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Comparison of practical application steps of the previously used adrenaline auto injector in Turkey (EpiPen) and the currently available adrenaline auto injector (Penepin): a multi-center study
No full textAim: It has been shown by a great number of studies that the correct use of adrenaline auto injectors prescribed to patients with anaphylaxis is associated with the design of the auto injector, in addition to training. The aim of this study was to compare the skills of adults in using two different auto injectors prescribed to patients with anaphylaxis.
Material and Methods: Parents of patients aged between 1 and 18 years who referred to allergy outpatients were included in the study.
Results: A total of 630 volunteers from nine centers were included in the study. Four hundred fifty-seven (72.5%) of the participants were females and 235 (37.3%) were undergraduates. The rate of showing all the steps of auto injector trainers correctly e by the participants was found as (60.2%) (n=379) for EpiPen and 42.9% (n=270) for Penepin (p<0.001). The most frequent mistake with both auto injector trainers was the step of "place appropriate injection tip into outer thigh/press the trigger so it clicks." When the preferences of the volunteers were asked after training and application, 527 (83.7%) chose EpiPen, stating that it was easier and simpler to use.
Conclusions: Our study showed that the correct usage rates of both adrenaline auto injectors were much lower than expected and there could be mistakes in the application of both. It could be appropriate to make improvements in the design of Penepin, which is still the only available adrenaline auto injector in Turkey, such that its application steps will be simpler and quicker
Meniere hastalığında gliserol testi ile rezonans frekans farklılığının değerlendirilmesi
No full textAMAÇ: Meniere hastalığında (MH) bir tanı metodu olarak kullanılan gliserol testi ile,
iç kulakta dehidratason etkisi meydana getirerek, eş zamanlı yapılan Multifrekans
timpanometrede elde ettiğimiz rezonans frekans değerleri ile de orta ve iç kulak mekaniğini
değerlendirmek.
GEREÇ VE YÖNTEM: Çalışmaya, Başkent Üniversitesi Tıp Fakültesi Ankara
Hastanesi KBB polikliniğine, baş dönmesi ile başvuran ve çalışma kriterlerine uyarak tek
taraflı Meniere hastalığı tanısı alan, 19 yaş üzeri 20 hasta dahil edildi (20 hasta kulak, 20
kontrol kulak). Saf ses odyometri ile işitme eşikleri (125-8000 kHz), saf ses ortalama eşikleri
(SSO) ve Multifrekans timpanometri ile rezonans frekans (RF) değerleri tespit edildi. Sağlıklı
50 kişinin RF değerleri ile hastalıklı ve kontrol kulaklar arasındaki değerler karşılaştırıldı.
Ardından sadece MH‟lere, gliserol kiloya 1 gr olacak şekilde oral yol ile içirildikten sonra ve
birer saat arayla üç kez saf ses eşik ve RF değerleri belirlenerek kulaklar arası karşılaştırma
yapıldı.
BULGULAR: Toplam 20 hastanın yaş ortalaması 47.25 ± 10.5, 9‟u kadın (%45), 11‟i
erkekti (%55). Gliserol öncesi ortalama RF değerleri sağlıklı kulaklarda 979.41±156.26 Hz,
hasta kulaklarda 808.0±410.09, kontrol kulaklarda ise 972.5±499.07 Hz‟di. Gliserol test
öncesi hasta kulaklar ile sağlıklı kulaklar arasında RF değerleri arasında anlamlı düzeyde
farklılık tespit edildi (p=0.047). Hasta kulaklarda Gliserol öncesi ve sonrası RF değerleri
karşılaştırıldığında: gliserol öncesi RF ortalamasının 808.0±410.1 Hz den gliserol alımı
sonrası 1. saatte 748.0±402.1 Hz‟e gerilediği, sonraki birer saat aralıklarda yapılan ölçümlerde
ise bu değer de artış olduğu ve 3. saatte eski değerine ulaştığı gözlenmiştir. Gliserol öncesi ve
1. saat RF ölçümleri arasında istatistiksel olarak anlamlı sonuç elde edilmiştir (p=0.030).
Hasta kulaklarda frekans dağılımına göre, gliserol öncesi ve sonrası 1. ve 3. saatler
karşılaştırıldığında, 1. saatte anlamlı farklılık gözlenmemiş, fakat 3. saatte 125, 250, 500 ve
1000 Hz‟lerde istatistiksel olarak, işitme eşik değerlerinde anlamlı düzeyde düşme elde
edilmiştir (sırasıyla, p=0.000, p=0.000, p=0.000, p=0.000).SONUÇ: Dehidratasyon etkisi ile mevcut değerin normal kulak değerlerine gelmesi
beklenirken değerde düşme görülmesi, MH de iç kulağın farklı bir dinamiğe sahip ve
normalizasyon değerlerinin sağlıklı kulaklara göre farklı değerlerde olduğunu göstermektedir.
İç kulak basıncının azalması ile kütle etkisinde azalma ve anuler ligaman üzerindeki katılık
etkisinin azalarak normal değerine (ataklar arası) yaklaştığı gözlenmiştir. Gliserol testi ile RF
değerlerinde değişim 1. saatte gözlenmektedir.
AIM: Evaluate the resonance frequency values by forming dehidration effect in the
inner ear by glycerol test which is used as a diagnostic method in Meniere‟s Disease (MD).
MATERIAL AND METHODS: Twenty Meniere‟s disease patients over 19 years of
age (20 affected ears, 20 control ears)wo meet the criteria were admitted to the Ear Nose
Throat (ENT) Department of Baskent University. Pure-tone hearing levels (125-8000 kHz),
pure-tone mean values, and multifrequency tympanometry with resonant frequency (RF) tests
were performed. RF values of 50 healthy persons were compared between affected and
control ears. Pure-tone thresholds and RF values were compared between only MH ears
before and at 1, 2 and 3 hours after administration of glycerol 1g/kg.
RESULTS: The mean age of the 20 patients was 47.25 ± 10.5, 9 women (45%) and 11
men (55%). Average RF values in healthy ears were 979.41 ± 156.26 Hz, in affected ears
808.0 ± 410.09 Hz, and in control ears 972.5 ± 499.07 Hz before glycerol intake. There was a
significant difference between the RF values between the affected ears and healthy ears before
the glycerol intake (p = 0.047). When RF values were compared of affected ears, average RF
values decreased to 748.0 ± 402.1 Hz to 808.0 ± 410.1 Hz at the first hour of glycerol intake,
and this value increased at the following hours. Statistically significantdifferences were
obtained between RF values, 1 hour before and after glycerol intake(p = 0.030). However, in
the affected ears, there was no statistically significant difference between the pure-tone levels
before and one hour after glycerol intake, but a significant decrease in hearing thresholds at
125, 250, 500 and 1000 Hz at 3 h (p = 0.000, p = 0.000, p = 0.000, p = 0.000, respectively).
CONCLUSION: We observed decreased RF values when we expected to reach to
normal ear values with dehydration effect. According to these results, we suggest that MH has
different inner ear dynamics and the normal RF values of MD are different from the healthy
ears. Also, we think that the decrease of the inner ear pressure causes the reduction of the
mass effect and the stiffness effect on the anulus ligament. Thus, RF reach the normal values
(between attacks). Changes in RF values with glycerol test are observed at 1 hour
Uzaklık ve cinsiyet tabanlı akıllı reklam görüntüleme sistemi
No full textSon yirmi yılda artan teknolojik gelişmelere paralel olarak örüntü tanıma ve bilgisayarlı görme alanlarını kullanan ve gündelik hayata entegre olan birçok çalışma ve araştırma bulunmaktadır. Bu tezde, gerçek zamanlı olarak kamera kaynağından alınan yayın üzerinde tespit edilen yüz görüntülerinden elde edilen cinsiyet bilgisine ve kameraya uzaklığına bağlı olarak çalışan akıllı reklam görüntüleme sistemi geliştirilmiştir.
Sistem temelde iki ayrı kısımdan oluşmaktadır. İlk kısımda kamera kaynağından alınan veriler, canlı yayındaki çerçeveler işlendikten sonra algılanan yüzlerden cinsiyet tespiti ve uzaklık kestirimi yapılarak canlı yayına eklenmektedir. Sistemin ikinci kısmında ise algılanan yüze ait resim, cinsiyet etiketi ve kameraya uzaklık bilgisi reklam bilgisinin gösterileceği uygulamaya web servis yolu ile iletilip, veritabanına kaydedilmektedir. Sistem için önceden tanımlanmış süre içerisinde veritabanında bulunan yüz ve uzaklık bilgileri analiz edilerek farklı detay seviyelerinde reklam gösterimi yapılmaktadır. Analiz işleminde, sistem için tanımlanmış süre zarfında veritabanından elde edilen veriler doğrultusunda cinsiyet ve uzaklığa bağlı olarak farklı ilgi seviyelerinde reklam gösterimi gerçekleştirilmektedir. Sistemin verimli çalışması için cinsiyet tespitinin doğru yapılması oldukça önem arz etmektedir.
Çalışmada, geliştirilen yüz algılama sınıflandırıcısıyla beraber cinsiyet tespit işlemi için Fisher Yüz Algoritması (Fisherfaces), Destek Vektör Makineleri (SVM) ve Evrişimsel Sinir Ağları (CNN) sınıflandırıcıları kullanılmıştır. SVM sınıflandırıcısındaki doğruluk yüzdesini arttırmak için Yerel İkili Örüntü (LBP) ve Yönlü Gradyanlar Histogramı (HOG) öznitelik çıkarım yöntemleri kullanılmıştır.Derin öğrenme yöntemlerinin en popülerlerinden biri olan CNN ağ çeşidi GoogleNet mimarisi ile eğitilmiştir. Sınıflandırıcılar için günlük hayat akışına uygun olarak belirlenmiş LFW, IMDB ve WIKI veri kümeleri eğitim için, FaceScrub veri kümesi ise test veri kümesi olarak kullanılmıştır. Cinsiyet tespiti için geliştirilen SVM ve CNN sınıflandırıcıları üzerinde gerekli optimizasyon çalışmaları yapılmıştır. Fisher Yüz algoritması ile %61.30, SVM sınıflandırıcısının LBP ve HOG öznitelik çıkarım yöntemleri ile sırasıyla %75.32 ve %80.58, CNN sınıflandırıcısı ile %94.76’lık başarı elde edilmiştir.
The vast number of researchers have been focused on pattern recognition and computer vision fields in parallel with recent technological developments over the last two decades. Studies on these subjects have become widespread in recent years. In this thesis, a smart advertisement display system has been developed which feeds real time data from the camera source to get gender information and calculate distance from the camera source.
The developed system has two main stages. Firstly, live broadcast stream, which gets data from the camera source, is handled frame by frame. Then, the face detection part is employed for predicting the gender and distance information. Secondly, detected face images along with the gender labels and distance values are sent to the advertisement display application via the web service and saved into the database. The advertisement system is run in a time counter and analyses the records from the database. The analysis process is based on statistical information such as gender label and distance value to determine advertisements having different levels of detail. Determination of gender information is very important for proper system operation.
For this study, face detection and gender recognition classifiers were implemented. Fisherfaces, Support Vector Machines (SVM) and Convolutional Neural Networks (CNN) classifiers for gender recognition were trained. The SVM classifier with Local Binary Pattern (LBP) and Histogram of Oriented Gradients (HOG) features were used at different times. Besides, various optimization works were performed by changing the parameters. One of the most popular deep learning methods, the CNN network type, was trained with GoogleNet architecture and the optimization was performed depending on the parameters. The LFW, IMDB and WIKI were used as training data sets and the FaceScrub was used as the test data set. Fisherfacesalgorithm yielded an accuracy of 61.30%. When LBP feature extraction method is combined with SVM classifier, the accuracy rate of 75.32% was reached. The HOG feature extraction method with SVM was found to be more successful than LBP and reached an accuracy of 80.58%. Finally, CNN was determined to be the best classifier among all having an accuracy rate of 94.76%
İstikamet-Durum bilgisi veren sistem sensörlerinin hata parametrelerinin kestirimi ve analizi
No full textİstikamet-Durum bilgisi veren sistem, ataletsel ölçüm birimi ve manyetometre sensörlerini kullanarak bir cismin yalpalanma, yunuslama, savrulma açılarını bir düzlemi referans alarak kestirim yapmaktadır. İstikamet-Durum bilgisinin kestirimi için ileri kestirim algoritmalarından faydalanır. Sensör hataları, kestirim performansını yani sistem performansını etkileyen önemli etkenlerdendir. Bu durumda İstikamet -Durum bilgisi veren sistemin ne kadar iyi çalışacağını ataletsel ölçüm birimi ve manyetometrenin performansı belirler.
Bu tez çalışmasında ataletsel ölçüm birimi ve manyetometre hata parametrelerinin kestirim çalışmalarına yer verilmiştir. Ataletsel ölçüm birimi hata kestiriminden önce sıcaklığa bağımlı hatanın telafisi için sıcaklık kalibrasyonu yapılmış, sonra hata parametrelerinin kestirimi için iki ayrı yöntem olan Allan deviasyon ve güç tayf yoğunluğu yöntemlerine başvurulmuş ve sonuçları karşılaştırılmıştır. Önerilmiş yöntemler ayrıca denenmiş ve performansları irdelenmiştir. Manyetometrenin sert-demir ve yumuşak-demir hata parametreleri belirlenerek hataların telafisi sağlanmıştır. Hata telafisi yapılmış sonuçlar hatalı sonuçlar ile karşılaştırılıp yorumlanmıştır.Ataletsel ölçüm birimi verileri robotik seviye düşük maliyetli bir MEMS sensör modülü ile elde edilmiştir. Manyetometre verileri için düşük maliyetli hall sensörü tipi bir manyetometre kullanılmıştır.
Attitude-heading reference system estimates roll, pitch and yaw angles by taking a plane as reference using inertial measurement unit and magnetometer sensors. It utilizes advance estimation algorithm while estimating attitude-heading information. The error parameters of inertial measurement unit and magnetometer sensors are key factors that affect estimation performance, in other words the system performance.
In this thesis, estimation studies of inertial measurement unit and magnetometer error parameters have been performed. Before estimating the errors parameters of inertial measurement unit, temperature calibration has been done to compensate temperature dependent error. Then, two different methods that are Allan deviation and power spectral density methods have been applied for error parameter estimation and the results have been compared. In addition, the proposed methods have been tested and their performances have been examined. Soft-iron and hard-iron error parameters of magnetometer have been estimated and compensated. The compensated and erroneous results have been compared.
Inertial measurement unit datum have been obtained with robotics grade low cost MEMS sensor module. Low cost hall sensor type magnetometer have been used for magnetometer datum
Zorunlu alternatif uyuşmazlık çözüm yollarının anayasa'ya uygunluğu
No full textUyuşmazlık içerisine düşmek insanların olağan hayatında rastlanılan bir durumdur. Düşülen uyuşmazlıkların çözümlenmesi ve toplumun barış içerisinde yaşamasını sağlamak ise devletlerin görevidir. Dolayısıyla uyuşmazlık çözümlerinde başvurulması gereken asli yerler devlet eli ve kanunlar aracılığı ile çözümlenmektedir. Ancak günümüzde artan uyuşmazlık sayısı mahkemelerin iş yükünü çok artırmaktadır. Yoğun ve uzun süreçler uyuşmazlık içerisinde olan tarafların hem haklarına geç ulaşmasına neden olmakta hem de ilerleyen dönemlerde tarafların arasındaki ilişkilerin bozulmasına yol açmaktadır. Bu sebeple barışçıl yöntemler olan alternatif uyuşmazlık çözüm yollarına başvurunun artırılması ve bu yolların kullanılmasının teşvik edilmesi sağlanmalıdır. Bu teşvikler alternatif yolların dava ön şartı veya zorunlu olarak düzenlenmesi ile sağlanabilir. Taraflar bu şekilde alternatif uyuşmazlık çözüm yollarını kullanmayı birer alışkanlık haline getireceklerdir.
Yargılama ve uyuşmazlık çözümlerinde Avrupa İnsan Hakları Sözleşmesi ve Anayasa’da yargılamaya ilişkin olarak düzenlenmiş ilkelerin uygulanması gerekmektedir. Dolayısıyla zorunlu olarak düzenlenen alternatif uyuşmazlık çözüm yollarının da bu ilkelere uyması gerekmektedir. Mukayeseli hukuk ve Türk Hukukunda birçok zorunlu alternatif uyuşmazlık çözüm yolu düzenlenmektedir. Hem mukayeseli hukuk hem Türk Hukuku bakımından bu zorunlu düzenlemelerin Anayasal ilkeler ile bağdaşıp bağdaşmadığı; hangi koşullarda bu zorunluluğun Anayasal ilkelere uygun olacağı tartışılacaktır.
Having conflicts is a common occurrence in people's ordinary lives. States are responsible to resolve the disagreements and to ensure that the society lives in peace. Therefore, the principal places to be resorted to in the dispute resolution are resolved by the State by means of laws. Today however, the increasing number of disputes causes the courts to become very slow because of increasing workload. Lengthy and slow processes cause conflicting parties to resolve their dispute in a very long process and as a result parties do not maintain relations with each other in the future. For this reason, it should be encouraged to increase the application of alternative dispute resolution methods, which are peaceful methods, and to encourage the use of these disputes. These incentives can be provided by pre-condition or mandatory regulations of alternative methods. Parties will thus make it a habit to use alternative dispute resolution methods.
In the trials and dispute resolutions, it is necessary to apply the principles set out in the European Convention on Human Rights and the Constitution. Therefore, compulsory alternative dispute resolution methods must comply with these principles. There are many compulsory alternative dispute resolution methods in comparative law and Turkish law. Both in terms of comparative law and Turkish law, these compulsory regulations are incompatible with constitutional principles; in this paper it will be discussed under which conditions these mandatory regulations will be compatible with the constitutional principles
Pulmonary complications in adult patients with sickle cell disease
No full textSickle cell disease (SCD) is an inherited hemoglobin disorder, associated with recurrent painful episodes, ongoing hemolytic anemia and progressive multi-organ failure. While survival beyond the fourth decade of life for a patient with SCD was previously considered unusual; nowadays, in countries with developed health care systems, patients with SCD could reach into adulthood. However, irreversible organ damages have become more prevalent along with the patients' reaching adulthood. The lungs as well are among the organs involved in SCD. Pulmonary complications are significant causes of morbidity and mortality and are substantially responsible for deaths. Although our understanding of these conditions has improved over the past 10-15 years, there remains no specific treatment of pulmonary complications of SCD. Limited data on health care issues, particularly in older adults with SCD, poses multiple challenges to patients, their families and health care providers. The incidence and severity of pulmonary complications require the physicians' further interest in this subject. The present review comprises the following pulmonary complications of SCD: i) acute chest syndrome, ii) venous thromboembolus, iii) asthma, iv) respiratory dysfunction, v) respiratory disorders during sleeping, vi) pulmonary hypertension
Cerebral Sinus Venous Thrombosis: Evaluation of Nineteen Patients
No full textObjective: Cerebral sinus venous thrombosis (CSVT) is a disease that can be seen in all age groups with various clinical findings and usually a good prognosis. In this study, evaluation of the complaints on admission, the possible risk factors, localization, findings and treatment approaches, and discussion of these findings with comparison to the literature were aimed.
Materials and Methods: The demographic, clinical, laboratory and the radiological characteristics of 19 patients with diagnosed with CSVT and followed at the Sakarya University Training and Research Hospital Clinic of Neurology.
Results: Nineteen patients (15 female, 4 male) with the diagnosis of CSVT were included. The mean age of the patients was determined as 31.3 +/- 11.2. Headache was determined to be the first symptom on admission in 17 patients. Nauseavomiting (n=10), blurred vision (n=4) and epileptic seizures (n=3) had accompanied headache. Altered state of consciousness (n=2), papilledema (n=4), dysarthria (n=1), and cerebellar disorder (n=1) were determined. Two of the patients were pregnant and 6 patients were in the postpartum period. CSVT due to infection was determined in 2 patients. No reason for etiological investigation was found in 4 of the cases. In 11 patients, more than one etiology were detected. Two patients had been diagnosed with Behcet's disease. MTHFR A1298Cgene heterozygous mutation was most detected. Fourteen patients were determined to have a single sinus venous thrombosis and 5 patients had more than one sinus venous thrombosis on magnetic resonance venography. Six patients had venous infarction.
Conclusion: Pregnancy and postpartum period are significant risk factors for CSVT. The association of more than one reason in the etiological investigations of patients despite the presence of one significant risk factor has been emphasized
Complications of Formaldehyde Injection for a Cystic Mass of the Neck
No full textFormaldehyde is a colorless reactive chemical with suffocating and pungent odor. It is irritant to mucous membranes and can enter the body by either oral ingestion or inhalation. Formaldehyde is toxic to living tissue. In this report, we present the case of a 22-year-old woman who was treated with formaldehyde injection for a cystic mass of the neck with developing complications
Case report and the surgical treatment of two cases with pulmonary atresia in which pulmonary arteries is circulated by coronary arteries
No full textPulmonary atresia (PA) and ventricular septal defect (VSD) can occur in a variety of ways, from simple valve atresia to a condition in which circulation to the pulmonary bed occurs through collateral arteries separated from the aorta and there are no real pulmonary arteries, or they are present but hypoplastic. The size of the pulmonary arteries and concomitant complex cardiac lesions are important in making decisions about treatment and correctional alternatives. While complete correction surgeries in the style of a correction of tetralogy of Fallot are performed in simpler cases, many very invasive procedures are also performed and the resulting quality of life is very variable. The size of the pulmonary artery and its branches and the presence of accompanying collateral vessels are determining factors in the management of the disease. In this report, 2 cases of VSD and PA, in which the circulation of the pulmonary arteries was through the coronary arteries, diagnosed as a result of echocardiography performed following murmurs heard during examination, are described. The first patient was 40 days old and the second was 2 days old. In the second case, diagnosis was confirmed by catheter angiography, and in the first case, the final diagnosis was made during surgery. The aim of this report is to emphasize the importance of pulmonary artery size, the presence of pulmonary confluence, the origin of circulation, and concomitant collateral arteries when considering treatment methods
An empirical study in software engineering: the effects of project-based and project-supported methods on product and academic achievements
No full textThe studies show that many software projects exceed the estimated budget and schedule every year, or they are canceled on account of failure, and thus, this causes the waste of resources expressed in billion dollars. Software engineering education is one of the research areas aiming to produce solutions to this important problem. However, it is seen that there is still a need for large amount of skilled and educated software engineers required for the industry, and this workforce gap is also in an increasing fashion. One of the main reasons is thought to be the traditional or teacher-centered methods that are widely adopted in universities. On the other hand, software product development as well as learning and teaching processes, include a series of activities, which require their applications with a range at different levels. Therefore, the instructional methods should be adopted, which primarily concern the knowledge and skills that need to be acquired by engineering students together with the requirements and attributes of software systems to be developed in courses. Project-Assisted Instruction (PAI) and Project-Based Learning (PBL) can be given as examples for this type of methods. Therefore, in this research, the PBL and PAI methods are used in teaching the Database Management Systems Course, and their effects on academic achievements, product and project performances are explored. It is possible to say that the study has two contributions to the engineering research domain. First, (a) it is a study that compares PAI and PBL in an experimental setting. Second, (b) it presents the guidelines and prescriptions for the application of these methods for the domains of computer and software engineering education based on empirical findings