Reproducibility of endometrial intraepithelial neoplasia diagnosis is good, but influenced by the diagnostic style of pathologists

Endometrial intraepithelial neoplasia (EIN) applies specific diagnostic criteria to designate a monoclonal endometrial preinvasive glandular proliferation known from previous studies to confer a 45-fold increased risk for endometrial cancer. In this international study we estimate accuracy and precision of EIN diagnosis among 20 reviewing pathologists in different practice environments, and with differing levels of experience and training. Sixty-two endometrial biopsies diagnosed as benign, EIN, or adenocarcinoma by consensus of two expert subspecialty pathologists were used as a reference comparison to assess diagnostic accuracy of 20 reviewing pathologists. Interobserver reproducibility among the 20 reviewers provided a measure of diagnostic precision. Before evaluating cases, observers were self-trained by reviewing published textbook and/or online EIN diagnostic guidelines. Demographics of the reviewing pathologists, and their impressions regarding implementation of EIN terminology were recorded. Seventy-nine percent of the 20 reviewing pathologists' diagnoses were exactly concordant with the expert consensus (accuracy). The interobserver weighted kappa values of 3-class EIN scheme (benign, EIN, carcinoma) diagnoses between expert consensus and each of reviewing pathologists averaged 0.72 (reproducibility, or precision). Reviewing pathologists demonstrated one of three diagnostic styles, which varied in the repertoire of diagnoses commonly used, and their nonrandom response to potentially confounding diagnostic features such as endometrial polyp, altered differentiation, background hormonal effects, and technically poor preparations. EIN diagnostic strategies can be learned and implemented from standard teaching materials with a high degree of reproducibility, but is impacted by the personal diagnostic style of each pathologist in responding to potential diagnostic confounders

Bilgisayar Destekli Eğitimde Teknolojik Kolaylaştırıcı Olarak Facebook Platformu ve Avantajları

Bilgisayar destekli eğitimde bilgi ve deneyim içeriğine erişmeye çalışırken temel noktalarda aksamalar olduğu düşünülmektedir. Temel sorunsal, teknoloji ile karşılaşan öğrencinin, bu etkileşim sürecini başka bir aracı olmadan sağlıklı bir şekilde tamamlayamamasıdır. Gündemdeki uygulamalarda, teknoloji, etkileşimi kolaylaştırıcı bir rol üstlenmekten öte temel ve tek araç rolündedir. Çeşitli araştırmalar etkileşime destek olacakşekilde bir aracının varlığını önemli bir gereklilik olarak önermektedir. Bu çalışma,teknolojiyi temel araç olarak görmek yerine, etkileşimin sağlıklı ve eksiksiz yürümesini sağlayacak bir kolaylaştırıcı olarak ele almayı tercih etmektedir. Teknolojik etkileşimden kolaylaştırıcı olarak bahsedildiğinde ise sosyal medya ve özellikle Facebook gündeme gelmektedir. Günümüzde hala en aktif kullanıcı sayısı bu platformda bulunmaktadır. Çalışma Facebook’un bir etkileşim platformu olarak; paylaşma, beğeni, bildirim, sayfa-grup yapılanmaları, yorumlama, rekabet ve takip gibi temel etkileşim aksiyonları aracılığıyla sunduğu hazır platformu, bilgisayar destekli eğitimde sağladığı avantajlar açısından tartışmaktadır. Bu tartışmayı yürütmek adına, alanda yapılan çeşitli teorik ve saha çalışmalarına ait detaylar incelenmekte ve öne sürülen görüşler üzerinden platformun avantajlarına dair unsurlar saptanmaktadır

The Highway Technique: a new stenting technique to treat coronary bifurcation lesions

WOS: 000294133900012PubMed ID: 20142197Aims: We report a new stenting technique which was employed in 12 patients to treat coronary bifurcation lesions. Methods and results: A stent is positioned in the main vessel together with a balloon in the side branch, which is positioned slightly proximal to the main vessel stent that also has enough length to cover the side branch ostium. Both the stent in the main vessel and the balloon in the side branch are inflated simultaneously. Following deflation, a double lumen is created in the main vessel, proximal to the bifurcation. The stent balloon is removed with the side branch balloon left deflated in its initial position. The main vessel is rewired with a third guidewire. The side branch balloon and guidewire are removed. The initial guidewire in the main vessel is directed to the side branch. A balloon is advanced and inflated in the side branch to dilate the struts of the main vessel stent that will provide the side branch entrance. The side branch balloon is left in place. A size matched balloon is advanced on the third guidewire that was advanced in the main vessel and inflated inside the stent with high pressure. Finally, kissing balloon inflation is performed at the bifurcation. Provisional stenting of the side branch can be performed when necessary. Final kissing balloon inflation is recommended after stenting of the side branch. Conclusions: As a new coronary bifurcation stenting method, the Highway Technique has some advantages in side branch protection, with favourable immediate and 30-day clinical outcomes

The interaction between endothelin-1 and C-reactive protein and their impact on long-term prognosis after percutaneous coronary interventions

WOS: 000267405600008Introduction: Previous studies have demonstrated unfavourable outcomes in coronary artery disease and percutaneous coronary intervention (PCI) patients with high endothelin-1 (ET-1) or high sensitivity C-reactive protein (hs-CRP) levels. The aim of our study was to investigate the impact of pre-procedural ET-1 and hs-CRP levels on major adverse coronary events (MACE) after PCI and to analyse a possible correlation between ET-1 and hs-CRP in this study population. Material and methods: Eighty consecutive PCI patients with a single de novo, non-occlusive coronary lesion were included. Blood samples were obtained immediately before the procedure. The study endpoint was the occurrence of MACE, which was defined as death (all causes), non-fatal myocardial infarction or repeat coronary revascularization (PCI or surgery). Results: At the end of the 24 months' follow-up, 28 patients (35%) reached an end-point. We could not observe any correlation between ET-1 and hs-CRP in the overall patient group (r = 0.141, p = 0.213). Neither ET-1 nor hs-CRP levels were found to be predictive for MACE after PCI in multivariate analyses (p = 0.605 and 0.757 respectively). Conclusions: We could not demonstrate a relationship between pre-procedural ET-1 or hs-CRP levels and MACE at 24 months after successful PCI with single stent implantation to single de novo lesions. This study also could not show any correlation between ET-1 and hs-CRP levels in PCI patients

Aneurysm of the membranous septum detected during left ventriculography and demonstrated by cardiac magnetic resonance imaging

WOS: 000268628100029PubMed ID: 18674835

The Combined Evaluation of Biometric Data Collection Technique and Sensory Analysis of Food Products: A New Proposal for Interdisciplinary Field Studies

Sensory analysis process of food products; It is evaluated together with four different sensory approaches: scoring scale, category scale, graphic value scales and hedonic scales. At this point, the characteristics of the foods such as smell, taste, texture and appearance are examined by the participants of the research and they are expected to make sensory evaluations. It is known that in this and similar field research processes, differences that may negatively affect the research, such as bias towards data or proneness to random actions, can occur at both the researcher and participant level. Our study aims to include biometric data collection techniques in sensory analysis processes in foods with an interdisciplinary approach, in order to eliminate the possibility of consistency in the responses given in studies such as sensory food analysis and the shift of the data set. In this context, it proposes to introduce the biometric data harvesting technique, which is compiled with the mixed method, into the research field. Thus, during the sensory analysis of foods, both the subjective sensory responses of the participants can be detected and data can be collected simultaneously from biometric stimuli connected to the autonomic nervous system. During the sensory analysis of foods, the primary goal is eye tracking and autonomous biometric data collection with electrodermal data technique. With the pilot field approaches to be realized, it is aimed to establish sensory analysis fields for food products, including biometric data techniques, in the future. Thus, it is expected that pioneering steps will be taken in order to conduct researches involving interdisciplinary large data sets. Keywords: Sensory Analysis of Food, Biometric Data Collection, Electrodermal Activity, Eye Tracking</p

Macroeconomics of Climate Change in a Dualistic Economy

Macroeconomics of Climate Change in a Dualistic Economy: A Regional General Equilibrium Analysis generates significant, genuinely novel insights about dual economies and sustainable economic growth. These insights are generalize-able and applicable worldwide. The authors overcome existing limitations in general equilibrium modeling. By concentrating on tensions between green growth and dualism, they consider the global efforts against climate change and opposition by specific countries based on economic development needs. Using Turkey as their primary example, they address these two most discussed and difficult issues related to policy setting, blazing a path for those seeking an applied economic research framework to study such economic considerations

Evaluation of Graft Patency After Coronary Artery Bypass Grafting by Using Stress Echocardiography Combined With Strain Imaging

29th Turkish Cardiology Congress of the Turkish-Society-of-Cardiology (TSC) with International Participation -- OCT 26-29, 2013 -- Antalya, TURKEYWOS: 000329858400113…Turkish Soc Cardio

Effects of accidental ammonium Sulphate poisoning on antioxidant/oxidant status in lambs

In this study, the effects of the ammonium sulphate intoxication on the blood antioxidant /oxidant status were investigated in Sakiz crossbred lambs. For that, circulating blood urea nitrogen (BUN), nitric oxide (NO), malondialdehyde (MDA), glutathione (GSH), beta-carotene, retinol and ceruloplasmin concentrations were measured in 6 lambs accidentally poisoned with ammonium sulphate and in 6 healthy control lambs. Oral treatment with 10% glutamic acid (1g/kg), 2.5% acetic acid (2.5 mL/kg) and vitamin A (400 IU/kg) was daily administered to diseased animals for five days. Poisoned lambs exhibited neurological signs (sleepiness, ataxia, tonic and clonic spasms) coupled to a rumen atony and acceleration of heart and respiratory rates compared to healthy controls. Biochemically, the circulating MDA, NO and BUN concentrations were markedly increased and the GSH, beta-carotene and vitamin A concentrations were significantly depressed compared to healthy controls whereas the ceruloplasmin concentrations were not significantly altered. After treatment, clinical and biochemical signs were significantly alleviated but, however 2 lambs died. For them, the histopathological examinations after haematoxylin-eosin staining revealed cell degeneration in liver, lungs and kidney associated to mononuclear cell infiltrates and proliferation of Kiipffer cells. These results clearly showed the occurrence of an oxidative stress induced by ammonium sulphate poisoning leading to cell damage and proved the efficiency of a treatment based on organic acids and retinol supplementation

Effects of 2,4-D (dichlorophenoxyacetic acid) on blood anti-oxidant oxidant balance and on tissues in lambs

In this study, the effects of the common herbicide 2,4-D (dichlorophenoxyacetic acid) on blood antioxidant / oxidant status and on various organs were investigated in Sakiz crossbred lambs. For that, 6 lambs were poisoned accidentally with the herbicide whereas 6 other healthy animals served as negative controls and plasma MDA and GSH concentrations as well as serum ascorbate, retinol and beta-carotene concentrations were determined by spectrophotometry two days later. In parallel, conventional histological analysis was performed on lungs, liver, kidney and heart front a lamb dead after 2,4-D exposure. Blood antioxidant/oxidant balance was altered due to a significant increase of MDA concentrations coupled to a significant decrease of GSH concentrations in intoxicated lambs compared to controls. Congestive lesions and some haemorrhages were evidenced in lungs and kidneys and cell degeneration associated with lymphocyte infiltrate were observed in liver, kidneys and in heart. These results highly suggest that the herbicide 2.4-D induces an oxidative stress leading to cell destructions and tissue injury