Browsing by Author "Tunali V."
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Item Effectiveness of tablet computer use in achievement of schedule-following skills by children with autism using graduated guidance(Turkish Education Association, 2016) Eliçin Ö.; Tunali V.Tablet computers are frequently used in the education of children with autism. Studies show that educational activities involving tablet computers have positive effects on the acquisition of target skills by children with autism. In this research, the effectiveness of the use of tablet computers in teaching children with autism to use schedules was evaluated. Three male students of ages 5 to 7 diagnosed with autism participated in the research. A single-case multiple-probe-design-across-participants was used in the research. Independent variable of the research was the education provided via tablet computers using the graduated guidance technique, and the dependent variable was the acquisition of schedule-following skill. Follow-up and generalization data were collected on the 7th, 14th, and 21st days after the teaching sessions ended. Follow-up sessions were completed with 100% performance for all three subjects. Generalized correct responses were found 90% for one subject, and 100% for the other two. The results indicated that the subjects acquired, maintained, and generalized the schedule-following skills after the teaching sessions completed. In addition, the teachers of the subjects were asked their opinions about the application. These opinions that form the social validity data of the research support the research findings.Item The importance of the contribution of rapid test, serological and molecular methods in the diagnosis of two imported malaria cases with atypical microscopy; [Mikroskopide Atipik Gorunumlu Dis Kaynakli Iki Sitma Olgusunda Hizli Test, Serolojik ve Molekuler Yontemlerin Taniya Katkisinin Onemi](Ankara Microbiology Society, 2017) Zorbozan O.; Pullukcu H.; Sahar E.A.; Karakavuk M.; Can H.; Tunali V.; Doskaya M.; Turgay N.; Toz S.; Ozbilgin A.Malaria is a widespread and life-threatening disease in tropical and subtropical regions. In patients with typical clinical symptoms, malaria is considered as a preliminary diagnosis if there is a travel history to malaria-endemic areas. The basis of the laboratory diagnosis of malaria is the microscopic examination of Giemsa stained smears. On the other hand, the diagnosis and differentiation of Plasmodium species with microscopic examination may have some difficulties. In the first case, adifferent appearance from the classical Plasmodium vivax erythrocytic forms in infected erythrocytes were detected in 1% of all erythrocytes in thin smear blood preparations of a 26-year-old male with complaints of fever and chills and a story of travel to Nigeria. It was observed that parasitic nuclei were not prominent, and were located in the cytoplasm irregularly as chromatin or dye particles, nucleus fragments similar to Schiiffner's granules in the form of scattered and granular spots were present in some erythrocytes, the cytoplasm of some Plasmodium erythrocytic forms were irregular and nuclei were not seen. There were no Schiiffner's granules in any of the infected erythrocytes. PMvax was detected by the rapid diagnostic test (OptiMAL, DiaMed GmbH, Switzerland), which searches for the antigens of Plasmodium species, in the peripheral blood sample of the patients. The P.vlvax 18S rRNA gene was also detected by the multiplex real-time polymerase chain reaction. Antibodies against Plasmodium species were searched by using the Pan Malaria Antibody CELISA (CeLLabs Pty Ltd, Brookvale, Australia) kit in the patient's serum sample and the optical density (OD) value of the patient sample was measured five times the OD value of the positive control. In the second case, adifferent appearance from the classical P.faldparum erythrocytic forms in infected erythrocytes were detected in 12% of all erythrocytes in thin smear blood preparations of a 31-year-old male who has been suffering from persistent fever, severe headache, pain in the eyes and was known to be working in Nigeria. It was observed that some Plasmodium trophozoites have 1 /3 of the size of erythrocytes such as P.vivax and have non-granular cytoplasm, some erythrocytic forms were round and the nucleus and cytoplasm were hardly distinguished, some of them were seen as crescent and close to the nucleus of the cytoplasm and some erythrocytic forms had characteristically a single nucleus and a scattered cytoplasm, similar to mature trophozoites of P.vivax. Although the Plasmodium young trophozoites were similar to Rvtvax in means of magnitude, the forms in which the nude adhered to the erythrocyte wall were common. There were no Rfalciparum gametocyte forms. Rfalciparum like young trophozoite was observedonly in one of the four smears. P.falciparum was detected by the commercial rapid diagnostic test and Rfalciparum 18S rRNA gene was also detected by the multiplex real-time polymerase chain reaction. Antibody formation against Plasmodium species was not detected in the ELISA test. In these case reports, the importance of the support of rapid diagnostic tests, serological and molecular methods to microscopic diagnosis and species determination of two imported malaria cases were demonstrated.Item Infecting glial cells with antimony resistant Leishmania tropica: A new ex-vivo model; [Glia Hücrelerinin Antimona Dirençli Leishmania tropica ile Enfekte Edilmesi: Yeni Bir ex-vivo Modeli](Ankara Microbiology Society, 2018) Zorbozan O.; Harman M.; Evren V.; Erdoǧan M.A.; Kilavuz A.; Tunali V.; Çavuş I.; Yilmaz O.; Özbilgin A.; Turgay N.Leishmaniasis is a vector-borne zoonotic disease that shows different clinical features like cutaneous, mucocutaneous, visceral and viscerotropic forms. The protocols used in the treatment of leishmaniasis are toxic and have many limitations during administration. One of the limitations of treatment is the resistance against the protocols in practice. There is also a need to define new treatment options especially for resistant patients. Ex-vivo models using primary cell cultures may be a good source for evaluating new drug options in patients with antimony resistance, in addition to in-vitro and in-vivo studies. In this study, it was aimed to define a new ex-vivo culture model to evaluate treatment options in patients with cutaneous leishmaniasis who did not respond to treatment. In our experimental model of ex-vivo infection, Leishmania tropica promastigotes isolated from a case previously diagnosed with cutaneous leishmaniasis were used. The primary astroglial cell culture used for the ex-vivo model was prepared from 2-3 days old neonatal Sprague Dawley rat brains under sterile conditions by the modification McCarthy's method. The astroglia cells, which reached sufficient density, were infected with antimony resistant Ltropica promastigotes. After 24 hours of incubation, the supernatant on the cells were collected, the cell culture plate was dried at room temperature, then fixed with methyl alcohol and stained with Giemsa to search for Ltropica amastigotes. Amastigotes were intensely observed in glia cells in primary cell cultures infected with Ltropica promastigotes. No promastigotes were seen on Giemsa stained preparations of the precipitates prepared from the bottom sediment after the centrifugation of the liquid medium removed from the infected plates. In this study, promastigotes from a cutaneous leishmaniasis patient unable to respond to pentavalent antimony therapy were shown to infect rat glia cells and converted to amastigote form. This amastigote glial cell model, as far as we know, is the first model in the literature produced by Ltropica. The occurrence of Ltropica amastigote forms in glia cells may be indicative of the ability of Leishmania species to infect the central nervous system. The central nervous system may be an area for the Leishmania amastigotes to escape from the immune system in cases of leishmaniasis without a treatment response. Our study is important because it is the first study to show the infection of glia cells with L.tropica amastigotes. © 2018 Ankara Microbiology Society. All rights reserved.Item Supervised Learning Approaches to Flight Delay Prediction(Sakarya University, 2020) Atlioğlu M.C.; Bolat M.; Şahin M.; Tunali V.; Kilinç D.Delays in flights and other airline operations have significant consequences in quality of service, operational costs, and customer satisfaction. Therefore, it is important to predict the occurrence of delays and take necessary actions accordingly. In this study, we addressed the flight delay prediction problem from a supervised machine learning perspective. Using a real-world airline operations dataset provided by a leading airline company, we identified optimum dataset features for optimum prediction accuracy. In addition, we trained and tested 11 machine learning models on the datasets that we created from the original dataset via feature selection and transformation. CART and KNN showed consistently good performance in almost all cases achieving 0.816 and 0.807 F-Scores respectively. Similarly, GBM, XGB, and LGBM showed very good performance in most of the cases, achieving F-Scores around 0.810. © 2020, Sakarya University. All rights reserved.Item Refugees at the Crossroads of Continents: A Molecular Approach for Cutaneous Leishmaniasis Among Refugees in Turkey(Springer, 2020) Özbilgin A.; Gencoglan G.; Tunali V.; Çavuş İ.; Yıldırım A.; Gündüz C.; Harman M.Purpose: Due to mass population movements driven by internal conflicts and wars, cutaneous leishmaniasis (CL) is becoming increasingly important in Turkey. This study is aimed at determining the clinical aspects, diagnosis and genotyping of CL patients coming to Turkey from abroad. Methods: In our study, the clinical materials obtained from the patients or sent for diagnostic purposes from other centers to our laboratory between years 2012 and 2016 were assessed retrospectively. In total, there were 38 patients from Syria, Iraq, Afghanistan, Iran, and Turkmenistan. Results: 29 (76%), 28 (73%) and 33 (87%) samples were positive by light microscopy, Novy-McNeal-Nicolle(NNN), and enriched medium, respectively. By ITS-1 gene region PCR, 31 (81%) of the cases were positive. 35 of the patients were tested positive by at least one of the diagnostic methods. By genotyping, 21 Leishmania tropica, 8 Leishmania major, 3 Leismania infantum, 2 Leishmania donovani, and 1 Leishmania aethopica were detected. Conclusion: This study is aimed at informing the clinicians working in the field for the import CL cases and recording the changing epidemiological features of CL in the region as well as discussing the possible focus for L. aethiopica infection which has not been shown in the region before. © 2019, Witold Stefański Institute of Parasitology, Polish Academy of Sciences.Item Efficacy of AI-Assisted Personalized Microbiome Modulation by Diet in Functional Constipation: A Randomized Controlled Trial(MDPI, 2022) Arslan N.Ç.; Gündoğdu A.; Tunali V.; Topgül O.H.; Beyazgül D.; Nalbantoğlu Ö.U.Background: Currently, medications and behavioral modifications have limited success in the treatment of functional constipation (FC). An individualized diet based on microbiome analysis may improve symptoms in FC. In the present study, we aimed to investigate the impacts of microbiome modulation on chronic constipation. Methods: Between December 2020–December 2021, 50 patients fulfilling the Rome IV criteria for functional constipation were randomized into two groups. The control group received sodium picosulfate plus conventional treatments (i.e., laxatives, enemas, increased fiber, and fluid intake). The study group underwent microbiome analysis and received an individualized diet with the assistance of a soft computing system (Enbiosis Biotechnology®, Sariyer, Istanbul). Differences in patient assessment constipation–quality of life (PAC-QoL) scores and complete bowel movements per week (CBMpW) were compared between groups after 6-weeks of intervention. Results: The mean age of the overall cohort (n = 45) was 31.5 ± 10.2 years, with 88.9% female predominance. The customized diet developed for subjects in the study arm resulted in a 2.5-fold increase in CBMpW after 6-weeks (1.7 vs. 4.3). The proportion of the study group patients with CBMpW > 3 was 83% at the end of the study, and the satisfaction score was increased 4-fold from the baseline (3.1 to 10.7 points). More than 50% improvement in PAC-QoL scores was observed in 88% of the study cohort compared to 40% in the control group (p = 0.001). Conclusion: The AI-assisted customized diet based on individual microbiome analysis performed significantly better compared to conventional therapy based on patient-reported outcomes in the treatment of functional constipation. © 2022 by the authors.Item Artificial intelligence-based personalized diet: A pilot clinical study for irritable bowel syndrome(Taylor and Francis Ltd., 2022) Karakan T.; Gundogdu A.; Alagözlü H.; Ekmen N.; Ozgul S.; Tunali V.; Hora M.; Beyazgul D.; Nalbantoglu O.U.We enrolled consecutive IBS-M patients (n = 25) according to Rome IV criteria. Fecal samples were obtained from all patients twice (pre-and post-intervention) and high-throughput 16S rRNA sequencing was performed. Six weeks of personalized nutrition diet (n = 14) for group 1 and a standard IBS diet (n = 11) for group 2 were followed. AI-based diet was designed based on optimizing a personalized nutritional strategy by an algorithm regarding individual gut microbiome features. The IBS-SSS evaluation for pre- and post-intervention exhibited significant improvement (p < .02 and p < .001 for the standard IBS diet and personalized nutrition groups, respectively). While the IBS-SSS evaluation changed to moderate from severe in 78% (11 out of 14) of the personalized nutrition group, no such change was observed in the standard IBS diet group. A statistically significant increase in the Faecalibacterium genus was observed in the personalized nutrition group (p = .04). Bacteroides and putatively probiotic genus Propionibacterium were increased in the personalized nutrition group. The change (delta) values in IBS-SSS scores (before-after) in personalized nutrition and standard IBS diet groups are significantly higher in the personalized nutrition group. AI-based personalized microbiome modulation through diet significantly improves IBS-related symptoms in patients with IBS-M. Further large-scale, randomized placebo-controlled trials with long-term follow-up (durability) are needed. © 2022 ENBIOSIS Biotechnologies Limited. Published with license by Taylor & Francis Group, LLC.Item Culture-independent assessment of probiotic supplement consistency in commercially available probiotic supplements(Elsevier Ltd, 2023) Gundogdu A.; Nalbantoglu O.U.; Sarikaya I.; Karis G.; Erdogan M.N.; Hora M.; Tunali V.The probiotic products market has experienced significant growth in recent years, driven by increasing consumer demand for health benefits. This demand is largely fueled by the widespread promotion of probiotic products, and is compounded by relatively lax regulations regarding these products compared to those for drugs. In this study, we sought to evaluate the consistency of product labels and contents for probiotic supplements in the Turkish and USA markets. A total of 44 commercially available probiotic products were included in the analysis, comprising 40 products from Turkey and 4 from the USA. Shotgun metagenome sequencing was performed to determine the microbiological content and functional characteristics of the products. Additionally, we evaluated the presence of antibiotic-resistance genes and virulence genes in each product. Our findings showed that 38.6% of the products contained microorganisms not indicated on their labels, while 15.9% of products did not contain one or more of the probiotic microorganisms specified on their labels. Moreover, over half of the probiotic products (68.2%) were found to contain at least one resistance gene, and 40.9% of the products carried multiple virulence genes. Streptococcus thermophilus being the primary contributor to the detected virulence genes. This study is the first to examine the label and content discrepancies of probiotic products in the Turkish market and one of the largest to analyze resistance gene profiles of probiotic supplements in the literature. These findings may suggest a potential public health risk and the need for whole genome sequencing analysis of probiotic supplements. © 2023 Elsevier LtdItem Emerging and Re-Emerging Parasitic Infections of the Central Nervous System (CNS) in Europe(Multidisciplinary Digital Publishing Institute (MDPI), 2023) Tunali V.; Korkmaz M.In a rapidly evolving global landscape characterized by increased international travel, migration, and ecological shifts, this study sheds light on the emergence of protozoal and helminthic infections targeting the central nervous system (CNS) within Europe. Despite being traditionally associated with tropical regions, these infections are progressively becoming more prevalent in non-endemic areas. By scrutinizing the inherent risks, potential outcomes, and attendant challenges, this study underscores the intricate interplay between diagnostic limitations, susceptibility of specific population subsets, and the profound influence of climate fluctuations. The contemporary interconnectedness of societies serves as a conduit for introducing and establishing these infections, warranting comprehensive assessment. This study emphasizes the pivotal role of heightened clinician vigilance, judicious public health interventions, and synergistic research collaborations to mitigate the potential consequences of these infections. Though rare, their profound impact on morbidity and mortality underscores the collective urgency required to safeguard the neurological well-being of the European populace. Through this multifaceted approach, Europe can effectively navigate the complex terrain posed with these emergent infections. © 2023 by the authors.Item A Multicenter Randomized Controlled Trial of Microbiome-Based Artificial Intelligence-Assisted Personalized Diet vs Low-Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols Diet: A Novel Approach for the Management of Irritable Bowel Syndrome(Wolters Kluwer Health, 2024) Tunali V.; Çidem Arslan N.; Ermiş B.H.; Hakim G.D.; Gündoğdu A.; Hora M.; Nalbantoğlu Ö.U.INTRODUCTION: Personalized management strategies are pivotal in addressing irritable bowel syndrome (IBS). This multicenter randomized controlled trial focuses on comparing the efficacy of a microbiome-based artificial intelligence-assisted personalized diet (PD) with a low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet (FODMAP) for IBS management. METHODS: One hundred twenty-one patients participated, with 70 assigned to the PD group and 51 to the FODMAP diet group. IBS subtypes, demographics, symptom severity (IBS-SSS), anxiety, depression, and quality of life (IBS-QOL) were evaluated. Both interventions spanned 6 weeks. The trial’s primary outcome was the within-individual difference in IBS-SSS compared between intervention groups. RESULTS: For the primary outcome, there was a change in IBS-SSS of 2112.7 for those in the PD group vs 299.9 for those in the FODMAP diet group (P 5 0.29). Significant improvement occurred in IBS-SSS scores (P < 0.001), frequency (P < 0.001), abdominal distension (P < 0.001), and life interference (P < 0.001) in both groups. In addition, there were significant improvements in anxiety levels and IBS-QOL scores for both groups (P < 0.001). Importantly, PD was effective in reducing IBS SSS scores across all IBS subtypes IBS-Constipation (IBS-C; P < 0.001), IBS-Diarrhea (IBS-D; P 5 0.01), and IBS-Mixed (IBS-M; P < 0.001) while FODMAP diet exhibited comparable improvements in IBS-C (P 5 0.004) and IBS-M (P < 0.001). PD intervention significantly improved IBS-QOL scores for all subtypes (IBS-C [P < 0.001], IBS-D [P < 0.001], and IBS-M [P 5 0.008]) while the FODMAP diet did so for the IBS-C (P 5 0.004) and IBS-D (P 5 0.022). Notably, PD intervention led to significant microbiome diversity shifts (P < 0.05) and taxa alterations compared with FODMAP diet. DISCUSSION: The artificial intelligence-assisted PD emerges as a promising approach for comprehensive IBS management. With its ability to address individual variation, the PD approach demonstrates significant symptom relief, enhanced QOL, and notable diversity shifts in the gut microbiome, making it a valuable strategy in the evolving landscape of IBS care. Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.Item Response to Dahly and Morris(Wolters Kluwer Health, 2025) Tunali V.; Ermiş B.H.; Nalbantoǧlu O.U.[No abstract available]Item Update on Blastocystis: highlights from the Fourth International Blastocystis Conference(F1000 Research Ltd, 2025) Figueiredo A.M.; Shaw D.; Tunali V.; Gentekaki E.; Tsaousis A.D.; Carmena D.While the stramenopile Blastocystis, first discovered in 1911, is considered the most prevalent enteric protist in humans, its biology remains largely unexplored. Clinical studies have only recently begun investigating the role of Blastocystis in the gut and its relationship with the gut microbiome, and whether it plays a pathogenic role in human and animal health. Aiming to gather leading researchers in the field to encourage and stimulate cross-disciplinary dialogue while fostering long-term international collaborations, the Fourth International Blastocystis Conference was hosted from the 17 th to the 19 th of September 2024 in Heraklion (Crete, Greece). The event was mainly supported by the COST Action CA21105, “ Blastocystis under One Health”, and the Microbiology Society. The multi- and interdisciplinary conference programme covered all aspects related to Blastocystis evolutionary biology and advances in omics, intestinal ecology (gut microbiome), clinical significance and association with disease, diagnosis and molecular characterisation, as well as epidemiology and One Health. The high-quality presentations discussed at the conference provided researchers with a synthesis of recent advancements, while key research questions, knowledge gaps, and future steps in Blastocystis research were identified. Herein, we aim to provide a thorough overview of the presentations at the congress. The COST Action CA21105, 'Blastocystis under One Health,' will build on the insights and collaborations fostered during the conference, promoting integrative research approaches, advancing our understanding of Blastocystis, and driving future efforts to translate these findings into improved public health strategies. Copyright: © 2025 Figueiredo AM et al.Item Response to Melton et al(Wolters Kluwer Health, 2025) Tunali V.; Ermiş B.H.; Nalbantoğlu Ö.U.[No abstract available]