Development of Achievement Test: Validity and Reliability Study for Achievement Test on Matter Changing

For "Matter Changing" unit included in the Secondary School 5th Grade Science Program, it is intended to develop a test conforming the gains described in the program, and that can determine students' achievements. For this purpose, a multiple-choice test of 48 questions is arranged, consisting of 8 questions for each gain included in the training program. The test, of which the content validity is reviewed and ensured by 2 chemistry domain experts and 2 science lecturers, is applied to 354 6th grade students (ages 11-12) in the Black Sea Region of Turkey, in a city centre. Item analysis of the test is carried out and 16 items of which the distinctiveness are below 0,30 are excluded from the test. As a result of item analysis the average difficulty of the questions are estimated to be 0,38 and it is seen that their difficulty level is intermediate. Likewise, the average distinctiveness of the questions are estimated to be 0,38 and it is seen that the distinctiveness strength of the questions are well. After the questions are excluded, Kuder Richardson-20 reliability coefficient is estimated to be 0,763. As a result of the study, an effective and reliable achievement test including 32 questions with intermediate difficulty level and well distinction strength created for "Matter Changing" unit is brought to the science education. Keywords: Validity, reliability, matter changing, science

Poli fonksiyonel metal komplekslerinin sentezi karakterizasyonu ve farklı monomerlerle polimerleşebilme özelliklerinin araştırılması

06.03.2018 tarihli ve 30352 sayılı Resmi Gazetede yayımlanan “Yükseköğretim Kanunu İle Bazı Kanun Ve Kanun Hükmünde Kararnamelerde Değişiklik Yapılması Hakkında Kanun” ile 18.06.2018 tarihli “Lisansüstü Tezlerin Elektronik Ortamda Toplanması, Düzenlenmesi ve Erişime Açılmasına İlişkin Yönerge” gereğince tam metin erişime açılmıştır.Bu çalışma, yeni tip poli-fonksiyonel metal komplekslerinin sentezi, karakterizasyonu ve farklı monomerle polimerleşebilme şartlarının araştırılmasına dayanmaktadır. Sentezlenen poli -OH fonksiyonel komplekslerin, 1,4-toluendiizosiyanat varlığında üretan polimerlerine ve glisidil eter türevleri ile epoksi polimerlerine dönüştürülmesi şartları araştırılmıştır. Çalışmamızda sırası ile (E)-1-((2-(2-hidroksietoksi)etilimino)metil)naftalen-2-ol (LIH2); (E)-1-((2-(2-(2-hidroksietoksi)etiltiyo)fenilimino)metil)naftalen-2-ol (LIIH2); (E)-2,4-di-tert-butil-6-(2-(2-(2-hidroksietoksi)etiltiyo)fenilimino)metil)fenol (LIIIH2) Schiff bazı ligantı ve son olarak 2-aminoetoksi etanol ile 3,5-ditertbutil-2- (E)-2,4-di-tert-butil-6-((2-(2-hidroksietoksi)etilimino)metil)fenol (LIVH2) Schiff bazı ligantları sentezi gerçekleştirilmiştir. Ardından metal asetat tuzları ile (Cu+2, Ni+2, Zn+2, Mn+2, Cd+2, Co+2) Schiff bazı metal kompleksleri elde edilmiştir. Elde edilen poli-OH fonksiyonel grup içeren Cu(LIH)2, Ni(LIH)2, Cu(LIIH)2 ve Ni(LIIH)2 kompleksleri 1,4-toluendiizosiyanat varlığında üretan polimerlerine dönüştürülme şartları araştırılmıştır. Cu(LIIH)2, Ni(LIIH)2, Co(LIIH)2, Cd(LIIH)2, Mn(LIIH)2, Zn(LIIH)2, Cu(LIIIH)2, Ni(LIIIH)2, Co(LIIIH)2, Cd(LIIIH)2, Cu(LIVH)2, Ni(LIVH)2, Co(LIVH)2, Mn(LIVH)2 ve Zn(LIVH)2 komplekslerinin diglisidil eter bis fenol A (DGEBFA) ile epoksi polimerlerine dönüştürülmesi şartları araştırılmıştır. Polimerleşebilen fonksiyonel gruplar içeren ligandlar, bunların metal kompleksleri ve elde edilen metallopolimerler UV, FT-IR, NMR, MASS, GPC ve termal analiz spektroskopileri ile karakterize edilmiştir.  In this study, the synthesis and characterization of new type poly-functional schiff bases metal complexes, and the investigation of their polymerizability properties with different monomers were examined. Sentezlenen poli -OH fonksiyonel komplekslerin, 1,4-toluendiizosiyanat varlığında üretan polimerlerine ve glisidil eter türevleri ile epoksi polimerlerine dönüştürülmesi şartları araştırılmıştır. The Synthesized poly OH-functional complexes were investigated to determine the polymerization condition to urethane polymers in presence of 1,4–toluenediisocyanate and to epoxy polymers with diglycidyl ether, respectively. The synthesis of (E) -1-((2-(2-hydroxyethoxy)ethylimino)methyl)naphthalene-2-ol (LIH2), (E)-1-((2-(2-(2-hydroxyethoxy)ethylthio)phenylimino)methyl)naphthalene-2-ol (LIIH2), (E)-2,4-di-tert-butyl-6-((2-(2-(2-hydroxyethoxy)ethylthio)phenylimino) methyl) phenol (LIIIH2) and (E)-2,4-di-tert-butyl-6-((2-(2-hydroxyethoxy) ethylimino)methyl) phenol (LIVH2) as schiff bases ligands were performed. The hydroxyl armed complexes were prepared by utilizing the concentrated synthesis method using metal acetate salts of Cu+2, Ni+2, Zn+2, Mn+2, Cd+2 and Co+2 ions due to receiving higher yield and easy purification. Metal containing polyurethanes (PUP) were synthesized by the addition polymerization of 1,4-toluene diisocyanate (TDİ) with the prepared bis-OH functionalized Schiff base complexes [Cu(LIH)2, Ni(LIH)2, Cu(LIIH)2, Ni(LIIH)2] and chararacterized. Metal containing epoxy polymers (EPO) were prepared with the prepared bis -OH functionalized Schiff base complexes [Cu(LIIH)2, Ni(LIIH)2, Co(LIIH)2, Cd(LIIH)2, Mn(LIIH)2, Zn(LIIH)2, Cu(LIIIH)2, Ni(LIIIH)2, Co(LIIIH)2, Cd(LIIIH)2, Cu(LIVH)2, Ni(LIVH)2, Co(LIVH)2, Mn(LIVH)2, Zn(LIVH)2] in the presence of diglycydil ether bis phenol A (DGEBFA) and investigated. The prepared ligands, complexes and their PUP, EPO polymers were characterized by the combination of 1H-NMR, 13C-NMR, FT-IR, Maldi-TOF MS, GPC, UV-vis., fluorescent spectroscopy and elemental analysis data.

Rate of history of tuberculosis among healthcare workers in Turkey: A cross-sectional study

OBJECTIVES: Healthcare workers (HCWs) possess a high risk for both latent tuberculosis infection (LTBI) and active disease. This study aimed to investigate tuberculosis (TB) disease history in hospital staff working in healthcare institutions in the Eastern Black Sea Region of Turkey. MATERIAL AND METHODS: This study included 460 HCWs employed in 5 hospitals in the Eastern Black Sea Region of Turkey. Between May 01 and July 31, 2016, the participants were asked to answer a questionnaire, including data about TB history. The data about family TB history, Bacilli Calmette-Guerin (BCG) vaccination, or tuberculin skin test (TST) application before starting work were also evaluated. RESULTS: Of the 460 participants, 69.3% were women (n=319) and 30.7% (n=141) were men. The mean age was 32 (17-63) years. A total of 8 participants (1.7 %) had TB history. There was no statistically significant relationship between TB history and age, sex, body mass index (BMI), smoking habits, or presence of comorbidities (p>0.05 for all variables); family history of TB (p0.05). The duration of work (years) was higher in participants with a TB history. The p value was very close but did not reach the limits of significance (p=0.059). CONCLUSION: In this study, the rate of TB among HCWs was 1.7% (8 of 460 HCWs). Family history of TB and TST positivity are strong predictors of TB in HCWs

Is it worth using thrombolytic therapy in elderly patients with pulmonary embolism

Objective: Antithrombotic treatment is avoided in geriatric population owing to its side effects. Thus, we aimed to examine complication rates related to thrombolytic treatment in geriatric patients with pulmonary thromboembolism (PTE). Materials and Methods: The study included patients aged >65 years who received thrombolytic treatment for a diagnosis of PTE. Patient files were screened retrospectively to extract data on etiology, clinical risk scores, laboratory values, thrombolytic treatment-related complications, and early mortality development. Results: The study included 68 patients (female: 70.6%; mean age: 77.8 years). The Simplified Pulmonary Embolism Severity Index score was high in all patients. Early mortality risk classification at admission was high, medium-high, and medium-low risk in 64.7%, 23.5%, and 11.8% patients, respectively. In-hospital mortality was 30.9%. The causes of death were secondary to PTE in 85.7% patients, respiratory failure in 9.6%, and sepsis in 4.7%. Complication-related mortality was not observed. The only independent risk factor for mortality was change in consciousness. Conclusion: Mortality and complication rates in geriatric patients receiving thrombolytic treatment are not as high as expected

Comparison of the Different Dyspnea Scales in Patients with Complaints of Dyspnea

Giriş: Kronik Obstrüktif Akciğer Hastalığı (KOAH)'nda dispne semptomunun doğru olarak tanımlanması tıbbi tedavinin planlanması veetkili bakımın verilmesinde önemli bir unsurdur. Amaç: Bu çalışma, KOAH'lı hastalarda dispnenin şiddetinin değerlendirilmesindeModifiye Borg Skalası (MBS), Medical Research Council Scale (MRCS) ve Görsel Kıyaslama Ölçeği (GKÖ)'ni karşılaştırmak ve ölçeklerinklinik kullanımını değerlendirmek amacıyla yapılmıştır. Yöntem: Araştırmanın örneklemini, Zonguldak Uzunmehmet Göğüs ve MeslekHastalıkları Hastanesi'nde KOAH tanısı alan, olasılıksız örnekleme yöntemi ile seçilen ve araştırmayı katılmayı kabul eden 50 hastaoluşturdu. Hastaların solunum fonksiyon testleri, arteriyel kan gazı analizleri yapıldı ve üç farklı dispne ölçeği ile dispne şiddetlerisorgulandı. Bulgular: Hastaların dispne şiddetleri; MBS ortalaması 4.20 ± 2.10, MRCS ortalaması 2.48 ± 1.05, GKÖ ortalaması ise 5.30 ±2.79 olarak saptandı. Solunum fonksiyon testi parametrelerinden FEV1/FVC değeri ile MBS (r = -.42, p = .002) ve GKÖ (r = -.34, p = .016),FEV1% değeri ile MRCS (r = -.31, p = .025) arasında, kan gazı analizi parametrelerinden PaO2 değeri ile MBS (r = -.47, p = .000), GKÖ (r= -.49, p = .000), MRCS (r = -.46, p = .001), SaO2 değeri ile MBS (r = -.46, p = .001), GKÖ (r = -.45, p = .001) ve MRCS (r = -.45, p = .001)arasında anlamlı bir ilişki bulundu. MBS, MRCS ve GKÖ'nin birbirleriyle güçlü derecede ilişkili olduğu saptandı. Sonuç: Günümüzdedispne şiddetini saptamak için en sık kullanılan; MBS, MRCS ve GKÖ birbirleriyle ilişkili ölçeklerdir. Background: Accurate identification of the symptom of dyspnea in the Chronic Obstructive Pulmonary Disease (COPD) is curicial inplanning of medical treatment and delivering of effective care. Objectives: Our aims were to compare the Modifiye Borg Scale (MBS),Medical Research Council Scale (MRCS) and Visual Analog Scale (VAS) in the assessment of the severity of dyspnea in patients withCOPD and to evaluate clinic utilization of these scales. Methods: The sample of the study consisted of 50 patients with COPD who are inZonguldak Uzunmehmet Chest and Occupational Diseases Hospital, who are selected by random sampling, and who agreed to participate inthe study. The patient's pulmonary function tests and arterial blood gas analysis has been performed and their dyspnea severity has beenevaluated using three different dyspnea scales. Results: The mean dyspnea severities measured by MBS, MRCS and VAS were 4.20 ± 2.10,2.48 ± 1.05, 5.30 ± 2.79 respectively. There was significant correlation the value of FEV1/FVC which is the parameters of pulmonaryfunction tests with MBS (r = -.42, p = .002) and VAS (r = -.34, p = .016); FEV1% and MRCS (r = -.31, p = .025); PaO2 which is theparameters of arterial blood gas analysis with MBS (r = -.47, p = .000), VAS (r = -.49, p = .000), MRCS (r = -.46, p = .001); SaO2 with thevalue of MBS (r = -.46, p = .001), VAS (r = -.45, p = .001) and MRCS (r = -.45, p = .001). It was found that MBS, MRCS and VAS werestrongly correlated with each other. Conclusion: Today, the most commonly used to determine the severity of dyspnea, MBS, MRCS andVAS scales are related scales to each other

Elevated red blood cell distribution width is associated with intrahepatic cholestasis of pregnancy

Objectives: Intrahepatic cholestasis of pregnancy is the most common pregnancy specific liver disease and related with adverse maternal and perinatal outcome. Red blood cell distribution width, an anisocytosis marker in a complete blood count, has been used as an inflammation marker in various diseases. However the association of red blood cell distribution width with intrahepatic cholestasis of pregnancy is unknown. We aimed to evaluate the relationship between red blood cell distribution width and intrahepatic cholestasis of pregnancy. Material and methods: Ninety pregnant women with intrahepatic cholestasis of pregnancy and ninety healthy pregnant women were included in the study. Their clinical and laboratory characteristics including red blood cell distribution width, liver function tests, fasting and postprandial bile acid concentrations were analyzed. Results: Serum red blood cell distribution width cell levels were significantly higher in pregnants with intrahepatic cholestasis of pregnancy than healthy pregnants. We also demonstrated that red blood cell distribution Width levels were higher in severe disease than mild disease and was significantly correlated with fasting and postprandial bile acid concentration in intrahepatic cholestasis of pregnancy group. Conclusions: Our study showed that red blood cell distribution width, an easy and inexpensive marker; were associated with intrahepatic cholestasis of pregnancy and can be used as a diagnostic and prognostic marker in intrahepatic cholestasis of pregnancy

Thyroid Hypoplasia as a Cause of Congenital Hypothyroidism in Monozygotic Twins Concordant for Rubinstein-Taybi Syndrome.

Rubinstein-Taybi syndrome (RSTS), a genetic disorder characterized by growth retardation, mental deficiency, dysmorphic face, broad thumbs and large toes, generally affects monozygotic twins concordantly. Thyroid hypoplasia (TH) is a common cause of congenital hypothyroidism (CH) and often accompanies dysmorphic syndromes. A pair of female twins were admitted to our neonatology unit 16 hours after delivery. They were born at 35 weeks of gestation. Both twins had an unusual dysmorphic facial appearance with microcephaly, as well as broad short thumbs and large toes. Based on the presence of characteristic dysmorphic features, the twins were diagnosed as RSTS. Thyroid function tests in the first twin revealed the following results: free thyroxine (T4) 8.4 pg/mL, thyrotropin (TSH) 4.62 mIU/L, thyroglobulin (TG) 213.24 ng/mL and a normal level of urinary iodine excretion (UIE). Thyroid function test results in the second twin in the second week were: free T4 5.9 pg/mL, TSH 9.02 mIU/L, TG 204.87 ng/mL, and normal UIE levels. Thyroid volumes were 0.36 mL and 0.31 mL in the first and second twin, respectively. TH was confirmed by technetium 99 m pertechnetate thyroid scans in both infants. Thyroid function tests normalized with L-thyroxine replacement therapy (10 μg/kg/day) around the end of the 3rd week of life. The infants were discharged planning their follow-up by both endocrinology and cardiology units. The rarity of cases of twins with RSTS (concordant) co-existing with CH led us to present this report

Risk factors for hysterectomy among patients with placenta previa totalis

Objective: The aim of the study is to assess risk factors for hysterectomy among patients with placenta previa totalis (PPT). Methods: The medical records of all patients delivered by cesarean section (CS) for PPT were retrospectively reviewed. Eligible cases were divided into those who underwent peripartum hysterectomy (PH) and those who did not. The two groups were compared in terms of demographics, operative features and perinatal outcomes. Logistic regression analysis was used to identify risk factors associated with hysterectomy. Results: PH was performed in 43 (44.7%) patients with PPT. Referral patients were older when compared with those without hysterectomy (p: 0.029). The median values for gravidity, parity, number of live children and previous CS were statistically significantly higher in the hysterectomy group (p<0.05). Perioperative need for blood transfusion, anteriorly placed placenta and abnormal placental invasion were statistically significantly more frequent in the hysterectomy group (p<0.001). Intraoperative complication rate was higher in this group, and bladder injury was the most common complication. No significant differences were observed between the groups in terms of perinatal outcomes. In binomial logistic regression analysis; advanced maternal age (≥ 31 years), number of previous CS (≥2), preoperative need for blood transfusion, and abnormal placental invasion were found to be independent risk factors for PH in patients with PPT. Conclusion: The findings of this study suggest that placenta invasion anomaly, advanced maternal age, increased number of previous CS, and increased need for blood transfusion are important risk factors for PH in patients with PPT

Diurnal changes in capecitabine clock-controlled metabolism enzymes are responsible for its pharmacokinetics in male mice

The circadian timing system controls absorption, distribution, metabolism, and elimination processes of drug pharmacokinetics over a 24-h period. Exposure of target tissues to the active form of the drug and cytotoxicity display variations depending on the chronopharmacokinetics. For anticancer drugs with narrow therapeutic ranges and dose-limiting side effects, it is particularly important to know the temporal changes in pharmacokinetics. A previous study indicated that pharmacokinetic profile of capecitabine was different depending on dosing time in rat. However, it is not known how such difference is attributed with respect to diurnal rhythm. Therefore, in this study, we evaluated capecitabine-metabolizing enzymes in a diurnal rhythm-dependent manner. To this end, C57BL/6J male mice were orally treated with 500 mg/kg capecitabine at ZT1, ZT7, ZT13, or ZT19. We then determined pharmacokinetics of capecitabine and its metabolites, 5 '-deoxy-5-fluorocytidine (5 ' DFCR), 5 '-deoxy-5-fluorouridine (5 ' DFUR), 5-fluorouracil (5-FU), in plasma and liver. Results revealed that plasma C-max and AUC(0-6h) (area under the plasma concentration-time curve from 0 to 6 h) values of capecitabine, 5 ' DFUR, and 5-FU were higher during the rest phase (ZT1 and ZT7) than the activity phase (ZT13 and ZT19) (p < 0.05). Similarly, C-max and AUC(0-6h) values of 5 ' DFUR and 5-FU in liver were higher during the rest phase than activity phase (p < 0.05), while there was no significant difference in liver concentrations of capecitabine and 5 ' DFCR. We determined the level of the enzymes responsible for the conversion of capecitabine and its metabolites at each ZT. Results indicated the levels of carboxylesterase 1 and 2, cytidine deaminase, uridine phosphorylase 2, and dihydropyrimidine dehydrogenase (p < 0.05) are being rhythmically regulated and, in turn, attributed different pharmacokinetics profiles of capecitabine and its metabolism. This study highlights the importance of capecitabine administration time to increase the efficacy with minimum adverse effects.Istanbul Universit

Alopesi areata hastalarında nötrofil/lenfosit oranının ve diğer inflamatuar parametrelerin normal popülasyon ile karşılaştırılması

Amaç: Bu çalışmanın amacı; alopesi areata(AA) hastalarında nötrofil/lenfosit oranını (NLR), Eritrosit sedimentasyon hızı(ESR), C reaktif protein(CRP) gibi inflamatuar parametreleri normal populasyon ile kıyaslayarak bu parametrelerin AA hastalarında inflamasyonun şiddetini ölçebilecek bir marker olarak kullanılabilirliğini değerlendirmektir.Yöntem: Çalışmaya klinik olarak AA tanısı konmuş 234 hasta dahil edildi. 37 sağlıklı kişi alındı. Hasta dosyalarından lökosit, nötrofil ve lenfosit sayıları ile ESR ve CRP sonuçları kaydedildi. NLR ise hesaplanarak bulunup kaydedilmiştir. Bulgular: Hasta ve kontrol grubu arasında Lökosit, Nötrofil, ,Hb ve Esr değerleri ile NLR açısından anlamlı fark saptanmazken(p>0.05) Lenfosit sayıları(p=0,02) ve Crp( P <0.001) değeri AA hastalarında yüksek olduğu tesbit edilmiştir. Sonuç: Sonuç olarak AA hastalığında NLR değerinin kullanılabilecek bir belirteç olmadığı kanaatine varılmıştır. CRP'nin AA için kullanılabilir bir marker olduğunu gösterebilmek için daha geniş ölçekli çalışmalar yapmak gereklidir.Objective: The objective of this study is to calculate the neutrophil-lymphocyte ratio (NLR) and other inflamatory paramaters like erythrocyte sedimentation rate (ECR) and C-reactive protein results (CRP) in Alopecia areata(AA) patients and determine the association between thoose laboratory values and AA.Method: 234 patients with AA and 37 healthy subjects were enrolled in the study. Number of neutrophil, lymphocyte, leucocyte, ESR and CRP were ascertained from patient's medical records. NLR was calculated and recorded.Results: While the difference between patient and control groups in terms of value of Neutrophils, Leukocytes, Hb and Esr were found to be insignificant (p&gt;0.05), numbers of Lymphocyte (p=0,02) and value of Crp ( P &lt;0.001) in patients were found to be higher than those of healthy controls.Conclusion: This study demonstrates that NLR can not serve as a usuful marker for AA. And, as for CRP, larger-scale studies need to be done in order to demonstrate if it can serve as a marker or not