Uykuda saç koparma: Bir pediyatrik olgu

Kişinin kendi kılını karşı konulamaz bir şekilde çekip koparması olarak tanımlanan trikotilomani, DSM-IV-TR'da Başka Türlü Adlandırılamayan Dürtü Kontrol Bozuklukları başlığı altında sınıflandırılmaktadır. Bu davranış, artmış öfke ve kaygı gibi duygular nedeni ile ortaya çıkan gerilimi ortadan kaldırmak için yapılmaktadır. Olgumuz, tüm gece boyunca uyurken saçını koparma ve altını ıslatma bulguları gösteren 11 yaşında erkek çocuğuydu. Ayırıcı tanı için olgumuza tüm gece süresince uyku sırasında polisomnografi uygulanarak, epileptik deşarjların ayırt edilmesi amaçlandı. Sonuçlar normal sınırlarda bulundu. Trikotilomani ön tanısı tartışıldı. Trikotilomaninin parasomni tanısı adı altında değerlendirilmesinin daha uygun olacağı sonucuna varıldı.Trichotillomania, defined as an irresistible urge to pull and pluck one's own hair, is categorized as an impulse control disorder not otherwise specified in DSM-IV-TR. This behavior is performed in response to a number of emotions such as increasing temper or anxiety and gives resultant tension relief. Our case is an 11-year-old boy who showed signs of pulling his hair overnight and bedwetting when he was sleeping. Polysomnography was performed on him overnight during sleep to differentiate epileptic discharge, for a differential diagnosis. The results were within normal limits. The initial diagnosis of trichotillomania was discussed and we concluded that it would be more appropriate to evaluate the case under the diagnosis of parasomnia

A Parametric Study of Pile Behavior In Liquefied Soils

Liquefaction in saturated sandy soils under cyclical loads has a significant part in the structural damage cases. Pile foundations, used for soils with bearing capacity problems, might get exposed to various liquefaction-based damages. The finite element program FLAC2D is utilized to understand the pile behavior in liquefied soils under dynamic loads. The 1999 Kocaleli earthquake record was used in the numerical analysis for a single pile element in the layered soil profile with liquefied and non-liquefied soil. The pile-head of the model used in the layered soil sample was left free for rotation. Calculations for a single pile profile where axial load and horizontal load are affected simultaneously were performed by considering both the kinematic and inertial effect. Finite difference analyzes were performed by changing the embedded lengths of pile socket according to the existence and absence of a non-liquefying crust layer on the liquefied soil in the layered soil profile. As the results of the pile-head displacement and maximum moment value output were assessed

The Effect of Mixture Parameters on the Surface Properties of Roller Compacted Concrete (RCC) Pavements

In Turkey, the use of RCC pavements is increasing in urban and rural roads. However, a detailed study examining the effect of RCC mixture parameters on the pavement surface properties that affect road driving comfort and safety is not available in literature. In this study, in order to cover that gap in literature 12 RCC mixtures prepared with different cement dosages, aggregate gradations and water amounts were compacted by "Superpave-Gyratory-Compactor" at different levels. Later, the surface characteristics were evaluated with British pendulum and sand patch tests. It was concluded that cement dosage, water content and gradation have an effect not only in terms of strength but also in terms of pavement surface properties, and recommendations were made for RCC mixture optimization.Ülkemizde SSB kaplamaların şehir içi ve köy yollarında kullanımı gittikçe artmaktadır. Fakat yol sürüş konforunu ve güvenliğini etkileyen kaplama yüzey özelliklerine, karışım parametrelerinin etkisini inceleyen detaylı bir çalışma uluslararası literatürde mevcut değildir. Bu eksikliği gidermeye yönelik yapılan bu çalışmada, farklı çimento dozajları, agrega gradasyonları ve su oranları ile hazırlanan 12 SSB karışımı, “Superpave-Yoğurmalı-Presi” ile farklı seviyelerde sıkıştırılıp yüzey özellikleri, İngiliz pandülü ve kum yama testleriyle değerlendirilmiştir. Yapılan istatistiksel analizlerde, yoğurma sayısının etkisi görülmezken; SSB çimento dozajı, su muhtevası ve gradasyonun yalnızca mukavemet yönünden değil aynı zamanda yüzey özellikleri bakımından da etkili olduğu sonucuna varılmış ve SSB karışım optimizasyonu için öneriler getirilmiştir

Biochemical, biomechanical and imaging biomarkers of ischemic stroke:Time for integrative thinking

Stroke is one of the leading causes of adult disability affecting millions of people worldwide. Post-stroke cognitive and motor impairments diminish quality of life and functional independence. There is an increased risk of having a second stroke and developing secondary conditions with long-term social and economic impacts. With increasing number of stroke incidents, shortage of medical professionals and limited budgets, health services are struggling to provide a care that can break the vicious cycle of stroke. Effective post-stroke recovery hinges on holistic, integrative and personalized care starting from improved diagnosis and treatment in clinics to continuous rehabilitation and support in the community. To improve stroke care pathways, there have been growing efforts in discovering biomarkers that can provide valuable insights into the neural, physiological and biomechanical consequences of stroke and how patients respond to new interventions. In this review paper, we aim to summarize recent biomarker discovery research focusing on three modalities (brain imaging, blood sampling and gait assessments), look at some established and forthcoming biomarkers, and discuss their usefulness and complementarity within the context of comprehensive stroke care. We also emphasize the importance of biomarker guided personalized interventions to enhance stroke treatment and post-stroke recovery.</p

Covid-19 ve Nörolojik Bozukluklar

Dünya Sağlık Örgütü tarafından 11 Mart 2019’da pandemi olarak kabul edilen COVID-19 hastalığının pandeminin ilk döneminde öncelikle solunum yollarını etkileyen ve ciddi akut solunum yetmezliğine (SARS) neden olan bir viral enfeksiyon olduğu kabul edilmiştir. Zaman içinde vasküler sistemler başta olmak üzere diğer organ sistemlerini ve en önemlisi de diğer sistemlerle beraber nörolojik sistemleri ve hatta bazen sadece nörolojik sistemleri etkilediği ortaya konmuştur. Ciddi semptomu olmayan hastalarda bile koku alma kaybı sık olarak görülmekte olup bazı hastalarda ilk veya tek belirti olabilmektedir. Viral enfeksiyonun iyileşmesine rağmen koku alma fonksiyonunun aynı hızla kazanılamaması yaşam kalitesini etkileyen önemli bir nörolojik tutulumdur. Dünyada pandemi sürecinde vaka bildirimleri ve klinik verilerin analizleri ile hızlı bilgi akışı devam etmektedir. Bu yazıda literatür incelemesi ile dünyada bildirilen nörolojik tutulumlar ışığında kranial sinir tutulumları, serebrovasküler hastalıklar ve inme, ansefalit, epilepsi, Guillain Barré sendromu, psikiyatrik bozukluklar ile ilgili güncel bilgilerin paylaşılması amaçlanmıştır

Modelling long term effects of cropping and managements systems on soil organic matter, C/N dynamics and crop growth

While simulation of cropping systems over a few years might reflect well the short term effects of management and cultivation, long term effects on soil properties and their consequences for crop growth and matter fluxes are not captured. Especially the effect on soil carbon sequestration/depletion is addressed by this task. Simulations of an ensemble of crop models are performed as transient runs over a period of 120 year using observed weather from three stations in Czech Republic (1961-2010) and transient long time climate change scenarios (2011-2080) from five GCM of the CMIP5 ensemble to assess the effect of different cropping and management systems on carbon sequestration, matter fluxes and crop production in an integrative way. Two cropping systems are regarded comprising two times winter wheat, silage maize, spring barley and oilseed rape. Crop rotations differ regarding their organic input from crop residues, nitrogen fertilization and implementation of catch crops. Models are applied for two soil types with different water holding capacity. Cultivation and nutrient management is adapted using management rules related to weather and soil conditions. Data of phenology and crop yield from the region of the regarded crops were provided to calibrate the models for crops of the rotations. Twelve models were calibrated in this first step. For the transient long term runs results of four models were submitted so far. Outputs are crop yields, nitrogen uptake, soil water and mineral nitrogen contents, as well as water and nitrogen fluxes to the atmosphere and groundwater. Changes in the carbon stocks and the consequences for nitrogen mineralisation, N fertilization and emissions also considered.

The frequency of Duchenne muscular dystrophy/Becker muscular dystrophy and Pompe disease in children with isolated transaminase elevation: results from the observational VICTORIA study

IntroductionElevated transaminases and/or creatine phosphokinase can indicate underlying muscle disease. Therefore, this study aims to determine the frequency of Duchenne muscular dystrophy/Becker muscular dystrophy (DMD/BMD) in male children and Pompe disease (PD) in male and female children with isolated hypertransaminasemia.MethodsThis multi-center, prospective study enrolled patients aged 3–216 months with serum alanine transaminase (ALT) and/or aspartate transaminase (AST) levels &gt;2× the upper limit of normal (ULN) for ≥3 months. Patients with a known history of liver or muscle disease or physical examination findings suggestive of liver disease were excluded. Patients were screened for creatinine phosphokinase (CPK) levels, and molecular genetic tests for DMD/BMD in male patients and enzyme analysis for PD in male and female patients with elevated CPK levels were performed. Genetic analyses confirmed PD. Demographic, clinical, and laboratory characteristics of the patients were analyzed.ResultsOverall, 589 patients [66.8% male, mean age of 63.4 months (standard deviation: 60.5)] were included. In total, 251 patients (188 male and 63 female) had CPK levels above the ULN. Of the patients assessed, 47% (85/182) of male patients were diagnosed with DMD/BMD and 1% (3/228) of male and female patients were diagnosed with PD. The median ALT, AST, and CPK levels were statistically significantly higher, and the questioned neurological symptoms and previously unnoticed examination findings were more common in DMD/BMD patients than those without DMD/BMD or PD (p &lt; 0.001).DiscussionQuestioning neurological symptoms, conducting a complete physical examination, and testing for CPK levels in patients with isolated hypertransaminasemia will prevent costly and time-consuming investigations for liver diseases and will lead to the diagnosis of occult neuromuscular diseases. Trial RegistrationClinicaltrials.gov NCT04120168

Asfalt betonunun dinamik sünme davranışı için seçilen matematiksel modeller üzerinde parametrik çalışma.

Rut formation has long been recognized as a distress mechanism in flexible pavements. One of the causes of rut formation in flexible pavements is permanent deformation of uppermost asphalt concrete layers due to repeatedly applied traffic loading. The long term permanent deformation of asphalt concrete under repeated load is commonly called as dynamic creep. The primary objective of this thesis is to examine dynamic creep behavior of asphalt concrete specimens tested in laboratory and also study some suitable mathematical models for representing dynamic creep behavior. In this study, a set of uniaxial repeated load creep tests were performed on standard Marshall specimens prepared at three different bitumen contents. The effects of bitumen content and test condition parameters on dynamic creep behavior are examined. Among several mathematical creep models suggested by researchers, two well known models and a model proposed by the author are selected for representing the laboratory creep behavior. For each of these models, the interactions of the model parameters with varying bitumen content and test conditions are studied to detect probable definite trends, and to evaluate whether some relations for the model parameters as functions of bitumen content and test conditions can be developed or not. The results of analyses showed that all three mathematical models used in this study are successful in representing the laboratory dynamic creep behavior of asphalt concrete. The Power Model which has only two parameters is found to be the most stable and suitable model for parametric study among the three selected models. More consistent and definite interactions are observed between the parameters of this model and test conditions. However, within the scope of this study, no relations could be developed for the parameters of selected models as functions of bitumen content and test conditions because of limited test data.M.S. - Master of Scienc

İklim Değişikliğinin Asfalt Kaplamalari üzerindeki etkileri ve yeni yapim stratejileri

Karayolu inşaat sektörü, hem ekonomihem de kalkınma açısından önemlibir rol oynamaktadır, fakatkarbon salınımının da önemli bir kaynağıdır. Bu sebeple, enerji tasarrufu ve karbon emisyonlarının azaltılması küresel iklim değişikliği nedeniyle kritik konulardan birihaline gelmiştir. Bu çalışma kapsamında iklim değişiminin ülkemiz ve özellikle de asfalt kaplamalar üzerindeki etkileri detaylıca ele alınmıştır. Bu bağlamda iklim değişikliği eylem planı çerçevesinde ulaşım sektöründe enerji tüketiminde verimliliğin arttırılması hedefine uygun olarak Ilık Karışım Asfalt (IKA) kullanımı teşvik edilmesi veayrıca asfalt kaplamanın geri kazanımı halinde karbon salınımıüzerinde etkileri literatür taraması ile ortaya konmuştur. Bu yöntemlerin hem çevresel hem de ekonomik açıdan birçok kazanım getirmesi beklenmektedir