Search results for: Kemal Özeralp

Authors: Feyzan Tuzkaya, Nihan S. Soylu, Çağlar Solak, Hilal Peker, Mehmet Peker, Kemal Özeralp, Ceren Mete, Ezgi Mehmetoğlu, Mehmet Karasu, Cihan Elçi, Ece Akca, Melek Göregenli

Abstract:

Perception, evaluation and representation of the environment have been the subject of many disciplines including psychology, geography and architecture. In environmental and social psychology literature there are several evidences which suggest that cognitive representations about a place consisted of not only geographic items but also social and cultural. Mental representations of residence area or a country are influenced and determined by social-demographics, the physical and social context. Thus, all mental representations of a given place are also social representations. Cognitive maps are the main and common instruments that are used to identify spatial images and the difference between physical and subjective environments. The aim of the current study is investigating the mental and social representations of Turkey in university students’ minds. Data was collected from 249 university students from different departments (i.e. psychology, geography, history, tourism departments) of Ege University. Participants were requested to reflect Turkey in their mind onto the paper drawing sketch maps. According to the results, cognitive maps showed geographic aspects of Turkey as well as the context of symbolic, cultural and political reality of Turkey. That is to say, these maps had many symbolic and verbal items related to critics on social and cultural problems, ongoing ethnic and political conflicts, and actual political agenda of Turkey. Additionally, one of main differentiations in these representations appeared in terms of the East and West side of the Turkey, and the representations of the East and West was varied correspondingly participants’ cultural background, their ethnic values, and where they have born. The results of the study were discussed in environmental and social psychological perspective considering cultural and social values of Turkey and current political circumstances of the country.

Keywords: Cognitive maps, East and West, politics, social representations, Turkey.

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Authors: Kemal Efe, Gui-Liang Feng

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The optimal bisection width of r-dimensional N× · · ·× N grid is known to be Nr-1 when N is even, but when N is odd, only approximate values are available. This paper shows that the exact bisection width of grid is Nr -1 N-1 when N is odd.

Keywords: Grids, Parallel Architectures, Graph Bisection, VLSI Layouts.

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Authors: Bahaddin Bukcu, Murat Kemal Karacan

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In this study, we have defined slant helix according to Bishop frame in Euclidean 3-Space. Furthermore, we have given some necassary and sufficient conditons for the slant helix.

Keywords: Slant helix, Bishop frame, Parallel transport frame

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Authors: Mustafa M. Donma

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Circumference measurements may give meaningful information about the varying stages of obesity. Some formulas may be derived from a number of body circumference measurements to estimate body fat. Waist (WC), hip (HC) and neck (NC) circumferences are currently the most frequently used measurements. The aim of this study was to develop a formula derived from these three anthropometric measurements for the differential diagnosis of morbid obesity with and without metabolic syndrome (MetS), MOMetS+ and MOMetS-, respectively. 187 children were recruited from the pediatrics outpatient clinic of Tekirdag Namik Kemal University, Faculty of Medicine. Signed informed consent forms were taken from the participants. The study was carried out according to the Helsinki Declaration. The study protocol was approved by the institutional non-interventional ethics committee of Tekirdag Namik Kemal University Medical Faculty. The study population was divided into four groups as normal-body mass index (N-BMI) (n = 35), obese (OB) (n = 44), morbid obese (MO) (n = 75) and MetS (n = 33). Age- and gender-adjusted BMI percentile values were used for the classification of groups. The children in MetS group were selected based upon the nature of the MetS components described as MetS criteria. Anthropometric measurements, laboratory analysis and statistical evaluation confined to study population were performed. BMI values were calculated. A circumference index, advanced Donma circumference index (ADCI) was presented as WC*HC/NC. The statistical significance degree was chosen as p < 0.05. BMI values were 17.7 ± 2.8, 24.5 ± 3.3, 28.8 ± 5.7, 31.4 ± 8.0 kg/m2, for N-BMI, OB, MO, MetS groups (p = 0.001), respectively. An increasing trend from N-BMI to MetS was observed. However, the increase in MetS group compared to MO group was not significant. For the new index, significant differences were obtained between N-BMI and OB, MO, MetS groups (p = 0.001). A significant difference between MO and MetS groups was detected (p = 0.043). A significant correlation was found between BMI and ADCI. In conclusion, in spite of the strong correlation between BMI and ADCI values obtained when all groups were considered, ADCI, but not BMI, was the index, which was capable of differentiating cases with morbid obesity from cases with morbid obesity and MetS.

Keywords: Anthropometry, body mass index, childhood obesity, body circumference, metabolic syndrome.

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Authors: Mehmet Sagbas, Kemal Fidanboylu, M. Can Bayram

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A new voltage-mode triple-input single-output multifunction filter using only two current conveyors is presented. The proposed filter which possesses three inputs and single-output can generate all biquadratic filtering functions at the output terminal by selecting different input signal combinations. The validity of the proposed filter is verified through PSPICE simulations.

Keywords: Active Filters, Voltage mode, Current conveyor

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Authors: Kemal Çomakli, Uğur Çakir

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This research evaluated and compared the thermodynamic performance of heat pump systems which can be run under two different modes as air to air and air to water by using only one compressor. To achieve this comparison an experimental performance study was made on a traditional vapor compressed heat pump system that can be run air to air mode and air to water mode by help of a valve. The experiments made under different thermal conditions. Thermodynamic performance of the systems are presented and compared with each other for different working conditions.

Keywords: Air source heat pump, Energy Analysis, Heat Pump

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Authors: Kemal Bicakci, Yusuf Uzunay

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It is well-known that in wireless local area networks, authenticating nodes by their MAC addresses is not secure since it is very easy for an attacker to learn one of the authorized addresses and change his MAC address accordingly. In this paper, in order to prevent MAC address spoofing attacks, we propose to use dynamically changing MAC addresses and make each address usable for only one session. The scheme we propose does not require any change in 802.11 protocols and incurs only a small performance overhead. One of the nice features of our new scheme is that no third party can link different communication sessions of the same user by monitoring MAC addresses therefore our scheme is preferable also with respect to user privacy.

Keywords: Authentication, MAC address spoofing, security, wireless networks.

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Authors: Hilmi Yazıcı

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M. Kemal Ataturk was a great leader who was fond of art and he had displayed his being fond of art many times. In his speeches and writings you can see that he had showed his approval to art and the importance of artists and art for the society. During the foundation of republic, he also wanted renovation in art as in other fields and ordered many novelties both in art and society. One of the greatest steps in realizing this was to prepare a national Turkish opera. In this study, it was studied how a Turkish opera, Özsoy was prepared in the context of social and political conditions of that time and what kind of processes it passed. As a result, it is seen that there was two main aims for Ataturk with this opera. First, Ataturk wanted to abolish the sectarian conflict between Iran and Turkey going on for centuries. The second and maybe the most important is that he wanted to make a revolution in the field of art and aimed to reach the level of civilized countries.

Keywords: Opera, Atatürk, Özsoy, Adnan Saygun, The first Turkish opera.

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Authors: Erol Seke, Kemal Özkan

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Linear approximation of point spread function (PSF) is a new method for determining subpixel translations between images. The problem with the actual algorithm is the inability of determining translations larger than 1 pixel. In this paper a multiresolution technique is proposed to deal with the problem. Its performance is evaluated by comparison with two other well known registration method. In the proposed technique the images are downsampled in order to have a wider view. Progressively decreasing the downsampling rate up to the initial resolution and using linear approximation technique at each step, the algorithm is able to determine translations of several pixels in subpixel levels.

Keywords: Point Spread Function, Subpixel translation, Superresolution, Multiresolution approach.

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Authors: Mehmet Sagbas, Kemal Fidanboylu, Mehmet C. Bayram

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A new current-mode multifunction filter using minimum number of passive elements is proposed. The proposed filter has single-input and four high-impedance outputs. It uses four passive elements (two capacitors and two resistors) and four dual output second generation current conveyors. Each output provides a different filter response, namely, low-pass, high-pass, band-pass and band-reject. The sensitivity analysis is also carried out on both ideal and non-ideal filter configurations. The validity of the proposed filter is verified through PSPICE simulations.

Keywords: Active filter, Universal filter, Currentconveyors.

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Authors: Sema Kurtuluş, Kemal Kurtuluş

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The objective of this paper is to review and assess the methodological issues and problems in marketing research, data and knowledge mining in Turkey. As a summary, academic marketing research publications in Turkey have significant problems. The most vital problem seems to be related with modeling. Most of the publications had major weaknesses in modeling. There were also, serious problems regarding measurement and scaling, sampling and analyses. Analyses myopia seems to be the most important problem for young academia in Turkey. Another very important finding is the lack of publications on data and knowledge mining in the academic world.

Keywords: Marketing research, data mining, knowledge mining, research modeling, analyses.

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Authors: Nasıf Ekiz, Tara Salih, Sibel Küçüköner, Kemal Fidanboylu

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Continuation of an active call is one of the most important quality measurements in the cellular systems. Handoff process enables a cellular system to provide such a facility by transferring an active call from one cell to another. Different approaches are proposed and applied in order to achieve better handoff service. The principal parameters used to evaluate handoff techniques are: forced termination probability and call blocking probability. The mechanisms such as guard channels and queuing handoff calls decrease the forced termination probability while increasing the call blocking probability. In this paper we present an overview about the issues related to handoff initiation and decision and discuss about different types of handoff techniques available in the literature.

Keywords: Handoff, Forced Termination Probability, Blocking probability, Handoff Initiation, Handoff Decision, Handoff Prioritization Schemes.

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Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Obesity is known to be associated with many clinically important diseases including metabolic syndrome (MetS). Vitamin B₁₂ plays essential roles in fat and protein metabolisms and its cooperation with vitamin B₉ is well-known. The aim of this study is to investigate the possible contributions as well as associations of these micronutrients upon obesity and MetS during childhood. A total of 128 children admitted to Namik Kemal University, Medical Faculty, Department of Pediatrics Outpatient Clinics were included into the scope of this study. The mean age±SEM of 92 morbid obese (MO) children and 36 with MetS were 118.3±3.8 months and 129.5±6.4 months, respectively (p > 0.05). The study was approved by Namık Kemal University, Medical Faculty Ethics Committee. Written informed consent forms were obtained from the parents. Demographic features and anthropometric measurements were recorded. WHO BMI-for age percentiles were used. The values above 99 percentile were defined as MO. Components of MetS [waist circumference (WC), fasting blood glucose (FBG), triacylglycerol (TRG), high density lipoprotein cholesterol (HDL-Chol), systolic pressure (SP), diastolic pressure (DP)] were determined. Routine laboratory tests were performed. Serum vitamin B₁₂ concentrations were measured using electrochemiluminescence immunoassay. Vitamin B₉ was analyzed by an immunoassay analyzer. Values for vitamin B₁₂ < 148 pmol/L, 148-221 pmol/L, > 221 pmol/L were accepted as low, borderline and normal, respectively. Vitamin B₉ levels ≤ 4 mcg/L defined deficiency state. Statistical evaluations were performed by SPSSx Version 16.0. p≤0.05 was accepted as statistical significance level. Statistically higher body mass index (BMI), WC, hip circumference (C) and neck C were calculated in MetS group compared to children with MO. No difference was noted for head C. All MetS components differed between the groups (SP, DP p < 0.001; WC, FBG, TRG p < 0.01; HDL-Chol p < 0.05). Significantly decreased vitamin B₉ and vitamin B₁₂ levels were detected (p < 0.05) in children with MetS. In both groups percentage of folate deficiency was 5.5%. No cases were below < 148 pmol/L. However, in MO group 14.3% and in MetS group 22.2% of the cases were of borderline status. In MO group B₁₂ levels were negatively correlated with BMI, WC, hip C and head C, but not with neck C. WC, hip C, head C and neck C were all negatively correlated with HDL-Chol. None of these correlations were observed in the group of children with MetS. Strong positive correlation between FBG and insulin as well as strong negative correlation between TRG and HDL-Chol detected in MO children were lost in MetS group. Deficiency state end-products of both B₉ and B₁₂ may interfere with the expected profiles of MetS components. In this study, the alterations in MetS components affected vitamin B₁₂ metabolism and also its associations with anthropometric body measurements. Further increases in vitamin B₁₂ and vitamin B₉ deficiency in MetS associated with the increased vitamin B₁₂ as well as vitamin B₉ deficiency metabolites may add to MetS parameters.

Keywords: Children, cobalamin, folate, metabolic syndrome, obesity.

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Authors: Dogan Ciloglu, Abdurrahim Bolukbasi, Kemal Comakli

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In this study, the effect of nanofluids on the pool film boiling was experimentally investigated at saturated condition under atmospheric pressure. For this purpose, four different water-based nanofluids (Al2O3, SiO2, TiO2 and CuO) with 0.1% particle volume fraction were prepared. To investigate the boiling heat transfer, a cylindrical rod with high temperature was used. The rod heated up to high temperatures was immersed into nanofluids. The center temperature of rod during the cooling process was recorded by using a K-type thermocouple. The quenching curves showed that the pool boiling heat transfer was strongly dependent on the nanoparticle materials. During the repetitive quenching tests, the cooling time decreased and thus, the film boiling vanished. Consequently, the primary reason of this was the change of the surface characteristics due to the nanoparticles deposition on the rod-s surface.

Keywords: Heat transfer, nanofluid, nanoparticles, pool film boiling

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Authors: Kemal Izci

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Assessment forms an important part of instruction. Assessment that aims to support learning is known as formative assessment and it contributes student’s learning gain and motivation. However, teachers rarely use assessment formatively to aid their students’ learning. Thus, reviewing the factors that limit or support teachers’ practices of formative assessment will be crucial for guiding educators to support prospective teachers in using formative assessment and also eliminate limiting factors to let practicing teachers to engage in formative assessment practices during their instruction. The study, by using teacher’s change environment framework, reviews literature on formative assessment and presents a tentative model that illustrates the factors impacting teachers’ adoption of formative assessment in their teaching. The results showed that there are four main factors consisting personal, contextual, resource-related and external factors that influence teachers’ practices of formative assessment.

Keywords: Assessment practices, formative assessment, teachers, factors for use of formative assessment.

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Authors: Kemal Comakli, Meryem Terhan

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In this study, the potential of heat recovery from waste flue gas was examined in 60 MW district heating system of a university, and fuel saving was aimed by using the recovered heat in the system as a source again. Various scenarios are intended to make use of waste heat. For this purpose, actual operation data of the system were taken. Besides, the heat recovery units that consist of heat exchangers such as flue gas condensers, economizers or air pre-heaters were designed theoretically for each scenario. Energy analysis of natural gas-fired boiler’s exhaust flue gas in the system, and economic analysis of heat recovery units to predict payback periods were done. According to calculation results, the waste heat loss ratio from boiler flue gas in the system was obtained as average 16%. Thanks to the heat recovery units, thermal efficiency of the system can be increased, and fuel saving can be provided. At the same time, a huge amount of green gas emission can be decreased by installing the heat recovery units.

Keywords: Heat recovery from flue gas, energy analysis of flue gas, economical analysis, payback period.

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Authors: Mevlüt Burak Dalmış, Kemal Yaman

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In this study, flutter characteristics of cantilever rectangular plate structure under incompressible flow regime are investigated by comparing the results of commercial flutter analysis program ZAERO^© with wind tunnel tests conducted in Ankara Wind Tunnel (ART). A rectangular polycarbonate (PC) plate, 5x125x1000 mm in dimensions, is used for both numerical and experimental investigations. Analysis and test results are very compatible with each other. A comparison between two different solution methods (g and k-method) of ZAERO^© is also done. It is seen that, k-method gives closer result than the other one. However, g-method results are on conservative side and it is better to use conservative results namely g-method results. Even if the modal analysis results are used for the flutter analysis for this simple structure, a modal test should be conducted in order to validate the modal analysis results to have accurate flutter analysis results for more complicated structures.

Keywords: Flutter, plate, subsonic flow, wind tunnel.

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Authors: Kemal Çomakli, Uğur Çakir, Ayşegül Çokgez Kuş, Erol Şahin

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A lower consumption of thermal energy will contribute not only to a reduction in the running costs, but also in the reduction of pollutant emissions that contribute to the greenhouse effect. Cogeneration or CHP (Combined Heat and Power) is the system that produces power and usable heat simultaneously by decreasing the pollutant emissions and increasing the efficiency. Combined production of mechanical or electrical and thermal energy using a simple energy source, such as oil, coal, natural or liquefied gas, biomass or the sun; affords remarkable energy savings and frequently makes it possible to operate with greater efficiency when compared to a system producing heat and power separately. This study aims to bring out the contributions of cogeneration systems to the environment and sustainability by saving the energy and reducing the emissions. In this way we made a comprehensive investigation in the literature by focusing on the environmental aspects of the cogeneration systems. In the light of these studies we reached that, cogeneration systems must be consider in sustainability and their benefits on protecting the ecology must be investigated.

Keywords: Sustainability, cogeneration systems, energy economy, energy saving.

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Authors: Kemal Tutuncu, Recai Ozcan

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Having done in this study, air-conditioning automation for patisserie shopwindow was designed. In the cooling sector it is quite important to cooling up the air temperature in the shopwindow within short time interval. Otherwise the patisseries inside of the shopwindow will be spoilt in a few days. Additionally the humidity is other important parameter for the patisseries kept in shopwindow. It must be raised up to desired level in a quite short time. Traditional patisserie shopwindows only allow controlling temperature manually. There is no humidity control and humidity is supplied by fans that are directed to the water at the bottom of the shopwindows. In this study, humidity and temperature sensors (SHT11), PIC, AC motor controller, DC motor controller, ultrasonic nebulizer and other electronic circuit members were used to simulate air conditioning automation for patisserie shopwindow in proteus software package. The simulation results showed that temperature and humidity values are adjusted in desired time duration by openloop control technique. Outer and inner temperature and humidity values were used for control mechanism.

Keywords: Air conditioning automation, temperature and humidity, SHT11, AC motor controller, open-loop control.

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Authors: M. Zamurad Shah, M. Kemal Özgören, Raza Samar

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This paper presents a 3D guidance scheme for Unmanned Aerial Vehicles (UAVs). The proposed guidance scheme is based on the sliding mode approach using nonlinear sliding manifolds. Generalized 3D kinematic equations are considered here during the design process to cater for the coupling between longitudinal and lateral motions. Sliding mode based guidance scheme is then derived for the multiple-input multiple-output (MIMO) system using the proposed nonlinear manifolds. Instead of traditional sliding surfaces, nonlinear sliding surfaces are proposed here for performance and stability in all flight conditions. In the reaching phase control inputs, the bang-bang terms with signum functions are accompanied with proportional terms in order to reduce the chattering amplitudes. The Proposed 3D guidance scheme is implemented on a 6-degrees-of-freedom (6-dof) simulation of a UAV and simulation results are presented here for different 3D trajectories with and without disturbances.

Keywords: Unmanned Aerial Vehicles, Sliding mode control, 3D Guidance, Path following, trajectory tracking, nonlinear sliding manifolds.

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Authors: Ahmet Oguz Akturk, Kemal Izci, Gurbuz Caliskan, Ismail Sahin

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Rapid developments in technology in the present age have made it necessary for communities to follow technological developments and adapt themselves to these developments. One of the fields that are most rapidly affected by these developments is undoubtedly education. Determination of the attitudes of preservice teachers, who live in an age of technology and get ready to raise future individuals, is of paramount importance both educationally and professionally. The purpose of this study was to analyze attitudes of preservice teachers towards technology and some variables that predict these attitudes (gender, daily duration of internet use, and the number of technical devices owned). 329 preservice teachers attending the education faculty of a large university in central Turkey participated, on a volunteer basis, in this study, where relational survey model was used as the research method. Research findings reveal that preservice teachers’ attitudes towards technology are positive and at the same time, the attitudes of male preservice teachers towards technology are more positive than their female counterparts. As a result of the stepwise multiple regression analysis where factors predicting preservice teachers’ attitudes towards technology, it was found that duration of daily internet use was the strongest predictor of attitudes towards technology.

Keywords: Attitudes towards technology, preservice teachers, gender, stepwise multiple regression analysis.

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Authors: Murat Sengoz, Mustafa Kemal Topcu

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This study aims to contribute to efforts of Turkey to increase research and development to overcome mid-income level trap by discussing regulations on patenting and licensing. Knowledge and technology transfer from universities to business world is attached great significance to increase innovation. Through literature survey, it is observed that the States accomplished to boost the economy and increase welfare by the Bayh-Dole Act enacted in 1980. Thus, this good practice is imitated by other nations to make technological developments. The Act allows universities to acquire patent right in research programs funded by government to increase technology transfer from universities whilst motivating real sector to use research pools in the universities. An act similar with Bayh-Dole could be beneficial to Turkey since efforts in Turkey are to promote research, development and innovation. Towards this end, the impact of Bayh-Dole Act on the patent system for universities in the Sates is deliberately examined, applicability in Turkey is discussed. However, it is conceded that success rate of applying Bayh-Dole Act in Turkey would be low once Turkey mainly differs from the States regarding social, economic and cultural traits.

Keywords: Bayh-Dole act, knowledge transfer, license, patent, spin-off.

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Authors: Uğur Çakır, Erol Sahin, Kemal Çomaklı, Aysegül Çokgez Kus

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Greenhouses offer us suitable conditions which can be controlled easily for the growth of the plant and they are made by using a covering material that allows the sun light entering into the system. Covering material can be glass, fiber glass, plastic or another transparent element. This study investigates the solar energy usability rates and solar energy benefitting rates of a semi-spherical (modified arch) type greenhouse system according to different orientations and positions which exists under climatic conditions of Bayburt. In the concept of this study it is tried to determine the best direction and best sizes of a semi-spherical greenhouse to get best solar benefit from the sun. To achieve this aim a modeling study is made by using MATLAB. However, this modeling study is run for some determined shapes and greenhouses it can be used for different shaped greenhouses or buildings. The basic parameters are determined as greenhouse azimuth angle, the rate of size of long edge to short and seasonal solar energy gaining of greenhouse. The optimum azimuth angles of 400, 300, 250, 200, 150, 100, 50 m2 modified arch greenhouse are 90o, 90o, 35o, 35o, 34o, 33o and 22o while their optimum k values (ratio of length to width) are 10, 10, 10, 10, 6, 4 and 4 respectively. Positioning the buildings in order to get more solar heat energy in winter and less in summer brings out energy and money savings and increases the comfort.

Keywords: Greenhousing, solar energy, direct radiation, renewable energy.

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Authors: Kemal Polat

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In this paper, an attribute weighting method called fuzzy C-means clustering based attribute weighting (FCMAW) for classification of Diabetes disease dataset has been used. The aims of this study are to reduce the variance within attributes of diabetes dataset and to improve the classification accuracy of classifier algorithm transforming from non-linear separable datasets to linearly separable datasets. Pima Indians Diabetes dataset has two classes including normal subjects (500 instances) and diabetes subjects (268 instances). Fuzzy C-means clustering is an improved version of K-means clustering method and is one of most used clustering methods in data mining and machine learning applications. In this study, as the first stage, fuzzy C-means clustering process has been used for finding the centers of attributes in Pima Indians diabetes dataset and then weighted the dataset according to the ratios of the means of attributes to centers of theirs. Secondly, after weighting process, the classifier algorithms including support vector machine (SVM) and k-NN (k- nearest neighbor) classifiers have been used for classifying weighted Pima Indians diabetes dataset. Experimental results show that the proposed attribute weighting method (FCMAW) has obtained very promising results in the classification of Pima Indians diabetes dataset.

Keywords: Fuzzy C-means clustering, Fuzzy C-means clustering based attribute weighting, Pima Indians diabetes dataset, SVM.

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Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Obesity and weight gain are associated with increased risk of developing cardiovascular diseases and the progression of liver fibrosis. Aspartate transaminase–to-platelet count ratio index (APRI) and fibrosis-4 (FIB-4) were primarily considered as the formulas capable of differentiating hepatitis from cirrhosis. However, to the best of our knowledge, their status in children is not clear. The aim of this study is to determine APRI and FIB-4 status in obese (OB) children and compare them with values found in children with normal body mass index (N-BMI). A total of 68 children examined in the outpatient clinics of the Pediatrics Department in Tekirdag Namik Kemal University Medical Faculty were included in the study. Two groups were constituted. In the first group, 35 children with N-BMI, whose age- and sex-dependent BMI indices vary between 15 and 85 percentiles, were evaluated. The second group comprised 33 OB children whose BMI percentile values were between 95 and 99. Anthropometric measurements and routine biochemical tests were performed. Using these parameters, values for the related indices, BMI, APRI, and FIB-4, were calculated. Appropriate statistical tests were used for the evaluation of the study data. The statistical significance degree was accepted as p < 0.05. In the OB group, values found for APRI and FIB-4 were higher than those calculated for the N-BMI group. However, there was no statistically significant difference between the N-BMI and OB groups in terms of APRI and FIB-4. A similar pattern was detected for triglyceride (TRG) values. The correlation coefficient and degree of significance between APRI and FIB-4 were r = 0.336 and p = 0.065 in the N-BMI group. On the other hand, they were r = 0.707 and p = 0.001 in the OB group. Associations of these two indices with TRG have shown that this parameter was strongly correlated (p < 0.001) both with APRI and FIB-4 in the OB group, whereas no correlation was calculated in children with N-BMI. TRG are associated with an increased risk of fatty liver, which can progress to severe clinical problems such as steatohepatitis, which can lead to liver fibrosis. TRG are also independent risk factors for cardiovascular disease. In conclusion, the lack of correlation between TRG and APRI as well as FIB-4 in children with N-BMI, along with the detection of strong correlations of TRG with these indices in OB children, was the indicator of the possible onset of the tendency towards the development of fatty liver in OB children. This finding also pointed out the potential risk for cardiovascular pathologies in OB children. The nature of the difference between APRI vs. FIB-4 correlations in N-BMI and OB groups (no correlation vs. high correlation), respectively, may be the indicator of the importance of involving age and alanine transaminase parameters in addition to AST and PLT in the formula designed for FIB-4.

Keywords: APRI, FIB-4, obesity, triglycerides.

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Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Anthropometric measurements are essential for obesity studies. Waist circumference (WC) is the most frequently used measure and along with hip circumference (HC), it is used in most equations derived for the evaluation of obese individuals. Morbid obesity (MO) is the most severe clinical form of obesity and such individuals may also exhibit some clinical findings leading to metabolic syndrome (MetS). Then, it becomes a requirement to discriminate MO children with MetS (MOMetS+) from MO children without MetS (MOMetS-). Almost all obesity indices can differentiate obese (OB) children from children with normal body mass index (N-BMI). However, not all of them are capable of making this distinction. The aim of this study was to find out the clinical availability of (waist circumference + hip circumference)/2 ((WC+HC)/2) for the differential diagnosis of MOMetS+ and MOMetS- and to compare the possible preponderance of it over some other anthropometric or fat-based obesity indices. 45 MOMetS+ and 45 MOMetS- children were included in the study. Participants have submitted informed consent forms. The study protocol was approved by the Non-interventional Clinical Studies Ethics Committee of Tekirdag Namik Kemal University. Anthropometric measurements were performed. BMI, waist-to-hip circumference (WHR), (WC+HC)/2, trunk-to-leg fat ratio (TLFR), trunk-to-appendicular fat ratio (TAFR), trunk fat+leg fat/2 ((trunk+leg fat)/2), diagnostic obesity notation model assessment index-2 (D2I) and fat mass index (FMI) were calculated for both groups. Study data were analyzed statistically and 0.05 for p value was accepted as the statistical significance degree. Statistically higher BMI, WC, (WC+HC)/2, (trunk+leg fat)/2 values were found in MOMetS+ children than MOMetS- children. No statistically significant difference was detected for WHR, TLFR, TAFR, D2I and FMI between two groups. The lack of difference between the groups in terms of FMI and D2I pointed out the fact that the recently developed fat-based index; (trunk+leg fat)/2 gives much more valuable information during the evaluation of MOMetS+ and MOMetS- children. Upon evaluation of the correlations, (WC+HC)/2 was strongly correlated with D2I and FMI in both MOMetS+ and MOMetS- groups. Neither D2I nor FMI was correlated with W/H. Strong correlations were calculated between (WC+HC)/2 and (trunk+leg fat)/2 in both MOMetS- (r = 0.961; p < 0.001) and MOMetS+ (r = 0.936; p < 0.001) groups. Partial correlations between (WC+HC)/2 and (trunk+leg fat)/2 after controlling the effect of basal metabolic rate were r = 0.726; p < 0.001 in MOMetS- group and r = 0.932; p < 0.001 in MOMetS+ group. The correlation in the latter group was higher than the first group. In conclusion, recently developed anthropometric obesity index (WC+HC)/2 and fat-based obesity index (trunk+leg fat)/2 were of preponderance over the previously introduced classical obesity indices such as WHR, D2I and FMI during the differential diagnosis of MOMetS+ and MOMetS- children.

Keywords: Hip circumference, metabolic syndrome, morbid obesity, waist circumference.

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Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Zinc (Zn) is a vital element required for growth and development particularly in children. It exhibits some protective effects against cardiovascular diseases (CVDs). Zn may be a potential biomarker of cardiovascular health. High sensitive cardiac troponin T (hs-cTnT) and cardiac myosin binding protein C (cMyBP-C) are new generation markers used for prediagnosis, diagnosis and prognosis of CVDs. The aim of this study is to determine Zn as well as new generation cardiac markers’ profiles in children with normal body mass index (N-BMI), obese (OB), morbid obese (MO) children and children with metabolic syndrome (MetS) findings. The association among them will also be investigated. Four study groups were constituted. The study protocol was approved by the institutional Ethics Committee of Tekirdag Namik Kemal University. Parents of the participants filled informed consent forms to participate in the study. Group 1 is composed of 44 children with N-BMI. Group 2 and Group 3 comprised 43 OB and 45 MO children, respectively. 45 MO children with MetS findings were included in Group 4. World Health Organization age- and sex-adjusted BMI percentile tables were used to constitute groups. These values were 15-85, 95-99 and above 99 for N-BMI, OB and MO, respectively. Criteria for MetS findings were determined. Routine biochemical analyses including Zn were performed. hs-cTnT and cMyBP-C concentrations were measured by enzyme-linked immunosorbent assay. Data were analyzed by using SPSS software. p < 0.05 was accepted as significant. Four groups were matched for age and gender. Decreased Zn concentrations were measured in Groups 2, 3 and 4 compared to Group 1. Groups did not differ from one another in terms of hs-cTnT. There were statistically significant differences between cMyBP-C levels of MetS group and N-BMI as well as OB groups. There was an increasing trend going from N-BMI group to MetS group. There were statistically significant negative correlations between Zn and hs-cTnT as well as cMyBP-C concentrations in MetS group. In conclusion, inverse correlations detected between Zn and new generation cardiac markers (hs-TnT and cMyBP-C) have pointed out that decreased levels of Zn accompany increased levels of hs-cTnT as well as cMyBP-C in children with MetS. This finding emphasizes that both Zn and these new generation cardiac markers may be evaluated as biomarkers of cardiovascular health during severe childhood obesity precipitated with MetS findings and also suggested as the messengers of the future risk in the adulthood periods of children with MetS.

Keywords: Cardiac myosin binding protein-C, cardiovascular diseases, children, high sensitive cardiac troponin T, obesity.

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Authors: Mustafa M. Donma

Abstract:

Metabolic syndrome (MetS) components are noteworthy among children with obesity and morbid obesity, because they point out the cases with MetS, which have the great tendency to severe health problems such as cardiovascular diseases both in childhood and adulthood. In clinical practice, considerable efforts are being observed to bring into the open the striking differences between morbid obese cases and those with MetS findings. The most privileged aspect is concerning cardiometabolic features. The aim of this study was to derive an index, which behaves different in children with and without MetS from the cardiac point of view. For the purpose, aspartate transaminase (AST), a cardiac enzyme still being used independently to predict cardiac-related problems was used. 124 children were recruited from the outpatient clinic of Department of Pediatrics in Tekirdag Namik Kemal University, Faculty of Medicine. 43 children with normal body mass index, 41 and 40 morbid obese (MO) children with MetS and without the characteristic features of MetS, respectively, were included in the study. Weight, height, waist circumference (WC), hip circumference (HC), head circumference (HdC), neck circumference (NC), systolic and diastolic blood pressure values were measured and recorded. Body mass index and anthropometric ratios were calculated. Fasting blood glucose (FBG), insulin (INS), triglycerides (TRG), high density lipoprotein cholesterol (HDL-C) analyses were performed. The values for AST, alanine transaminase (ALT) and AST/ALT were obtained. Advanced Donma cardiac index (ADCI) values were calculated. Statistical evaluations including correlation analysis were done by a statistical package program. The statistical significance degree was accepted as p < 0.05. The index, ADCI, was developed from both anthropometric and biochemical parameters. All anthropometric measurements except weight were included in the equation. Besides all biochemical parameters concerning MetS components were also added. This index was tested in each of three groups. Its performance was compared with the performance of cardiometabolic index (CMI). It was also checked whether it was compatible with AST activity. The performance of ADCI was better than that of CMI. Instead of double increase, the increase of three times was observed in children with MetS compared to MO children. The index was correlated with AST in MO group and with AST/ALT in MetS group. In conclusion, this index was superior in discovering cardiac problems in MO and in diagnosing MetS in MetS groups. It was also arbiter to point out cardiovascular and MetS aspects among the groups.

Keywords: Aspartate transaminase, cardiac index, metabolic syndrome, obesity.

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Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Alterations in lipid parameters as well as in the fat distribution of the body are noteworthy during the evaluation of obesity stages. Total cholesterol (TC), triglycerides (TRG), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C) are basic lipid fractions. Fat deposited in trunk and extremities may give considerable amount of information. Ratios such as trunk-to-leg fat ratio (TLFR) and trunk-to-appendicular fat ratio (TAFR) are derived from distinct fat distribution in these areas. In this study, lipid fractions and TLFR as well as TAFR were evaluated and the distinctions among healthy, obese (OB) and morbid obese (MO) groups were investigated. Three groups [normal body mass index (N-BMI), OB, MO] were constituted. Ages and sexes of the groups were matched. The study protocol was approved by the Non-interventional Ethics Committee of Tekirdag Namik Kemal University. Written informed consent forms were obtained from the parents of the participants. Anthropometric measurements (height, weight, waist circumference, hip circumference, head circumference, neck circumference) were recorded during the physical examination. BMI values were calculated. Total, trunk, leg and arm fat mass values were obtained by TANITA Bioelectrical Impedance Analysis. These values were used to calculate TLFR and TAFR. Systolic (SBP) and diastolic blood pressures (DBP) were measured. Routine biochemical tests including lipid fractions were performed. Data were evaluated using SPSS software. p value smaller than 0.05 was accepted as significant. There was no difference among the age values and gender ratios of the groups. Any statistically significant difference was not observed in terms of DBP, TLFR as well as serum lipid fractions. Higher SBP values were measured both in OB and MO children than those with N-BMI. TAFR showed a significant difference between N-BMI and OB groups. Statistically significant increases were detected between insulin values of N-BMI group and OB as well as MO groups. There were bivariate correlations between LDL and TLFR as well as TAFR values in MO group. When adjusted for SBP and DBP, partial correlations were calculated for LDL-TLFR as well as LDL-TAFR. Much stronger partial correlations were obtained for the same couples upon controlling for TRG and HDL-C. Much stronger partial correlations observed in MO children emphasize the potential transition from morbid obesity to metabolic syndrome. These findings have concluded that LDL-C may be suggested as a discriminating parameter between OB and MO children.

Keywords: Children, lipid parameters, obesity, trunk-to-leg fat ratio, trunk-to-appendicular fat ratio.

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Authors: Mustafa M. Donma, Orkide Donma

Abstract:

The number of indices developed for the evaluation of obesity and metabolic syndrome (MetS) both in adults and pediatric population is ever increasing. These indices can be weight-dependent or weight–independent. Some are extremely sophisticated equations and their clinical utility is questionable in routine clinical practice. The aim of this study was to compare presently available obesity indices and find the most practical one. Their associations with MetS components were also investigated to determine their capacities in differential diagnosis of morbid obesity with and without MetS. Children with normal body mass index (N-BMI) and morbid obesity were recruited for this study. Three groups were constituted. Age- and sex-dependent BMI percentiles for morbid obese (MO) children were above 99 according to World Health Organization tables. Of them, those with MetS findings were evaluated as MetS group. Children, whose values were between 85 and 15, were included in N-BMI group. The study protocol was approved by the Ethics Committee of Tekirdag Namik Kemal University, Faculty of Medicine. Parents filled out informed consent forms to participate in the study. Anthropometric measurements and blood pressure values were recorded. BMI, hip index (HI), conicity index (CI), triponderal mass index (TPMI), body adiposity index (BAI), body shape index (BSI), body roundness index (BRI), abdominal volume index (AVI), waist-to-hip ratio (WHR) and [waist circumference (WC) + hip circumference (HC)]/2 were the formulas examined in this study. Routine biochemical tests including fasting blood glucose (FBG), insulin (INS), blood lipids were performed. Statistical program SPSS was used for the evaluation of study data; p < 0.05 was accepted as the statistical significance degree. HI did not differ among the groups. A statistically significant difference was noted between N-BMI and MetS groups in terms of ABSI. All the other indices were capable of making discrimination between N-BMI-MO, N-BMI- MetS and MO-MetS groups. No correlation was found between FBG and any obesity indices in any groups. The same was true for INS in N-BMI group. Insulin was correlated with BAI, TPMI, CI, BRI, AVI and (WC+HC)/2 in MO group without MetS findings. In the MetS group, the only index, which was correlated with INS, was (WC+HC)/2. These findings have pointed out that complicated formulas may not be required for the evaluation of the alterations among N-BMI and various obesity groups including MetS. The simple easily computable weight-independent index, (WC+HC)/2, was unique, because it was the only index, which exhibits a valuable association with INS in MetS group. It did not exhibit any correlation with other obesity indices showing associations with INS in MO group. It was concluded that (WC+HC)/2 was pretty valuable practicable index for the discrimination of MO children with and without MetS findings.

Keywords: Fasting blood glucose, insulin, metabolic syndrome, obesity indices.

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