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Matbaa, azınlıklar tarafından 15. yüzyıldan itibaren Osmanlı topraklarında kullanılmaya başlansa da ilk Türk matbaasının Osmanlı Devletinde açılması 18. yüzyılın başlarında gerçekleşmiştir. Osmanlı toplumunda o döneme kadar yazma kitaplar özenle hazırlanmış ve birçok kesim tarafından büyük ilgi görmüştür. Matbaanın kullanılması ile birlikte yazma kitaptan baskı kitaba geçiş süreci, üzerinde durulması gereken bir husustur. Resmi olarak 1727 yılında açılan bu matbaanın ilk kitabı 1729 tarihinde baskıdan çıkmış ve yayın hayatına girmiştir. Yaklaşık olarak 1850 tarihine gelindiğinde artık hem matbaaların sayısında hem de baskı kitapların sayısında önemli bir artış olduğu görülür. İlk matbu kitabın basılmasından 1850’ye kadar geçen sürede basılmış olan kitapların incelenmesi bu geçiş sürecinin anlaşılabilmesinde yol gösterici olacaktır. Tıp ve sağlık konusu zaruri olarak insanların çok eski tarihlerden beri ilgilendiği bir alan olmuştur. Bu konularla ilgili matbaadan önce kitaplar hazırlandığı gibi matbaadan sonra da eserler hazırlanmıştır. Kimi zaman eğitim kurumlarında öğrencilere okutulmak üzere kimi zamanda bu alana ilgi duyanların faydalanması için matbaada kitaplar basılmıştır. Bu yayınların bir kısmı resimsiz olarak bir kısmı ise resimlerle beraber hazırlanmıştır. Çalışmamızda resimli olarak basılan tıp ve sağlık konulu ilk matbu kitaplar ele alınacaktır. Bu bağlamda yapılan araştırmalar sonucu resimli üç matbu esere ulaşılmıştır. Bu üç eserden biri anatomi üzerinedir ve bu doğrultuda eserde insan bedeni üzerine çok sayıda resim bulunmaktadır. Diğer iki eserden biri kaplıcalar hakkında bir diğeri de frengi hastalığı üzerine yazılmıştır. Bu çalışmada söz konusu eserlerin yazarı, konusu, yazıldığı tarih, sayfa sayısı, basıldığı matbaa ve resimleri hakkında bilgiler verilmiştir. Ayrıca eserlerde yer alan resimler baskı tekniği açısından, hazırlayanlar bakımından ve canlı figürü kullanımı yönünden incelenmiştir., Although the printing press started to be used by the minorities in the Ottoman lands from the 15th century onwards, the first Turkish printing house was opened in the Ottoman Empire at the beginning of the 18th century. In Ottoman society, until that time, manuscripts were carefully prepared and attracted great attention by many people. With the use of the printing press, the transition process from a manuscript to a printed book is an issue that needs to be emphasized. The first book of this printing house, which was officially opened in 1727, came out of print in 1729 and entered the publishing life. When it comes to approximately 1850, it is seen that there has been a significant increase in both the number of printing houses and the number of printed books. Examining the books published in the period from the first printed book to 1850 will guide the understanding of this transition process.The subject of medicine and health has been a field that people have been interested in since ancient times. Books on these subjects were prepared before the printing house, as well as after the printing press. Sometimes books were printed in the printing house to be taught to students in educational institutions and sometimes for the benefit of those who are interested in this field. Some of these publications have been prepared without pictures and some with pictures. In our study, the first printed books on medicine and health will be discussed. As a result of the researches carried out in this context, three printed works with pictures have been reached. One of these three works is on anatomy and in this direction, there are many pictures on the human body in the work. One of the other two works was about hot springs and the other was about syphilis. In this study, information is given about the author, subject, date of writing, number of pages, printing house and pictures of the works in question. In addition, the pictures in the works were examined in terms of printing technique, the creators and the use of living figures.

Recent discoveries and advancements of gene editing tools and artificial transcription factors as well as delivery vectors are extending the frontiers for potential applications in the gene therapy field. Gene-editing tools like CRISPR (Clustered Regularly Interspaced Palindromic Repeats)-Cas9, transcription activator-like effector nucleases (TALENs), and zinc-finger nucleases (ZFNs) are mainly used for correcting disease mutations or modifying genome for research purposes. However, artificial transcription factors (non-cutting gene-editing tools) together with transcriptional activators or repressors are mostly used for establishing synthetic gene regulatory networks that will either overexpress or repress several genes in a controlled manner. Applications of gene editing tools and artificial transcription factors in humans have been the focus of research for years, however, the required efficiency, safety, and applicability were not achieved until recently. Moreover, the number of human trials using these tools for gene therapy applications is increasing tremendously. With the recent discovery of a highly efficient protein delivery method, we can now further benefit from gene regulatory and gene editing tools in a transient fashion, which will minimize the undesired side effects and off-target modifications. In this chapter, we summarized the origins, mechanisms, and recent progress on gene regulation and gene editing tools with a focus on the recent translational applications.

Bölgelerarası sosyo-ekonomik analizlerinin yapılması ve Avrupa Birliği (AB) ile karşılaştırılabilir veriler üretilmesi amacıyla AB bölgesel sınıflandırması olan NUTS kriterlerine göre bölgeler tanımlanmıştır. Avrupa Birliği Komisyonu’nun İBBS bölgeleri için eşik nüfus büyüklükleri İBBS düzey 1 için 3.000.000-7.000.000, İBBS düzey 2 için 800.000-3.000.000 ve İBSS düzey 3 için 150.000- 800.000 arası nüfus miktarları olarak belirlenmiştir. Çalışma sahamızın odak noktasını oluşturan İstanbul ise her üç düzeyde de müstakil olarak ele alınan tek birimdir. Hem iç göç hem de hızlı kentleşmenin birlikte şekillendirdiği İstanbul’un nüfus değişimine baktığımızda ilk nüfus sayımının yapıldığı 1927 yılında toplam nüfusun 800.000 iken, 1945 yılında 1000.000, 1970 yılında 3000.000, 1990 yılında 7000.000 ve 2000 yılında 10 milyon 2014 yılında ise 14 milyon olduğu bilinmektedir. 2019 ve 2020 yıllarında ki nüfusun değişimini değerlendirdiğimizde ise; toplam nüfusun15 milyonu aştığını görmekteyiz. İstanbul, Türkiye toplam nüfusunun %18,49’unu barındırmaktadır. 2020 TÜİK verilerine göre Türkiye aritmetik nüfus yoğunluğu 109 kişi iken, İstanbul’un aritmetik nüfus yoğunluğu ise 2976 kişidir. Kentleşme ve göç denilince akla ilk gelen metropol kent İstanbul için, yapılması gereken çok çalışma ve söylenmesi gereken çok söz olmasına rağmen çalışmada kentin maruz kaldığı iç göç olgusu diğer bölgelerle karşılaştırılarak değerlendirilmiştir.

Objective: This study intends to evaluate the violence committed against the resident physicians who worked in a university hospital during the COVID-19 outbreak. Methods: This cross-sectional descriptive study was conducted between September-October 2022. The required institutional permissions and ethics committee approval in order to conduct this study were obtained. The sample size of the research was calculated as 160 persons. This research was completed with these 163 persons who accepted to participate in it. With the questionnaire form prepared by the researchers of this study, the data of the research was gathered online. The chi-square test was used to assess the statistical analysis. Results: The average age of participants is 28 (24-52). The women make up 52.1 per cent of them. While the rate of physicians who had suffered from the violence was 40.5% this figure became 49.1% during COVID-19 outbreak. 93.8% of the physicians stated that they were exposed to verbal violence. 48% of the physicians expressed that they experienced violence for the first time, which respectively occurred in the emergency service (59.3%). 60% of women and 37.2% of men was subjected to violence during COVID-19. Therefore, the violence rate against female physicians is significantly higher than the rate for males (p=0.004). Conclusion: About half of the physicians participated in this research stated that they did not suffer from any violence either before or during COVID-19 outbreak. Almost all of the acts of violence occurred during the COVID-19 outbreak was verbal violence. The necessary measurements must be taken in emergency services where the acts of violence mostly happened in order to stop these incidents. As the physicians suffered highly from the violence during the COVID-19 outbreak and they largely suppose that the legal protection lacks to protect them against perpetrators, their professional motivation and psychological resilience may be badly affected.

Yersinia enterocolitica is widely found in nature and foods including those implicated in foodborne infections. The ability of this organism to multiply at refrigeration temperatures in food products with a prolonged shelf-life renders it a potential health risk for consumers. Y. enterocolitica isolates from food were investigated for biofilm formation and siderophore production at different temperatures (12, 25 and 37 °C) using the microtiter plate and CAS agar plate methods, respectively. The isolates were also evaluated with PCR for the presence of virulence genes and rep-PCR for genetic diversity. Most of the isolates showed high capability to form biofilm at all temperatures after 24 and 48 h of incubation. The results at 12 and 25 °C (P < 0.05) as well as at 25 and 37 °C (P < 0.05) showed a statistically significant difference in quantification of biofilm formation after 24 h; however, no difference was observed between findings at 12 and 37 °C (P > 0.05). There was a significant difference at 12 and 37 °C (P < 0.05) as well as at 25 and 37 °C (P < 0.05) after 48 h of incubation; conversely, no significant difference was observed between 12 and 25 °C (P > 0.05). Strong biofilm-producing isolates at 12 °C were found to be more after 48 h than after 24 h of incubation. Siderophore production was observed in 83.3% and 100% of the isolates at 25 and 37 ºC, respectively. However, no isolate produced siderophores at 12 °C. Genes myfA, fepA, fepD, fes, hreP, tccC and ymoA were detected in 16.7%, 33.3%, 100%, 100%, 44.4%, 5.6%, and 33.3% of the isolates, respectively. The rep-PCR revealed a high level of genetic differentiation among the isolates. The results indicated that Y. enterocolitica from food may act as a potential pathogen producing biofilm and siderophore while carrying virulence-associated genes.

Anadolu Selçuklu Devleti kısa hükümranlığı süresince Anadolu’da hem imar faaliyetleri gerçekleştirmiş hem de ticaretin gelişmesi için fiziki koşulları uygun hale getirmeye uğraşmıştır. Bu kapsamda Anadolu’nun birçok yerine özellikle de ticaret güzergâhlarına belli aralıklarla kervanların güvenliği için hanlar yaptırmışlardır. Yapıldıkları dönemde aktif olarak kullanıldıkları düşünülen bu yapılar hakkında edinilen bilgiler oldukça sınırlıdır. Nitekim söz konusu hanların taç kapılarında yer alan inşa kitabeleri ait olduğu yapı hakkında en doğru bilgiyi vermesi bakımından belge hükmündedir. Bu kitabeler sadece yapı hakkında bilgi vermez aynı zamanda dönemin yaygın yazı stili, hükümdarların nasıl tanıtıldığı ve sosyal devlet açısından yapıların inşa hedeflerinin ne olduğu gibi konulara da açıklık getirmektedir. Çalışma kapsamında 17 han kısa bilgilerle tanıtılmıştır. Ayrıca taç kapılarında bulunan inşa kitabelerinin okunuşu ve Türkçeye çevrilmiş kısmı çalışmada yer almaktadır. İnşa kitabelerinin taç kapıların neresinde yer aldığı, kitabelerin şekli ve muhtevaları da çalışmada ele alınan konulardır.

Background: Identification of critically ill patient is particularly important in the emergency department (ED). The prolonged duration from hospital admission to delivering intensive care service is related to increased mortality. The aim of this study is to evaluate the effectiveness of Modified Early Warning Score (MEWS) for identifying critical patients with malignancy in ED settings. Methods: We evaluated patients with malignancy who were admitted to our ED of a tertiary university hospital in Turkey over a three-month period. We evaluated MEWS on admission as MEWS 1. After the initial treatment depending on the patients’ health status in ED, at 2 hours after admission, we evaluated MEWS again and recorded as MEWS 2. All patients were followed up for 30 days after the initial admission. Results: Mean age (SD) was 59.2 (13.5) and male/female ratio was 295/206. MEWS1 was higher than MEWS2, (MEWS1: 3.05 ± 3.31, MEWS2: 2.35 ± 3.17, P < 0.001). A total of 362 patients (72.3%) survived and 139 (27.7%) died within 30 days of initial admission. MEWS1/MEWS2 values for alive and dead patients were 1.66/0.87, and 6.67/6.21, respectively, and the difference was significant (P < 0.001). ROC analysis was performed for MEWS 1; the area under curve (AUC) for hospitalization was 0.768 (95% CI 0.729 to 0.804) and for mortality was 0.900 (95% CI 0.870 to 0.924). ROC analysis revealed a cut-off value of 2 for predicting both hospitalization and mortality in these patients. The sensitivity of the presented cut-off was 77.32% (72.1%–82.0%) for hospitalization and 76.24% (95% CI 71.5–80.5) for mortality; the specificity was 69.52 (95% CI 62.8–75.7) for hospitalization and 90.65 (95% CI 84.65–94.9) for mortality. Conclusion: We found in our study that MEWS evaluation for patients with malignancy on admission to ED is predictive of mortality in the subsequent 30 days, and it is a valuable tool for identifying the critical group. Also, AVPU scores alone can predict mortality in patients admitted to ED.

Purpose: Herein, we aimed to compare two commonly used single embryo transfer (ET) strategies, fresh and frozen-thawed euploid blastocyst transfer protocols via trophectoderm biopsy after preimplantation genetic screening (PGS) in advanced maternal aged (AMA).Study Design: This study was designed as a single-center cohort study.A total of 317 patients aged older than 37 years old who underwent single fresh or frozen-thawed day five or day 6 ET with trophectoderm biopsy examined retrospectively. PGS was performed on the embryos of 138 patients, and fresh transfers were preferred, while embryos of 179 patients were vitrified, and then frozen-thawed euploid single ET was chosen after PGS. Percentage of the euploid embryo, implantation rates, pregnancy rates, pregnancy continuity rates, clinical and biochemical abortion rates were compared.Results: Age, body mass index, infertility duration,previous ART cycles,days of stimulation, andAnti-Mullerian hormone levels did not reveal statistically significant difference between the groups. The retrieved oocyte, MII oocytes, and fertilized ovum (2PN) numbers were higher in the Frozen-thawed group. The percentage of a euploid embryo (32% vs. 34.8%) was similar between the groups. Implantation rates (46% vs. 62%), pregnancy rates (49% vs. 66%), ongoing pregnancy rates (36.7% vs. 52.6%), and live birth percentage (35.4% vs. 51.6%) were significantly higher in the frozen-thawed embryo transfer group, while the clinical and biochemical abortion rates did not reveal significant difference. Conclusion: Frozen-thawed single euploid ET provides sufficient time for comprehensive genetic evaluations and increases the rates of implantation and pregnancy rates compared to the fresh single euploid ET in AMA patients with PGS.

With a high capacity to acquire antimicrobial resistance, Staphylococcus aureus is an important pathogen causing severe infections in animals and humans. A total of 50 Staphylococcus aureus isolates from retail ground beef, chicken meat, and fish were characterized by antimicrobial resistance profiling, staphylococcal protein A gene (spa) typing, and multilocus sequence typing (MLST). The broth microdilution test results showed that all isolates were resistant to penicillin and sulphamethoxazole but had varying resistance rates to tetracycline (24%), erythromycin (4%), gentamicin (2%), ciprofloxacin (2%), trimethoprim (2%), and chloramphenicol (0%). The blaZ and sulI genes were detected in 100% of the isolates followed by grlA (94%), norA (92%), tetK (80%), chlA (60%), tetM (26%), aacA-aphD (2%), ermA (2%), fexA (0%), and dfrA (0%). Moreover, 26% of the isolates were multidrug-resistant, with five or more resistance genes. The spa typing analysis revealed 22 spa types, with t091 (16%), t1677 (8%), and t14538 (8%) being the most common, and one new spa type, t19851, was uncovered. MLST identified seven sequence types (STs), with ST7 (40%), ST15 (20%), and ST199 (13%) being the most common, and two STs (ST7435 and ST7436) were newly identified. In this study, S. aureus isolated from raw meat showed multidrug resistance and different clones associated with human infections. As a result, foods of animal origin may act as potential vehicles for transmission of multidrug-resistant S. aureus isolates, and the dissemination of potentially pathogenic clonal types, posing a health risk to humans.

Introduction Rhinocerebral mucormycosis is a rare disease, which causes serious and life-threatening fungal infections.The disease usually develops in immunocompromised individuals and usually begins by mimicking cellulite, especially in the face area, and shows a very rapid course. Case Report A 75-year-old male patient previously admitted to an external center with 3-4 days complaints of headache, numbness in the right half of his face and closure of his left eye was brought to our emergency department for further investigation.The cranial magnetic resonance imaging (MRI) revealed suspected opportunistic fungal infection or malignancy in the ethmoidal and sphenoidal sinuses.The patient was hospitalized with the diagnosis of opportunistic fungal infection after consultations to relevant clinics. Biopsy revealed polypes and mucocele like cystic tissues. The patient, followed-up and treated with rhinocerebral mucormicosis, was transferred to intensive care unit after deterioration of his general condition.After approximately 45 days of follow-up and treatment, the patient was lost due to multiple organ failure. Conclusion Rhinocerebral mucormycosis is an emergency that requires a multidisciplinary approach. Presence of one or more of the non-traumatic orbital apex syndrome findings should alert emergency physicians. In this and similar infections with high mortality rates, early diagnosis and treatment may lead to good results.

The first Turkish printing house in the Ottoman lands officially opened in the first half of the 18th century and the book began to be published as a result of the initiatives of Ibrāhīm Müteferrika and Čelebizāde Mehmed Said Efendi. The use of the printing press in Ottoman society, where manuscripts were carefully prepared and attracted great attention by many segments of society, brings to mind the question of what this transition period was like. Books printed from 1729, when the first book was published, until 1850, when printing houses and printed books became widespread, will of course be a guide in understanding the process of transition from writing book culture to print book.Geography has been a field that has attracted people's attention and books have been written since ancient times. In this context, the first books published in the field of geography and the pictures, maps and figures seen in these books will show how the visual elements were included in the first printed books. 7 works that were found to contain pictures, maps and figures were examined within the scope of the study. Information was given about the author of these books, the date they were written, the subject, the printing house, the number of pages and pictures. In addition, the visuals of the works were scrutinized in terms of technical aspects, authors and the use of living figures. When considered on the basis of numbers, the use of maps in the works is quite high compared to other paintings. It is seen that the maps were prepared in modern mapping technique. Apart from the maps, there are other figures and drawings related to geography. These figures, which clarify more technical issues, are drawings far from the picture feature. In addition to these, one of the striking visuals - seen in two works - is the pages with traditional horoscope pictures. There are human beings, animals and fantastic creatures, some of which are depicted as naked, enclosed in two hemispheres in a circular style. In one work, it is seen that the human aspect of geography is depicted. In this work, employing slaves, saluting the people of the king, hunting scenes are conveyed in visual language. Two techniques are thought to be used when preparing print pictures. One of them is lithography technique. This technique is very convenient in terms of preparing prints and even adding texts to pictures. Another way to prepare print pictures is the engraving technique. It is understood that two of the works evaluated within the scope of the study were printed in lithography technique. As can be understood from the text parts, the others are seen to be printed in the classical printing method. Although it does not seem possible to say directly with which technique the pictures were printed, it can be concluded that the paintings of the lithographed works were prepared and printed in the form of engraving, based on the printing techniques, and the paintings of the works printed in the classical printing technique with the lithography method. Although it does not seem possible to say directly with which technique the pictures were printed, based on the printing techniques, it can be concluded that the pictures of the lithographed works were prepared lithography method, the pictures of the works printed in the classical printing technique were also prepared and printed in the form of engraving. Although there is not enough information about who prepared the pictures, the names of the masters and printing house records in some of the pictures have provided a little information on this subject., Osmanlı topraklarında ilk Türk matbaası İbrahim Müteferrika ve Çelebizade Mehmed Said Efendi’nin girişimleri sonucunda 18. yüzyılın ilk yarısında resmî olarak açılmış ve kitap basımına başlanmıştır. Yazma kitapların özenle hazırlandığı ve birçok kesim tarafından büyük ilgi gördüğü Osmanlı toplumunda matbaanın kullanılması beraberinde bu geçiş sürecinin ne şekilde olduğu sorusunu akla getirmektedir. İlk kitabın yayınlandığı 1729’dan matbaaların ve baskı kitapların yaygınlaştığı 1850 tarihine kadar basılmış olan kitaplar elbette ki yazma kitap kültüründen baskı kitaba geçme sürecini anlamada yol gösterici olacaktır. Coğrafya çok eski tarihlerden beri insanların ilgisini çeken ve üzerine kitaplar yazılan bir alan olmuştur. Bu bağlamda coğrafya alanında basılmış ilk kitaplar ve bu kitaplarda görülen resim, harita ve şekiller görsel öğelerin ilk matbu kitaplarda ne şekilde yer aldığını gösterecektir. İçerisinde resim, harita ve şekillerin olduğu tespit edilen 7 eser çalışma kapsamında incelemeye alınmıştır. Bu kitapların yazarı, yazıldığı tarih, konusu, basıldığı matbaa, sayfa sayısı ve resimleri hakkında bilgiler verilmiştir. İlaveten eserlerin görselleri teknik açıdan, hazırlayanlar bakımından ve canlı figürü kullanımı yönünden mercek altına alınmıştır. Sayı bazında bakıldığında eserlerde harita kullanımı diğer resimlere oranla oldukça fazladır. Haritaların modern harita tekniğinde hazırlandığı görülmektedir. Haritaların dışında coğrafya ile alakalı başka şekil ve çizimler de bulunmaktadır. Daha çok teknik konulara açıklık getiren bu şekiller resim özelliğinden uzak çizimlerdir. Bunların yanında dikkat çeken görsellerden biri de -iki eserde görülen- geleneksel tarzda hazırlanmış burç resimlerinin olduğu sayfalardır. Dairevi tarzda iki yarım kürenin içine konumlandırılmış bazıları çıplak olarak resmedilmiş insan, hayvan ve yarı insan yarı hayvan görünümünde fantastik canlılar bulunmaktadır. Bir eserde ise coğrafyanın beşerî yönünün resmedildiği görülür. Bu eserde kölelerin çalıştırılması, kralın halkı selamlaması, av sahneleri görsel dile aktarılmıştır. Baskı resim hazırlanırken iki teknik kullanıldığı düşünülmektedir. Bunlardan biri taş baskı tekniğidir. Bu teknik baskı resim hazırlama ve hatta resimlere yazılar ekleyebilme açısından oldukça elverişlidir. Baskı resim hazırlamanın diğer yolu ise gravür tekniğidir. Çalışma kapsamında değerlendirilen eserlerden iki tanesinin taş baskı tekniğinde basıldığı anlaşılmaktadır. Diğerlerinin ise metin kısımlarından anlaşıldığı üzere klasik matbaa yönteminde basıldığı görülmektedir. Doğrudan resimlerin hangi teknikle basıldığını söylemek pek mümkün görünmese de baskı tekniklerinden yola çıkarak taş baskı eserlerin resimlerinin taş baskı yöntemi ile klasik matbaa tekniğinde basılan eserlerin resimlerinin de gravür şeklinde hazırlanıp basıldığı kanaatine varılabilir. Resimlerin kim tarafından hazırlandığı hakkında ise yeterli malumat olmasa da bazı resimlerde imzası bulunan usta isimleri ve matbaa kayıtları bu konuda az da olsa bilgi edinilmesini sağlamıştır.

Objective: Yersinia enterocolitica which is an important foodborne pathogen causing illness in humans is an extremely heterogeneous species consisting of different subtypes. It has the intrinsic resistance to β-lactam antibiotics because of the production of β-lactamases, BlaA and BlaB. Y. enterocolitica exhibits variable susceptibilities to β-lactams. Materials and Methods: The expression of the blaA and blaB genes by polymerase chain reaction, and the susceptibility to some β-lactams including penicillins and cephalosporins using the broth microdilution and disk diffusion methods were determined. A total of 18 Y. enterocolitica isolates were examined. Results: Overall, 33.3% of these isolates carried the blaA and blaB genes, all of which were recovered from chicken meat. The wide range of MIC for ampicillin (≤ 2-128 µg/mL) and ceftazidime (≤ 0.0625-2 µg/mL) was also observed. Of the Y. enterocolitica isolates, 55.6% were resistant to ampicillin (≥ 32 µg/mL) while the remaining isolates (44.4%) were susceptible to ampicillin (≤ 8 µg/mL). All isolates were susceptible to ceftazidime at the concentration tested. According to the disk diffusion test, 55.6% and 33.3% of the isolates were resistant to ticarcillin and cefoxitin, respectively. No resistance to piperacillin and ceftriaxone was found. Conclusion: The results showed that the presence of the blaA and blaB genes and intrinsic resistance against penicillins and cephalosporins were variable among Y. enterocolitica food isolates. Furthermore, the blaA and blaB genes were expressed in most of the resistant isolates to β-lactams, which may indicate the contribution of the genes to the drug resistance.

Bacillus species are common in the environment due to their spore-forming ability and nutritional versatility and cause food contamination. Bacilli play a significant role in foodborne illnesses and food spoilage. In this study, 52 Bacillus isolates from retail fish and ground beef were identified and differentiated based on 16S rRNA, gyrB, and rpoB gene sequencing. The presence of genes encoding emetic toxin (ces), hemolytic enterotoxin hemolysin BL (hbl), nonhemolytic enterotoxin (nhe) and cytotoxin K (cytK1) was assessed in all Bacillus isolates. The ability of the Bacillus isolates to produce several extracellular enzymes that contribute to pathogenicity and food spoilage was investigated. The 16S rRNA, rpoB, and gyrB gene sequence similarities of the Bacillus isolates tested were 96.1%, 83.2%, and 77.5%, respectively. The gyrB gene demonstrated a higher degree of sequence variation than the 16S rRNA and rpoB genes. The prevalence of Bacillus isolates producing at least two of the genes of the HBL and NHE complexes was 23.1% and 15.4%, respectively. Of the B. cereus isolates, 10 (41.7%) possessed two or more enterotoxin genes. None of the isolates carried the ces and cytK1 genes. All isolates were positive for the production of enzymes such as protease, lipase, gelatinase, and DNase. However, only 92.3% of the tested isolates were positive for amylase. In conclusion, our results revealed that the presence of genes involved in toxin production and enzyme production in meat-originated B. cereus and other Bacillus isolates may cause spoilage of food and pose a health risk for consumers. PRACTICAL APPLICATION: Bacillus species can be found in various foods due to their ubiquitous nature. Bacillus spp., especially B. cereus, are associated with food poisoning and other infections in humans. Toxins and many extracellular enzymes produced by Bacillus spp. are the causative agents of foodborne outbreaks, food spoilage, and low-quality food with significantly reduced edibility. This study highlights the characterization of Bacillus spp. and presence of potentially pathogenic Bacillus species in meats.

In the present paper, we introduce a new kind of Riemannian submersion such that the fibers of such submersion are generic submanifolds in the sense of Ronsse that we call generic submersion. Some examples are given for generic submersion. Necessary and sufficient conditions are found for the integrability and totally geodesicness of the distributions which are mentioned in the definition. The geometry of the fibers is investigated. New results are obtained by considering the parallelism condition of canonical structures.

Göç dinamik bir olgudur ayrıca göç veren ve göç alan ülkelerin demografik yapısını değiştiren, yeniden şekillendiren bir niteliğe sahiptir. Suriye topraklarında 2011 yılında ortaya çıkan iç savaşın etkisiyle milyonlarca insan evini, anavatanını terk ederek göç etmek zorunda kalmıştır. Türkiye bu dev göç dalgasından en çok etkilenen ülke konumundadır. Kasım 2019 itibariyle resmi rakamlar neticesinde Türkiye topraklarında yaşamakta olan üç buçuk milyonu aşkın Suriyeli sığınmacı bulunmaktadır. Türkiye bu büyük göç hareketinden; öncelikle demografik, ekonomik, politik ve sosyo-kültürel alanda etkilenmiştir. Bu çalışmada; Mersin ilinin merkez ilçelerinde, başka bir ifadeyle Mersin şehrinde yaşayan Suriyeli sığınmacıların varlıkları istatistiksel veriler ışığında analiz edilerek incelenmiştir. 2012 yılından 2018 yılına kadar olan süreçde Mersin ili dahilinde olan 4 merkez ilçede (Akdeniz, Toroslar, Mezitli, Yenişehir) Suriyeli sığınmacıların sosyo-ekonomik ve sosyo-kültürel alanda yeni düzenlemeleri gerektirdiği tespit edilmiş ve bu sürecin kentsel alanda yansımaları araştırılmıştır. Bu bağlamda çalışmada geçici koruma statüsünde yer alan Suriyelilerin Mersin kentinde istihdama katılım, eğitim ve sağlık gibi kentsel hizmetlerden faydalanma durumları incelenmiş ve coğrafi bakış açısıyla değerlendirilmelerde bulunulmuştur., Migration is a dynamic phenomenon that also encompasses the quality of changing and reshaping the demographic structure of countries that become sources of migration and those that receive migrants. The civil war that erupted on Syrian soil in 2011 forced millions of people to emigrate, leaving behind their homes and homelands. Turkey is the country most affected by this massive wave of migration. According to official statistics, more than three and a half million Syrians live on Turkish soil as of November 2019. Turkey is a partner to one of the world’s most significant migration movements, and the nation has been majorly influenced in terms of its demographic, economic, political, and sociocultural aspects. The present study analyzed the assets of Syrian asylum-seekers living in Mersin city in light of statistical data from the central districts of Mersin province, a coastal settlement located in the Mediterranean and Adana regions. The results revealed that Syrian refugees in four central districts (Akdeniz, Toroslar, Mezitli, and Yenisehir) in Mersin province required new socioeconomic and sociocultural arrangements between 2012 and 2018. The indicators of such processes in urban areas were further investigated. Urban cohesion incorporates multidimensional integration activities. The conditions of Syrians in temporary protection status in Mersin city were examined in this context and were evaluated from the geographical perspective vis-à-vis benefits, for example, their participation in urban services such as employment, education, and health.

Aim:The aim of this research is to examine the viewpoints of theprimary health care workersin Turkey regarding directing the patients to the emergency service by providing them with telephone consultancy (TC). Methods:In thiscross-sectional study,the universe of the research is composed of the primary health care workers in Turkey. The online questionnaire technique was used to obtain the data. SPSS 15.0 statistical package was used in data analysis and p< 0.05 is considered significant. Results:1083 healthcare worker participated in the study.The proposal of "I support the TC project" is a statistically significant difference in terms of profession, and it was found out that family health employees looked more positively at this project than the doctors(p=0,028). The total proportion of the health professionals supporting the project was found out to be as low as 17.4%. A statistically significant difference was determined between ages(p=0,005), gender(p=0,005), profession(p=0,000)and years of professional experience(p=0,000)with the proposal of“TC is a populist approach”.The proposal of "TC service reduces the intensity in the emergency service" in term of the profession, the statistical difference was found significant(p=0,023). Compared with family health employees; it was determined that the physicians did not think TC would reduce urgent applications. Conclusion:In Turkey, the primary healthcare workers mostly oppose the TC issue. As the professional experience increase, this rate increases much more.Giriş: Bu araştırmanın amacı, Türkiye’de aile hekimliği çalışanlarının hastalara telefon danışmanlığı (TD) hizmeti vererek acil servise yönlendirme konusundaki bakış açılarını incelemektir. Yöntem: Kesitsel tipteki bu çalışmada, araştırmanın evrenini Türkiye’de birinci basamak sağlık çalışanları oluşturmaktadır. Verilerin elde edilmesinde online anket tekniği kullanılmıştır. İstatistiksel analizde SPSS.15.0 paket programı kullanıldı ve p

We study Riemannian and semi-invariant submersions whose total man-ifolds are locally product Riemannian. The necessary and sufficient conditions for the integrability and totally geodesicness of all distributions which are introduced in the denition of the semi-invariant submersion are obtained. We also give a charac- terization theorem for the proper semi-invariant submersions with totally umbilical fibers and find some results for such submersions with parallel canonical structures. Moreover, we define first variational formula on the fibers of a semi-invariant sub-mersion and by the virtue of that we prove a new theorem which has a condition for the harmonicity of a semi-invariant submersion.Mathematics Subject Classication (2010): Primary 53C15, 53B20.Key words: Riemannian submersion, semi-invariant submersions, horizontal distribution fiber, locally product Riemannian manifold, rst variational formula.

A wide variety of foods can be contaminated with Listeria species, especially L. monocytogenes. Ready-to-eat (RTE) foods are predominantly associated with human listeriosis caused by L. monocytogenes. Therefore, this study aimed to assess the presence of Listeria species in RTE foods and to characterize L. monocytogenes isolates by means of detection of virulence markers, serotypes and genetic relatedness. Of the 300 RTE food samples, 59 (19.7%) were positive for Listeria species: L. innocua (13.3%), L. monocytogenes (5%), L. welshimerii (2.3%), L. grayi subsp. murrayi (1.3%), L. grayi (1%), L. ivanovii (1%) and L. ivanovi subsp. londoniensis (0.3%). All L. monocytogenes isolates identified were positive for the actA, iap, inlA, inlB, inlC, inlJ, plcA and prfA virulence genes and biofilm. The isolates were serotyped as 1/2c (33.3%), 4b (26.7%), 1/2a (26.7%), 1/2b (6.7%) and 3c (6.7%) by the multiplex-PCR and agglutination methods. PCR-restriction fragment length polymorphism with AluI and MluCI resulted in three and two profiles, respectively. Pulsed-field gel electrophoresis differentiated the L. monocytogenes isolates into 15 ApaI and 12 AscI patterns. Antimicrobial resistance of all Listeria isolates was determined by the disk diffusion method. Most L. monocytogenes isolates were sensitive to antimicrobials used in the treatment of listeriosis. This study shows the presence of potential pathogenic and antimicrobial-resistant L. monocytogenes in RTE foods that may lead to consumer health risks.

In this paper, we study Riemannian, anti-invariant and Lagrangian submersions from locally product Riemannian manifolds onto Riemannian manifolds. We first give a characterization theorem for Riemannian submersions. It is proved that the fibers of a Lagrangian submersion are always totally geodesic. We also consider the first variational formula of anti-invariant Riemannian submersions and give a new condition for the harmonicity of such submersions.

Amac: Bu calismada, erken yasantilarin baglanmada kaygi ve kacinmayi etkileyip etkilemedigi ve baglanmada kaygi ve kacinmanin major depresyon (MD) tanisi konulan hastalari panik bozuklugu (PB) tanisi konulanlardan ayirt edip etmeyecegi arastirildi. Hastalar ve yontemler: Calismaya Ekim 2009 - Ekim 2011 tarihleri arasinda In.nu Universitesi Tip Fakultesi Turgut Ozal Tip Merkezi Psikiyatri klinigine basvuran, Ruhsal Bozukluklarin Tanisal ve Sayimsal El Kitabi-IV-TR (DSM-IV-TR) tani olcutlerine gore PB tanisi konulan (PB grubu) 100 hasta (32 erkek, 68 kadin; ort. yas 34.2±1.04 yil) ve MD tanisi konulan (MD grubu) 100 hasta (34 erkek, 66 kadin; ort. yas 34.1±9.03 yil) ile PB veya MD sorunu olmayan 146 saglikli birey (kontrol grubu) (54 erkek, 92 kadin; ort. yas 33.2±9.4 yil) dahil edildi. Panik bozuklugu ve MD tanisi DSM-IV-TR kriterlerine gore duzenlenmis yapilandirilmis gorusme formu kullanilarak konuldu. Bulgular: Major depresyon ve PB grubunun baglanmada kaygi ve kacinma puani saglikli kontrollere kiyasla istatiksel olarak anlamli sekilde daha yuksekti. Major depresyon hastalarinin baglanmada kaygi puani hem kontrollere hem de PB hastalarina kiyasla anlamli olarak daha yuksekti. Major depresyon ve PB hastalari arasinda baglanmada kacinma puani acisindan anlamli farklilik yoktu. Major depresyon hastalarinda alti aydan az anne sutu almis olmanin anlamli farklilik olusturdugu goruldu. Erken donem yasantilarinin baglanmada kaygi ve kacinmayi anlamli olarak etkilemedigi goruldu. Sonuc: Panik bozuklugu hastalarinda saglikli kontrollere kiyasla baglanmada kaygi ve kacinma puaninin yuksek, baglanmada kaygi puaninin MD hastalarindan dusuk cikmasi, Malatya ornekleminin Turkiye orneklemi ile uyumlu oldugunu gosterdi. Calismamiz MD ve PB hastalarinda ve saglikli kontrollerde baglanma boyutlarinin farklilastigina isaret etmektedir.

In this paper, Weyl manifolds, denoted by $WS(g,w,\pi,\mu)$, having a special a semisymmetric recurrent-metric connection are introduced and the uniqueness of this connection is proved. We give an example of $WS(g,w,\pi,\mu)$ with a constant scalar curvature. Furthermore, we define sectional curvatures of $WS(g,w,\pi,\mu)$ and prove that any isotropic Weyl manifold $WS(g,w,\pi,\mu)$ is locally conformal to an Einstein manifold with a semisymmetric recurrent-metric connection, $EWS(g,w,\pi,\mu)$.

Bacillus species are common in the environment due to their spore-forming ability and nutritional versatility and cause food contamination. Bacilli play a significant role in foodborne illnesses and food spoilage. In this study, 52 Bacillus isolates from retail fish and ground beef were identified and differentiated based on 16S rRNA, gyrB, and rpoB gene sequencing. The presence of genes encoding emetic toxin (ces), hemolytic enterotoxin hemolysin BL (hbl), nonhemolytic enterotoxin (nhe) and cytotoxin K (cytK1) was assessed in all Bacillus isolates. The ability of the Bacillus isolates to produce several extracellular enzymes that contribute to pathogenicity and food spoilage was investigated. The 16S rRNA, rpoB, and gyrB gene sequence similarities of the Bacillus isolates tested were 96.1%, 83.2%, and 77.5%, respectively. The gyrB gene demonstrated a higher degree of sequence variation than the 16S rRNA and rpoB genes. The prevalence of Bacillus isolates producing at least two of the genes of the HBL and NHE complexes was 23.1% and 15.4%, respectively. Of the B. cereus isolates, 10 (41.7%) possessed two or more enterotoxin genes. None of the isolates carried the ces and cytK1 genes. All isolates were positive for the production of enzymes such as protease, lipase, gelatinase, and DNase. However, only 92.3% of the tested isolates were positive for amylase. In conclusion, our results revealed that the presence of genes involved in toxin production and enzyme production in meat-originated B. cereus and other Bacillus isolates may cause spoilage of food and pose a health risk for consumers. PRACTICAL APPLICATION: Bacillus species can be found in various foods due to their ubiquitous nature. Bacillus spp., especially B. cereus, are associated with food poisoning and other infections in humans. Toxins and many extracellular enzymes produced by Bacillus spp. are the causative agents of foodborne outbreaks, food spoilage, and low-quality food with significantly reduced edibility. This study highlights the characterization of Bacillus spp. and presence of potentially pathogenic Bacillus species in meats.

A total of 300 food samples including 180 milk and 120 meat products have been examined for the presence of Yersinia spp. using the ISO 10273 and the cold enrichment method. The overall prevalence of Yersinia spp. was 84 (28%). Yersinia enterocolitica was isolated from 18 (6%) of the 300 samples. The other Yersinia species were detected in the samples Yersinia rohdei 15 (5%), Yersinia intermedia 14 (4.7%), Yersinia pseudotuberculosis 12 (4%), Yersinia ruckeri 12 (4%), Yersinia mollaretii 5 (1.7%), Yersinia bercovieri 4 (1.3%), and atypical Yersinia spp. 4 (1.3%). The conventionally identified Y. enterocolitica strains were also confirmed by the 16S rRNA gene sequencing. All Y. enterocolitica strains biotyped as 1A had negative results in the phenotypic virulence tests. The 84 Yersinia strains were also examined genotypically for the presence of virulence genes. None of the Y. enterocolitica and other Yersinia strains contained the ail, ystA, yadA, and virF except only 1 Y. intermedia and 2 Y. enterocolitica strains that were found to be positive for ystB. Antimicrobial resistance of 84 Yersinia to 16 antimicrobial agents was determined by the disk diffusion method. All strains were sensitive to tobramycine and imipenem while resistant to clindamycin. Although 84.5% of the strains were resistant to at least 3 or more antimicrobial agents, 64.3% of them were resistant to 4 or more antimicrobial agents. Practical Application The present study has indicated that the presence of some Yersinia spp., including Y. enterocolitica strains found to be biotype 1A in meat and milk products, which have virulence factors and multi-drug resistance, may be regarded as a potential health hazard for consumers depending upon the state of their immune system. Therefore, the distribution of virulence markers and antibiotic resistance in Yersinia strains from food sources should be considered and monitored concurrently.

Aim: In our study, we aimed to evaluate the trauma patients who were admitted to Department of Emergency Medicine, Uludag University Hospital for demographic characteristics, triage categories, and necessity of a third-level emergency service. Materials and Methods: Data of the trauma patients admitted between November 1, 2012 and November 1, 2013 were selected by a retrospective systematic sampling. The patient age, sex, admission date, trauma mechanism, body part affected by trauma, and triage categories have been recorded. Results: In all, 3251 patients were included. Most cases were men (66%); the age of trauma exposure was 18-64 years age. Most patients were admitted between April and June, and the most frequent mechanism of trauma was sprain and crush. The hospital admission rate is higher in triages 1 and 2, and discharge rates were higher in triages 4 and 5. Conclusion: To determine the severity of the trauma patients that comprised a special group in the emergency department, triage categories can be effectively used. Considering emergency admissions, 80.4% were not found to be emergent patients group, and these patients should be referred to outpatient clinics. (JAEM 2015; 14: 60-4)

Background: This study investigated the effects of cooled and standard centrifuges on the results of coagulation tests to examine the effects of centrifugation temperature. Methods: Equal-volume blood samples from each patient were collected at the same time intervals and subjected to standard (25°C) and cooled centrifugation (2–4°C). Subsequently, the prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (aPTT), fibrinogen, and D-dimer values were determined in runs with the same lot numbers in the same coagulation device using the Dia-PT R (PT and INR), Dia-PTT-liquid (aPTT), Dia-FIB (fibrinogen), and Dia-D-dimer kits, respectively. Results: The study enrolled 771 participants. The PT was significantly (p < 0.018) higher in participants on anticoagulant therapy. The respective median values of the test parameters determined using the standard and cooled centrifuges were as follows: PT 10.30 versus 10.50 s; PT (INR) 1.04 versus 1.09 s; APTT 28.90 versus 29.40 s; fibrinogen 321.5 versus 322.1 mg/dL; and D-dimer 179.5 versus 168.7 µg FEU/mL. There were significant differences (p < 0.001) in the parameters between the values obtained with the standard and cooled centrifuges. Conclusions: Centrifuge temperature can have a significant effect on the results of coagulation tests. However, broad and specific disease-based studies are needed.

In this work, we consider a Riemannian manifold $$M$$ with an almost quaternionic structure $$V$$ defined by a three-dimensional subbundle of $$(1,1)$$ tensors $$F$$ , $$G$$ , and $$H$$ such that $$\{F,G,H\}$$ is chosen to be a local basis for $$V$$ . For such a manifold there exits a subbundle $$\mathcal{{H}} (M)$$ of the bundle of orthonormal frames $$\mathcal{{O}}(M)$$ . If $$M$$ admits a torsion-free connection reducible to a connection in $$\mathcal{{H}}(M)$$ , then we give a condition such that the torsion tensor of the bundle vanishes. We also prove that if $$M$$ admits a torsion-free connection reducible to a connection in $$\mathcal{{H}}(M)$$ , then the tensors $$\widetilde{F}^2$$ , $$\widetilde{G}^2$$ , and $$\widetilde{H}^2$$ are torsion-free, that is, they are integrable. Here $$\widetilde{F}$$ , $$\widetilde{G}$$ , $$\widetilde{H}$$ are the extended tensors of $$F$$ , $$G$$ , and $$H$$ defined on $$M$$ . Finally, we show that if the torsions of $$\widetilde{F}^2$$ , $$\widetilde{G}^2$$ and $$\widetilde{H}^2$$ vanish, then $$M$$ admits a connection with torsion which is reducible to $$\mathcal{{H}}(M)$$ , and this means that $$\widetilde{F}^2$$ , $$\widetilde{G}^2$$ , and $$\widetilde{H}^2$$ are integrable.

Objective: Acid-base disorders (ABDs) are usually correlated with high rates of morbidity and mortality. The objective of this study was to analyze the causes, outcomes, types and incidences of ABDs in patients presenting at the emergency department (ED). Material and Methods: We prospectively analyzed data from patients who presented between January 2011 and May 2011. Data on age, gender, chief complaint, and diagnosis in the ED were collected for ABD cases. Results: Of the 736 cases with an ABD, 173 patients (23.5%) had simple ABD and 563 patients (76.5%) had mixed ABD. The most common ABD was a mixed metabolic acidosis and respiratory alkalosis (MACRAL) (n=408, 55.4%). All ABD types were most commonly observed in patients over 65 years of age. Dyspnea was the most common complaint among ABD patients who presented at the ED (44.4%). In cases of ABD, pneumonia was the most common diagnosis (16.3%). Of the ABD cases, 379 patients (51.6%) were discharged, while 318 patients (43.2%) were hospitalized. Death was more commonly observed in cases with mixed metabolic and respiratory acidosis (MRAC) (n=6) and MACRAL (n=11). Conclusion: ABDs are quite common in patients presenting at the ED, especially among patients in a critical condition (71%). Mixed MACRAL was the most commonly noted ABD. Dyspnea and pneumonia were the most common diagnoses in ABD patients. Mortality was more common in cases with a mixed MRAC and MACRAL. This knowledge may provide important information concerning the diagnosis, treatment and early prognosis of patients. (JAEM 2014; 13: 4-9)