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Doğu Avrupa ve Orta Asya Ülkelerinde Ulaştırma Yatırımları, Lojistik Performans ve Dış Ticaret İlişkisi: Bir Panel Veri Analizi
No full textKüreselleşen dünyada lojistik altyapı ve ulaştırma yatırımları, ülkelerin dış ticaret performansını doğrudan etkileyen temel unsurlardan biri haline gelmiştir. Ulaştırma altyapısının geliştirilmesi, ticaret maliyetlerini azaltarak ithalat ve ihracat hacmini artırmakta, aynı zamanda ekonomik büyümeye katkı sağlamaktadır. Bu çalışmada, Doğu Avrupa ve Orta Asya ülkelerinde ulaştırma yatırımları ve lojistik performansın dış ticaret üzerindeki etkisi panel veri analizleri kullanılarak incelenmiştir. Çalışma, 2005-2021 dönemi için Azerbaycan, Bulgaristan, Çin, Gürcistan, Yunanistan, Macaristan, İtalya, Romanya ve Türkiye'yi kapsamaktadır. Pedroni eşbütünleşme testleri ile değişkenler arasında uzun dönemli ilişkiler tespit edilmiş ve Driscoll-Kraay standart hataları ile sabit etkiler modeli kullanılarak tahminler yapılmıştır. Bulgular, lojistik performansın ithalat üzerinde güçlü bir etkisi olduğunu, ancak ihracat üzerindeki etkisinin sınırlı kaldığını göstermektedir. Ekonomik büyüklük ise dış ticaretin hem ithalat hem de ihracat tarafında önemli bir belirleyici olarak öne çıkmaktadır. Bu çalışma, ulaştırma yatırımları ve lojistik performansın dış ticaret süreçlerindeki rolünü daha iyi anlamaya yönelik önemli katkılar sunmayı amaçlamaktadır
Longitudinal Evaluation of Listening Effort and Speech Perception in Noise in CROS and BiCROS Hearing Aid Users With Single-Sided Deafness
No full textPurpose: The purpose of this study is to longitudinally investigate the effects of using CROS/BiCROS hearing aids on the listening effort and speech perception in noise skills of individuals with single-sided deafness (SSD). Methods: Nineteen people with SSD who were going to use CROS/BiCROS hearing aids for the first time participated in the study. Participants were evaluated before they started using hearing aids and after 1 week, 3, and 6 months after they started using them. In every session, a dual-task paradigm was applied to measure listening effort, and the Turkish Matrix Test (TM) was applied to measure speech understanding performance in noise. The dual-task paradigm was evaluated at three different individual signal-to-noise ratios (SNR) determined according to the subjects' TM performance. Repeated measures ANOVA tests were used to evaluate whether the participants' dual-task paradigm and TM performances differed according to sessions. Results: A significant difference was observed between both the dual-task paradigm and TM scores according to measurement time (p < 0.001). In pairwise comparisons with Bonferroni corrections, it was observed that there was a significant difference between all periods (p < 0.001). While the dual-task paradigm reaction times obtained in all three difficult listening conditions were highest before using the device, they were lowest at the sixth-month evaluation. Conclusion: This is the first study to longitudinally examine how CROS/BiCROS hearing aid use affects both speech-in-noise ability and listening effort. As a result of this study, it was seen that the use of CROS/BiCROS increased speech understanding performance in noise and reduced listening effort after starting to use them. Furthermore, as the use of the device continued, it was observed that speech performance in noise increased and listening effort decreased over time
Integrated Energy Management and Grid Support Functions for Multi-Type RES and EV Enhanced Microgrid Operations
No full text12th IEEE Conference on Technologies for Sustainability, SusTech 2025 -- -- Los Angeles; CA -- 209521This paper presents a comprehensive energy management model tailored for microgrid optimization, focusing on enhanced integration of Renewable Energy Sources (RESs) into the distribution system. The model encompasses a microgrid hosting RESs, catering to an all-in-one electric vehicle (EV) station which can accommodate plug-in EVs, battery swappable EVs, and fuel cell EVs. Augmented by hydrogen storage, electrolyzers, and flexible loads for demand response applications, the RESs are adept at active and reactive power modulation within the grid. Notably, the study discusses the grid impact of diverse objective functions concerning voltage deviation minimization via reactive power support and active power curtailment (APC), evaluating microgrid profitability within a bi-level framework by considering carbon cost and APC penalty. The paper concludes by establishing an optimal power flow model to test the efficacy of the proposed framework. The study results with a zero APC, a better voltage profile accommodated by a fair microgrid profit even without a direct focus on APC minimization. © 2025 Elsevier B.V., All rights reserved.et al.; Foothill Section; IEEE Oregon Section; IEEE Region 6; Orange County Section; San Fernando Valley Sectio
The effect of 3D printed assistive technology intervention on the older adults' independence in activities of daily living: A single-group intervention study
No full textThere is need for innovative approaches in the production of assistive devices. This study aimed to examine the effects of a Three-Dimensional (3D) Printed Assistive Technology Intervention. Twelve older adults (mean age of 67.83 +/- 2.72 years) participated in the study. Assistive devices were designed using a 3D printer. The participants completed the Canadian Occupational Performance Measure (COPM), the Functional Independence Measure (FIM), and the Lawton-Brody IADL scale. Also they completed the Visual Analog Scale (VAS) to evaluate their satisfaction with the 3D printed assistive device. The participants' mean satisfaction score with the assistive devices was found to be 7.00 +/- 1.12. After the intervention, significant improvements were observed in the COPM performance subscale (p = 0.016), the FIM motor subscale (p = 0.012), the FIM total score (p = 0.018), and the Lawton-Brody IADL Index (p = 0.024). However, no significant changes were detected in the COPM satisfaction subscale (p = 0.094) or the FIM cognitive subscale (p = 0.069). This study suggest that economically feasible and easily accessible 3D printed assistive devices may serve as an effective alternative to enhance the occupational performance and independence of older adults.Research Project Support Program for Undergraduate Students - TUBIdot;TAK (The Scientific and Technological Research Council of Turkiye)This study was conducted with the support of the 2209-A Research Project Support Program for Undergraduate Students, funded by TUB & Idot;TAK (The Scientific and Technological Research Council of Turkiye)
Effect of animated video education designed for children with asthma on asthma management and quality of life: a randomized controlled trial
No full textThis study aimed to determine the effect of a newly developed animated video, Living with Asthma (LIWA) on asthma management, inhaler technique skills, and quality of life in Turkey. The LIWA employs animated characters and voice-over narrations, following established guidelines. This randomized controlled study sample consisted of 78 children (intervention = 39; control = 39) diagnosed with asthma, aged 7-11 years. All participants received basic asthma education from their physicians and were randomly divided into two groups. One group received an animated video education program, while the other group did not receive any additional education. Both groups took two posttests at the end of the first and third months following the intervention. The intervention group demonstrated improved inhaler technique skills at the 1 and 3-month follow-ups (p < .001). Compared to the control group, the intervention group had significantly lower rescue medication usage, fewer asthma attacks, fewer emergency hospital visits, and lower symptom scores at the 3-month follow-up (p < .05). Additionally, the intervention group had higher asthma control scores (p < .01) and higher mean scores for total quality of life and psychosocial health (p < .05) at the 3-month follow-up. This newly developed video positively affected asthma management, inhaler technique skills, and quality of life among children with asthma.Trakya University Scientific Research Projects Unit [TUBAP 2019/25]; Vertigo University Scientific Research Projects Unit [TUBAP 2019/25]; Trakya UEniversitesi [TUBAP 2019/25]This work was supported by the Trakya University Scientific Research Projects Unit [grant numbers TUBAP 2019/25]; Turkey, as part of a doctoral thesis project. Vertigo University Scientific Research Projects Unit [grant numbers TUBAP 2019/25]; Trakya UEniversitesi [TUBAP 2019/25]
Investigation of the inhibitory effect of the fennel (Foeniculum vulgare) on some metabolic enzymes
No full textRezene (Foeniculum vulgare) Maydanozgillere ait keskin kokulu aromatik bir bitkidir. Ülkemizde özellikle Ege Bölgesi'nde arapsaçı (yabani rezene) olarak bilinir ve mevsiminde Ege mutfağında sıkça tüketilir. Sunulan tez çalışmasında vücutta bulunan enzimlerden üçü model olarak seçilerek, rezene yapraklarının bu enzimler üzerindeki olası inhibitör etkisinin in vitro araştırılması amaçlanmıştır. Rezene yaprakları %80'lik etanol ile çalkalayıcılı su banyosunda altı saat boyunca ekstrakte edildi. Elde edilen ham ekstraktın karbonhidrat metabolizmasında görev alan ?-amilaz, lipid metabolizmasında etkili lipaz ve melanin biyosentezinde görevli tirozinaz enzimlerinin katalitik aktivitesi üzerine etkisi araştırıldı. Ekstraktın toplam fenolik madde miktarı Folin-Ciocalteu yöntemi ile ve serbest radikal giderme aktivitesi DPPH metodu ile belirlendi. Rezene yapraklarından Clevenger aparatı kullanılarak hidrodestilasyonla uçucu yağ elde edildi ve yağın uçucu bileşenleri GC-MS yöntemiyle ile analiz edildi. Ayrıca ekstraktın ve uçucu yağın fenolik bileşen içerikleri LC-MS/MS ile belirlendi. Çalışma sonucunda rezene ham ekstraktının yüksek konsantrasyonlarında ?-amilaz ve lipaz enzimlerini inhibe ettiği, ancak tirozinaz enzimini önemli derecede inhibe etmediği gözlendi. Toplam fenolik madde miktarı 52,79±0,84 µg GAE/g, DPPH radikali giderme gücü için EC50=500 µg/mL olarak belirlendi. LC-MS/MS ile yapılan fenolik bileşen analizinde bitki ekstraktında analizlenen bileşiklerden onaltı adedi tanımlanmış olup, en yüksek oranda absisik asit, indol-3 asetik asit, trans-ferulik asit, rutin, protokateşik asit, p-kumarik asit ve jasmonik asit bulunurken, uçucu yağında en fazla rosmarinik asit olmak üzere on adet bileşik tanımlandı. GC-MS ile yapılan uçucu bileşen analizinde trans-anetol baskın olmakla birlikte timol, DL-fenkon ve alfa-felandren bileşikleri tayin edildi. Rezene bitkisi diğer bitkisel kaynaklar gibi fonksiyonel ikincil metabolitlerce zengindir. Bitkinin ham ekstraktının gösterdiği anti-amilaz etkinliği nedeniyle gelecekteki antidiyabetik aktivite çalışmaları için potansiyeli olduğu söylenebilir.Fennel (Foeniculum vul
Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of adults with osteoporotic vertebral compression fractures
No full textBACKGROUND CONTEXT: The North American Spine Society's (NASS) Evidence-Based Clinical Guideline for the Diagnosis and Treatment of Adults with Osteoporotic Vertebral Compression Fractures features evidence-based recommendations for diagnosing and treating adult patients with osteoporotic vertebral compression fractures. The guideline is intended to reflect contemporary treatment concepts for osteoporotic vertebral compression fractures as reflected in the highest quality clinical literature available on this subject as of September 2020. PURPOSE: The purpose of the guideline is to provide an evidence-based educational tool to assist spine specialists when making clinical decisions for adult patients with osteoporotic vertebral compression fractures. This article provides a brief summary of the evidence-based guideline recommendations for diagnosing and treating patients with this condition. STUDY DESIGN: This is a guideline summary review. METHODS: This guideline is the product of NASS' Clinical Practice Guidelines Committee. The methods used to develop this guideline are detailed in the complete guideline and technical report available on the NASS website. In brief, a multidisciplinary work group of spine care specialists convened to identify clinical questions to address in the guideline. The literature search strategy was developed in consultation with a medical librarian. Upon completion of the systematic literature search, evidence relevant to the clinical questions posed in the guideline was reviewed. Work group members utilized NASS evidentiary table templates to summarize study conclusions, identify study strengths and weaknesses, and assign levels of evidence. Work group members participated in recommendation meetings to update and formulate evidence-based recommendations and incorporate expert opinion when necessary. The draft guideline was submitted to an internal and external peer review process and ultimately approved by the NASS Board of Directors. RESULTS: Twenty-nine clinical questions were addressed, and the answers are summarized in this article. The respective recommendations were graded according to the levels of evidence of the supporting literature. CONCLUSIONS: The evidence-based clinical guideline has been created using techniques of evidence-based medicine and best available evidence to aid practitioners in the diagnosis and treatment of adult patients with osteoporotic vertebral compression fractures. The entire guideline document, including the evidentiary tables, literature search parameters, literature attrition flowchart, suggestions for future research, and all of the references, is available electronically on the NASS website at http://www.spine.org/guidelines. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.Department of Veterans Affairs, Veterans Health Administration, Office of Academic Affiliations VA Quality Scholars Advanced Fellowship Program [3Q052019C]All authors have disclosed potential conflicts of interest consistent with NASS' disclosure policy (http:// www.spine. org/DisclosurePolicy) . The Technical Report associated with this document includes the disclosures of all authors. The following approach was applied for sequencing the complete author list: Evidence-Based Guideline Committee Co-Chair and Project Lead, Section Chairs (alphabetically) , Work Group Members and NASS staff (alphabetically) . Additionally, Paul Matz, MD provided project lead support (resigned from project November 1, 2021) . In memoriam: John E. Easa, MD, FIPP served as a section chair and passed away before publication of this document. The fol-lowing individuals contributed to project activities during development: Christina L. Goldstein, MD, FRCSC; Richard J. Meagher, MD; Isaac L. Moss, MD; Adeolu Olasunkanmi, MS, MD; Manuel Sanchez-Lugo, MD; Anil K. Sharma, MD; Erika V. Tapia Flores, MD. Irum Hameeduddin, MPH, MSMOB, Aashka Trivedi, Natalie Neps, PT, DPT, and Kelly Campbell, MS provided additional staff support. Tyler Verity, AAOS Medical Research Librarian, con-ducted the literature search. The work of Andrea Strayer, PhD, ARNP, CNRN was supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Academic Affiliations VA Quality Scholars Advanced Fellowship Program. The views expressed in this article are those of the authors and do not necessarily reflect the posi-tion or policy of the Department of Veterans Affairs or the United States government. Program Award Number 3Q052019C
Evaluation of the success of high flow nasal oxygen therapy in type 1 respiratory failure using ROX index, alveolar-arterial oxygen gradient and HACOR score
No full textÇalışmada hipoksemik solunum yetmezliği nedeniyle yüksek akımlı nazal oksijen tedavisi gören hastalarda, 0. ve 12. saatteki ROX indeksi, HACOR skoru ve alveoloarteryal oksijen gradiyentinin erken dönemde tedavi başarısını öngörme yeteneği ve bu skorlardaki dinamik değişimlerin tedavi başarısıyla ilişkisi incelenmiştir. Mart 2023-Ocak 2025 tarihleri arasında yüksek akımlı nazal oksijen tedavisi uygulanan 75 hastayla prospektif, gözlemsel bir çalışma yapıldı. Hastaların demografik bilgileri, özgeçmişleri, başvuru anındaki klinik ve laboratuvar verileri kaydedilerek 0. ve 12. saatlerde ROX indeksi, HACOR skoru ve alveoloarteryal oksijen gradiyenti hesaplandı. İlk 48 saatteki başarı durumları; yoğun bakım ve hastane yatış süreleri; yoğun bakım, hastane ve 28 günlük mortaliteleri kaydedildi. Çalışmada erken dönemde 57 hastada tedavi başarılıyken, 18 hastada başarısızlıkla sonuçlanmıştır. Tedavi başarısızlığını öngörmede en güçlü belirtecin 12. saatteki HACOR skoru olduğu saptandı (p=0,002; eğri altındaki alan:0,768). HACOR skoru için kesim değeri ?5 alındığında duyarlılık %61,5; özgüllük %82,5 olarak bulundu. Hesaplanan HACOR skor değişimi (?HACOR=0.saat-12.saat) değerlendirildiğinde, başarılı grup ve başarısız grupta anlamlı fark izlendi (3[1,5-5,0] vs. 1[-3-3]; p=0,02). 0 ve 12. Saatlerde hesaplanan ROX indekslerinde gruplar arası anlamlı fark saptanmamakla birlikte; alt grup analizinde başarılı grupta tedavi başlangıcına göre 12.saatte ROX indeksi anlamlı artış gösterdi (4,89[4,22-5,98]) vs. 9,56[7,88-11,61]; Z:-6,5, p<0.001) Başarısız grupta da anlamlı artış izlendi (4,88[3,43-6,12] vs. 8,65[5,27-10,8]; Z:-3.10 p<0,001). Hesaplanan ROX indeksi değişimi (?ROX=0.saat-12.saat) değerlendirildiğinde, başarılı ve başarısız gruplar arasında anlamlı fark saptandı (-4,48[-8,8- -2,90] vs. -2,78[-5,9 - -0,62]; p=0,04). Dinamik olarak izlenen ROX ve özellikle HACOR skorlarının yüksek akımlı nazal oksijen tedavisi başarısını öngörme gücü yüksek olup skorların takipteki değişimlerine de odaklanılması klinik karar alma süreçlerini iyileştirebilir. Anahtar kelimeler: hipoksemik solunum yetmezliği, yüksek akımlı nazal kanül, rox indeksi, hacor skoruIn this study, the ability of th
Analyse isolierter Patellafrakturen: Beeinflusst es das Gehen?
No full textIntroduction The patella is an important part of the extensor mechanism of the knee. Due to its subcutaneous location, it can be easily exposed to trauma. In this study, we aimed to clarify the effect of patella fractures on walking by examining the results of gait analysis of patients with patella fractures. Methods Patients who were treated due to a patella fracture in the last 10 years were selected from the hospital archive. A total of 18 patients and 36 healthy control subjects were included. Clinical, radiological, and functional results were collected for the fracture group retrospectively, and gait analysis was performed for all patients and control subjects. Results were evaluated statistically. Results The mean follow-up time for the fracture group was 64.9 +/- 47.02 months. Foot rotation ( p = 0.026), step width (SW; p < 0.001), lateral symmetry (LSIM; p < 0.001,) and anterior-posterior variability ( p = 0.012) were found to be statistically increased on the injured sides of the fracture group compared to the control group. Conclusion In this study, it was found that patellar fractures resulted in increased foot rotation, and it was thought that this result might be related to the compensatory mechanism of knee joint arthrosis to reduce the knee adduction moment and the lateral-medial shear force. Multivariate analyses showed that LSIM and FR were associated with patella fracture. A multicenter study with a greater number of patients is needed for more accurate results
Effectiveness of Maternal Voice and Lullabies on Pain and Physiological Parameters in Preterm Infants During Aspiration: A Randomized Controlled Study
No full textBACKGROUND: Painful procedures like oropharyngeal aspiration often disrupt preterm infants' physiological stability in neonatal intensive care units (NICUs). Although maternal voice and lullabies are safe non-pharmacological options for pain relief, their effectiveness remains uncertain. PURPOSE: This study examined the effects of maternal voice and lullabies on pain and physiological parameters in preterm infants during oropharyngeal aspiration procedures in the NICU. METHODS: This randomized controlled trial included 66 preterm infants (28-36 weeks gestation) randomly assigned to maternal voice (n = 22), lullaby (n = 22), or control (n = 22) groups. Intervention groups received a recording of maternal voice or lullaby for 15 minutes before, during, and 15 minutes after aspiration. The control group received no auditory stimulation. Pain was assessed using the Neonatal Infant Pain Scale, and heart rate, oxygen saturation, and respiration were recorded at 3 time points. Data analysis included chi-square and Kruskal-Wallis tests with Bonferroni-adjusted Mann-Whitney U tests for post-hoc comparisons ( P < .05). RESULTS: The maternal voice group exhibited significantly lower pain levels during and after the procedure than other groups ( P < .001). Both intervention groups showed improved physiological parameters ( P < .05), with maternal voice showing the most effective outcomes ( P < .05). IMPLICATIONS FOR PRACTICE AND RESEARCH: Maternal voice and lullabies may effectively reduce pain and enhance physiological stability in preterm infants during aspiration. Integrating maternal voice into NICU care may enhance pain management and physiological stability in preterm infants. Future research should explore long-term effects, the role of maternal voice characteristics, and the impact of ambient NICU noise levels on intervention effectiveness. This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicin