Determination of quality and quantity for primary schoolyards in Artvin city center by using geographical ınformation system

Betonlaşmanın hızla artması ve buna bağlı olarak kişi başına düşen açık-yeşil alan miktarının azalması, kentlerde yaşayan insanlar için önemli bir sorun haline gelmiştir. Bu sorundan en fazla etkilenenler ise, çok katlı binalar arasına hapsolarak oyuna hasret kalan çocuklardır. Özellikle zamanlarının çoğunu okulda geçiren ilköğretim öğrencileri için okul bahçelerinin nitelik ve nicelik açısından yeterliliği çocukların fiziksel ve ruhsal açıdan gelişmesinde büyük önem taşımaktadır. Bu önem, eğitim sürecinin başarıyla tamamlanabilmesi için okul binası niteliklerininin artırılması kadar okul dış mekânlarının da dikkate alınması gereğini ortaya çıkarmıştır. Bununla birlikte imar mevzuatında, eğitim alanlarının tayininde mesafe, yoğunluk ve nüfus gibi kriterlerin dikkate alınmasıyla belirlenen planlama ilkeleri her kentin sosyal, ekonomik, topoğrafik ve benzeri özellikler açısından uygun koşullarda olduğu varsayılarak geliştirilmiştir. Her kent için aynı sayılamayacak bu kriterler oldukça engebeli arazi yapısına ve çarpık kentleşmeye sahip olan Artvin ili için de geçerlidir. Bu çalışmada, okul bahçelerinin Artvin’deki mevcut durumunun ortaya konularak nitelik ve nicelik açısından incelenmesi amaçlanmıştır.Rapid increase in concretion rate and a related decrease in the amount of public-green areas per capita have become an important issue for people living in cities. Children that are stuck in between tall buildings and have longing for play are the most affected ones from this issue. Adequateness of schoolyards both in quality and quantity is very important for physical and mental development of children especially for those attending primary schools and spending the most of their time in schoolyards. This importance has revealed not only the issue of increasing the quality of school buildings but also the necessity of better outdoor spaces for schools in order to have more successful education period. Moreover, some criterions such as distance, density and population should be taken into account when determining education areas in local zoning legislation. Even though it is assumed that every city has optimal social, topographical and other similar features for application of planning principles, these are not applicable for many cities such as Artvin due to its rugged land formation and irregular urbanization. The main objective of this study was to evaluate schoolyards in Artvin by stating their current status in Artvin both in quality and quantity aspects, since both have important effects on child’s physical and mental development

Identification of extracellular enzyme producing alkalophilic bacilli from Izmir province by 16S-ITS rDNA RFLP

Aims: To screen industrially important extracellular enzymes from the newly isolated alkalophilic bacilli and to characterize them by phenotypic and 16S-internal transcribed spacer (ITS) rDNA restriction pattern analysis. Methods and Results: Three different environmental samples, soil, leather and horse faeces, were collected within the province of Izmir. Isolates grown on Horikoshi-I medium for 24 h at 37°C were screened for extracellular enzyme activity by using eight different substrates: birchwood xylan, carboxymethylcellulose, casein, citrus pectin, polygalacturonic acid, soluble starch, and Tween 20 and 80. In total, 115 extracellular enzyme-producing bacilli were obtained. Casein was hydrolysed by 78%, soluble starch by 67%, citrus pectin by 63%, polygalacturonic acid by 62%, Tween 20 by 34%, birchwood xylan by 16%, Tween 80 by 12%, and carboxymethylcellulose by 3% of the isolates. The isolates were differentiated into 19 distinct homology groups by the 16S-ITS rDNA restriction pattern analysis. Conclusions: Eight different extracellular enzyme activities were determined in 115 endospore forming bacilli. The largest 16S-ITS rDNA homology group (HT1) included 36% of the isolates, 98% of which degraded casein, polygalacturonic acid, pectin and starch. Significance and Impact of the Study: This study is the first report on the characterization of the industrial enzyme-producing alkalophilic bacilli by 16S-ITS rDNA restriction fragment length polymorphism (RFLP). Restriction profiles of 64% of the isolates were found to be different from those of five reference strains used

Procjena odnosa između kvocijenta inteligencije i potrebe za ortodontskom terapijom

Objective: Low cognitive ability may reduce the ability to understand the importance of oral health and to perform the necessary practices to maintain proper oral hygiene. Early loss of primary teeth following high caries risk may lead to malocclusion of permanent dentition. This study aimed to evaluate the relationship between the cognitive levels of adolescents and their orthodontic treatment needs. Material and Methods: Between January 2018 and May 2018, 200 adolescents aged 10 – 15 who applied to the Pediatric Dentistry Clinic of Marmara University and sought orthodontic treatment were invited to participate in the study. The orthodontic treatment needs of 150 adolescents who agreed to participate were evaluated with the Index of Orthodontic Treatment Need - Aesthetic Component and their cognitive levels were evaluated with the Raven Standard Progressive Matrices (SPM) Test. P-value < 0.05 was considered statistically significant. Results: The mean age (± stan-dard deviation) of 126 adolescents (77 females and 49 males) who completed the SPM test was 11.8 (± 1.3). There was no consistency between the intellectual level and the need for orthodontic treatment (Kappa value = 0.071, p-value = 0.081). There was no correlation between malocclusion severity and intelligence quotient scores of adolescents (ρ [rho] = -0.089, p = 0.322). According to Multiple logistic regression results, there was no difference between ‘borderline need’ (p = 0.059) and ‘great need’ (p = 0.881) from ‘no need’ for orthodontic treatment in adolescents with different intelligence quotients. Conclusions: The results showed no evidence for an association between malocclusion and intelligence quotient.Svrha rada: Niske kognitivne sposobnosti mogu smanjiti sposobnost razumijevanja važnosti oralnoga zdravlja i obavljanja potrebnih postupaka za održavanje pravilne oralne higijene. Rani gubitak mliječnih zuba u slučaju visokog rizika od karijesa može rezultirati nepravilnom okluzijom trajne denticije. Materijali i metode: Između siječnja 2018. i svibnja 2018., 200 djevojčica i dječaka u dobi od 10 do 15 godina koji su se prijavili u Kliniku za dječju stomatologiju Sveučilišta Marmara i tražili ortodontsku terapiju pozvani su da sudjeluju u istraživanju. Potreba za ortodontskom terapijom njih 150 koji su pristali sudjelovati procijenjena je indeksom potrebe za ortodontskom terapijom – estetska komponenta, a njihove kognitivne razine procijenjene su Ravenovim testom standardne progresivne matrice (SPM). P-vrijednost < 0,05 smatrala se statistički značajnom. Rezultati: Prosječna dob (± standardna devijacija) 126 adolescenata (77 djevojčica i 49 dječaka) koji su podvrgnuti SPM testu bila je 11,8 (± 1,3). Nije bilo povezanosti između intelektualne razine i potrebe za ortodontskom terapijom (Kappa vrijednost = 0,071, p-vrijednost = 0,081). Nije bilo korelacije između težine malokluzije i rezultata kvocijenta inteligencije adolescenata [ρ ˙(rho) = -0,089, p = 0,322]. Prema rezultatima višestruke logističke regresije nije bilo razlike između „granične potrebe” (p = 0,059) i „velike potrebe” (p = 0,881) te „nema potrebe” za ortodontskom terapijom kod adolescenata/djece s različitim kvocijentima inteligencije. Zaključak: Rezultati ne daju nikakve dokaze o povezanosti malokluzije i kvocijenta inteligencije

Epidemiology of surgery associated acute kidney injury (EPIS-AKI): a prospective international observational multi-center clinical study

Purpose: The incidence, patient features, risk factors and outcomes of surgery-associated postoperative acute kidney injury (PO-AKI) across different countries and health care systems is unclear. Methods: We conducted an international prospective, observational, multi-center study in 30 countries in patients undergoing major surgery (&gt; 2-h duration and postoperative intensive care unit (ICU) or high dependency unit admission). The primary endpoint was the occurrence of PO-AKI within 72&nbsp;h of surgery defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Secondary endpoints included PO-AKI severity and duration, use of renal replacement therapy (RRT), mortality, and ICU and hospital length of stay. Results: We studied 10,568 patients and 1945 (18.4%) developed PO-AKI (1236 (63.5%) KDIGO stage 1500 (25.7%) KDIGO stage 2209 (10.7%) KDIGO stage 3). In 33.8% PO-AKI was persistent, and 170/1945 (8.7%) of patients with PO-AKI received RRT in the ICU. Patients with PO-AKI had greater ICU (6.3% vs. 0.7%) and hospital (8.6% vs. 1.4%) mortality, and longer ICU (median 2 (Q1-Q3, 1-3) days vs. 3 (Q1-Q3, 1-6) days) and hospital length of stay (median 14 (Q1-Q3, 9-24) days vs. 10 (Q1-Q3, 7-17) days). Risk factors for PO-AKI included older age, comorbidities (hypertension, diabetes, chronic kidney disease), type, duration and urgency of surgery as well as intraoperative vasopressors, and aminoglycosides administration. Conclusion: In a comprehensive multinational study, approximately one in five patients develop PO-AKI after major surgery. Increasing severity of PO-AKI is associated with a progressive increase in adverse outcomes. Our findings indicate that PO-AKI represents a significant burden for health care worldwide

Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure: a prespecified analysis of the SELECT trial

Background: Semaglutide, a GLP-1 receptor agonist, reduces the risk of major adverse cardiovascular events (MACE) in people with overweight or obesity, but the effects of this drug on outcomes in patients with atherosclerotic cardiovascular disease and heart failure are unknown. We report a prespecified analysis of the effect of once-weekly subcutaneous semaglutide 2·4 mg on ischaemic and heart failure cardiovascular outcomes. We aimed to investigate if semaglutide was beneficial in patients with atherosclerotic cardiovascular disease with a history of heart failure compared with placebo; if there was a difference in outcome in patients designated as having heart failure with preserved ejection fraction compared with heart failure with reduced ejection fraction; and if the efficacy and safety of semaglutide in patients with heart failure was related to baseline characteristics or subtype of heart failure. Methods: The SELECT trial was a randomised, double-blind, multicentre, placebo-controlled, event-driven phase 3 trial in 41 countries. Adults aged 45 years and older, with a BMI of 27 kg/m2 or greater and established cardiovascular disease were eligible for the study. Patients were randomly assigned (1:1) with a block size of four using an interactive web response system in a double-blind manner to escalating doses of once-weekly subcutaneous semaglutide over 16 weeks to a target dose of 2·4 mg, or placebo. In a prespecified analysis, we examined the effect of semaglutide compared with placebo in patients with and without a history of heart failure at enrolment, subclassified as heart failure with preserved ejection fraction, heart failure with reduced ejection fraction, or unclassified heart failure. Endpoints comprised MACE (a composite of non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death); a composite heart failure outcome (cardiovascular death or hospitalisation or urgent hospital visit for heart failure); cardiovascular death; and all-cause death. The study is registered with ClinicalTrials.gov, NCT03574597. Findings: Between Oct 31, 2018, and March 31, 2021, 17 604 patients with a mean age of 61·6 years (SD 8·9) and a mean BMI of 33·4 kg/m2 (5·0) were randomly assigned to receive semaglutide (8803 [50·0%] patients) or placebo (8801 [50·0%] patients). 4286 (24·3%) of 17 604 patients had a history of investigator-defined heart failure at enrolment: 2273 (53·0%) of 4286 patients had heart failure with preserved ejection fraction, 1347 (31·4%) had heart failure with reduced ejection fraction, and 666 (15·5%) had unclassified heart failure. Baseline characteristics were similar between patients with and without heart failure. Patients with heart failure had a higher incidence of clinical events. Semaglutide improved all outcome measures in patients with heart failure at random assignment compared with those without heart failure (hazard ratio [HR] 0·72, 95% CI 0·60-0·87 for MACE; 0·79, 0·64-0·98 for the heart failure composite endpoint; 0·76, 0·59-0·97 for cardiovascular death; and 0·81, 0·66-1·00 for all-cause death; all pinteraction&gt;0·19). Treatment with semaglutide resulted in improved outcomes in both the heart failure with reduced ejection fraction (HR 0·65, 95% CI 0·49-0·87 for MACE; 0·79, 0·58-1·08 for the composite heart failure endpoint) and heart failure with preserved ejection fraction groups (0·69, 0·51-0·91 for MACE; 0·75, 0·52-1·07 for the composite heart failure endpoint), although patients with heart failure with reduced ejection fraction had higher absolute event rates than those with heart failure with preserved ejection fraction. For MACE and the heart failure composite, there were no significant differences in benefits across baseline age, sex, BMI, New York Heart Association status, and diuretic use. Serious adverse events were less frequent with semaglutide versus placebo, regardless of heart failure subtype. Interpretation: In patients with atherosclerotic cardiovascular diease and overweight or obesity, treatment with semaglutide 2·4 mg reduced MACE and composite heart failure endpoints compared with placebo in those with and without clinical heart failure, regardless of heart failure subtype. Our findings could facilitate prescribing and result in improved clinical outcomes for this patient group. Funding: Novo Nordisk

The genetic history of the Southern Arc: a bridge between West Asia and Europe

By sequencing 727 ancient individuals from the Southern Arc (Anatolia and its neighbors in Southeastern Europe and West Asia) over 10,000 years, we contextualize its Chalcolithic period and Bronze Age (about 5000 to 1000 BCE), when extensive gene flow entangled it with the Eurasian steppe. Two streams of migration transmitted Caucasus and Anatolian/Levantine ancestry northward, and the Yamnaya pastoralists, formed on the steppe, then spread southward into the Balkans and across the Caucasus into Armenia, where they left numerous patrilineal descendants. Anatolia was transformed by intra–West Asian gene flow, with negligible impact of the later Yamnaya migrations. This contrasts with all other regions where Indo-European languages were spoken, suggesting that the homeland of the Indo-Anatolian language family was in West Asia, with only secondary dispersals of non-Anatolian Indo-Europeans from the steppe