1,009 research outputs found
Finitely presented quadratic algebras of intermediate growth
In this article, we give two examples of finitely presented quadratic
algebras (algebras presented by quadratic relations) of intermediate growth
EU Market Access: The Way Of Licensed Warehousing System for Turkish Food Producers and Exporters
Licensed warehousing system plays a very important role in all transfers of food products from the place of origin to ultimate users in developed countries. Public warehouses, operated as an independent business offering a range of services, such as storage, handling and transportation. Licensed Warehousing Law, was accepted on 10.02.2005 and this is a new subject in Turkey. In this research, the licensed warehousing system in Turkey is evaluated from the point of view of industrial and agriculture officials. Confidential face to face interviews were held with the authorities of Industry and Trade Ministry in Ankara. The very new licensed warehousing law connote many questions. Who will be getting the benefits of qualified storing, small-sized enterprises or big ones? What will be benefits to producers, product markets, and government? Are all the necessary legal, institutional, and technical enabling ready? During the study, authorities of Industry and Trade Ministry has met, qualified storing law and its system, function, benefits, world samples information were given by using literatures, then action of the qualified storing system in Turkey and its possible problems were discussed.Licensed warehousing, agriculture, food produce, food trade, Agribusiness, International Relations/Trade,
Early postoperative interventional ASD-closure for severe atrial right to left shunt in a neonate with common arterial trunk
Although closure of an atrial septal defect (ASD II) with an occluding device in the first year of life is not a routine procedure, it is a feasible treatment, even in neonates. Case reports on the off-label use of Amplatzer devices have been repeatedly published, but there are no reports on using the Amplatzer Duct Occluder (ADO) to close an atrial septal defect in a neonate. We report on a successful catheter closure of an ASD II with ADO in a severely cyanotic neonate, seven days after surgical repair of common arterial trunk. Due to progressive cyanosis and clinical signs of right ventricular failure, which developed after common arterial trunk repair, the neonate underwent cardiac catheterization. Diastolic filling impairment of the right ventricle (right ventricle hypertrophy, pulmonary regurgitation, and residual right ventricle outflow tract obstruction) was thought to be the cause of impaired right ventricle diastolic filling, resulting in the right-to-left shunt at the atrial level. Under transesophageal echocardiographic guidance, ADO was delivered through a 5 French sheath into the atrial septal defect. Amplatzer duct occluder closed the defect and proved to be stable in position after disconnection. During the procedure, the child was stable and then transferred to the intensive care unit with significantly improved oxygen saturation. This is the first report on placing a duct occluder in the atrial septal position, which is a novel procedure for-small neonates
Teaching of Newton\u27s Laws: Force and Motion: The Effectiveness of Demonstrations
In this study, we investigated effects of demonstrations on teaching of force and motion concepts compared with traditional instruction. The participants of this study consisted of 68 undergraduate students who taking the course in two different classes from the same teacher. One of the classes was assigned randomly to the control group, and the other class was assigned randomly to the experimental group. During teaching the topic of force and motion concepts in the physics curriculum, demonstrations were applied in the experimental group whereas in the control group traditional instruction was followed for the period of four weeks. As a result, we determined that the experimental group showed better performance than control group in terms of the success
Message Oriented Approach to WOM Effects in Service Industries
In this study a search-based and an experience-based service were examined in Word-of-Mouth (WOM) context. The study aimed at revealing the extent to which consumer choices in movie theatre and repair and maintenance shop services are influenced by the experience communicated by personal sources. Four key contributions are planned. Firstly, although it has attracted attention and criticism there is no empirical examination regarding message characteristics. In this study, the effects of messages delivered by senders concerning purchase decisions are investigated. Secondly, a more powerful scale regarding active information search was developed. Thirdly, perceptual homophily and sender characteristics were added to the model in a unique construct. Fourthly, to measure the effects of personal sources a classification of services is applied for the first time in WOM researches in this context. Data was subjected to an exploratory factor analysis (EFA) and reliability analysis in the first stage of the analysis. At the second stage, confirmatory factor analysis (CFA) was conducted and the model's hypotheses were tested by using structural equation modeling (SEM)
“Tip-In” or “Randezvouz“ techniques as a first choice in retrograde chronic total occlusion interventions
Introduction: The “Tip-In” method is a technique first described in 2015 and is developed to overcome some limitations of commonly used methods in retrograde approach in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).1,2 The most commonly applied retrograde technique is placing a guidewire just distal to the distal cap using collateral vessels, with subsequent retrograde crossing of the occlusive segment which is followed by advancement of a microcatheter and externalization of a long guidewire to allow PCI, but sometimes the microcatheter fails to advance into the antegrade guide, obstructing attempts at guidewire externalization.3 The “tip-in” technique involves the advancement of an antegrade microcatheter over the retrograde guidewire enabling subsequent antegrade wiring of the CTO segment and facilitates successful completion of a retrograde CTO procedure. Wiring can be completed by threading an antegrade wire through the retrograde microcatheter and crossing the CTO which is named rendezvous method. To our knowledge there are no published reports of a use of this technique as a primary strategy in retrograde CTO. Here we present a case where the “tip-in” technique was used not as a “bail-out” method after an unsuccessful completion of an applied retrograde technique, but as a first line strategy of retrograde approach.
Case report: 57-year-old male patient was presented with angina class III. Echocardiography shoved good ejection fraction of the left ventricle with viable myocardium. Coronary angiography showed occlusion of the mid-segment of the right coronary artery (RCA) with J-CTO 3 score (ambiguous cap, length, calcium). With bilateral vascular access, left snuffbox and right transulnar, Amplatz left 0.75 7F, and Extra backup 3.5 6F guiding catheters were engaged to the right and left coronary arteries respectively. Several methods were tried in an anterograde manner with the support of Corsair Pro 135 microcatheter (Asahi Intecc). First, anterograde wire escalation (AWE) technique, with wires Sion, Gaia first, Gaia second, Gaia third, was attempted with many redirections, always subintimal. (Figure 1A). Second, the parallel wire technique was tried unsuccessfully (Figure 1B), and also anterograde fenestration technique (AFR) with Sion Black wire, and 2.5x15 SC balloon on Gaia third was unsuccessful, due to probably too small balloon (Figure 1C). The bigger balloon was planned, but with retrograde injection, the subintimal hematoma was compressing the distal vessel. Switch to the retrograde procedure was done with Corsair Pro 150 microcatheter and septal surfing with Sion and finally Suoh03 wire through long septo-epicardial collateral (Figure 1D). Retrograde wire escalation (RWE) was not succesfull after that reverse CART method was used to externalize wire towards the anterograde guiding catheter (Figure 1E). Rather than the externalization wire technique, the „tip-in“ maneuver was done with retrograde wire positioning into anterograde microcatheter on the convex part of the anterograde guiding catheter (Figure 1F). After that, anterograde microcatheter was advanced over the retrograde guidewire distal to the CTO, to convert the procedure to the anterograde method. Finally, a good result was achieved with the implantation of 3 drug-eluting stents. (Figure 1G). Discussion: Tip-in or rendezvous techniques with fast conversion to the anterograde procedure are suggested as a first approach because of some pitfalls of classic externalization wire technique. First, there is no need for long externalization wires like RG3 from Asahi Intecc, or R350 from Teleflex. Second, in many cases of the retrograde procedure, there are difficulties in microcatheter crossing over the collaterals, bandings and calcified lesions or due to a shortage of microcatheter length. Third, excessive rotation and pushing of the microcatheter increase the risk of vessel injury. Fourth, prolonged duration of retrograde gear position is producing donor vessel ischemia, which can lead to left system injury, like left main trauma, etc. Fifth, with retrograde equipment in situ, there is a need for more meticulously activated clotting time (ACT) controlling, with much higher ACT needed, which can result in more bleeding. Sixth, in some cases, especially when snaring of the wire is performed, the spring coil segment of the externalized wire is disrupted, which can compromise navigation of the materi-als to the wire. Seventh, the externalized wire can be stuck in the system, and extraction can produce serious complications like left main and ostial right coronary artery lesion, collaterals trauma/dissection, „cutting“ of the interventricular septum, and some examples of so-called „chocking heart“ phenomenon. Accordingly, tip-in and rendezvous methods cannon provide strong support in delivering balloons and stents as the externalization method can, which is the main advantage of this technique. Another main pitfall of tip-in and rendezvous is that one can easily lose anterograde wire position and with that putting the whole procedure to the beginning.
Conclusion: In this case report, we demonstrated that the “tip-in” technique can be successfully obtained as a first-line strategy in retrograde CTO with lower cost and rate of possible complications of the procedure as this technique doesn’t require an “externalization” wire, with fast extraction of retrograde equipment and movement towards the straightforward anterograde procedure
Effects of Captioned TV Shows on Language Learners Motivation and Perception
This study aimed at identifying the possible effects of using English TV shows with captions on adult Turkish learners’ language learning motivation. It also investigated how learners perceived the use of captions as a language learning tool. Two different learner groups, A2 and B1, studied the printed captions of TV shows before watching them. Later, they watched the captioned shows three hours a week for approximately three months. The data from semi-structured interviews, questionnaires and observations indicated that captioned shows contributed to the instrumental motivation of the learners. The data also revealed that captions served as an aural and visual aid which played a very crucial role in comprehension. Watching captioned shows lowered the affective filter of the learners and resulted in interaction. In addition to being a major source of structural patterns, captions were used as a means of negotiation of meaning. Most important of all, captioned shows turned out to be effective authentic language materials, which may make up for a lack of interaction with native speakers.Straipsnyje tiriama galima subtitruotų angliškų filmų įtaka kalbos mokymosi motyvacijai ir subtitrų, kaip kalbos mokymo priemonės, suvokimas. Subtitruoti filmai iš dalies tenkina bendravimo su gimtakalbiais poreikį, nes filmais galima demonstruoti tokias situacijas ir diskursus, kurie yra labai panašūs į tikroviškus. Be to, tai galėtų būti ir reikšminga paskata mokytis kalbos. Pirmiausia studijoje aiškinamasi, kaip subtitruotų angliškų filmų žiūrėjimas veikia turkų, kurie mokosi anglų kalbos, motyvaciją. Tiriama ir tai, ar subtitruotus anglų kalbos filmus dalyviai suvokia kaip kalbos mokymosi priemonę. Taikyti kokybiniai tyrimo metodai. Buvo pasitelkti tokie duomenų rinkimo įrankiai: pusiau struktūruotas interviu, pamokų video įrašai, atvirų klausimų klausimynas. Darytina išvada, kad filmo „supratimas“ – itin svarbus motyvas mokytis užsienio kalbos. Subtitravimas padėjo sutelkti dėmesį į akustiką ir vizualizaciją, suteikė papildomos informacijos. Be to, subtitruoti filmai leido besimokantiesiems lengviau įsiminti anksčiau sužinotas gramatikos taisykles. Pastebėta, kad šie veiksniai žmonėms, kurie mokosi anglų kalbos, padėjo įveikti emocinį filtrą ir skatino labiau pasitikėti savimi bendraujant žodžiu
“De-novo DCB-only” in complex coronary interventions and chronic total occlusion percutaneous coronary intervention
Introduction: Drug-coated balloon (DCB, PACCOCATH® technology) is recognized from 2014 ESC Guidelines on myocardial revascularization in treatment of DES/BMS ISR (IA recommendation)1 and its indications are expanding. DCB in “de-novo” lesions is validated mostly in Small Vessel Disease (PEPCAD I, PICCOLETO, BASKET-SMALL 2, International SVD Register). Information on Large Vessel Disease are scarce and based on preparation of the lesion with DCB followed with BMS implantation: PEPCAD IV and OCTOPUS I, PEPCAD V (Bifurcations), DEBAMI (Acute Myocardial Infarction) and PEPCAD CTO, but “de-novo DCB–only” concept is still practically “off label”.2 Available conclusions on “de-novo DCB-only” concept can be drawn from the World-wide “all comer” Registry and single center studies such as Potsdam Heart Center, trials such as OCTOPUS II (Stabile CAD), DCB Bifurcation Study (Side Branch Treatment), study on Primary Percutaneous Coronary Intervention3 and works of Kleber and coworkers which studied Late Lumen Enlargement in DCB-only concept, but again, mainly in small vessels. “De-novo DCB-only” in complex coronary interventions is practically “off label”, especially in CTO PCI. In this paper we present a complex PCI based on “de-novo DCB-only” concept and a novel approach to CTO PCI based on this method.
Case 1: 85-years-old female patient was admitted due to acute coronary syndrome. Diffuse coronary disease was found, occlusion of LCx, CTO of ostial PD. Heart team decided for PCI. Procedure was done via bilateral radial approach with support of dual lumen microcatheter, and AWE technique. Final angioplasty (Figure 1) was done with DCB 3.0x30 Sequent Please NEO (B. Braun).
Case 2: 78-years-old male patient with multiple previous PCIs was admitted for elective PCI of in-stent restenosis CTO of OM1. Previously, ostial lesion of OM2 was also p treated with DCB. CTO procedure was done via right transradial approach with support of microcatheter and AWE technique. Final procedure (Figure 2) was done with 2 DCBs covering ostial and distal OM1, and 1 DES covering fractured microcatheter tip.
Case 3: 78-years-old male patient with multiple comorbidities and previously done CABG was admitted for elective PCI after verification of vein grafts degeneration. CTO PCI of LAD (Figure 3) was done with AWE technique and finalized with angioplasty with DCB 2.0x30.
Case 4: 85-years-old male patient was admitted for elective PCI CTO of RCA. Procedure was done via left transradial approach and single guiding catheter. AWE technique was done, after which CTO body was treated with DCBs 2.0x25 and 2.5x25 and mid segment of the RCA was treated with DES 2.75x33 (Figure 4).
Case 5: 78-years-old female patient was admitted for elective PCI CTO of LAD. Procedure was done with AWE technique, and finalized with two DCBs, 2.0x30 in mid and 2.5x30 in distal segment of the LAD, and 1 DES at the bifurcation of LAD-D1 (Figure 5). Figure 5. Angiogram before and after the procedure.
Conclusion: “De-novo DCB-only” concept in complex coronary interventions in chronic coronary syndrome as well as in the setting of primary PCI shows promising results, especially for ostial lesions and by simplifying bifurcations techniques without compromising final result. Concept of de-novo DCB-only CTO procedure depicted here, with “true to-true crossing” and optimal lesion preparation, shows excellent results, but follow-up and further studies are warranted
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