A decision consultancy case on strategy formulation of a livestock project

Ankara : Faculty of Management and the Graduate School of Business Administration of Bilkent University, 1994.Thesis (Master's) -- İhsan Doğramacı Bilkent University, 1994.Includes bibliographical references (leaves 65-66).The purpose of this thesis is to assist in a project that combines decision support mechanisms and their probable results to assist top management in decision making. Government regulation obliges the subject firm to enter daily cattle artificial insemination business. This study covers an analysis for the industry structure, financial estimation and present value calculations, suggested value chain, marketing strategy, and sei-vice guarantee - quality with a motivation program.Akar, MustafaM.S

Resilience in intentionally destroyed historic settlements: An examination on Kirkuk Citadel and the old town of Van

Armed conflict is considered a major risk for cultural heritage since the Second World War and guidelines are prepared by international organizations such as UNESCO and ICCROM on risk management and protection of cultural heritage in conflict-affected areas. However, the main concerns are reducing risks prior to the armed conflict by identifying, analyzing, evaluating, treating and monitoring risks and managing them before the risk occurs. The literature is quite narrow in respect to the ways of protecting cultural heritage and sustaining life for both buildings and people in intentionally destroyed historic settlements. Within this context, this study aims to raise the question on how to manage change in the intentionally destroyed historic settlements and how to strengthen resilience in conflict-affected areas. In order to achieve this aim, an examination on two case studies, Kirkuk Citadel and the Old Town of Van, which were both intentionally destroyed as a result of armed conflict is made using comparative analysis method. The cases are chosen to represent different time periods, scales and types of destruction. Depending on the international law and guidelines, the study tries to understand the impact of armed conflict on the historic settlements embracing tangible and intangible cultural heritage, types of risks that threaten them and the ways to strengthen resilience in such areas. It is revealed as a result of the study that for both case study areas, being in the tentative list of UNESCO World Heritage is seen a primary step to be internationally recognized and to claim help for future actions aiming to reduce risks. Nevertheless, it can be argued that strategies have to be developed depending on the size and level of destruction, and the level of intervention to preserve and to rehabilitate life in such historic settlements, as each intentionally destroyed historic settlement has unique cultural, political and economic characteristics

Hafif elektrikli araç için FDAM tasarım ve uygulaması

The popularity of electrical vehicles is increasing rapidly in recent years due to energy generation/consumption ratio, transportation costs, decrease in fossil fuel reserves with increasing population as well as the environmental damage caused by fossil fuels. Therefore, Brushless Direct Current (BLDC) Motor design was actualized in the present study for use in electrical vehicles expected to replace the transportation vehicles of today. Firstly, analytical design of the targeted motor was completed after which the Finite Elements Method was used for modelling. Ansys Maxwell Program is one of the package programs used in FEM. This study was carried out with Ansys Maxwell Electromagnetic Suite version 17.2 . The prototype motor was manufactured after reaching the desired results with Finite Elements Method and experimental studies commenced with the experiment setup prepared in the laboratory environment. Experimental results were compared with electromagnetic results. Finally, the prototype motor was mounted on the ElektroGOP vehicle and it was observed to work without problem at the expected performance during the test drives.Son yıllarda artan nüfusla birlikte enerji üretim/tüketim oranı, ulaşım giderleri, fosil yakıt rezervlerinin azalması ve fosil yakıtların çevreye verdikleri zararlar gibi başlıca etkenler sebebiyle elektrikli araçların popülaritesi hızlı bir şekilde artmaktadır. Dolasıyla elektrikli araç ve ekipmanları üzerine yapılan çalışmalar da artmaktadır. Bu çalışmada günümüz ulaşım araçlarının yerini alan elektrikli araçlarda kullanılması hedeflenen Fırçasız Doğru Akım Motor (FDAM) tasarımı gerçekleştirilmiştir. Öncelikle hedeflenen motorun analitik tasarımı yapılarak Sonlu Elemanlar Yöntemi (SEY) ile modellemesi yapılmıştır. Ansys Maxwell Programı SEY'de kullanılan paket programlardan biridir. Bu çalışma Ansys Maxwell Elektromanyetik Suite 17.2 versiyonu ile gerçekleştirilmiştir. SEY ile hedeflenen sonuçlara ulaşıldıktan sonra motorun protorip üretimi gerçekleştirilmiş ve prototip motorun, laboratuvar ortamında hazırlanan deney düzeneği ile deneysel çalışmaları yapılmıştır. Deneysel sonuçlar elektromanyetik sonuçlarla karşılaştırılmıştır. Son olarak prototip motor ElektroGOP aracına monte edilmiş ve sürüş denemelerinde motorun hedeflenen performansta ve sorunsuz şekilde çalıştığı görülmüştür

Real life data of second generation direct acting oral antivirals in the treatment of chronic hepatitis C: a single center and heterogeneous patient group

Kronik hepatit C enfeksiyonu karaciğer sirozu ve hepatoselüler karsinomun nedenleri arasındadır. Bu çalışmada primer olarakkronik hepatit C’li heterojen bir hasta grubunda güncel olarak kullanılanikinci kuşak direk etkili oral antivirallerin tedavi etkinliği ve yan etki profillerinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Retrospektifolan bu çalışmaya ikinci kuşak direk etkili oral antiviral tedavi alan 72hasta dahil edilmiştir. Hastalara ait klinik ve laboratuvar verileri polikliniktakip dosyalarından elde edilmiştir. Bulgular: Hastaların yaş ortalaması 58±14 olup, 39’u (%54) kadın idi. Baskın genotip 1b idi (%74.6).Non-sirotik, kompanse siroz ve dekompanse siroz hastaların sayıları sırasıyla; 56 (%77.8), 14 (%19.4) ve 2 (%2.8) idi. On sekiz hasta (%25)tedavi deneyimli idi. Paritaprevir/ritonavir/ombitasvir + dasabuvir, ledipasvir/sofosbuvir, ledipasvir/sofosbuvir + ribavirin, sofosbuvir + ribavirin, glekaprevir + pibrentasvir ve paritaprevir/ritonavir/ombitasvir +ribavirin alan hasta sayıları sırasıyla; 38 (%52.8), 13 (%18.1), 7 (%9.7),7 (%9.7), 6 (%8.3) ve 1 (%1.4) idi. Toplam 71 hasta tedaviyi tamamladıve bunların 69’unda (%97.2) kalıcı viral yanıt elde edildi. Ayrıca başlangıç aspartat aminotransferaz, alanin amimotransferaz, gama glutamiltransferaz ve alfa fetoprotein düzeylerinde tedavi ile birlikte anlamlı birdüşüş izlendi (p <0.05). Bilirübin düzeyleri ise tedavi esnasında anlamlıbir şekilde yükselmekle beraber (p <0.05), tedavinin sona ermesiyle birlikte düşüş göstermekteydi. Yan etki profilleri açısından, kullanılan tümrejimlerde gözlenen yan etkiler hafif şiddette olup, tedaviyi kesecek vasıfta değildi. Sonuç: Ülkemizde kronik hepatit C infeksiyonunda güncelolarak kullanılan ikinci kuşak direk etkili oral antiviraller yüksek etkinlikve düşük yan etki profiline sahiptirler.Chronic hepatitis C infection is one of the causes of liver cirrhosis and hepatocellular carcinoma. The purpose of this study was primarily to examine the treatment efficacy and side effect profiles of second-generation direct-acting oral antivirals currently used in a heterogeneous patient group with chronic hepatitis C. Materials and Methods: This retrospective study included 72 patients who received second-generation direct-acting oral antiviral therapy. Clinical and laboratory data of the patients were collected from outpatient follow-up files. Results: The mean age of the patients was 58±14 years, of which 39 (54%) were women. The predominant genotype was 1b (74.6%). Patients with no cirrhosis, compensated cirrhosis, and decompensated cirrhosis were 56 (77.8%), 14 (19.4%), and 2 (2.8%), respectively. Eighteen patients (25%) were treatment experienced. On the other hand, patients treated with paritaprevir/ritonavir/ombitasvir + dasabuvir, ledipasvir/sofosbuvir, ledipasvir/sofosbuvir + ribavirin, sofosbuvir + ribavirin, glecaprevir + pibrentasvir, and paritaprevir/ritonavir/ombitasvir + ribavirin were 38 (52.8%), 13 (18.1%), 7 (9.7%), 7 (9.7%), 6 (8.3%), and 1 (1.4%), respectively. A total of 71 patients completed the treatment and 69 of them (97.2%) was obtained sustained viral response. In addition, a significant decrease was observed in the initial aspartate aminotransferase, alanine aminotransferase, gamma glutamyl transferase, and alpha fetoprotein levels during treatment (p <0.05). Although bilirubin levels increased significantly during treatment (p <0.05), they decreased at the end of treatment. In terms of the side effect profile, side effects observed in all regimes were mild and not severe enough to discontinue treatment. Conclusion: Therefore, the second-generation direct-acting oral antivirals widely used in chronic hepatitis C infection in our country have high efficacy and low side effect profile

The predictive value of neutrophil-lymphocyte ratio and mean platelet volume in patients with colorectal carcinoma

Aim: This study aimed to investigate neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV) for predicting colorectalcancer (CRC).Material and Methods: We investigated retrospectively patients who underwent colonoscopy. The study consisted of 75 patientswith CRC and 91 study participants with normal colonoscopy as control group, and MPV and NLR were compared between groups.MPV and NLR were also investigated for tumor stage and metastasis.Results: Among the CRC patients the mean NLR value (3.09 vs 2.26) and PLT count (287080 vs 251857) were significantly higher,whereas the mean MPV (9.62 vs 10.68 fL) and hemoglobin level (11.62 vs 14.18 g/dl) were significantly lower in the CRC group. WBCcount was not significantly different between the groups. Mean NLR in metastatic patients and non-metastatic patients were 3.56and 2.73, respectively (p:0.01).Conclusion: We showed that high NLR and low MPV are associated with CRC. Elevated NLR is related with presence of CRC and itcan be used for risk prediction. Although we found lower MPV levels, conflicting results about MPV in CRC prevents it from using asa marker in CRC

Az adóamnesztia magatartási vonatkozásai és hatása tizenkét ország vizsgálatán keresztül

A jelen tanulmány az adóamnesztia elméleti és empirikus kutatásáról nyújt áttekintést a vonatkozó előnyök és hátrányok mérlegelésével. Kutatásunkban arra keressük a választ, hogy az adóamnesztia közép- és hosszú távon ösztönzi-e az adózási fegyelmet az egyes tanulmányok megállapításaival összhangban, vagy igazságtalan és romboló hatása miatt inkább gátolja az adófegyelem kialakulását. Tanulmányunkban tizenkét országra vonatkozóan – elsősorban Törökországra fókuszálva – vizsgáljuk az adóamnesztia-programok adóbevétel/GDP arányra gyakorolt hatásának elérhető adatait a Giniegyüttható értékeivel együtt. A tanulmány célja az adóamnesztiával szembeni – mind az adóbevétel, mind az adóigazságosság szempontjából – kedvezőbb alternatívák azonosítása. A kutatás eredményei azt mutatják, hogy míg az adóamnesztia rövid távú bevételi hatása bizonytalan, az adóigazságosságra és jövedelemelosztásra gyakorolt negatív hatása közép- és hosszú távon szinte bizonyosnak mondható. A kutatás arra is rámutat, hogy az adóamnesztiák hátterében többnyire aligha az adóbevétel növelésének legfőbb szándéka áll

Effect of Direct-acting Oral Anticoagulants and Warfarin on Hospital Outcomes in Upper Gastrointestinal Bleeding

Objective: To evaluate the comparison of direct-acting oral anticoagulants (DOACs) and warfarin for their effects on major bleeding and hospital outcomes in patients with acute nonvariceal upper gastrointestinal bleeding (NVUGIB). Study Design: An observational study. Place and Duration of Study: Tekirdag Namik Kemal University Hospital, Hitit University Erol Olçok Education and Research Hospital, between January and December 2021. Methodology: Adult patients prescribed warfarin and DOACs were followed up for one year. Their length of hospital stay, need for intensive care unit admission, need for red blood cell transfusion, and major bleeding rates were compared. Results: Thirty-two patients (61.5%) were user of DOACs (DOAC group), and 20 patients (38.5%) were users of warfarin (warfarin group). No statistically significant difference was determined between patients in warfarin group and DOAC group for the number of packed red blood cells transfused [median 3 (0-6) units, 3 (0-10) units, p=0.229, respectively], length of hospital stay [median 5 days (3-10), and 4.5 days (2-20), p=0.739, respectively], rate of intensive care unit admission [(n=9, 45%; and n=10 (31%), p=0.623, respectively] and the occurrence of major bleeding events (warfarin-70%; DOACs-78%; p=0.529). Conclusion: Major bleeding episodes and hospital outcomes of acute NVUGIB were similar between patients receiving warfarin and DOACs. © 2022 College of Physicians and Surgeons Pakistan. All rights reserved

Investigation of Serum NO, ADMA and Apelin Levels in Thyroid Dysfunction

Thyroid gland diseases are among the most common endocrine diseases and still continue to be an important health problem especially in developing countries. It was aimed to investigate serum NO, ADMA and Apelin levels in patients with thyroid dysfunction. This study was conducted with 150 thyroid patients and 50 healthy subjects. Study subjects were divided into three groups; control (n=50), hyperthyroid ( n=75) and hypothyroid (n=75). Serum TSH, FT3, FT4   levels  were  measured  by  chemiluminescence  method  NO  level  were  measured  by spectrophotometric method, ADMA and apelin levels were measured by ELISA. Serum NO levels were higher in hypothyroid group than in hyperthyroid group, and the difference was statistically significant. Serum ADMA levels of the hyperthyroid group were significantly higher than the other two groups and the difference was statistically significant. The levels  of  serum  apelin  were  statistically significantly higher in the hyperthyroid group than the other two groups. In patients with hyperthyroidism, ADMA and Apelin levels were higher, while NO level was lower. However, NO level was higher in patients with hypothyroidims than the other two groups. Apelin, which has been emphasized  as  a  preventive  and  therapeutic  agent  particularly  for  the cardiovascular system, might have increased in hyperthyroid patients, regardless of NO, to protect cardiovascular system from possible adverse effects of ADMA. Keywords: Asymmetric dimethylarginine, apelin, nitric oxide, thyroid dysfunction DOI: 10.7176/JMPB/67-03 Publication date:August 31st 202

Clinical relevance of virulence genes in Helicobacter pylori isolates recovered from adult dyspeptic patients in Turkey

Purpose: Bacterial virulence factors play a major role in the pathogenesis of Helicobacter pylori infection. The aims of this study were to evaluate virulence genes in H. pylori isolates and to compare the presence of these genes and associated clinical pathologies. Methods: A total of 148 H. pylori isolates, recovered from adult dyspeptic patients, were used. The patients, from whom the isolates were obtained, were assigned to two groups by their endoscopic findings, which manifested as chronic gastritis or peptic ulcer. The presence of gastric atrophy and intestinal metaplasia was recorded for each patient, based on histopathological examination. Analyses of the virulence genes were performed by the polymerase chain reaction technique. Results: The patients had a mean age of 47 ?± ?15 years and 86 (58%) of them were female. Based on endoscopic examination, 103 (69.6%) patients were diagnosed with chronic gastritis and 45 (30.4%) with peptic ulcer. Histopathological examination revealed intestinal metaplasia in 30 (20%) patients and gastric atrophy in 12 (8%) patients. The prevalence rates of cagA, cagE, iceA1, iceA2, and babA2 were determined to be 87%, 74%, 58%, 26%, and 95%, respectively. The most prevalent vacA alleles were s1/s1a (82%/97%) and the least prevalent allele was s2 (20%). A new vacA genotype (s1as1bs1c) was detected, for the first time, in 18 (12%) isolates. No significant difference was found between the patient groups with chronic gastritis and peptic ulcer for the prevalences of the virulence genes (p ?> ?0.05). Furthermore, intestinal metaplasia and gastric atrophy showed no significant correlation with the virulence genes (p ?> ?0.05). Conclusions: It is thoughted that H. pylori isolates with predominant cagA, cagE, VacA (s1, s1a), and babA2 virulence genes are associated with gastroduodenal diseases. However, there is no correlation between gastric premalignant lesions and virulence genes. © 2022 Indian Association of Medical Microbiologist

Primary Left Cardiac Angiosarcoma with Mitral Valve Involvement Accompanying Coronary Artery Disease

We report here on a 43-year-old female patient presenting with non-ST elevation myocardial infarction, severe mitral regurgitation, and mild mitral stenosis secondary to encroachment of the related structures by a primary cardiac angiosarcoma. A coronary angiography revealed significant stenosis in the left main and left circumflex arteries and at exploration, the tumour was arising from posterior left atrial free wall, invading the posterior mitral leaflet, and extending into all of the pulmonary veins and pericardium. Therefore, no further intervention was performed, except for left internal mammarian artery to left anterior descending artery anastomosis and biopsy. As far as we know, this case is unique with respect to its presentation