Tolerance, Mıgratıon And Hybrıd Identities: Normative Reasoning Of Intercultural Dialogue In A Blurring Structure

The aim of this study is to proof the argument – i.e. ‘there are significant linkages amongst tolerance, hybrid identities and migration.’ These linkages can be comprehended by means of conceptualising extensions of hybrid identities in aggregate trans/inter-migration processes. It can be put forward that arising hybrid identities are embedded in a blurring structure of thoughts, beliefs, states of affairs, facts, belongings and so forth. From multiculturalism and cosmopolitanism viewpoints, it is argued that tolerance and migration ought to be analysed in frame of sociology of law, human rights, international migration law, and of course the European Union law. So far, normative arguments and soft law approaches are very much well integrated with social aspects of migration, tolerance, identity and culture. In this context, the study examines to what extent cultural and human components are protected by law in multiple levels from an interdisciplinary perspective. In this framework, it is crucial to raise the research enquiries: What are possible criteria for the limits of tolerance? To what extent tolerance is related to human rights and morality? What ought to be the limit of tolerance towards hybrid identities in multicultural and cosmopolitan societies? In a consistent manner, the criteria and standards developed by some leading scholars were reconstructed and discussed throughout this paper. These criteria and standards are both moral (part of a universal system of morality) and legal (international, supranational, or national – i.e. constitutional). In order to apply such standards their validity was discussed (i.e. the respective normative power has the norms at the various levels). In the case of morals, their difference to particular ethnic systems was established (i.e. criteria by which the two can be distinguished). Then the research argument was elaborated on whether and how the legal standards comply with the moral standards, how national standards comply with supranational or international standards. Likewise, the study highlights the crucial contributions of “World Society and World System Paradigms” that are associated with social space, global civil society, cosmopolitanism, ethnic diversity, cultural hybridity, human rights activism and public sphere. Recent debates in Refugee Studies (e.g. Syrian Refugee Crisis, Dual and Multiple Citizenship Issues and so forth) highlight the fact that the European Union needs to consider new aspects of tolerance for hybrid identities and tolerate cultural rights of hybrid identities, create cohesion in communities and establish intercultural dialogue amongst home-states and host-states. Sanguinely, the efforts of hybrid identities are strengthening the relations between home-host states and these ought to attract some considerable attention. The authors of this study hope that their endeavours may contribute somewhat towards that

Prediction of strain limits via the marciniak-kuczynski model and a novel semi-empirical forming limit diagram model for dual-phase DP600 advanced high strength steel

The prediction capability of a forming limiting diagram (FLD) depends on how the yield strength and anisotropy coefficients evolve during the plastic deformation of sheet metals. The FLD predictions are carried out via the Marciniak-Kuczynski (M-K) criterion with anisotropic yield functions for DP600 steel of various thicknesses. Then, a novel semi-empirical FLD criterion is proposed, and prediction capabilities of the criterion are tested with different yield criteria. The results show that the yield functions are very sensitive to anisotropic evolution. Thus, while the FLD curves from the M-K model and the proposed model are not the same for each thickness, the proposed model has better prediction than the M-K model. © 2020 Journal of Mechanical Engineering. All rights reserved

Ertapenem Related Neurotoxicity Presented with Visual Halusinations in Chronic Kidney Failure Patient

During the follow-up of patients with renal failure, many medications may be required due to the clinical condition and comorbidities. Care should be taken in terms of the nephrotoxic effect of these drugs used or the accumulation of renally excreted drugs in the body and causing toxic effects. One of the most important side effects of carbapenems is neurotoxicity. Although Imipenem is the most frequently mentioned in this respect, similar side effects can be seen due to other carbapenems. Even if the dose is adjusted according to the glomerular filtration rate, these side effects can be seen. When the literature is examined, it has been determined that neurotoxicity due to ertapenem is seen more frequently than expected. In this study, we wanted to draw attention to this issue by presenting our case of visual hallucination observed after the use of ertapenem in a patient with chronic renal failure

HAVACILIKTA KULLANILAN BAZI SÜPERALAŞIMLARIN YÜKSEK SICAKLIK GAZ OKSİTLENME DAVRANIŞLARININ KARŞILAŞTIRILMASI

Havacılıkta yüksek sıcaklık bölgelerinde kullanılan malzemeler, korozyona dirençli ve yüksek mukavemet değerlerine sahip olmalıdırlar. Sektörden temin edilen ısıl işlem görmüş Ni esaslı süperalaşımları (Hastelloy X, Inconel 718 ve Inconel 738) öncelikle metalografik olarak hazırlandıktan sonra optik mikroskopta mikroyapıları görüntülenmiştir. Daha sonra oksitlenme deneyi için uygun boyuta getirilen numunelere 600 ve 900 °C sıcaklıklarında termogravimetrik analiz (TGA) cihazı ile 48 saat havada oksitlenme işlemi uygulanmıştır. Oksitlenen numunelerin yüzeylerinde oluşan oksit tabakaları tarayıcı elektron mikroskobu (SEM/ EDS) ile görüntülenmiş ve elementel analizi gerçekleştirilmiştir. Arrhenius eşitliği kullanılarak difüzyon kat sayıları hesaplanmış ve oksijen difüzyon kinetiği belirlenmiştir. Bu çalışmanın önemi bazı süperalaşımların oksitlenme kinetiklerinin ortaya çıkarılarak karşılaştırılması ve sektörün ihtiyacı olan kullanım açısından değerlendirme verilerine ulaşılmasını kolaylaştırmaktır

A patient presented with genital eruptions: The second case of monkeypox from Turkiye

İnsan maymun çiçeği (MPX) hastalığı, vaccinia ve variola gibi “poxviridae” ailesine ait maymun çiçeği virüsünün neden olduğu, yeniden önem kazanan zoonotik bir hastalıktır. Avrupa Hastalık Önleme ve Kontrol Merkezi [European Center for Disease Prevention and Control (ECDC)] tarafından Avrupa’da olağandışı bulaşma yollarına sahip bir MPX salgını bildirilmiştir. Bu raporda, erkekten erkeğe cinsel ilişki ilk kez insandan insana yakın bir temas yolu olarak tanımlanmıştır. Türkiye Cumhuriyeti Sağlık Bakanlığı, Türkiye’de MPX virüsü polimeraz zincir reaksiyonu [polymerase chain reaction (PCR)] ile doğrulanmış ilk olgunun 30 Haziran 2022’de bir hastanede kabul edildiğini ve izole edildiğini sosyal medya paylaşımı ile bildirmiştir. Bu bildiriden dört gün sonra merkezimize başvuran yirmi dört yaşında Türk erkek hasta lokal cerrahi işlem sonrası peniste ve skrotumda ortaya çıkan bakteriyel yumuşak doku enfeksiyonu ile kliniğimize yatırılmıştır. Öyküsünde bir hafta önce ortaya çıkan siğil benzeri lezyonlar nedeni ile dış merkezde lokal radyofrekans ablasyon tedavisi yapıldığını belirtmiştir. Yatışından bir gün sonra yüzünde, burun ucunda, vücudunda, kollarında ve parmaklarında giderek belirginleşen farklı evrelerde cilt lezyonları (makül, papül, göbekli papül) ve birkaç erüpsiyon gözlenen hasta, risk faktörleri değerlendirilerek MPX hastalığı açısından izole edilmiş ve Sağlık Bakanlığı rehberine göre MPX virüsü aranmak üzere örnekleri referans laboratuvara gönderilmiştir. Alınan örneklerde PCR ile MPX nükleik asidi saptanmıştır. Hastanın sekonder bakteriyel enfeksiyon tedavisi ve 21 günlük izolasyon süresi tamamlanarak taburcu edilmiştir. Bu olgu raporunda daha önce Türkiye’den bildirilmemiş olan MPX hastalığı, cinsel yolla bulaşan enfeksiyonlar (CYBE) ayırıcı tanısının ve tarama testlerinin önemi ve MPX hastalığı olgusuna uygulanan lokal ablasyon tedavisi sonrası gelişen yumuşak doku enfeksiyonu sunulmuştur. Yeni ve yeniden önem kazanan enfeksiyon hastalıklarına hazırlıklı olmak için güncel epidemiyolojik verilere dayalı iyi kurgulanmış sürekli eğitimin gerekliliğine vurgu yapılmıştır. Son zamanlarda, cinsel temas, MPX hastalığının yeni bulaşma yolu olarak tanımlanmaktadır ve semptom ve bulgular, “molluscum contagiousum” veya sifilis gibi diğer ülseratif cinsel yolla bulaşan enfeksiyonları (CYBE) taklit edebilir. Türkiye için ORF hastalığı da MPX hastalığı ayırıcı tanısı içindedir. Ayrıca bildirimi zorunlu olmayan CYBE ile başvuran hastalar, diğer tarama testleri yapılmadan sağlık hizmeti alabilmektedir. Kolay ulaşılabilen tanısal yeterliliği yüksek CYBE tarama merkezlerinin yaygınlaşması ile bu hastalıkların kontrol altına alınması sağlanabilir.Human monkeypox (MPX) disease is a re-emerging zoonotic infection caused by the monkeypox virus belonging to the same family as vaccinia and variola. The European Center for Disease Prevention and Control (ECDC) has documented an outbreak of MPX with atypical transmission paths throughout Europe. In this report, male-to-male sexual intercourse was first defined as a means of close human -to-human contact. The Ministry of Health of the Republic of Turkey announced via social media on June 30, 2022 that the first case confirmed by polymerase chain reaction (PCR) for the MPX virus in Turkey was admitted and isolated in a hospital. Four days after this statement, a 24-year-old Turkish man was hospitalized in our clinic with a bacterial infection of the penis and scrotum following local radiofrequency ablation therapy. A week ago, lesions resembling warts were noted in his medical history, for which a local radiofrequency ablation procedure was conducted at an external center. One day after his hospitalization, skin lesions of different stages (from macules, papules to umbilical papules) and several eruptions were detected on his face, nose tip, body, arms, and fingers, which gradually became more evident. After evaluating the risk factors, the patient was isolated with a preliminary diagnosis of MPX disease and samples were collected and sent for MPX virus detection to the reference laboratory according to the Ministry of Health guidelines. MPX virus nucleic acid was detected by PCR in samples taken from the lesion. The patient was discharged after 21 days of isolation and treatment for a secondary bacterial infection. In this case report the significance of differential diagnosis and screening tests for sexually transmitted infections (STI), a previously unreported case of MPX disease in Turkey, and a soft tissue infection that developed after local ablation treatment which was administered to a patient with MPX disease were presented. To be prepared for new and re-emerging infectious diseases, it was emphasized that well-structured continuing education based on current epidemiological data is required. Sexual contact has recently been identified as a new mode of transmission for MPX disease, and symptoms and signs may resemble those of other ulcerative sexually transmitted infections (STIs), such as "molluscum contagiousum" or syphilis. ORF disease is also in the differential diagnosis of MPX disease in Turkey. In addition, patients admitted with unreported STIs are permitted to receive health services without additional screenings. For this reason, easily accessible sexually transmitted disease centers with a high diagnostic efficiency can provide greater control over these diseases

Gallstone disease does not predict liver histology in nonalcoholic fatty liver disease

Background/Aims: We sought to examine whether the presence of gallstone disease (GD) in patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD) is associated with liver fibrosis and histological nonalcoholic steatohepatitis (NASH) score. Methods: We included 441 Turkish patients with biopsy-proven NAFLD. GD was diagnosed in the presence of sonographic evidence of gallstones, echogenic material within the gallbladder with constant shadowing and little or no visualization of the gallbladder or absence of gallbladder at ultrasonography, coupled with a history of cholecystectomy. Results: Fifty-four patients (12.2%) had GD (GD+ subjects). Compared with the GD- subjects, GD+ patients were older, had a higher body mass index and were more likely to be female and have metabolic syndrome. However, GD+ patients did not have a higher risk of advanced fibrosis or definite NASH on histology. After adjustment for potential confounding variables, the prevalence of GD in NAFLD patients was not associated with significant fibrosis (>= 2) (odds ratio [OR], 1.06; 95% confidence interval [Cl], 0.53 to 2.21; p=0.68) or definite NASH (OR, 1.03; 95% Cl, 0.495 to 2.12; p=0.84). Conclusions: The presence of GD is not independently associated with advanced fibrosis and definite NASH in adult Turkish patients with biopsy-proven NAFLD

Relation between Apolipoprotein E Gene Polymorphism and Severity of Coronary Artery Disease in Acute Myocardial Infarction

Apolipoprotein E (ApoE) is a plasma protein and associated with cholesterol transport system. In several studies, the relationship between ApoE gene polymorphism and severity of coronary artery disease (CAD) has been shown. However, the relationship between ApoE gene polymorphism and severity of CAD in patients with acute myocardial infarction (MI) has not been well known. The aim of this study is to investigate the relation between ApoE polymorphism and severity of CAD in patients with acute MI by using the Gensini Score. In this study, 138 patients were admitted to cardiology clinic with diagnosis of acute MI, and angiographic assessment was performed using the Gensini Score. Blood samples were obtained from all patients in the first day. The patients with ApoE34 genotype had high Gensini scores. Besides, the patients with E4 allele carriers were associated with high Gensini score compared with the patients without E4 allele carriers (p:0,22). The patients with E4 allele carriers were associated with higher LDL cholesterol and total cholesterol compared with the patients without E4 allele carriers (p:0,001 and p:0,03, resp.). There were no statistically significant differences between ApoE genotypes and severity of CAD by using the Gensini Score. But, the patients with E4 allele carriers were associated with high lipid levels

Putative second hit rare genetic variants in families with seemingly GBA-associated Parkinson’s disease

Rare variants in the beta-glucocerebrosidase gene (GBA1) are common genetic risk factors for alpha synucleinopathy, which often manifests clinically as GBA-associated Parkinson’s disease (GBA-PD). Clinically, GBA-PD closely mimics idiopathic PD, but it may present at a younger age and often aggregates in families. Most carriers of GBA variants are, however, asymptomatic. Moreover, symptomatic PD patients without GBA variant have been reported in families with seemingly GBA-PD. These observations obscure the link between GBA variants and PD pathogenesis and point towards a role for unidentified additional genetic and/or environmental risk factors or second hits in GBA-PD. In this study, we explored whether rare genetic variants may be additional risk factors for PD in two families segregating the PD-associated GBA1 variants c.115+1G>A (ClinVar ID: 93445) and p.L444P (ClinVar ID: 4288). Our analysis identified rare genetic variants of the HSP70 co-chaperone DnaJ homolog subfamily B member 6 (DNAJB6) and lysosomal protein prosaposin (PSAP) as additional factors possibly influencing PD risk in the two families. In comparison to the wild-type proteins, variant DNAJB6 and PSAP proteins show altered functions in the context of cellular alpha-synuclein homeostasis when expressed in reporter cells. Furthermore, the segregation pattern of the rare variants in the genes encoding DNAJB6 and PSAP indicated a possible association with PD in the respective families. The occurrence of second hits or additional PD cosegregating rare variants has important implications for genetic counseling in PD families with GBA1 variant carriers and for the selection of PD patients for GBA targeted treatments

Putative second hit rare genetic variants in families with seemingly GBA-associated Parkinson's disease

Rare variants in the beta-glucocerebrosidase gene (GBA1) are common genetic risk factors for alpha synucleinopathy, which often manifests clinically as GBA-associated Parkinson's disease (GBA-PD). Clinically, GBA-PD closely mimics idiopathic PD, but it may present at a younger age and often aggregates in families. Most carriers of GBA variants are, however, asymptomatic. Moreover, symptomatic PD patients without GBA variant have been reported in families with seemingly GBA-PD. These observations obscure the link between GBA variants and PD pathogenesis and point towards a role for unidentified additional genetic and/or environmental risk factors or second hits in GBA-PD. In this study, we explored whether rare genetic variants may be additional risk factors for PD in two families segregating the PD-associated GBA1 variants c.115+1G>A (ClinVar ID: 93445) and p.L444P (ClinVar ID: 4288). Our analysis identified rare genetic variants of the HSP70 co-chaperone DnaJ homolog subfamily B member 6 (DNAJB6) and lysosomal protein prosaposin (PSAP) as additional factors possibly influencing PD risk in the two families. In comparison to the wild-type proteins, variant DNAJB6 and PSAP proteins show altered functions in the context of cellular alpha-synuclein homeostasis when expressed in reporter cells. Furthermore, the segregation pattern of the rare variants in the genes encoding DNAJB6 and PSAP indicated a possible association with PD in the respective families. The occurrence of second hits or additional PD cosegregating rare variants has important implications for genetic counseling in PD families with GBA1 variant carriers and for the selection of PD patients for GBA targeted treatments

Parental psychological distress associated with COVID-19 outbreak: A large-scale multicenter survey from Turkey

Aims: Pandemics can cause substantial psychological distress; however, we do not know the impact of the COVID-19 related lockdown and mental health burden on the parents of school age children. We aimed to comparatively examine the COVID-19 related the stress and psychological burden of the parents with different occupational, locational, and mental health status related backgrounds. Methods: A large-scale multicenter online survey was completed by the parents (n = 3,278) of children aged 6 to 18 years, parents with different occupational (health care workers—HCW [18.2%] vs. others), geographical (İstanbul [38.2%] vs. others), and psychiatric (child with a mental disorder [37.8%]) backgrounds. Results: Multivariable logistic regression analysis showed that being a HCW parent (odds ratio 1.79, p <.001), a mother (odds ratio 1.67, p <.001), and a younger parent (odds ratio 0.98, p =.012); living with an adult with a chronic physical illness (odds ratio 1.38, p <.001), having an acquaintance diagnosed with COVID-19 (odds ratio 1.22, p =.043), positive psychiatric history (odds ratio 1.29, p <.001), and living with a child with moderate or high emotional distress (odds ratio 1.29, p <.001; vs. odds ratio 2.61, p <.001) were independently associated with significant parental distress. Conclusions: Parents report significant psychological distress associated with COVID-19 pandemic and further research is needed to investigate its wider impact including on the whole family unit. © The Author(s) 2020