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Surgical Outcomes Of Insertional Achilles Tendinopathy: A Comparison Of Techniques With And Without FHL Augmentation
No full textADÖLESAN HASTADA MANDİBULADA GÖRÜLEN OSTEOSARKOM: BİR OLGU SUNUMU
No full textAmaç: Osteosarkom en sık uzun kemiklerin metafizyal büyüme plaklarını etkileyen malign bir tümördür. Osteosarkomun çenelerde görülmesi ise oldukça nadirdir ve tüm osteosarkom vakalarının %6-7’sini oluşturur. Çene osteosarkomlarının en sık görülen semptomları ağrı, şişlik ve parestezidir. Osteosarkom, radyolojik olarak hem kemik yıkımı hem de yeni kemik oluşumu içeren karışık radyolüsent-radyopak bir görünüm sergileyebilir. Bu olgu sunumunun amacı, 16 yaşındaki kadın hastanın sol mandibular ramus ve kondil bölgesinde teşhis edilen osteosarkom vakasının klinik ve radyolojik bulgularını sunmaktır. Olgu Sunumu: 16 yaşındaki kadın hasta, yüzünün sol tarafında hızla büyüyen şişlik, ağız açmada zorlanma ve ağrı şikayetiyle kliniğe başvurdu. Ekstraoral muayenesinde sol temporomandibular eklem bölgesinde ağrılı, sert bir şişlik tespit edildi. Sol submabdibular lenf nodları sert ve fikse olarak palpe edildi. Ağız açıklığında kısıtlılık nedeniyle intraoral muayenesi yapılamadı. Panoramik radyografi görüntüsünde herhangi bir patolojiye rastlanmadı. Lezyonun lokalizasyon ve boyutunun detaylı değerlendirilmesi amacıyla konik ışınlı bilgisayarlı tomografi (KIBT) çekildi. KIBT görüntülerinde mandibulada sol angulustan sol kondil başına kadar uzanan bölgede yer yer destrüktif alanlar ve güneş ışığı tarzında periost reaksiyonu izlendi. Hasta malignite şüphesi ile kulak burun boğaz anabilim dalına konsülte edildi. Lezyon sınırlarının net olarak belirlenebilmesi için hastaya bilgisayarlı tomografi, manyetik rezonans görüntüleme ve pozitron emisyon tomografisi tetkikleri yapıldı. Sol retromolar bölgeden insizyonel biyopsi alındı. Histopatolojik inceleme sonrasında osteosarkom tanısı konuldu. Hastaya kemoterapiye başlandı ve tedavisi devam etmektedir. Sonuç: Çene osteosarkomlarının tanısı ve tedavisi zordur ve multidisipliner yaklaşım gereklidir. Erken teşhis ve geniş çaplı cerrahi müdahaleye ek olarak uygulanan kemoterapi, metastaz riskini azaltmak ve sağ kalımı artırmak için önemlidir. Anahtar Kelimeler: Osteosarkom, mandibula, konik ışınlı bilgisayarlı tomografi Objective: Osteosarcoma is a malignant tumor that primarily affects the metaphyseal growth plates of long bones. However, its occurrence in the jaws is rare, accounting for only 6–7% of all osteosarcoma cases. The most common clinical symptoms of jaw osteosarcomas include pain, swelling, and paresthesia. Radiographically, osteosarcomas exhibit a mixed radiolucentradiopaque pattern, characterized by both bone destruction and new bone formation. This case report presents the clinical and radiological findings of osteosarcoma diagnosed in the left mandibular ramus and condyle of a 16-year-old female patient. Case Report: A 16-year-old female presented with a rapidly growing swelling on the left side of her face, accompanied by pain and difficulty opening her mouth. Extraoral examination revealed a firm, painful swelling in the left temporomandibular joint region and fixed left submandibular lymph nodes. Due to limited mouth opening, an intraoral exam could not be conducted. A panoramic radiograph showed no apparent pathology. Cone-beam computed tomography was performed for detailed evaluation, revealing destructive lesions extending from the left mandibular angulus to the condylar head, with a sunburst periosteal reaction. The patient was referred to otorhinolaryngology, where further imaging was performed, including computed tomography, magnetic resonance imaging, and positron emission tomography. An incisional biopsy from the left retromolar region confirmed osteosarcoma. The patient has begun chemotherapy, and treatment is ongoing. Conclusion: Jaw osteosarcomas require a multidisciplinary approach due to their complex diagnosis and treatment. Early detection, wide surgical resection, and adjunctive chemotherapy are crucial to reducing metastasis risk and improving survival outcomes. Keywords: Osteosarcoma, mandible, cone-beam computed tomography </p
Promoting teacher reflective practice in Turkish schools: the roles of teacher self-efficacy, cognitive flexibility and trust
No full textThis study investigates the relationships of teacher self-efficacy and teacher cognitive flexibility with teacher reflective practice and explores whether teacher trust moderates these relationships. Survey data were collected from 532 teachers working in Turkish schools and analysed using confirmatory factor analysis and structural equation modelling. Grounded in the Job Demands-Resources (JD-R) theory, this study extends the framework beyond its traditional focus on workplace stress and burnout to examine teacher learning and reflective practice. The findings supported the proposed model, indicating that teacher self-efficacy and cognitive flexibility are both positively and directly associated with teacher reflective practice. The results also revealed that teacher trust moderates the relationships of teacher self-efficacy and cognitive flexibility with teacher reflective practice. The authors conclude with implications for policy and practice, such as integrating structured peer collaboration time into teachers’ schedules to strengthen trust and create opportunities for reflective dialogue
Routes to optimum conditions of plant based microbial fuel cells by reinforcement learning
No full textPlant-based microbial fuel cells (PMFC) are fascinating technologies that have the potential to combine plants and bacteria to produce electricity from different solid and aqueous media like constructed wetlands and wastewater treatment facilities. Although PMFCs are evolving and demonstrating promising performance results for the development of sustainable energy and water treatment, they have not reached their full potential due to issues with continuous bioenergy generation and fuel cell system optimization through plant selection, operating conditions, electrodes, and light source, all of which are critical for optimum microbial activity on the roots and exudate rhizodeposition. In light of this, the Q learning algorithm was used in this study to determine the routes that lead to the best operating and material conditions for PMFCs. A database of 231 observations from 51 recent publications with 271 descriptors (input variables) and 3 output variables (under 9 categories were used to determine the routes leading to high maximum power density, medium open circuit potential and current density. It was seen that high maximum power density routes are achievable through the nodes of stainless-steel mesh cathode with metal-based chitosan smart catalysts, bicarbonate wastewater, and anaerobic wetland sediment. Data visualizations by radar charts also exhibited similar results for cathode material and wastewater type. For medium open circuit potential, Iris pseudacorus and for medium maximum current density anaerobic sludge inoculation and steel wire mesh/nickel current collectors are found to be important indicators
DİRENÇLİ EPİLEPSİDE VNS TEDAVİSİNİN ETKİNLİĞİ: GAZİ ÜNİVERSİTESİ TIP FAKÜLTESİ NÖROLOJİ DENEYİMİ
No full textKültürel Dirençlilik Bağlamında Bibliyometik Analiz
No full textKentlerin kültürel birikimleri zaman içerisinde gelişim göstermektedir ve bu birikim birden fazla değişkenle şekillenmektedir. Bireylerin mekâna ve zamana göre uyum sağlaması ve yer edinmesi bu bağlamda büyük önem arz etmektedir. Mekanla uyumunun gücü mekâna dair aidiyetini de belli etmektedir ve direncinin gücünü de betimlemektedir. Kültürel bilgi ve pratikler, değişen koşullara adaptasyon için kritik öneme sahiptir ve kültürel dirençliliğin önemli bir parçasıdır. Kültürel dirençlilik, toplulukların ve kültürel sistemlerin değişen çevresel, sosyal ve ekonomik koşullara karşı dayanıklılığını ve adaptasyon yeteneklerini ifade eden bir kavram olarak kullanılmaktadır. Bu kavram, kültürel kimliğin, normların, değerlerin ve uygulamaların sürdürülebilirliğini ve devamlılığını sağlamaktadır. Bu çalışma, kültürel dirençliliğin özellikle afet sonrası toplumsal yapılar üzerindeki etkilerini ve bu kavramın literatürde nasıl ele alındığını incelemeyi amaçlamaktadır. Çalışmanın yöntemi, literatürdeki eğilimleri, kavramsal farklılıkları ve boşlukları belirlemek amacıyla bibliyometrik analiz yaklaşımına dayanmaktadır. Literatür taramasının ardından, "cultural resilience" anahtar kelimesiyle Web of Science veri tabanından elde edilen veriler VOSviewer kullanılarak görselleştirilmiştir. Bulgular, kültürel dirençliliğin, afet sonrası toplumsal iyileşme süreçlerinde kültürel mirasın korunması, sosyal dayanışma ağlarının güçlendirilmesi ve ekonomik sürdürülebilirlik açısından kritik bir rol oynadığını göstermektedir. Sonuç olarak, çalışma, kültürel dirençliliğin sürdürülebilir ve dayanıklı topluluklar oluşturmadaki önemini vurgulayarak, gelecekteki araştırmalar ve stratejiler için bir çerçeve sunmaktadırThe cultural accumulation of cities develops over time and this accumulation is shaped by more than one variable. In this context, it has great importance for individuals to adapt and find a place according to space and time. The strength of their adaptation to space also reveals their sense of belonging to the space and describes the strength of their resistance. Cultural knowledge and practices are of critical importance for adaptation to changing conditions and are an important part of cultural resilience. Cultural resilience is used as a concept that expresses the resilience and adaptation abilities of communities and cultural systems against changing environmental, social and economic conditions. This concept ensures the sustainability and continuity of cultural identity, norms, values and practices. This study aims to examine the effects of cultural resilience especially on post-disaster social structures and how this concept is addressed in the literature. The method of the study is based on the bibliometric analysis approach in order to determine trends, conceptual differences and gaps in the literature. After the literature review, the data obtained from the Web of Science database with the keyword "cultural resilience" were visualized using VOSviewer. The findings show that cultural resilience plays a critical role in post-disaster community recovery processes in terms of preserving cultural heritage, strengthening social networks, and economic sustainability. In conclusion, the study provides a framework for future research and strategies by highlighting the importance of cultural resilience in building sustainable and resilient communities.</p
Colorless distributed combustion effects on hydrogen-enriched methane fuels combustion in a laboratory-scale combustor
No full textThis research explores the burning of methane fuel enriched with hydrogen in a distributed mode within a laboratory-scale combustor. The objective is to improve the combustion efficiency of these fuels by incorporating hydrogen enrichment. However, it is evident that hydrogen enrichment increases flame temperature. Therefore, the application of colorless distributed combustion (CDC), an advanced combustion technique that controls flame temperature by slowing down reaction rates, is proposed to achieve ultralow emissions and a uniform temperature with an expanded combustion flame. To achieve this goal, a Computational Fluid Dynamics (CFD) code was employed to model hydrogen-enriched methane fuels. The findings suggest that the introduction of hydrogen enrichment raises flame combustion temperatures from around 1625 K to 1654 K when up to 20 % H2 is present in the fuel. This temperature elevation correlates with a rise in the anticipated levels of NOX within the combustion chamber. As the oxygen percentage decreases, the flame expands, and flame temperatures, for instance, for fuel containing 20% H2, decrease from around 1654 K to 1359 K at 15% O2. Consequently, NOX levels in the combustion chamber drop from approximately 565 ppm to values below 0,98 ppm. The distributed regime demonstrates the capability to mitigate the increases in temperature and emission levels associated with hydrogen, thereby suggesting that hydrogen-enriched gas turbines could operate within broader flammability limits