Erzincan Binali Yıldırım University

Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in the emergency departments worldwide. The cornerstones of effective treatment of IAIs are early recognition, adequate source control, and appropriate antimicrobial therapy. Prompt resuscitation of patients with ongoing sepsis is of utmost important. In hospitals worldwide, non-acceptance of, or lack of access to, accessible evidence-based practices and guidelines result in overall poorer outcome of patients suffering IAIs. The aim of this paper is to promote global standards of care in IAIs and update the 2013 WSES guidelines for management of intra-abdominal infections.

PURPOSE: Acute myocardial infarction (AMI) is the most common cause of death in the world. Comprehensive risk assessment of patients presenting with chest pain and eliminating undesirable results should decrease morbidity and mortality rates, increase the quality of life of patients, and decrease health expenditure in many countries. In this study, the advantages and disadvantages of the enzymatic and nonenzymatic biomarkers used in the diagnosis of patients with AMI are given in historical sequence, and some candidate biomarkers - hFABP, GPBB, S100, PAPP-A, RP, TNF, IL6, IL18, CD40 ligand, MPO, MMP9, cell-adhesion molecules, oxidized LDL, glutathione, homocysteine, fibrinogen, and D-dimer procalcitonin - with a possible role in the diagnosis of AMI are discussed. METHODS: The present study was carried out using meta-analyses, reviews of clinical trials, evidence-based medicine, and guidelines indexed in PubMed and Web of Science. RESULTS: These numerous AMI biomarkers guide clinical applications (diagnostic methods, risk stratification, and treatment). Today, however, TnI remains the gold standard for the diagnosis of AMI. Details in the text will be given of many biomarkers for the diagnosis of AMI. CONCLUSION: We evaluated the advantages and disadvantages of routine enzymatic and nonenzymatic biomarkers and the literature evidence of other candidate biomarkers in the diagnosis of AMI, and discuss challenges and constraints that limit translational use from bench to bedside.

Acute colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in the acute setting. An international multidisciplinary panel of experts from the World Society of Emergency Surgery (WSES) updated its guidelines for management of acute left-sided colonic diverticulitis (ALCD) according to the most recent available literature. The update includes recent changes introduced in the management of ALCD. The new update has been further integrated with advances in acute right-sided colonic diverticulitis (ARCD) that is more common than ALCD in select regions of the world.

Neutrophil-to-lymphocyte ratio (NLR) was introduced as a potential marker to determine inflammation in end-stage renal disease (ESRD) patients. Recently, platelet-to-lymphocyte ratio (PLR) and NLR were found to positively correlated with inflammatory markers including tumor necrosis factor-α (TNF-α) and interleukin (IL)-6 in cardiac and noncardiac patients. Data regarding PLR and its association with inflammation are lacking in hemodialysis (HD) and peritoneal dialysis (PD) patients. Hence, we aimed to determine the relationship between PLR, NLR, and inflammation in ESRD patients. This was a cross-sectional study involving 62 ESRD patients (29 females, 33 males; mean age, 49.6 ± 14.6 years) receiving PD or HD for ≥6 months in the Dialysis Unit of Necmettin Erbakan University. PLR, NLR, C-reactive protein, TNF-α, IL-6 levels were measured. PLR, NLR, serum high sensitive C-reactive protein, IL-6, and TNF-α levels were significantly higher in PD patients when compared with HD patients. ESRD patients with PLR ≥ 140 had significantly higher NLR, IL-6, and TNF-α levels when compared to patients with PLR < 139. In the bivariate correlation analysis, PLR was positively correlated with NLR, IL-6, and TNF-α in this population. When we compared the association of PLR and NLR with IL-6 (r = 0.371, P = 0.003 vs. r = 0.263, P = 0.04, respectively) and TNF-α (r = 0.334, P = 0.008 vs. r = 0.273, P = 0.032, respectively), PLR was found to be superior to NLR in terms of inflammation in ESRD patients. Simple calculation of PLR can predict inflammation better than NLR in ESRD patients.

Abstract The measurement of the luminosity recorded by the CMS detector installed at LHC interaction point 5, using proton–proton collisions at $$\sqrt{s}=13\,{\text {TeV}} $$ <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow> <mml:msqrt> <mml:mi>s</mml:mi> </mml:msqrt> <mml:mo>=</mml:mo> <mml:mn>13</mml:mn> <mml:mspace/> <mml:mtext>TeV</mml:mtext> </mml:mrow> </mml:math> in 2015 and 2016, is reported. The absolute luminosity scale is measured for individual bunch crossings using beam-separation scans (the van der Meer method), with a relative precision of 1.3 and 1.0% in 2015 and 2016, respectively. The dominant sources of uncertainty are related to residual differences between the measured beam positions and the ones provided by the operational settings of the LHC magnets, the factorizability of the proton bunch spatial density functions in the coordinates transverse to the beam direction, and the modeling of the effect of electromagnetic interactions among protons in the colliding bunches. When applying the van der Meer calibration to the entire run periods, the integrated luminosities when CMS was fully operational are 2.27 and 36.3 $$\,\text {fb}^{-1}$$ <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow> <mml:mspace/> <mml:msup> <mml:mtext>fb</mml:mtext> <mml:mrow> <mml:mo>-</mml:mo> <mml:mn>1</mml:mn> </mml:mrow> </mml:msup> </mml:mrow> </mml:math> in 2015 and 2016, with a relative precision of 1.6 and 1.2%, respectively. These are among the most precise luminosity measurements at bunched-beam hadron colliders.

BACKGROUND: Reconstructive breast surgeons often prefer autologous tissue for those patients who can tolerate it. However, reconstruction with implants is technically easier, quicker, less traumatic, and less costly. Nevertheless, inherent problems associated with implants present some limitations to their use in reconstruction. In this study, a multipurpose application of allogenic dermal grafts to solve the problems seen in immediate breast reconstruction with implants was examined. METHODS: After skin-sparing mastectomy, a subpectoral pocket is created for the implant. After the origins of the pectoralis major muscle are released, AlloDerm is sewn to the lower pole of the released muscle. Grafts are tailored according to the dimensions of the defect. AlloDerm, an allogenic dermal graft, is fixed to the pectoralis major superiorly, to the chest wall inferiorly and inferomedially, and to the serratus anterior flap laterally. A postoperative adjustable implant is placed into the pocket that has bene created. RESULT: Allografts were used to reconstruct 30 breasts in 24 patients immediately after skin- or nipple-sparing mastectomy. There was no complication related to simultaneous allograft application. No rippling, symmastia, or bottoming-out deformity was seen. CONCLUSIONS: Breast reconstruction with implant and AlloDerm enables the surgeon to create a submuscular pocket large enough to place a fully inflated breast implant. Interposition of a lower-pole internal sling, to increase the capacity of the pectoralis major pocket while providing immediate ability to achieve full or subtotal prosthetic fill and optimal aesthetic breast contouring and to maintain thicker muscle coverage in the upper and medial pole areas and stronger lower pole support, would obviate many of the current disadvantages to implant reconstruction.

Background: Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments. Methods: This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016-September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study. Results: A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%. Conclusions: The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low.

Abstract Measurements from the CMS experiment at the LHC of dihadron correlations for charged particles produced in PbPb collisions at a nucleon–nucleon centre-of-mass energy of 2.76 TeV are presented. The results are reported as a function of the particle transverse momenta ( p T ) and collision centrality over a broad range in relative pseudorapidity (Δ η ) and the full range of relative azimuthal angle (Δ ϕ ). The observed two-dimensional correlation structure in Δ η and Δ ϕ is characterised by a narrow peak at (Δ η ,Δ ϕ )≈(0,0) from jet-like correlations and a long-range structure that persists up to at least |Δ η |=4. An enhancement of the magnitude of the short-range jet peak is observed with increasing centrality, especially for particles of p T around 1–2 GeV/ c . The long-range azimuthal dihadron correlations are extensively studied using a Fourier decomposition analysis. The extracted Fourier coefficients are found to factorise into a product of single-particle azimuthal anisotropies up to p T ≈3–3.5 GeV/ c for at least one particle from each pair, except for the second-order harmonics in the most central PbPb events. Various orders of the single-particle azimuthal anisotropy harmonics are extracted for associated particle p T of 1–3 GeV/ c , as a function of the trigger particle p T up to 20 GeV/ c and over the full centrality range.

This study’s aim is to examine the relationship among job satisfaction, organizational commitment, and turnoverintention of employees. A model of job satisfaction, organizational commitment, and turnover intention isdeveloped and tested in one field study. In this study, using a 250 employees of a Turkish manufacturingcompany, were given questionnaires to complete during regular working hours; 188 completed questionnaireswere returned.. Job satisfaction, organizational commitment, and turnover intention are popular topics in thestudy of work related attitudes. The main objective of this article is to test the relationships among jobsatisfaction, organizational commitment and turnover intention. Structural equation modeling to test researchhypotheses is used and the model that has high reliability and validity is developed. The results indicate that jobsatisfaction is one of the most antecedents of organizational commitment and turnover intention and suggest thathigh levels of job satisfaction results in higher commitment and lower turnover intention so job satisfactionpositively influences on affective commitment, continuance commitment, and normative commitment while it isnegatively impact on turnover intention. The results emphasize the need to consider the factors can be havingeffects on the relationship by highlighting to studies conducted on job satisfaction, organizational commitment,and turnover intention.

There is no doubt that the revolutionary concept of the blockchain, which is the underlying technology behind the famous cryptocurrency Bitcoin and its successors, is triggering the start of a new era in the Internet and the online services. While most people focus only at cryptocurrencies; in fact, many administrative operations, fintech procedures, and everyday services that can only be done offline and/or in person, can now safely be moved to the Internet as online services. What makes it a powerful tool for digitalizing everyday services is the introduction of smart contracts, as in the Ethereum platform. Smart contracts are meaningful pieces of codes, to be integrated in the blockchain and executed as scheduled in every step of blockchain updates. E-voting on the other hand, is another trending, yet critical, topic related to the online services. The blockchain with the smart contracts, emerges as a good candidate to use in developments of safer, cheaper, more secure, more transparent, and easier-to-use e-voting systems. Ethereum and its network is one of the most suitable ones, due to its consistency, widespread use, and provision of smart contracts logic. An e-voting system must be secure, as it should not allow duplicated votes and be fully transparent, while protecting the privacy of the attendees. In this work, we have implemented and tested a sample e-voting application as a smart contract for the Ethereum network using the Ethereum wallets and the Solidity language. Android platform is also considered to allow voting for people who do not have an Ethereum wallet. After an election is held, eventually, the Ethereum blockchain will hold the records of ballots and votes. Users can submit their votes via an Android device or directly from their Ethereum wallets, and these transaction requests are handled with the consensus of every single Ethereum node. This consensus creates a transparent environment for e-voting. In addition to a broad discussion about reliability and efficiency of the blockchain-based e-voting systems, our application and its test results are presented in this paper, too.

Bu çalışmanın amacı kapsam geçerlik oranları ve kapsam geçerlik indeksi tanıtılarak kapsam geçerlik çalışmalarının ne şekilde yapılabileceği ile ilgili çalışmacılara bir yol haritası sunmaktır. Yol haritası, örnek bir çalışma üzerinden, Lawshe (1975) tarafında geliştirilen teknik ile Ayre ve Scally (2014) tarafından belirtilen ölçütler dikkate alınarak verilmiştir. Örnek çalışmaya 26 uzman katılmıştır. Veri toplama aracı olarak 66 maddenin sorgulandığı “Uzman Formu” kullanılmıştır.

Acute left sided colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in acute setting. A World Society of Emergency Surgery (WSES) Consensus Conference on acute diverticulitis was held during the 3rd World Congress of the WSES in Jerusalem, Israel, on July 7th, 2015. During this consensus conference the guidelines for the management of acute left sided colonic diverticulitis in the emergency setting were presented and discussed. This document represents the executive summary of the final guidelines approved by the consensus conference.

BACKGROUND: To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression. METHODS: The WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (range 18-99) were enrolled in the WISS study. RESULTS: Univariate analysis has shown that all factors that were previously included in the WSES Sepsis Severity Score were highly statistically significant between those who died and those who survived (p < 0.0001). The multivariate logistic regression model was highly significant (p < 0.0001, R2 = 0.54) and showed that all these factors were independent in predicting mortality of sepsis. Receiver Operator Curve has shown that the WSES Severity Sepsis Score had an excellent prediction for mortality. A score above 5.5 was the best predictor of mortality having a sensitivity of 89.2 %, a specificity of 83.5 % and a positive likelihood ratio of 5.4. CONCLUSIONS: WSES Sepsis Severity Score for patients with complicated Intra-abdominal infections can be used on global level. It has shown high sensitivity, specificity, and likelihood ratio that may help us in making clinical decisions.

Monodisperse Ni/Pd core/shell nanoparticles (NPs) have been synthesized by sequential reduction of nickel(II) acetate and palladium(II) bromide in oleylamine (OAm) and trioctylphosphine (TOP). The Ni/Pd NPs have a narrow size distribution with a mean particle size of 10 nm and a standard deviation of 5% with respect to the particle diameter. Mechanistic studies showed that the presence of TOP was essential to control the reductive decomposition of Ni-TOP and Pd-TOP, and the formation of Ni/Pd core/shell NPs. Using the current synthetic protocol, the composition of the Ni/Pd within the core/shell structure can be readily tuned by simply controlling the initial molar ratio of the Ni and Pd salts. The as-synthesized Ni/Pd core/shell NPs were supported on graphene (G) and used as catalyst in Suzuki-Miyaura cross-coupling reactions. Among three different kinds of Ni/Pd NPs tested, the Ni/Pd (Ni/Pd = 3/2) NPs were found to be the most active catalyst for the Suzuki-Miyaura cross-coupling of arylboronic acids with aryl iodides, bromides and even chlorides in a dimethylformamide/water mixture by using K2CO3 as a base at 110 °C. The G-Ni/Pd was also stable and reusable, providing 98% conversion after the 5th catalytic run without showing any noticeable Ni/Pd composition change. The G-Ni/Pd structure reported in this paper combines both the efficiency of a homogeneous catalyst and the durability of a heterogeneous catalyst, and is promising catalyst candidate for various Pd-based catalytic applications.

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.

In this paper, we introduce and investigate an interesting subclass N?h,p (?, ?) of analytic and bi-univalent functions in the open unit disk U. For functions belonging to the class N?h,p (?, ?), we obtain estimates on the first two Taylor-Maclaurin coefficients |a2| and |a3|. The results presented in this paper would generalize and improve some recent works of ?a?lar et al. [3], Xu et al. [10], and other authors.

The aim of this study is to determine whether perceived social support is a meaningful predictor of subjective well-being. 87 students registered to primary classroom teacher training department joined to this survey. In the phase of data collection, “Subjective Well-Being Scale” and “Multi-Dimensional Perceived Social Support Scale” were used. It was discovered that perceived social support predicted 43 per cent of subjective well-being. In addition to this, it was determined that perceived family support predicted subjective well-being, and on the other hand the support which was perceived towards a special person and perceived friend support did not predicted subjective well-being.

BACKGROUND: In oldest-old patients (>80), few trials showed efficacy of treating hypertension and they included mostly the healthiest elderly. The resulting lack of knowledge has led to inconsistent guidelines, mainly based on systolic blood pressure (SBP), cardiovascular disease (CVD) but not on frailty despite the high prevalence in oldest-old. This may lead to variation how General Practitioners (GPs) treat hypertension. Our aim was to investigate treatment variation of GPs in oldest-olds across countries and to identify the role of frailty in that decision. METHODS: Using a survey, we compared treatment decisions in cases of oldest-old varying in SBP, CVD, and frailty. GPs were asked if they would start antihypertensive treatment in each case. In 2016, we invited GPs in Europe, Brazil, Israel, and New Zealand. We compared the percentage of cases that would be treated per countries. A logistic mixed-effects model was used to derive odds ratio (OR) for frailty with 95% confidence intervals (CI), adjusted for SBP, CVD, and GP characteristics (sex, location and prevalence of oldest-old per GP office, and years of experience). The mixed-effects model was used to account for the multiple assessments per GP. RESULTS: The 29 countries yielded 2543 participating GPs: 52% were female, 51% located in a city, 71% reported a high prevalence of oldest-old in their offices, 38% and had >20 years of experience. Across countries, considerable variation was found in the decision to start antihypertensive treatment in the oldest-old ranging from 34 to 88%. In 24/29 (83%) countries, frailty was associated with GPs' decision not to start treatment even after adjustment for SBP, CVD, and GP characteristics (OR 0.53, 95%CI 0.48-0.59; ORs per country 0.11-1.78). CONCLUSIONS: Across countries, we found considerable variation in starting antihypertensive medication in oldest-old. The frail oldest-old had an odds ratio of 0.53 of receiving antihypertensive treatment. Future hypertension trials should also include frail patients to acquire evidence on the efficacy of antihypertensive treatment in oldest-old patients with frailty, with the aim to get evidence-based data for clinical decision-making.

Distinguished Scientist Fellowship Program at King Saud University

This study examines the antecedents and outcomes of classroom engagement of 412 Turkish English as a Foreign Language (EFL) learners. Grounded in self-determination theory and the self-system model of motivation, this mixed-methods study examined the relations between context (perceived autonomy-support from the instructor), self (basic psychological needs), action (behavioral, emotional, agentic, and cognitive engagement), and outcome (achievement and absenteeism). The results of structural equation modeling supported the hypothesized model and showed that learners’ perception of their teachers’ autonomy-support within the classroom predicted their need satisfaction, which in turn predicted self-determined engagement. Engagement predicted achievement and absenteeism within English courses. Semi-structured interviews showed patterns consistent with the quantitative results, and also that students felt their engagement would best be supported in classes with a positive social atmosphere. As well, their comments underscored the important role of language teachers in supporting learners’ psychological need satisfaction, classroom engagement, and positive academic outcomes. The findings suggest strategies for English language educators to bolster students’ engagement within the classrooms, including students who seem to be unmotivated, reluctant language learners.