Showing papers by "Başkent University published in 2022"

Comparing Antibiotic Pastes with Electrospun Nanofibers as Modern Drug Delivery Systems for Regenerative Endodontics

Abstract: : Nanomaterials can be applied in different biomedical applications like diagnosis, treatment, and drug delivery due to their unique features. Using such materials in the endodontic treatment processes may prove challenging as these materials must exhibit antibacterial effects without posing any harm to the host cells. The approach involving nanofibers loaded with various antibacterial drugs offers a potential treatment method to enhance the elimination procedure of intracanal biofilms. Clinically, many models of bacterial biofilms were prepared under in vitro conditions for different aims. The process of drug delivery from polymeric nanofibers is based on the principle that the releasing ratio of drug molecules increases due to the increase in the surface area of the hosted structure. Our review discusses diverse approaches to loading/releasing drugs on/from nanofibers; we summarized many studies on electrospun nanofibers loaded with various drugs applied in the endodontic field. Moreover, we discussed both the advantages and the limitations of these modern endodontic treatment materials, comparing them with the traditional ones.

Immunogenicity after two doses of inactivated virus vaccine in healthcare workers with and without previous COVID-19 infection: Prospective observational study.

Abstract: Vaccines have been seen as the most important solution for ending the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study is to evaluate the antibody levels after inactivated virus vaccination. We included 148 healthcare workers (74 with prior COVID-19 infection and 74 with not). They received two doses of inactivated virus vaccine (CoronaVac). Serum samples were prospectively collected three times (Days 0, 28, 56). We measured SARS-CoV-2 IgGsp antibodies quantitatively and neutralizing antibodies. After the first dose, antibody responses did not develop in 64.8% of the participants without prior COVID-19 infection. All participants had developed antibody responses after the second dose. We observed that IgGsp antibody titers elicited by a single vaccine dose in participants with prior COVID-19 infection were higher than after two doses of vaccine in participants without prior infection (geometric mean titer: 898 and 607 AU/ml). IgGsp antibodies, participants with prior COVID-19 infection had higher antibody levels as geometric mean titers at all time points (p < 0.001). We also found a positive correlation between IgGsp antibody titers and neutralizing capacity (rs = 0.697, p < 0.001). Although people without prior COVID-19 infection should complete their vaccination protocol, the adequacy of a single dose of vaccine is still in question for individuals with prior COVID-19. New methods are needed to measure the duration of protection of vaccines and their effectiveness against variants as the world is vaccinated. We believe quantitative IgGsp values may reflect the neutralization capacity of some vaccines.

Determination of calreticulin using Fe3O4@AuNPs core-shell functionalized with PT(COOH)2 polymer modified electrode: A new platform for the impedimetric biosensing of cancer biomarkers

Abstract: An innovative biosensing design strategy was utilized for the first time to develop a label-free and practical immunosensor for ultrasensitive analysis of calreticulin (CRT), a potential biomarker of breast carcinoma. Unlike strategies used in literature, a conjugated polymer carrying carboxyl groups on its backbone was synthesized and utilized as an immobilization matrix. This immunosensor design strategy was composed of the attachment of anti-CRT antibodies onto iron oxide [email protected] [email protected](3-thiophenemalonic acid) polymer (Fe3O4@[email protected](COOH)2) functionalized indium tin oxide (ITO) electrode through carbodiimide coupling reaction. EIS measurement results illustrated significant changes in charge transfer resistance (Rct) on immunoreaction between anti-CRT and CRT proteins. The proposed immunosensor enabled the detection of CRT over the range of 0.02 pg/mL and 100 pg/mL with a correlation coefficient of 0.9994 under optimal conditions. The detection limit (LOD), the quantification limit (LOQ) and the sensitivity were also determined to be 8.2 fg/mL, 27.4 fg/mL and 270 kΩ fg mL−1cm2, respectively. Furthermore, it also exhibited good repeatability, excellent reproducibility, long storage stability and reusability. Experimental results analyzed with T-test to compare the means of the repeatability and reproducibility data, and F-test to the distribution of the repeatability and reproducibility data. According to T and F-tests, the experimental results achieved from the studies with the suggested immunosensor were relatively satisfactory. Furthermore, this immunosensor was tested to measure CRT levels in human serum and spiked human serum samples, and acceptable recovery rates ranging from 94.05% to 106.62% were obtained. In sum, considering its fast and easy-to-fabricate properties, this new strategy offers a potential tool for CRT biomarker detection.

The Role of Standardized Patient Programs in Promoting Equity, Diversity, and Inclusion: A Narrative Review

Abstract: Purpose Integrating equity, diversity, and inclusion (EDI) in curricula for training health professionals is a frequent institutional goal. The use of standardized (or simulated) patient programs (SPPs) to support EDI in health sciences training is not well described. Here the authors present a theoretical model based on a synthesis of the literature for using SPPs in EDI training, along with a narrative review of the available literature. Method The authors searched PubMed, Scopus, Science Direct, and Google Scholar databases for studies published between January 2000 and October 2019 describing the use of SPPs to support EDI in health sciences education. Studies were included if they described standardized patient (SP) education involving EDI and reported empiric data about its design, delivery, or effectiveness. The authors conducted a narrative review and provided a synthesis of the available literature, identifying key themes. Results Out of 117 studies identified, 17 met the inclusion criteria. Most studies (53%; n = 9) focused on cultural competence; many focused on communication with diverse patients (29%; n = 5) or health inequity (18%; n = 3). Studies employed portrayal of diversity (71%; n = 12) or learning objectives supported by diversity (29%; n = 5) as approaches to EDI relevant to SP training. Three primary themes emerged: improving cultural competence, effective communication with diverse patients, and highlighting health inequalities. Conclusions This review outlines approaches to EDI-based SPPs, with the perspectives and priorities of institutional approaches in mind. SP education around specific EDI issues is reported; however, programmatic approaches to EDI by SPPs are lacking. More research is needed to provide further evidence for the challenges, effectiveness, and outcomes of developing and implementing EDI-based SPPs in health sciences education.

Hemoglobin‐to‐platelet ratio in predicting the incidence of trismus after concurrent chemoradiotherapy

Abstract: The significance of pre-hemoglobin-to-platelet ratio (HPR) in predicting the occurrence of radiation-induced trismus (RIT) in locally advanced nasopharyngeal carcinoma patients (LA-NPC) who received concurrent chemoradiotherapy (C-CRT).The records of LA-NPC patients with oral examination before and after C-CRT were analyzed. Maximum mouth openings (MMO) were measured before and after C-CRT to confirm RIT status, with an MMO of ≤35 mm defined as RIT. HPR values were calculated on the first day of C-CRT. The relationship between the HPR values and RIT status was discovered using the receiver operating characteristic curve analysis.A total of 43 patients RIT cases among 198 individuals were diagnosed. The optimal HPR cutoff that stratified the patients into two groups was 0.54. RIT incidence was found to be significantly higher in the HPR ≤0.54 group than its HPR >0.54 counterpart(p < 0.001). Univariately T3-4 stage, mean masticator apparatus dose>57.2Gy, and pre-C-CRT MMO ≤40.7 mm were found as the other significant correlates of increased RIT rates(p < 0.05). All four variables seemed to be independently connected to greater RIT incidence in multivariate analysis (p < 0.05, for each).The risk of post-C-CRT RIT may be significantly increased when pre-treatment HPR levels are low.

Optical coherence tomography angiography (OCTA) in differential diagnosis of aquaporin-4 antibody seronegative NMOSD and multiple sclerosis

Abstract: Optic neuritis(ON) is a common feature of both relapsing-remitting multiple sclerosis(RRMS) and neuromyelitis optica spectrum disorders(NMOSD). It is crucial to early differentiate these two diseases, as they differ in pathophysiology and treatment.To compare NMOSD and RRMS patients using optical coherence tomography(OCT) and OCT angiography(OCTA) to assess retinal microvascular network differences.Fourteen RRMS (28 eyes) and 9 NMOSD patients(18 eyes), and 11 controls were enrolled. Seropositivity for aquaporin-4 antibody (anti-AQP4 Abs) was 44.4%. Peripapillary and macular retinal nerve fiber layer(RNFL) thickness, superficial peripapillary and macular vessel density(VD), area, perimeter and circularity of foveal avascular zone(FAZ) were analyzed.OCTA showed reduction in peripapillary and macular VD and FAZ size in NMOSD+ON compared to RRMS+ON and controls (p = 0.001, p<0.001 and p = 0.010, p<0.001 respectively). Peripapillary VD was similar in RRMS +ON and controls. Peripapillary VD in monophasic seronegative NMOSD+ON eyes was significantly lower than monophasic RRMS+ON eyes (p = 0.030), which was no different from controls. FAZ area was smaller in unaffected eyes in NMOSD than RRMS and controls.Both OCT and OCTA revealed considerable differences between RRMS and NMOSD patients, providing promising results in favor of clinical utility of OCTA in differential diagnosis of ON, particularly in anti-AQP4 antibody negative patients. OCTA might be a useful biomarker in differentiating NMOSD from MS.

Risk factors and frequency of acute and permanent femoral arterial occlusion in neonates with CHD who undergo ultrasound-guided femoral arterial access

Abstract: Abstract Objective: We investigated frequency and risk factors of acute loss of the arterial pulse and permanent femoral arterial occlusion in neonates with CHD who underwent ultrasound-guided femoral arterial access. Methods: We divided the patients into groups according to the presence of acute loss of the arterial pulse and permanent femoral arterial occlusion. We obtained data related to patient characteristics and access variables of ultrasound-guided femoral arterial access from our database of cardiac catheterisation between August, 2017 and May, 2021. We used an echocardiography-S6, 12-MHz linear probe, 21-gauge needle, 0.018"guidewire, and a 4F sheath for arterial access. Results: Ultrasound-guided femoral arterial access was obtained in 323 (98.8%) of the 327 neonates. We identified acute loss of the arterial pulse in 130 (40.2%) patients and permanent femoral arterial occlusion in 19 (5.9%) patients. Median weight was 3.05 (Interquartile range (IQR): 2.80–3.40) kg, first attempt success rate was 88.2%, and median access time was 46 sec (IQR: 23–94). Logistic regression analysis identified coarctation of the aorta (odds ratio: 2.46; 95% CI: 1.30–4.66; p = 0.006) as independent risk factor for acute loss of the arterial pulse, but did not identify any independent risk factors for permanent femoral arterial occlusion. Conclusions: This study showed coarctation of the aorta as an independent risk factor for acute loss of the arterial pulse, but did not identify any independent factors for permanent femoral arterial occlusion in neonates with CHD. Although most cases of acute loss of the arterial pulse resolve in the early period, the frequency of permanent femoral arterial occlusion remains high despite effective treatment.

Adım Adım Doğu Türkistan Sir Marc Aurel Stein (1862-1943), Hayatı ve Eserleri

Abstract: Keşif seferleri, 17-20. yüzyıllarda dünyanın sömürgeleştirme üzerine kurulan yeni düzenine destek veren, veri altyapısını sağlayan, alanında uzman bir ekibin gerçekleştirdiği uzun soluklu araştırma gezileridir. Etkin güç olma yarışında önde kalmayı hedefleyen ülkelerin finansal destek sağladığı bu gezilerde, arkeolojik kazı çalışmaları, demografik incelemeler, filoloji araştırmaları, maden taramaları, fiziki harita çıkarma, su haritası oluşturma gibi farklı alanlarda eş zamanlı araştırmalar yürütülmüştür. Sir Marc Aurel Stein, 20. yüzyılın ilk yarısında Türkistan coğrafyasında gerçekleştirilen keşif seferlerinin önde gelen ismidir. 1862 yılında Budapeşte’de dünyaya gelmiş ve Avrupa’nın farklı kurumlarında eğitim görmüştür. Hindistan’da çalışmaya başlamasıyla, küçük çaplı seferlerini ortaya koymuştur. 1900-1901 yıllarında birinci keşif seferini, 1906-1908 yıllarında ikinci keşif seferini ve 1913-1916 yıllarında üçüncü büyük keşif seferini Türkistan coğrafyasında gerçekleştirmiş, çok sayıda buluntu ve yazma eseri İngiltere ve Hindistan arşivlerine taşımıştır. Bunların yanı sıra Orta Doğu coğrafyasında orta ve küçük ölçekli, karadan ve havadan keşif gezileri ortaya koymuştur. Her birinin raporlarını kitap ve makale şeklinde kaleme almıştır. Bununla birlikte çok sayıda fotoğraflarından ve detaylı günlüklerinden de araştırmaları incelenebilmektedir. Kadim Türk tarihinin izlerini sürebildiğimiz Türkistan coğrafyasından edinilen bu eserlere, günümüz Türkoloji çalışmalarında başvurulmakta, Türk tarihi ve kültürüne ışık tutmaktadır. Çalışmamızda, Stein’ın hayatı temel alınarak, seferlerine, eserlerine ve diğer çalışmalarına değinilecek, bunlardan hem kendi çağının araştırmalarında hem de kadim dönemlerin incelemelerinde nasıl faydalanılacağı hususunda değerlendirmelerde bulunulacaktır.

The Effect of the 3‐D Structure on Strain Accumulation and the Interseismic Behavior Along the North Anatolian Fault in the Sea of Marmara

Abstract: The 150-km seismic gap in the Sea of Marmara is the longest section of the North Anatolian Fault that has not ruptured in the last century. Recent geodetic studies suggest that the interseismic coupling along the Main Marmara Fault (MMF) is heterogeneous with locked and creeping segments. Alternatively, the MMF is fully locked, but the strain is localized asymmetrically around the fault due to the deep basins. In this study, we build a 3-D model of the region, including the basins and the 3-D fault geometry, to study the competing effects of deep basins and the interseismic locking distribution using the observed Global Navigation Satellite System velocities. We conclude that the basins along the fault localize the interseismic strain, leading to slightly deeper-estimated locking depths. The on-land data are too far to constrain the full interseismic coupling, especially in the Central Marmara. The Western Marmara is better resolved, where we infer a ∼50-km creeping zone. The transition from the creeping to the locked behavior in Western Marmara is around the Ganos Bend. The creeping zone correlates well with a higher rate of diffuse seismicity and repeating earthquakes, implying that the seismicity could be an indicator of interseismic behavior. Variations of earthquake focal mechanisms and associated regional stresses are also consistent with compressional and dilatational quadrants due to the creeping segment. The significant thrust components observed in the 2019 Silivri earthquake sequence north of the MMF can also be explained by the compressional loading due to the interseismic creep further west.

A Case of Priapism in a Child With Autism Spectrum Disorder, Possibly Due to Risperidone Treatment With Addition of Atomoxetine

Abstract: In Brief Objectives Risperidone is an effective drug used for the treatment of irritability in children with autism spectrum disorder (ASD). Atomoxetine (ATX) is a well-tolerated drug used in first-line therapy in children with attention-deficit/hyperactivity disorder (ADHD). However, uncommon adverse effects of risperidone and ATX are a concern among mental health professionals. To our knowledge, this is the first case report of priapism after addition of ATX upon existing treatment with risperidone. Methods Written informed consent for publication was obtained from the patient and his parents, and their identities were concealed for ethical reasons. Results Here, we report a case of priapism as an adverse effect of ATX and risperidone treatment in a 7-year-old boy with ASD and comorbid ADHD. In this case, priapism was not observed with risperidone until ATX was added. Conclusions Priapism is a condition viewed as a medical emergency. Although risperidone-induced priapism is a rare phenomenon, it is advised for clinicians to consider the drug interactions in treatment of ASD and ADHD in terms of early diagnosis and intervention. The patient and his parents gave written consent for the use of patient information for publication.

A Genetic Algorithm for the Redundancy Allocation Problem with Repairable Components

Abstract: The complexity of the structures of modern engineering systems in the communication and electronic fields, the demand for high reliable system evaluation methods has increased. While improving the system’s reliability, the cost is also on the upswing. Redundancy allocation is important approach for designing telecommunication systems. The reliability is increased by increasing number of redundant components in a system. The Redundancy Allocation Problem (RAP) is the design of new systems with higher reliability using redundant components in parallel arrangement. This paper presents a genetic algorithm (GA) with discrete event simulation (DES) to solve RAP with repairable components. The promising proposed approach is illustrated and investigated by some RAP benchmark/test problems involving repairable systems.

Living Kidney Donation Criteria of Baskent University

Abstract: Kidney transplant is the best treatment for patients with end-stage renal disease. Preparation of living related kidney donors and recipients is the major step to achieve their best long-term outcomes. Here, we present the Baskent University criteria for living kidney donors and recipients.The Baskent team has performed >2000 kidney transplants from 1985 to 2022 under leadership of Prof. Mehmet Haberal, a transplantation pioneer in Turkey, who facilitated Turkish legislation on procurement, storage, engraftment, and transplant of organs and tissues in June 1979, which has been adopted in other countries with few changes. Although the main frame is similar, we have constant principles in kidney donation. Baskent University is now known as an exceptional transplant center in Turkey, the Middle East, Europe, and the world and has established its own donor criteria for both kidney and liver transplant.Volunteerism remains a core principle of living kidney donation, regardless of other criteria. At Baskent University, donor protection from social, psychological, and health problems is paramount. Loss-profit and risk of transplant are assessed for every case. Donors must be followed up and remedies sought for failed criteria. Dr. Haberal's principles are the basis of Baskent University donation criteria, and unrelated kidney transplant donors are accepted only in cases of cross-donation. Major distinctions of Baskent University's living related donor criteria are (1) absence of unrelated or nondirected donation, (2) lowest acceptable donor glomerular filtration rate of 100 mL/min, (3) rejection of hypertensive donor candidates (regardless of medication), and (4) obesity must be corrected before transplant if body mass index (measured as body weight in kilograms divided by height in meters squared) is >30.The Baskent University donor selection criteria provide excellent long-term outcomes of kidney donors that have been proved by our recent studies.

Bone Only Oligometastatic Renal Cell Carcinoma Patients Treated with Stereotactic Body Radiotherapy: A MULTI-Institutional Study

Abstract:

Purpose/Objective(s)

Previous studies demonstrated the efficacy of stereotactic-body radiotherapy (SBRT) for oligometastatic renal cell carcinoma (RCC) patients. However, it has not been well-studied in patients with bone-only metastatic RCC. This study aimed to analyze the prognostic factors associated with overall survival (OS) and progression-free survival (PFS) in patients with bone-only metastatic RCC who have five or fewer lesions treated with SBRT.

Materials/Methods

The clinical data of 54 patients with 70 bone metastases undergoing SBRT treated between 2013 and 2020 with a fraction dose of at least 6 Gy per fraction, and a biologically effective dose (BED) of at least 90 Gy was retrospectively evaluated. The prognostic factors associated with OS and PFS were assessed.

Results

The majority of lesions were located in the spine (57.4%), and had only one metastasis (64.8%). The median SBRT fraction and total doses were 10 Gy (range: 6–18 Gy) and 20 Gy (range: 12–40 Gy), and SBRT was administered with a median fraction of 3 (range, 1–5). The median BED of SBRT was 108.4 Gy (range: 90.0–202.2 Gy). After a median follow-up of 22.4 months, the 1- and 2-year OS rates were 84.6% and 67.3%, respectively, and median OS was 43.1 months. The 1- and 2-year PFS rate, and median PFS were 63.0%, 38.9%, and 15.3 months, respectively. After completion of metastasis-directed treatment (MDT), disease progression occurred in 26 patients (48.1%) at a median of 12.7 months (IQR 7.1–29.9 months). There were 22 (84.6%) with distant metastasis, one (3.8%) with in-field local recurrence, and three (11.6%) with both distant metastasis and local recurrence. In SBRT-treated lesions, only 4 patients (7.4%) experienced local recurrence, and the 1- and 2-year LC rates per lesion were 94.9% and 92.0% per lesion. Age, metastasis localization, and number of fractions for SBRT were significant prognostic factors for OS in univariate analysis. In multivariate analysis, patients with spine metastasis had a better OS [HR=3.1 (95% CI, 1.3–7.7; p = 0.001)] compared to their counterparts, and patients who received single fraction SBRT [HR=2.2 (95%, 1.2–4.2; p = 0.01)] had a better PFS than those who did not. No patient experienced acute or late toxicities of grade 3 or greater.

Conclusion

To the best of our knowledge, this is the first multicenter study of bone-only oligometastatic RCC patients treated with SBRT. Despite excellent LC at the oligometastatic site treated with SBRT, disease progression was observed in nearly half of patients 13 months after MDT, particularly as distant disease progression other than treated lesion, necessitating an effective systemic treatment to improve treatment outcomes. Prospective trials of SBRT for oligometastatic bone sites are warranted because they may shed light on disease control, survival, and quality of life after such therapy.

Traveling Repairmen Problem: A Biogeography-Based Optimization

Abstract: Traveling Repairman Problem (TRP), which is also known by names cumulative traveling salesman problem, the deliveryman problem and the minimum latency problem, is a special variant of Traveling Salesman Problem (TSP). In contrast to the minimization of completion time objective of TSP, the desired objective of TRP is to minimize the cumulative latency (waiting time or delay time) of all customers. In this paper, a generalized version of TRP with multi depots and time windows, namely Multi Depot Traveling Repairman Problem with Time Windows (MDTRPTW) is considered. A group of homogeneous repairmen initiate and finish their visit tours at multiple depots. Each customer must be visited exactly by one repairman within their provided earliest end latest times. Being a challenging Nondeterministic Polynomial-hard (NP-hard) optimization problem, exact solution approaches are not expected to scale to realistic dimensions of MDTRPTW. Thus, we propose a biogeography-based optimization algorithm (BBOA) as a metaheuristic approach to solve large size MDTRPTW problems. The proposed metaheuristic is analyzed in terms of solution quality, coefficient of variation as well as computation time by solving some test problems adapted from the related literature. The efficacy of the proposed solution methodology is demonstrated by solving instances with 288 customers within seconds.

Historical Background of Pediatric Kidney and Liver Transplantation in Turkey

Abstract: The cornerstone events of kidney and liver transplant history in Turkey are summarized herein. In 1975, we performed the first pediatric living-related renal transplant in Turkey. We followed this in 1978 with the first deceased donor kidney transplant, using an organ supplied by Eurotransplant. In 1979 the law on harvesting, storage, grafting, and transplant of organs and tissues was enacted; the first local deceased donor kidney transplant was performed by our team in 1979. In 1988, another ground-breaking event in Turkey, the Middle East, and North Africa was successfully achieved: the first successful deceased-donor liver transplant, and in 1990, the first pediatric living-related segmental liver transplant in Turkey, the region and Europe was performed by our team. One month later, an adult-to-adult living-related liver transplant (left lobe) in the World was successfully performed. On May 16, 1992, we performed the first combined liver-kidney transplant from a living-related donor, which was the first operation of its kind in the World. Between November 1975 and January 2022, we have performed 3288 kidney (380 pediatric) at the Hacettepe University Hospitals and later on at Baskent University; since 1988, 701 (334 pediatric) liver transplants have been performed. In over 40 years of kidney and liver transplants history in Turkey, 46876 kidney (2502 pediatric patients) and 18203 liver (2612 pediatric patients) transplants have been performed nationwide. In 2001, the Ministry of Health established the National Coordination Center as an umbrella organization to promote transplant activities, especially for deceased donor organ procurement. Transplant activities are accelerating daily throughout the country, but deceased donors are still far below the desired rates.

The Digital Transformation of Higher Education

Abstract: The improvements in digital technologies have changed societies in many ways. This process is commonly called “digital transformation.” Many sectors have been affected by digital transformation, including higher education institutions. Also, the COVID-19 pandemic, which started in 2019 in China, triggered the use of digital technologies in everyday activities and at every level of education. This chapter primarily presents the process of digital transformation in higher education by giving examples from various countries based on recent research, providing challenges of digital transformation of higher education, and then examining the challenges and reflections of the COVID-19 pandemic on the digital transformation of higher education. Lastly, the current situation is evaluated, and suggestions are proposed.