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Although considerable efforts have been made to incorporate simulation-based learning (SBL) in undergraduate medical education, to date, most of the medical school curricula still focus on pure knowledge or individual assessment of objective structured clinical examination skills (OSCE). To this end, we designed a case study named "iG4 (integrated generation 4) virtual on-call (iVOC)". We aimed to simulate an on-call shift in a high-fidelity virtual hospital setting in order to assess delegates' team-based performance on tasks related to patient handovers (prioritisation, team allocation).A total of 41 clinical year medical students were split into 3 cohorts, each of which included 3 groups of 4 or 5 people. The groups consisted of a structured mix of educational and cultural backgrounds of students to achieve homogeneity. Each performing group received the handover for 5 patients in the virtual hospital and had to identify and deal with the acutely unwell ones within 15 minutes. We used TEAMThe mean handover performance was 5.44/10 ± 2.24 which was the lowest across any performance marker. The overall global performance across any team was 6.64/10 ± 2.11. The first rotating team's global performance for each cycle was 6.44/10 ± 2.01, for the second 7.89/10 ± 2.09 and for the third 6.78/10 ± 1.64 (p = 0.099 between groups).This is one of the first reported, high-fidelity, globally reproducible SBL settings to assess the capacity of students to work as part of a multinational team, highlighting several aspects that need to be addressed during undergraduate studies. Medical schools should consider similar efforts with the aim to incorporate assessment frameworks for individual performances of students as part of a team, which can be a stepping-stone for enhancing safety in clinical practice.

This study aimed to evaluate the technical aspects of the Da Vinci Xi Surgical System in minimally invasive extreme lateral lumbar interbody fusion (XLIF) surgery in a swine model.Endoscopic discectomy and XLIF cage insertion were performed using a robot-assisted system. The time taken and the pros and cons of each step were recorded.Operative time was 80 min. For the surgery, four ports were used: one for the endoscope camera, two for bipolar forceps, and one auxiliary port modified for discectomy. Discectomy was performed using a punch and curette, following which the cage was inserted through the auxiliary port. Cage position was manipulated using the C-arm. No complications or cage malposition's were noted during the procedure.This study shows that the robot-assisted XLIF approach is safe and feasible, and it protected the neurovascular structures. High image quality was also obtained during the procedure.

Introduction The immense progress in science and technology has changed our daily lives. This change has also had its impact on our educational system. In this regard, numerous studies have been found in the literature investigating the integration of new technologies in the learning-teaching process, and as such these studies led to the use of web-based educational tools as an alternative or an adjunct to the traditional learning methods. Method Our quasi-experimental study focused on two separate teaching methods, web-based and traditional. The effectiveness of web-based learning was investigated based on an objective structured clinical examination of 177 vocational health students enrolled to Acibadem Mehmet Ali Aydinlar University's 2017-spring term. The study compared the objective structured clinical examination grades of these two methods. Two groups had been formed, and the students were randomly allocated either into a study or a control group. The study group watched an online video clip, whereas the control group received a traditional lecture. Mann-Whitney U test was used to determine whether students' successful attempts statistically differ according to the educational methodology, also effective size and single factor variance analysis (ANOVA) was performed. Results Based on the objective structured clinical examination, the study group performed better in pediatric basic life support as opposed to the control group. Conclusion This study suggests that the use of web-based video clips enhances the learning process and in certain subjects yields better performance results when compared to the traditional learning method. Our findings are in-line with the reported studies in the literature and provide additional insight for developing countries, where simulation based education is limited.

Background: The most common problem encountered by medical students is the management of unstable emergency patients. Simulation-based education (SBE) is widely used for improving the management of unstable patients. In this study, the aim is to evaluate the SBE Clinical Preparation Program and to understand whether our final-year medical students could transfer the skills acquired in the program to clinical encounters in their emergency medicine clerkship, with the aim of easing this transition.Materials and methods: Final-year medical students at the Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine and their educators were included in this qualitative study. After participating in the SBE Clinical Preparation Program for two weeks, interns completed a two-month emergency medicine clerkship. At the end of the clerkship, four focus group discussions with 5 or 7 interns (n=24) and in-depth interviews with two educators were held. The digital audio recordings were transcribed verbatim within 48 hours of the interviews. The texts were reviewed by two different researchers, and thematic codes were identified.Results: In this study, the effectiveness of the SBE Clinical Preparation Program was evaluated. The participants stated that the program prepared them very well for critical patient management and that the content of the program was sufficient and comprehensive. The trainers stated that the simulation program prepared the students well for the clinic and provided a strong foundation, which was very important, but the students had to overcome an emotional barrier when approaching real patients, a process that took one or two weeks. The characteristics of the students (motivation, anxiety levels), the quality of the processes experienced during the program (seeing a sufficient number of patients, communication and interaction with other healthcare professionals and patients) and the environment/context in which these practices took place (learning climate) were the important factors influencing the transfer of the learning outcomes to the clinical environment.Conclusion SBE transition programs are effective in preparing students for the management of critical patients and facilitate the transition to the clerkship. SBE programs are not sufficient by themselves and should be developed in a continuous and integrated manner with training programs in actual clinical settings.

Cerebral stroke continues to be one of the leading causes of mortality and long-term morbidity, therefore, carotid endarterectomy (CEA) remains to be a popular treatment for both symptomatic and asymptomatic patients with carotid stenosis. Cranial nerve injuries remain one of the major contributor to the postoperative morbidities. Anatomical dissections were carried out on 44 sides of 22 cadaveric heads following the classical CEA procedure to investigate the variations of the local anatomy as a contributing factor to cranial nerve injuries. Concurrence of two variations was found to be important in hypoglossal nerve injury: the presence of a direct smaller vein in proximity of the carotid bifurcation, and the intersection of the hypoglossal nerve (HN) with this vein. Based on the sample investigated, this variation was observed significantly higher on the right side. Awareness of possible anatomical variations and early ligation of any small veins can significantly decrease iatrogenic injury risk.

Robot-assisted surgery systems are a recent breakthrough in minimally invasive surgeries, offering numerous benefits to both patients and surgeons including, but not limited to, greater visualization of the operation site, greater precision during operation and shorter hospitalization times. Training on robot-assisted surgery (RAS) systems begins with the use of high-fidelity simulators. Hence, the increasing demand of employing RAS systems has led to a rise in using RAS simulators to train medical doctors. The aim of this study was to investigate the brain activity changes elicited during the skill acquisition of resident surgeons by measuring hemodynamic changes from the prefrontal cortex area via a neuroimaging sensor, namely, functional near-infrared spectroscopy (fNIRS). Twenty-four participants, who are resident medical doctors affiliated with different surgery departments, underwent an RAS simulator training during this study and completed the sponge suturing tasks at three different difficulty levels in two consecutive sessions/blocks. The results reveal that cortical oxygenation changes in the prefrontal cortex were significantly lower during the second training session (Block 2) compared to the initial training session (Block 1) (p &lt, 0.05).

BACKGROUND Serious games enrich simulation-based health care trainings and improve knowledge, skills, and self-confidence of learners while entertaining them. OBJECTIVE A platform which can combine performance data from a basic life support (BLS) serious game app and hands-on data based on the same scoring system is not available in the market. The aim of this study was to create such a platform and investigate whether performance evaluation of BLS trainings would be more objective compared to conventional Objective Structured Clinical Examination (OSCE) examinations if these evaluations were carried out with the platform which combines OSCE scoring criteria with sensor data retrieved from the simulator’s sensors. METHODS Participants were 25 volunteers (11 men [44.0%] and 14 [56.0] women) among Acıbadem Mehmet Ali Aydınlar University students without prior knowledge of the BLS protocol. A serious game module has been created for teaching learners the European Resuscitation Council Basic Life Support 2015 protocol. A second module called the hands-on module was designed for educators. This module includes a checklist used for BLS OSCE examinations and can retrieve sensor data such as compression depth, compression frequency, and ventilation volume from the manikin (CPR Lilly; 3B Scientific GmbH) via Bluetooth. Data retrieved from the sensors of the manikin enable educators to evaluate learners in a more objective way. Performance data retrieved from the serious gaming module have been combined with the results of the hands-on module. Data acquired from the hands-on module have also been compared with the results of conventional OSCE scores of the participants, which were obtained by watching the videos of the same trainings. RESULTS Participants were considered successful in the game if they scored 80/100 or above. Overall, participants scored 80 or above in an average of 1.4 (SD 0.65) trials. The average BLS serious game score was 88.3/100 (SD 5.17) and hands-on average score was 70.7/100 (SD 17.3), whereas the OSCE average score was 84.4/100 (SD 12.9). There was no statistically significant correlation between success on trials (score ≥80/100), serious game, hands-on training app, and OSCE scores (Spearman rho test, P>.05). The mean BLS serious game score of the participants was 88.3/100 (SD 5.17), whereas their mean hands-on training app score was 70.7/100 (SD 17.3) and OSCE score was 84.4/100 (SD 12.9). CONCLUSIONS Although scoring criteria for OSCE and hands-on training app were identical, OSCE scores were 17% higher than hands-on training app scores. After analyzing the difference of scores between hands-on training app and OSCE, it has been revealed that these differences originate from scoring parameters such as compression depth, compression frequency, and ventilation volume. These data suggest that evaluation of BLS trainings would be more objective if these evaluations were carried out with the modality, which combines visual OSCE scoring criteria with sensor data retrieved from the simulator’s sensors. CLINICALTRIAL ClinicalTrials.gov NCT04533893; https://clinicaltrials.gov/ct2/show/NCT04533893

Objectives The aim of this study is to evaluate a simulation-based team performance course for medical students and compare its low- and high-fidelity components. Study design This is a prospective crossover observational study. Groups participated in one low- and one high-fidelity session twice. Low-fidelity scenarios included management of an emergency case on a simulated-patient, whereas high-fidelity scenarios constituted of multiple-trauma cases where simulated-patients wore a hyper-realistic suit. Team performance was assessed objectively, using the TEAM™ tool, and subjectively using questionnaires. Questionnaires were also used to assess presence levels, stress levels and evaluate the course. Results Participants’ team performance was higher in the low-fidelity intervention as assessed by the TEAM™ tool. An overall mean increase in self-assessed confidence towards non-technical skills attitudes was noted after the course, however there was no difference in self-assessed performance between the two interventions. Both reported mean stress and presence levels were higher for the high-fidelity module. Evaluation scores for all individual items of the questionnaire were ≥4.60 in both NTS modules. Students have assessed the high-fidelity module higher (4.88 out of 5, SD = 0.29) compared to low-fidelity module (4.74 out of 5, SD = 0.67). Conclusions Both the low- and high-fidelity interventions demonstrated an improvement in team performance of the attending medical students. The high-fidelity intervention was more realistic, yet more stressful. Furthermore, it proved to be superior in harvesting leadership, teamwork and task management skills. Both modules were evaluated highly by the students, however, future research should address retention of the taught skills and adaptability of such interventions., Highlights • The high-fidelity intervention was superior in harvesting leadership, teamwork and task management skills, yet more stressful. • We set the group to develop a novel group of team-based OSCE performance. • The next step is to adapt such taught skills to different specialties and implement initiatives in the medical school curricula.

In the last decade, robotic surgery has enhanced doctors’ capabilities and enabled surgeons to operate complex procedures even through smaller incisions. Due to the increasing trend of using of robotic surgery there is a need for training the surgeons of different disciplines including urology, general surgery, gynecology, cardiovascular surgery, endocrine surgery and thoracic surgery. Training surgeons with the robotic surgery simulator (RSS) is the common and initial procedure. This study focuses on monitoring training effect of robotic surgery simulators with neurophysiological assessment via functional near-infrared spectroscopy (fNIRS) and with the embedded scoring systems of the RSS. fNIRS allow researchers to record hemodynamic responses within the prefrontal cortex (PFC) in response to stimuli. Cortical oxygenation changes of the PFC from participants were monitored while they were performing suturing tasks with various difficulty levels. Twenty four resident surgeons from two different disciplines without prior robotic surgery experience (mean age ± SD = 28.25 ± 1.98 years19 OB&GYN residents, 5 general surgery residents) completed the experimental protocol consisting of two standard training blocks. On both blocks, participants completed suture sponge tasks on three different difficulty levels. Simulator scoring provided task performance assessment of each trainee. Participants’ oxygen consumption levels were higher on the first block, where they familiarized themselves with the suturing task using RSS. On the second block, oxygen consumption levels decreased while performance scores significantly increased compared to the first block.

Bu araştırma Tokat ili merkez ve merkeze bağlı okullarda görev yapan 22 kadın ve 45 erkek bilgisayar öğretmeninden oluşan toplam 67 bilgisayar öğretmeninin, bir eğitim aracı bilgisayara ilişkin tutumlarını ölçmek amacıyla ve % 97lik katılım oranıyla gerçekleştirilmiştir. Araştırmaya Tokat merkez ilçe ve yakın yerleşim birimlerinde görev yapan bilgisayar öğretmenlerinin tamamı alınmıştır. Araştırmada, 3 bölümden oluşan bilgi toplama aracı kullanılmıştır. Birinci bölümü oluşturan kişisel bilgiler, 25 sorudan oluşturulmuştur. Kendi kendini değerlendirme formatındaki 2. bölüm, bizzat araştırmacı tarafından geliştirilen 34 tutum cümlesinden oluşturulmuştur. Yine araştırmacı tarafından geliştirilen 3.bölüm, 4 alt bölümden oluşturulmuştur. Bu bölümlerden, kendi kendini değerlendirmede 34, eğitim politikası ve felsefesinde 19, izlenecek yaklaşımda 15, eğitim programının öğelerinde 54 ve öğretmen yetiştirmeye ilişkin 12 olmak üzere, toplam 134 öğretmen tutum cümleleri yer almış ve bu çerçevede kendilerine “ iyi”,” orta” ve “iyi değil” şeklinde değerler vermişlerdir. Araştırmada ortaya çıkan bulgulara göre öğretmenler artık tek kaynaktan eğitim fakültelerinden yetiştirilmektedirler. Araştırmanın en önemli bulgularında biri de, kadın ve erkek öğretmenlerin belirlenen kategorilerdeki tutumları arasında, tutum farklarının olmamasıdır. Tüm öğretmenlerin öğrencileri öğrenimin merkezine alan anlayışlara sahip olmaları araştırmanın bir başka önemli bulgusudur. Öğretmenlerin çoğunun, yurt dışı deneyimleri olmamasına rağmen teknolojiyi sürekli takip ediyor olmaları araştırma sonuçlarının ortaya çıkardığı olumlu tutumlardan bir başkasıdır. Öğretmenler ekonomik gelirleri ile ilgili herhangi bir şikâyette bulunmamışlardır. This research was carried out with a 97% participation rate to measure the attitudes of a total of 67 computer teachers consisting of 22 female and 45 male computer teachers working in the central and central schools of the city of Tokat with an educational tool.In the research, information collection tool consisting of 3 parts was used. The personal information constituting the first part was formed from 25 questions. The second part of the self-assessment format was formed from 34 attitude schedules. Section 3 is composed of 4 sub-sections.These sections included a total of 134 teacher attitude statements, including 34 self- assessed, 19 on the educational policy and philosophy, 15 on the tracked approach, 54 on the training program's items and 12 on teacher training, and in this frame they gave themselves the values of "good", "medium" and "not good".According to the findings in the research, teachers are now raised from one source, education faculties.One of the most important findings of the research is the lack of attitude differences among the attitudes of the male and female teachers in the determined categories.It is another important finding of research that all teachers should have in sights in to the center of teaching students. Despite the fact tha tmost of the teachers do not have experience abroad, they must be following the technology constantly, which is one of the positive attitudes of the research results. Teachers have not found any comment on theire conomic in come.

Background Serious games enrich simulation-based health care trainings and improve knowledge, skills, and self-confidence of learners while entertaining them. Objective A platform which can combine performance data from a basic life support (BLS) serious game app and hands-on data based on the same scoring system is not available in the market. The aim of this study was to create such a platform and investigate whether performance evaluation of BLS trainings would be more objective compared to conventional Objective Structured Clinical Examination (OSCE) examinations if these evaluations were carried out with the platform which combines OSCE scoring criteria with sensor data retrieved from the simulator’s sensors. Methods Participants were 25 volunteers (11 men [44.0%] and 14 [56.0] women) among Acıbadem Mehmet Ali Aydınlar University students without prior knowledge of the BLS protocol. A serious game module has been created for teaching learners the European Resuscitation Council Basic Life Support 2015 protocol. A second module called the hands-on module was designed for educators. This module includes a checklist used for BLS OSCE examinations and can retrieve sensor data such as compression depth, compression frequency, and ventilation volume from the manikin (CPR Lilly; 3B Scientific GmbH) via Bluetooth. Data retrieved from the sensors of the manikin enable educators to evaluate learners in a more objective way. Performance data retrieved from the serious gaming module have been combined with the results of the hands-on module. Data acquired from the hands-on module have also been compared with the results of conventional OSCE scores of the participants, which were obtained by watching the videos of the same trainings. Results Participants were considered successful in the game if they scored 80/100 or above. Overall, participants scored 80 or above in an average of 1.4 (SD 0.65) trials. The average BLS serious game score was 88.3/100 (SD 5.17) and hands-on average score was 70.7/100 (SD 17.3), whereas the OSCE average score was 84.4/100 (SD 12.9). There was no statistically significant correlation between success on trials (score ≥80/100), serious game, hands-on training app, and OSCE scores (Spearman rho test, P>.05). The mean BLS serious game score of the participants was 88.3/100 (SD 5.17), whereas their mean hands-on training app score was 70.7/100 (SD 17.3) and OSCE score was 84.4/100 (SD 12.9). Conclusions Although scoring criteria for OSCE and hands-on training app were identical, OSCE scores were 17% higher than hands-on training app scores. After analyzing the difference of scores between hands-on training app and OSCE, it has been revealed that these differences originate from scoring parameters such as compression depth, compression frequency, and ventilation volume. These data suggest that evaluation of BLS trainings would be more objective if these evaluations were carried out with the modality, which combines visual OSCE scoring criteria with sensor data retrieved from the simulator’s sensors. Trial Registration ClinicalTrials.gov NCT04533893; https://clinicaltrials.gov/ct2/show/NCT04533893

The aim of this study was to determine the causes of social media addiction of individuals, who define themselves as social media addicts, in a clearer and more concrete way. In order to achieve this aim, participants have been tested with an addiction test, and 25 university students who perceive themselves as social media addicts were selected for the study. The findings of the research showed that participants' reasons for using social media were lack of friends, social necessity of social media, feeling of fulfillment, fear of missing out, intertwining of social media and daily life. The study also pointed out that social media addiction has a beginning and a continuity phase. It has been shown that the individuals who were in the beginning phase tended to start using social media for reasons such as not being able to find friends, lack of socialization, and monotony of life. In the continuity stage of individual addiction, they stated that they use social media for reasons such as, fulfilling a duty, and protecting social relations that they had. One of the reasons for addiction was the need to socialize, while male participants were more interested in acquiring new friends, female participants were more interested in communicating with their real life friends. © 2018 Eurasian Society of Educational Research. All rights reserved.

Background Computer-based learning methodologies have become more prevalent in the last decade. Web based serious gaming and virtual patients are novel in medical education, which have the potential to become important tools to improve today's medical students' knowledge and performance.Methods A total of 81 medical students participated in our study. They were either assigned to an intervention group or a control group . The intervention group completed a serious game module designed for Basic Life Support education. The control group received a theoretical lecture on the same content. On the next day both groups received simulation-based hands-on training for BLS using the same criteria. All students were assessed with an Objective Structured Clinical Examination (OSCE) the following week. Results There was no difference between the intervention group that used a web based serious game module for BLS and the control group that received a standard theoretical lecture from the faculty. Discussion and Conclusion Computer based interactive serious games seem to present a favourable additional tool for medical education. OSCE results imply, that the use of serious games as a self-learning strategy can be as useful as theoretical lectures; which means that it is saving time of learners and educators

Dear editor The letter by Ah-kee and Khan1 arguing that a mandatory year for studying leadership management within an already overcrowded undergraduate curriculum is not realistic and feasible drew our attention. We strongly support this idea because of the difficulties we met during integration of simulation programs into the undergraduate curriculum in Turkey. The Turkish Higher Education Council plans the curriculum for medical faculties in Turkey. Till date, actually, medical simulation has still not been implemented into the national curricula. Medical simulation trainings are essential for improving both basic and advanced skills in a safe environment and their competency for crisis resource management, which is very important for leadership, communication, and teamwork in health care education.2 For this purpose, our faculty, which is part of a foundation university, decided to integrate medical simulation into our undergraduate program. Center of Advanced Simulation and Education (CASE) has been founded by our university in 2013 and is the first large-scale interdisciplinary medical simulation center in our country. CASE offers different types of simulation-based experiential learning via standardized patients, virtual reality task trainers, high-fidelity manikin-based simulators, wet lab sessions for robotic and laparoscopic surgery, and cadaver-based training sessions. Between 2013 and 2015, the total number of trainees who took part in the training events at our center was 23,450. As periodic inspections are performed by representatives of Turkish Higher Education Council in terms of compatibility of undergraduate medical simulation programs to minimum competency requirements of the Turkish Ministry of Health, simulation sessions have to be well integrated into the curricula to fulfill these criteria. In our faculty, undergraduate training programs have been organized by the Education and Research Committee consisting of medical faculty educational directors, nursing faculty educational directors, paramedic trainers, and anesthesiology technicians’ educational directors. The committee develops department-specific curricula and evaluates their programs. The committee has selected specific educators from each department who are responsible for simulation trainings. Orientation programs and training the trainer courses are organized by the core team of our simulation center. However, most of faculty staff had negative attitude against this kind of changes and resisted to adapt to additional practice hours and content related with simulation sessions. Overcrowded undergraduate curriculum caused another problem in organizing time slots. Because of this resistance and limitations, only 40% integration could be achieved into the existing curriculum in the first year and all sessions had to be given by simulation center’s core staff. The first issue was negative attitude toward simulation. To overcome this, we organized simulation sessions for pilot groups from each department such as advanced life support courses for nursing students, boot camp courses for intern medical students, and interdisciplinary crisis resource management trainings for the academic staff to show how this type of education can be implemented into the existing program. The second issue was organizing time slots. To solve this problem, we used free time of the students with their approval. We assessed the performances of the trainees and determined positive effects in their clinical performances. Interdisciplinary trainings and their impact on clinical performances of students drew attention of academic staff, who afterward wanted to be part of this process. After evaluating the programs with feedbacks of trainees and educators, the governing board of CASE and Education and Research Committee concluded that more simulation-based trainings should be embedded into the curricula. The Board of Trustees of our university evaluated the effectiveness of simulation programs and decided to give more financial support. In the third year of the implementation process, all departments are actively using CASE and the time slots are well organized according to the existing curricula. In conclusion, implementing different teaching initiatives into the undergraduate curriculum is a difficult process that has to be well organized and needs collaboration of both academic staff and administration. Defining target groups and their needs, learning how to optimize, refine, and adapt to existing programs could be the starting point of program implementation. Initiating integration with pilot groups and controlling each step by feedbacks could be the second step. For integration, collaboration of students is also required to overcome barriers. Their positive feedbacks and ambition to act in simulation environment helped us to overcome this complex process. However, we still have difficulties in implementing medical simulation into the curricula of Turkish universities, as the impact of simulation on clinical performances has still not been accepted in our country and there is no national curriculum embedded with simulation programs. Therefore, each university is trying to solve this problem by its own resources.

3rd World Conference on Educational Sciences (WCES) -- FEB 03-07, 2011 -- Bahcesehir Univ, Istanbul, TURKEY WOS:000466750604009 The purpose of this research is to present a sample study analyzing data gathered from an educational study using data mining techniques appropriate for processing these data. In order to achieve this aim, a "Computer Self-efficiency Scale" used in educational sciences was selected and this scale was applied in a study group. Data was analyzed using descriptive statistics (t-test and analysis of variance), and the data mining techniques of decision tree, dependency networks and clustering. The descriptive statistics used were calculated not using common statistical software packages, but by running a program written in Delphi 2009 programming language on Microsoft SQL Server 2008. Microsoft SQL Server 2008 was directly used for the data mining techniques of dependency networks and clustering. Some of the findings of the research, which cannot be obtained by common statistical techniques but can be obtained by data mining methods, were as follows: "those who think they are competent with computer terms and concepts believe they have a special talent in using computers"; "those who believe they have a special talent in using computers feel as if the computer is part of their body", and "students who have been using computers for more than six years believe they have a special talent in using computers". Ankara Univ, Near E Univ

To compete in today’s technology-intensive competitive environment, universities need to be aware of their limitations and collaborate with other universities to overcome them. Several indices that attempt to measure innovation and rank institutions have been proposed. Nevertheless, most innovation indices measure innovation at the political or country level that focuses on a specific country or region. Moreover, national innovation indices investigating innovation level of the universities in Turkey focuses only on their academic activities. This motivated us to design a significantly improved model that attempts to increase collaboration among the universities in Central Black Sea region, providing these under developing universities to observe their innovativeness level in terms of infrastructure as well. Thus, they may identify their infrastructure limitations, specifically for high-tech and high-cost devices, and develop strategic plans that can help them collaborate with other universities to address the limitations. Similar to other indices, the proposed models is neither exhaustive nor definitive, and is open to improvements. The model can be continuously upgraded based on the constructive feedbacks and future researches.

Training multidisciplinary teams using simulation allows for communication, development and maintenance of teamwork. In this study we compared the behavior of residents from emergency and anesthesiology departments on treatment of cardiac arrest.42 anesthesiology and 29 emergency residents are included in the study. Two scenarios were designed for diagnosis and treatment of asystole and ventricular fibrillation. First scenario was a case with ventricular fibrillation (VF) and the second was an asystole case. ACLS protocols were used for assessment. Age, years of training, and years in practice were compared for each group.Anesthesiology residents attempted to secure the airway immediately after checking the carotid pulse and began the cardiac compressions. After intubation, the vast majority (88%) of participants monitorized the patient. Only 11.9% of the residents started compressions and were reminded to monitorize the patient. Emergency residents immediately started CPR with compressions and ventilation by mask. 79.3% of them decided to intubate after a few compressions but 20.7% of them didn't attempt it. 50% of the residents monitorized the simulator whereas the other half was reminded to. There was no significant difference between the groups in terms of ventricular fibrillation and asystole management, but the age of the doctors was a decisive factor affecting the success in the VF simulation.This study demonstrates the use of simulation to identify the deficiencies in basic knowledge and the skills of emergency and anesthesiology residents. It highlights the need to emphasize criteria that should be used in resuscitation.

Aim: The objective of this study is to compare the image quality of flat panel systems that have cesium iodide (CsI) and gadolinium oxysulfate (GOS) scintillators in their detectors. Method: CDRAD 2.0 phantom and CDRAD analyzer software is used for objective evaluation and comparison of image quality of flat panel systems with CsI and GOS scintillators. The image quality is investigated in terms of contrast and detail. Nine different flat panel systems from 6 different manufacturers are evaluated in this study. Four of these flat panels have CsI scintillators and the remaining 5 have GoS scintillators. For evaluations, 20 layers of plexiglass were placed on the top (10 layers) and bottom (10 layers) of the CDRAD 2.0 phantom to simulate a patient. 3 images were taken from each system at each dose level, which were analyzed by the CDRAD 2.0 analyzer software. Image qualities were investigated at four different dose levels (50, 100, 150, and 200 μGys). IQFinv is used as the quality metric. Results: IQFinv values of GOS systems have little variance both within the same system and between all systems. On the other hand, CsI systems have higher variance in IQFinv values within the same system and between the systems. In addition, same CsI detectors (same model from the same manufacturer) used in different systems resulted in considerably different IQFinv values. CsI systems demonstrate 4–5 times more improvement in IQFinv value with increasing dose levels compared to GOS systems. Finally, IQFinv values of CsI systems are higher than GOS systems with statistically significance (p

High flux dialysis the first choice of therapy for hemodialysis patients within the last decade due to its clinical outcome. In this study the effect of dialysis environment on the mechanical and structural stability of high flux dialyzers containing polysulfone membranes were investigated. Dialysis sessions were performed on a certain group of patients with dialysis ages less than two years and without any other accompanying disease. Mechanical data and XRD results revealed the differences in material characteristics between virgin and used membranes obtained from polysulfone membranes. With the help of tensile tests it was shown that the mechanical properties used membranes were reduced in terms of ultimate tensile strength. XRD experiments revealed that the degree of crystallinity of the polysulfone dialysis membranes were raised. It was concluded that high flux dialyzer membranes are becoming more brittle and having more crystallinity after dialysis session. By this way the membranes are more prone to mechanical defects during dialysis. The degree of crytallinity increases under cyclic loading which resembles the changing of the pump speed or transmembrane pressure during dialysis in case of clinical situations like hypotension during dialysis. This issue is very important for dialysis centers performing reuse procedures for dialysis centers, because any damage to dialysis membranes would cause very serious clinical complications.

High flux dialysis the first choice of therapy for hemodialysis patients within the last decade due to its clinical outcome. In this study the effect of dialysis environment on the mechanical and structural stability of high flux dialyzers containing polysulfone membranes were investigated. Dialysis sessions were performed on a certain group of patients with dialysis ages less than two years and without any other accompanying disease. Mechanical data and XRD results revealed the differences in material characteristics between virgin and used membranes obtained from polysulfone membranes. With the help of tensile tests it was shown that the mechanical properties used membranes were reduced in terms of ultimate tensile strength. XRD experiments revealed that the degree of crystallinity of the polysulfone dialysis membranes were raised. It was concluded that high flux dialyzer membranes are becoming more brittle and having more crystallinity after dialysis session. By this way the membranes are more prone to mechanical defects during dialysis. The degree of crytallinity increases under cyclic loading which resembles the changing of the pump speed or transmembrane pressure during dialysis in case of clinical situations like hypotension during dialysis. This issue is very important for dialysis centers performing reuse procedures for dialysis centers, because any damage to dialysis membranes would cause very serious clinical complications.

Summary Background and objectives: Apoptosis occurs after thermal injury and may result from either ischaemic intestinal insult or inflammatory mediators released after burn injury. The aim of the study was to investigate the effects of propofol and ketamine on gut epithelium apoptosis after burn injury. Methods: Sixty male Wistar Albino rats were randomly assigned into four groups. Anaesthesia was induced and maintained with propofol in Groups 1 and 2, and ketamine in Groups 3 and 4 over 12 h. Groups 2 and 4 received 30% total body surface area burn. Groups 1 and 3 had no burn injury. Mean arterial pressure was maintained within 10% of baseline levels in all animals. At 12 h postburn, animals were sacrificed and tissue samples were taken from small intestine for determination of lipid peroxidation, apoptosis and proliferation. Also blood samples were taken for measurement of serum tumor necrosis factor-alpha (TNF-� ) levels. Results: Ileal malondialdehyde (MDA) concentration (extent of lipid peroxidation) increased significantly in Group 4 (112.4 � 10.2 nmol g � 1 ) compared to Group 3 (48.4 � 5.6 nmol g � 1 ) and Group 2 (59.8 � 3.2 nmol g � 1 ). The mean TNF-� level in Group 4 (118.9 � 10.5 pg mL � 1 ) at 12 h postburn was significantly higher than the mean in Group 2 (56.4 � 4.3 pg mL � 1 ). Group 4 had the highest mean TUNEL index (terminal deoxyuridine nick-end labelling – an index of extent of apoptosis) of all the groups (265/10). Also the mean TUNEL index value in Group 2 (53/10) was higher than that of Group 1 (3/10) and Group 3 (5/10). The proliferating cell nuclear antigen index (extent of proliferation) remained unchanged among groups. Conclusions: Propofol could offer a protection against apoptosis of enterocytes with a stable tissue MDA and serum TNF-� level compared to ketamine anaesthesia in an animal model of burn injury.

The objectives of this paper were to determine the levels of contaminants or elements in the dialysis water and dialysate, to compare them with the standard levels of contaminants, to judge the quality of water treated by the systems used at some hemodialysis centers, and to aid in solving hemodialysis water quality problems. Atomic absorption spectrometry was used to determine the levels of elements in samples collected from feed water, treated or product water at different stages of purification, and dialysate solutions.

World Conference on Educational Technology Researches (WCETR) -- JUL 05-09, 2011 -- East Univ, Nicosia, CYPRUS WOS:000299618300111 Gazi Univ, Cyprus Educ Sci Assoc

In order to reveal the effect of reuse solution and the hemodialysis environment on the stability of high flux polyamide hollow fiber membranes, mechanical tests, surface and X-ray diffraction studies were performed on both virgin 17S high flux polyamide hollow fiber and used-processed 17S high flux polyamide hollow fiber membranes. Used fibers were left in 4% formaldehyde solution for 14 hours and then in 5% sodium hypochloride (bleach) solution for 6 hours in order to disinfect the membrane for the reuse idea. Tensile tests performed on both virgin and used-processed fibers reveal that toughness and ductility of the used-processed fibers are lower than the virgin ones. Scanning electron microscopy (SEM) and atomic force microscopy (AFM) studies performed on virgin and used-processed fiber visualized the morphological changes. Rough surface with defects and cracks was seen in used-processed fiber, whereas a smoother surface morphology was seen in virgin fibers. Alterations in pore morphology and the size of the pores became greater in used processed fibers. Cracks, merging of pores and also more defects were visualized in used-processed fibers. Thus, easy crack initiations and easy propagations were expected in used-processed fibers which were also confirmed by tensile test experiments. In addition to these mechanical and surface studies experiments, X-ray diffractometry studies also revealed the changes in the structure of the used-processed fibers. New or growth of the existing phases and orientations were observed in usedprocessed fibers. This study showed that dialysis environment caused structural changes on membranes which may cause clinical complications.