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    Comparison of GAM and DLNM Methods for Disease Modeling in Environmental Epidemiology
    (2021) Karadağ, Mehmet; Kul, Seval; Yologlu, Saim; Boğan, Mustafa; Al, Behcet
    ABSTRACT Objective: In this study, it was aimed to compare the performance results of the methods modeled by using generalized additive models (GAM) and distributed lag non-linear models (DLNM) methods from real data of three different outcome variables of three separate diseases related to air pollution. Material and Methods: The data were retrospectively obtained from three hospitals under the General Secretariat of Gaziantep province public hospitals for a total of 1,916 days between 01 January 2009 and 31 March 2014. Response variables were number of the emergency unit admission, hospitalization and mortality due to asthma, chronic obstructive pulmonary disease (COPD) and pneumonia. The response variables were estimated by GAM and DLNM methods by building four different models and the performances of the models were compared. Results: When the estimation performances of GAM and DLNM methods are compared for each of the dependent variables in the prediction of hospitalizations due to asthma, GAM model IV [Akaike Information Criteria (AIC) (4,280.63)] values were found to perform the best. It was observed that DLNM method performed better than GAM in models established for the prediction of almost all other dependent variables. For when compare the odds ratio (OR) plot estimated on particulate matter (PM10); it was seen that GAM method made predictions with lower standard error compared to DLNM methods. Conclusion: When the models created with each dependent variable were compared; it was generally observed that superior performance was obtained from the DLNM method. However, the lowest standard error in the OR charts were observed in the models using the GAM method.
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    The Effect of Caffeic Acid Phenethyl Ester (CAPE) Against Cholestatic Liver Injury in Rats
    (Academic Press Inc Elsevier Science, 2010) Coban, Sacid; Yildiz, Fahrettin; Terzi, Alpaslan; Al, Behcet; Ozgor, Dincer; Ara, Cengiz; Polat, Alaattin
    Objectives. Caffeic acid phenethyl ester (CAPE) has been subjected to considerable investigations that have revealed its antioxidant and anti-inflammatory activities in different conditions. But there is not a previous investigation about its effect on cholestatic liver injury. The aim of this study was to investigate the effect of CAPE in rat liver against cholestatic liver injury induced by bile duct ligation. Methods. Swiss-albino rats were recruited in the study as follows; Group 1 rats subjected to simple laparotomy known as the sham group; Group 2 rats subjected to bile duct ligation (BDL); Group 3 bile duct ligated rats treated with CAPE. The third group received CAPE (10 mu mol/kg) intraperitoneally daily throughout 14 d. Results. Data showed a decrease in gamma glutamyl transferase (GGT), aspartate aminotransferase (AST), and alanine aminotransferase levels (ALT) of the CAPE treated rats, compared with BDL group (P < 0.001, P < 0.01, and P < 0.02, respectively). In the CAPE treated rats, tissue levels of malondialdehyde (MDA) and myeloperoxidase (MPO) were significantly lower than that of the BDL group (P < 0.001). The levels of glutathione (GSH) in CAPE treated rats were significantly higher than that of BDL group (P < 0.001). In CAPE treated group, the levels of interleukin-1alpha (IL-1 alpha) and interleukin-6 (IL-6) were significantly lower than that of BDL group (P < 0.03, P < 0.02, respectively). Administration of CAPE in the rats with biliary obstruction resulted in inhibition of necro-inflammation. Conclusion. These results suggest that treatment of CAPE maintains antioxidant defenses, reduces oxidative liver injury, cytokine damage, and necro-inflammation in bile duct ligated rats. Thus, CAPE seems to be a promising agent for the attenuation of cholestatic liver injury. (C) 2010 Elsevier Inc. All rights reserved.
  • Küçük Resim
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    The effect of caffeic acid phenethyl ester CAPE against cholestatic liver injury in rats
    (J Surg Res, 0–0., 2010) Çoban, Sacid; Yıldız, Fahrettin; Alpaslan, Terzi; Al, Behcet; Özgör, Dinçer; Ara, Cengiz; Ara, Cengiz; Polat, Alaadin; Esrefoğlu, Mukaddes
    Objectives. Caffeic acid phenethyl ester (CAPE) has been subjected to considerable investigations that have revealed its antioxidant and anti-inflammatory activities in different conditions. But there is not a previous investigation about its effect on cholestatic liver injury. The aim of this study was to investigate the effect of CAPE in rat liver against cholestatic liver injury induced by bile duct ligation. Methods. Swiss-albino rats were recruited in the study as follows; Group 1 rats subjected to simple laparotomy known as the sham group; Group 2 rats subjected to bile duct ligation (BDL); Group 3 bile duct ligated rats treated with CAPE. The third group received CAPE (10 mmol/kg) intraperitoneally daily throughout 14 d. Results. Data showed a decrease in g glutamyl transferase (GGT), aspartate aminotransferase (AST), and alanine aminotransferase levels (ALT) of the CAPE treated rats, compared with BDL group (P < 0.001, P < 0.01, and P < 0.02, respectively). In the CAPE treated rats, tissue levels of malondialdehyde (MDA) and myeloperoxidase (MPO) were significantly lower than that of the BDL group (P < 0.001). The levels of glutathione (GSH) in CAPE treated rats were significantly higher than that of BDL group (P < 0.001). In CAPE treated group, the levels of interleukin1alpha (IL-1a) and interleukin-6 (IL-6) were signifi- cantly lower than that of BDL group (P < 0.03, P < 0.02, respectively). Administration of CAPE in the rats with biliary obstruction resulted in inhibition of necro-inflammation. Conclusion. These results suggest that treatment of CAPE maintains antioxidant defenses, reduces oxidative liver injury, cytokine damage, and necroinflammation in bile duct ligated rats. Thus, CAPE seems to be a promising agent for the attenuation of cholestatic liver injury. 2010 Elsevier Inc. All rights reserved.
  • Küçük Resim
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    Emergency service units in Turkey don't have enough resources to implement the one- hour sepsis bundle components and sepsis guidelines recommendations, 238 emergency department directors opinion
    (2020) Elay, Gulseren; Al, Behcet
    Aim: Aim of this study is to investigate whether emergency rooms in Turkey have sufficient resources to treat sepsis patients. Sepsis has a high incidence and can result in multiple organ failure and death within hours if not rapidly intervened. Septic patients, are generally first admitted to the emergency departments. In the management of these patients, it is very important to have well -knowledged team and enough resources.Materials and Methods: A questionnaire regarding whether education and emergency room resources were sufficient to diagnose and treat sepsis was e-mailed to the directors of emergency department. Data collection took place from December 17, 2019 to December 27, 2019.Results: The study included 238 participants, of who worked in university hospitals, training and research hospitals, state hospitals, and inprivate hospitals. The first health care professional to examine emergency patients was a physician in 162 of the hospitals, and a nurse in 76. Sepsis treatment was delayed due to laboratory test delays in 77 hospitals, triage patient non-determinability in 62, and diagnosis delays in 33. Staffing was inadequate, with 54 participants reporting difficulties in reaching an emergency medicine physician, 124 in reaching an infectious disease physician, 203 in reaching a microbiologist, and 125 in reaching an intensive care physician.Conclusion: Emergency rooms in Turkey suffer from limited resources to properly implement sepsis treatment guidelines and bundles. Resources should be improved.