Comparison of the dose distribution obtained from dosimetric system with intensity modulated radiotherapy planning system in the treatment of prostate cancer

Prostat kanseri, diğer kanser türlerinde olduğu gibi vücuttaki normal hücre büyümesinin bozularak prostat bezinin kötü huylu büyümesi olarak bilinir. Tedavi yöntemlerinden biri olan ışınlama, eksternal (dış) radyoterapi ve brakiterapi olmak üzere iki şekilde yapılır. Prostat kanseri tedavisinde daha yüksek oranda tümör kontrolünü daha az yan etki ile sağlamak için yoğunluk ayarlı radyoterapi (YART) planlaması kullanılır. YART ile tedavi edilen hastaların bütün tedavi alanlarının tedaviden önce dozimetrik olarak hesaplanan doz dağılımı ile karşılaştırılarak kontrol edilmesi gerekir. Bu tez çalışmasında, YART planlamalarında hedef hacmin almış olduğu doz termolüminesans dozimetre (TLD), iyon odası ve 2D-ARRAY dedektör sistemi gibi dozimetrik sistemler kullanılarak ölçülüp karşılaştırılmıştır. Üç prostat kanseri hastası için, YART yöntemi ile oluşturulmuş tedavi planları, 2D-ARRAY ve TLD ölçümlerinin gerçekleştirildiği katı su fantomu üzerine aktarılmıştır. Her üç hasta için dozimetrik sistemlerden elde edilen sonuçlar YART ile karşılaştırılmıştır. 2D-ARRAY ile yapılan karşılaştırmada 3 mm DTA, %3 DD kriteri için γ değerlendirmesini geçen noktalar bulunmuştur. Karşılaştırmada γ değerlendirmesini geçen noktaların yüzdesine bakıldığında 2D-ARRAY ile yapılan ölçümlerin tedavi planlama sistemi ile uyumlu sonuçlar verdiği belirlenmiştir. Ġyon odası ile gerçekleştirilen nokta doz ölçümleri ve planlamalardan okunan dozlar arasındaki fark %3’den küçük bulunmuştur. TL dozimetreler ile ölçülen ve planlama sisteminden okunan doz değerleri arasındaki fark % 1–5 arasında bulunmuştur. Elde edilen sonuçlar ışığında dozimetrik sistemlerin avantaj ve dezavantajları kendi aralarında kıyaslanmıştır.As in other types of cancer, prostate cancer is the deterioration of normal cell growth in the body, known as malign enlargement of the prostate gland. Irradiation which is one of the treatment methods done in two ways as external radiotherapy and brachytherapy. In order to achieve high tumor control rate with minimum side effects Intensity Modulated Radiotherapy (IMRT) planning is used for prostate cancer treatment. Before treatment, all treatment fields in IMRT must be controlled and compared with dosimetrically obtained dose distribution. In this thesis, dose received by the target volume for IMRT plannings is measured and compared with the dosimetric systems such as thermoluminescent dosimeter (TLD), ionization chamber and 2D-array. For three prostate cancer patients, the treatment plans created with IMRT technique are transferred onto 2D-ARRAY and onto the solid water phantom which TLD studies are carried out. For the patients the results obtained from dosimetric systems are compared with those obtained from IMRT technique. For 2D-ARRAY measurements, the points that passed γ assessment for 3 mm DTA, %3 DD criteria have been found. According to the percentage of the points passed γ assessment, it is determined that 2D-ARRAY measurements have given consistent results with treatment planning system. The differences between point doses measured in ionization chamber and the doses read from planning system have been obtained less than %3. It is found that the difference between dose values of TLDs and planning system are in the range of 1-5%. According to the results the advantages and disadvantages of dosimetric systems are compared with each other

Hasan Akay, Hiç Ferahlığı

[No Abstract Available

Robust auction design under multiple priors

Cataloged from PDF version of article.In optimal auction design literature, it is a common assumption that valuations of buyers are independently drawn from a unique distribution. In this thesis, we study auctions with ambiguity for an environment where valuation distribution is uncertain itself and introduce a linear programming approach to robust auction design problem. We develop an algorithm that gives the optimal solution to the problem under certain assumptions when the seller is ambiguity averse with prior set P and the buyers are ambiguity neutral with a prior f ∈ P. Also, we consider the case where the buyers are ambiguity averse as the seller and formulate this problem as a mixed integer programming problem. Then, we propose a hybrid algorithm that enables to achieve a good solution for this problem in a reduced time.Koçyiğit, ÇağılM.S

Safahatta insanın zaman, mekân ve eşya ile ilişkisi

Bu çalışma Mehmed Âkif Ersoy’un Safahat adlı eseri temel alınarak hazırlanmıştır. Çalışmanın amacı, Mehmed Âkif Ersoy’un şiirlerinde insanın zaman, mekân ve eşya ile ilişkisini ortaya koymaktır. Giriş bölümü hariç üç bölümden oluşan çalışmada sırasıyla insanın zamanla, mekânla ve eşya ile olan ilişkisi irdelenmiş, sonuç ve değerlendirme bölümünde ise bu ilişkinin oluşturduğu tablo ve bu tabloya yapılan yorumlar genel olarak özetlenmiştir. Çalışmanın kapsamı Safahat ve Safahat dışında yer alan şiirler olmakla beraber yer yer düz yazılara ve kaynak eserlere de değinilmiştir. Bu tez, Mehmed Âkif Ersoy’un zaman, mekân ve eşya şuuruyla insanı yeniden inşa etme teklifi sunduğunu savunmaktadı

Invitations / Implications of the Concepts: “İstiklal Marşı in the Context of Intertextuality

Geçmişten günümüze kadar eserler çeşitli şekillerde yorumlanmış, farklı odak noktaları esas alınarak tek bir eserden farklı farklı anlamlar, okumalar, değerlendirmeler sunulmuştur. Türk milli marşı olan İstiklâl Marşı, hem tarihi hem manevi olarak değer verilmiş, çeşitli şekillerde yorumlanmış bir eserdir. Bu çalışmada İstiklâl Marşı, metinlerarası ilişkiler kuramına uygun şekilde bir okumaya tabi tutulacaktır. Metinlerarasılık kuramı metni kendinden önceki ve dönemindeki metinlerle ilişkili olarak ele alan bir kuramdır. Bu kurama göre İstiklâl Marşı’nın metinlerarası okumaya uygunluğu incelenmiş ve elde edilen verilere göre bu bağlamda okunduğunda dikkat çekici sonuçlar elde edildiği belirtilmiştir.Throughout the past up until the present day, works are interpreted in various ways; different meanings, readings, evaluations of a single work based are presented, taking different points to focus on and base their work. The Turkish national anthem, the “İstiklâl Marşı”, has been ascribed both historical and spiritual value, and is a work that has been interpreted in various ways. In this study, the “İstiklâl Marşı” will be subject to study according to the theory of intertextuality. Intertextuality is a theory that discusses a text in relation to texts that preceded it and texts of the same era. The eligibility of the İstiklâl Marşı to an intertextual reading is examined according to this theory, and in light of the data obtained when read in this context, remarkable results are obtained, and are specified in this study

A Juxtaposition of Happiness and Sadness on the Same Page

A Juxtaposition of Happiness and Sadness on the Same PageA Juxtaposition of Happiness and Sadness on the Same Pag

Would FRAX define the high fracture risk if the patients were evaluated the day before hip fracture?

Objective: The aim of this study was to evaluate the 10-year major osteoporotic and hip fracture risks in patients with a recent hip fracture. Material and Methods: The study population comprised 58 patients (32 male and 26 female, mean age 79.1 years) with a recent hip fracture. A bedside questionnaire including fracture risk assessment tool (FRAX®) variables and fall frequency was administered to the patients. The FRAX® 10-year major osteoporotic and hip fracture risks were calculated. Statistical analyses were performed to compare different age groups (60–69 years, 70–79 years, and ≥80 years). Results: The mean 10-year major osteoporotic and hip fracture risks were 13.9% and 78%, respectively. If the National Osteoporosis Foundation guidelines were taken into account according to major osteoporotic and hip fracture risks using FRAX® the day before the fracture, treatment would not be initiated in 75.8% and 18.9% of patients, respectively. There were significant differences between the age groups according to the 10-year major osteoporotic and hip fracture probability and fall frequency (p<0.001, p<0.001, and p=0.005, respectively). Conclusion: In our study group, the FRAX® 10-year major osteoporotic fracture probability had an underestimation in younger patients with a history of frequent falling and did not seem to improve the definition of high-risk patients. The 10-year probability of hip fracture by the FRAXObjective: The aim of this study was to evaluate the 10-year major osteoporotic and hip fracture risks in patients with a recent hip fracture. Material and Methods: The study population comprised 58 patients (32 male and 26 female, mean age 79.1 years) with a recent hip fracture. A bedside questionnaire including fracture risk assessment tool (FRAX®) variables and fall frequency was administered to the patients. The FRAX® 10-year major osteoporotic and hip fracture risks were calculated. Statistical analyses were performed to compare different age groups (60–69 years, 70–79 years, and ≥80 years). Results: The mean 10-year major osteoporotic and hip fracture risks were 13.9% and 78%, respectively. If the National Osteoporosis Foundation guidelines were taken into account according to major osteoporotic and hip fracture risks using FRAX® the day before the fracture, treatment would not be initiated in 75.8% and 18.9% of patients, respectively. There were significant differences between the age groups according to the 10-year major osteoporotic and hip fracture probability and fall frequency (p<0.001, p<0.001, and p=0.005, respectively). Conclusion: In our study group, the FRAX® 10-year major osteoporotic fracture probability had an underestimation in younger patients with a history of frequent falling and did not seem to improve the definition of high-risk patients. The 10-year probability of hip fracture by the FRAX® tool can classify populations at risk more effectively. tool can classify populations at risk more effectively. © 2015 by Turkish Society of Physical Medicine and Rehabilitation

Ruminasyon ve varsayılan mod ağı (DMN): bir beyin ağı incelemesi

Rumination is one of the most common repetitive negative thinking patterns and described as a pathological structure that involves focusing negatively on the past events and their consequences. Two subtypes of rumination are defined, while brooding is considered as an unsuccessful problem-solving attempt focusing on the consequences of depressive symptoms, reflection is considered as a relatively successful problem-solving attempt focusing on the causes of the depressive state. Within the last decade, rumination has been studied by its connection with the activity of the Default Mode Network (DMN), which is known as a structure that connects specific brain regions that increase their activity during the resting state (rs) and was associated with selfreferential thinking, memory and mind wandering. Additionally, a few recent studies suggest that besides the activity within the DMN, some networks working simultaneously with the DMN may also play a significant role in rumination. Therefore, five rs-fMRI (resting state functional magnetic resonance imaging) articles assessing the relationship between rumination and DMN are discussed in this study. These studies show that while the communication of some DMN subsystems are increased during the process of ruminative thinking, some subsystems of DMN seems to communicate less. Moreover, some evidence suggests that DMN synchronization might be impaired in high-trait ruminators. Finally, it has been tried to emphasize the points and suggestions that are valuable for future studies.Ruminasyon, en yaygın tekrarlayıcı olumsuz düşünme örüntülerinden biridir ve geçmiş olaylar ile bunların sonuçlarına olumsuz bir şekilde odaklanmayı içeren patolojik bir yapı olarak tanımlanır. Ruminasyonun iki alt tipi tanımlanmıştır; kara kara düşünme, depresif semptomların sonuçlarına odaklanan başarısız bir problem çözme girişimi olarak kabul edilirken yansıtma, depresif durumun nedenlerine odaklanan nispeten başarılı bir problem çözme girişimi olarak kabul edilir. Ruminasyon, son on yılda, kişi dinlenme halindeyken etkinleşen belirli beyin bölgelerini birbirine bağlayan ve kendine yönelik düşünme, hafıza ve dalgınlık ile ilişkilendirilmiş bir yapı olarak bilinen Varsayılan Mod Ağı (DMN) ile güçlü bir bağlantı göstermiştir. Ek olarak, son zamanlarda yapılan birkaç çalışma, DMN içindeki etkinliğin yanı sıra, DMN ile eş zamanlı çalışan bazı ağların da ruminasyonda rol oynayabileceğini ortaya koymaktadır. Ruminasyon ve DMN arasındaki ilişkiyi gösteren beş rs-fMRI (resting state functional magnetic resonance imaging) makalesi incelenmiş ve sonuçlar özetlenmiştir. Çalışmalardan elde edilen veriler, ruminatif düşünme sürecinde bazı DMN alt sistemlerinin iletişimlerinin artarken, bazı DMN alt sistemlerinin daha az iletişim kurduğunu göstermektedir. Ayrıca, bazı kanıtlar, yüksek ruminatif düşünce stiline sahip kişilerde DMN senkronizasyonunun bozulmuş olabileceğini düşündürmektedir. Son olarak ileride yapılacak çalışmalar için değerli olan hususlar ve öneriler vurgulanmaya çalışılmıştır.Publisher's Versio

The relationship between COVID-19 and fibromyalgia syndrome: prevalence, pandemic effects, symptom mechanisms, and COVID-19 vaccines

On March 11, 2020, the World Health Organization, realizing the level of spread worldwide and the severity of the condition, accepted coronavirus disease 19 (COVID-19) as a pandemic. Subsequently, quarantine conditions were implemented around the world, and these triggered particular results. Like all other individuals, fibromyalgia syndrome (FMS) patients were affected by these conditions. The stress load in pandemic conditions, difficulties in accessing healthcare services, changes in exercise compliance, variations in physiotherapy programs, and remote work conditions all had an impact on FMS patients. Although general expectations were negative, some FMS patients were able to manage the pandemic conditions and even turn them in their favor. This is thought to be due to this patient group having established strategies to cope with stress in the pre-pandemic period, and they had sufficient ability to adapt to changing situations. FMS-related symptoms occur in a subset of individuals following COVID-19. One of the factors is the increased psychological burden after COVID-19. There is evidence that neuroinflammatory pathways affect neuroplasticity in the central nervous system and trigger the onset of FMS-related symptoms. Among the probable mechanisms are alterations in inflammatory and anti-inflammatory pathways. Changes in the autonomic nervous system with the effect of SARS-CoV-2 may induce the emergence of FMS-related symptoms. FMS and COVID-19 can coexist, and FMS may create a tendency to vaccine hesitancy. Future studies should focus on elucidating FMS-related symptoms occurring post-COVID-19. There is a need to determine distinctions between the FMS clinical status that emerged following COVID-19 and the regular patient group in terms of diagnosis, treatment, and follow-up. © 2022, The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR)

Fibromyalgia syndrome: epidemiology, diagnosis and treatment

Fibromyalgia syndrome (FMS) profoundly impacts patients’ quality of life with its symptoms and clinical signs. Fibromyalgia syndrome impairs daily living activities, reduces work efficiency and raises health-related costs. Although the prevalence rates vary depending on geographical location and diagnostic criteria, it is a common disorder worldwide. Females have a higher prevalence of fibromyalgia syndrome, with varied rates, and there is an increase in prevalence rates with age. Although its etiopathogenesis has not been fully elucidated, various hypotheses have been proposed that central sensitization is at the core of the process. Fibromyalgia syndrome diagnostic approaches have advanced significantly over time, moving away from pain assessments alone and emphasizing multiple clinical signs of FMS. This condition has raised physicians’ and researchers’ awareness of non-pain symptoms. Considering the complicated etiopathogenesis of fibromyalgia syndrome, diverse pathways connected with symptoms, and multiple clinical presentations, it becomes clear that drug and non-drug treatments should be chosen in combination. © 2022 Termedia Publishing House Ltd.. All rights reserved