İstanbul Sağlık ve Teknoloji Üniversitesi Kurumsal Akademik Arşivi
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Ofloksasin, cerrahi olmayan periodontal tedaviyle beraber kullanılan amoksisilin metronidazolün alternatifi olabilir mi?
No full textObjective: The best antibiotic approach for generalized periodontitis remains under debate. Therefore, in this study, the systemic administration of ofloxacin was compared against amoxi cillin–metronidazole in terms of clinical periodontal parameters. Materials and Methods: A prospective, experimental, double-blind, active-controlled, randomized, parallel-grouped, and single-centered clinical trial was carried out at a university hospital in Istanbul, Turkey, between April 2017 and August 2019. Seventy-four patients with generalized periodontitis were randomized into 2 study groups (ofloxacin and amoxicillin–metronidazole groups). Clinical periodontal parameters were recorded at baseline and at 1-, 3-, and 6-month follow-ups following phase 1 periodontal therapy. Changes in clinical periodontal parameters from baseline to 6 months were evaluated and compared between groups. Results: Thirty-eight patients were lost to follow-up and excluded from the analysis. Thirty-six patients completed the study (ofloxacin group, n=18; amoxicillin–metronidazole group, n=18). The clinical periodontal parameters were significantly reduced in both groups at all time points compared to baseline (P .05). Bleeding on probing at 1 month as well as probing depth and clinical attachment loss at 6 months were significantly lower in the amoxicillin–met ronidazole group compared to the ofloxacin group (P 0.05). Ofloksasin grubuyla karşılaştırıldığında amoksisilin-metronidazol grubunda birinci ayda sondalamada kanama, altıncı ayda sondalama derinliği ve klinik ataşman kaybı anlamlı olarak daha düşüktü (p < 0.05). Herhangi bir yan etki bildirilmemiştir. Sonuç: Cerrahi olmayan periodontal tedaviye ek olarak kullanılan sistemik ofloksasin uygulaması, ilk üç ayda önemli klinik iyileşme gösterirken, altıncı ayda amoksisilin-metronidazol kadar etkili değildi
Development and initial validation of an innovative virtual reality simulation in teaching fetal development of midwifery students: Qualitative analysis
No full textObjective: The aim of this pilot study is to teach midwifery students fetal development with the Fetal Development Application created by virtual reality (VR) technology, an innovative application, and to acquire their reflections on their experiences. Methods: A descriptive qualitative research design was used. The VR application was created by visualizing the fetal development, umbilical cord and placenta localization week by week and transferring them to the virtual environment. Forty-two midwifery students who experienced the practice were included in the study. Students who had previously taken fetal development in the normal pregnancy course were shown the application with VR glasses in the laboratory environment. Data were collected through face-to-face interviews with a semi-structured interview form and a Presence Questionnaire developed by the researchers. They evaluated students’ perceptions of the practice’s strengths and weaknesses and whether the game would be useful as a learning too. Results: The thematic analysis resulted in the following components of the practice experience: interaction, motivation, knowledge, and realism. Students reported that it is effective for understanding fetal development and can be used in lessons. These results highlighted students’ acceptance of technology as a teaching and learning resource and showed potential for future developments. Conclusion: In line with these results, it was seen that the effect of the application was permanent. It has been seen that the VR method has a good practice effect in teaching fetal development and midwifery practice. More research is needed to assess whether students’ learning and retention of knowledge are improved using this new technology
Gastrik band revizyonları
No full textİlk başlarda takılması basit ve sıfıra yakın komplikasyon oranları ile kolay öğrenilebilir bir teknik olması nedeniyle çok iyimser bir yaklaşımla tüm dünyada hızla yaygınlaşmıştır. LAGB kullanıma girdikten sonra birçok merkezde cerrahi teknik olarak yerleştirme kolaylığı, geri dönüşümlü olması, nispeten düşük morbidite profili ve kalıcı kilo kaybı sağlayabilme umudu ile bir anda en çok uygulanan obezite cerrahisi yöntemi olmuştur. Ancak zaman içerisinde beklenmedik bir şekilde kayma, prolapsus, erozyon, mide içine göç gibi komplikasyon oranlarının yüksek olması ve istenilen kilo kaybı hedefine ulaşamama veya tekrar kaybedilen kilonun geri alınması ile sonuçta %20-30 hastada revizyonel cerrahi ve/veya başka tekniğe konversiyon cerrahisi gerekmesi, yöntemin popülerliğini yitirmesine neden olmuştur. Revizyon cerrahisinde seçilecek teknik konusunda fikir birliği olmayıp bandın çıkarılması ve takip, yeniden band yerleştirme, Revizyonel-SleeveGastrektomi, Revizyonel-LaparoskopikRoux n Y Bypass, Revizyonel One Anastomosis Gastric Bypass (Mini Gastric Bypass) gibi geniş bir yelpazede ele alınmalı, hastaya özel olarak hastayla birlikte komplikasyonun tipine ve midede meydana gelen hasar şiddetine göre karar verilmelidir.Initially, it rapidly spread worldwide with an optimistic approach due to its ease of application and low complication rates. LAGB became the most commonly performed obesity surgery method, thanks to its surgical ease, reversibility, relatively low morbidity profile, and potential for sustained weight loss. However, over time, high rates of complications such as slippage, prolapse, erosion, and migration into the stomach, as well as the inability to achieve desired weight loss or regaining lost weight in 20-30% of patients, led to a decline in its popularity, necessitating revisional surgery and/or conversion to other techniques. The choice of technique for revision surgery varies, and options include band removal and follow-up, re-placement of the band, Revisional-Sleeve Gastrectomy, Revisional-Laparoscopic Roux-en-Y Bypass, and Revisional One Anastomosis Gastric Bypass (Mini Gastric Bypass), which should be decided individually based on the type of complication and severity of damage to the stomach
Переоценка парадокса Тодаро: расширенный панельный анализ данных по развивающимся странам
No full textThis paper empirically analyzes the Todaro Paradox for eight developing countries for the period from 1992 to 2019. Having different data characteristics, we apply three different panel approaches (Fixed Effect, Random Effect, and Full Modified Ordinary Least Square) by using distinct models. Our findings from different models depict that the Todaro Paradox is valid for the sample economies. Specifically, we observe a negative relationship between the price level ratio of purchasing power parity conversion factor (GDP) to market exchange rate and urban population contrary to the price level ratio of the purchasing power parity conversion factor (GDP) to the market exchange rate – rural population nexus. Thanks to obtaining these links, we apply the third empirical model to verify the Todaro Paradox. The analysis of the price level ratio of the purchasing power parity conversion factor (GDP) to the market exchange rate and total unemployment in the urban population provides strong evidence for the validity of this paradox. Deviated from the previous literature, this paper applies the price level ratio of the purchasing power parity conversion factor (GDP) to the market exchange rate since the higher the purchasing power parity of a country, the lower the rate of rural-urban migration is expected. By using one extra variable (unemployment), we test the Todaro Paradox. This combination of variables as well as different panel techniques (Fixed Effect, Random Effect, and Full Modified Ordinary Least Square) allow us to draw more robust conclusions. To address the challenges posed by rural-urban migration, policies should be designed to promote sustainable development in both urban and rural areas. This can include measures to create employment opportunities and improve the quality of life in both areas, as well as policies to regulate migration and manage the pressures caused by rapid urbanization.Аннотация. В работе проводится эмпирический анализ парадокса Тодаро для восьми развиваю щихся стран за период с 1992 по 2019 год. С учетом различных характеристик данных приме няется три панельных подхода (фиксированный эффект, случайный эффект и полностью моди фицированный обычный метод наименьших квадратов). Результаты, полученные с помощью различных моделей, показывают, что парадокс Тодаро справедлив для экономик выборки. В частности, наблюдается отрицательная взаимосвязь между «соотношением уровня цен по ко эффициенту пересчета по ППС (ВВП) к уровню цен по рыночному обменному курсу» и числен ностью городского населения, в отличие от взаимосвязи «соотношения уровня цен по коэффи циенту пересчета по ППС (ВВП) к уровню цен по рыночному обменному курсу» и численностью сельского населения. Благодаря получению этих взаимосвязей мы применяем третью эмпири ческую модель для проверки парадокса Тодаро. Анализ соотношения уровня цен коэффициен та пересчета паритета покупательной способности к рыночному обменному курсу и показателя общей безработицы среди городского населения дает убедительные доказательства справедли вости этого парадокса. В отличие от предыдущих исследований в данной работе используется соотношение уровня цен по паритету покупательной способности и рыночного обменного кур са, так как чем выше паритет покупательной способности страны, тем ниже ожидаемый уровень миграции из села в город. Используя одну дополнительную переменную (безработица), можно проверить парадокс Тодаро. Такое сочетание переменных, а также применение различных па нельных методов (фиксированный эффект, случайный эффект и полностью модифицирован ный обычный метод наименьших квадратов) позволяют сделать более достоверные выводы. Для решения проблем, связанных с миграцией из села в город, необходимо разрабатывать стратегии, способствующие устойчивому развитию как городских, так и сельских районов. Например, они могут включать меры по созданию возможностей для трудоустройства и повышению качества жизни населения, регулированию миграции и контролю ситуации, связанной с быстрой урба низацией
Outcomes of random-start letrozole protocol with PGT-A in women with breast cancer undergoing fertility preservation
No full textPURPOSE : To compare the cycle characteristics and outcomes of random-start-controlled ovarian stimulation (RSCOS) protocols to the outcomes of standard-start-controlled ovarian stimulation (SSCOS) cycles and to report the utility of PGT-A in these cycles. Methods: One hundred and seventeen who underwent SSCOS and 39 who underwent RSCOS for oocyte and/or embryo cryopreservation before breast cancer chemotherapy were retrospectively evaluated. Mean number of embryos and blastocyst euploidy rates were the main outcome measures. Results: A majority of RSCOS cycles were initiated in the luteal phase (66.6% luteal vs. 33.3% follicular). While the total dose of gonadotropins was significantly higher in the RSCOS (3720.8 ± 1230.0 vs. 2345.1 ± 803.6 IU; P < 0.001), the mean number of mature oocytes and embryos was similar to SSCOS. However, there was a trend for a higher number of mean embryos with luteal start RSCOS (6.9 ± 2.7 in late follicular start vs. 9.4 ± 4.2 in luteal start, P = 0.08). PGT-A was performed in 48% of the cases that underwent embryo cryopreservation in RSCOS (12 women, mean age = 35.3 ± 4.1; 87 blastocysts), revealing a euploidy rate of 36.2 ± 22.3% per patient. This rate was comparable to a 45% aneuploidy rate from similarly aged published data. Of the 7 RSCOS patients who returned for frozen embryo transfer, 5 delivered and one has an ongoing pregnancy, while in SSCOS, 18 out of 40 cycles resulted in live birth. Conclusion: Our data suggests that RSCOS fertility preservation cycle outcomes are similar to those with SSCOS and result in age-appropriate euploidy rates.United States Department of Health & Human Services National Institutes of Health (NIH) - USA
NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) RO1 HD05311
Menopozda ilaç dışı (Non-Farmakolojik yaklaşımlar)
No full textMenopozda kadın sıcak basmaları, uyku sorunları, cinsel işlev bozukluğu gibi vazomotor, fizyolojik ve psikososyal pek çok sıkıntı yaşayabilir. Menopozal dönemde semptomların giderilmesinde kadınlar hormon tedavisine yönelik bildiği yanlış bilgiler ve mitler nedeniyle sıklıkla non-farmakolojik yöntemlere yönelmektedirler. Menopozda ilaç dışı (non-farmakolojik) yaklaşımlar dünya çapında binlerce yıldır kullanılmaktadır. Menopoz semptomlar: için kadınlar tarafından sıklıkla tercih edilen ilaç dışı yöntemlerin riskleri ve yararları konusunda sağlık çalışanlarının bilgisinin olması kadınlara rehberlik etmek açısından önemlidir
Use of AI and IoT in the context of healtcare and space design
No full textEndüstri 4.0 ile bilişim alanındaki güncel buluşlar, sağlık endüstrisinde de veri paylaşma özelliği sağlayan cihazlann, sensörlerin, giyilebilir teknolojilerin ve hasta odalarındaki Medikal cihazlann gelişimine katkı sağlayarak; hastalıklarla mücadelede ve acil müdahalede daha hızlı ve verimli bir hizmet sunabilmeyi sağlamaktadır. Medikal nesnelerin interneti (IoMT) teknolojisi ve yapay zeka (Al), günümüzde sağlık alanında hızlı ve etkin bir çözüm üretmede önemli bir rol oynamaktadır. Dijital hastane teknolojileri ile sağlıkta verimlilik, kalite artışına yönelik yapılan projelerde, nesnelerin interneti (IoMT) ve AI, gibi analitik veri temelli sistemler, verilerin toplanması, işlenmesi ve depolanmasını mümkün kılmaktadır. İlaveten, mekan tasanmında Al ile en iyi tasanm altematifinin seçimine yönelik; analiz, öneri ve çözüm yöntemleri üretebi !inek, tasanm ve uygulama alanında hata payını azaltmaktadır. Bu anlamda, IoMT ile mekan tasarımının birbiri ile uyumlu çalışabilmesini için, tasanm gereksinimlerini tanımlayabilmek, tasarımcı ve mimarlar için önem arz etmektedir. Özetle bu çalışma, sağlık hizmeti ve mekan tasanmı bağlamında, yapay zeka (Al) ve nesnelerin interneti (loT) kavramlannı; sağlık ve tasarım odaklı bakış ile yeniden değerlendirmeyi amaçlamaktadır.In the field of healthcare, the advancements in the digital and communication technologies brought by Industry 4.0, such as the development of data-sharing devices, sensors, wearable technologies, and medical equipment in patient rooms, contribute to providing faster and more efficient services in disease management and emergency response. The Internet of Medical Things (IoMT) technology and Artificial Intelligence (AI) play a crucial role in delivering rapid and effective solutions in healthcare. Digital hospital technologies, aimed at increasing efficiency and quality, allow for the collection, processing, and storage of data through analytical data-based systems such as loT and Al. In addition, AI may help in selecting the best design alternatives in facility design through analyzing, recommending, and solving the design methods, reducing the mistake margin in the design and implementation phase. Therefore, defining the design requirements to ensure the compatibility of facility design by IoT, which means It is beneficial for architects and designers. In summary, this study aims to re-evaluate the concepts of Artificial Intelligence (AI) and Internet of Things (IoT) in the context of healthcare services and space design, with a focus on health and design
Gender dysphoria in childhood and adolescence: Current approaches and ethical issues
No full textCinsiyet disforisi, bir bireyin cinsiyet kimliği ile doğumda kendisine atanan cinsiyet arasındaki tutarsızlıktan kaynaklanan önemli bir rahatsızlığı ifade eder. Çocukluk ve ergenlik çağı cinsiyet disforisi, bu durumu yaşayan gençlerin ihtiyaçlarına nasıl yanıt vermemiz gerektiğine dair önemli etik soruları gündeme getiren karmaşık ve zorlu bir konudur. Şu anda tıp uzmanları arasında cinsiyet disforik çocukları ve ergenleri tedavi etmek için en uygun yaklaşım konusunda bir fikir birliği yoktur. Cinsiyet disforisine yönelik daha önceki yaklaşımlar, cinsiyet ifadesindeki farklılıkları psikososyal nedenlere atfetme eğilimindeyken, son araştırmalar, cinsiyet disforisinin gelişimsel seyrinin, biyolojik faktörlerle etkileşime giren çok sayıda psikososyal faktörden etkilendiğini savunmaktadır. Bu şekilde, bazı profesyoneller ve Hollanda modeli, cinsiyetin onaylanmasını teşvik etmek ve psikolojik sıkıntı riskini azaltmak için erken müdahaleyi savunurken, diğerleri tıbbi müdahale yerine cinsiyet kimliğinin keşfedilmesine öncelik veren daha temkinli bir yaklaşım önermektedir. Güncel tedavi önerileri ve Hollanda modeli, cinsiyet disforisi ile ilgili etik sorunlara çözümler üretemediği gibi çocuğun üstün yararı, yararlı olma ve zarar vermeme ilkeleri ile çelişen yeni problemler ortaya çıkarmaktadır. Bu makalede, cinsiyet disforik çocuk ve ergenlerin tedavisini çevreleyen klinik ve etik hususları eleştirel bir şekilde inceleyeceğiz ve farklı yaklaşımların potansiyel risklerini ve faydalarını tartışacağız.Gender dysphoria refers to a significant discomfort that results from a discrepancy between an individual’s gender identity and the gender assigned to them at birth. Gender dysphoria in childhood and adolescence is a complex and challenging issue, which raises important ethical questions about how we should respond to the needs of young people experiencing this condition. There is currently no consensus among medical professionals on the optimal approach for treating gender dysphoric children and adolescents. While earlier approaches to gender dysphoria tended to attribute differences in gender expression to psychosocial causes, recent studies suggest that the developmental course of gender dysphoria is influenced by multiple psychosocial factors that interact with biological factors. In this way, some professionals and the Dutch model advocate for early intervention to promote gender affirmation and reduce the risk of psychological distress, while others recommend a more cautious approach that prioritizes the discovery of gender identity over medical intervention. However, both current treatment recommendations and the Dutch model raise ethical concerns related to gender dysphoria, as they may conflict with the principles of the best interest of the child, being beneficial and not causing harm. In this article, we will critically examine the clinical and ethical considerations surrounding the treatment of gender dysphoric children and adolescents, and discuss the potential risks and benefits of different approaches
A user and item-based, wide and deep learning based travel recommendation system
No full textTeknolojinin gelişmesi ile birlikte artan dijital bilgi miktarı ve internetin yaygınlaşması ile internet üzerinden ürün, hizmet, abonelik gibi ticaret işlemlerinin gerçekleştiği web sitelerinin sayısının da artması, beraberinde, müşterilere kişiselleştirilmiş ve doğru; ürün, hizmet ve abonelikleri sunmanın (önermenin) de önemini artmıştır. Müşterilere önerilerde yaygın olarak kullanılan ürün bazlı, kullanıcı tabanlı ve bu ikisinin birlikte kullanıldığı hibrit geleneksel yaklaşımlar çoğu çalışmada kullanılmaktadır. Geleneksel yaklaşımların, büyük ve seyrek veriler ile çalışma, kullanıcı ve ürün arasındaki karışık ilişkileri bulamama ve soğuk başlangıç (cold start) gibi problemlerinin üstesinden gelmek, derin ve geniş öğrenme sistemlerinin kullanımı ile mümkün olmuştur. Bu çalışma kapsamında, öncelikle derin ve geniş sinir ağlarına ve bunların seyahat öneri sistemlerindeki uygulamalarına kapsamlı bir bakış açısı sunulmuş ve en popüler öneri algoritmaları olan Google'ın Geniş ve Derin Algoritması ve Facebook'un Deep Learning Recommendation Model (DLRM) algoritmasına yer verilmiştir. Ardından, geniş ve derin öğrenme yaklaşımı ile kullanıcı ve ürün özelliklerinin kategorik olanlarının gömme işlemi uygulanarak, nümerik veriler ile modele beslendiği yeni bir seyahat öneri sistemi oluşturulmuştur. Önerilen yöntem gerçek bir seyahat acentesi şirketinin veri seti üzerinde uygulanmıştır. Sonuçta, kullanıcılara verilen en iyi beş öneride, %82.37 doğruluk oranı yakalanmıştır.With the development of technology, the increasing amount of digital information and the widespread use of the internet, and the increase in the number of websites where trade transactions such as products, services and subscriptions are carried out on the internet, along with it, personalized and accurate; The importance of recommending products, services and subscriptions has also increased. Product-based, user-based, and hybrid traditional approaches, which are widely used in recommendations to customers, are used in most studies. Overcoming the problems of traditional approaches such as working with large and sparse data, inability to find complex relationships between user and product, and cold start has been possible with the use of deep and wide learning systems. Within the scope of this study, first, a comprehensive view of deep and wide neural networks and their applications in travel recommendation systems is presented. After giving the basic information about deep learning, Google's Wide and Deep Algorithm and Facebook's Deep Learning Recommendation Model (DLRM) algorithm, which are the most popular recommendation algorithms, are included. Then, a new travel recommendation system was created in which numerical data is fed to the model by applying the embedding process of categorical user and product features with a broad and deep learning approach. The proposed method was applied on the data set of a real travel agency company. As a result of this study, 82.37% accuracy rate was achieved in the top five recommendations given to the user
Evaluation of shaping performance and surface changes of two different minimally invasive shaping file systems used in resin blocks
No full textAims: This study aimed to compare the shaping ability of T-endo MIS and TruNatomy (TRN) file systems in J-shaped resin root canals and to investigate the deformation of the files after two acrylic block preparation and two sterilization cycles. Methods: Forty acrylic blocks were numbered, then four file groups (n=10) were established: T-endo MIS glider (15.04) + T-endo MIS Finisher (25.04) (first and second usage) and TRN Glider (17.02) + TRN Prime (26.04) (first and second usage). Preoperative and postoperative images after the root canal preparation of simulated acrylic blocks were taken for each sample, and superimposed. The amount of resin removed from both the inner and outer walls of the canal to the level of 3, 5, and 7 mm from the apical point was measured, and the amount of transportation was calculated. Additionally, the deformation of the files was examined under a scanning electron microscope before and after usage and sterilization process. Results: Tip deformation of TRN files increased with the number of uses (p=0.007). With the second use, the surface deformation of the MIS files increased (p=0.015). There was no difference in cutting-edge deformation in either file type according to the number of uses (p>0.05). There was no difference in transportation values between the MIS and TRN file systems at any level (p>0.05). The file systems did not show a significant difference in the amount of transportation between first and second use (p>0.05). Conclusion: When TRN (26.04) and MIS (25.04) NiTi rotary files were used twice on acrylic blocks, the amount of deformation did not differ. Both file types were similar in terms of transportation values