Intuitive Development of the Concept of Integers among Primary School Students

This paper investigated the intuitive development of the concept of integers among primary school students. In order to reveal if primary school students had an intuitive sense of integers, an assessment consisting of five questions was prepared and applied to a total 100 4th grade students. A variety of integer concepts were utilized in the assessment including; integer ordering, less-than greater-than relations, as well as, integer addition and subtraction. In order to analyse the assessment data a coding system was utilized. Two researchers separately coded the students’ answer responses, and later met with a third researcher to resolve any differences of rater reliability. According to the findings from this research, the 4th grade students investigated did exhibit an intuitive understanding of integers. In order to build upon students understand-ing of integers, examples from daily life as well as cardinal and ordinal meanings of numbers should be utilized in future instruction

Fuzzy multiattribute consumer choice among health insurance options

People buy insurance to protect themselves against possible financial loss in the future. Health insurance provides protection against the possibility of financial loss due to health care use. A selection among health insurance options is a multiattribute decision making problem including many conflicting criteria. This problem can be better solved using the fuzzy set theory since human decision making is generally based on vague and linguistic data. We propose an integrated methodology composed of fuzzy AHP and fuzzy TOPSIS to select the best health insurance option. The considered option types, Health Savings Account (HSA), Flexible Spending Accounts (FSA), and Health Reimbursement Arrangement (HRA) are evaluated using eight different criteria under fuzziness. A sensitivity analysis is also realized. First published online: 18 Jun 201

Fuzzy COPRAS method for performance measurement in total productive maintenance: a comparative analysis

Modern manufacturing firms should be supported by effective maintenance to become successful in their operations. One of the approaches for improving the performance of maintenance activities is to implement a total productive maintenance (TPM) strategy. Overall equipment effectiveness (OEE) is the key measure of TPM. According to the results of the literature review, the performance elements measured by the OEE tool are not sufficient to describe the effectiveness of TPM implementation. Hence, we aim at developing and evaluating new performance measures oriented towards the quantification of TPM implementation effectiveness under fuzzy environment. For the evaluation of each performance measure, at first, the nominal group technique has been used. Then to determine whether these performance measures are statistically significant, conjoint analysis based experimental design has been applied. In the second step, COmplex PRo-portional ASsessment of alternatives with Grey relations (COPRAS-G) and the fuzzy COPRAS method has been developed to evaluate these performance measures in TPM. Proposed fuzzy COPRAS method gives the reassuring results of ranking newly developed performance measures in TPM

Vagal Nerve Schwannoma Clinically Mimicking Gastrointestinal Stromal Tumor: Report of a Case

Introduction: Mesenchymal tumors of the gastrointestinal (GI) tract are mainly comprised of a spectrum of spindle cell tumors which include gastrointestinal stromal tumors (GISTs), leiomyomas or leiomyosarcomas, and schwannomas. As all of these tumors of the GI are located in the submucosal layer of the bowell wall, differential diagnosis is very difficult. Histopathological evaluation using immunohistochemical staining is required for the definitive diagnosis.Presentation of case: A 20-year-old female patient was presented with an upper abdominal pain and dyspepsia since 2 months duration.This case  is initially thought as GIST but finally diagnosed as vagal nerve schwannoma by histopathological evaluation after resection of the mass.Conclusion: Schwannomas should be considered in the differential diagnosis of other mesenchimal tumors, such as gastrointestinal stromal tumors and leiomyomas or leiomyosarcomas, indeed it can grow in any part of the peripheral nerves along the gastrointestinal tract. Histopathological evaluation including immunohistochemical staining is required for the definitive diagnosis

GC/MS Evaluation and In Vitro Antioxidant Activity of Essential Oil and Solvent Extracts of an Endemic Plant Used as Folk Remedy in Turkey: Phlomis bourgaei

This study was outlined to examine the chemical composition of hydrodistilled essential oil and in vitro antioxidant potentials of the essential oil and different solvent extracts of endemic Phlomis bourgaei Boiss. used as folk remedy in Turkey. The chemical composition of the oil was analyzed by GC and GC-MS, and the predominant components in the oil were found to be β-caryophyllene (37.37%), (Z)-β-farnesene (15.88%), and germacrene D (10.97%). Antioxidant potentials of the solvent extracts and the oil were determined by four testing systems including β-carotene/linoleic acid, DPPH, reducing power, and chelating effect. In β-carotene/linoleic acid assay, all extracts showed the inhibition of more than 50% at all concentrations. In DPPH, chelating effect, and reducing power test systems, the water extract with 88.68%, 77.45%, and 1.857 (absorbance at 700 nm), respectively, exhibited more excellent activity potential than other extracts (hexane, ethyl acetate and methanol) and the essential oil at 1.0 mg/mL concentration. The amount of the total phenolics and flavonoids was the highest in this extract (139.50 ± 3.98 μg gallic acid equivalents (GAEs)/mg extract and 22.71 ± 0.05 μg quercetin equivalents (QEs)/mg extract)

The assessment of twin pregnancies delivered in our clinic: three-year experience

Objective: Twin pregnancies constitute 1–2% of all pregnancies. With the recent developments in assisted reproductive technologies, the incidence of multiple pregnancy has increased. Preterm labor is held responsible for the poor neonatal outcomes primarily. In our study, we aimed to assess fetal-maternal outcomes of twin pregnancies seen in our clinic. Methods: One hundred and thirty twin pregnancy cases out of 4241 pregnant women who delivered in our clinic between 01.01.2017 and 01.01.2020 were included in the study. The labor records of the patients were reviewed retrospectively and their data for age, week of gestation, delivery type, birth weight, fetal sex, chorionicity characteristics and laboratory parameters were recorded. Definitive statistics and SPSS 21.0 for statistical analyses were used to evaluate the data obtained from the study. The data were presented as mean ± SD (standard deviation). Results: The incidence of twin pregnancy was found 3%. In the ultrasonographic imaging evaluated during diagnosis, 27.7% of the cases were monochorionic and 72% of them were dichorionic. Of the pregnant women, 12.3% were at term and 87.7% were at preterm period. When the preterm fetuses were evaluated, 37.7% of 114 preterm fetuses were delivered at late preterm period, 29.2% of them at mid-preterm period and 20.8% at premature preterm period. The rates of treatment pregnancy (pregnancy provided by ovulation induction and assisted reproductive technologies) and spontaneous twin pregnancy were 20% and 80%, respectively. Mean maternal age was found 31.3. When evaluated in terms of maternal morbidity, preterm labor and premature rupture of membrane were the most common problems. Mean newborn weight was 1832g and 59.3% of the newborns had low birth weight and 21.8% of them had very low birth weight. While one fetus had transverse presentation in 12.5% of the patients, at least one fetus had breech presentation in 53.1% of the cases and 34.4% of the cases had head-head presentation. Conclusion: Twin pregnancies are characterized by the increased feto-maternal risks. Therefore, both antenatal and intrapartum management should be maintained diligently

The assessment of maternal deaths between 2015 and 2020 in Elazığ, Turkey

Objective: To determine the maternal deaths and the factors affecting them in our city. Methods: The maternal deaths occurred in our city between January 2015 and June 2020 were reviewed retrospectively. The review was conducted by checking “Maternal Death Registry Forms” of the Provincial Directorate of Health. In cases where additional data related with the cause of death were required, the relatives of the cases, associated family practitioner, The Council of Forensic Medicine or local authorities were contacted. The data of the cases including age, gravida, parity, abortion, delivery type, week of gestation during delivery, period of death and maternal deaths due to direct, indirect and incidental causes were recorded. Based on total live births and maternal deaths within 6.5 years, maternal mortality rate was found as the maternal death number per 100,000 live births. Descriptive statistics were used for the statistical analysis of the data. Results: A total of 46.618 live births occurred between 2015 and 2020 in Elazığ. The number of maternal deaths due to direct and indirect causes is 7, and maternal mortality rate was found 15.01/100,000. Hypertensive diseases during pregnancy (n=3, 42.8%), pulmonary embolism (n=1, 14.3%) and cerebral thrombosis (n=1, 14.3%) were among the natural causes of maternal deaths. Indirect cause for maternal death was cardiac diseases (n=2, 28.6%). When they were categorized according to the Three Delays Model, there were 3 death cases in the first delay model and 2 death cases in the third delay model, but there was no maternal death in the second delay model. Conclusion: Maternal death is an significant public health issue which develops due to the generally preventable causes and maintains its importance. The factors contributing to death should be paid attention in order to decrease maternal death rates

Examination of perception dimension of engineering technology and ergonomics principles in terms of healthcare personnel: a scale development study

In general terms, ergonomics is the conformity of human and equipment. Unconformity between human and equipment is more likely to give harm either to the equipment or to human. This conformity may go for both daily domestic tasks and work life. Domestic furniture and equipment are designed by taking average features of individuals into consideration. For example; chairs, tables, beds and similar things are manufactured with the measurements which are accepted as standard all over the world. People spend most of their time at their homes and workplaces. Similarly, the ergonomics considered in the manufacture of domestic furniture takes an important place in working life, as well. This is highly significant in terms of both health of workers and efficiency of the work done. On the other hand, ergonomics possesses importance in terms of patients except from workers and work efficiency in health sector. Working in non-ergonomic settings may both endanger health of healthcare personnel and cause decrease in work efficiency as well as posing negative effects for recovery of the patients. From this point of view, ergonomics in health sector becomes more important in many aspects. In this study, it was aimed to develop a scale with regard to finding out perceptions of the healthcare personnel on engineering technologies and ergonomics principles