Diatom Silika İskeletleri ile Güçlendirilmiş Polihidroksibutirat-kohidroksivalerat/Pullulan Üç Boyutlu Doku İskelelerinin Kemik Doku Mühendisliğinde Kullanılabilirliğinin Araştırılması

TÜBİTAK MAG Proje01.11.2018Kemik dokusu kayıplarının tedavisinde kullanılan greft yaklaşımlarında donör kısıtlılığı,bulaşıcı hastalık ve immün reaksiyon riski ile karşılaşılmaktadır. Doku mühendisliği amacıylageliştirilen hücre taşıyıcıları bu sorunların önüne geçmektedir. Projede, kemik dokurejenerasyonunu destekleyecek, temelde doğal malzemelerden oluşan üç boyutlu yeni birtaşıyıcı geliştirilmiştir. Birlikte elektroeğirme yöntemiyle hazırlanan taşıyıcının birinci fiberyapısı temelde bakteriden üretilebilen Poli(3-hidroksibütrat-ko-3-hidroksivalerat) (PHBV) veyapıyı desteklemek için az miktarda Polikaprolakton (PCL) polimerinden, ikinci fiber isepullulan (PUL) polimeri ve tek-hücreli bir alg olan diatomun silika kabuklarından (DS)oluşmaktadır. DS parçacıkları taşıyıcıya eklenmeden önce saflaştırılmış, hücre canlılığınıdestekleyen konsantrasyon ve boyut özellikleri belirlenmiş ve elektroeğirme sırasında fiberleriçerisine başarıyla hapsedilebildiği gösterilmiştir. Projede öncelikle ticari olarak satın alınan(yurt dışı kaynaklı) PHBV ile taşıyıcının hazırlanma koşulları ve özellikleri araştırılmış, dahasonra proje kapsamında Cupriavidus necator bakteri suşu?ndan PHBV üretimi ve valeratyüzdesi optimize edilip bu polimerle taşıyıcılar hazırlanmış ve özellikleri karşılaştırılmıştır. İkifiberli hücre taşıyıcı yapı olarak PHBV/PCL/SA:PUL/DS grubu üretilmiş ve PUL fiberlerininelektroeğirme sırasında çapraz bağlanması için yeni bir yöntem sunulmuştur. Projede ayrıca,Sefuroksim aksetil (SA) antibiyotiği, hidrofobik olan PHBV fiberlerine elektroeğirme sırasındahapsedilmiştir. Geliştirilen bu yeni taşıyıcının yavaş hızda bozunduğu, çok az su alarakyapısını koruduğu, kontrollü antibiyotik salımını desteklediği, içerdiği DS ve çift fiber yapısısayesinde daha yüksek basma dayanımına sahip olduğu görülmüştür. Saos-2 hücreleriyleyapılan in vitro deneylerde DS içeren grupların daha yüksek hücre canlılığı sağladığı ve L929hücreleri ile yapılan deneylerde hidrofilik PUL fiberleri varlığı sayesinde birlikte elektroeğrilmiştaşıyıcıların canlılığı daha iyi desteklediği sonucu elde edilmiştir. SEM ve lazer taramalıkonfokal mikroskobu analizlerinde, hücrelerin taşıyıcı içinde yayıldığı, sağlıklı morfolojideolduğu görülmüştür. Projede üretilen PHBV ile hazırlanan taşıyıcılar aynı karakterizasyonaşamalarına tabi tutulmuştur ve hücre canlılığını aynı şekilde desteklediği görülmüştür.Projede, kemik doku kayıplarının tedavisi için ürüne dönüşme potansiyeli bulunan ve tümmalzemeleri ülkemiz kaynaklarından elde edilebilecek veya üretilebilecek yeni bir 3 boyutluhücre taşıyıcı geliştirilmiştir

Effect of final irrigation with sodium hypochlorite at different temperatures on postoperative pain level and antibacterial activity: a randomized controlled clinical study

Objective: To evaluate the effect of final irrigation of root canals with NaOCl solution at different temperatures on postoperative pain level and antimicrobial activity. Methodology: 45 patients were randomly divided into three groups using a web program according to the irrigation selected: NaOCl 2ºC, NaOCl 25ºC and NaOCl 45ºC. First root canal samples were collected before treatment (S1). After chemo-mechanical preparation, final irrigation was performed with the selected irrigant (NaOCl 2ºC, NaOCl 25ºC and NaOCl 45ºC) and second samples were collected (S2). Samples were subjected to quantitative real-time polymerase chain reaction to evaluate the levels of total bacteria. The root canal treatments were completed and the participants were given instructions to record postoperative pain levels at 24, 48 and 72 hours, 5 days and 1 week after treatment using a visual analog scale (VAS). Results: The reduction in the number of total bacterial cell equivalents from S1 to S2 was statistically significant in all groups (p<0.001). The NaOCl 2˚C group reported significantly less postoperative pain than the NaOCl 45˚C group (p<0.05). Postoperative analgesic intake was significantly higher in the NaOCl 45˚C group than in the NaOCl 2˚C group (p<0.05). Conclusion: We conclude that final irrigation with NaOCl at different temperatures results in similar antibacterial effectiveness. Final irrigation with cold NaOCl (2˚C) is better than NaOCl 45˚C when comparing postoperative pain levels

The relationship between postpartum social support and attitudes towards breastfeeding: A cultural perspective

Aim: This study intends to provide an analysis of the relationship between postpartum social support and women’s breastfeeding attitudes from different cultural perspectives. Method: This study was conducted between April-September 2019.The study population comprised of 430 women with 4-24 week old babies who visited health centers in the provinces of Adıyaman (Region 1), Kahramanmaraş (Region 2) and Malatya (Region 3). Findings: The mean scores of women from the BAES were 105.54 ± 13.16 in Region 1, 103.30 ± 15.77 in Region 2, and 99.46 ± 13.47 in Region 3 (P<0.05).The mean scores of women from the “Importance of the Need” subscale on the PSQ were 157.38±45.57 in Region 1, 140.73±55.18 in Region 2, and 144.89±48.144 in Region 3 (P<0.05).The mean scores of women from the “Support Received” subscale on the PSQ were 112.39±51.58 in Region 1; 116.87±52.69 in Region 2, and 108.89±50.79 in Region 3 (P>0.05).In Region 2, a significant and positive correlation was found between the subscales “Importance of the Need” and the “Perceived Support” on the BAES and the PSQ (r=0.259, r=0.255, P<0.05, respectively). Conclusion: A comparison of the relationship between postpartum social support and attitudes towards breastfeeding revealed major differences between the Regions

The Moderating Effect of Birth Satisfaction on the Correlation Between Mother-Infant Bonding and Psychological Resilience

Objectives:This study was conducted to evaluate the moderator role of birth satisfaction in its correlation with mother-infant bonding and psychological resilience. Methods:This study was a cross-sectional study. The population of this study consisted of puerperal women who gave birth in a public hospital in Turkey. The sample size was calculated as at least 437 puerperal women and included 491 puerperal women in total. Personal Introduction Form, the Brief Resilience Scale (BRS), Mother to Infant Bonding Scale (MIBS), and Birth Satisfaction Scale–Short Form (BSS–Short) were used to collect data. Results:Mean age of puerperal women included in this study was 28.07±5.17. The mean BSS-Short total score was 20.35±6.07, the mean MIBS total score was 1.73±2.44, and the mean BRS total score was 19.18± 4.50. In this study, it was determined that the correlation between birth satisfaction and mother-infant bonding increased as the level of psychological resilience increased. In addition to this, the simple slope analysis revealed that the effect of psychological resilience on mother-infant bonding was not significant in cases where birth satisfaction was high(B=-0.22,p=0.10) and the effect of psychological resilience on mother-infant bonding was significant in cases where birth satisfaction was moderate(B=-0.44,p=0.001) and high(B=-.71,p=0.001). Conclusion:It was concluded that the strength of the correlation between psychological resilience and mother-infant binding increased in cases where birth satisfaction was high

A qualitative study on loss of a spouse, coping strategies after loss and the future expectations among eldersYaşlılarda eş kaybı, kayıp sonrası başa çıkma stratejileri ve gelecek beklentileri üzerine nitel bir araştırma

With this study, it is aimed to present data about the important effects of losing a spouse among elders, especially to the related areas which provide services for elderly people such as healthcare, nursing and psychological counseling. Three sub-objectives were examined within the scope of the current study, namely, (1) emotional, cognitive, social and physical influences caused by the loss of a spouse in the elderly, (2) coping strategies used by the elders to cope with the loss of a spouse, and (3) the future expectations of elders after loss of a spouse.In the research, phenomenological approach is used from qualitative research methods. Semi-structured interviews were conducted with ten participants (5 males, 5 females) who were were 65 years old or older, have lost their spouses, and were not in the nursing home. The gathered data was analyzed with frequency and categorical analysis.The results of the analysis demonstrated that the loss of a spouse in the elderly can be classified in five main general area namely, “cognitive, emotional, social and physical effects of losing of a spouse”, “methods used to cope with loss of a spouse”, “future expectations of the elders”, “expressions related the loss of a spouse”, and “other expressions”. When the statements on the effects of the losing a spouse were examined, it was seen that “cognitive effects” were the most frequent, and “physical effects” were the least frequent subcategories. Besides, “lifestyle habits” were the most frequent and “receiving psychological support from an expert” was the least frequent subcategories of the second main general category which is called as the coping strategies after loss of a spouse among elders. Lastly, “expectations, plans and objectives” were the oftenest subcategory in the future expectations category of the current study.The findings of the study were discussed in comparison to the relevant information in the field of psychology, and suggestions were provided in the context of guidance and psychological counseling.Extended English summary is in the end of Full Text PDF (TURKISH) file. ÖzetBu çalışma ile yaşlılık döneminde önemli etkileri olan eş kaybı hakkında özellikle yaşlılara sağlık, bakım, psikolojik danışma gibi hizmet veren ilgi gruplarına veri sunulması amaçlanmıştır. Çalışma kapsamında; (1) yaşlılarda eş kaybetmenin yarattığı duygusal, bilişsel, sosyal ve fiziksel etkilerin (2) yaşlıların eş kaybıyla baş etmede kullandıkları stratejilerin ve  (3) yaşlılarda eş kaybı sonrası geleceğe ilişkin beklentilerin neler olduğu alt amaç olarak incelenmiştir. Araştırmada nitel araştırma yöntemlerinden fenomenolojik yaklaşım kullanılmıştır. Belirlenen amaçlar doğrultusunda 65 yaş ve üzeri eşini kaybetmiş ve bakım evinde olmayan on katılımcı (5 erkek, 5 kadın) ile yarı yapılandırılmış görüşmeler gerçekleştirilmiştir. Görüşmelerde toplanan veriler frekans analizi ve kategorisel analiz yöntemleri kullanılarak incelenmiştir. Yapılan analizler sonucunda “yaşlılarda eş kaybetmenin bilişsel, sosyal, duygusal ve fiziksel etkileri”, “eş kaybıyla baş etmede kullanılan stratejiler”, “geleceğe ilişkin beklentiler”, “eş kaybına ilişkin söylemler” ve “diğer ifadeler” şeklinde sıralanan beş genel alan kategorisi oluşturulmuştur. Yaşlılarda eş kaybetmenin yarattığı etkilere ilişkin ifadeler incelendiğinde en sık “bilişsel etkilerden” en az ise, “fiziksel etkilerden” bahsedildiği görülmüştür. Bununla birlikte yaşlıların eş kaybı ve bu kaybın ortaya çıkardığı durumlarla baş etmede en sık “yaşam alışkanlıkları” en az da  “uzmandan destek alma” alt alanına ilişkin söylemleri olduğu belirlenmiştir. Yaşlıların geleceğe ilişkin beklentilerine yönelik söylemleri incelendiğinde en sık “beklentiler, planlar ve hedefler” alt alanına ilişkin ifadelerin yer aldığı görülmüştür. Çalışmanın bulguları alan yazındaki bilgilerle karşılaştırılarak tartışılmış, bulgular doğrultusunda psikolojik danışma ve rehberlik alanında yaşlılara verilecek hizmetler çerçevesinde öneriler sunulmuştur.

Evaluation of Acoustic Reflex and Reflex Decay Tests in Geriatric Group

Objective: To determine average acoustic reflex thresholds in geriatric groups by assessing ipsilateral and contralateral acoustic reflex and reflex decay tests.Methods: A total of 25 elders between ages 65-84 years (74.3±5.4) and 25 individuals between ages 18-45 years (30.4±4.2) were recruited for the study. After ear, nose, and throat examination, ipsilateral and contralateral acoustic reflex thresholds at 500, 1000, 2000, and 4000 Hertz (Hz) were determined and a reflex decay test at contralateral 500 Hz was conducted. Ipsilateral acoustic reflex thresholds were obtained with high-frequency band, low-frequency band, and wide band noise, and the results were compared with ipsilateral acoustic reflexes at 500, 1000, 2000, and 4000 Hz.Results: There was no statistically significant difference between the two groups in ipsilateral and contralateral acoustic reflex measurements at 500, 1000, 2000, and 4000 Hz (p>0.05). Negative reflex decay was obtained in all participants and no statistically significant difference between the two groups was observed in terms of reflex decay thresholds (p>0.05). Acoustic reflex with high-frequency band noise was observed in five of nine elders whose acoustic reflexes were not obtained at 2000 and 4000 Hz, whereas acoustic reflex with low-frequency band noise was observed in one of six elders who did not show reflexes at 500 and 1000 Hz.Conclusion: It was concluded that although some changes were observed due to age, middle ear and stapes muscles work normally in geriatric group. In the reflex decay test, reliable results were obtained at contralateral 500 Hz. Acoustic reflex measurements with low- and high-frequency band noise may also be used to assess middle ear functions

Impact of clinicopathological variables on laparoscopic hysterectomy complications, a tertiary center experience

Objectives: To analyze intraoperative and postoperative complications according to Clavian-Dindo Classification (CDC) and evaluate the influence of clinicopathological features on the feasibility and safety of total laparoscopic hysterectomy (TLH) in patients that underwent surgery in a tertiary center. Material and methods: We retrospectively reviewed the database of 469 patients that underwent surgery for patients who underwent extra facial TLH from 2013 to 2020. Results: A total of 86 (18.3%) peri-postoperative complications were observed. The incidence of intraoperative complications was 2% (n = 10). The overall conversion rate to open surgery was 1.9% (n = 9). A total of 76 postoperative complications were observed in 61 patients (14.3%). The incidence of minor (Grade I [n = 16, 3.4%] and II [n = 42, 8.9%]) and major complications (Grade III [n = 15, 3.2%], IV [n = 2, 0.4%] and V [n = 1, 0.2 %]) were 12.3% and 3.8%, respectively. A higher BMI and performing surgery at the first step of learning are found to be associated with intraoperative and postoperative complications (p < 0.05). Postoperative complications related to having a history of the cesarean section, additional comorbidities, and uterine weight ≥ 300 g (p < 0.05). Conclusions: The implementation of TLH by experienced surgeons appears to have remarkable advantages over open surgery. However, the risk factor for complications should be taken into account by surgeons in the learning curve in selecting the appropriate patient for surgery.

Asimetrik Topolojik Uzaylar

The aim of this thesis is to make a compilation about asymmetric topological spaces and dual spaces which are defined in order to provide asymmetric spaces to have better topological properties. This work consists of five chapters. The first chapter is an introduction. The second chapter contains the fundamental information which will be used in posterior chapters of the thesis.In the third chapter, asymmetric topological spaces and topological duality are mentioned. In addition, for a given topology, weak, Alexandroff and de Groot duals are defined and with the help of bitopological spaces, relations between a topology and its dual are investigated.Bu tezin amacı; asimetrik topolojik uzaylar ve bu uzayların daha iyi topolojik özelliklere sahip olmalarını sağlamak amacıyla tanımlanan dual uzaylar özerine bir derleme yapmaktır.Tez bes bölömden oluşmaktadır. Birinci bölöm giris bolömudör. ikinci bolum, tezin sonraki bolömlerinde kullanılacak temel bilgileri icermektedir.Ucundi bolumde asimetrik topolojik uzaylar ve topolojik dualiteden bahsedilmistir. Ayrıca verilen bir topoloji için, zayıf, Alexandroff ve de Groot duallerin tanımları ve-rilmis ve ikili topolojik uzaylar yardımıyla, bir topoloji ile duali arasındaki iliskiler incelenmiçsti