A Decision support system for machine tool selection

Business globalization, increased worldwide competition, decreased product lifecycles and continuous introduction of new technologies force companies to use new machine tools. Appropriate selection of a machine tool for a production system resultsin increased precision, productivity, flexibility, and manufacturing responsiveness.Meanwhile, machine tool selection is a multi-faceted manufacturing planning problem,typically involving a variety of conflicting goals. Thus, selecting the most suitablemachine from the increasing number of available machines is a difficult and demandingtask. In this thesis, a decision support system (DSS) is developed to aid in selection of machine tools for a production system. The DSS uses multi-criteria weighted averagemethod (MCWA) as the decision-making approach. MCWA method considers a set ofconflicting objectives such as productivity, flexibility, and adaptability that typically cannot be achieved simultaneously. Each machine tool is assigned a score according to itsproperties in relation to the machines in the database. These scores are then used to rankthe machines according to various criteria. A stepwise approach is used in the selectionprocess. The entire tool selection process is demonstrated with examples. Sensitivity analysis is used to determine the most critical criterion and the most critical measure ofperformance. Cost / benefit analysis is carried out involving the purchasing decision of aselected machine tool and its additional options

Evaluation of the mean platelet volume in patients with cardiac syndrome X

OBJECTIVE: Cardiac syndrome X is characterized by angina-lke chest pain, a positive stress test, and normal coronary arteries. A patient's mean platelet volume, which potentially reflects platelet function and activity, is associated with coronary atherosclerosis and endothelial dysfunction. The aim of the present study was to evaluate the mean platelet volumes of patients with cardiac syndrome X, those with coronary artery disease and normal subjects. METHODS: Two hundred thirty-six subjects (76 patients with cardiac syndrome X, 78 patients with coronary artery disease, and 82 controls) were enrolled in the study. All of the subjects were evaluated with a detailed medical history, physical examination, and biochemical analyses. The mean platelet volumes were compared between the three groups. RESULTS: The mean platelet volumes in the patients with cardiac syndrome X and with coronary artery disease were significantly higher than those that were observed in the control group. There were no significant differences in the mean platelet volumes between the cardiac syndrome X and the coronary artery disease groups. CONCLUSION: We have established that patients with cardiac syndrome X and coronary artery disease exhibit higher mean platelet volumes compared to controls. Patients with cardiac syndrome X exhibited higher mean platelet volumes compared to the controls, reflecting the presence of subclinical atherosclerosis. These findings suggest that, in addition to endothelial dysfunction, the presence of atherosclerosis may also contribute to the etiopathogenesis of cardiac syndrome X

A decision support system for machine selection

Globalization of business, the worldwide competitive economy and the decrease in product life force companies to use new equipments that are continuously introduced to the market with the advances in technology. An improper selection can negatively affect productivity, precision, flexibility and company’s responsive manufacturing capabilities. Thus, selecting the most suitable machine from the increasing number of available machines can be highly demanding. A decision support system is developed for the selection of machine tools. It will guide the selection process and help a decision maker solve the selection problem. Multi-criteria weighted average is used in decision-making process to rank the machines evaluated with respect to several criteria. The method is demonstrated with an example

Successful Treatment of Propafenone Intoxication With Intravenous Lipid Emulsion

Severe cardiac effects, including cardiac arrest, are a rare complication of high-dose propafenone intake. Among patients who experience cardiac arrest, the survival rate is low. This report presents the case of a young female patient who developed cardiac arrest linked to propafenone intake. While spontaneous circulation was restored with cardiopulmonary resuscitation, vital signs did not recover despite supportive treatment. However, after the administration of intravenous lipid emulsion (ILE), vital signs and cardiac functions resolved and the patient survived. This case is the second to describe the successful use of ILE for propafenone intoxication. However, as all of the findings of this patient were clearly linked to propafenone, we believe the benefits of ILE were more clearly defined in this case than in the other

New sites of the endangered Marmaris Salamander, Lyciasalamandra flavimembris (Mutz and Steinfartz 1995), (Caudata: Salamandridae) from Mugla, Turkey

WOS: 000455396600001Reported are seven new sites of Lyciasalamandra flavimembris found in southeastern Anatolia, Turkey. These data extend the species' distribution range by 45 km in the southwest creating a total species' area of 115 km(2). We compared morphological and color-pattern characteristics from the new sites with previously published data. The new populations are considered to be L. f. flavimembris.Rufford Foundation; Akdeniz Koruma DernegiThis study is part of a project supported by Rufford Foundation and Akdeniz Koruma Dernegi (www.akdenizkoruma.org.tr/).We are grateful to these organizations and the Rufford Foundation (Rufford Small Grants) for their generous financial support. We thank Lisa Ernoul (Tour du Valat) for valuable comments and reviewing the English

A Case of Placenta Increta Mimicking Submucous Leiomyoma

In recent years with the increase in cesarean section rates, the frequency of placenta accreta cases rises. It causes 33–50% of all emergency peripartum hysterectomies. We present a 42-year-old case who was caught with early postpartum hemorrhage due to retained placental products. The ultrasonography showed a 65 × 84 mm mass in the uterine cavity after the delivery. Due to presence of early postpartum hemorrhage which needs transfusion, an intervention decision was made. The patient underwent curettage but the mass could not be removed so that placental retention was ruled out. Submucous leiomyoma was made as first-prediagnosis. Hysterectomy operation was performed as a curative treatment. Placenta increta diagnosis was made as a final diagnosis with pathological examination. As a result, placental attachment disorders may be overlooked if it is not a placenta previa case

Systemic immune-inflammation index predicts mortality in infective endocarditis

© 2019 The AuthorsObjectives: The aim of our study was to evaluate the usefulness of systemic immune-inflammation index (SII) at admission in predicting in-hospital mortality in patients with infective endocarditis. Methods: 133 definite IE patients (≥18 years) according to modified Duke criteria, treated in our tertiary care hospital between December 2009 and May 2019, were retrospectively analysed. Symptoms, comorbidities, predisposing valvular diseases, prosthetic valve, device, history of injectable drug use, blood culture results, echocardiography findings, and complications were collected. We calculated the SII as follows: SII = platelet count × neutrophil count/lymphocyte count at admission. Results: The median age of the patients was 56 (40–66) years. Prosthetic valve disease was the most frequent predisposing valve lesion. Staphylococcus species were the most common microorganisms. The most frequent complication was in-hospital mortality (22%) followed by renal failure. Older population, syncope, increased inflammatory markers, high systolic pulmonary artery pressure (PAPs), heart failure, renal failure, and septic shock were associated with high mortality. However age, syncope, hypocalcemia, not going to surgery, and SII were independent predictors of in-hospital mortality. According to receiver operating characteristic curve analysis, the optimal SII cut-off value for predicting mortality was 2314 (area under the curve 0.641; P = 0.019). Conclusion: We demonstrated that high SII levels are independently associated with in-hospital mortality. The SII may be a promising prognostic predictor for patients with infective endocarditis

Systemic immune-inflammation index predicts mortality in infective endocarditis

© 2019 The AuthorsObjectives: The aim of our study was to evaluate the usefulness of systemic immune-inflammation index (SII) at admission in predicting in-hospital mortality in patients with infective endocarditis. Methods: 133 definite IE patients (≥18 years) according to modified Duke criteria, treated in our tertiary care hospital between December 2009 and May 2019, were retrospectively analysed. Symptoms, comorbidities, predisposing valvular diseases, prosthetic valve, device, history of injectable drug use, blood culture results, echocardiography findings, and complications were collected. We calculated the SII as follows: SII = platelet count × neutrophil count/lymphocyte count at admission. Results: The median age of the patients was 56 (40–66) years. Prosthetic valve disease was the most frequent predisposing valve lesion. Staphylococcus species were the most common microorganisms. The most frequent complication was in-hospital mortality (22%) followed by renal failure. Older population, syncope, increased inflammatory markers, high systolic pulmonary artery pressure (PAPs), heart failure, renal failure, and septic shock were associated with high mortality. However age, syncope, hypocalcemia, not going to surgery, and SII were independent predictors of in-hospital mortality. According to receiver operating characteristic curve analysis, the optimal SII cut-off value for predicting mortality was 2314 (area under the curve 0.641; P = 0.019). Conclusion: We demonstrated that high SII levels are independently associated with in-hospital mortality. The SII may be a promising prognostic predictor for patients with infective endocarditis

Evaluation of the mean platelet volume in patients with cardiac syndrome X

OBJECTIVE: Cardiac syndrome X is characterized by angina-lke chest pain, a positive stress test, and normal coronary arteries. A patient's mean platelet volume, which potentially reflects platelet function and activity, is associated with coronary atherosclerosis and endothelial dysfunction. The aim of the present study was to evaluate the mean platelet volumes of patients with cardiac syndrome X, those with coronary artery disease and normal subjects. METHODS: Two hundred thirty-six subjects (76 patients with cardiac syndrome X, 78 patients with coronary artery disease, and 82 controls) were enrolled in the study. All of the subjects were evaluated with a detailed medical history, physical examination, and biochemical analyses. The mean platelet volumes were compared between the three groups. RESULTS: The mean platelet volumes in the patients with cardiac syndrome X and with coronary artery disease were significantly higher than those that were observed in the control group. There were no significant differences in the mean platelet volumes between the cardiac syndrome X and the coronary artery disease groups. CONCLUSION: We have established that patients with cardiac syndrome X and coronary artery disease exhibit higher mean platelet volumes compared to controls. Patients with cardiac syndrome X exhibited higher mean platelet volumes compared to the controls, reflecting the presence of subclinical atherosclerosis. These findings suggest that, in addition to endothelial dysfunction, the presence of atherosclerosis may also contribute to the etiopathogenesis of cardiac syndrome X

Characterization, epidemiological profile and risk factors for clinical outcome of infective endocarditis from a tertiary care centre in Turkey

Background: We aimed to investigate the clinical, laboratory, microbiological characteristics of IE in a single tertiary care centre in Turkey and to identify the factors associated with in-hospital mortality. Methods: A total of 155 consecutive adult patients (>= 18 years) admitted to our single tertiary care hospital between 2009 and 2019 with definite infective endocarditis were retrospectively included in the study. Results: The mean age of the patients was 58 years. Among 155 endocarditis episodes, 60% involved prosthetic valves, 35.5% had native valve endocarditis (NVE) and 4.5% were device related. Prosthetic valve disease was the most frequent predisposing valve lesion followed by degenerative valvular disease. Vegetations were detected in 103 (66.5%) patients by transthoracic echocardiography and in 145 (93%) patients by transoesophageal echocardiography. The most commonly affected valve was the mitral valve in 84 (54.2%) patients, followed by 67 (43.2%) aortic valve. Staphylococci were the most frequent causative microorganisms isolated in both NVE (31.8%), prosthetic valve endocarditis (38.9%) and device related IE cases. At least one complication was present in 70 patients (45.2%). One hundred and eight patients underwent surgical therapy (69.7%). Age, syncope, heart failure, perforation, septic shock, renal failure, high red cell distribution width, atrial fibrillation, hypocalcaemia, pulmonary hypertension were associated with high mortality. Conclusions: We identified a 10-year presentation of IE in a referral centre in Turkey. Likely other series, we observed more staphylococcus endocarditis with the aging of the population. Surgery was associated with higher in-hospital survival. Age, syncope, perforation, septic shock were independent predictors of mortality