Search

Abstract Background It is aimed to compare the block onset times and performance features of costoclavicular techniques (medial and lateral approach) versus lateral sagittal technique. Methods Patients were randomized into three groups. For costoclavicular techniques, ultrasound probe was placed parallel to clavicle obtaining nerve cords, axillary artery and axillary vein visual from lateral-to-medial, respectively. The block needle was advanced from lateral (Group CLB) or medial (Group CMB) to perform costoclavicular block. For lateral sagittal technique (Group LSB), ultrasound probe was placed sagittal and perpendicular below the coracoid process to obtain sagittal artery image with the cords around. Total 20 ml of 0.5% bupivacaine and 10 ml of 2% lidocaine were deposited for all groups. Sensory and motor block onset times, block performance properties, complications, and patient/surgeon satisfactions were investigated. Results Among 56 patients, the primary outcome, sensory block onset time was shorter in Group CLB than Group CMB and Group LSB (10 [5–15], 10 [10–20], and 15 [10–15] minutes, respectively, p

Bu çalışmada ortaokul matematik öğretmenlerinin etkinlik uygulama sürecinde karşılaştıkları sorunları teşhis ve müdahale biçimlerinin yapıları belirlenmeye çalışılmıştır. Araştırmanın verileri etkinlik tasarım ve uygulamaları çerçevesinde haftada 3 saat olmak üzere 14 hafta süren bir mesleki gelişim eğitimi sonunda toplanmıştır. Eğitimlere 13 ortaokul matematik öğretmeni katılmıştır. Eğitimlerin 12. haftasından sonra katılımcılara iki hafta süre verilerek sınıflarında bir etkinlik uygulamaları, uygulama sürecini video kaydına almaları ve uygulama sonrasında uygulamanın niteliğine dair bir rapor yazmaları istenmiştir. 14. hafta sonunda ise katılımcılarla eş zamanlı olarak bir görüşme yapılmıştır. Görüşmede etkinlik uygulama sürecinde herhangi bir sorunla karşılaşıp karşılaşmadıkları, sorunları nasıl teşhis ettikleri, müdahale biçimleri ve müdahalelerden elde ettikleri sonuçlar üzerinde durulmuştur. Görüşmelerde 5 öğretmen süreçte karşılaştığı sorunlardan bahsetmiştir. Bu öğretmenlerden üçünün dile getirdiği sorun video kayıtlarında da izlenebildiği için bu üç öğretmen çalışmanın katılımcılarını oluşturmuş ve bu öğretmenlerden elde edilen veriler analiz edilmiştir. Araştırmadan elde edilen bulgulara göre katılımcıların, karşılaştıkları sorunların kaynağından ziyade sorunu görünür kılan faktörlere odaklandıkları ve buna dönük müdahalelerde bulundukları görülmüştür. Bu sonuçlara dayalı olarak öğretmenlerin sorunları teşhis etmeleri, müdahaleleri ve müdahale sonuçlarına dair bir model çıkarılmıştır.

Bu çalışmada ortaokul 7. sınıf matematik ders kitaplarında yer verilen etkinliklerin matematiksel potansiyel düzeyleri incelenmiştir. Çalışmada doküman incelemesi yöntemi kullanılmıştır. Doküman olarak Milli Eğitim Bakanlığı Talim ve Terbiye Kurulu (MEB-TTK) tarafından ders kitabı olarak okutulması için onay verilen iki kitap seçilmiştir. Bu kitaplar A ve B kitabı olarak isimlendirilmiştir. A kitabında 36 ve B kitabında ise 13 etkinliğe yer verilmiştir. Kitaplarda yer verilen etkinliklerin matematiksel potansiyel düzeyleri derinlik, matematiksel odak ve komplekslik bileşenlerine göre betimsel olarak analiz edilmiştir. Etkinlikler bu bileşenlerin her birine göre çok düşük (0 puan), düşük (1 puan), orta (2 puan) ve yüksek (3 puan) olmak üzere dört düzeye göre puanlanmıştır. Derinlik bileşeni kapsamında her iki kitapta yer verilen etkinliklerin ağırlıklı olarak orta ve yüksek puanlı etkinlikler olduğu gözlenmiştir. Matematiksel odak bileşeni kapsamında B kitabında yer verilen etkinliklerin A kitabındaki etkinliklere göre daha yüksek puanlı etkinlikler olduğu görülmüştür. Her iki kitapta da özellikle komplekslik bileşeni düzeyleri düşük çıkmıştır. Veri analizlerinden elde edilen bulgular incelenen her iki ders kitabında yer verilen etkinliklerin matematiksel potansiyel bileşenleri kapsamında farklı öğrenme fırsatları sunduklarını göstermiştir. Ayrıca her iki kitapta yer verilen ve aynı kazanıma yönelik olan bazı etkinliklerin aynı bağlama sahip olmalarına rağmen matematiksel potansiyel bileşenleri özelinde farklı puan dağılımlarına sahip olabildikleri görülmüştür.

The aim of this study was to compare the effect of using L-PRF in patients undergoing impacted lower third molar surgery with either primary or secondary closure techniques. Methods: This prospective, randomized, double-blind, split-mouth clinical trial was conducted on patients with bilateral impacted lower third molars of a similar position. Primary closure was performed in group 1 and secondary closure in group 2. The group 1 closure technique was applied to one side of the patients, and the group 2 closure technique was applied to the other side at different times. Of the 45 patients evaluated, 9 patients were excluded from the study because of alveolitis and failure to attend regular control visits out. Results: Of the 36 patients included in the study, 23 were female and 13 were male, with a mean age of 22.42 ± 3.36 years. The secondary closure group had lower VAS scores at hour 6 (p < 0.05). Pain decreased more in the primary closure group when comparing changes between the VAS scores at 6 hours and 7 days (p < 0.05). Conclusions: The results of this study, showing that both secondary and primary closure are effective, with similar outcomes in terms of pain, swelling, and trismus, should be supported by future clinical trials.

While studies that address the relationship between social media and social movements generally use the functionalist paradigm, the critical analysis of the public sphere in the era of distributed media emphasizes the importance of political economy and political communication. Based on the critical political economy analysis of distributed media, this study examined the Twitter-mediated protest “Petrocaribe Challenge” in relation to a possible political public sphere in Haiti. To this end, a qualitative method based on critical discourse analysis was used in the study. Also, 163 tweets purposely selected by the researchers were analyzed. The research findings showed that the Twitter-mediated Petrocaribe Challenge is a political protest with no leadership and a significant lack of online engagement and communication. Besides, the study found that in a political sphere characterized by extreme social inequalities, universal participation is crucial to the formation of a critical public sphere. Although most educated people in Haiti use social media, the majority of Haitians do not have access to these online platforms, which goes against the principles of the public sphere. While the findings of the present study do not allow for generalization, they make up a significant contribution to the critical analysis of social media as a public sphere.

Abstract In this study, pumice from different regions of Turkey (Diyarbakir, Southeast Turkey and Bitlis, East Turkey) has been supplied and used as supporting material for nanoscale zero-valent iron (nFe0). Native Bitlis pumice (NBP)-supported nanoscale zero-valent iron (BP-nFe0) and native Diyarbakir pumice (NDP)-supported nanoscale zero-value iron (DP-nFe0) were synthesized under the same conditions. Native pumice (NDP, NBP) and pumice-supported nFe0 (DP-nFe0 and BP-nFe0) adsorbents were morphologically and structurally characterized by SEM, EDX, XRF and BET. When using NBP as support material, the iron content of the BP-nFe0 increased 1.9-fold from 1.99 to 3.83%. However, iron content of NDP (2.08%) increased approximately 29 times after it is used as a support material in synthesis of DP-nFe0 (60%). The removal potential of native pumice (NBP and NDP) and iron-modified pumice (BP-nFe0 and DP-nFe0) samples was investigated to remove Cr(VI) ions. The parameters of solution pH, initial metal concentration, contact time and the amount of adsorbent in the removal of chromium (VI) ions were investigated. Langmuir, Freundlich, Temkin, Dubinin–Radushkevich and Jovanovic isotherm models were used to evaluate the adsorption equilibrium data. The equilibrium adsorption was found so as to be well described by the Langmuir isotherm model for all the adsorbents studied. The maximum adsorption capacity of Cr(VI) ions for NDP, NBP, DP-nFe0 and BP-nFe0 was 10.82, 14.30, 161.29 and 17.39 mg/g, respectively. The rate of Cr(VI) removal was subjected to kinetic analysis using pseudo-first-order, pseudo-second-order, intraparticle diffusion and Elovich models. Kinetic studies suggest that adsorption of NDP, NBP, DP-nFe0 and BP-nFe0 described more favorably by the pseudo-second-order kinetic model. The results showed that NDP is a much better support material for nFe0 when compared to NBP.

Bu çalışmada, tam sayılarla çıkarma işleminin fark anlamına uygun olarak hazırlanmış bir etkinliğin tasarım, uygulama ve değerlendirme süreçleri sunulmuştur. Bu kapsamda tam sayılarla çıkarma işleminde sonuç ve sonucun işaretinin bulunması öğrenme nesnesi olarak belirlenmiştir. Etkinlik sayı doğrusu modeli kullanılarak tasarlanmıştır. Tam sayılarla çıkarma işleminde eksilen ve çıkanın, işaret ve büyüklüklerine göre karşılaşılabilecek dört farklı durum belirlenmiştir. Tasarlanan etkinlikte öğrencilerin her bir durum için öncelikle uygulama yapmaları ve daha sonra ulaştıkları sonuçları genellemeleri beklenmektedir. Etkinlik uygulamasına 27 ortaokul 7. sınıf öğrencisi katılmıştır. Uygulamadan toplanan verilerin analizi sonucunda, çıkarma işleminin fark anlamına uygun olarak hazırlanan etkinliğin, tam sayılarla çıkarma işleminde doğru sonucu bulmada etkili olduğu tespit edilmiştir.

ABSTRACT: Objective: Metastases to the thyroid gland are rare. The most common tumors that metastasize to the thyroid are kidney, lung, gastrointestinal tract, and breast tumors. Metastases from other primary cancer sites into a primary thyroid cancer (defined as tumor-to-tumor metastases) are even rarer.Methods: In this case report we present the 10th published case of lung cancer metastasizing into a thyroid neoplasm.Results: A 53-year-old male patient had been diagnosed with metastatic non-small cell lung carcinoma 18 months previously (adenocarcinoma of the lung that had spread to both lungs) and was admitted to the endocrine surgery department for a mass in the thyroid. The biopsy of the mass revealed follicular neoplasia of the hurthle cell type. He underwent total thyroidectomy and the final histopathologic evaluation was reported as papillary thyroid cancer (hurthle cell type) with invasion of the adenocarcinoma with papillary structures showing different morphology inside the tumor.Conclusion: The most common tumors that metastasize are kidney, lung, gastrointestinal tract, and breast cancers. Routine pathological examination may not be adequate to diagnose other, less common metastases and careful review of medical history and systemic examination should be performed to reach the correct diagnosis. Immunohistochemical staining could aid in diagnosis given that trefoil factor 1 is positive in thyroid neoplasms, adenocarcinomas, and small cell tumors of the lung. Identification of the primary or metastatic status of a tumor is a diagnostic challenge, however it is essential as thyroid malignancies are usually treated by excision while widespread metastatic tumors of other organs could require chemotherapy and radiotherapy.

(1) Background: In our study, we aimed to determine the accuracy rates of imaging methods for sigmoid, rectosigmoid colon, and rectum cancer. (2) Methods: Patients with tumors located in the rectosigmoid colon, sigmoid colon, and rectum who were operated on were included. Upon admission, we examined the patients’ first diagnostic colonoscopies and their preoperative repeat control colonoscopies and computed tomography (CT) report. (3) Results: In this study, 23 patients (57.5%) were male. The overall accuracy rates were 80.0% (32/40) in colonoscopy, 65.0% (26/40) in preoperative CT, and 87.5% (35/40) in retro CT, and the differences among the examination methods were statistically significant (p = 0.049). The sensitivity levels decreased to 50.0% for colonoscopy and preoperative CT and 75.0% for retro CT in rectosigmoid colon tumors. In rectal tumors, the sensitivity levels were 75.0% in colonoscopy, 60.0% in preoperative CT, and 80.0% in retro CT. In two patients, the tumor location was given incorrectly, and postoperative pathological evaluations indicated T3N0 tumors; the initially planned treatment was thus changed to include radiotherapy in addition to chemotherapy in the postoperative period because the tumor was located in the middle rectum. (4) Conclusions: Accuracy in tumor localization in sigmoid, rectosigmoid, and rectum tumors still needs to be improved, which could be accomplished with prospective studies. CT evaluations for cancer localization in this patient group should be re-evaluated by a radiologist.

Clouds play a pivotal role in determining the weather, impacting the daily lives of everyone. The cloud type can offer insights into whether the weather will be sunny or rainy and even serve as a warning for severe and stormy conditions. Classified into ten distinct classes, clouds provide valuable information about both typical and exceptional weather patterns, whether they are short or long-term in nature. This study aims to anticipate cloud formations and classify them based on their shapes and colors, allowing for preemptive measures against potentially hazardous situations. To address this challenge, a solution is proposed using image processing and deep learning technologies to classify cloud images. Several models, including MobileNet V2, Inception V3, EfficientNetV2L, VGG-16, Xception, ConvNeXtSmall, and ResNet-152 V2, were employed for the classification computations. Among them, Xception yielded the best outcome with an impressive accuracy of 97.66%. By integrating artificial intelligence technologies that can accurately detect and classify cloud types into weather forecasting systems, significant improvements in forecast accuracy can be achieved. This research presents an innovative approach to studying clouds, harnessing the power of image processing and deep learning. The ability to classify clouds based on their visual characteristics opens new avenues for enhanced weather prediction and preparedness, ultimately contributing to the overall accuracy and reliability of weather forecasts.

In recent years, radical changes in journalism due to political developments and technological innovations have accelerated the debate on the quality and future of journalism education. Today, as in the rest of the world, journalism academics in Turkey are faced with the need to restructure journalism education in line with the transformation of journalism and the problems as well as needs that come with it. Considering the structural problems of the media sector in Turkey and the need for quality journalism, the role of journalism academics in this process becomes even more important. On the other hand, in Turkey, where journalism education is a field with multifaceted problems because of neoliberal policies, how communication faculties and journalism departments can respond to the current needs of journalism education constitutes a critical issue. Based on these evaluations, this study focuses on the current needs and the pursuits for future journalism education of journalism academics in Turkey and their experiences under current conditions. With a qualitative research approach, interviews were conducted with seven faculty members of different backgrounds working in journalism departments affiliated to public and foundation universities in Turkey. According to the results, journalism academics had practices to structure training programs in line with the developments and needs in journalism and there were inequalities in this regard, especially in newly established departments. It was also revealed that the ongoing problems arising from higher education policies in journalism education generally complicate the efforts of journalism academics to respond to current needs.

Objective To investigate the role of positron emission tomography (PET) and magnetic resonance imaging (MRI) in evaluating the feasibility of skin-sparing mastectomy in patients with locally-advanced breast cancer (LABC) who will undergo neoadjuvant chemotherapy (NAC) by evaluating the sensitivity and specificity of PET and MRI compared with skin biopsy results before and after NAC treatment. Methods Patients with LABC who were treated with NAC between November 2013 and November 2015 were included in this study. Demographic, clinical, radiological and histopathological features of the patients were recorded. Results A total of 30 patients were included in the study with a mean age of 52.6 years (range, 35–70 years). Sensitivity and specificity for detecting skin involvement in LABC was 100%/10% (62%/85%) with MRI and 60%/80% (12%/92%) with PET before (after) NAC, respectively. When radiological skin involvement was assessed in relation to the final histopathological results, the preNAC PET results and histopathological skin involvement were not significantly different; and there was no difference between postNAC MRI and histopathological skin involvement. Conclusions As preNAC PET and postNAC MRI more accurately determined skin involvement, it might be possible to use these two radiological evaluation methods together to assess patient suitability for skin-sparing mastectomy in selected patients.

Objective To compare urinary iodine excretion levels in patients with breast cancer and control subjects. Methods In this prospective pilot study, patients with breast cancer and normal controls were recruited. Age and menopausal status were recorded. Levels of serum thyroid-stimulating hormone, blood urea nitrogen and creatinine and urine iodine concentration (UIC) were measured. UIC levels were divided into three categories: low (200 µg/l). Results A total of 24 patients with breast cancer and 48 controls were included in the study. There were no statistically significant differences between the two groups with regard to thyroid-stimulating hormone, blood urea nitrogen or creatinine levels. When considered overall, there was no statistical difference in UIC between patients and controls. However, comparisons within each category (low, normal or high UIC) showed a significantly higher percentage of patients with breast cancer had a high UIC compared with controls. Conclusions A high UIC was seen in a significantly higher percentage of patients with breast cancer than controls. UIC may have a role as a marker for breast cancer screening. Further studies evaluating UIC and iodine utilization in patients with breast cancer are warranted.

Introduction. Despite recent advances in surgical techniques, pancreatic fistulas are common. We aimed to determine the role of C-reactive protein in the prediction of clinically relevant fistula development. Materials and Methods. Data from patients who underwent pancreaticoduodenectomy between 2012 and 2015 is collected. Postoperative 1st, 3rd, and 5th day (POD1, POD3, and POD5) C-reactive protein (CRP) levels, postoperative pancreatic fistula (POPF) development, other complications, length of hospital stay, and mortality were recorded. Results. Of 117 patients, 43 patients (36.8%) developed complications (including fistulas). Of the patients developing fistulas, 21 (17.9%) had POPF A, 2 (1.7%) had POPF B, and 7 (6.0%) had POPF C. POD5 CRP and POD3 CRP were shown to be significantly correlated with mortality and development of clinically relevant POPF (p=0.001 and p=0.0001, resp.) and with mortality (p=0.017), respectively. The development of clinically relevant POPFs (B and C) could be predicted with 90% sensitivity and 82.2% specificity by POD5 CRP cut-off level of 19 mg/dL and with 100% sensitivity and 63.6% specificity by the difference between POD5 and POD1 CRP cut-off level of >2.5 mg/dL. Conclusion. CRP levels can effectively predict the development of clinically relevant pancreatic fistulas.