Search results for: Ahmet Kaplan
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 183

Search results for: Ahmet Kaplan

63 Assessing the Survival Time of Hospitalized Patients in Eastern Ethiopia During 2019–2020 Using the Bayesian Approach: A Retrospective Cohort Study

Authors: Chalachew Gashu, Yoseph Kassa, Habtamu Geremew, Mengestie Mulugeta

Abstract:

Background and Aims: Severe acute malnutrition remains a significant health challenge, particularly in low‐ and middle‐income countries. The aim of this study was to determine the survival time of under‐five children with severe acute malnutrition. Methods: A retrospective cohort study was conducted at a hospital, focusing on under‐five children with severe acute malnutrition. The study included 322 inpatients admitted to the Chiro hospital in Chiro, Ethiopia, between September 2019 and August 2020, whose data was obtained from medical records. Survival functions were analyzed using Kaplan‒Meier plots and log‐rank tests. The survival time of severe acute malnutrition was further analyzed using the Cox proportional hazards model and Bayesian parametric survival models, employing integrated nested Laplace approximation methods. Results: Among the 322 patients, 118 (36.6%) died as a result of severe acute malnutrition. The estimated median survival time for inpatients was found to be 2 weeks. Model selection criteria favored the Bayesian Weibull accelerated failure time model, which demonstrated that age, body temperature, pulse rate, nasogastric (NG) tube usage, hypoglycemia, anemia, diarrhea, dehydration, malaria, and pneumonia significantly influenced the survival time of severe acute malnutrition. Conclusions: This study revealed that children below 24 months, those with altered body temperature and pulse rate, NG tube usage, hypoglycemia, and comorbidities such as anemia, diarrhea, dehydration, malaria, and pneumonia had a shorter survival time when affected by severe acute malnutrition under the age of five. To reduce the death rate of children under 5 years of age, it is necessary to design community management for acute malnutrition to ensure early detection and improve access to and coverage for children who are malnourished.

Keywords: Bayesian analysis, severe acute malnutrition, survival data analysis, survival time

Procedia PDF Downloads 53
62 Eight-Week Exercise for Women: Impact on Anomalies in Width Depth and Environmental Dimension

Authors: Yalcin Kaya, Fatma Arslan, Ahmet Selim Kaya

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This study aimed to determine the undesirable hypertrophic anomalies in the body of females and to investigate how they can be affected by the exercise program according to the applied 8 week individual conditions. The research was carried out on 35 women who did not have any regular previous sports practice and had an approximate age of 30 ± 5.0 at the gymnasium because of their asymmetric structure and weight gain of the body. Measurements of width, depth, and periphery were taken from the participants' body, and the exercise protocol was applied for 8 weeks according to the individual measurements in accordance with the obtained measurements. After 8 weeks, the same measurements were applied again. Measurements were made by using ruler and paper tape. The findings were evaluated and differences were analyzed by paired sample t test. According to the findings obtained, ulnae distal proiecturas width averages were 44.77 ± 3.65 and 43.52 ± 3.47 pre- and post-exercise respectively. Bithorachanteric width averages were 29.3 ± 3.12 before exercise and 26.67 ± 3.27 after exercise. Average abdominal widths were observed as 18.64 ± 4.14 (before exercise) and 18.01 ± 6.27 (after exercise). The distances between the malleolus were measured as 16.98 ± 1.62 (before exercise) and 16.70 ± 1.64 (after exercise). The results were statistically significant (p < 0.05). The mean of pre-exercise Externus abdominis circumference was 93.97 ± 8.91, and the mean of post-exercise mean was 90.82 ± 8.24. The results are statistically significant (p < 0.05). In conclusion, findings of the study show that inactivity, daily uncontrolled activities or erroneous postural postures, malnutrition cause some anomalies in the human body. However, with consciously standardized and regular exercises, these abnormalities are reduced by an eight-week exercise protocol in parallel with the expulsion of excess kilos and can be removed when working much longer and fitter, it is proposed to be healthier and more beautiful in appearance.

Keywords: women, body, circumference-width and depth measurements, hypertrophy, exercise

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61 Cerebral Pulsatility Mediates the Link Between Physical Activity and Executive Functions in Older Adults with Cardiovascular Risk Factors: A Longitudinal NIRS Study

Authors: Hanieh Mohammadi, Sarah Fraser, Anil Nigam, Frederic Lesage, Louis Bherer

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A chronically higher cerebral pulsatility is thought to damage cerebral microcirculation, leading to cognitive decline in older adults. Although it is widely known that regular physical activity is linked to improvement in some cognitive domains, including executive functions, the mediating role of cerebral pulsatility on this link remains to be elucidated. This study assessed the impact of 6 months of regular physical activity upon changes in an optical index of cerebral pulsatility and the role of physical activity for the improvement of executive functions. 27 older adults (aged 57-79, 66.7% women) with cardiovascular risk factors (CVRF) were enrolled in the study. The participants completed the behavioral Stroop test, which was extracted from the Delis-Kaplan executive functions system battery at baseline (T0) and after 6 months (T6) of physical activity. Near-infrared spectroscopy (NIRS) was applied for an innovative approach to indexing cerebral pulsatility in the brain microcirculation at T0 and T6. The participants were at standing rest while a NIRS device recorded hemodynamics data from frontal and motor cortex subregions at T0 and T6. The cerebral pulsatility index of interest was cerebral pulse amplitude, which was extracted from the pulsatile component of NIRS data. Our data indicated that 6 months of physical activity was associated with a reduction in the response time for the executive functions, including inhibition (T0: 56.33± 18.2 to T6: 53.33± 15.7,p= 0.038)and Switching(T0: 63.05± 5.68 to T6: 57.96 ±7.19,p< 0.001) conditions of the Stroop test. Also, physical activity was associated with a reduction in cerebral pulse amplitude (T0: 0.62± 0.05 to T6: 0.55± 0.08, p < 0.001). Notably, cerebral pulse amplitude was a significant mediator of the link between physical activity and response to the Stroop test for both inhibition (β=0.33 (0.61,0.23),p< 0.05)and switching (β=0.42 (0.69,0.11),p <0.01) conditions. This study suggests that regular physical activity may support cognitive functions through the improvement of cerebral pulsatility in older adults with CVRF.

Keywords: near-infrared spectroscopy, cerebral pulsatility, physical activity, cardiovascular risk factors, executive functions

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60 High Aspect Ratio Micropillar Array Based Microfluidic Viscometer

Authors: Ahmet Erten, Adil Mustafa, Ayşenur Eser, Özlem Yalçın

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We present a new viscometer based on a microfluidic chip with elastic high aspect ratio micropillar arrays. The displacement of pillar tips in flow direction can be used to analyze viscosity of liquid. In our work, Computational Fluid Dynamics (CFD) is used to analyze pillar displacement of various micropillar array configurations in flow direction at different viscosities. Following CFD optimization, micro-CNC based rapid prototyping is used to fabricate molds for microfluidic chips. Microfluidic chips are fabricated out of polydimethylsiloxane (PDMS) using soft lithography methods with molds machined out of aluminum. Tip displacements of micropillar array (300 µm in diameter and 1400 µm in height) in flow direction are recorded using a microscope mounted camera, and the displacements are analyzed using image processing with an algorithm written in MATLAB. Experiments are performed with water-glycerol solutions mixed at 4 different ratios to attain 1 cP, 5 cP, 10 cP and 15 cP viscosities at room temperature. The prepared solutions are injected into the microfluidic chips using a syringe pump at flow rates from 10-100 mL / hr and the displacement versus flow rate is plotted for different viscosities. A displacement of around 1.5 µm was observed for 15 cP solution at 60 mL / hr while only a 1 µm displacement was observed for 10 cP solution. The presented viscometer design optimization is still in progress for better sensitivity and accuracy. Our microfluidic viscometer platform has potential for tailor made microfluidic chips to enable real time observation and control of viscosity changes in biological or chemical reactions.

Keywords: Computational Fluid Dynamics (CFD), high aspect ratio, micropillar array, viscometer

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59 A Conceptual Approach for Evaluating the Urban Renewal Process

Authors: Muge Unal, Ahmet Cilek

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Urban identity, having a dynamic characteristic spatial and semantic aspects, is a phenomenon in an ever-changing. Urban identity formation includes not only a process of physical nature but also development and change processes that take place in the political, economic, social and cultural values, whether national and international level. Although the concept of urban transformation is basically regarded as the spatial transformation; in fact, it reveals a holistic perspective and transformation based on dialectical relationship existing between the spatial and social relationship. For this reason, urban renewal needs to address as not only spatial but also the impact of spatial transformation on social, cultural and economic. Implementation tools used in the perception of urban transformation are varied concepts such as urban renewal, urban resettlement, urban rehabilitation, urban redevelopment, and urban revitalization. The phenomenon of urban transformation begins with the Industrial Revolution. Until the 1980s, it was interpreted as reconsidering physical fossil on urban environment factor like occurring in rapid urbanization, changing in the spatial structure of the city, concentrating of the population in urban areas. However, after the 1980s, it has resided in a conceptual structure which requires to be addressed physical, economic, social, technological and integrity of information. In conclusion, urban transformation, when it enter the literature as a practice of planning, has been up to date in terms of the conceptual structure and content and also hasn’t remained behind converting itself. Urban transformation still maintains its simplest expression, while it transforms so fast converts the contents. In this study, the relationship between urban design and components of urban transformation were discussed with strategies used as a place in the historical process of urban transformation besides a general evaluation of the concept of urban renewal.

Keywords: conceptual approach, urban identity, urban regeneration, urban renewal

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58 The Importance of Erythrocyte Parameters in Obese Children

Authors: Orkide Donma, M. Metin Donma, Burcin Nalbantoglu, Birol Topcu, Feti Tulubas, Murat Aydin, Tuba Gokkus, Ahmet Gurel

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Increasing prevalence of childhood obesity has increased the interest in early and late indicators of gaining weight. Cell blood counts may be indicators of proinflammatory states. The aim was to evaluate associations of hematological parameters, including Hematocrit (HTC), hemoglobin, blood cell counts, and their indices with the degree of obesity in pediatric population. A total of 249; -139 morbidly obese (MO), 82 healthy Normal Weight (NW) and 28 Overweight (OW) children were included into the scope of the study. WHO BMI-for age percentiles were used to form age- and sex-matched groups. Informed consent forms and the Ethics Committee approval were obtained. Anthropometric measurements were performed. Hematological parameters were determined. Statistical analyses were performed using SPSS. The degree for statistical significance was p≤0.05. Significant differences (p=0.000) between waist-to-hip ratios and head-to-neck ratios (hnrs) of MO and NW children were detected. A significant difference between hnrs of OW and MO children (p=0.000) was observed. Red cell Distribution Width (RDW) was higher in OW children than NW group (p=0.030). Such finding couldn’t be detected between MO and NW groups. Increased RDW was prominent in OW children. The decrease in Mean Corpuscular Hemoglobin Concentration (MCHC) values in MO children was sharper than the values in OW children (p=0.006 vs p=0.042) compared to those in NW group. Statistically higher HTC levels were observed between MO-NW (p=0.014), but none between OW-NW. Though the cause-effect relationship between obesity and erythrocyte indices still needs further investigation, alterations in RDW, HTC, MCHC during obesity may be of significance in the early life.

Keywords: anthropometry, children, erythrocytes, obesity

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57 Epidemiology of Congenital Heart Defects in Kazakhstan: Data from Unified National Electronic Healthcare System 2014-2020

Authors: Dmitriy Syssoyev, Aslan Seitkamzin, Natalya Lim, Kamilla Mussina, Abduzhappar Gaipov, Dimitri Poddighe, Dinara Galiyeva

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Background: Data on the epidemiology of congenital heart defects (CHD) in Kazakhstan is scarce. Therefore, the aim of this study was to describe the incidence, prevalence and all-cause mortality of patients with CHD in Kazakhstan, using national large-scale registry data from the Unified National Electronic Healthcare System (UNEHS) for the period of 2014-2020. Methods: In this retrospective cohort study, the included data pertained to all patients diagnosed with CHD in Kazakhstan and registered in UNEHS between January 2014 and December 2020. CHD was defined based on International Classification of Diseases 10th Revision (ICD-10) codes Q20-Q26. Incidence, prevalence, and all-cause mortality rates were calculated per 100,000 population. Survival analysis was performed using Cox proportional hazards regression modeling and the Kaplan-Meier method. Results: In total, 66,512 patients were identified. Among them, 59,534 (89.5%) were diagnosed with a single CHD, while 6,978 (10.5%) had more than two CHDs. The median age at diagnosis was 0.08 years (interquartile range (IQR) 0.01 – 0.66) for people with multiple CHD types and 0.39 years (IQR 0.04 – 8.38) for those with a single CHD type. The most common CHD types were atrial septal defect (ASD) and ventricular septal defect (VSD), accounting for 25.8% and 21.2% of single CHD cases, respectively. The most common multiple types of CHD were ASD with VSD (23.4%), ASD with patent ductus arteriosus (PDA) (19.5%), and VSD with PDA (17.7%). The incidence rate of CHD decreased from 64.6 to 47.1 cases per 100,000 population among men and from 68.7 to 42.4 among women. The prevalence rose from 66.1 to 334.1 cases per 100,000 population among men and from 70.8 to 328.7 among women. Mortality rates showed a slight increase from 3.5 to 4.7 deaths per 100,000 in men and from 2.9 to 3.7 in women. Median follow-up was 5.21 years (IQR 2.47 – 11.69). Male sex (HR 1.60, 95% CI 1.45 - 1.77), having multiple CHDs (HR 2.45, 95% CI 2.01 - 2.97), and living in a rural area (HR 1.32, 95% CI 1.19 - 1.47) were associated with a higher risk of all-cause mortality. Conclusion: The incidence of CHD in Kazakhstan has shown a moderate decrease between 2014 and 2020, while prevalence and mortality have increased. Male sex, multiple CHD types, and rural residence were significantly associated with a higher risk of all-cause mortality.

Keywords: congenital heart defects (CHD), epidemiology, incidence, Kazakhstan, mortality, prevalence

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56 Association of a Genetic Polymorphism in Cytochrome P450, Family 1 with Risk of Developing Esophagus Squamous Cell Carcinoma

Authors: Soodabeh Shahid Sales, Azam Rastgar Moghadam, Mehrane Mehramiz, Malihe Entezari, Kazem Anvari, Mohammad Sadegh Khorrami, Saeideh Ahmadi Simab, Ali Moradi, Seyed Mahdi Hassanian, Majid Ghayour-Mobarhan, Gordon A. Ferns, Amir Avan

Abstract:

Background Esophageal cancer has been reported as the eighth most common cancer universal and the seventh cause of cancer-related death in men .recent studies have revealed that cytochrome P450, family 1, subfamily B, polypeptide 1, which plays a role in metabolizing xenobiotics, is associated with different cancers. Therefore in the present study, we investigated the impact of CYP1B1-rs1056836 on esophagus squamous cell carcinoma (ESCC) patients. Method: 317 subjects, with and without ESCC were recruited. DNA was extracted and genotyped via Real-time PCR-Based Taq Man. Kaplan Meier curves were utilized to assess overall and progression-free survival. To evaluate the relationship between patients clinicopathological data, genotypic frequencies, disease prognosis, and patients survival, Pearson chi-square and t-test were used. Logistic regression was utilized to assess the association between the risk of ESCC and genotypes. Results: the genotypic frequency for GG, GC, and CC are respectively 58.6% , 29.8%, 11.5% in the healthy group and 51.8%, 36.14% and 12% in ESCC group. With respect to the recessive genetic inheritance model, an association between the GG genotype and stage of ESCC were found. Also, statistically significant results were not found for this variation and risk of ESCC. Patients with GG genotype had a decreased risk of nodal metastasis in comparison with patients with CC/CG genotype, although this link was not statistically significant. Conclusion: Our findings illustrated the correlation of CYP1B1-rs1056836 as a potential biomarker for ESCC patients, supporting further studies in larger populations in different ethnic groups. Moreover, further investigations are warranted to evaluate the association of emerging marker with dietary intake and lifestyle.

Keywords: Cytochrome P450, esophagus squamous cell carcinoma, dietary intake, lifestyle

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55 Development of a Smart System for Measuring Strain Levels of Natural Gas and Petroleum Pipelines on Earthquake Fault Lines in Turkiye

Authors: Ahmet Yetik, Seyit Ali Kara, Cevat Özarpa

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Load changes occur on natural gas and oil pipelines due to natural disasters. The displacement of the soil around the natural gas and oil pipes due to situations that may cause erosion, such as earthquakes, landslides, and floods, is the source of this load change. The exposure of natural gas and oil pipes to variable loads causes deformation, cracks, and breaks in these pipes. Cracks and breaks on the pipes cause damage to people and the environment due to reasons such as explosions. Especially with the examinations made after natural disasters, it can be easily understood which of the pipes has more damage in the regions followed. It has been determined that the earthquakes in Turkey caused permanent damage to the pipelines. This project was designed and realized because it was determined that there were cracks and gas leaks in the insulation gaskets placed in the pipelines, especially at the junction points. In this study, A new SCADA (Supervisory Control and Data Acquisition) application has been developed to monitor load changes caused by natural disasters. The newly developed SCADA application monitors the changes in the x, y, and z axes of the stresses occurring in the pipes with the help of strain gauge sensors placed on the pipes. For the developed SCADA system, test setups in accordance with the standards were created during the fieldwork. The test setups created were integrated into the SCADA system, and the system was followed up. Thanks to the SCADA system developed with the field application, the load changes that will occur on the natural gas and oil pipes are instantly monitored, and the accumulations that may create a load on the pipes and their surroundings are immediately intervened, and new risks that may arise are prevented. It has contributed to energy supply security, asset management, pipeline holistic management, and sustainability.

Keywords: earthquake, natural gas pipes, oil pipes, strain measurement, stress measurement, landslide

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54 Protective Effects of Urtica dioica Seed Extract in Aflatoxicosis: Histopathological and Biochemical Findings

Authors: Ahmet Uyar, Zabit Yener, Abdulahad Dogan

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(1). The ameliorative potential and antioxidant capacity of an extract of Urtica dioica seeds (UDS) were investigated using histopathological changes in liver and kidney of broiler, measuring serum marker enzymes, antioxidant defence systems and lipid peroxidation (malondialdehyde (MDA)) content in various tissues of broilers exposed to aflatoxin (AF). (2). A total of 32 broilers were divided randomly into 4 groups: control, UDS extract-treated, AF-treated and AF+UDS extract-treated. Broilers in control and UDS extract-treated groups were fed on a diet without AF. The AF-treated group and AF+UDS extract-treated groups were treated with an estimated 1 mg total AF/kg feed. The AF+UDS extract groups received in addition 30 ml UDS extract/kg diet for 21 days. (3). The AF-treated group had significantly decreased body weight gain when compared to the other groups. (4). Biochemical analysis showed a small increase in the concentrations of serum aspartate aminotransferase, alanine aminotransferase, gamma glutamyl transpeptidase and lactate dehydrogenase in the AF-treated group compared to that of the control group, whereas concentrations of these enzymes were decreased in the AF+UDS group compared to that of the AF-treated group. (5). Administration of supplementary UDS extract helped restore the AF-induced increase in MDA and reduced the antioxidant system towards normality, particularly in the liver, brain, kidney and heart. Hepatorenal protection by UDS extracts was further supported by the almost normal histology in AF +UDS extract-treated group as compared to the degenerative changes in the AF-treated broilers. (6). It was concluded that UDS extract has a protective hepatorenal effect in broilers affected by aflatoxicosis, probably acting by promoting the antioxidative defence systems.

Keywords: aflatoxicosis, biochemistry, broiler, histopathology, Urtica dioica seed extract

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53 Self-Efficacy Perceptions of Pre-Service Art and Music Teachers towards the Use of Information and Communication Technologies

Authors: Agah Tugrul Korucu

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Information and communication technologies have become an important part of our daily lives with significant investments in technology in the 21st century. Individuals are more willing to design and implement computer-related activities, and they are the main component of computer self-efficacy and self-efficacy related to the fact that the increase in information technology, with operations in parallel with these activities more successful. The Self-efficacy level is a significant factor which determines how individuals act in events, situations and difficult processes. It is observed that individuals with higher self-efficacy perception of computers who encounter problems related to computer use overcome them more easily. Therefore, this study aimed to examine self-efficacy perceptions of pre-service art and music teachers towards the use of information and communication technologies in terms of different variables. Research group consists of 60 pre-service teachers who are studying at Necmettin Erbakan University Ahmet Keleşoğlu Faculty of Education Art and Music department. As data collection tool of the study; “personal information form” developed by the researcher and used to collect demographic data and "the perception scale related to self-efficacy of informational technology" are used. The scale is 5-point Likert-type scale. It consists of 27 items. The Kaiser-Meyer-Olkin (KMO) sample compliance value is found 0.959. The Cronbach alpha reliability coefficient of the scale is found to be 0.97. computer-based statistical software package (SPSS 21.0) is used in order to analyze the data collected by data collection tools; descriptive statistics, t-test, analysis of variance are used as statistical techniques.

Keywords: self-efficacy perceptions, teacher candidate, information and communication technologies, art teacher

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52 Promoter Methylation of RASSF1A and MGMT Genes in Head and Neck Squamous Cell Carcinoma

Authors: Vitor Rafael Regiani, Carlos Henrique Viesi Do Nascimento Filho, Patricia Matos Biselli-Chicote, Claudia Aparecida Rainho, Luiz Sergio Raposo, José Victor Maniglia, Eny Maria Goloni-Bertollo, Erika Cristina Pavarino

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Promoter hypermethylation of tumor-related genes has been associated with prognosis in early-stage head-and-neck cancers, providing strong evidence that these hypermethylated genes are valuable biomarkers for prognostic evaluation. Hence, we selected the MGMT and RASSF1A genes to examine the methylation status in head and neck squamous cell carcinomas (HNSCC) samples matched with non-tumor tissues (tumor-surrounding tissues or peripheral blood samples). DNA methylation analysis was based on Methylation-Sensitive High Resolution Melting, and the methylation status was correlated with clinic-pathological characteristics of the patients. RASSF1A and MGMT promoter methylation was detected in 43.24% (16/37) and in 44.44% (16/36) of the tumors, respectively. RASSF1A and MGMT methylation was significantly more frequent in tumor tissue than non-tumor tissues, as well as, simultaneous methylation of RASSF1A and MGMT also was higher in tumor tissue than non-tumor tissues. In relation to anatomic site, larynx cancer presented significant methylation of MGMT gene compared to tumor-surrounding tissue. The frequency of RASSF1A and MGMT promoter methylated was higher in tumor tissues in relation to peripheral blood from the same patient. No association was found between methylation and the variables analyzed, including gender, age, smoking or alcohol drinking habits. Clinic-pathological characteristics also showed no association in the presence of methylation. The Kaplan–Meier's method showed no association of methylation and both disease-free and overall survival. In conclusion, the presence of epigenetic abnormalities in normal-appearing tissue corroborates the hypothesis of the ‘field cancerization', or it can reflect preneoplastic and/or preinvasive. Moreover, MGMT methylation may serve as an important laryngeal cancer biomarker because it showed significant difference between laryngeal cancer and surrounding tumor tissues.

Keywords: head and neck cancer, DNA methylation, MGMT promoter methylation, RASSF1A promoter methylation

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51 Investigation of Electrospun Composites Nanofiber of Poly (Lactic Acid)/Hazelnut Shell Powder/Zinc Oxide

Authors: Ibrahim Sengor, Sumeyye Cesur, Ilyas Kartal, Faik Nuzhet Oktar, Nazmi Ekren, Ahmet Talat Inan, Oguzhan Gunduz

Abstract:

In recent years, many researchers focused on nano-size fiber production. Nanofibers have been studied due to their different and superior physical, chemical and mechanical properties. Poly (lactic acid) (PLA), is a type of biodegradable thermoplastic polyester derived from renewable sources used in biomedical owing to its biocompatibility and biodegradability. In addition, zinc oxide is an antibacterial material and hazelnut shell powder is a filling material. In this study, nanofibers were obtained by adding of different ratio Zinc oxide, (ZnO) and hazelnut shell powder at different concentration into Poly (lactic acid) (PLA) by using electrospinning method which is the most common method to obtain nanofibers. After dissolving the granulated polylactic acids in % 1,% 2,% 3 and% 4 with chloroform solvent, they are homogenized by adding tween and hazelnut shell powder at different ratios and then by electrospinning, nanofibers are obtained. Scanning electron microscope (SEM), Fourier transform infrared spectroscopy (FTIR), Differential scanning calorimeter (DSC) and physical analysis such as density, electrical conductivity, surface tension, viscosity measurement and antimicrobial test were carried out after production process. The resulting structures of the nanofiber possess antimicrobial and antiseptic properties, which are attractive for biomedical applications. The resulting structures of the nanofiber possess antimicrobial, non toxic, self-cleaning and rigid properties, which are attractive for biomedical applications.

Keywords: electrospinning, hazelnut shell powder, nanofibers, poly (lactic acid), zinc oxide

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50 Marker Assisted Breeding for Grain Quality Improvement in Durum Wheat

Authors: Özlem Ateş Sönmezoğlu, Begüm Terzi, Ahmet Yıldırım, Leyla Gündüz

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Durum wheat quality is defined as its suitability for pasta processing, that is pasta making quality. Another factor that determines the quality of durum wheat is the nutritional value of wheat or its final products. Wheat is a basic source of calories, proteins and minerals for humans in many countries of the world. For this reason, improvement of wheat nutritional value is of great importance. In recent years, deficiencies in protein and micronutrients, particularly in iron and zinc, have seriously increased. Therefore, basic foods such as wheat must be improved for micronutrient content. The effects of some major genes for grain quality established. Gpc-B1 locus is one of the genes increased protein and micronutrients content, and used in improvement studies of durum wheat nutritional value. The aim of this study was to increase the protein content and the micronutrient (Fe, Zn ve Mn) contents of an advanced durum wheat line (TMB 1) that was previously improved for its protein quality. For this purpose, TMB1 advanced durum wheat line were used as the recurrent parent and also, UC1113-Gpc-B1 line containing the Gpc-B1 gene was used as the gene source. In all of the generations, backcrossed plants carrying the targeted gene region were selected by marker assisted selection (MAS). BC4F1 plants MAS method was employed in combination with embryo culture and rapid plant growth in a controlled greenhouse conditions in order to shorten the duration of the transition between generations in backcross breeding. The Gpc-B1 gene was selected specific molecular markers. Since Yr-36 gene associated with Gpc-B1 allele, it was also transferred to the Gpc-B1 transferred lines. Thus, the backcrossed plants selected by MAS are resistance to yellow rust disease. This research has been financially supported by TÜBİTAK (112T910).

Keywords: Durum wheat, Gpc-B1, MAS, Triticum durum, Yr-36

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49 Incidence and Predictors of Mortality Among HIV Positive Children on Art in Public Hospitals of Harer Town, Enrolled From 2011 to 2021

Authors: Getahun Nigusie

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Background; antiretroviral treatment reduce HIV-related morbidity, and prolonged survival of patients however, there is lack of up-to-date information concerning the treatment long term effect on the survival of HIV positive children especially in the study area. Objective: To assess incidence and predictors of mortality among HIV positive children on ART in public hospitals of Harer town who were enrolled from 2011 to 2021. Methodology: Institution based retrospective cohort study was conducted among 429 HIV positive children enrolled in ART clinic from January 1st 2011 to December30th 2021. Data were collected from medical cards by using a data extraction form, Descriptive analyses were used to Summarized the results, and life table was used to estimate survival probability at specific point of time after introduction of ART. Kaplan Meier survival curve together with log rank test was used to compare survival between different categories of covariates, and Multivariate Cox-proportional hazard regression model was used to estimate adjusted Hazard rate. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables. Results: The study participants had followed for a total of 2549.6 child-years (30596 child months) with an overall mortality rate of 1.5 (95% CI: 1.1, 2.04) per 100 child-years. Their median survival time was 112 months (95% CI: 101–117). There were 38 children with unknown outcome, 39 deaths, and 55 children transfer out to different facility. The overall survival at 6, 12, 24, 48 months were 98%, 96%, 95%, 94% respectively. being in WHO clinical Stage four (AHR=4.55, 95% CI:1.36, 15.24), having anemia(AHR=2.56, 95% CI:1.11, 5.93), baseline low absolute CD4 count (AHR=2.95, 95% CI: 1.22, 7.12), stunting (AHR=4.1, 95% CI: 1.11, 15.42), wasting (AHR=4.93, 95% CI: 1.31, 18.76), poor adherence to treatment (AHR=3.37, 95% CI: 1.25, 9.11), having TB infection at enrollment (AHR=3.26, 95% CI: 1.25, 8.49),and no history of change their regimen(AHR=7.1, 95% CI: 2.74, 18.24), were independent predictors of death. Conclusion: more than half of death occurs within 2 years. Prevalent tuberculosis, anemia, wasting, and stunting nutritional status, socioeconomic factors, and baseline opportunistic infection were independent predictors of death. Increasing early screening and managing those predictors are required.

Keywords: human immunodeficiency virus-positive children, anti-retroviral therapy, survival, Ethiopia

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48 Effect of Substrate Temperature on Some Physical Properties of Doubly doped Tin Oxide Thin Films

Authors: Ahmet Battal, Demet Tatar, Bahattin Düzgün

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Various transparent conducting oxides (TCOs) are mostly used much applications due to many properties such as cheap, high transmittance/electrical conductivity etc. One of the clearest among TCOs, indium tin oxide (ITO), is the most widely used in many areas. However, as ITO is expensive and very low regarding reserve, other materials with suitable properties (especially SnO2 thin films) are be using instead of it. In this report, tin oxide thin films doubly doped with antimony and fluorine (AFTO) were deposited by spray at different substrate temperatures on glass substrate. It was investigated their structural, optical, electrical and luminescence properties. The substrate temperature was varied from 320 to 480 ˚C at the interval of 40 (±5) ºC. X-ray results were shown that the films are polycrystalline with tetragonal structure and oriented preferentially along (101), (200) and (210) directions. It was observed that the preferential orientations of crystal growth are not dependent on substrate temperature, but the intensity of preferential orientation was increased with increasing substrate temperature until 400 ºC. After this substrate temperature, they decreased. So, substrate temperature impact structure of these thin films. It was known from SEM analysis, the thin films have rough and homogenous and the surface of the films was affected by the substrate temperature i.e. grain size are increasing with increasing substrate temperature until 400 ºC. Also, SEM and AFM studies revealed the surface of AFTO thin films to be made of nanocrystalline particles. The average transmittance of the films in the visible range is 70-85%. Eg values of the films were investigated using the absorption spectra and found to be in the range 3,20-3,93 eV. The electrical resistivity decreases with increasing substrate temperature, then the electrical resistivity increases. PL spectra were found as a function of substrate temperature. With increasing substrate temperature, emission spectra shift a little bit to a UV region. Finally, tin oxide thin films were successfully prepared by this method and a spectroscopic characterization of the obtained films was performed. It was found that the films have very good physical properties. It was concluded that substrate temperature impacts thin film structure.

Keywords: thin films, spray pyrolysis, SnO2, doubly doped

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47 Demographic Characteristics and Factors Affecting Mortality in Pediatric Trauma Patients Who Are Admitted to Emergency Service

Authors: Latif Duran, Erdem Aydin, Ahmet Baydin, Ali Kemal Erenler, Iskender Aksoy

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Aim: In this retrospective study, we aim to contribute to the literature by presenting the proposals for taking measures to reduce the mortality by examining the demographic characteristics of the pediatric age group patients presenting with trauma and the factors that may cause mortality Material and Method: This study has been performed by retrospectively investigating the data obtained from the patient files and the hospital automation registration system of the pediatric trauma patients who applied to the Adult Emergency Department of the Ondokuz Mayıs University Medical Faculty between January 1, 2016, and December 31, 2016. Results: 289 of 415 patients involved in our study, were males. The median age was 11.3 years. The most common trauma mechanism was falling from the high. A significant statistical difference was found on the association between trauma mechanisms and gender. An increase in the number of trauma cases was found especially in the summer months. The study showed that thoracic and abdominal trauma was relevant to the increased mortality. Computerized tomography was the most common diagnostic imaging modality. The presence of subarachnoid hemorrhage has increased the risk of mortality by 62.3 fold. Eight of the patients (1.9%) died. Scoring systems were statistically significant to predict mortality. Conclusion: Children are vulnerable to trauma because of their unique anatomical and physiological differences compared to adult patient groups. It will be more successful in the mortality rate and in the post-traumatic healing process by administering the patient triage fast and most appropriate trauma centers in the prehospital period, management of the critical patients with the scoring systems and management with standard treatment protocols

Keywords: emergency service, pediatric patients, scoring systems, trauma, age groups

Procedia PDF Downloads 199
46 Development of Automatic Farm Manure Spreading Machine for Orchards

Authors: Barış Ozluoymak, Emin Guzel, Ahmet İnce

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Since chemical fertilizers are used for meeting the deficiency of plant nutrients, its many harmful effects are not taken into consideration for the structure of the earth. These fertilizers are hampering the work of the organisms in the soil immediately after thrown to the ground. This interference is first started with a change of the soil pH and micro organismic balance is disrupted by reaction in the soil. Since there can be no fragmentation of plant residues, organic matter in the soil will be increasingly impoverished in the absence of micro organismic living. Biological activity reduction brings about a deterioration of the soil structure. If the chemical fertilization continues intensively, soils will get worse every year; plant growth will slow down and stop due to the intensity of chemical fertilizers, yield decline will be experienced and farmer will not receive an adequate return on his investment. In this research, a prototype of automatic farm manure spreading machine for orange orchards that not just manufactured in Turkey was designed, constructed, tested and eliminate the human drudgery involved in spreading of farm manure in the field. The machine comprised several components as a 5 m3 volume hopper, automatic controlled hydraulically driven chain conveyor device and side delivery conveyor belts. To spread the solid farm manure automatically, the machine was equipped with an electronic control system. The hopper and side delivery conveyor designs fitted between orange orchard tree row spacing. Test results showed that the control system has significant effects on reduction in the amount of unnecessary solid farm manure use and avoiding inefficient manual labor.

Keywords: automatic control system, conveyor belt application, orchard, solid farm manure

Procedia PDF Downloads 288
45 Effects of Renin Angiotensin Pathway Inhibition on Efficacy of Anti-PD-1/PD-L1 Treatment in Metastatic Cancer

Authors: Philip Friedlander, John Rutledge, Jason Suh

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Inhibition of programmed death-1 (PD-1) or its ligand PD-L1 confers therapeutic efficacy in a wide range of solid tumor malignancies. Primary or acquired resistance can develop through activation of immunosuppressive immune cells such as tumor-associated macrophages. The renin angiotensin system (RAS) systemically regulates fluid and sodium hemodynamics, but components are expressed on and regulate the activity of immune cells, particularly of myeloid lineage. We hypothesized that inhibition of RAS would improve the efficacy of PD-1/PD-L-1 treatment. A retrospective analysis was performed through a chart review of patients with solid metastatic malignancies treated with a PD-1/PD-L1 inhibitor between 1/2013 and 6/2019 at Valley Hospital, a community hospital in New Jersey, USA. Efficacy was determined by medical oncologist documentation of clinical benefit in visit notes and by the duration of time on immunotherapy treatment. The primary endpoint was the determination of efficacy differences in patients treated with an inhibitor of RAS ( ace inhibitor, ACEi, or angiotensin blocker, ARB) compared to patients not treated with these inhibitors. To control for broader antihypertensive effects, efficacy as a function of treatment with beta blockers was assessed. 173 patients treated with PD-1/PD-L-1 inhibitors were identified of whom 52 were also treated with an ACEi or ARB. Chi-square testing revealed a statistically significant relationship between being on an ACEi or ARB and efficacy to PD-1/PD-L-1 therapy (p=0.001). No statistically significant relationship was seen between patients taking or not taking beta blocker antihypertensives (p= 0.33). Kaplan-Meier analysis showed statistically significant improvement in the duration of therapy favoring patients concomitantly treated with ACEi or ARB compared to patients not exposed to antihypertensives and to those treated with beta blockers. Logistic regression analysis revealed that age, gender, and cancer type did not have significant effects on the odds of experiencing clinical benefit (p=0.74, p=0.75, and p=0.81, respectively). We conclude that retrospective analysis of the treatment of patients with solid metastatic tumors with anti-PD-1/PD-L1 in a community setting demonstrates greater clinical benefit in the context of concomitant ACEi or ARB inhibition, irrespective of gender or age. This data supports the development of prospective assessment through randomized clinical trials.

Keywords: angiotensin, cancer, immunotherapy, PD-1, efficacy

Procedia PDF Downloads 76
44 Responses to Germination and Seedling Emergence Capacity of Durum Wheat Cultivars in Long Term Storage

Authors: S. Ahmet Bagci, Hayati Akman

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This study was conducted at the research laboratory and greenhouse conditions to determine the effect on germination and emergency values of long-term stored seed (7 years) and non-stored seed (control) of nine durum wheat varieties. Three replicates of 20 seeds were germinated between double layered rolled germination papers in the Petri plates. Seeds were allowed to germinate at 20±1°C in the dark for 8 days. The seeds were counted on the 8th day as per ISTA rules and calculated in percent to determine germination capacity. Seedling emergency values were determined by testing 20 seeds placed into the sands with three replications of pots. Plants were counted on the 7th day and 12th day to determined seedling emergency rate and capacity, respectively. According to results, there are significant differences among the varieties in terms of germination capacity, seedling emergency rate and capacity of long-term stored and non-stored seeds. Germination capacity values declined from 100% to 93,3% of non-stored seeds whereas they were from 96,7% to 71,7% of long-term stored seeds. Percentage of seedling emergency capacity varied from 65,0% to 93,3% for non-stored seeds, however, the percentage of it was between 11,7 and 86,7% for long-term stored seeds. Results indicate that germination and emergence values responses to long-term stored condition varied significantly among durum wheat cultivars. Research results showed that the long-term-storage resulted in significant decrease with 13.5 % for germination, 36.4 % for emergence on the seventh day and 32.4 % for emergence on the twelfth day. Germination values ranged from 93.3 to 100.0 % for control and 71.7 to 96.7 % for storage. Emergence values in seventh day varied between 51.7 % and 90.0 % for control and 75.0 % and 10.0 % for storage, however values in twelfth day were between 93.3 % and 65.0 % for control and 86.7 % and 11.7 % for storage. According to research results, germination and emergence responses to long-term storage condition varied significantly among durum wheat cultivars.

Keywords: germination, emergence, long-term-storage, durum wheat

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43 A Double-Blind, Randomized, Controlled Trial on N-Acetylcysteine for the Prevention of Acute Kidney Injury in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation

Authors: Sara Ataei, Molouk Hadjibabaie, Amirhossein Moslehi, Maryam Taghizadeh-Ghehi, Asieh Ashouri, Elham Amini, Kheirollah Gholami, Alireza Hayatshahi, Mohammad Vaezi, Ardeshir Ghavamzadeh

Abstract:

Acute kidney injury (AKI) is one of the complications of hematopoietic stem cell transplantation and is associated with increased mortality. N-acetylcysteine (NAC) is a thiol compound with antioxidant and vasodilatory properties that has been investigated for the prevention of AKI in several clinical settings. In the present study, we evaluated the effects of intravenous NAC on the prevention of AKI in allogeneic hematopoietic stem cell transplantation patients. A double-blind randomized placebo-controlled trial was conducted, and 80 patients were recruited to receive 100 mg/kg/day NAC or placebo as intermittent intravenous infusion from day -6 to day +15. AKI was determined on the basis of the Risk-Injury-Failure-Loss-Endstage renal disease and AKI Network criteria as the primary outcome. We assessed urine neutrophil gelatinase-associated lipocalin (uNGAL) on days -6, -3, +3, +9, and +15 as the secondary outcome. Moreover, transplant-related outcomes and NAC adverse reactions were evaluated during the study period. Statistical analysis was performed using appropriate parametric and non-parametric methods including Kaplan–Meier for AKI and generalized estimating equation for uNGAL. At the end of the trial, data from 72 patients were analyzed (NAC: 33 patients and placebo: 39 patients). Participants of each group were not different considering baseline characteristics. AKI was observed in 18% of NAC recipients and 15% of placebo group patients, and the occurrence pattern was not significantly different (p = 0.73). Moreover, no significant difference was observed between groups for uNGAL measures (p = 0.10). Transplant-related outcomes were similar for both groups, and all patients had successful engraftment. Three patients did not tolerate NAC because of abdominal pain, shortness of breath and rash with pruritus and were dropped from the intervention group before transplantation. However, the frequency of adverse reactions was not significantly different between groups. In conclusion, our findings could not show any clinical benefits from high-dose NAC particularly for AKI prevention in allogeneic hematopoietic stem cell transplantation patients.

Keywords: acute kidney injury, N-acetylcysteine, hematopoietic stem cell transplantation, urine neutrophil gelatinase-associated lipocalin, randomized controlled trial

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42 Assessment of Incidence and Predictors of Mortality Among HIV Positive Children on Art in Public Hospitals of Harer Town Who Were Enrolled From 2011 to 2021

Authors: Getahun Nigusie Demise

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Background; antiretroviral treatment reduce HIV-related morbidity, and prolonged survival of patients however, there is lack of up-to-date information concerning the treatment long term effect on the survival of HIV positive children especially in the study area. Objective: The aim of this study is to assess the incidence and predictors of mortality among HIV positive children on antiretroviral therapy (ART) in public hospitals of Harer town who were enrolled from 2011 to 2021. Methodology: Institution based retrospective cohort study was conducted among 429 HIV positive children enrolled in ART clinic from January 1st 2011 to December30th 2021. Data were collected from medical cards by using a data extraction form, Descriptive analyses were used to Summarized the results, and life table was used to estimate survival probability at specific point of time after introduction of ART. Kaplan Meier survival curve together with log rank test was used to compare survival between different categories of covariates, and Multivariate Cox-proportional hazard regression model was used to estimate adjusted Hazard rate. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables. Results: The study participants had followed for a total of 2549.6 child-years (30596 child months) with an overall mortality rate of 1.5 (95% CI: 1.1, 2.04) per 100 child-years. Their median survival time was 112 months (95% CI: 101–117). There were 38 children with unknown outcome, 39 deaths, and 55 children transfer out to different facility. The overall survival at 6, 12, 24, 48 months were 98%, 96%, 95%, 94% respectively. being in WHO clinical Stage four (AHR=4.55, 95% CI:1.36, 15.24), having anemia(AHR=2.56, 95% CI:1.11, 5.93), baseline low absolute CD4 count (AHR=2.95, 95% CI: 1.22, 7.12), stunting (AHR=4.1, 95% CI: 1.11, 15.42), wasting (AHR=4.93, 95% CI: 1.31, 18.76), poor adherence to treatment (AHR=3.37, 95% CI: 1.25, 9.11), having TB infection at enrollment (AHR=3.26, 95% CI: 1.25, 8.49),and no history of change their regimen(AHR=7.1, 95% CI: 2.74, 18.24), were independent predictors of death. Conclusion: more than half of death occurs within 2 years. Prevalent tuberculosis, anemia, wasting, and stunting nutritional status, socioeconomic factors, and baseline opportunistic infection were independent predictors of death. Increasing early screening and managing those predictors are required.

Keywords: human immunodeficiency virus-positive children, anti-retroviral therapy, survival, treatment, Ethiopia

Procedia PDF Downloads 52
41 Determination of Temperature Dependent Characteristic Material Properties of Commercial Thermoelectric Modules

Authors: Ahmet Koyuncu, Abdullah Berkan Erdogmus, Orkun Dogu, Sinan Uygur

Abstract:

Thermoelectric modules are integrated to electronic components to keep their temperature in specific values in electronic cooling applications. They can be used in different ambient temperatures. The cold side temperatures of thermoelectric modules depend on their hot side temperatures, operation currents, and heat loads. Performance curves of thermoelectric modules are given at most two different hot surface temperatures in product catalogs. Characteristic properties are required to select appropriate thermoelectric modules in thermal design phase of projects. Generally, manufacturers do not provide characteristic material property values of thermoelectric modules to customers for confidentiality. Common commercial software applied like ANSYS ICEPAK, FloEFD, etc., include thermoelectric modules in their libraries. Therefore, they can be easily used to predict the effect of thermoelectric usage in thermal design. Some software requires only the performance values in different temperatures. However, others like ICEPAK require three temperature-dependent equations for material properties (Seebeck coefficient (α), electrical resistivity (β), and thermal conductivity (γ)). Since the number and the variety of thermoelectric modules are limited in this software, definitions of characteristic material properties of thermoelectric modules could be required. In this manuscript, the method of derivation of characteristic material properties from the datasheet of thermoelectric modules is presented. Material characteristics were estimated from two different performance curves by experimentally and numerically in this study. Numerical calculations are accomplished in ICEPAK by using a thermoelectric module exists in the ICEPAK library. A new experimental setup was established to perform experimental study. Because of similar results of numerical and experimental studies, it can be said that proposed equations are approved. This approximation can be suggested for the analysis includes different type or brand of TEC modules.

Keywords: electrical resistivity, material characteristics, thermal conductivity, thermoelectric coolers, seebeck coefficient

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40 Computational Fluid Dynamics Modeling of Physical Mass Transfer of CO₂ by N₂O Analogy Using One Fluid Formulation in OpenFOAM

Authors: Phanindra Prasad Thummala, Umran Tezcan Un, Ahmet Ozan Celik

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Removal of CO₂ by MEA (monoethanolamine) in structured packing columns depends highly on the gas-liquid interfacial area and film thickness (liquid load). CFD (computational fluid dynamics) is used to find the interfacial area, film thickness and their impact on mass transfer in gas-liquid flow effectively in any column geometry. In general modeling approaches used in CFD derive mass transfer parameters from standard correlations based on penetration or surface renewal theories. In order to avoid the effect of assumptions involved in deriving the correlations and model the mass transfer based solely on fluid properties, state of art approaches like one fluid formulation is useful. In this work, the one fluid formulation was implemented and evaluated for modeling the physical mass transfer of CO₂ by N₂O analogy in OpenFOAM CFD software. N₂O analogy avoids the effect of chemical reactions on absorption and allows studying the amount of CO₂ physical mass transfer possible in a given geometry. The computational domain in the current study was a flat plate with gas and liquid flowing in the countercurrent direction. The effect of operating parameters such as flow rate, the concentration of MEA and angle of inclination on the physical mass transfer is studied in detail. Liquid side mass transfer coefficients obtained by simulations are compared to the correlations available in the literature and it was found that the one fluid formulation was effectively capturing the effects of interface surface instabilities on mass transfer coefficient with higher accuracy. The high mesh refinement near the interface region was found as a limiting reason for utilizing this approach on large-scale simulations. Overall, the one fluid formulation is found more promising for CFD studies involving the CO₂ mass transfer.

Keywords: one fluid formulation, CO₂ absorption, liquid mass transfer coefficient, OpenFOAM, N₂O analogy

Procedia PDF Downloads 220
39 Correlations among Their Characteristics and Determination of Some Morphological Characteristics of Perennial Ryegrass Genotypes

Authors: Abdullah Özköse, Ahmet Tamkoç

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This study aimed to determine some plant characteristics of perennial ryegrass (Lolium perenne L.) genotypes collected from the natural flora of Ankara and correlations between these characteristics. In order to evaluate for breeding purposes according to Turkey's environmental conditions, perennial ryegrass plants collected from natural pasture of Ankara at 2004 were utilized. The collected seeds of plants were sown in pots and seedlings were prepared in greenhouse. Seedlings were transplanted to the experimental field at 50x50 cm intervals in Randomized Complete Blocks Design in 2005. Data were obtained from the observations and measurements of 568 perennial ryegrasses in 2007 and 2008. Perennial ryegrass plants’ in the spring re-growth time, color, density, growth habit, tendency to inflorescences, time of inflorescence, plant height, length of upper internode, spike length, leaf length, leaf width, leaf area, leaf shape, number of spikelets per spike, seed yield per spike, and 1000 grain weight were investigated and correlation analyses were made on the data. Correlation coefficients were estimated between all paired combinations of the traits. The yield components exhibited varying trends of association among themselves. Seed yield per spike showed significant and positive association with number of spikelets per spike, 1000 grain weight, plant height, length of upper internode, spike length, leaf length, leaf width, leaf area and color, but significant and negative association with growth habit and in the spring re-growth time spring.

Keywords: correlation, morphological traits, Lolium perenne

Procedia PDF Downloads 456
38 Postoperative Radiotherapy in Cancers of the Larynx: Experience of the Emir Abdelkader Cancer Center of Oran, about 89 Cases

Authors: Taleb Lotfi, Benarbia Maheidine, Allam Hamza, Boutira Fatima, Boukerche Abdelbaki

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Introduction and purpose of the study: This is a retrospective single-center study with an analytical aim to determine the prognostic factors for relapse in patients treated with radiotherapy after total laryngectomy with lymph node dissection for laryngeal cancer at the Emir Abdelkader cancer center in Oran (Algeria). Material and methods: During the study period from January 2014 to December 2018, eighty-nine patients (n=89) with squamous cell carcinoma of the larynx were treated with postoperative radiotherapy. Relapse-free survival was studied in the univariate analysis according to pre-treatment criteria using Kaplan-Meier survival curves. We performed a univariate analysis to identify relapse factors. Statistically significant factors have been studied in the multifactorial analysis according to the Cox model. Results and statistical analysis: The average age was 62.7 years (40-86 years). It was a squamous cell carcinoma in all cases. Postoperatively, the tumor was classified as pT3 and pT4 in 93.3% of patients. Histological lymph node involvement was found in 36 cases (40.4%), with capsule rupture in 39% of cases, while the limits of surgical excision were microscopically infiltrated in 11 patients (12.3%). Chemotherapy concomitant with radiotherapy was used in 67.4% of patients. With a median follow-up of 57 months (23 to 104 months), the probabilities of relapse-free survival and five-year overall survival are 71.2% and 72.4%, respectively. The factors correlated with a high risk of relapse were locally advanced tumor stage pT4 (p=0.001), tumor site in case of subglottic extension (p=0.0003), infiltrated surgical limits R1 (p=0.001), l lymph node involvement (p=0.002), particularly in the event of lymph node capsular rupture (p=0.0003) as well as the time between surgery and adjuvant radiotherapy (p=0.001). However, in the subgroup analysis, the major prognostic factors for disease-free survival were subglottic tumor extension (p=0.001) and time from surgery to adjuvant radiotherapy (p=0.005). Conclusion: Combined surgery and postoperative radiation therapy are effective treatment modalities in the management of laryngeal cancer. Close cooperation of the entire cervicofacial oncology team is essential, expressed during a multidisciplinary consultation meeting, with the need to respect the time between surgery and radiotherapy.

Keywords: laryngeal cancer, laryngectomy, postoperative radiotherapy, survival

Procedia PDF Downloads 106
37 Intensity Modulated Radiotherapy of Nasopharyngeal Carcinomas: Patterns of Loco Regional Relapse

Authors: Omar Nouri, Wafa Mnejja, Nejla Fourati, Fatma Dhouib, Wicem Siala, Ilhem Charfeddine, Afef Khanfir, Jamel Daoud

Abstract:

Background and objective: Induction chemotherapy (IC) followed by concomitant chemo radiotherapy with intensity modulated radiation (IMRT) technique is actually the recommended treatment modality for locally advanced nasopharyngeal carcinomas (NPC). The aim of this study was to evaluate the prognostic factors predicting loco regional relapse with this new treatment protocol. Patients and methods: A retrospective study of 52 patients with NPC treated between June 2016 and July 2019. All patients received IC according to the protocol of the Head and Neck Radiotherapy Oncology Group (Gortec) NPC 2006 (3 TPF courses) followed by concomitant chemo radiotherapy with weekly cisplatin (40 mg / m2). Patients received IMRT with integrated simultaneous boost (SIB) of 33 daily fractions at a dose of 69.96 Gy for high-risk volume, 60 Gy for intermediate risk volume and 54 Gy for low-risk volume. Median age was 49 years (19-69) with a sex ratio of 3.3. Forty five tumors (86.5%) were classified as stages III - IV according to the 2017 UICC TNM classification. Loco regional relapse (LRR) was defined as a local and/or regional progression that occurs at least 6 months after the end of treatment. Survival analysis was performed according to Kaplan-Meier method and Log-rank test was used to compare anatomy clinical and therapeutic factors that may influence loco regional free survival (LRFS). Results: After a median follow up of 42 months, 6 patients (11.5%) experienced LRR. A metastatic relapse was also noted for 3 of these patients (50%). Target volumes coverage was optimal for all patient with LRR. Four relapses (66.6%) were in high-risk target volume and two (33.3%) were borderline. Three years LRFS was 85,9%. Four factors predicted loco regional relapses: histologic type other than undifferentiated (UCNT) (p=0.027), a macroscopic pre chemotherapy tumor volume exceeding 100 cm³ (p=0.005), a reduction in IC doses exceeding 20% (p=0.016) and a total cumulative cisplatin dose less than 380 mg/m² (p=0.0.34). TNM classification and response to IC did not impact loco regional relapses. Conclusion: For nasopharyngeal carcinoma, tumors with initial high volume and/or histologic type other than UCNT, have a higher risk of loco regional relapse. Therefore, they require a more aggressive therapeutic approaches and a suitable monitoring protocol.

Keywords: loco regional relapse, modulation intensity radiotherapy, nasopharyngeal carcinoma, prognostic factors

Procedia PDF Downloads 128
36 Design and Evaluation of an Online Case-Based Library for Technology Integration in Teacher Education

Authors: Mustafa Tevfik Hebebci, Ismail Sahin, Sirin Kucuk, Ismail Celik, Ahmet Oguz Akturk

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ADDIE is an instructional design model which has the five core elements: analyze, design, develop, implement, and evaluate. The ADDIE approach provides a systematic process for the analysis of instructional needs, the design and development of instructional programs and materials, implementation of a program, and the evaluation of the effectiveness of an instruction. The case-based study is an instructional design model that is a variant of project-oriented learning. Collecting and analyzing stories can be used in two primary ways -perform task analysis and as a learning support during instruction- by instructional designers. Besides, teachers use technology to develop students’ thinking, enriching the learning environment and providing permanent learning. The purpose of this paper is to introduce an interactive online case-study library website developed in a national project. The design goal of the website is to provide interactive, enhanced, case-based and online educational resource for educators through the purpose and within the scope of a national project. The ADDIE instructional design model was used in the development of the website for the interactive case-based library. This web-based library contains the navigation menus as the follows: “Homepage”, "Registration", "Branches", "Aim of The Research", "About TPACK", "National Project", "Contact Us", etc. This library is developed on a web-based platform, which is important in terms of manageability, accessibility, and updateability of data. Users are able to sort the displayed case-studies by their titles, dates, ratings, view counts, etc. In addition, they encouraged to rate and comment on the case-studies. The usability test is used and the expert opinion is taken for the evaluation of the website. This website is a tool to integrate technology in education. It is believed that this website will be beneficial for pre-service and in-service teachers in terms of their professional developments.

Keywords: design, ADDIE, case based library, technology integration

Procedia PDF Downloads 479
35 Risk Factors of Hospital Acquired Infection Mortality in a Tunisian Intensive Care Unit

Authors: Ben Cheikh Asma, Bouafia Nabiha, Ammar Asma, Ezzi Olfa, Meddeb Khaoula, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

Abstract:

Background: Hospital Acquired Infection (HAI) constitutes an important worldwide health problem. It was associated with high mortality rate in intensive care units (ICU). This study aimed to determine HAI mortality rate in Tunisian intensive care units and identify its risk factors. Methods: We conducted a prospective observational cohort study over a 12 months period (September 15th 2015 to September 15 th 2016) in the adult medical ICU of University Hospital-Farhat Hached (Sousse-Tunisia). All patients admitted in the ICU for more than 48 hours were included in the study. We used an anonymous standardized survey record form to collect data by a medical hygienist assisted by an intensivist. We adopted definitions of Center for Diseases Control and prevention of Atlanta to detect HAI, Kaplan Meier survival analysis and Cox proportional hazard regression to identify independent risk factor of HAI mortality. Results: Of 171 patients, 67 developed ICU-acquired infection (global incidence rate=39.2%). The mean age of patients was 59 ± 21.2 years and 60.8% were male. The most frequently identified infections were pulmonary acquired infection (ventilator associated pneumonia (VAP) and infected atelectasis with density rates 21.4 VAP/1000 days of mechanical ventilation and 9.4 infected atelectasis /1000 days of mechanical ventilation; respectively) and central venous catheter associated infection (CVC - AI) with density rate 28.4 CVC-AI / 1000 CVC-days). HAI mortality rate was 66.7% (n=44). The median survival was 20 days 3.36, 95% Confidential Interval [13.39 – 26.60]. Specific mortality rates according to infectious site were 65.5%, 36.4% and 4.5% respectively for VAP, CVC associated infection and infected atelectasis. In univariate analysis, a significant associations between mortality and cardiovascular history (p=0.04) tracheotomy (p=0.00), peripheral venous catheterization (p=0.04), VAP (p=0.04) and infected atelectasis (p=0.04) were detected. Independent risk factors for HAI mortality were VAP with Hazard Ratio = 3.14, 95% Confidential Interval [1.63 – 6.05] (p=0.001) and tracheotomy (Hazard Ratio=0.22, 95% Confidential Interval [0.10 – 0.44], p=0.000). Conclusions: In the present study, hospital acquired infection mortality rate was relatively high. We need to intensify the fight against these infections especially ventilator-associated pneumonia that is associated with higher risk of mortality in many studies. Thus, more effective infection control interventions were necessary in our hospital.

Keywords: hospital acquired infection, intensive care unit, mortality, risk factors

Procedia PDF Downloads 486
34 The Determination of Pb and Zn Phytoremediation Potential and Effect of Interaction between Cadmium and Zinc on Metabolism of Buckwheat (Fagopyrum Esculentum)

Authors: Nurdan Olguncelik Kaplan, Aysen Akay

Abstract:

Nowadays soil pollution has become a global problem. External added polluters to the soil are destroying and changing the structure of the soil and the problems are becoming more complex and in this sense the correction of these problems is going to be harder and more costly. Cadmium has got a fast mobility in the soil and plant system because of that cadmium can interfere very easily to the human and animal food chain and in the same time this can be very dangerous. The cadmium which is absorbed and stored by the plants is causing to many metabolic changes of the plants like; protein synthesis, nitrogen and carbohydrate metabolism, enzyme (nitrate reductase) activation, photo and chlorophyll synthesis. The biological function of cadmium is not known over the plants and it is not a necessary element. The plant is generally taking in small amounts the cadmium and this element is competing with the zinc. Cadmium is causing root damages. Buckwheat (Fagopyrum esculentum) is an important nutraceutical because of its high content of flavonoids, minerals and vitamins, and their nutritionally balanced amino-acid composition. Buckwheat has relatively high biomass productivity, is adapted to many areas of the world, and can flourish in sterile fields; therefore buckwheat plants are widely used for the phytoremediation process.The aim of this study were to evaluate the phytoremediation capacity of the high-yielding plant Buckwheat (Fagopyrum esculentum) in soils contaminated with Cd and Zn. The soils were applied to differrent doses cd(0-12.5-25-50-100 mg Cd kg−1 soil in the form of 3CdSO4.8H2O ) and Zn (0-10-30 mg Zn kg−1 soil in the form of ZnSO4.7H2O) and incubated about 60 days. Later buckwheat seeds were sown and grown for three mounth under greenhouse conditions. The test plants were irrigated by using pure water after the planting process. Buckwheat seeds (Gunes and Aktas species) were taken from Bahri Dagdas International Agricultural Research. After harvest, Cd and Zn concentrations of plant biomass and grain, yield and translocation factors (TFs) for Cd and Cd were determined. Cadmium accumulation in biomass and grain significantly increased in dose-dependent manner. Long term field trials are required to further investigate the potential of buckwheat to reclaimed the soil. But this could be undertaken in conjunction with actual remediation schemes. However, the differences in element accumulation among the genotypes were affected more by the properties of genotypes than by the soil properties. Gunes genotype accumulated higher lead than Aktas genotypes.

Keywords: buckwheat, cadmium, phytoremediation, zinc

Procedia PDF Downloads 418