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    Artificial neural networks
    (Ortadogu Ad Pres & Publ Co, 2007) Yazici, Ayse Canan; Oegues, Ersin; Ankarali, Seyit; Canan, Sinan; Ankarali, Handan; Akkus, Zeki
    Artificial neural networks (ANNs) are computer softwares that were developed by simulating the working mechanism of human brain to accomplish the basic functions of the brain. ANNs have capability to learn, remember and then generalize the data to produce new information, and to detect the relationships between variables. There are considerable relations between the statistical methods and the neural networks. In the present study, biological neural network and neurons of the human brain and the general structure of ANNs were introduced. Then ANNs' relations with the statistical methods were investigated. ANNs' advantages and disadvantages as statistical methods were discussed. Many neural networks methods are considered generalizations of some of the classical statistical techniques. Generally, in statistics ANNs are used as flexible, nonlinear regression and classification models. Many neural network architectures have close links with the nonparametric statistical methods. Results may be obtained by training the feed forward ANNs algorithms with the nonlinear models of many statistical techniques.
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    Mortality Associated with Surgical Site Infections Following Cardiac Surgery: Insights from the International ID-IRI Study
    (Elsevier Ltd, 2025) Erdem, Hakan; Ankarali, Handan; Al-Tawfiq, Jaffar A.; Angamuthu, Kumar; Piljic, Dragan; Umihanic, Ajdin; Dayyab, Farouq
    Objectives: Surgical site infections (SSIs) after cardiac surgery increase morbidity and mortality rates. This multicenter study aimed to identify mortality risk factors associated with SSIs after heart surgery. Methods: Conducted from January to March 2023, this prospective study included 167 patients aged >16 years with post-heart surgery SSIs. The primary focus was the 30-day mortality. Univariate analysis and multivariate logistic regression utilizing the backward elimination method were used to establish the final model. Results: Several factors significantly correlated with mortality. These included urinary catheterization (odds ratio [OR] 14.197; 90% confidence interval [CI] 12.198-91.721]), emergent surgery (OR 8.470 [90% CI 2.028-35.379]), valvular replacement (OR 4.487 [90% CI 1.001-20.627]), higher quick Sequential Organ Failure Assessment scores (OR 3.147 [90% CI 1.450-6.827]), advanced age (OR 1.075 [90% CI 1.020-1.132]), and postoperative re-interventions within 30 days after SSI (OR 14.832 [90% CI 2.684-81.972]). No pathogens were isolated from the wound cultures of 53 (31.7%) patients. A total of 43.1% of SSIs (n = 72) were due to gram-positive microorganisms, whereas 27.5% of cases (n = 46) involved gram-negatives. Among the gram-positive bacteria, Staphylococci (n = 30, 17.9%) were the predominant microorganisms, whereas Klebsiella (n = 16, 9.6%), Escherichia coli (n = 9, 5.4%), and Pseudomonas aeruginosa (n = 7, 4.2%) were the most prevalent. Conclusions: To mitigate mortality after heart surgery, stringent infection control measures and effective surgical antisepsis are crucial, particularly, in the elderly. The clinical progression of the disease is reflected by the quick Sequential Organ Failure Assessment score and patient re-intervention, and effective treatment is another essential component of SSI management. © 2025 The Authors
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    Öğe
    Survival in rhino-orbito-cerebral mucormycosis: An international, multicenter ID-IRI study
    (Elsevier, 2022) Cag, Yasemin; Erdem, Hakan; Gunduz, Mehmet; Komur, Suheyla; Ankarali, Handan; Ural, Serap; Tasbakan, Meltem
    Background: Mucormycosis is an emerging aggressive mold infection. This study aimed to assess the outcome of hospitalized adults with rhino-orbito-cerebral mucormycosis (ROCM). The secondary objective was to identify prognostic factors in this setting. Methods: This study was an international, retrospective, multicenter study. Patients' data were collected from 29 referral centers in 6 countries. All qualified as proven cases according to the EORTC/MSGERC criteria. Results: We included 74 consecutive adult patients hospitalized with ROCM. Rhino-orbito-cerebral type infection was the most common presentation (n = 43; 58.1%) followed by rhino-orbital type (n = 31; 41.9%). Twenty (27%) had acquired nosocomial bacterial infections. A total of 59 (79.7%) patients (16 in combination) received appropriate antifungal treatment with high-doses of liposomal amphotericin B. Fifty-six patients (75.7%) underwent curative surgery. Thirty-five (47.3%) required intensive care unit admission (27; 36.5% under mechanical ventilation). Hospital survival was 56.8%, being reduced to 7.4% in patients with invasive mechanical ventilation. A multivariate binary backward logistic regression model identified confusion at admission (OR 11.48), overlapping hospital-acquired infection (OR 10.27), use of antifungal treatment before diagnosis (OR 10.20), no surgical debridement (OR 5.92), and the absence of prior sinusitis (OR 6.32) were independently associated with increased risk for death. Conclusion: Today, ROCM still has high mortality rate. Improving source control, rational therpy, and preventing nosocomial infections may improve survival in this severe infection.