An ınvestigation on accuracy analysis of global and regional (high resolution) digital elevation models

Topografik yükseklikler birçok mühendislik uygulamasında ve yerbilimlerine ilişkin araştırmalarda kullanılmaktadır. Yüksek çözünürlüklü Sayısal Yükseklik Modelleri (SYM), günümüzde yükseklik verilerini elde etmenin en pratik ve ekonomik yoludur. SYM’lerinin üretiminde farklı yöntemler uygulanır. Bu modeller çeşitli hata kaynaklarından etkilenirler. Bu nedenle, SYM verilerini kullanmadan önce çalışma alanlarındaki performanslarını test etmek çalışmada gereksinim duyulan yükseklik doğruluğunun sağlanması için önemlidir. Genel bir yaklaşım olarak, Sayısal Yükseklik Modellerinin doğruluk analizinde topografyaya uygun dağılmış kontrol noktalarında Global Navigation Satellite System (GNSS) ve/veya nivelman yükseklikleri ile modelden elde edilen yükseklik farklarının karesel ortalama hata (k.o.h.) değerleri dikkate alınır. Bu çalışmada, yüksek çözünürlüklü global SYM’leri: ASTER GDEM (Advanced Spaceborne Thermal Emission and Reflection Radiometer-Gelişmiş Uzay Kaynaklı Termal Emisyon ve Yansıma Radyometresi), SRTM (Shuttle Radar Topography Mission-Mekik Radar Topografya Misyonu) ile bölgesel HGM DTED2 modellerinin doğrulukları GNSS/nivelman verileri kullanılarak analiz edilmiştir. Bu amaçla farklı topografik özellikteki alanları temsil eden üç ayrı GNSS/nivelman veri seti kullanılarak kontrol noktalarının dağılımının yanı sıra test alanı topografyasının SYM doğruluğuna etkisi incelenmiştir. Sonuçlar Türkiye'nin kuzeybatısındaki test edilen global ve bölgesel SYM’lerinin doğruluğunu topografyanın değişen özelliklerine bağlı olarak karşılaştırmakta ve değerlendirmektedir. Testler sonucu global SYM’lerinin doğruluğu 8.0 m iken bölgesel DTED2 SYM doğruluğu 6.0 m olarak bulunmuştur.The topographical heights are required in practice for a number of engineering applications as well as their specific use in many Earth science disciplines. Using a high-resolution Digital Elevation Model (DEM) is the most practical and economical way for obtaining the height data nowadays. These models include errors. So, it is important to clarify the quality as well as the accuracy of the DEM in the study areas before using its data. In general, validating DEMs using independent point-wise data such as GNSS and leveling heights provide an overall accuracy measure in terms of root means square error (r.m.s.e.) of the DEM derived heights. In this study three high-resolution digital elevation models ASTER, SRTM and Turkey Digital Topographic Data (DTED2) in 1 and 3 resolutions are assessed using GNSS/leveling data. Using three different sets of GNSS/leveling data invalidations it is aimed to clarify the role of the distribution of the ground-control points as well as the region’s characteristics, such as roughness of topography, land-cover, etc., in the validation results. The conclusions report the accuracy of the validated DEMs in northwest Turkey and hence include a categorization of DEM performances, generated from remotely sensed data and terrestrial techniques, depending on the topographical characteristics. In the test results the accuracies for global DTMs is 8.0 m, and for regional DTED2 DEM is 6.0 m

Survival results according to Oncotype Dx recurrence score in patients with hormone receptor positive HER-2 negative early-stage breast cancer: first multicenter Oncotype Dx recurrence score survival data of Turkey

BackgroundThe Oncotype Dx recurrence score (ODx-RS) guides the adjuvant chemotherapy decision-making process for patients with early-stage hormone receptor-positive, HER-2 receptor-negative breast cancer. This study aimed to evaluate survival and its correlation with ODx-RS in pT1-2, N0-N1mic patients treated with adjuvant therapy based on tumor board decisions.Patients and methodsEstrogen-positive HER-2 negative early-stage breast cancer patients (pT1-2 N0, N1mic) with known ODx-RS, operated on between 2010 and 2014, were included in this study. The primary aim was to evaluate 5-year disease-free survival (DFS) rates according to ODX-RS.ResultsA total of 203 eligible patients were included in the study, with a median age of 48 (range 26-75) and median follow-up of 84 (range 23-138) months. ROC curve analysis for all patients revealed a recurrence cut-off age of 45 years, prompting evaluation by grouping patients as ≤45 years vs. >45 years. No significant difference in five-year DFS rates was observed between the endocrine-only (ET) and chemo-endocrine (CE) groups. However, among the ET group, DFS was higher in patients over 45 years compared to those aged ≤45 years. When stratifying by ODx-RS as 0-17 and ≥18, DFS was significantly higher in the former group within the ET group. However, such differences were not seen in the CE group. In the ET group, an ODx-RS ≥18 and menopausal status were identified as independent factors affecting survival, with only an ODx-RS ≥18 impacting DFS in patients aged ≤45 years. The ROC curve analysis for this subgroup found the ODx-RS cut-off to be 18.ConclusionThis first multicenter Oncotype Dx survival analysis in Turkey demonstrates the importance of Oncotype Dx recurrence score and age in determining treatment strategies for early-stage breast cancer patients. As a different aproach to the literature, our findings suggest that the addition of chemotherapy to endocrine therapy in young patients (≤45 years) with Oncotype Dx recurrence scores of ≥18 improves DFS

Urban wastewater treatment plants and operation problems

Bu çalışmada, kentsel atıksu arıtma tesislerine gelen atıksuların kaynakları, miktarı, özellikleri ile uygulanan arıtım prosesleri değerlendirilerek karşılaşılan işletme sorunları ve sorunlara yönelik çözüm önerileri belirlenmiştir. Kocaeli ilinde faaliyet gösteren evsel ve endüstriyel atıksuların arıtıldığı 42 Evler Atıksu Arıtma Tesisi ile sadece evsel atıksuların arıtıldığı Plajyolu Atıksu Arıtma Tesisi'nin son iki yıla ait proses, giriş ve çıkış atıksu analiz sonuçları değerlendirilerek atıksu karakterizasyonu yapılmıştır. Tesislerde uygulanan arıtma prosesleri hakkında detaylı bilgi verilmiş, karşılaşılan işletme sorunları tanımlanmış ve çözüm önerileri sunulmuştur. Atıksu arıtma tesislerinin planlama ve işletme sürecinde atıksu karakterizasyonunun bilinmesi, uygun işletme parametrelerinin seçilmesi ve yapılan sağlıklı bir bakım yönetiminin işletme sorunlarının çözümünde önemli rol oynadığı belirlenmiştir.In this study, the sources, amount and characteristics of municipal wastewater and applied treatment processes are assessed; the operating problems encountered and the solutions advised are reviewed as well. The last two years process, inlet and outlet wastewater analysis and wastewater characterization of Kocaeli 42 Evler Domestic and Industrial Wastewater Treatment Plant and Kocaeli Plajyolu Domestic Wastewater Treatment Plant are represented. Detailed information about applied wastewater treatment processes in these plants is given, operating problems encountered are defined and solutions are recommended. Knowing the characterization of wastewater during planning and operating period, choosing the appropriate parameters for operation and sufficient method of maintenance play significant role according to this thesis

An Assessment of the GOCE High-Level Processing Facility (HPF) Released Global Geopotential Models with Regional Test Results in Turkey

The launch of dedicated satellite missions at the beginning of the 2000s led to significant improvement in the determination of Earth gravity field models. As a consequence of this progress, both the accuracies and the spatial resolutions of the global geopotential models increased. However, the spectral behaviors and the accuracies of the released models vary mainly depending on their computation strategies. These strategies are briefly explained in this article. Comprehensive quality assessment of the gravity field models by means of spectral and statistical analyses provides a comparison of the gravity field mapping accuracies of these models, as well as providing an understanding of their progress. The practical benefit of these assessments by means of choosing an optimal model with the highest accuracy and best resolution for a specific application is obvious for a broad range of geoscience applications, including geodesy and geophysics, that employ Earth gravity field parameters in their studies. From this perspective, this study aims to evaluate the GOCE High-Level Processing Facility geopotential models including recently published sixth releases using different validation methods recommended in the literature, and investigate their performances comparatively and in addition to some other models, such as GOCO05S, GOGRA04S and EGM2008. In addition to the validation statistics from various countries, the study specifically emphasizes the numerical test results in Turkey. It is concluded that the performance improves from the first generation RL01 models toward the final RL05 models, which were based on the entire mission data. This outcome was confirmed when the releases of different computation approaches were considered. The accuracies of the RL05 models were found to be similar to GOCO05S, GOGRA04S and even to RL06 versions but better than EGM2008, in their maximum expansion degrees. Regarding the results obtained from these tests using the GPS/leveling observations in Turkey, the contribution of the GOCE data to the models was significant, especially between the expansion degrees of 100 and 250. In the study, the tested geopotential models were also considered for detailed geoid modeling using the remove-compute-restore method. It was found that the best-fitting geopotential model with its optimal expansion degree (please see the definition of optimal degree in the article) improved the high-frequency regional geoid model accuracy by almost 15%

COVID-19 SONRASI ANTİKOAGÜLAN KULLANAN HASTADA BİLATERAL EMBOLİNİN AKCİĞER PERFÜZYON SİNTİGRAFİSİ İLE GÖSTERİLMESİ

Bu vaka sunumunda orta şiddette COVİD-19 pnömonisi geçiren ve profilaktik dozda (1x4000 IU) enoksaparin kullanımı olan hastanın Akciğer Perfüzyon Sintigrafisi/SPECT-BT bulgularını sunmayı hedefledik.56 yaşında erkek hasta, renal transplant alıcısı; bilinen hipertansiyon ve diabetes mellitus öyküsü mevcut. Mayıs 2020’de 37.4 ℃ ateş ve öksürük şikayetiyle İstanbul Tıp Fakültesi COVİD Triyaj birimine başvurdu. COVİD-19 PCR testi negatif olmasına rağmen BT bulgularıyla orta şiddette COVİD-19 pnömonisi tanısı sonrasında hastane yatışı yapıldı. 5 gün süren yatışı sırasında 4 lt/dk nazal oksijen ihtiyacı oldu. Taburculuk sonrası profilaktik amaçla 4 hafta bemiparin ve dipiridamol kullanan hastanın takipte D-Dimer düzeylerinin 8.000’e kadar yükseldiği gözlendi. Poliklinik takipleri sürdürülen hastaya Post-Covid 3. Ayda D-Dimer düzeyi 2090 iken profilaktik dozda enoksaparin tekrar başlandı. Takibin 5. ayında azalarak devam eden D-Dimer yüksekliğine (D-Dimer:1420) rağmen birkaç gündür izole öksürük şikayeti eklenen hastaya pulmoner emboli ön tanısıyla Akciğer Perfüzyon Sintigrafisi ve SPECT-BT çekildi. Görüntülerinin incelenmesinde sol akciğer lingular segmentte segmenter, sağ akciğer üst lob anterior segmentte büyük subsegmenter uyumsuz perfüzyon defektleri, bilateral alt lob bazal segmentlerde ise parankimde yaygın retiküler dansite artışının eşlik ettiği yaygın uyumlu perfüzyon azalması izlendi. Görünüm bilateral pulmoner emboli ve parankim hastalığı ile uyumlu olarak değerlendirildi. COVİD-19 pnömonisinin yol açtığı parankimal infiltrasyonun yoğun olduğu akciğer sahalarında normal perfüzyonun çoğunlukla korunduğu dikkat çekti. Tanı öncesinde hastanın proflaktik antikoagülan kullanımı olması, başvuru anında D-Dimer düzeyinin düşme eğiliminde olması ve semptomlarının hafif seyretmesi nedeniyle ön planda kronik pulmoner emboli düşünüldü. Hastaya bu bulgularla tedavi dozunda antikoagülan başlandı. Takipte hastanın D-Dimer düzeylerinin bir ay sonra 690 düzeyine gerilediği gözlendi.SARS-CoV-2 virüsünün neden olduğu COVİD-19 pandemisinin başlangıcından bu yana sıklığı artan ve hastalığın ciddi komplikasyonlarından biri olan pulmoner embolinin tespitinde Akciğer Perfüzyon Sintigrafisinin kullanımı gün geçtikçe yaygınlaşmaktadır. Hastane yatışı süresince ve sonrasında antikoagülan kullanımının emboli gelişimini önleyeceği düşünülmekle birlikte sunduğumuz vakada görüldüğü üzere bunun kesin bir çözüm olmadığı ve profilaksi altındaki hastaların da emboli açısından risk altında olduğu görülmektedir.Hiperkoagülabiliteye eğilimde IL-6, IL-1β ve TNF-α gibi proinflamatuar sitokinlerin aşırı üretimi sonucu oluşan sitokin fırtınasının ve beraberinde gelişen yaygın endotelyal disfonksiyonun önde gelen nedenler arasında olduğu kanısı yaygınlaşmaktadır. Bizim vakamızda parankimal infiltrasyon alanları dışındaki bölgelerde yoğunlaşan embolik tutulumlar, hiperkoagülabilite gelişim mekanizmasında lokal olmaktan ziyade yaygın sistemik bir endotelyal disfonksiyonun altta yatan neden olduğunu düşündürmektedir.Akciğer Perfüzyon Sintigrafisi; BT Anjiografinin kontrendike olduğu hastalarda pulmoner emboli tanısı koymada ilk tercih edilen yöntemdir. Post COVİD dönemde bu hastalar pulmoner emboli semptomları göstermese dahi D-Dimer düzeyleri uyarıcı olmalı ve hayatı tehdit edici komplikasyonlar gelişmeden görüntüleme yöntemleri ile tanı konularak gerekli tedavileri başlanmalıdır

Are the Early Postoperative Outcomes of Coronary Artery Bypass Grafting Surgery in Elderly Women Worse Compared to Men's?

Abstract Objective: To investigate the impact of gender difference in early postoperative outcomes in elderly patients (aged 70 or older) undergoing coronary artery bypass grafting surgery. Methods: Between October 2009 and December 2013, a total of 223 elderly patients (aged 70 or older) undergoing isolated primary coronary artery bypass grafting surgery were included in this retrospective observational cohort study. Patients were divided into two groups according to their gender. The patients' medical records were collected, their baseline preoperative characteristics, operative data, and postoperative outcomes were retrospectively reviewed, and the effect of gender difference in the early postoperative outcomes was analyzed. Results: Group 1 (female patients) and Group 2 (male patients) consisted of 71 and 152 patients, respectively. Mean age of patients was 74.4±3.6 years (range: 70-84 years). The level of EuroSCORE I, the incidence of hypertension and hyperlipidemia were significantly higher in Group 1, while the rate of smoking was significantly higher in Group 2. Mean postoperative intubation time, length of intensive care unit and hospital stay were longer in female patients than in male patients, but these differences were not statistically significant. No statistically significant difference between two groups in terms of the transfusion of blood products was observed. The rates of in-hospital mortality and major postoperative complications were statistically similar between the two groups. Conclusion: In conclusion, the female gender was not associated with worse early postoperative outcomes in elderly patients undergoing coronary artery bypass grafting surgery

(Z)-2-[(E)-2-(1-Benzothio-phen-3-yl-methyl-idene)hydrazin-1-yl-idene]-1, 2-diphenyl-ethanone

The title compound, C23H16N2OS, is not planar, the phenyl ring of the benzoyl group making a dihedral of 77.61 (7)°with the benzothio-phene system ring. The benzothio-phene system and the remaining phenyl ring make an angle of 12.71 (13)°. The conformation around the imine functions is E for the C=N bond towards the benzothio-phene system and Z for the C=N bond towards the benzoyl group. The packing of the mol-ecules shows C-H?? inter-actions. A weak intramolecular C-H?N bond also occurs

Are the Early Postoperative Outcomes of Coronary Artery Bypass Grafting Surgery in Elderly Women Worse Compared to Men's?

<div><p>Abstract Objective: To investigate the impact of gender difference in early postoperative outcomes in elderly patients (aged 70 or older) undergoing coronary artery bypass grafting surgery. Methods: Between October 2009 and December 2013, a total of 223 elderly patients (aged 70 or older) undergoing isolated primary coronary artery bypass grafting surgery were included in this retrospective observational cohort study. Patients were divided into two groups according to their gender. The patients' medical records were collected, their baseline preoperative characteristics, operative data, and postoperative outcomes were retrospectively reviewed, and the effect of gender difference in the early postoperative outcomes was analyzed. Results: Group 1 (female patients) and Group 2 (male patients) consisted of 71 and 152 patients, respectively. Mean age of patients was 74.4±3.6 years (range: 70-84 years). The level of EuroSCORE I, the incidence of hypertension and hyperlipidemia were significantly higher in Group 1, while the rate of smoking was significantly higher in Group 2. Mean postoperative intubation time, length of intensive care unit and hospital stay were longer in female patients than in male patients, but these differences were not statistically significant. No statistically significant difference between two groups in terms of the transfusion of blood products was observed. The rates of in-hospital mortality and major postoperative complications were statistically similar between the two groups. Conclusion: In conclusion, the female gender was not associated with worse early postoperative outcomes in elderly patients undergoing coronary artery bypass grafting surgery.</p></div

A Multi-Center Study on the Efficacy of Eltrombopag in Management of Refractory Chronic Immune Thrombocytopenia

Objective: The aim of the present study was to evaluate the efficacy and safety of eltrombopag, an oral thrombopoietin receptor agonist, in patients with chronic immune thrombocytopenia (ITP). Materials and Methods: A total of 285 chronic ITP patients (187 women, 65.6%; 98 men, 34.4%) followed in 55 centers were enrolled in this retrospective cohort. Response to treatment was assessed according to platelet count (/mm3) and defined as complete (platelet count of >100,000/mm3), partial (30,000-100,000/mm3 or doubling of platelet count after treatment), or unresponsive (<30,000/mm3). Clinical findings, descriptive features, response to treatment, and side effects were recorded. Correlations between descriptive, clinical, and hematological parameters were analyzed. Results: The median age at diagnosis was 43.9±20.6 (range: 3-95) years and the duration of follow-up was 18.0±6.4 (range: 6-28.2) months. Overall response rate was 86.7% (n=247). Complete and partial responses were observed in 182 (63.8%) and 65 (22.8%) patients, respectively. Thirty-eight patients (13.4%) did not respond to eltrombopag treatment. For patients above 60 years old (n=68), overall response rate was 89.7% (n=61), and for those above 80 years old (n=12), overall response rate was 83% (n=10). Considering thrombocyte count before treatment, eltrombopag significantly increased platelet count at the 1st, 2nd, 3rd, 4th, and 8th weeks of treatment. As the time required for partial or complete response increased, response to treatment was significantly reduced. The time to reach the maximum platelet levels after treatment was quite variable (1-202 weeks). Notably, the higher the maximum platelet count after eltrombopag treatment, the more likely that side effects would occur. The most common side effects were headache (21.6%), weakness (13.7%), hepatotoxicity (11.8%), and thrombosis (5.9%). Conclusion: Results of the current study imply that eltrombopag is an effective therapeutic option even in elderly patients with chronic ITP. However, patients must be closely monitored for response and side effects during treatment. Since both response and side effects may be variable throughout the follow-up period, patients should be evaluated dynamically, especially in terms of thrombotic risk factors.PubMedWoSScopu

Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy.

Background There is no standard treatment recommended at category 1 level in international guidelines for subsequent therapy after cyclin-dependent kinase 4/6 inhibitor (CDK4/6) based therapy. We aimed to evaluate which subsequent treatment oncologists prefer in patients with disease progression under CDKi. In addition, we aimed to show the effectiveness of systemic treatments after CDKi and whether there is a survival difference between hormonal treatments (monotherapy vs. mTOR-based). Methods A total of 609 patients from 53 centers were included in the study. Progression-free-survivals (PFS) of subsequent treatments (chemotherapy (CT, n:434) or endocrine therapy (ET, n:175)) after CDKi were calculated. Patients were evaluated in three groups as those who received CDKi in first-line (group A, n:202), second-line (group B, n: 153) and >= 3rd-line (group C, n: 254). PFS was compared according to the use of ET and CT. In addition, ET was compared as monotherapy versus everolimus-based combination therapy. Results The median duration of CDKi in the ET arms of Group A, B, and C was 17.0, 11.0, and 8.5 months in respectively; it was 9.0, 7.0, and 5.0 months in the CT arm. Median PFS after CDKi was 9.5 (5.0-14.0) months in the ET arm of group A, and 5.3 (3.9-6.8) months in the CT arm (p = 0.073). It was 6.7 (5.8-7.7) months in the ET arm of group B, and 5.7 (4.6-6.7) months in the CT arm (p = 0.311). It was 5.3 (2.5-8.0) months in the ET arm of group C and 4.0 (3.5-4.6) months in the CT arm (p = 0.434). Patients who received ET after CDKi were compared as those who received everolimus-based combination therapy versus those who received monotherapy ET: the median PFS in group A, B, and C was 11.0 vs. 5.9 (p = 0.047), 6.7 vs. 5.0 (p = 0.164), 6.7 vs. 3.9 (p = 0.763) months. Conclusion Physicians preferred CT rather than ET in patients with early progression under CDKi. It has been shown that subsequent ET after CDKi can be as effective as CT. It was also observed that better PFS could be achieved with the subsequent everolimus-based treatments after first-line CDKi compared to monotherapy ET