calculated as the difference between breast and under-breast circumferences. We found that when controlling for body mass index (BMI), both right and left digit ratios correlate positively with breast size. This relationship is stronger for the digit ratio of the right hand, which confirms that this side is a better measure of sex differences. Thus, higher exposure to oestrogens in prenatal life is related with stronger expression of a sexually dimorphic trait, such as breast size, in adult women.

Automatic flying target detection and tracking in video sequences acquired from a camera mounted on another Unmanned Aerial Vehicle (UAV) is a challenging task due to the presence of non-stationary cameras in the system, dynamic motion of the moving target, and high-cost computation for real-time applications. In this paper, our aim is to automatically detect and track moving UAV by another one while simultaneously flying in the air. In order to provide efficiently in real-time applications, we develop a vision-based low-cost hardware system integrated with an independent ground control station. We initially created a new public dataset called ATAUAV that includes different types of UAV images obtained from videos recording in our experiments and searches on Google Images for the training process. Deep learning-based YOLOv3-Tiny (You Only Look Once) is used for target detection with the highest accuracy and fastest results. Kernelized Correlation Filter (KCF) adapted with YOLO, which runs on low-cost hardware, is used for real-time detected target tracking. We compared the performance of the proposed approach with different tracking algorithms. Experimental results show that the proposed approach provides the highest accuracy rate as 82.7% and a mean fps speed as 29.6 on CPU. The dataset can be downloaded at http://cogvi.atauni.edu.tr/ResearchLab/PageDetail/Our-ATAUAVs-Dataset-86.

Objective(s): Infections due to carbapenemase-producing Klebsiella pneumoniae are associated with high morbidity and mortality. In this study, we report a hospital outbreak due to co-producing OXA-48 and NDM-1 K. pneumoniae clone. The aim of the study is to investigate the clonal relationship of strains, risk factors of outbreak and infection control measures.Materials and Methods: Once an outbreak was suspected at the end of December 2017 in our intensive care unit (ICU), carbapenem resistance K. pneumoniae identified in patients’ specimens. An outbreak analysis was begun to determine the risk factors and dissemination of the cases. A case-control study was conducted to determine the risk factors. To control the outbreak; tight contact prevention, good clean-up the medical devices and hospital environment, were done. Staff training programs such as hand hygiene, disinfection, wearing aprons, good cleaning were created. Carbapenem resistance genes determined by PCR. Clonal relationships of strains investigated by PFGE.Results: We investigate 21 carbapenem-resistant K. pneumonia strains. Nine of them were found co-produced NDM-1 and OXA-48, 11 strains produced OXA-48, and one strain produced NDM-1. Seven strains of co-producing NDM-1 and OXA-48 were found clonally related with PFGE. We could not determine any risk factor except rectal colonization in the case-control study.Conclusion: The interventions that successfully controlled this outbreak were hand hygiene, tight contact prevention, good clean-up of the hospital environment and medical devices. As a result, we believe that it would be beneficial to take infection control measures to prevent the spread of these strains to the community and hospital settings.

Introduction:Acromegaly is a rare disease caused by overproduction of growth hormone (GH) secreted from a benign pituitary adenoma. It has been shown in many studies that the incidence of cancer is increased in patients with acromegaly with increased GH and insulin-like growth factor-1 (IGF-1). Especially, colon cancer is more common. Thrombospondin-1 (TSP-1) is a glycoprotein that is thought to play an important role in cancer formation. This study aimed to evaluate circulating TSP-1 levels in patients with acromegaly.Methods:This study was a case-control study. Fifty-two patients with active acromegaly with GH

3D printing technologies enable medicine customization adapted to patients’ needs. There are several 3D printing techniques available, but majority of dosage forms and medical devices are printed using nozzle-based extrusion, laser-writing systems, and powder binder jetting. 3D printing has been demonstrated for a broad range of applications in development and targeting solid, semi-solid, and locally applied or implanted medicines. 3D-printed solid dosage forms allow the combination of one or more drugs within the same solid dosage form to improve patient compliance, facilitate deglutition, tailor the release profile, or fabricate new medicines for which no dosage form is available. Sustained-release 3D-printed implants, stents, and medical devices have been used mainly for joint replacement therapies, medical prostheses, and cardiovascular applications. Locally applied medicines, such as wound dressing, microneedles, and medicated contact lenses, have also been manufactured using 3D printing techniques. The challenge is to select the 3D printing technique most suitable for each application and the type of pharmaceutical ink that should be developed that possesses the required physicochemical and biological performance. The integration of biopharmaceuticals and nanotechnology-based drugs along with 3D printing (“nanoprinting”) brings printed personalized nanomedicines within the most innovative perspectives for the coming years. Continuous manufacturing through the use of 3D-printed microfluidic chips facilitates their translation into clinical practice.

The TD-NMR technique mostly involves the use of T1 (spin-lattice) and T2 (spin-spin) relaxation times to explain the changes occurring in food systems. However, these relaxation times are affected by many factors and might not always be the best indicators to work with in food-related TD-NMR studies. In this study, the non-conventional TD-NMR approaches of Solid Echo (SE)/Magic Sandwich Echo (MSE) and Spin Diffusion in food systems were used for the first time. Soft confectionary gelatin gels were formulated and conventional (T1) and non-conventional (SE, MSE and Spin Diffusion) TD-NMR experiments were performed. Corn syrups with different glucose/fructose compositions were used to prepare the soft candies. Hardness, °Brix (°Bx), and water activity (aw) measurements were also conducted complementary to NMR experiments. Relaxation times changed (p < 0.05) with respect to syrup type with no obvious trend. SE/MSE experiments were performed to calculate the crystallinity of the samples. Samples prepared with fructose had the lowest crystallinity values (p < 0.05). Spin Diffusion experiments were performed by using Goldman–Shen pulse sequence and the interface thickness (d) was calculated. Interface thickness values showed a wide range of variation (p < 0.05). Results showed that non-conventional NMR approaches had high potential to be utilized in food systems for quality control purposes.

Summary: To identify surgical techniques applied in case of recurrence in patients with pilonidal sinus, who have undergone primary treatment with Limberg flap, and to present our cases treated with Limberg flap reconstruction prepared from the contralateral gluteal region. Nine patients with recurrence out of 219 patients who underwent Limberg flap reconstruction between 2009 and 2016 at our clinics, and 6 patients who have been referred to our clinics with total 15 recurrence after primary Limberg flap reconstruction at other institutes were included in the study. Total excision and primary repair was applied in 3 patients while 2 patients underwent excision with lay open procedures. The remaining 10 patients underwent rhomboid excision of the recurrence area and Limberg flap repair from the contralateral gluteal area. All patients who underwent primary repair or excision-lay open procedures recurred again. These two patients also underwent contralateral Limberg flap reconstruction as their second revision surgery. There were no complications or recurrences in the study group. We believe that reconstruction with contralateral Limberg flap is an effective and feasible method in recurrent pilonidal sinus cases who have been initially treated surgically by the Limberg flap. Keywords: Pilonidal sinus, Limberg flap, Recurrence, Contralateral

INTRODUCTION[|]Diabetic nephropathy (DN) is the major cause of chronic renal failure, and proteinuria is an independent risk factor for the end stage renal disease. The random urine protein: creatinine ratio (P: C ratio) can accurately predict the amount of 24-hour urinary protein excretion. Apelin is thought to be associated with endothelial dysfunction, angiogenesis, and inflammation. This study investigated the apelin concentration and its association with the urine P: C ratio, and metabolic parameters in subjects with and without type 2 diabetes mellitus (T2D).[¤]METHODS[|]This study involved 86 subjects: 56 with newly diagnosed and untreated T2D and 30 non-diabetic controls. All subjects underwent a complete clinical examination that included anthropometric and laboratory measurements.[¤]RESULTS[|]Twenty-four males and sixty-two females participated in this study, and their mean age was 52.27+-11.34 years. There were no differences in age, thyrotropin-stimulating hormone (TSH), creatinine clearance, and apelin levels between groups. As expected, fasting plasma glucose, weight, body mass index, and HbA1C were higher in T2D subjects (p=0.001, p=0.02, p=0.03, and p=0.001, respectively). Although apelin levels were higher in the control group, the differences were not statistically significant (p=0.93). The P: C ratio levels were lower in the control group, and the differences were statistically significant (p=0.006). A Spearman correlation analysis revealed that serum apelin levels were not correlated with the urine P: C ratio.[¤]DISCUSSION AND CONCLUSION[|]Our study demonstrates that T2D is associated with decreased serum apelin levels and increased urine P: C ratios compared to those in non-diabetic subjects. This association may depend on impaired glucose homeostasis. Our results show that the serum apelin levels were not correlated with the urine protein: creatinine ratio and provide further evidence regarding the relationship between apelin and DN.[¤]

Çalışmanın amacı, Cumhuriyetin ilk yıllarında (1924 – 1925) Samsun’da spor hayatının çeşitli yönlerini ortaya koymaktır. Bu amaçla; yapılan spor faaliyetleri, faaliyetlerin gerçekleştiği mekânlar, sporu yöneten üst kurumsal yapı, idman dernekleri, kulüplerin geçim kaynakları, yapılan seyahatler, kulüpler arası karşılaşmalar ve spor kulüplerinin sosyal hayat açısından önemi üzerinde durulmuştur. Araştırma yapılırken müracaat edilen ana kaynak Haber gazetesinin nüshaları olmuştur. Cumhuriyet Hükümeti’nin spora bakışı, Türkiye Cumhuriyeti Cumhurbaşkanlığı Devlet Arşivleri Başkanlığı Cumhuriyet Arşivi’nden yararlanılarak tespit edilmiştir. Türk sporunun kurumsal üst yapısı ile ilgili bilgilere, doktora tezleri, kitaplar ve makalelerden yararlanılarak ulaşılmıştır.

Kuzey Kıbrıs Türk Cumhuriyeti’nde (KKTC) planlamanın örgütlenmesi veişleyişi Türkiye’deki planlamanın örgütlenmesi ve işleyişiyle büyük benzerliklertaşımaktadır. 1976 yılında Türkiye’deki Devlet Planlama Teşkilatı örnek alınarakulusal planlama örgütü olarak Devlet Planlama Örgütü (DPÖ) kurulmuştur. Ancak1980’lerde yükselişe geçen, neo-liberalizm olgusu ve rekabet ilkesi üzerine kurulanserbest piyasa sistemi, gerek Türkiye Cumhuriyeti gerekse KKTC’deki planlamaanlayışında önemli değişiklikler getirmiştir. Kuzey Kıbrıs’taki etkisi 2000’lerdenitibaren Avrupa Birliği katılım süreci ile belirgin olarak hissedilen bu yeni planlamaanlayışı, DPÖ’nün işlevinde önemli dönüşümlere yol açmıştır. Bu çalışmadaamaçlanan, DPÖ’nün planlama anlayışının Kıbrıs’ın kendine özgü yönetsel,ekonomik ve siyasal yapısından kaynaklanan bazı farklılıklara sahip olmasınarağmen Türkiye’deki kalkınma planlaması uygulamasının merkezinde yer alanDPT’nin yapısı, işleyişi ve dönüşümüyle büyük benzerlik taşıdığını ortaya koymaktır.