Öz: Sosyal Kaynaşma giderek önem kazanan akademik bir inceleme alanı olarak son yıllarda devletler için de politik bir üst hedef hâline gelmiştir. Bireylerin ve toplumların refaha ulaşması için ...çeşitli argümanlar ile dengeli kalkınmayı tesis etmeyi öngören Sosyal Kaynaşma kavramı farklı perspektifler eşliğinde tartışılsa da üzerinde uzlaşılmış bir tanımı hâlen bulunmamaktadır. Uluslararası kurumların ve ulusal hükûmetlerin de ilgisini çeken kavram ulus üstü yapısı ile Avrupa Birliği’nin de önem verdiği bir hedef olmuştur. Kuruluş felsefesi, uzun yıllar süren savaşlar nedeniyle yoksullaşmış Avrupalıları ve bu savaşlar nedeniyle yıpranmış Avrupalı devletleri bir çatı altında toplayarak barışı ve gönenci sağlamak ve sürdürmek olan Avrupa Birliği, kıtaya barışı ve adil paylaşımı hâkim kılmayı hedeflemiştir. Öncelikle Avrupalılar arasında kaynaşmayı sağlayarak oluşturulmak istenen “Yurttaşlar Avrupası”süreci, yaşanan çeşitli krizler ve kültürel farklılıklar nedeniyle istenen seviyeye getirilememiştir. Son yıllarda hâkim olan küreselleşme rüzgârıise sosyal kaynaşmanın giderek daha da zorlaşmasına neden olmaktadır. Bu noktadan hareketle çalışma sosyal kaynaşma kavramını çeşitli yönleriyle incelerken, Avrupa Birliği’nin alana dair çabalarını, hedeflerini ve seviyesini de analiz etmektedir. Abstract: Social cohesion is an academic field of study, which has gained importance especially in recent years. At the same time, it has also became a high politics issue for states too. The concept of Social Cohesion, which aims at balanced development with various arguments for the prosperity of individuals and society, has different approaches from many different perspectives. Therefore, there is no single definition accepted by everyone about the Social Cohesion. So, this concept, which attracts the attention of international institutions and national governments, has also become a goal of importance for the European Union with its supranational structure.The European Union's vision of founding is to bring together European and European states that have become impoverished due to years of wars under a common umbrella, to ensure peace and prosperity. Hereby, the eventual aim is to make peace and fair sharing dominate the continent. Primarily, the “Citizens' Europe” process, which was intended to be created by ensuring the fusion among Europeans, could not be brought to the desired level due to various crises and cultural differences. Subsequently the windsof globalization, which has prevailed in recent years, is making social cohesion more and more difficult. Based on this point, this study while examining the concept of social cohesion in various aspects, also analyzes the efforts, goals and current level of the European Union in the field.
ChatGPT, developed by OpenAI, represents the cutting-edge in its field with its latest model, GPT-4. Extensive research is currently being conducted in various domains, including cardiovascular ...diseases, using ChatGPT. Nevertheless, there is a lack of studies addressing the proficiency of GPT-4 in diagnosing conditions based on Electrocardiography (ECG) data. The goal of this study is to evaluate the diagnostic accuracy of GPT-4 when provided with ECG data, and to compare its performance with that of emergency medicine specialists and cardiologists.
This study has received approval from the Clinical Research Ethics Committee of Hitit University Medical Faculty on August 21, 2023 (decision no: 2023–91). Drawing on cases from the “150 ECG Cases” book, a total of 40 ECG cases were crafted into multiple-choice questions (comprising 20 everyday and 20 more challenging ECG questions). The participant pool included 12 emergency medicine specialists and 12 cardiology specialists. GPT-4 was administered the questions in a total of 12 separate sessions. The responses from the cardiology physicians, emergency medicine physicians, and GPT-4 were evaluated separately for each of the three groups.
In the everyday ECG questions, GPT-4 demonstrated superior performance compared to both the emergency medicine specialists and the cardiology specialists (p < 0.001, p = 0.001). In the more challenging ECG questions, while Chat-GPT outperformed the emergency medicine specialists (p < 0.001), no significant statistical difference was found between Chat-GPT and the cardiology specialists (p = 0.190). Upon examining the accuracy of the total ECG questions, Chat-GPT was found to be more successful compared to both the Emergency Medicine Specialists and the cardiologists (p < 0.001, p = 0.001).
Our study has shown that GPT-4 is more successful than emergency medicine specialists in evaluating both everyday and more challenging ECG questions. It performed better compared to cardiologists on everyday questions, but its performance aligned closely with that of the cardiologists as the difficulty of the questions increased.
Statistical analysis revealed no significant differences between the two sources, suggesting that ChatGPT-4 generated responses at an equal level with content produced directly by hospitals (Table ...1). According to AMA and NIH guidelines, patient education materials are recommended to be at a 6th-grade reading level or below 9,10. Source of answers Flesch Reading Ease Flesch-Kincaid Grade Level Mean (± SD) P value Mean (± SD) P value AI 43,3 (± 4,24) 0,084 11,9 (± 1,13) 0,013 Non-AI 65,6 (±0,36) 7,13 (± 0,9) Table 2 Comparison of Reading Levels of Answers from AI and Non-AI (Hospital Websites).
There have been continuous discussions over the ethics of using AI in healthcare. We sought to identify the ethical issues and viewpoints of Turkish emergency care doctors about the use of AI during ...epidemic triage.
Ten emergency specialists were initially enlisted for this project, and their responses to open-ended questions about the ethical issues surrounding AI in the emergency room provided valuable information. A 15-question survey was created based on their input and was refined through a pilot test with 15 emergency specialty doctors. Following that, the updated survey was sent to emergency specialists via email, social media, and private email distribution.
167 emergency medicine specialists participated in the study, with an average age of 38.22 years and 6.79 years of professional experience. The majority agreed that AI could benefit patients (54.50%) and healthcare professionals (70.06%) in emergency department triage during pandemics. Regarding responsibility, 63.47% believed in shared responsibility between emergency medicine specialists and AI manufacturers/programmers for complications. Additionally, 79.04% of participants agreed that the responsibility for complications in AI applications varies depending on the nature of the complication. Concerns about privacy were expressed by 20.36% regarding deep learning-based applications, while 61.68% believed that anonymity protected privacy. Additionally, 70.66% of participants believed that AI systems would be as sensitive as humans in terms of non-discrimination.
The potential advantages of deploying AI programs in emergency department triage during pandemics for patients and healthcare providers were acknowledged by emergency medicine doctors in Turkey. Nevertheless, they expressed notable ethical concerns related to the responsibility and accountability aspects of utilizing AI systems in this context.
The management of postoperative pain following lumbar disc herniation (LDH) surgery is crucial for the quality of recovery. The effectiveness of multimodal analgesia plans increases when interfascial ...plane blocks are included. This study sought to compare the analgesic efficacy of preoperative ultrasound-guided TLIP (thoracolumbar interfascial plane) blocks and posterior QLBs (quadratus lumborum blocks) in patients undergoing LDH surgery.
Patients undergoing elective LDH surgery under general anesthesia were randomized into two groups: thoracolumbar interfascial plane block (Group T) and posterior quadratus lumborum block (Group Q). Block applications were performed 30 min before anesthesia induction. In the postoperative period, analgesia control was provided with a patient-controlled analgesia device. The patients' 24 h cumulative opioid consumption was examined. Pain scores were evaluated in the 0th, 3rd, 6th, 9th, 12th, and 24th hours.
The mean 24 h cumulative morphine consumption for patients was statistically insignificant when Groups T and Q were compared (9.14 ± 7.03 mg vs. 8.66 ± 6.58 mg,
= 0.788). Pain scores at rest and during movement as well as morphine consumption were similar between groups in the 0th, 3rd, 6th, 9th, 12th, and 24th hours (
> 0.05).
The study determined that the utilization of TLIP blocks and posterior QLBs prior to anesthesia induction yielded comparable outcomes in terms of reducing postoperative analgesic consumption and enhancing the efficacy of multimodal analgesia in individuals undergoing single-distance lumbosacral spine surgery under general anesthesia.
Background Early diagnosis and accurate assessment of the severity of the disease are critical factors in the management of acute pancreatitis (AP). In this study, we investigated the success rates ...of combinations of Bedside Index of Severity in Acute Pancreatitis (BISAP) scores with C-reactive protein (CRP) values in predicting severe AP. Methods The medical records of all patients with AP admitted to our hospitals from September 2015 to September 2018 were reviewed retrospectively. To evaluate the severity of AP, the revised Atlanta criteria were used, and patients who developed organ failure lasting more than 48 hours were considered to have severe AP. We analyzed patient CRP values at the 24-hour mark via receiver operating characteristic (ROC) curve analysis. Four groups were then formed to separate mild AP from moderate to severe AP. The first group had BISAP scores ≥ 3, the second group had CRP values ≥ 90.7 mg/L, the third group had BISAP scores ≥ 3 and CRP values ≥ 90.7 mg/L, and the fourth group had BISAP scores ≥ 3 or measured CRP values ≥ 90.7 mg/L. Predictive accuracy, sensitivity, specificity, and positive and negative predictive values of groups in the prediction of severe AP were calculated. Results Our study population consisted of 207 patients, and according to the revised Atlanta scoring, 165 patients (79.7%) had mild AP, 30 (14.4%) had moderate, and 12 (5.8%) had severe AP. Comparing the mild, moderate, severe AP groups, we noted a significant difference between the mean hospital stay time, BISAP scores, and CRP values (p<0.001). Group 1, 2, 3, and 4 values of mild AP and all severe AP (moderate and severe) were significant (p<0.001). The highest specificity values were found in Group 3 (97.6%), while the highest sensitivity values were observed in Group 4 (88.1%). Conclusion CRP may increase the success of BISAP scoring in predicting the severity of AP.
•The effects of external E+ and E- on thermal and electrical conductivity•K were determined by the longitudinal heat flow methods•σ were determined by the four-point probe methods•K and σ values ...varied with temperature depending on E+ and E- values
This study aims to investigate the effects of external positive and negative static electric fields (E+ and E- respectively) on thermal conductivity (K) and electrical conductivity (σ) in Al-33 wt. % Cu, Al-6.4 wt. % Ni and Al-12 wt. % Si eutectic alloys. For this purpose, the solidifications of Al-Cu, Al-Ni, and Al-Si eutectic alloys were directionally done under E+ and E-. The directions of E were chosen to be parallel (E+) and antiparallel (E-) to the solid-liquid (S-L) growth direction and the magnitudes of E were approximately (+10) and (−10) kV cm−1 and (+16) and (-16) kV cm−1 for the Al-Cu, Al-Ni, and Al-Si eutectic alloys, respectively. The effects of E+ and E− on the K and σ were determined by the longitudinal heat flow and the four-point probe methods, respectively. While the K and σ values decreased with increasing temperature, the K and σ were increased and decreased with E+ and E−, respectively.
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Tetanus, caused by a grave and potentially lethal bacteria, is a medical condition that severely affects the central nervous system and demands vigilant attention and comprehensive preventive ...measures to safeguard public health. The onset of this condition is sudden and characterized by the emergence of intense tonic muscle spasms, underscoring its critical nature. In Türkiye, around 50 cases are officially reported each year; however, it is widely suspected that numerous cases remain unreported, contributing to an even more significant impact. This report aims to shed light on a remarkable case involving a 24-year-old male patient. Despite having a complete vaccination history, this individual contracted tetanus and required intensive care and mechanical ventilation due to the severity of his tetanus infection. This case serves as a poignant reminder of the importance of booster administration, highlighting the significance of continued and timely reinforcement of vaccinations.
Key Clinical Message
Septic pulmonary embolism (SPE) can originate from unusual sources like small boils, warranting consideration of diverse etiologies in respiratory distress. Prompt diagnosis, ...tailored antibiotics, and vigilant complication management optimize outcomes. Early recognition and treatment of minor infections, especially in diabetes are crucial.
Thrombosis in the inferior vena cava (IVC) is a rare but serious condition that can lead to significant morbidity and mortality. We present a case report of a 39-year-old male who presented to the ...emergency department with right flank pain that had progressed to severe back pain, bilateral flank pain, scrotal pain, and leg pain over the course of two days. The pain was severe enough to affect his daily activities. Laboratory investigations revealed a D-dimer level of 17 ng/mL, creatinine level of 110 µmol/L, and a white blood cell count of 10 × 109/L with a CRP level of 5 mg/L. Urine analysis was positive for blood. Doppler ultrasound of both legs showed deep vein thrombosis extending from the external iliac veins to the distal veins of both legs. Further investigation with computed tomography of the abdomen revealed a large thrombus in the distal vena cava extending to the renal artery and both external and internal iliac veins. The patient was diagnosed with Factor V Leiden syndrome based on genetic testing, which revealed a heterozygous mutation in the F5 gene. He was successfully treated with low molecular weight heparin and warfarin, and after five days of hospitalization, he was discharged with warfarin for long-term anticoagulation. This case report emphasizes the importance of considering IVC thrombosis in patients with a constellation of symptoms, including scrotal pain, and the role of genetic testing in identifying underlying hypercoagulable states.
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