Apoptosis biomarkers (Apaf-1, sFa s, sFa s-L, and caspase-9), albumin, and fetuin-A levels in pulmonary thromboembolic patients

INTRODUCTION: Pulmonary thromboembolism (PE) is the third most common medical emergency with mortality due to ischemia and reperfusion lung injury. Lung ischaemia-reperfusion injury. Lung reperfusion damage is believed to cause cellular damage and apoptosis. The aim of the present study was to evaluate the levels of fetuin-A, albumin, and apoptosis biomarkers (Apaf-1, sFas, and sFasL) among pulmonary thromboembolic patients. MATERIAL AND METHODS: Blood samples were collected from 45 volunteer patients and 40 healthy control volunteers. Human apoptosis biomarkers (Apaf-1, sFas, sFasL, and caspase-9) and fetuin-A values were measured by ELISA device. Student’s t-test or Mann-Whitney U test were used for continuous variables, and categorical variables were compared with the chi-square test to assess the significance of intergroup differences. The mean values of apoptosis biomarkers and acute phase reactants between dead and survival patients were also compared. RESULTS: While the apoptosis mean values of Apaf-1, sFas, sFasL, and caspase-9 for the control group were 0.12 ± 0.01, 332.1 ± 28.0, 130.4 ± 34.6, and 74.3 ± 2.6, for the patient group they were 0.14 ± 0.02, 509.1 ± 67.6, 139.9 ± 23.7, and 79.4 ± 2.8, respectively. The group differences were significant for all the biomarkers (p = 0.01, p = 0.001, p = 0.19, and p = 0.01, respectively). The negative acute phase fetuin- A and albumin levels decreased significantly in the patient groups (p = 0.01 and p = 0.01, respectively). CONCLUSİONS: Intrinsic and extrinsic apoptosis pathways are stimulated during pulmonary embolism, and negative acute phase reactants are decreased. There was a correlation with the mortality and Apaf-1, sFas, caspase-9, fetuin, and albumin levels

Student’s opinions for using tablet pcs in education: A case study

Tablet bilgisayarlar geleneksel derslerde karşılaşılan bazı problemlere çözüm üretebilecek araçlar olabilir. Bu nitel durum çalışmasının amacı eğitim-öğretim sürecinin etkinliğinin arttırılması için bir derste gerçekleştirilen sınıf içi tablet bilgisayar uygulaması ile ilgili öğrenci görüşlerinin değerlendirilmesidir. Çalışmaya eğitim fakültesi öğrencilerinden 20 (%62.5) erkek ve 12 (%37.5) kız öğrenci katılmıştır. Katılımcılara açık uçlu olarak şu iki soru yöneltilmiştir: Derste tablet bilgisayar kullanımı için görüşleriniz nelerdir? ve Tablet bilgisayarlar derslerde nasıl kullanılırsa daha etkili olur? Ayrıca katılımcıların cinsiyetleri ve dokunmatik ekran kullanımı tecrübeleri ile ilgili veriler toplanmıştır. Katılımcıların görüşleri doğrultusunda belirlenen beş tema (öğretim yaklaşımı, öğrenci deneyimi, zaman yönetimi, teknik alt yapı ve aidiyet) altında ifadeler gruplanmıştır. Buna göre, tablet bilgisayarların öğretim sürecine entegrasyonu ile alakalı görüşlerinin genelde negatif yönde olduğu ve bu süreçte pek çok problemle karşılaştıkları görülmüştür.Tablet PCs may produce solutions to some problems experienced in the traditional classes. The purpose of this qualitative case study is to evaluate students' suggestions about a tablet-enhanced learning environment which aims to increase the efficiency of the instructional process in the classroom. The participants of the study were 20 (62.5%) male and 12 (37.5%) female pre-service teachers. Two open-ended questions were directed to the participants: (I) What are your suggestions about the tablet-enhanced learning environment? and (II) How could tablet PCs be used more effectively during the lessons? Also, information regarding the pre-service teachers’ genders and their experiences with touch screen devices was collected. It was found that students’ opinions about the tablet-enhanced instruction were negative with respect to the five themes found (instructional approach, student experience, time management, technical problems and ownership) and they faced some problems during the instructions in the classroom

A Novel Concept for In-Situ Gas-Phase Laser Raman Spectroscopy for SOFC

Gas-phase laser Raman spectroscopy has recently been adopted to determine the concentrations of relevant gaseous species within the anode flow channel with high spatial and temporal resolution during operation at technically relevant operating conditions. The paper describes the configuration of an optically accessible SOFC, the laser system and optical setup for 1 D Raman spectroscopy as well as the challenges associated with the measurements of an electrolyte supported cell of a size of 50 x 50 mm2. At different operating conditions Raman spectra were recorded and concentration profiles of gas species along the flow path in the anode were determined demonstrating this new experimental approach for a better understanding of SOFC processes

Dual cells with mixed protonic-anionic conductivity for reversible SOFC/SOEC operation

International audienceThe dual cell concept is a novel design for solid oxide fuel cells operating at intermediate temperature. The cell comprises a series of five layers with different compositions, alternating two dense electrolytes and three porous layers, i.e. the outer electrodes and a central membrane. The dual cell concept makes it possible to separate the compartment for water formation from both fuel and oxidant chambers. Such a three-chamber configuration gives many advantages related to fuel dilution, materials corrosion, and reversibility between fuel cell and electrolyser operational modes (SOFC/SOEC) at high temperature. Dual conductivity (protonic/anionic) can be achieved by joining two dense BaCe0.85Y0.15O3-δ (BCY) and Ce0.85Y0.15O2-δ (YDC) electrolytes through a porous ceramic central membrane made up of both materials. Complete anode-supported dual cells have been fabricated by a combination of pressing, casting, printing, wet spraying, and plasma spraying techniques. Electrochemical tests carried out by impedance spectroscopy showed the feasibility of the concept and successful reversible operation of the dual cell. The fabrication route, the microstructural and electrochemical testing results are reported in this work, and partially compared to simulated results from an electrochemical model developed describing the dual cell concept

Belief scale towards learning : Study of validity and reliability

The aim of this research was to develop a measurement tool for determining teachers’ beliefs towards learning and also to examine the psychometric properties of the scale. The study group of research consists of 233 teachers who work at primary school in the city centre of Gaziantep during the First Semester of 2011-2012 Academic Year. Content validity of the scale was provided via expert judgment. Exploratory Factor Analyses were done for construct validity. Exploratory Factor Analysis showed that there were 34 items in the scales loaded under 4 factors. Identified factors were named as “Social constructivism”, “Traditional”, “Cognitive Constructivism” and “Radical constructivism”. As for in the scope of reliability study for Belief Scale towards Learning, the reliability coefficient that is obtained by Cronbach Alpha internal consistency coefficient and split-half method has been examined. As a result of reliability analysis, the internal coefficient is determined as .86 for “Traditional Constructivist” subscale, .85 for “Social constructivist” subscale, .74 for “Cognitive constructivist” subscale and .73 for “Radical constructivist” subscale. 85. The reliability coefficients for subscales assessed by the way of split-half method are .77 for social constructivist subscale, .84 for traditional subscale, .66 for cognitive constructivist subscale, and .67 for radical constructivist subscale. These results indicate Belief Scale towards Learning is at the level of sufficient reliability. Corrected item-total correlations ranged .27 to .68, and according to t-test results differences between each item’s means of upper 27% and lower 27% points were significant. Based on these results, it can be concluded that belief scale towards learning can be used as a valid and reliable tool for determining the beliefs of teachers towards learning

Istraživanje o uvjerenjima što ih učitelji imaju o učenju

The aim of this study was to investigate teachers’ beliefs about learning. So, we investigated the level of teachers’ beliefs about the traditional and constructivist approach (cognitive, social and radical). Further, it was questioned how teachers developed qualifications needed for the constructivist approach. The study was conducted on 233 teachers working in the city centre of Gaziantep in Turkey during 2011-2012 school year. “Beliefs about Learning Scale”, developed by the researchers, was used for data collection. The results revealed that the teachers adopted the constructivist approach at a higher level than the traditional approach. Speaking about the constructivist approach dimensions, the teachers adopted the social constructivist approach at a higher level than cognitive and radical constructivist approaches.  According to the gender variable, the extent to which the female teachers adopted the constructivist approach was higher in comparison with the male teachers. Moreover, it was found that the level of classroom teachers’ beliefs about the traditional approach was higher than that of subject teachers’ beliefs according to seniority. Another finding was that the increase in seniority increased the teachers’ beliefs about the traditional approach. The findings indicated that the teachers adopted qualifications for the constructivist approach mostly during their undergraduate and post-graduate education.Cilj je ovog istraživanja odrediti uvjerenja koja učitelji imaju o učenju. Istražili smo stoga razinu njihovih uvjerenja o tradicionalnim i konstruktivističkim pristupima (kognitivni, društveni i radikalni). Štoviše, tražili smo odgovor na pitanje kako učitelji razvijaju kompetencije potrebne za konstruktivistički pristup. Istraživanje je provedeno na uzorku od 233 učitelja koji poučavaju u središtu turskog grada Gaziantepa tijekom šk. godine 2011./2012. Ljestvica za utvrđivanje uvjerenja o učenju, koju su izradili sami autori, korištena je za prikupljanje podataka. Rezultati su otkrili da učitelji usvajaju konstruktivistički pristup na višoj razini u odnosu na tradicionalni pristup. Kada je riječ o dimenzijama konstruktivističkog pristup, učitelji usvajaju društveni konstruktivizam na višoj razini nego kognitivni ili radikalni konstruktivizam. S obzirom na rod kao varijablu, učiteljice usvajaju konstruktivistički pristup na višoj razini od učitelja. Pokazalo se, štoviše, da je razina uvjerenja što ih razredni učitelji imaju o tradicionalnom pristupu viša nego u slučaju predmetnih učitelja kada se promatraju godine staža. S porastom godina staža rastu i uvjerenja učitelja o tradicionalnom pristupu. Rezultati istraživanja ukazuju na to da učitelji usvajaju kompetencije potrebne za konstruktivistički pristup uglavnom tijekom dodiplomskog i poslijediplomskog obrazovanja

The efficacy of fibrin glue to control hemorrhage from the gallbladder bed during laparoscopic cholecystectomy

Amaç: Laparoskopik kolesistektomi sırasında safra kesesi yatağından gelişen ve klasik yöntemlerle durdurulamayan kanamalarda fibrin yapıştırıcı uygulama deneyimimizi sunmak.Gereç ve Yöntemler: Laparoskopik kolesistektomi uygulanan 382 hastadan, safra kesesi yatağında kanama meydana gelen ve konservatif yöntemlerle durdurulamayan ve bu nedenle de fibrin glue kullanılan 14 hasta retrospektif olarak incelendi.Bulgular: Fibrin yapıştırıcı kullanılan hastaların 10'u (%71) kadın, 4'ü (%29) erkekti. Hastaların ortalama yaşı 55,7 idi. 14 hasta da semptomatik safra kesesi taşı nedeniyle ameliyat edildi. On üç hastada (%92) yandaş bir hastalık mevcuttu. Kanamanın kontrol altına alınarak hemostazın sağlanması için harcanan zaman ortalama olarak 23,9 dakika olarak saptandı. Hemoglobin değeri 8 mg/dL altına düşen 2 hastaya kan transfüzyonu yapıldı. Bir hastada fibrin yapıştırıcı kullanılmasına rağmen kanama kontrolü sağlanamadı ve açık cerrahiye geçildi.Sonuç: Laparoskopik kolesistektomi yapılan hastalarda, karaciğerde safra kesesi yatağından meydana gelen kanamalarda fibrin yapıştırıcı uygulanmasının açığa geçme oranlarını düşürdüğü saptanmış olup bu konu ile ilgili daha geniş çalışmalara da ihtiyaç duyulmaktadırObjective: The aim of the study is to report our experience with fibrin glue application in the management of bleeding from the gallbladder bed during laparoscopic cholecystectomy, which could not be controlled by conventional methods.Material and Methods: Three hundred eighty-two patients underwent laparoscopic cholecystectomy. Fourteen patients with bleeding from the gallbladder bed, which could not be controlled by conventional methods, were analyzed retrospectively.Results: Fibrin glue was used in 10 patients, 6 (71%) were female and 4 were (29%) male. The mean age was 55.7 years. Fourteen patients were operated for the presence of symptomatic gallstones. Thirteen patients (%92) had a concomitant pathology. The mean time spent to maintain hemostasis was 23.9 minutes . Blood products were used in two patients with hemoglobin under 8 mg/dL. Hemostasis could not be achieved in a patient despite fibrin glue application, and the operation was converted to open surgery. Conclusion: The application of fibrin glue for bleeding from the gallbladder bed during laparoscopic cholecystectomy can reduce conversion rates, further studies including more patients are require

Diagnosis of comorbid migraine without aura in patients with idiopathic/genetic epilepsy based on the gray zone approach to the International Classification of Headache Disorders 3 criteria

BackgroundMigraine without aura (MwoA) is a very frequent and remarkable comorbidity in patients with idiopathic/genetic epilepsy (I/GE). Frequently in clinical practice, diagnosis of MwoA may be challenging despite the guidance of current diagnostic criteria of the International Classification of Headache Disorders 3 (ICHD-3). In this study, we aimed to disclose the diagnostic gaps in the diagnosis of comorbid MwoA, using a zone concept, in patients with I/GEs with headaches who were diagnosed by an experienced headache expert.MethodsIn this multicenter study including 809 consecutive patients with a diagnosis of I/GE with or without headache, 163 patients who were diagnosed by an experienced headache expert as having a comorbid MwoA were reevaluated. Eligible patients were divided into three subgroups, namely, full diagnosis, zone I, and zone II according to their status of fulfilling the ICHD-3 criteria. A Classification and Regression Tree (CART) analysis was performed to bring out the meaningful predictors when evaluating patients with I/GEs for MwoA comorbidity, using the variables that were significant in the univariate analysis.ResultsLonger headache duration (<4 h) followed by throbbing pain, higher visual analog scale (VAS) scores, increase of pain by physical activity, nausea/vomiting, and photophobia and/or phonophobia are the main distinguishing clinical characteristics of comorbid MwoA in patients with I/GE, for being classified in the full diagnosis group. Despite being not a part of the main ICHD-3 criteria, the presence of associated symptoms mainly osmophobia and also vertigo/dizziness had the distinguishing capability of being classified into zone subgroups. The most common epilepsy syndromes fulfilling full diagnosis criteria (n = 62) in the CART analysis were 48.39% Juvenile myoclonic epilepsy followed by 25.81% epilepsy with generalized tonic-clonic seizures alone.ConclusionLonger headache duration, throbbing pain, increase of pain by physical activity, photophobia and/or phonophobia, presence of vertigo/dizziness, osmophobia, and higher VAS scores are the main supportive associated factors when applying the ICHD-3 criteria for the comorbid MwoA diagnosis in patients with I/GEs. Evaluating these characteristics could be helpful to close the diagnostic gaps in everyday clinical practice and fasten the diagnostic process of comorbid MwoA in patients with I/GEs

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception