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Article Citation - WoS: 4Citation - Scopus: 4Incidence and Predictors of Permanent Pacemaker Implantation After Transcatheter Aortic Valve Implantation With a Balloon-Expandable Biosprosthesis in Patients With Bicuspid Aortic Valves(Termedia Publishing House Ltd, 2024) Suygun, Hakan; Kasapkara, Haci Ahmet; Guney, Murat Can; Polat, Melike; Bozkurt, EnginIntroduction:
There are few data on permanent pacemaker implantation (PPMI) in patients who have undergone transcatheter aortic valve implantation (TAVI) for bicuspid aortic valve (BAV) stenosis.
Aim:
The purpose of this study was to evaluate the predictors and incidence of PPMI in bicuspid patients using a balloon-expandable (BE) TAVI device.
Material and methods:
A total of 62 patients with bicuspid morphology who had undergone successful TAVI using a BE device without previous PPMI were included (retrospectively). Their baseline clinical, electrocardiographic (ECG), echocardiographic, and multislice computed tomography (MSCT) details were collected.
Results:
The incidence of PPMI after TAVI in this BAV cohort was 12.9%. All eight patients with PPMs were found to have type 1 left-right (LR) fusion morphology. In univariate analysis, the presence of right bundle branch block (RBBB) in preprocedural ECG ( p < 0.0001), short membraneous septum (MS) evaluated in MSCT ( p < 0.0001), and increased annulus-left main coronary artery distance ( p = 0.02) were statistically significant for PPMI. Among these parameters included in the model using multivariate Firth logistic regression analysis, the presence of preprocedural RBBB ( p = 0.001) and shortness of the MS in MSCT ( p = 0.004) were independent risk factors for predicting postprocedural PPMI in patients who underwent TAVI among those with BAV.
Conclusions:
Preprocedural RBBB on ECG and shorter MS are independent risk factors for PPMI after TAVI in BAV patients and these parameters should be considered before the procedure to guide clinical decision making. Type 1 LR patients may be considered at increased risk of PPMI.Article Citation - WoS: 5Evaluation of the Efficacy of Silymarin and Dexmedetomidine on Kidney and Lung Tissue in the Treatment of Sepsis in Rats With Cecal Perforation(Spandidos Publ Ltd, 2024) Yavuz, Aydin; Kucuk, Aysegul; Ergorun, Aydan Iremnur; Dursun, Ali Dogan; Yigman, Zeynep; Alkan, Metin; Arslan, MustafaSepsis is a systemic inflammatory response syndrome that develops in the host against microorganisms. This response develops away from the primary infection site and results in end-organ damage. The present study aimed to investigate the protective and therapeutic effects on lung and kidney tissue of silymarin (S) and dexmedetomidine (DEX) applied 1 h before and after sepsis induced by the cecal ligation and puncture (CLP) method in rats. A total of 62 rats was randomly divided into eight groups: i) Control (n=6); ii) cecal perforation (CLP; n=8); iii) S + CLP (n=8; S + CLP; S administered 1 h before CPL); iv) CLP + S (n=8; S administered 1 h after CLP); v) DEX + CLP (n=8; D + CLP; DEX administered 1 h before CLP); vi) CLP + D (n=8; DEX administered 1 h after CLP); vii) SD + CLP (n=8; S and DEX administered 1 h before CLP) and viii) CLP + SD (n=8; S and DEX administered 1 h after CLP). After the cecum filled with stool, it was tied with 3/0 silk under the ileocecal valve and the anterior surface of the cecum was punctured twice with an 18-gauge needle. A total of 100 mg/kg silymarin and 100 mu g/kg DEX were administered intraperitoneally to the treatment groups. Lung and kidney tissue samples were collected to evaluate biochemical and histopathological parameters. In the histopathological examination, all parameters indicating kidney injury; interstitial edema, peritubular capillary dilatation, vacuolization, ablation of tubular epithelium from the basement membrane, loss of brush border in the proximal tubule epithelium, cell swelling and nuclear defragmentation; were increased in the CLP compared with the control group. Silymarin administration increased kidney damage, including ablation of tubular epithelium from the basement membrane, compared with that in the CLP group. DEX significantly reduced kidney damage compared with the CLP and silymarin groups. The co-administration of DEX + silymarin decreased kidney damage, although it was not as effective as DEX-alone. To conclude, intraperitoneal DEX ameliorated injury in CLP rats. DEX + silymarin partially ameliorated injury but silymarin administration increased damage. As a result, silymarin has a negative effects with this dosage and DEX has a protective effect. In the present study, it was determined that using the two drugs together had a greater therapeutic effect than silymarin and no differences in the effects were not observed any when the application times of the agents were changed.Article Citation - WoS: 23Citation - Scopus: 25Evaluation of the Efficiency of the Nursing Care Plan Applied Using Nanda, Noc, and Nic Linkages To Elderly Women With Incontinence Living in a Nursing Home: a Randomized Controlled Study(Wiley, 2018) Gencbas, Dercan; Bebis, Hatice; Cicek, HaticePURPOSE: Evaluate the efficiency of the nursing care plan, applied with the use of NANDA-I, NOC, and NIC (NNN) linkages, for elderly women with incontinence who live in nursing homes. METHODS: A randomized controlled experimental design was applied. NNN linkages were prepared and applied for 12 weeks in an experimental group. NOC scales were evaluated again for two groups. RESULTS: A 0.5 NOC point change targeted in all elderly in the experimental group were provided between pretest-posttest scores. The experimental group had higher life quality and lower incontinence severity/symptoms than the control group. CONCLUSION: It is important that NNN linkages effective for solving the problems are used in different groups and with larger samples to create further evidence linking NNN.Article Citation - WoS: 2Citation - Scopus: 2A Metagenomic Survey of Bacterial Communities From Kurut: the Fermented Cow Milk in Kyrgyzstan(Wiley-v C H verlag Gmbh, 2024) Yegin, Zeynep; Mamatova, Zhanylbubu; Yurt, Mediha Nur Zafer; Tasbasi, Behiye Busra; Acar, Elif Esma; Ucak, Samet; Sudagidan, MertKurut is a traditional dry dairy product mostly consumed in Central Asia. In this study, the distribution of the dominant bacteria present in kurut samples (n=84) originated from seven (Chuy, Issyk-Kul, Talas, Naryn, Jalal-Abad, Osh, and Batken) regions in Kyrgyzstan were analyzed with Illumina iSeq100 platform. The dominant phylum detected was Firmicutes followed by Proteobacteria, Actinobacteria, Cyanobacteria/Chloroplast, and Tenericutes. The most abundant family detected was Lactobacillaceae followed by Streptococcaceae, Enterococcaceae, Chloroplast, and Leuconostocaceae. At the genus level, Lactobacillus was the predominant one in samples and Streptococcus, Enterococcus, Lactococcus, and Streptophyta followed this. Further comprehensive characterization analyses in kurut samples may have potential applications both in industrial starter culture developments and also future therapeutic approaches based on potential strains with probiotic properties. imageArticle The Pediatric Provider Communication Skills Assessment Scale(Wiley, 2023) Boztepe, Handan; Ozbay, Sevil Cinar; Akcam, Aysun; Kanbay, YalcinProblemBuilding rapport and trust between healthcare professional and patient/parents would improve satisfaction of patient/parents. The purpose of this study was to develop "The Pediatric Provider Communication Skills Assessment Scale" in this study. MethodsA trial form, with linguistic and psychometric validation and consisting of 44 statements, was administered to a sample of 325 individuals. Data were collected between January 20 and October 22, 2021. The validity of the scale was concluded after examining its construct validity and internal validity. "Exploratory factor analysis" was used for determining construct validity, and "comparison of lower-upper groups" for internal validity. "Cronbach's & alpha; reliability coefficient" and "split half test consistency coefficient" were calculated for testing the reliability of the scale. FindingsThe Pediatric Provider Communication Skills Assessment Scale that we developed consists of one dimension and 20 items, and the variance it can explain was calculated as 62.3%. The Cronbach & alpha; reliability coefficient of the scale was calculated as 0.90, indicating high reliability. ConclusionsAccording to the findings, "The Pediatric Provider Communication Skills Assessment Scale" is a scale with features that can measure in a valid and reliable way, with high variance and a low number of items. The study aims to develop the "The Pediatric Provider Communication Skills Assessment Scale," and present it to the literature as a validated and reliable new objective measurement tool. This study will enable us to understand more about the complex communication processes involved in pediatric care and how these may influence care delivery.Article Citation - WoS: 7Citation - Scopus: 7Classification of Intermediate and Novice Surgeons' Skill Assessment Through Performance Metrics(Sage Publications inc, 2019) Topalli, Damla; Cagiltay, Nergiz ErcilBackground. Endoscopic surgeries have become an alternative for open procedures whenever possible. For such types of operations, surgeons are required to gain several skills, whose development needs hands-on practice. Accordingly, gaining these skills today is a challenge for surgical education programs. Despite the development of several technology-enhanced training environments, there are still problems to better integrate these technologies into educational programs. For an appropriate integration, it is critical to assess the skill levels and adapt the training content according to the trainees' requirements. In the literature, there exist several methods for assessing these skill levels. However, there are still problems in practice for objective and repetitive assessment. Methods. The present study aims to estimate the skill levels of participants in surgical training programs in an objective manner by collecting experimental data from residents in an endoscopic surgical simulation environment and gathering performance metrics. Results. It is shown that, by comparing the results of a number of classification algorithms for the best accuracy estimation and feature set, the "novice" and "intermediate" skill levels can be estimated with an accuracy of 86%. Conclusions. The outcomes help surgical educators and instructional system designers to better assess the skill levels of the trainees and guide them accordingly. In addition, objective assessments as highlighted in this study can be beneficial when designing technology-enhanced adaptive learning environments.Article Citation - Scopus: 7Comparison of the Stability of Sandblasted, Large-Grit, and Acid-Etched Treated Mini-Screws with Two Different Surface Roughness Values: A Histomorphometric Study(Lippincott Williams & Wilkins, 2022) Seker, Elif Dilara; Yavuz, Ibrahim; Yucesoy, Turker; Cenkci, Ebru; Yay, ArzuPurpose:To evaluate the effects of 2 different surface roughness values produced by sandblasted, large-grit, and acid-etched treatments at different loading conditions on the stability of mini-screws.Material and Methods:A total of 56 mini-screws (Group 1; 28 with Ra value of 1 mu m, Group 2; 28 with Ra value of 1.5 mu m) were inserted into the tibia of fourteen New Zealand rabbits. Surface analysis was performed before the placement of the miniscrews using multi-technique characterization. The mini-screws were loaded with 500 grf after different healing times: unloaded, immediate, 4 and 8 weeks. Resonance frequency analyses were performed immediately after mini-screw placement and at the end of loading. Biomechanical and histomorphometric analyses were also performed at the end of the loading period.Results:All mini-screws preserved their stability at the end of the loading period. However, the resonance frequency analyses showed higher implant stability quotient scores for 8-week group, unlike the immediate loading and unloaded groups (P < 0.05). According to the infinite focus microscopy results, prolongation of healing time resulted in a greater bone area on the loaded mini-screws in Group 2 (P < 0.05). Similarly, the histomorphometric analysis revealed higher bone-to-implant contact values in the 8-week group. There was no significant difference in the stability between the miniscrews with the Ra values of 1 and 1.5 mu m.Conclusions:Sandblasted, large-grit, and acid-etched treated mini-screws showed significantly higher stability with healing time under heavy forces. Sandblasted, large-grit, and acid-etched treated mini-screws can be removed without fracture of the screw or the bone surfaces.Article The Predictive Effect of "Real Amylase Value": A More Accurate Predictor for Postoperative Pancreatic Fistula(Wiley, 2025) Emral, Ahmet Cihangir; Cetinkaya, Gokay; Dikmen, Kuersat; Kerem, MustafaBackgroundPostoperative pancreatic fistula (POPF) is a common and serious complication following pancreatic surgery. While several studies have attempted to predict the development of POPF using drain amylase concentration, predictive values vary widely due to factors like abdominal irrigation and chylous drainage, which can dilute the amylase levels. This study aims to evaluate whether the "Real Amylase Value" (RAV), calculated as the product of drain amylase concentration and drainage volume, provides a more reliable prediction of POPF compared to conventional amylase concentration. Better prediction of pancreatic fistula development could lead to closer clinical monitoring of these patients, reassessment of hospital stay duration, and more careful management of drains over an extended period. Additionally, carefully managing the timing of drain removal may improve patient recovery and discharge process.MethodologyData from 198 patients who underwent pancreaticoduodenectomy (PD) and distal pancreatectomy (DP) were retrospectively analyzed. Drain amylase concentrations and drainage volumes were measured on postoperative days (POD) 1 and 3, and the RAV (U) was calculated. Real Amylase Value (RAV) (U) was calculated using the formula: RAV (U) = Drain Amylase Concentration (U/L) x Drainage Amount (L). Predictive values for POPF were evaluated using receiver operating characteristic (ROC) curve analysis, comparing conventional amylase concentration (U/L) and RAV (U).ResultsOn POD1, the RAV (U) demonstrated greater predictive value for POPF compared to the conventional drain amylase concentration (U/L) with an area under the ROC curve (AUROC) of 0.85 versus 0.79, respectively. Similarly, on POD3, RAV showed superior predictive accuracy (AUROC 0.89) compared to amylase concentration (AUROC 0.79).ConclusionThe RAV (U) offers a more accurate and reliable prediction of POPF than traditional drain amylase concentration (U/L), with improved sensitivity and specificity. This method could refine clinical management, particularly in the timing of drain removal and early intervention strategies for patients at high risk of developing pancreatic fistulas.Article Citation - WoS: 16Citation - Scopus: 18Modeling and Forecasting of Monthly Pm2.5 Emission of Paris by Periodogram-Based Time Series Methodology(Springer, 2021) Akdi, Yilmaz; Golveren, Elif; Unlu, Kamil Demirberk; Yucel, Mustafa ErayIn this study, monthly particulate matter (PM2.5) of Paris for the period between January 2000 and December 2019 is investigated by utilizing a periodogram-based time series methodology. The main contribution of the study is modeling the PM2.5 of Paris by extracting the information purely from the examined time series data, where proposed model implicitly captures the effects of other factors, as all their periodic and seasonal effects reside in the air pollution data. Periodicity can be defined as the patterns embedded in the data other than seasonality, and it is crucial to understand the underlying periodic dynamics of air pollutants to better fight pollution. The method we use successfully captures and accounts for the periodicities, which could otherwise be mixed with seasonality under an alternative methodology. Upon the unit root test based on periodograms, it is revealed that the investigated data has periodicities of 1 year and 20 years, so harmonic regression is utilized as an alternative to Box-Jenkins methodology. As the harmonic regression displayed a better performance both in and out-of-sample forecasts, it can be considered as a powerful alternative to model and forecast time series with a periodic structure.Article Citation - WoS: 6Citation - Scopus: 6High Prevalence of Arma-16s Rrna Methyltransferase Among Aminoglycoside-Resistant klebsiella Pneumoniae Bloodstream Isolates(Microbiology Soc, 2022) Isler, Burcu; Falconer, Caitlin; Vatansever, Cansel; Ozer, Berna; Cinar, Gule; Aslan, Abdullah Tarik; Paterson, David L.Introduction. Aminoglycosides are used for the treatment of carbapenemase-producing Klebsiella pneumoniae (CPK) infections. 16S rRNA methyltransferases (RMTs) confer resistance to all aminoglycosides and are often cocarried with NDM. Hypothesis/Gap Statement. There is a dart of studies looking at the aminoglycoside resistance mechanisms for invasive CPK isolates, particularly in OXA-48 endemic settings. Aim. We aimed to determine the prevalence of RMTs and their association with beta lactamases and MLSTs amongst aminoglycoside-resistant CPK bloodstream isolates in an OXA-48 endemic setting. Methodology. CPK isolates (n=181), collected as part of a multicentre cohort study, were tested for amikacin, gentamicin and tobramycin susceptibility using custom-made sensititre plates (GN2XF, Thermo Fisher Scientific). All isolates were previously subjected to whole-genome sequencing. Carbapenemases, RMTs, MLSTs and plasmid incompatibility groups were detected on the assembled genomes. Results. Of the 181 isolates, 109(60 %) were resistant to all three aminoglycosides, and 96 of 109(88 %) aminoglycoside-resistant isolates carried an RMT (85 ArmA, 10 RmtC, 4 RmtF1; three isolates cocarried ArmA and RmtC). Main clonal types associated with ArmA were ST2096 (49/85, 58%) and ST14 (24/85, 28 %), harbouring mainly OXA-232 and OXA-48 +NDM, respectively. RmtC was cocarried with NDM (5/10) on ST395, and NDM +OXA-48 or NDM +KPC (4/10) on ST14, ST15 and ST16. All RMT producers also carried CTX-M- 15, and the majority cocarried SHV-106, TEM-150 and multiple other antibiotic resistance genes. The majority of the isolates harboured a combination of IncFIB, IncH and IncL/M type plasmids. Non-NDM producing isolates remained susceptible to ceftazidime-avibactam. Conclusion. Aminoglycoside resistance amongst CPK bloodstream isolates is extremely common and mainly driven by clonal spread of ArmA carried on ST2096 and ST14, associated with OXA-232 and OXA48 +NDM carriage, respectively.
