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Laparoscopic versus open portoenterostomy for treatment of biliary atresia: a meta-analysis
No full textAbstract
Objective Our goal was to compare laparoscopic portoenterostomy versus open portoenterostomy for the treatment of
biliary atresia.
Materials and methods Using the databases EMBASE, PubMed, and Cochrane, we carried out a thorough literature search
up to 2022. Studies comparing laparoscopic and open surgery for the treatment of biliary atresia were included.
Results Twenty-three studies comparing laparoscopic portoenterostomy (LPE) (n=689) and open portoenterostomy (OPE)
(n=818) were considered appropriate for meta-analysis. Age at surgery time was lower in the LPE group than OPE group
(I
2=84%), (WMD − 4.70, 95% CI − 9.14 to − 0.26; P=0.04). Signifcantly decreased blood loss (I
2=94%), (WMD − 17.85,
95% CI − 23.67 to − 12.02; P<0.00001) and time to feed were found in the laparoscopic group (I
2=97%), (WMD − 2.88,
95% CI − 4.71 to − 1.04; P=0.002). Signifcantly decreased operative time was found in the open group (I
2=85%), (WMD
32.52, 95% CI 15.65–49.39; P=0.0002). Weight, transfusion rate, overall complication rate, cholangitis, time to drain
removal, length of stay, jaundice clearance, and two-year transplant-free survival were not signifcantly diferent across the
groups.
Conclusions Laparoscopic portoenterostomy provides advantages regarding operative bleeding and the time to begin feeding. No diferences in remain characteristics. Based on the data presented to us by this meta-analysis, LPE is not superior
to OPE in terms of overall results
The Moderating Role of Information Quality in the Relationship Between guides’ Communication Skills and Tour Satisfaction
No full textThis study aims to determine the moderating effect of the quality of information given by guides on the relationship between guides’ communication skills and tour satisfaction. The data for this study were collected from 300 foreign tourists who participated in guided tours in Nevsehir province, Core Cappadocia, by means of surveys. The partial least squares method was used to test the developed model. According to the analysis results, guides’ communication skills significantly affect tourist tour satisfaction. However, guides’ empathy skills had no significant impact on tourists’ satisfaction with tours. The quality of information given by guides was found to have a moderating role in the relationship between guides’ respect toward tourists and tour satisfaction. On the other hand, information quality had no moderating effect on the relationship between guides’ self-expression skills and tour satisfactio
Investigation of the protective efficacy of trans-chalcone application again stcytotoxicity, oxidative stress and apoptosis caused by acute high-dose arsenic exposure in human umbilical vein endothelial cells (HUVEC)
No full textBu çalışma, İnsan Umblikal Ven Endotel Hücreleri (HUVEC), arsenik maruziyeti sonucunda hücre hasarı uyarılacaktır. HUVEC hücrelerinde arsenik kaynaklı hücresel hasarı ve bu hasara karşı Trans-chalcone'nun olası koruyucu rolünü belirlemek amacıyla yapılacaktır. Trans-chalcone'nın hasara uğramış hücreler üzerindeki sitotoksisite, apoptotizis, oksidatif strese etkileri araştırılacaktır. Arsenik ile indükleniş hücreler Trans-chalcone ile tedavi edilerek, hücre canlılığı, sitotoksisite, Oksidatif stres parametreleri ve DNA hasarı in vitro olarak gösterilecektir. Arsenik büyük ölçüde çevreye yayılan ve yer kabuğunda metalloid olarak biriken toksik bir elementtir. Arsenik ve türevleri içme suyunda, besinlerde, toprak ve hava partiküllerinde bulunmaktadır. Özellikle içme suyu arsenik maruziyetinin en yaygın kaynağıdır. Arsenik Uluslararası Kanser Araştırmaları Ajansı tarafından grup I insan karsinojeni olarak sınıflandırılmıştır. Arseniğe maruziyet; akciğer, kan, cilt kanseri ve çeşitli cilt lezyonları ile ilişkilidir.In this study, Human Umbilical Vein Endothelial Cells (HUVEC) will induce cell damage as a result of arsenic exposure. This will be done to determine arsenic-induced cellular damage in HUVEC cells and the possible protective role of Trans-chalcone against this damage. The effects of trans-chalcone on cytotoxicity, apoptosis and oxidative stress will be investigated on damaged cells. Cell viability, cytotoxicity, Oxidative stress parameters and DNA damage will be demonstrated in vitro by treating arsenic-derived cells with Trans-chalcone. Arsenic is a toxic element that is widely found in the environment and accumulates as a metalloid in the earth's crust. Arsenic and its derivatives are found in drinking water, food, soil and air particles. Drinking water, in particular, is the most common source of arsenic exposure. Arsenic is classified as a group 1 human carcinogen by the International Agency for Research on Cancer. arsenic exposure; associated with lung, blood, skin cancer, and various skin lesions
Social media networks as an effective way to promote events
No full textToday, we have witnessed many events and festivals organized by different countries throughout the years. Some of these are organized locally, while the others are international. Social media networks are one of the essential marketing strategies which included advertising and promotion for event organizers. In this chapter, social media platforms, which can be used in promoting events and festivals, will be discussed conceptually by making a comprehensive literature review based on relevant literature. After reviewing the literature, this chapter will report how social media networks can be used as a promotional strategy for the event industry. So, this chapter aims to analyze in depth the relationship between social media platforms and promotions of events, and assessed how social media applications can be used to promote tourism events and festivals. At the end of the chapter, some practical implications will be presented to events marketers about social media tools used effectively to build effective promotional strategies for events and festivals
The prognostic value of ORBIT risk score in predicting major bleeding in patients with acute coronary syndrome
No full textBackground: The most significant adverse effect of antithrombotic medication in acute coronary syndrome (ACS) is major bleeding, which is related to increased mortality. Studies on ORBIT risk score in predicting major bleeding in ACS patients are limited.
Objective: This research aimed to examine whether the ORBIT score calculated at the bedside can identify major bleeding risk in patients with ACS.
Methods: This research was retrospective, observational, and conducted at a single center. Analyses of receiver operating characteristics (ROC) were utilized to define the diagnostic value of CRUSADE and ORBIT scores. The predictive performances of the two scores were compared using DeLong's method. Discrimination and reclassification performances were evaluated by the integrated discrimination improvement (IDI), and net reclassification improvement (NRI).
Results: The study included 771 patients with ACS. The mean age was 68.7 ± 8.6 years, with 35.3 % females. 31 patients had major bleeding. Twenty-three of these patients were BARC 3 A, five were BARC 3 B, and three were BARC 3 C. Bleeding history [OR (95 % CI), 2.46 (1.02-5.94), p = 0.021], hemoglobin levels [OR (95 % CI), 0.54 (0.45-0.63), p 74 years [OR (95 % CI), 1.03 (1.01-1.06), p = 0.039] were independent predictors of major bleeding. The ORBIT score was an independent predictor of major bleeding in the multivariate analysis: continuous variables [OR (95 % CI), 2.53 (2.61-3.95), p < 0.001] and risk categories [OR (95 % CI), 3.06 (1.69-5.52), p < 0.001]. Comparison of c-indexes for major bleeding events revealed a non-significant difference for the discriminative ability of the two tested scores (p = 0.07) with a continuous NRI of 6.6 % (p = 0.026) and an IDI of 4.2 % (p < 0.001).
Conclusion: In ACS patients, the ORBIT score independently predicted major bleeding
Effect of fungal-based nanomaterials against some plant pathogens
No full textDünya nüfusundaki hızlı artış yaşam için gerekli olan gıda kaynaklarını muhafaza etmeyi gerektirmektedir. Yabani otlar, böcekler ve çeşitli bitki hastalıkları gıda kaynaklarını tehdit eden önemli unsurlardandır. Bu amaçla gıdayı korumak için kullanılan sentetik kimyasalların doğaya ve canlılara zarar verdiği bilinmektedir. Mevcut durumda, etkili bir biçimde mahsulleri zararlılardan korumak ve ekosisteme zarar vermeyen yeni alternatiflerin getirilmesi gerekmektedir. Fungisitlerin doğru kullanılmaması canlı sistemler için her zaman bir tehdit oluşturmaktadır. Bununla beraber fungal patojenlerde direnç oluşturduğu bilinmektedir. Yeniden değerlendirilen stratejiler kapsamında nanofungusit gibi nanoteknolojik yaklaşımlar çok önemli potansiyele sahiptir. Yapılan çalışmada, Pleurotus eryngii ekstraktı (PEE), Lesitin-(L) Kitosan (K) kullanılarak, etkili, düşük maliyetli, sürdürülebilir ve toksik olmayan ,çevre dostu PEELKN nanomateryali sentezlendi. Biyonanomateryalin yapısı FTIR, SEM, TGA, XRD ve zetapotansiyel ile karakterize edilmiştir. SEM analizi, nanoyapının düzenli şekillerden oluşmuş pürüzlü, topaklanmış ve boşluklu bir yapıya sahip olduğunu göstermiştir. Nanoyapının XRD analiz sonucu (2?=19.29°) yayvan bir pike sahip olası kitosan ve lesitin ile işlevselleşmesini göstermiş ve ortalama kristalit boyutu 13 nm olarak tespit edilmiştir. Çalışmada kullanılan PEELKN nanomateryalinin fitopatojenik mantar türleri Neoscytalidium dimidiatum, Alternaria alternata, Verticillium dahlia, Bipolaris sorokiniana ve Fusarium oxysporum karşı antifungal etkinliği ilk kez araştırıldı. Veriler, PEE ve PEELKN'nin bazı bitki patojenleri üzerinde ciddi etkisi olduğu ancak bu etkinin farklılıklar gösterdiği görülmektedir. Tür çeşitliliğinden kaynaklandığı düşünülen bu farklılıklar nedeniyle PEE ve PEELKN'nin farklı patojenik türler üzerinde de etkili olabileceği düşünülmektedir. PEE ve sentezlenen PEELKN, bazı yaygın fitopatojenik mantarların çimlenmesi ve büyümesine karşı inhibe edici etkiye sahiptir ve daha kapsamlı çalışmalarda kullanılabilir.The rapid increase in the world population requires preserving the food resources necessary for life. Weeds, insects and various plant diseases are important factors that threaten food sources. It is known that synthetic chemicals used to protect food for this purpose harm nature and living things. Currently, it is necessary to effectively protect crops from pests and introduce new alternatives that do not harm the ecosystem. Improper use of fungicides always poses a threat to living systems. However, it is known to form resistance in fungal pathogens. Within the scope of reassessed strategies, nanotechnological approaches such as nanofungicides have very important potential. In the study, an effective, low-cost, sustainable and non-toxic, environmentally friendly PELKN nanomaterial was synthesized by using Pleurotus eryngii extract (PEE), Lecithin (L), Chitosan (K). The structure of the bionanomaterial was characterized by FTIR, SEM, TGA, XRD and zetapotential. SEM analysis showed that the nanostructure has a rough, agglomerated and porous structure composed of regular shapes. The result of XRD analysis of the nanostructure (2?=19.29°) showed possible functionalization with chitosan and lecithin with a broad peak, and the average crystallite size was determined as 13 nm. The antifungal activity of PELKN nanomaterial used in the study against phytopathogenic fungal species Neoscytalidium dimidiatum, Alternaria alternata, Verticillium dahlia, Bipolaris sorokiniana and Fusarium oxysporum was investigated for the first time. The data show that PEE and PEELKN have a serious effect on some plant pathogens, but this effect differs. Due to these differences, which are thought to be caused by species diversity, it is thought that PEE and PEELKN may also be effective on different pathogenic species. PEE and synthesized PEELKN have inhibitory effect on the germination and growth of some common phytopathogenic fungi and can be used in more extensive studies
First report of needle blight of blue spruce (Picea pungens) caused by Neoscytalidium dimidiatum in Turkey
Get PDFThe blue spruce (Picea pungens Engelm.) is an exotic conifer species widely used for decorative purposes in landscaping and private gardens. In 2020, 60% of forty blue spruce trees between 20 and 25 years old planted in front of buildings in Kavaklıdere, Ankara, displayed needle blight symptoms. Needles on the lower and interior crown closest to the trunk were infected from the bottoms of branches. They showed a brown-colored or burned appearance before dropping off, starting from their tips, resulting in up to a 65% reduction of the canopy. On the surface of infected tissues, a black-colored fungal mass was observed. Fungal colonies isolated from twenty symptomatic branches and needles were initially dark gray and became black within 4 to 7 days. Zero- to one-septate dark brown conidia (4.6 to 9.8 × 3.6 to 7.5 μm) formed in arthric chains were disarticulating and cylindrical-truncate to rod-shaped, oblong, ellipsoidal, doliiform, or globose, consistent with the description of Neoscytalidium spp. (Crous et al. 2006). The internal transcribed spacer, translation elongation factor 1-α, and β-tubulin loci of a randomly selected isolate (Nd_Pp01) were sequenced using the primers ITS1/4, EF1-728 F/986R, and Bt2a/Bt2b and deposited in GenBank under the accession numbers OK643641, OK666381, and OK666382, respectively. The sequences had 99.77–100% nucleotide identity with those of the type specimen of N. dimidiatum, CBS 145.78. Phylogenetic analysis with concatenated sequences further confirmed the identification. The isolate was deposited in the Bolu Abant Izzet Baysal University Culture Collection with accession number BAIBU-179. A pathogenicity test was conducted with ten 1-year-old P. pungens plants by spraying a conidial suspension (105 conidia/ml) of the isolate Nd_Pp01 onto the needles (Türkölmez et al. 2019). Five seedlings sprayed with sterile water were used as controls. All plants were placed in a growth chamber at 28°C with 70% RH. Spray-inoculated needles initially showed yellow spots within two weeks and turned brown six weeks after inoculation, whereas the controls remained symptom-free. The pathogen was re-isolated from the inoculated needles but not from controls. To our knowledge, this is the first report of N. dimidiatum causing needle blight on P. pungens in Turkey and worldwide (Farr and Rossman 2023)
The effects of different concentration methods on the chemical composition, functional and sensory attributes of molasses produced from grape (Vitis vinifera L.) juice
No full textThe efects of concentration by outdoor (OCM) and vacuum (VCM) and traditional (TCM) methods for the production of
molasses from fresh grape juice (FGJ) were evaluated concerning volatile compounds, sugars, organic acids, hydroxymethylfurfural (HMF), total phenolic (TPC), total favonoid (TFC) contents, and antioxidant capacity (TAC), and sensory properties.
Compared to FGJ, its molasses had lower TPC, TFC, TAC, and total organic acids and total sugars (except for the OCM) in
total soluble solids (TSS). Additionally, the most of (60.7%) volatile compounds in FGJ disappeared with the production of
the molasses. Moreover, all investigated features were signifcantly infuenced by the concentration method used. The TCMconcentration method markedly increased the amounts of both HMF (~ 180- and 50-fold greater than of the OCM and TCM,
respectively) and total volatile furans (~20- and 3.6-fold greater than that of OCM and TCM, respectively). Additionally, this
method presented the best antioxidant properties in terms of greater TPC, TFC, and TAC, whereas both TPC and TFC in the
molasses produced by the OCM-method were not signifcantly diferent from those they obtained by the VCM-method. The
principal component analysis (PCA) based on the chemical characteristics revealed close similarity between the OCM and
VCM, even though the OCM had higher contents for sugars and organic acids. According to the sensory evaluation, there
were no signifcant diferences between the scores of favor and overall acceptability for the TCM and OCM. In conclusion,
an adapted the OCM-concentrating method to industrial-type can be proposed to produce high-quality molasses
Zuhd in Ibn Arabi
No full textBu çalışma İslâm düşüncesinde tasavvuf felsefesinin temsilcilerinden biri olan İbn Arabî'nin zühd anlayışının İslâm tasavvuf geleneğindeki yerini ortaya koymayı amaçlamaktadır. Bu doğrultuda çalışma iki bölümden meydana gelmektedir. Birinci bölümde zühdün mahiyeti, doğuşuna etki eden amiller, zühd ekolleri ve zühde anlam bakımından yakın olan bazı kavramlar genel hatlarıyla anlatılmış ve İbn Arabî öncesi zühdün tarihsel süreç içerisindeki gelişimi ortaya konulmuştur. İkinci bölümde ise İbn Arabî'nin zühd anlayışı ortaya konulmuş ve Fârâbî, İbn Sîna, Gazâlî, İbn Bâcce, İhvân-ı Safâ, İbn Miskeveyh ve Şihâbüddin es-Sühreverdî'nin zühde dair düşünceleriyle karşılaştırmalı olarak ele alınmıştır. Bu bağlamda İbn Arabî kendisinden önceki düşünürler gibi ilâhi hakikâtlere ulaşmak için zühdün gerekli olduğunu savunur. Ancak zühdün hakikât yolculuğundaki geçici duraklardan biri olduğunu vahdet-i vücûd düşüncesiyle temellendirerek onlardan ayrılır.This study aims to reveal the place of Ibn Arabi's ascetic understanding, one of the representatives of Sufi philosophy in Islamic thought, in the Islamic Sufi tradition. Accordingly, the study consists of two parts. In the first chapter, the nature of ascetism, the factors affecting its birth, ascetic schools and some concepts that are close to ascetism in terms of meaning are explained in general terms and the development of ascetism in the historical process before Ibn Arabi is revealed. In the second part, Ibn Arabi's understanding of ascetism is revealed and compared with al-Fârâbî, Ibn Sina, Ghazali, Ibn Bajja, Ikhwan al-Safa, Ibn Miskeveyh and Sihâbuddin as-Suhrawardî's thought on ascetism. In this context, Ibn Arabi, like the thinkers before him, argues that ascetism is necessary to reach divine truths. However he differs from them by grounding that ascetism is one of the temporary destination in the journey of truth with the idea of unity of existence
Local Against General Anesthesia For Transcatheter Aortic Valve Replacement
No full textBackground/Aims: Transcatheter aortic valve replacement (TAVR) poses significant challenges concerning anesthesia management. There is no consensus on the type of safer anesthesia for TAVR procedures. We aimed to evaluate the effectiveness and safety of TAVR performed with trans-femoral approach under local anesthesia with sedation (LAS) against general anesthesia (GA).
Methods: This observational and retrospective analysis included individuals who were admitted on a planned basis from 2016 to 2022 and underwent Transfemoral TAVR. Effectiveness and safety outcomes were evaluated at 30 days. İndividuals were separated into two groups: GA and LAS. Demographic characteristics and procedural data were recorded during hospitalization.
Results: 115 patients were included, of whom 62 (53.9%) received LAS and 53 received GA (46.1%). 59 female (48.8%) patients with a mean age of 83.2±5.7 participated in the study. Successful TAVR procedure was performed in 100 (86.9%) of 115 patients with the transfemoral approach. The mean procedure time was 136.7±46.7 minutes, and the procedure time was shorter in patients who underwent LAS against GA (p=0.001). There were no differences among the groups including fluoroscopy time, contrast, and radiation dose (p>0.05). In 2 patients (3.2%), significant vascular complications necessitated immediate surgical intervention, necessitating a change in the anesthesia technique. Overall 30-day mortality was 5.2%, with no significant differences among the groups (GA 7.5% vs. LAS 3.2%, p =0.28). GA had substantially longer ICU and total hospitalization stays than LAS (p=0.009 and p =0.004, respectively).
Conclusions: In our study, TAVR via the transfemoral route using LAS was an alternative for GA