A research on outsourcing practices of travel agencies operating in Batman

Günümüzün değişen ve çeşitlenen turizm faaliyetleriyle birlikte değişen turist ihtiyaçlarının seyahat acentaları tarafından takip edilerek karşılanması işletmelerin devamlılığı açısından önemlidir. Bu nedenle seyahat acentaları yerine getirdikleri hizmetlerinin yanında farklı hizmetleri de sunmaya çalışmaktadırlar. Ancak seyahat acentaları bu hizmetleri yerine getirirken ekonomik nedenler, talep eksikliği, uzmanlık alanına girmemesi vb. nedenlerden dolayı dış kaynak kullanımı yoluna gidebilmektedir. Bu çalışmada Batman ilinde faaliyet gösteren seyahat acentalarının dış kaynak kullanım düzeyi ve hangi alanlarda yapıldığı, dış kaynak kullanmaya iten nedenler ve gelecekte dış kaynak kullanımına yönelik görüşleri ölçülmeye çalışılmıştır. Veriler yarı yapılandırılmış görüşme formuyla toplanmıştır. Toplanan veriler içerik analizi yöntemi kullanılmak suretiyle analiz edilmiştir. 21 seyahat acentasının yöneticisiyle görüşme gerçekleştirilmiştir. Buna göre işletmelerin rehberlik hizmetleri, vize ve gümrük işlemleri, araç kiralama gibi faaliyetlerin yanı sıra otobüs kiralama, turların pazarlanması, muhasebe gibi sermaye ve uzmanlık gerektiren alanlarda dış kaynak kullanımına gittikleri tespit edilmiştir. Seyahat acetanlarının dış kaynak kullanımına gitme nedenlerin başında ise finansal nedenler gelmektedir

Three-dimensional assessment of nasal changes after maxillary advancement with impaction using stereophotogrammetry

Objective: To evaluate the changes in the nose in three dimensions after Le Fort I osteotomy in patients with skeletal Class III malocclusion. Methods: The subjects were 40 adult patients (20 females and 20 males; mean age, 20.3 +/- 3.0 years; range, 17.0 to 31.1 years) who underwent one-piece Le Fort I osteotomy with maxillary advancement and impaction treatment for maxillary hypoplasia. The mean maxillary advancement was 4.56 +/- 1.34 mm, and the mean maxillary impaction was 2.03 +/- 1.04 mm. Stereophotogrammetry was used to acquire three-dimensional images before and at least 6 months after surgery. Results: Alare (Al) and alare curvature (Ac) points had moved vertically and anterolaterally postoperatively. A significant increase was observed in the nasal ala width and alar base width, and no changes were noted in the columellar length, nasolabial angle, and nasal area. There was a significant relationship between maxillary impaction and nasal ala width and horizontal and sagittal positions of the bilateral Al and Ac. The only relationship found was between maxillary advancement and postoperative sagittal location of the subnasale and pronasale. Conclusions: Nasal soft tissues were highly affected by the vertical movement of the maxilla; however, the soft tissue responses were individual-dependent

Sınıf III maloklüzyonların hızlı üst çene genişletmesi ve ortopedik yüz maskesi ile tedavisinde mandibulada lingual ark kullanımının dentoalveolar yapılar üzerine etkilerinin incelenmesi

ÖZ &nbsp;Amaç: Bu retrospektif çalışmanın amacı, iskeletsel Sınıf III maloklüzyona sahip büyüme dönemindeki çocuklarda hızlı üst çene genişletmesi ile birlikte yüz maskesi ve yüz maskesine ilave olarak mandibulada lingual ark &nbsp;kullanılan bireylerin faz I tedavileri sonunda sefalometrik sonuçlarının değerlendirilmesi ve elde edilen sonuç- &nbsp;ların gruplar arasında karşılaştırılmasıdır. Yöntemler: Çalışmamıza genişletme ve yüz maskesi ile tedavi edilen 30 hasta (I. grup; 14 kız 16 erkek, yaş ort.: &nbsp;11,92 ± 1,21yıl) ve genişletme ile yüz maskesine ilave olarak lingual ark kullanılarak tedavi edilen 30 hasta (II. &nbsp;grup; 16 kız 14 erkek, yaş ort.: 11,61 ± 1,25) olmak üzere toplam 60 birey dahil edilmiştir. Tedaviden öncesi ve &nbsp;sonrası lateral sefalometrik radyografilerin çizimleri Dolphin görüntüleme programı (versiyon 11.95) aracılığı ile &nbsp;yapılmıştır. Grup içi ve gruplar arası parametrik veriler için sırasıyla eşleştirilmiş t testi (Paired Samples t-test) &nbsp;ve Bağımsız örneklem t testi (Independent Samples t-test); non-parametrik veriler için sırasıyla Wilcoxon Rank &nbsp;testi ve Mann-Whitney U testi kullanılmıştır. &nbsp;Bulgular: Her iki grupta SNA(°), ANB(°), SN-GoGn(°), N-A(mm), Co-A(mm), L1-MP(mm), L6-MP(mm) mesafeleri ve overjet(mm) anlamlı şekilde artarken; SNB(°) ile N-Pog(mm) ve L1-Apog(mm) mesafeleri anlamlı şekilde azalmıştır. &nbsp;U1-SN(°) ve interinsizal açıda yalnızca II. grupta anlamlı değişiklikler gözlenirken; oklüzal düzlem açısında ise &nbsp;yalnızca I. grupta anlamlı değişiklik gözlenmiştir. Gruplar arası karşılaştırmada II. grupta SNA(°), ANB(°), Co-A(mm) &nbsp;daha fazla artarken; interinsizal açı daha fazla azalmıştır. U1-SN(°) ve IMPA(°) ile L1-NB(mm) uzaklığı II. grupta &nbsp;artarken I. grupta azalmış; U1-NA(°) ve oklüzal düzlem açısı ise II. grupta azalırken I. grupta artmıştır. L6-MP(mm) &nbsp;mesafesi ise I. grupta daha fazla artmıştır. &nbsp;Sonuç: Büyüme gelişimi devam eden iskeletsel Sınıf III maloklüzyona sahip hastalarda alt keserleri retrokline &nbsp;etmemek ve oklüzal düzlem açısını arttırmamak için yüz maskesi tedavilerine ilaveten lingual ark kullanımı &nbsp;etkili bir seçenektir.ABSTRACT &nbsp;Objective: The aim of this retrospective study is to evaluate the cephalometric changes of growing children &nbsp;with skeletal Class III malocclusion treated with rapid palatal expansion and face mask alone or rapid palatal &nbsp;expansion with face mask and mandibular lingual arch, and to compare the two groups at the end of phase I &nbsp;treatment. &nbsp;Methods: Thirty patients (14 girls, 16 boys, mean age: 11.92 ± 1.21 years) treated with rapid palatal expansion &nbsp;and face mask alone (group I) and 30 patients treated with rapid palatal expansion and face mask and lingual &nbsp;arch (group II), a total of 60 individuals were included in his study. The lateral cephalometric radiographs taken &nbsp;before and after treatment were traced using the Dolphin imaging program (version 11.95). For intragroup and &nbsp;intergroup comparisons of parametric data, 'Paired Samples t-test' and 'Independent Samples t-test' were &nbsp;used, respectively; 'Wilcoxon Rank test' and 'Mann-Whitney U-test' were used for intragroup and intergroup &nbsp;comparisons of non-parametric data, respectively. &nbsp;Results: SNA(°), ANB(°), SN-GoGn(°), N-A(mm), Co-A(mm), L1-MP(mm), L6-MP(mm) measurements, and overjet(mm) increased significantly in both groups while SNB(°), N-Pog(mm) and L1-Apog(mm) measurements were significantly &nbsp;decreased. Significant changes were observed in U1-SN(°) and interincisal angle only in group II and in the &nbsp;occlusal plane angle was significantly changed only in group I. While SNA(°), ANB(°), Co-A(mm) increased more&nbsp;in the group II; interincisal angle is further reduced. While U1-SN(°), IMPA(°), L1-NB(mm) increased in group II, it decreased in group I; U1-NA(°) and &nbsp;occlusal plane angle decreased in group II and increased in group I. L6-MP(mm) further increased in group I. Conclusion: In patients with skeletal Class III malocclusion who have not completed growth development, the use of a lingual arch is an effective &nbsp;option in addition to face mask treatments in order not to retrocline the lower incisors and increase the occlusal plane angle.</p

Pruning deficits of the developing Drosophila mushroom body result in mild impairment in associative odour learning and cause hyperactivity

The principles of how brain circuits establish themselves during development are largely conserved across animal species. Connections made during embryonic development that are appropriate for an early life stage are frequently remodelled later in ontogeny via pruning and subsequent regrowth to generate adult-specific connectivity. The mushroom body of the fruit fly Drosophila melanogaster is a well-established model circuit for examining the cellular mechanisms underlying neurite remodelling. This central brain circuit integrates sensory information with learned and innate valences to adaptively instruct behavioural decisions. Thereby, the mushroom body organizes adaptive behaviour, such as associative learning. However, little is known about the specific aspects of behaviour that require mushroom body remodelling. Here, we used genetic interventions to prevent the intrinsic neurons of the larval mushroom body (γ-type Kenyon cells) from remodelling. We asked to what degree remodelling deficits resulted in impaired behaviour. We found that deficits caused hyperactivity and mild impairment in differential aversive olfactory learning, but not appetitive learning. Maintenance of circadian rhythm and sleep were not affected. We conclude that neurite pruning and regrowth of γ-type Kenyon cells is not required for the establishment of circuits that mediate associative odour learning per se, but it does improve distinct learning tasks

Dopamine Modulates Serotonin Innervation in the Drosophila Brain

Parkinson’s disease (PD) results from a progressive degeneration of the dopaminergic nigrostriatal system leading to a decline in movement control, with resting tremor, rigidity and postural instability. Several aspects of PD can be modeled in the fruit fly, Drosophila melanogaster, including α-synuclein-induced degeneration of dopaminergic neurons, or dopamine (DA) loss by genetic elimination of neural DA synthesis. Defective behaviors in this latter model can be ameliorated by feeding the DA precursor L-DOPA, analogous to the treatment paradigm for PD. Secondary complication from L-DOPA treatment in PD patients are associated with ectopic synthesis of DA in serotonin (5-HT)-releasing neurons, leading to DA/5-HT imbalance. Here we examined the neuro-anatomical adaptations resulting from imbalanced DA/5-HT signaling in Drosophila mutants lacking neural DA. We find that, similar to rodent models of PD, lack of DA leads to increased 5-HT levels and arborizations in specific brain regions. Conversely, increased DA levels by L-DOPA feeding leads to reduced connectivity of 5-HT neurons to their target neurons in the mushroom body (MB). The observed alterations of 5-HT neuron plasticity indicate that loss of DA signaling is not solely responsible for the behavioral disorders observed in Drosophila models of PD, but rather a combination of the latter with alterations of 5-HT circuitry

Efficacy of Capecitabine and Temozolomide Regimen in Neuroendocrine Tumors: Data From the Turkish Oncology Group

INTRODUCTION: This study aims to report the efficacy and safety of capecitabine plus temozolomide (CAPTEM) across different lines of treatment in patients with metastatic neuroendocrine tumors (NETs). METHODS: We conducted a multicenter retrospective study analyzing the data of 308 patients with metastatic NETs treated with CAPTEM between 2010 and 2022 in 34 different hospitals across various regions of Turkey. RESULTS: The median follow-up time was 41.0 months (range: 1.7-212.1), and the median age was 53 years (range: 22-79). Our results across the entire patient cohort showed a median progression-free survival (PFS) of 10.6 months and a median overall survival (OS) of 60.4 months. First-line CAPTEM treatment appeared more effective, with a median PFS of 16.1 months and a median OS of 105.8 months (median PFS 16.1, 7.9, and 9.6 months in first-, second- and ≥third-line respectively, P = .01; with median OS values of 105.8, 47.2, and 24.1 months, respectively, P = .003) In terms of ORR, the first-line treatment again performed better, resulting in an ORR of 54.7% compared to 33.3% and 30.0% in the second and third or higher lines, respectively (P < .001). Grade 3-4 side effects occurred only in 22.5% of the patients, leading to a discontinuation rate of 9.5%. Despite the differences in outcomes based on treatment line, we did not observe a significant difference in terms of side effects between the first and subsequent lines of treatment. CONCLUSIONS AND RELEVANCE: The substantial superior outcomes in patients receiving first-line CAPTEM treatment highlight its potential as an effective treatment strategy for patients with metastatic NET