Late perforation of anterior mitral leaflet after surgical resection of the subaortic membrane

AbstractA 54-year-old woman who underwent surgical resection of the subaortic membrane 10 years earlier presented with new onset dyspnea. Cardiovascular examination revealed 3–4/6 pansystolic murmur at the apex. She was found to have severe mitral regurgitation (MR) with transthoracic echocardiography; 2D and real-time-3D transesophageal echocardiography demonstrated severe MR through anterior mitral leaflet perforation with precise localization. The patient was treated with surgery in which the perforated segment was closed by direct suture technique and discharged on postoperative 5th day.<Learning objective: Late anterior mitral leaflet perforation after surgical or interventional procedures has rarely been reported. We present this case to emphasize the role of traumatic injury to weak endothelial surfaces such as a valve leaflet in the development of late leaflet perforation after surgical or interventional procedures.

Robust Face Alignment for Illumination and Pose Invariant Face Recognition

In building a face recognition system for real-life scenarios, one usually faces the problem that is the selection of a feature-space and preprocessing methods such as alignment under varying illumination conditions and poses. In this study, we developed a robust face alignment approach based on Active Appearance Model (AAM) by inserting an illumination normalization module into the standard AAM searching procedure and inserting different poses of the same identity into the training set. The modified AAM search can now handle both illumination and pose variations in the same epoch, hence it provides better convergence in both point-to-point and point-to-curve senses. We also investigate how face recognition performance is affected by the selection of feature space as well as the proposed alignment method. The experimental results show that the combined pose alignment and illumination normalization methods increase the recognition rates considerably for all featurespaces. 1

Total serum protein predicted mortality in patients with st-elevation myocardial ınfarction who underwent primary percutaneous coronary ıntervention: Results of 8-year follow-up

Objectives: ST-elevation myocardial infarction (STEMI) is globally one of the leading causes of mortality. Determining modifiable mortality predictors to improve outcomes is critical. Total serum protein (TSP) is a composite indicator of immunity, nutrition, and inflammation and it plays a vital role in biological pathways contributing to cardiovascular diseases. TSP level has not been evaluated in patients with STEMI in the prediction of mortality previously. Materials and Methods: The patients diagnosed with STEMI between March 2007 and May 2009 were included in the study. TSP was obtained at admission to the hospital. Follow-up period of the study was 8 years and primary endpoint was all-cause mortality. Participants were separated according to the presence of mortality and clinical parameters compared between these two groups. Results: The mean age of the total 99 patients was 61±12.4 years and 82 (82.8%) of them were male. While left ventricular ejection fraction (LVEF) (p=0.001), serum albumin (p=0.014), and TSP (p<0.001) were lower, serum creatinine was higher (p=0.003) in the mortality group. Diabetes mellitus (p=0.007), increased age (p=0.027), LVEF (p=0.006), serum creatinine level (p=0.023), and TSP (hazard ratio: 0.159, 95% confidence interval: 0.062-0.408, p<0.001) predicted mortality independently. Conclusion: TSP level predicted all-cause mortality independently in STEMI patients who underwent primary percutaneous coronary intervention during 8-year follow-u

Relation of apolipoprotein E gene polymorphism with the severity of coronary artery disease in patients with stable ischemic heart diseas

Aim: Atherosclerosis begins from an early age and manifests in later years as Coronary artery disease (CAD). This inflammatory process is aggravated by age, smoking, hypercholesterolemia, hypertension, diabetes mellitus, and genetic factors. We aimed to investigate which isoform of APOE is related to extensive coronary lesions in patients with stable coronary heart disease. Materials and Methods: This study was carried on single center. One hundred and ten patients diagnosed with stable coronary artery disease by coronary angiogram were enrolled consecutively. Syntax score was calculated by a tool of website calculator (www. syntax.com). According to the Syntax score, patients were split into three groups. APOE genotyping was performed through blood samples. Patients split into three groups according to the APOE genotypes: E4 (3/4 and 4/4 genotypes), E3(3/3 genotype), E2 (2/2 and 2/3 genotypes). APOE groups were compared according to baseline characteristics and syntax scores. (%82.6) değil (82.6%) olacak. Lütfen İngilizce kurala göre düzeltiniz. Tüm sayısal değerlerde virgülleri de nokta yapmayı unutmayınız. Results: Coronary angiography and APOE genotypes of 98 patients were analyzed. 81 of patients (%82.6) had E3E3 allele; 6 of patients (%6.1) had E2E3 allele; 10 patients (%10.2) had E3E4 allele and 1 patient (%1) had E2E4 allele. Due to the contrast effect of E2 and E4 on CAD, we excluded patients with E2E4 allele from the study. Firstly, we assessed distribution of APOE genotype E2 (E2E3), E3 (E3E3 and E3E4), E4 (E3E4) within 3 groups of syntax scores. Total of 6 patients of E2 allele was at low syntax score group. 83 patients of E3 allele were at the low-risk group of syntax score. 10 patients of E3 allele were at the mid group and 4 patients were at the high-risk group of syntax score. 7 patients of E4 allele subjects were at the low-risk and 1 patient was at the high-risk group of syntax score. Compared to syntax score groups and APOE genotypes, E2 alleles were in lower syntax score group versus E3 (P=0.046) and E4 (P=0.003) alleles. However E4 alleles were in higher syntax score group versus E3 alleles (P= 0.034). The Syntax score was seemed to be lower in the E2 allele group versus E4 and E2 groups (P=0.013). Conclusion: we reported the first study that E2 allele was related with less and E4 allele was more extensity and severity of CAD in patients with stable ischemic coronary diseas

Investigating Student Opinions about Classroom Management in a Virtual Classroom

Bu araştırmada sanal sınıf üzerinden eğitim gören öğrencilerin, sınıf yönetimine yönelik görüşlerinin incelenmesi amaçlanmıştır. Araştırma betimsel tarama modeli ile desenlenmiştir. Araştırmanın çalışma grubunu Afyon Kocatepe Üniversitesi, Fen Bilimleri Enstitüsü İnternet ve Bilişim Teknolojileri Yönetimi (Tezli Yüksek Lisans) bölümünde okuyan 56 öğrenci oluşturmaktadır. Veri toplama aracı olarak Sınıf Yönetimi Ölçeği (SYÖ) kullanılmıştır. Verilerin toplanması aşamasında çevrimiçi anket kullanılmıştır. Verilerin analizinde öğrencilerin ölçeğin tamamından ve alt boyutlarından almış oldukları betimsel istatistikler kullanılmıştır. Araştırma bulguları, sanal sınıf ortamında öğrenim gören öğrencilerin, SYÖ ve yedi alt faktörüne ilişkin görüşlerinin pozitif yönde olduğu görülmüştür. Araştırmanın sonucunda, öğrencilerin SYÖ alt boyutlarından almış olduğu puanlar incelenmiş ve orta seviyenin üstünde çıkmıştır. Öğrencilerin sanal sınıf ortamında iletişim kurmanın kolay olduğu, öğretim elemanı ve sınıf arkadaşlarıyla iletişim kurmanın başarısını arttırdığı, öğretim elemanının dersi yönlendirici etkide olduğu, ders işlenişi planlaması iyi yapıldığında öğrencinin motivasyonunun arttığı, zaman yönetiminin iyi planlandığında etkin olduğu sonucuna ulaşılmıştır.In this research, it is aimed to examine the opinions of students who are studying through virtual classroom. The research was designed with a descriptive survey model. The study group of the study consists of 56 students studying in Afyon Kocatepe University, Graduate School of Natural and Applied Sciences Internet and Information Technologies Management master program. Classroom Management Scale was used as data collection tool. An online questionnaire was used during the collection of data. In the analysis of the data, descriptive statistics are used which are taken from the students' complete and subscales of the scale. The findings of the research showed that the students in the virtual classroom environment had positive views on the Classroom Management Scale and the seven sub-factors. As a result of the research, the scores that the students have taken from the subscales of the Classroom Management Scale were examined and they reached higher than middle level. It is aimed that the students who are studying in the study virtual class have their opinions about class management in the direction of this purpose and include the suggestions

Aktif görünüm modeline dayalı gürbüz yüz hizalama

In building a face recognition system for real-life scenarios, one usually faces the problem that is the selection of a feature-space and preprocessing methods such as alignment under varying illumination conditions and poses. In this study, we developed a robust face alignment approach based on Active Appearance Model (AAM) by inserting an illumination normalization module into the standard AAM searching procedure and inserting different poses of the same identity into the training set. The modified AAM search can now handle both illumination and pose variations in the same epoch, hence it provides better convergence in both point-to-point and point-to-curve senses. We also investigate how face recognition performance is affected by the selection of feature space as well as the proposed alignment method. The experimental results show that the combined pose alignment and illumination normalization methods increase the recognition rates considerably for all feature spaces. In this paper, we focus on the problems induced by varying illumination and poses. Our primary aim is to eliminate the negative effect of illumination and pose on the face recognition system performance through illumination and pose-invariant face alignment based on Active Appearance Model. Pose normalization is required before recognition in order to reach acceptable recognition rates. We developed AAM based pose normalization method which uses only one AAM. There are two important contributions over the previous studies. By using the proposed method: One can synthetically generate appearances for different poses when only frontal face image is available. One can generate frontal appearance of the face when there is only non-frontal face image is available. The same variation in pose imposes similar effect on the face appearance for all individuals. Deformation mostly occurs on the shape whereas the texture is almost constant. Since the number of landmarks in AAM is constant, the wireframe triangles are translated or scaled as pose changes. So as we change pose, only wireframe triangles undergo affine transformation but the gray level distribution within these triangles remains the same. One can easily generate frontal face appearance if AAM is correctly fitted to any given non-frontal face of the same individual provided that there is no self-occlusion on face. Self-occlusion usually is not a problem for angles less than ±45. For 2D pose generation, we first compute how each landmark point translates and scales with respect to the corresponding frontal counterpart landmark point for 8 different poses, and obtain a ratio vector for each pose. We use the ratio vector to create the same pose variation over the shape of another individual. Appearances are also obtained through AAM using synthetically generated landmarks. It is important to note that the generated faces contain no information about the individual used in building the ratio matrix. An AAM model trained by using only frontal faces can only fit into frontal faces well and fail to fit into non-frontal faces. Our purpose here is to enrich the training database by inserting synthetically generated faces at different poses so that AAM model trained by frontal faces can now converge to images at any pose. In this paper we developed AAM based face alignment method which handles illumination and pose variations. The classical AAM fails to model the appearances of the same identity under different illuminations and poses. We solved this problem by inserting histogram fitting based normalization into the searching mechanism and inserting different poses of the same identity into the training set. From the experimental results, we showed that the proposed face restoration scheme for AAM provides higher accuracy for face alignment in point-to-point error sense. Recognition results based on PCA and LDA feature spaces showed that the proposed illumination and pose normalization outperforms standard AAM. Keywords: Face alignment, active appearance models, illumination invariant face recognition.Y&uuml;z g&ouml;r&uuml;n&uuml;m&uuml;ndeki şekil ve doku değişimine bağlı farklılıklar y&uuml;z tanıma problemini olduk&ccedil;a zor hale getirmektedir. Bireyler arası y&uuml;z g&ouml;r&uuml;n&uuml;m farklılıklarının fazla olmasına karşın, her bireyin kendi y&uuml;z g&ouml;r&uuml;n&uuml;m&uuml;n&uuml; farklı hale getirecek değişimlerde mevcuttur. &Ouml;zellikle aydınlatma ve poz değişimleri y&uuml;z tanıma sistemlerinin başarımını etkileyen zorlukların başında gelmektedir. Bu &ccedil;alışmada otomatik y&uuml;z hizalama i&ccedil;in aydınlatma ve poz değişimlerine karşı g&uuml;rb&uuml;z yeni bir y&ouml;ntem tanıtılmıştır. Klasik aktif g&ouml;r&uuml;n&uuml;m modeli (AGM) yapısına y&uuml;z i&ccedil;in &ouml;zelleştirilmiş aydınlatma normalizasyonu eklenerek AGM&rsquo;nin farklı aydınlatma koşullarındaki arama ve yakınsama performansını arttıran yeni bir y&ouml;ntem &ouml;nerilmiştir. AGM ile y&uuml;z b&ouml;l&uuml;tlemede, &ouml;zg&uuml;n y&uuml;z aydınlatma normalizasyonunu AGM b&uuml;kme (warping) işleminden hemen sonra ve her &ccedil;evirimde uygulayarak aydınlatma değişimlerine karşı g&uuml;rb&uuml;z bir model oluşturulmuştur. Y&ouml;ntem giriş olarak verilen farklı aydınlatılmış ve farklı bir poza sahip y&uuml;z g&ouml;r&uuml;nt&uuml;s&uuml;n&uuml; hem iyileştirmeye hem de hizalamaya &ccedil;alışmaktadır. Ayrıca tam karşıdan &ccedil;ekilmiş tek bir y&uuml;z g&ouml;r&uuml;nt&uuml;s&uuml;nden, o kişinin farklı pozlara sahip g&ouml;r&uuml;nt&uuml;lerini sentezleyen bir y&ouml;ntem tanıtılmış ve sentetik olarak sentezlenen poz verileri ile AGM şekil uzayı g&uuml;&ccedil;lendirilerek poz değişimlerine karşı g&uuml;rb&uuml;z bir y&ouml;ntem &ouml;nerilmiştir. &Ouml;nerilen y&ouml;ntemde, model eğitimi i&ccedil;in aynı bireyin farklı aydınlatma ve poza sahip g&ouml;r&uuml;nt&uuml;lerine ihtiya&ccedil; duyulmamaktadır. &Ouml;nerilen y&ouml;ntemde aydınlatma değişimlerine karşı bağışık bir yapı oluşturulması i&ccedil;in karmaşık aydınlatma modelleri gerekmemektedir. Deneysel &ccedil;alışmalardan da g&ouml;r&uuml;leceği gibi &ouml;nerilen y&ouml;ntem, farklı aydınlatma ve pozlarda bile klasik AGM&rsquo;ye g&ouml;re olduk&ccedil;a iyi sonu&ccedil;lar vermiştir.&nbsp;Anahtar Kelimeler: Y&uuml;z hizalama, aktif g&ouml;r&uuml;n&uuml;m modelleri, aydınlatmadan bağımsız y&uuml;z tanıma

Investigation of the effects of earthquake characteristics on slope stability using model slope

Bu çalışmada, geoteknik mühendisliğinin başlıca konuları arasında yer alan güvenli şevlerin tasarımı konusu incelenmiştir. Güvenli şevlerin tasarımı için dikkat edilmesi gereken statik yükler kadar önemli bir diğer etken ise, sismik yüklerdir. Sismik yükler altında şev davranışının irdelenmesi niyetiyle tasarlanmış olan model şeve farklı özellikteki depremler etki ettirilerek sonlu eleman yazılımı ile bir dizi şev stabilite analizleri yapılmıştır. Bu kapsamda tasarlanan model şev, farklı özelliklerdeki senaryolar ile çeşitli bölgelerde meydana gelmiş, çok sayıda istasyon ölçümleri bulunan 12 adet gerçek deprem kayıt verisi ile analiz edilmiştir. Sonuç olarak, bu depremlerin tasarlanmış olan model şevin stabilitesine olan etkileri ortaya koyulmuş ve elde edilen veriler doğrultusunda şev tasarımında daha güvenli ve daha ekonomik sonuçlar alınması için dikkat edilmesi gereken hususlara değinilmiştir.In this study, the design of safe slopes was investigated, which is one of the main topics in geotechnical engineering. Another factor that should be considered in the design of safe slopes is seismic loads in addition to static loads. As part of the study, a series of slope stability analyzes were performed using finite element software by applying earthquakes with different characteristics to the model slope, which was designed with the intention of investigating slope behavior under seismic loads. The model slope designed in this context was analyzed with 12 real earthquake record data that occurred in different regions with different scenarios and had many station measurements. As a result, the effects of these earthquakes on the stability of the designed model slope were pointed out and the points that should be considered to obtain safer and more economical results in slope design in the direction of the obtained data

A THREE-DIMENSIONAL EVALUATION OF THE EFFECTS OF DIFFERENT INCISOR INTRUSION MECHANICS TO THE PERMANENT MAXILLARY FIRST MOLAR TEETH BY USING CONE BEAM COMPUTED TOMOGRAPHY

Objective: The present study aims to evaluate the impacts of the upper incisor teeth intrusion in deepbite patients by two different techniques to the permanent maxillary first molar tooth using the three-dimensional cephalometric analysis in the individuals. Materials and Methods: The population of this study consists of 34 patients with &gt;4 mm overbite and a ≥2 mm gummy smile during post-pubertal period. Patients who underwent intrusion of upper incisor teeth were randomized to receive Connecticut intrusion arch (CTA) or miniscrew anchorage intrusion system (MAIS) to compare the impacts on permanent maxillary first molar teeth. Cone Beam Computed Tomography (CBCT) data obtained before (T1) and after (T2) intrusion were evaluated through three-dimensional (3D) cephalometric analysis. Intragroup assessment of treatment-related variables were performed via “t-test in dependent samples” and intergroup comparisons were assessed by “t-test in independent samples”.Results: In patients who underwent intrusion of upper incisors, permanent maxillary first molar teeth became deviated distally (1.48 mm/7.63 degree) only in CTA group, a statistically significant difference was found between two groups (p&lt;0.05). The distance between resistance centers of maxillary first molar teeth was only increased in CTA group (0.31 mm), which also statistically differed from MAIS group. Conclusion: CTA and MAIS techniques resulted in similar intrusive effects overall at the end of the treatment. While MAIS is recommended when anchorage from posterior region is not desired in patients with deep overbite, we believe that CTA may serve a suitable treatment alternative where miniscrew technique could not be performed