Meslek Yüksekokulları

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    Bilateral locked posterior shoulder dislocation overlooked for 15 months treated with the modified McLaughlin procedure: A case report
    (Bayçınar Tıbbi Yayıncılık, 2023) Saylık, Murat; Gökkuş, Kemal
    Neglected bilateral posterior shoulder dislocation is a rare injury caused primarily by an epileptic seizure. The injury is usually associated with a reverse Hill-Sachs lesion in the anteromedial aspect of the humeral head. The modified McLaughlin technique may avoid instability and osteoarthritis when 20 to 40% of the articular surface is affected by reverse Hill-Sachs. In this article, we present the clinical results of a case overlooked in the literature for the longest time, i.e., for 15 months. A 46-year-old male patient was receiving treatment for epilepsy for five years. There was no fall or trauma in the four seizures he had during this time. The last seizure was 15 months ago. When the patient presented to our clinic, both shoulders were symmetrically deformed, the anterior shoulder contour disappeared (empty socket sign), and there was a loss of upper contour. The computed tomography (CT) scan revealed a posteriorly locked dislocation with a reverse Hill-Sachs lesion in 32% of the left shoulder and 36% of the right shoulder. We applied the modified McLaughlin procedure to the dominant right shoulder and, two months later, we used it to the left shoulder (with a graft taken from the anterior superior iliac spine). At one-year of follow-up, both shoulders were moderately functional: forward elevation left 70° and right 50°, abduction left 40° and right 60°, and internal rotation: the back of the hand could touch the fifth lumbar vertebra. Meanwhile, the patient did not suffer from recurrent dislocation. The pre- and postoperative Constant-Murley Scores for the right and left shoulder were 30/52 and 11/48, respectively. Although the operational outcomes using the modified McLaughlin technique were not ideal, with no recurrence, the patient seemed to be satisfied with this outcome. In conclusion, in neglected locked shoulder fracture-dislocations, the modified McLaughlin technique is a method that can respond to the pathophysiology by eliminating reverse Hill–Sachs lesion.
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    Exploring Cognitive Enhancements and Default Mode Network Connectivity in Relapsing-Remitting Multiple Sclerosis: Insights from a Prospective Study Investigating the MIND Diet
    (Sage, 2024-09) Demirel, Mert; Daşgın, Hacer; Acar, Nazire Pınar; Özçelik-Eroğlu, Elçin; Atabilen, Büşra; Ertuğrul, Aygün; Akdevelioğlu, Yasemin; Oğuz, Kader Karlı; Tuncer, Meryem Aslı; 396621
    The potential therapeutic impact of the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet on relapsing-remitting multiple sclerosis (RRMS) remains an underexplored area. Objectives/Aims: This study aims to evaluate the influence of the MIND diet on RRMS by examining neurological, cognitive, and functional magnetic resonance imaging (fMRI) parameters. Methods: Seventeen early-stage RRMS patients (aged 20-40, disease duration < 10 years, Beck Depression Inventory Score < 17) underwent MRI at baseline and following a 9-month adherence to the MIND diet. They were matched with 10 healthy controls. Diet adherence was assessed using the MIND Diet scale score. MRI encompassed structural and resting-state fMRI (RS-fMRI) sequences. Neurological evaluation (Expanded Disability Status Scale [EDSS], Timed 25-Foot Walk [T25W], 9-Hole Peg Test [9HPT]), and cognitive assessments (Mini-Mental State Examination [MMSE], Rey Auditory Verbal Learning Test [AVLT], phonemic and semantic fluency, forward and backward digit span tests [FDST, BDST]) were conducted. Functional connectivity was assessed using seed-based correlation (SBC) and global correlation by general linear model (GLM), focusing on Default Mode Network (DMN), Central Executive Network (CEN), Dorsal Attention Network (DAN), Salience Network (SN), Visual Network (VN), and Sensorimotor Network (SMN). Results: Patients exhibited high adherence to the diet throughout the 9-month period. Significant improvements were observed in dominant hand 9-HPT (p=0.023) and AVLT parameters (p<0.001), except delayed recall (p=0.982), following the intervention. Increased connectivity within the whole brain was noted in the left frontal orbital cortex of the 9th-month group compared to healthy controls (p=0.000005). Moreover, RRMS patients in the 9th-month group displayed enhanced functional connectivity in the bilateral caudate, bilateral pallidum, and right putamen within the DMN compared to baseline (p=0.000034). Conclusion: The findings of this study suggest potential cognitive benefits of the MIND diet, as evidenced by improvements in AVLT scores. Furthermore, the observed alterations in Default Mode Network (DMN) connectivity in RRMS patients following the dietary intervention indicate a promising avenue for further investigation into cognitive deficit management in this population
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    Fabrication of Al/n-GaN/p-Si/Al diodes by thermal evaporation and evaluation of effect of gamma irradiation on device properties
    (Elsevier, 2024-12) Olkun, Ali; Kaplan, Hüseyin Kaan; Akay, Sertan Kemal; Sarsıcı, Serhat; Erdoğan, Nursev; 414025
    This study investigates the impact of gamma-irradiation on the material and device properties of Al/n-GaN/p-Si/Al heterojunction diodes. GaN thin films were deposited on glass and p-Si substrates using thermal evaporation, followed by annealing at 450 degrees C. The diodes were subjected to gamma-irradiation doses of 0, 3, and 6 kGy. X-ray diffraction (XRD) measurements revealed significant structural changes, including phase transitions influenced by radiation. Electrical characteristics were assessed through current-voltage (I-V) measurements within the +/- 2 V range. Notably, the ideality factor for the annealed diodes improved from 6.60 to 4.62 and 3.85 with increased gamma-irradiation. The barrier height was determined to be 0.85 eV, and it did not exhibit a significant change upon gamma-irradiation dose. The results provided valuable insights into the response of heterojunction diodes to radiation exposure, aiding in the understanding and potential improvement of the radiation resistance of GaN-based electronic devices.
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    Fixation of superolateral platysma flap to the mastoid fascia: a novel isolated neck lift technique
    (Springer, 2024-09) Okumuş, Ayhan; 293876
    Background This study aimed to evaluate the utility of a novel neck lift technique based on fixation of superolateral platysma flap to the mastoid fascia in terms of postoperative aesthetic outcome and patient satisfaction within an 18-month follow-up period. Methods A total of 145 female patients who underwent isolated neck lift operation with the superolateral platysma flap technique were included. Global Aesthetic Improvement Scale (GAIS) scores (by the investigator) and the patient reported outcomes were recorded in terms of improvement in the cervicofacial angle, jowls, platysmal bands and malpositioned cervical fats, at 6 and 18 months, postoperatively. The complications were recorded at early postoperative period and at 1, 6 and 18 months, postoperatively. Results The median duration of follow-up was 18 months (range, 6–48 months). GAIS scores at 18th months, revealed exceptional improvement in the cervicofacial angle (82.8%), the jowls (93.1%), platysmal bands (93.1%) and malpositioned cervical fat (97.2%). Majority of patients were very satisfied with the treatment in terms of the aesthetic improvement. Complications involved the minor ecchymosis (17.2%) and minor skin circulatory problem (11.7%) in the early postoperative period, suture exposure (12.4%) in the postoperative 1st month, and cervical band reformation in the 6th (0.7%) and 18th (1.4%) months. Conclusion In conclusion, lateral displacement and fixation of superolateral platysma flap to the mastoid fascia seems to be a useful neck lift technique for correction of platysma- and skin-derived aging sings with minor and manageable complications, immediate return to everyday activities and a high patient satisfaction.
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    Game-based teaching in teacher education: a systematic review
    (ICETOL, 2022-06) Aydın, Sevim; Bertiz, Yasemin; Parlak Yılmaz, Nuray; 385249
    Today, technological tools have entered almost all fields and have been used extensively. Games have inevitably been affected by this process and games have become played in virtual environments with digital tools. Today, people of all ages interact with games and children can spend long hours playing games without getting bored, and the results of the research have paved the way for the use of games in education. The research, it is aimed to systematically deal with the studies on game-based teaching used in teacher education. The distribution of these studies by years, the distribution of their methods, data collection tools, data analysis methods, keywords, citations and country distribution of citations were revealed. Advanced search modules ERIC, EBSCO, Web of Science and TR Index are used. Keywords in the search are “game-based teaching” or “digital game-based learning”. Among the research articles, articles used as teaching methods and educational studies in higher education were taken. In this context, the PRISMA statement was used in research and report creation. The obtained data and results were analyzed by discussing with other findings obtained from the literature.
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    İleri malzemeler ve simülasyon teknikleriyle otomotiv sac şekillendirme süreçlerinde kenar çatlaklarının incelenmesi
    (Bilsel Yayıncılık, 2024-12) Şahin, Umut Fırat; Özer, Hakkı; Şahin, Eslem; 414011; Diaconu Maxim, Laura; Altunok, Bahar
    Otomotiv endüstrisinde hafiflik ve dayanıklılık arayışı, sac metal şekillendirme süreçlerindeki zorlukları artırmıştır. Gelişmiş yüksek mukavemetli çelikler ve alüminyum alaşımlarının yaygınlaşmasıyla birlikte, kenar çatlaması sorunu daha da önemli hale gelmiştir. Kenar çatlağı, sac metal şekillendirme süreçlerinde malzemenin kenar bölgesinde oluşan çatlaklardır ve genellikle kesme, delme veya şekillendirme işlemleri sırasında meydana gelir. Bu sorun, özellikle gelişmiş yüksek mukavemetli çelikler ve alüminyum alaşımlarında daha sık görülmekte olup, malzemelerin ince kesitlerinde yüksek gerilmeler nedeniyle ortaya çıkar. Kenar çatlakları, parça dayanımını ve estetik kalitesini olumsuz etkileyerek otomotiv sektöründe kalite ve güvenlik problemlerine yol açabilir. Bu tür çatlakların oluşumunda, malzemenin mikroyapısal özellikleri, kesme yöntemi, kenar hazırlama teknikleri ve şekillendirme proses parametreleri gibi faktörler önemli rol oynar. Bu sorununun önlenmesi, doğru malzeme seçimi, optimize edilmiş proses tasarımı ve yenilikçi kesme teknolojilerinin uygulanmasını gerektirir. Bu çalışmada, gelişmiş simülasyon araçlarından biri olan AutoForm kullanılarak farklı malzemelerin şekillendirme davranışları incelenmiştir. Parçaya uygulanan kesme yöntemleri, hazırlama teknikleri ve proses parametrelerinin çatlak oluşumu ve ilerlemesi üzerindeki etkileri vurgulanmaktadır. Bu sayede, kenar çatlağının başlangıç ve yayılımı daha iyi anlaşılmış ve üretim süreçleri için önem arz eden veriler elde edilmiştir. Simülasyon sonuçlarına dayanarak, malzeme yenilikleri, üretim tekniklerindeki iyileştirmeler ve tasarım optimizasyonu gibi farklı boyutlarda kenar çatlaması azaltma stratejileri önerilmektedir. Bu stratejiler hem malzemelerin mikroyapısal özelliklerini hem de şekillendirme süreç parametrelerini kapsayacak şekilde tasarlanmıştır. Bu çalışma, gelişmiş malzemelerin üretim sürecindeki simülasyon araçları arasındaki karmaşık etkileşimi ortaya koyarak, mühendisler ve araştırmacılar için önemli bir bakış açısı sunmaktadır. Elde edilen bulgular, otomotiv sektöründe sürdürülebilirlik ve performans beklentilerini karşılayacak, aynı zamanda güvenilir ve dayanıklı otomotiv bileşenlerinin geliştirilmesine katkı sağlayacaktır. Sonuç olarak, bu çalışma kenar çatlaması sorununa bütüncül bir yaklaşımla çözüm önerileri sunarak sektördeki gelişmelere önemli bir katkı sağlayacaktır.
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    Impact of pre-stenting and bladder dranaige on intrapelvic pressure during retrograde intrarenal surgery
    (Wiley, 2024-12) Yeni, Sezgin; Kılıçarslan, Hakan; Ocakoğlu, Gökhan; Coşkun, Burhan; Çiçek, Mehmet Çağatay; Günseren, Kadir Ömür; Yavaşçaoğlu, İsmet; 278343
    Purpose: This study aims to assess the effect of pre-stenting and bladder drainage on intrapelvic pressure (IP) during Retrograde Intrarenal Surgery (RIRS). Methods: Eighty-five consecutive patients were prospectively enrolled and meticulously recorded in a data form. Forty-two patients meeting the inclusion criteria after applying exclusion factors. The patients were divided into two groups: Group 1 (21 patients with preoperative JJ stents) and Group 2 (21 patients without preoperative JJ stents). IP was measured during RIRS, and the impact of various factors, including pre-stenting, bladder drainage and hydronephrosis (HN) grade, on IP was analysed through univariate and multiple linear regression. Results: The perioperative mean highest IP (78 ± 18.2 mmHg vs. 110 ± 23.9 mmHg), median lowest IP (29 mmHg vs. 42 mmHg) and median overall IP (41 mmHg vs. 69 mmHg) were significantly lower in Group 1 compared to Group 2 (all p < 0.001). Multivariate analysis showed that pre-stenting and mild HN (Grade 0–1) were independent predictors of reduced IP. Conclusion: Pre-stenting led to a significant reduction in IP during RIRS, likely due to passive ureteral dilation. Additionally, bladder drainage with urethral catheter further decreased IP. These findings suggest that pre-stenting and bladder drainage should be considered as strategies to reduce IP during RIRS, potentially improving surgical outcomes.
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    Increasing Cases of Retroperitoneal Fibrosis After Covid-19: Case Report, Did She Die Retroperitoneal Fibrosis or Cancer?
    (Emergency Medicine Physicians Assoc Turkey, 2024-03) Deniz, Gulnihal; Cakir, Murteza; Bilgin Akyagci, Serpil
    This case report details the unfortunate journey of a 59-year-old breast cancer survivor who developed secondary Retroperitoneal Fibrosis (RPF) in 2022. Despite diligent treatment efforts, her condition took a devastating turn when, in June 2023, she was diagnosed not only with persistent RPF but also with advanced liver, omental, and duodenal cancer. Tragically, her condition deteriorated rapidly, leading to her passing on day 41 following her presentation. This case underscores the challenges of diagnosing and treating RPF. It highlights the importance of considering cancer development in advanced RPF cases that do not respond to treatment, often leaving limited options for effective intervention.
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    Interventional therapy of acute coronary syndromes in very old patient population and results of 2 years follow‑up
    (Springer, 2023) Boyraz, Bedrettin; Peker, Tezcan; Akgümüş, Alkame; Balun, Ahmet; 313898
    Background Research on cardiovascular treatment options and prognosis in very old age groups of patients is warranted. In our study, we evaluated and followed up on clinical conditions on admission and comorbidities of patients older than 80 years who were admitted to our hospital with acute myocardial infarction and shared our findings. Results A total of 144 patients were included in the study, with a mean age of 84.56 ± 5.01 years. No complications resulting in death or requiring surgery were observed in the patients. All-cause mortality was found to be related to heart failure, chronic pulmonary disease shock, and C-reactive protein levels. Cardiovascular mortality was correlated to heart failure, shock on admission, and C-reactive protein levels. No significant difference in mortality was observed between Non-ST elevated myocardial infarction and ST-elevation myocardial infarction. Conclusions Percutaneous coronary intervention is a safe treatment option with low complication and mortality rates in very old patients with acute coronary syndromes.
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    Investigation of pepsin levels in bronchial lavage in patients with interstitial lung disease and chronic cough
    (Elsevier, 2024-11) Ala Çitlak, Fatma Selen; Köksal, Nurhan; Avci, Bahattin; Tibel Tuna, Nazmiye; Güllü, Yusuf Taha; 156045
    Aim: Pepsin is an enzyme that helps digest protein secreted only from the gastric chief cell in an inactive state. Pepsin is a good marker for acidic gastroesophageal reflux (GER). Its presence in sputum or saliva is considered pathologic. In GER, cough is stimulated by broncho-esophageal neurogenic reflex and aspiration of gastric contents into the airways. GER is the most common cause of cough. Gastric acid reflux is also thought to play a role in Interstitial Lung Disease (ILD) etiology. In many studies, pepsin and bile acid levels in bronchial lavage were high in patients with interstitial lung disease and chronic cough. In our study, we aimed to evaluate pepsin levels in bronchial lavage in patients with ILD and chronic cough and to investigate the relationship between symptoms and reflux treatment. Methods: Between January 2021 and February 2022, 212 patients who underwent bronchoscopy in our tertiary clinic were evaluated. These patients were divided into three groups: 52 patients with interstitial lung disease, 81 patients with chronic cough, and 79 patients who underwent bronchoscopy with a pre-diagnosis of lung cancer as the control group. Bronchial lavage obtained by bronchoscopy was analyzed for pepsin levels. Results: Shortness of breath and cough were the most common symptoms in all three groups. Pepsin levels were 16.71 ± 8.6 ng/ml in the chronic cough group, 15.6 ± 8.9 ng/ml in the ILD group, and 10.58 ± 5.4 ng/ml in the lung cancer (control) group. Pepsin levels in the ILD and chronic cough group were statistically significantly higher than in the lung cancer group (p:0.00). There was no statistical difference between the ILD group and the chronic cough group regarding pepsin levels. It was found that pepsin levels were lower in the three groups who received anti-reflux treatment. There was no difference in pepsin levels between ILD subgroups. Conclusion: Pepsin levels in bronchial lavage were higher in the ILD and chronic cough groups. This suggests that reflux may be involved in the etiology of chronic cough and ILD. Low pepsin values in patients receiving antireflux therapy have shown that occult reflux may occur. In our study, the high level of pepsin in bronchial lavage, especially in the chronic cough and ILD group, may be instructive in the etiology and treatment planning of the disease.
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    Investigation of the effect of computer-aided animations on conceptual understanding through metaphors: an example of artificial intelligence
    (ICETOL, 2022-06) Aydın, Sevim; Duman, Emel; Bertiz, Yasemin; Birişçi, Salih; 385249
    In this research, Information Technology and Software (IT) course the differences between the conceptual understanding of fifth grade students regarding the concept of artificial intelligence before and after computer-aided animation monitoring were tried to be determined through metaphors. In the 2021-2022 academic year, 39 teachers working in the field of Information Technologies and 101 fifth-grade students studying at a secondary school in the Nilufer District of Bursa participated in the study. The purposeful sampling method was used to select the sample of the study. At the first stage of the study, the “Information Technology and Software Course Concept Teaching Questionnaire” prepared by the researchers was applied to the teachers online in order to identify the concepts that had difficulty in teaching within the scope of the BTY course. As a result of the survey dec, many concepts that are difficult to teach have been revealed, and among them, the concept of “artificial intelligence” has been included in the study due to its current and open to development. In the second stage of the study, in order to determine the metaphorical perceptions of students about the concept of artificial intelligence, students were asked to “Artificial intelligence is like ... because …”. In the light of the themes obtained from the metaphor results, computer-aided animation was developed by the researchers, which takes the concept of artificial intelligence as a subject. After the animation was shown to the students, the metaphor study was repeated and the change in the students' understanding of the concept of artificial intelligence was tried to determine. As a result of the study, although the conceptual categories related to artificial intelligence had similar characteristics in general, it was found that the justifications in the conceptual perceptions after animation were more meaningful
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    Multi-inflammatory index as a novel predictor of new-onset atrial fibrillation after off-pump coronary artery bypass grafting
    (Polish Cardiac Soc, 2024-05) Yüksel, Ahmet; Velioğlu, Yusuf; Atasoy, Mustafa Selçuk; Müdüroğlu, Ayhan; Deşer, Serkan Burç; Gürbüz, Orçun; Aldemir, Mustafa; Çetintaş, Demir; Kılıç, Ali Önder; Badem, Serdar
    Background: To our knowledge, a possible predictive relationship of the multi-inflammatory index (MII) with new-onset atrial fibrillation (AF) after off-pump coronary artery bypass grafting (CABG) has not yet been studied in the literature. Aims: We aimed to investigate whether the MII is a novel group of hematological markers for predicting postoperative new-onset AF in patients undergoing off-pump CABG. Methods: A total of 427 patients undergoing isolated off-pump CABG between October 2021 and December 2023 were enrolled in this retrospective observational cohort study and allocated to two groups: the AF group (n = 108) and the non-AF group (n = 319). The groups were compared in terms of baseline clinical patient characteristics, laboratory parameters, and operative and postoperative data. Results: The median values of age, length of hospital stay, platelet and neutrophil count, C-reactive protein level, systemic immune-inflammation index, MII-1, MII-2, and MII-3 were significantly greater in the AF group compared to the non-AF group in univariate analyses. In multiple explanatory variable logistic regression analysis, MII-1, MII-2, and MII-3 were determined to be significant hematological variables, and thereby these indices were considered the independent predictors of postoperative new-onset AF. Receiver operating characteristic curve analyses showed that to predict postoperative new-onset AF, MII-1 of 22.47 constituted the cut-off value with 62.0% sensitivity and 57.0% specificity, MII-2 of 141.77 constituted the cut-off value with 43.5% sensitivity and 76.8% specificity, and MII-3 of 5669 constituted the cut-off value with 63.8% sensitivity and 58.3% specificity. Conclusion: This study demonstrated for the first time that all MIIs predicted new-onset AF after off-pump CABG.
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    Open and arthroscopic excision of the distal clavicle for osteoarthritis of the acromioclavicular joint--results over 5 years
    (TMMOB Makina Mühendisleri Odası, 2022) Saylık, Murat
    Objective: Initially performed as open surgery, arthroscopic applications of distal clavicle excision (DCE) have gained prevalence in recent years. Literature reviews about the long-term results give no clear indication that one method is superior to the other. This study aims to compare the follow-up results of patients treated with arthroscopic and open DCE for more than five years and to detect the superiority of each method. Material and Method: The study involved 328 patients treated with DCE between February 2008 and April 2017. One hundred and fourteen patients (66 male and 48 female; 81 arthroscopic and 33 open surgery), who had their records available and under went no other surgery than DCE, were included in the study. The Disability of the Arm, Shoulder, and Hand (DASH) score and Visual Analogue Scale (VAS) were used to assess post-DCE shoulder functions and pain, respectively. Within the study's scope, surgery duration, excision extent, complications (frozen shoulder, hematoma, surgical site infection, and instability), and revisions were compared. Results: In the >5-year follow-up process, no statistically significant difference was observed between pre-DCE DASH and VAS values or between post-DCE DASH and VAS values of the two groups, one involving 32 patients who underwent open surgery and the other involving 82 patients treated with arthroscopic surgery. However, there was a statistically significant difference between the pre- and post-DCE DASH and VAS scores of both groups, and it was observed that both surgical methods were effective. No statistically significant difference was observed between the two groups regarding the surgery duration. Arthroscopic DCE was measured to be 4.70 mm on average, while the average measure for open surgery was 5.53 mm, which indicated a statistically significant difference between the two groups. However, no significant association was observed between the excision extent and the DASH and VAS scores. Furthermore, no significant difference was observed between complication and revision rates. Conclusion: In the >5-year follow-up of patients who underwent arthroscopic or open DCE due to their acromioclavicular joint osteoarthritis, which could not be treated with conservative treatment, no statistically significant difference was observed in the two groups' post-DCE DASH scores, VAS scores, complication rates, and revision rates. There was, however, a statistically significant difference between both groups' pre- and post-DCE VAS and DASH scores, and both methods were effective.
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    Outcomes of Liver Transplantation in Infants: A Retrospective Cohort Study
    (Elsevier, 2024-12) Erbiş, Halil; Kılınç, Eyyüp Mehmet; Fırat, Aynur; Aliosmanoğlu, Çiğdem; Ağca, Mevlüt Harun; Aliosmanoğlu, İbrahim; 104930
    Background. Liver transplantation (LT) is a crucial treatment for infants with end-stage liver disease, yet specific data on LT outcomes in infants under 12 months old remain limited. This study aims to present the clinical course and outcomes of infants who underwent LT, assessing the impact of demographic and etiological differences on mortality and survival. Methods. A retrospective analysis was conducted on 64 infants (< 12 months) who underwent LT between January 2019 and March 2024. Demographic, clinical, and laboratory data were collected from their medical records. LT-specific details, postoperative complications, and survival data were analyzed. Results. The median age of the infants was 157 days, with 37 boys (57.8%) and 27 girls (42.2%). Biliary atresia was the most common diagnosis (85.9%), and seven infants had undergone a previous Kasai procedure. The median pediatric end-stage liver disease (PELD) score was 15.5. Left lateral segmentectomy was the predominant graft type (60.9%). The median pediatric intensive care unit (PICU) and hospital stays were 5 and 21 days, respectively. Complications occurred in 20 infants (31.3%), with vascular and biliary complication rates both at 12.5%. The overall mortality rate was 17.2%, with early (30-day) and late mortality rates of 6.3% and 10.9%, respectively. The median overall survival (OS) was 204.5 days, and the 1-year survival rate was 32.8%. Kaplan-Meier and log rank analyses showed no significant impact of sex, age, diagnostic groups, graft type, or surgical complications on OS (P> .05). Conclusions. LT in infants can be performed with acceptable morbidity and mortality rates, particularly with increased experience and standardized protocols.
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    Problems and solution suggestions related to logistics processes in cross-border e-commerce: evaluations towards e-export in Bursa province
    (Süleyman Demirel University, 2024-08) Sönmezay, Mine; Yıldırır Keser, Hilal; 409821
    Rapidly growing e-commerce, due to globalization and the impact of the Covid-19 epidemic, has significantly increased global demand, and cross-border e-commerce has become a frequently mentioned concept. Cross-border e-commerce, which also triggers the development of international trade, has begun to influence the economic policies of countries, especially with its e-export dimension. The most important factor behind the development and success of cross-border e-commerce can be expressed as being its logistics services. E-commerce processes achieve success with the effectiveness of these services. However, as in many countries, problems may occur in logistics processes in Türkiye, which may prevent cross-border e-commerce companies from using their potential. In this context, in the study, firstly, the concepts of e-commerce and cross-border e-commerce are discussed and the concept of e-export is clarified. Then, logistics services in cross-border e-commerce are explained. Finally, a qualitative research is conducted to reveal the logistics problems encountered in cross-border e-commerce, and the findings of in-depth interviews with companies engaged in e-export in Bursa are evaluated.
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    Prognostic value of the leuko-glycemic index in coronary chronic total occlusion patients
    (Prusa Medikal Yayıncılık, 2023) Peker, Tezcan; Özbek, Mehmet; Boyraz, Bedrettin; Aslan, Selen Filiz; Demir, Muhammed; Aslan, Burhan; 313898
    Objectives: Inflammation parameters are related to the prevalence and mortality of coronary artery disease (CAD). We aimed to evaluate the prognostic value of the leuko-glycemic index (LGI) and determine mortality in patients with chronic coronary total occlusion (CTO). Methods: A total of 546 patients were evaluated in the study. All-cause death was the primary endpoint. The leuko-glycemic index was calculated from the blood samples at admission and patients were divided into 3 groups according to their LGI levels. Kaplan-Meier survival curves were performed and logistic regression analyses was used for all multivariable analysis. Results: The mean age of the study population was 63.1 ± 11.1 years and 70.3% were male. Median follow-up time 58.2 ± 22.4 months. The mortality rate was 33.6% in the high LGI group and significantly higher compared to the other group. In multivariable analysis, LGI (OR: 1.05, 95% CI: 1,0-1.2; p = 0.02) and age (OR: 1.07, 95% CI: 1.04-1.11; p = 0.001) were found as predictors of all-cause death. Conclusions: The study revealed that high LGI is associated with all-cause death in CTO patients and LGI was a predictor of all-cause death.
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    Sac metal şekillendirme prosesleri
    (Bidge Yayınları, 2024-12) Şahin, Umut Fırat; Özer, Hakkı; Şahin, Eslem; 414011; Köten, Hasan
    Sac metal şekillendirme, otomotivden havacılığa, beyaz eşyadan inşaat sektörüne kadar geniş bir yelpazede modern endüstrinin temel taşlarını oluşturmaktadır. Sac metal şekillendirme, sac levhalara (Şekil 1) farklı yöntemlerle istenilen geometrik formların verilmesi işlemidir. Malzeme, mekanik, tasarım ve üretim mühendisliğinin ortak noktasını oluşturmaktadır. Bu teknoloji, yüksek hacimli üretimlerde hassas, dayanıklı, düşük maliyetli ve yüksek performanslı parçaların üretilmesini sağlayarak endüstriyel üretimin verimliliğine ve rekabetçiliğine önemli katkılar sunar.
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    Sac şekillendirme simülasyonlarında triboform ve triboformsuz yaklaşımlar
    (Bilsel Yayıncılık, 2024-12) Şahin, Umut Fırat; Özer, Hakkı; Şahin, Eslem; 414011; Diaconu Maxim, Laura; Altunok, Bahar
    Otomotiv endüstrisi başta olmak üzere, karmaşık geometrilere sahip sac parçaların tasarımı ve üretimi, günümüz imalat süreçlerinin vazgeçilmez bir parçasıdır. Bu süreçlerin optimize edilmesi ve üretim maliyetlerinin düşürülmesi amacıyla, sac şekillendirme simülasyonları sıklıkla tercih edilmektedir. Simülasyonların gerçekçi sonuçlar vermesi için, sürtünme ve yağlama gibi parametrelerin doğru bir şekilde modellenmesi büyük önem taşımaktadır. AutoForm yazılımının TriboForm modülü, bu alanda geleneksel sabit katsayı yaklaşımlarına kıyasla daha fiziksel gerçekçi bir sürtünme modeli sunarak önemli avantajlar sağlamaktadır. TriboForm modülü, sac şekillendirme simülasyonlarında sürtünme davranışını daha gerçekçi bir şekilde modelleyerek, geleneksel sabit katsayı yaklaşımlarına göre önemli avantajlar sunmaktadır. Bu modül, yüzey pürüzlülüğü, yağlama türü, basınç, sıcaklık ve kayma hızı gibi değişkenleri dikkate alarak, malzeme ve takım yüzeylerinin şekillendirme sürecindeki etkileşimlerini daha doğru bir şekilde temsil eder. Standart simülasyonlarda kullanılan sabit sürtünme katsayısı, şekillendirme sırasında yüzeylerin dinamik koşullarda gösterdiği değişken sürtünme davranışını yansıtamaz. Bu durum, malzeme akışı, geri esneme ve şekil bozukluklarının tahmininde sapmalara yol açar. Diğer yandan, TriboForm modülü, kenar çatlağı, geri esneme ve burkulma gibi şekil kusurlarını daha hassas bir şekilde öngörerek, üretim hatalarının önceden tespit edilmesini amaçlar. AutoForm'un TriboForm modülü, otomotiv sektöründe karmaşık geometrilere sahip parçaların üretiminde yaygın olarak kullanılmaktadır. Bu modül, hafifletilmiş yapıların tasarımı, kalıp ömrünün uzatılması ve yeni malzemelerin değerlendirilmesi gibi konularda önemli avantajlar sunar. TriboForm, üretim süreçlerinde daha detaylı analizler yapılmasını sağlayarak optimizasyon çalışmalarını hızlandırır. Ancak düşük karmaşıklıktaki şekillendirme süreçlerinde triboformsuz simülasyonlar da uygun maliyetli bir alternatif olabilir. Üretimdeki sürtünme katsayısı hala araştırılan konular arasında yer almaktadır. Bu çalışmada, basit bir model oluşturularak triboformun etkisi araştırılmıştır.
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    Short-term prognostic value of the culprit-SYNTAX score in patients with acute myocardial infarction
    (MDPI, 2023) Peker, Tezcan; Boyraz, Bedrettin; 313898
    Background: The SYNergy between Percutaneous Coronary Intervention with TAXus and Cardiac Surgery (SYNTAX) score is a scoring system that helps to decide on surgery or percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (MI), and studies are showing the prognostic value of this scoring system in both MI and coronary artery disease patients undergoing PCI. In acute coronary syndrome (ACS) patients, the infarct-related artery and the complexity of the lesions are also important in terms of mortality and morbidity. Our study aimed to determine the prognostic value of the culprit vessel’s SYNTAX score (cul-SS) in patients presenting with MI. Methods: In our study, 1284 patients presenting with MI were analyzed retrospectively. The SYNTAX scores and cul-SS of the patients were calculated. In-hospital and 30-day deaths and major complications were accepted as primary outcomes. The SYNTAX scores and cul-SS were compared in terms of predicting primary outcomes. Conclusions: Major complications were observed in 36 (2.8%) patients, death in 42 (3.3%) patients, and stent thrombosis in 24 (1.9%) patients. The area under the curves for SYNTAX and cul-SS for predicting primary outcomes is 0.64 and 0.68 (p = 0.026), respectively. Cul-SS was as successful as the SYNTAX score in predicting stent thrombosis and was superior in predicting short-term death and major complications.
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    Teoriden uygulamaya yapay zekânın temelleri: geçmiş, gelecek ve güçlü promptlar
    (Serüven Yayınevi, 2024-12) Pilavcı, Sevim; 385249; Şengel, Erhan
    Günümüzün en popüler kavramı haline gelen yapay zeka; aslında 1936 yılında Alan Turing tarafından ortaya atılmıştır. “Makineler düşünebilir mi?” sorusuna cevap vermek isteyen Turing, çalışmasında makineleri ve düşünebilme durumlarını karşıt görüşlere de cevap vererek ayrıntılı olarak açıklamıştır. Yapay zekanın oluşturucusu olarak anılmaktadır (Yılmaz, 2022). Yapay zeka kavramını tam olarak anlamak için öncelikle temel kavramlar olan zeka, akıl ve düşünme üzerine odaklanmak gerekmektedir. Bu kavramlar, hem insan zihninin işleyişini anlamak hem de makinelerin bu işleyişi taklit etme kapasitesini değerlendirmek açısından önemlidir. Zeka, Türk Dil Kurumu’na (TDK) göre “insanın düşünme, akıl yürütme, öğrenme, kavramları ve nesneleri zihinde canlandırabilme, objektif gerçekleri algılama, yargılama, sonuç çıkarma, bedeni kontrol edebilme, duyguları doğru algılayabilme, değerlendirebilme, icat edebilme vb. yeteneklerinin ve becerilerinin tamamını” kapsayan bir beceri seti olarak tanımlanmaktadır (TDK, 2024). Yani, zeka insanın çevresiyle etkileşim kurma ve yeni bilgilere uyum sağlama kabiliyetidir. Akıl ise, düşünme ve kavrama gücü olarak tarif edilir; yani, bir durumu analiz etme, karar verme ve doğru yolu bulma yetisidir (TDK, 2024). Her iki kavram da düşünme eylemiyle yakından ilişkilidir; düşünme ise aklın bağımsız olarak kavramları, bağlantıları ve biçimleri ayırt etme yetisi olarak tanımlanır (TDK, 2024).