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The aim of this study is to report on the short-term and mid-term outcomes of preterm infants who underwent patent ductus arteriosus ligation through anterior mini-thoracotomy.
Data for 103 preterm infants who underwent patent ductus arteriosus clipping through an anterior mini-thoracotomy at the 2nd intercostal space between 2009 and 2019 were retrospectively reviewed. The patients were divided into two groups according to their weight at the time of surgery. The complications, morbidity, and mortality rates of each group were compared at postoperative day 30 and at the end of 1 year after surgery.
During the operation, the median weight of the patients was 900 g (IQR 800–1125 g), the median age was 21 days (IQR 14.5–29 days). The lowest body weight was 460 g. In three patients (3%), there was intraoperative bleeding from the patent ductus arteriosus that required transition to median sternotomy. In one patient (1%) a residual patent ductus arteriosus that required reoperation was observed. Twelve patients (12%) died in the first 30 days postoperatively. Six patients (6%) died between the postoperative day 30 and 1 year. There was no statistically significant difference in the rates of mortality, morbidity, and complication between the groups.
Based on our observations of over a hundred preterm infants with patent ductus arteriosus over a decade, ligation through anterior mini-thoracotomy is the main surgical procedure of choice for this patient group in our clinic. Our findings demonstrate the safety of this approach and we believe that it can be successfully replicated in other institutions.
We aimed to investigate the effect of Celiac disease on myocardial functions and aortic elasticity parameters.
Materials and Methods:
Thirty children with Celiac disease and 30 healthy children were enrolled in the study. Both the groups were similar in terms of age and gender. Cardiac functions of all children in the patients and control group were evaluated using conventional transthoracic echocardiography and tissue Doppler imaging. Aortic strain, distensibility, and stiffness index were calculated by M-mode echocardiography.
The demographic findings, height, weight, and body mass index of cases were similar among two groups. No statistical difference was found between E wave velocity for conventional transthoracic echocardiography and tissue Doppler imaging measurements of the mitral valve; early diastolic flow peak velocity, A wave velocity; late diastolic flow peak velocity; and E/A ratio. Isovolumetric relaxation time and isovolumetric contraction time ratios were statistically different between the groups (p = 0.000, p = 0.000, p = 0.000). The myocardial performance index calculated according to the pulse Doppler measurement results was found to be statistically different between the groups (p = 0.000). There was no statistical difference between the groups in terms of aortic strain, distensibility, and stiffness index.
In this study, both conventional transthoracic echocardiography and tissue Doppler imaging revealed the affection of the myocardial functions during systole and diastole in children with Celiac disease. Therefore, early follow-up and routine cardiac evaluation of celiac patients may be appropriate due to the increased risk of cardiac affection.
Plans and actions for collaboration of different disciplines and sectors for promotion of mental health and preventing mental disorders should include the involvement of different partners at various levels of expertise.
Objectives and aims
Examples of various implementations are to be shared among all parties so that exchange of experiences (including successes and failures) can enhance and stimulate further cooperation.
There has been several “learning together” activities carried out in Kocaeli, Turkey, in the last fifteen years, with the involvement of different governmental and nongovernmental organisations to raise awareness and to improve collaboration among decision makers, service providers and service users.
Results and conclusions
Physicians (including psychiatrists), psychologists, social workers, nurses, counsellors, teachers, members of armed forces, lawyers, administrators, service users, their family members have all been part of different implementations, most of them at local and a few at national level. It has not been possible in all cases to achieve the intended results, but it would be fair to conclude that there were lessons to be learned from all trials.
Some of the reasons of missing the intended results were different backgrounds, expectations, attributions, various and sometimes conflicting agendas of partners; limited experience regarding working and learning together for almost all partners… Some of the achievements were related with common interests, having experienced a major disaster (an earthquake), challenge of working against stigma with limited resources, openness and friendship at most of the cases… Several examples are planned to be discussed during the presentation.
Oxidative stress may contribute to the pathogenesis of congenital heart defects, but the role of dynamic thiol/disulphide homeostasis has not been evaluated. The objective of this study was to assess whether there are changes in thiol/disulphide homeostasis and nitric oxide levels in children with tetralogy of Fallot (TOF) and ventricular septal defect (VSD). A total of 47 children with congenital heart defects (24 TOF and 23 VSD) and 47 healthy age- and sex-matched controls were included in this study. Serum total thiol and native thiol levels were measured using a novel automatic spectrophotometric method. The amount of dynamic disulphide bonds and related ratios were calculated from these values. Serum nitric oxide levels were detected using a chemiluminescence assay. We found that the average native thiol, total thiol, and disulphide levels were decreased in patients with VSD when compared with healthy individuals (p < 0.001, p < 0.001, and p < 0.01, respectively). While native thiol levels were decreased (p < 0.01), disulphide levels were elevated in the TOF group (p < 0.05). We observed marked augmentation of disulphide/native thiol (p < 0.001) and disulphide/total thiol ratios (p < 0.01) in the TOF group. However, there was a significant decrease in native thiol/total thiol ratio in patients with TOF. No significant changes in these ratios were noted in the VSD group. We detected significant elevations in serum nitric oxide levels in children with TOF and VSD (p < 0.001 for all). These results are the first to demonstrate that thiol/disulphide homeostasis and nitric oxide are associated with TOF and VSD in children.
This article reports on the development of the Facial Emotion Recognition and Empathy Test (FERET) as a reliable and valid tool for assessing facial emotion recognition and empathy skills in primary school-aged children. Pictures of human faces developed by the researcher were used as response options for the children. The range of response options and their associated scores were constructed based on the Two Factorial Consensual Mood Structure, which indicates dimensions of emotions. Four hundred and twenty-two primary school children participated in the research. The children were asked to recognise emotions and display the appropriate empathetic response. Data were analysed through item analysis, exploratory factor analysis (EFA) and Item Response Theory (IRT). As a result of item analysis, FERET has been designed to include 6 items related to facial expressions of key emotions and has been found to have an internal consistency coefficient of .82 and be unidimensional. Results from the IRT indicated that all the items in FERET discriminate better responders from poor responders. It was concluded that FERET can produce reliable and valid results in measuring facial emotion recognition and empathy skills among primary school children.
Antimicrobial textiles received considerable attention due to public health and personal hygiene concerns. On the other hand, pathogenic microorganisms gain immunity against existing antibacterial products. For these reasons, new and stronger antibacterial agents need to be developed immediately. In this work, silver nanowires (Ag NWs) were decorated onto conventional fabrics via facile and scalable dip and dry method. Antimicrobial activity of the nanowire-decorated fabrics was investigated against a Gram-positive coccus (Staphylococcus aureus), a Gram-negative bacillus (Escherichia coli), a Gram-positive and spore-forming bacillus (Bacillus cereus), and a yeast-like fungus (Candida albicans) via disk diffusion and time–dependent killing methods. The effect of Ag NW content was investigated, and the decorated fabrics showed promising antibacterial activity even with a small amount of Ag NW decoration (0.095 mg/cm2). Moreover, decorated fabrics maintained their activity for 24 h. This work shows that Ag NW-modified fabrics can be used as antimicrobial textiles against a wide spectrum of bacteria.
Natural factors (solar and volcanic activities, orbital changes, etc.) changed the Earth’s climate in the past. Climate change nowadays differs. Human influence on the climate system is clear, and recent anthropogenic emissions of greenhouse gases are the highest in history. Current continued emission rate of greenhouse gases will cause further warming and long-lasting changes in all components of the climate system, increasing the likelihood of severe, pervasive and irreversible detrimental impacts for people and ecosystems. Warmer temperature, reduced surface and groundwater resources, increased extreme events, sea level rise, ocean acidification, extinction of species, melting glaciers, reduced permafrost extent, loss of Amazon rain forest, widespread drought and undermined food security, increased poverty and hunger, increased displacement of people, exacerbated human health problems and national security implications are some of the expected mega changes in the Future Earth. While stressing these threats, we are actually expressing a longing for a better world for our future and our children.
In this paper, we show that the cohomology of a general stable bundle on a Hirzebruch surface is determined by the Euler characteristic provided that the first Chern class satisfies necessary intersection conditions. More generally, we compute the Betti numbers of a general stable bundle. We also show that a general stable bundle on a Hirzebruch surface has a special resolution generalizing the Gaeta resolution on the projective plane. As a consequence of these results, we classify Chern characters such that the general stable bundle is globally generated.
Measles is an important childhood infection targeted to be eliminated by the World Health Organization (WHO). Virus circulation has not been interrupted in the European Region because high vaccination rates could not be achieved among some countries of the WHO European Region including Turkey. The purpose of this study was to evaluate the laboratory findings of measles cases confirmed in the last nine years, to assess the epidemiological data of the cases, to determine the molecular genotyping studies and to emphasise the importance of laboratory-based surveillance in measles. From 2007 to 2010, only 18 imported cases were detected in Turkey. However, this number increased with a local outbreak of 111 cases in 2011, followed by another outbreak in 2012 in Istanbul that spread countrywide in the following two years; a total of 8661 laboratory-confirmed measles cases were reported from 2012 to 2015. After ELISA detection of a measles IgM-positive result in serum samples of potential measles cases, RT–PCR was performed with urine or nasopharyngeal swab samples of patients, and amplicons were subjected to sequencing. In the samples of 2010 and 2011, D4 and D9 genotypes were mainly detected; as of 2012, the D8 genotype has gained importance. Although D8 was also identified in 2014, in the same year genotype H1 viruses were detected in Turkey for the first time. Therefore, it is important to perform a genotypic analysis of the virus causing the outbreak, analyse epidemiological connections of the contact, determine the source of the outbreak and plan measures based on this information.
The relief block at the centre of this study was found in 2004 in a ploughed field in the northern region of Lydia near the village of Gökçeler in the district of Akhisar, in what is today the Manisa province. A standing male figure is depicted on the block, which probably belonged to a chamber tomb. Holding a cock and a bud in his hands, stylistically the figure points to a date between the late sixth century BC and the early fifth century BC. He has short, spiral curls and wears a long-sleeved, tight-fitting garment that appears to be influenced by the Persian style. Within the scope of Anatolian-Persian funerary reliefs, this example is particularly significant due to its typological and iconographical elements. Specifically, following comparisons with other works of the Persian period, it is possible to suggest that the figure on the Gökçeler relief is an African who is offering a gift to the tomb owner; the latter may have been Persian or have served a Persian. Thus, this relief has particular significance since it is the only known work of Anatolian-Persian sculpture which indicates that individuals of African origin lived in the Anatolian region under Persian rule.
In a rapidly changing global market, it has become increasingly important and vital for the survival of the organization to be competitive and adaptive. In order to achieve this, organizational leadership needs a better understanding of the business cultures in which their companies are operating. One of the challenges is the lack of literature on ethical business cultures in emerging markets. This is also the case for Turkey, a fast growing emerging market. In this chapter, we use Donaldson and Dunfee’s Integrative Social Contracts Theory (ISCT) to explore the ethical business culture of Turkey as an emerging market. Hofstede’s cultural dimensions are used to analyze the role of Turkish national culture in shaping business behavior. The role of religion and of the political and administrative institutional structures is also discussed in detail. The development of ethical business cultures in Turkish business organizations is also discussed, with special emphasis on challenges presented by globalization and rapid economic development. Implications for leadership are also discussed.
The Morrison–Kawamata Cone Conjecture predicts that the action of the automorphism group on the effective nef cone and the action of the pseudo-automorphism group on the effective movable cone of a klt Calabi–Yau pair have rational, polyhedral fundamental domains. In [CPS], we proved the conjecture for certain blowups of Fano manifolds of index n - 1. In this paper, we consider the Morrison–Kawamata conjecture for blowups of Fano manifolds of index n - 2.
The aim of this study was to evaluate the anxiety and depression status, family functions, parenting attitudes, and quality of life in the mothers of children with CHD.
The study enrolled 120 mothers: 40 of children with cyanotic CHD, 40 of children with non-cyanotic CHD, and 40 of healthy controls. Short Form-36 for quality of life, Hospital Anxiety–Depression Scale for anxiety and depression, Family Assessment Device for the detection of problems affecting family functions, and Parental Attitude Research Instrument for measuring child-rearing attitudes were used in the study.
Statistically significant decreases were found in the general health standards of mothers of non-cyanotic children (p=0.035) and in the emotional and physical role difficulty of mothers of cyanotic children (p=0.006, p=0.010). When anxiety and depression levels of the parents were examined, the anxiety level of the cyanotic group was found to be significantly higher than that of the other groups (p=0.031). When family behaviours were assessed, there was a statistically significant decrease in role status in the families having a child with cyanotic CHD (p=0.035). In the Parental Attitude Research Instrument test, the husband and wife incompatibility sub-scale was found to be statistically significantly lower in the cyanotic CHD group (p=0.030).
When there is a diseased person in the family, the focus should not be solely on the problems of the patient but also on preventive methods to be implemented in order to protect the mental health of all family members.
This article argues that the effects of high-level corruption scandals on the future of a dominant party depend on the existence of a rule of law system based on the separation of powers. The article will study two examples from a comparative perspective to concretise its theoretical claims: the Christian Democracy Party in Italy, which was the dominant party from 1948 to 1992, and the Justice and Development Party in Turkey. The comparison will be based on an institutionalist perspective. The first part tries to provide a theoretical clarification of the concepts of predominant party systems and corruption. The second part discusses whether the Turkish and Italian party systems can be classified as predominant and the characteristics of these systems. The final section seeks to draw out similarities and differences between these two systems and the effects corruption has on them.
This study aimed to investigate the diagnostic value of wideband acoustic absorbance testing in otitis media with effusion.
This prospective study compared middle-ear wideband acoustic absorbance rates in three paediatric patient groups: a healthy group of 34 volunteers; 48 patients diagnosed with otitis media with effusion; and 28 patients with chronic effusion but no sign of effusion during myringotomy. The diagnostic value of absorbance testing was analysed with the receiver operating characteristic test.
The wideband acoustic absorbance rate was significantly lower in the otitis media with effusion group than in both the otitis media and healthy groups at the 0.375–2 kHz averaged mean absorbance (p < 0.017 and p < 0.001, respectively). Receiver operating characteristic analysis showed the highest diagnostic value for the 0.375–2 kHz averaged mean (area under the curve 0.984), followed by those at 1 and 1.5 kHz (area under the curve: 0.973 and 0.967, respectively).
The wideband acoustic absorbance test is more accurate for detecting middle-ear effusion compared with conventional 226-Hz tympanometry. Its practicality and objectivity suggest that the wideband acoustic absorbance test may be a better alternative for diagnosing otitis media with effusion.
The use of endoscopic techniques is becoming more widespread in otological and neuro-otological surgery. One such procedure, endoscopic tympanoplasty, is used in chronic otitis media treatment. This study aimed to analyse the results of endoscopic transcanal cartilage tympanoplasty.
Data of tubotympanic chronic otitis media patients who underwent transcanal endoscopic type I cartilage tympanoplasty between June 2012 and May 2013 were analysed. The main outcome measures were graft success and hearing improvement.
Graft success rates were 94.3 per cent and 92.5 per cent at post-operative months one and six, respectively. Post-operative air–bone gap values were significantly improved over pre-operative values (p < 0.01).
Transcanal endoscopic type I cartilage tympanoplasty is a minimally invasive, effective and reliable surgical treatment option for chronic otitis media.
Despite its relatively protected position, the liver is the most frequently injured solid intra-abdominal organ.1 Most liver injuries can be managed conservatively, but about 5% to 10% require urgent laparotomy, usually when the mechanism of injury involves a vehicle accident and hemodynamic instability persists, in spite of 40 mL/kg of blood transfusion.2,3 In particular, grades IV and V liver injuries may pose a challenge to the surgeon trying to control hemorrhage, the leading cause of mortality.4 Traumatic injuries to the portal vein are rare but devastating. The mortality rate for portal vein injury ranges from 50% to 70%. A recent study of portal triad injuries has highighted the higher mortality rates associated with combination injuries involving multiple portal triad components, especially those that include portal vein injury.5 This case study describes a unique case of relatively minor trauma in a child resulting in portal triad injury, sudden demise, and surgical repair.
The aim of this study is to investigate whether there were any associations between the T102C and 1438 A/G polymorphisms of the 5-HT2A receptor gene and schizophrenia. We conducted a case–control study of the T102C and 1438 A/G polymorphisms in Turkish patients.
We compared genotypes and allele frequencies of T102C and 1438 A/G polymorphisms of 5-HT2A receptor gene in 102 patients with schizophrenia diagnosed, according to DSM-IV, and 107 healthy controls. Genotyping was performed by real-time polymerase chain reaction.
We found no significant association between schizophrenia and genotypic or allele frequencies of HTR2A gene 102T/C (rs6313) and 1438 A/G (6311) polymorphisms. However, comparison of HTR2A gene 102 T/C and 1438 A/G polymorphisms in terms of genotypic and allele frequencies between the two patient groups, with or without a family history of schizophrenia, shows that T- and A-allele frequencies were significantly higher (p < 0.05) in the case group that has a history of schizophrenia in their family.
In conclusion, our results do not support the hypothesis that the T102C and 1438 A/G polymorphisms in the 5-HT2A receptor gene are associated with schizophrenia, but further studies in a larger sample are needed.