Search results for: Ayşe Dilek Maden

Authors: Nura Brimo, Dilek Cokeliler Serdaroglu, Tansel Uyar, Busra Uysal, Elif Bahar Cakici, Miris Dikmen, Zerrin Canturk

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Background: A combination of antibiotics, including metronidazole (MET), ciprofloxacin (CIP), and minocycline (MINO), has been demonstrated to disinfect bacteria in necrotic teeth before regenerative processes. It has been presented clinically that antibiotic pastes may drive to possible stem cell death and difficulties in removing from the canal system, which can limit the regenerative procedure. This study was designed to (1) synthesize nanofibrous webs containing various concentrations of different medicaments (triple, double, and calcium hydroxide,Ca(OH)2), and (2) coat thiselectrospun fibrous gutta-percha (GP) cones. Methods: Poly(vinylpyrrolidone) (PVP)-based electrospun fibrous webs were processed with low medicaments concentrations. Scanning Electron Microscopy (SEM), Energy Dispersive X-Ray Spectroscopy (EDX), and X-Ray Photoelectron Spectroscopy (XPS) were carried out to investigate fiber morphology, antibiotic incorporation, and characterized GP-coated fibrous webs, respectively. The chemical and physical properties of dentine were carried out via Fourier Transform Infrared Spectroscopy (FTIR) and Nano-SEM, respectively. The antimicrobial properties of the different fibrous webs were assessed against various bacteria by direct nanofiber/bacteria contact. Cytocompatibility was measured by applying the MTT method. Results: The mean fiber diameter of the experiment groups of medicament-containing fibers ranged in the nm scale and was significantly smaller than PVP fibers. EDX analysis confirmed the presence of medicaments in the nanofibers. XPS analysis presented a complete coating of the fibers with GPs; FTIR and Nano-SEM showed no chemical and physical configuration of intracanal medicaments on the dentine surface. Meanwhile, nanofibrous webs led to a significant reduction in the percentage of viable bacteria compared with the negative control and PVP. Conclusion: Our findings suggest that TA-NFs, DA-NFs, and Cₐ(OH)₂)-NFs coated GP cones have significant potential in eliminating intracanal bacteria, cell-friendly behavior, and clinical usage features.

Keywords: drug delivery, drug carrier, electrospinning, nano/microfibers, regenerative endodontic, morphology

Procedia PDF Downloads 112

Authors: Bahar Tunctan, Sefika Pinar Kucukkavruk, Meryem Temiz-Resitoglu, Demet Sinem Guden, Ayse Nihal Sari, Seyhan Sahan-Firat, Mahesh P. Paudyal, John R. Falck, Kafait U. Malik

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We hypothesized that 20-hydroxyeicosatetraenoic acid (20-HETE) mimetics such as N-(20-hydroxyeicosa-5[Z],14[Z]-dienoyl)glycine (5,14-HEDGE) may be beneficial for preventing mortality due to inflammation induced by lipopolysaccharide (LPS). This study aims to assess the effect of 5,14-HEDGE on the LPS-induced changes in nucleotide binding domain and leucine-rich repeat protein 3 (NLRP3)/apoptosis-associated speck-like protein containing a caspase activation and recruitment domain (ASC)/pro-caspase-1 inflammasome. Rats were injected with saline (4 ml/kg) or LPS (10 mg/kg) at time 0. Blood pressure and heart rate were measured using a tail-cuff device. 5,14-HEDGE (30 mg/kg) was administered to rats 1 h after injection of saline or LPS. The rats were sacrificed 4 h after saline or LPS injection and kidney, heart, thoracic aorta, and superior mesenteric artery were isolated for measurement of caspase-1/11 p20, NLRP3, ASC, and β-actin proteins as well as interleukin-1β (IL-1β) levels. Blood pressure decreased by 33 mmHg and heart rate increased by 63 bpm in the LPS-treated rats. In the LPS-treated rats, tissue protein expression of caspase-1/11 p20, NLRP3, and ASC in addition to IL-1β levels were increased. 5,14-HEDGE prevented the LPS-induced changes. Our findings suggest that inhibition of renal, cardiac, and vascular formation/activity of NLRP3/ASC/pro-caspase-1 inflammasome involved in the protective effect of 5,14-HEDGE on LPS-induced septic shock in rats. This work was financially supported by the Mersin University (2015-AP3-1343) and USPHS NIH (PO1 HL034300).

Keywords: 5, 14-HEDGE, lipopolysaccharide, NLRP3, inflammasome, septic shock

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Authors: Ayse Ozbil, Gorsev Argin, Demet Yesiltepe

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Data for this cross-sectional study were drawn from questionnaires conducted in 10 elementary schools (1000 students, ages 12-14) located in Istanbul, Turkey. School environments (1600 meter buffers around the school) were evaluated through GIS-based land-use data (parcel level land use density) and street-level topography. Street networks within the same buffers were evaluated by using angular segment analysis (Integration and Choice) implemented in Depthmap as well as two segment-based connectivity measures, namely Metric and Directional Reach implemented in GIS. Segment Angular Integration measures how accessible each space from all the others within the radius using the least angle measure of distance. Segment Angular Choice which measures how many times a space is selected on journeys between all pairs of origins and destinations. Metric Reach captures the density of streets and street connections accessible from each individual road segment. Directional Reach measures the extent to which the entire street network is accessible with few direction changes. In addition, socio-economic characteristics (annual income, car ownership, education-level) of parents, obtained from parental questionnaires, were also included in the analysis. It is shown that surrounding street network configuration is strongly associated with both walk-mode shares and average walking distances to/from schools when controlling for parental socio-demographic attributes as well as land-use compositions and topographic features in school environments. More specifically, findings suggest that the scale at which urban form has an impact on pedestrian travel is considerably larger than a few blocks around the school.

Keywords: Istanbul, street network layout, urban form, walking to/from school

Procedia PDF Downloads 409

Authors: Ayşe Defne Öz, Özlem Bozkurt

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Alzheimer's Disease (AD) is counted as one of the most important global health problems and the main cause of dementia. The term dementia refers to a wide spectrum of disorders characterized by global, chronic, and generally irreversible cognitive deterioration. It is estimated that %60 % to 80 of the cases of dementia are because of AD. Alzheimer's is a slowly progressive brain disease. The reason for AD is unknown to the author's best knowledge, yet it is one of the topics that is most researched. AD shows the histopathologically abnormal accumulation of the protein beta-amyloid (plague) outside neurons and twisted strands of the protein tau (tangles) inside neurons in the brain. These changes are accompanied by damage to the brain tissue and the death of neurons. AD causes people to have difficulty remembering names or conversations. Some of the later symptoms are difficulty in talking and walking. Alzheimer's Disease is elevated by the illness and mortality of COVID-19. COVID-19 has affected many lives globally and had profound effects on human lives. COVID-19 is caused by SARS-CoV-2, which is a virus that attacks the respiratory and central nervous system and has neuroinvasive potential. More than %80 of COVID-19 patients have ageusia or anosmia, representing the pathognomic features of the disease. Patients with dementia are frail, and with the COVID-19 pandemic, including isolation, cognitive decline may exacerbate. Furthermore, patients with AD can be unable to follow the directions, such as covering their mouth and nose while coughing and can live in nursing homes which makes them more open to being infected. As COVID-19 is highly infectious and its management requires isolation and quarantine, the need for caregivers for AD management conflicts with that of COVID-19 and adds an extra burden on AD patients, caregivers, families, society, and the economy. Due to the entry of SARS-CoV-2 into the central nervous system, inflammation caused by COVID-19, prolonged hospitalization, and delirium, it has been reported that COVID-19 causes many neurological disorders and predisposition to AD.

Keywords: Alzheimer's disease, COVID-19, dementia, SARS-CoV-2

Procedia PDF Downloads 76

Authors: Sultan Çağırıcı, Arsida Bajrami, Beyza Aslan, Hacı Ali Erdoğan, Nejla Sözer Topçular, Dilek Bozkurt, Vildan Yayla

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Objective: Corticobasal syndrome (CBS) is phenotypically characterized by asymmetric rigidity, apraxia, alien-limb phenomenon, cortical sensory loss, dystonia and myoclonus. The underlying pathologies consists of corticobasal degeneration (CBD), progressive supra nuclear palsy, Alzheimer's, Creutzfeldt-Jakob and frontotemporal degeneration. CBD is a degenerative disease with clinical symptoms related to the prominent involvement of cerebral cortex and basal ganglia. CBD is a pathological diagnosis and antemortem clinical diagnosis may change many times. In this paper, we described the clinical features and discussed a cases diagnosed with symmetric CBS because of its rarity. Case: Seventy-five-year-old woman presented with a three years history of difficulty in speaking and reading. Involuntary hand jerks and slowness of movement also had began in the last six months. In the neurological examination the patient was alert but not fully oriented. The speech was non-fluent, word finding difficulties were present. Bilateral limited upgaze, bradimimia, bilateral positive cogwheel' rigidity but prominent in the right side, postural tremor and negative myoclonus during action on the left side were detected. Receptive language was normal but expressive language and repetition were impaired. Acalculia, alexia, agraphia and apraxia were also present. CSF findings were unremarkable except for elevated protein level (75 mg/dL). MRI revealed bilateral symmetric cortical atrophy prominent in the frontoparietal region. PET showed hypometabolism in the left caudate nucleus. Conclusion: The increase of data related to neurodegenerative disorders associated with dementia, movement disorders and other findings results in an expanded range of diagnosis and transitions between clinical diagnosis. When considered the age of onset, clinical symptoms, imaging findings and prognosis of this patient, clinical diagnosis was CBS and pathologic diagnosis as probable CBD. Imaging of CBD usually consist of typical asymmetry between hemispheres. Still few cases with clinical appearance of CBD may show symmetrical cortical cerebral atrophy. It is presented this case who was diagnosed with CBD although we found symmetrical cortical cerebral atrophy in MRI.

Keywords: symmetric cortical atrophy, corticobasal degeneration, corticobasal syndrome

Procedia PDF Downloads 459

Authors: A. Aslihan Gokaltun, Martin L. Yarmush, Ayse Asatekin, O. Berk Usta

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In the last decade microfabrication processes including rapid prototyping techniques have advanced rapidly and achieved a fairly matured stage. These advances encouraged and enabled the use of microfluidic devices by a wider range of users with applications in biological separations, and cell and organoid cultures. Accordingly, a significant current challenge in the field is controlling biomolecular interactions at interfaces and the development of novel biomaterials to satisfy the unique needs of the biomedical applications. Poly(dimethylsiloxane) (PDMS) is by far the most preferred material in the fabrication of microfluidic devices. This can be attributed its favorable properties, including: (1) simple fabrication by replica molding, (2) good mechanical properties, (3) excellent optical transparency from 240 to 1100 nm, (4) biocompatibility and non-toxicity, and (5) high gas permeability. However, high hydrophobicity (water contact angle ~108°±7°) of PDMS often limits its applications where solutions containing biological samples are concerned. In our study, we created a simple, easy method for modifying the surface chemistry of PDMS microfluidic devices through the addition of surface-segregating additives during manufacture. In this method, a surface segregating copolymer is added to precursors for silicone and the desired device is manufactured following the usual methods. When the device surface is in contact with an aqueous solution, the copolymer self-organizes to expose its hydrophilic segments to the surface, making the surface of the silicone device more hydrophilic. This can lead to several improved performance criteria including lower fouling, lower non-specific adsorption, and better wettability. Specifically, this approach is expected to be useful for the manufacture of microfluidic devices. It is also likely to be useful for manufacturing silicone tubing and other materials, biomaterial applications, and surface coatings.

Keywords: microfluidics, non-specific protein adsorption, PDMS, PEG, copolymer

Procedia PDF Downloads 267

Authors: Seyhan Sahan-Firat, Meryem Temiz-Resitoglu, Demet Sinem Guden, Sefika Pinar Kucukkavruk, Bahar Tunctan, Ayse Nihal Sari, Zumrut Kocak

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We hypothesized that mTOR inhibition may prevent the multiple organ failures following severe multiple tissue injury associated with increased NADPH oxidase system activity occur in zymosan-induced systemic inflammation. Therefore, we investigated the role of mTOR in oxidative/nitrosative stress associated with increase in NADPH oxidase activity in zymosan-induced systemic inflammation model in rats. Male Wistar rats received saline (4 ml/kg, i.p.) and zymosan (500 mg/kg, i.p.) at time 0. Saline, or zymosan-treated rats were given rapamycin (1 mg/kg, i.p.) 1 h after saline or zymosan injections. Rats were sacrified 4 h after zymosan challenge and kidney, heart, thoracic aorta, and superior mesenteric artery were collected. NADPH oxidase activity, p22phox, gp91phox, and p47phox protein expression and nitrotyrosine levels were measured in tissue samples. Zymosan administration caused an increase in NADPH oxidase activity, p22phox, gp91phox, and p47phox protein expression and nitrotyrosine levels in kidney, heart, thoracic aorta, and superior mesenteric artery. These changes caused by zymosan reversed by rapamycin, a selective mTOR inhibitor. Rapamycin alone had no effect on the parameters measured. Our results demonstrated that zymosan-induced oxidative/nitrosative stress presumably due to enhanced activity of NADPH oxidase, expression of p22phox, gp91phox, and p47phox and production of peroxynitrite were mediated by mTOR. [This work was financially supported by Research Foundation of Mersin University (2016-2-AP3-1900)].

Keywords: oxidative stress, mTOR, nitrosative stress, zymosan

Procedia PDF Downloads 315

Authors: Bahar Tunctan, Sefika Pinar Kucukkavruk, Meryem Temiz-Resitoglu, Demet Sinem Guden, Ayse Nihal Sari, Seyhan Sahan-Firat

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We hypothesized that rexinoids such as bexarotene, a selective retinoid X receptor α (RXRα) agonist, may be beneficial for preventing mortality due to inflammation associated with increased expression/activity of inducible nitric oxide synthase (iNOS) induced by lipopolysaccharide (LPS). Therefore, we investigated effects of bexarotene on the changes in circulating protein levels of iNOS (an index for systemic iNOS expression), myeloperoxidase (MPO) (an index for systemic inflammation), and lactate dehydrogenase (LDH) (an index for systemic tissue injury) in LPS-induced systemic inflammation model resulting in septic shock in rats. Rats were injected with saline (4 ml/kg; i.p.), LPS (10 mg/kg; i.p.), dimethylsulphoxide (4 ml/kg, 0.1%; s.c.) at time 0. Mean arterial blood pressure and heart rate were measured using a tail-cuff device. Bexarotene (0.03, 0.1, 0.3, and 1 mg/kg; s.c.) was administered to separate groups of rats 1 h after injection of saline or LPS. The rats were sacrificed 4 h after saline or LPS injection and blood was collected for measurement of serum iNOS, MPO, and LDH protein levels. Blood pressure decreased by 31 mmHg and heart rate increased by 63 bpm in the LPS-treated rats. Bexarotene at 0.3 and 1 mg/kg doses caused 20% mortality 4 h after LPS injection. In the LPS-treated rats, serum iNOS, MPO, and LDH protein levels were increased. Bexarotene only at 0.1 mg/kg dose prevented the LPS-induced hypotension and increased in iNOS, MPO, and LDH protein levels. These data are consistent with the view that a decrease in systemic iNOS levels contributes to the beneficial effect of bexarotene to prevent the hypotension associated with inflammation and tissue injury during rat endotoxemia. [This work was financially supported by The Scientific and Technological Research Council of Turkey (SBAG-109S121)].

Keywords: bexarotene, inflammation, iNOS, lipopolisaccharide, RXRa

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Authors: Ayse Pekrioglu Balkis, Sawash Mecid

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Due to continued growth and rapid development of road construction in worldwide, road sub-layers consist of soil layers, therefore, identification and recognition of type of soil and soil behavior in different condition help to us to select soil according to specification and engineering characteristic, also if necessary sometimes stabilize the soil and treat undesirable properties of soils by adding materials such as bitumen, lime, cement, etc. If the soil beneath the road is not done according to the standards and construction will need more construction time. In this case, a large part of soil should be removed, transported and sometimes deposited. Then purchased sand and gravel is transported to the site and full depth filled and compacted. Stabilization by cement or other treats gives an opportunity to use the existing soil as a base material instead of removing it and purchasing and transporting better fill materials. Classification of soil according to AASHTOO system and USCS help engineers to anticipate soil behavior and select best treatment method. In this study soil classification and the relation between soil classification and stabilization method is discussed, cement stabilization with different percentages have been selected for soil treatment based on NCHRP. There are different parameters to define the strength of soil. In this study, CBR will be used to define the strength of soil. Cement by percentages, 0%, 3%, 7% and 10% added to soil for evaluation effect of added cement to CBR of treated soil. Implementation of stabilization process by different cement content help engineers to select an economic cement amount for the stabilization process according to project specification and characteristics. Stabilization process in optimum moisture content (OMC) and mixing rate effect on the strength of soil in the laboratory and field construction operation have been performed to see the improvement rate in strength and plasticity. Cement stabilization is quicker than a universal method such as removing and changing field soils. Cement addition increases CBR values of different soil types by the range of 22-69%.

Keywords: California Bearing Ratio, cement stabilization, clayey soil, mechanical properties

Procedia PDF Downloads 397

Authors: Melike Sultan Karasu Asnaz, Ayse Ozdogan Dolcek

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Crop drying, which aims to reduce the moisture content to a certain level, is a method used to extend the shelf life and prevent it from spoiling. One of the oldest food preservation techniques is open sunor shade drying. Even though this technique is the most affordable of all drying methods, there are some drawbacks such as contamination by insects, environmental pollution, windborne dust, and direct expose to weather conditions such as wind, rain, hail. However, solar dryers that provide a hygienic and controllable environment to preserve food and extend its shelf life have been developed and used to dry agricultural products. Thus, foods can be dried quickly without being affected by weather variables, and quality products can be obtained. This research is mainly devoted to investigating the modelling of drying kinetics of cantaloupe in a forced convection solar dryer. Mathematical models for the drying process should be defined to simulate the drying behavior of the foodstuff, which will greatly contribute to the development of solar dryer designs. Thus, drying experiments were conducted and replicated five times, and various data such as temperature, relative humidity, solar irradiation, drying air speed, and weight were instantly monitored and recorded. Moisture content of sliced and pretreated cantaloupe were converted into moisture ratio and then fitted against drying time for constructing drying curves. Then, 10 quasi-theoretical and empirical drying models were applied to find the best drying curve equation according to the Levenberg-Marquardt nonlinear optimization method. The best fitted mathematical drying model was selected according to the highest coefficient of determination (R²), and the mean square of the deviations (χ^²) and root mean square error (RMSE) criterial. The best fitted model was utilized to simulate a thin layer solar drying of cantaloupe, and the simulation results were compared with the experimental data for validation purposes.

Keywords: solar dryer, mathematical modelling, drying kinetics, cantaloupe drying

Procedia PDF Downloads 127

Authors: Misra Ayse Adsiz, Selim Selvi

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In today's world, technology is competing with time. In order to catch up with the world's companies and adapt quickly to the changes, it is necessary to speed up the processes and keep pace with the rate of change of the technology. The missile system design processes, which are handled with classical methods, keep behind in this race. Because customer requirements are not clear, and demands are changing again and again in the design process. Therefore, in the system design process, a methodology suitable for the missile system design dynamics has been investigated and the processes used for catching up the era are examined. When commonly used design processes are analyzed, it is seen that any one of them is dynamic enough for today’s conditions. So a hybrid design process is established. After a detailed review of the existing processes, it is decided to focus on the Scrum Framework and Agile Philosophy. Scrum is a process framework. It is focused on to develop software and handling change management with rapid methods. In addition, agile philosophy is intended to respond quickly to changes. In this study, it is aimed to integrate Scrum framework and agile philosophy, which are the most appropriate ways for rapid production and change adaptation, into the missile system design process. With this approach, it is aimed that the design team, involved in the system design processes, is in communication with the customer and provide an iterative approach in change management. These methods, which are currently being used in the software industry, have been integrated with the product design process. A team is created for system design process. The roles of Scrum Team are realized with including the customer. A scrum team consists of the product owner, development team and scrum master. Scrum events, which are short, purposeful and time-limited, are organized to serve for coordination rather than long meetings. Instead of the classic system design methods used in product development studies, a missile design is made with this blended method. With the help of this design approach, it is become easier to anticipate changing customer demands, produce quick solutions to demands and combat uncertainties in the product development process. With the feedback of the customer who included in the process, it is worked towards marketing optimization, design and financial optimization.

Keywords: agile, design, missile, scrum

Procedia PDF Downloads 169

Authors: Ayse Inel Manav, Nuray Simsek

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The number of people with dementia and the problems that are experienced by these people are increasing along with aging world population. This study was carried out to assess the effects of reminiscence therapy using internet videos on the cognitive condition and apathy levels of elderly people who had mild dementia and lived in nursing homes. This randomly controlled experimental study was conducted between 25 May-25 August 2016 in the nursing home, elderly care and rehabilitation centers in Adana and Seyhan, Turkey. A total of 32 individuals participated in this study, 16 in the experimental group and 16 in the control group. Data were collected using a personal information form developed on the basis of the published literature, the Standardized Mini Mental Test (SMMT) and the Apathy Rating Scale (ARS). The Clinical Research Ethics Committee's approval, written institutional permission, and the written consent of the participants were obtained before data collection. The individuals in the experimental group received reminiscence therapy using internet videos for 60 minutes one day a week for three months. During the same period, 25-30 minutes of unstructured interviews on subjects unrelated to reminiscence were carried out with individuals in the control group. The SMMT and ARS were administered before the applications in the experimental group and at the end of the third month. The collected data were analyzed using descriptive statistics (means, standard deviations, and frequencies) as well as Student's t-test, the Mann-Whitney U-test, and Wilcoxon's signed ranks test. In this study, the total SMMT post-test scores of the experimental group were higher than those of the control group (p = 0.001; p < 0.01). There was a difference between experimental and control groups' total SMMT post-test scores (p = 0.001; p < 0.01). The experimental group's ARS total post-test scores were higher than those of the control group (p = 0.001; p < 0.01). This study found that group reminiscence therapy using internet videos improved the cognitive functions and apathy levels of elderly individuals with mild dementia.

Keywords: apaty, cognitive testing, dementia, elderly, reminisence threapy

Procedia PDF Downloads 198

Authors: Şefika Dilek Güven, Gülden Küçükakça

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Objective: Learning the process of interaction with patient occurs within the process of nursing education. For this reason, it is considered to provide an opportunity for questioning and rearrangement of nursing education programs by assessing attitudes of nursing students towards caring nurse-patient interaction. Method: This is a descriptive study conducted in order to assess attitudes of nursing students towards caring nurse-patient interaction. The study was conducted with 318 students who were studying at nursing department of Semra and Vefa Küçük Health High School, Nevşehir Hacı Bektaş Veli University in 2015-2016 academic year and agreed to participate in the study. “Personal Information Form” prepared by the researchers utilizing the literature and “Caring Nurse-Patient Interaction Scale (CNPIS)”, who Turkish validity and reliability were conducted by Atar and Aştı, were used in the study. The Cronbach α coefficient of CNPIS was found as 0.973 in the study. Permissions of the institution and participants were received before starting to conduct study. Significance test of the difference between two means, analysis of variance, and correlation analysis were used to assess the data. Results: Average age of nursing students participating in the study was 20.72±1.91 and 74.8% were female, and 28.0% were the fourth-year students. 52.5% of the nursing students stated that they chose nursing profession willingly, 80.2% did not have difficulty in their interactions with patients, and 84.6% did not have difficulty in their social relationships. CNPIS total mean score of nursing students was found to be 295.31±40.95. When the correlation between total CNPIS mean score of the nursing students in terms of some variables was examined; it was determined there was a significant positive correlation between ages of the nursing students and total mean score of CNPIS (r=0.184, p=0.001). CNPIS total mean score was found to be higher in female students compared to male students, in 3rd–year students compared to students studying at other years, in those choosing their profession willingly compared to those choosing their profession unwillingly, in those not having difficulty in relations with the patients compared to those having difficulty, and in those not having difficulty in social relationships compared to those having difficulty. It was determined there was a significant difference between CNPIS total mean scores in terms of the year and state of having difficulty in social relationships (p<0,005). Conclusion: Nursing students had positive attitudes towards caring nurse-patient interactions, attitudes of nursing students, who were female, studying at 3rd year, chose nursing profession willingly, did not have difficulty in patient relations, and did not have difficulty in social relationships, towards caring nurse-patient interaction were found to be more positive. In the line with these results; it can be recommended to organize activities for introducing nursing profession to the youth preparing for the university, to use methods that will increase further communication skills to nursing students during their education, to support students in terms of communication skills, and to involve activities that will strengthen their social relationships.

Keywords: nurse-patient interaction, nursing student, patient, communication

Procedia PDF Downloads 223

Authors: A. Aslihan Gokaltun, Martin L. Yarmush, Ayse Asatekin, O. Berk Usta

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Poly(dimethylsiloxane) (PDMS) is one of the most widely used materials in the fabrication of microfluidic devices. It is easily patterned and can replicate features down to nanometers. Its flexibility, gas permeability that allows oxygenation, and low cost also drive its wide adoption. However, a major drawback of PDMS is its hydrophobicity and fast hydrophobic recovery after surface hydrophilization. This results in significant non-specific adsorption of proteins as well as small hydrophobic molecules such as therapeutic drugs limiting the utility of PDMS in biomedical microfluidic circuitry. While silicon, glass, and thermoplastics have been used, they come with problems of their own such as rigidity, high cost, and special tooling needs, which limit their use to a smaller user base. Many strategies to alleviate these common problems with PDMS are lack of general practical applicability, or have limited shelf lives in terms of the modifications they achieve. This restricts large scale implementation and adoption by industrial and research communities. Accordingly, we aim to tailor biocompatible PDMS surfaces by developing a simple and one step bulk modification approach with novel smart materials to reduce non-specific molecular adsorption and to stabilize long-term cell analysis with PDMS substrates. Smart polymers that blended with PDMS during device manufacture, spontaneously segregate to surfaces when in contact with aqueous solutions and create a < 1 nm layer that reduces non-specific adsorption of organic and biomolecules. Our methods are fully compatible with existing PDMS device manufacture protocols without any additional processing steps. We have demonstrated that our modified PDMS microfluidic system is effective at blocking the adsorption of proteins while retaining the viability of primary rat hepatocytes and preserving the biocompatibility, oxygen permeability, and transparency of the material. We expect this work will enable the development of fouling-resistant biomedical materials from microfluidics to hospital surfaces and tubing.

Keywords: cell culture, microfluidics, non-specific protein adsorption, PDMS, smart polymers

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Authors: Esra Yuksel, Dilek Duman, Levent Yeniay, Sezgin Ulukaya

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Sentinel lymph node biopsy (SLNB) is a minimal invasive technique with lower morbidity in axillary staging of breast cancer. Isosulfan blue stain is frequently used in SLNB and regarded as safe. The present case report aimed to report severe decrement in SpO2 following isosulfan blue administration, as well as skin and urine signs and inconsistency with clinical picture in a 67-year-old ,77 kg, ASA II female case that underwent SLNB under general anesthesia. Ten minutes after subcutaneous administration of 10 ml 1% isosulfan blue by the surgeons into the patient, who were hemodynamically stable, SpO2 first reduced to 87% from 99%, and then to 75% in minutes despite 100% oxygen support. Meanwhile, blood pressure and EtCO2 monitoring was unremarkable. After specifying that anesthesia device worked normally, airway pressure did not increase and the endotracheal tube has been placed accurately, the blood sample was taken from the patient for arterial gas analysis. A severe increase was thought in MetHb concentration since SpO2 persisted to be 75% although the concentration of inspired oxygen was 100%, and solution of 2500 mg ascorbic acid in 500 ml 5% Dextrose was given to the patient via intravenous route until the results of arterial blood gas were obtained. However, arterial blood gas results were as follows: pH: 7.54, PaCO2: 23.3 mmHg, PaO2: 281 mmHg, SaO2: %99, and MetHb: %2.7. Biochemical analysis revealed a blood MetHb concentration of 2%.However, since arterial blood gas parameters were good, hemodynamics of the patient was stable and methemoglobin concentration was not so high, the patient was extubated after surgery when she was relaxed, cooperated and had adequate respiration. Despite the absence of respiratory or neurological distress, SpO2 value was increased only up to 85% within 2 hours with 5 L/min oxygen support via face mask in the surgery room as the patient was extubated. At that time, the skin of particularly the upper part of her body has turned into blue, more remarkable on the face. The color of plasma of the blood taken from the patient for biochemical analysis was blue. The color of urine coming throughout the urinary catheter placed in intensive care unit was also blue. Twelve hours after 5 L/min. oxygen inhalation via a mask, the SpO2 reached to 90%. During monitoring in intensive care unit on the postoperative 1st day, facial color and urine color of the patient was still blue, SpO2 was 92%, and arterial blood gas levels were as follows: pH: 7.44, PaO2: 76.1 mmHg, PaCO2: 38.2 mmHg, SaO2: 99%, and MetHb 1%. During monitoring in clinic on the postoperative 2nd day, SpO2 was 95% without oxygen support and her facial and urine color turned into normal. The patient was discharged on the 3rd day without any problem.In conclusion, SLNB is a less invasive alternative to axillary dissection. However, false pulse oximeter reading due to pigment interference is a rare complication of this procedure. Arterial blood gas analysis should be used to confirm any fall in SpO2 reading during monitoring.

Keywords: isosulfan blue, pulse oximetry, SLNB, methemoglobinemia

Procedia PDF Downloads 315

Authors: Berfu Guley Goren, Ayse Lale Berkoz

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The aim of the study is to analyze the concept of universal design and accessibility to make the city which allows equality and independence for individuals. In the content of the study, literature researches and observations of samples in Istanbul, Turkey are analyzed. As a result proposals are going to be developed to create the cities which are designed for everyone. In globalization process, in cities, population have been increasing dramatically with social and economic activities. Medical developments have been effective in prolonging human life and the disability that comes with aging has also increased in parallel with the disabled population. Nowadays disability is an important phenomenon. Because approximately 1 billion people live with disabilities. The heterogeneous structure formed by the rapid gathering of individuals with different social, economic and physical characteristics in the cities creates great spatial diversity and richness in the cities with different needs brought together. Unlike the cultural and physical wealth in these places and the potential to integrate and diversify the urban people, unfortunately, the designs in practice cause the urban areas to break apart, the urbanities to tear themselves apart, to interfere with their communication and interactions. The social and physical structure of the city is important to feel belonging to the urban society. In most cities when an observation is made, obstructions for people with disabilities can be seen in urban physical structure and design. With these obstructions, people with disabilities cannot live in urban space, and they are desolated in urban life. The city, which offers equal opportunity, the relation between economic development, social justice and built environment must be planned synchronous. Isolation and stigmatization must be abolished by regulations, activities of awareness and universal urban design. Without regard to social, economical and physical features every individual has the same right, which is using the freedom of movement. Supporting freedom of movement of every individual may be ensured by universal design and its principles. So urban spaces are going to be for every individual. For equal opportunity in urban services, urban design must be the focus on every individual including people with disabilities. In built environment practices, democratic suitable spaces should be created. In this respect, urban planners, architects, political decision-makers and other relevant actors should work together and should think very versatile.

Keywords: disability, equality, universal design, urban design

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Authors: Ayse Ozturk Samur, Gozde Inal Kiziltepe

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No matter what level of education it is, starting a school is an exciting process as it includes new experiences. In this process, child steps into a different environment and institution except from the family institution which he was born into and feels secure. That new environment is different from home; it is a social environment which has its own rules, and involves duties and responsibilities that should be fulfilled and new vital experiences. The children who have a positive attitude towards school and like school are more enthusiastic and eager to participate in classroom activities. Moreover, a close relationship with the teacher enables the child to have positive emotions and ideas about the teacher and school and helps children adapt to school easily. In this study, it is aimed to identify children’s perceptions of academic competence, attitudes towards school and ideas about their teachers. In accordance with the aim a mixed method that includes both qualitative and quantitative data collection methods are used. The study is supported with qualitative data after collecting quantitative data. The study group of the research consists of randomly chosen 250 children who are 60-72 month old and attending a preschool institution in a city center located West Anatolian region of Turkey. Quantitative data was collected using Feelings about School scale. The scale consists of 12 items and 4 dimensions; school, teacher, mathematic, and literacy. Reliability and validity study for the scale used in the study was conducted by the researchers with 318 children who were 60-72 months old. For content validity experts’ ideas were asked, for construct validity confirmatory factor analysis was utilized. Reliability of the scale was examined by calculating internal consistency coefficient (Cronbach alpha). At the end of the analyses it was found that FAS is a valid and reliable instrument to identify 60-72 month old children’ perception of their academic competency, attitude toward school and ideas about their teachers. For the qualitative dimension of the study, semi-structured interviews were done with 30 children aged 60-72 month. At the end of the study, it was identified that children’s’ perceptions of their academic competencies and attitudes towards school was medium-level and their ideas about their teachers were high. Based on the semi structured interviews done with children, it is identified that they have a positive perception of school and teacher. That means quantitatively gathered data is supported by qualitatively collected data.

Keywords: feelings, preschool education, school, teacher, thoughts

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Authors: Elcin Timur Cakmak, Ayse Oguzlar

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This study presents the results of the tweets sent by Twitter users on social media about the Russia-Ukraine war by bigram and trigram methods. On February 24, 2022, Russian President Vladimir Putin declared a military operation against Ukraine, and all eyes were turned to this war. Many people living in Russia and Ukraine reacted to this war and protested and also expressed their deep concern about this war as they felt the safety of their families and their futures were at stake. Most people, especially those living in Russia and Ukraine, express their views on the war in different ways. The most popular way to do this is through social media. Many people prefer to convey their feelings using Twitter, one of the most frequently used social media tools. Since the beginning of the war, it is seen that there have been thousands of tweets about the war from many countries of the world on Twitter. These tweets accumulated in data sources are extracted using various codes for analysis through Twitter API and analysed by Python programming language. The aim of the study is to find the word sequences in these tweets by the n-gram method, which is known for its widespread use in computational linguistics and natural language processing. The tweet language used in the study is English. The data set consists of the data obtained from Twitter between February 24, 2022, and April 24, 2022. The tweets obtained from Twitter using the #ukraine, #russia, #war, #putin, #zelensky hashtags together were captured as raw data, and the remaining tweets were included in the analysis stage after they were cleaned through the preprocessing stage. In the data analysis part, the sentiments are found to present what people send as a message about the war on Twitter. Regarding this, negative messages make up the majority of all the tweets as a ratio of %63,6. Furthermore, the most frequently used bigram and trigram word groups are found. Regarding the results, the most frequently used word groups are “he, is”, “I, do”, “I, am” for bigrams. Also, the most frequently used word groups are “I, do, not”, “I, am, not”, “I, can, not” for trigrams. In the machine learning phase, the accuracy of classifications is measured by Classification and Regression Trees (CART) and Naïve Bayes (NB) algorithms. The algorithms are used separately for bigrams and trigrams. We gained the highest accuracy and F-measure values by the NB algorithm and the highest precision and recall values by the CART algorithm for bigrams. On the other hand, the highest values for accuracy, precision, and F-measure values are achieved by the CART algorithm, and the highest value for the recall is gained by NB for trigrams.

Keywords: classification algorithms, machine learning, sentiment analysis, Twitter

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Authors: Ayşe Büşra Yakut Kubaş

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This paper addresses a long-standing theological conflict within the “Abrahamic religions” by presenting the views of the 21st century Sufi master Haji Galip Hasan Kuşçuoğlu (1919-2013). The orthodox theological viewpoints share a confessional salvation concept in which only the followers of their prophet will be redeemed and rewarded while the rest of the world will be banished to hell. The conveyed commandments, sharīʿahs have been regarded as separate religions each claiming none will enter Paradise except those of their own faith. In contrast to this orthodox hierarchal conception, an interconfessional universalism manifests itself within the works of various Sufi masters such as Yunus Emre and Maulana Jalaluddin Rumi (13th century) and more recently the founder of Galibi Order Haji Galip H. Kuşçuoğlu who supports a peaceful coexistence and respect for multiplicity under the religion of Allah. Bringing evidence from a number of ayahs in the Qur’an (e.g. 2:62, 111-112, 131-133, 136, 285; 3:113-114; 4:123-125, 5:43-44, 47-48, 51, 66-69, 112), Kuşçuoğlu argues that whoever submits themselves to Allah, meaning the One and Indivisible who has no partners (112:1) is called a Muslim. There are no Abrahamic “religions” but Abraham’s “religion” which is Islam, literally translating to total devotion to Allah. Starting from the very first prophet, Adam, all the prophets sent upon the earth as mentors to humanity revealed that there is no god but Allah and thus in the proper meaning of the word, they were Muslims. When it comes to those who follow the shariah of Moses, Jesus or Muhammed are called Judaic Muslims, Christian Muslims and Muhammadian Muslims respectively and as such they are brothers and sisters, which is why Islam cannot be a property of Muhammadian Muslims only. Kuşçuoğlu underscores the ayahs which show that the Qur’an does not abrogate other scriptures but completes them and Allah does not banish the People of the Book to hell but gives good tidings to the believers who do good (17:9). He points out a number of intellectuals such as Goethe and Prof. Dr. Süleyman Ateş (1933-) who understood the true meaning of Islam. Goethe states that if Islam means devotion to Allah then “In Islam, we live and die all.” Kuşçuoğlu underscores the fatal consequences of this terminological misinterpretation throughout the history and emphasizes the significance of the unity of religion for the believers of Allah. His perspective provides a significant contribution to the religious conflict resolution and provides a solid basis for sustainable dialogue among the people belonging to different confessions.

Keywords: interfaith dialogue, Islam, religious conflict resolution, Sufism

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Authors: Mohsen Bahrami, Banafsheh Nikmehr, Yueqiang Song, Anuradha Koduru, Ayse K. Vuruskan, Hongkun Lu, Tamer M. Yalcinkaya

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In recent years, we have witnessed an explosion of studies aimed at using a combination of artificial intelligence (AI) and time-lapse imaging data on embryos to improve IVF outcomes. However, despite promising results, no study has used a matched cohort of transferred embryos which only differ in pregnancy outcome, i.e., embryos from a single clinic which are similar in parameters, such as: morphokinetic condition, patient age, and overall clinic and lab performance. Here, we used time-lapse data on embryos with known pregnancy outcomes to see if the rich spatiotemporal information embedded in this data would allow the prediction of the pregnancy outcome regardless of such critical parameters. Methodology—We did a retrospective analysis of time-lapse data from our IVF clinic utilizing Embryoscope 100% of the time for embryo culture to blastocyst stage with known clinical outcomes, including live birth vs nonpregnant (embryos with spontaneous abortion outcomes were excluded). We used time-lapse data from 200 elective single transfer embryos randomly selected from January 2019 to June 2021. Our sample included 100 embryos in each group with no significant difference in patient age (P=0.9550) and morphokinetic scores (P=0.4032). Data from all patients were combined to make a 4th order tensor, and feature extraction were subsequently carried out by a tensor decomposition methodology. The features were then used in a machine learning classifier to classify the two groups. Major Findings—The performance of the model was evaluated using 100 random subsampling cross validation (train (80%) - test (20%)). The prediction accuracy, averaged across 100 permutations, exceeded 80%. We also did a random grouping analysis, in which labels (live birth, nonpregnant) were randomly assigned to embryos, which yielded 50% accuracy. Conclusion—The high accuracy in the main analysis and the low accuracy in random grouping analysis suggest a consistent spatiotemporal pattern which is associated with pregnancy outcomes, regardless of patient age and embryo morphokinetic condition, and beyond already known parameters, such as: early cleavage or early blastulation. Despite small samples size, this ongoing analysis is the first to show the potential of AI methods in capturing the complex morphokinetic changes embedded in embryo time-lapse data, which contribute to successful pregnancy outcomes, regardless of already known parameters. The results on a larger sample size with complementary analysis on prediction of other key outcomes, such as: euploidy and aneuploidy of embryos will be presented at the meeting.

Keywords: IVF, embryo, machine learning, time-lapse imaging data

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Authors: Dilek Ozturk, Narin Ozturk, Zeliha Pala Kara, Engin Kaptan, Serap Sancar Bas, Nurten Ozsoy, Alper Okyar

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Most physiological processes oscillate in a rhythmic manner in mammals including metabolism and energy homeostasis, locomotor activity, hormone secretion, immune and endocrine system functions. Endocrine body rhythms are tightly regulated by the circadian timing system. The hypothalamic-pituitary-thyroid (HPT) axis is under circadian control at multiple levels from hypothalamus to thyroid gland. Since circadian timing system controls a variety of biological functions in mammals, circadian rhythms of biological functions may modify the drug tolerability/toxicity depending on the dosing time. Selective mTOR (mammalian target of rapamycin) inhibitor everolimus is an immunosuppressant and anticancer agent that is active against many cancers. It was also found to be active in medullary thyroid cancer. The aim of this study was to investigate the dosing time-dependent toxicity of everolimus on the thyroid gland and hormones in mice. Healthy C57BL/6J mice were synchronized with 12h:12h Light-Dark cycle (LD12:12, with Zeitgeber Time 0 – ZT0 – corresponding to Light onset). Everolimus was administered to male (5 mg/kg/day) and female mice (15 mg/kg/day) orally at ZT1-rest period- and ZT13-activity period- for 4 weeks; body weight loss, clinical signs and possible changes in serum thyroid hormone levels (TSH and free T4) were examined. Histological alterations in the thyroid gland were evaluated according to the following criteria: follicular size, colloid density and viscidity, height of the follicular epithelium and the presence of necrotic cells. The statistical significance between differences was analyzed with ANOVA. Study findings included everolimus-related diarrhea, decreased activity, decreased body weight gains, alterations in serum TSH levels, and histopathological changes in thyroid gland. Decreases in mean body weight gains were more evident in mice treated at ZT1 as compared to ZT13 (p < 0.001, for both sexes). Control tissue sections of thyroid glands exhibited well-organized histoarchitecture when compared to everolimus-treated groups. Everolimus caused histopathological alterations in thyroid glands in male (5 mg/kg, slightly) and female mice (15 mg/kg; p < 0.01 for both ZT as compared to their controls) irrespective of dosing-time. TSH levels were slightly decreased upon everolimus treatment at ZT13 in both males and females. Conversely, increases in TSH levels were observed when everolimus treated at ZT1 in both males (5 mg/kg; p < 0.05) and females (15 mg/kg; slightly). No statistically significant alterations in serum free T4 levels were observed. TSH and free T4 is clinically important thyroid hormones since a number of disease states have been linked to alterations in these hormones. Serum free T4 levels within the normal ranges in the presence of abnormal serum TSH levels in everolimus treated mice may suggest subclinical thyroid disease which may have repercussions on the cardiovascular system, as well as on other organs and systems. Our study has revealed the histological damage on thyroid gland induced by subacute everolimus administration, this effect was irrespective of dosing time. However, based on the body weight changes and clinical signs upon everolimus treatment, tolerability for the drug was best following dosing at ZT13 in both male and females. Yet, effects of everolimus on thyroid functions may deserve further studies regarding their clinical importance and chronotoxicity.

Keywords: circadian rhythm, chronotoxicity, everolimus, thyroid gland, thyroid hormones

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Authors: Tuba Denkceken, Ayse Nur Sarı, Volkan Ihsan Tore, Mahmut Denkceken

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The aim of the presented study was to develop a newly motorized spectroscopy system. Our system is composed of probe and motor parts. The probe part consists of bioimpedance and fiber optic components that include two platinum wires (each 25 micrometer in diameter) and two fiber cables (each 50 micrometers in diameter) respectively. Probe was examined on tissue phantom (polystyrene microspheres with different diameters). In the bioimpedance part of the probe current was transferred to the phantom and conductivity information was obtained. Adjacent two fiber cables were used in the fiber optic part of the system. Light was transferred to the phantom by fiber that was connected to the light source and backscattered light was collected with the other adjacent fiber for analysis. It is known that the nucleus expands and the nucleus-cytoplasm ratio increases during the cancer progression in the cell and this situation is one of the most important criteria for evaluating the tissue for pathologists. The sensitivity of the probe to particle (nucleus) size in phantom was tested during the study. Spectroscopic data obtained from our system on phantom was evaluated by multivariate statistical analysis. Thus the information about the particle size in the phantom was obtained. Bioimpedance and fiber optic experiments results which were obtained from polystyrene microspheres showed that the impedance value and the oscillation amplitude were increasing while the size of particle was enlarging. These results were compatible with the previous studies. In order to motorize the system within the motor part, three driver electronic circuits were designed primarily. In this part, supply capacitors were placed symmetrically near to the supply inputs which were used for balancing the oscillation. Female capacitors were connected to the control pin. Optic and mechanic switches were made. Drivers were structurally designed as they could command highly calibrated motors. It was considered important to keep the drivers’ dimension as small as we could (4.4x4.4x1.4 cm). Then three miniature step motors were connected to each other along with three drivers. Since spectroscopic techniques are quantitative methods, they yield more objective results than traditional ones. In the future part of this study, it is planning to get spectroscopic data that have optic and impedance information from the cell culture which is normal, low metastatic and high metastatic breast cancer. In case of getting high sensitivity in differentiated cells, it might be possible to scan large surface tissue areas in a short time with small steps. By means of motorize feature of the system, any region of the tissue will not be missed, in this manner we are going to be able to diagnose cancerous parts of the tissue meticulously. This work is supported by The Scientific and Technological Research Council of Turkey (TÜBİTAK) through 3001 project (115E662).

Keywords: motorized spectroscopy, phantom, scanning system, tissue scanning

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Authors: Habib Muhammetoglu, I. Ethem Karadirek, Selami Kara, Ayse Muhammetoglu

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The problem of non-revenue water (NRW) from municipal water distribution networks is common in many countries such as Turkey, where the average yearly water losses are around 50% . Water losses can be divided into two major types namely: 1) Real or physical water losses, and 2) Apparent or commercial water losses. Total water losses in Antalya city, Turkey is around 45%. Methods: A research study was conducted to develop appropriate methodologies to reduce NRW. A pilot study area of about 60 thousands inhabitants was chosen to apply the study. The pilot study area has a supervisory control and data acquisition (SCADA) system for the monitoring and control of many water quantity and quality parameters at the groundwater drinking wells, pumping stations, distribution reservoirs, and along the water mains. The pilot study area was divided into 18 District Metered Areas (DMAs) with different number of service connections that ranged between a few connections to less than 3000 connections. The flow rate and water pressure to each DMA were on-line continuously measured by an accurate flow meter and water pressure meter that were connected to the SCADA system. Customer water meters were installed to all billed and unbilled water users. The monthly water consumption as given by the water meters were recorded regularly. Water balance was carried out for each DMA using the well-know standard IWA approach. There were considerable variations in the water losses percentages and the components of the water losses among the DMAs of the pilot study area. Old Class B customer water meters at one DMA were replaced by more accurate new Class C water meters. Hydraulic modelling using the US-EPA EPANET model was carried out in the pilot study area for the prediction of water pressure variations at each DMA. The data sets required to calibrate and verify the hydraulic model were supplied by the SCADA system. It was noticed that a number of the DMAs exhibited high water pressure values. Therefore, pressure reducing valves (PRV) with constant head were installed to reduce the pressure up to a suitable level that was determined by the hydraulic model. On the other hand, the hydraulic model revealed that the water pressure at the other DMAs cannot be reduced when complying with the minimum pressure requirement (3 bars) as stated by the related standards. Results: Physical water losses were reduced considerably as a result of just reducing water pressure. Further physical water losses reduction was achieved by applying acoustic methods. The results of the water balances helped in identifying the DMAs that have considerable physical losses. Many bursts were detected especially in the DMAs that have high physical water losses. The SCADA system was very useful to assess the efficiency level of this method and to check the quality of repairs. Regarding apparent water losses reduction, changing the customer water meters resulted in increasing water revenue by more than 20%. Conclusions: DMA, SCADA, modelling, pressure management, leakage detection and accurate customer water meters are efficient for NRW.

Keywords: NRW, water losses, pressure management, SCADA, apparent water losses, urban water distribution networks

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Authors: Ayse Gul Bilen

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Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed antidepressants that are used clinically for the treatment of anxiety disorders, obsessive-compulsive disorder (OCD), panic disorders and eating disorders. The first SSRI, fluoxetine (sold under the brand names Prozac and Sarafem among others), had an adverse effect profile better than any other available antidepressant when it was introduced because of its selectivity for serotonin receptors. They have been considered almost free of side effects and have become widely prescribed, however questions about the safety and tolerability of SSRIs have emerged with their continued use. Most SSRI side effects are dose-related and can be attributed to serotonergic effects such as nausea. Continuous use might trigger adverse effects such as hyponatremia, tremor, nausea, weight gain, sleep disturbance and sexual dysfunction. Moderate toxicity can be safely observed in the hospital for 24 hours, and mild cases can be safely discharged (if asymptomatic) from the emergency department once cleared by Psychiatry in cases of intentional overdose and after 6 to 8 hours of observation. Although fluoxetine is relatively safe in terms of overdose, it might still be cardiotoxic and inhibit platelet secretion, aggregation, and plug formation. There have been reported clinical cases of seizures, cardiac conduction abnormalities, and even fatalities associated with fluoxetine ingestions. While the medical literature strongly suggests that most fluoxetine overdoses are benign, emergency physicians need to remain cognizant that intentional, high-dose fluoxetine ingestions may induce seizures and can even be fatal due to cardiac arrhythmia. Our case is a 35-year old female patient who was sent to ER with symptoms of confusion, amnesia and loss of orientation for time and location after being found wandering in the streets unconsciously by police forces that informed 112. Upon laboratory examination, no pathological symptom was found except sinus tachycardia in the EKG and high levels of aspartate transaminase (AST) and alanine transaminase (ALT). Diffusion MRI and computed tomography (CT) of the brain all looked normal. Upon physical and sexual examination, no signs of abuse or trauma were found. Test results for narcotics, stimulants and alcohol were negative as well. There was a presence of dysrhythmia which required admission to the intensive care unit (ICU). The patient gained back her conscience after 24 hours. It was discovered from her story afterward that she had been using fluoxetine due to post-traumatic stress disorder (PTSD) for 6 months and that she had attempted suicide after taking 3 boxes of fluoxetine due to the loss of a parent. She was then transferred to the psychiatric clinic. Our study aims to highlight the need to consider toxicologic drug use, in particular, the abuse of selective serotonin reuptake inhibitors (SSRIs), which have been widely prescribed due to presumed safety and tolerability, for diagnosis of patients applying to the emergency room (ER).

Keywords: abuse, amnesia, fluoxetine, intoxication, SSRI

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Authors: Ayse Collins

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The Agenda 2030 puts Higher Education Institutions (HEIs) in the situation where they should emphasize ways to promote sustainability accordingly. However, it is still unclear: a) how sustainability is understood, and b) which actions have been taken in both discourse and practice by HEIs regarding the three pillars of sustainability, society, environment, and economy. There are models of sustainable universities developed by different authors from different countries; For Example, The Global Reporting Initiative (GRI) methodology which offers a variety of indicators to diagnose performance. However, these models have never been developed for universities in particular. Any model, in this sense, cannot be completed adequately without defining the appropriate tools to measure, analyze and control the performance of initiatives. There is a need to conduct researches in different universities from different countries to understand where we stand in terms of sustainable higher education. Therefore, this study aims at exploring the actions taken by a university in Ankara, Turkey, since Agenda 2030 should consider localizing its objectives and targets according to a certain geography. This university just announced 2021-2022 as “Sustainability Year.” Therefore, this research is a multi-methodology longitudinal study and uses the theoretical framework of the organization and transition management (TM). It is designed to examine the activities as being strategic, tactical, operational, and reflexive in nature and covers the six main aspects: academic community, administrative staff, operations and services, teaching, research, and extension. The preliminary research will answer the role of the top university governance, perception of the stakeholders (students, instructors, administrative and support staff) regarding sustainability, and the level of achievement at the mid-evaluation and final, end of year evaluation. TM Theory is a multi-scale, multi-actor, process-oriented approach with the analytical framework to explore and promote change in social systems. Therefore, the stages and respective methodology for collecting data in this research is: Pre-development Stage: a) semi-structured interviews with university governance, c) open-ended survey with faculty, students, and administrative staff d) Semi-structured interviews with support staff, and e) analysis of current secondary data for sustainability. Take-off Stage: a) semi-structured interviews with university governance, faculty, students, administrative and support staff, b) analysis of secondary data. Breakthrough stabilization a) survey with all stakeholders at the university, b) secondary data analysis by using selected indicators for the first sustainability report for universities The findings from the predevelopment stage highlight how stakeholders, coming from different faculties, different disciplines with different identities and characteristics, face the sustainability challenge differently. Though similar sustainable development goals ((social, environmental, and economic) are set in the institution, there are differences across disciplines and among different stakeholders, which need to be considered to reach the optimum goal. It is believed that the results will help changes in HEIs organizational culture to embed sustainability values in their strategic planning, academic and managerial work by putting enough time and resources to be successful in coping with sustainability.

Keywords: higher education, sustainability, sustainability auditing, transition management

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Authors: Banafsheh Nikmehr, Mohsen Bahrami, Yueqiang Song, Anuradha Koduru, Ayse K. Vuruskan, Hongkun Lu, Mallory Pitts, Tolga B. Mesen, Tamer M. Yalcinkaya

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The number of people who receive in vitro fertilization (IVF) treatment has increased on a startling trajectory over the past two decades. Despite advances in this field, particularly the introduction of intracytoplasmic sperm injection (ICSI) and the preimplantation genetic screening (PGS), the IVF success remains low. A major factor contributing to IVF failure is embryonic aneuploidy (abnormal chromosome content), which often results in miscarriage and birth defects. Although PGS is often used as the standard diagnostic tool to identify aneuploid embryos, it is an invasive approach that could affect the embryo development, and yet inaccessible to many patients due its high costs. As such, there is a clear need for a non-invasive cost-effective approach to identify euploid embryos for single embryo transfer (SET). The reported differences between morphokinetic behaviors of aneuploid and euploid embryos has shown promise to address this need. However, current literature is inconclusive and further research is urgently needed to translate current findings into clinical diagnostics. In this ongoing study, we found significant differences between morphokinetic behaviors of euploid and aneuploid embryos that provides important insights and reaffirms the promise of such behaviors for developing non-invasive methodologies. Methodology—A total of 242 embryos (euploid: 149, aneuploid: 93) from 74 patients who underwent IVF treatment in Carolinas Fertility Clinics in Winston-Salem, NC, were analyzed. All embryos were incubated in an EmbryoScope incubator. The patients were randomly selected from January 2019 to June 2021 with most patients having both euploid and aneuploid embryos. All embryos reached the blastocyst stage and had known PGS outcomes. The ploidy assessment was done by a third-party testing laboratory on day 5-7 embryo biopsies. The morphokinetic variables of each embryo were measured by the EmbryoViewer software (Uniesense FertiliTech) on time-lapse images using 7 focal depths. We compared the time to: pronuclei fading (tPNf), division to 2,3,…,9 cells (t2, t3,…,t9), start of embryo compaction (tSC), Morula formation (tM), start of blastocyst formation (tSC), blastocyst formation (tB), and blastocyst expansion (tEB), as well as intervals between them (e.g., c23 = t3 – t2). We used a mixed regression method for our statistical analyses to account for the correlation between multiple embryos per patient. Major Findings— The average age of the patients was 35.04 yrs. The average patient age associated with euploid and aneuploid embryos was not different (P = 0.6454). We found a significant difference in c45 = t5-t4 (P = 0.0298). Our results indicated this interval on average lasts significantly longer for aneuploid embryos - c45(aneuploid) = 11.93hr vs c45(euploid) = 7.97hr. In a separate analysis limited to embryos from the same patients (patients = 47, total embryos=200, euploid=112, aneuploid=88), we obtained the same results (P = 0.0316). The statistical power for this analysis exceeded 87%. No other variable was different between the two groups. Conclusion— Our results demonstrate the importance of morphokinetic variables as potential biomarkers that could aid in non-invasively characterizing euploid and aneuploid embryos. We seek to study a larger population of embryos and incorporate the embryo quality in future studies.

Keywords: IVF, embryo, euploidy, aneuploidy, morphokinteic

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Authors: Yasar Samet Gokceoglu, Ayse Nur Incesu, Furkan Okatar, Berk Nimetoglu, Serkan Bayram, Turgut Akgul

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Ankle syndesmosis injuries pose a significant challenge in orthopedic practice due to their potential for prolonged recovery and chronic ankle dysfunction. Accurate diagnosis and management of these injuries are essential for achieving optimal patient outcomes. The use of radiological methods, such as X-ray, computed tomography (CT), and magnetic resonance imaging (MRI), plays a vital role in the accurate diagnosis of syndesmosis injuries in the context of ankle fractures. Treatment options for ankle syndesmosis injuries vary, with surgical interventions such as screw fixation and suture-button implantation being commonly employed. The choice of treatment is influenced by the severity of the injury and the presence of associated fractures. Additionally, the mechanism of injury, such as pure syndesmosis injury or specific fracture types, can impact the stability and management of syndesmosis injuries. Ankle fractures with syndesmosis injury present a complex clinical scenario, requiring accurate diagnosis, appropriate reduction, and tailored management strategies. The interplay between the mechanism of injury, associated fractures, and treatment modalities significantly influences the outcomes of these challenging injuries. The long-term outcomes and patient satisfaction following ankle fractures with syndesmosis injury are crucial considerations in the field of orthopedics. Patient-reported outcome measures, such as the Foot and Ankle Outcome Score (FAOS), provide essential information about functional recovery and quality of life after these injuries. When diagnosing syndesmosis injuries, standard measurements, such as the medial clear space, tibiofibular overlap, tibiofibular clear space, anterior tibiofibular ratio (ATFR), and the anterior-posterior tibiofibular ratio (APTF), are assessed through radiographs and computed tomography (CT) scans. These parameters are critical in evaluating the presence and severity of syndesmosis injuries, enabling clinicians to choose the most appropriate treatment approach. Despite advancements in diagnostic imaging, challenges remain in accurately diagnosing and treating ankle syndesmosis injuries. Traditional diagnostic parameters, while beneficial, may not capture the full extent of the injury or provide sufficient information to guide therapeutic decisions. This gap highlights the need for exploring additional diagnostic parameters that could enhance the accuracy of syndesmosis injury diagnoses and inform treatment strategies more effectively. The primary goal of this research is to evaluate the usefulness of traditional radiographic measurements in comparison to new CT-based measurements for diagnosing ankle syndesmosis injuries. Specifically, this study aims to assess the accuracy of conventional parameters, including medial clear space, tibiofibular overlap, tibiofibular clear space, ATFR, and APTF, in contrast with the recently proposed CT-based measurements such as the delta and gamma angles. Moreover, the study intends to explore the relationship between these diagnostic parameters and functional outcomes, as measured by the Foot and Ankle Outcome Score (FAOS). Establishing a correlation between specific diagnostic measurements and FAOS scores will enable us to identify the most reliable predictors of functional recovery following syndesmosis injuries. This comparative analysis will provide valuable insights into the accuracy and dependability of CT-based measurements in diagnosing ankle syndesmosis injuries and their potential impact on predicting patient outcomes. The results of this study could greatly influence clinical practices by refining diagnostic criteria and optimizing treatment planning for patients with ankle syndesmosis injuries.

Keywords: ankle syndesmosis injury, diagnostic accuracy, computed tomography, radiographic measurements, Tibiofibular syndesmosis distance

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