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Evaluating artificial intelligence for a focal nodular hyperplasia diagnosis using magnetic resonance imaging: preliminary findings
No full textPURPOSE This study aimed to evaluate the effectiveness of artificial intelligence (AI) in diagnosing focal nod-ular hyperplasia (FNH) of the liver using magnetic resonance imaging (MRI) and compare its perfor-mance with that of radiologists. METHODS In the first phase of the study, the MRIs of 60 patients (30 patients with FNH and 30 patients with no lesions or lesions other than FNH) were processed using a segmentation program and introduced to an AI model. After the learning process, the MRIs of 42 different patients that the AI model had no experience with were introduced to the system. In addition, a radiology resident and a radiology specialist evaluated patients with the same MR sequences. The sensitivity and specificity values were obtained from all three reviews. RESULTS The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the AI model were found to be 0.769, 0.966, 0.909, and 0.903, respectively. The sensitivity and speci-ficity values were higher than those of the radiology resident and lower than those of the radiology specialist. The results of the specialist versus the AI model revealed a good agreement level, with a kappa (kappa) value of 0.777. CONCLUSION For the diagnosis of FNH, the sensitivity, specificity, PPV, and NPV of the AI device were higher than those of the radiology resident and lower than those of the radiology specialist. With additional studies focused on different specific lesions of the liver, AI models are expected to be able to diag-nose each liver lesion with high accuracy in the future. CLINICAL SIGNIFICANCE AI is studied to provide assisted or automated interpretation of radiological images with an accu-rate and reproducible imaging diagnosis
Process Optimization and Storage Evaluation of Explosion Puffing Dried Reduced-Fat White Cheese Snacks
No full textThis study builds on the previous research that explored the effects of different pre-drying methods on the quality of reduced-fat white cheese (RFWC) snacks before explosion puffing drying (EPD). The microwave + freeze hybrid drying (MD + FD) method was identified as the optimal pre-drying approach, with a target moisture content of 45 g/100 g in the RFWC sample, based on textural, chemical, color, and sensory attributes. In this continuation study, the MD + FD pre-drying method and moisture content were maintained, whereas response surface methodology (RSM) with a Box-Behnken design was applied to optimize the EPD process parameters for producing high-protein RFWC snacks. The independent variables (puffing temperature, puffing time, and vacuum temperature) were evaluated for their effects on protein content, crispness, volumetric expansion, and sensory acceptability. Statistical analysis showed that vacuum temperature significantly influenced all responses; puffing time played a key role in protein content and crispness, whereas puffing temperature primarily affected volumetric expansion. The optimal EPD conditions were determined as 100 degrees C puffing temperature, 5 min puffing time, and 60 degrees C vacuum temperature, yielding a protein content of 60.33 g/100 g DM, crispness of 34.40, volumetric expansion of 16.60%, and an overall sensory score of 7.46. A 6-month storage study revealed that the product retained its quality for 4 months, with noticeable moisture uptake, oxidation, and texture degradation from the fifth month onward. These findings highlight EPD's potential for developing high-protein, crispy cheese snacks while underscoring the importance of selecting appropriate packaging to maintain product stability.Practical ApplicationsBy showing that explosion puffing drying (EPD) can be tuned to produce crispy, protein-rich cheese snacks with exceptional texture and sensory appeal, this work contributes to the invention of high-protein snacks. The findings provide the food industry a scalable way to create nutrient-dense, shelf-stable treats that are not manufactured with conventional grains. Additionally, the 6-month storage analysis provides important information on packaging techniques to increase shelf life, increasing the viability of these snacks for mass manufacture and international distribution. The new generation of clean-label, high-protein snacks in the quickly expanding health-conscious market is made possible by our research.Scientific and Technological Research Council of Turkey [TUBITAK 117 O 954]Financial support was provided by the Scientific and Technological Research Council of Turkey (TUBITAK 117 O 954)
Toxicity of the two insect growth regulators, pyriproxyfen and Lufox® against cotton bollworm
No full textThis study investigated the field effects of two insect growth regulators, pyriproxyfen and lufenuron+fenoxycarb (A commercial combination), on some biological and physiological characteristics of third instar larvae of the cotton bollworm, Helicoverpa armigera Hubner. The insecticides significantly affected the weight and duration of larval and pupal development, the longevity of males and females, the egg laying and hatching rates. The larvae treated with sublethal concentrations showed an increase in the total number of hemocytes, plasmatocytes and granulocytes. A significant increase in aminotransferase activity was also observed in the hemolymph of treated larvae. The increased activity of acid phosphatase and alkaline phosphatase was also observed in the treated H. armigera larvae. The total activity of esterase and glutathione S-transferase as detoxifying enzymes also increased significantly after pyriproxyfen and lufenuron+fenoxycarb treatments compared to control. In contrast, the amount of storage macromolecules, protein, triglycerides and glycogen, which are related to the energy cost of pesticide treatment, decreased in the treated larvae compared to the control. According to the results of the present research, the pesticides pyriproxyfen and lufox can be used to control the popul ation of H. armigera by interfering with the intermediate metabolism and cellular immunity of the larvae, but their efficiency and compatibility should be considered with other control methods, especially biological factors. © 2025 Elsevier B.V., All rights reserved
Corrosive Substance Ingestion: When to Perform Endoscopy?
No full textAimIngestion of corrosive substances is a difficult and important medical problem to manage. The aim of this study is to present an algorithm that will regulate the treatment and follow-up of paediatric patients with corrosive ingestion.MethodsChildren who were admitted to the paediatric emergency department with corrosive substance ingestions between July 2015 and December 2021 were included. Between July 2015 and January 2020, endoscopy was performed on all patients. After January 2020, endoscopy was performed only for patients presenting with hypersalivation and dysphagia.Results172 patients were followed up and treated in our clinic due to corrosive substance ingestion. Endoscopic evaluation of 19 patients with hypersalivation revealed oesophageal corrosion stages as follows: grade I in 5 patients, grade II-A in 1 patient, grade II-B in 3 patients, and normal findings in the remaining patients. Of the 14 patients with dysphagia, 1 had grade I, 2 had grade II-A, and 4 had grade II-B corrosion, and the remaining patients had normal endoscopic findings. In the long-term follow-up of the patients without hypersalivation and dysphagia, no complications developed and no additional treatment was required.ConclusionsIn patients presenting with suspicion of ingestion of high risk corrosive substances, there is no need for endoscopy unless hypersalivation and dysphagia are present simultaneously
React Native vs Flutter: Hibrit yazılım geliştirme araçlarının native donanım özelliklerinin kullanımı ile performans ve enerji tüketiminin karşılaştırılması
Get PDFDeğişen dünya ve gelişen teknolojiler ile birlikte mobil cihazlar insan hayatında önemli bir yere sahip olmuştur. Farklı mobil uygulama yayınlama ve geliştirme platformları, zamanla ortaya uygulamanın platformlar arası tutarlılığı, iş gücü verimliliği, güncel teknoloji takibi, geliştirme ve bakım maliyeti gibi konularda sorunlara neden olmuştur. Çapraz platform yazılım geliştirme teknolojisi bu sorunlara çözüm olması hedeflenerek ortaya çıkmıştır. Çapraz platform yazılım geliştirme çerçeveleri, birden fazla platform ve işletim sistemine tek bir kod tabanı ile uygulama geliştirmeyi sağlamaktadır. Bu yaklaşım mobil uygulama geliştirme süreçlerini basitleştirir, verimliliğini arttırır, bakım maliyetini düşürür ve farklı platformlardaki uygulama tutarlılığını arttırarak kullanıcı deneyimini iyileştirmektedir. React Native ve Flutter popüler çapraz platform yazılı geliştirme çerçevelerindendir. Bu çerçeveler cihazdaki yerel donanımlara erişim, kullanıcı arayüzlerinin hazırlanması ve cihaz kaynaklarının verimli kullanılması için bir dizi yöntem sağlamaktadır. Tüm bu bilgiler ışığında bu çalışmanın amacı çapraz platform yazılım geliştirme teknolojileri içerisinde yaygın olarak kullanılan React Native ve Flutter çerçevelerinin mimari yapılarının, yerel donanım kaynaklarına erişim için kullandığı yapı ve metotların, bu kaynakları kullanarak oluşturulan geliştirmelerdeki performanslarının karşılaştırılmasıdır. Çalışma kapsamında çerçevelerin yerel kaynakları kullanarak kullanıcıya sunduğu bazı geliştirmelerin kopya demoları iki platform için de hazırlanmış, bu demolar üzerinden performans testleri gerçekleştirilmiş, farklı performans parametrelerinde karşılaştırmalar yapılmış ve iki çerçevenin mimari yapıları ile yerel donanım kaynaklarına erişim için kullandığı metotlar incelenmiş ve değerlendirilmiştir. Elde edilen sonuçlarda enerji tüketimleri açısından net farklar gözlemlenemiş olsa da, performans metrikleri incelendiğinde okuyuculara belirli farklar sunmuştur. Değerlendirilen mimari yapı ve yerel kaynaklara erişim metotları ile beraber elde edilen tüm sonuçlar geliştiricilere ve yatırımcılara bir mobil uygulama geliştirmeden önce tercih edecekleri çerçeve konusunda fikir sunmaktadır.With the evolving world and advancing technologies, mobile devices have become an integral part of human life. Various mobile application development and publishing platforms have introduced challenges over time, such as cross-platform consistency, workforce efficiency, keeping up with technological advancements, and development and maintenance costs. Cross-platform software development technologies have emerged as solutions to address these challenges. Cross-platform frameworks enable the development of applications for multiple platforms and operating systems using a single codebase. This approach simplifies mobile application development processes, enhances efficiency, reduces maintenance costs, and improves user experience by increasing consistency across platforms. React Native and Flutter are among the most popular cross-platform development frameworks. These frameworks provide a variety of methods for accessing native hardware on devices, designing user interfaces, and utilizing device resources efficiently. In light of this information, this study aims to compare the architectural structures of React Native and Flutter, two widely used frameworks in crossplatform software development, focusing on the methods and structures they employ for accessing native hardware resources and their performance in implementations utilizing these resources. Within the scope of this study, copy demos of certain functionalities utilizing native resources were developed for both platforms. Performance tests were conducted on these demos, and comparisons were made across various performance parameters. Additionally, the architectural structures of the two frameworks and the methods that used for accessing native hardware resources were examined and evaluated. While the results did not reveal significant differences in energy consumption, notable distinctions in performance metrics were observed, offering insights to readers. The findings, combined with the evaluated architectural structures and resource access methods, provide developers and investors with guidance on selecting the appropriate framework before embarking on mobile application development
A survey on the attitudes of pediatric residents toward rational use of medicines and associated factors in Izmir, Turkey
No full textBackground Considering children's sensitive and developmental needs, pediatricians play a pivotal role in ensuring rational use of medicines (RUM), alongside healthcare systems, pharmacists and patients. Aim To assess pediatric residents' attitudes toward RUM in three Izmir hospitals. Study design A cross-sectional study. Methods The attitude of pediatric residents at three tertiary hospitals in Izmir toward RUM was assessed using the Scale for Determining Family Physicians' Attitudes on RUM. Independent variables included sociodemographic characteristics, prescribing practices, and RUM-related education. Data were analyzed using Student's t-test, One-Way ANOVA, and Linear Regression. Results The study included 187 participants with a 98.9% coverage rate. Pediatric residents prescribed an average of 2.4 +/- 0.7 medicines, with only 12.8% prescribing injectables. The most common source of prescribing information for residents is application programs (84.5%). Pediatric residents excelled in explaining diseases (91.5%) and treatments (93.1%), though only 52.9% believed patients understood the information, and 49.7% sometimes prescribed medications upon request. Most (89.8%) considered treatment feasibility, but only 46.6% frequently accounted for costs. While 93.6% avoided prescribing without examination, only 23.6% knew medication prices, and 41.2% reported occasional influence from pharmaceutical promotions. Participants scored an average of 3.6 +/- 0.3 on the total RUM attitudes scale. Multivariate analysis showed that the scale mean was 0.018 points higher for those using peer-reviewed publications and 0.012 points higher for those reporting adverse effects, while it was 0.024 points lower for those relying on pharmaceutical promotional resources (p < 0.05), explaining 17.3% of the variance. Conclusion Pediatric residents in Izmir show a positive attitude toward RUM, excelling in communication and prescribing, though gaps persist in cost-awareness, evidence use, and managing external influences. Targeted education focusing on cost-conscious prescribing and the critical appraisal of information sources is necessary. Implementing active monitoring and feedback systems can further promote adherence to RUM principles, ensuring safer and more effective pediatric care
Inborn Errors of Immunity in Pediatric Intensive Care: Prevalence, Characteristics, and Prognosis
No full textInborn errors of immunity (IEI) are a heterogeneous group of genetic diseases characterized by impaired immune system function. This prospective study aimed to determine the frequency, characteristics, and clinical course of IEI patients admitted to the pediatric intensive care unit (PICU) and identify mortality-related factors. Using a comprehensive immunological evaluation protocol, we screened 753 PICU admissions for potential IEIs during three years. Patients with pre-existing IEI diagnoses, chronic diseases, ongoing chronic medication regimens, other known comorbidities, trauma cases, post-surgical cases, and poisonings were excluded. Thirty-three patients were newly diagnosed with IEIs during or as a result of their PICU stay, representing an incidence of 4.39%. The most common disorders were immunodeficiencies with immune dysregulation (48.5%), followed by combined immunodeficiencies (24.2%). Severe viral infections (61%) and life-threatening infections (51.7%) were the most frequent warning signs. Only 31% of patients exhibited at least two Jeffrey Modell Foundation warning signs. The mortality rate was 58%, highlighting the need for early diagnosis and treatment. Newborn screening and family segregation studies are crucial to improving outcomes for IEI patients in intensive care settings. © 2024 Elsevier B.V., All rights reserved
Kesirli lineer olmayan homojen ve homojen olmayan diferansiyel denklemlerin Laplace çözümü üzerine
Get PDFBu çalışmada, Lineer olmayan, homojen ve homojen olmayan kesirli diferansiyel denklemlerin Laplace ile çözümü ele alınmıştır. Bu tezde, Caputo tanımıyla ifade edilen kesirli türevli denklemler incelenmiştir. Bu denklemlerin Laplace dönüşümü ile çözümünde çıkan zorluklarda, Adomian Ayrıştırma Yöntemi’nden yardım alınmıştır. Oluşturulan, başlangıç koşullu kesirli, lineer olmayan, homojen olma durumlarına göre kesirli diferansiyel denklemlerin çözümünde Laplace dönüşümü kullanılması; denklemlerin çözümünde kolaylık sağlaması açısından tercih edilmiştir. Denklemlerin çözümünde karşımıza çıkan doğrusal olmayan terimin çözümünde ise Adomian polinomları kullanılmıştır. Verilen denklemin çözümü iteratif yapıya dönüştürülerek yaklaşık çözümleri farklı türev mertebeleri (α) için elde edilmiş, bu çözümler grafiksel olarak karşılaştırılmış ve analiz edilmiştir. Yapılan analizler sonucunda, kesirli türevlerin hafıza etkisi yarattığı; tamsayılı mertebeden türevli diferansiyel denklemlere kıyasla daha iyi sonuçlar verdiği gözlemlenmiştir.In this study, the solution of nonlinear, homogeneous, and non-homogeneous fractional differential equations using the Laplace transform is addressed. In this thesis, fractional differential equations defined in terms of the Caputo derivative are examined. The Adomian Decomposition Method is employed to overcome the difficulties encountered in solving these equations with the Laplace transform. The use of the Laplace transform in the solution of fractional, nonlinear differential equations with initial conditions and according to their homogeneity is preferred due to its facilitation in solving the equations. Adomian polynomials are utilized to handle the nonlinear terms that arise in the solution of the equations.The given equations are converted into an iterative structure, and approximate solutions are obtained solutions are obtained for different derivative orders (α); these solutions are graphically compared and analyzed. As a result of the conducted analyses, it has been observed that fractional derivatives exhibit a memory effect and provide better results compared to differential equations with integer-order derivatives
Firmalarda yeni ürün geliştirme stratejilerinde Yeşil PLM'nin rolü ve seçim kriterlerinin araştırılması
No full textTez çalışmasında iş yönetimini kolaylaştırıcı bir anlayış olan PLM (Product Lifecycle Management) yazılımlarının sürdürülebilirlik çerçevesinde firmaların adaptasyon süreçleri analiz edilmiştir. Mevcut PLM yazılımları firmaların iş süreçlerini yönetmede etkili olmakla birlikte sürdürülebilirlik faaliyetlerini tam kapsamamaktadır. Bu bağlamda, tez çalışması PLM kullanan veya geçiş yapmak isteyen özellikle KOBİ firmaların iş modellerine Yeşil PLM anlayışını katmaları amacı ile bir yol haritası hedeflemiştir. Çalışma kapsamında; çevresel, sosyal ve ekonomik anlamda sürdürülebilirlik parametreleri araştırılmış, KOBİ ölçekli firmalara ihtiyaç analizi anketi uygulanmış ve QFD analizi yapılmıştır. Firmalarda sürdürülebilirlik faaliyetleri kapsamında %77,8 oranında "Atıkların bertarafı ve doğru geri dönüşümü" ve "Çevre yasalarına uyum", %69,4 oranında "Malzeme kullanımı tasarrufu" ve %66,7 oranında "Enerji verimliliği" başlıklarında iyileştirici faaliyetlerin yapıldığı görülmüştür. Ek olarak bir ürünün yaşam döngüsü boyunca çevreye etkisi karbon ayak izi açısından bir model oluşturularak belirlenmeye çalışılmıştır. Tez çalışmasında, Yeşil ürün geliştirme stratejileri kapsamında firmaların iş süreçlerinin güncellenmesi ve iyileştirilmesi noktasında neler yapılabileceği ve Yeşil PLM'e geçişte süreç yönetim stratejilerinde kullanılacak başlıklar sunulmuştur.In this study, the adaptation processes of companies within the framework of sustainability of PLM (Product Lifecycle Management) software, which is an understanding that facilitates business management, were analyzed. Although existing PLM is effective in managing the business processes of companies, it does not fully cover sustainability activities. In this context, the thesis aims to provide a roadmap for especially SMEs that use PLM or want to make a transition and add Green PLM understanding to their business models. Within the scope of the study; environmental, social and economic sustainability parameters were investigated, a needs analysis survey was applied to SMEs and QFD analysis was performed. Within the scope of sustainability activities in companies, it was observed that improvement activities were carried out under the titles of "Disposal of waste and correct recycling" and "Compliance with environmental laws" at 77.8%, "Savings in material use" at 69.4% and "Energy efficiency" at 66.7%. In addition, a model was created to determine the environmental impact of a product throughout its life cycle in terms of carbon footprint. In the study, what can be done to update and improve the business processes of companies within the scope of Green product development strategies and the headings to be used in process management strategies in the transition to Green PLM are presented
Dynamic blood-based biomarkers predict early response to ipilimumab and nivolumab in advanced melanoma
No full textBackground Despite the therapeutic advances of immune checkpoint inhibitors in advanced melanoma, early identification of treatment non-responders remains a major clinical need. Dynamic changes in peripheral blood biomarkers may provide a cost-effective and non-invasive strategy to monitor treatment response during the early phase of immunotherapy. Methods We retrospectively analyzed 70 patients with advanced melanoma treated with combination ipilimumab and nivolumab between 2017 and 2025. Dynamic changes in neutrophil-to-lymphocyte ratio (Delta NLR), lymphocyte-to-monocyte ratio (Delta LMR), platelet-to-lymphocyte ratio (Delta PLR), systemic immune-inflammation index (Delta SII), eosinophil count (Delta Eosinophils), and lactate dehydrogenase (Delta LDH) were calculated as the ratio of post-treatment (prior to the third cycle) to pre-treatment (baseline) values. ROC analysis and logistic regression models assessed each biomarker's predictive value for objective response. Each delta marker was tested in a separate multivariate model adjusted for clinical covariates identified through univariate analysis. Results Among 70 patients, 28 (40.0%) achieved an objective response. Delta NLR and Delta LMR showed the strongest discriminative performance (AUCs: 0.836 and 0.793, respectively). In multivariate models incorporating univariate-selected clinical covariates, high Delta NLR (OR = 20.3, 95% CI 4.65-88.45) and low Delta LMR (OR = 22.66, 95% CI 5.07-101.34) remained independently associated with non-response (both p < 0.001). These biomarkers also improved the predictive performance of the clinical model (Delta AUC: + 7.7%). Conclusions Routine assessment of early dynamic changes in Delta NLR and Delta LMR after two cycles of ipilimumab-nivolumab therapy can enable timely identification of non-responders in advanced melanoma, allowing early discontinuation or switching of treatment to avoid unnecessary toxicity and cost. These biomarkers rely on standard blood counts and are readily applicable in clinical practice. Nevertheless, the retrospective single-center design and moderate sample size limit the generalizability of our findings, and prospective validation in larger, independent cohorts is warranted