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Sağlık Kurumlarında Finansal Yönetim ve Kaynak Kullanımı: Otoimmün Hastalıklar ve Sağlık Harcamalarının Değer Temelli İlişkisi
No full textAmaç – Bu çalışmanın amacı, Türkiye’de otoimmün hastalıkların yarattığı hastalık yükü ile sağlık harcamaları arasındaki ilişkiyi sağlık yönetimi perspektifinden, değer temelli finansal yönetim çerçevesinde incelemektir. Yöntem – 2010–2021 yılları arasındaki Küresel Hastalık Yükü (GBD) 2021 verileri ile Dünya Sağlık Örgütü Küresel Sağlık Harcamaları Veritabanı (WHO-GHED) verileri kullanılmıştır. Otoimmün hastalıkların mortalite, morbidite ve yıllara göre engelliliğe ayarlanmış yaşam yılı (DALY) değerleri değerlendirilmiş; aynı döneme ait sağlık harcamaları ile karşılaştırılmıştır. Tanımlayıcı istatistikler, trend analizleri, korelasyon ve çoklu regresyon yöntemleri kullanılmıştır. Bulgular – Türkiye’de otoimmün hastalıkların DALY yükünün yıllar içinde artış eğiliminde olduğu; sağlık harcamaları içinde otoimmün hastalık yükü ile ilişkili harcama payının giderek yükseldiği görülmüştür. Harcama artışı ile DALY yükü arasında anlamlı ve pozitif bir korelasyon saptanmıştır (p<0.05). Tartışma- Bulgular, sağlık kurumlarında finansal yönetim ve kaynak kullanımı açısından değer temelli yaklaşımların gerekliliğini vurgulamaktadır. Elde edilen bulgular, hastane işletmeciliği bağlamında maliyet-etkililik, kaynak dağılımı ve sürdürülebilirlik için önemli stratejik ipuçları sunmaktadır. Otoimmün hastalıkların sağlık sistemine getirdiği yük giderek artmakta olup, sağlık harcamalarının değer temelli yaklaşımlar doğrultusunda yeniden yapılandırılması gerekmektedir. Değer temelli sağlık yönetimi uygulamalarının, artan kronik hastalık yükü karşısında finansal yönetiminin etkinliğini sağlamada politika yapıcılar ve hastane yöneticileri için kritik olduğu görülmektedir
Cardiac rhythm disturbances associated with hydroxychloroquine and azithromycin combination in children with COVID-19 pneumonia
No full textAims: At the beginning of the COVID-19 pandemic; it has been shown that receiving hydroxychloroquine and azithromycin treatment decrease viral carriage of coronavirus in patients. In this study, we aimed to evaluate electrocardiography (ECG) abnormalities in pediatric patients with COVID-19 pneumonia receiving combined therapy with hydroxychloroquine and azithromycin. Methods: In this study; ECG and laboratory parameters of 24 children with COVID-19 pneumonia who were treated with hydroxychloroquine and azithromycin at Health Sciences University between June 2020 and November 2020 were analyzed retrospectively. P wave dispersion (PWd), QT interval (QT), QT dispersion (QTd), QTc interval (QTc), QTc dispersion (QTcd), Tpeak-Tend interval (Tp-e), Tp-e dispersion (Tp-ed), Tp-e/QT, Tp-Te/QTc ratios were evaluated with 12 lead ECG. ECG parameters and QTc interval were compared before and after (5 days) the treatment. Results: The mean age was 13±4.5 years and 62.5% were female. Median hospitalization length was 6 days. There was no statistically significant difference between the PWd, QT and QTc interval, QTd, QTcd, Tp-e interval, Tp-e dispersion, Tp-e/QT, Tp-e/QTd measurements and ratios of the before and after treatment. A significant difference was found for the decrease in hearth rate in regard to the measurement before and after the treatment. Conclusion: In our study, there were no rhythm problems which were observed on ECG in pediatric patients receiving hydroxychloroquine and azithromycin combination therapy for COVID-19 pneumonia. We also found that laboratory parameters were not specific for COVID-19 pneumonia in children
Sex Prediction Using Geometric Morphometry with Parameters Obtained from the Orbit, Nasal Bone and Pyriforme Aperture
No full textSex-related changes in the morphometry of the orbit and upper face is an important topic in plastic surgery, forensic sciences and basic medical sciences. With this hypothesis, the aim of this study is to estimate sex using geometric morphometry method with parameters obtained from orbits, nasal bone and pyriforme aperture. The study was performed on Computed Tomography images of 326 individuals aged 25-65 years. The images were three-dimensionalized and superimposed. The real magnification images were then converted to TPS format and 19 homologous landmarks were added to the images. Generalized Procrustes Analysis (GPA) was applied to the obtained coordinates and repositioned around the center of gravity. Principal Component Analysis (PCA) was applied to the new data positioned around the center of gravity to reduce the dimensionality. Linear discriminate analysis (LDA) was applied to the dimensionality-reduced images to obtain sex estimation accuracy. The stud found that 77.126 % of the coordinates gathered around the center of gravity could be explained by the first 3 Principal Component (PCs). LDA analysis applied to the new coordinates yielded a 96.01 % sex prediction rate. As a result of the study, a high accuracy rate was obtained in terms of sex prediction using geometric morphometry method with parameters obtained from the orbit, nasal bone and pyriforme aperture
Acil Yardım Dağıtımında İnsansız Hava Araçlarının Etkin Rotalanması
No full textZorlu coğrafi koşullar ve yıkılmış altyapılar nedeniyle erişimin zor olduğu durumlarda İnsansız Hava Araçlarının (İHA) kullanımı, afet yönetimi ve acil müdahale süreçlerinde kritik bir çözüm olarak öne çıkmaktadır. Bu çalışmada, doğal afetler gibi acil durumlar sonrasında İHA’lar ile yardım malzemesi dağıtımını optimize etmek amacıyla bir Araç Rotalama Problemi (ARP) ele alınmıştır. Bu problemin çözümü için k-means kümeleme algoritması ile ziyaret noktalarını gruplara ayırma ve her bir grup için en yakın komşu (Nearest Neighbor – NN) algoritması ile en kısa rotaları belirleme yöntemleri kullanılmıştır. Çalışmada, öncelikle çalışılan ARP’nin temel kısıtları tanıtılmış, ardından, k-means ve NN algoritmalarının nasıl entegre edildiği açıklanmıştır. Önerilen algoritma, belirli kısıtlar altında (araç kapasitesi ve kat edilen maksimum mesafe gibi) çalışacak şekilde tasarlanmış ve gerçek dünya verileri kullanılarak Gaziantep ilindeki acil toplanma alanları üzerinde test edilmiştir. Elde edilen deneysel sonuçlar, Gaziantep ilindeki 34 acil toplanma alanına yardım paketlerinin 6 İHA ile 20 dakikadan az bir süre içinde ulaştırılabileceğini göstermektedir. Bu çalışma, İHA kullanımının zorlu ve acil durumlar için lojistik destek sağlama konusunda ne kadar etkili ve verimli olabileceğini göstermiştir
Understanding Iran's policy towards the Ukraine war: the significance of ideational factors and factional rivalries
No full textThis study examines the role of factional and ideational factors in shaping Iran's foreign policy towards the Ukraine war and its alignment with Russia. It addresses two key questions: Why did Iran side with Russia instead of remaining neutral or using the war to improve relations with the West? And how did the influential conservative factions justify this policy as serving national or factional interests? To answer these, the study adopts a constructivist neoclassical realism framework that allows for a nuanced analysis of how domestic and systemic stimuli interact within a social context shaped by material and ideational factors. This theoretical approach enables the use of critical discourse analysis to examine conservative media narratives and factional discourses. The findings reveal that conservatives perceive the war as a geopolitical struggle between Western and anti-Western blocs. While they anticipate that a Russian victory will weaken Western hegemony and bolster Iran's regional influence, they also fear that a Russian defeat could strengthen Western liberal values and empower domestic opposition. The study underscores how competing interpretations of global events shape divergent perceptions of risk and opportunity, highlighting the necessity of incorporating both material and ideational dimensions when analysing the foreign policy of revolutionary states
Comparative analysis of different machine learning algorithms in prediction of student academic success
No full textMakine öğrenmesi eğitim alanında, öğrenci akademik başarısının öngörülmesi ve eğitim politikalarının geliştirilmesi açısından önemli katkılar sunmaktadır. Bu çalışma, öğrencilerin akademik başarılarını tahmin etmek için, Karar Ağacı, Rassal Orman, k-En Yakın Komşuluk ve Adaptif Yükseltme algoritmaları kullanılmıştır. Hiper parametre optimizasyonu Genetik Algoritma yöntemiyle gerçekleştirilmiş, model doğruluğu 10 katlı çapraz doğrulama ile test edilmiştir. Çalışmada kullanılan veri seti, Kaggle platformundan alınmış olup, 2392 öğrenciye ait demografik bilgiler, akademik bilgiler, ders katılım oranları ve etkinlik katılım durumları gibi çeşitli değişkenleri içermektedir. Öğrenci başarısını öngörmek için yapılan analizler sonucunda en başarılı model Adaptif Yükseltme olarak belirlenmiş olup, R² değeri 0.937 olarak elde edilmiştir. Rassal Orman'da R², 0.932; KNN'da R², 0.918; Karar Ağacı'nda R²,0.892 değerleri elde edilmiştir. Sonuç olarak, Makine Öğrenmesi algoritmalarında hiper parametre optimizasyonunun model performansını önemli ölçüde arttırdığı, Adaptif Yükseltme ve Rassal Orman algoritmalarının ise diğer yöntemlere kıyasla daha yüksek doğruluk oranları sunduğu gözlemlenmiştir.Machine learning offers significant contributions to the field of education in terms of predicting student academic success and in developing educational policies. In this study, Decision Tree, Random Forest, K-Nearest Neighbors and Adaptive Boosting algorithms are applied to predict students' academic performance. Hyperparameter optimization is performed using a Genetic Algorithm and model accuracy is evaluated with 10-fold cross validation. The dataset used in the study is obtained from the Kaggle platform and includes various variables such as demographic data, academic information, course participation rates and activity participation status of 2392 students. As a result of the analyses conducted to predict student performance, Adaptive Boosting emerges as the most successful model, achieving an R² value of 0.937. R² is 0.932 for Random Forest, 0.918 for KNN, and 0.892 for Decision Tree. Overall, the findings show that hyperparameter optimization significantly enhances model performance, with Adaptive Boosting and Random Forest offering higher prediction accuracy compared to the other methods
Assessing Turkey's Environmental Performance: Insights from the Environmental Performance Index (EPI)
No full textThe study delves into Turkey's environmental performance using the Environmental Performance Index (EPI) data from 1995 to 2022. Using data from the Environmental Performance Index (EPI) for the years 1995 to 2022, the study explores Turkey's environmental performance. It searches at several factors, such as climate change, environmental health, and ecosystem vitality, and it clarifies Turkey's position relative to other countries. The EPI scores—which are derived from 40 indicators spanning three policy objectives—are examined to identify patterns and areas in need of development. Signs of progress, particularly in waste management and recycling initiatives, are highlighted along with challenges in waste management, environmental health, and mitigating climate change. However, challenges like declining water and air quality and unsustainable agriculture currently exist. While discussing the shortcomings of the EPI approach, such as missing data and ranking computation, the article also highlights the significance of thorough research in comprehending and addressing environmental concerns. An alternative approach to ranking nations and carrying out additional environmental performance analysis is presented: the TOPSIS method. With its insights into Turkey's environmental challenges and advancements over time, the article is an informative resource for policymakers, researchers, and stakeholders interested in environmental sustainability and policy development
Is it safe to perform coronary artery bypass grafting surgery in patients with hemophilia? A case series of four patients
No full textHemophilia is a genetic disorder that mainly affects males and leads to a higher risk of bleeding. There is a lack of clarity regarding the safety of coronary artery bypass grafting (CABG) surgery in patients with hemophilia. In this case series, real-life data of four male hemophilia patients aged 45 to 66 years who underwent CABG was presented. One patient needed to undergo reexploration due to nonsurgical bleeding. However, all patients were discharged in good condition. The current experience revealed that CABG in hemophilia patients is safe to perform with a multidisciplinary approach involving hematologists, anesthesiologists, and cardiovascular surgeons
Evaluation of the Effects of Two Different Types of Chirp Stimuli on Auditory Brainstem Response in Young Adults
No full textBackground: The chirp stimulus is a type of stimulus designed to neutralize the lack of temporal synchronization in the cochlea caused by progressive wave delay. The CE-Chirp® stimulus is a modified form of the chirp stimulus that allows for better neural synchronization and the recording of larger amplitude responses. Purpose: This study compared wave V latencies and amplitudes of CE-Chirp and chirp stimuli in auditory evoked brainstem responses (ABRs). Research Design: This was a cross-sectional analytical research study. Study Sample: Data of 25 healthy individuals (15 female and 10 male individuals) between 20 and 26 years of age (22.84 ± 1.81?years) were included. Data Collection and Analysis: Pure-tone audiometry, tympanometry, chirp ABR, and CE-Chirp ABR tests were applied. Chirp (broadband [BB] chirp [BB-chirp] and narrowband [NB] chirp [NB-chirp]) and CE-Chirp ABRs were evaluated at 20, 40, 60, and 80 decibels for normal hearing level (dBnHL) at BB and NB frequencies (1,000, 2,000, and 4,000 Hz). Results: The BB frequency evaluation showed a significant difference between the BB-chirp stimulus and CE-Chirp stimulus in terms of latency (p = 0.01 at 20, 40, 60, and 80 dBnHL), but no significant difference in amplitude (p > 0.05 at 20, 40, 60, and 80 dBnHL). The comparison of the NB-chirp stimulus and CE-Chirp stimulus showed that CE-Chirp stimulus latencies were significantly shorter than chirp stimulus latencies when a high stimulus intensity was applied at NB frequencies. Conclusions: A comparison of chirp and CE-Chirp stimuli revealed a significant difference in latency at BB frequencies, but different results were observed at NB frequencies. Amplitude comparisons of stimuli revealed different findings at different frequencies and different stimulus intensities. Additional research is necessary to determine the latency and amplitude differences between chirp and CE-Chirp stimuli. This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicin
Physicochemical and Antimicrobial Evaluation of Bacterial Cellulose Derived from Spent Tea Waste
No full textBacterial cellulose (BC) is a high-purity biopolymer with excellent physicochemical and mechanical properties, including high crystallinity, water absorption, biocompatibility, and structural tunability. However, its large-scale production is hindered by high substrate costs and limited sustainability. In this study, spent black tea waste was utilized as a low-cost and eco-friendly carbon source for BC synthesis by Komagataeibacter xylinus ATCC 53524 under varying initial pH conditions (4-9). Six different BC membranes were produced and systematically characterized in terms of mechanical strength, water absorption capacity, electrical conductivity, antimicrobial performance, and polyvinyl alcohol (PVA) attachment efficiency. Morphological and chemical analyses were conducted using SEM and FTIR techniques to investigate pH-induced structural variations. The results revealed that the BC6 sample (pH 6) exhibited the highest tensile strength (2.4 MPa), elongation (13%), PVA incorporation (12%), and electrical conductivity, confirming the positive impact of near-neutral conditions on nanofiber assembly and functional integration. In contrast, the BC4 sample (pH 4) demonstrated strong antimicrobial activity (log reduction = 3.5) against E. coli, suggesting that acidic pH conditions enhance bioactivity. SEM images confirmed the most cohesive and uniform fiber morphology at pH 6, while FTIR spectra indicated the preservation of characteristic cellulose functional groups across all samples. Overall, this study presents a sustainable and efficient strategy for BC production using food waste and demonstrates that synthesis pH is a key parameter in tuning its functional performance. The optimized BC membranes show potential for biomedical, flexible electronic, and antibacterial material applications, particularly in wearable electrode technologies.European Union and European Education and Culture Executive Agency (EACEA); European Union [101140250-ERASMUS-EDU-2023-PI-ALL-INNO]; European Education and Culture Executive Agency (EACEA)This work is partially based on the works of the FOOD CHASE project co-funded by the European Union and European Education and Culture Executive Agency (EACEA) (grant number 101140250-ERASMUS-EDU-2023-PI-ALL-INNO). Views and opinions expressed are, however, those of the authors only and do not necessarily reflect those of the European Union or the European Education and Culture Executive Agency (EACEA). Neither the European Union nor EACEA can be held responsible for them