Apical multiple muscular ventricular septal defects (VSDs) are difficult to visualize, and closing these VSDs is technically troublesome. For these reasons, the surgical outcome of the lesion is unsatisfactory. Some surgical techniques have been reported to improve the outcome, but they are not definite. We present a case with atrial septal defect, multiple muscular and perimembranous VSDs, and pulmonary hypertension due to high pulmonary blood flow. In the first operation during the infantile period, the patient received closure of the perimembranous and muscular VSD through the right atrium and atrial septal defect closure. However, postoperative pulmonary blood flow was not decreased compared with that of before the operation, and pulmonary hypertension was also not improved. In addition to these lesions, tricuspid valve insufficiency was also observed after the operation. Postoperative computed tomography showed channels of apical muscular VSDs in the apex of the right ventricle. In the second operation, exclusion of apex muscular VSDs using the felt sandwich technique and tricuspid valve repair were performed. After closing multiple muscular VSDs during the operation, pulmonary blood flow was significantly decreased, and pulmonary hypertension was improved as well. After the second operation, postoperative echocardiography and catheter examination showed decreased VSD shunt and pulmonary blood flow, resulting in improved pulmonary hypertension.

La filtrazione a membrana nel trattamento delle acque e delle acque reflue è una tecnologia promettente, grazie alla sua capacità di fornire elevati rendimenti depurativi. Tuttavia, il problema del fouling della membrana limita la sua applicazione poiché riduce  l’efficienza del sistema. Quindi, le membrane necessitano di pulizia, la quale comporta costi notevoli e danni alla membrana, con possibili tempi di inattività.Le recenti ricerche mirano a nuove tecnologie per ridurre le incrostazioni. Il presente lavoro analizza l’utilizzo di ultrasuoni per controllare la formazione del fouling: le membrane ultrafiltranti utilizzate sono state sottoposte a bagno ultrasonico al fine di controllare le incrostazioni. Dopo le prove è stato osservato il danneggiamento delle membrane e valutata la possibilità di riutilizzo.Seppur promettente in termini di prestazione, questa tecnologia ha dei limiti, che devono essere valutati con attenzione prima dell’utilizzo su scala reale.

Le molestie olfattive indotte da impianti di trattamento di acque reflue costituiscono un vero e proprio problema ambientale. In particolare, le emissioni odorigene derivanti dall’esercizio di impianti in zone turistiche sono considerate la principale causa di disturbo notato dalla popolazione esposta. La valutazione dell’impatto indotto può essere effettuata attraverso la misurazione degli odori, utilizzando un metodo analitico o sensoriale. Quest’ultimo, legato al “sensore umano” è causa di notevole incertezza. Pertanto, nel presente articolo si vuole mostrare l’applicazione di una procedura innovativa di tipo senso-strumentale, il cui obiettivo è quello di rimuovere la componente soggettiva nella misura degli odori. I risultati ottenuti in uno SWWTP hanno dimostrato l’applicabilità di tale procedura nel monitoraggio delle emissioni odorigene ed hanno permesso l’identificazione di 39 sostanze diverse di cui quasi la metà responsabili di disturbi olfattivi.  

The 15 species of small carnivorous marsupials that comprise the genus Antechinus exhibit semelparity, a rare life-history strategy where death occurs after one breeding season. Antechinus males, but not females, age rapidly (demonstrate organismal senescence) during the breeding season and show promise as new animal models of ageing. Some antechinus species are also threatened or endangered. Here, we report chromosome-level genomes of the yellow-footed antechinus Antechinus flavipes. The genome assembly has a total length of 3.2 Gb with a contig N50 of 51.8 Mb and a scaffold N50 of 636.7 Mb. We anchored and oriented 99.7% of the assembly on seven pseudochromosomes and found that repetitive DNA sequences occupy 51.8% of the genome. Draft genome assemblies of three related species in the subfamily Phascogalinae, two additional antechinus species (A. argentus and A. arktos) and the iteroparous sister species Murexia melanurus were also generated. Preliminary demographic analysis supports the hypothesis that climate change during the Pleistocene isolated species in Phascogalinae and shaped their population size. A transcriptomic profile across the A. flavipes breeding season allowed us to identify genes associated with aspects of the male die-off. The chromosome-level A. flavipes genome provides a steppingstone to understanding an enigmatic life-history strategy and a resource to assist the conservation of antechinuses.

Ecosystem degradation is a process during which different ecosystem components interact and affect each other. The microbial community, as a component of the ecosystem whose members often display high reproduction rates, is more readily able to respond to environmental stress at the compositional and functional levels, thus potentially threatening other ecosystem components. However, very little research has been carried out on how microbial community degradation affects other ecosystem components, which hampers the comprehensive understanding of ecosystems as a whole. In this study, we investigated the variation in a soil microbial community through the extinction gradient of an ectomycorrhizal species (Tricholomas matsutake) and explored the relationship between microbial community degradation and ectomycorrhizal species extinction. The result showed that during degradation, the microbial community switched from an interactive state to a stress tolerance state, during which the interactivity of the microbial community decreased, and the reduced community interactions with T.matsutake marginalized it from a large central interactive module to a small peripheral module, eventually leading to its extinction. This study highlights the mechanisms of T.matsutake extinction due to the loss of soil microbial community interactivity, offering valuable information about soil microbial community degradation and the plant ectomycorrhizal species conservation.

Phosphorus (P) is often one of the most limiting nutrients in highly weathered soils of humid tropical forests, which may regulate the responses of carbon (C) feedback to climate warming. Based on a 7-year continuous field warming experiment conducted by translocating microcosm forest ecosystems from a high-elevation site to low-elevation sites, we detected changes in the ecosystem P cycle in response to warming. We report that warming drives sustained plant P demand by increasing P uptake and thus decreasing foliar N:P. This increased plant P content is supplied by multiple processes including enhanced plant P resorption, soil P mineralization and dissolution without changing litter P mineralization and leachate P. These findings suggest that warming may alleviate initial P deficiency and/or limitation of plant growth and contribute to sustaining plant C fixation in these tropical forests.

This paper concerns the impact of stochastic perturbations on the intra-layer synchronization of the duplex networks. A duplex network contains two layers ([1,2]). Different from the previous works, environmental noise is introduced into the dynamical system of the duplex network. We incorporate both the inter-layer delay and the intra-layer delay into the dynamical system. Both of the delays are time-varying. However, the paper [1] only considered the intra-layer delays and they are assumed as the constants. While the paper [2] did not consider the inter-layer delay or intra-layer delay. When the system does not achieve automatic intra-layer synchronization, we introduce two controllers: one is the state-feedback controller, the other is the adaptive state-feedback controller. Interestingly, we find that the intra-layer synchronization will achieve automatically if the inter-layer coupling strength $c_1$ is large enough when the time-varying inter-layer delays are absent. Finally, some interesting simulation results are obtained for the Chua-Chua chaotic system with application of our theoretic results, which show the feasibility effectiveness of our control schemes.

Mutualisms are ubiquitous in nature, provide important ecosystem services, and involve many species of interest for conservation. Theoretical progress on the population dynamics of mutualistic interactions, however, has comparatively lagged behind that of trophic and competitive interactions. Consequently, ecologists still lack a generalized framework to investigate the population dynamics of mutualisms. Here, we review historical models of two-species mutualisms from over the last 90 years. We find that population dynamics of mutualisms are qualitatively robust across derivations, including levels of detail, types of benefit, and inspiring systems. Specifically, mutualisms exhibit stable coexistence at high density and destabilizing thresholds at low density. We distinguish between thresholds resulting from Allee effects, low partner density, and high partner density, and their mathematical and conceptual causes. The dynamics of stable coexistence and thresholds in partner density emerge when benefits of mutualism saturate, whether due to intrinsic or extrinsic density dependence in intraspecific, interspecific, or both. These results suggest that there exists a robust population dynamic theory of mutualism that can make general predictions.

Populus has a wide ecogeographical range spanning the Northern Hemisphere, and exhibits abundant distinct species and hybrids globally. Populus tomentosa Carr. is widely distributed and cultivated in the eastern region of Asia, where it plays multiple important roles in forestry, agriculture, conservation, and urban horticulture. Reference genomes are available for several Populus species, however, our goals were to produce a very high quality de novo, chromosome-level genome assembly in P. tomentosa genome that could serve as a reference for evolutionary and ecological studies of hybrid speciation. Here, combining long-read sequencing and Hi-C scaffolding, we present a high-quality, haplotype-resolved genome assembly. The genome size was 740.2 Mb, with a contig N50 size of 5.47 Mb and a scaffold N50 size of 46.68 Mb, consisting of 38 chromosomes, as expected with the known diploid chromosome number (2n=2x=38). A total of 59,124 protein-coding genes were identified. Phylogenomic analyses revealed that P. tomentosa is comprised of two distinct subgenomes, which we deomonstrate is likely to have resulted from hybridization between Populus adenopoda as the female parent and Populus alba var. pyramidalis as the male parent, approximately 3.93 Mya. Although highly colinear, significant structural variation was also found between the two subgenomes. Our study provides a valuable resource for ecological genetics and forest biotechnology.

Celiac disease is a common immune-mediated inflammatory disease of the small intestine caused by sensitivity to gluten. It's commonly associated with various autoimmune disease, but rarely with cardiomyopathy. Our case describes a 33 year old woman presented with exertional dyspnea and fatigue, found to have celiac disease and dilated cardiomyopathy.

Seasonal epidemics of influenza and the respiratory syncytial virus are the cause of substantial morbidity and mortality among children. During the global COVID-19 pandemic, the epidemiology of these viruses seems to have changed dramatically. In Australia and New Zealand, a significant decrease in both influenza and bronchiolities have been noticed during usual peak seasons. Data from early months of winter seasons in Europe are showing similar trends. This current scenario imposes a reconsideration of the paradigm that toddlers and young schoolchildren are the main drivers of seasonal RSV outbreaks and respiratory epidemics in general. In this paper, we summarize current literature, address current knowledge or role of adults in the respiratory syncitial virus epidemiology, describe the lessons learned from pertussis epidemics and call the international community to better understand the community transmission dynamics of respiratory infections in all age-groups. This can allow the establishment of better and more affordable preventive measures in the whole population level, which can ultimately save millions of child lives.

Background and Purpose: Cholinergic neurotransmission is a key signal pathway in the peripheral nervous system (PNS) and in several branches of the central nervous system (CNS). Despite the fact that it has been studied extensively for a long period of time, some aspects of its regulation still have not yet been established. One is relationship between nicotine-induced autoregulation of acetylcholine (ACh) release with changes in the concentration of presynaptic calcium levels. Experimental Approach: The mouse neuromuscular junction of m. Levator Auris Longus was chosen as the model of the cholinergic synapse. ACh release was assessed by electrophysiological methods. Changes in the calcium transients were recorded using a calcium-sensitive dye. Functional interaction between nicotinic ACh receptors and calcium channels was investigated pharmacologically using specific agonists and antagonists. Key Results: Nicotine hydrogen tartrate salt (considered as a stable form for potential therapeutic delivery of nicotine) effects on the parameters of ACh release from the nerve ending were analyzed. Nicotine application (10 μM) decrease the amount of evoked ACh release, while calcium transient increase in the motor nerve terminal. Both of these effects of nicotine were abolished by the neuronal ACh receptor antagonist dihydro-beta-erythroidine and Cav1 blockers, verapamil and nitrendipine. Conclusion and Implications: Neuronal nicotinic ACh receptors activation decreases the number of ACh quanta released by boosting calcium influx through Cav1 channels. Understanding of mechanisms of autoregulation of ACh release is important for the searching new approaches treat diseases associated with cholinergic dysfunction.

A document by Luzmaria Del Risco. Click on the document to view its contents.

Objective: Migration can lead to a change in the demographic dynamics of host populations in terms of communicable diseases in destination countries. This is a potential public health challenge for health authorities. HBV and HCV infections can lead to the development of chronic liver diseases, cirrhosis and hepatocellular carcinoma, and HIV infection can lead to the development of serious opportunistic diseases. The aim of this study is to evaluate the seroprevalence of HBV, HCV and HIV in Syrian refugees and Turkish patients who were evaluated preoperatively in our hospital. Materials and methods: HBsAg, Anti-HBs, Anti-HBc, Anti-HCV and Anti-HIV results of Syrian refugee and Turkish patients who applied to surgical clinics between 2011-2021 were retrospectively reviewed. Results: The study is comprised of 54446 patients: Turkish patient group (n=20569) and Syrian refugee patient group (n=33877). The Syrian refugee patients had a significantly higher HBsAg seropositivity rate and a significantly lower anti-HBs seropositivity rate than the Turkish patients (p=0.002 and p<0.001, respectively). The anti-HCV and anti-HIV seropositivity rates were similar. The annual preoperative prevalance of HBsAg seropositivity in the Syrian refugee patients tended to significantly decrease gradually from year 2011 to year 2021 (p<0.001 for ≤30 and p=0.001 for >30 years old). Conclusion: As a result, although HBV seroprevalence gradually decreases and HCV and HIV seroprevalence is low; screening, information and treatment programs should be given due importance because of the serious disease potential and preventable conditions with precautions. In addition, preoperative screening of refugee patients coming for major surgery may be important for the safety of healthcare professionals.

Using thin-walled cone-pipe welded joints of stainless steels, fatigue tests under bending loads were carried out. The test data were statistically analyzed with the Benard’s approximation, Gaussian, 2P-Weibull, and 3P-Weibull distributions. Stress–life curves at different failure probabilities by a constant strength scatter band model were obtained. The metallographic structures were investigated, and the stress concentration states were analyzed to elucidate the causes of the strengths and scatters. In the high-cycle fatigue regime, the 3P-Weibull distribution was mostly in agreement with the Benard’s approximation, and the coefficient of determination was 0.9642. The microstructure of the weld metal with a high weld opening angle was mainly ferrite phase with 20% austenite distribution. The crack initiation point was close to the weld interface, but the propagation direction was at a right angle, and initially penetrated the heat affected zone of the cone, leading to the high fatigue strength. The stress concentration factors depended on the weld opening angles, indicating the main factor which affected strengths and scatters.

Medicine has always reflected the behavior of its practitioners. It can look back on an impressive history with the Hippocratic Oath, which is approximately 2000 to 2500 years old. But despite this history, the question remains why there should be medical ethics or whether it is not sufficient to demand morally of a physician what is to be demanded of every citizen anyway. A paper by the “Ethics in Medicine Working Group“ of the International Association of Therapists & Medical Doctors (IAAT).

Community ecology includes linking variation in system functions to the distribution and abundance of taxa. In inferring processes, functions, and causal taxa, it is common practice to assume a core community can be defined and that attributes of the core are representative of the entire dataset. Assuming categorical thresholds in abundance exist has the potential to be misleading, especially if rare taxa are contributing to ecological processes. Additionally, there are no standard criteria for core membership, complicating comparisons across studies. Rather, the existence of a core set of taxa can be treated as a hypothesis that may or may not be supported. We considered four methods commonly used for defining a core in studies of microbiomes and applied them to two published microbial data sets and simulations covering a range of plausible communities. We evaluated the ability of each method to correctly categorize taxa. Assignment of core taxa varied substantially among methods and datasets. Additionally, the ability of evaluated methods to capture the simulated core was contingent on the distribution of taxon abundances. While able to correctly identify core taxa in select cases, the methods disagreed more often than not. Given the lack of agreement among core assignment methods, categorization of taxa into sets corresponding to core and non-core is questionable and requires testing and validation before use in any particular context. Our results do not support applying methods of dimension reduction for core taxa classification, but instead provide additional rationale to favor analyses that use abundance data in their entirety.

Introduction The COVID-19 vaccination programme is under way. Anecdotal evidence is increasing that some people with Type 1 Diabetes Mellitus (T1DM) experience temporary instability of blood glucose (BG) levels post-vaccination which normally settles within 2-3 days. We report an analysis of BG profiles of 20 individuals before and after vaccination. Methods We examined the BG profile of 20 consecutive adults (18 years of age or more) with T1DM using the FreeStyle® Libre flash glucose monitor in the period immediately before and after COVID-19 vaccination. The primary outcome measure was percentage(%) BG readings in the designated target range 3.9-10mmmol/L as reported on the LibreView portal for 7 days prior to the vaccination (week -1) and the 7 days after the vaccination (week +1). Results There was a significant decrease in the %BG on target following the COVID-vaccination for the 7 days following vaccination (mean 45.2% ±se 4.2%) vs pre-COVID-19 vaccination (mean 52.6% ±se 4.5%). This was mirrored by an increase in the proportion of readings in other BG categories 10.1-13.9%/ ≥14%. There was no significant change in BG variability in the 7days post COVID-19 vaccination. This change in BG proportion on target in the week following vaccination was most pronounced for people taking Metformin/Dapagliflozin+basal bolus insulin (-23%) vs no oral hypoglycaemic agents (-4%), and median age <53 vs ≥53 years (greater reduction in %BG in target for older individuals (-18% vs -9%)). Conclusion In T1DM, we have shown that COVID-19 vaccination can cause temporary perturbation of BG, with this effect more pronounced in patients talking oral hypoglycaemic medication plus insulin, and in older individuals. This may have consequences for patients with T2DM who are currently not supported by flash glucose monitoring.

BACKGROUND: Systemic thromboembolism is a known complication of rheumatic mitral stenosis (RMS) in sinus rhythm (SR). Left atrial appendage (LAA), the commonest site of thrombus formation is usually hypocontractile (inactive) in such patients. We aimed to study the prevalence of LAA inactivity (LAAI) in severe RMS and assess its independent predictors. METHODS: The study population consisted of 100 patients of severe RMS in sinus rhythm. Transthoracic and transesophageal echocardiography were done to assess LAA contractile function. Patients with LAA-peak emptying velocity <25 cm/sec were defined as having LAAI. RESULTS: The mean age of study subjects was 31.66±8.69 years and 56% were females. 73% patients had LAAI (Group A), while remaining 27% had normal LAA function (Group B). Mitral-valve area (MVA) and lateral annulus systolic velocity (Sa-wave) were significantly lower while mean pressure gradient across mitral valve (MGMV) and serum fibrinogen were significantly higher (all p-values <0.001) in group A patients. On multivariate regression analysis, MGMV (p<0.001), Sa-wave (p=0.02) and serum fibrinogen (p=0.005) were independent predictors of LAAI. Optimal cut-off values of MGMV, Sa-wave and serum fibrinogen for predicting LAAI were 11.5mmHg, 6.8cm/sec and 300mg/dL respectively.67(90.55%) patients in group A compared to 13(48.1%) in group B had LA/LAA smoke. LAAI was the only independent predictor of left atrium (LA)/LAA smoke and associated thrombus. CONCLUSION: There is high prevalence of LAAI in patients of severe MS in SR. MGMV, Sa-wave and serum fibrinogen levels are independent predictors of LAAI. LAAI is an independent predictor of LA/LAA smoke and associated thrombus.

We reflect on the progress in the area of Explainable AI (XAI) Program relative to previous work in the area of intelligent tutoring systems (ITS). A great deal was learned about explanation—and many challenges uncovered—in research that is directly relevant to XAI. We suggest opportunities for future XAI research deriving from ITS methods, as well as the challenges shared by both ITS and XAI in using AI to assist people in solving difficult problems effectively and efficiently.

Neural network architectures are achieving superhuman performance on an expanding range of tasks. To effectively and safely deploy these systems, their decision-making must to be understandable to a wide range of stakeholders. Methods to explain AI have been proposed to answer this challenge, but a lack of theory impedes the development of systematic abstractions which are necessary for cumulative knowledge gains. We propose Bayesian Teaching as a framework for unifying explainable AI (XAI) by integrating machine learning and human learning. Bayesian Teaching formalizes explanation as a communication act of an explainer to shift the beliefs of an explainee. This formalization decomposes any XAI method into four components: (1) the inference to be explained, (2) the explanatory medium, (3) the explainee model, and (4) the explainer model. The abstraction afforded by Bayesian Teaching to decompose any XAI method elucidates the invariances among them. The decomposition of XAI systems enables modular validation, as each of the first three components listed can be tested semi-independently. This decomposition also promotes generalization through recombination of components from different XAI systems, which facilitates the generation of novel variants. These new variants need not be evaluated one by one provided that each component has been validated, leading to an exponential decrease in development time. Finally, by making the goal of explanation explicit, Bayesian Teaching helps developers to assess how suitable an XAI system is for its intended real-world use case. Thus, Bayesian Teaching provides a theoretical framework that encourages systematic, scientific investigation of XAI.

The field of Explainable AI (XAI) has focused primarily on algorithms that can help explain decisions and classification and help understand whether a particular action of an AI system is justified. These \emph{XAI algorithms} provide a variety of means for answering a number of questions human users might have about an AI. However, explanation is also supported by \emph{non-algorithms}: methods, tools, interfaces, and evaluations that might help develop or provide explanations for users, either on their own or in company with algorithmic explanations. In this article, we introduce and describe a small number of non-algorithms we have developed. These include several sets of guidelines for methodological guidance about evaluating systems, including both formative and summative evaluation (such as the self-explanation scorecard and stakeholder playbook) and several concepts for generating explanations that can augment or replace algorithmic XAI (such as the Discovery platform, Collaborative XAI, and the Cognitive Tutorial). We will introduce and review several of these example systems, and discuss how they might be useful in developing or improving algorithmic explanations, or even providing complete and useful non-algorithmic explanations of AI and ML systems.

How would you describe the features that a deep learning model composes if you were restricted to measuring observable behaviours? Explainable artificial intelligence (XAI) methods rely on privileged access to model architecture and parameters that is not always feasible for most users, practitioners, and regulators. Inspired by cognitive psychology research on humans, we present a case for measuring response times (RTs) of a forward pass using only the system clock as a technique for XAI. Our method applies to the growing class of models that use input-adaptive dynamic inference and we also extend our approach to standard models that are converted to dynamic inference post hoc. The experimental logic is simple: If the researcher can contrive a stimulus set where variability among input features is tightly controlled, differences in response time for those inputs can be attributed to the way the model composes those features. First, we show that RT is sensitive to difficult, complex features by comparing RTs from ObjectNet and ImageNet. Next, we make specific a priori predictions about RT for abstract features present in the SCEGRAM dataset, where object recognition in humans depends on complex intra-scene object-object relationships. Finally, we show that RT profiles bear specificity for class identity, and therefore the features that define classes. These results cast light on the model’s feature space without opening the black box.

Yükseköğretim programlarının akreditasyon ölçütlerinden biri, programın öğretim elemanı nitelikleri ve sayısı açısından değerlendirilmesidir. Gelecekte sağlıklı nesiller oluşturabilmek için, bugün formal eğitimin ilk basamağı olan okul öncesi eğitime öğretmen yetiştiren okul öncesi öğretmenliği programlarında ders veren öğretim elemanlarının nitelikleri ve sayısı önemlidir. Bu çalışmanın amacı Türkiye'deki üniversitelerde bulunan okul öncesi öğretmenliği programlarında ders veren kadrolu öğretim elemanlarının akreditasyon kriterlerine uygunluğunu incelemektir. Ayrıca Temel Eğitim Bölümü Okul öncesi Eğitimi Anabilim Dalı ve Okul öncesi Öğretmenliği konusunda farkındalık yaratmak, mevcut durumları hakkında tanımlayıcı istatistikî bilgi elde etmek amaçlanmıştır. Çalışmada nitel araştırma yöntemlerinden durum çalışması kullanılmıştır. Bu kapsamda öğretim elemanlarının lisans, yüksek lisans ve doktora mezuniyetleri taranmıştır. Veriler doküman analizine dayalı değerlendirilmiştir. Türkiye'deki 75 üniversitenin okul öncesi eğitimi anabilim dalında görev yapan 415 öğretim elemanının 164'ünün tüm mezuniyetlerinin alana temel teşkil eden programlardan olduğu görülmüştür. Araştırmanın sonucunda, hem öğretim elemanı sayısı hem de niteliği açısından Gazi Üniversitesi'nin diğer üniversitelerin önünde olduğu saptanmıştır. Giriş Bir ülkenin toplumsal sistemlerinin kalitesi o ülkenin gelişmişlik göstergelerindendir. Adalet, eğitim, güvenlik ve üretim gibi sistemlerin, ülkeler arası faaliyet ve ilişkilerin zirveye ulaştığı 21. yüzyılda, dünya standartlarında olması gerektiğine dair inançlar giderek artmaktadır. Bunlardan eğitim sistemi diğer sistemleri doğrudan etkilemesi açısından stratejik bir öneme sahiptir. Eğitimin her kademesinde kalite standartları belirlenmiş bir hizmet ile toplumun tüm bireylerinin işini hakkıyla yapan bir profile ulaşması ve ülkesini en iyiler arasına dahil etmeye katkı sağlaması beklenir. Bu anlamda Demirtaş ve Yılmaz'ın da (2013) belirttiği gibi Türkiye, globalleşen dünyaya kendi disiplininde küresel standartlarda bilgi ve becerilere sahip kişilikler yetiştirebilecek ve milli yeterliliklerinin uluslararası kabul edilebilir olabileceği yükseköğretim sistemine sahip olarak uyum sağlayabilecektir. Türkiye eğitim öğretim faaliyetleri açısından birçok dönemden geçmiştir. Miras alınan Osmanlı Devleti'nden günümüze bu duruma geniş bir perspektiften bakıldığında birçok dünya devletiyle paralel olarak Bardak ve Topaç'ın (2019) da ifade ettiği gibi sivil toplum kuruluşlarının elinde bulunan eğitim faaliyetleri 1824-1924 arasında yaşanan değişim ve dönüşüm süreciyle tamamen devlet kontrolüne geçmiştir. Fakat okul öncesi eğitim, temel eğitim ve ortaöğretimi öğretmen yetiştirme yönüyle besleyen yükseköğretim basamağında nitelik ve nicelik sorunları uzun yıllar her an patlak vermeye hazır bir durumu yansıtmıştır. Ülkeler arası etkileşimin ve dünya üzerindeki mobilitenin artması ve beyin göçü olgusu nedeniyle yükseköğretimde küresel bir rekabet bulunmaktadır. Araştırma geliştirme ve en iyi öğrencileri çekme gibi bir takım unsurlar bu rekabette ön plandadır. Işık ve Beykoz (2018) bu rekabet ortamında üniversitelerin nitelikli bilgiyi yenileşmenin gücüyle harmanlayarak daha çok yatırım ve fon çekmeye ve nitelikli insan yetiştirmeye odaklandıklarını belirtmiştir. Bogue (1998), yükseköğretim kurumlarında etkin kalite güvence sisteminin kurulmasına yönelik dört çağdaş yaklaşımdan söz etmektedir. Bu yaklaşımlar; geleneksel akran değerlendirmesi, değerlendirme ve sonuç hareketi, toplam kalite yönetimi, hesap verebilirlik ve performans göstergesi raporlaması'dır. Eğitim sektöründeki alternatiflerin çoğalması durumunda rekabetin artacağı okul seçiminde performans göstergelerinin göz önünde bulundurulacağı, ailelerin buna önem vereceği, bu durumun ise kalite artışını getireceği düşünülmektedir (Yirci & Kocabaş, 2013). Türkiye'de halen 129'u devlet 78'i