bluuebunny/crossref_metadata_2025 huggingface dataset:
Preoperative rehabilitation in patients undergoing pulmonary resections
Authors: Kużdżał Emilia , Gambuś Karolina , Kużdżał Błażej
Published: August 2021

Introduction: Pulmonary resections result in permanent impairment of the respiratory function due to reduction of the gas-exchange surface. Most of these procedures are elective, which makes it possible to implement a preoperative rehabilitation programme, aimed at increasing general fitness, improving chest and diaphragm mobility, muscle strength and lung ventilation, and also at training the proper breathing pattern, effective coughing and pain-relief techniques. Improvement of patients' respiratory function and general fitness may contribute to the limitation of postoperative functional impairment, and therefore morbidity.

Objectives: The aim of this systematic review was analysis of the effect of the preoperative rehabilitation on the postoperative course following pulmonary resections in lung cancer patients.

Method: Systematic review of the literature published within the last 15 years was performed using PubMed and Worldcat databases. Methodological quality of selected papers was assessed using the PEDro scale.

Results: Eight out of the 236 initially retrieved papers met the pre-set criteria, and search of the attached references found an additional 2 papers. In 9 of the papers included in the final analysis positive impact of the preoperative rehabilitation was shown, and no effect was found in one of them. There were no studies showing any negative effect of the preoperative rehabilitation.

Conclusions: Preoperative rehabilitation may be beneficial, and its effects may last for several months after surgery. Rehabilitation programmes longer than 2 weeks were associated with functional improvement.
FMS assessment and core stability in a group of amateur climbers
Authors: Golec Joanna , Cieślik Kinga , Nowak Monika , Szczygieł Eżbieta , Golec Justyna
Published: August 2021

Background: The objective of the study was to assess the functional status of people who regularly climb for recreational purposes, using the FMS (Functional Movement Screen) and core stability tests (McGill's torso muscular endurance tests). This paper also attempts to determine the relation between the assessment of functional efficiency and the results obtained in core stability tests.

Material and methods: The study group were consisted of 30 amateur climbers (aged 26 ±3), who were compared to a control group of 30 people who don’t climb but recreationally practice volleyball (aged 22 ±3). All participants performed each of the seven FMS trials and the three McGill's tests.

Results: Amateur climbers, in comparison to non-climbers, were achieved higher scores in each of the core stability trials (p<0,05). Climbers also scored significantly higher results in all FMS trials as well as in the final average (19,0 3 ±1,54 vs. 16,60 ±3,60; p<0,01). In addition, there were found positive correlations between FMS and core stability trials in the group of climbers (Deep Squad vs. Side bridge test; In-Line Lunge vs. Side bridge test; Rotational Stability vs. all trials of the core stability test).

Conclusions: People recreational practicing climbing are characterized by a high level of functional efficiency and above-average levels of deep trunk muscles endurance, responsible for the proper functioning of the central stabilization. Relationship between the overall results of the FMS and the core stability tests in the climbers' group shows that proper stability training, which is a part of the climbers training, may result in higher athletes’ performance.
Assessment of the influence of intermittent ischemic compression of latent trigger points on changes on the range of the lumbar spine mobility and myoelectric changes in the dorsal extensor muscle
Authors: Gamrot Sara , Pawłowski Mateusz
Published: August 2021

Introduction: Pain in the lumbar spine (L) is a very serious health problem. The appearance of pain in the area of the back muscles with palpable small, sensitive points may indicate the presence of myofascial trigger points. There are many techniques used in the therapy of trigger points, including ischemic compression, which gives a therapeutic effect in the form of biomechanical normalization of muscle tissue restoring the normal functional state of a given muscle.

Aim of the study: The aim of the study was to assessment of the influence of intermittent ischemic compression of latent trigger points on changes on the range of motion of the L spine and on myoelectric changes in the back extensor muscle.

Material and Methods: The study included 32 students who were subjected to a single technique of intermittent ischemic compression according to Chaitow. The participants of the study performed the Thomayer test before and after the therapy to assess the range of spine mobility. The myoelectric changes in the back extensor muscle were assessed using NORAXON's EMG before and after the treatments following a protocol specifically developed for this purpose. The statistical analysis of the data was calculated using the Statistica 13 program.

Results: One-time ischemic intermittent compression of the back extensor muscle statistically significantly increased the range of spine motion. The mean value of the tension of the back extensor muscle at rest after the therapy was reduced, showing statistically significant changes. The myoelectric changes in the back extensor muscle during flexion were not statistically significant

Conclusions: The results showed the effectiveness of the ischemic intermittent compression technique in increasing the range of spine mobility after the treatment on the back extensor muscle. Intermittent ischemic compression leads to a decrease in the resting tension of the back extensor muscle, without affecting any significant changes during the flexion movement.
Intact Stability of Historic Passenger Ships in Light of the Second Generation Intact Stability Criteria
Authors: Bačkalov I , Rudaković S , Cvijović M
Published: August 2021

The paper examines the intact stability of historic passenger ships from the point of view of the contemporary notion of the intact stability, i.e. the Second Generation Intact Stability Criteria (SGISC) framework. An intact stability assessment using the Vulnerability Level 2 calculation procedures of SGISC for the dead ship condition was performed on four ocean liners: RMS Titanic, RMS Queen Mary, SS United States and SS Michelangelo, and two cruise ships: MS Song of America and MS Costa Concordia. In addition, the intact stability of the selected ships was appraised using the present-day mandatory intact stability requirements contained in the 2008 Intact Stability Code. The selected ships are believed to be good representatives of the main trends in passenger ship design over a one-hundred-year span bounded by two well-known maritime catastrophes: the sinking of the Titanic in 1912 and the Costa Concordia disaster in 2012. The paper offers an insight into how major design changes have affected the intact stability properties of passenger ships over this period. It was found that the examined ocean liners would perform well in terms of intact stability in the dead ship condition even from the point of view of the SGISC. The analysis also confirmed the advantages of the approach using the SGISC framework over simplified, (semi)empirical stability assessment methods. By looking into the evolution of the intact stability of ocean liners and cruise ships from the contemporary perspective, the paper draws the conclusions which are considered useful for the design of future passenger ships.
English Narrowboats: From Industrial Revolution to the Urban Housing Problem
Authors: Pérez-Martínez J , Pérez Fernández R
Published: August 2021

The housing scene in major cities is driving people into unconventional real estate options, and London is no exception. As rental and purchase prices have risen, some individuals have turned to houseboats for an affordable option. The waterbodies, that were a main driver of the development of the city, have experienced the consequences of that growth and the degradation that followed. In this paper, the impact of the increase in waterway short-stay and permanent moorings is explored. Several events in the rich history of English canals are discussed, as well as their relevance to the current situation. The needs and main limitations are also considered, as these are putting pressure on the communities, agencies and authorities involved. The constraints, especially spatial, of this type of housing present an interesting challenge for boat designers who need to adapt to the next generation of boaters’ requirements. Additionally, improvement of the facilities and infrastructure is important to protect the rights of all waterway users and the wider public.
Vessel Motions and Work Interruptions Aboard a Fast Rescue Craft
Authors: Garvin M , Harris T
Published: August 2021

A set of field trials were carried out aboard a Canadian Coast Guard fast rescue Rigid Hull Inflatable Boat. The vessel was outfitted with a data acquisition system to collect vessel and engine performance data and trialled in three wave conditions (approx. Beaufort 2 to 7). This paper focusses on the methodologies and results for calculating and investigating Motion-Induced Interruptions (MIIs). MIIs due to lateral and longitudinal overbalancing and sliding were investigated using the counting of motion events which are expected to cause an interruption, supported by a statistical analysis and examination of the distribution of the MII data. We conclude that MII assessments of small, light, high-speed craft such as the one studied should include longitudinal acceleration and pitch angle, typically assumed to be non-influential in MII assessments. Statistical treatments have promise for analysis of field-acquired MII data.
Operation of Ride Control Systems to Minimise Slamming of Wave-Piercing Catamarans
Authors: Davis M R
Published: August 2021

Wave slam produces dynamic loads on the centre bow of wave piercing catamarans that are related to the relative vertical motion of the bow to the encountered wave surface. Rapid slam forces arise when the arch sections between centre bow and main hulls fill with rising water. In this paper time domain solutions for high speed ship motion in waves, including the action of active motion controls, are used to compute the slam forces. Slamming occurs at specific immersions of the bow whilst the peak slam force is characterised by the maximum relative vertical velocity of the bow during bow entry. Vertical motions of bow and encountered wave are in antiphase at encounter frequencies where slamming is most severe. The range of encounter frequencies where slamming occurs increases with wave height. Wave slam loads reduce ship motions, the heave motion being most reduced. Deployment of a fixed, inactive T-foil can reduce slamming loads by up to 65 %. With active controls peak slamming loads on the bow can be reduced by up to 73% and 79% in 4 m and 3 m seas, local control feedback being marginally the most effective mode of control for reduction of slamming.
Risk-Based Conceptual Ship Design of a Bulk Carrier Accounting for Energy Efficiency Design Index (EEDI)
Authors: Garbatov Y , Georgiev P
Published: August 2021

The paper covered a study aimed at developing a risk-based conceptual ship design method for bulk carriers, while taking into account the life cycle assessment and energy efficiency of the ship propulsion system. The study included conceptual ship design as a part of the risk-based ship design approach. In such conceptual design, using the long-time experience and statistics, the main dimensions and hull form, resistance and propulsion, weights, initial stability, freeboard, seakeeping and manoeuvrability were initially derived and the capital expenditure, operational expenditure, and decommissioning expenditure obtained. An optimal design solution was obtained, based on the energy efficiency design index, shipbuilding, operation, and resale costs at the end of the service life, which were used as input variables in a riskbased analysis.
A Roll Damping Analysis of a Standard US Naval Hull Form (DTMB 5415)
Authors: Hu L F , Gong Q T , Yuan Z M , Wang X Y , Duan J X
Published: August 2021

Accurate prediction of roll damping is important in calculating the roll motion of a ship. This paper presents a roll decay analysis of an intact US Navy Destroyer hull form (DTMB 5415) using a Navier–Stokes (NS) solver with the volume of fluid (VOF) method. Dynamic overset mesh techniques were employed to handle mesh updating required to obtain transient ship motions. The VOF method was used to capture the fluid interface. The effect of turbulence was considered by means of a k-w and a k-e model. A sensitivity analysis was conducted, in terms of the grid, timesteps and degree of freedom. The roll decay results of the numerical simulation have been compared with those of prior physical model testing (Gokce and Kinaci, 2018), and the different roll decay responses used to predict the roll damping. It is intended that this research be a useful step towards establishing intact ship stability criteria, as part of current research.
Numerical and Experimental Analyses of a Variable Buoyancy System for an Autonomous Underwater Vehicle
Authors: Tiwari B K , Sharma R
Published: August 2021

Autonomous Underwater Vehicles (AUVs) are widely used for marine survey, in both the coastal and deep sea areas and they are applicable to both civil and defense applications. They are pre-programmed and can operate without human intervention and this makes them attractive to many marine industries. A concern with AUVs is the high energy consumption required by their thrusters for depth control, buoyancy change and manoeuvrability and that adversely affects their performance and endurance. This paper presents the design and development of novel stand-alone variable buoyancy system for AUVs and investigates its performance through numerical and experimental investigations. The design idea is based upon the Pump Driven Variable Buoyancy System (PDVBS) and uses a hydraulic based method to control the buoyancy. The VBS is integrated into a medium sized AUV of 3 m length and the performance of the vehicle in vertical plane is investigated. The results are presented for a buoyancy change requirement of 5 kg and a diaphragm type positive displacement pump, with a buoyancy change rate of 5 kg/min, is utilized. Depth control performance of the AUV and its hovering capabilities, at a desired depth of 60 m using the Linear Quadratic Regulator (LQR) controller, are analysed in detail. Finally, the results indicate that the designed and developed VBS is effective in changing the buoyancy and controlling the heave velocity. These two features are expected to provide higher endurance and better performance in AUVs involved in rescue/attack operations.
An Investigation into Switching Vessel Sizes for Efficient Container Terminal Operations: A Case Study of Kaohsiung Port
Authors: Chang En-Wei , Tai Hui-Huang
Published: August 2021

Given the continued growth in the size of container ships, major hub ports around the world have carried out large-scale upgrades of their port facilities to attract shipping companies to choose their ports, thereby enhancing the competitiveness of their ports. This study takes Kaohsiung Port as an example and uses the Decision Analytic Network Process (DANP) method to investigate container terminal operations by switching container terminal operations to appropriate new locations. The results of the study indicate that, despite the external issues (such as a lack of deep-water terminals and hinterland in the port area, the upsizing of ships, and new strategic shipping alliances), Kaohsiung Port authority must accelerate the upgrade of its container terminals, integrate its port resources to build deep-water berth facilities with highefficient container operating system, and improve the operating efficiency of its existing terminals, as a means to maintain the status of Kaohsiung Port as a regional centre.
Modelling Route Choice in Crowd Evacuation on Passenger Ships
Authors: Li Y , Cai W , Kana A A , Atasoy B
Published: August 2021

This paper proposes an agent-based simulation model with route choice process to predict the crowd behaviours and evaluate the evacuation safety on passenger ships. The model focuses on the behaviours of two common types of passengers that are not typically accounted for during most evacuation analyses, namely, passengers who are not familiar with the ship layout and passengers who have family members or friends with them. In the proposed model, a marker concept is introduced to represent critical routing points of the layout and passenger agents make a route choice based on their surroundings and characteristics instead of just following the shortest routes. The simulation model is tested by two small but targeted scenarios and one comprehensive scenario on a ship deck. For ship designers, a more realistic evacuation time is provided to better assess the evacuation performance of a ship, and a heat map of crowd density is presented to identify possible bottleneck areas.
Approach for the Design of Specialized Ships: The Case of Cargo Transport to an Ocean Island
Authors: Santos V M F S , Duarte H O , Melo S E G , Peres M N , Domingues E C
Published: August 2021

The island of Fernando de Noronha (FN) is a marine protected area, located about 293 nautical miles from Recife, Brazil. Supplies are transported out by improvised boats and the main freight contractor, the Administration of FN (AFN) spends large sums with outsourced shipping services, some of which could be redirected to problems of major concern such as health, environment and education. Using a sequence of five steps, including the construction of a database, mathematical simulation and economic feasibility analysis, it was possible to develop a preliminary design for a specialized economically viable vessel, which meets the requirement, draught limitations and needs of the island of FN. It is shown that the approach is feasible through the construction of a mathematical optimization model and a design of a vessel of about 450 tons of displacement that allows cost savings to AFN of around US$ 1.76M per year.
Numerical Fluid-Structure Interaction Analysis for a Flexible Marine Propeller Using Co-Simulation Method
Authors: Kumar A , Vijayakumar R , Subramanian VA
Published: August 2021

Carbon fibre composite has exceptionally high strength, low density and corrosion resistance in the marine environment compared to conventional materials. These characteristics make it a favourable alternative material to be considered for manufacturing marine screw propellers. Despite these advantages, the flexibility of the material leads to a significant change in blade geometry due to loads acting on blades which alter hydrodynamic performance. A two-way coupled fluid-structure interaction analysis is required to accurately capture its hydrodynamic performance due to the reduced stiffness and material anisotropy. The present study focuses on numerical investigation for the hydro-elastic based performance analysis of a composite marine propeller in open water condition. The procedure involves the coupling of Reynolds-Averaged Navier-Stokes Equation based computational fluid dynamics solver with the finite element method solver using co-simulation technique. The open water characteristics, including thrust coefficient, torque coefficient and open water efficiency, are discussed as a function of advance ratio. This paper presents a comparison of the hydrodynamic performance and structural responses between a carbon fibre composite propeller and a conventional steel propeller which are geometrically identical. The results for the composite propeller show a significant improvement in hydrodynamic performance compared to the metallic propeller while remaining structurally safe throughout the tested range.
Intelligent Layout Design of Ship Pipeline Using a Particle Swarm Optimisation Integrated Genetic Algorithm
Authors: Wang Yunlong , Wei Hao , Guan Guan , Li Kai , Lin Yan , Chai Shuhong
Published: August 2021

This paper proposes a Particle Swarm Optimisation Integrated Genetic (PSOIG) algorithm to define ship pipeline layout, where the pipeline layout environment is complex and changeable. The pipeline layout space model includes a cabin model, an obstacle model, a pipe model and a regional model of layout. Given the characteristics of ship pipeline layout, the direction guidance mechanism for automatic pipeline layout is introduced, and a direction parameter setting are put forward to further improve the efficiency of the algorithm. At the same time, the crossover and mutation strategies of the genetic algorithm are introduced into the particle swarm optimisation to establish the PSOIG algorithm for ship pipeline intelligent layout. This fully optimises the advantages of particle swarm optimisation and genetic algorithms to improve the diversity of solutions and the convergence speed of the algorithm. Finally, the simulation results demonstrate the feasibility and efficiency of the proposed algorithm.
The Role of Human Factors in Maritime Environmental Risk Assessment: A Case Study of Oil Spill Response
Authors: Erdem P , Akyuz E , Arslan O
Published: August 2021

Human error is one of the significant factors attributed to marine accidents. This paper aims to assess the potential contribution of human errors in improving maritime environmental risk management. Success Likelihood Index Method (SLIM), has been adopted to systematically estimate human error potentials for designated tasks in pollution prevention, along with fuzzy sets to deal with subjectivity in the process of using experts’ judgments. An oil spill response operation was investigated due to its considerable risks for the marine environment. Environmental factors, familiarity, and fatigue were observed as having a high impact on human performance. Besides its theoretical insight, the paper provides practical insights into the prevention of marine pollution. This study is presented as a reference providing a contribution to estimating the impact of human errors on maritime accidents. The paper is also intended to contribute to other risky industries where human errors can lead to fatal consequences.
An Approach to Measuring Ship Design Complexity
Authors: Ebrahimi A , Erikstad S O , Brett P O , Asbjørnslett B E
Published: August 2021

Understanding different aspects of complexity and measuring them properly are important steps of handling ship design complexity effectively. The main objective of this article is to develop a practical and comprehensive method to measure ship design complexity. In engineering design, complexity is measured today by different indexes and methods. This paper initially explores the applicability of such measures in a ship design context supported by a review of different relevant user-cases. However, it is acknowledged that most of these measurement methods focus on product-related complexity aspects and rarely address or quantify complexities generated by the design process, the organisation of the firm, or the market situation. Therefore, this paper introduces a new and comprehensive model to measure ship design complexity including all these aspects. The model quantifies ship design complexity by means of the following nine different descriptive factors: directional, spatial, decision-making, structural, behavioral, contextual, perceptual, temporal, and technological complexity.
The Effects of Ethyl Pyruvate on Behavioral and Biochemical Parameters in Immobilization Stress-Induced Mice
Authors: ABUL Mihrab , AKKOC Hasan , UYAR Emre , DONMEZDİL Suleyman
Published: August 2021

Objective: Ethyl pyruvate (EP) is a molecule with antioxidant, anti-inflammatory, and anti-apoptotic features. The present study investigates EP's effects on behavioral and biochemical alterations induced by immobilization (IM) stress.

Methods: In this outcome, 45 male BALB/c mice were separated into five groups [CONT (control), IM, IM+EP, EP, IM+F (fluoxetine)]. IM applied groups had 6 hours of immobilization stress procedure a day for a week. EP (50 mg/day) and fluoxetine (5 mg/day) were applied to the mice intraperitoneally. After the stress induction protocol, passive avoidance, open field (OF), and forced swimming tests (FST) were executed. After behavioral tests, brain tissues were obtained for biochemical investigations.

Results: Immobilization application increased immobility times in the FST and decreased the total distance moved and the center time in the OF test. Immobile times were reduced with fluoxetine and EP applied groups compared with the IM group due to decreased learned helplessness. The IM group had decreased brain-derived neurotrophic factor (BDNF), superoxide dismutase, and glutathione peroxidase levels, which were increased with EP applications.

Conclusion: These results show that EP generates antidepressant-like effects with decreasing oxidation and increasing BDNF levels.
Comparison of Therapeutic Plasma Exchange and Double Filtration Plasmapheresis: Five Year Experience of Nephrology Unit
Authors: GOKCAY BEK Sibel , BAKIRDÖĞEN Serkan , EREN Necmi , HANAZAY Yusuf , KALENDER GONULLU Betul
Published: August 2021

Objective: The aim of the study was to evaluate the outcomes and characteristics of therapeutic plasma exchange (TPE) and double filtration plasmapheresis (DFPP) in one center.

Method: The data of cases treated with therapeutic plasmapheresis at the university hospital between 2007 and 2012 were retrospectively analyzed. 445 TPE and 391 DFPP sessions were done totally.

Results: In the 5.5 years, in 116 cases 445 TPE and 391 DFPP sessions were done. The mean age was 46.61±16.83 years. There were 49 female and 67 male patients. Guillain-Barre syndrome ( 8.6%) was the commonly encountered indication for neurological diseases, glomerulonephritis ( 25%) was the leading indication for the renal-related diseases. Skin involvement due to diabetes mellitus (13.8%) and Pemphigus Vulgaris (5.2%) were the dermatological diseases. Complication rates were similar between DFPP and TPE sessions (p= 0.411).

Conclusion: TPE and DFPP are safe and vital membrane separation techniques used as a treatment for a wide spectrum of diseases. These treatments can be safely done in hemodialysis units intensive care units and DFPP should be considered for the therapy refractory neurological diseases.
Ratlarda Rottlerin’in Otofaji Üzerine Etkili Doz Düzeyinin Araştırılması
Authors: YILDIRIMCAN KADIÇEŞME Şebnem , KARA Fatih , ADALI Yasemen , ÖNEN Özlem , AYDIN Uğur
Published: August 2021

Amaç: Otofaji, hücresel homeostazda rol oynayan fizyolojik bir süreçtir. Bununla birlikte, otofajik anomaliler kanser, nörodejeneratif hastalıklar ve kardiyovasküler hastalıklar gibi birçok patolojik durumla ilişkilidir. Rottlerin, otofajinin hastalıklarla ilişkisini değerlendirmek için kullanılabilecek ve tedavi stratejilerinde uygulanabilecek önemli bir otofaji aktivatörüdür. Ancak literatürde sıçanlarda otofajinin aktive edilmesinde bu molekülün dozları ile ilgili herhangi bir çalışma bulunmamaktadır. Bu çalışmanın amacı, Rottlerin’in sıçanlarda otofaji üzerindeki etkili doz düzeyinin araştırılmasıdır.

Yöntemler: Yirmi dört rat, her biri altı rat içeren dört gruba ayrıldı. Grup I'e (kontrol grubu) Rottlerin’in çözücüsü (DMSO) verildi. Grup II, III ve IV’e, sırasıyla, 0,5, 2 ve 4 mg/kg Rottlerin intraperitoneal olarak uygulandı. Ratların kalp dokuları otofajik vakuol, LC3B seviyeleri ve anti-LC3B boyanma paterni açısından incelendi. Ayrıca, kan örneklerinde LC3B seviyeleri ölçüldü.

Bulgular: Kalp dokularında otofajik vakuol, LC3B düzeyleri ve anti-LC3B boyanma paternleri açısından gruplar arasında anlamlı bir farklılık yoktu. Rottlerin dozu arttıkça, serum LC3B seviyelerinde artış eğilimi gözlendi; ancak, farklılıklar istatistiksel olarak anlamlı değildi.

Sonuçlar: Sonuç olarak, bu çalışmanın bulgularına göre, ratlarda Rottlerin kullanılarak kalp dokusunda otofajiyi aktive etmek için mevcut dozların ve/veya uygulama süresinin artırılması gerektiği görülmektedir. Bununla birlikte, serum sonuçları, farklı dokularda otofajik aktivitenin artmış olabileceğini göstermektedir.
Türk Silahlı Kuvvetleri´de Görevli Sözleşmeli Er ve Erbaşlarda Görülen Kas İskelet Sistemi Yaralanmaların Profili
Authors: ERGÜN Tuğrul , KORKMAZ Mehmet
Published: August 2021

Giriş: Askerlik mesleği zorlu fiziksel eğitim koşulları barındırır ve yaygın kas iskelet sistemi yaralanmalarına yol açabilir. Bu çalışmanın amacı Türk Silahlı Kuvvetleri (TSK) bünyesinde sözleşmeli er ve erbaş olarak görev yapan askerlerde gözlenen yaygın kas iskelet sistemi yaralanmalarının profilini çıkararak bunları önlemeye yönelik geliştirilebilecek stratejilerine kaynak olmaktır.

Yöntemler: Veriler son bir yıl içinde rutin sağlık kontrolleri yapılan sağlıklı ve herhangi bir kas iskelet sistemi yakınması olan sözleşmeli er ve erbaş askerlerin hastane kayıtlarından elde edilmiştir. Kas iskelet sistemi yaralanmaları vücuttaki lokalizasyonu, oluş mekanizması, yapılan askeri aktivite ile ilişkisi ve yaralanma sonrası oluşan iş gücü kaybı incelenmiştir.600 kişilik askeri popülasyonda görülen kas iskelet sistemi yaralanmaları hastane kayıtlarından tarandı (n=108 %9,3).

Bulgular: En sık diz çevresinin etkilendiği gözlendi (n=36,%33,3). Yumuşak doku yaralanması en yaygın olan yaralanma tipi idi. (n=50, %46,2). Askeri yürüyüşler ve spor aktiviteleri, yaralanmaya sebep olan en yaygın aktivitelerdi (n=81 %75). En çok etkilenen grup 25 yaş ve altıydı(n=52,%48,1).Yaralanma şiddetine göre iki hafta ile bir yıl arası süre iş gücü kaybı olduğu görüldü.

Tartışma ve Sonuç: Askeri yürüyüşler ve spor aktiviteleri sırasında gelişen yumuşak doku ve diz çevresini ilgilendiren kas iskelet yaralanmalarının önlenmesi için stratejiler geliştirilmelidir.
Tilt Table Tedavisi Uygulanan Nörolojik Rehabilitasyon Hastalarında Ortostatik Hipotansiyon Gelişimi ile Anksiyetenin İlişkisi
Authors: EROĞLU Selma
Published: August 2021

Amaç: Nörolojik rehabilitasyon uygulanan hastalarda sıklıkla görülen ortostatik hipotansiyon (OH), yaşam kalitesini ve bağımsızlığı azaltmakta, hastanede yatış süresini artırmaktadır. Tilt table’da vasovagal senkop gelişen hastalarda anksiyetenin semptomları tetiklediği bildirilmiştir. Nörolojik rehabilitasyon hastalarında anksiyete sıklıkla görülür. Ancak, nörojenik OH ile anksiyete arasındaki ilişki incelenmemiştir. Bu çalışmada tilt table tedavisi (TTT) uygulanan nörolojik rehabilitasyon hastalarında OH gelişimiyle anksiyete arasındaki ilişkinin incelenmesi amaçlandı.

Yöntemler: Nörolojik rehabilitasyon ve TTT uygulanan hastaların yaşı, cinsiyeti, tanısı ve hastalık süresi kaydedildi. Hastalar Fonksiyonel Bağımsızlık Ölçeği (FBÖ) ve Beck Anksiyete Ölçeği (BAÖ) ile değerlendirildi. TTT sırasında nörojenik OH gelişip gelişmediği ve gelişme süresi (dakika) kaydedildi.

Bulgular: Çalışmaya alınan 39 hastanın (12 kadın) yaş ortalaması 43±17,7 yıldı. Hastalardan 22’sinde OH gelişti. Hastalar OH (+) ve OH (-) şeklinde gruplandığında yaş, cinsiyet, hastalık süresi ve FBÖ skorları benzerdi (tümü için p>0.05), BAÖ skorları arasında da anlamlı fark izlenmedi (p=0.580). OH (+) hastalar anksiyete düzeylerine göre (minimal, hafif, orta, yüksek) gruplandırıldı ve gruplar arasında OH gelişim süresi açısından fark gözlenmedi (p=0.424). OH gelişim süresiyle anksiyete, yaş, hastalık süresi ve FBÖ arasında ilişki izlenmedi. Cinsiyet açısından incelendiğinde, OH (+) kadınlarda anksiyete skoru erkeklere kıyasla daha yüksekken (p=0.048), OH (-) grupta cinsiyet açısından anksiyete skoru benzerdi (p=0.111).

Sonuç: Nörolojik rehabilitasyon uygulanan hastalardan TTT alanlarda nörojenik OH gelişimi ile anksiyete arasında ilişki gösterilemedi. OH (+) kadın hastaların anksiyete skorları erkek hastalara oranla daha yüksek bulundu. Nörojenik OH’lu kadın hastalarda yüksek anksiyetenin klinik öneminin ve hasta özelliklerine göre yaklaşım sonuçlarının belirlenmesi açısından daha kapsamlı çalışmalara ihtiyaç vardır.
İntravitreal Bevacizumab ile Tedavi Edilen Prematüre Retinopatili Bebeklerde Risk Faktörlerinin Değerlendirilmesi
Authors: HAZAR Leyla , KARAHAN Mine , DURSUN Mehmet Emin , AVA Sedat , ERDEM Seyfettin , VURAL Esra , KEKLİKÇİ Uğur
Published: August 2021

Amaç: Prematüre retinopatisi (PR) olgularında retinopatinin şiddeti ile anne ve bebekteki risk faktörlerinin ilişkisini analiz etmek

Yöntemler: Haziran 2017- Ekim 2020 yılları arasında Dicle Üniversitesi Tıp Fakültesinde prematüre retinopatisi nedeniyle takip edilen bebeklerin verileri retrospektif olarak değerlendirildi. Prematüre bebeklerin, doğum yaşı, doğum ağırlığı, takip süresince eşlik eden komorbid hastalıklar, annenin gebelik problemleri kaydedildi. Tedavisiz takip edilenler (grup 1) ve intravitreal bevacizumab tedavisi uygulananlar (grup 2) karşılaştırıldı.

Sonuçlar: Çalışmaya 167 prematüre bebek alındı. Prematüre bebeklerin 99’unda (%60) tedavi gerektirmeyen PR vardı (grup 1), 68’ine (%40) intravitreal bevacizumab (grup 2) uygulandı. Grup 2’nin gestasyonel yaşı ve doğum ağırlığı grup 1’den anlamlı olarak düşük iken (p
COVID-19 Pandemisi Asistan Hekimlerin Yaşam Tarzı Davranışlarını Nasıl Etkiledi?
Authors: AKBAYRAM Hatice Tuba , KETEN Hamit Sırrı , AKSOY Yunus , YILDIZ Muhammed Mustafa
Published: August 2021

Giriş: Pandemi sürecinde hekimlerin sağlıklı yaşam tarzı davranışlarıyla kendi sağlıklarını korumaları çok önemlidir. Bu çalışma asistan hekimlerin yaşam tarzı davranışlarını ve pandeminin bu davranışlara etkisini değerlendirmek amacıyla yapılmıştır.

Yöntemler: Bu kesitsel çalışma 1-15 Temmuz 2021 tarihleri arasında bir üniversite hastanesinde gerçekleştirildi. Online anket formunda asistan hekimlerin bazı özellikleri (sosyo-demografik bilgiler, COVID-19 geçirme, COVID-19 aşısı, COVID-19 endişe düzeyi, boy uzunluğu, vücut ağırlığı, son bir yıldaki uyku kalitesi) ve pandemi sürecinde egzersiz, sigara, alkol, fastfood, şekerli yiyecek ve meyve-sebze tüketimindeki değişikler sorgulandı.

Bulgular: Çalışmaya alınan 192 hekimin yaş ortalaması 28,95±3,19 (24-45) yıl, %54,2’si (n=104) erkekti. COVID-19’u geçirenlerin oranı %46,4 (n=89) idi. COVID-19’u geçirenlerin %50,6'sı semptomların şiddetini "orta şiddetli" olarak tanımladı. Beden kitle indeksine göre hekimlerin %8,3’ü (n=16) obez, %33,3’ü (n=64) fazla kiloluydu. Hekimlerin %7,3’ünün (n=14) kronik hastalığı olduğu, %29,7’sinin (n=57) sigara içtiği, %23,4 (n=45)’ünün alkol kullandığı ve %31,3’ünün (n=60) hiç egzersiz yapmadığı saptandı. Pandemi sürecinde sigara ve alkol kullanımında artma sırasıyla %56,1 ve %20 olarak bulundu. Hekimlerin %39,6’sının (n=76) pandemi sürecinde egzersiz yapmayı azalttığı ve %35,4’ünün (n=68) kilo aldığı, %18,2’sinin (n=35) meyve-sebze tüketimini azalttığı, %38,5'inin (n=74) şekerli yiyecekleri ve %40,1'inin (n=77) fast food/hazır gıdaları daha fazla tükettiği belirlendi.

Sonuç: Çalışmamızın sonuçları hekimlerin önemli bir kısmının sağlıklı yaşam tarzı davranışlarına dikkat etmediklerini göstermektedir. Pandemi sürecinde hekimlerin yarısından fazlasının meyve-sebze tüketiminin değişmediği, önemli bir kısmının sigara, şekerli gıda ve fastfood/hazır gıdaları daha çok tükettiği, egzersiz yapmayı azalttığı ve kilo aldığı bulunmuştur.
A Rare Anatomical Location of Necrotizing Enterocolitis; Neonatal Appendicitis
Authors: KONAK Murat , SARIKAYA Mehmet , SEKMENLİ Tamer , TİYEK Fatma Hicret , KARABAĞLI Pınar , SOYLU Hanifi
Published: August 2021

Necrotizing enterocolitis(NEC) is the most significant gastrointestinal emergency in neonates, particularly affecting those who are premature. Neonatal appendicitis is highly uncommon in term infants and its diagnosis is typically incidental. The clinical presentation of newborn appendicitis is nonspecific and usually mimics that of NEC. Pneumatosis intestinalis is a finding that is extremely specific to NEC; it is very surprising to observe this finding in a patient with acute appendicitis. A 2730-g male infant was born at 39 weeks gestation to a 33-year-old mother. 30 minutes after delivery , the patient exhibited grunting and respiratory distress and was subsequently admitted to the Neonatal Intensive Care Unit. On the 7th day, the patient developed nutrition intolerance. The feeding was discontinued and the nasogastric catheter was switched to free drainage. Abdominal examination and laboratory parameters were not significant, but direct abdominal radiographs showed findings suggesting pneumatosis intestinalis. NEC was considered and the antibiotics were revised accordingly. The department of pediatric surgery was consulted as the patient’s abdominal examination and radiographs showed abnormalities suggestive of advanced NEC. The patient was taken into operation, gangrenous appendicitis was detected and an appendectomy was performed. When considering the differential diagnosis of NEC in neonatal patients, especially in term infants, clinicians should be mindful of acute appendicitis. In this study, we present a case of neonatal appendicitis, which is relatively common in pediatric cases but uncommon in the neonatal period, presenting as atypical NEC.
What do Emergency Physicians Know About Immune Checkpoint Inhibitor-Related Toxicities: A Brief Report
Authors: Butters Thomas , Liu Wing Kin , Grant Michael , Jackson-Spence Francesca , Zaynub Ghufoor , So Alfred , Lam James , Ashfar Mehran , Enting Deborah , Powles Thomas , Szabados Bernadett
Published: August 2021

Background: Cancer types eligible for treatment with immune checkpoint inhibitors (ICI) have increased over the past decade thus simultaneously growing the number of patients presenting to emergency departments (ED) with immune mediated toxicities. Objectives: The objective of this study was to ascertain information regarding the knowledge and management of immune checkpoint inhibitor mediated toxicities amongst emergency department physicians. Methods: A multiple-choice questionnaire was developed assessing the understanding of ICI usage and management of immune mediated toxicities, amongst ED physicians in 6 major ED departments in London. Participating clinicians included all levels of trainees and ED physicians. Questionnaires were distributed during weekly ED educational sessions, followed by training on immune-mediated toxicities. Results: Between March 2019 and September 2019, the questionnaire was delivered to 126 participants (80% junior grade, 20% specialist ED consultants). There was no significant association between clinician's seniority and overall score reached on the questionnaire. Amongst all participants, 56, 49, and 36% identified correctly ICIs as the first-line treatment regimen for melanoma, renal cell carcinoma, and non-small cell lung cancer, respectively. Overall, 90% of the participants recognized correctly cisplatin as a chemotherapy agent and 77% pembrolizumab as an ICI agent. Generally, there was a good understanding of chemotherapy related toxicities, however, the participants scored less well on questions relating to ICIs. Ten months following the initial audit and educational intervention, a single site re-audit was performed. The total average correct score was similar pre- and post-intervention (8, 13%, respectively). Conclusions: Knowledge and management of immune mediated toxicities is inferior compared to chemotherapy across physicians working in major ED departments in London. This survey highlights the need for increased education on ICI amongst ED clinicians.
Evaluation of the Medical Students' Satisfaction with Learning About Diabetes Through the Mobile App During the COVID-19 Pandemic
Authors: Ghaheri Seyedeh Zeinab , Hazbenejad Alireza , Maghsoudi Fatemeh , Radmanesh Esmat
Published: August 2021

Background: The use of technology in distance education can help cross the borders of space and time for lifelong learning. One of the active learning methods is the use of the mobile apps with the potential to develop medical education. Objectives: The aim of this study was to evaluate the efficacy of using diabetes educational mobile app in the endocrine physiology virtual classroom during the COVID-19 pandemic. Methods: In the present study, an educational mobile app for diabetes, including the information modules, as well as educational videos made by the researchers of this study, was designed for 32 medical students of Abadan University of Medical Sciences who had endocrine physiology courses in the first semester of the academic year 2019 - 2021. A researcher-made questionnaire consisting of 10 questions about learning the educational content of diabetes through the application containing educational videos in the virtual classroom of endocrine physiology, scoring based on a five-point Likert scale, was provided. The data were analyzed by SPSS 21 using descriptive statistics. Results: The results obtained based on the highest satisfaction percentage were as follows: creativity in learning (90.625%), fast learning (87.5%), accessible learning (84.375%), practical learning (81.25%), sustainable learning (81.25%), eagerness to learn (78.78%), attractive learning (78.125%), accurate learning (78.125%), reducing the student's dependence on the teacher (75%), and feeling more confident (75%). Conclusions: Using educational applications along with other teaching methods can lead to fast, creative, practical, accurate, and lasting learning, and due to its attractiveness, it creates a desire to learn in people.
Limping Along: Toward a Crip Phenomenology
Authors: Hall Kim Q. ,   Philosophy Documentation Center
Published: August 2021

A queer crip embodied experience of limping is the point of departure for my reflections on the differences between a crip phenomenology and a phenomenology of disability. I argue that a crip phenomenology can further understanding of how ableism and heternormativity work together, along with other structures of violence, to shape experiences at the edges of ability and disability, and, indeed, the possibility of queer crip movement in and through worlds.
How Strong Is a Counterfactual?
Authors: Boylan David , Schultheis Ginger ,   Journal of Philosophy Inc.
Published: August 2021

The literature on counterfactuals is dominated by strict accounts (SA) and variably strict accounts (VSA). Counterexamples to the principle of Antecedent Strengthening were thought to be fatal to SA; but it has been shown that by adding dynamic resources to the view, such examples can be accounted for. We broaden the debate between VSA and SA by focusing on a new strengthening principle, Strengthening with a Possibility. We show dynamic SA classically validates this principle. We give a counterexample to it and show that extra dynamic resources cannot help SA. We then show VSA accounts for the counterexample if it allows for orderings on worlds that are not almost-connected, and that such an ordering naturally falls out of a Kratzerian ordering source semantics. We conclude that the failure of Strengthening with a Possibility tells strongly against Dynamic SA and in favor of an ordering source-based version of VSA.
On Choosing the Difference Principle Behind the Veil of Ignorance
Authors: Chung Hun ,   Journal of Philosophy Inc.
Published: August 2021

In a recently published paper entitled, “The Difference Principle Would Not Be Chosen behind the Veil of Ignorance”, Johan E. Gustafsson attempts to demonstrate that the parties in Rawls’s original position would not choose the difference principle. Gustafsson’s main strategy was to show that Rawls’s difference principle in both of its ex post and ex ante versions imply counterintuitive distributional prescriptions in a few contrived examples. The purpose of this paper is to precisely demonstrate exactly how Gustafsson’s arguments have failed to show that the difference principle would not be chosen behind the veil of ignorance.
Schrödinger’in Yaşam Nedir? Kitabı, Gen-Merkezcilik ve Biyolojik Organizasyon
Authors: Karaca Çağlar ,   Kilikya Felsefe Dergisi
Published: August 2021

Bu makalede, Erwin Schrödinger’in kuramsal biyolojiye önemli bir katkıda bulunan Yaşam Nedir? adlı kitabındaki fikirlerini ve bu kitabın da etkisiyle gelişen gen-merkezci yaklaşımı eleştirel olarak değerlendirmeyi amaçlıyorum. Schrödinger’in canlılık konusundaki entelektüel mirasının tartışmaya açılması moleküler biyolojinin yaşam bilimlerinde hakim hale gelişinin ve yaşamın organizasyona dayalı temelinin anlaşılması açısından özel bir önem taşıyor. Yayınlandığından beri biyoloji felsefesinde önemli tartışmaları beraberinde getiren Yaşam Nedir? kitabı, yaşamı termodinamiğin yasaları doğrultusunda ele alması açısından biyolojide organizasyonu vurgular. Bununla birlikte Schrödinger’in canlılığın kodu olarak tasavvur ettiği aperiyodik kristal kavramı gen-merkezciliği destekleyen öncül fikirleri barındırmaktadır. Schrödinger, canlı varlıkların doğadaki entropi artışı eğilimiyle baş etmesi gereken nitelikte olması gerektiğini savundu ve bu görüş, canlılığa dair temel bir ilke olarak yaygın kabul gördü. Schrödinger’in yaşamın düzenliliğini mikro düzeyde aperiyodik kristal hipotezi ile açıklama girişimi ise nispeten daha tartışmalıdır. Makalede, bu tartışmalı konuları aydınlatmak amacıyla Schrödinger ve ardından gelişen gen-merkezci yaklaşımlara yönelik eleştirileri ele alıyorum. Ardından, gen-merkezciliğin sınırlılıklarına karşı yaşamın organizasyonunun organizma seviyesinde ele alınması değerlendiriyorum. Bu görüş, Kant’ın self-organizasyon kavramıyla tanımladığı, parça-bütün ilişkilerindeki karşılıklılığı temel alır. Son olarak, yaşamın organizasyonuna dair felsefî yaklaşımları ve entropinin buradaki rolünü tartışıyorum. Organizma düzeyinde ve organizma-çevre ilişkisindeki çoklu etmenlerin geri-besleme ilişkilerine dayanan ağ yapısı, gen-merkezciliğin indirgemeci yaklaşımına karşı kapsayıcı bir alternatif sunmaktadır.
Farabi’nin Eğitim Felsefesi Bağlamında Din ve Felsefeyi Konumlandırışı
Authors: Yeşilçayir Celal ,   Kilikya Felsefe Dergisi
Published: August 2021

Antik Yunan Felsefesi ile İslam dini arasında sentez inşa etmeye çalışan Farabi, sonraki dönemlere oldukça zengin bir düşünsel miras bırakmıştır. Onun düşünsel mirası bağlamında eğitimle ilgili kaleme aldığı düşüncelerin de önemli bir payının olduğu anlaşılmaktadır. Onun eğitim felsefesi, siyaset ve ahlak anlayışları ile yakın bir ilişki içinde olmakla birlikte bu alanda belirgin bir biçimde karşımıza çıkan iki unsur din ile felsefedir. Böylelikle onun, söz konusu sentezci yönteme eğitimle ilgili düşünceleri çerçevesinde de başvurduğu ortaya çıkmaktadır. Elinizdeki çalışmada Farabi’nin din ve felsefeyi eğitim alanında nasıl konumlandırdığının ele alınıp, irdelenmesi amaçlanmaktadır. Bu bağlamda toplumun birliğini sağlama ve insanların yetkinleşmesi sürecinde din ile felsefeye yüklenen anlamlar serimlenmektedir. Son tahlilde ise onun eğitim felsefesinde din ile felsefenin kendi aralarında nasıl ilişkilendirildiğinin ve derecelendirildiğinin de tartışılması amaçlanmaktadır.
Aristoteles ve Badiou'de Devlet ve Adalet
Authors: Taşkin Fahrettin ,   Kilikya Felsefe Dergisi
Published: August 2021

Bu yazıda Aristoteles ve Badiou’nün devlet ve adalet kavramlarını karşılaştırarak (iki bin yıldan uzun bir sürede) söz konusu kavramların nasıl bir değişim geçirdiğini genel çizgileriyle saptamaya ve bu değişimden hareketle adalet ve devlet kavramları üzerinde tekrar düşünmeye çalıştık. Kuşkusuz çok farklı dönemlerde yaşamış olup fikirleri arasında birçok ortaklık bulunabilecek başka filozoflar seçilebilirdi. Başka düşünürlerin değil de Aristoteles ve Badiou’nün bu kavramlarla ilgili görüşlerini karşılaştırmamızın sebebi, sadece yaşadıkları dönemlerin değil, ayrıca konu hakkındaki görüşlerinin de birbirinden oldukça farklı olmasıdır. Bu farklılık, etiğin daha sahih bir soruşturmasını yapma olanağını verecektir. Buradan çıkan sonuçlar, belli bir adalet tanımına veya etiğe bağlı kalınmaması gerektiğini ortaya çıkarabilir. Ancak burada asıl üzerinde durulmak istenen, etiğin hiçbir vakit temellendirilemeyeceği değil, temellendirmek için kendilerinden hareket edilmiş aksiyomların doğruluğunu tartışmaktır. Nihayetinde bu temelin insanın akıllı bir varlık olması kabulüne dayandığını ve onun bu özelliğiyle diğer tüm canlılardan koparıldığını ileri sürerek, etiğin ancak onun dünyayla bağı gerçekleştirildiğinde mümkün olabileceğini savunacağız.