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Extended-Spectrum Beta-Lactamase Production and Carbapenem Resistance in Elderly Urinary Tract Infection Patients: A Multicenter Retrospective Study from Turkey
No full textIntroduction: Urinary tract infections (UTIs) remain a significant public health issue worldwide, particularly affecting the geriatric population with increased morbidity and mortality. Aging-related immune changes, comorbidities, and urogenital abnormalities contribute to the higher incidence and complexity of UTIs in elderly patients. Antimicrobial resistance, especially extended-spectrum beta-lactamase (ESBL) production and carbapenem resistance, poses a major challenge in managing UTIs in this group. Methods: This retrospective, multicenter study included 776 patients aged 65 and older, hospitalized with a diagnosis of urinary tract infection between January 2019 and August 2024. Clinical, laboratory, and microbiological data were collected and analyzed. Urine samples were obtained under sterile conditions and pathogens identified using conventional and automated systems. Antibiotic susceptibility testing was performed according to CLSI standards. Logistic regression analyses were conducted to identify factors associated with ESBL production, carbapenem resistance, and mortality. Results: Among the patients, the median age was 78.9 years, with 45.5% female. ESBL production was detected in 56.8% of E. coli isolates and carbapenem resistance in 1.2%. Klebsiella species exhibited higher carbapenem resistance (37.8%). Independent predictors of ESBL production included the presence of urogenital cancer and antibiotic use within the past three months. Carbapenem resistance was associated with recent hospitalization, absence of kidney stones, and infection with non-E. coli pathogens. Mortality was independently associated with intensive care admission at presentation, altered mental status, Gram-positive infections, and comorbidities such as chronic obstructive pulmonary disease and urinary incontinence. Discussion: Our findings suggest that urinary pathogens and resistance patterns in elderly patients are similar to those in younger adults reported in the literature, highlighting the need for age-specific awareness in empiric therapy. The identification of risk factors for multidrug-resistant organisms emphasizes the importance of targeted antibiotic stewardship, especially in high-risk geriatric populations. Multicenter data contribute to regional understanding of resistance trends, aiding clinicians in optimizing management strategies for elderly patients with UTIs. Conclusions: This study highlights that E. coli and Klebsiella species are the primary causes of UTIs in the elderly, with resistance patterns similar to those seen in younger adults. The findings also contribute important data on risk factors for ESBL production and carbapenem resistance, supported by a robust patient sample
Ürün yaşam döngüsünde tasarım verilerinin yönetimi ve PDM/SAP entegrasyonu
Full text linkBu tez çalışmasında savunma sanayisinde faaliyet gösteren büyük ölçekli bir mühendislik şirketinde Ürün Veri Yönetimi (PDM) sistemi Teamcenter ile Kurumsal Kaynak Planlaması (ERP) sistemi SAP arasındaki entegrasyon eksikliğinden doğan veri tutarsızlıkları incelenmiştir. Bu amaç doğrultusunda iki farklı sistemdeki verileri otomatik olarak karşılaştıran ve tespit edilen hataları sınıflandıran özgün bir yazılım aracı geliştirilmiş ve araçtan elde edilen bulgular doğrultusunda iyileştirme önerileri sunulmuştur. Araştırma mekanik tasarım meta verilerinin PDM sisteminden ERP’ye manuel aktarım sürecine odaklanmıştır. Bu amaçla Tasarım Bilimi Araştırması (DSR) ile Vaka Çalışması metodolojileri eş zamanlı kullanılmıştır. DSR yaklaşımı nedeniyle Java ve C++/ITK tabanlı özgün bir yazılım aracı geliştirilmiş ve bu araç sistemler arası verileri otomatik olarak karşılaştırıp hataları önceden tanımlı kategorilere ayırmıştır. Analizler sistemler arasında kayda değer ve ölçülebilir tutarsızlıkların varlığını kanıtlamıştır. Örneğin 2017 öncesinde hatasız veri oranı %17’nin altında kalırken standart iş akışının devreye alınması sonrası bu oran %88’in üzerine çıkmıştır. Geliştirilen teşhis aracı mevcut hataları açıkça ortaya koyarak veri temizliği çalışmalarına yol göstermiş ve kurumun gelecekteki tam entegrasyon projeleri için stratejik bir hazırlık adımı niteliği taşımıştır.In this thesis the data inconsistencies caused by the lack of integration between the Product Data Management (PDM) system Teamcenter and the Enterprise Resource Planning (ERP) system SAP at a large engineering company in the defense industry are examined. To this end, a unique software tool was developed that automatically compares data from two different systems and classifies the errors detected, and improvement recommendations were made based on the findings obtained from the tool. The research focused on the manual transfer of mechanical design metadata from the PDM system to the ERP system. To achieve this, Design Science Research (DSR) and Case Study methodologies were used simultaneously. As part of the DSR approach, a custom software tool built in Java and C++/ITK was created, and this tool automatically compared data between the systems and sorted errors into predefined categories. The analyses proved that significant and measurable inconsistencies existed between the systems. For example, before 2017 the error-free data rate was below 17 percent while after the standard workflow was introduced it climbed above 88 percent. By clearly revealing current errors, the diagnostic tool guided data-cleaning efforts and served as a strategic preparatory step for the organization’s future full-integration projects
Julius Caesar Arantius (Aranzi) (1530-1589): insights into the fourth ventricle, hippocampus and eye muscles
No full textJulius Caesar Arantius (Giulio Cesare Aranzi, 1530-1589) was a pioneering anatomist of the Renaissance, a period marked by the transition from scholastic Galenism to empirical observation and experimentation. Through meticulous cadaveric dissections, Arantius made several lasting contributions to anatomical science. He introduced the term hippocampus, although its modern interpretation remains debated. Beyond his renowned work on the hippocampus, Arantius signi icantly advanced knowledge of the fourth ventricle by providing a detailed description of its location, proposing an early concept of cerebrospinal luid, and tracing its historical references. Arantius also challenged the belief that ocular structures were extensions of brain tissue, arguing instead-based on dissections-that the sclera was of embryonic origin and that extrinsic eye muscles arose from bony structures. Despite some anatomical inaccuracies, his observations marked a bold and foundational step in the evolution of ocular and neuroanatomy.Council of Higher Education (CoHE) of Turkiye; Scientific and Technological Research Council of TurkiyeThe authors would like to thank the Council of Higher Education (CoHE) of Turkiye for supporting Esra Candar under 100/2000 CoHE Ph.D. Scholarship Program in the field of Translational Medicine, and The Scientific and Technological Research Council of Turkiye for their support of Ibrahim Demircubuk through National Ph.D. Scholarship Program
Adapting organizational culture scale into healthcare professional education: a scale validity and reliability analysis
No full textBackgroundOrganizational culture significantly influences the quality of healthcare services and healthcare professional education. Although various scales exist to measure organizational culture at the undergraduate level, validated instruments specifically tailored for healthcare professional education remain scarce. The study aims to validate the adapted scale and provide empirical insights into organizational culture in healthcare professional education.MethodsThe adaptation process involved expert consultations to ensure content and face validity, followed by a mixed-methods approach. Quantitative data were collected from 402 students enrolled in the Faculties of Medicine, Dentistry, and Health Sciences during the 2023-2024 academic year. Exploratory and confirmatory factor analyses were performed to examine the scale's structure. Reliability was assessed using Cronbach's alpha and McDonald's omega coefficients.ResultsExpert review led to the removal of redundant and unclear items, refining the scale to 30 items across five subscales: Structural Order and Formality, Belonging and Collective Responsibility, Achievement and Performance Orientation, Authority and Hierarchy, and Competition Orientation. The Kaiser-Meyer-Olkin measure (0.846) and Bartlett's test confirmed sample adequacy. Exploratory factor analysis explained 40% of the total variance. Confirmatory factor analysis showed acceptable model fit indices (chi 2/df = 3.37, RMSEA = 0.091, CFI = 0.95, TLI = 0.94). The scale demonstrated strong internal consistency (overall McDonald's omega = 0.878; Cronbach's alpha = 0.874), although lower reliability was noted for Authority and Hierarchy and Competition Orientation subscales.ConclusionsThe adapted organizational culture scale is a valid and reliable tool for assessing organizational culture in healthcare professional education. Its use is recommended for tracking cultural changes and supporting strategic educational improvements. Further validation across different institutions and cultural contexts is encouraged to reinforce its generalizability.University of SheffieldThis study was supported by University of Sheffield Institutional Open Access Fund
Sürdürülebilir moda ürünleri ile ilgili markaların tasarım yönetimi stratejilerinin ve tüketici algılarının araştırılması
No full textBu araştırma, sürdürülebilir moda ürünleri geliştiren markaların tasarım yönetimi stratejilerini ve tüketicilerin bu ürünlere yönelik algılarını incelemektedir. Araştırmanın temel amacı, tüketicilerin moda ürünü satın alma davranışlarında sürdürülebilirlik olgusunun etkisini belirlemek ve markaların tasarım stratejilerinin bu bağlamdaki rolünü anlamaktır Araştırmada hem marka yöneticileri hem de tüketiciler ile yarı yapılandırılmış görüşmeler yapılmıştır. Marka yöneticileriyle yapılan görüşmeler, sürdürülebilirlik stratejilerinin tasarım ve üretim süreçlerine nasıl entegre edildiğini anlamaya yönelik olup; tüketicilerle yapılan görüşmeler ise bu stratejilerin tüketici algılarına ve satın alma niyetine etkisini ortaya koymayı hedeflemiştir. Görüşmelerden elde edilen veriler içerik analizi yöntemiyle değerlendirilmiştir. Araştırma bulguları, tüketicilerin sürdürülebilir moda ürünlerine artan bir ilgi gösterdiğini ancak hızlı moda kültüründen tamamen uzaklaşmanın zorluklarını ortaya koymaktadır. Markalar açısından ise sürdürülebilirlik stratejilerinin, hem üretim süreçlerinde çevresel etkilerin azaltılmasını hem de tüketici güveninin artırılmasını hedeflediği görülmektedir Sonuç olarak, bu çalışma, sürdürülebilir modanın geleceği için hem tüketici hem de marka perspektifinden önemli iç görüler sunmakta, sektördeki dönüşüm süreçlerine ışık tutmaktadır. Araştırma, markalara yönelik stratejik öneriler geliştirilmesi açısından literatüre katkı sağlamaktadır.This research examines the design management strategies of brands developing sustainable fashion products and explores consumers’ perceptions of these products. The primary aim of the study is to determine the impact of the concept of sustainability on consumers’ fashion purchasing behaviors and to understand the role of brands’ design strategies in this context. In the study, semi-structured interviews were conducted with both brand managers and consumers. Interviews with brand managers aimed to understand how sustainability strategies are integrated into design and production processes, while interviews with consumers sought to reveal the impact of these strategies on consumer perceptions and purchase intentions. The data obtained from the interviews were evaluated using content analysis methods. The research findings indicate that consumers are showing increasing interest in sustainable fashion products but also highlight the challenges of completely moving away from the fast fashion culture. From the brands’ perspective, it is observed that sustainability strategies aim to both reduce environmental impacts in production processes and enhance consumer trust. In conclusion, this study offers significant insights from both consumer and brand perspectives for the future of sustainable fashion, shedding light on transformation processes in the industry. The research contributes to the literature by developing strategic recommendations for brands and establishing a sustainable fashion design language
Liver Transplantation for Autoimmune Hepatitis: Infections are the Major Cause of Mortality
No full text[Abstract Not Acaileble
Yoga for healthy children
No full textYoga is defined as an ancient Indian philosophical system used to train the body and spirit. Yoga, also defined as the art of healthy living, aims to ensure harmony between mind and body. Yoga is an ancient system of relaxation, exercise, and healing. It first emerged in India and spread all over the world over time. Although there are many different types of yoga, practices usually focus on physical postures (asanas), breathing techniques (pranayama), and meditation (dyana). Yoga provides many benefits for all age groups. It increases flexibility, strength, and endurance, reduces stress and anxiety, and improves sleep and mental clarity. Yoga postures (asanas) are reported to increase body functions such as strength, balance, and flexibility, as well as strengthen immunity, increase hand-eye coordination, and have positive effects on memory and learning. As emphasized in the World Health Organisation's recently published "Global Action Plan on Physical Activity 2018-2030, " "the routine practice of yoga, a 5000-year-old tradition, is a valuable tool for people of all ages to make physical activity an integral part of life and reach the level needed to improve health. " The effects of yoga, especially on health, have been the subject of much more research than its mental effects, and research on the subject has been carried out in various hospitals and institutions in India since the early 1900s. Yoga, which has a positive effect on mental health, has not only been limited to use in treatment areas but has also been used in educational and school environments where it is aimed to provide individuals with skills related to health and fitness. It is stated that yoga practices in schools have positive effects on the development of children and adolescents. It is emphasized that yoga and mindfulness improve the physical and mental health of school-age children (6-12 years). Yoga develops balance, strength, and endurance in children. Research has found that yoga can improve concentration, memory, self-esteem, and academic performance and even reduce anxiety and stress in children. Yoga helps teenagers to improve their physical condition without focusing on their appearance. Teenagers try to balance many things, such as exams, homework, and their social life. Yoga can help teens take time for themselves while developing strong coping mechanisms for stress and anxiety. Yoga can provide teens with a regular practice of self-love, helping them to build confidence and a positive self-image around their identity and body. © 2025 Elsevier B.V., All rights reserved
Investigating Length and Mean-Fuzzy Subalgebras in Sheffer Stroke Hilbert Algebras
No full textThe aim of this paper is to introduce the notions of the length and the mean of an interval-valued fuzzy structure in Sheffer stroke Hilbert algebras. The notions of length-fuzzy subalgebras and mean-fuzzy subalgebras of Sheffer stroke Hilbert algebras are introduced, and related properties are investigated. Characterizations of length-fuzzy subalgebras and mean-fuzzy subalgebras are discussed. Relations between length-fuzzy subalgebras (resp., mean-fuzzy subalgebras) and subalgebras are established. Moreover, we discuss the relationships among length-fuzzy subalgebras (resp., mean-fuzzy subalgebras) and upper and lower-level subsets of the length (resp., mean) of an interval-valued fuzzy structure in Sheffer stroke Hilbert algebras. © 2025 Elsevier B.V., All rights reserved
Investigation of the usability of Ce- and N-doped hybrid carbon quantum dots for the removal of neodymium ions
No full textThis study evaluates Ce and N doped carbon quantum dots (CQDs) integrated into hydrogel matrices for neodymium (Nd) ion removal from aqueous solutions. CQDs were synthesized using Agaricus Bisporus mushrooms and incorporated into hydrogels with 1% mushroom loading, achieving a maximum adsorption capacity of 78.55 mg/g under 180 min, pH 5.0, 298 K, and 1 g/L solid-to-liquid ratio. Adsorption followed the Langmuir isotherm and pseudo-second-order kinetics, with thermodynamic analyses confirming a spontaneous and endothermic process. These findings demonstrate the effectiveness of Ce-N/CQDs@HG composites for environmental remediation.Scientific and Technological Research Council of Turkiye (TUBIdot;TAK)Open access funding provided by the Scientific and Technological Research Council of Turkiye (TUB & Idot;TAK). No funding was received to assist with the preparation of this manuscript
Structure and substructure connectivity of folded divide-and-swap cube
No full textLet H be a connected subgraph of a graph G. The H-structure connectivity of G, denoted by kappa(G;H), is the minimum cardinality of a set of connected subgraphs in G, whose removal either disconnects G or reduces it to a trivial graph, where each element in the set is isomorphic to H. The H-substructure connectivity of G, denoted by kappa(s)(G;H), is the minimum cardinality of a set of connected subgraphs in G, whose removal either disconnects G or reduces it to a trivial graph, where each element in the set is isomorphic to a connected subgraph of H. In this paper, we investigate the H-structure connectivity and H-substructure connectivity of folded divide-and-swap cube FDSCn for H is an element of{K-1,K-1,K-1,K-1,K-m(2 = 3 and kappa(FDSCn;K-1,K-m)=kappa(s)(FDSCn;K-1,K-m) = left perpendicular d/2 right perpendicular +1 for d >= 1 and 2 = 1 and we provide a bound for kappa(FDSCn;K-1,K-d+2) when d >= 3.Scientific and Technological Research Council of Turkiye (TUBITAK); TUBITAK (Scientific and Technological Research Council of Turkiye) [122F276]Open access funding provided by the Scientific and Technological Research Council of Turkiye (TUBITAK). This work was financially supported by TUBITAK (Scientific and Technological Research Council of Turkiye) under the 1002 Project (Grant No. 122F276)