Atrioventricular Septal Defects Repair: Comparison of Classic Single Patch and Double-Patch Techniques

Objective: Different patch techniques were virtually always used in the surgery of pediatric patients with complete atrioventricular septal defects. In this study, we described our single center, single surgeon experiences and results about the classic single patch and double patch techniques to repair complete atrioventricular septal defects. Materials and Methods: This retrospective descriptive study included 30 patients who underwent intracardiac repair of complete atrioventricular septal defect in Ankara Bilkent City Hospital Department of Pediatric Cardiovascular Surgery. The study was conducted between February 2019 to December 2021. Patients in group S underwent surgery using the traditional single-patch method, while group D included patients who underwent repair using the double patch approach (n = 10). Patients’ demographic and clinical information was taken from institutional databases and medical records. Postoperative complications were recorded. Results: When the preoperative/postoperative insufficiency levels of the valves were compared with the Wilcoxon Signed rank test, the findings were not statistically significant for the left atrioventricular valves, but were statistically significant for the right atrioventricular valves. (p=0.02) When we compared postoperative valve regurgitation of both techniques with the Kruskall-Wallis test, no significant difference was found between postoperative valve regurgitation and function, independent of preoperative findings. Conclusion: Both operation techniques did not make a difference between operative or late mortality and morbidity. Depending on the surgeon’s experience, ventricular septal defect size does not play a restrictive role in the selection of the technique to be used. The single-patch and double patch method as described here is methodical, comprehensible, repeatable, and reasonably long-lasting

Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population.Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed.Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%).Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL

Rantiye devlette yenilenebilir enerjinin rolünü anlamak: Birleşik Arap Emirlikleri örneği

The overall purpose of this thesis can be put as the search for the prospects of the establishment of a renewable energy paradigm in a conventional example of an oil-rich state. The sample actor of the oil paradigm is chosen as the United Arab Emirates, as it represents the overall character of the Arab Gulf region, as well as being an appropriate example of what is termed as the ‘rentier state’. Within this framework, firstly it is aimed to shed light on the negative impacts of the oil paradigm in terms of economic problems, social imbalances, and environmental consequences. Secondly, it is sought to answer the question of what has been done for the incorporation of a renewable energy policies into various aspects of Emirati governance, ever since the country’s independence in 1971. Thirdly, the causal relationship between the country’s renewable energy policies and certain positive outcomes will be highlighted. This thesis would be informative to show whether United Arab Emirates could be a model for other rentier states of the region and beyond, towards the embracing of renewable energy paradigm in the face of depleting oil resources.M.S. - Master of Scienc

Understanding Input and Output Legitimacy of Environmental Policymaking in The Gulf Cooperation Council States

This article analyses environmental policymaking in the Gulf Cooperation Council (GCC) states, with a focus on the output legitimacy of renewable energy uptake. Most environmental policy research so far has focused on either Western industrialized countries with established democracies or developing countries with either democratic or autocratic policymaking systems, and few studies have yet analyzed the overall effectiveness of these monarchies in environmental decisionmaking. The degree of this policy effectiveness is hence the focus of this paper. Specifically, the paper argues that, although there are a number of input legitimacy deficits in the six GCC countries (United Arab Emirates, Saudi Arabia, Qatar, Kuwait, Bahrain and Oman), there has been progress regarding renewable energy uptake. Thus, these monarchies may be relying more on output legitimacy than input legitimacy. Following up on the studies on input and output legitimacy, the main argument is that in certain cases useful policy results can be reached in the presence of not so strong input legitimacy, and other factors also have an impact on policymaking. The paper bases its analysis on an extensive study of primary and secondary sources, specifically institutional publications, international organization reports, newspaper articles and academic papers. With its analysis, the paper contributes to larger debates in environmental governance research on the relative effectiveness of renewable energy uptake in monarchical, resource-rich, rentier states

Felsefi açıdan tolerans ve hoşgörü

Bu tezin amacı, aynı anlamda olduğu düşünülen batı kaynaklı tolerans kelimesi ile tamamen Türk halk kültürünü yansıtan hoşgörü kelimesi arasındaki farkı ortaya çıkarmaktır. İlk bölümde kelimeler ayrı ayrı ele alınarak etimolojileri ve ortaya çıktıkları kültürlerdeki kullanımları incelenmiştir. İkinci bölümde kelimelerin tarihsel arka planları, içerikleri unsurları ve alanları sunularak kelimeler arasında bir karşılaştırma yapılmıştır. Üçüncü bölümde toleransla ilgili felsefi argümanlardan örnekler sunulmuştur. Bu çalışma ile tolerans ve hoşgörü kavramlarının aynı anlamı karşılamadıkları, toleransın kurumsal bir yapısı olduğu, hoşgörünün ise bireysel bir tutumu ifade ettiği sonucuna ulaşılmıştır. Anahtar Kelimeler: Tolerans, Hoşgörü, Farklılık, Hristiyan, Aydınlanma, Kilise, Devlet.\ud The aim of this thesis is to reveal the difference between tolerance of which source is Europe and hoşgörü which reflects Turkish folk culture completely and which are thought to have the same meaning. In the first part the etymology of the words and their usage where they emerged have been examined separately. In the second part tolerance and hoşgörü have been compared by giving their historical backgrounds, contents, elements and fields. In the third part samples related with tolerance from philosophical arguments have been given. In this thesis it has been inferred that tolerance and hoşgörü do not mean the same sense, tolerance has an institutional manner whereas hoşgörü expresses a personal manner. Key Words: Tolerance, Hoşgörü, Difference, Christian, Enlightenment, Church, State

Renewable energy support mechanisms in the Gulf Cooperation Council states: Analyzing the feasibility of feed-in tariffs and auction mechanisms

Renewable energy will be a crucial ingredient in the transition to a more sustainable future. The renewable energy sector requires a variety of financial support mechanisms in order to further consolidate and expand. Currently, the most prominent renewable energy support mechanisms are feed-in tariffs and renewable energy auctions. Although these mechanisms have been used and analyzed extensively in Western countries and, more recently, economies in transition, they have rarely been examined in the Arab Gulf region. Yet, particularly the Gulf Cooperation Council (GCC) states have undertaken important steps towards renewable energy adoption, which could be greatly facilitated with the use of financial support mechanisms. This paper analyzes the feasibility of feed-in tariffs and renewable energy auctions adoption in GCC. Based on an extensive meta-analysis of the literature on these two mechanisms in both developed and developing countries, the paper identifies a set of conditions necessary for success and evaluates the presence of favorable these conditions in the GCC context. Our findings reveal that while conditions that would ensure political feasibility are largely absent for both types of mechanisms, auctions could be a more successful strategy at the moment

Human Hepatocellular Carcinoma Classification from H&amp;E Stained Histopathology Images with 3D Convolutional Neural Networks and Focal Loss Function

This paper proposes a new Hepatocellular Carcinoma (HCC) classification method utilizing a hyperspectral imaging system (HSI) integrated with a light microscope. Using our custom imaging system, we have captured 270 bands of hyperspectral images of healthy and cancer tissue samples with HCC diagnosis from a liver microarray slide. Convolutional Neural Networks with 3D convolutions (3D-CNN) have been used to build an accurate classification model. With the help of 3D convolutions, spectral and spatial features within the hyperspectral cube are incorporated to train a strong classifier. Unlike 2D convolutions, 3D convolutions take the spectral dimension into account while automatically collecting distinctive features during the CNN training stage. As a result, we have avoided manual feature engineering on hyperspectral data and proposed a compact method for HSI medical applications. Moreover, the focal loss function, utilized as a CNN cost function, enables our model to tackle the class imbalance problem residing in the dataset effectively. The focal loss function emphasizes the hard examples to learn and prevents overfitting due to the lack of inter-class balancing. Our empirical results demonstrate the superiority of hyperspectral data over RGB data for liver cancer tissue classification. We have observed that increased spectral dimension results in higher classification accuracy. Both spectral and spatial features are essential in training an accurate learner for cancer tissue classification

Classification of Human Carcinoma Cells Using Multispectral Imagery

In this paper, we present a technique for automatically classifying human carcinoma cell images using textural features. An image dataset containing microscopy biopsy images from different patients for 14 distinct cancer cell line type is studied. The images are captured using a RGB camera attached to an inverted microscopy device. Texture based Gabor features are extracted from multispectral input images. SVM classifier is used to generate a descriptive model for the purpose of cell line classification. The experimental results depict satisfactory performance, and the proposed method is versatile for various microscopy magnification options