Istanbul Metropolitan Municipality

To compare anatomical and functional outcomes as well as postoperative complication rates between cryotherapy and illuminated endolaser retinopexy in chandelier-assisted scleral buckling (CASB) for rhegmatogenous retinal detachment. This retrospective study included 63 eyes from 63 patients treated with CASB between January 2021 and January 2024. Group 1 (n = 31) underwent retinopexy with cryotherapy, whereas Group 2 (n = 32) received illuminated endolaser through the same cannula as the chandelier light. All surgeries were performed using a noncontact wide-angle viewing system by a single experienced vitreoretinal surgeon. Outcome measures included best-corrected visual acuity (BCVA), intraocular pressure, swept-source OCT, and postoperative complications. Mean BCVA improved significantly in both groups. In Group 1, BCVA improved from 1.39 ± 0.74 logMAR (approx. Snellen 20/490) to 1.01 ± 0.63 (20/204), P < 0.001. In Group 2, BCVA improved from 1.50 ± 0.67 (20/632) to 1.14 ± 0.66 (20/276), P < 0.001. Final BCVA ( P = 0.21) and retinal reattachment rates ( P = 0.67) were similar. However, cystoid macular edema (CME) occurred significantly more in Group 1 (19.3%) than in Group 2 (3.1%) ( P = 0.04). Rates of epiretinal membrane, cataract, and intraocular pressure elevation did not differ significantly ( P > 0.05). No buckle exposure or infection was observed. Both techniques are effective for CASB. Endolaser provides a lower risk of CME and enhanced surgical precision, suggesting it may be a favorable option in selected cases.

During anterior cruciate ligament (ACL) reconstruction, intraoperative graft contamination or postoperative infection remains a notable clinical concern. While antiseptic solutions are increasingly employed for graft decontamination and infection prophylaxis, the potential impact of these agents on the biomechanical integrity of tendon grafts has not been fully elucidated. This experimental study aimed to evaluate the biomechanical effects of soaking tendon grafts in vancomycin, chlorhexidine, and povidone-iodine solutions. Fresh bovine deep digital flexor tendons were used to simulate ACL autografts and randomly assigned to four groups (n = 6): 4% chlorhexidine, 10% povidone-iodine, 5 mg/mL vancomycin, and 0.9% isotonic saline (control). After 30-minute soaking, tendons were sutured using a four-rip-stop technique and biomechanically tested using a servohydraulic tensile system. Failure load, stiffness, and cyclic elongation were measured. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U tests with Bonferroni correction. Vancomycin and chlorhexidine groups exhibited significantly lower cyclic elongation compared to control and povidone-iodine groups. Failure load was also significantly higher in these groups, particularly compared to povidone-iodine, which demonstrated the weakest biomechanical performance. No significant differences in stiffness were observed across groups. Vancomycin and chlorhexidine can be safely used for short-term antiseptic soaking without compromising graft mechanical integrity. In contrast, povidone-iodine may weaken tendon structure. These findings may guide antiseptic use during ACL reconstruction and in managing contaminated tendons in open injuries.

Structural health monitoring (SHM) is a critical concern, especially for metropolitan cities exposed to natural hazards and environmental influences. Remote sensing plays a vital role in monitoring surface movements by taking advantage of regional image acquisition at regular intervals. In this study, the persistent scatterer interferometric synthetic aperture radar (PSInSAR) method was applied to Sentinel-1 satellite data acquired between 2018 and 2021 to monitor surface deformations in the lagoon region between the Büyükçekmece and Küçükçekmece Lakes, Istanbul. This region is particularly significant due to its proximity to the North Anatolian Fault Zone, the presence of active landslides, and clay-rich geological formations. Analysis of line-of-sight (LOS) deformation results from both ascending and descending orbits revealed deformation rates ranging from −9.5 to +7.3 mm/year and −9.9 to +6.6 mm/year, respectively. Six regions containing various engineering structures were selected for investigation. The study identified the impacts of active landslides on structures as well as the seasonal effects associated with clayey geological formations. Additionally, the deformations observed in coastal structures (e.g., piers and breakwaters) and thermal effects on bridge structures (e.g., viaducts) were evaluated based on the obtained results. Overall, the findings demonstrate that PSI effectively captures both regional and structure-specific deformation patterns. The study highlights the potential of PSI-based multi-temporal InSAR techniques for establishing continuous monitoring frameworks that support early warning, maintenance planning, and informed decision-making in urban renewal and infrastructure management in Istanbul.

Background and Objectives: Predictive performance of the modified myocardial performance index (Mod-MPI) for emergency cesarean delivery secondary to intrapartum fetal compromise (IFC) was examined in late-onset fetal growth restriction (FGR) or small-for-gestational-age (SGA) pregnancies. Materials and Methods: This prospective observational cohort comprised 120 singleton term pregnancies affected by late-onset FGR or SGA, classified in line with the Delphi consensus criteria, for whom a trial of vaginal delivery was planned. The primary endpoint was emergency cesarean delivery indicated by IFC, while the secondary endpoint was the development of composite adverse perinatal outcomes (CAPO). Measurements of Mod-MPI, the umbilical artery, the middle cerebral artery, and the cerebroplacental ratio (CPR) were performed within the final 72 h before delivery and were blinded to the clinicians managing the intrapartum period. Results: IFC constituted 28.3% (n = 34) of the study cohort. The IFC group exhibited significantly higher Mod-MPI values and lower CPR values (p < 0.001). In multivariable analysis, elevated Mod-MPI (≥0.61) and reduced CPR (<5th percentile) were identified as independent predictors of IFC. On receiver operating characteristic analysis, Mod-MPI demonstrated superior discriminative performance compared with CPR for predicting IFC (area under the curve [AUC]: 0.835 vs. 0.759). In contrast, CPR showed the highest diagnostic performance for predicting CAPO (AUC: 0.779). Conclusions: Mod-MPI reflects subclinical cardiac dysfunction in fetuses with late-onset FGR and SGA and represents a valuable parameter for predicting tolerance to acute intrapartum stress. Rather than routine implementation, it appears most appropriate as a complementary tool contributing to intrapartum risk assessment in selected high-risk cases.

Inherited kidney diseases represent a genetically and clinically heterogeneous group of disorders affecting both pediatric and adult populations. Advances in next-generation sequencing (NGS) have improved diagnostic precision; however, genotype-phenotype correlations and diagnostic yield vary substantially across disease entities. We retrospectively evaluated 165 patients referred for genetic testing due to suspected inherited kidney disease. Patients were classified into three clinical groups: polycystic kidney disease, Alport syndrome, and other syndromic patients with inherited kidney diseases. Genetic analysis was performed using NGS with Human Phenotype Ontology-based gene filtering and included evaluation of both single-nucleotide variants and copy number variations. Overall diagnostic yield differed markedly between groups. A molecular diagnosis was achieved in 71.4% of Alport patients, 41.0% of PKD patients, and 70.2% of patients in the Other syndromic group. In the Alport group, variants were identified exclusively in COL4A3, COL4A4, and COL4A5, with pathogenicity and gene involvement correlating with disease severity and the presence of extrarenal manifestations. The PKD group showed predominant involvement of PKD1, followed by PKHD1 and PKD2, while a substantial proportion of patients remained genetically negative, reflecting technical and biological complexity. The Other group exhibited pronounced genetic heterogeneity, with variants distributed across multiple genes involved in tubular, glomerular, metabolic, and ciliopathy-related pathways. Computational assessments demonstrated that several variants of uncertain significance (VUS) were located in functionally critical domains and were predicted to disrupt protein stability, intermolecular interactions, or conserved structural motifs, thereby supporting the biological plausibility of their potential pathogenic impact. Phenotype-driven NGS enables effective molecular diagnosis across diverse inherited kidney diseases while revealing disease-specific differences in diagnostic yield and genotype-phenotype correlations. Systematic inclusion of variants of uncertain significance and careful integration of genetic and clinical data are essential for accurate interpretation and long-term patient management. Collectively, this study enhances understanding of inherited kidney diseases and underscores the value of integrating comprehensive genomic and computational approaches into routine nephrogenetic practice.

Nowadays, using internet services gives anybody and everyone access to a wide range of information from across the globe. This survey was conducted to learn people's attitudes on the information found on the Internet to go to the intended location. Many tourists today choose to travel independently because they believe it offers more comfortable circumstances and chances for privacy for them and their families. However, a study of 300 respondents is the finest illustration of how much information is sufficient for different tourist locations in Kosovo. Out of the 300 respondents, 248 claimed to reside in Kosovo, 48 claimed to reside abroad, and 2 said they were unsure. The study's findings support the conclusion that there are significant differences in the knowledge people have about Kosovo's tourist attractions depending on their age and level of income. I have demonstrated that both domestic and foreign tourists have sufficient knowledge of Kosovo's tourist hotspots based on the nation's most recent tourism data. I support the institutions taking a more professional stance while creating a shared tourist data block for Kosovo.

Zenith Total Delay (ZTD) derived from Global Navigation Satellite System (GNSS) observations is a critical parameter for precise positioning and atmospheric studies. ZTD is continuously estimated at GNSS stations, forming high-resolution temporal time series that reflect the dynamic behavior of the troposphere. In recent years, deep learning approaches have been increasingly applied to ZTD estimation due to their ability to model nonlinear relationships. However, particularly for time-series reconstruction problems, it remains an open question whether the added architectural complexity of such models is always necessary.In this study, feature-driven classical machine learning models and a data-driven neural network approach are systematically compared for reconstructing missing ZTD values in GNSS time series. The analysis is based on ZTD observations from six International GNSS Service (IGS) stations covering the period from February 2023 to January 2024. All models are trained using an identical feature set comprising lagged ZTD values, tropospheric gradients, ZTD variances, station coordinates, and temporal attributes. This design ensures a fair and interpretable comparison between different modeling approaches.Linear Regression is considered as a baseline model, while Random Forest represents a nonlinear yet interpretable machine learning approach, and a Fully Connected Neural Network (FNN) is employed as a deep learning model. Model performance is evaluated using Mean Absolute Error (MAE), Root Mean Square Error (RMSE), and the coefficient of determination (R²), with a leave-one-station-out validation strategy applied to assess generalization capability.The results indicate that the Random Forest model achieves accuracy comparable to that of the FNN, while exhibiting greater stability and consistency across stations. The results highlight that incorporating physically meaningful features into the input space can be as effective as increasing model complexity for ZTD reconstruction. The study provides methodological and practical insights for selecting appropriate modeling strategies in tropospheric delay estimation.

Abstract Objectives Coagulation tests are essential for diagnosing bleeding disorders and for monitoring anticoagulant therapy. However, analyzer-dependent variability and pre-analytical interferences such as hemolysis and lipemia may affect test accuracy. This study aimed to compare the analytical performance of Roche Cobas t 711 and Sysmex CS-2500 analyzers for Prothrombin Time (PT), International Normalized Ratio (INR), Activated Partial Thromboplastin Time (APTT), and fibrinogen measurements, and to evaluate the effect of hemolysis and lipemia on test results. Methods Plasma samples from 100 patients were used. Repeatability and intermediate precision were assessed, and method comparison was performed using Passing-Bablok regression and Bland-Altman analysis according to Clinical and Laboratory Standards Institute (CLSI) EP09-A3 guideline. Artificial hemolysis and lipemia were induced to simulate pre-analytical interference. Results Both analyzers showed acceptable precision (coefficient of variation [CV] &lt;5 %). Fibrinogen measurements showed strong agreement (median difference −2.17 %), while PT and APTT results differed significantly (PT: −25.21 %; APTT: 22.76 %). PT was more affected by hemolysis (&gt;6 g/L) and lipemia (&gt;11.3 mmol/L) than APTT. These interferences appeared to affect Roche Cobas t 711 to a greater degree because of its optical detection method. Conclusions Although both devices performed reliably under standard conditions, significant differences were observed in PT and APTT measurements. Hemolysis and lipemia also caused clinically relevant bias at certain levels, especially in PT. Local validation and awareness of interference effects are essential for accurate coagulation testing, highlighting the need for careful testing of multiple measurands when transitioning between systems.

Foetal macrosomia is a significant obstetric problem that can lead to serious maternal/neonatal complications. The aim of this study was to determine which of the 75 g oral glucose tolerance test (OGTT) glucose values-fasting, first-hour, or second-hour-most strongly predicts foetal macrosomia in non-diabetic patients. This cross-sectional study prospectively screened 1,047 pregnant women who underwent a 75 g OGTT. Women with pregestational or gestational diabetes mellitus (GDM) were excluded from the main analysis. A total of 185non-diabetic women were included. Among the included patients, those who delivered macrosomic foetuses constituted Group 1 (n=16), while those who delivered normal birth weight infants constituted Group 2 (n=169). Fasting, first-hour, and second-hour glucose values from the 75 g OGTT were compared between the groups. No statistically significant differences were found between the two groups in terms of demographic variables (p>0.05). The mean fasting glucose values in Groups 1 and 2 were 77.75 and 76.11 mg/dL, respectively (p=0.42), the mean first-hour glucose values were 116.25 and 111.51 mg/dL, respectively (p=0.43), and the mean second-hour glucose values were 104.38 and 95.19 mg/dL, respectively (p=0.04). Receiver operating characteristic (ROC) curve analysis was performed for the second-hour glucose concentration, with an AUC of 0.675, and a threshold of 99.5 mg/dL was established. The second-hour glucose value of the 75 g OGTT may be a marker for foetal macrosomia in nondiabetic patients. These findings suggest that when the second-hour glucose value exceeds 99.5 mg/dL, foetal macrosomia may develop.