A design model proposal for digital learning platform based on interactive e-books

One of the most important factors in the successful results of electronic learning environments is the strengthening of student-content interaction. In creating this interaction structure, it is of great importance that the content used is interesting by the student. The digital transformation in the traditional publishing industry allows the use of electronic books in different formats. The possibilities brought by new technologies allow students to use Interactive Electronic Books (IEB) as an educational material, independent of time and place, through smart devices. The IEB is a program that can be accessed with new digital devices such as computers, tablets, smartphones, and students can use Augmented Reality (AR), 3D animation, video files, etc. It is a technology in which it is integrated with electronic media and technologies. The use of interactive e-books as an educational material can also enable instructors to monitor student activities on these books. This study has been developed to convey the design and development processes of IEB, AR applications in IEB and a simple LMS in which IEB can be integrated, which is thought to contribute to student-content interaction. In the study, first the theoretical approach of the integrated system, then the development processes of LMS, IEB and AR applications are presented within the framework of the System Development Life Cycle (SDLC) approach

Lms Selection Process For Effective Distance Education System In Organizations

 Towards the end of the 20th century, especially development of science and technology brought some innovation to some conceptual area such as education. In society, to build a quality and civilized life, education emerges as a one of the most important actors. Unfortunately, the rights in education of the every person in society may be delayed due to financial problems, physical disabilities, time pressure, geographical distances or any other reasons. Distance learning is a one of the method that provides education for people by eliminating these disadvantages. Since end of the 19th century, distance education has been provided with some methods such as TV, radio, mail and etc. Especially, in the beginning of 21th century; internet is widely used by everybody. New technological environment has brought a new opportunity for distance education. Learning Management System (LMS) is the most important actor of the internet based distance learning that brings together educators and students for training. LMS allows to deliver materials, having assignment and quizzes and other educational activities. Whether educational institutions or organizations that are emphasis on the training of employees can use LMS platform. Every organization has to decide which LMS is suitable for them. Decision makers face to solve this kind of problems because every LMS has different characteristics and different learning process. This study is focused on choosing suitable LMS for organizations by using AHP methods. Two groups of LMS, open source software’s (Moodle and Sakai) and commercial software’s (BlackBoard and Sharepoint LMS), are compared by using selecting criteria’s. These criteria’s are license costs, flexibility, security, user interface and prevalence of use. In the decision process, different weight ratios are used depending on their priority. The findings of this AHP Process are discussed. Keywords: Distance Learning, LMS, AHP, Decision Making Proces

Decreased heart rate recovery may predict a high SYNTAX score in patients with stable coronary artery disease

An impaired heart rate recovery (HRR) has been associated with increased risk of cardiovascular events, cardiovascular, and all‐cause mortality. However, the diagnostic ability of HRR for the presence and severity of coronary artery disease (CAD) has not been clearly elucidated. Our aim was to investigate the relationship between HRR and the SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) score in patients with stable CAD (SCAD). A total of 406 patients with an abnormal treadmill exercise test and ≥50% coronary stenosis on coronary angiography were included. The HRR was calculated by subtracting the HR in the first minute of the recovery period from the maximum HR during exercise. The SYNTAX score ≥23 was accepted as high. Correlation of HRR with SYNTAX score and independent predictors of high SYNTAX score were determined. A high SYNTAX score was present in 172 (42%) patients. Mean HRR was lower in patients with a high SYNTAX score (9.8 ± 4.5 vs. 21.3 ± 9, p < 0.001). The SYNTAX score was negatively correlated with HRR (r: -0.580, p < 0.001). In multivariate logistic regression analysis, peripheral arterial disease (OR: 13.3; 95% CI: 3.120–34.520; p < 0.001), decreased HRR (OR: 0.780; 95% CI: 0.674–0.902; p = 0.001), peak systolic blood pressure (OR: 1.054; 95% CI: 1.023–1.087; p = 0.001), and peak HR (OR: 0.950; 95% CI: 0.923–0.977; p < 0.001) were found to be independent predictors of a high SYNTAX score. Our results showed that HRR is significantly correlated with the SYNTAX score, and a decreased HRR is an independent predictor of a high SYNTAX score in patients with SCAD

Retrospective analysis of the effect of topical diltiazem treatment in addition to botulinum toxin injection in anal fissure on recovery and relapse

Amaç: Anal fissürde botulinum toksin enjeksiyonuna ek olarak uygulanan topikal diltiazemli pomad tedavisinin semptomatik iyileşme ve nüks oranları üzerine olan etkisini araştırmak. Yöntem: Ekim 2017-Şubat 2022 tarihleri arasında anal fissür tanısıyla botulinum toksin enjeksiyonu uygulanan ve botulinum toksini enjeksiyonuna ek topikal diltiazemli pomad uygulanan iki ayrı gruptaki hastaların verileri analiz edildi. Hastalardan takip süresi en az 18 ay olanlar çalışmamıza dahil edildi. Hastalara internal anal sfinktere 4 ayrı kadrandan 100 IU Botulinum Toksin Serotip A uygulandı. Hastalara işlem sonrası 3.gün, 10.gün ve 2.ay poliklinik kontrolü yapıldıktan sonra 6, 12 ve 18. aylarda hastalar telefonla aranarak değerlendirildi. Botulinum Toksini uygulaması sonrası 8. haftadaki poliklinik kontrolünde hastanın semptomlarının tamamen geçmesi ve fissürde epitelizasyon mevcudiyeti tam iyileşme olarak tanımlandı. Hastaların 8. Hafta poliklinik kontrolünde perianal ağrı ve kanama şikayetlerinin devam etmesi fissür epitelizasyonu olsun ya da olmasın tedaviye yanıtsızlık olarak değerlendirildi. Takiplerde tam iyileşme gerçekleştikten sonra yakınmaların tekrarlaması ise nüks olarak kabul edildi. Botulinum toksin ve botulinum toksinine ek topikal diltiazem krem uygulamasının iyileşme, nüks, tedaviye yanıtsızlık oranları üzerine etkisi karşılaştırıldı. Bulgular: Çalışmamızda ortalama yaş 34.5±10.6 olup 157/217 (%72.4) hasta kadın ve 60/217 (%27.6) hasta erkek idi. Ortalama izlem süresi 55.9±18.4 aydı ve minimum izlem süresi 19 ay ve maksimum izlem süresi 242 aydı. Çalışmamızda toplam 161/217 (%74.2) hastada tam iyileşme görüldü. Sadece botulinum toksini uygulanan grupta 107/143 (%74.8) hastada tam iyileşme görüldü. Botulinum toksin enjeksiyonuna ek topikal diltiazem pomad uygulanan grupta 54/74 (%73) hastada tam iyileşme görüldü (p= 0.328). Tam iyileşme oranları açısından iki grup arasında istatistiksel olarak anlamlı farklılık yoktu. Çalışmamızda 24/217 (%11.1) hasta tedaviye yanıt vermedi. Sadece botulinum toksini uygulanan grupta 18/143 (%12.6) hasta tedaviye yanıtsızdı. Botulinum toksini enjeksiyonuna ek topikal diltiazem pomad uygulanan grupta 6/74 (%8.1) hasta tedaviye yanıtsızdı (p=0.661). Tedaviye yanıtsızlık oranları her iki grup arasında benzerdi. Çalışmamızda 32/217 (%14.7) stada nüks görüldü. Sadece botulinum toksin uygulanan grupta 18/143 (%12.6) hastada nüks görüldü. Botulinum toksin enjeksiyonuna ek topikal diltiazem pomad uygulanan grupta 14/74 (%18.9) hastada nüks görüldü (p= 0.661). Nüks oranları açısından iki grup arasında istatistiksel olarak anlamlı farklılık bulunamadı. Çalışmamızda sadece botulinum toksini uygulanan grupta nükse kadar geçen ortalama süre 8.9±2.5 aydı. Botulinum toksini enjeksiyonuna ek topikal diltiazem pomad uygulanan grupta nükse kadar geçen ortalama süre 8.4±3.2 aydı (p= 0.661). Nükse kadar geçen süre gruplar arasında benzerdi. Çalışmamızda sadece botulinum toksini uygulanan grupta 4/143 (%2.8) hastada, botulinum toksini enjeksiyonuna ek topikal diltiazem pomad uygulanan grupta 2/74 (%2.7) hastada minör inkontinans görüldü ve geçici minör inkontinans oranları her iki grup arasında benzer oranlarda dağılmıştı. Sonuç: Kronik anal fissürde kombine botulinum toksin ve topikal diltiazem pomad tedavisi, botulinum toksin enjeksiyonu tedavisine üstün değildi. Her iki grupta da semptomatik tam iyileşme, tedaviye yanıtsızlık ve nüks oranları benzer olarak bulundu. Araştırmamızın sonucu olarak, kimyasal sfinkterotomiden potansiyel olarak fayda görebilecek kronik anal fissürlü hasta alt gruplarını belirlemek için uzun süreli takiplerle daha fazla hastayı içeren daha çok randomize kontrollü araştırmaya ihtiyaç olduğunu düşünmekteyiz.Aim: To investigate the effect of topical diltiazem ointment applied in addition to botulinum toxin injection in anal fissure on symptomatic relief and recurrence rates. Methods: The data of patients from two different groups were collected between October 2017 and February 2022. One group consisted of patients who were administered botulinum injection due to anal fissure and the other group of patients who were applied topical diltiazem in addition to botulinum toxin. Patients with a follow-up period of at least 18 months were included in the study. The patients were administered 100 IU botulinum toxin serotype A from 4 quadrants to the internal anal sphincter. Evaluation was made with an outpatient clinical control on the 3rd day, 10th day, and 2nd month after the procedure as well as by phone call at 6, 12 and 18 months. Complete regression of symptoms and epithelialization in the fissure was accepted as complete recovery at the 8th week post-application control. If a patient still complained of pain or bleeding at the 8th week follow-up period, it was considered unresponsive to treatment, regardless of the epithelialization of the fissure. Reappearance of symptoms after complete recovery was defined as recurrence. The effects of botulinum toxin and topical diltiazem application in addition to botulinum toxin on healing, recurrence, as well as unresponsiveness to treatment were compared. Results: In our study, the mean age was 34.5±10.6, 157/217 (72.4%) patients were women, and 60/217 (27.6%) patients were men. The mean follow-up time was 55.9±18.4 months, the minimum follow-up time was 19 months, and the maximum follow-up time was 242 months. Complete recovery was observed in a total of 161/217 (74.2%) patients in our study, of whom were 107/143 (74.8%) patients in the botulinum toxin-only group and 54/74 (73%) patients in the group that received topical diltiazem in addition to botulinum toxin injection (p= 0.328). There was no statistically significant difference between the two groups in terms of complete recovery rates. In our study, 24/217 (11.1%) patients did not respond to treatment. In the group who was applied only botulinum toxin, 18/143 (12.6%) patients were unresponsive to treatment. In the group that received topical diltiazem in addition to botulinum toxin injection, 6/74 (8.1%) patients were unresponsive to treatment (p=0.661). The rates of non-response to treatment were similar between both groups. In our study, recurrence was seen in 32/217 (14.7%) patients, of whom were 18/143 (12.6%) patients in the botulinum toxin-only group and 14/74 (18.9%) patients in the group that received topical diltiazem in addition to botulinum toxin injection (p= 0.661). There was no statistically significant difference between the two groups in terms of recurrence rates. In our study, the mean time to recurrence in the botulinum toxin group was 8.9±2.5 months. The mean time to recurrence in the group that received topical diltiazem in addition to botulinum toxin injection was 8.4±3.2 months (p= 0.661). There was no statistically significant difference between the groups in time of recurrence. In our study, minor incontinence was seen in 4/143 (2.8%) patients in the botulinum toxin-administered group, and in 2/74 (2.7%) patients in the group that received topical diltiazem in addition to botulinum toxin injection. Transient minor incontinence rates were similarly distributed between the two groups. Conclusion: Combined botulinum toxin and topical diltiazem therapy is not superior to botulinum injection therapy. Symptomatic complete recovery, unresponsiveness to treatment and recurrence rates were similar in both groups. We think that more randomized controlled trials involving more patients with long-term follow-up are needed to identify subgroups of patients with chronic anal fissures that could potentially benefit from chemical sphincterotomy

Investigation On The Structural Changes Of Al Doped Zno Thin Films With Gamma Transmission Technique

Tez (Yüksek Lisans) -- İstanbul Teknik Üniversitesi, Enerji Enstitüsü, 2010Thesis (M.Sc.) -- İstanbul Technical University, Energy Institute, 2010Bu Yüksek Lisans Tezinde, Gama Transmisyon Tekniği ile Cs-137 gama radyoizotop kaynağı kullanarak, Al katkılı ZnO ince filmlerin yapısındaki değişimlerin incelenmesi amaçlanmıştır. Günümüzde ince film teknolojisi endüstride; solar enerji panelleri başta olmak üzere çok geniş uygulama alanı bulmaktadır. İnce filmlerde optik geçirgenlik ve iletkenlik özellikleri kullanım alanlarını belirlemektedir. Bu amaçla, Sol-Gel tekniklerinden daldırarak kaplama yöntemi kullanılarak üretilmiş 29 farklı Al katkılı ZnO ince filmin, gama geçirgenliğini incelemek için deneyler yapılmıştır. Tek gama radyoizotop kaynağı ile çalışılmasındaki amaç, 0,662 MeV enerjili fotonlar yayınlayan Cs-137 kaynağı ile ZnO:Al ince filmlerin gama geçirgenliğini monokromatik olarak incelemektir. Gama transmisyon tekniğine uygun deney seti hazırlanmış, 29 farklı Al katkılı ZnO ince film için deneyler gerçekleştirilmiştir. Deneyler sonucunda bütün ince filmlerin gama geçirgenlik ve gama ışınları için soğurma katsayısı ? (1/mm), Al (at.%) konsantrasyonuna göre incelenmiştir. Deneylerden elde edilen sonuçlara göre, Al katkı oranlarının ve tavlama sıcaklığının artması veya tavlama atmosferinin değişmesi, ışınlanmamış ve 0.2 Gy'de Co-60 radyoizotopu ile ışınlanmış ince filmlerin gama geçirgenliklerde etkili olmuştur. Ayrıca ince filmlerin üretim aşamasında mekanik ve elektriksel özelliklerinin geliştirilmesi amaçlı bir radyasyon kaynağı ile ışınlanmaları durumunda gama geçirgenliği azalmaktadır.The aim of this study is to investigate the structural changes of Al doped ZnO thin films with gamma transmission technique, using Cs-137 gamma radioisotope. Thin film technology find today wide application areas in industry, mainly in solar energy panels. The optical transmittance and conductivity properties of thin films define areas of use. To investigate the gamma transmittance of 29 different Al doped ZnO thin films that produced by Sol-Gel dip method, experiments have been made. The purpose of working with Cs-137 gamma radioisotope source at 0,662 MeV is to observe the optical transmittance of Al doped ZnO thin films in monochromatic conditions. Experiment set was prepared according to gamma-transmission technique, and for 29 different Al doped ZnO thin films, experiments have been made. As the result of the experiments, gamma transmittance and gamma absorption coefficient, ?? (1/mm) were investigated via Al (at.%) concentration. The results obtained from experiments showed that increase of annealing temperature and Al doped rate or annealing atmosphere affected the gamma transmittance of unirradiated thin films and irradiated thin films at 0.2Gy by Co-60 radioisotope. In addition, the irradiation process to develop the mechanical and electrical properties of thin films also decreases the gamma transmittance as well.Yüksek LisansM.Sc