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Article Citation - WoS: 25Citation - Scopus: 33Hybrid Eeg-Fnirs Bci Fusion Using Multi-Resolution Singular Value Decomposition (msvd)(Frontiers Media Sa, 2020) Khan, Muhammad Umer; Hasan, Mustafa A. H.Brain-computer interface (BCI) multi-modal fusion has the potential to generate multiple commands in a highly reliable manner by alleviating the drawbacks associated with single modality. In the present work, a hybrid EEG-fNIRS BCI system-achieved through a fusion of concurrently recorded electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) signals-is used to overcome the limitations of uni-modality and to achieve higher tasks classification. Although the hybrid approach enhances the performance of the system, the improvements are still modest due to the lack of availability of computational approaches to fuse the two modalities. To overcome this, a novel approach is proposed using Multi-resolution singular value decomposition (MSVD) to achieve system- and feature-based fusion. The two approaches based up different features set are compared using the KNN and Tree classifiers. The results obtained through multiple datasets show that the proposed approach can effectively fuse both modalities with improvement in the classification accuracy.Article Citation - WoS: 4Citation - Scopus: 5Individualized Luteal Phase Support in Frozen-Thawed Embryo Transfer After Intramuscular Progesterone Administration Might Rectify Live Birth Rate(Frontiers Media Sa, 2024) Boynukalin, Fazilet Kubra; Tohma, Yusuf Aytac; Yarkiner, Zalihe; Gultomruk, Meral; Bozdag, Gurkan; Ozkavukcu, Sinan; Demir, BerfuBackground: The serum P concentrations are suggested to have an impact on pregnancy outcome. However there is no consensus about the optimal progesterone cut-off during the luteal phase. Few studies evaluated the effectiveness of a "rescue protocol" for low serum P concentrations and most of these studies used vaginal progesterone administration. There is paucity of data on the effectiveness of rescue protocol using intramuscular progesterone (IM-P) in frozen-thawed embryo transfer (FET). Methods: This study is a retrospective cohort study included 637 single or double blastocyst FETs with artificially prepared endometrium receiving 100 mg IM progesterone (P) after incremental estrogen treatment. Serum P concentrations were evaluated using blood samples obtained 117-119 hours after the first IM-P administration and 21 +/- 2 hours after the last IM-P administration. Patients with serum P concentrations <20.6 ng/ml on the ET day were administrated 400 mg vaginal progesterone for rescue. Results: Demographic and cycle characteristics were similar between patients receiving rescue vaginal P (embryo transfer (ET)-day P concentration < 20.6 ng/ml) and patients who did not need rescue vaginal P (ET-day P concentration >= 20.6 ng/ml). Clinical pregnancy, miscarriage, and live birth rates were similar between two groups: 52.9%(45/85) vs 59.6%(326/552), p=0.287; 11.1%(5/45) vs 14.1%(46/326), p=0.583; and 47.1%(40/85) vs 50.7%(280/552), p=0.526, respectively. Logistic regression analysis revealed that the female age (p = 0.008, OR=0.942, 95% CI = 0.902-0.984) and embryo quality (ref: good quality for moderate: p=0.02, OR=0.469, 95% CI =0.269-0.760; for poor: p=0.013, OR= 0.269, 95% CI = 0.092-0.757) were independent variables for live birth. Following rescue protocol implementation, ET-day P concentration was not a significant predictor of live birth. Conclusions: Rescue vaginal P administration for low ET day serum P concentrations following IM-P yields comparable live birth rates.Review Citation - WoS: 9Citation - Scopus: 11Current Surgical Techniques for the Management of Pediatric Glaucoma: a Literature Review(Frontiers Media Sa, 2023) Aktas, Zeynep; Ikiz, Gokcen Deniz Gulpinar; Surgical Sciences; Surgical SciencesPediatric glaucoma surgery is challenging due to its diverse and complex pathophysiology, altered anterior segment anatomy, greater potential for failure, and complications compared to adult patients. Moreover, numerous challenges are associated with long-term postoperative management. Thus, when dealing with childhood glaucoma, it is important to consider the potential complications in addition to the benefits of each intervention. The purpose of this article is to review recently published literature to shed light on the most recent surgical techniques for the safe and effective treatment of childhood glaucoma. Current literature shows that goniotomy and trabeculotomy are the first choices for the management of primary congenital glaucoma. Although older children with phakic eyes seem to benefit from trabeculectomy with adjunctive mitomycin C, it carries a long-term risk of bleb-related endophthalmitis. Glaucoma drainage devices may be preferred for patients with secondary or refractory glaucoma. However, hypotony or tube-related complications are common and encountered more often in children than in adults. Cyclodestructive procedures are also an option for cases in which filtering surgery has failed, but they can also be used as a temporizing measure to reduce the rate of complications in high-risk patients. However, their outcomes can be unpredictable, in terms of efficiency and complications. Finally, minimally invasive glaucoma surgery (MIGS) as the sole alternative treatment or as an adjunctive surgical procedure is a relatively new path for pediatric patients.Article Citation - WoS: 8Citation - Scopus: 10Convergence of Economic Growth and Health Expenditures in Oecd Countries: Evidence From Non-Linear Unit Root Tests(Frontiers Media Sa, 2023) Celik, Esref Ugur; Omay, Tolga; Tengilimoglu, DilaverIntroductionThe relationship between human capital, health spending, and economic growth is frequently neglected in the literature. However, one of the main determinants of human capital is health expenditures, where human capital is one of the driving forces of growth. Consequently, health expenditures affect growth through this link. MethodsIn the study, these findings have been attempted to be empirically tested. Along this axis, health expenditure per qualified worker was chosen as an indicator of health expenditure, and output per qualified worker was chosen as an indicator of economic growth. The variables were treated with the convergence hypothesis. Due to the non-linear nature of the variables, the convergence hypothesis was carried out with non-linear unit root tests. ResultsThe analysis of 22 OECD countries from 1976 to 2020 showed that health expenditure converged for all countries, and there was a significant degree of growth convergence (except for two countries). These findings show that health expenditure convergence has significantly contributed to growth convergence. DiscussionPolicymakers should consider the inclusiveness and effectiveness of health policies while making their economic policies, as health expenditure convergence can significantly impact growth convergence. Further research is needed to understand the mechanisms behind this relationship and identify specific health policies most effective in promoting economic growth.Article Citation - WoS: 2Citation - Scopus: 2Phase and Wave Dependent Analysis of Health Expenditure Efficiency: a Sample of Oecd Evidence(Frontiers Media Sa, 2023) Boduroglu, Elif; Atici, Kazim Baris; Omay, TolgaIntroductionHealth expenditures are a factor that reflects the government's public health policy and contributes to the protection of national health. Therefore, this study focuses on measuring the effectiveness of health expenditures in order to evaluate and improve the public health system and policy during the pandemic period. MethodIn order to examine the effectiveness of health expenditures, the behaviors of the pandemic process were analyzed in two stages. The number of daily cases is analyzed in the first stage by dividing it into waves and phases according to the transmission coefficient (R). For this classification, the discrete cumulative Fourier function estimation is used. In the second stage, the unit root test method was used to estimate the stationarity of the number of cases in order to examine whether the countries made effective health expenditures according to waves and phases. The series being stationary indicates that the cases are predictable and that health expenditure is efficient. Data consists of daily cases from February 2020 to November 2021 for 5 OECD countries. ConclusionThe general results are shown that cases cannot be predicted, especially in the first stage of the pandemic. In the relaxation phase and at the beginning of the second wave, the countries that were seriously affected by the epidemic started to control the number of cas es by taking adequate measures, thus increasing the efficiency of their health systems. The common feature of all the countries we examined is that phase 1, which represents the beginning of the waves, is not stationary. After the waves fade, it can be concluded that the stationary number of health cases cannot be sustainable in preventing new waves' formation. It is seen that countries cannot make effective health expenditures for each wave and stage. According to these findings, the periods in which countries made effective health expenditures during the pandemic are shown. DiscussionThe study aims to help countries make effective short- and long-term decisions about pandemics. The research provides a view of the effectiveness of health expenditures on the number of cases per day in 5 OECD countries during the COVID-19 Pandemic.Article Citation - WoS: 1Citation - Scopus: 2The Detailed Transseptal Puncture Technique for Optimal Closure in Patients With a Patent Foramen Ovale(Frontiers Media Sa, 2024) Ilkay, Erdogan; Saricam, Ersin; Kacmaz, Fehmi; Yakici, Aysel; Koca, Cigdem; Ozeke, Ozcan; Onal, Mehmet ZulkufBackground The closure of a patent foramen ovale (PFO) using transseptal puncture has particular advantages and disadvantages. Thus, transseptal puncture should be re-evaluated in detail. Aims We aimed to assess the effectiveness of the detailed transseptal puncture technique in patients who underwent PFO closure due to cryptogenic stroke or transient ischemic attack in terms of residual shunts and atrial fibrillation. Methods We prospectively analyzed 144 consecutive patients who underwent PFO closure by the detailed transseptal puncture technique between February 2013 and April 2023 in two centers. All of the patients had a >10 mm long-tunnel PFO. Results The procedural success rate was 100%. However, after the procedure, moderate pericardial effusion developed in one patient (0.7%) and an acute pulmonary embolism related to femoral vein thrombosis was observed in one patient (0.7%) during the first month. Complications related to the procedure were noted in two patients (1.4%) during the first month of follow-up. Residual shunts were observed in 1.4% of cases after PFO closure. Conclusion We demonstrated that the detailed transseptal technique is safe and effective for PFO closure. The detailed transseptal PFO closure technique significantly reduced the risk of atrial fibrillation, and the occurrence of residual shunts was significantly low following the closure.Article Citation - WoS: 10Citation - Scopus: 12Distinguishing Intermediate and Novice Surgeons by Eye Movements(Frontiers Media Sa, 2020) Menekse Dalveren, Gonca Gokce; Cagiltay, Nergiz ErcilSurgical skill-level assessment is key to collecting the required feedback and adapting the educational programs accordingly. Currently, these assessments for the minimal invasive surgery programs are primarily based on subjective methods, and there is no consensus on skill level classifications. One of the most detailed of these classifications categorize skill levels as beginner, novice, intermediate, sub-expert, and expert. To properly integrate skill assessment into minimal invasive surgical education programs and provide skill-based training alternatives, it is necessary to classify the skill levels in as detailed a way as possible and identify the differences between all skill levels in an objective manner. Yet, despite the existence of very encouraging results in the literature, most of the studies have been conducted to better understand the differences between novice and expert surgical skill levels leaving out the other crucial skill levels between them. Additionally, there are very limited studies by considering the eye-movement behaviors of surgical residents. To this end, the present study attempted to distinguish novice- and intermediate-level surgical residents based on their eye movements. The eye-movement data was recorded from 23 volunteer surgical residents while they were performing four computer-based simulated surgical tasks under different hand conditions. The data was analyzed using logistic regression to estimate the skill levels of both groups. The best results of the estimation revealing a 91.3% recognition rate of predicting novice and intermediate surgical residents on one scenario were selected from four under the dominant hand condition. These results show that the eye-movements can be potentially used to identify surgeons with intermediate and novice skills. However, the results also indicate that the order in which the scenarios are provided, and the design of the scenario, the tasks, and their appropriateness with the skill levels of the participants are all critical factors to be considered in improving the estimation ratio, and hence require thorough assessment for future research.Article Evaluation of the Relationship Between Dietary Acid Load and Cardiovascular Risk Factors in Patients With Type 2 Diabetes: a Case-Control Study(Frontiers Media Sa, 2024) Gungor, Sedef; Saka, MendaneBackround Diets high in dietary acid load are thought to be associated with metabolic diseases. However, the number of studies examining the relationship between dietary acid load and metabolic diseases in Turkey is insufficient. The aim of this study was to investigate the relationship between cardiovascular disease risk factors and dietary acid load in individuals with type 2 diabetes.Materials and methods In this case-control study, 51 participants aged 30-65 years with type 2 diabetes and 59 participants in the control group were included. Blood pressure and biochemical findings were measured. Anthropometric measurements and body composition measurements were made. Dietary intake was assessed using a 3-day (1 day on weekends, 2 days on weekdays) food consumption record. Dietary acid load scores, including potential renal acid load (PRAL) and net endogenous acid production (NEAP), were calculated based on dietary intake. NEAP and PRAL scores were categorized as low and high according to the median value. Smoking status, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), trigylceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL), waist-hip ratio (WHR), waist-to- height ratio (WtHR), hemoglobin and fat mass (%) were evaluated as cardiovascular risk factors.Results The cut-off values of PRAL and NEAP were 3.61 and 44.78 mEq/d, respectively. After adjustment for various covariates, a significant positive association between PRAL and TG levels was observed in the diabetic group [odds ratio (OR), 5.98; 95% CI, 1.45-24.67; p = 0.013]. In contrast, a negative association was found between PRAL and SBP in the control group [odds ratio (OR), 0.21; 95% CI, 0.05-0.83; p = 0.026]. However, these associations were not observed for NEAP values in either group.Conslusions A higher PRAL value was consistently associated with higher TG level, but other cardiovascular risk factors were not. More longitudinal and interventional studies are needed to better establish a causal effect between dietary acid load and cardiovascular risk factors in individuals with diabetes.Article Citation - WoS: 6Citation - Scopus: 6Quantitative Lipidomic Analysis of Takotsubo Syndrome Patients' Serum(Frontiers Media Sa, 2022) Karnati, Srikanth; Guntas, Gulcan; Rajendran, Ranjithkumar; Shityakov, Sergey; Hoering, Marcus; Liebisch, Gerhard; Foerster, Carola Y.Takotsubo syndrome (TTS), also known as the transient left ventricular apical ballooning syndrome, is in contemporary times known as novel acute cardiac syndrome. It is characterized by transient left ventricular apical akinesis and hyperkinesis of the basal left ventricular portions. Although the precise etiology of TTS is unknown, events like the sudden release of stress hormones, such as the catecholamines and the increased inflammatory status might be plausible causes leading to the cardiovascular pathologies. Recent studies have highlighted that an imbalance in lipid accumulation might promote a deviant immune response as observed in TTS. However, there is no information on comprehensive profiling of serum lipids of TTS patients. Therefore, we investigated a detailed quantitative lipid analysis of TTS patients using ES-MSI. Our results showed significant differences in the majority of lipid species composition in the TTS patients compared to the control group. Furthermore, the computational analyses presented was able to link the altered lipids to the pro-inflammatory cytokines and disseminate possible mechanistic pathways involving TNF alpha and IL-6. Taken together, our study provides an extensive quantitative lipidome of TTS patients, which may provide a valuable Pre-diagnostic tool. This would facilitate the elucidation of the underlying mechanisms of the disease and to prevent the development of TTS in the future.Article Citation - WoS: 4Citation - Scopus: 5Evaluating Efficacy and Outcomes: Comparison of Laser Treatment and Crystallized Phenol in Pilonidal Sinus Disease(Frontiers Media Sa, 2025) Emral, Ahmet Cihangir; Gulen, Merter; Ege, BahadirObjective The aim of this study is to comprehensively evaluate the efficacy of laser ablation and crystallized phenol application in the treatment of pilonidal sinus disease, focusing on treatment success, recurrence rates, complications, and the patients' return to normal life.Material and method Data from patients treated for pilonidal sinus disease with laser ablation and crystallized phenol application at our clinic between January 2020 and September 2023 were retrospectively reviewed. Preoperative data including pit counts, disease stage, preoperative pilonidal abscess history, disease duration (week), treatment success, recurrence/persistent disease, postoperative complications, healing time (days), and visual analogue scale (VAS) scores on postoperative days 1 and 7, as well as return to normal life (days), were analyzed.Results A total of 121 patients were included in the study, with 51 receiving laser ablation and 70 receiving crystallized phenol application. The postoperative outcomes revealed that the wound healing period and postoperative VAS values were statistically significantly better in the laser ablation group.Conclusion Wound healing was faster and postoperative pain was less in the laser group compared to the phenol group. According to this study, both methods can successfully treat the disease in selected cases.
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