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Background/Aim: The frequency of eosinophilic esophagitis has been rising over the last decades. It is diagnosed primarily based on symptoms and endoscopic and histopathological examination findings. Although eosinophilic esophagitis is not associated with malignancy, it remains an important condition affecting both children and adults, as it is associated with morbidity such as dysphagia, food impaction, and esophageal strictures. This study aimed to define clinical and endoscopic characteristics of adult patients diagnosed with eosinophilic esophagitis based on recently recommended histopathological criteria. Methods: This retrospective cross-sectional descriptive study included 54 adult patients (mean age: 33.6 yr, range: 16–61 yr) who underwent upper gastrointestinal system endoscopy for dyspeptic complaints (epigastric pain, reflux, dysphagia, or food impaction) and diagnosed with eosinophilic esophagitis based on the latest histopathological criteria (≥15 eosinophils per high-power field). Patients with a history of malignancy were excluded. Patients’ clinical, endoscopic, and histopathological data were examined. Results: In patients diagnosed with eosinophilic esophagitis, the most common presenting complaint was dysphagia (61.1%), followed by dyspepsia (24.0%), regurgitation (16.6%), chest pain (16.6%), epigastric pain (12.9%), food impaction (11.1%), and halitosis (3.7%), without any age predilection for the complaints. White papules and linear furrow were the most frequent findings on endoscopic examination (35.1% each), followed by circular rings (24.0%), paleness (22.2%), normal endoscopic finding (20.3%), and small-caliber esophagus (11.1%). Conclusion: The diagnosis of eosinophilic esophagitis remains challenging due to considerable variations in definitions and in the relative frequencies of endoscopic findings. Therefore, we recommend combining clinical, endoscopic, and histologic criteria to establish diagnosis. The identification of standards for diagnosis in future studies is warranted.

Embedded systems are designed for many different applications including navigation, thief warning, smart home, tracking. We designed an embedded system, Care4HIP, Care for Hearing Impaired People, which presents a solution for discerning the hear-impaired people in traffic. Our solution aims that drivers will be able to notice the hear-impaired people. Care4HIP calculates the locational information of these people which close to the vehicle and determines the direction of these people with respect to the vehicle. Location information refers to the latitude and longitude data of each person's location. The proposed system involves server, mobile and embedded system based applications. We think that Care4HIP offers an original and practical solution with minimal overhead for hear-impaired people.

Background The progression to gastric cancer has been linked to chronic infection with Helicobacter pylori (H. pylori). Immune checkpoint inhibitors (programmed cell death -1, PD-1; programmed cell death –ligand 1, PD-L1) have a role in cancer immune escape. The relationship between H. pylori virulence factors with PD-1, PD-L1 T helper 1 (Th1), T helper 17 (Th17), and regulatory T cell (Treg) response genes, has not been thoroughly investigated in the development of gastric cancer. Therefore, we evaluated how H. pylori virulence factors influence the expression levels of immune-related genes in the development of gastric immunopathology. Methods A total of 92 gastric tissues of normal controls and patients with gastritis, gastric ulcer, and gastric cancer were examined for the expression of immune-checkpoint inhibitor genes (PD-1 PD-L1), Th1 (interferon- γ, IFN-γ), Th17 (interleukin- 17, IL-17, Retinoic-acid-receptor- related orphan nuclear receptor gamma t, RORγ-t), and Treg (Forkhead box P3, FOXP3) response genes with quantitative real-time PCR (qRT-PCR). Furthermore, correlation of H. pylori virulence factors’ (cytotoxin-associated gene A, cagA; vacuolating cytotoxin gene A, vacA (s1,s2,m1,m2); blood group antigen-binding adhesin gene A, babA, duodenal ulcer promoting gene A, dupA; the putative neuraminyllactose-binding hemagglutinin homolog, hpaA; neutrophil-activating protein A napA; outer inflammatory protein A, oipA; urease A, ureA; and urease B, ureB) genotypes with a degree of inflammation and density of H. pylori were investigated. Next, the relationship between H. pylori virulence factors and immune-checkpoint inhibitor genes, and T-cell response genes was evaluated. Eventually, a decision tree model was developed to determine the clinical outcome of patients using expression data. Results The intensity of PD-1 and PD-L1 mRNA expression was increased significantly in gastric tissue of patients with gastric ulcer (PD-1: 2.3 fold, p=0.01; PD-L1: 2.1 fold, p=0.004), and gastric cancer (PD-1: 2 fold, p= 0.04; PD-L1: 1.8 fold, p=0.05) compared with control subjects. Also, PD-1: PD-L1 expression was significantly higher in patients with gastritis, who were infected with a marked density of H. pylori compared with its mildly infected counterparts. Furthermore, a novel negative correlation was found between PD-1 (r= -0.43) and PD-L1 (r= -0.42) with FOXP3 in patients with gastritis. CagA-positive H. pylori strain's negative association with PD-L1 expression (r=-0.34) was detected in patients with gastritis. Interestingly, PD-1 mRNA expression correlated positively with vacA s2/m2, in gastritis (r=0.43) and ulcer (r=0.43) patients. Furthermore, PD-1: PDL1 expression negatively correlated with vacA m1/m2 (r=-0.43 for PD-1; r=-0.38 for PD-L1) in gastritis patients. Moreover, an inverse correlation of PDL1 was present with vacA m1 (r=0.52) and vacA s1/m1 (r=0.46) versus vacA m2 (r=-0.44) and vacA m1 (r=0.52) and vacA s1/m2 (r=-0.14) in ulcer patients, respectively. Also, a correlation of vacA m2 (r=-0.47) and vacA s1/s2 (r= 0.45) with PD-1 was detected in ulcer patients. In addition, a novel negative correlation between FOXP3 mRNA levels and napA was shown in patients with gastritis and ulcer (r=-0.59). Finally, a computer-based model that was developed showed that knowing the expression levels of PD-L1, RORγ-t, and vacA s1/m2 would be useful to detect the clinical outcome of a patient. Conclusion Our results suggested that PD-1:PD-L1 immune checkpoint inhibitors were increased in gastric pre-cancerous lesions that progress to gastric cancer. Herein, we report the relationship between H. pylori virulence factors and expression of host immune checkpoint inhibitors for diagnostic prediction of gastric malignancies using computer-based models.

PurposeThe aim of this study was to demonstrate that measuring the medial gap before bone resection during total knee arthroplasty (TKA) provides an optimum gap adjustment in varus knees.MethodsPatients were separated into two groups, Group 1 being those whose medial joint gap was measured prior to bone resection and Group 2 comprising those who underwent conventional measured resection technique without measuring. The medial joint gap was measured with a custom-made gap measuring device up to the point that the knee was corrected and aligned along its mechanical axis. Medial joint gap distances, distal medial femoral bone cut thicknesses, amounts of tibial resection calculated, gap internal distances measured after cutting, and the thicknesses of the trial inserts were recorded. A comparison was made between the groups in terms of the number of patients requiring an additional tibial bone cut and the distribution of insert thicknesses.ResultsExtra tibial bone resections performed in two (5.7%) patients in Group 1 and in 10 (28.6%) patients in Group 2. In Group 1, where the medial joint gap was measured, the need for an additional bone resection was statistically less. (p=0.018). In the comparison of distribution of insert size by group, the number of patients on whom an 8 mm insert had been used was significantly greater in Group 1 (p=0.024). ConclusionMeasuring the medial joint gap prior to bone resection in total knee arthroplasty may prevent repeated bone recutting and additional bone resections. Furthermore, we can use this method to avoid the disadvantages of the measured resection technique.

Eğitim alanındagerçekleştirilen çalışmalar mühendislik tasarım süreçlerinin disiplinlerarasıbilgi ve becerilerin öğrencilere kazandırılması açısından öneminin altınıçizmektedir. Rube Goldberg Makineleri tasarımının STEM eğitimi ve mühendisliktasarımı noktasındaki potansiyelinden yola çıkılarak, bu çalışma kapsamındailkokul 4. sınıf öğrencilerinin okul dışı etkinlikler kapsamında altı haftaboyunca Rube Goldberg Makinesi tasarımı sürecindeki deneyimlerinin veedinimlerinin ortaya konulması amaçlanmaktadır. Bu doğrultuda tek bir analizbiriminin (ilköğretim dördüncü sınıf öğrencilerinin oluşturduğu tasarım ekibi)kapsamlı bir biçimde ele alındığı bütüncül tek durum deseni temel alınarakçalışma yürütülmüştür. Araştırmanın çalışma grubunu bir devlet okulundadördüncü sınıf düzeyinde öğrenim gören dört öğrenci (3 kız 1 erkek)oluşturmaktadır. Veri toplama araçlarını yarı-yapılandırılmış görüşmeler vekatılımcı gözlemleri oluşturmaktadır. Verilerin analizinde, birbirine benzeyenverilerin belirli kavramlar ve temalar çerçevesinde bir araya getirilerekyorumlanmasını amaçlayan içerik analizi yöntemi uygulanmıştır. Verilerinanalizi neticesinde ortaya çıkan kodlar: tasarım süreci, disipliner bilgilerinkullanımı, beceri kullanımı, karşılaşılan güçlükler, problem çözme, ekipçalışması işbirliği ve iletişim, proje süreci ve sınıf içi uygulamalarınkarşılaştırılması, öğrenme ve eğitmenin rolüdür. Çalışmanın bulgularıöğrencilerin gözünden tasarım sürecini ve bu süreçte kazandıklarınıdüşündükleri bilgi ve becerileri ortaya koymuştur., The literaturehighlights the importance of engineering design processes for bringing studentsin interdisciplinary knowledge and skills. Considering the potential ofdesigning Rube Goldberg Machines in STEM education, this study aims to portraythe experiences of fourth grade students designing Rube Goldberg machines in anafter-school program for six weeks. A single case study design that approachesan analysis unit holistically was employed. The participants of the study arefour fourth grade students (a design team with three female and one malestudents). The data collection tools were semi-structured interviews andparticipant observation. The analysis of the data were done via contentanalysis by creating categories and then themes. The themes that emerged basedon the data analysis were design process, use of disciplinary knowledge, use ofskills, difficulties faced, problem solving, teamwork cooperation andcommunication, the comparison between project design and classroom practices,learning, and the role of educator. The findings of the study illustrated thedesign process and the knowledge and skills they obtained from their ownperspectives.

VERGILI, OZGE/0000-0002-5312-7684 WOS: 000513233500011 PubMed ID: 30644769 Introduction: Due to the continual increase in the number of children engaging in sports today, physicians encounter finger injuries at an increasing frequency. This study sought to investigate the effectiveness of the method of Kinesio taping versus classic finger splint technique on pediatric patients with PIP (proximal interphalangeal) joint sprains of the fingers. Method: This is a retrospective cohort study. Forty-nine pediatric patients with PIP joint sprains were included in the study. The patients were divided into two groups, Group 1 being those treated with Kinesio taping and Group 2, those treated with splints. The area around the PIP joint was measured before and after treatment. Visual analog scale (VAS) evaluation: nighttime pain, numbness, pain at rest, and pain during activity were each separately evaluated before and after treatment. Also, flexion was measured at rest and in active motion before and after treatment. Results: The patients' periarticular measurements of the affected joint were statistically significant in both groups after treatment (p < 0.001). In the comparison between the groups, it was found that the group treated with Kinesio taping displayed a better outcome (p < 0.021). According to the VAS for PIP joint pain, it was observed that in both groups, pain at rest, pain during activity, nighttime pain, and numbness were statistically significant after treatment (p < 0.001). In the comparison of the groups, it was seen that the difference was statistically significant only in terms of nighttime pain (p < 0.013). Conclusions: The study conducted supported the literature that Kinesio taping method does not restrict the function of the extremity to which it is applied and also does not produce the complications reported in other treatment techniques. Kinesio taping was found to have a higher patient compliance and the outcomes were better in terms of edema and joint range of motion as well as night time pain when compared to the group treated with splint.

Gultac, Emre/0000-0003-1943-2199; Serbest, Sancar/0000-0003-2696-8303 WOS:000571509200016 PubMed: 30644789 Background:Here we have defined a novel technique for repairing posterior acetabular wall fractures called the "crescent technique," in which dual C-shaped reconstruction plates overlap at the distal ends and, if necessary, at the proximal ends. We also analyzed the efficacy and reliability of this method.Patients and Methods:This was a retrospective analysis of 27 patients undergoing the crescent technique. All of the fractures were treated by the senior author for a mean of 7.9 days (0-15 days) after the trauma. The mean follow-up period was 19 months (13-29 months). The clinical results were evaluated using the modified clinical grading system developed by Merle d'Aubigne and Postel, and then modified by Matta. The radiographs were graded according to the criteria described by Matta.Results:In the clinical grading, 16 (59%) of the patients were excellent and very good, 5 (19%) were good, 3 (11%) were moderate, and 3 (11%) were poor. According to the Matta radiological evaluation criteria, 19 (70%) were excellent, 4 (15%) were good, 4 (15%) were fair, and none were poor. Statistically significant consistency was seen between the clinical and radiological results (p = 0.002).Conclusions:The crescent technique is a dual plate technique modification that can provide a stable fixation. It appears to be an effective and reliable method for treating posterior wall fractures of the acetabulum.

Colonic diverticula are outpouchings of mucosa and submucosa through the large intestine wall. Inverted colonic diverticula can be confused with colonic adenoma. It is important to differentiate them. Here we report two cases of inverted diverticula that seem to like adenomas.

Bu çalışmanın konusu toplum yararına faaliyet gösteren sivil toplum kuruluşlarında (STK) çalışanların gönüllülük motivasyonu ve gönüllülük motivasyonunu etkileyen faktörlerdir. Bu bağlamda çalışmanın amacı, toplum yararına çalışan, insani yardım faaliyetlerinde bulunan profesyonel veya gönüllü olarak hizmet veren kişilerin gönüllü olma eğilimleri artırmak, motivasyonlarını yükseltmek ve kamusal veya bireysel anlamda akademik bir farkındalık oluşturarak mevcut yapının tespitini yapmaktır. Bu çalışmada STK çalışanlarının gönüllülük motivasyon düzeyleri ve motivasyonlarını etkileyen etmenler tespit edildiğinden, elde edilen bilgiler hem daha sonra yapılacak benzer nitelikteki akademik çalışmalar için veri sunacak, hem de gönüllülük motivasyonlarını artırmaya yönelik çalışma yapacak uygulayıcılar için gönüllü motivasyonuna etki eden faktörler hakkında bilgi verecektir Tez çalışmasında, örnek olarak seçilen dernek ve vakıf çalışanlarının gönüllülük eğilimleri 51 sorudan oluşan ankete verilen cevaplar ile bu kurumlarda çalışan orta ve üst düzey yöneticilerle yapılan 9 sorudan oluşan gönüllülük motivasyon mülakat sorularının deşifre edilerek elde edilen bulguların değerlendirilmesi altında incelenmiştir. Araştırmanın sonucu; Türk Kızılay ve Türkiye Diyanet Vakfı çalışanları arasında gönüllülük motivasyon eğilimlerinde genel olarak bir farklılık bulunmadığı hem vakıf hem de dernek çalışanlarının gönüllülük motivasyonların yüksek ve birbirine yakın olduğu ancak alt faktörlerine göre değerlendirildiğinde ise birbirlerinde farklı motivasyonlara sahip oldukları tespit edilmiştir. Dernek çalışanlarının gönüllüğünü artıran faktörler kariyer ve fırsat, problem çözme ve takdir edilme iken vakıf çalışanlarının, gelişim ve katkı sunma, merhamet, toplumsal ilgi, empati ve acıma duygularının gönüllü olma nedenleri arasında daha ön planda olduğu sonucuna ulaşılmıştır. This study aims to examine the relationship between voluntary activities and motivational factors in civil society institutions , which work in pro-social field. Our intention is to study people, who work in the field of humanitarian and social aid professionally or voluntarily. We hope that our study would contribute to the awareness regarding pro-social activities and institutions.Our study is a pioneering work, which provide theoretical knowledge and ampirical data as well as it could open ways for future studies about how to increase the motivation of people, who work and participate pro-social activities under the umbrella of institutions.Our study examine two majör civic society institutions, namely Türkiye Diyanet Vakfı (The Endowment of Turkish Religious Affairs-TDV) and Türk Kızılayı (Turkish Crescent).We distribute a questionnaire, which has been consisted of 51 questions, to workers in these two institutions in order to measure their tendencies for voluntary activities.We also interviewed 8 people, who work as administrative staff regarding the issue. In these interviews we asked nine questioned to them and then we analyzed their responses. In the light of our reserach, we reach the conclusion that people, who work for two institutions, have higher levels of motivation regarding their voluntary activities. We also found that although people have higher level of motivation for voluntary activities, their motivational factors are different from each other.There are important factors, such as promotion and opportunity in the job, getting recognition and appreciation for their works, personal development and make contribution, feeling of solidarity and cooperation, social interest, sympathy- which motivate people to participate voluntary activities in the highest levels. 101

In this paper, turbulent flow simulations of a typical LWR unit-cell are presented. Three subgrid scale turbulence models (WALE, VLES ( k − e ) and VLES ( k − ω )) have been implemented in open source lattice-Boltzmann code Palabos. The Smagorinsky-Lilly model already exists in the code. The simulations also include Smagorinsky-Lilly model results. The standard wall function implementation is made for all turbulence model simulations. The simulation results are compared with the Hooper's experimental data. Additionally, fine grid ANSYS Fluent simulations are performed using WALE turbulence model. The results show that VLES ( k − e ) and VLES ( k − ω ) models give better agreement with experimental results even if the grid is intermediate in size.

Uğur Tiftikçi,1 Sancar Serbest,1 Veysel Burulday2 1Department of Orthopaedics and Traumatology, 2Department of Radiology, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey Background: In total knee arthroplasty, it is better to use more than one reference point for correct alignment of the components. By measuring the distances of Achilles tendon (AT) and other conventional landmarks from the mechanical axis in magnetic resonance imaging (MRI) of the ankle, we aimed to demonstrate that, as a novel landmark which can help for correct alignment in the coronal plane, AT is a better option than other landmarks. Materials and methods: This retrospective study was done on 53 ankle MRIs that met the criteria for inclusion to the study among 158 ankle MRIs. After identification of the mechanical axis, the distances of distal landmarks, which were extensor hallucis longus tendon (EHLT), tibialis anterior tendon (TAT), dorsalis pedis artery (DPA), AT, extensor digitorum longus tendon (EDLT), and malleoli, were measured from the mechanical axis and were statistically evaluated. Results: In proximal measurements, the distances of the landmarks to the mechanical axis (on average) were AT, 2.64±1.62 mm lateral; EHLT, 3.89±2.45 mm medial; DPA, 4.69±2.39 mm medial; TAT, 8.24±3.60 mm medial; and EDLT, 14.2±4.14 mm lateral (P