Isolation and characterization of an adhesin protein from the surface of a respiratory pathogen Moraxella catarrhalis

Ankara : The Department of Molecular Biology and Genetics and the Institute of Engineering and Science of Bilkent University, 2002.Thesis (Master's) -- Bilkent University, 2002.Includes bibliographical references leaves 53-59.Moraxella catarrhalis is a member of the normal flora of upper respiratory tract. Starting in the early 1980s it gained importance as an important cause of otitis media in children and lower respiratory tract infections in adults with chronic obstructive pulmonary disease. β-lactamase producing strains of M. catarrhalis has been increasing at a very fast rate. In some locations, 100% of the strains are β- lactamase producer. The pathogenesis of infection by this bacterium is not clearly understood which hindered the development of a vaccine. In this study, a surface protein of about 55 kDa was isolated from M. catarrhalis by celite chromatography. It is a heat stable protein and is not affected by 2-mercaptoethanol or dithiothreitol treatment. The immunogenic property of the protein has been determined by immunizing rabbits with M. catarrhalis and detecting the antibody response in serum against 55 kDa protein by Western blotting. In addition, the protein is immunogenic in humans as antibody against 55 kDa protein can be detected in the sputum of patients with M. catarrhalis infection. Moreover, we determined upto 40 amino acids at the N-terminal and also two fragments of the protein. To determine the function of the protein, attachment inhibition assays were performed and it was found that 55 kDa protein competetively inhibits attachment of M. catarrhalis to human pharyngeal epithelial cells (HPEC). Similarly, monoclonal antibody against 55 kDa (mAb) blocks the protein and inhibits the attachment of M. catarrhalis to HPEC. These two lines of evidence show that 55 kDa protein is an adhesin of M. catarrhalis which mediate attachment to HPEC. In addition, immunoflourescence experiments further verified that 55 kDa protein binds to HPEC. To sequence the gene encoding 55 kDa protein, PCR was done using degenerate primers constructed from the Nterminal amino acid sequence. PCR amplification of the possible gene of 55 kDa protein resulted in a 500 bp fragment, but no homology can be obtained with Nterminal amino acid sequence. In addition, a genomic library of M. catarrhalis is prepared and screened with mAb and with a radiolabelled oligonucleotide probe. We isolated several positive clones; therefore in future it might be possible to sequence the gene encoding 55 kDa protein from these clones.Turan, TolgaM.S

A 16-Year Retrospective Study Examining Socio-Demographic Factors among Suicide Decedents in Bolu Province, Northwestern Turkey

This study aimed to examine the socio-demographic features of completed suicides in Bolu province, northwestern Turkey, between 2003 and 2019, using corpse examinations and autopsy reports to provide epidemiological data with a view to helping prevent suicidal behavior. Of the 108 suicides examined, males accounted for 84.3%, and females accounted for 15.7%. The suicide rate was the highest in the 25–34 age groups and among those of an unknown marital status. Suicide in an unknown location in the group aged 24 years and below was significantly higher than among age groups, while the workplace was significantly higher in those aged 35–64 years. In both genders, the home and its surroundings comprised the leading location of the suicide event, with an unknown location found to be significantly higher in males. The most common suicide method was identified as hanging, with no statistically significant difference between demographic groups with respect to method, and the highest suicide rate was observed in 2016–2019. With regard to time of year, winter was found to be significantly higher among those aged 24–34 years, whereas those aged 65 years and above were likelier to die in spring or summer (p=0.014). Several risk factors were identified, most of which could be detected and resolved before the suicidal act. Studies such as this are extremely valuable for their contribution to preventing suicide by identifying such risk factors

Exophytic Giant Cell Glioblastoma in a Patient with Neurofibromatosis Type 1: Case Report

Giant cell glioblastoma multiforme (GCGBM) is an uncommon subtype within the spectrum of glioblastoma multiforme (GBM) tumors. Neurofibromatosis type 1 (NF1) has an increased risk of developing neoplasms that generally are of a benign nature. We report a rare case of an exophytic GCGBM in a 43-year-old woman with NF1. The tumor located in the right frontal region was removed totally and the patient underwent radiotherapy with 60 Gy and chemotherapy with temozolomide

The preoperative serum CA125 can predict the lymph node metastasis in endometrioid-type endometrial cancer

Objectives: To evaluate the predictive value of preoperative CA125 in extra-uterine disease and its association with poorprognostic factors in endometrioid-type endometrial cancer (EC).Material and methods: A total of 423 patients with pathologically proven endometrioid-type EC were included in thestudy. The association between preoperative CA125 level and surgical–pathological factors was evaluated. The conventional cut-off value was defined as 35 IU/mL.Results: A high CA125 level ( > 35 IU/mL) was significantly associated with all of the studied poor prognostic factors,except grade. The risk of lymph node metastasis (LNM) increased from 15.9% to 45.7% when CA125 level was > 35 IU/mL (p < 0.05). The optimal cut-off value for the prediction of LNM in patients aged > 50 years was determined to be 16 IU/mL (sensitivity, specificity, positive predictive value, and negative predictive value were 71%, 60%, 35%, and 87%, respectively.)Conclusions: Preoperative CA125 level was significantly related with the extent of the disease and LNM. The age-dependent cut-off level of CA125 can improve the prediction of LNM in endometrioid-type EC. For older patients, CA125 level of > 16 IU/ml could be used to predict LNM. However, further studies are needed to evaluate the appropriate cut-off level of CA125 for younger patients

Results from a phase 1b/2 study of ibrutinib combination therapy in advanced urothelial carcinoma

Ibrutinib is a first-in-class Bruton’s tyrosine kinase inhibitor approved for the treatment of various B-cell malignancies and chronic graft-versus-host disease. We evaluated the safety and efficacy of ibrutinib, alone or combined with standard-of-care regimens, in adults with advanced urothelial carcinoma (UC). Once-daily ibrutinib was administered orally at 840 mg (single-agent or with paclitaxel) or at 560 mg (with pembrolizumab). Phase 1b determined the recommended phase 2 dose (RP2D) of ibrutinib, and phase 2 assessed progression-free survival (PFS), overall response rate (ORR), and safety. Thirty-five, eighteen, and fifty-nine patients received ibrutinib, ibrutinib plus pembrolizumab, and ibrutinib plus paclitaxel at the RP2D, respectively. Safety profiles were consistent with those of the individual agents. The best-confirmed ORRs were 7% (two partial responses) with single-agent ibrutinib and 36% (five partial responses) with ibrutinib plus pembrolizumab. Median PFS was 4.1 months (range, 1.0–37.4+) with ibrutinib plus paclitaxel. The best-confirmed ORR was 26% (two complete responses). In previously treated patients with UC, ORR was higher with ibrutinib plus pembrolizumab than with either agent alone (historical data in the intent-to-treat population). ORR with ibrutinib plus paclitaxel was greater than historical values for single-agent paclitaxel or ibrutinib. These data warrant further evaluation of ibrutinib combinations in UC

Volume CXIV, Number 4, November 7, 1996

Objective: Turner syndrome (TS) is a chromosomal disorder caused by complete or partial X chromosome monosomy that manifests various clinical features depending on the karyotype and on the genetic background of affected girls. This study aimed to systematically investigate the key clinical features of TS in relationship to karyotype in a large pediatric Turkish patient population.Methods: Our retrospective study included 842 karyotype-proven TS patients aged 0-18 years who were evaluated in 35 different centers in Turkey in the years 2013-2014.Results: The most common karyotype was 45,X (50.7%), followed by 45,X/46,XX (10.8%), 46,X,i(Xq) (10.1%) and 45,X/46,X,i(Xq) (9.5%). Mean age at diagnosis was 10.2±4.4 years. The most common presenting complaints were short stature and delayed puberty. Among patients diagnosed before age one year, the ratio of karyotype 45,X was significantly higher than that of other karyotype groups. Cardiac defects (bicuspid aortic valve, coarctation of the aorta and aortic stenosis) were the most common congenital anomalies, occurring in 25% of the TS cases. This was followed by urinary system anomalies (horseshoe kidney, double collector duct system and renal rotation) detected in 16.3%. Hashimoto's thyroiditis was found in 11.1% of patients, gastrointestinal abnormalities in 8.9%, ear nose and throat problems in 22.6%, dermatologic problems in 21.8% and osteoporosis in 15.3%. Learning difficulties and/or psychosocial problems were encountered in 39.1%. Insulin resistance and impaired fasting glucose were detected in 3.4% and 2.2%, respectively. Dyslipidemia prevalence was 11.4%.Conclusion: This comprehensive study systematically evaluated the largest group of karyotype-proven TS girls to date. The karyotype distribution, congenital anomaly and comorbidity profile closely parallel that from other countries and support the need for close medical surveillance of these complex patients throughout their lifespa

Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)

Türkiye'nin İsrail'e yönelik dış politikası: batı ile olan ilişkilerin etkisi

This thesis aims to analyze the Turkish foreign policy towards the State of Israel in a historical perspective and to examine how the foreign policy perceptions of the AKP Government having Islamic roots that came to power in 2002 affected this policy. The thesis argues that, historically, the Western connection of the Turkish Republic has determined the Turkish foreign policy towards Israel and the foreign policy perceptions of the AKP Government strengthened this connection rather than weakening it. It is argued that, the fundamental reason underlying this situation is the efforts of the AKP Government to use its compromising foreign policy as a leverage against the constitutional legitimacy question it faced in domestic politics. As a result, during the AKP era, it is concluded that, Turkish foreign policy towards Israel has not undergone fundamental changes at least as long as the domestic legitimacy question exists.M.S. - Master of Scienc

Mesleki eğitimde istihdam sorunları: (İstanbul örneği)

İşsizlik; bireysel, ekonomik ve sosyal boyutları olan ve dünyanın hemen her bölgesinde yaşanan önemli bir sorundur. Gençler, işsizlik sorununu yetişkinlere oranla daha fazla yaşamaktadır. Genç işsizlikle mücadelede kullanılan yöntemlerin en önemlilerinden biri de bireylerin nitelikli bir mesleki eğitim alarak piyasada ihtiyaç duyulan yetkinliklere sahip olmasıdır. Bu araştırmada mesleki eğitimde yaşanan istihdam sorunları ortaya koyularak konuya ilişkin çözüm önerilerinin geliştirilmesine çalışılmaktadır. Bu çalışma nicel ve nitel yöntemlerin birlikte kullanıldığı bir karma araştırmadır. Araştırma probleminin çok boyutlu oluşundan doğan birbirinden farklı kaynaklardan veri toplama ihtiyacı sebebiyle karma araştırma yöntemi tercih edilmiştir. Çalışmada genç işsizliğinin bireysel etkileri, öğrencilerin mesleki eğitimde yaşadıkları sorunlar gibi direkt olarak gençleri etkileyen boyutlar öğrencilerin; genç işsizliğinin ekonomik ve sosyal sonuçları, mesleki ve teknik eğitimin niteliğinin geliştirilmesi için yapılması gerekenler gibi deneyim gerektiren boyutlar ise mesleki eğitim yöneticilerinin görüşlerine dayalı olarak ortaya koyulmuştur. Araştırmanın nicel boyutunun örneklemi 2014-2015 öğretim yılında İstanbul ilindeki 16 okulda eğitim almakta olan 639 Mesleki Açık Öğretim Lisesi, Mesleki Eğitim Merkezi ve Telafi Eğitimi öğrencisinden oluşmaktadır. Bu öğrenciler; okul hayatından çalışma hayatına geçiş sürecine daha yakın olmaları ve çoğunluğunun piyasada kısa süreli dahi olsa bir iş deneyimine sahip olmaları sebebiyle tercih edilmiştir. Araştırmanın nitel boyutunun çalışma grubu ise mesleki ve teknik eğitim kurumlarında yöneticilik deneyimine sahip 25 teknik öğretmenden oluşmaktadır. Genç işsizlik sebeplerinin bireysel boyutuna ilişkin araştırma sonuçlarında; yeterli nitelikte eğitim alamamış olma, işe giriş aşamasında ihtiyaç duyulan becerilere sahip olamama ve iş bulmak için gerekli kanallara ulaşamamanın ön plana çıktığı görülmektedir. Mesleklere ilişkin toplumsal algı, norm ve inanışlar sebebiyle gençlerin popüler meslek alanlarına yığılması da bir diğer önemli işsizlik sebebidir. Türkiye’de insan gücü planlaması yeterince etkin olarak yapılamamakta, gençler ihtiyaç olan mesleki alanlara yönlendirilememektedir. İşsizlik genç bireylerin umutsuzluğa, karamsarlığa düşmesine ve işsizliğin ilerleyen zamanlarında toplumsal yaşama uyumsuzluk göstermelerine sebep olabilmektedir. İşsizlik, gençler arasında suç oranlarının artışında önemli bir etkendir. Türkiye sahip olduğu dinamik genç nüfusu ekonomik katma değere yeterince dönüştürememektedir. Türkiye’de mesleki eğitim almış olan gençlerin yetkinliklerinin yetersiz olması sebebiyle istihdam edilmelerinde sorunlar yaşanmaktadır. Gençlerin doğru mesleklere yönlendirilmesi, mesleki eğitimin nitelik sorunun aşılması ve çalışan – işletme eşleştirmelerinin daha işlevsel bir şekilde yapılması durumunda mesleki eğitimde istihdam sorunlarının önemli ölçüde giderilebileceği söylenebilir. Türkiye’de etkin bir mesleki yönlendirme sisteminin olmayışı mesleki eğitim mezunlarının eğitimini aldıkları alanlarda çalışmasının önündeki en önemli engellerden biridir. Okullarda sadece mesleklerin tanıtımının yapılması 15 yaşındaki gençlerin ömür boyu sürdürecekleri mesleklerini seçmeleri için yeterli olmamaktadır. Aile ve çevre etkisi gençlerin yanlış tercihler yapmalarına sebep olabilmektedir. Mesleki eğitimin yürütülme sürecinde; mesleki eğitim politikaları, eğitim programları, müfredatlar, okul yönetimi, okulların fiziki durumu ve donanımı, teknik öğretmenlerin nitelikleri, okul sanayi iş birliği, beceri eğitimi ve yaygın mesleki eğitim boyutlarında yaşanan çeşitli sorunlar mesleki eğitimin niteliğini etkilemektedir. Mesleki eğitimden mezun olan gençlerin işe giriş sürecinin kolaylaştırılması için çağın teknolojilerini ve mesleki okulların sahip olduğu piyasa ile iletişim imkânlarını kullanan sistematik ve etkin bir yapı bulunmamaktadır. Araştırmanın nicel ve nitel bulguları birbirini desteklemekte ve tamamlamaktadır. Sonuç bölümünde araştırmadan elde edilen tüm bulgular; gerçekleştirilen literatür taraması ile bir arada yorumlanmıştır. Sonrasında mesleki eğitimde istihdam sorunları ile mücadele için uygulayıcılara yönelik olarak öneriler geliştirilmiştir. Son olarak gelecekte bu çalışmanın konusu ile ilgili çalışmak isteyecek araştırmacılara öneriler sunulmuştur. Anahtar Kelimeler: Genç istihdamı, mesleki eğitim, okuldan çalışma hayatına geçiş. ABSTRACT Unemployment is a worldwide problem which has personal, economical and social dimensions. The youth faces the problem of unemployment more than adults. One of the most effective ways of dealing with youth unemployment is an individual’s having the vocational education which enables them to have the competency to work in the market. This research identifies how Turkey can improve the functions of vocational education and training in its challenge of youth unemployment and suggests some solution strategies to the youth employment problems. This research is a mixed research in which both quantitative and qualitative methods have been used. The fact that the problem this research deals with is multidimensional, there was the necessity to gather information from different sources and thus a mixed research method was used. The research identifies subjects such as the individual effects of youth unemployment and the issues students face during vocational education through the views of the students as they directly affect students whereas it identifies subjects such as its economical and sociological effects and the requirements to develop the quality of vocational and technical education through the views of directors of vocational education as they require experience. Sampling for the quantitative dimension of the research have been provided by 639 Open Vocational School, Vocational Training Center and Vocational Continuing Education students who were being educated in 16 schools in Istanbul during 2014-2015 educational term. The reasons why these students were chosen were their proximity to the transition period from school life to the work force, the fact that the majority had work experience in the market even if it was short-term, and the fact that they are growing beyond the age of formal education into a more mature period. The study group of the qualitative dimension of the research is made up of 25 teachers who have management experience in vocational and technical schools. The findings of the individual dimension of reasons for youth unemployment were not having had an education with the necessary qualities, not having had the necessary skills upon entrance to a job, and not being able to reach the necessary resources to find a job. Another important reason for unemployment is the fact that youth targets popular job titles due to social perception, norms and beliefs. In Turkey, human workforce planning is not being done efficiently and the youth cannot be directed to professions where there is a real need. Turkey, in its fight against unemployment, needs more competent employees who have had better quality vocational education. If youth is directed to the right professions, the quality issue of vocational education is fixed, and if the criticisms of the institutions are made more efficiently, it can be said that a majority of the issues being faced in relation to vocational school students’ unemployment should be resolved. In addition to the fact that Turkey is struggles with high unemployment rates, it needs employees who have had a good quality vocational education. It can be said that there will be a decrease in youth unemployment rates if the youth is directed to the right professions, the quality issue of vocational education is fixed, and if the criticisms of the institutions are made more efficiently. The fact that there is no efficient system to direct students to the right occupations prevents vocational school graduates from working in the area of their study. Only the advertising of occupations at schools is not sufficient for a 15 year old student to make the right job choice which will be in his or her entire lives. Families and peers can have adverse effects on students making the right choices for themselves. Vocational education strategies, education programs, syllabus, school management, physical condition and resources of schools, quality of technical teachers, collaborations between school and commercial institutions, on the job training and certain problems faced in informal vocational education system affect the quality of vocational education. There currently isn’t a systematic and efficient structure in place that uses today’s technologies and market communication capabilities in order to ease the entry of vocational school graduates to the workforce. The research’s qualitative and quantitative aspects have components which complement and support each other. In the conclusion section, all the findings from the research have been analyzed together with the literature review. And then, suggestions to managers of vocational education have been made in order to increase the efficiency of vocational education in an attempt to battle unemployment. Finally, suggestions have been made to researchers who would like to work on the subject matter of this research in the future. Key Words: Youth employment, vocational education, transition from school to work