İlköğretim müfettişlerinin ders teftişlerinin öğretmenler tarafından değerlendirilmesi

Bu çalışma, Sarayköy İlçesinde 2014-2015 Eğitim ve Öğretim Yılında resmi ilköğretim kurumlarında görev yapmakta olan öğretmenlerin, ilköğretim müfettişlerinin ders teftişi görevlerini yerine getirmelerine ilişkin yeterliklerinin değerlendirilmesine yönelik betimsel bir araştırma olup, araştırmada tarama modeli kullanılmıştır. Bu çalışmada, Denizli ili Sarayköy İlçesinde bulunan ilköğretim kurumunda 2014-2015 Eğitim ve Öğretim Yılında görev yapmış toplam 166 öğretmen ile görüşülmüştür. Söz konusu çalışmada, öğretmenlerin görüşleri, müfettişlerin ders teftişi ile ilgili rollerini yerine getirme düzeyi ile ilgili olarak; müfettişlerin cinsiyetleri, yaşları, branşları, mesleki kıdemleri, mezun oldukları okullara göre farklılık gösterip göstermediği gibi sorulara cevap aranmıştır

Tabakalı Elastik Ortamların Dönel Simetrik Yükleme Altında Statik Analizi

Konferans Bildirisi -- Teorik ve Uygulamalı Mekanik Türk Milli Komitesi, 2015Conference Paper -- Theoretical and Applied Mechanical Turkish National Committee, 2015Bu çalışmada, dönel simetrik yükleme altında tabakalı elastik ortamın statik analizi rijitlik matrisi metodu ile incelenmiştir. Tabakalarda meydana gelen yer değiştirme ve gerilmeler elde edilerek elastisite ve sonlu eleman çözümleriyle karşılaştırılmıştır. Anahtar Kelimeler: Tabakalı elastik ortam, Dönel simetrik yükleme, Rijitlik matrisi metodu, Sonlu elemanlar metoduIn this study, static analysis for elastic layered media under axisymmetric loading are investigated by the stiffness matrix method. Displacements and stresses occurring in the layer are obtained and compared with elasticity and finite element solutions Keywords: Multilayered elastic media, Axisymmetric loading, Stiffness matrix method, Finite element metho

Is adiponectin elevation associated with left atrial remodeling and impaired mechanical functions? (a speckle tracking study)

Objectives Recent studies demonstrated that elevated adiponectin levels predicted an increased risk of atrial fibrillation (AF) and stroke; however, a causal relationship is yet to be unknown. Reduced left atrium (LA) functions detected by two-dimensional echocardiographic speckle tracking (2D-STE) can predict AF development. We aimed to investigate the relationship between adiponectin level and LA functions in hypertensive and diabetic patients at high risk for incident AF. Material and methods The study consisted of 80 hypertensive diabetic patients. All patients underwent echocardiography, and venous blood samples were taken. The relationship between adiponectin levels and LA functions was analyzed. Results We divided patients into two groups according to the mean adiponectin level (13.63 ng/ml). In the high adiponectin group, the mean age (p=0.001) and high-density lipoprotein (HDL) cholesterol (p=0.015) were higher, whereas estimated glomerular filtration rate (eGFR) (p=0.036) and hemoglobin (p=0.014) levels were lower. Although LA maximum volume, LA minimum volume, and LA pre-A volume were higher in the group with high adiponectin levels, they did not reach a statistical significance. Peak early diastolic LA strain (S-LAe) (p=0.048) and strain rate (SR-LAe) (p=0.017) were lower in this group. Multivariate logistic regression analysis demonstrated that age (p=0.003) and hemoglobin (p=0.006) were predictors of elevated adiponectin levels. On the contrary, S-LAe, HDL cholesterol, and eGFR lost their statistical significance. Conclusion In patients with HT and DM, elevated adiponectin level is associated with impaired LA mechanical functions. Increased age and hemoglobin level are independent predictors of elevated adiponectin levels

Two new Oxynoemacheilus species in western Anatolia (Teleostei, Nemacheilidae)

Oxynoemacheilus sakaryaensis sp. nov., is restricted to the Sakarya River basin, and O. melenicus sp. nov., is distributed in both the Sakarya River and Büyükmelen Stream. Oxynoemacheilus sakaryaensis is distinguished by having a flank plain or with numerous irregularly shaped pale brownish bars and a caudal-peduncle depth 2.8–3.2 times in its length. Oxynoemacheilus melenicus is distinguished by having a flank with 10–13 irregular shaped brownish bars or blotches and the caudal peduncle depth 1.9–2.8 times in its length. Oxynoemacheilus banarescui, O. samanticus, O. simavicus, O. fatsaensis, O. sakaryaensis, and O. melenicus are valid, which belong to the O. bergianus species group. O. melenicus and O. sakaryaensis were differentiated from all other Oxynoemacheilus species in western Anatolia by two diagnostic and unique nucleotide substitution sites in the COI barcoding region. Also, species delineation tests (ABGD, GMYC, ASAP) and phylogenetic analyses support the validity of O. melenicus and O. sakaryaensis as distinct species

Myocardial injury in COVID-19 patients is associated with the thickness of epicardial adipose tissue

Aim High sensitive troponin (hs-TnI) levels may increase secondary to Coronavirus disease-2019 (COVID-19), and this increase is associated with cardiovascular mortality in COVID-19 patients. Epicardial adipose tissue (EAT) is associated with myocardial injury directly as a reservoir tissue for coronavirus, and indirectly through mediators it secretes as an apocrine gland. We aimed to evaluate the relationship between myocardial injury secondary to COVID-19 infection and EAT thickness. Material and methods Thoracic computed tomography (CT) was performed in 73 consecutive patients diagnosed with COVID-19. EAT thickness and volume were calculated by two radiologists blind to the study data. We formed two groups according to hs-TnI concentrations, patients with myocardial damage (hs-TnI >= 11.6 ng/l) and without myocardial damage (hs-TnI<11.6 ng/dl). Results A total of 46 patients were women (63.0%). The mean age was 66.4 +/- 12.3 yrs in the myocardial injury group and 55.9 +/- 9.7 yrs in the group without myocardial injury (p<0.001). There were 20 hypertensive patients (68.9%) in the injury group, while there were 12 hypertensive patients (27.3%) in the group without injury (p=0.001). Glucose, C-reactive protein, D-dimer, white blood cell count, neutrophil, and neutrophil/lymphocyte ratio were higher in the injury group (p<0.05, for all variables). The mean EAT thickness was 5.6 +/- 1.6 mm in the injury group, whereas it was 4.8 +/- 1.8 mm in the group without injury (p=0.031). EAT thickness of 4.85 mm and above was associated with the myocardial injury with 65% sensitivity and 39% specificity (AUC=0.65, 95% CI: 0.52-078, p=0.031). Conclusion In patients with COVID-19 infection, higher rates of myocardial injury were observed as the EAT thickness increased. Epicardial adipose tissue, contributes to cytokine-mediated myocardial injury either directly or indirectly by acting as a reservoir for coronavirus. Increased EAT thickness is associated with myocardial injury in COVID-19 patients

Epicardial fat thickness is associated with retinopathy in patients with newly diagnosed hypertension

OBJECTIVE: Hypertensive retinopathy develops based on endothelial dysfunction, inflammation, and atherosclerosis. Epicardial fat secretes various cytokines associated with endothelial dysfunction, oxidative stress, inflammation, and atherosclerosis. We aimed to evaluate whether epicardial adipose tissue (EAT) thickness is a marker for retinopathy in newly diagnosed hypertensive patients. METHODS: A total of 73 newly diagnosed hypertension (HT) patients were included in the study. Transthoracic echocardiography (TTE) was used to measure EAT thickness. To evaluate the presence of retinopathy in HT patients, hypertensive retinopathy staging was performed by ophthalmologists, according to Scheie classification. RESULTS: Retinopathy was detected in 27 (37.0%) of 73 patients. EAT thickness in HT patients with retinopathy was higher than the group without retinopathy (5.07 +/- 1.45 mm vs. 4.19 +/- 1.20 mm, p=0.007). Low-density lipoprotein cholesterol (LDL-C) levels in HT patients with retinopathy were higher than the group without retinopathy (162.4 +/- 41.2 mg/dl vs. 138.1 +/- 35.6 mg/dl, p=0.010). As a result of the regression analysis, LDL-C (OR=1.016, 95% CI 1.001-1.031, p=0.043) and EAT thickness (OR=1.674, 95% CI 1.069-2.626, p=0.043) were the independent predictors of retinopathy. CONCLUSION: Increased EAT thickness is associated with the presence of retinopathy in hypertensive patients

The effect of ısolated coronary artery ectasia on mortality in long-term follow-up in patients with stable angina pectoris

Amaç: Koroner arter ektazisi koroner anjiyografi ile tespit edilen bir koroner anomalidir. Koroner arter ektazisinin klinik ve progrostik öne‐ mi hala daha aydınlatılabilmiş değildir. Çalışmamızda izole koroner arter ektazisinin uzun süreli takip sonucunda normal koroner ar ter li hasta grubuna göre ölüm gelişimi ile ilişkili olup olmadığını değerlendirerek bu alandaki çelişkili sonuçlara cevap vermeyi amaç la dık. Gereç ve Yöntem: Çalışmaya göğüs ağrısı ve/veya eşdeğeri semptomlarla hastaneye başvuran, koşu bandı egzersiz testi ile iskemi lehi‐ ne bulgu izlenen, stabil anjina pektoris tanılı hastalar alındı. Koroner anjiyografi işlemi sonucunda koroner darlık oluşturan lezyonu ol‐ mayan, izole koroner arter ektazisi ve normal koroner arterli 262 hasta ile çalışmaya devam edildi ve hastalar ortalama 8.2 yıl boyunca takip edildi. Takip sürecinde ölüm gelişen hastalar belirlenerek analiz edildi. Bulgular: Çalışma takip süresince 35 hastada ölüm gerçekleşti. Takip süresi içerisinde koroner arter ektazili ve normal koroner arterli hasta grupları arasında ölüm oranları açısından istatistiki olarak anlamlı farklılık izlenmedi (p=0,179). İzole koroner arter ektazisinin ile‐ ri yaş (p<0,001), erkek cinsiyet (p<0,001), diabetus mellitus (p=0,011), serum kreatinin düzeyi yüksekliği (p=0,036) ve dislipidemi (p=0,006) ile normal koroner arterli gruba göre daha yakından ilişkili olduğu izlendi. Sonuç: İzole koroner arter ektazisinin, uzun süreli takip sonucunda normal koroner arterlere göre ölüm oranlarında artışa neden olma‐ dığı gösterilmiştirObjective: Coronary artery ectasia is a common coronary anomaly detected by coronary angiography. The clinical and prognostic significance of coronary artery ectasia is still unclear. We compared isolated coronary artery ectasia patients to the patients with normal coronary arteries in terms of mortality during long‐term following. Material and Method: Stable angina pectoris patients who were admitted to the hospital with chest pain or equivalent symptoms and diag‐ nosed as ischemia with treadmill exercise test were included in the study. As a result of coronary angiography, 262 patients with isolated co‐ ronary artery ectasia or normal coronary artery without coronary stenosis were included, and patients were followed for an average of 8.2 years. We identified and analyzed patients in terms of mortality during the follow‐up period. Results: A total of 35 patients died during follow‐up. There was no statistical difference between the normal coronary artery group and the iso‐ lated coronary artery ectasia group in terms of mortality (p=0.179). Age (p<0.001), male gender (p<0.001), serum creatinine level (p=0.036), diabetes mellitus (p=0.011), and dyslipidemia (p=0.006) were more closely related to coronary artery ectasia than normal coronaries. Conclusion: Isolated coronary artery ectasia cause no increase in mortality rates compared to normal coronary arteries after long‐term following

COVID-19 hastalarında mitral anüler kalsifikasyonun mortalite ve miyokard hasarı ile ilişkisi

Coronavirus disease-2019 (COVID-19) can particularly affect the respiratory and cardiovascular systems and cause serious mortality. Mitral annular calcification (MAC) is a mitral valve pathology associated with cardiac mortality. We aimed to evaluate the effect of MAC on myocardial injury (MI) and mortality, which can develop secondary to COVID-19 infection. Materials and Methods After applying the exclusion criteria, thorax computed tomography (CT) images of the remaining 1151 consecutive COVID-19 patients were evaluated. Calculation of MAC scores was done by two expert radiologists blinded to the study data. MI was defined as those with hs-TnI level (≥34 ng/dl). Patients included in the study were classified as having mortality and not occurring. Results Male gender, advanced age (>65), hypertension, diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease (CKD), coronary artery disease, heart failure and atrial fibrillation rates were statistically higher in the mortality group (p<0.05). The presence of MAC was 34.1% in the mortality group, while it was 16% in the survival group (p<0.001). MI was observed 49.3% in the mortality group, while it was 16.2% in the survival group (p<0.001). Presence of MAC was associated with MI (14.8% vs 38.7%, p<0.001). Age (OR=1.976, 95% CI 1.166-3.346, p=0.011), male gender (OR=1.784, 95% CI 1.101-2.892, p=0.019), CKD (OR=2.293, 95% CI 1.085-4.485, p=0.030), MI (OR=2.893, 95% CI 1.735-4.823, p<0.001) and advanced lung involvement on CT (OR=2.231, 95% CI 1.084-4.594, p=0.029) were the independent predictors of mortality Conclusion In terms of MI and mortality risk in COVID-19 patients, it may be recommended to evaluate MAC from the CT images.Koronavirüs hastalığı-2019 (COVID-19) özellikle solunum ve kardiyovasküler sistemleri etkileyerek mortaliteye ve ciddi morbiditelere neden olabilir. Mitral halka şeklindeki kalsifikasyon (MAC), kardiyak mortalite ile ilişkili bir mitral kapak patolojisidir. Bu çalışmada, MAC’ın COVID-19 enfeksiyonuna sekonder gelişebilen miyokard hasarı (MI) ve mortalite üzerine etkisini değerlendirmeyi amaçladık. Gereç ve Yöntemle Dışlama kriterleri uygulandıktan sonra geriye kalan 1151 ardışık COVID-19 hastasının toraks bilgisayarlı tomografi (BT) görüntüleri değerlendirildi. MAC puanlarının hesaplanması, çalışma verilerine kör olan iki uzman radyolog tarafından yapıldı. MI, hs-TnI düzeyi (≥34 ng/dl) olanlar olarak tanımlandı. Çalışmaya dahil edilen hastalar mortalitesi olan ve olmayan olarak sınıflandırıldı. Bulgular Mortalite grubunda erkek cinsiyet, ileri yaş (>65), hipertansiyon, diabetes mellitus, kronik obstrüktif akciğer hastalığı, kronik böbrek hastalığı (KKD), koroner arter hastalığı, kalp yetmezliği ve atriyal fibrilasyon oranları istatistiksel olarak daha yüksekti (p<0.05). Mortalite grubunda MAC varlığı %34.1, sağkalım grubunda ise %16 idi (p<0.001). Miyokardiyal hasar mortalite grubunda %49.3, sağkalım grubunda ise %16.2 olarak saptandı (p<0.001). MAC varlığı MI ile ilişkiliydi (%14.8’e karşılık %38.7, p<0.001).Yaş (OR=1.976, 95% CI 1.166-3.346, p=0.011), erkek cinsiyet (OR=1.784, 95% CI 1.101-2.892, p=0.019), kronik böbrek yetersizliği (OR=2.293, 95% CI 1.085-4.485, p=0.030), MI (OR=2.893, 95% CI 1.735-4.823, p<0.001) ve küçük hücreli akciğer tutulumu (OR=2.231, 95% CI 1.084-4.594, p=0.029) mortalitenin bağımsız belirleyicileri idi. Sonuç COVID-19 hastalarında MI ve mortalite riski açısından BT görüntülerinden MAC değerlendirilmesi önerilebilir

Evaluation of Emergency Interhospital Patient Transfers from Province of Mardin to Out-of-Province Hospitals in a Year

Abstract Objective: This study aimed to assess patients who were transferred from emergency services throughout the province of Mardin to out-of-province hospitals by ambulance in a year. Material and Methods: In this study, all patients transferred from emergency services in the province of Mardin to out-of-province hospitals via ambulances by the Patient Referral Assessment Committee, founded under the Provincial Directorate of Health, between the dates of December 31, 2010 and December 31, 2011 were evaluated retrospectively. No exclusion criteria were used. Patients were grouped and analyzed according to their demographic characteristics, transport properties, and reasons for referral. Results: The total number of the patients included in the study was 1518 (55.8% males, 41±27 mean age). Of all, 621 patients (40.9%) were transferred from the center of Mardin province, and the other patients were transferred from 8 district hospitals and two private hospitals. It was found that the patients were transferred to 37 hospitals in 8 provinces, and a total of 562 patients (37%) were transferred to private hospitals. Cardiology (23.3%), pediatrics (11.5%), and obstetrics and gynecology (8.8%) departments were the first three clinics that patients were transferred to frequently, respectively. In total, 274 patients (18.1%) were transferred inappropriately. There was a statistically significant difference between patients&apos; transfer hospitals (state hospital/private hospital) and the age of the patients (younger than 18 years/18 years or older) (p&lt;0.001). In addition, the rate of adult patients&apos; transfers to tertiary healthcare centers was significantly higher (p&lt;0.001). Conclusion: In Mardin, cardiology, pediatrics and obstetrics and gynecology patients are the most common group of emergency patients transferred by 112 ambulances to out-of-province hospitals. Approximately 40% of the patients were transferred to private hospitals. Inappropriate patient transfers seem to be a major problem in this study, as in other studies conducted in Turkey. (JAEM 2014; 13: 62-6

Ulusaldan Küresele: Popülizm, Demokrasi, Güvenlik Konferansı

Öngörülmesi giderek güçleşen, sarsıntılı ve savrulmalı zamanlardan geçiyoruz. İkinci Dünya Savaşı ve Soğuk Savaş ortak deneyimleri sonrasında 1950’lerden ve 1990’lardan itibaren demokratik sistemlerin peş peşe dalgalarla meşrulaşacağı, yaygınlaşacağı ve güçleneceği öngörüsü hakimdi. Ancak son yıllarda yaşanan bazı gelişmelerle demokrasilerin geleceği tekrar sorgulanmaya başladı. Gerek 11 Eylül ile başlayan ve IŞİD ile devam eden ve şiddet içeren İslamcı radikalizm, gerek Batı demokrasilerinde popülist radikal sağ hareketlerin ve beyaz ırkçı grupların yükselişi ve iktidara gelişi, bir yandan güvenlik-özgürlük ikileminin demokrasi dengesini bozdu, bir yandan da hem demokratik sistemlerin hem dünya barışının geleceğini bizi tekrar sorgular, sorgulatır hale getirdi. Demokrasileri bildiğimizi zannediyoruz, ama demokrasiler ile ilgili daha öğrenmemiz gereken çok şey var. Demokrasi kaderimiz de geleceğimiz de olmak zorunda değil belki de. Ya da belki yanlış yerden soru sormaya başlıyoruz, belki demokrasi yerine yeni bir referansa ihtiyacımız var. Aslında demokrasileri çantada keklik görmeyip, sabırla büyütüp yeşertmek, geliştirmek, korumak, ileri safhalara taşımak ve bizden sonraki nesillere aktarmak bir sorumluluk, ve bu sorumluluk bizlere ait. Popülizm, demokrasi, güvenlik kavramlarının her biri bugün sıkça ve yaygın olarak kullandığımız kavramlar olarak gündelik sohbetlerimizin içine kadar girmiş durumda. Bu yaygın kullanımlarına rağmen her bir kavram, üzerine düşünmeye, tartışmaya ve değerlendirmeye tekrar tekrar olanak verecek derinlikte. Her bir tartışma bir diğerini açarken, farklı gibi görünen bu kavramların birbirleriyle kesiştikleri zeminler bulmak mümkün. Popülist liderlerin politikaları bütün siyaset yapma biçimlerini kendine çeken ya da kendinden uzaklaştıran eksenler yaratarak her ikisini de aynı anda besleyebiliyor. Popülist politikaya angaje olan liderler ve grupların yanında bu politikaya karşı mücadele eden kişiler ve kitleler de yok değil, ancak kimi zaman bu kitleler eleştirdiği bu siyaset biçiminin kurucu öznesi haline de gelebiliyor. Bunun karşısında tabandan gelen demokratikleşme talepleri ve popülist siyasetle beraber kurumsallaşan diğer politika yapma biçimleri, demokrasi anlayışımızı farklı yönlere çekebiliyor. Bu demokratikleşme talepleri kimi zaman olumlu karşılıklar alsa da, kimi zaman devletlerin güvenlik politikaları ile etkisizleştirilmeye ve bastırılmaya çalışılıyor. Güvenlik politikalarının alanı günümüz teknolojisi sebebiyle o kadar genişledi ki, bu politikanın nesnesi haline gelmemiş varlık ve alan bulmak neredeyse mümkün değil. Ulusaldan Küresele: Popülizm, Demokrasi, Güvenlik konferansımız bu alanların kendine özgülüklerini göz önünde bulundururken, aralarındaki kesişimleri de ortaya koyan pek çok değerli sunuma ev sahipliği yaptı. Konferansın düzenlenmesinde emeği geçen herkese, ve bu bildiri kitabında tam metinleri ve özetleri bulunan bütün katılımcılarımıza çok teşekkür ederiz.Publisher's Versio