Search results for: Ayse Ozge Demir

Authors: Recep Kesli, Cengiz Demir, Riza Durmaz, Zekiye Bakkaloglu, Aysegul Bukulmez

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Objective: Acute diarrhea disease in children is a major cause of morbidity worldwide and is a leading cause of mortality, and it is the most common agent responsible for acute gastroenteritis in developing countries. With hospitalized children suffering from acute enteric disease up to 50% of the analyzed specimen were positive for rotavirus. Further molecular surveillance could provide a sound basis for improving the response to epidemic gastroenteritis and could provide data needed for the introduction of vaccination programmes in the country. The aim of this study was to investigate the prevalence of viral etiology of the gastroenteritis in children aged 0-6 years with acute gastroenteritis and to determine predominant genotypes of rotaviruses in the province of Afyonkarahisar, Turkey. Methods: An epidemiological study on rotavirus was carried out during 2016. Fecal samples obtained from the 144 rotavirus positive children with 0-6 years of ages and applied to the Pediatric Diseases Outpatient of ANS Research and Practice Hospital, Afyon Kocatepe University with the complaint of diarrhea. Bacterial agents causing gastroenteritis were excluded by using bacteriological culture methods and finally, no growth observed. Rotavirus antigen was examined by both the immunochromatographic (One Step Rotavirus and Adenovirus Combo Test, China) and ELISA (Premier Rotaclone, USA) methods in stool samples. Rotavirus RNA was detected by using one step real-time reverse transcription-polymerase chain reaction (RT-PCR). G and P genotypes were determined using RT-PCR with consensus primers of VP7 and VP4 genes, followed by semi nested type-specific multiplex PCR. Results: Of the total 144 rotavirus antigen-positive samples with RT-PCR, 4 (2,8%) were rejected, 95 (66%) were examined, and 45 (31,2%) have not been examined for PCR yet. Ninety-one (95,8%) of the 95 examined samples were found to be rotavirus positive with RT-PCR. Rotavirus subgenotyping distributions in G, P and G/P genotype groups were determined as; G1:45%, G2:27%, G3:13%, G9:13%, G4:1% and G12:1% for G genotype, and P[4]:33%, P[8]:66%, P[10]:1% for P genotype, and G1P[8]:%37, G2P[4]:%21, G3P[8]:%10, G4P[8]:%1, G9P[8]:%8, G2P[8]:%3 for G/P genotype . Not common genotype combination were %20 in G/P genotype. Conclusions: This study subscribes to the global agreement of the molecular epidemiology of rotavirus which will be useful in guiding the alternative and application of rotavirus vaccines or effective control and interception. Determining the diversity and rates of rotavirus genotypes will definitely provide guidelines for developing the most suitable vaccine.

Keywords: gastroenteritis, genotyping, rotavirus, RT-PCR

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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

Procedia PDF Downloads 52

Authors: Recep Keşli, Gülşah Aşık, Cengiz Demir, Onur Türkyılmaz

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Objective: Serratia species are identified as aerobic, motile Gram negative rods. The species Serratia marcescens (S. marcescens) causes both opportunistic and nosocomial infections. The genus Providencia is Gram-negative bacilli and includes urease-producing that is responsible for a wide range of human infections. Although most Providencia infections involve the urinary tract, they are also associated with gastroenteritis, wound infections, and bacteremia. The aim of this study was evaluate the antimicrobial resistance rates of S. marcescens and Providencia spp. strains which had been isolated from various clinical materials obtained from different patients who belongs to intensive care units (ICU) and inpatient clinics. Methods: A total of 35 S. marcescens and Providencia spp. strains isolated from various clinical samples admitted to Medical Microbiology Laboratory, ANS Research and Practice Hospital, Afyon Kocatepe University between October 2013 and September 2015 were included in the study. Identification of the bacteria was determined by conventional methods and VITEK 2 system (bio-Merieux, Marcy l’etoile, France) was used additionally. Antibacterial resistance tests were performed by using Kirby Bauer disc (Oxoid, Hampshire, England) diffusion method following the recommendations of CLSI. Results: The distribution of clinical samples were as follows: upper and lower respiratory tract samples 26, 74.2 % wound specimen 6, 17.1 % blood cultures 3, 8.5%. Of the 35 S. marcescens and Providencia spp. strains; 28, 80% were isolated from clinical samples sent from ICU. The resistance rates of S. marcescens strains against trimethoprim-sulfamethoxazole, piperacillin-tazobactam, imipenem, gentamicin, ciprofloxacin, ceftazidime, cefepime and amikacin were found to be 8.5 %, 22.8 %, 11.4 %, 2.8 %, 17.1 %, 40 %, 28.5 % and 5.7 % respectively. Resistance rates of Providencia spp. strains against trimethoprim-sulfamethoxazole, piperacillin-tazobactam, imipenem, gentamicin, ciprofloxacin, ceftazidime, cefepime and amikacin were found to be 10.2 %, 33,3 %, 18.7 %, 8.7 %, 13.2 %, 38.6 %, 26.7%, and 11.8 % respectively. Conclusion: S. marcescens is usually resistant to ampicillin, amoxicillin, amoxicillin/clavulanate, ampicillin/sulbactam, cefuroxime, cephamycins, nitrofurantoin, and colistin. The most effective antibiotic on the total of S. marcescens strains was found to be gentamicin 2.8 %, of the totally tested strains the highest resistance rate found against to ceftazidime 40 %. The lowest and highest resistance rates were found against gentamiycin and ceftazidime with the rates of 8.7 % and 38.6 % for Providencia spp.

Keywords: Serratia marcescens, Providencia spp., antibiotic resistance, intensive care unit

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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: Emre Kara, Metehan Demir, Şura Karakuzu, Kadir Koç, Ahmet F. Geylan, Halil Aykul

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While the polymeric foam cored sandwiches have been realized for many years, recently there is a growing and outstanding interest on the use of sandwiches consisting of aluminum foam core because of their some of the distinct mechanical properties such as high bending stiffness, high load carrying and energy absorption capacities. These properties make them very useful in the transportation industry (automotive, aerospace, shipbuilding industry), where the "lightweight design" philosophy and the safety of vehicles are very important aspects. Therefore, in this study, the sandwich panels with aluminum alloy foam core and various types and thicknesses of glass fiber reinforced polymer (GFRP) skins produced via Vacuum Assisted Resin Transfer Molding (VARTM) technique were obtained by using a commercial toughened epoxy based adhesive with two components. The aim of this contribution was the analysis of the bending response of sandwiches with various glass fiber reinforced polymer skins. The three point bending tests were performed on sandwich panels at different values of support span distance using a universal static testing machine in order to clarify the effects of the type and thickness of the GFRP skins in terms of peak load, energy efficiency and absorbed energy values. The GFRP skins were easily bonded to the aluminum alloy foam core under press machine with a very low pressure. The main results of the bending tests are: force-displacement curves, peak force values, absorbed energy, collapse mechanisms and the influence of the support span length and GFRP skins. The obtained results of the experimental investigation presented that the sandwich with the skin made of thicker S-Glass fabric failed at the highest load and absorbed the highest amount of energy compared to the other sandwich specimens. The increment of the support span distance made the decrease of the peak force and absorbed energy values for each type of panels. The common collapse mechanism of the panels was obtained as core shear failure which was not affected by the skin materials and the support span distance.

Keywords: aluminum foam, collapse mechanisms, light-weight structures, transport application

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Authors: Medine Demir, Volker John

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Fluid equations in a rotating frame of reference have a broad class of important applications in meteorology and oceanography, especially in the large-scale flows considered in ocean and atmosphere, as well as many physical and industrial applications. The Coriolis and the centripetal forces, resulting from the rotation of the earth, play a crucial role in such systems. For such applications it may be required to solve the system in complex three-dimensional geometries. In recent years, the Navier--Stokes equations in a rotating frame have been investigated in a number of papers using the classical inf-sup stable mixed methods, like Taylor-Hood pairs, to contribute to the analysis and the accurate and efficient numerical simulation. Numerical analysis reveals that these classical methods introduce a pressure-dependent contribution in the velocity error bounds that is proportional to some inverse power of the viscosity. Hence, these methods are optimally convergent but small velocity errors might not be achieved for complicated pressures and small viscosity coefficients. Several approaches have been proposed for improving the pressure-robustness of pairs of finite element spaces. In this contribution, a pressure-robust space discretization of the incompressible Navier--Stokes equations in a rotating frame of reference is considered. The discretization employs divergence-free, $H^1$-conforming mixed finite element methods like Scott--Vogelius pairs. However, this approach might come with a modification of the meshes, like the use of barycentric-refined grids in case of Scott--Vogelius pairs. However, this strategy requires the finite element code to have control on the mesh generator which is not realistic in many engineering applications and might also be in conflict with the solver for the linear system. An error estimate for the velocity is derived that tracks the dependency of the error bound on the coefficients of the problem, in particular on the angular velocity. Numerical examples illustrate the theoretical results. The idea of pressure-robust method could be cast on different types of flow problems which would be considered as future studies. As another future research direction, to avoid a modification of the mesh, one may use a very simple parameter-dependent modification of the Scott-Vogelius element, the pressure-wired Stokes element, such that the inf-sup constant is independent of nearly-singular vertices.

Keywords: navier-stokes equations in a rotating frame of refence, coriolis force, pressure-robust error estimate, scott-vogelius pairs of finite element spaces

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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: U. Demir

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18th century which is the period of 'change' in the Ottoman Empire, affects the architecture as well, where the Classical period is left behind, architecture is differentiated in the form language. This change is especially noticeable in monumental buildings and thus manifested itself in the mosques. But, is it possible to talk about the structural context of the 'change' which has been occurred in decoration? The aim of this study is to investigate the changes and classical relations of the 18th century mosques through plan schedules and structure systems. This study focuses on the monumental mosques constructed during the reign of the three sultans who ruled in the second half of the century (Mustafa the 3rd 1757-1774, Abdülhamid the 1st 1774-1789 and Selim the 3rd). According to their construction years these are 'Ayazma, Laleli, Zeyneb Sultan, Fatih, Beylerbeyi, Şebsefa Kadın, Eyüb Sultan, Mihrişah Valide Sultan and Üsküdar-Selimiye' mosques. As a plan scheme, four mosques have a square or close to a rectangular square scheme, while the others have a rectangle scheme and showing the longitudinal development of the mihrab axis. This situation is widespread throughout the period. In addition to the longitudinal development plan, which is the general characteristic of the 18th century mosques, the use of the classical plan schemes continued in the same direction. Spatialization of the mihrab area was applied to the five mosques while other mosques were applied as niches on the wall surface. This situation is widespread in the period of the second half of the century. In the classical period, the lodges may be located at the back of the mosques interior, not interfering with the main worship area. In the period, the lodges were withdrawn from the main worship area. They are separated from the main interior with their own structural and covering systems. The plans seem to be formed as a result of the addition of lodge parts to the northern part of the Classical period mosques. The 18th century mosques are the constructions where the change of the architectural language and style can be observed easily. This change and the break from the classical period manifest themselves quickly in the structural elements, wall surface decorations, pencil work designs, small scale decor elements, motifs. The speed and intensity of change in the decor does not occur the same as in structural context. The mosque construction rules from the traditional and classical era still continues in the century. While some mosque structures have a plan which is inherited from the classical successor, some of were constructed with the same classical period rules. Nonetheless, the location and transformation of the lodges, which are affecting the interior design, are noteworthy. They provide a significant transition on the way to the new language of the mosque design that will be experienced in the next century. It is intended to draw attention to the structural evolution of the 18th century Ottoman architecture through the royal mosques within the scope of this conference.

Keywords: mosque structure, Ottoman architecture, structural evolution, 18th century architecture

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Authors: Emre Kara, Şura Karakuzu, Ahmet Fatih Geylan, Metehan Demir, Kadir Koç, Halil Aykul

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The material selection in the design of the sandwich structures is very crucial aspect because of the positive or negative influences of the base materials to the mechanical properties of the entire panel. In the literature, it was presented that the selection of the skin and core materials plays very important role on the behavior of the sandwich. Beside this, the use of the correct adhesive can make the whole structure to show better mechanical results and behavior. By this way, the sandwich structures realized in the study were obtained with the combination of aluminum foam core and three different glass fiber reinforced polymer (GFRP) skins using two different commercial adhesives which are based on flexible polyurethane and toughened epoxy. The static and dynamic tests were already applied on the sandwiches with different types of adhesives. In the present work, the static three-point bending tests were performed on the sandwiches having an aluminum foam core with the thickness of 15 mm, the skins with three different types of fabrics ([0°/90°] cross ply E-Glass Biaxial stitched, [0°/90°] cross ply E-Glass Woven and [0°/90°] cross ply S-Glass Woven which have same thickness value of 1.75 mm) and two different commercial adhesives (flexible polyurethane and toughened epoxy based) at different values of support span distances (L= 55, 70, 80, 125 mm) by aiming the analyses of their flexural performance. The skins used in the study were produced via Vacuum Assisted Resin Transfer Molding (VARTM) technique and were easily bonded onto the aluminum foam core with flexible and toughened adhesives under a very low pressure using press machine with the alignment tabs having the total thickness of the whole panel. The main results of the flexural loading are: force-displacement curves obtained after the bending tests, peak force values, absorbed energy, collapse mechanisms, adhesion quality and the effect of the support span length and adhesive type. The experimental results presented that the sandwiches with epoxy based toughened adhesive and the skins made of S-Glass Woven fabrics indicated the best adhesion quality and mechanical properties. The sandwiches with toughened adhesive exhibited higher peak force and energy absorption values compared to the sandwiches with flexible adhesive. The core shear mode occurred in the sandwiches with flexible polyurethane based adhesive through the thickness of the core while the same mode took place in the sandwiches with toughened epoxy based adhesive along the length of the core. The use of these sandwich structures can lead to a weight reduction of the transport vehicles, providing an adequate structural strength under operating conditions.

Keywords: adhesive and adhesion, aluminum foam, bending, collapse mechanisms

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Authors: Demet Devrimsel Dogan, Ecem Deniz Kirkpantur, Muharrem Dogan, Ahmet Aykut, Ebru Unal Akoglu, Ozge Ecmel Onur

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Introduction: Median Arcuate Ligament Syndrome (MALS) is a rare cause of chronic abdominal pain due to external compression of the celiac trunk by a fibrous arch that unites diaphragmatic crura on each side of the aortic hiatus. While 10-24% of the population may suffer from compression of celiac trunk, it rarely causes patients to develop symptoms. The typical clinical triad of symptoms includes postprandial epigastric pain, weight loss and vomiting. The diagnosis can be made using thin section multi-detector computed tomography (CT) scans which delineate the ligament and the compressed vessel. The treatment of MALS is aimed at relieving the compression of the celiac artery to restore adequate blood flow through the vessel and neurolysis to address chronic pain. Case: A 68-year-old male presented to our clinic with acute postprandial epigastric pain. This was patients’ first attack, and the pain was the worst pain of his life. The patient did not have any other symptoms like nausea, vomiting, chest pain or dyspnea. In his medical history, the patient has had an ischemic cerebrovascular stroke 5 years ago which he recovered with no sequel, and he was using 75 mg clopidogrel and 100 mg acetylsalicylic acid. He was not using any other medication and did not have a story of cardiovascular disease. His vital signs were stable (BP:113/72 mmHg, Spo2:97, temperature:36.3°C, HR:90/bpm). In his electrocardiogram, there was ST depression in leads II, III and AVF. In his physical examination, there was only epigastric tenderness, other system examinations were normal. Physical examination through his upper gastrointestinal system showed no bleeding. His laboratory results were as follows: creatinine:1.26 mg/dL, AST:42 U/L, ALT:17 U/L, amylase:78 U/L, lipase:26 U/L, troponin:10.3 pg/ml, WBC:28.9 K/uL, Hgb:12.7 gr/dL, Plt:335 K/uL. His serial high-sensitive troponin levels were also within normal limits, his echocardiography showed no segmental wall motion abnormalities, an acute myocardial infarction was excluded. In his abdominal ultrasound, no pathology was founded. Contrast-enhanced abdominal CT and CT angiography reported ‘thickened diaphragmatic cruras are compressing and stenosing truncus celiacus superior, this is likely compatible with MALS’. The patient was consulted to general surgery, and they admitted the patient for laparoscopic ligament release. Results: MALS is a syndrome that causes postprandial pain, nausea and vomiting as its most common symptoms. Affected patients are normally young, slim women between the ages of 30 and 50 who have undergone extensive examinations to find the source of their symptoms. To diagnose MALS, other underlying pathologies should initially be excluded. The gold standard is aortic angiography. Although diagnosis and treatment of MALS are unclear, symptom resolution has been achieved with multiple surgical modalities, including open, laparoscopic or robotic ligament release as well as celiac ganglionectomy, which often requires celiac artery revascularisation.

Keywords: differential diagnosis, epigastric pain, median arcuate ligament syndrome, celiac trunk

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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: Özge Çeliker Tosun, Melda Başer Secer, İsmail Düşmez, Sedat Çapar, İlkay Kozak, Melahat Aktaş, Furkan Can Şimşek, Gökhan Tosun

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Purpose: Portable innovative balance room system with digital game program; It was created to be able to be divided into small areas, such as inside the house, garden, balcony, to enable the person to enter and perform both evaluation and exercise safely, and to ensure that these results can be stored and sent to the therapist live or later when desired. The aim is to compare the effectiveness of the exercise program applied by the elderly within this system and the exercise program implemented under the supervision of a physiotherapist on balance and urinary incontinence symptoms. Materials and Methods: The study was conducted in a randomized controlled manner on 63 people with urinary incontinence (mean age: 75.5 years) at Narlıdere Nursing Home Elderly Care and Rehabilitation Center. Elderly people participating in the study were divided into 3 groups: 1. Group, an exercise program consisting of pelvic floor muscle training and OTOGA exercises, 2. Group, only pelvic floor muscle training, and 3. Group, pelvic floor muscle training and Otoga exercises in the form of a digital game program in a portable balance room system. (self-administered) for 12 weeks. Pelvic floor distress inventory (PTDE-20) and bladder diary were used to evaluate the incontinance symptoms of the cases. Pelvic floor muscle function was evaluated with superficial EMG. Berg, Fall Effectiveness Scale (FES) and Functional Status Evaluations (Chair Stand Test, Eight (8) Food Up and Go Test, Chair Sit and Reach Test, Two Minutes Step Test) were used to evaluate balance. The existence of differences between groups was analyzed using Krusskal Wallis analysis of variance, and the difference between before and after exercise was analyzed with Wilcoxon tests. Results: After treatment, PTDE-20, daily urinary incontinence and toilet visits values decreased significantly in all three groups (p < 0.001). While there was a statistically significant increase in pelvic floor muscle EMG values in the 2nd and third groups after treatment, there was no change in the other group (2nd Group PFM average EMG before-after: 5.5 (4.15-10.95) - 10.95 (8.68-13.68), P=0.05, 3 Group PFM average EMG before-after: 6.5 (4.28-11.55) - 11.75 (8.67-14.26), p=0.04). While BERG score, Chair Stand Test, Eight (8) Food Up and Go Test, and Two Minutes Step Test values increased in all groups (p<0.05), Fall Effectiveness Scale (FES) values did not change after treatment. Conclusion: Although pelvic floor muscle training combined with balance exercises reduces symptoms, it may not lead to a positive improvement in the functions of the pelvic floor muscles. For this reason, recovery lasts for a short time, and then symptoms may reoccur in the future. However, thanks to the new system, when balance exercises are combined with a game program for the pelvic floor muscles, a double effect can be achieved with a single application and both incontinence and balance problems can be treated in a safe environment where the person can do it himself. But more work needs to be done on this subject. However, thanks to the new system, a double effect can be achieved with a single application, and both incontinence and balance problems can be treated in a safe environment where the person can do it himself. But more work needs to be done on new system

Keywords: fall, urinary incontinance, balance, elderly

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Authors: Emre Kara, Ahmet Fatih Geylan, Kadir Koç, Şura Karakuzu, Metehan Demir, Halil Aykul

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The structures obtained with the use of sandwich technologies combine low weight with high energy absorbing capacity and load carrying capacity. Hence, there is a growing and markedly interest in the use of sandwiches with aluminium foam core because of very good properties such as flexural rigidity and energy absorption capability. The static (bending and penetration) and dynamic (dynamic bending and low velocity impact) tests were already performed on the aluminum foam cored sandwiches with different types of outer skins by some of the authors. In the current investigation, the static three-point bending tests were carried out on the sandwiches with aluminum foam core and glass fiber reinforced polymer (GFRP) skins at different values of support span distances (L= 55, 70, 80, 125 mm) aiming the analyses of their flexural performance. The influence of the core thickness and the GFRP skin type was reported in terms of peak load, energy absorption capacity and energy efficiency. For this purpose, the skins with two different types of fabrics ([0°/90°] cross ply E-Glass Woven and [0°/90°] cross ply S-Glass Woven which have same thickness value of 1.5 mm) and the aluminum foam core with two different thicknesses (h=10 and 15 mm) were bonded with a commercial polyurethane based flexible adhesive in order to combine the composite sandwich panels. The GFRP skins fabricated via Vacuum Assisted Resin Transfer Molding (VARTM) technique used in the study can be easily bonded to the aluminum foam core and it is possible to configure the base materials (skin, adhesive and core), fiber angle orientation and number of layers for a specific application. The main results of the bending tests are: force-displacement curves, peak force values, absorbed energy, energy efficiency, collapse mechanisms and the effect of the support span length and core thickness. The results of the experimental study showed that the sandwich with the skins made of S-Glass Woven fabrics and with the thicker foam core presented higher mechanical values such as load carrying and energy absorption capacities. The increment of the support span distance generated the decrease of the mechanical values for each type of panels, as expected, because of the inverse proportion between the force and span length. The most common failure types of the sandwiches are debonding of the upper or lower skin and the core shear. The obtained results have particular importance for applications that require lightweight structures with a high capacity of energy dissipation, such as the transport industry (automotive, aerospace, shipbuilding and marine industry), where the problems of collision and crash have increased in the last years.

Keywords: aluminum foam, composite panel, flexure, transport application

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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: Recep Kesli, Cengiz Demir, Onur Turkyilmaz, Hayriye Tokay

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Objective: Gram-negative rods are a large group of bacteria, and include many families, genera, and species. Most clinical isolates belong to the family Enterobacteriaceae. Resistance due to the production of extended-spectrum β-lactamases (ESBLs) is a difficulty in the handling of Enterobacteriaceae infections, but other mechanisms of resistance are also emerging, leading to multidrug resistance and threatening to create panresistant species. We aimed in this study to evaluate resistance rates of Gram-negative rods bacteria isolated from clinical specimens in Microbiology Laboratory, Afyon Kocatepe University, ANS Research and Practice Hospital, between October 2012 and September 2015. Methods: The Gram-negative rods strains were identified by conventional methods and VITEK 2 automated identification system (bio-Mérieux, Marcy l’etoile, France). Antibiotic resistance tests were performed by both the Kirby-Bauer disk-diffusion and automated Antimicrobial Susceptibility Testing (AST, bio-Mérieux, Marcy l’etoile, France) methods. Disk diffusion results were evaluated according to the standards of Clinical and Laboratory Standards Institute (CLSI). Results: Of the totally isolated 1.701 Enterobacteriaceae strains 1434 (84,3%) were Klebsiella pneumoniae, 171 (10%) were Enterobacter spp., 96 (5.6%) were Proteus spp., and 639 Nonfermenting gram negatives, 477 (74.6%) were identified as Pseudomonas aeruginosa, 135 (21.1%) were Acinetobacter baumannii and 27 (4.3%) were Stenotrophomonas maltophilia. The ESBL positivity rate of the totally studied Enterobacteriaceae group were 30.4%. Antibiotic resistance rates for Klebsiella pneumoniae were as follows: amikacin 30.4%, gentamicin 40.1%, ampicillin-sulbactam 64.5%, cefepime 56.7%, cefoxitin 35.3%, ceftazidime 66.8%, ciprofloxacin 65.2%, ertapenem 22.8%, imipenem 20.5%, meropenem 20.5 %, and trimethoprim-sulfamethoxazole 50.1%, and for 114 Enterobacter spp were detected as; amikacin 26.3%, gentamicin 31.5%, cefepime 26.3%, ceftazidime 61.4%, ciprofloxacin 8.7%, ertapenem 8.7%, imipenem 12.2%, meropenem 12.2%, and trimethoprim-sulfamethoxazole 19.2 %. Resistance rates for Proteus spp. were: 24,3% meropenem, 26.2% imipenem, 20.2% amikacin 10.5% cefepim, 33.3% ciprofloxacin and levofloxacine, 31.6% ceftazidime, 20% ceftriaxone, 15.2% gentamicin, 26.6% amoxicillin-clavulanate, and 26.2% trimethoprim-sulfamethoxale. Resistance rates of P. aeruginosa was found as follows: Amikacin 32%, gentamicin 42 %, imipenem 43%, merpenem 43%, ciprofloxacin 50%, levofloxacin 52%, cefepim 38%, ceftazidim 63%, piperacillin/tacobactam 85%, for Acinetobacter baumannii; Amikacin 53.3%, gentamicin 56.6 %, imipenem 83%, merpenem 86%, ciprofloxacin 100%, ceftazidim 100%, piperacillin/tacobactam 85 %, colisitn 0 %, and for S. malthophilia; levofloxacin 66.6 % and trimethoprim/sulfamethoxozole 0 %. Conclusions: This study showed that resistance in Gram-negative rods was a serious clinical problem in our hospital and suggested the need to perform typification of the isolated bacteria with susceptibility testing regularly in the routine laboratory procedures. This application guided to empirical antibiotic treatment choices truly, as a consequence of the reality that each hospital shows different resistance profiles.

Keywords: antibiotic resistance, gram negative rods, ESBL, VITEK 2

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Authors: Ayse Collins

Abstract:

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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