An efficient heuristic for the multi-vehicle one-to-one pickup and delivery problem with split loads

In this study, we consider the Multi-vehicle One-to-one Pickup and Delivery Problem with Split Loads (MPDPSL). This problem is a generalization of the one-to-one Pickup and Delivery Problem (PDP) where each load can be served by multiple vehicles as well as multiple stops by the same vehicle. In practice, split deliveries is a viable option in many settings where the load can be physically split, such as courier services of third party logistics operators. We propose an efficient heuristic that combines the strengths of Tabu Search and Simulated Annealing for the solution of MPDPSL. Results from experiments on two problems sets in the literature indicate that the heuristic is capable of producing good quality solutions in reasonable time. The experiments also demonstrate that up to 33\% savings can be obtained by allowing split loads; however, the magnitude of savings is dependent largely on the spatial distribution of the pickup and delivery points

Huzurevindeki geriatrik diyabetli bireylerde proprioseptif egzersizin denge ve duyusal fonksiyona etkisi: Randomize kontrollü çalışma

Objective: Diabetes is a chronic disease whose prevalence increases with age and causes severe damages in all systems of the body. The aim of our study was to assess the effects of proprioceptive exercises on balance and sensory function in the geriatric adults with Type 2 diabetes mellitus. Material and Methods: Forty individuals aged 65 and over with Type 2 diabetes mellitus were divided as a study group (n=20) and as a control group (n=20). All patients were evaluated at the baseline and after 8 weeks training. Balance was mea-sured using Berg Balance Scale and Nintendo Wii system. Balance and gait were evaluated by Tinetti Balance and Gait Test. Semmes-Wein-stein monofilament test was used for assessing tactile sensory, diapa-son for vibration and active matching test for joint position sense. Study group received 45 minutes long proprioceptive exercise training 3 times/week for 8 weeks and the control group only received diabetic patient education. Results: Study group demonstrated significant differences in Berg Balance Scale, Wii Fit balance age and Tinetti Balance and Gait Test scores (p<0.05). Vibration perception duration yielded a higher duration in the study group after treatment (p<0.05). Active matching movement and tactile sensory of the sole showed statistically improvement in the study group (p<0.05). Conclusion: Proprioceptive exercises recommended to individuals with geriatric diabetes can be a beneficial approach to increase balance ability to prevent falling and somatosensory loss.Amaç: Diyabet, prevalansı yaşla birlikte artan ve vücudun tüm sistemlerinde ciddi hasarlara neden olan kronik bir hastalıktır. Çalışmamızın amacı, Tip 2 diabetes mellituslu geriatrik erişkinlerde proprioseptif egzersizlerin denge ve duyusal fonksiyon üzerine etkilerini değerlendirmektir. Gereç ve Yöntemler: Tip 2 diabetes mellituslu 65 yaş ve üzeri 40 birey çalışma grubu (n=20) ve kontrol grubu (n=20) olarak ayrıldı. Tüm hastalar başlangıçta ve 8 haftalık eğitimden sonra değerlendirildi. Denge, Berg Denge Ölçeği ve Nintendo Wii sistemi kullanılarak ölçüldü. Denge ve yürüme, Tinetti Denge ve Yürüyüş Testi ile değerlendirildi. Dokunma duyusunu değerlendirmek için SemmesWeinstein monofilament testi, titreşim için diyapazon ve eklem pozisyon duyusu için aktif eşleştirme testi kullanıldı. Çalışma grubu 8 hafta boyunca haftada 3 kez 45 dk’lık proprioseptif egzersiz eğitimi aldı ve kontrol grubuna sadece diyabetik hasta eğitimi verildi. Bulgular: Çalışma grubu, Berg Denge Ölçeği, Wii Fit denge yaşı ve Tinetti Denge ve Yürüyüş Testi puanlarında anlamlı farklılıklar gösterdi (p<0,05). Titreşim algılama süresi, tedaviden sonra çalışma grubunda daha yüksek bir süre ile sonuçlandı (p<0,05). Aktif eşleştirme hareketi ve tabanın taktil duyusu, çalışma grubunda istatistiksel olarak gelişme gösterdi (p<0,05). Sonuç: Geriatrik diyabetli bireylere önerilen proprioseptif egzersizler, düşme ve somatosensoriyel kaybı önlemek için denge becerisini artırmada faydalı bir yaklaşım olabilir

Treatment of Ileus after hysterectomy with Drain and medical applications; a case repor

Postoperatif ileus (POI), önemli morbidite ve mortalitesi olan karmaşık bir olgu olup, birçok cerrahi alanda görülebilmektedir. Bilinen riski olmayan 50 yaşında bir kadın hastaya tedaviye dirençli menometroraji tanısı ile total abdominal histerektomi ve bilateral salpenjeooferektomi (TAH+BSO) uygulandı. Peroperatif ve postoperatif dönemde herhangi bir problemi olmayan, gaz gaita çıkışı gözlemlenen hasta postoperatif 4. günde taburcu edildi. Ancak postoperatif 6. günde kusma karın ağrısı (akut batın tablosu) ile acil servise başvurduğunda kliniği, tahlilleri ve görüntüleme yöntemleriyle ileus gelişmiş olduğu saptandı. Bunun üzerine, hastada oral alım kapatıldı, medikal tedavi olarak metoklopramid ve laktasif lavman başlandı. Yapılan görüntülenme yöntemlerinde batın içi ve cilt altı ileusa bağlı seröz sıvı izlendi ve hastaya cilt altı hemovac dren konularak batın rahatlatıldı. Yaklaşık 5 gün içinde re-operasyona gerek duyulmadan hastanın ileusu sonlandı ve hasta şifa ile taburcu edildi. Biz bu olgu sunumumuzda basit ama etkili yöntemlerle POI’nin önlenip, erken dönemde operasyona gerek kalmadan, tedavi edilebileceğini göstermiş olduk.Postoperative ileus (POI) is a complex phenomenon with significant morbidity and mortality and can be seen in many surgical fields. A 50-year-old woman with no known risk was diagnosed with treatment-resistant menometrorrhagia and underwent total abdominal hysterectomy and bilateral salpingeooophorectomy (TAH+BSO). The patient, who did not have any problems in the perioperative and postoperative periods, and gas-fecal output was observed, was discharged on the 4th postoperative day. However, on the 6th postoperative day, when he applied to the emergency service with vomiting and abdominal pain (acute abdomen), ileus was found to have developed by his clinic, analyzes and imaging methods. Thereupon, oral intake was stopped in the patient, and metoclopramide and lactase enema were started as medical treatment. In the imaging methods performed, serous fluid related to the intra-abdominal and subcutaneous ileus was observed and the patient was relieved by placing a subcutaneous hemovac drain. In about 5 days, the patient's ileus ended without the need for re-operation and the patient was discharged with full recovery. In this case report, we have shown that POI can be prevented and treated without the need for an operation in the early period with simple but effective methods

4. Endüstri devrimi için yol haritası belirlenmesinde farklı ülke örneklerinin incelenmesi ve Türkiye için model önerisi

06.03.2018 tarihli ve 30352 sayılı Resmi Gazetede yayımlanan “Yükseköğretim Kanunu İle Bazı Kanun Ve Kanun Hükmünde Kararnamelerde Değişiklik Yapılması Hakkında Kanun” ile 18.06.2018 tarihli “Lisansüstü Tezlerin Elektronik Ortamda Toplanması, Düzenlenmesi ve Erişime Açılmasına İlişkin Yönerge” gereğince tam metin erişime açılmıştır.İlk kez 2011 yılında Hannover Fuarı'nda ortaya atılan, aynı zamanda 4. Endüstrii Devrimini ifade eden Endüstri 4.0 kavramı temel olarak teknolojinin üretimle harmanlamasıyla ortaya çıkan insansız iş gücüne yönelik gelişmeleri ifade eder. Türkiye'nin, modern endüstrinin geldiği son nokta olan 4. Endüstri devrim çağına uyum sağlamakta zorlandığı ve gelişmekte olan bir ülke olarak sanayi toplumu olmaktan uzak olduğu yadsınamaz bir gerçektir. Bu tezin yazılma amacı ise bu gerçekler ışığında geri kalınma sebeplerinin tespit edilerek çözümleme süreci için Türkiye adına ileri yönelik bir hareket planı çıkartmaktır. Bu bağlamda 4. Endüstri devrimi kavramı kronolojik olarak incelenmiş, ulusal ve küresel etkileri örnekleme yoluna gidilerek veri haline getirilmiş ve Türkiye için örnek bir model oluşturulmuştur.The Industry 4.0 concept, which was first introduced at the Hannover Fair in 2011, expressing the 4th Industrial Revolution at the same time, expresses the developments towards the unmanned labor power emerging from the blending of technology with production. It is an undeniable fact that Turkey is far from being an industrial society as a developing country and it is difficult to adapt to the era of the Industrial 4.0, the last point where modern industrialism is coming. The purpose of writing this thesis is to determine the causes of backwardness in the light of these facts and to prepare an action plan for the resolution process in the name of Turkey. In this context, the concept of Industry 4.0 was examined in chronological order, national and global effects were considered by sampling, and a model for Turkey was created

Investigation of the relationship between temporomandibular disorder and postural analysis

INTRODUCTION: Muscular and ligamentous structures connect the temporomandibular joint (TMJ) to the cervical region to form a functional unit. Changes in one of the two regions, either TMJ or cervical spine, may affect the other region due to changes in the muscle segment. Our aim is to evaluate and compare whether individuals with temporomandibular disorders differ from healthy individuals in the global postural alignment by objective evaluation method. METHODS: Group 1 (N=30) consist of mixed type temporomandibular disorder (TMD), Group 2 (N=30) consist of healthy temporomandibular joint, totally 60 individuals between the ages of 18-35 were included in this study. Posture Screen Mobile® (PSM) and New York Posture Scale (NYPS) were used for assessment of posture and Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) for diagnosis of TMD and healthy joints. DISCUSSION AND CONCLUSION: It may be beneficial to consider that some postural disorders can be caused by TMD or that TMD can lead to this posture. Being careful about postural alignment in these patients may be important in terms of multidisciplinary approach to TMD patients for proper treatment program and prevention of possible disorders.GİRİŞ ve AMAÇ: Kas ve ligamentöz yapılar temporomandibular eklemi (TME) servikal bölgeye bağlayarak fonksiyonel bir birimoluşturur. İki bölgeden birinde, TME veya servikal omurgada meydana gelen değişiklikler, kas segmentindeki değişiklikler nedeniyle diğer bölgeyi etkileyebilir. Amacımız, temporomandibular bozukluğu olan bireylerin global postural dizilimde sağlıklı bireylerden bir farklılık gösterip göstermediğini objektif değerlendirme methodu ile değerlendirip karşılaştırmaktır. YÖNTEM ve GEREÇLER: Grup 1 (N = 30) mixed tip temporomandibular bozukluktan (TMD), Grup 2 (N = 30) sağlıklı temporomandibular eklemden oluşmakta olup, 18-35 yaşları arasında toplam 60 kişi çalışmaya alındı. Postürü değerlendirmek için PostureScreen Mobile® (PSM) ve New York Postür Skalası (NYPS), sağlıklı eklem ve temporomandibular disfonksiyon tanısı için ise Temporomandibular BozukluklardaAraştırma Teşhis Kriterleri (RDC / TMD) kullanıldı. BULGULAR: Sagital düzlemde diz translasyonu Grup 1’de daha yüksekti (p <0,05). Diğer bölgelerde anlamlı postüral farklılıklar bulunmadı (p≥0,05). NYPS toplam skorları Grup 1’de anlamlı olarak düşüktü (p <0,05). TARTIŞMA ve SONUÇ: Bu postural bozuklukların TMD’den kaynaklanabileceğini veya TMD’nin bu duruşa yol açabileceğini düşünmek yararlı olabilir. Bu hastalarda postüral dizilim konusunda dikkatli olmak, uygun tedavi programı ve olası bozuklukların önlenmesi için TMD hastalarına multidisipliner yaklaşım açısından önemli olabilir

CHANGING HABITS: THE EFFECT OF CULTURAL CONSUMPTION ON RESTAURANT PREFERENCES

The purpose of this research is to examine the effect of cultural omnivorousness levels on restaurant preferences. Qualitative research approach was adopted in this study. At the same time, ethnographic interview method was used in order to examine the cultural consumption patterns of individuals in the study.  As a result of the research, the findings are presented in two categories: cultural participation and the relationship between cultural participation and restaurant preferences. The result of the research shows that some people interviewed have a different and hierarchical judgment of taste in restaurant preferences. Cultural consumption, as a reflection of cultural omnivorousness, serves to make sense of people's tastes/likes. However, there has not been found such an examination of restaurant choice and its use in cultural omnivorousness studies. This article fills the identified gap, adding to the discussion about restaurant choice and cultural consumption

Reliability and validity of the Turkish version of the prejudice toward people with mental illness scale

Objectives: This study was conducted to assess the validity–reliability and psychometric properties of the Turkish version of the Prejudice toward People with Mental Illness scale. Methods: This was a methodological study conducted between June 1, 2021, and September 1, 2021. The sample of this study consisted of 297 people who were registered at a family health center in Gaziosmanpaşa. The personal information form consisted of 17 questions. It had eight sociodemographic characteristics questions and nine situations participants might find themselves in with people with mental illness. In the data analysis, descriptive statistics, confirmatory factor analysis, item–total correlation, test–retest correlation, Pearson correlation, and Cronbach’s alpha coefficient were used. According to experts’ opinions, the content validity index of the items was 0.97. Results: As a result of confirmatory factor analysis, it was determined that the scale had a four-factor structure and consisted of 19 items. The item–total correlations of the Turkish version of the scale ranged from r=0.30 to r=0.68. The total Cronbach’s alpha coefficient of the scale was found to be 0.86. Test–retest correlations were found to be statistically significant for the total scale and subscales (r=0.48; p[removed

Migrenli hastalarda fiziksel aktivite seviyesinin ağrı, fonksiyonellik ve yaşam kalitesine etkisi

OBJECTIVES: This study aimed to determine the physical activity (PA) level of individuals with migraine and examine its effects on pain intensity (PI), disability, and quality of life (QoL). METHODS: Individuals diagnosed with migraine between the ages of 18 and 55 were included in the study. PA levels are assessed by the International PA Questionnaire Short Form (IPAQ-SF), PI with the McGill Melzack Pain Questionnaire, disability with the Migraine Disability Assessment Scale (MIDAS), and QoL with the World Health Organization QoL Scale Short Form (WHOQOL-BREF). RESULTS: A total of 88 individuals, with a mean age of 34.11±10.51 years, were included in the study; 53.41% were low active (LA), 30.68% were moderate active (MA), and 15.91% were high active (HA). The physical health of LAs (p=0.047) was lower than that of MAs. General (p<0.001), physical (p[removed].Amaç: Bu çalışmada, migrenli bireylerin fiziksel aktivite düzeylerinin belirlenmesi ve ağrı şiddeti, engellilik seviyesi ve yaşam kalitesi üzerindeki etkilerinin incelenmesi amaçlandı. Gereç ve Yöntem: Çalışmaya 18-55 yaş arası migren tanısı almış bireyler dahil edildi. Uluslararası Fiziksel Aktivite Anketi Kısa Formu (IPAQ-SF), McGill Melzack Ağrı Anketi ile ağrı şiddeti, Migren Özürlülük Değerlendirme Ölçeği (MIDAS) ile engellilik ve Dünya Sağlık Örgütü Yaşam Kalitesi Skalası Kısa Formu (WHOQOL-BREF) ile yaşam kalitesi değerlendirildi. Bulgular: Çalışmaya yaş ortalaması 34,11±10,51 yıl olan toplam 88 kişi dahil edildi; %53,41’i düşük aktif, %30,68’i orta aktif, %15,91’i yüksek aktifti. Düşük aktiflerin fiziksel sağlığı (p=0,047) orta aktiflerden daha düşüktü. Genel (p<0,001), fiziksel (p<0,001), psikolojik (p=0,003) sağlık puanları yüksek aktiflerden daha düşüktü. Düşük aktifler yüksek aktiflerden daha yüksek engelliliğe (p=0,042) ve ağrı şiddetine (p=0,001) sahipti. Fiziksel aktivite ile ağrı şiddeti (p=0,001) ve engellilik (p=0,005) arasında zayıf negatif korelasyon, fiziksel aktivite düzeyleri ile sosyal (p=0,007) ve çevresel (p=0,013) sağlık puanları arasında zayıf pozitif korelasyon ve fiziksel (p=0,000), genel (p=0,000) ve psikolojik (p=0,000) puanlarıyla orta düzeyde pozitif korelasyon vardı. Sonuç: Migrenli hastalarda fiziksel aktivite düzeyi arttıkça ağrı şiddetinin azaldığı, fonksiyonellik ve yaşam kalitesinin arttığı gözlendi. Egzersiz devamlılığının sağlanması migrenin olumsuz etkilerini iyileştirmede etkili görünmektedir

Predictors of eHealth literacy in pregnant women: A structural equation model analysis

Objective To develop and evaluate a theoretical model to explain the relationships between eHealth literacy and perception of health, and perception of pregnancy risk in pregnant women. Method This cross-sectional study was carried out with 238 pregnant women in one of the hospitals in Turkey between March 15, 2021 and May 15, 2021. Data were collected using an Information Form, eHealth Literacy Scale, Perception of Health Scale, and Perception of Pregnancy Risk Questionnaire. Results The mean scores of the pregnant women participating in the study on eHealth literacy and perception of health were 30.45 +/- 6.56 and 51.42 +/- 6.91, respectively and their mean score on perception of pregnancy risk was 42.6 +/- 29.38. The direct effect of the eHealth Literacy Scale on the "Risk for Baby" subscale of the Perception of Pregnancy Risk Questionnaire was insignificant whereas the scale's effect became significant with the Perception of Health Scale (beta = -0.006; 0.057). Conclusion To reduce the perception of risk in pregnant women, it is important to improve not only their eHealth literacy but also their knowledge and attitudes about being healthy

Impact of modified atmosphere packaging on fruit quality and postharvest life of ‘0900 Ziraat’ cherries

The sweet cherry is highly perishable with a restricted storage and shelf-life and in some cases unable to reach the final consumer at optimal eating quality after being transported to the market. For this reason, in this research, the effects of different modified atmosphere packaging materials on postharvest life and fruit quality of ‘0900 Ziraat’ cherries (Prunus avium L.) were investigated to extend storage and marketing period. For this purpose, cherries were stored for 50 days at 0°C temperature with 90-95% relative humidity in three different types of packaging materials. The first group of cherries was packed in micro-perforated Xtend bags (MAP-1). The second group of cherries was packed in ordinary non-perforated polyethylene bags (MAP-2) and the third group of cherries was packed in ordinary perforated polyethylene bags (MAP-3-Control). Fruit samples were taken from different storage rooms at intervals of 10 days and physical and chemical changes were determined in the fruits. Experiment results showed that the lowest weight losses were obtained on the cherries stored in MAP-1. The cherries stored in MAP-2 had higher soluble solids content. Titratable acidity increased during the first 10 days of storage and then decreased. The fruit stored in MAP-1 had the highest flesh firmness, titratable acidity, L*, C* and taste values. The most effective MAP treatment for controlling pitting and stem browning was MAP-1. It can be concluded that ‘0900 Ziraat’ cherry fruits were successfully stored at 0°C temperature and 90-95% RH up to 50 days in MAP-1