CT dose management for neurologic events in patients with cardiac devices: Radiation exposure variation in patients with cardiac devices

PURPOSE:To compare the inter-center cranial computed tomography (CT) acquisition rates, CT findings, CT related radiation dose, and variability of CT acquisition parameters for neurologic events among patients with implantable cardioverter-defibrillator (ICD) or left ventricular assist device (LVAD).METHODS:A total of 224 patients [ICD group (n = 155) and LVAD group (n = 69)] who had at least one cranial CT scan were enrolled from three medical centers. The variability and effect of the number, indication, and findings of cranial CT scans as well as CT acquisition parameters including tube potential, tube current, tube rotation time (TI), slice collimation (cSL), and spiral or sequential scanning techniques on CT dose index volume (CTDIvol), total dose length product (DLP) were analyzed.RESULTS:The mean DLP value of Center A and mean CTDIvol values of Center A and C were significantly lower than Center B (p < 0.001). The mean CTDIvol and DLP values in the ICD group were substantially lower than the LVAD group (p<0.001). The most potent parameters causing the changes in CTDIvol and DLP were kV, mAs values, and CT scanning technique as sequential or spiral according to multivariate linear regression analysis.CONCLUSION:Cranial CT acquisition parameters and radiation doses vary significantly between centers, which necessitates optimization of cranial CT protocols to overcome the cumulative radiation dose burden in patients with neurologic events

SOSYAL BİLGİLER ÖGRETMEN ADAYLARININ DÜSÜNME BECERİLERİNİN ÖGRETİMİNE YÖNELİK ÖZ-YETERLİKLERİNİN DEGERLENDİRİLMESİ

Bu tezin baslıgı sosyal bilgiler ögretmen adaylarının düsünme becerilerinin ögretimine yönelik öz-yeterliklerinin degerlendirilmesi dir. Tezin yapılma amacı, Üniversitelerin, Egitim Fakültelerinin, Sosyal Bilgiler Egitimi Anabilim Dalı dördüncü sınıf ögrencilerinin (ögretmen adaylarının), düsünme becerilerinin ögretimine yönelik öz-yeterlik düzeylerini çesitli degiskenler açısından incelemektir. Tezin problem cümlesi ise sudur, Üniversitelerin, Egitim Fakültelerinin, Sosyal Bilgiler Egitimi Anabilim Dalı dördüncü sınıf ögrencilerinin (ögretmen adaylarının), düsünme becerilerinin ögretimine yönelik öz-yeterlik düzeyleri, ögrencinin cinsiyeti, yası, ögretim türü, mezun oldugu ortaögretim kurumu, bölümünü ÖSS sınavında kaçıncı sırada tercih ettigi, fakülte akademik basarı ortalaması, lisans düzeyi boyunca almıs oldugu dersler ile düsünme becerilerinin ögretimi konusunda kendisini ne derecede yeterli hissettigi, kendisini analitik, pratik, yaratıcı, elestirel olarak görmesi, bir senede ders kitabı dısında okudugu kitap sayısı ve ögrenim gördügü fakülte degiskenlerine göre anlamlı düzeyde farklılasmakta mıdır? Bu betimsel arastırmada, kullanılan ölçegin güvenirlik için pilot çalısması Nigde Üniversitesi Egitim Fakültesi, Sosyal Bilgiler Egitimi Anabilim Dalı'nda ögrenim gören 77 dördüncü sınıf ögrencisi (ögretmen adayı) ile yapılmıstır. Arastırmanın çalısma grubunu ise Ankara Üniversitesi, Gazi Üniversitesi, Selçuk Üniversitesi, Egitim Fakültelerinde ögrenim gören 312 Sosyal Bilgiler Egitimi Anabilim Dalı dördüncü sınıf ögrencisi (ögretmen adayları) olusturmaktadır. Arastırmanın çalısma grubunun olusturulmasında olasılıksız yöntemlerden amaçlı örnekleme teknigi kullanılmıstır. Arastırmada elde edilen bazı bulgu ve sonuçlar sunlardır: Sosyal bilgiler ögretmen adaylarının düsünmeye uygun sınıf ortamı yaratma (Faktör-1) üst düzeyli düsünme becerilerinin ögretimi (Faktör-2) transferin ögretimi (Faktör-3) ve ögrencilerin nasıl düsündügünü fark etme (Faktör-4) iliskin maddelere verdikleri cevaplara göre kendilerinin öz-yeterlik düzeylerini oldukça yeterli buldukları görülmüstür. Sosyal bilgiler ögretmen adaylarının düsünme becerilerinin ögretimine yönelik öz-yeterlik düzeylerinin akademik basarı ortalamalarına göre farklılastıgı görülmüstür. Bulunan bu farklılık, akademik basarı ortalaması 2.01-2.50 olan ögretmen adaylarının düsünme becerilerinin ögretimine yönelik öz-yeterlik düzeyleri ile akademik basarı ortalaması 3.51-4.00 olan ögretmen adaylarının düsünme becerilerinin ögretimine yönelik öz-yeterlik düzeyleri arasındadır. Bu iki grup arasında bulunan farklılık ise akademik basarı ortalaması 3.51-4.00 olan ögretmen adaylarının lehinedir. Kadın ve erkek sosyal bilgiler ögretmen adaylarının düsünme becerilerinin ögretimine yönelik öz-yeterlik düzeyleri arasında anlamlı bir fark bulunamamıstır. Yas degiskenine göre ögretmen adaylarının düsünme becerilerinin ögretimine yönelik öz-yeterlik düzeyleri arasında anlamlı bir farklılık bulunamamıstır. Düsünme becerilerinin ögretimine yönelik öz-yeterlik düzeylerinin, sosyal bilgiler ögretmen adaylarının ögrenim gördükleri üniversitelerden etkilenmedigi görülmüstür. İkinci ve normal ögretimde ögrenim gören sosyal bilgiler ögretmen adaylarının düsünme becerilerinin ögretimine yönelik öz-yeterlik düzeyleri arasında anlamlı bir farklılık bulunamamıstır.The title of this thesis is assessing social studies preservice teachers' selfefficacy towards teaching thinking skills. Aim of this thesis is to examine the selfefficacy levels with various parameters on teaching thinking skills of universities, education faculties, and fourth class students of social studies education discipline (preservice teachers). The problem sentence of the thesis is Do the self-efficacy levels on teaching thinking skills of universities, education faculties and fourth class students of social studies education discipline (preservice teachers) varies according to the parameters like, gender and age of student, type of education, secondary school which the student was graduated from, in which order did he/she preferred the branch in OSS examination, academic achievement degree (average), the lessons which he/she took during the higher education period and how sufficient does he/she feel for teaching thinking skills, seeing himself/herself as analytical, practical, creative, critical, the number of books he/she read in one year except lesson books and the faculty he/she has been educated? In this descriptive research, for the reliability of the scale, the pilot research was carried out with 77 fourth class students (preservice teachers) in Nigde University Education Faculty, Social Studies Education Discipline. The working group of the research consists of 312 fourth class social studies students (preservice teachers) from the education faculties of Ankara University, Gazi University, Selçuk University. In the preparation of the working group, purposive sampling method was used from the randomized sampling methods. Some of the findings and conclusions which were gained in the research are: It has been realized that, the social studies preservice teachers consider themselves considerably sufficient according to the answers to questions like; creating a class environment available for thinking (Factor-1), teaching higher order thinking skills (Factor-2), teaching transfer (Factor-3) and to notice how students think (Factor-4). It has been realized that the level of self efficacy of social studies preservice teachers on teaching thinking skills varies according to their average academic iv achievements. This difference is between the self-efficacy levels of teaching thinking skills of the preservice teachers whose academic achievement degree is 2.01-2.50 and the preservice teachers whose academic achievement degree is 3.51-4.00. This difference between these two groups is in favor of the preservice teachers whose academic achievement degree is 3.51-4.00. A significant difference has not been found between female and male social studies preservice teachers' level of self efficacy on teaching thinking skills. A significant difference has not been found according to the age variable of social studies preservice teachers' level of self efficacy on teaching thinking skills. It has been realized that the level of self efficacy on teaching thinking skills is not affected from the universities where the preservice teachers are having education. A significant difference has not been found between social studies preservice teachers' level of self efficacy on teaching thinking skills, who has second and normal education

Atherosclerotic Vascular Disease and Risk Factors in Turkey: From Past To Present

The prevalance of atherosclerotic vascular disease is unexpectedly high in Turkey despite its young population, with a median age of 29. The mean total cholesterol is lower than in Western European countries; however, smoking is very prevalant, the incidence of metabolic syndrome is high and obesity, diabetes and hypertension are becoming a major problem, especially in women. Having these risk factors as well as lower HDL levels leads to high cardiovascular morbidity and mortality at younger ages. This problem is expected to become worse with increasing industrialisation, adaptation to Western diets, a sedentary lifestyle and increasing obesity. A National Heart Health Policy has been developed to overcome this epidemic and combat the risk factors and reduce the burden of atherosclerotic vascular disease.Wo

Atrial Myocardial Deformation Properties Are Temporarily Reduced After Cardioversion For Atrial Fibrillation And Correlate Well With Left Atrial Appendage Function

Aim This study was conducted to evaluate whether left atrial strain and strain rate correlate well with transesophageal parameters of stunning after atrial fibrillation. Methods and results Twenty-two consecutive patients with chronic atrial fibrillation >= 3 months and < 1 year were enrolled in the study. Transthoracic (TTE) and transesophageal (TEE) echocardiography with color Doppler myocardial imaging were performed before, 1 day after and 10 days after successful cardioversion. Left atrial transthoracic strain (S) and strain rate (SR) from lateral, inferior and anterior atrial walls, left atrial appendage tissue velocities, strain and strain rate values were measured with offline analysis. Left atrial appendage emptying (LAAEV) and filling (LAAFV) velocities were obtained from transesophageal echocardiography. Left atrial transthoracic, and left atrial appendage strain and strain rates were significantly lower following 1 day after cardioversion (TTE S/SR, 5.0 +/- 2.8%/2.3 +/- 1.0; TEE (septal) S/SR, 7.6 +/- 3.6%/1.6 +/- 0.7). There was a good correlation between these parameters and LAAEV (LA systolic strain and LAAEV, r = 0.73, P = 0.007). Left atrial and LAA strain and strain rate values improved over time, and correlated well with LAAEV, measured 10 days after cardioversion. Conclusions Transthoracic atrial and TEE LAA strain and strain rate, which are quantitative measures of atrial function, are reduced after cardioversion, and recover subsequently. The good correlation between LAA function and TTE strain and strain rate suggests that TTE atrial parameters may help determine duration of anticoagulation.WoSScopu

An observational, multicenter, registry-based cohort study of Turkish Neonatal Society in neonates with Hypoxic ischemic encephalopathy

BACKGROUND: Hypoxic ischemic encephalopathy (HIE) is a significant cause of mortality and short- and long-term morbidities. Therapeutic hypothermia (TH) has been shown to be the standard care for HIE of infants ≥36 weeks gestational age (GA), as it has been demonstrated to reduce the rates of mortality, and adverse neurodevelopmental outcomes. This study aims to determine the incidence of HIE in our country, to assess the TH management in infants with HIE, and present short-term outcomes of these infants. METHODS: The Turkish Hypoxic Ischemic Encephalopathy Online Registry database was established for this multicenter, prospective, observational, nationally-based cohort study to evaluate the data of infants born at ≥34 weeks GA who displayed evidence of neonatal encephalopathy (NE) between March, 2020 and April 2022. RESULTS: The incidence of HIE among infants born at ≥36 weeks GA (n = 965) was 2.13 per 1000 live births (517:242440), and accounting for 1.55% (965:62062) of all neonatal intensive care unit admissions. The rates of mild, moderate and severe HİE were 25.5% (n = 246), 58.9% (n = 568), and 15.6% (n = 151), respectively. Infants with severe HIE had higher rates of abnormal magnetic resonance imaging (MRI) findings, and mortality (p6 h) (p>0.05). TH was administered to 85 (34.5%) infants with mild HIE, and of those born of 34-35 weeks of GA, 67.4% (n = 31) received TH. A total of 58 (6%) deaths were reported with a higher mortality rate in infants born at 34-35 weeks of GA (OR 3.941, 95% Cl 1.446-10.7422, p = 0.007). CONCLUSION: The incidence of HIE remained similar over time with a reduction in mortality rate. The timing of TH initiation, whether <3 or 3-6 h, did not result in lower occurrences of brain lesions on MRI or mortality. An increasing number of infants with mild HIE and late preterm infants with HIE are receiving TH; however, the indications for TH require further clarification. Longer follow-up studies are necessary for this vulnerable population