bluuebunny/crossref_metadata_2025 huggingface dataset:
Bilateral Simultaneous Total Knee Arthroplasty May Not Be Safe Even in the Healthiest Patients
Authors: Warren Jared A. , Siddiqi Ahmed , Krebs Viktor E. , Molloy Robert , Higuera Carlos A. , Piuzzi Nicolas S.
Published: December 2020

Background:

Bilateral total knee arthroplasty (TKA) has been shown to increase both mortality and complications, but has potential benefits including decreased length of stay, rehabilitation time, and costs. The purpose of this study was to use data from a nationally representative database to identify if there is a population of patients undergoing TKA in whom bilateral TKA can be safely performed, by comparing 30-day mortality and complication rates with those of patients undergoing unilateral TKA.

Methods:

The National Surgical Quality Improvement Program (NSQIP) was queried to compare 30-day rates of mortality and any complication between bilateral TKA and unilateral TKA. A total of 8,291 patients who underwent bilateral TKA were matched 1:1 with a unilateral TKA control cohort (n = 315,219) by morbidity probability, which is a cumulative variable encompassing demographic characteristics, comorbidities, and laboratory values. Patients were divided into quartiles based on morbidity probability. Binary logistic regression comparing bilateral TKA and unilateral TKA for the same quartiles was performed to establish if any population could safely have bilateral TKA performed.

Results:

Bilateral TKA had an increased risk for all complications (p < 0.001) and major complications (p < 0.001) when compared with unilateral TKA regardless of health status. For all complications, there was a greater than threefold increase for the first quartile (healthiest patients) (p < 0.001), a greater than fourfold increase for the second and third quartiles (p < 0.001), and a greater than threefold increase for the fourth quartile (least healthy patients) (p < 0.001). For major complications, there was a greater than twofold increase for the first quartile (p = 0.001) and the second quartile (p < 0.001), an almost threefold increase for the third quartile (p < 0.001), and a 57% increase for the fourth quartile (p = 0.005).

Conclusions:

This study will assist shared decision-making between orthopaedic surgeons and patients by suggesting that bilateral TKA may not be as safe an option for even healthy individuals compared with unilateral TKA.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Reconstructing Complex Open Back Wounds with a Modified Minimal-Access Keystone Flap
Authors: Anderson Spencer R. , Rako Kyle M. , Wimalawansa Sunishka M.
Published: December 2020

Case:

A 61-year-old patient was referred 12 days postoperative with complex, infected, and dehisced paraspinal wound. After debridement and revision of hardware, deep dead space was eliminated through bilateral paraspinal muscle flap advancement. After hardware coverage, a large skin and tissue defect remained. The defect was reconstructed using a modified Keystone flap, eliminating the lateral cutaneous incision. Our patient healed without complication.

Conclusion:

The modified Keystone flap is an option for reconstructing spinal wound defects, yielding excellent tissue coverage and advancement, grants additional flap advancement if necessary because of elimination of the lateral cutaneous incision, and an overall pleasing aesthetic result.
Palmfarne im Palmengarten – eine einzigartige Nacktsamer-Gruppe
Authors: Dörken Veit Martin , Steinecke Hilke
Published: December 2020

Palmfarne sind eine ursprüngliche Gruppe von Samenpflanzen und werden daher oft auch als lebende Fossilien bezeichnet. Der Palmengarten beherbergt eine umfangreiche Palmfarn-Sammlung. Biologie, Ökologie, Kultur und Verwendung von Palmfarnen werden erläutert. Zudem werden einige markante Arten, die im Palmengarten kultiviert werden, erläutert.
Orobanchen, verkannte Schönheiten
Authors: Uhlich Holger
Published: December 2020

Sommerwurz-Arten (Orobanche, Phelipanche) sind Vollparasiten, die lokal auch Schäden in der Landwirtschaft anrichten können. Einige parasitieren nur ganz bestimme Arten. Die in Hessen vorkommenden Sommerwurz-Arten werden kurz vorgestellt. Einen schöner Bestand von Phelipanche ramosa existiert im Botanischen Garten Frankfurt
Halbwüste blüht
Authors: Bakhtiari-Kish Kristina , Steinecke Hilke
Published: December 2020

Das Halbwüsten-Haus im Tropicarium des Palmengartens umfasst eine artenreiche Sammlung diverser Kakteen und anderer Sukkulenten. Einige von ihnen sind schon seit vielen Jahrzehnten im Palmengarten in Kultur und haben sich zu stattlichen Exemplaren entwickelt. Im Jahr 2013 blühten manche Pflanzen des Palmengartens erstmalig, darunter Dasylirion longissimum und Pachycereus pringlei. Besondere Blühereignisse und einige Pflanzenveteranen im Schauhaus werden kurz vorgestellt.
Sizilien-Tanne (Abies nebrodensis), eine der seltensten Koniferen der Welt
Authors: Nimsch Hubertus , Dörken Veit Martin
Published: December 2020

Die Sizilien-Tanne (Abies nebrodensis) ist mit lediglich nur noch ca. 30 Individuen am Naturstandort eine der seltensten und am meisten bedrohten Koniferen-Arten der Welt. Im Forstarboretum Freiburg-Günterstal, Deutschland, wurde eine Fläche von 0,3 ha als Erhaltungskultur angelegt.
Echte Rentierflechte (Cladonia rangiferina) und ihre Verwandtschaft
Authors: Loos Götz Heinrich
Published: December 2020

Rentierflechte (Cladonia rangiferina) ist eine hellgraue Flechte aus der Familie der Cladoniaceae. Die Rentierflechte ist oft eine dominierende Art auf dem Boden borealer Nadelwälder. Sie kommt in verschiedenen Lebensräumen vor, an feuchten Standorten, in lichten Wäldern, auf Felsen und in Heidevegetation. In Alaska kochen Ureinwohner (Dena‘ina) die Rentierflechte auf und trinken den dabei entstehenden Saft als Mittel gegen Durchfall. Biologie, Ökologie, Verbreitung und Verwendung der Rentierflechte werden erläutert.
neue Hibiskus-Beet
Authors: Steinecke Hilke
Published: December 2020

Hibiscus moscheutos (Sumpf-Eibisch) ist ein Vertreter der Malvaceae. Im Frühling 2015 wurde im Palmengarten ein neues Beet mit Sumpf-Eibisch angelegt. Vorgestellt werden Blütenbau und verschiedene Kultivare. Es gibt verschiedene Sorten und Hybriden mit unterschiedlichen Blütenfarben und vor allem außergewöhnlich großen Blüten.
Karl Josef Strank & Jutta Meures-Balke (Hrsg.): „…dass man im Garten alle Kräuter habe…“ Obst, Gemüse und Kräuter Karls des Grossen
Authors: Schneckenburger Stefan
Published: December 2020

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Bach-Nelkenwurz – Blume des Jahres 2007
Authors: Baumann Kurt
Published: December 2020

Bach-Nelkenwurz (Geum rivale) ist Blume des Jahres 2007. Ihre Biologie, Ökologie und Verwendung als Heilpflanze werden vorgestellt.
Unbekanntes Kuba – Eindrücke einer botanischen Exkursion Teil 3. Der botanische Garten in Havanna
Authors: Grasmück Hans
Published: December 2020

Der botanische Garten Havanna wurde 1968 gegründet. Mit einer Fläche von etwa 600 ha ist er der größte botanische Garten Lateinamerikas. Charakteristisch für den Garten sind seine vielen Gehölze, besonders beeindruckend ist der Palmenhain. Die wichtigsten kubanischen Arten werden hier im Garten kultiviert. Zusammen mit dem angeschlossenen Herbar werden wissenschaftliche Arbeiten zur Erforschung der endemitenreichen Flora Kubas geleistet.
Cerro Duida – „Vergessene Welt“ - Vegetation eines Tafelberges im Süden Venezuelas
Authors: Engwald Stefan , Szarzynski Jörg , Tarff Eloisa Beatriz
Published: December 2020

Isoliert im Süden Venezuelas ragt der Tafelberg Cerro Duida 2350 m aus dem umgebenden Tieflandregenwald hervor. 1996 führte eine Expedition auf seinen Gipfel mit dem Ziel, Pflanzenmaterial für das Nationalherbar von Venezuela zu sammeln sowie die Vegetationszonierung, epiphytische Flora und Klimabedingungen an der Südwestflanke zu dokumentieren. Fünf verschiedene Vegetationszonen konnten unterschieden werden: 1. der basimontane Hangwald (100 – 500 m ü. NN), 2. der submontane Hangwald bis zur Baumgrenze (500 – 1350 m ü. NN), 3. die Baumfarnzone innerhalb der submontanen Stufe (1200 – 1300 m ü. NN), 4. die strauchige Hangvegetation (1350 – 2100 m ü. NN) und 5. die Gipfelvegetation mit einem offenen und niedrigen Tepui-Wald (2100 – 2350 m ü. NN). Neben einer detaillierten Beschreibung dieser Zonen enthält der Artikel persönliche Erfahrungen während des Aufstiegs und allgemeine Beobachtungen zur Tepui- Flora.
Palmengarten-Gedicht von Friedrich Stoltze
Authors: Breitkreuz Petra
Published: December 2020

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Goldlärche (Pseudolarix amabilis), ein attraktives Ziergehölz aus China
Authors: Dörken Veit Martin , Höggemeier Annette
Published: December 2020

Die Goldlärche (Pseudolarix amabilis) ist eine ostasiatische Konifere mit einer langen evolutionären Geschichte. Den volkstümlichen Namen kann man erst im Herbst verstehen, wenn sich die Nadeln vor dem Abwerfen in ihrer prächtig leuchtenden Herbstfärbung präsentieren.
Palmengarten auf dem 11. Fürstlichen Gartenfest auf Schloss Wolfsgarten in Langen
Authors: Steinecke Hilke
Published: December 2020

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Branklyn-Garten in Ost-Schottland
Authors: Steinecke Hilke
Published: December 2020

Der Branklyn-Garten wurde 1922 von dem Ehepaar Renton angelegt. Nach Rentons Tod übernahm der National Trust for Scotland den Garten. Der kleine Garten gehört zu den schönsten Gärten Schottlands. Ein Sammlungsschwerpunkt sind Pflanzen aus dem Himalaya und China.
Sommerflor 2019 im Eingangsbereich und am Tropicarium
Authors: Steinecke Hilke
Published: December 2020

Im Sommerhalbjahr zeigt der Palmengarten auf verschiedenen Beeten einen Sommerflor. Die Pflanzen hierfür werden in der Gärtnerei des Palmengartens herangezogen. Das Farbkonzept ist jedes Jahr etwas anders. Im Sommer 2019 waren vor allem Leonotis nepetifolius und Salvia uliginosa zwei recht hohe auffällige und üppig gedeihende Gewächse im Sommerflor.
Wollemia nobilis (Araucariaceae) – Von einem der seltensten australischen Endemiten zur Massenpflanze
Authors: Nimsch Hubertus , Dörken Veit Martin
Published: December 2020

Wollemia nobilis (Wollemi-Kiefer) wurde erst 1994 in Australien in den Blue Mountains entdeckt. Die Art gilt als lebendes Fossil. Seit einigen Jahren sind Wollemia-Bäume auch bei uns im Fachhandel erhältlich. Entdeckungsgeschichte, Morphologie und Ökologe werden vorgestellt. Außerdem werden Erfahrungen zur Winterhärte mit in Deutschland ausgepflanzten Exemplaren zusammengefasst.
Eindrücke aus der Citrus-Ausstellung 2019
Authors: Steinecke Hilke
Published: December 2020

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Wechselbeziehungen zwischen Vögeln und Gehölzen im äußersten Nordosten Asiens
Authors: Mochalova Olga , Andrijanova Elena , Firsov Gennady
Published: December 2020

Der Einfluss von Vögeln auf die Vegetation im Nordosten Asiens ist bisher nur wenig untersucht. Einige Vögel (verschiedene Auer- und Schneehühner), die sich von Knospen, Trieben und Blättern verschiedener Pflanzen ernähren, beeinflussen sehr stark die Wuchsform mancher Bäume. Das Felsenauerhuhn bewirkt bei Cajander’s Lärche eine runde, dichte Krone. Weiden-Schnee- hühner sitzen im Winter auf dem Schnee und fressen niedrige Zweige kleinerer Weiden ab. Durch das regelmäßige Befressen bilden die Weiden besonders im unteren Teil eiförmige, dichte Kronen.
Garten-Ringelblume (Calendula officinalis). – Heilpflanze des Jahres 2009
Authors: Kasielke Till
Published: December 2020

Calendula officinalis ist Heilpflanze des Jahres 2009. Zudem ist sie eine beliebte Zierpflanze. Ihr Biologie, Ökologie und Heilwirkung werden erklärt. Außerdem wird die eng verwandte kleinere Calendula arvensis vorgestellt.
Osagedorn, Maclura pomifera (Raf.) C.K. Schneid.
Authors: Dörken Veit Martin , Höggemeier Annette
Published: December 2020

Osagedorn (Maclura pomifera = M. aurantiaca) ist ein kleiner Baum aus den südlichen USA. Die kugeligen Früchte erinnern an ein Gehirn. Der Bau liefert ein wertvolles Holz für verschiedene Verwendungen. Maclura ist außerdem eine traditionelle Färbepflanze.
Second Language Acquisition Instructional Models in International Schools in East Asia
Authors: Lehman Clayton Wayne , Welch Brett
Published: December 2020

The international school market continues to grow at a rapid pace, and a considerable amount of growth is taking place in East Asia. With the majority of international school enrollment being local students, care should be taken when developing or restructuring the second language acquisition (SLA) instructional model employed in the school. The purpose of this study was to explore the current use and preference of SLA instructional models in international schools in East Asia. The researchers further sought to explore the difference in preference of SLA instructional models between administrators and teachers. This quantitative exploratory survey-based study had 543 participants, all of whom were active administrators and teachers in international schools in East Asia. The main findings of the study revealed that there are differences between implemented and preferred SLA instructional models in international schools in East Asia. Additional findings include the frequency of SLA instructional model implementation and that there was no statistically significant difference in SLA instructional model preference between administrators and teachers. Findings from this study can allow stakeholders and policymakers to understand current practices and potential future shifts in SLA instructional models in international schools in East Asia.
Inventive Thinking 21st Century Skills Among Preparatory Course Science Students
Authors: Turiman Punia , Osman Kamisah , Tengku Wook Tengku Siti Meriam
Published: December 2020

Inventive thinking is one of the constructs in 21st century skills. The 21st century skills are the skills needed by future workforce in the new global economy that driven by knowledge, technology and innovation. Inventive thinking comprises of
six elements which are flexibility, self-regulation, curiosity, creativity, risk taking and higher order thinking. This study aimed to measure the level of inventive thinking among preparatory course science students at two MARA colleges. Besides, this study has also examined the effect of gender and previous school location on the level of inventive thinking. This quantitative approach study employed 21st century skills instrument. Total of 240 respondents of first year students that attended to these colleges have answered the questionnaires. Findings revealed that the levels of all subconstructs in inventive thinking were high except for creativity that revealed a moderate level. Meanwhile, there were no effects of gender and former school location on the levels of inventive thinking. However, these findings have given insight that the level of creativity should be enhanced. Science students should master all subconstructs in inventive thinking in order to become great innovators who can contribute to the nation’s prosperity.
Çan Linyitlerinin Kendiliğinden Yanma Yatkınlıklarının Araştırılması
Authors: ŞENSÖĞÜT Cem , ÖREN Özer
Published: December 2020

Yapılan bu çalışmada, Türkiye Kömür İşletmeleri (TKİ) bünyesinde faaliyet gösteren Çan Linyitleri İşletme Müdürlüğü (ÇLİ) açık ocak ve stoklarından temin edilen kömür numunelerinin kendiliğinden yanma karakteristikleri kesişim noktası metodu ile belirlenmiştir. Buna göre elde edilen sonuçlarda, kömürlerin ortalama sıcaklık artışlarının (OSA) 0,92-3,93 °C dk-1; tutuşma ya da kesişim noktası sıcaklıklarının (KNS) 150-182 °C; yatkınlık indeksi (IFCC) değerlerinin ise 5,04-33,33 dk-1 arasında değiştiği yapılan deneylerde tespit edilmiştir. Sonuç olarak; 21 adet kömür örneğinin kendiliğinden yanmaya yatkınlıklarının “orta-yüksek” risk kategorisinde yer aldığı belirlenmiştir.
Bir Top ve Çubuk Sisteminin Ayrıklaştırılmış Geri Adımlamalı Kayan Kipli Kontrolü
Authors: ATA Barış
Published: December 2020

Bu çalışmada, eksik eyleyicili mekanik sistemlerin bir örneği olan top ve çubuk sistemi için bir ayrıklaştırılmış geri adımlamalı kayan kipli kontrol kuralı tasarlanmıştır. Kayan kipli kontrol ve geri adımlamalı kontrol yöntemlerini birleştiren ve bir ayrıklaştırma algoritması ile bu yöntemin eksik eyleyicili sistemlere uygulanmasını sağlayan ayrıklaştırılmış geri adımlamalı kayan kipli kontrol yöntemi top ve çubuk sisteminin kontrolünde kullanılmıştır. Kontrolörün tasarım yöntemi Lyapunov teoremine dayandığı için sistemin kararlılığı garanti altına alınmıştır. Tasarlanan kontrolörün etkinliği benzetim çalışmaları ile test edilmiştir. Benzetim bulguları ayrıklaştırılmış geri adımlamalı kayan kipli kontrol yönteminin geleneksel ayrıklaştırılmış kayan kipli kontrol yöntemi ile karşılaştırıldığında dış bozuculara karşı etkili bir kontrol sinyali ürettiğini göstermiştir.
BN İlavesinin Sıkıştırma Döküm Yöntemi ile Üretilen B4C/Al Hibrit Kompozitlerin Mekanik Özellikleri Üzerine Etkileri
Authors: İPEKOĞLU Mehmet , NEKOUYAN Amin , ALBAYRAK Önder , ALTINTAŞ Sabri
Published: December 2020

Yürütülen çalışma kapsamında, bor nitrür (BN) ilavesinin bor karbür (B4C) ile güçlendirilmiş alüminyum (Al) kompozitlerinin mekanik özellikleri üzerindeki etkileri incelenmiştir. Ağırlıkça %5 B4C katkılı olarak hazırlanan alüminyum matriks kompozit malzemelere ağırlıkça %3, %5 ve %10 BN ilave edilerek ve 75 MPa basınç altında sıkıştırma döküm yöntemi ile döküm işlemi gerçekleştirilerek BN-B4C/Al hibrit kompozit malzeme üretilmiştir. Kontrol ve karşılaştırma amacıyla, BN ve B4C ilavesi olmaksızın alüminyumdan elde edilen numuneler kullanılmış; BN ve B4C ilavesinin üretilen malzemelerin yoğunlukları üzerine etkileri ve ortalama talaş uzunlukları incelenmiştir. BN katkısının mekanik özellikler üzerindeki etkisini belirlemek amacıyla, sertlik ölçümleri gerçekleştirilmiş; malzemelerin akma dayanımları, çekme dayanımları ve yüzde uzama miktarları çekme testi yardımıyla belirlenmiş ve karşılaştırılmıştır.
Horzum (Feke/Adana) Çinko-Kurşun Cevherleşmesinin 3 Boyutlu Modellemesi
Authors: ÇETİN Ceren Gizem , AKYILDIZ Mustafa
Published: December 2020

Horzum kurşun Çinko yatakları Kozan-Feke ilçeleri arasında yer almaktadır. Cevherleşme K-G yönlü yaklaşık 20 km boyunca devam etmektedir. Kurşun çinko cevherleşmesi kristalize kireçtaşları, dolomit ve dolomititik kireçtaşlarından oluşan orta Kambriyen yaşlı Çaltepe formasyonuna ait açık renkli kireçtaşları içinde bulunmakta, cevheleşmenin genel duruşu KD-GB doğrultulu ve GD’ye eğimli olarak gözlenmektedir. Cevherleşme kristalize kireçtaşları, dolomit ve dolomititik kireçtaşlarından oluşan orta Kambriyen yaşlı Çaltepe formasyonuna ait açık renkli kireçtaşları içinde bulunmaktadır. Cevherleşmede birincil sülfürlü mineraller; galenit, sfalerit, pirit ve az miktarda kalkopirittir. Oksitlenmiş cevher zonunda ise hidrozinkit, simitsonit, götit, limonit ve az oranda serüzit mineralleri gelişmiştir. Blok model yöntemiyle yapılan hesaplamalarda Horzum Kurşun-Çinko yatağında %5 üzeri tenörde 108000 ton cevher rezervi tespiti edilmiştir.
Evaluation of CNT/MOSFET Based Active Electrode with ECG, EMG, and EEG Signals
Authors: İSTANBULLU Mustafa , AVCI Mutlu
Published: December 2020

In this study, the electrical circuit equivalents of the previously designed novel CNT/MOSFET based active electrode and commonly used wet electrode are simulated by applying different biopotentials. Responses of the electrode models are compared within the certain skin surface circumstances. Fourier transforms and total harmonic distortion calculations of obtained biopotentials are examined to assess the electrodes. The simulation results demonstrate that the CNT / MOSFET based electrode predominates the wet electrode and can measure biopotentials with high quality.
Assuring water quality along multi-barrier treatment systems for agricultural water reuse
Authors: Mohr Marius , Dockhorn Thomas , Drewes Jörg E. , Karwat Sybille , Lackner Susanne , Lotz Bryan , Nahrstedt Andreas , Nocker Andreas , Schramm Engelbert , Zimmermann Martin
Published: December 2020

Based on three pilot- and demonstration-scale projects investigating agricultural irrigation practices with reclaimed water, risks associated with these water reuse practices are highlighted and processes and strategies to minimize associated microbial risks were evaluated. A number of treatment processes and combinations were tested regarding their efficacy for pathogen removal, representing the biggest threat to the quality of products from reuse irrigation practices. In addition, the importance of regrowth potential and different methods for monitoring risks associated with pathogens were discussed. One method for online monitoring is flow cytometry. The results of an exemplary quantitative microbial risk assessment (QMRA) were discussed to determine the significance of microbial risks. Multi-barrier approaches comprised of technical and administrative barriers can reduce the risks of water reuse significantly. Quality management also needs to address all stakeholders involved in a reuse project, starting from source control in the sewershed to marketing of the final products. In addition, environmental risks of water reuse need to be addressed by quality management as well.
1999’dan 2002 Genel Seçimlerine Giden Süreçte Türkiye’de Kritik Yeniden Saflaşma Ve Kritik Seçim Teorisi Üzerine Bir Değerlendirme
Authors: Tokdemir Kinem , Karakuş Aykut
Published: December 2020

Seçimler, demokratik toplumlarda vatandaşların yönetime katılımının sağlanması ve hükümetin kurulması için önemli ve vazgeçilmez bir araçtır. Seçimler sonunda seçmenlerin oylarıyla bürokratik ya da siyasi görevleri üstlenecek ve iş başına gelecek kişiler belirlenir. Ancak seçimler, yalnızca bir seçme eylemi değildir zira bir sürecin parçasını da oluşturmaktadır. Dolayısı ile seçmenin oy verme davranışları çeşitli faktörlere göre değişirken; bu faktörlerin hangi çerçevede değiştiğinin anlaşılması seçmenlerin kritik yeniden saflaşmaları ve kritik seçimlerin ortaya çıkmasının anlaşılması için önemlidir. Kritik seçim teorisi, seçim dönemlerinde seçmenlerin süregiden bir durumu ani ve radikal bir biçimde değiştirecek yeniden saflaşmasını ifade eder. Kritik yeniden saflaşmalar ve kritik seçimler sonucunda seçime giren partilerin önceki seçimlere göre oyları artar veya oylarda radikal bir azalma yaşanır. Bu teoriye göre seçmenlerin oy verme davranışı oy verilen partiye duyulan memnuniyetsizlik, sosyo-ekonomik durum, dış politika, seçmen psikolojisi, lider etkisi veya seçim zamanlarında partilerin kullandıkları söylemler gibi birçok etmene göre değişebilmektedir. Türkiye’de 1999’dan 2002’ye giden süreçte ekonomik, siyasi ve toplumsal alanlarda gerçekleşen iç ve dış dinamikler, seçmenlerin oy kullanma tercihi üzerinde etkili olmuştur. Bu bağlamda bu makalede kritik yeniden saflaşma ve kritik seçim teorisi ışığında Türkiye’de 18 Nisan 1999 genel seçimlerinden 3 Kasım 2002 genel seçimlerine giden süreç, iç ve dış dinamikler çerçevesinde incelenmiştir. Çalışmada öncelikle kritik yeniden saflaşma ve kritik seçim teorisi üzerinde durulmuştur. Ardından Türkiye’de belirtilen süreçte iç ve dış dinamikler ayrıntılı olarak incelenmiştir. Bu çalışmada, seçimlerden başarılı bir sonuç alan Genç Parti ve Adalet ve Kalkınma Partisi üzerinden bir değerlendirme sunulmuştur. Genç Parti’nin yükselişi ve Adalet ve Kalkınma Partisi’nin koalisyon hükümetlerinin ardından tek parti hükümeti kurması konu bağlamında analiz edilmiştir. Çalışmada Türkiye’de 1999 ve 2002 genel seçimlerinin siyasi, ekonomik, sosyal yapısını iç ve dış dinamikler bağlamında çözümlemek, “kritik yeniden saflaşma” ve “kritik seçim” ile ilgili kavramsal ve metodolojik tartışmanın ana hatlarını oluşturmaktadır.
Facile Synthesis of Boc-Protected Selenocystine and its Compatibility with Late-Stage Farnesylation at Cysteine Site
Authors: Zhu Peng-Cheng , Chen Yong-Xiang
Published: December 2020

Background:

The unique hypervariable C-terminal region (HVR) of K-Ras4B, one of
the most frequently mutated proteins in many powerful cancers, contains a C-terminal farnesylated
and methylated Cys and a poly-lysine motif, which decides the association of K-Ras4B to the inner
leaflet of plasma membrane for activating the downstream signaling activity. In our previous work,
we inserted an additional Cys in K-Ras4B HVR peptide synthesis for NCL in the semi-synthesis of
K-Ras4b protein, but it is not suitable for application in protein dimerization research. The recently
developed selenocysteine (Sec, U) mediated native chemical ligation reaction followed by selective
deselenization, which can help to broaden the scope of protein synthesis, requires the generation of
the peptide fragment with an N-terminal Sec.

Objective:

To synthesize K-Ras4B HVR peptide containing both N-terminal Sec and C-terminal farnesylated and
methylated Cys to achieve traceless protein semi-synthesis.

Methods and Results:

We have developed a facile synthesis approach for producing Boc-Sec)2-OH
using economic Se powder, which can facilitate scaling up preparation of peptides containing Sec
at the N-terminus. Furthermore, we synthesized K-Ras4B HVR peptide containing selenocystine
by utilization of Boc-Sec)2-OH. Finally, we took K-Ras4B HVR peptide as an example to test the
compatibility of farnesylation reaction at Cys with the N-terminal Sec)2, and the farnesyl group
was successfully added to the thiol group of Cys.
Clinical Relevance and Immunohistochemical Patterns of Silent Pituitary Adenomas: 10 Years of Single-centre Experience
Authors: Akkus Gamze , Karagun Barış , Çetinalp Nuri E. , Açıkalın Arbil , Evran Mehtap , Sengöz Sinem , Sert Murat , Zorludemir Suzan , Tetiker Tamer
Published: December 2020

Background:

Silent pituitary adenomas are clinically non-functional (i.e., without clinically evident pituitary hormone production).

Introduction:

The aim of this study was to investigate subjects with silent pituitary adenomas for possible variations in their clinical status.

Methods:

A total of 102 patients who had undergone surgery for pituitary adenoma and had been diagnosed with silent pituitary adenoma was included in the study. The patients’ preoperative and postoperative hormonal parameters and magnetic resonance imaging (MRI) features were collected, and pathological specimens were re-evaluated.

Results:

Immunohistochemistry results of the 102 patients were as follows: hormone-negative adenomas (n=35) 35.5%; FSH+LH-positivity (n=32) 31.3%; ACTH-positivity (n=11) 10.7%; α-subunit- positivity (n= 9) 8.8%; prolactin-positivity (n=8) 7.8%; GH-positivity (n=6) 5.4%; and plurihormonal adenoma (n=1). The mean sizes of SGA, SGHA, and SCA were 28.0±12.7, 30.0±16.0, and 27.7±8.9mm (p>0.05), respectively. With the exception of silent gonadotroph adenomas (SGAs), female gender dominance was shown in patients with silent growth hormone adenoma (SGHA) and silent corticotroph adenoma (SCA). Although no clinical relevance was observed in relation to hormonal excess, preoperative GH (4.21±4.6, vs. 0.27±0.36 p=0.00) was slightly more elevated in SGHA than in GH-negative adenomas. Additionally, preoperative basal ACTH values (47.3±28.7 vs. 23.9±14.4, p=0.003) were also higher in SCA compared to the other types. Our findings revealed SCAs to be of more aggressive behaviour than SGHAs and SGAs due to invasiveness in radiological imaging, their elevated re-operation, and postoperative ACTH values.

Conclusion:

Silent pituitary adenomas represent a challenging diagnostic tumour group. Careful initial evaluation of patients with pituitary adenomas should consider any mild signs and symptoms of functionality, particularly in cases of GH- and ACTH-secreting adenomas.
Significance of MRI Guided Focused Ultrasound Thalamotomy for Parkinson’s Disease: A Review
Authors: Pooja N.A. , Pahuja S.K. , Veer K.
Published: December 2020

Background:

Magnetic-Resonance guided Focused Ultrasound (FUS) thalamotomy is a
new and less invasive surgical technique for treating Parkinson’s disease (PD). During therapy, the
required part of the cerebral (as STN, Internal Globus Pallidus, and Ventral Intermediate Nucleus)
is ablated with less possibility of infection and brain hemorrhage as it normally happens in invasive
procedures.

Introduction:

New advancement in the technique enable it for transcranial transportation of US. Now a days, US coupling
with MRI confirms the accurate energy transferring and monitoring. So, MRI guided FUS lesioning is discovered for
various psychiatrics and brain disorders.

Methods:

A technical overview of non-invasive MRI-FUS thalamotomy to treat various tremors is described here.
Research, review articles, and book chapters are extracted from online resources using related search strings from year
1994-2020.

Results:

MRgFUS is concluded a non-invasive, satisfactory, and safe technique to reduce the tremor.

Conclusion:

MRgFUS is comparatively a new method that is being explored as a non-invasive cerebral
ablation to solve the problems of movement disorder.
Zinc Supplementation in Preterm Neonates with Jaundice: Is it Beneficial?
Authors: Elfarargy Mohamed S. , Al-Ashmawy Ghada M. , Abu-Risha Sally E. , Khattab Haidy
Published: December 2020

Background:

Neonatal jaundice is a common neonatal disease that has adverse effects
on neonates, especially preterm neonates, when indirect bilirubin level is adequately high to pass
the blood-brain barrier, causing bilirubin encephalopathy or kernicterus.

Aim:

This study aimed to investigate the value of zinc (Zn) supplementation in preterm neonates
with jaundice and whether it will be beneficial.

Patients and Methods:

A prospective randomized clinical trial, with the identification number TCTR20200504007,
was conducted at Tanta University Hospital from July 2016 to March 2018 on
200 preterm neonates with jaundice. The studied neonates were divided into two groups: group 1,
which received Zn and phototherapy, and group 2, which received phototherapy only and did not
receive Zn. In group 1, 100 preterm neonates with jaundice received Zn as 0.6 mL (cm3) of zinc
origin/kg/day orally through the oro-nasogastric tube divided into two doses (every 12 h), which
was equal to 1.2 mg elemental zinc/kg/day orally for 10 days.

Results:

There was no significant difference in serum bilirubin level between the two groups on
the 2nd, 4th, and 6th days of admission, while the serum bilirubin level was significantly decreased
in group 1 compared with that in group 2 only on the 8th, 9th, and 10th days of admission. The p--
values were 0.045*, 0.027*, and 0.004*, respectively.

Conclusions::

Zn administration to preterm neonates with jaundice was found to be beneficial in decreasing
serum bilirubin level.

Recommendation:

Zn supplementation should be provided to preterm neonates with jaundice.
Comparison of Biomechanical Parameters between Medial and Lateral Compartments of Human Knee Joints
Authors: Devaraj Ashwin Kumar , Acharya Kiran Kumar V , Adhikari Raviraja
Published: December 2020

Background:

The knowledge of biomechanics helps in predicting stresses in different parts of the knee joint during daily activities.

Objective:

The objective of this study is to evaluate the biomechanical parameters of the knee joint, such as contact pressure, contact area, and maximum compressive stress, at full extension position during the gait cycle.

Methods:

The three-dimensional finite element models of human knee joints are developed from magnetic resonance images (MRI) of multiple healthy subjects. The knee joints are subjected to an axial compressive force of 1150 N at full extension position.

Results:

The maximum compressive stresses on the medial and lateral tibial cartilages were 2.98±0.51 MPa and 2.57±0.53 MPa, respectively. The maximum compressive stresses on the medial and lateral menisci were 2.81±0.92 MPa and 2.52±0.97 MPa, respectively. The contact area estimated on medial and lateral tibial cartilages were 701±89 mm2 and 617±63 mm2, respectively.

Conclusion:

The results were validated using experimental and numerical results from literature and were found to be in good agreement. The magnitude of maximum compressive stress and the contact pressure was found to be higher at the medial portion of the cartilages as compared to that in the lateral portion of the cartilages. This study shows that the medial meniscus is more prone to tear under severe loading conditions, as the stresses in the medial meniscus are higher than that in the lateral meniscus. The total contact area in the medial tibial cartilage is larger than that in the lateral tibial cartilage.
Water Pipe Tobacco Smoking and Risk of Coronary Artery Disease: A Systematic Review and Meta-Analysis
Authors: Morovatdar Negar , Poorzand Hoorak , Bondarsahebi Yones , Hozhabrossadati Seyyed A. , Montazeri Sanaollah , Sahebkar Amirhossein
Published: December 2020

Background:

Water pipe smoking has become a vitally important public health issue in the world with
untruthful assumed less harmful effect.

Objective:

The aim of this study was to systematically review the association of water pipe tobacco smoking and risk of
coronary artery disease (CAD).

Methods:

Up to September 25, 2018, we electronically searched the PubMed, Embase, and ISI Web of Science with no
time restriction. We included observational studies and excluded conference abstracts, editorials, case-reports, case series,
and reviews. With fixed model effect, we conducted Meta-analysis to evaluate the association between Water pipe
smoking and coronary artery disease. Heterogeneity among studies was assessed by I2 square test. Publication bias was
assessed by Egger test. P<0.05 set as significant level.

Results:

Among 248 paper records identified through database search, 52 full texts were eligible for full text assessment
whereas 49 papers were excluded. Additionally, three studies were eligible for meta-analysis, which involved 58,960
adults with 1334 in the water pipe smoker group. Risk of CAD was increased in water pipe smokers compared to
individuals who had never smoked water pipe but the result did not reach statistical significance (OR=1.18, 95% CI: 0.98-
1.38, p=0.06). We found that heavy water pipe smoking (40 to 50 sessions of water-pipe smoking/year) was associated
with CAD compared to lower smokers defined as less than 40 to 50 water pipe/year (OR=2.001, 95% CI: 1.13-2.87).

Conclusions:

Heavy Water pipe smoking was associated to coronary artery disease on a clinical level. It seems very
crucial to increase public awareness on adverse effects of water pipe smoking and its cessation in clinical setting.
Perceptions of Physical Activity among Students Living on and off Campus in a University in the Western Cape
Authors: Nyangiwe Simamkele , Mgwambane Tshegofatso , Malema Makhaya J.
Published: December 2020

Background:

Universities are said to have a responsibility to offer holistic education and should, therefore, include ways to prevent risky behaviour such as sedentary living. University students are expected to make informed decisions about their future endeavours. About 23% of adults and 8% of adolescents globally do not meet the global recommendations on minimum Physical Activity (PA) for general health promotion of the World Health Organisation.

Objective:

The objectives of the current study were to explore factors that lead to participation and non-participation in PA among university students, as well as their preferred PA participation activities.

Methods:

The study used a qualitative ethnographic design to purposefully collect data from nine (9) participants by means of semi-structured one-on-one interviews. Open coding was applied when analysing the transcribed data through the ATLAS.ti software programme.

Results:

The findings reveal six themes: Factors that lead to Physical Activity (PA) participation; factors that lead to non-participation in PA; environmental convenience for PA participation; a definition of PA; PA participation preference and benefits of PA. Despite the known benefits of regular physical activity, research shows a significant decline in physical activity participation and an increase in sedentary behaviour in university students.

Conclusion:

Further studies are needed to interrogate PA and its related concepts to raise awareness of each concept. In conclusion, the study recognises that since lifestyle changes during the university period are sustained into adulthood, students tend to engage in risky behaviour such as alcohol and tobacco use, and physical inactivity, which may have long-term negative implications for their health and lead to poor perceptions about their body structure.
In-silico Discovery of Fungal Metabolites Bergenin, Quercitrin and Dihydroartemisinin as Potential Inhibitors against Main Protease of SARSCoV- 2
Authors: Patel Ravi S , Vanzara Akash G , Patel Nimisha R , Vasava Ajit M , Patil Sachin M , Rajput Kishore S
Published: December 2020

Background:

Emergence of severe acute respiratory syndrome coronavirus 2 (SARSCoV-
2) infection has given rise to COVID-19 pandemic, which has become a wreaking havoc
worldwide. Therefore, there is an urgent need to find out novel drugs to combat SARS-CoV-2 infection.
In this backdrop, the present study aimed to assess potent bioactive compounds from different
fungi as potential inhibitors of SARS-CoV-2 main protease (Mpro) using an in-silico analysis.

Methods:

High-Resolution Liquid Chromatography Mass Spectrometry analysis (HR-LCMS) was
used for the bioactive profiling of ethanolic crude extract of Dictyophora indusiata, Geastrum triplex
and Cyathus stercoreus. Of which, only bergenin (D. indusiata), quercitrin (G. triplex) and dihydroartemisinin
(C. stercoreus) were selected based on their medicinal uses, binding score and
the active site covered. The 6LU7, a protein crystallographic structure of SARS-CoV-2 Mpro, was
docked with bergenin, quercitrin and dihydroartemisinin using Autodock 4.2.

Results:

A total of 118 bioactive compounds were analyzed from the crude extract of used fungi
and identified using HR LC/MS analysis. The binding energies obtained were -7.86, -10.29 and
-7.20 kcal/mol, respectively, after docking analysis. Bergenin, quercitrin and dihydroartemisinin
formed hydrogen bond, electrostatic interactions and hydrophobic interactions with foremost active
site amino acids THR190, GLU166, GLN189, GLY143, HIS163, HIS164, CYS145 and PHE140.

Conclusion:

Present investigation suggests that these three compounds may be used as alternative
inhibitors against SARS-CoV-2 Mpro. However, further research is necessary to assess in vitro potential
of these compounds. To the best of our knowledge, the present investigation reported these
three bioactive compounds of fungal origin for the first time.
Autoimmune Hemolytic Anemia Causing Group 5 Pulmonary Hypertension: A Rare Case
Authors: Dzikrul Haq Karimullah Muchammad , Ardining Hiradipta
Published: December 2020

Pulmonary hypertension (PH)has been associated with hemolytic anemia. The prevalence of PH in hemolytic anemia is estimated to be as high as 10-40%, and reportsarepresenting poor prognosis in this subset of patients. PH associated with autoimmune hemolytic anemia (AIHA) is still rarely discussed,and there is paucity of literature regarding its precise pathophysiology and treatment. Here, we describe a case of PH associated with AIHA. A 34-year old woman came to our center with chief complaint of dyspnea on exertion. She was previously diagnosed with AIHA with positive direct Coomb's test. Physical examination, chest X-ray and echocardiography were consistent with pulmonary hypertension. The diagnosis of group 5 pulmonary hypertension was made. Although rare, the association between chronic hemolytic anemia and PH is evident, through several mechanisms involving nitric oxide inactivation, direct injury oftheendothelium, oxidative damage, thromboembolic formation, and left ventricular dysfunction. The management of PH in hemolytic disorders comprises treatment of underlying hemolytic disorder and PH-specific therapies. For PH specific therapy, to date, there are no therapies that have been fully studied for these specific patient population. Our patient was given bisoprolol, furosemide, amlodipine, spironolactone, candesartan, beraprost sodium and sildenafil. On follow up twomonths later, her functional status was improved. In summary, PH associated with AIHA develop via multifactorial and complex mechanisms. PH in AIHA could be detected with meticulous history taking, physical examination, chest X-ray and echocardiography, and treatment with vasodilating agents were shown to improve the PH.
Wat bepaalt de meerwaarde van een hoortoestel bij ouderen? De interacties tussen hoortoestellen, auditief-cognitieve training, cognitie en luisterinspanning: een review
Authors: Kestens Katrien , Degeest Sofie , Keppler Hannah
Published: December 2020

De meest frequente klachten van slechthorende ouderen zijn gerelateerd aan een verminderd spraakverstaan en een toegenomen luisterinspanning, voornamelijk in rumoerige luistersituaties. Ondanks gehoorrevalidatie in het kader van leeftijdsgebonden gehoorverlies (d.i. presbyacusis) voornamelijk met behulp van hoortoestellen verloopt, blijkt het hoortoestelvoordeel variabel te zijn. Recent wordt in de literatuur meer aandacht gegeven aan de link tussen cognitie en spraakverstaan. Een mogelijke hypothese is dat de variabiliteit in hoortoestelvoordeel te wijten zou zijn aan intersubject verschillen op vlak van cognitie. Het doel van dit review artikel is dan ook om de relatie tussen hoortoestellen, cognitie, auditief-cognitieve training en luisterinspanning in kaart te brengen en dit specifiek bij volwassen binaurale hoortoestelgebruikers.

Vier interacties tussen binauraal hoortoestelgebruik, digitale hoortoestelfeatures, cognitie en luisterinspanning werden onderzocht: (1) Wat is de invloed van binauraal hoortoestelgebruik op cognitie? (2) Hoe beïnvloedt de cognitieve status van de hoortoestelgebruiker het hoortoestelvoordeel met betrekking tot spraakverstaan? (3) Wat is de invloed van binauraal hoortoestelgebruik op luisterinspanning? (4) Hoe beïnvloedt de cognitieve status van de hoortoestelgebruiker het hoortoestelvoordeel met betrekking tot luisterinspanning?

Daarnaast werd ook het effect van auditief-cognitieve training op het hoortoestelvoordeel onderzocht.

De huidige literatuur omtrent de besproken interacties is beperkt en toont variabele resultaten. Het is daarom niet mogelijk algemene uitspraken te definiëren. Verder onderzoek naar het hoortoestelvoordeel vanuit een auditief-cognitief perspectief is essentieel voor het optimaliseren van het hoortoestelvoordeel.
Reliability and Validity of the Questionnaire for Autism Environment: A pilot survey
Authors: Ghazali Roslinda binti , Md Sakip Siti Rasidah , Samsuddin Ismail
Published: December 2020

The increasing numbers of autism give impact to the country, community and family. The only way to help autistic children is to provide them with proper education. Thus, architects play roles in creating responsive buildings. A pilot test has carried out on a group of people similar to the research population. The objective is to assess the reliability and validity of a questionnaire. Four sections (144 items) determining the frequency of Sensory Sensitivity, Sensory Stimulation, Sensory Design and Physical Learning Environment. Respondent (N=35) completed the survey and the reliability test resultant to reveal inconsistencies and revising the criteria accordingly.
Keywords: Autism; validity; reliability; pilot test;
eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v5i15.2470.
Usage of Cosmetic Remover and Dry Eye Symptoms
Authors: Norazman Fatin Nur Najwa , Anuar Nurul Aqilah
Published: December 2020

Eye cosmetics are the contributing factors of dry eye, yet the effectiveness of cosmetic remover usage to reduce this problem is unknown. This study aimed to investigate the effect of regular use of cosmetic remover on dry eye symptoms. An online questionnaire consisting of 23 questions regarding dry eye symptoms and the frequency of cosmetic removal usage was distributed. Eighty-five female respondents answered the questionnaire, with the majority (74.1%) reported used more than three types of cosmetic remover products. There was no significant difference in dry eye symptoms between regular and light cosmetic remover users (p=0.83).
Keywords: cosmetic ; dry eye ; ocular discomfort
eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v5i15.2493.
YAPAY ZEKÂ TEKNİKLERİYLE YAZILIM TANIMLI AĞ UYGULAMASI
Authors: DEGİRMENCİ Sukran , YILTAS Derya
Published: December 2020

Bu çalışma yazılım tanımlı ağ denetleyicisi kullanarak ağ trafiğini takip etme amacıyla yapılmıştır. Bu doğrultuda denetleyici olarak Floodlight ve çalışma platformu olarak Eclipse kullanılmıştır. Doğruluğu artırmak adına beş ayrı topoloji üzerinde gerçekleştirilen takipler sonrasında paket istatistik bilgileri elde edilmiştir. İstatistik verileri MATLAB üzerinde işlenerek istenilen veri setleri oluşturulmuştur. Bu veri setleri MATLAB’de yer alan nntool vasıtasıyla yapay sinir ağlarında kullanılarak belirli zamanlardaki paket akışı tahmin edilmiştir. Yapay sinir ağları beş ayrı topoloji üzerinde denenmiş ve doğrulukları MAPE ve R2 denklemleri ile test edilmiştir. Yapılan testler sonucunda doğruluğu en yüksek çıkan topoloji üzerinde optimizasyon işlemleri uygulanmıştır. Bu amaç doğrultusunda doğrusal arama, tabu arama, değiştirilmiş tabu arama ve tavlama benzetimi ile tabu arama algoritmasının karışımı olmak üzere toplamda dört ayrı optimizasyon tekniği ile optimizasyon testleri gerçekleştirilmiştir. Sonuç olarak çalışmada önerilen karışım algoritması ile gerçekleştirilen optimizasyon sonucunda en yoğun olan güzergâh en kısa sürede tespit edilmiştir.
ÇOK BİLEŞENLİ KALIPLAMA YÖNTEMİNE UYGUN SÜREKLİ ELYAFLI TERMOPLASTİK KOMPOZİT AKÜ TAŞIYICI PARÇASININ GELİŞTİRİLMESİ
Authors: KÜÇÜKOĞLU Ayça , ÖZYAPI Gökçe , ACAR Atanur , BAĞRIYANIK Ali Ozan , ÇOLPAN Osman , ÇELİK Hafize , YAĞCI Yavuz Emre
Published: December 2020

Emisyon standartlarının sürekli geliştirilmesinden dolayı ağırlık azaltma bu standartları yakalama açısından önem kazanmıştır. Yakıt tüketimi ve performans iyileştirmeleri için maliyetleri kontrol altında tutarken tüm araç bileşenlerinin ağırlığını azaltmak, araç ağırlık azaltması için yenilikçi çözümlere yol açmıştır. Araç ağırlık azaltma çalışmalarında çelik yerine çelik kullanımını azaltmak için polimer kompozit malzemelerin kullanılması dikkat çekicidir. Farklı sektörlerde yaygın olarak kullanılan termoset malzeme bazlı kompozitler, üretim kısıtlamaları ve geri dönüşüm eksikliği nedeniyle binek araçların üretiminde yer bulamamıştır. Seri üretime uygun olarak üretilen ve aynı mekanik performanslarla geri dönüştürülen sürekli elyaf takviyeli termoplastik kompozitler, otomotiv sektöründe artan uygulamalar bulmaktadır. Bu çalışmada, araçlarda metal akü taşıyıcı kısmı yerine sürekli elyaf takviyeli termoplastik kompozit akü taşıyıcı geliştirilmiştir. Bu çalışmada; yapısal olan taşıyıcı çelik bir akü taşıyıcı, hafifletme amaçlı sürekli elyaf takviyeli termoplastik kompozit malzemelere uygun olarak tasarlanmış, sanal analizleri yapılarak üretilmiş ve araç başına 0.5 kg ağırlık azaltımı sağlanmıştır. Tasarım aşamasından itibaren parça için detaylı güvenlik, doğal frekans ve aşırı yükleme analizleri yapılarak meydana gelen yüksek gerinim değerlerini azaltmak için iyileştirmeler yapılmıştır.