Decompressive hemicraniectomy in acute ischemic stroke

INTRODUCTION: Cerebral edema is the leading cause of mortality and morbidity in ischemic stroke patients. Decompressive hemicraniectomy may be beneficial to patients that fail to respond to medical treatment. In this study, clinical features and prognostic factors of patients that underwent decompressive hemicraniectomy due to acute ischemic stroke were evaluated. METHODS: We examined 21 ischemic stroke patients who underwent decompressive hemicraniectomy. Demographic features and neuroimaging findings were recorded. Functional status of patients were evaluated with modified Rankin Scale. Clinical features and neuroimaging findings of the patients who died were compared with the survivors during hospitalization. RESULTS: Twenty-one patiens were included in this study. Twelve of the patients were male, 9 were female. The mean age of these patiens was 58.7±8.2 (46 - 78). The main initial NIHSS score was 12.5±4.5. Territory of infarctions were supplied by middle cerebral arter in 17 patients, internal carotis arter in 4 patients. The mean time of decompressive hemicraniectomy was 2.9±2.5 days, hospitalization duration was 42.6±39.2 days. Five (% 23.8) patiens died in-hospital. There were no relation between clinical features, neuroimaging findings and mortality. DISCUSSION AND CONCLUSION: Decompressive hemicraniectomy is a significant treatment option for ischemic stroke patients who deteriorate despite receiving medical treatment

Documenting the initial appearance of domestic cattle in the Eastern Fertile Crescent (northern Iraq and western Iran)

In this paper we address the timing of and mechanisms for the appearance of domestic cattle in the Eastern Fertile Crescent (EFC) region of SW Asia through the analysis of new and previously published species abundance and biometric data from 86 archaeofaunal assemblages. We find that Bos exploitation was a minor component of animal economies in the EFC in the late Pleistocene and early Holocene but increased dramatically in the sixth millennium BC. Moreover, biometric data indicate that small-sized Bos, likely representing domesticates, appear suddenly in the region without any transitional forms in the early to mid sixth millennium BC. This suggests that domestic cattle were imported into the EFC, possibly associated with the spread of the Halaf archaeological culture, several millennia after they first appear in the neighboring northern Levant

Der Domestikationsprozess in der Südosttürkei: Der Beleg von Mezraa-Teleilat

Mezraa-Teleilat, located in the province of Sanli Urfa (5 Km south of Birecik), is a settlement in southeastern Anatolia with a sequence without interruption from the PPN to the PN (excavations were under the direction of Prof. Dr. M. Özdogan, Istanbul University). The site was excavated between 1999-2004. The faunal remains were analyzed for the work described above. More than 34,900 (165.21 kg bones) animal bones were recovered from the Neolithic levels. A total of 10,930 of them have been identified to taxon and element. Sheep/goat, pig and cattle predominate. They represent all together about 96% of the identified faunal remains. Over time the proportions of the taxa indicate few differences. The size diminution of the animal bones and the survival curves based on epiphyseal fusion indicate that sheep, goat, pig and cattle were probably domesticated at high percentage rates. Domestic sheep and goat played an increasingly important role in the economy of the site. There is a strong possibility that sheep and goat were not domesticated locally but were brought to the site as domesticated animals. In contrast to the ovicaprids, cattle and pig appeared to have been domesticated locally. The hunting of wild animals (with a focus on gazelle, but also on fallow deer and half ass) continued throughout the PN, but did not play an important role in the subsistence economy at Mezraa-Teleilat. Pig skeletons were found in the PN levels, providing evidence that these animals were kept in the settlement.Die Siedlung Mezraa-Teleilat liegt in der Provinz Sanli Urfa, 5 km südlich von Birecik in Südostanatolien. Die Ausgrabungen erbrachten eine Sequenz vom akeramischen bis zum keramischen Neolithikum (Ausgrabungen unter der Leitung von Prof. Dr. M. Özdogan, Universität Istanbul). Die Feldarbeiten fanden von 1999 bis 2004 statt. Für die vorliegende Doktorarbeit wurden die Tierknochen ausgewertet. Mehr als 34.900 (165,21 kg) Knochen aus den neolithischen Schichten wurden analysiert. 10.930 von ihnen konnten tierartlich bestimmt werden. Demnach dominieren Schaf/Ziege, Schwein und Rind. Sie haben einen Anteil von ca. 96%. Im Laufe der Besiedlungszeit am Fundplatz ändern sich die Anteile der Tierarten geringfügig. Sie deuten darauf hin, dass Schaf, Ziege, Schwein und Rind in einem hohen Anteil wohl domestiziert waren. Domestizierte Schafe und Ziegen spielten eine bedeutende Rolle für die Fleischversorgung. Mit grosser Wahrscheinlichkeit sind Schaf und Ziege nicht lokal domestiziert und von ausserhalb eingeführt worden. Im Gegensatz dazu sind Rinder und Schweine vermutlich lokal domestiziert. Die Jagd auf Wildtiere (hauptsächlich Gazelle, auch Hirsch und Equus hemionus) erfolgte weiterhin, bis in das keramische Neolithikum. Sie spielte aber keine wichtige Rolle für die Subsistenz von Mezraa-Teleilat. Schweineskelette wurden in Schichten des keramischen Neolithikums gefunden. Sie geben einen Hinweis darauf, dass die Tiere innerhalb der Siedlungen gehalten wurden

Le processus de domestication des Ongulés à Çayönü, Turquie du Sud-Est : approche multidisciplinaire à propos de <i>Bos</i> sp. et de <i>Cervus elaphus</i>

Les restes de Bos et de Cervus provenant des niveaux néolithiques précéramiques et à poterie à Çayönü Tepesi ont été étudiés en suivant une approche multidisciplinaire, combinant l\u27analyse morphologique, les profils d\u27âge et les isotopes stables dans le collagène des os. Les résultats montrent que le processus de domestication du bétail a commencé en même temps que trois autres Ongulés (moutons, chèvres et cochons) par la phase Channelled Building (fin du PPNB récent/ début du PPNB moyen). Deux étapes sont mises en évidence dans le processus de domestication : les premières traces d\u27animaux domestiques peuvent être détectées dans les restes de faune par l\u27apparition de quelques individus de petite taille et de subtils changements dans les modèles d\u27abattage, évolution attestée par l\u27observation de changements dans les ratios des isotopes stables du carbone et de l\u27azote. Bien que des animaux sauvages aient continué à être chassé, on note une diminution globale des individus sauvages dans les assemblages. La deuxième étape du processus du domestication commence dans le PPNB tardif, comme le suggèrent une nette réduction de la taille, un changement démographique, à savoir l\u27augmentation des femelles, et aussi l\u27augmentation dramatique des moutons et des chèvres.Bos and Cervus remains from Prepottery and Pottery Neolithic levels at Çayönü Tepesi are examined employing a multidisciplinary approach, combining the analysis of morphology, age profiles, and stable isotopes in bone collagen. The results show that the process of cattle domestication started at about the same time as three other ungulate taxa (sheep, goats and pigs), by the Channelled Building Subphase (end of Early PPNB/ beginning of Middle PPNB). Two stages are evident in the process of domestication: the initial appearance of domestic animals could be detected in the faunal remains by the appearance of some small-sized individuals and subtle changes in the kill-off patterns, as well as in the changes in stable isotope ratios of carbon and nitrogen. While hunting of wild progenitors continued, there was an overall decrease in the proportion of miscellaneous wild taxa in the assemblage. The second stage of the domestication process begins in the late-final PPNB, suggested by marked size reduction and demographic change, namely the increase of females in the assemblage, as well as dramatic increase in sheep and goats.</p

Imagining RÜM in Mamluk Cairo ABD Al-Basıt Al Malati and the Ottoman domains

This thesis is a study of a neglected late Mamluk scholar and historian Abd al-Basit b. Khalil b. Shahin al-Malati with a special focus on the image of the Ottomans and their patronage in his historical works and especially his biographical dictionary. Al-Malati depicts the Ottoman sultans as generous patrons of knowledge and portrays the contemporary Ottoman ruler Bayezid II as a scholar-king. The present thesis attempts to introduce al-Malati and his oeuvre, contextualize his historical works, also searching for how he learned about the Rumi sultans. Informal networks between these two regions played a significant role in al-Malati’s description of Ottoman patronage. By informal networks here, we mean al-Malati’s encounters with various scholars, merchants, emigres, and captives from the Ottoman lands outside the formal channels of diplomacy and scholarly activities. The thesis also contextualizes al-Malati’s observations about Rumi scholars and Bayezid II’s patronage and argues that al-Malati’s trouble with contemporary Mamluk patronage led him to adopt a pro-Ottoman attitude amid the power struggle between the Mamluks and the Ottomans in the eastern Mediterranean. Building on these points, the study also seeks to problematize the idea that the Ottoman lands were marginal to Islamic learning before the Ottoman conquest of Greater Syria and Egypt in 1517. A careful study of al-Malati and his environment suggests that Ottoman scholarly life was appreciated in Mamluk scholarly circles in the late fifteenth century, already before the Ottoman expansion into the Arab land

The Ongoing Challenge of Diagnosing Non-convulsive Status Epilepticus: What About Generalized Non-reactive Rhythmic Alpha Activity in the Salzburg Criteria?

The ILAE Task Force on Classification released a report in 2015 to clarify the classification of status epilepticus. Non-convulsive status epilepticus (NCSE) was defined as SE without prominent motor symptoms, with or without coma. This diverse entity’s electrophysiological diagnosis, which is more consistent in clinical recognition, may be challenging. Some classifications and revisions have been proposed recently, making NCSE diagnosis easier. There are, however, patients who remain in the ‘grey zone’. The increasing evidence in patients, who do not meet the Salzburg Consensus Criteria for NCSE diagnosis of ‘NCSE’ or ‘possible NCSE’, but whose clinical and electrophysiological features are still suspicious for NCSE, may pave the way for developing more comprehensive criteria. Therefore, we present here the ‘generalized non-reactive alpha activity’ in the electroencephalogram (EEG) of an elderly patient with no known epilepsy before, who presented with acute confusional state of unexplained cause, which we suspected as NCSE and managed a ccordingly with success. Considering that ‘time is brain’, early and correct NCSE diagnosis is critical and the NCSE EEG criteria should be more inclusive for the patients in the ‘grey zone like the one presented here with ‘generalized non-reactive alpha activity’

Organizational Learning for the Development of Sustainability Culture in Life Science Organizations in Oresund Region

This research sought to understand the role of organizational learning and the experience of the use of organizational learning for the development of sustainability culture in life science companies. Therefore, the study utilized a phenomenological qualitative approach to find out the perspectives of life science companies and life science non-governmental organizations (NGOs) about the subject matter. Furthermore, this study was exploratory and inductive and used a combination of research methods (triangulation). It was found that organizational learning creates sustainability awareness and engagement which contributes to the development of sustainability culture. This in turn would lead to the organization becoming a learning organization that focuses on sustainability. Government policies, quality management systems and internal standards serve as factors that create awareness of sustainability issues and encourage life science small-medium enterprises (SMEs) to continuously engage in sustainability business practices. It was found that various learning methods can be used internally and externally to learn about sustainability. However it is important that learning that is done externally or on an individual level be shared with the organization in a group or organizational level. The study acknowledged a heightened awareness for more sustainability focused practices within the operations of life science companies, however the financial constraints negatively influence how they prioritize their actions. It also identified how collaborations with life sciences NGOs help facilitate the implementation of a long-term sustainability vision and strategies into life science companies

Organizational Learning for the Development of Sustainability Culture in Life Science Organizations in Oresund Region

This research sought to understand the role of organizational learning and the experience of the use of organizational learning for the development of sustainability culture in life science companies. Therefore, the study utilized a phenomenological qualitative approach to find out the perspectives of life science companies and life science non-governmental organizations (NGOs) about the subject matter. Furthermore, this study was exploratory and inductive and used a combination of research methods (triangulation). It was found that organizational learning creates sustainability awareness and engagement which contributes to the development of sustainability culture. This in turn would lead to the organization becoming a learning organization that focuses on sustainability. Government policies, quality management systems and internal standards serve as factors that create awareness of sustainability issues and encourage life science small-medium enterprises (SMEs) to continuously engage in sustainability business practices. It was found that various learning methods can be used internally and externally to learn about sustainability. However it is important that learning that is done externally or on an individual level be shared with the organization in a group or organizational level. The study acknowledged a heightened awareness for more sustainability focused practices within the operations of life science companies, however the financial constraints negatively influence how they prioritize their actions. It also identified how collaborations with life sciences NGOs help facilitate the implementation of a long-term sustainability vision and strategies into life science companies

Hydroxyurea associated leg ulcer succesfully treated with hyperbaric oxygen in a diabetic patient

Oxygen tension in healing tissues is heterogeneous. Increased oxygen mostly stimulates repair mechanisms and enhances tissue healing. Hyperbaric oxygen therapy increases blood and tissue oxygen content and may help maintain cellular integrity and function. Hydroxyurea (HU) is a cytotoxic agent, which leads to inactivation of ribonucleotide reductase, inhibition of cellular DNA synthesis, and cell death in the S phase. HU induced leg ulcers occur after use of this agent for a long time and at higher cumulative doses. Here we describe a diabetic patient with foot ulcer associated with HU treatment for polycythemia vera, who was treated successfully with hyperbaric oxygen and general wound care after discontinuation of HU. Faster improvement of leg ulcer in our patient compared to literature regarding HU withdrawal as single therapy suggests that hyperbaric oxygen may be helpful in the management of HU associated leg ulcers, especially in diabetic subjects

Çayyolu Höyük - A Late Chalcolithic/Early Bronze Age settlement in Ankara

Burada sunulan makale, Ankara’nın güneyinde Yenimahalle sınırları içinde yer alan Çayyolu Höyük’ te 2011 yılından itibaren yürütülen kazı çalışmalarının bir ön raporunu içermektedir. Yerleş- mede gerçekleştirilen araştırmalar bize Geç Kalkolitik’ten (M.Ö. yak. 4. binin sonları) Orta Tunç Çağ’a Geçiş dönemine (M.Ö. yak. 2000) kadar süren ve birçok tabakayı ihtiva eden uzun bir silsileyi vermektedir. Yayın, iki kazı sezonu boyunca höyük stratigrafisi ve buluntular hakkında elde edilen verileri kapsamaktadır.The article presented here includes a preliminary report on the rescue excavation at çayyolu Höyük carried out since 2011. The site is located in southern Ankara within the boundaries of Yenimahalle. The fieldwork at the settlement provided a long stratigraphy with many levels from the late Chalcolithic (ca. late 4th millennium BCE) to the transitional period into the Middle Bronze Age (around ca. 2000 BCE). This publication covers information on the stratigraphy, on the find- ings, and the finds after two campaigns