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Article 4b Fmrı Tabanlı Alzheimer Hastalığının Ön Tespiti için 3b-capsnet ve Rnn Modellerinin Kullanılması(2024) İsmail, Ali; Dalveren, Gonca Gökçe MenekşeAlzheimer hastalığının (AH) ilerlemesinin erken tahmini, bilişsel gerilemenin daha etkili bir şekilde yavaşlatılmasına yardımcı olabilmektedir. Dinlenme durumu fonksiyonel manyetik rezonans görüntüleme (dd-fMRG) kullanılarak otomatik AH tanısı için evrişimli sinir ağlarına (ESA) dayalı farklı yöntemlerin uygulanmasına yönelik çeşitli çalışmalar yapılmıştır. Bu çalışmalarda tanıtılan yöntemler iki büyük zorlukla karşılaşmaktadır. Birincisi, fMRG veri kümeleri küçük boyutta olduğundan aşırı uyum gözlemlenebilmektedir. İkincisi, fMRG oturumlarının 4 boyutlu (4B) bilgilerinin verimli bir şekilde modellenmesi gerekmektedir. Çalışmalardan bazıları, derin öğrenme yöntemlerini, 4B bilgiyi modellemek için fMRG verilerinden oluşturulan fonksiyonel bağlantı matrislerine veya ayrı 2B dilimler veya 3B hacimler olarak fMRG verilerine uygulamıştır. Ancak bu durumun her iki yöntem türünde de bilgi kaybına neden olduğu gözlemlenmiştir. Bu çalışmada, AD tanısı için fMRG verilerinin uzay-zamansal (4B) bilgilerini modellemek amacıyla Kapsül ağı (CapsNet) ve tekrarlayan sinir ağını (RNN) temel alan yeni bir model önerilmektedir. Önerilen modelin etkinliğini değerlendirmek için deneyler yapılmıştır. Sonuçlara göre, önerilen modelin AH’na karşı normal kontrol (NK) ve geç hafif bilişsel bozukluk (GHBB) ile erken hafif bilişsel bozukluk (EHBB) sınıflandırma görevlerinde sırasıyla %94.5 ve %61.8 doğruluk elde edebildiği görülmüştür.Article Covid-19 Pandemic: Depression and Sleep Quality in Hemodialysis Patients(2022) Yavuz, Demet; Balakbabalar, Ayse Pinar Doğru; Demirağ, Mehmet Derya; Sezer, SirenIntroduction: Depression and sleep disturbance are prevalent comorbidities in hemodialysis patients. This study aimed to investigate the relationship between depressive mood, sleep disturbance, and the fear of COVID-19 Scale in hemodialysis patients during the pandemic process. Material and Method: 116 hemodialysis patients followed up in our clinic and volunteered were included in the study. The socio- demographic characteristics of the patients and the laboratory test results studied in their routine follow-ups were obtained from the file records. Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and the Fear of COVID-19 Scale (FCV-19S) were applied through face-to-face interviews. Results: 116 patients (70 males, 46 females) with a hemodialysis duration of 40 months (13-295) and age of 60.2±13.3 years were included in the study. The patients were divided into two groups according to their PSQI score as good sleeper (PSQI ≤ 5, n=66) and poor sleeper (PSQI >5, n=50). When evaluated by gender 28 (56%) female patients were in the poor sleeper group (p=0.002). Dialysis time was longer, BDI score and FCV-19 scale were higher in the poor sleeper group than the good sleeper group. PSQI score was positively correlated with dialysis time (r=0.259 p=0.005), BDI score (r=0.279 p=0.002), and FCV-19 scale (r=0.304 p=0.001). In the Multiple Logistic Regression analysis established to evaluate the risk factors affecting sleep quality, BDI was determined as an independent risk factor for poor sleep (OR: 1.084, 95%CI [1.021-1.152], p=0.008). Subjects were divided into two groups according to their BDI scores as those with depressive mood (BDI score ≥ 17, n=47) (40.5%) and those without (BDI score < 17, n=69) (59.5%). Thirty-two of the cases with depressive mood were women (68.1%) (p<0.001). There was a female predominance in the depressed patient group. The economic status was worse in the depressed group compared to the non-depressed group, and the PSQI score and FVC-19 scale were higher. In addition, BDI score was positively correlated with age (r=0.225 p =0.015), female gender (r=0.473 p=0.001), poor economic status (r=0.576 p =0.001), FVC-19 scale (r=0.330 p =0.001), while negatively correlated with serum albumin level (r=-0.279 p=0.003) and serum creatinine level (r=-0.2455 p =0.008). In the Multiple Logistic Regression model established, female gender (OR: 7.857, 95%CI [2.463-25.065], p<0.001) and poor economic status (OR: 7.569, 95%CI [2,300-24,908], p=0.001) were determined as independent risk factors for depressive mood. Conclusion: Nearly half of the patients had sleep disorders and depressive mood. Patients in the depressive mood and poor sleep group had a higher FVC-19 scale. We think it would be beneficial not to ignore the increased frequency of depressive mood and sleep disorders in hemodialysis patients during the COVID-19 pandemic.Article Retrospective Evaluation of Childhood Central Nervous System Tumors Followed in a Pediatric Hematology Oncology Center: a Single Center Experience(Akad Doktorlar Yayinevi, 2024) Erdem, Arzu Yazal; Emır, Suna; Özyörük, Derya; Genç, Aslı; Yazal Erdem, ArzuCentral nervous system (CNS) tumors are one of the main causes of cancer-related deaths in childhood. Although approximately 60% of all patients are alive 5 years after diagnosis, a sequela due to the disease and treatments are common. In this study, we aimed to evaluate the demographic, clinical characteristics, and outcomes of the childhood CNS tumors in our center. A total of 141 patients between 0-18 years who were followed up and completed their treatment in our pediatric oncology center were included. The files were reviewed retrospectively. The median age of patients was 7 years (range 1 month-17.6 years). The male/female ratio was 1.1: 1. The most common presenting symptom was headache. The median time from the first symptom to diagnosis was 1.4 months. Medulloblastoma was the most common diagnosis (n= 28, 19.9%), followed by pilocytic astrocytoma (18.4%, n= 26) respectively. Out of 141 patients, a sequela was seen in 55 (39%) patients. The relationship between high-dose radiotherapy and the development of short stature was statistically significant (p= 0.009). The patients with metastatic disease were likely to have lower survival rates than nonmetastatic disease (p= 0.001). The presence of metastasis increased the death status 6.482 times (OR: 6,482, p= 0.001). The overall 5-year survival rate of all patients was found 80%. There was an association between the histopathological subtypes and overall survival rates (p= 0.001). In the multivariate analysis, metastasis was the most important factor in survival. According to Cox regression analysis, the two most important factors affecting overall survival were the histopathological subtype and the presence of metastasis.Article Citation - WoS: 2Citation - Scopus: 2The Relationship Between Lung Function, Exercise Capacity, Oxidant and Antioxidant Response in Primary Ciliary Dyskinesia and Cystic Fibrosis(Turkish J Pediatrics, 2024) Kartal, Yasemin; Ozel, Cemile Bozdemir; Cakmak, Aslihan; Ulu, Hazal Sonbahar; Ince, Deniz Inal; Tural, Dilber Ademhan; Sabuncuoglu, Suna; Özçelik, Uğur; Inal-ınce, Deniz; Budak, Murat; Arıkan, HülyaBackground. There is a need to identify the complex interplay between various physiological mechanisms in primary ciliary dyskinesia (PCD) and cystic fibrosis (CF). The study investigated the interaction between respiratory function, exercise capacity, muscle strength, and inflammatory and oxidant/antioxidant responses in patients with PCD and CF. Methods. The study included 30 PCD patients, 30 CF patients, and 29 age and sex-matched healthy subjects. Exercise capacity was assessed using the modified shuttle walk test (MSWT). Handgrip strength (HGS) was used to evaluate general muscle strength. Oxidative stress-inflammatory parameters were also assessed. Pulmonary function test was performed by spirometry. Regarding the forced expiratory volume in 1 second (FEV1) 1 ) z-score, patients with PCD and CF were subdivided into normal, mild, and severe/moderate groups. Results. Forced vital capacity (FVC) z-scores were lower in PCD and CF patients than controls. FEV1, 1 , FEV1/ 1 / FVC, peak expiratory flow (PEF), and forced mid expiratory flow (FEF 25-75% ) z-scores were lower in PCD than in the other groups. HGS was lower in both mild PCD and normal CF patients relative to the controls. MSWT distance was lower in severe/moderate PCD patients than controls. Catalase (CAT), glutathione S-transferase (GST), glutathione peroxidase (GPx), and malondialdehyde (MDA) levels did not differ significantly among the study groups, but superoxide dismutase (SOD) level in severe/moderate PCD, and glutathione (GSH) level in normal CF were higher than in controls. Interleukin-6 (IL-6) level was higher in patients with normal PCD and CF compared to the controls. IL-1 beta level was higher in PCD compared to controls. Additionally, correlations among these parameters were also determined in some patient groups. Conclusion. Homeostasis related to respiratory function, aerobic performance, muscle strength, inflammatory response, and oxidant/antioxidant balance were affected in PCD and CF. Evaluating these mechanisms together may contribute to elucidating the pathophysiology of these rare diseases.
