Oyunlaştırma ile zenginleştirilmiş çevrimiçi öğrenmenin başarı, çevrimiçi bağlılık ve öğrenme motivasyonu üzerindeki etkisi

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 araştırmada, oyunlaştırmayla zenginleştirilmiş çevrimiçi öğrenme ile oyunlaştırma içermeyen çevrimiçi öğrenmenin; başarı, öğrenme motivasyonu ve çevrimiçi bağlılık üzerindeki etkilerinin karşılaştırmalı olarak incelenmesi amaçlanmıştır. Araştırma 2x2 faktöriyel deneysel desende yürütülmüştür. Desenlerde kullanılan bağımlı değişkenler: başarı, öğrenme motivasyonu (içsel hedef yönelimi, dışsal hedef yönelimi, görev değeri, öz-yeterlik algısı, kontrol inancı ve sınav kaygısı) ve çevrimiçi bağlılıktır (bilişsel bağlılık, davranışsal bağlılık, duyuşsal bağlılık). Bu bağımlı değişkenler üzerinde etkisi incelenen bağımsız değişken ise oyunlaştırma stratejisidir. Bu değişkenin oyunlaştırma ile zenginleştirme ve oyunlaştırma içermeme olmak üzere iki düzeyi ele alınmıştır. Bu düzeyler; öğrenme-öğretme sürecinde iki deneysel koşul, iki deney grubu oluşturularak incelenmiştir. Araştırmanın çalışma grubunu Sakarya Üniversitesi Eğitim Fakültesi'nde öğrenim gören ve Eğitim Filmleri (SAU 205) üniversite ortak dersini alan 72 öğrenci oluşturmuştur. Veri toplama aracı olarak; Güdülenme Ölçeği, Çevrimiçi Öğrenme Ortamlarında Öğrenci Bağlılık Ölçeği, Başarı Testi, Demografik Bilgiler Formu, Görüşme Formu ve Çevrimiçi Öğrenme Sistem Kayıtları kullanılmıştır. Deneysel işlemlerin iki haftası uygulamaya hazırlık olmak üzere toplamda altı hafta boyunca öğrencilere oyunlaştırma ile zenginleştirilmiş ve oyunlaştırma içermeyen çevrimiçi öğrenmeler uygulanmış, deneysel işlemler öncesinde ve sonrasında veriler toplanmıştır. Uygulama sonunda oyunlaştırma içeren çevrimiçi öğrenme grubundaki öğrenciler ile uygulama sürecine yönelik görüşmeler yapılmıştır. Araştırmadan elde edilen nicel veriler ANCOVA analizi, korelasyon analizi, ilişkisiz örneklemler için t testi; nitel veriler ise içerik analizi kullanılarak analiz edilmiştir. Araştırmanın nicel bulgularına göre oyunlaştırma ile zenginleştirilmiş çevrimiçi öğrenme grubunda yer alan öğrenciler ile oyunlaştırma içermeyen çevrimiçi öğrenme grubunda yer alan öğrencilerin arasında yalnızca Güdülenme Ölçeği Özyeterlik ve Görev Değeri, Çevrimiçi Öğrenme Ortamlarında Öğrenci Bağlılık Ölçeği Duyuşsal Bağlılık alt boyutları açısından oyunlaştırma ile zenginleştirilmiş çevrimiçi öğrenme grubunda öğrenim gören öğrencilerin lehine anlamlı farklılık tespit edilmiştir. Bununla birlikte oyunlaştırma içeren grupta yer alan öğrencilerin sisteme giriş sayısı ortalamaları oyunlaştırma içermeyen grupta yer alan öğrencilere göre anlamlı olarak yüksek bulunmuştur. Araştırmanın nitel bulgularına göre oyunlaştırma ile zenginleştirilmiş çevrimiçi öğrenme grubunda öğrenim gören ve görüşmelere katılan öğrenciler uygulamanın verimli olduğunu, herhangi bir teknik sorun yaşamadan sorunsuz kullandıklarını belirtmişlerdir. Buna ilave olarak uygulamanın öğrenmede esneklik sağlayan konforlu bir öğrenme deneyimi sağladığını ifade etmişlerdir. Görüşmeye katılan öğrencilerin genel anlamda oyunlaştırmaya yönelik olumlu tutuma sahip olduğu görülmektedir. Bununla birlikte öğrenciler puanların, erişimi kısıtlama ve meraklandırma ögelerinin sisteme giriş sayısını artırdığı; tartışma platformunun motivasyona katkı sağladığını ve lider tahtasının ders başarısına katkıda bulunduğunu belirtmişlerdir.The aim of this study is to determine the effects of online learning enhanced with gamification and online learning without gamification on academic achievement, learning motivation and student's engagement to online learning environment. The research were conducted with 2x2 factorial experimental design. The dependent variables used in the research design was academic achievement, learning motivation (internal goal orientation, external goal orientation, task value, self-efficacy perceptions, control beliefs and test anxiety) and online student engagement (cognitive engagement, behavioural engagement, affective engagement). Meanwhile, gamification strategy was the independent variable the effect of which was examined on these dependent variables. This variable was studied on two levels: gamification enhancement and non-gamification. These levels were examined by forming two experimental condition and two experimental groups throughout the teaching-learning process. The study group consisted of 72 students studying at Sakarya University Faculty of Education and taking Educational Films (SAU 205) course. Motivation Scale, Student Engagement Scale in Online Learning Environments, Academic Achievement Test, Demographics Information Form, Interview Form and Online Learning System Records were used as data collection tools. Experimental procedures were applied to the students for a total of eight weeks, three weeks of which were preparation for the implementation. Moreover, data were collected before and after the experimental procedures. At the end of the experimental process, interviews were conducted with the students in the group that online learning enhanced with gamification. Quantitative data were analyzed using ANCOVA, correlation analysis, independent samples T test. Qualitative data were analyzed using content analysis. According to the quantitative findings of the research, only Self-Efficacy and Task Value that sub-factors of Motivation Scale, that Affective Engagement that sub-factor of Student Engagement Scale in Online Learning Environments was found significant in favour of the students participated the online learning enhanced with gamification. Moreover, the mean of student's log-in numbers to the online system was significantly higher in the group that participated in online learning enhanced with gamification compared to the group that participated in online learning without gamification. According to the qualitative findings, the students who participated online learning group enhanced with gamification and accepted to participate in the interviews stated that the course was efficient and they completed the course without having any technical problems. In addition, they mentioned that the application provided a comfortable learning experience that offering flexibility in learning. According the results the students who participated in the interview had a positive attitude towards gamification usage within online educational setting. In addition, it was found out that points, components of restriction of access and curiosity increased the number of system log-in. Likewise, it was also seen that discussion platform contributed to the motivation and leader board contributed to the course achievement

Salter-Harris Type III and Type IV Combined Fracture of the Distal Femoral Epiphysis: A Case Report

Distal femoral physeal fractures are not common but have a high rate of complications. They generally follow one of the patterns described in the Salter-Harris classification. We present a case of combination of Salter-Harris type III and type IV injury. Our case was a 15-year-old boy who had a motor vehicle accident. There was swelling, ecchymosis, severe pain, and valgus deformity, because of medial proximal fracture fragment, on the left knee. We deemed that Salter-Harris type III and type IV combination fracture in our case has not been previously reported. We prepared this paper in consideration of its contribution to the literature

Targeting novel antigens in the arterial wall in thromboangiitis obliterans.

Thromboangiitis obliterans is an inflammatory disease possibly resulting from cigarette smoking as a primary etiologic factor, perhaps as a delayed type of hypersensitivity or toxic angiitis. As little is known about the pathogenesis of the disease, we aimed to determine novel antigens that might be responsible from the local inflammatory reactions and structural changes observed in this disease. An indirect immunoperoxidase technique is used to examine the tissue samples obtained from the dorsalis pedis artery of affected individuals with twenty monoclonal antibodies. Among these several antigens which are not previously reported in TAO like CD34, CD44 and CD90 were determined in the tissue samples examined. On the other hand, many other antigens like cytokine/chemokine receptors, several enzymes and leukocyte/lymphocyte antigens were lacking giving some clues about the local pathological reactions. We briefly discussed our findings for several critical antigens those first described in the present work, possibly having roles in the development of the disease. Expression of the CD90/CD11c receptor/ligand pair seems to play an important role in mononuclear cell recruitment to the damage site. Vascular invasion of not only tunica intima but also the tunica media in affected vessels is clearly demonstrated using endothelial cell specific antigens

Učinci COVID-19 pandemije na obrazovanje na daljinu u visokom obrazovanju: bibliometrijsko istraživanje

This study aimed to examine the COVID-19 effect on distance education in higher education in the pre-COVID-19 pandemic (January to November 2019) and post- COVID-19 pandemic periods (December 2019 and January to December 2020). Two different meta-data sets, consisting of 580 articles for the pre-COVID-19 period and 746 for the post-COVID-19 period, obtained by querying the Web of Science database, were used for analysis. SciMAT and Vosviewer software were used for bibliometric analysis. Publications from the two different periods were compared according to keywords, words from abstracts, based on the criteria using co-occurrence and co-word analysis. The results of the keyword co-occurrence analysis show that the keywords “e-learning” and “online learning” were used more in the post-COVID-19 period compared to the pre-pandemic period. In the pre-pandemic period, the thematic trend of academic studies largely aligned with students and satisfaction. However, in the post-pandemic period, the research trend was mostly toward such themes as video lectures and web 2.0 technologies. The research results show that the impact of COVID-19 was reflected in the research published in the post-pandemic period, with the interest in e-learning and online learning increasing in higher education, alongside a trend towards investigating the delivery of instruction rather than conducting student-centered studies.Ovo istraživanje imalo je za cilj ispitati učinke COVID-19 pandemije na obrazovanje na daljinu u području visokoga obrazovanja u periodu prije COVID-19 pandemije (od siječnja do studenoga 2019.) i poslijepandemijskom razdoblju (prosinac 2019. i od siječnaj do prosinca 2020.). Za analizu korištena su dva niza metapodataka koji su obuhvatili 580 radova iz predpandemijskoga perioda i 746 radova iz razdoblja nakon pandemije izazvane Covid-19 virusom, a dobiveni su pretraživanjem Web of Science baze podataka. SciMAT i Vosviewer programi korišteni su za provođenje bibliometrijske analize. Uspoređene su publikacije iz dva spomenuta razdoblja u odnosu na ključne riječi i riječi iz sažetaka, prema kriterijima zasnovanim na analizi zajedničkih riječi i njihova istodobnoga pojavljivanja. Rezultati istovremenoga pojavljivanja ključnih riječi pokazuju da su riječi „e-učenje” i „online učenje” više korištene u poslijepandemijskom nego u predpandemijskom razdoblju, u kojemu su se teme istraživanja u velikoj mjeri odnosile na studente i zadovoljstvo. Ipak, u postpandemijskom razdoblju sklonost istraživača većinom se odnosila na teme poput videopredavanja i mrežne 2.0 tehnologije. Rezultati istraživanja pokazuju da je učinak pandemije COVID-19 vidljiv u istraživanjima objavljenima u poslijepandemijskom razdoblju, s porastom interesa za e-učenje i online učenje u visokom obrazovanju te većom sklonosti istraživanju osiguravanja poučavanja nego tema vezanih za studente

Investigation of the Effectiveness of a CEIT Undergraduate Program on Students’ Competencies

Bu çalışma, bir Bilgisayar ve Öğretim Teknolojileri Eğitimi (BÖTE) lisans programının öğrencilerin farklı mesleklere yönelik yeterliklerine katkısının incelenmesi amacıyla gerçekleştirilmiştir. Bu amaçla, 2015 yılında Sakarya Üniversitesi Eğitim Fakültesi, Bilgisayar ve Öğretim Teknolojileri Öğretmenliği Programında öğrenim gören son sınıf öğrencilerinin dört yıl boyunca aldıkları eğitimin, gerçekleştirebilecekleri farklı mesleklere yönelik yeterliklerine ve ayrıca öğretim programında yer alan derslerin bu mesleklere yönelik yeterliklerine etkisi incelenmeye çalışılmıştır. Araştırmanın çalışma grubunu, Sakarya Üniversitesi Eğitim Fakültesi BÖTE bölümünde; birinci öğretim ve ikinci öğretim olmak üzere son sınıfta öğrenim gören toplam 108 öğrenci oluşturmaktadır. Araştırma 2014–2015 güz yarıyılında gerçekleştirilmiştir. Bu tarih aralığında programların öz değerlendirmelerinin yapılması ve sürekli geliştirilmesine yönelik yapılan bilimsel çalışmalardan biridir. Çalışma kesitsel tarama modelinde yürütülmüştür. Çalışma kapsamında, öğrencilerin gelecekte yapmayı düşündükleri meslek, bu meslek ile ilgili kendilerini yeterli görme düzeyleri, BÖTE lisans programı ve bu programda dört yıl boyunca gördükleri derslerin yeterliklerine ne kadar katkı sağladığıyla ilgili görüşlerini belirlemeyi içeren bir anket veri toplama aracı olarak kullanılmıştır. Veriler betimleyici ve anlam çıkarıcı istatistikler kullanılarak analiz edilmiştir. Araştırma sonuçlarına göre öğrenciler gelecekte en çok bilgisayar öğ- retmeni, bilişim teknolojileri rehber öğretmeni, formatör öğretmen ve eğitim teknoloğu mesleklerini yapmakta kendilerini yeterli görmektedirler. Kendilerini en az yeterli gördükleri meslekler ise; sunucu sistemleri uzmanı, yazılım geliştirici, ağ sistemleri uzmanı ve web yazılımı geliştirici şeklindedir. Bunlara ek olarak “ölçme değerlendirme”, “özel öğretim yöntemleri”, “çoklu ortam tasarımı ve üretimi” ve “eğitimde bireysel farklılıklar” derslerinin kendilerine en çok katkı sağladığını ifade etmişlerdir. Araştırma sonucunda, öğrencilerin devlet sektöründe istihdam edilebilecekleri meslekler dışında kalan meslekleri yeterince tanımadığı, mesleki çeşitlilik sağlaması açısından verilen yazılım vb. derslerin mesleki yeterliklerine yeterince katkı sağlamadı- ğı görülmüştür. Araştırmanın sonuçları dikkate alınırken yayına hazırlanma ve değerlendirme süreçlerinde geçen zaman göz ardı edilmemelidir. Fakat yöntem ve öz değerlendirme açısından benzer çalışmalar yapılarak öğretim programlarının kalitesinin artırılmaya çalışılması önerilmektedir. Ayrıca mesleki yeterliklerin ve farkındalıkların artırılması için mezuniyet öncesi mesleki rehberlik konusunda öğrencilere destek olmak üzere, üniversitelerde lisans programlarıyla iş birliği içinde çalışan kariyer rehberlik servislerinin açılmasının fayda sağlayabileceği düşünülmektedir.This study was carried out to examine the contribution of the undergraduate program of a Computer Education and Instructional Technologies_x000D_ (CEIT) to students’ various professional competencies. For this purpose,_x000D_ CEIT preservice teachers’ views on the adequacy of their undergraduate_x000D_ education to develop their competencies for various professions offering_x000D_ potential employment and the effect of the CEIT undergraduate courses on_x000D_ these competencies were investigated. The participants were enrolled in the_x000D_ CEIT Undergraduate Program of the Faculty of Education at Sakarya_x000D_ University. The study was conducted with 108 senior students in the fall_x000D_ semester of 2014–2015 by applying the cross-sectional survey model, as part_x000D_ of a self-assessment and continuous development of the program. A questionnaire was used for the data collection that included questions about target professions of preservice teachers, efficacy beliefs as an indicator of their_x000D_ competencies related to the profession, their perceptions about the CEIT_x000D_ program, and their perceptions about the contribution of the undergraduate_x000D_ courses to their professional competencies. The data were analyzed via inferential statistics. The results indicate that the preservice teachers felt the most_x000D_ qualified in working as a computer teacher, information technology counsellor, formative teacher, and an educational technologist. The professions in_x000D_ which the participants saw themselves the least qualified were server systems_x000D_ specialist, software developer, network systems specialist, and web software_x000D_ developer. Moreover, it was reported that the courses in the CEIT curriculum providing the highest benefit for improving their competencies were_x000D_ “measurement and evaluation”, “special teaching methods”, “multimedia_x000D_ design”, and “individual differences in education”. Furthermore, the participants did not know much about the jobs that they can work except for those_x000D_ in the public sector, such as working as a teacher or information technology_x000D_ counsellor. Additionally, the software courses in the CEIT curriculum did_x000D_ not contribute enough to develop their competencies to work in softwarerelated jobs. To interpret the results of the current study in a more appropriate way, it is important to take into account the time lost before the publication of the study. However, it is strongly recommended to conduct further research to find out the effects of the CEIT undergraduate program_x000D_ curricula on developing job-related competencies and to conduct self-evaluation studies for continuous development. Besides, establishing career guidance services in universities may help CEIT students to be aware of the_x000D_ potential job prospects related to their competencies, and help them gain_x000D_ better knowledge and skills regarding their major

Psychometric properties of university student form of student engagement scale in online learning : Çevrimiçi öğrenmede öğrenci bağlılığı ölçeği üniversite öğrencisi formunun psikometrik özellikleri

Research Problem / Aim The aim of this study was to introduce the psychometric properties of the Student Engagement Scale for Online Learning which was used to measure the engagement of students in online learning environment by using the validity and reliability study in the sample of university students who took lessons online. Method There were studies conducted with the scale in Turkey. However, this study carried out with a sample of students who meet the requirement of taking online course. Original scale consists of three sub-dimensions. Name of the sub-dimensions are “Behavioral Engagement”, “Emotional Engagement” and “Cognitive Engagement”. The psychometric properties of the instrument were presented by translation, linguistic equivalence, validity and reliability studies. Translation to Turkish of the scale was made by the researchers. A preliminary form was formed by taking the opinions of a total of six experts that one of them from the department of ELT (English language teaching), one of them from educational measurement & evaluation, one of them from Turkish language teaching, one of them from education psychology, and two of them were educational technology.  For linguistic equivalence, the preliminary form was applied to 20 ELT students. The correlation analysis show that the linguistic equivalence of the scale had shown significant correlation between the Turkish and English forms. After the linguistic equivalence was provided, last form of the scale was applied to 587 university students enrolled at the Vocational School of Technical Sciences, Amasya University. Results and Conclusions As a result of the analyzes, confirmatory factor analysis fit indices was calculated as Χ2/sd: 2.827, GFI: .93, AGFI: .91, CFI: .98, NFI: .97, RMSEA: .05 and SRMR: .06. Cronbach alpha internal consistency coefficients that calculated for the reliability of the sub-dimensions were between .71 and .86. The results obtained from confirmatory factor analysis and reliability analyses was indicated that the scale is reliable and valid. It is suggested to use the scale in determining the student's engagement in online learning environments research. ​Extended English summary is in the end of Full Text PDF (TURKISH) file.   Özet Araştırma Problemi/Amaç Bu çalışmanın amacı, çevrimiçi öğrenme ortamlarında öğrencilerin öğrenme ortamına bağlılıklarını ölçmek için “Çevrimiçi Öğrenmede Öğrenci Bağlılığı Ölçeği”nin çevrimiçi ders almış üniversite öğrencileri örnekleminde geçerlik ve güvenirlik çalışmasının yapılarak psikometrik özelliklerinin ortaya konulmasıdır. Yöntem Ölçekle ilgili Türkiye’de yapılmış çalışmalar bulunmaktadır fakat bu çalışmada çevrimiçi ders alma koşulunu sağlayan öğrencilerden oluşan bir örneklem üzerinde çalışılmıştır. Ölçeğin orijinali; davranışsal bağlılık, duyuşsal bağlılık ve bilişsel bağlılık şeklinde adlandırılan üç faktörden oluşmaktadır. Ölçeğin psikometrik özellikleri çeviri, dilsel eşdeğerlik, geçerlik ve güvenirlik çalışmaları sonucunda ortaya konulmuştur. Ölçeğin çevirisi araştırmacılar tarafından yapıldıktan sonra bir İngilizce, bir ölçme değerlendirme, bir Türkçe, bir eğitim psikolojisi, iki eğitim teknolojisi uzmanı olmak üzere toplam altı uzmandan görüş alınmıştır. Görüşler doğrultusunda ön uygulama formu oluşturulmuştur. Oluşturulan form dilsel eşdeğerlik için İngilizce öğretmenliği programında öğrenim gören 20 öğrenciye bir hafta ara ile uygulanmıştır. Ölçeğin dilsel eşdeğerliğini ölçmek için yapılan korelasyon analizi ölçeğin Türkçe ve İngilizce formları arasında korelasyonun anlamlı olduğunu göstermiştir. Dil eşdeğerliğinin sağlanmasının ardından ölçek formu Amasya Üniversitesi Teknik Bilimler Meslek Yüksekokulunda öğrenim gören 587 üniversite öğrencisine uygulanmıştır. Sonuçlar ve Öneriler Analizler sonucunda doğrulayıcı faktör analizi uyum katsayıları Χ2/sd: 2.827, GFI: .93, AGFI: .91, CFI: .98, NFI: .97, RMSEA: .05 ve SRMR: .06 olarak hesaplanmıştır. Ölçeğin alt boyutlarının güvenirliği için hesaplanan Cronbach alfa iç tutarlık katsayıları .71 ile .86 aralında değişmektir. Ölçeğin doğrulayıcı faktör analizi ve güvenirliğine yönelik bulgular, ölçeğin geçerli ve güvenilir olduğunu göstermektedir. Ölçeğin, çevrimiçi öğrenme ortamlarında gerçekleştirilen çalışmalarda öğrenci bağlılığını belirlemek üzere kullanılması önerilmektedir

Relationship between Teacher Efficacy and Information and Communication Technology Competencies of Pre-Service Teachers

The main purpose of this study was to determine the relationship between teacher efficacy levels, information and communication technology competencies, and demographic variables of pre-service teachers. In addition to the main problem, teacher efficacy levels and the technological competencies were also reviewed in terms of variables such as gender, grade, the status of choosing the teaching profession willingly, and if they were given the opportunity to select the teaching profession again. The study was designed in a correlational screening model, and the sample of the study consisted of pre-service teachers. Ohio State Teacher Efficacy Scale (OSTES) and Information and Communication Technology Competencies Scale (ICTCS) were used as the data collection tools. Multiple linear regression analysis was conducted to reveal how the variables of teacher efficacy, gender, grade level, willingly choosing to become a teacher, and re-choosing to become a teacher if having a chance predict ICTCS. As a result of correlational and regression significance tests, it was determined that only the teacher efficacy variable predicted ICTCS to a large extent in the established regression model. Additionally, it was found that the teacher efficacy and the information communication technology competencies of pre-service teachers showed differences in terms of grade and the status of choosing the teaching profession willingly variables, while they did not differ in terms of gender and if they were given the opportunity to select the teaching profession again. Recent studies show that the most important conditions for attaining these skills are that teachers have general competencies for using information and communication technologies in their lessons. So, this study can contribute to the field by determining the positive relationship between teaching efficacy levels and information and communication technologies competencies of pre-service teachers, as well as presenting the results of some specific variables

Relationship of left atrial global peak systolic strain with left ventricular diastolic dysfunction and brain natriuretic peptide level in patients presenting with non-st elevation myocardial infarction

PubMed: 25338184Background: In patients presenting with non-ST elevation myocardial infarction, we investigated the relationship of left atrial deformational parameters evaluated by 2-dimensional speckle tracking imaging (2D-STI) with conventional echocardiographic diastolic dysfunction parameters and brain natriuretic peptide level.Material/Methods: We enrolled 74 non-ST segment elevation myocardial infarction patients who were treated with percutaneous coronary intervention and 58 healthy control subjects. Non-ST segment elevation myocardial infarction patients had echocardiographic examination 48 h after the percutaneous coronary intervention procedure and venous blood samples were drawn simultaneously. In addition to conventional echocardiographic parameters, left atrial strain curves were obtained for each patient. Average peak left atrial strain values during left ventricular systole were measured.Results: BNP values were higher in non-ST segment elevation myocardial infarction patients compared to controls. Mean left atrium peak systolic global longitudinal strain in Group 2 (the control group) was higher than in the nonST segment elevation myocardial infarction group. Left atrium peak systolic global longitudinal strain was significantly correlated with left ventricular ejection fraction. There was a significant inverse correlation between left atrium peak systolic global longitudinal strain and brain natriuretic peptide level, left atrium volume maximum, and left atrium volume minimum.Conclusions: Our study shows that Left atrium peak systolic global longitudinal strain values decreased consistently with deteriorating systolic and diastolic function in non-ST segment elevation myocardial infarction patients treated with percutaneous coronary intervention. Left atrium peak systolic global longitudinal strain measurements may be helpful as a complimentary method to evaluate diastolic function in this patient population. © Med Sci Monit, 2014

Ozone Therapy and Hyperbaric Oxygen Treatment in Lung Injury in Septic Rats

Various therapeutic protocols were used for the management of sepsis including hyperbaric oxygen (HBO) therapy. It has been shown that ozone therapy (OT) reduced inflammation in several entities and exhibits some similarity with HBO in regard to mechanisms of action. We designed a study to evaluate the efficacy of OT in an experimental rat model of sepsis to compare with HBO. Male Wistar rats were divided into sham, sepsis+cefepime, sepsis+cefepime+HBO, and sepsis+cefepime+OT groups. Sepsis was induced by an intraperitoneal injection of Escherichia coli; HBO was administered twice daily; OT was set as intraperitoneal injections once a day. The treatments were continued for 5 days after the induction of sepsis. At the end of experiment, the lung tissues and blood samples were harvested for biochemical and histological analysis. Myeloperoxidase activities and oxidative stress parameters, and serum proinflammatory cytokine levels, IL-1β and TNF-α, were found to be ameliorated by the adjuvant use of HBO and OT in the lung tissue when compared with the antibiotherapy only group. Histologic evaluation of the lung tissue samples confirmed the biochemical outcome. Our data presented that both HBO and OT reduced inflammation and injury in the septic rats' lungs; a greater benefit was obtained for OT. The current study demonstrated that the administration of OT as well as HBO as adjuvant therapy may support antibiotherapy in protecting the lung against septic injury. HBO and OT reduced tissue oxidative stress, regulated the systemic inflammatory response, and abated cellular infiltration to the lung demonstrated by findings of MPO activity and histopathologic examination. These findings indicated that OT tended to be more effective than HBO, in particular regarding serum IL-1β, lung GSH-Px and histologic outcome

Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey

IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score