Velocity-based Storage Assignment in Semi-automated Storage Systems

Our research focuses on the storage decision in a semi-automated storage system, where the inventory is stored on mobile storage pods. In a typical system, each storage pod carries a mixture of items, and the inventory of each item is spread over multiple storage pods. These pods are transported by robotic drives to stationary stations on the boundary of the storage zone where associates conduct pick or stow operations. The storage decision is to decide to which storage location within the storage zone to return a pod upon the completion of a pick or stow operation. The storage decision has a direct impact on the total travel time, and hence the workload of the robotic drives. We develop a fluid model to analyze the performance of velocity-based storage policies. We characterize the maximum possible improvement from applying a velocity-based storage policy in comparison to the random storage policy. We show that class-based storage with two or three classes can achieve most of the potential benefits and that these benefits increase with greater variation in the pod velocities. To validate the findings, we build a discrete-time simulator with real industry data. We observe an 8% to 10% reduction in the travel distance with a 2-class or 3-class storage policy, depending on the parameter settings. From a sensitivity analysis we establish the robustness of the class-based storage policies as they continue to perform well under a broad range of warehouse settings including different zoning strategies, resource utilization and space utilization levels

Gastrointestinal Tract Multiple Lymphomatous Polyposis Presented As Mantle Cell Lymphoma

DergiPark: 640245tmsjAims: Mantle cell lymphoma is a mature B cell non-Hodgkin lymphoma which may be presented with the involvement of the gastrointestinal tract as multiple lymphomatous polyposis. The aim of this case report is to increase the awareness of including lymphomatoid polyposis as an entity in the differential diagnosis of multiple polyposis of the gastrointestinal tract. Case Report: A 69-year-old male patient was admitted to the Trakya University Emergency Department with acute abdominal pain. His cli-nical findings were anorexia that started 3-4 months ago together with constipation and nausea causing him to lose 10-15 kg in 7-8 months, with denial of other parameters of B-symptoms (fevers and night sweats). Endoscopic biopsies that were taken from bulbus and duodenum were investigated and he was diagnosed with mantle cell lymphoma. The patient went through an ileoce-cal resection due to his intussusception that caused abdominal pain in the first place. Conclusion: Although being an infrequent disease, gastrointestinal lymphomatoid polyposis should be an entity comprised in differential diagnosis for multiple polyposis of the gastrointestinal tract. On the other hand, there is still not a therapeutic protocol with a definitive cure for gastrointestinal tract mantle cell lymphoma. Elderly patients in high risk group such as our patient should be given treatment by taking their conditions into consideration. Keywords: Mantle cell lymphoma, polyp, non-Hodgkin lymphom

The relationship between molecular profile and prognosis of muscle invasive bladder cancer

Mesane kanserleri, tanısı, tedavisi ve takibinde invaziv işlemlerin uygulandığı ve bu nedenle getirdiği mali yükün fazla olan orta sıklıkta görülen kanserlerdir. Bu tümörlerin oluşma sürecindeki moleküler mekanizmalar son yıllarda ortaya çıkarılmaktadır. Mesane kanseri patogenezinde rol oynayan genlerdeki mutasyonları ve kullanımının fayda sağlayabileceği düşünülen antikorları incelediğimiz çalışmamızda, immünohistokimyasal boyama yöntemi ile elde edilen ekspresyon durumlarının prognostik verilerle karşılaştırılması amaçlandı. Ayrıca polimeraz zincir reaksiyonu çalışması sonucu elde edilen mutasyon durumlarının hastalarda neoadjuvan tedaviye yanıt ile ilişkili olup olmadığı ve bu mutasyon durumlarının prognostik parametreler ile ilişkisinin olup olmadığı incelendi. Trakya Üniversitesi Tıp Fakültesi hastanesi patoloji laboratuvarında tanı almış ve neoadjuvan tedavi verilmiş 23 mesane kanseri olgusu çalışmaya dahil edildi. Olgulara ait klinik ve prognostik veriler onkoloji birimi aracılığıyla elde edildi. Olgulara ait Hematoksilen & Eozin kesitleri ışık mikroskobunda incelendi. Her olguya ait 1 operasyon öncesi transüretral rezeksiyon 1 tane de sistektomi materyalindeki uygun blok seçilerek Keratin 5, Keratin14, Keratin20 ve GATA3 antikorlarıyla çalışma uygulandı. Ayrıca 12 olguda Hematoksilen & Eozin kesitlerinden uygun tümör alanı seçilerek gerçek zamanlı polimeraz zincir reaksiyonu uygulandı. Preop transüretral rezeksiyon materyalinde Keratin 14 ekspresyonu olan olgularda genel sağkalım (p=0,007) ve progresyonsuz sağkalım süresinin (p=0,02) daha kısa olduğu istatistiksel yönden anlamlı olarak bulunmuştur. GATA binding protein 3 antikoru ile preop transüretral rezeksiyon materyalinde ekspresyon gösteren olgularda genel sağkalım süresi 43 ay iken, ekspresyon göstermeyen olgularda bu süre 16 ay olarak hesaplanmıştır. Bu durum istatistiksel yönden anlamlı olmasa da oldukça dikkat çekicidir. 12 olguya uygulanan ve 9 gendeki mutasyonun incelendiği moleküler çalışmalarda 3 olguda ‘tümör proteini 53’ mutasyonu ve 1 olguda ‘Fosfatidilinozitol-4,5-bisfosfat 3-kinaz katalitik subunit alfa’ mutasyonu belirlenmiştir. Moleküler çalışma sonuçları prognostik verilerle karşılaştırıldığında anlamlı sonuca ulaşılamamıştır. Sonuç olarak, Keratin 14 ve GATA3 antikorlarının beraber kullanımı preop hastalarda prognoz tahmininde rutin pratikte kullanılabileceği görülmüştür. Keratin 5 antikorunun kullanımı ile ilgili somut kanıt elde edilememiştir. Tümör proteini 53 ve Fosfatidilinozitol-4,5-bisfosfat 3-kinaz katalitik subunit alfa mutastonlarıyla ilgili daha geniş olgu sayılarını içeren moleküler incelemeye dayalı çalışmalara ihtiyaç vardır.Bladder cancers are moderately common cancers with a high financial burden due to the invasive measures used in diagnosis, treatment and follow-up. The molecular mechanisms in development process of these tumors have recently been discovered. In our study, which examines mutations in genes playing a role in bladder cancer pathogenesis and antibodies that are considered to be helpful when used, it is aimed to compare expression situations determined using immunohistochemical staining method with prognostic data. In addition, it is examined whether the mutation situations detected using polymerase chain reaction have a relationship with the patient’s respond to neo-adjuvant therapy and prognostic parameters. Twenty three bladder cancer cases, diagnosed in Trakya University Faculty of Medicine, Laboratory of Pathology and treated with neo-adjuvant therapy, were included in the study. Clinical and prognostic data of the cases were obtained from the oncology unit. Hematoxylin & Eosin-stained tissue sections were examined using light microscopy. Two suitable blocks of each case, one pre-operational trans-urethral resection and one cystectomy material, were chosen and Keratin 5, Keratin 14, Keratin 20 and GATA binding protein 3 antibodies were applied to these sections. Also in twelve cases, suitable tumor fields chosen from Hematoxylin & Eosin-stained tissue sections were examined using real-time polymerase chain reaction. In cases showing expression of Keratin 14 in pre-operational transurethral resection material, overall survival (p=0,007) and progression-free survival (p=0,02) were found statistically significantly shorter. While overall survival period was calculated as 43 months in cases showing expression of GATA3 antibody and pre-operative transurethral resection material, it was 16 months in cases showing no expression. This situation, although not statistically significant, is quite remarkable. In the molecular studies examining mutations in nine genes in twelve cases, ‘tumor protein 53’ mutation in three cases and ‘Phosphatidylinositol 4,5-bisphosphate 3-kinase catalytic subunit alpha’ mutation in one case have been determined. When the results of molecular studies were compared with prognostic data, no significant results have been found. In conclusion, it is seen that the use of Keratin 14 and GATA3 antibodies together can be applied in routine practice to predict prognosis in pre-operative patients. No concrete evidence has been obtained regarding the use of Keratin 5 antibody. Further molecular studies involving higher number of cases on Tumor protein 53 and Phosphatidylinositol 4,5-bisphosphate 3kinase catalytic subunit alpha mutations are necessary

The evaluation of adherence in chronic diseases of elderly hypertensive patients in Edirne City center

Hipertansiyon toplumda sık görülen, tedavi edilmediği takdirde komplikasyonlara yol açan önemli bir sağlık problemdir ve yaşla birlikte toplumda görülme sıklığı artmaktadır. Çalışmamızın amacı, hipertansiyon tanısı olan yaşlı bireylerin hastalıklarına uyumlarını değerlendirmek ve uyumlarını belirleyen faktörleri belirlemektir. Çalışmanın örneklemini Edirne il merkezindeki 23 aile sağlığı merkezine kayıtlı 65 yaş ve üzeri 421 birey oluşturmaktadır. Veriler 75 sorudan oluşan bir anketle toplanmıştır. Anketin içinde 25 sorudan oluşan Kronik Hastalıklara Uyum Ölçeği uygulanmıştır. Katılımcıların 226’sı (% 53,7) kadın, 195’i (% 46,3) ise erkektir. Katılımcıların yaş ortalaması 75,21 ± 7,686, minimum yaş 65 ve maksimum yaş 91 şeklindedir. Hem sistolik kan basıncı hem diastolik kan basıncı değerleri 2019 Türk Hipertansiyon Uzlaşı Raporu’na göre hedefte olan katılımcı sayısı 34’tür (% 8,07). Katılımcıların ölçekten aldıkları ortalama puan 87,04 ± 9,77 olup minimum puan 62, maksimum puan 116’dır. Ölçek alt boyutlarına bakıldığında ise fiziksel uyum puanı ortalama 38,50 ± 5,70 (minimum 23, maksimum 53 puan), sosyal uyum puanı 25,10 ± 3,08 ( minimum 16, maksimum 47 puan), psikolojik uyum puanı 23,45 ± 3,25 (minimum 16, maksimum 31 puan) puandır. 65-74 yaş grubun uyum puanı 75-84 yaş grubu (p=0,003) ve 85 yaş üzeri gruptan (p=0,009) daha yüksektir. Dul bireylerin (p < 0,001), okuryazar olmayan bireylerin (p < 0,001) ve yalnız yaşayanların (p < 0,001) uyum puanı anlamlı derecede daha düşüktür. Beden kitle indeksi ile uyum puanı arasında ters yönlü bir ilişki mevcuttur (p=0,001). Hastalığı ve tedavisi ile ilgili ailesi de bilgilendirilen (p=0,025), aile desteği olan (p < 0,001) katılımcıların uyum puanı daha yüksektir. Çalışmamızdan elde ettiğimiz veriler değerlendirildiğinde, hipertansiyon kontrol oranının oldukça düşük olduğu görülmektedir. Bireylerin kronik hastalıklara uyumunu etkileyen birçok faktör olduğu belirlenmiştir. Hastalık uyumunu sağlamak için hekim-hasta ilişkisinin güçlendirilmesi, hastanın ve ailesinin bilgilendirilerek sürece aktif katılımlarının sağlanması, psikososyal stres faktörlerinin belirlenip yapılması gerekenler için rehberlik edilmesi, beslenme ve egzersiz danışmanlığı yapılması bireylerin hastalık uyumlarını ve yaşam kalitelerini olumlu yönde etkileyecektir.Hypertension is a common and significant health problem causing complications if left untreated, and its prevalence increases by age. Our study aims to determine the adherence to disease of elderly individuals and identify the related factors of adherence to disease. The study sample includes 421 patients above the age of 65 and registered to 23 family health centers in Edirne city center. The data were obtained through a questionnaire comprising of 75 questions. Adaptation to Chronic Illness Scale comprising of 25 questions were applied in the questionnaire. Two hundred and twenty six of the participants (53.7%) were female, and 195 (46.3%) were male. The mean age of the participants was 75.21 ± 7,686, their minimum age was 65 and maximum age was 91. The number of participants having both systolic blood pressure and diastolic blood pressure values within the target range according to 2019 Turkish Hypertension Consensus Report was 34 (8.07%). The mean scale score of participants were 87.04 ± 9.77, minimum score was 62 and maximum score was 116. When subscales were evaluated, mean physical adherence score was 38.50 ± 5.70 (minimum 23, maximum 53 points), social adherence score was 25.10 ± 3.08 (minimum 16, maximum 47 points), and psychological adherence score was 23.45 ± 3.25 points (minimum 16, maximum 31 points). The adherence score of 65-74 age group was higher than the score of 75-84 age group (p=0.003) and above 85 years group (p=0.009). The adherence scores of widowed individuals (p < 0.001), illiterate individuals (p < 0.001) and the individuals living alone (p < 0.001) were significantly lower. There was an inverse relationship between Body Mass Index and adherence score (p=0.001). The adherence scores of the participants whose families were also informed about the disease (p=0.025), who have family support (p < 0.001) were higher. When the data obtained from our study is evaluated, hypertension control rate is observed to be considerably low. It is determined that there are many factors affecting the adherence of individuals to chronic diseases. Strengthening the physician-patient relationship, ensuring the active participation of the patient and his family to the process by informing them, providing guidance in actions to be taken by determining psychological stress factors, providing nutrition and exercise consultation will positively affect the adherence of individuals to the disease and their life quality

Coping with trauma in the contemporary South African novel

Das Apartheidsystem in Südafrika (1948-1991 ), mit seiner zutiefst menschenfeindlichen Politik, kann als traumatisierendes Ereignis für das gesamte Land sowie für seine Bevölkerung betrachtet werden. Noch immer sind die Folgen der organisierten Gewalt und Diskriminierung deutlich zu erkennen. Umso bedeutender ist es, das Geschehene nicht in Schweigen zu hüllen, sondern die Gräueltaten erneut ins Bewusstsein zu rufen und gezielt aufzuarbeiten. Der zeitgenössische südafrikanische Roman leistet dabei seinen ganz eigenen Beitrag. Indem er die verdrängte Vergangenheit hemmungslos und unverblümt in die Gegenwart zurückholt, trägt er einerseits zur allgemeinen Bewusstseinsbildung bei und beteiligt sich zudem an einem kollektiven, aktiven Traumaverarbeitungsprozess. Diese Diplomarbeit befasst sich damit, wie ‚Traumaverarbeitung‘ (‚Coping‘) im zeitgenössischen südafrikanischen Roman zum Tragen kommt. Hierzu werden zunächst in einem einführenden Teil die Phänomene ‚Trauma‘ und ‚Coping‘ theoretisch fundiert und ihr Zusammenhang mit menschlicher Identität/dem menschlichen Selbst sowie mit Literatur (unter spezieller Berücksichtigung des ‚Romans‘) diskutiert. In den weiteren Kapiteln wird je ein südafrikanischer Roman, basierend auf dem zuvor dargelegten Theoriengut, diskutiert und analysiert. Die vier zu diesem Zwecke gewählten Romane sind 'A Quilt of Dreams' (Patricia Schonstein), 'Ways of Dying' (Zakes Mda), 'Gem Squash Tokoloshe' (Rachel Zadok) und 'Quarter Tones' (Susan Mann)

Cuts for mixed 0-1 conic programming

In this we paper we study techniques for generating valid convex constraints for mixed 0-1 conic programs. We show that many of the techniques developed for generating linear cuts for mixed 0-1 linear programs, such as the Gomory cuts, the lift-and-project cuts, and cuts from other hierarchies of tighter relaxations, extend in a straightforward manner to mixed 0-1 conic programs. We also show that simple extensions of these techniques lead to methods for generating convex quadratic cuts. Gomory cuts for mixed 0-1 conic programs have interesting implications for comparing the semidefinite programming and the linear programming relaxations of combinatorial optimization problems, e.g. we show that all the subtour elimination inequalities for the traveling salesman problem are rank-1 Gomory cuts with respect to a single semidefinite constraint. We also include results from our preliminary computational experiments with these cuts

Staffing Multiskill Call Centers via Linear Programming and Simulation

We study an iterative cutting-plane algorithm on an integer program for minimizing the staffing costs of a multiskill call center subject to service-level requirements that are estimated by simulation. We solve a sample average version of the problem, where the service levels are expressed as functions of the staffing for a fixed sequence of random numbers driving the simulation. An optimal solution of this sample problem is also an optimal solution to the original problem when the sample size is large enough. Several difficulties are encountered when solving the sample problem, especially for large problem instances, and we propose practical heuristics to deal with these difficulties. We report numerical experiments with examples of different sizes. The largest example corresponds to a real-life call center with 65 types of calls and 89 types of agents (skill groups).call centers, staffing, optimization by simulation, integer programming, cutting planes, skill-based routing, subgradient cuts